Occupational Cohort Research Articles

The Relationship between Insomnia and Lifestyle-Related Diseases among Japanese Male Truck Drivers.

Previously, insomnia and adverse lifestyle were prevalent among truck drivers, but the association between the two remains unknown in this particular occupational cohort. This study aimed to examine the relationship between insomnia and lifestyle-related diseases among truck drivers. We investigated 875 male truck drivers of the Japan Truck Association, Akita branch, as of July 2020. The definition of insomnia was based on the International Classification of Sleep Disorders, Third Edition (ICSD-3). Data from a self-administered questionnaire were merged with health records and health insurance claims data of 2020. In total, 40.1% had either one of the lifestyle-related diseases including hypertension (29.7%), diabetes mellitus (11.7%), and dyslipidemia (24.8%), whereas according to ICSD-3, 13.2% had insomnia. Multivariate logistic regression models demonstrated that individuals with insomnia had approximately 2-fold increased risk of having at least one lifestyle-related disease (p < 0.001), hypertension (p = 0.0027), diabetes mellitus (p = 0.0654) and dyslipidemia (p < 0.001). Occupational characteristics including daily driving hours, driving distance, and travel days were not associated with any lifestyle-related diseases except for an association between short-haul and at least one disease. In conclusion, insomnia is significantly associated with increased risks of lifestyle-related diseases among male truck drivers in Japan.

Esteatose hepática como preditor de diabetes incidente em adultos: avaliação prospectiva no Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil)

Increasing epidemiological evidence suggests a bidirectional relationship between non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes, and that NAFLD may precede and/or promote the development of diabetes. This study aimed to investigate whether liver steatosis is associated with the incidence of diabetes in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). The ELSA-Brasil is an occupational cohort study of active or retired civil servants, aged 35-74 years, in six capital cities in Brazil. We excluded participants with diabetes at baseline, those who reported excessive alcohol consumption or with missing information on relevant covariates, and those with self-referred hepatitis or cirrhosis. In total, 8,166 individuals participated, and the mean duration of follow-up was 3.8 years. The Cox proportional regression model was used to estimate the adjusted hazard ratio (HR) for the associations. Abdominal ultrasonography was used to detect liver steatosis. In the follow-up period, the cumulative incidence of diabetes was 5.25% in the whole sample, 7.83% and 3.88% in the groups with and without hepatic steatosis, respectively (p &lt; 0.001). Compared to those without steatosis, individuals with hepatic steatosis had an increased risk of developing diabetes (HR = 1.31; 95%CI: 1.09-1.56) after adjustment for potential confounders, including body mass index (BMI). Hepatic steatosis was an independent predictor of incident diabetes in the ELSA-Brasil cohort study. Physicians should encourage changes in lifestyle and screen for diabetes in patients with fatty liver.

Hospitalization, death, and probable reinfection in Peruvian healthcare workers infected with SARS-CoV-2: a national retrospective cohort study

BackgroundPeru has some of the worst outcomes worldwide as a result of the SARS-CoV-2 pandemic; it is presumed that this has also affected healthcare workers. This study aimed to establish whether occupation and other non-occupational variables were risk factors for possible reinfection, hospitalization, and mortality from COVID-19 in cohorts of Peruvian healthcare workers infected with SARS-CoV-2.MethodsRetrospective cohort study. Healthcare workers who presented SARS-CoV-2 infection between March 1, 2020, and August 6, 2021, were included. Occupational cohorts were reconstructed from the following sources of information: National Epidemiological Surveillance System, molecular tests (NETLAB), results of serology and antigen tests (SICOVID-19), National Registry of Health Personnel (INFORHUS), and National Information System of Deaths (SINADEF). The incidence of probable reinfection, hospitalization, and death from COVID-19 was obtained in the cohorts of technicians and health assistants, nursing staff, midwives, dentists, doctors, and other healthcare workers. We evaluated whether the occupation and other non-occupational variables were risk factors for probable reinfection, hospitalization, and death from COVID-19 using log-binomial and probit binomial models, obtaining the adjusted relative risk (RRAJ).Results90,398 healthcare workers were included in the study. Most cases were seen in technicians and health assistants (38.6%), and nursing staff (25.6%). 8.1% required hospitalization, 1.7% died from COVID-19, and 1.8% had probable reinfection. A similar incidence of probable reinfection was found in the six cohorts (1.7–1.9%). Doctors had a higher incidence of hospitalization (13.2%) and death (2.6%); however, they were also those who presented greater susceptibility linked to non-occupational variables (age and comorbidities). The multivariate analysis found that doctors (RRAJ = 1.720; CI 95: 1.569–1.886) had a higher risk of hospitalization and that the occupation of technician and health assistant was the only one that constituted a risk factor for mortality from COVID-19 (RRAJ = 1.256; 95% CI: 1.043–1.512).ConclusionsPeruvian technicians and health assistants would have a higher risk of death from COVID-19 than other healthcare workers, while doctors have a higher incidence of death probably linked to the high frequency of non-occupational risk factors. Doctors present a higher risk of hospitalization independent of comorbidities and age; likewise, all occupations show a similar risk of probable reinfection.

Pain, mood, and suicidal behavior among injured working adults in Chile

BackgroundChronic pain is comorbid with psychiatric disorders, but information on the association of chronic pain with depressive symptoms, generalized anxiety, and suicidal behavior among occupational cohorts is inadequate. We investigated these associations among employed Chilean adults.MethodsA total of 1946 working adults were interviewed during their outpatient visit. Pain was assessed using the Short Form McGill Pain questionnaire (SF-MPG) while depression and generalized anxiety were examined using the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7), respectively. The Columbia–Suicide Severity Rating Scale was used to assess suicidal behavior and suicidal ideation. Multivariable logistic regression models were used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (95%CI) for the association of chronic pain with mood disorders, as well as suicidal behavior.ResultsHigh chronic pain (SF-MPG > 11) was reported by 46% of participants. Approximately two-fifths of the study participants (38.2%) had depression, 23.8% generalized anxiety, 13.4% suicidal ideation, and 2.4% suicidal behavior. Compared to those with low pain (SF-MPG ≤11), participants with high chronic pain (SF-MPG > 11) had increased odds of experiencing depression only (aOR = 2.87; 95% CI: 2.21–3.73), generalized anxiety only (aOR = 2.38; 95% CI: 1.42–3.99), and comorbid depression and generalized anxiety (aOR = 6.91; 95% CI: 5.20–9.19). The corresponding aOR (95%CI) for suicidal ideation and suicidal behavior were (aOR = 2.20; 95% CI: 1.58–3.07) and (aOR = 2.18 = 95% CI: 0.99–4.79), respectively.ConclusionsChronic pain is associated with increased odds of depression, generalized anxiety, and suicidal behavior. Mental health support and appropriate management of patients experiencing chronic pain are critical.

111 Overcoming diagnostic challenges in differentiation of psoriasis and eczema with molecular analysis

Differentiating psoriasis from eczema poses high demands on diagnostic abilities and still is error prone. The regulation of the genes NOS2 and CCL27 showed the most discriminatory power between both diseases and was used to train a highly accurate algorithm that can enhance conventional ways of diagnosis. The Molecular Classifier (MC) is used since 12/2021 in an occupational dermatological cohort that is later compared to an already existing cohort without MC use. The aim is to investigate if the diagnosis via molecular analysis influences course of the skin disease, therapeutic measures and quality of life.

Quantifying the impact of immune history and variant on SARS-CoV-2 viral kinetics and infection rebound: A retrospective cohort study.

The combined impact of immunity and SARS-CoV-2 variants on viral kinetics during infections has been unclear. We characterized 1,280 infections from the National Basketball Association occupational health cohort identified between June 2020 and January 2022 using serial RT-qPCR testing. Logistic regression and semi-mechanistic viral RNA kinetics models were used to quantify the effect of age, variant, symptom status, infection history, vaccination status and antibody titer to the founder SARS-CoV-2 strain on the duration of potential infectiousness and overall viral kinetics. The frequency of viral rebounds was quantified under multiple cycle threshold (Ct) value-based definitions. Among individuals detected partway through their infection, 51.0% (95% credible interval [CrI]: 48.3-53.6%) remained potentially infectious (Ct <30) 5 days post detection, with small differences across variants and vaccination status. Only seven viral rebounds (0.7%; N=999) were observed, with rebound defined as 3+days with Ct <30 following an initial clearance of 3+days with Ct ≥30. High antibody titers against the founder SARS-CoV-2 strain predicted lower peak viral loads and shorter durations of infection. Among Omicron BA.1 infections, boosted individuals had lower pre-booster antibody titers and longer clearance times than non-boosted individuals. SARS-CoV-2 viral kinetics are partly determined by immunity and variant but dominated by individual-level variation. Since booster vaccination protects against infection, longer clearance times for BA.1-infected, boosted individuals may reflect a less effective immune response, more common in older individuals, that increases infection risk and reduces viral RNA clearance rate. The shifting landscape of viral kinetics underscores the need for continued monitoring to optimize isolation policies and to contextualize the health impacts of therapeutics and vaccines. Supported in part by CDC contract #200-2016-91779, a sponsored research agreement to Yale University from the National Basketball Association contract #21-003529, and the National Basketball Players Association.

Downstream consequences of moral distress in COVID-19 frontline healthcare workers: Longitudinal associations with moral injury-related guilt

ObjectiveTo examine the longitudinal associations between dimensions of COVID-19 pandemic-related moral distress (MD) and moral injury (MI)-related guilt in a large sample of frontline COVID-19 healthcare workers (FHCWs).Methods: Data from a diverse occupational cohort of 786 COVID-19 FHCWs were collected during the initial peak of the COVID-19 pandemic in New York City and again 7 months later. Baseline MD and MI-related guilt at follow-up were assessed in three domains: family-, work-, and infection-related. Social support was evaluated as a potential moderator of associations between MD and MI-related guilt. ResultsA total of 66.8% of FHCWs reported moderate-or-greater levels of MI-related guilt, the most prevalent of which were family (59.9%) or work-related (29.4%). MD was robustly predictive of guilt in a domain-specific manner. Further, among FHCWs with high levels of work-related MD, those with greater perceptions of supervisor support were less likely to develop work-related guilt 7 months later. DiscussionMD was found to be highly prevalent in FHCWs during the initial wave of the COVID-19 pandemic and was linked to the development of MI-related guilt over time. Prevention and early intervention efforts to mitigate MD and bolster supervisor support may help reduce risk for MI-related guilt in this population.

Risk of first musculoskeletal disorder in Danish occupational fishermen – a register-based study

Abstract Background Occupational fishery increase risk of musculoskeletal disorders due to a combination of heavy workloads and strenuous settings. Scarce and inconsistent knowledge exists on work-related risk factors despite high prevalence is evident. The aim was to determine work-related risk factors for the first diagnosis of musculoskeletal disorders in Danish occupational fishermen. Methods This study was a register-based cohort study. We extracted data the from Nationwide Danish registers on work affiliation and health data for all persons registered as occupational fishermen between 1994 and 2017. Job titles were retrieved from the Danish Occupational Cohort with eXposure (DOC*X). Time-to-event analysis using cox regression with age as timescale was applied. Results Among 15.739 fishermen, forty percent (n = 6.218 cases) experienced first musculoskeletal disorder during 82.2 million person-years of follow-up. Adjusted gender-stratified analysis showed that male fishermen, who worked less than 5 years and more than 15 years had the highest significant risks of MSD (HR 2.40 (95%CI: 2.06, 2.80), HR: 2.40 (95%CI: 1.76, 2.35)) respectively, compared to working more than 20 years. In males, more years in workforce, a captain education and working part time significantly protected against first MSD, while shifting trades above three times increased risk. Women had estimates with greater uncertainties due to their small numbers in the industry. Conclusions A high incidence of musculoskeletal disorders was found in Danish occupational fishermen between 1994-2017. Findings suggest a bimodal relationship between occupational fishermen seniority level and their risk of musculoskeletal disorder, where highest risk was seen at five years in trade, afterwards from lower estimate slowly increasing with accumulating years until highest occupational seniority, compared to more than twenty years in trade. Continued development actions of preventive measures are suggested. Key messages

Associations between the urban exposome and type 2 diabetes: Results from penalised regression by least absolute shrinkage and selection operator and random forest models

BackgroundType 2 diabetes (T2D) is thought to be influenced by environmental stressors such as air pollution and noise. Although environmental factors are interrelated, studies considering the exposome are lacking. We simultaneously assessed a variety of exposures in their association with prevalent T2D by applying penalised regression Least Absolute Shrinkage and Selection Operator (LASSO), Random Forest (RF), and Artificial Neural Networks (ANN) approaches. We contrasted the findings with single-exposure models including consistently associated risk factors reported by previous studies. MethodsBaseline data (n = 14,829) of the Occupational and Environmental Health Cohort study (AMIGO) were enriched with 85 exposome factors (air pollution, noise, built environment, neighbourhood socio-economic factors etc.) using the home addresses of participants. Questionnaires were used to identify participants with T2D (n = 676(4.6 %)). Models in all applied statistical approaches were adjusted for individual-level socio-demographic variables. ResultsLower average home values, higher share of non-Western immigrants and higher surface temperatures were related to higher risk of T2D in the multivariable models (LASSO, RF). Selected variables differed between the two multi-variable approaches, especially for weaker predictors. Some established risk factors (air pollutants) appeared in univariate analysis but were not among the most important factors in multivariable analysis. Other established factors (green space) did not appear in univariate, but appeared in multivariable analysis (RF). Average estimates of the prediction error (logLoss) from nested cross-validation showed that the LASSO outperformed both RF and ANN approaches. ConclusionsNeighbourhood socio-economic and socio-demographic characteristics and surface temperature were consistently associated with the risk of T2D. For other physical-chemical factors associations differed per analytical approach.

Mortality among mine and mill workers exposed to respirable crystalline silica.

BackgroundMillions of workers are potentially exposed to respirable crystalline silica (RCS) which has been associated with several diseases. We updated the mortality experience of a cohort of 2,650 mine and mill workers at four manufacturing facilities to assess cause-specific mortality risks associated with estimated cumulative RCS exposure.MethodsStudy eligibility was defined as any employee who had ≥1 year of service by 2000, with work history experience available from 1945 through 2004. Vital status and cause of death were ascertained from 1945 through 2015. RCS exposure was estimated across plant-, department-, job-, and time-dependent categories using historic industrial hygiene sampling data and professional judgment. Associations between cumulative RCS (mg/m3-years) and cause-specific mortality were examined using Cox proportional hazard regression models.ResultsIn the exposure-response analysis defined on quartiles of cumulative RCS exposure, no increasing trend (ptrend = 0.37) in lung cancer mortality (n = 116 deaths) was observed (Hazard ratio (HR) = 1.00 (referent), 1.20, 1.85, 0.92). Mortality risk for non-malignant respiratory disease was increased across quartiles (HR = 1.00, 1.35, 1.89, 1.70; ptrend = 0.15), based on 83 deaths. Non-malignant renal disease mortality was increased across quartiles (HR = 1.00, 6.64, 3.79, 3.29; ptrend = 0.11), based on 26 deaths.ConclusionsAfter nearly seven decades of follow-up, the exposure-response analyses showed no evidence of a positive trend for lung cancer, and limited evidence of a trend for non-malignant respiratory disease, and non-malignant renal disease mortality as a result of cumulative RCS exposure in this occupational cohort.

Time course of health complaints attributed to RF-EMF exposure and predictors of electromagnetic hypersensitivity over 10 years in a prospective cohort of Dutch adults

BackgroundSome individuals attribute health complaints to radiofrequency electromagnetic field (RF-EMF) exposure. This condition, known as idiopathic environmental intolerance attributed to RF-EMFs (IEI-RF) or electromagnetic hypersensitivity (EHS), can be disabling for those who are affected. In this study we assessed factors related to developing, maintaining, or discarding IEI-RF over the course of 10 years, and predictors of developing EHS at follow-up using a targeted question without the condition of reporting health complaints attributed to RF-EMF exposure. MethodsParticipants (n = 892, mean age 50 at baseline, 52 % women) from the Dutch Occupational and Environmental Health Cohort Study AMIGO filled in questionnaires in 2011/2012 (T0), 2013 (T1), and 2021 (T4) where information pertaining to perceived RF-EMF exposure and risk, non-specific symptoms, sleep problems, IEI-RF, and EHS was collected. We fitted multi-state Markov models to represent how individuals transitioned between states (“yes”, “no”) of IEI-RF. ResultsAt each time point, about 1 % of study participants reported health complaints that they attributed to RF-EMF exposure. While this percentage remained stable, the individuals who reported such complaints changed over time: of nine persons reporting health complaints at T0, only one reported IEI-RF at both T1 and T4, and two newly reported health complaints at T4. Overall, participants had a 95 % chance of transitioning from “yes” to “no” over a time course of 10 years, and a chance of 1 % of transitioning from “no” to “yes”. Participants with high perceived RF-EMF exposure and risk had a general tendency to move more frequently between states. ConclusionsWe observed a low prevalence of IEI-RF in our population. Prevalence did not vary strongly over time but there was a strong aspect of change: over 10 years, there was a high probability of not attributing symptoms to RF-EMF exposure anymore. IEI-RF appears to be a more transient condition than previously assumed.

Work Intensity as a Risk Factor for Burnout, Anxiety and Depressive Disorders in Various Occupational Cohorts: A Literature Review

Introduction: Under current conditions of work intensification and introduction of information and communication technologies, there arise risks of developing the syndrome of emotional burnout, anxiety and depressive disorders among workers in various occupational cohorts. Objective: To analyze scientific publications and to establish the prevalence of psychological and emotional problems among people working under conditions of increased work intensity in order to identify predisposing factors, determine occupational cohorts at risk, and prevent burnout, anxiety and depressive disorders. Materials and methods: A scientific review of studies published in 2005–2022 in the Russian and English languages was carried out using such information platforms and databases as eLIBRARY.ru, Web of Science, PubMed, and Scopus. The search terms included work intensity, burnout syndrome, anxiety disorders, and depression. We chose prospective studies, in which neuropsychic stress at the workplace was assessed as an occupational health risk. Of 282 search results, 51 publications on psychological and emotional ill-being posed by neuropsychic overstrain were found eligible for inclusion in this review. Results: We established a high prevalence of psychological and emotional problems among workers in various occupational cohorts, including nurses, medical doctors of various specialties, teachers, psychologists, journalists, athletes, policemen and penitentiary police officers, emergency service members. Features of clinical manifestations of burnout symptoms, anxiety and depressive disorders in workers experiencing increased tension were discussed. Our findings showed that psychosocial risk factors for burnout, anxiety and depressive disorders were role uncertainty, role conflict, role stress, stressful events, workload, and pressure at work, and that burnout was associated with various non-occupational diseases. Conclusion: We highlight the necessity of assessing psychosocial factors at workplaces and screening for psychological and emotional disorders of employees for early diagnosis of burnout and related conditions and elimination of their negative outcomes at the individual and societal levels. We propose introduction of the international COPSOQ tool (the Copenhagen Psychosocial Questionnaire) into domestic healthcare practice to conduct a comprehensive individual assessment of psychosocial factors and to facilitate timely and appropriate preventive measures at work.

Time course of electromagnetic hypersensitivity in a prospective cohort of Dutch individuals

BACKGROUND Some individuals attribute health complaints to radiofrequency electromagnetic field (RF-EMF) exposure. This condition, known as electromagnetic hypersensitivity (EHS), can be disabling for those who are affected. Psychosocial factors are thought to play a role but little is understood about the time course of EHS. In this study we assessed factors related to developing, maintaining, or discarding EHS over the course of 10 years, defined as reporting health complaints attributed to RF-EMF exposure. METHODS Participants (n=892, mean age 50 at baseline, 52% women) from the Dutch Occupational and Environmental Health Cohort Study AMIGO filled in questionnaires in 2011/2012 (T0), 2013 (T1), and 2021 (T2) where information pertaining to perceived RF-EMF exposure and risk, symptoms, sleep problems, and EHS was collected. We fitted multi-state Markov models to represent how individuals transitioned between states (yes, no) of symptom attribution to RF-EMF exposure. RESULTS At each time point, about 1% or study participants reported health complaints that they attributed to RF-EMF exposure. While this percentage remained stable, the individuals who reported such complaints changed over time: of 9 persons reporting health complaints at T0, only 1 reported EHS at both T1 and T2. Overall, participants had a 95% chance of transitioning from yes to no over a time course of 10 years, and a chance of 1% of transitioning from no to yes. Participants with a high RF-EMF exposure and risk perception had a general tendency to move more frequently between states. CONCLUSIONS We observed a low prevalence of symptom attribution to RF-EMF exposure in our population. Prevalence did not vary strongly over time but there was a strong aspect of change: over 10 years, there was a high probability of not attributing symptoms to RF-EMF exposure anymore. Being EHS appears to be a more transient condition than previously assumed. KEYWORDS electromagnetic hypersensitivity

The urban exposome and type 2 diabetes: A deep learning approach

BACKGROUND AND AIM: Type 2 diabetes (T2D) is a chronic disease with high individual and societal burden. Risk of T2D is partly influenced by urban characteristics, such as air pollution, or indirectly through their relation with lifestyle behaviours (e.g. walkability, food environment). Environmental characteristics are generally studied individually in their association with T2D, but occur simultaneously in real life, and may associate with T2D in nonlinear and non-additive ways. We aimed to identify which factors of the urban exposome are associated with T2D by applying artificial neural networks (ANN). In addition, we compared results of ANN model with penalized regression LASSO, as a more conventional method. METHODS: We analyzed baseline data from 14,829 participants of the Occupational and Environmental Health Cohort study living across the Netherlands. Self-reported questionnaire data were used to identify participants diagnosed with T2D (n=676(4.6%)). Exposome variables (n=86) were linked to individual home addresses, including air pollution, traffic noise, green-space, chemicals in drinking water, built environmental and neighborhood socio-demographic characteristics. Models were adjusted for individual socio-demographic variables. Nested cross-validation was used to determine the optimal model parameters of both approaches (ANN and LASSO), and the cross-validated predictive accuracies were compared. RESULTS: One exposure was selected by each approach. Living in neighborhoods with a higher share of non-Western immigrants (selected by ANN) was associated with a higher risk of T2D. Higher average home value in residential neighborhood (selected by LASSO) was associated with a lower risk of T2D. Cross-validated prediction error logLoss (sd) was 0.177 (0.0060) for ANN and 0.167 (0.0022) for LASSO. CONCLUSIONS: Neighborhood socio-demographic characteristics are associated with the risk of T2D. Accuracy of the ANN model was lower than LASSO, which might be due to the low prevalence of diabetes and relatively weak signal in the data. KEYWORDS: Multiple exposures, Machine learning, Neighborhood socio-demographic characteristics

Trajectories of common mental disorders symptoms before and during the COVID-19 pandemic: findings from the ELSA-Brasil COVID-19 Mental Health Cohort.

AimEvidence indicates most people were resilient to the impact of the COVID-19 pandemic on mental health. However, evidence also suggests the pandemic effect on mental health may be heterogeneous. Therefore, we aimed to identify groups of trajectories of common mental disorders’ (CMD) symptoms assessed before (2017–19) and during the COVID-19 pandemic (2020–2021), and to investigate predictors of trajectories.MethodsWe assessed 2,705 participants of the ELSA-Brasil COVID-19 Mental Health Cohort study who reported Clinical Interview Scheduled-Revised (CIS-R) data in 2017–19 and Depression Anxiety Stress Scale-21 (DASS-21) data in May–July 2020, July–September 2020, October–December 2020, and April–June 2021. We used an equi-percentile approach to link the CIS-R total score in 2017–19 with the DASS-21 total score. Group-based trajectory modeling was used to identify CMD trajectories and adjusted multinomial logistic regression was used to investigate predictors of trajectories.ResultsSix groups of CMD symptoms trajectories were identified: low symptoms (17.6%), low-decreasing symptoms (13.7%), low-increasing symptoms (23.9%), moderate-decreasing symptoms (16.8%), low-increasing symptoms (23.3%), severe-decreasing symptoms (4.7%). The severe-decreasing trajectory was characterized by age < 60 years, female sex, low family income, sedentary behavior, previous mental disorders, and the experience of adverse events in life.LimitationsPre-pandemic characteristics were associated with lack of response to assessments. Our occupational cohort sample is not representative.ConclusionMore than half of the sample presented low levels of CMD symptoms. Predictors of trajectories could be used to detect individuals at-risk for presenting CMD symptoms in the context of global adverse events.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00127-022-02365-0.

Workplace Social Support and Reduced Psychological Distress: A 1-Year Occupational Cohort Study.

There is little evidence that workplace social support can relieve workers' mental health problems. Therefore, we examined whether social support from coworkers and supervisors was associated with reduced serious psychological distress among employees. We used two-wave panel data from 13 Japanese companies. The baseline survey was conducted in 2011, and the follow-up survey 1 year later. From 9889 respondents, we selected 759 who had psychological distress at baseline, defined as ≥13 on the Kessler Psychological Distress Scale (K6). Increased coworker support was significantly associated with employees' reduced psychological distress (odds ratio, 3.51; 95% confidence interval, 2.17 to 5.68). The association between increased supervisor support and reduced psychological distress was nonsignificant (odds ratio, 1.32, 95% confidence interval, 0.85 to 2.04). Encouraging coworker support may contribute to the secondary prevention of mental health problems among employees.

Indicators of recent COVID-19 infection status: findings from a large occupational cohort of staff and postgraduate research students from a UK university

BackgroundResearchers conducting cohort studies may wish to investigate the effect of episodes of COVID-19 illness on participants. A definitive diagnosis of COVID-19 is not always available, so studies have to rely on proxy indicators. This paper seeks to contribute evidence that may assist the use and interpretation of these COVID-indicators.MethodsWe described five potential COVID-indicators: self-reported core symptoms, a symptom algorithm; self-reported suspicion of COVID-19; self-reported external results; and home antibody testing based on a 'lateral flow' antibody (IgG/IgM) test cassette. Included were staff and postgraduate research students at a large London university who volunteered for the study and were living in the UK in June 2020. Excluded were those who did not return a valid antibody test result. We provide descriptive statistics of prevalence and overlap of the five indicators.ResultsCore symptoms were the most common COVID-indicator (770/1882 participants positive, 41%), followed by suspicion of COVID-19 (n = 509/1882, 27%), a positive symptom algorithm (n = 298/1882, 16%), study antibody lateral flow positive (n = 124/1882, 7%) and a positive external test result (n = 39/1882, 2%), thus a 20-fold difference between least and most common. Meeting any one indicator increased the likelihood of all others, with concordance between 65 and 94%. Report of a low suspicion of having had COVID-19 predicted a negative antibody test in 98%, but positive suspicion predicted a positive antibody test in only 20%. Those who reported previous external antibody tests were more likely to have received a positive result from the external test (24%) than the study test (15%).ConclusionsOur results support the use of proxy indicators of past COVID-19, with the caveat that none is perfect. Differences from previous antibody studies, most significantly in lower proportions of participants positive for antibodies, may be partly due to a decline in antibody detection over time. Subsequent to our study, vaccination may have further complicated the interpretation of COVID-indicators, only strengthening the need to critically evaluate what criteria should be used to define COVID-19 cases when designing studies and interpreting study results.

Psychosocial work environment as a dynamic network: a multi-wave cohort study

While characteristics of psychosocial work environment have traditionally been studied separately, we propose an alternative approach that treats psychosocial factors as interacting elements in networks where they all potentially affect each other. In this network analysis, we used data from a prospective occupational cohort including 10,892 participants (85% women; mean age 47 years) and repeated measurements of seven psychosocial work characteristics (job demands, job control, job uncertainty, team climate, effort-reward imbalance, procedural justice and interactional justice) assessed in 2000, 2004, 2008 and 2012. Results from multilevel longitudinal vector autoregressive models indicated that job demands as well as interactional and procedural justice were most broadly associated with the subsequent perceptions of the work-related psychosocial factors (high out-Strength), suggesting these factors might be potentially efficient targets of workplace interventions. The results also suggest that modifying almost any of the studied psychosocial factors might be relevant to subsequent perceptions of effort-reward imbalance and interactional justice at the workplace.

Development of Harmonized COVID-19 Occupational Questionnaires.

Harmonized tools and approaches for data collection can help to detect similarities and differences within and between countries and support the development, implementation, and assessment of effective and consistent preventive strategies. We developed open source occupational questionnaires on COVID-19 within COVID-19 working groups in the OMEGA-NET COST action (Network on the Coordination and Harmonisation of European Occupational Cohorts, omeganetcohorts.eu), and the EU funded EPHOR project (Exposome project for health and occupational research, ephor-project.eu). We defined domains to be included in order to cover key working life aspects of the COVID-19 pandemic. Where possible, we selected questionnaire items and instruments from existing questionnaire resources. Both a general occupational COVID-19 questionnaire and a specific occupational COVID-19 questionnaire are available. The general occupational COVID-19 questionnaire covers key working life aspects of the COVID-19 pandemic, including the domains: COVID-19 diagnosis and prevention, Health and demographics, Use of personal protective equipment and face covering, Health effects, Work-related effects (e.g. change in work schedule and work–life balance), Financial effects, Work-based risk factors (e.g. physical distancing, contact with COVID-19-infected persons), Psychosocial risk factors, Lifestyle risk factors, and Personal evaluation of the impact of COVID-19. For each domain, additional questions are available. The specific occupational COVID-19 questionnaire focusses on occupational risk factors and mitigating factors for SARS-CoV2 infection and COVID-19 disease and includes questions about the type of job, amount of home working, social distancing, human contact (colleagues, patients, and members of the public), commuting, and use of personal protective equipment and face coverings. The strength of this initiative is the broad working life approach to various important issues related to SARS-CoV-2 infection, COVID-19 disease, and potentially future pandemics. It requires further work to validate the questionnaires, and we welcome collaboration with researchers willing to do this. A limitation is the moderate number of questions for each of the domains in the general questionnaire. Only few questions on general core information like ethnicity, demographics, lifestyle factors, and general health status are included, but the OMEGA-NET questionnaires can be integrated in existing questionnaires about sociodemographic and health-related aspects. The questionnaires are freely accessible from the OMEGA-NET and the EPHOR homepages.

Safety and efficacy of low dose naltrexone in a long covid cohort; an interventional pre-post study

BackgroundUp to 37.7% of patients experience symptoms beyond 12 weeks after infection with SARS-CoV-2. To date care for people with long covid has centred around multidisciplinary rehabilitation, self care and self pacing. No pharmacotherapy has been shown to be beneficial. MethodsIn this single centre interventional pre post study, the safety of Low Dose Naltrexone (LDN) was explored in patients with Post COVID-19 Syndrome (PCS), defined by NICE as patients with ongoing symptoms 12 or more weeks after initial infections with SARS-CoV-2 where alternative explanation for symptoms cannot be found. Patients were recruited through a Post COVID clinic, had a baseline quality of life questionnaire in symmetrical Likert format, were prescribed 2 months (1 mg month one, 2 mg month two) of LDN and repeated the same questionnaire at the end of the second month. Patients were monitored to adverse events. FindingsIn total 52 patients participated of whom 40(76.9%) were female. The median age was 43.5 years(IQR 33.2–49). Healthcare workers represented the largest occupational cohort n = 16(34.8%). The median time from diagnosis of COVID-19 until enrolment was 333 days (IQR 171–396.5). Thirty-eight participants (73.1%) were known to commence LDN, two of whom (5.3%) stopped taking LDN post commencement due to new onset diarrhoea and also described fatigue. In total 36(69.2%) participants completed the questionnaire at the end of the two-month period. Improvement was seen in 6 of 7 parameters measured; recovery from COVID-19, limitation in activities of daily living, energy levels, pain levels, levels of concentration and sleep disturbance (p ≤ 0.001), improvement in mood approached but was not significant (p = 0.054). ConclusionsLDN is safe in patients with PCS and may improve well-being and reduce symptomatology in this cohort. Randomised control trials are needed to further explore this.