Cancer risk in information technology workers: a UK Biobank study.

BACKGROUND: The information technology (IT) workforce has been growing more rapidly than others, with occupational health (OH) risks of sedentary behaviour, physical inactivity and poor diet, yet studies of their non-communicable disease risk, notably cancer, are lacking. AIMS: To investigate cancer risk in IT workers compared to others in employment and the nine major Standard Occupational Classification (SOC) groups. METHODS: We evaluated incident diagnosed cancers in the UK Biobank cohort through national cancer registry linkage. Cox proportional hazard regression models, with 15-year follow-up, were used to compare incident cancer risk among IT workers with all other employed participants and with the nine major SOC groups. RESULTS: Overall, 10 517 (4%) employed participants were IT workers. Adjusting for confounders, IT workers had a slightly lower cancer incidence compared to all other employed participants (Model 2: hazard ratio = 0.91, 95% confidence interval [CI] 0.83-1.01). Compared to the nine major SOC groups, they had a similar (Major Groups 2, 5 and 8) or lower (Major Groups 1, 3, 4, 6, 7 and 9) cancer incidence. CONCLUSIONS: Despite their occupational risks of sedentary behaviour, poor diet and physical inactivity, IT workers do not have an increased cancer incidence compared to all other employed participants and the nine major SOC groups. This study paves the way for large, longitudinal health outcome studies of this under-researched and rapidly growing occupational group.

The impact of Covid-19 on research into work and health.

BACKGROUND: The global coronavirus (Covid-19) pandemic created a profound disruption to the delivery of planned scientific research with unknown immediate and potentially longer-term impacts. AIMS: We explored researchers' experiences of the impact of the pandemic on the continued development and delivery of research into work and health, and on research infrastructure in this field. METHODS: A cross-sectional study. RESULTS: Thirty-three questionnaires were completed, representing a response rate of 15%. Sixty-one per cent of respondents were female, the majority (78%) had over 11 years of research experience and 76% worked mainly in academia. Most respondents (88%) were able to progress with research during the pandemic. A small proportion (4%) had studies paused or suspended due to the pandemic, while a larger proportion (19%) had research staff redeployed to assist with other studies or furloughed. Respondents described a range of emerging practical and logistical issues for research into work and health during the pandemic. Some benefited from increased opportunities to collaborate on new multidisciplinary studies, opportunities to engage participants in work and health research, and more flexible and inclusive work practices. Others experienced challenges that had an adverse impact, such as hampering research delivery (e.g. barriers to participant screening and intervention delivery), poor (home) working environments, reduced team cohesion and isolation. A range of future priorities for research was highlighted. CONCLUSIONS: We describe lessons learned and opportunities that can be used to support or further research activities in the field of work and health research in the future.

Health, lifestyle and occupational risks in Information Technology workers.

BACKGROUND: Information technology (IT) and the IT workforce are rapidly expanding with potential occupational health implications. But to date, IT worker health is under-studied and large-scale studies are lacking. AIMS: To investigate health, lifestyle and occupational risk factors of IT workers. METHODS: We evaluated self-reported health, lifestyle and occupational risk factors for IT workers in the UK Biobank database. Using logistic regression, we investigated differences between IT workers and all other employed participants. Regression models were repeated for IT worker subgroups (managers, professionals, technicians) and their respective counterparts within the same Standard Occupational Classification (SOC) major group (functional managers, science and technology professionals, science and technology associate professionals). RESULTS: Overall, 10 931 (4%) employed participants were IT workers. Compared to all other employed participants, IT workers reported similar overall health, but lower lifestyle risk factors for smoking and obesity. Sedentary work was a substantially higher occupational exposure risk for IT workers compared to all other employed participants (odds ratio [OR] = 5.14, 95% confidence interval [CI]: 4.91-5.39) and their specific SOC group counterparts (managers: OR = 1.83, 95% CI: 1.68-1.99, professionals: OR = 7.18, 95% CI: 6.58-7.82, technicians: OR = 4.48, 95% CI: 3.87-5.17). IT workers were also more likely to engage in computer screen-time outside work than all other employed participants (OR = 1.42, 95% CI: 1.35-1.51). CONCLUSIONS: Improved understanding of health, lifestyle and occupational risk factors from this, the largest to date study of IT worker health, can help inform workplace interventions to mitigate risk, improve health and increase the work participation of this increasingly important and rapidly growing occupational group.

Research and teaching activity in UK occupational physicians.

BACKGROUND: For all doctors, including occupational physicians (OPs), research and teaching are considered core requirements of medical education and continuing professional development. Academic skills are also vital to evidence-based practice and advancement of occupational health (OH) as a specialty. In recent years, attention has focussed on the declining UK OH academic base and the research- practice gap, and increased practitioner participation in research is encouraged. AIMS: To establish a baseline of research and teaching activity among UK OPs, identify related barriers and inform strategies to overcome them. METHODS: An online survey including specific career profile questions derived from consensus following expert panel discussions. It formed part of a larger Delphi study on UK OH research priorities. RESULTS: We received 213 responses, about 18% of 1207 practising UK OPs. Of these, 162 (76%) undertook research at some career-point, of which 44 (27%) were currently research-active. Similarly, 154 (72%) undertook teaching at some career-point, of which 99 (64%) were currently teaching-active. Of those who had never undertaken research (n = 51) or teaching (n = 59), 40 and 42% were interested in doing so, respectively. Key barriers were lack of time and opportunity, the former particularly for respondents practising in industry, where 'commercial' demands take priority, rather than healthcare. CONCLUSIONS: This study establishes a benchmark of academic activity among UK OPs and identifies related barriers. These 'target' barriers can shape research funding priorities and education to increase participation and develop the UK OH academic base.

Emergency personnel neuroticism, health and lifestyle: A UK Biobank study.

BACKGROUND: Emergency personnel face unpredictable and challenging incidents and their resilience and ability to cope influences their well-being. Personality traits, such as neuroticism, are postulated to be robust predictors of health and health behaviours. Despite evidence in the general population that neuroticism can positively impact health and health behaviours; to date neuroticism in emergency personnel has primarily been associated with adverse health outcomes. AIMS: To assess whether neuroticism has a negative or positive impact on subjective and objective health and health behaviours in emergency personnel. METHODS: This study used cross-sectional UK Biobank baseline data of emergency personnel (police, firemen and paramedics). Logistic regression models examined the strength of the associations of neuroticism tertiles with subjective (self-reported overall health and chronic conditions) and objective health (abdominal obesity) and self-reported smoking, sleeping, alcohol use and exercise levels. RESULTS: High neuroticism was positively associated with poorer subjective health outcomes in all emergency personnel (n = 2483). The association between neuroticism and chronic disease/s was significant for police in the second (odds ratio [OR] = 1.93, 95% confidence interval [CI] = 1.15-1.94) and third (OR = 1.62, 95% CI = 1.21-2.16) neuroticism tertiles. Neuroticism in firemen was associated with reduced abdominal obesity (OR = 0.49, 95% CI = 0.25-0.96) and increased exercise (OR = 2.14, 95% CI = 1.07-4.25). CONCLUSIONS: We observed positive and negative associations between neuroticism and health outcomes and behaviours. While differences were observed across the emergency personnel groups, more research is needed to better understand how personality traits may impact health in workers with physically and mentally intense jobs.

Working Health Services Scotland: a 4-year evaluation.

Background: Working Health Service Scotland (WHSS) supports the self-employed and employees of small and medium-sized enterprises (SMEs) in Scotland with a health condition affecting their ability to work, who are either absent or at risk of becoming absent due to it. Aims: To evaluate the impact on health and work outcomes of WHSS clients over a 4-year period. Methods: Data were collected at enrolment, entry, discharge and follow-up at 3 and 6 months after discharge. Clients completed up to three validated health questionnaires at entry and discharge-EuroQol five dimensions (EQ-5D) and visual analogue scale (VAS); Hospital Anxiety and Depression Scale (HADS); and Canadian Occupational Performance Measure (COPM). Results: A total of 13463 referrals occurred in the 4-year period; 11748 (87%) were eligible and completed entry assessment and 60% of the latter completed discharge paperwork. The majority of referrals were due to musculoskeletal conditions (84%) while 12% were referred with mental health conditions. Almost a fifth (18%) of cases were absent at entry and back at work at discharge. Work days lost while in WHSS was associated with age, length of absence prior to entering WHSS, primary health condition and time in programme. All health measures showed significant improvements from entry to discharge. Improvement in general health was sustained at 3- and 6-month follow-up. Conclusions: The WHSS evaluation findings indicate that participation was associated with positive changes to health and return-to-work. The extent of the positive change in health measures and work ability can be highly important economically for employees and employers.

Core competencies for UK occupational health nurses: a Delphi study.

BACKGROUND: Occupational health nurses (OHNs) play a pivotal role in the delivery of occupational health (OH) services. Specific competency guidance has been developed in a number of countries, including the UK. While it is acknowledged that UK OHN practice has evolved in recent years, there has been no formal research to capture these developments to ensure that training and curricula remain up-to-date and reflect current practice. AIMS: To identify current priorities among UK OHNs of the competencies required for OH practice. METHODS: A modified Delphi study undertaken among representative OHN networks in the UK. This formed part of a larger study including UK and international occupational physicians. The study was conducted in two rounds using a questionnaire based on available guidance on training competencies for OH practice, the published literature, expert panel reviews and conference discussions. RESULTS: Consensus among OHNs was high with 7 out of the 12 domains scoring 100% in rating. 'Good clinical care' was the principal domain ranked most important, followed by 'general principles of assessment & management of occupational hazards to health'. 'Research methods' and 'teaching & educational supervision' were considered least important. CONCLUSIONS: This study has established UK OHNs' current priorities on the competencies required for OH practice. The timing of this paper is opportune with the formal launch of the Faculty of Occupational Health Nursing planned in 2018 and should inform the development of competency requirements as part of the Faculty's goals for standard setting in OHN education and training.

Trends in NHS doctor and dentist referrals to occupational health.

BACKGROUND: Ill-health in doctors can affect performance and fitness to practice, and consequently patient care and safety, placing an important responsibility on National Health Service (NHS) occupational health (OH) services. Anecdotal discussions amongst NHS occupational physicians suggest an increase in the number of doctor attendances over time, with continuing focus on mental illness. AIMS: To analyse OH referrals in doctors and dentists over 3 years. METHODS: A retrospective evaluation of all doctor and dentist referrals to the OH service in one Scottish NHS board from April 2011 to March 2014, comparing this to management-reported sickness absence (SA) data held by the organization. RESULTS: We found no significant change in overall OH referrals for doctors and dentists during the evaluation period. Mental illness was the commonest referral reason in all 3 years at 32, 38 and 30%, respectively, but no significant change in mental health referrals was demonstrated within the study period. SA events significantly increased during the three study years (356, 426 and 469, respectively; P < 0.05). OH referrals for those absent from work increased significantly between Years 1 and 3 (16 and 30, respectively; P < 0.05). CONCLUSIONS: SA events and OH referrals for those absent from work significantly increased between April 2011 and March 2014, but there was no commensurate (statistically significant) increase in overall OH referrals. These findings do not support anecdotal suggestions of increasing OH (or mental ill-health) attendances but can be used as a benchmark for other NHS organizations and for future trend comparisons.

Impact of peer review audit on occupational health report quality.

BACKGROUND: In a previous report, we described the implementation of a formal process for peer review of occupational health (OH) reports and a method of assessment of the outcomes of this process. The initial audit identified that 27% of OH reports required modifications. AIMS: To assess formally, following implementation of this process, if changes in practice had occurred, i.e. whether fewer deficiencies were being identified in reports. METHODS: We repeated a prospective internal audit of all peer reviewed OH reports between September and November 2011. We used an abbreviated assessment form, based on questions 4-8 and 10-12 of the modified SAIL (Sheffield Assessment Instrument for Letters), with four possible outcomes: no action, no changes made to report following discussion with author, changes made without discussion with author and changes made following discussion with author. RESULTS: One hundred seventy-three reports by 10 clinicians were audited. The audit identified a 13% reduction in OH reports requiring modifications (from 27 to 14%) compared with the previous cycle. Where modifications were required, 8% of these were related to minor typographical, spelling and grammar errors and 6% were for more complex reasons. Implementation of this process also produced a reduction in clinical complaints about OH reports from customers, from three in the preceding year to none 2 years later. CONCLUSIONS: Peer review improved the standard of OH reports and was associated with a reduction in customer complaints about reports.