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Madsen I.E.H.,Helmholtz Center Munich | Aust B.,Helmholtz Center Munich | Burr H.,Federal Institute of Occupational Safety and Health | Carneiro I.G.,Helmholtz Center Munich | And 3 more authors.
Depression and Anxiety | Year: 2012

Background Previous studies have reported that employees in paid care work (e.g., child, health, and elderly care) have increased rates of hospitalization with depression and treatment with antidepressants. It is unclear, however, whether these findings reflect a causal effect of the work on employee mental health or a selection into these professions. Methods We examined prevalences of antidepressant purchases during 1995-2008 in a cohort of female eldercare workers who entered their profession in 2004 (n = 1,946). These yearly prevalences were compared to those of a representative sample of the female Danish working population (n = 4,201). Trends in antidepressants prevalences were examined using generalized estimation equations. Further, to account for bias by treatment seeking, we compared self-reported depressive symptoms in 2005 measured by the mental health scale from the SF-36. Results Female eldercare workers had consistently higher prevalence of antidepressant treatment than the general female working population. The eldercare workers were also more likely to suffer from depressive symptoms in 2005 (standardized prevalence ratio = 1.28, 95% CI = 1.09-1.49). Prevalences of antidepressant treatment increased during follow up for both cohorts, with similar estimated odds ratios of about 1.15 per year. The trend in the antidepressant prevalences for the eldercare workers was unchanged by entering eldercare work. Conclusions These findings indicate that female eldercare workers are at increased risk of depression. Further, as the trend in the antidepressant prevalences among the eldercare workers was similar before and after entering their profession, the results suggest that this increased risk is due to selection into the profession. © 2012 Wiley-Liss, Inc. Source

Madsen I.E.H.,Helmholtz Center Munich | Hanson L.L.M.,University of Stockholm | Rugulies R.,Helmholtz Center Munich | Rugulies R.,Copenhagen University | And 4 more authors.
Social Psychiatry and Psychiatric Epidemiology | Year: 2014

Purpose: Emotionally demanding work has been associated with increased risk of common mental disorders. Because emotional demands may not be preventable in certain occupations, the identification of workplace factors that can modify this association is vital. This article examines whether effects of emotional demands on antidepressant treatment, as an indicator of common mental disorders, are buffered by good leadership. Methods: We used data from two nationally representative work environment studies, the Danish Work Environment Cohort Study (n = 6,096) and the Swedish Longitudinal Occupational Survey of Health (n = 3,411), which were merged with national registers on antidepressant purchases. All individuals with poor self-reported baseline mental health or antidepressant purchases within 8.7 months before baseline were excluded, and data analysed prospectively. Using Cox regression, we examined hazard ratios (HRs) for antidepressants in relation to the joint effects of emotional demands and leadership quality. Buffering was assessed with Rothman's synergy index. Cohort-specific risk estimates were pooled by random effects meta-analysis. Results: High emotional demands at work were associated with antidepressant treatment whether quality of leadership was poor (HR = 1.84, 95 % CI 1.32-2.57) or good (HR = 1.70, 95 % CI 1.25-2.31). The synergy index was 0.66 (95 % CI 0.34-1.28). Conclusions: Our findings suggest that good leadership does not substantially ameliorate any effects of emotional demands at work on employee mental health. Further research is needed to identify possible preventive measures for this work environment exposure. © 2014 The Author(s). Source

Rugulies R.,Helmholtz Center Munich | Rugulies R.,Copenhagen University | Aust B.,Helmholtz Center Munich | Madsen I.E.H.,Helmholtz Center Munich | And 3 more authors.
European Journal of Public Health | Year: 2013

Background: Depression is a major concern for public health. Both adverse working conditions and low socio-economic position are suspected to increase risk of depression. In a representative sample of the Danish workforce we investigated (i) whether adverse psychosocial working conditions, defined by the effort-reward imbalance (ERI) model, predicted onset of severe depressive symptoms after 5-year follow-up and (ii) whether the effect of ERI was differential across occupational grades. Methods: A cohort of 2701 Danish employees filled in a questionnaire on work and health in 2000 and 2005. ERI was measured with four effort and seven reward items. Depressive symptoms were assessed with the five-item Mental Health Inventory. Participants scoring 52 points were defined as cases. We used logistic regression to investigate the association of ERI and occupational grade in 2000 with onset of severe depressive symptoms in 2005. Analyses were adjusted for socio-demographics, health behaviours, survey method, self-rated health, sleep disturbances and non-severe depressive symptoms at baseline. Results: High ERI predicted onset of severe depressive symptoms at follow-up, after adjustment for co-variates and occupational grade (OR = 2.19, 95% CI = 1.12-4.25). Participants with high ERI and low occupational grade showed a considerably higher OR (2.43, 95% CI = 1.07-5.53) compared to participants with low/medium ERI and low grade (OR = 1.45, 95% CI = 0.72-2.92), high ERI and high grade (OR = 1.26, 95% CI = 0.59-2.70) and low/medium ERI and high grade (reference group). Conclusion: Adverse psychosocial working conditions predicted onset of severe depressive symptoms. The effect was stronger among employees of lower occupational grades compared to those of higher grades. © 2012 The Author. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved. Source

Vrezas I.,Cyprus University of Technology | Elsner G.,Goethe University Frankfurt | Bolm-Audorff U.,Labour Inspection | Bolm-Audorff U.,Justus Liebig University | And 3 more authors.
International Archives of Occupational and Environmental Health | Year: 2010

Aims The aim of this study is to examine the dose- response relationships between age, "lifestyle factors " (body mass index, tobacco smoking, sports), and symptomatic knee osteoarthritis in a population-based case- control study. Additionally, the study aims to investigate the mode of interaction between body mass index (BMI) and physical workload (occupational kneeling/squatting and lifting/carrying of loads) with respect to the risk of symptomatic knee osteoarthritis. Methods In five orthopedic clinics and five practices, 295 male patients aged 25-70 with radiographically confirmed knee osteoarthritis associated with chronic complaints were recruited. The control group comprised 327 male control subjects. In a structured personal interview, body weight at different ages, body height, cumulative amount of smoking, and cumulative duration of different sports activities until the date of first diagnosis of knee osteoarthritis were elicited. Adjusted odds ratios (OR) and 95% confidence intervals (CI) were calculated using unconditional logistic regression analysis. An interaction analysis for the parameters BMI and kneeling/squatting respective lifting/ carrying of loads was performed. Population attributable risks (PAR) for knee osteoarthritis were determined for BMI solely and for the combination of BMI with occupational kneeling/squatting and lifting/carrying of loads, respectively. Results Age and overweight were strongly associated with the diagnosis of knee osteoarthritis. Compared with persons less than 35 years old, persons who were at least 65 years old had an odds ratio (OR) of 19.0 (95% CI 6.1-58.7) for knee osteoarthritis. Persons with a BMI ≥28.41 kg/m2 had a strongly elevated risk of knee osteoarthritis (OR 10.8; 95% CI 4.8-24.3) compared to persons with a BMI≤ 22.86 kg/m2. Heavy tobacco smoking (≥55.5 pack years) was associated with a decreased knee osteoarthritis risk in comparison with never-smoking (OR 0.2; 95% CI 0.1-0.5). Ball games (handball, volleyball, basketball) and cycling were associated with symptomatic knee osteoarthritis (OR 4.0; 95% CI 1.8-8.9 and OR 3.7; 95% CI 1.7-7.8 in the highest category of cumulative duration, respectively); to a weaker degree jogging, swimming, and soccer also were positively related to symptomatic knee osteoarthritis.Combining the two parameters, BMI and kneeling/squatting into one variable led to a multiplicative interaction mode for symptomatic knee osteoarthritis. For persons with elevated BMI in combination with moderate to high exposure to occupational kneeling/squatting, the population attributable risk (PAR) was 4%. The PAR for elevated BMI in combination with moderate to high exposure to occupational lifting/carrying of loads was 7%. Conclusions In accordance with the literature, we find a strong association between BMI and knee osteoarthritis risk. Considering the relatively high prevalence of occupational manual materials handling, prevention of knee osteoarthritis should not only focus on body weight reduction, but should also take into account work organizational measures particularly aiming to reduce occupational lifting and carrying of loads. © Springer-Verlag 2009. Source

Hinz B.,Federal Institute of Occupational Safety and Health | Menzel G.,Federal Institute of Occupational Safety and Health | Bluthner R.,Federal Institute of Occupational Safety and Health | Seidel H.,Federal Institute of Occupational Safety and Health
Industrial Health | Year: 2010

Most research has investigated the seat-to-head transmissibility during single-axis excitations. Associations between head accelerations and discomfort or effects on vision were reported. Possible differences between the seat-to-head transmissibility determined during different vibration magnitudes with a variable number of excitation axes have not been systematically examined. An experimental study was performed with 8 male subjects sitting on a rigid seat with hands on a support. They were exposed to random whole-body vibration (E1=0.45 ms -2, E2=0.90 ms -2, and E3=1.80 ms -2) to single-and three-axis vibration. All translational and rotational seat-to-head transmissibilities were calculated. The effects of the factors vibration magnitude and number of axes on the peak modulus and frequency of the seat-to-head transmissibilities were tested. In general the head motions follow constant pattern. These pattern of head motions comprise a combination of rotational and translational shares of transmissions, i.e. the curves show a dependence on the factors 'vibration magnitude' and 'number of vibration axes'. Mechanical properties of the soft tissue, relative motions of body parts, and muscle reactions were supposed to cause the nonlinearities of the head. Future research should consider effects of multi-axis vibration, if conclusions shall be drawn for the evaluation of possible health effects and model validations. Source

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