The desastrous traffic accidents to date have provided the relevance for promotion of harmonization of work with treatment and prevention of sleep disordered breathing (SDB) in transport sectors. SDB is highly prevalent in commercial motor vehicle (CMV) drivers and is one cause of cognitive impairment and consequent traffic accidents, potentially costing billions and leading to many deaths. Various screening, diagnostic, and therapeutic approaches, some well established, are explored in this paper. Although drivers with SDB need to be appropriately diagnosed and treated, some are reluctant to continue their treatment or never submit to screening because of a lack of information. Thus, CMV drivers need to be well informed and screened, in addition to being encouraged to continue the treatment. The harmonization of work with treatment and prevention aids these objectives, providing benefits not only for individual health but also for transport companies, and further being an essential step towards uptake of “health and productivity management” in the transport sectors.
The maintenance of a balance between work and disease treatment is an important issue in Japan. This study explored factors that affect collaboration between occupational physicians (OPs) and attending physicians (APs). A questionnaire was mailed to 1,102 OPs. The questionnaire assessed the demographic characteristics of OPs; their opinions and behaviors related to collaboration, including the exchange of medical information with APs; and the occupational health service system at their establishments. In total, 275 OPs completed the questionnaire (25.0% response rate). Over 80% of respondents believed OPs should collaborate with APs. After adjusting for company size, collaboration ≥10 times/yr (with regard to both returning to work following sick leave and annual health check-ups for employees) was significantly associated with environmental factors, such as the presence of occupational health nurses (odds ratio (OR): 5.56 and 5.01, respectively, p<0.05) and the use of prescribed forms for information exchange (OR: 4.21 and 3.63, respectively, p<0.05) but not with the demographic characteristics of the OPs (p>0.05). The majority of OPs believed that collaboration with APs is important for supporting workers with illnesses. Support systems including prescribed forms of information exchange and occupational health nurses, play pivotal roles in promoting this collaboration.
This study aimed to clarify the difference between the durations of first and second periods of depression-induced sick leave and to identify predictors of a prolonged second period of depression-induced sick leave. Among Japanese employees who were registered in the Japan sickness absence and return to work (J-SAR) study, the subjects were those employees who returned to work after an initial period of depression-induced sick leave (F3; ICD-10, based on a psychiatrist’s certificate), and returned to work after a second period of depression-induced sick leave. The subjects’ second periods of sick leave (mean: 156.9 d) were longer than their first periods of sick leave (107.3 d) (Wilcoxon test, p=0.007). In the logistic regression analysis (Table 2), “longer duration of the first period of sick leave” (Odds ratio: 3.258, 95%CI: 1.780–5.963, p<0.001) was identified as a significant predictor of a longer recurrent period of sick leave. Individuals who experience a long initial period of depression-induced sick leave should be supported carefully by occupational health professionals after they RTW.
This study aims to make clear the following aspects of breast cancer patients and their occupation. 1. What percentage of patients have changed their working status around surgery? 2. When did patients change their employment? 3. What is the cause of the employment change? We investigated 269 patients who underwent curative surgery for primary breast cancer at one university hospital in Tokyo. Patients who were under the age of 58 at the time of surgery and had the experience of being a company or government employee during a year prior to the surgery were used as sample for analysis. To determine factors related to the employment change, multiple logistic regression analysis was performed. Nineteen percent patients changed the employment status before and after surgery. Of those, 19% changed the employment by the end of surgery month while 42% did by the fourth month after surgery. Treatment-related factors such as mastectomy and the combination of chemotherapy and hormone therapy affected changes in employment. We believe that the validity of our study can be confirmed by comparing with the previous study results. We show the potential large effects of cancer treatment on patients’ daily lives.
This study aimed to obtain a comprehensive collection of ideas and opinions from the perspective of various professionals and support providers for cancer treatment and employment balance. We performed a focus group interview, and a model diagram was created using categories created via classification of important items. The focus group interview revealed six strategies aligned with seven issues concerning the support needed to balance cancer treatment and employment. These strategies suggested the importance of not only the way of directly connecting among several specialists but also the presence and the role of the coordinators with their own specialties. Workers with cancer need supportive advices after their initial diagnosis, when returning to work, and after returning to work. After returning to work, a number of problems resulted from the lack of advice at the time of diagnosis or when returning to work. These results emphasized the necessity for the development of early comprehensive system for integrated collaboration between medical institutions, workplaces and other occupational health institutions. The results suggest that a multi-profession collaboration model is necessary to support cancer patients staying at work, which includes the cooperation between medical institutions and their counterparts from occupational health and the patients’ employers.
Several studies evaluated whether a person with multiple sclerosis is employed or not and investigated the main symptoms that hinder the job performance. However, despite occupational physicians are fundamental in managing disabled subjects, there is a serious lack of data regarding their role in improving employability of these workers. In this regard, we assessed occupational physicians’ professional activity and training/updating needs in order to identify and develop management tools, operative procedures and training programs helpful to support and implement adequate job-retention strategies. Four hundred three Italian occupational physicians compiled a self-administered questionnaire to evaluate individual demographics, health surveillance system, fitness for work and training needs. Our findings confirmed the suitability to adopt environmental adjustments at workplace (particularly referring to the ergonomics of workstation, the typology of occupational risk factors and the working time) to accommodate individual’s needs in order to improve working ability among multiple sclerosis workers. Moreover, training events discussing operational guidelines and standardized instruments and/or methodologies to adequately manage the disable workers should be fostered. Therefore, in this regard, occupational physicians could play a key role but they need more high-quality training especially concerning the different tools that are currently available to assess the work issues in multiple sclerosis patients.
A self-reported daily life note (LN) is an effective tool used by occupational physicians to assess the capacity of workers on sick leave due to mental illness to return to work (RTW). We aimed to clarify whether there were differences in the criteria used to define recovery for RTW between LN users and non-users, whether LN users were satisfied with LN, and whether non-users wanted to use LN. In total, 363 occupational physicians (238 LN users, 125 non-users) completed self-reported questionnaires covering demographic and occupational variables, and RTW assessment criteria. We investigated which of the 10 assessment criteria were considered most important for RTW. The proportion of LN users was higher among women, younger physicians, and occupational physicians with more working days per month. LN users emphasized four criteria in assessing RTW: 1) constant wake-up time, 2) constant bedtime, 3) no midnight waking, and 4) no feeling of drowsiness during the day. LN users regard regular sleep rhythm and the absence of drowsiness during the day as important criteria for RTW. Ninety-seven percent of users regarded LN as useful. Seventy-four percent of non-users had interest in using LN.
This study used health insurance claims data to examine the relationship between the length of sick leave and treatment administered to employees who received middle- to long-term accident and sickness benefits for ≥91 d due to mood disorders, anxiety, and dissociative, stress-related, somatoform and other nonpsychotic mental disorders. Employees who received psychotherapy had significantly shorter leaves of absence over one year compared to those that did not. Treatment with psychotropic drugs was significantly higher among those on leave for ≤365 d than those on leave for ≥366 d. Age, sex and hospital treatment were not significantly associated with length of sick leave. These results suggest that professional psychological treatment is associated with length of sick leave.
Home oxygen therapy (HOT), also known as long-term oxygen therapy, is prescribed to patients with chronic respiratory failure (CRF) due to advanced respiratory diseases, as it has been shown to improve the prognosis of patients with chronic obstructive pulmonary disease (COPD). However, the therapeutic impact of HOT does not fully reflect the “socialization” of patients, which is one of the final goals of “comprehensive pulmonary rehabilitation”, proposed by the Japanese Respiratory Society. Since working is one form of socialization, we evaluated a 55-yr-old worker prescribed with HOT for the management of advanced COPD to elucidate and assess the social barriers experienced by HOT users. This case demonstrates a variety of factors affecting patients, respiratory physicians, occupational physicians, and management teams, which prevents patients from working. By elucidating these factors and seeking solutions, the promotion of the “harmonization of work with treatment and prevention” will both improve working environments and encourage CRF patients to continue working, leading to better socialization. Thus, the “harmonization of working with treatment and prevention” for CRF patients is a core goal for the promotion of both “health and productivity management” and “comprehensive pulmonary rehabilitation.”
A validated questionnaire is not typically used for dietary assessment in health check-up counseling provided by occupational health nurses in Japan. We conducted a qualitative study to investigate the barriers and promoting factors affecting the use of validated questionnaires. Ten occupational health nurses and three registered dietitians, working at a health insurance society, were recruited for this study using an open-ended, free description questionnaire. Inhibiting factors, such as “Feeling of satisfaction with the current method,” “Recognition of importance,” and “Sense of burden from the questionnaire”, and as promoting factors, “Feeling the current method is insufficient”, “Recognition of importance,” “Reduction in the feeling of burden after the answer,” “Expectation of and reaction to the result,” and “Expectation for the effect of the counseling” were noted. Since a standardized dietary assessment method in health counseling might be desirable for the harmonization of work with diseases prevention in an occupational field, findings in this study could propose appropriate targets to reduce confusion in health professionals’ concerning the use of validated questionnaires.
Leisure-time physical activity (LTPA) and dietary energy intake are two important health behaviours, which at too low or high levels respectively, are associated with overweight and obesity. This study explores associations between subscales of the Job Demand-Control-Support (JDCS) model, LTPA and dietary energy intake. A cross-sectional design sampled current employees (N=433) from a South Australian cohort using a computer-assisted telephone interview and a self-completed food frequency questionnaire. In analyses adjusted for sex, age, and sociodemographic variables, higher levels of skill discretion were associated with increased odds for attaining sufficient physical activity (OR=2.45; 95% CI=1.10–5.47). Higher levels of decision authority were associated with reduced odds (OR=0.43; 95% CI=0.20–0.93) for being in the highest tertile of daily energy intake. Higher scores for coworker support were associated with increased odds (OR=2.20; 95% CI=1.15–4.23) for being in the highest tertile of daily energy intake. These findings support the consideration of the individual JDCS subscales, since this practice may reveal novel associations with health behaviour outcomes, thereby presenting new opportunities to improve employee health and wellbeing.
Shift work leads to adverse health outcomes including increased risk of cardiovascular disease. Heart rate (HR) and heart rate variability (HRV) are measures of cardiac autonomic activity and markers of cardiovascular disease and mortality. To investigate the effects of shift work on cardiac autonomic activity, we assessed the influence of simulated night work on HR and HRV, and dissociated the direct effects of circadian misalignment from those of sleep displacement and altered physical activity patterns. A total of 29 subjects each participated in one of two in-laboratory, simulated shift work studies. In both studies, EKG was continuously monitored via Holter monitors to measure HR and the high frequency (HF) component of HRV (HF-HRV). We found endogenous circadian rhythmicity in HR and HF-HRV. Sleep and waking physical activity, both displaced during simulated night work, had more substantial, and opposite, effects on HR and HF-HRV. Our findings show systematic but complex, interacting effects of time of day, sleep/wake state, and physical activity on cardiac autonomic activity. These effects need to be taken into account when evaluating HR and HRV in shift work settings and when interpreting these measures of cardiac autonomic activity as markers of cardiovascular disease.