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PubMed2000

Recognizing and labeling sex-based and sexual harassment in the health care workplace.

PURPOSE: To explore how registered nurses (RNs) recognized and labeled incidents of sex-based and sexual harassment in the Australian health care workplace. DESIGN: Qualitative, using 16 unstructured interviews with registered nurses in Australia. METHODS: Verbatim transcripts were analyzed largely by inductive analysis. Key categories were identified as themes or concepts for analysis. FINDINGS: RNs reported several indicators of sexual harassment, including the invasion of space, confirmation from others, lack of respect, the deliberate nature of the behavior, perceived power or control, overly friendly behavior, and a sexualized workplace. RNs rarely labeled harassing behaviors as sex-based or sexual harassment. CONCLUSIONS: Many forces reduce the likelihood that RNs will correctly recognize and label unwelcome sexualized behavior as sexual harassment. Recognition is associated with a variety of workplace behaviors that sometimes precede harassment. Implications for the health care workplace are discussed.

Australia↗

PubMed2006

The frequency of workplace exacerbation among health maintenance organisation members with asthma.

OBJECTIVES: Workplace conditions can potentially contribute to the worsening of asthma, yet it is unclear what percentage of adults with asthma experience workplace exacerbation of symptoms. The objective of this investigation was to determine the prevalence of workplace exacerbation of asthma (WEA). METHODS: Adults with asthma aged 18-44 were enrolled into the baseline survey of a longitudinal study. Members of a health maintenance organisation were considered candidates for participation if they fulfilled membership, diagnostic, and treatment criteria based on automated review of electronic billing, claims, and pharmacy records. Diagnosis and treatment were confirmed by manual review of medical records. A telephone questionnaire was administered. A work related symptom score was assigned to each participant based on responses to questions about work related asthma symptoms, medication use, and symptom triggers. Blinded to participants' answers to these questions, two researchers independently reviewed the self-reported work histories and assigned exposure ratings. A final exposure score was then calculated. Participants with sufficient evidence for work related symptoms and exposure were classified as having WEA. RESULTS: Of the 598 participants with complete data, 557 (93%) were working, and 136 (23%) fulfilled the criteria for WEA. Those with WEA were more likely to be male and to report that they had been bothered by asthma symptoms during the past seven days. CONCLUSIONS: Workplace exacerbation of asthma was common in this study population, occurring in over a fifth of these adults with asthma. Physicians should consider that work can contribute to the exacerbation of symptoms when treating adults with asthma.

Adolescent↗

PubMed2006

Can stress management at the workplace prevent depression? A randomized controlled trial.

BACKGROUND: Stress, mental health and depression at the workplace have emerged as common and significant problems. The effectiveness of a stress-management program at the workplace was investigated. METHODS: The effectiveness of a stress-management program was examined in workers at a highly stressful workplace using a randomized controlled trial. The 58 workers in the office were randomly assigned into a stress-management group (n = 28) and a control group (n = 30). The stress-management program included lectures on the perception of stress, measures to cope with it, stress-management recording sheets, and e-mail counseling. This program was based on the cognitive behavioral approach. The stress-management program was carried out for 3 months, and perceived work-related stress and psychological symptoms were evaluated using: General Health Questionnaire (GHQ)-30, Center for Epidemiologic Study for Depression (CES-D), the Questionnaire of Work-Related Stress and the Effort-Reward Imbalance Questionnaire. Twenty-one out of the 28 in the stress-management group and all in the control group were successfully followed up. RESULTS: In the stress-management group, a significant improvement in the depressive symptoms was observed, compared with the control group in CES-D (p = 0.003 by two-tailed paired t-test, and p = 0.042 by repeated measure analysis of variance). In the multiple regression analysis, the effect of stress management on depressive symptoms at follow-up was significant (p = 0.041), controlling for potential confounding factors. However, the alleviation of perceived occupational stress was limited. CONCLUSIONS: A stress-management program based on the cognitive behavioral approach at the workplace may have potential for the prevention of depression.

Adaptation, Psychological↗

PubMed1997

Employer attitudes toward breastfeeding in the workplace.

A descriptive, exploratory study of 69 male and female employers was done in a small rural community to determine their attitudes toward breastfeeding or expressing milk in the workplace. Business variables, such as experience working with women who have breastfed and knowledge of other businesses who have employed breastfeeding women, appeared to be better predictors of a positive level of support toward breastfeeding in the workplace than personal attributes, such as age, education level, and personal history with a spouse or friend who breastfed. The health care provider needs to become instrumental in promoting breastfeeding in the workplace by focusing on the positive effects on the business and providing employers with successful examples of workplace breastfeeding programs.

Adult↗

PubMed2001

A rapid appraisal method for reviewing the effectiveness of workplace smoking policies in large and medium sized organisations.

Workplace smoking policies have been developed in response to growing scientific evidence about the harmful effects of environmental tobacco smoke (ETS), increasing opposition from non-smokers, concern over escalating costs of health damage and productivity losses, and the emergence of relevant laws and codes of good practice. Much has been written on the development and implementation of workplace smoking policies, but little about their evaluation. This paper describes a rapid appraisal method for the evaluation of workplace smoking policies. The four-stage process involves rapid, focused consultation with policy makers in the workplace, appropriate risk assessment, rapid consultation with those affected by the policy and focused feedback of results for planning and ongoing monitoring. In the pilot site the existing health and safety committee members were effective informants for the identification of key issues in smoking policy. The risk assessment phase was incorporated into the main appraisal which involved a canvass of staff and others on ETS issues identified by the informants. In the final stage of the process the health and safety committee proved to be both responsive to identified need, and proactive in facilitating ongoing review of the smoking policy. It therefore proved possible to develop the rapid appraisal process for administration in a limited time frame, three months for the whole process, with the rapid canvass element being achieved within one week.

Focus Groups↗

PubMed2003

The application of online surveys for workplace health research.

Work has a synergistic relationship to health, and workplaces are increasingly the focus for both health promotion initiatives and health research. Electronic technologies are a common feature of many workplaces and as such are convenient low cost survey vehicles for the health researcher. The methods and the implications of employing Internet methods for health research are covered and a wide range of issues connected with online sampling and data collection are discussed. Because the workplace does not provide a neutral research environment, the security, anonymity and associated issues of using the two main forms of Internet surveys for workplace health research are examined and their advantages and disadvantages are debated.

Confidentiality↗

PubMed1998

Predictors of a healthy workplace for Swedish and English psychiatrists.

BACKGROUND: Few studies have attempted to analyse the organisational aspects of the workplace that may affect the well-being of psychiatrists and even fewer have offered insights into what a positive workplace might look like. This study provides an outline of such a workplace, with reference to individual and organisational factors. In addition, a comparison is made between two European cities to check for cultural differences. METHOD: Three hundred and eighty psychiatrists from Stockholm and Birmingham responded to a previously tested questionnaire on their work environment. RESULTS: Predictors of a positive workplace for psychiatrists were: high self-esteem, satisfactory support with work-related problems, lower perceived workload, positive view of leadership, low work-related exhaustion and having a sense of participation in the organisation. There were few cultural differences. CONCLUSIONS: Measures should be taken to improve leadership skills for managers, to offer more support for work-related problems, and to allow psychiatrists to participate more in the organisation.

Anxiety↗

PubMed2000

Violence in the workplace: new perspectives in forensic mental health services in the USA.

BACKGROUND: This paper reviews current research on workplace violence in the USA and offers suggestions concerning the roles that mental health professionals with forensic expertise can play in this expanding field. AIMS: To clarify the role of the mental health professional in evaluating issues related to workplace violence. METHOD: Manual and computer literature searches were performed. RESULTS: The incidence of reported workplace violence is on the rise and can be devastating beyond the immediate injury. Forensically oriented mental health professionals can assist companies by providing pre-employment screenings, fitness-for-duty evaluations and threat assessment by using the results of current research on potentially violent individuals. CONCLUSIONS: With the growing interest in workplace violence come many opportunities for mental health professionals to assist companies in assessment, intervention and prevention.

Forensic Psychiatry↗

PubMed1999

Workplace exposure to passive smoking and risk of cardiovascular disease: summary of epidemiologic studies.

We reviewed the published epidemiologic studies addressing the relationship between workplace exposure to environmental tobacco smoke (ETS) and cardiovascular disease risk in three case-control studies and three cohort studies. Although the point estimates of risk for cardiovascular disease exceeded 1.0 in five of six studies, none of the relative risks was statistically significant because of the small number of cardiovascular end points occurring in individual studies. In common with most epidemiologic investigations of the health risks of ETS, none of the workplace studies included independent biochemical validation of ETS exposure. In contrast to the evidence on increased cardiovascular disease risk from exposure to spousal ETS, studies of ETS exposure in the workplace are still sparse and inconclusive. Conversely, there is no biologically plausible reason to believe that the hazards of ETS exposure that have been demonstrated in the home should not also apply to the workplace.

Epidemiologic Studies↗

PubMed1999

Environmental tobacco smoke and low birth weight: a hazard in the workplace?

Low birth weight (LBW) increases infant morbidity and mortality worldwide. One well-established risk factor is maternal smoking. Environmental tobacco smoke (ETS) exposure has recently been focused on as another potential risk factor. In this article, we review epidemiologic literature on the effects of ETS on LBW and intrauterine growth retardation (IUGR), the cause of LBW related to maternal smoking. As we consider the feasibility of modifying women's exposure, we focus our discussion on workplace exposure to ETS. The workplace is particularly important to consider because women of child-bearing age are present in the workplace in greater numbers now than ever before. In addition, certain subgroups of working women may be particularly at risk from the effects of ETS on pregnancy because they work in environments with higher exposure or they are more susceptible to its effects. We conclude that there is consistent evidence to relate maternal ETS exposure to an increased risk of adverse pregnancy outcomes and that this association may be generalized to the work environment. In studies with positive findings, infants exposed to ETS antenatally were 1.5-4 times more likely to be born with LBW, but few studies examined LBW. Most studies looked at measures of IUGR. ETS was associated with reductions in birth weight (adjusted for gestational age) ranging from 25 to 90 g. Infants born to women exposed to ETS were generally 2-4 times more likely to be born small-for-gestational age. ETS exposure in the workplace can and should be minimized to protect pregnant women from its adverse effects.

Adult↗

PubMed2004

Workplace prevention and promotion strategies.

Psychosocial factors refer to all organizational factors and interpersonal relationships in the workplace that may affect the health of the workers. Currently, two psychosocial risk models are universally recognized for producing solid scientific knowledge regarding the vital link between social or psychological phenomena at work and the development of several diseases, such as cardiovascular diseases or depression. The first is the "job demand-contro-support" model, which was defined by Karasek and to which the concept of social support has been added; the second is the "effort/reward imbalance" model defined by Siegrist. The public health perspective calls for theoretical models based on certain psychosocial attributes of the work environment for which there is empirical evidence of their pathogenic potential for exposed workers. Not only do these models reduce the complexity of the psychosocial reality of the work to components that are significant in terms of health risks, but they also facilitate the development and implementation of workplace interventions. Psychosocial risk intervention strategies currently implemented by companies are predominantly individual-oriented and aim chiefly at reducing the effects of stressful work situations by improving individual ability to adapt to the situation and manage stress. Like personal protection equipment for exposure to physical or chemical risks, these secondary prevention measures are commendable but insufficient, because they aim to reduce only the symptoms and not the cause of problems. Any intervention program for these risks should necessarily include a primary prevention component with a view to eliminating, or at least reducing, the psychosocial pathogenic agents in the workplace. Several authors have suggested that well-structured organizational approaches are most effective and should generate more important, longer-lasting effects than individual approaches. However, the evidence should be strengthened by more systematic studies to assess the models, their implementation and the outcomes for employers and employees alike. The research agenda on mental health and the workplace should have the following goals; to foster the development and evaluation of well-adapted models of interventions designed to reduce adverse psychosocial factors and their mental health effects to give a better understanding of the prevalence of work organization risk factors in Canada, how they may be changing and how they affect mental health in the long term to acquire an understanding of the effects on mental health of prominent trends in organizational practices, such as restructuring, lean production and flexible staffing (all of which result in precarious employment), that may pose special risks for women, immigrants or aging workers in Canada to collect data on the considerable direct and indirect costs to business, workers and society of work-related stress in Canada.

Employment↗

PubMed2004

Mental health and mental illness in the workplace: diagnostic and treatment issues.

Mental health, mental illness and stress-related disability are especially ill-defined, complex and controversial issues when considered in the context of the workplace. A multi-determined disorder such as major depressive disorder (MDD) does not fit a simple cause and effect model, but is similar to other complex occupational illnesses such as low back pain. Currently, a knowledge gap exists between mental health professionals and employers regarding symptom-based models of illness and function-based models of work performance. As a result, psychiatric disorders affecting workers are under-identified and under-treated and likely result in unmitigated impairment and disability. The authors examine several conceptual models for workplace mental illness across medical and psychological disciplines and propose a unifying construct. The utility of the existing screening methods for common workplace illnesses and their potential application are reviewed. The challenges of diagnosis and effective treatment of workplace mental illness are highlighted within an "occupational mental health system" with suggestions for future research directions.

Major Depressive Disorder↗

PubMed2006

The effects of pre-entry career maturity and support networks in workplace on newcomers' mental health.

The present study examined the effects of pre-entry experiences (i.e. career maturity), as well as support networks (i.e. informational and friendship), on newcomers' mental health (i.e. depression, self-esteem, psychosomatic symptoms, and work motivation). We performed a longitudinal study of 890 men and women who first entered the workplace in 2003. Surveys were distributed at two time points: just prior to entering the workplace, and two months after entering. Results indicated that career maturity related positively to newcomers' mental health, and newcomers with high career maturity were more successful in establishing positive relationships with superiors and co-workers. Although, informational support networks positively related to work motivation, friendship networks did not show any direct effects on mental health. These results underscore the crucial roles of career maturity and informational networks in facilitating the transition to the workplace. The results also provide empirical support for an expanded view of the importance of pre-entry experiences to workplace newcomers' mental health.

Adult↗

PubMed2001

[Present condition of health information control and attitudes of occupational health professionals in collecting and utilizing health information in workplaces].

Since the Labor Safety and Health Law of Japan provides that the employer is responsible for taking custody of personal information obtained in periodic health examinations, we are anxious about infringement of privacy. This study was conducted to investigate the present condition of health information control in each workplace and attitudes of occupational health professionals in collecting and utilizing personal health information by means of self-administered mail questionnaires. The numbers of respondents were a total of 549 (physicians: 237, public health nurses: 175, nurses 122, others & unknown: 15). The major results were as follows. 1. Percentage of workplaces in which only health professionals can know personal health data from periodic health examinations was 24% altogether, but it was 39% in large workplaces where full-time occupational physicians were working. 2. More than half of the respondents were of the opinion that the results of routine health activities could be presented in academic conferences unconditionally or under comprehensive approval of the representative of each workplace. 3. About a half of the respondents believed that it was necessary to consider the intention of each examinee in utilizing blood specimen collected at health examinations for research purposes, even though personal identification had been erased. 4. There were many differences among types of occupation or age groups in the attitude to changing the procedure for health examination. And it was the majority opinion that personal health data provided to the employer should be the minimum in order to protect individual benefits. 5. The proportion of physicians who felt it necessity to ask about the occupational history at the employment health examination was significantly higher than that of public health nurses. 6. When a disease was discovered, there were great differences among types of disease in the attitude to give the name or condition of the disease to the employer without the consent of the patient or his family. In view of these results, we feel that occupational health professionals are in a dilemma in introducing modern ideas which lay stress on privacy into the Japanese occupational health care system which is still operating on the basis of traditional paternalism.

Attitude of Health Personnel↗

PubMed2006

[Changing the focus: an exploratory study of drug use and workplace violence among women of popular classes in Rio de Janeiro, Brazil].

This exploratory study aimed to investigate factors related to the use of illicit and licit drugs and workplace violence in a group of women from popular classes in the city of Rio de Janeiro. We used a descriptive and analytic quantitative approach was used, as well as a qualitative approach through in-depth interviews with women who suffered or were suffering workplace violence, using the collective subject discourse analysis methodology. The results showed sociodemographic and work situations that can be considered as possible risk factors for drug consumption and workplace violence. The qualitative analysis shows how this group perceives the phenomena of drug use and workplace violence, expanding the comprehension about these issues and providing conceptual and methodological elements for additional studies on this subject.

Adolescent↗

PubMed2005

Employer policies toward guns and the risk of homicide in the workplace.

This population-based case-control study of North Carolina workplaces evaluated the hypothesis that employers' policies allowing firearms in the workplace may increase workers' risk of homicide. Workplaces where guns were permitted were about 5 times as likely to experience a homicide as those where all weapons were prohibited (adjusted odds ratio=4.81; 95% confidence interval=1.70, 13.65). The association remained after adjustment for other risk factors. The findings suggest that policies allowing guns in the workplace might increase workers' risk of homicide.

Case-Control Studies↗

PubMed1997

Workplace conditions, socioeconomic status, and the risk of mortality and acute myocardial infarction: the Kuopio Ischemic Heart Disease Risk Factor Study.

OBJECTIVES: This study investigated whether the association between workplace conditions and the risk of all-cause and cardiovascular mortality and acute myocardial infarction differed by socioeconomic status. METHODS: Prospective data were used to examine these associations in 2297 Finnish men, with adjustment for prevalent diseases and biological, behavioral, and psychosocial covariates, and stratified by employment status and workplace social support. RESULTS: Elevated age-adjusted relative hazards for all-cause mortality were found for men who reported high demands, low resources, and low income; high demands, high resources, and low income; and low demands, high resources, and low income. Similar patterns were found for cardiovascular mortality. In contrast, elevated age-adjusted relative hazards for acute myocardial infarction were observed only in men who reported high demands, low resources, and low income. These results did not differ by level of workplace social support or employment status. CONCLUSIONS: The negative effects of workplace conditions on mortality and of myocardial infarction risk depended on income level and were largely mediated by known risk factors.

Adult↗

PubMed2001

The short-term impact of national smoke-free workplace legislation on passive smoking and tobacco use.

OBJECTIVES: This study sought to evaluate the short-term impact of national smoke-free workplace legislation on employee exposure to environmental tobacco smoke at work and on employee smoking habits. METHODS: We performed 2 cross-sectional studies in 9 medium-sized and large Finnish workplaces, before and after implementation of national smoke-free workplace legislation. We assessed tobacco smoke exposure via questionnaire and indoor air nicotine measurements. RESULTS: Exposure to environmental tobacco smoke declined considerably after the legislation was implemented. Tobacco consumption among smokers diminished. Nicotine concentrations fell significantly. CONCLUSIONS: Legislation was more efficient than voluntary workplace-specific smoking restrictions in reducing passive smoking and cigarette consumption.

Adult↗