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Contribution of job strain, job status and marital status to laboratory and ambulatory blood pressure in patients with mild hypertension.

The effects of job strain, occupational status, and marital status on blood pressure were evaluated in 99 men and women with mild hypertension. Blood pressure was measured during daily life at home and at work over 15 h of ambulatory blood pressure monitoring. On a separate day, blood pressure was measured in the laboratory during mental stress testing. As expected, during daily life, blood pressure was higher at work than at home. High job strain was associated with elevated systolic blood pressure among women, but not men. However, both men and women with high status occupations had significantly higher blood pressures during daily life and during laboratory mental stress testing. This was especially true for men, in that men with high job status had higher systolic blood pressures than low job status men. Marital status also was an important moderating variable, particularly for women, with married women having higher ambulatory blood pressures than single women. During mental stress testing, married persons had higher systolic blood pressures than unmarried individuals. These data suggest that occupational status and marital status may contribute even more than job strain to variations in blood pressure during daily life and laboratory testing.

Adult↗

Self-esteem in young men: a longitudinal analysis of the impact of educational and occupational attainment.

This paper analyzes relationships among self-esteem, educational attainment, and occupational status. Data from a nationwide longitudinal study of more than 1600 young men show a substantial increase in self-esteem between 19TT (when respondents were beginning tenth grade) and 1974. Reliability and construct validity data for the self-esteem measure are reported. As expected, both educational attainment and occupational status are correlated with self-esteem. Contrary to expectations, educational attainment as of 1974 is more strongly correlated with tenth grade self-esteem than with 1974 self-esteem. A path analysis led to these conclusions: (a) Self-esteem during high school has little or no direct causal impact on later educational and occupational attainment; self-esteem and attainment are correlated primarily because of shared prior causes including family background, ability, and scholastic performance. (b) Occupational status has a direct positive impact on self-esteem. (c) Post high school educational attainment has no direct impact on self-esteem and only a trivial indirect impact via occupational status. Additional findings indicate that factors associated with educational success become less central to the self-evaluations of young men during late high school and the years thereafter.

Achievement↗

Motor vehicle driver injury and socioeconomic status: a cohort study with prospective and retrospective driver injuries.

STUDY OBJECTIVE: To investigate the association between motor vehicle driver injury and socioeconomic status. DESIGN: Cohort study with prospective and retrospective outcomes. SETTING: New Zealand. PARTICIPANTS: 10 525 adults (volunteer sample of a multi-industry workforce, n=8008; and a random sample of urban electoral rolls, n=2517). OUTCOME MEASURE: Motor vehicle driver injury resulting in admission of the driver to hospital or the driver's death, or both, during the period 1988-98; hospitalisation and mortality data were obtained by record linkage to national health databases. MAIN RESULTS: After adjustment for age and sex, driver injury risk was inversely associated with both occupational status (p for linear trend <0.0001) and educational level (p for linear trend =0.007). Participants in the lowest approximate quartile of occupational status were four times as likely (HR 4.17, 95% CI 2.31 to 7.55) to have experienced a driver injury during follow up as participants in the highest approximate quartile. Participants who had been to secondary school for less than two years were twice as likely (HR 2.26, 95% CI 1.34 to 3.81) to have experienced a driver injury as those who had been to university or polytechnic. There was little evidence that driver injury risk was associated with neighbourhood income (p for linear trend =0.12) CONCLUSIONS: Occupational status and educational level seem to be important determinants of driver injury risk. Driver injury countermeasures should be targeted to people in low status occupations, as well as to people with comparatively little formal education.

Accidents, Traffic↗

Changes in occupation after aortocoronary vein-bypass operation.

The effect of aortocoronary vein-bypass operation on changes in occupational status was investigated in a cohort of 893 men. The median period of time between the operation and follow-up evaluation of postoperative occupational status was 14 months. The patients were divided into two age groups, with 55 years as the dividing point. The results showed that 11% of the younger men and 26% of the older group who were employed before the operation retired following the operation. In addition, 30% of the patients changed their occupational status following the operation. When occupational changes also resulted in changes in physical demands, 49% of the patients took new jobs that were less demanding physically, while 40% took jobs that were more demanding. Close to 9% of the patients were retired prior to the operation; about one fifth of them came out of retirement following the operation.

Adult↗

[Methodological problems of the impact of G-loads on the functional status and occupation health of the pilot].

The paper deals with the methodological aspects and conceptual models of the impact of g-loads on the functional status and occupational health of high-maneuvering plane pilots in the context of the effective dose conception. Quantitative approaches to evaluating the influence of this factor are considered by taking into account a risk for specific abnormalities and its combination with other factors and conditions of a pilot's work. Practical aspects of the application of the approaches developed to enhance the safety of flights and the promotion of flying personnel's health are also considered and promising avenues of further studies are outlined.

Adult↗

Socio-economic health differences among the elderly population in Krakow, Poland.

OBJECTIVES: To assess whether socio-economic health differences persist into old age in Poland and if there are SES-related differences in health by age group and gender. METHODS: 528 randomly chosen, not institutionalized elderly people aged 65-85 living in Krakow were interviewed about their socio-economic status (occupation, education, income, house ownership), health status (self-rated health) and quality of life (Cantril's ladder). RESULTS: People with higher level of education and higher occupational status reported significantly better health and better quality of life compared to people who were not as well off. Income level and house ownership had a significant influence on the quality of life of elderly people. In addition, some findings indicate differences in the patterning of health inequalities across particular age and gender groups. CONCLUSION: There are socio-economic differences in health and quality of life among the urban elderly population in Poland which are unfavourable for lower social strata.

Aged↗

Contemporary work characteristics, stress, and ill health.

This study investigates the relationship between work and ill health resulting from stressors originating in the work environment. The association between work and health has been well-documented. Factors in the work environment leading to ill health have included generalized psychological stress and/or specific physical environmental characteristics. Data for this study come from a 1998 telephone survey, the Indiana Survey of Work in a Polarized Economy, under the auspices of the Center for Survey Research at Indiana University. The dependent variable is an index that measures ill health among workers; control variables include sociodemographic and lifestyle characteristics of these workers as well as their job characteristics; and the four key independent variables are occupational status, organizational disruption, layoff experience, and educational discordance of the workers. Multiple regression analysis on the entire sample (n = 919) demonstrates that occupational status is negatively associated with ill health, while organizational disruption, layoff experience, and educational discordance are positively associated with it. Separate analyses for male (n = 474) and female (n = 445) respondents find significant sex differences in the effects of the key variables: for males, organizational disruption is positively related to ill health while for women occupational status is negatively related and layoff experience and educational discordance are positively related to ill health. The findings from the present research provide insight into the interrelationship of occupational environment and health within the framework of evolutionary medicine.

Adult↗

Association of environmental tobacco smoke exposure with socioeconomic status in a population of 7725 New Zealanders.

OBJECTIVE: To test the hypothesis that environmental tobacco smoke (ETS) exposure is inversely associated with socioeconomic status. DESIGN: Survey. SETTING: General community, New Zealand. PARTICIPANTS: 7725 non-smoking adults (volunteer sample of a multi-industry workforce, n = 5564; and a random sample of urban electoral rolls, n = 2161), including 5408 males; mean age 45 years. MAIN OUTCOME MEASURES: ETS exposure was assessed as self-reported number of hours per week spent near someone who is smoking, and as prevalence of regular exposure to some ETS. Socioeconomic status was assessed as educational level, occupational status, and median neighbourhood household income. RESULTS: Both measures of ETS exposure were steeply and inversely associated with all three indicators of socioeconomic status (all p < 0.0001). Geometric mean ETS exposure ranged from 16 minutes per week among university-educated participants to 59 minutes per week in the second lowest occupational quintile (95% confidence intervals: 14-18 minutes per week and 54-66 minutes per week). The associations with occupational status and educational level were steeper than those with neighbourhood income. The socioeconomic gradients of ETS exposure were steeper among participants aged less than 35 years than among participants aged over 50 years, among men than women, and among Maori than Europeans. CONCLUSIONS: In this study population, ETS exposure was inversely associated with socioeconomic status. Greater ETS exposure might therefore contribute to the higher risks of disease and death among low socioeconomic groups. These results provide a further rationale for targeting tobacco control measures to people in low socioeconomic groups.

Adult↗

Gender differences in suicide risk by socio-demographic factors in Hong Kong.

Some peculiarly low male-to-female suicide ratios have been reported in the Far Eastern populations. This article attempts to investigate whether there are gender differences in suicide risk by socio-demographic factors in Hong Kong, and hereby to explain the low male-to-female suicide ratios. The effects of marital status, duration-of-residence, and occupational status on suicide are first studied by periodic suicide rates in 1990-1992, and 2000-2002, then by Poisson regression. Some interesting results are found: Unlike most findings elsewhere, migration in Hong Kong did not induce suicide; occupational status was negatively related to suicide only for men but not for women; the particularly low male-to-female suicide ratio was not due to a larger protection from marriage for men than for women as reported in the literature, but very probably to a very high suicide rate for the non-working population. The authors suggest some plausible explanations of the findings and hence further research to be conducted.

Adult↗

Cancer awareness among African Americans: a survey assessing race, social status, and occupation.

Knowledge of cancer prevention and control was defined in terms of prevention, etiology, treatment, symptoms, cancer rates, screening, and detection examinations. A survey of 86 African Americans and 68 white Americans in Alameda County, California was completed in 1985. An index comprised of 69 knowledge items was assessed. A multivariate analysis of race, education, socioeconomic status, and occupation confirmed that these characteristics were independent predictors of knowledge. Blue collar work status was the most important predictor of low knowledge levels. African Americans were less knowledgeable than white Americans with regard to diet in preventing cancer and treatment modalities for cancer, and were most likely to perceive surgery as contributing to metastases. Low education and income status predicted low levels of knowledge. An important consideration in changing knowledge levels is the need to translate technical information about treatment and metastases in ways that are effective in reaching target populations at risk for low levels of knowledge. Cancer prevention and control programs need to develop materials and strategies that are responsive to communities whose members are predominantly African Americans or blue collar workers, or have low levels of education and income.

Black or African American↗

Life-long intellectual activities mediate the predictive effect of early education on cognitive impairment in centenarians: a retrospective study.

The purpose of this study was to examine the hypothesis of whether early education and/or maintaining intellectual activities over the life-course have the power to protect against cognitive impairment even in extremely old adults. Ninety centenarians from the population-based Heidelberg Centenarian Study were assessed with a modified version of the Mini Mental State Exam (MMSE). Data about education, occupational status, and life-long intellectual activities in four selected domains were obtained. Results demonstrated that 52% of the sample showed mild-to-severe cognitive impairment. Analyzing the influence of early education, occupational status, and intellectual activities on cognitive status we applied several (logistic) regression analyses. Results revealed independent, significant and strong influence of both formal school education and intellectual activities on the cognitive status in very late life, even after controlling for occupational status. However, about one fourth of the effect of early education on cognitive status was exerted indirectly via the assessed intellectual activities. In summary, the present study provides first evidence for the conclusion that even with regard to cognitive performance in very old age, both early education and life-long intellectual activities seem to be of importance.

Achievement↗

[The status of occupational morbidity in Ukraine today].

Data are submitted on the pattern and levels of occupational morbidity in Ukraine in different branches of national economy, by forms of pathology, with those individuals presenting with occupational health problems having gotten distributed by sex, age, and service duration. The article addresses the issue of significance in the formation of occupational pathology and its levels of different factors and causes (economical, social, medical). The status of the occupational pathology service in the country is considered, with special emphasis being placed on inadequacy of detecting occupational diseases.

Adult↗

Occupation, socioeconomic status, and brain tumor mortality: a death certificate-based case-control study.

The relationships between brain tumor mortality and occupation and socioeconomic status (SES) were evaluated in a death certificate-based case-control study. The cases consisted of 904 white men aged 20 years and older who died of a brain tumor in Washington state between 1969 and 1978. For each case a white male control of the same age was chosen. A consistent pattern of increasing risk with increasing SES was seen for all brain tumors as well as for gliomas and astrocytomas. After adjustment for SES, stationary engineers were found to be at excess risk across all histologies based on six cases vs no controls with lower 95% confidence intervals of 2.3 for all brain tumors, 2.8 for gliomas (based on three cases), and 2.1 for astrocytic tumors (based on two cases). Excesses of astrocytic tumors also were observed for petroleum refinery workers (OR = 8.8, CI = 2.2-35.2), forestry workers (OR = 8.5, CI = 1.1-63.4), and cleaning service workers (OR = 2.7, CI = 1.1-6.7).

Adult↗

Occupational therapy diagnostic reasoning: a component of clinical reasoning.

The occupational therapy process involves the assessment and treatment of problems in occupational status. Assessment entails the sensing and defining of patients' problems and is accomplished through diagnosis. As a process, diagnosis involves the creation of a clinical image of the patient through cue acquisition, hypothesis generation, cue interpretation, and hypothesis evaluation. This sequence of cognitive activities is called diagnostic reasoning. As a product, diagnosis summarizes a patient's occupational deficits in terms of occupational role performance, occupational performance, and the components of occupational performance. To serve adequately as a basis for planning intervention, the occupational therapy diagnosis describes the problem, explains the potential cause of the problem, gives the cues whereby the problem is recognized, and names the pathologic agent. Occupational therapy assessment is broader than diagnosis and includes a delineation of the patient's assets as well as deficits. In the resolution of problems in occupational status, assets may be used to offset deficits. The clinical image represents a balanced view of occupational status by reflecting assets and deficits.

Clinical Competence↗

Economic status and occupational correlates of stomach cancer in the rubber industry.

Associations between stomach cancer and occupational exposure to rubber remain uncertain, and thus far only a few studies have been carried out to investigate risks of stomach cancer in different jobs in the rubber industry, and confounding of the risk/exposure relationship by non-occupational risk factors, especially by the economic status. This study was aimed to explore these questions. Following a case-cohort design, we used the data of 36 stomach cancer deaths in 1973-95 and a random sample (sub-cohort) of 188 from among 1598 subjects employed in a rubber plant in Shanghai, China. We analysed stomach cancer risks by the economic status, smoking, alcohol consumption, and residential exposure to coal burning-related pollution, etc., and assessed by jobs and years, unadjusted and adjusted. The rate ratios for stomach cancer were found to be 1.70 for 1-19 yr of employment and 1.79 for 20 or more yr of employment in the inner tire tube department. After the economic status was adjusted, the rate ratios were 1.54 and 1.64, respectively. Although the front processing of rubber was also included in our analysis no evidence of any excess risk of stomach cancer was found. Rate ratios adjusted for four job groups were the highest in the low income group. The association followed a pattern of a dose-response relationship--increasing rate ratios correlated with decreasing annual income (statistic trend: chi 2(1) = 8.35, p = 0.004). The data obtained suggest that excess risks of stomach cancer in the rubber workers were mainly related to their economic status and only slightly (some 1.6) to the talc powder exposure. Results of this study fail to provide any statistically significant evidence to support the hypothesis that there was high risk of death from stomach cancer among the rubber workers employed in high dusty departments.

China↗

A comparison of methods for measuring socio-economic status by occupation or postal area.

Seven methods of estimating socio-economic status (SES) were compared, including four based on data specific to individuals (Blishen, Pineo-Porter, British Registrar General, Hollingshead) and three based on the average characteristics of the postal code area in which people live (income alone, education alone, income and education combined). Data from the files of 151 patients undergoing in vitro fertilization were used. The four individual scales were highly correlated among themselves (Spearman's correlation coefficient between 0.6 and 0.9) but only moderately correlated with the measures based on postal code (Spearman's correlation coefficient between 0.2 and 0.3).

Educational Status↗

Mortality in alcohol-related diseases in Sweden during 1971-80 in relation to occupation, marital status and citizenship in 1970.

A new Swedish population register, created by linking Census data to the Cause of Death Registry and covering over 99% of the population, has been used to study the relationship between occupational category, marital status and citizenship in 1970 and mortality in closely alcohol-related diseases during 1971-1980 for the ages 25-64 years. Age-standardized rate ratios (SRR) have been computed for mortality in alcoholism, alcohol intoxication and alcohol psychosis ("AAA") and in liver cirrhosis. SRR-values for both diagnose categories and both sexes were higher than average among not gainfully employed (SRR = 3.71 among males and SRR = 1.96 among females in 1976-80 for "AAA"), among employees in the service sector, engine-drivers and unskilled workers and increased in liver cirrhosis among artists and authors. Among females there were smaller variations in mortality for occupational groups than among males. The SRR-values showed a tendency to be higher in 1976-80 than in 1971-75, probably due to health-related selection to some extent. The alcohol-related mortality was also increased among divorced, widows (SRR = 1.37 for "AAA" and 2.81 for liver cirrhosis in 1976-80) and widowers and among never married males. SRR was much higher among Finnish citizens in Sweden (SRR for "AAA" = 3.85 among males and 2.35 among females in 1976-80) than among males and females living in Finland (SRR for "AAA" = 1.13 among males and 0.36 among females) and also higher than among immigrants from other countries, summed (SRR for "AAA" = 0.62 among males and 0.64 among females).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Occupation, employment status and chronic inflammatory bowel disease in Denmark.

BACKGROUND: Certain occupational groups have formerly been identified as having higher risks of suffering from chronic inflammatory bowel diseases. These were evaluated in an independent data set. METHODS: A cohort, comprising all 2 273 872 male and female Danes aged 20-59 years on 1 January 1986 were followed up for hospitalizations due to chronic inflammatory bowel disease until 31 December 1990. RESULTS: From 1981 to 1990 6296 first time admissions occurred. The incidence increased from 1981-1985 to 1986-1990. Of 363 male and 213 female occupational groups eight and five groups respectively had statistically significant raised standardized hospitalization ratios. Among 15 groups previously found to have significant odds ratios only female office staff and health occupations were found to have statistically significant raised standardized hospitalization ratios. Ratios for occupational groups with non-daytime work were not statistically significant. Compared to occupations without sedentary work occupations with predominantly sedentary work had a standardized hospitalization ratio of 125 (95% confidence interval [95% CI] : 116.9-133.1). Self-employed had low hospitalization rates, while 'other salaried staff' and 'not economically active' had high rates. CONCLUSIONS: We found no consistent pattern of occupations at increased risk except that sedentary work may increase the risk of attracting chronic inflammatory bowel disease.

Adult↗