The relationship between occupational burnout and work ability among firefighters: exploring the mediating effects of insomnia, depressive symptoms, loneliness and alcohol misuse.

Purpose: Firefighting is a profession associated with a high risk of elevated levels of occupational stress and burnout. The aim of this cross-sectional study was to explore the mediating effects of insomnia, depressive symptoms, loneliness and alcohol misuse in the relationship between two dimensions of burnout (i.e., exhaustion and disengagement) and work ability among firefighters. Methods: A total of 460 firefighters from various regions of Poland completed a set of self-report questionnaires to assess constructs of interest. A mediation model was constructed to verify hypothesized paths, adjusted for socio-demographic and work-related background characteristics. Model parameters were estimated using a bootstrapping procedure, with sampling set at N = 1000. Results: The proposed model explained 44% of variance in work ability. Higher levels of both exhaustion and disengagement predicted worsened work ability. When mediators were controlled for, these effects remained statistically significant. Depressive symptoms and feelings of loneliness were found to be partial mediators of the association between exhaustion and work ability, and between disengagement and work ability. The mediating effects of insomnia and alcohol misuse were non-significant. Conclusions: Interventions aimed at counteracting the decrement in work ability among firefighters should target not only occupational burnout, but also depressive symptoms and a sense of loneliness as factors mediating its detrimental effects.

Occupational and non-occupational risk factors for neck and lower back pain among computer workers: a cross-sectional study.

Objectives. The aim of this study was to identify major determinants for neck and lower back pain (LBP) among office workers of different ages. Methods. Computer workers (N = 2000) responded to a questionnaire on demographics, musculoskeletal disorders (MSDs), lifestyle characteristics, ergonomics of computer work and psychosocial and physical job characteristics. Results. Over 48% of respondents complained of MSDs last year, in particular neck pain and LBP. The results of logistic regression analysis revealed that prolonged computer time (odds ratio [OR] 1.92) and increased job demands (OR 1.06) were likely to increase the risk of neck pain, while social support (OR 0.96) and the use of seat-plate height adjustment (OR 0.64) would help to reduce the risk. Risk factors for LBP included smoking more than 14 cigarettes a day (OR 2.21), long hours spent working with a computer (OR 1.94), increased physical exertion at work (OR 1.29), increased work demands (OR 1.03) and older age (OR 1.03). Conclusions. The most effective way to eliminate MSD hazards in the workplace is to develop health programmes aimed at advocating healthy lifestyle behaviours and raising workers' awareness of workstation ergonomics and work organization, especially for women and older workers.

The influence of air humidity on human heat stress in a hot environment.

This article aims to present the physical adaptation capabilities of a human, seen as a response to extreme hot and dry or hot and humid conditions. Adaptation capabilities are expressed as safe exposure time in two variants: at rest and during physical activity. The study shows the results of calculations of the variability over time of the core temperature and skin temperature as well as heat balance. Calculations were made according to Standard No. EN ISO 7933:2005 on the basis of assumed and actual meteorological data. The results of the calculations show that in these conditions a hot but dry environment enables a human (although to a limited extent) to stay and perform low physical activity, provided access to drinking water is ensured. In contrast, a hot but humid environment causes more serious problems, due to the inability to reduce skin temperature by evaporation of sweat from the skin surface.

Effect of previous lowering of skin temperature on the time of safe exposure to a hot environment: a case study.

Objective. The purpose of the study was to determine the influence of initial conditions of a microclimate on volunteers' permissible exposure limits to a hot and humid environment. Materials and methods. Eighteen experimental studies with the participation of three volunteers were performed under controlled microclimate conditions (two climate chambers). The skin temperature and body core temperature were measured after they had stabilized in the following microclimate conditions: temperature of 17, 21 and 23 °C, relative humidity of 50% and hot microclimate conditions, i.e., temperature of 35 and 42 °C, humidity of 80% and physical work load at 30 W. The time needed to reach a body core temperature of 38 °C was determined under hot conditions. Heat accumulation was calculated. Results. Lowering volunteers' skin temperature under conditions of stabilized physiological parameters prolongs the time necessary for the body core temperature to reach 38 °C during physical work in a hot and humid environment. Conclusions. Appropriate acclimatization before exposure may prolong the time of safe work in a hot environment, e.g., during activities of rescue services.

Assessment of the impact of lifestyle and psychosocial working conditions on older employees' work ability.

Objective. The purpose of this article was to assess the impact of selected elements of lifestyle, psychosocial working conditions and general mental health on older employees' ability to work. Methods. Employees (N = 1067) aged 50-65 years (M 54.8, SD 3.95) responded to a questionnaire on demographics, lifestyle characteristics, general mental health (general health questionnaire), psychosocial job characteristics (job content questionnaire) and work ability (work ability index [WAI]). A logistic regression model was used to assess the impact of the selected factors on work ability. Results. Older employees were characterized by good (44.4%) and moderate (36.4%) work ability. The average WAI scores were significantly higher among employees who did not smoke, consumed the recommended daily intake of vegetables, drank enough water, ate breakfast every morning, cut down on sweets and were on a vegetarian diet. Good physical (no sick leave) and mental health, high level of job control, low job insecurity and use of over-the-counter drugs were found to be the strongest predictors of WAI scores. Conclusions. The results of the research indicate that most of the determinants of work ability identified at work are impacted, thus giving the opportunity to conduct some occupational health and preventive programmes in the workplace.

The relationship between work, mental health, physical health, and fatigue in patients with rheumatoid arthritis: A cross-sectional study.

To evaluate the relationship between work, mental health, physical health, and fatigue in patients with rheumatoid arthritis, the data of 282 participants were drawn from baseline. The results of structural equation modeling showed that among rheumatoid arthritis patients, those who were engaged in occupational activity had lower levels of fatigue compared to those who did not work and that this relationship was mediated by better mental health, not by physical health.

Mine rescuers' heat load during the expenditure of physical effort in a hot environment, using ventilated underwear and selected breathing apparatus.

Mine rescuers' heat load under the same physical effort load (25% of the maximal oxygen uptake), using three types of breathing apparatus, in newly developed heat-removing underwear and outerwear was assessed for typical work conditions of mine rescuers, under milder and harsher ambient conditions of 32 and 38 °C, respectively, both at relative humidity of 85% and air velocity of 1.0 m/s. Expending physical effort at the same load while using different kinds of breathing apparatus resulted in a similar heat load. Under both milder and harsher ambient conditions, heat storage and sweating intensity were greater than the average limit value recommended by hygienic standards, which indicates that the use of breathing apparatus significantly hinders heat exchange with the environment. The developed clothing for mine rescuers was highly rated, and was considered by most people to be better than that used currently.

Changes in the peripheral blood flow in legs in response to the cold: own studies using plethysmography.

The thermal environment in the workplace is an important factor which affects workers' health. During 2011 in Poland, 14,781 workers were exposed to a cold working environment, i.e., 3.8% of persons employed in hazardous work conditions. The aim of this study was to determine the cardiovascular response to continuous (4 °C for 60 min) and intermittent (10 min at 4 °C and 10 min at room temperature alternately) exposure to the cold in 30 healthy men aged 20-27 years. Peripheral blood flow was assessed with impedance plethysmography. Heart rate and arterial blood pressure were monitored with the Holter system. Having assessed the results, it is difficult to say which kind of exposure has a more severe impact on the cardiovascular system. Longer observation and a more detailed analysis would be necessary (e.g., Doppler echocardiography).

The Effect of Comprehensive Musculoskeletal Rehabilitation on Clinical Status of Ankylosing Spondylitis Patients.

BACKGROUND: This study aimed to compare the effectiveness of conventional and cryotherapy-based rehabilitation with respect to its impact on selected clinical parameters in AS patients. MATERIAL AND METHODS: Fifty working males aged 22-66 years were included in this study. Twenty-five of them underwent cryotherapy-based rehabilitation (cryogenic chamber, local cryotherapy; individual, instrumental, and nonweight-bearing exercises) for 3 weeks. The others received 3 weeks of conventional rehabilitation (magnetic field therapy; electrotherapy; individual and instrumental exercises). The patients were examined at three time points: before rehabilitation, immediately after its completion and at a three-month follow-up visit. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) was used to assess disease severity, the Bath Ankylosing Spondylitis Functional Index (BASFI) was used to assess musculoskeletal function and a visual analog scale (VAS) was used to assess pain. A global health index was also employed to assess patients' overall well-being. RESULTS: Cryotherapy-based rehabilitation improved the following parameters: BASDAI (P<0.001, P<0.001), BASFI (P<0.001, P=0.007), VAS (P<0.007, P=0.001) and global health index (P<0.001, P<0.001) at the second and third assessment, respectively. Conventional rehabilitation improved the BASDAI (P<0.001), VAS (P=0.029), and overall well-being (P<0.030) at the second assessment. Cryotherapy-based rehabilitation was more effective than conventional rehabilitation with respect to BASFI [F(2, 82)=6.571; P=0.004; eta2=0.120] and overall well-being [F(2, 96) =5.018; P=0.008; eta2=0.095)]. CONCLUSIONS: 1. Comprehensive rehabilitation in ankylosing spondylitis has a positive effect on patients' clinical status. 2. Rehabilitation involving cryotherapy is more effective in improving musculoskeletal function and overall well-being compared to conventional rehabilitation. 3. Cryotherapy-based rehabilitation significantly reduces the intensity of pain experienced by AS patients and decreases disease activity, with the positive effect maintained at 3 months post rehabilitation.

Complex rehabilitation and the clinical condition of working rheumatoid arthritis patients: does cryotherapy always overtop traditional rehabilitation?

AIM: Rehabilitation slows the progress of rheumatoid arthritis (RA) and prevents progression of disability. This study aimed to compare the impact of two rehabilitation programmes on pain, disease activity, locomotor function, global health and work ability forecast in RA patients. MATERIALS AND METHODS: Sixty-four employed women aged 24-65 years participated in the study. All patients underwent individual and instrumental kinesiotherapy. Thirty-two patients underwent cryogenic chamber therapy and local cryotherapy as well as non-weight-bearing, instrumental and individual kinesiotherapy. The remaining 32 patients received traditional rehabilitation in the form of electromagnetic and instrumental therapy, individual and pool-based non-weight-bearing kinesiotherapy. Rehabilitation lasted 3 weeks. Patients were examined three times: prior to rehabilitation, after 3 weeks of therapy and 3 months after completion of rehabilitation. The following study instruments were used: to assess disease activity: DAS-28; functional impairment: HAQ-DI; pain severity: VAS; patients' overall well-being: a scale from 0 to 100 (Global Health Index); and patients' own prognosis of fitness for work: the 6th question from Work Ability Index (WAI). Statistical analysis of data was performed using the STATISTICA 8.0 package. Mixed-design two-way analysis of variance was used for hypothesis testing. RESULTS: All patients improved after rehabilitation. The group of patients those who underwent cryotherapy had improved DAS-28, HAQ-DI, VAS and global health scores immediately following the 3-week rehabilitation programme (p < 0.001, p = 0.001, p = 0.007 and p < 0.001, respectively), as well as at the 3-month follow-up (p < 0.001, p < 0.001, p = 0.009 and p < 0.001, respectively). Rehabilitation using cryotherapy resulted in greater improvement in disease activity DAS-28 [F(2,105) = 5.700; p = 0.007; η(2) = 0.084] and HAQ-DI locomotor function scores [F(2,109) = 6.771; p = 0.003; η(2) = 0.098] compared to traditional rehabilitation. The impact of both forms of rehabilitation on patients' own prognosis of work ability in the next 2 years was not significant. Results of patients who underwent traditional approach showed decreased disease activity following the initial 3-week period; however, this improvement did not sustain to the end of follow-up, 3 months later. CONCLUSIONS: Complex rehabilitation in RA has a positive effect on patients' clinical condition. The rehabilitation programme that includes cryotherapy overtops traditional rehabilitation, particularly as regards improvement in locomotor function, disease activity and sustaining willingness to continue working and exerts long-lasting effect. IMPLICATIONS FOR REHABILITATION: Rehabilitation using cryotherapy is more effective in improving locomotor function, decreasing disease activity and sustaining willingness to continue working compared to traditional rehabilitation. Rehabilitation using cryotherapy significantly reduces the intensity of pain experienced by patients with RA, and this positive effect is maintained at 3 months post-rehabilitation. Complex rehabilitation, particularly treatment using cryotherapy, improves patients' subjective assessment of their overall well-being and perception of their disease. Complex rehabilitation in rheumatoid arthritis has a positive effect on patients' clinical condition.

Heart rate variability (HRV) during virtual reality immersion.

The goal of the study was assessment of the hour-long training involving handling virtual environment (sVR) and watching a stereoscopic 3D movie on the mechanisms of autonomic heart rate (HR) regulation among the subjects who were not predisposed to motion sickness. In order to exclude predispositions to motion sickness, all the participants (n=19) underwent a Coriolis test. During an exposure to 3D and sVR the ECG signal was continuously recorded using the Holter method. For the twelve consecutive 5-min epochs of ECG signal, the analysis of heart rate variability (HRV) in time and frequency domains was conducted. After 30 min from the beginning of the training in handling the virtual workstation a significant increase in LF spectral power was noted. The values of the sympathovagal LF/HF index while sVR indicated a significant increase in sympathetic predominance in four time intervals, namely between the 5th and the 10th minute, between the 15th and the 20th minute, between the 35th and 40th minute and between the 55th and the 60th minute of exposure.

Chronic musculoskeletal disorders as risk factors for reduced work ability in younger and ageing workers.

AIMS: The aim of the study was to assess the occurrence and intensity of musculoskeletal pain as a risk factor for reduced work ability. METHODS: In total, 1449 workers participated in the study, 64% were younger workers (<45 years old, M 31.4); 36% were ageing workers (≥45 years old, M 50.3), Their health condition was established on the basis of (a) subjective feeling of health on a 5-point scale, (b) pain in 6 parts of the body in the past year; and (c) intensity of pain on a 100-mm visual analogue scale (VAS). Work ability was assessed with the subjective work ability index (WAI). RESULTS: The results of the study showed that although in the both groups, i.e., younger and ageing workers, the occurrence and intensity of pain in the hands/wrists, neck and lower back were a significant factor which decreased WAI, in ageing workers only the occurrence of pain in the lower back generated higher risk factors for reduced work ability (WAI < 37). CONCLUSIONS: Improving physical and psychosocial working conditions to reduce musculoskeletal complaints, and identifying individuals with such complaints are important in increasing workers' work ability and thus extending their occupational activity.

Occupational exposure to natural UV radiation and premature skin ageing.

The skin is the part of the human body most vulnerable to ultraviolet (UV) radiation. The spectrum of the negative effects of UV radiation on the skin ranges from acute erythema to carcinogenesis. Between these extreme conditions, there are other common skin lesions, e.g., photoageing. The aim of this study was to assess the skin for signs of photoageing in a group of 52 men occupationally exposed to natural UV radiation. There were 2 types of examinations: an examination of skin condition (moisture, elasticity, sebum, porosity, smoothness, discolourations and wrinkles) with a device for diagnosing the skin, and a dermatological examination. The results of both examinations revealed a higher percentage of skin characteristics typical for photoageing in outdoor workers compared to the general population.

[Subjective sensations indicating simulator sickness and fatigue after exposure to virtual reality]. / Subiektywne odczucia wskazujace na wystepowanie choroby symulatorowej i zmeczenie po ekspozycji na rzeczywistosc wirtualna.

BACKGROUND: The study assessed the incidence and intensity of subjective symptoms indicating simulator sickness among the persons with no inclination to motion sickness, immersed in virtual reality (VR) by watching an hour long movie in the stereoscopic (three-dimensional - 3D) and non-stereoscopic (two-dimensional - 2D) versions and after an hour long training using virtual reality, called sVR. MATERIAL AND METHODS: The sample comprised 20 healthy young men with no inclination to motion sickness. The participants' subjective sensations, indicating symptoms of simulator sickness were assessed using the questionnaire completed by the participants immediately, 20 min and 24 h following the test. Grandjean's scale was used to assess fatigue and mood. RESULTS: The symptoms were observed immediately after the exposure to sVR. Their intensity was higher than after watching the 2D and 3D movies. A significant relationship was found between the eye pain and the type of exposure (2D, 3D and sVR) (Chi2)(2) = 6.225, p < or = 0.05); the relationship between excessive perspiration and the exposure to 31) movie and sVR was also noted (Chi2(1) = 9.173, p < or = 0.01). Some symptoms were still observed 20 min after exposure to sVR. The comparison of Grandjean's scale results before and after the training in sVR handing showed significant differences in 11 out of 14 subscales. Before and after exposure to 3D movie, the differences were significant only for the "tired-fatigued" subscale (Z = 2.501, p < or = 0.012) in favor of "fatigued". CONCLUSION: Based on the subjective sensation of discomfort after watching 2D and 3D movies it is impossible to predict symptoms of simulator sickness after training using sVR.

Comparative study of upper limb load assessment and occurrence of musculoskeletal disorders at repetitive task workstations.

This study explored the relationship between subjectively assessed complaints of pain in the arm, forearm and hand, and musculoskeletal load caused by repetitive tasks. Workers (n=942) were divided into 22 subgroups, according to the type of their workstations. They answered questions on perceived musculoskeletal pain of upper limbs. Basic and aggregate indices from a questionnaire on the prevalence, intensity and frequency of pain were compared with an upper limb load indicator (repetitive task index, RTI) calculated with the recently developed Upper Limb Risk Assessment (ULRA). There was relatively strong correlation of RTI and general intensity and frequency of pain in the arm, and general intensity and frequency of pain in the arm and forearm or prevalence of pain in the arm. Frequency and intensity of pain in the arm were weakly correlated. An aggregate indicator of evaluation of MSDs, which was calculated on the basis of the prevalence, intensity and frequency of pain, was to a higher degree associated with the musculoskeletal load of a task than basic evaluative parameters. Thus, such an aggregate indicator can be an alternative in comparing subjectively assessed MSDs with task-related musculoskeletal load and in establishing limit levels for that load.

Evaluation of activities and needs of older workers in the context of maintaining their employment.

BACKGROUND: The article presents the results of evaluation of activities for older workers (50+). The aim of the study was the examination of older workers' opinions on activities undertaken in their companies related to maintaining older workers' employment. MATERIAL AND METHODS: Data is derived from the questionnaire survey conducted on 50+ employees (250 women and 250 men). RESULTS: Almost one fifth of the employees admitted that they feel discriminated against in their company. Only a quarter of older workers declared that they had special offer of trainings, most of them concerned update trainings, expending knowledge (40% of responses). Only about one fifth of respondents admitted that they were encouraged to further their education. The smallest number of actions concerned health promotion. CONCLUSIONS: Older workers have different needs than younger ones, especially in the organization and working conditions. Activities related to the management of aging in Poland are still taken to a small extent. Disturbing is the fact that so few respondents admitted that in their companies, there were activities conducted concerning health promotion. From the point of view of working capacity and extending the retirement age, such initiatives should be carried out on a large scale among workers of all ages, with particular emphasis on the elderly.

Psychological factors at work and musculoskeletal disorders: a one year prospective study.

The etiology of musculoskeletal disorders is complex, with physical and psychosocial working conditions playing an important role. This study aimed to determine the relationship between psychosocial work conditions, such as psychological job demands, decision latitude, social support and job insecurity and musculoskeletal complains (MSCs) and (repetitive strain injuries (RSIs) in a 1-year prospective study. The job content questionnaire, the Nordic musculoskeletal questionnaire and provocation tests were used to study 725 employees aged 20-70 years. Pain in the lower back (58 % of subjects), neck (57 %), wrists/hands (47 %) and upper back (44 %) was most frequent. The carpal tunnel syndrome (CTS) (33.6 %), rotator cuff tendinitis (15.4 %), Guyon's canal syndrome (13.4 %), lateral epicondylitis (7.6 %), medial epicondylitis (5.3 %), tendinitis of forearm-wrist extensors (7.8 %) and tendinitis of forearm-wrist flexors (7.3 %) were the most frequent RSIs. Logistic analysis showed that increased psychological job demands statistically significantly increased the probability of lateral and medial epicondylitis, and increased control (decision latitude) statistically significantly decreased the risk of CTS. There was no relationship between job insecurity, social support and the studied RSIs. Psychosocial factors at work predict prevalence of MSCs and RSIs, irrespectively of demographic factors, e.g., age or gender, and organizational and physical factors.

[Evaluation of activities targeted at employability of older workers in Polish enterprises]. / Ocena dzialan ukierunkowanych na utrzymanie zatrudnienia przez starszych pracowników w Polsce.

BACKGROUND: The article presents the results of evaluation of activities for older workers (50+) undertaken by Polish small, medium and large enterprises. MATERIAL AND METHODS: Data are derived from the questionnaire survey conducted on a nationwide sample of 200 small (9-49 employees), medium (50-249 employees) and large (> 250 employees) companies. RESULTS: In the total number of persons employed in the surveyed companies there were 27% of older workers. Special programs aimed at employing people aged over 50 were implemented in only less than 10% of the enterprises. In less than 18% of the companies employees 50+ were offered training/courses/conferences, addressed specially to them. In only 7% of companies counseling on healthy lifestyle was provided. For the companies surveyed, the most important benefit of hiring workers 50+ was the transfer of knowledge to young workers (86%). CONCLUSION: Due to the low employment rate of employees over 50, it is necessary to implement the principles of age management in companies, especially in medium and large ones. It is alarming that only less than 7% of the enterprises provide counseling on health care. In terms of ability to work and extending working life, such activities should be conducted on a large scale among workers of all ages, with particular emphasis on the elderly.

Analysis of conditions and organization of work of notebook computer users.

AIM: The aim of this study was to evaluate working conditions with a notebook computer (notebook) as a potential cause of musculoskeletal disorders. MATERIAL AND METHODS: The study had 2 stages. The first one was a questionnaire survey among 300 notebook users. The next stage was an expert analysis of 53 randomly selected workstations. The questionnaire survey included questions about the participants, their working conditions, work organization and also duration of work with a notebook. RESULTS AND CONCLUSIONS: The results of the research showed that most examined operators used a notebook as a basic working tool. The most important irregularities included an unadjustable working surface, unadjustable height of the seat pan and backrest, unadjustable height and distance between the armrests and no additional ergonomic devices (external keyboard, docking station, notebook stand or footstool).

[Eye symptoms in office employees working at computer stations]. / Dolegliwosci ze strony narzadu wzroku u pracowników biurowych zatrudnionych na komputerowych stanowiskach pracy.

BACKGROUND: The aim of the study was to measure the prevalence and intensity of eye symptoms in office workers who use computers on a regular basis, and to find out if the symptoms depend on the duration of computer use and other work-related factors. MATERIAL AND METHODS: Office workers employed at large social services companies in two cities (Warszawa and Katowice) were invited to fill in a questionnaire (cross-sectional study). The questions included work history and history of last-week eye symptoms and eye-related complains. Altogether 477 men and women returned the completed questionnaires. Between-group symptom differences were tested by the chi-square test and verified by the results of multivariate logistic analysis. The examined effects included the role of daily computer use and lighting conditions at work stations. RESULTS: The examined persons complained of such eye symptoms as eye strain, visual acuity impairment and mucosal dryness or eye burning. The following values of symptom prevalence were found in women and men, respectively: eye strain 50.7% and 32.6%, disturbed visual acuity 38.3% and 21.2%, mucosal dryness and eye burning 46.5% and 24.2%. The results of multivariate analysis confirmed the statistically significant effects of lighting intensity and screen flickering on the occurrence of symptoms. CONCLUSIONS: Frequent occurrence of eye symptoms and their associatation with some characteristics of the work environment point to the need of observing ergonomic standards of work stations and of the usage of computers at work.