A precarização jurídica das relações de trabalho como fator de sofrimento das(os) trabalhadoras(es) no setor da saúde durante a pandemia de COVID-19 / The legal precariousness of work relations in the health sector during the COVID-19 pandemic, as a factor of worker suffering

Resumo O artigo analisou o processo de precarização das relações de trabalho no setor da saúde, demonstrando como essa situação gerou sofrimento dos trabalhadores. O texto buscou registrar como a adoção institucional das concepções econômicas neoliberais, de redução das políticas sociais de Estado, acopladas a um histórico de rejeição cultural aos direitos trabalhistas, proporcionou a atração dos mecanismos de precarização do trabalho, notadamente, a terceirização da mão de obra e da prestação de serviços. No segundo momento, o texto aponta as impropriedades jurídicas cometidas, apresentando as consequências da fragilização do vínculo jurídico nas condições de trabalho desses trabalhadores, principalmente no que se refere às jornadas de trabalho e a remuneração, destacando-se, também, o quanto a disseminação desses vínculos representou um fator de rebaixamento geral dos salários e direitos trabalhistas e previdenciários no setor. Foram apresentados, ainda, dados das pesquisas da Fiocruz sobre condições de trabalho durante a pandemia. Conclui mostrando a urgência de se resgatarem os institutos jurídicos trabalhistas que foram abandonados no percurso histórico estudado, para direcionar a novo rumo as políticas públicas na saúde.

Abstract The present article analyzed the process of precarious work relations in the health sector, demonstrating how this situation generated illness and suffering among workers. The text sought to register how the institutional adoption of neoliberal economic conceptions, of the reduction of State social policies, coupled with a history of cultural rejection of labor rights, provided the attraction of mechanisms of precarious work for the public sector, notably, the outsourcing of labor and the provision of services. In a second moment, the text points out the legal improprieties committed, presenting the consequences of the weakening of the legal bond in the working conditions of these workers, mainly regarding working hours and remuneration, also highlighting how much the dissemination of these links represented a factor of a general reduction in wages and labor and social security rights in the sector. Data from Fiocruz surveys on working conditions during the pandemic were also presented. The article concludes by showing the urgency of rescuing the legal labor institutes that were abandoned in the historical path studied in order to guide the public health policies in a new direction.

Effects of long working hours exposure on occupational stress and depression symptoms in couriers in Zhejiang Province / 中华劳动卫生职业病杂志

Objective: To understand the current situation of long working hours exposure of couriers in Zhejiang Province, and to analyze the influence of long working hours exposure levels on their occupational stress and depression symptoms, and provide a basis for promoting the physical and mental health of couriers. Methods: From September to December 2021 , 1159 couriers from Zhejiang Express Transport Companies were selected as respondents by cluster sampling, and their basic information were collected. The occupational stress and depression symptoms of the couriers were assessed using the Core Occupational Stress Scale (COSS) and the Patient Health Questionnaire-9 (PHQ-9). The effects of long work hours (>48 h per week) on the occupational stress and depression symptoms of the couriers were analyzed. Results: The average age of 1159 courier in Zhejiang Province was (33.24±8.42) years, the average weekly working hours were (63.21±18.77) h, and 75.15% (871/1159) were long-term workers. The detection rates of occupational stress and depression symptoms in courier were 32.44% (376/1159) and 32.53% (377/1159), respectively. There were significant differences in the detection rates of occupational stress and depression symptoms among couriers with different ages, educational background, marital status, monthly average income, length of service, position or post, shift status, drinking status, and average weekly working hours (P <0.05). The adjusted logistic regression analysis showed that, after adjusting for the influence of confounding factors such as age, educational background, marital status, monthly average income, length of service, position or post, shift status and drinking status, compared with the weekly working hours ≤48 h, weekly working hours of 63-77 h, 78-92 h, ≥93 h were the risk factors for occupational stress (OR=1.547, 95%CI: 1.019-2.350; OR=1.886, 95%CI: 1.184-3.006; OR=2.338, 95%CI: 1.188-4.062) and depression symptoms (OR=1.897, 95%CI: 1.258-2.860; OR=2.041, 95%CI: 1.290-3.230; OR=4.978, 95%CI: 2.551-9.715) of couriers (P<0.05) . Conclusion: Long working hours could increase the risk of occupational stress and depression symptoms among couriers. It is necessary to arrange working hours reasonably to reduce the occurrence of occupational stress and depression symptoms of couriers.

Effect of long working hours on work-related musculoskeletal disorders among operation and maintenance workers of power supply enterprises / 环境与职业医学

Background Long working hours is harmful to the physical and mental health of occupational groups, and should receive active attention. Objective To evaluate the current status of long working hours among operation and maintenance workers of power supply enterprises, and explore its effects on work-related musculoskeletal disorders (WMSDs) of the population. Methods From March to June 2021, a cross-sectional survey was conducted among 1433 operation and maintenance workers from 10 power supply enterprises in Jilin Province, Shandong Province, and Tianjin Municipality using cluster sampling. A total of 1433 copies of revised Mus-culoskeletal Disorders Questionnaire were distributed, 1343 questionnaires were recovered, and the recovery rate was 93.72%. The questionnaire included general information, personal health behaviors, weekly working hours, work-related factors, and musculoskeletal pain or discomfort in nine body parts in the past 12 months. χ2 test and multiple logistic regression models were used to investigate the relationships between long working hours (>40 h per week) and WMSDs. Results The average age of the workers was (39.42±9.89) years, and the average work experience was 11.00 (5.00, 21.00) years. There were 1158 males (86.22%) and 185 females (13.78%). The average weekly working hours of the workers were (47.98±11.35) h, and the proportion of long working hours (>40 h per week) was 61.06% (820/1343). The proportions of long working hours were higher among the workers with characteristics of male, power distribution, shift work, often/very often long-time standing, often/very often holding awkward postures, often handling heavy objects, limited space to operate, long-time neck tilting backward, keeping arms above shoulders, frequent elbow bending, repeating knee movement every minute, and repeating lower limb or foot movement every minute (all P<0.05). The prevalence rate of WMSDs was 81.53% (1095/1343) among the workers. The results of multiple logistic regression showed that after adjusting education, smoking, exercise, awkward postures, often handling heavy objects, limited space to operate, long-time heavy trunk bending, long-time neck tilting backward, and keeping arms above shoulders, compared with working ≤40 h per week, the risk of WMSDs among workers working >49 h per week was higher (OR=1.406, 95%CI: 1.011-1.955). Conclusion Long working hours is prominent among operation and maintenance workers of power supply enterprises, and increases the risk of reporting WMSDs.

Superexploração da força de trabalho na saúde em um contexto de pandemia de Covid-19 no Brasil / Superexploitation of the health workforce in the context of the COVID-19 pandemic in Brazil / Sobreexplotación de la fuerza de trabajo de salud en el contexto de la pandemia de COVID-19 en Brasil

Resumo O capitalismo, na sua etapa de dominância do capital fictício, acentuado pelas dimensões de sua crise pandêmica, econômica e ecológica, tem intensificado a superexploração da força de trabalho no mundo e, particularmente, no Brasil. Nessa perspectiva, o presente artigo tem como objetivo analisar as manifestações da superexploração da força de trabalho entre trabalhadores(as) da saúde em um contexto de pandemia de Covid-19 no Brasil. O artigo está estruturado em quatro partes. A primeira discute as dimensões do valor da força de trabalho. A segunda aborda os mecanismos de superexploração da força de trabalho. A seção seguinte discorre acerca das manifestações da superexploração entre os(as) trabalhadores(as) da saúde, nos últimos anos. E a parte final apresenta dados de como tem ocorrido ou acontecido a superexploração no cenário da pandemia de Covid-19 no Brasil. Atualmente, em um cenário de pandemia de Covid-19, observa-se um percentual significativo de profissionais da saúde com sobrecarga de trabalho, com jornadas para além das 40 horas semanais, alguns tendo que recorrer a mais de um vínculo de trabalho para poder sobreviver. Tais manifestações representam as péssimas condições de trabalho dessa categoria de trabalhadores, além de contribuir para o adoecimento e o elevado número de acidentes de trabalho.

Abstract Capitalism, in its stage of dominance of fictitious capital, accentuated by the dimensions of its pandemic, economic and ecological crisis, has intensified the superexploitation of the labor force in the world and, particularly, in Brazil. In this perspective, this article aims to analyze the manifestations of the superexploitation of the workforce among health workers in the context of the COVID-19 pandemic in Brazil. The article is structured in four parts. The first discusses the dimensions of the value of labor power. The second deals with the mechanisms of superexploitation of the workforce. The following section discusses the manifestations of superexploitation among health workers in recent years. And the final part presents data on how superexploitation has occurred in the scenario of the COVID-19 pandemic in Brazil. Currently, in the COVID-19 pandemic scenario, there is a significant percentage of health professionals with work overload, with working hours beyond 40 hours per week, some having to resort to more than one employment relationship to survive. Such manifestations represent the terrible working conditions of this category of workers, in addition to contributing to illness and the high number of accidents at work.

Resumen El capitalismo, en su etapa de dominación del capital ficticio, acentuado por las dimensiones de su crisis pandémica, económica y ecológica, ha intensificado la sobreexplotación de la fuerza de trabajo en el mundo y, particularmente, en Brasil. Desde esta perspectiva, este artículo tiene como objetivo analizar las manifestaciones de sobreexplotación de la fuerza de trabajo entre los trabajadores y trabajadoras de la salud en un contexto de pandemia de COVID-19 en Brasil. El artículo está estructurado en cuatro partes. La primera discute las dimensiones del valor de la fuerza de trabajo. La segunda aborda los mecanismos de sobreexplotación de la mano de obra. En la siguiente sección se analizan las manifestaciones de la sobreexplotación entre los trabajadores y trabajadoras de la salud en los últimos años. Y la parte final presenta datos sobre cómo se ha producido u ocurrió la sobreexplotación en el contexto de la pandemia de COVID-19 en Brasil. Actualmente, en un escenario de la pandemia del COVID-19, existe un porcentaje importante de profesionales de la salud con sobrecarga laboral, trabajando más de 40 horas a la semana, teniendo algunos que recurrir a más de un empleo para poder subsistir. Tales manifestaciones representan las malas condiciones de trabajo de esta categoría de trabajadores, además de contribuir a la enfermedad y al elevado número de accidentes de trabajo.

Association of long working hours and shift work with occupational stress in level A tertiary hospitals / 预防医学

Objective@#To examine the association of long working hours and shift work with occupational stress among medical staff in level A tertiary hospitals, so as to provide insights into promotion of physical and mental health among medical personnel. @*Methods@#One level A tertiary hospital was sampled using a stratified cluster sampling method from southern and northern Xinjiang Uygur Autonomous Region, and all medical personnel were recruited from these two hospitals. Participants' demographics, working duration, and working in shifts were collected using questionnaires, and occupational stress was measured using the Core Scale for Measurement of Occupational Stress proposed by National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention. The associations of long working hours (weekly working duration of >40 hours) and shift work with occupational stress were examined using a multiple linear regression model.@*Results@#A total of 2 529 questionnaires were allocated, and 2 262 were valid, with an effective rate of 89.44%. The respondents had a mean age of (35.12±8.71) years, and included 1 696 women (74.98%). Of all respondents, there were 722 doctors (31.92%), 1 033 nurses (45.67%), 361 medical or pharmaceutical technicians (15.96%), 1 808 with long working hours (79.93%) and 1 264 with shift work (55.88%). The score of occupational stress was (44.79±8.49) points, and the prevalence of occupational stress was 28.69% among respondents. Multiple linear regression analysis showed that after adjustment for age, marital status, length of service, position, smoking and physical exercise, long working hours (>40 h, β'=0.124; >48 h, β'=0.175; ≥55 h, β'=0.323) and shift work (β'=0.203) were influencing factors for occupational stress among medical personnel（P<0.05）; however, there was no interaction between long working hours and shift work (P>0.05). @*Conclusion@#Long working hours and shift work may increase the risk of occupational stress among medical personnel in level A tertiary hospitals.

Influencing factors of sleep disorders of employees of a steel enterprise / 环境与职业医学

Background Steel workers are exposed to occupational hazardous factors such as dust, noise, and heat, and often work in shifts, making them prone to sleep disorders. Objective To explore potential influencing factors of sleep disorders among workers in a steel enterprise in Gansu Province, and provide a basis for reducing the risk of sleep disorders among them. Methods From January to March 2022, a self-made questionnaire combined with the Pittsburgh Sleep Quality Index (PSQI) were used to investigate the employees of a steel enterprise in Gansu Province. According to their PSQI scores, they were divided into a normal sleep group and a sleep disorder group. The general demographic variables of the two groups were balanced by 1∶1 propensity score matching (PSM). Multiple logistic regression was used to analyze the contributing factors of sleep disorders. Restricted cubic spline (RCS) model was used to analyze potential dose-response relationship between weekly working hours and sleep disorders. Results The prevalence of sleep disorders in the steel workers was 48.06% (6029/12544). After PSM, 5847 pairs were successfully matched, and the distributions of matched variables were well balanced between the two groups. The results of multiple logistic regression showed that hypertension (OR=1.39, 95%CI: 1.24, 1.56), diabetes mellitus (OR=1.34, 95%CI: 1.07, 1.66), three-shift system (OR=1.26, 95%CI: 1.12, 1.41), dust exposure (OR=1.14, 95%CI: 1.01, 1.29), noise exposure (OR=1.23, 95%CI: 1.09, 1.39), heat exposure (OR=1.16, 95%CI: 1.04, 1.29), and work injury (OR=1.22, 95%CI: 1.02, 1.46) increased the risk of sleep disorders. Compared with workers with < 10 years of service, those with 10-20 years (OR=1.31, 95%CI: 1.19, 1.44), 20-30 years (OR=1.34, 95%CI: 1.19, 1.52), and ≥30 years of service (OR=1.35, 95%CI: 1.19, 1.53) had a higher risk of sleep disorders. Compared with non-exercise workers, the risk of developing sleep disorders was lower in workers with occasional exercise (OR=0.61, 95%CI: 0.56, 0.66) and regular exercise (OR=0.55, 95%CI: 0.49, 0.62). The RCS model showed that the weekly working hours and sleep disorders in the steel workers showed a nonlinear dose-response relationship (P<0.05 for overall trend, P<0.05 for nonlinear test). The relationship between weekly working hours and sleep disorders showed a "U" shaped distribution, with a significant increase in the risk of sleep disorders when the weekly working hours exceeded 49 h. Conclusion The non-occupational influencing factors of sleep disorders of employees in the steel enterprise include hypertension, diabetes, physical exercise, and occupational influencing factors include length of service, weekly working hours, shifts, dust exposure, noise exposure, heat exposure, and work injuries. It is recommended to consider both occupational and non-occupational factors to formulate appropriate sleep disorder prevention and control measures for steel employees to reduce the risk of sleep disorders.

Association between long working hours and occupational stress/fatigue accumulation in medical staff of tertiary grade A hospitals in Shanghai / 环境与职业医学

Background Long working hours are a common occupational health risk factor. The problem of long working hours and its impact on health of medical staff cannot be ignored. Objective To investigate long working hours in medical staff of tertiary grade A hospitals in Shanghai, and evaluate the relationships of long working hours with occupational stress and fatigue accumulation. Methods A total of 1531 medical staff in departments of emergency, internal medicine, surgery, intensive care unit (ICU), anesthesiology, and obstetrics and gynecology from 6 hospitals in 6 districts of Shanghai were selected using stratified random sampling. A structured questionnaire was used to collect information on social demographics, occupational characteristics, andbehavior and lifestyle. The Core Occupational Stress Scale (COSS) and the Self-diagnostic Questionnaire on the Accumulation of Fatigue of Laborers were used to assess occupational stress and fatigue accumulation condition. Chi-square test and Kruskal-Wallis H test were used to analyze the distributions of long working hours, occupational stress, and fatigue accumulation, log-binomial models were used to analyze the relationships of long working hours with occupational stress and fatigue accumulation, and job title stratified models were also constructed. Results The average weekly working hours of the study subjects was (47.84±11.40) h, 65.90% of the medical staff worked more than 40 h every week. The percentages of the weekly working hours categories of 41-48 h, 49-54 h, and ≥55 h were 31.42%, 13.46%, and 21.03%, respectively. The positive rates of occupational stress and fatigue accumulation were 25.87% and 65.64% respectively, and the differences among different age, gender, job title, education, length of service, and shift system groups were statistically significant (P<0.05). The results of log-binomial regression showed that after adjusting for gender, age, monthly income, marital status, education, physical exercise, smoking, job position, length of service, and shift system, weekly working hours were an influencing factor of occupational stress and fatigue accumulation (P<0.05). Compared with weekly working hours≤40 h, the risk, PR(95%CI), of reporting occupational stress and fatigue accumulation increased to 2.595 (1.989, 3.385) and 1.578 (1.349, 1.845) times respectively for weekly working hours≥55 h (P<0.001). The results of job title stratification analysis showed that the risk of occupational stress among physicians, nurses, and medical technicians increased when weekly working hours≥55 h versus ≤40 h, and the PR (95%CI) values were 2.003 (1.383, 2.902), 1.971 (1.068, 3.636), and 2.770 (1.220, 6.288), respectively (P<0.05). The risk of fatigue accumulation was increased in physicians when weekly working hour≥55 h versus ≤40 h, with a PR (95%CI) value of 1.594 (1.208, 2.103) (P<0.001). Conclusion Long working hours are common among medical personnel and related to the occurrence of occupational stress and fatigue accumulation.

Research progress on health effects associated with exposure to long working hours / 环境与职业医学

The phenomenon of workers working beyond standard working hours is called long working hours. In recent years, more and more relevant studies at home and abroad have shown the association between long working hours and adverse health effects of occupational populations, such as increased risks of cardiovascular diseases, diabetes, and various psychological conditions such as depression and occupational stress. However, the current research has not yet reached a consistent conclusion. The main reason is that the physiological and psychological effects of exposure to long working hours need to be explored in depth. Therefore, based on the relevant research progress at home and abroad, this article introduced the health effects of long working hours from both physical and psychological aspects, including hypertension, cardiovascular diseases, diabetes, depression, and job burnout, expounded related mechanisms involved, and indicated deficiencies in current research on long working hours and the next research directions.

Correlations of long working hours and shift work with sleep of migrant workers / 环境与职业医学

Background Long working hours (LWH) and shift work are harmful to the physical and mental health of occupational groups. Objective To understand the status quo of LWH and shift work of migrant workers in Shanghai, and to analyze the influence of the above two factors on sleep of the population. Methods From July to September 2018, a cross-sectional survey using questionnaires was conducted among 3215 in-service employees at seven workplaces with more than 300 employees in six selected districts of Shanghai using multi-stage random sampling method. A total of 2976 valid questionnaires were collected, with a valid response rate of 92.6%. The questionnaires included general demographic characteristics, personal health behavior, work-related factors, weekly working hours, shift work, and sleep. Univariate analysis and logistic regression analysis were used to investigate the relationships of LWH and shift work with sleep, and an interaction item was included to evaluate potential interaction between LWH and shift work. Result The average age of the subjects was (30.98±9.49) years old, the male to female ratio was 1∶1.20, and 2382 workers were reported without local residency (80.0%). Among the migrant workers, the average weekly working hours was (57.23±13.14) h, the proportions of LWH (weekly working hours>40 h), extra LWH (weekly working hours>55 h), and shift work were 80.6% (1919/2382), 60.3% (1436/2382), and 25.4% (600/2366), respectively, all above were significantly higher than those of local workers. The prevalence rates of insomnia and lack of sleep among the migrant workers were 46.3% (1091/2356) and 25.4% (597/2354), respectively. The results of logistic regression model showed that after adjusting demographic characteristics such as gender, age, education level, and monthly income, as well as occupation and personal health behavior, compared with working hours ≤40 h per week, working 55-60 h per week was a risk factor for insomnia of migrant workers (OR=1.33, 95%CI: 1.02-1.72), while working >60 h per week was a risk factor for both insomnia (OR=1.37, 95%CI: 1.05-1.78) and insufficient sleep (OR=1.73, 95%CI: 1.28-2.35) of migrant workers. Shift work was only associated with insomnia (OR=1.37, 95%CI: 1.11-1.69). Meanwhile, working hours>60 h per week and shift work had an interaction effect on insomnia of migrant workers (OR=2.35, 95%CI: 1.20-4.60). Conclusion LWH and shift work are prominent among migrant workers, and there is an interaction between LWH and shift work with insomnia.

Using a Variable Working Hour System in Compliance with Labor Standards Law in a Japanese Residency Program / 医学教育

Introduction: Work style reform of medical doctors is now an actively discussed matter in Japan. There is also the problem of how to balance the management of legal working hours and the value of medical education in junior residency programs. In particular night and holiday shifts in emergency departments are one of the most important causes of working hour elongation for junior residents. We tried to construct a legally appropriate management method to control their working hours including night and holiday shifts. Method: One-Month Variable Working Hours System and two-shift system were applied to labor management in the medical residency program. Night and holiday working hours were included in regular working hours. Day-time working hours were adjusted to the weekly schedule of each clinical department to cover most of its daily work. Result: Overtime working hours of all residents, including the night and holyday shifts, were managed within the legal limits of 45 hours a month, unless additional overtime work was required. Discussion: Managing worktime through the use of the One-Month Variable Working Hours System is thought to be feasible. In the junior residency program, night and holiday shifts in the emergency department could also be balanced.

Relación entre estrés percibido y calidad de sueño en enfermeras de turnos nocturno y rotativo / Relationship between perceived stress and sleep quality in night-shift and rotating nurses

Objetivo: determinar si existe relación entre el estrés percibido y la calidad de sueño en las enfermeras de los turnos nocturno y rotativo de la empresa social del Estado Hospital San Rafael de Facatativá. Metodología: estudio transversal con alcance correlacional donde se evaluó el estrés percibido y la calidad de sueño por medio de la escala de estrés percibido - versión 14 y el índice de calidad de sueño de Pittsburg -versión colombiana, respectivamente, en una muestra de 98 enfermeras que cumplieron con los criterios de inclusión. Resultados: se presentó una prevalencia del 72,45% de estrés percibido y del 79,59% de mala calidad de sueño; entre estas dos variables se halló una correlación baja (r=0,258; p=0,010). Se puede asegur ar con un 95 % de confianza que mientras una variable aumenta, la otra también lo hace, queriendo decir que a mayor puntaje en la escala de estrés percibido, mayor puntaje en el índice de calidad de sueño de Pittsburgh, lo que sugiere que el nivel de estrés es un factor que tiene relación directamente proporcional con el sueño, es decir, entre mayor estrés, peor calidad de sueño. Conclusiones: se concluye que sí existe relación entre el estrés percibido y la calidad de sueño, lo cual evidencia, por un lado, que en las enfermeras a mayor estrés, peor calidad de sueño, y por otro, que a peor calidad de sueño, mayor estrés.

Objective: To determine if there is a relationship between perceived stress and sleep quality in nurses in the night and rotating shifts of the social enterprise of the State Hospital San Rafael of Facatativá. Methodology: Study cross-sectional with a correlational scope where the perceived stress was assessed through the Perceived Stress Scale, Version 14, and sleep quality using the Pittsburg Sleep Quality Index, Colombian Version, in a sample of 98 nurses who met the inclusion criteria. Results: a prevalence of 72.45% of stress and 79.59% of poor sleep quality were perceived; there was a low correlation between these two variables (r= 0.258; p=0.010). It may be ensured with 95% of confidence that while a variable increases, the other one does the same; this means that higher stress level in the perceived stress scale implies a higher score in the Pittsburgh Sleep Quality Index; which suggests that stress level is a factor that has directly proportional relationship with sleep; so, higher stress level is equal to worse sleep quality. Conclusions: It is concluded that there is a relationship between perceived stress and sleep quality, showing that, the greater the stress in the nurses, the worse the quality of sleep, as well as the worse the quality of sleep, the greater the stress

Long Commute Time and Sleep Problems with Gender Difference in Work–Life Balance: A Cross-sectional Study of More than 25,000 Workers

BACKGROUND: There is a lack of statistical analysis investigating the relationship between sleep problems and commute time in Korea. We aimed to analyze the association between representative health symptoms, sleep disturbances, and commute time according to working hours in Korea.METHODS: The 4th Korean Working Conditions Survey data were used for analysis, and unpaid family workers and workers who work fewer than three days in a week were excluded. Commute time, working hours, and sleep hours were assessed using self-reported questionnaires. Odds ratios (ORs) with 95% confidence intervals (CIs) for sleep problems were calculated using a multivariate logistic regression model with ≤10 min commute time as the reference group.RESULTS: Among a total of 28,804 workers (men = 14,945, women = 13,859), 2.6% of men and 3.2% of women experienced sleep problems. In both sexes, long commute time (51–60 minutes and >60 minutes) showed an increased OR [men, 2.03 (CI = 1.32–3.13) and 2.05 (CI = 1.33–3.17); women, 1.58 (CI = 1.05–2.39) and 1.63 (CI = 1.06–2.50), respectively]. In stratification analysis of working hours, long commute time (51–60 and > 60 minutes) showed an increased OR in men working >40 hours/week [2.08 (CI = 1.16–3.71) and 1.92 (CI = 1.08–3.41), respectively]. Furthermore, long commute time (41–50, 51–60, and >60 minutes) showed an increased OR in women working >40 hours/week [2.40 (CI = 1.27–4.55), 2.28 (CI = 1.25–4.16), and 2.19 (CI = 1.17–4.16), respectively]. Moreover, commute time >60 minutes showed an increased OR in women working ≤40 hours/week [1.96 (CI = 1.06–3.62)].CONCLUSION: This large cross-sectional study highlights that long commute time is related to sleep problems in both sexes. Shorter commute times and decreased working hours are needed to prevent sleep problems in workers.

Relationship between working hours and probability to take alopecia medicine among Korean male workers: a 4-year follow-up study

BACKGROUND: Many studies have reported the negative effects of long working hours on various health problems. However, whether hair loss is associated with working hours has been rarely investigated so far. The main purpose of this study is to explore the relationship between long working hours and the development of alopecia among Korean male workers. METHODS: A total of 13,391 male workers not to take alopecia medicine in 2013 were followed up to see if they have alopecia medicine after 4 years, and that was used to confirm the alopecia development. Weekly working hours were categorized into three groups: reference working hours (RWH; 52 hours/week). Multiple logistic regression analyses were conducted to investigate the relationship between long working hours and the development of alopecia after adjusting age, marital status, education, monthly household income, smoking, and work schedule within strata of the covariates. RESULTS: Long working hours was significantly related to the development of alopecia. The adjusted odds ratios (ORs) for the development of alopecia were 1.57 (95% confidence interval [CI]: 1.21–2.05) for LWH group and 1.74 (95% CI: 1.23–2.47) for MLWH group relative to RWH group. CONCLUSIONS: Our findings suggest that unintentional development of alopecia is another potential health consequence of long working hours among Korean male workers. Preventive interventions to promote appropriate and reasonable working hours are required in our society.

Trabalho e saúde nas lutas dos operários da construção civil do Complexo Petroquímico do Rio de Janeiro / Work and Health in the struggles of the construction workers of Rio de Janeiro Petrochemical Complex

Resumo Introdução: o Complexo Petroquímico do Rio de Janeiro (Comperj) é uma das maiores obras da construção civil pesada no Brasil. A obra constitui-se em cenário de lutas operárias que expressam conflitos das relações de trabalho com implicações na saúde dos trabalhadores. Objetivo: analisar o trabalho e a saúde dos operários da construção civil do Comperj a partir da perspectiva dos trabalhadores, tendo por referência suas lutas e greves. Métodos: pesquisa social de caráter qualitativo com observação participante, levantamento documental e entrevistas com trabalhadores e dirigentes sindicais. Resultados: as práticas de exploração constatadas nos canteiros de obras foram analisadas sob três categorias: terceirização e a saúde dos trabalhadores, prolongamento do tempo de trabalho e gestão por estresse. Conclusão: considerados em conjunto, os resultados representam uma contínua imposição de agravos à saúde dos trabalhadores da construção civil. Nesse contexto, a luta coletiva dos trabalhadores constitui uma condição básica para a proteção à saúde dos trabalhadores.

Abstract Introduction: Rio de Janeiro Petrochemical Complex (Comperj) is one of the largest heavy construction in Brazil. It has constituted a scenario of workers' struggles that express conflicts of labor relations with implications on workers' health. Objective: to analyze the work and health of Comperj's construction workers from their perspective, adopting as reference their struggles and strikes. Methods: qualitative social research with participant observation, documentary survey and workers and union leaders' interviews. Results: the exploration practices observed in the workplaces were analyzed in three categories: outsourcing and workers' health, extension of working time and management by stress. Conclusion: taken together, the results represent a continuous imposition of damages on the construction workers' health. In this context, the workers' collective struggle constitutes a basic condition for the protection of workers' health.

Association between Long Working Hours and Job Stress and Depression among Employees from a State Grid Company / 中华劳动卫生职业病杂志

Objective@#This study was to understand the current situation of long working hours and identify the association of long working hours and job stress and depression among workers from one district company of state grid. @*Methods@#The project was done with the cross-sectional survey. All questionnaires were completed by self-administered with informed consent. Employees’ weekly working hours was reported by themselves; Using the PHQ-9 scale to assess depression, the JDC Model to evaluate job stress, and SPSS software to analyze data, the single factor chi-square test and multivariate Logistic analysis were performed to identify the association between long working hours and job stress, depression. @*Results@#there were 35.3 percent employees with over 44 hours a week. The association between increasing weekly working hours and job stress and depression was statistically significant. Compared to the reference group (≤44 h) , for those who worked more than 44 hours per week, the odds ratio of job stress was 2.02 (95%CI=1.27-3.23) times increased, and the odds ratio of depression was 1.60 (95%CI=1.01-2.55) times increased, especially for those (≥60 h) , the odds ratio was 3.69 (95%CI=1.45-9.41) and 2.76 (95%CI=1.09-7.03) respectively. @*Conclusion@#Long working hours can significantly increase the risk of job stress and depression among workers. When their weekly working hours exceeds 60, long working hours will be the independent risk factor for both job stress and depression.

Marginal socio-economic effects of an employer's efforts to improve the work environment

BACKGROUND: Workplace health promotion (WHP) strongly requires the employer’s efforts to improve the psychosocial, ergonomic, and physical environments of the workplace. There are many studies discussing the socio-economic advantage of WHP intervention programmes and thus the internal and external factors motivating employers to implement and integrate such programmes. However, the socio-economic impacts of the employer’s multifactorial efforts to improve the work environment need to be adequately assessed. METHODS: Data were collected from Swedish company Sandvik Materials Technology (SMT) through a work environment survey in April 2014. Different regression equations were analysed to assess marginal effects of the employer’s efforts on overall labour effectiveness (OLE), informal work impairments (IWI), lost working hours (LWH), and labour productivity loss (LPL) in terms of money. RESULTS: The employer’s multifactorial efforts resulted in increasing OLE, decreasing IWI and illness-related LWH, and cost savings in terms of decreasing LPL. CONCLUSION: Environmental factors at the workplace are the important determinant factor for OLE, and the latter is where socio-economic impacts of the employer’s efforts primarily manifest.

The associations between work-related factors and temporomandibular disorders among female full-time employees: findings from the Fourth Korea National Health and Nutrition Examination Survey IV (2007–2009)

BACKGROUND: The aim of this study was to investigate the association between work-related factors and temporomandibular disorders (TMD) among female full-time employees using representative data from a national population-based survey. METHODS: Data from the Fourth Korea National Health and Nutrition Examination Survey IV (2007–2009) were used to analyze 1,612 women. Complex samples logistic regression was applied for adjusting for general characteristics and work-related factors to examine the association between work-related factors and TMD. RESULTS: The prevalence of TMD was 12.8% in this study population. With respect to age, educational status, marital status, problem drinking, exercise, and stress, there were statistically significant differences in the prevalence of TMD. In logistic regression analyses on complex samples, based on 40 h or less per week, odds ratios (ORs) for respondents who worked 40–48 working hours, 49–60 working hours, and more than 60 h were 1.16 (95% confidence interval (CI) 0.69–1.94), 1.41 (95% CI 0.79–2.54), and 2.43 (95% CI 1.29–4.59), after adjusting for general characteristics, working schedule, employment status, and occupation. CONCLUSIONS: This study found that long working hours were significantly associated with TMD in Korean female full-time employees.

Working hours and depressive symptoms: the role of job stress factors

BACKGROUND: South Korea is one of the countries with the longest working hours in the OECD countries. The aim of this study was to evaluate the effect of working hours on depressive symptoms and the role of job stress factors between the two variables among employees in South Korea. METHODS: This study used data from the Korea Working Conditions Survey in 2014. Study subjects included 23,197 employees aged 19 years or older who work more than 35 h per week. Working hours were categorized into 35–39, 40, 41–52, 53–68, and more than 68 h per week. Depressive symptoms were assessed using the WHO’s Well-Being Index with a cut-off score of 13. We calculated prevalence ratios of depressive symptoms according to working hours using log-binomial regression. Through the percentage change in prevalence ratios, we identified the extent of the role of job stress factors that explain depressive symptoms. RESULTS: The risks of depressive symptoms were significantly higher in people who worked 35–39 h per week (PR: 1.09, CI: 1.01–1.18), 53–68 h/week (PR: 1.21, CI: 1.16–1.25), and more than 68 h/week (PR: 1.14, CI: 1.07–1.21) than 40 h/week, after adjusting for confounding variables. Job stress explained the effects of long working hours on depressive symptoms in about 20–40% of the groups working more than 40 h/week. Among the factors of job stress, social support was 10–30%, which showed the highest explanatory power in all working hours. Reward explained 15–30% in the more than 52 h working group, and reward was the most important factor in the working group that exceeded 68 h. CONCLUSIONS: We showed the working hours could be an independent risk factor for depressive symptoms in employees. To improve workers’ mental health, it is important to strengthen social support in the workplace, to provide adequate rewards as they work, and ultimately to regulate the appropriate amount of working hours.

The association between long working hours and work-related musculoskeletal symptoms of Korean wage workers: data from the fourth Korean working conditions survey (a cross-sectional study)

BACKGROUND: It has been reported that long working hours are hazardous to the workers’ health. Especially, work-related musculoskeletal disorders (WMSDs) have been considered as one of the significant health issues in workplace. The objective of this study was to identify the association between long working hours and work-related musculoskeletal symptoms. METHODS: The analysis was conducted using data from the Fourth Korean Working Conditions Survey (KWCS). Subjects of this study were 24,783 wage workers and divided into three groups according to the weekly working hours, which were ≤ 40, 41–52 and > 52 h. The relationship between long working hours and work-related musculoskeletal symptoms was analyzed by multivariate logistic regression method after adjusting for general, occupational characteristics including specific working motions or postures and psychosocial factors. RESULTS: Approximately 18.4% of subjects worked more than 52 h per week and 26.4 and 16.4% of male subjects and 33.0 and 23.4% of female subjects experienced work-related upper and lower limb pains, respectively, over the last 12 months. Moreover, the prevalence of upper and lower limb pain was increased in both genders as the weekly working hours increased. The odds ratios (ORs) of upper limb pain for those working 41–52 h and more than 52 h per week when adjusted for general, occupational characteristics including specific motions or postures and psychosocial factors were 1.36 and 1.40 for male workers and 1.26 and 1.66 for female workers compared to the reference group, respectively. Furthermore, ORs of lower limb pain for the same weekly working hour groups were 1.26 and 1.47 for male workers and 1.20 and 1.47 for female workers, respectively. CONCLUSIONS: Long working hours were significantly related to work-related musculoskeletal symptoms in Korean wage workers and appropriate interventions should be implemented to reduce long working hours that can negatively affect workers’ health.

Comparative analysis of the depressive state, stressor, and stress-relieving factors of novice first year residents and established residents in Japan / 医学教育

Aim: We sought to compare the depression state of first-year residents, who were new to the system of clinical resident training, with those who had become completely familiar with the system.Method: A questionnaire-based survey on stress reaction was distributed to 250 resident training hospitals in Japan. The survey was taken by 1,753 first year residents who started postgraduate clinical training in 2011. The survey was given to the students once before the training and-again months after the training had started. The results were compared with those from a similar survey in 2004.Result: 3 months after the training had started, 30.5% of residents suffered from a depressive state. At that time, the prevalence of residents with newly developed symptoms of depression, who had no depressive state before the training, significantly decreased compared to those in 2004 (19.6 vs. 25.2%, p<0.001). The decrease of depressive state in 2011 may be due to the decrease of working hours, the improvement of stressor and stress-relieving factors.Discussion: Many residents still experienced a stress reaction. Further improvement of the training environment should be considered.