Night work and sustainable working life - a prospective trajectory analysis of Swedish Twins

Abstract Objectives Night work has been widely studied for the associations with diseases, sickness absence (SA) and disability pension (DP), but less for sustainable working life. We aimed to investigate the longitudinal changes in sustainable working life among those with or without baseline night work. Methods Using data from Swedish national registers, sustainable working life was defined as employment during follow-up without interruptions due to SA/DP, unemployment, and old-age pension. Survey data for two cohorts (i.e., born before or after 1959) were utilized to assess night work at baseline (yes/no) in 1998-2003 and 2004-2006, respectively. The final samples for the two cohorts were 34680 and 19637, respectively. Group-based trajectory models were applied. Results Among those born before 1959 (mean age 59 years, 13 years follow-up), a five-trajectory solution was best for those with and without night work. The trajectory groups were stable sustainable working life (38-42%), stable unsustainable working life (24-25%), early (13%) or later (13%) decreasing sustainable working life, and between sustainable and unsustainable working life (7%). Among those born after 1958 (mean age 37 years, follow-up 10 years), four trajectories were detected for those with night work: stable sustainable working life (81%), stable unsustainable working life (6%) and increasing (7%) and decreasing (5%) sustainable working life. For those without nightwork, a three-trajectory solution was best: stable sustainable working life (83%), stable unsustainable working life (6%) and between sustainable and unsustainable working life (11%). Conclusions Sustainable working life was similar across baseline night work statuses of older cohort but differed in younger cohort. The findings suggest that at least night work at one time point does not affect sustainable working life. However, night work at early stages of working life could be accompanied with lifestyle counselling for sleep and recovery. Key messages • Trajectories of sustainable working life seem similar for those with or without night work adding to the understanding of effects of such work to health. • From public health perspective, counselling employees with night work already at early stages of working life for health behaviours including sleep and recovery could support sustainable working life.


Background:
In a large city in the Netherlands, professionals of one department of the municipality focus on rapid return to work, even if that work is not directly in line with education, experience or preference of the client. The first aim was to investigate the effects of this work-first strategy of the municipality on entering paid employment and on health among unemployed persons. The second aim was to determine whether these effects differed between persons, depending on age, sex, education, health, and employment history.

Methods:
To identify the effectiveness of employment services of the municipality, a judge leniency instrumental variable (IV) design was used, based on referral behaviour of case workers. In total, 3272 persons who applied for welfare in a large city in the Netherlands in the year 2015, were included in the study. Information on employment services was derived from the municipality. Information on individual characteristics and employment status was derived from register data from Statistics Netherlands. Information on diseases was derived from a medication register. IV regression models and ordinary least squares (OLS) regression models were performed.

Results:
The work-first strategy increased the likelihood of entering paid employment by 27% points (b = 0.26, se = 0.07) and had a positive influence on health by 4% points (b = 0.06, se 0.03) of welfare recipients compared to other employment services. Although standard errors were larger for subgroups, the positive effect of the work-first strategy on employment was driven by relatively young (18-30 yrs) and old (45-65 yrs) welfare recipients, with low and intermediate education level.

Conclusions:
The instrumental variable approach is a valuable approach to investigate the effect of employment services on entering paid employment and health. To improve health of unemployed persons, it is important to promote entering paid employment. Key messages: Active labour market policies, such as the work-first approach, are beneficial for individuals, by increasing employment participation and health, and society, by increasing the employment rate. The IV approach is a promising approach to study causal relations in a quasi-experimental study. By using large datasets, differential effects across different groups of participants can be studied.
the longitudinal changes in sustainable working life among those with or without baseline night work.

Methods:
Using data from Swedish national registers, sustainable working life was defined as employment during follow-up without interruptions due to SA/DP, unemployment, and oldage pension. Survey data for two cohorts (i.e., born before or after 1959) were utilized to assess night work at baseline (yes/ no) in 1998-2003 and 2004-2006, respectively

Background:
Studying the relationship between work-related stress and sick leave is valuable in taking actions for workers' health. This study aimed to analyse the association between work-related stress, measured with the Work Stress Questionnaire (WSQ), and registered sick leave among primary health care patients in Sweden.

Methods:
The prospective longitudinal study included 232 patients who were non-sick-listed, employed, aged 18-64 years and sought care for mental and/or physical health complaints. Logistic regression analysis was performed with questionnaire data on work-related stress from baseline together with sick leave data from a national register for the following 12 months.

Results:
High stress due to indistinct organization and conflicts was reported by 21% (n = 49), while 45% (n = 105) reported high stress due to individual demands and commitment. During 12 months 36% (n = 83) were on sick leave for 15 days or more. The odds of being on sick leave was twice as high for patients perceiving high stress due to indistinct organization and conflicts, high stress due to individual demands and commitment, low influence at work, or high interference between work and leisure time. Perceiving high stress due to both indistinct organization and conflicts as well as individual demands and commitment quadrupled the odds of sick leave, OR 4.15 (95% CI 1.84; 9.38).

Conclusions:
Work-related stress and sick leave were prevalent among the patients. Primary health care can therefore be a suitable arena for addressing these issues. Perceiving work-related stressors and stress within one or multiple areas increased the odds of registered sick leave by two to four times. Hence, a wide spectrum of factors needs to be considered, to capture the dynamic interaction between the individual and the work environment.
Key messages: Work-related stress is associated with future sick leave for primary health care patients. Early identification of patients with work-related stress is important for the primary health care.

Background:
Violence against healthcare workers (HCWs) has gained increasing attention in recent years, both because it is on the rise and because there is growing concern about these incidents, which are classified as sentinel events by the Italian Ministry of Health. Since little is known about the actual burden of this phenomenon, especially during the stressful COVID-19 vaccination campaign, we decided to explore the problem in our region.

Methods:
Between January and March 2022, in the 1.2 millioninhabitant Friuli Venezia Giulia region (Italy), we conducted an anonymous online survey to collected data on episodes of violence and their consequences for HCWs. Data from validated tools assessing characteristics of violent episodes and post-trauma impact were analyzed in conjunction with socio-demographic data of respondents. Results: 200 HCWs participated in the survey, most of whom were women (72%), worked as nurses (107) or doctors (71), and had a mean age of 47 years. More than half of them (59%) reported at least one episode of violence, mainly in the form of a verbal assault (64%); there were no differences between victims. In 72 cases, these incidents affected the HCW's private life, mainly disturbing sleep or concentration (68%). Most HCWs stated that inadequate communication was a trigger for the violence (97%). Although 80% of HCWs would readily report any violent incident, to improve the situation they called for certainty of action against the perpetrator (87%), more organizational support (85%), standard procedures (75%) and self-defense courses (75%).