Associations of combining paid work and family care with gender-specific differences in depressive symptoms among older workers and the role of work characteristics.

OBJECTIVES: This study aims to provide insight into (i) how the combination of paid work and family care is longitudinally associated with gender-related differences in depressive symptoms and (ii) the role of work characteristics in this association. METHODS: Data were derived from STREAM, a Dutch prospective cohort study of older workers aged 45-64 years. Respondents were included if they were employed in at least one measurement between 2015 and 2017 (N=12 447). Mixed-models were applied to disentangle between-person (BP) and within-person (WP) effects of family caregiving on depressive symptoms. Analyses were stratified by gender. Work characteristics (social support, autonomy, emotional and mental workload) were separately added to the multivariable models. RESULTS: For older employees, family caregiving was positively associated with depressive symptoms between and within persons for both women [BP B=0.80, 95% confidence interval (CI) 0.52-1.08; WP B=0.32, 95% CI 0.08-0.56] and men (BP B=0.75, 95% CI 0.45-1.05; WP B=0.25, 95% CI 0.01-0.48). Social support at work reduced the adverse effect of family care on depressive symptoms for women (BP) and men (BP and WP). Emotional workload partly explained the effect of family care for both women and men (BP). CONCLUSIONS: The longitudinal association between family care and mental health was similar for male and female employees. Resources at work (ie, social support) could protect caregiving employees against depressive symptoms. More research is needed regarding the relative impact of the care context compared to the work context of working family caregivers.

Economic burden of work injuries and diseases: a framework and application in five European Union countries.

BACKGROUND: Estimates of the economic burden of work injuries and diseases can help policymakers prioritize occupational health and safety policies and interventions in order to best allocate scarce resources. Several attempts have been made to estimate these economic burdens at the national level, but most have not included a comprehensive list of cost components, and none have attempted to implement a standard approach across several countries. The aim of our study is to develop a framework for estimating the economic burden of work injuries and diseases and implement it for selected European Union countries. METHODS: We develop an incidence cost framework using a bottom-up approach to estimate the societal burden of work injuries and diseases and implement it for five European Union countries. Three broad categories of costs are considered-direct healthcare, indirect productivity and intangible health-related quality of life costs. We begin with data on newly diagnosed work injuries and diseases from calendar year 2015. We consider lifetime costs for cases across all categories and incurred by all stakeholders. Sensitivity analysis is undertaken for key parameters. RESULTS: Indirect costs are the largest part of the economic burden, then direct costs and intangible costs. As a percentage of GDP, the highest overall costs are for Poland (10.4%), then Italy (6.7%), The Netherlands (3.6%), Germany (3.3%) and Finland (2.7%). The Netherlands has the highest per case costs (€75,342), then Italy (€58,411), Germany (€44,919), Finland (€43,069) and Poland (€38,918). Costs per working-age population are highest for Italy (€4956), then The Netherlands (€2930), Poland (€2793), Germany (€2527) and Finland (€2331). CONCLUSIONS: Our framework serves as a template for estimating the economic burden of work injuries and diseases across countries in the European Union and elsewhere. Results can assist policymakers with identifying health and safety priority areas based on the magnitude of components, particularly when stratified by key characteristics such as industry, injury/disease, age and sex. Case costing can serve as an input into the economic evaluation of prevention initiatives. Comparisons across countries provide insights into the relevant performance of health and safety systems.

The Influence of Multi-morbidity on the Work Ability of Ageing Employees and the Role of Coping Style.

Purpose With an ageing workforce, employees are increasingly confronted with multi-morbidity. Especially physical and mental health problems often occur together. This study aims to (i) explore the effect of multi-morbidity on work ability of ageing employees, more specifically the effects of the number of health problems and the combination of physical and mental health problems, and to (ii) explore to what extent the effects of physical and mental health problems on work ability are explained by applying differing coping styles. Methods A 1 year follow up study (2012-2013) was conducted among 7175 employees aged 45-64 years. Linear regression analyses were conducted to examine longitudinal relationships between multi-morbidity, coping styles and work ability. To determine whether coping styles mediate the effects of multi-morbidity on work ability, Sobel tests were conducted. Results A higher number of health problems was related to poorer work ability, but this negative effect stabilized from three health problems onwards. The combination of physical and mental health problem(s) was more strongly related to poorer work ability than only physical health problems. The negative relation between physical health problems and work ability was partly suppressed by active coping, while the negative relation between the combination of physical and mental health problem(s) on work ability was partly explained by avoidant coping. Conclusions Ageing employees with multi-morbidity have a reduced work ability, especially when mental health problems are present. The greater negative effects of the combination of physical and mental health problems on work ability are partially due to unfavorable coping styles.

Towards exposure limits for working postures and musculoskeletal symptoms - a prospective cohort study.

Occupational postures are considered to be an important group of risk factors for musculoskeletal pain. However, the exposure-outcome association is not clear yet. Therefore, we aimed to determine the exposure-outcome association of working postures and musculoskeletal symptoms. Also, we aimed to establish exposure limits for working postures. In a prospective cohort study among 789 workers, intensity, frequency and duration of postures were assessed at baseline using observations. Musculoskeletal pain was assessed cross-sectionally and longitudinally and associations of postures and pain were addressed using logistic regression analyses. Cut-off points were estimated based on ROC-curve analyses. Associations were found for kneeling/crouching and low-back pain, neck flexion and rotation and neck pain, trunk flexion and low-back pain, and arm elevation and neck and shoulder pain. The results provide insight into exposure-outcome relations between working postures and musculoskeletal symptoms as well as evidence-based working posture exposure limits that can be used in future guidelines and risk assessment tools. Practitioner Summary: Our study gives insight into exposure-outcome associations of working postures and musculoskeletal symptoms (kneeling/crouching and low-back pain, neck flexion/rotation and neck pain, trunk flexion and low-back pain, and arm elevation and neck and shoulder pain). Results furthermore deliver evidence-based postural exposure limits that can be used in guidelines and risk assessments.

How do older employees with health problems remain productive at work?: a qualitative study.

PURPOSE: The goal of this qualitative study was to gain insight into how older employees remain productive at work in spite of health problems. METHODS: Twenty-six semi-structured telephone interviews were conducted with older employees, 46-63 years of age, who reported a poor health in the Study on Transitions in Employment, Ability, and Motivation. Demographic, health, and work information was gathered, followed by information on adjustments made in response to health problems. Inductive and deductive analyses were done independently by two researchers. RESULTS: Four pathways through which poor health could influence productivity were identified: (1) poor health did not influence productivity; (2) poor health created a temporary imbalance in demands and external and internal resources after which adjustments were made and productivity was maintained; (3) adjustments were made in response to an imbalance, but productivity remained reduced; and (4) no adjustments were made and productivity was reduced. Whether and which adjustments occurred was influenced by factors in various domains, such as: visibility of the problem (health), autonomy (work-related), support (relational), and the ability to ask for help (personal). Sustainable productivity was influenced by internal factors that enhanced or hindered the creation of a balance, and by whether appropriate adjustments were made. CONCLUSIONS: The influence that health can have on productivity depends on the individuals' unique imbalance and personal disposition. Helpful a priori work place characteristics and personal well-being should be promoted so that a balance between demands and resources can be found in times of poor health.