Work-related Environmental Factors Research Articles

The Prevalence of Weight Gain After Obtaining Employment: A Cross-Sectional Survey of Employees at the Ministry of National Guard Health Affairs, Eastern Region, Saudi Arabia.

Background and objective Even though obesity is a major global health concern, few studies in the literature have discussed obesity in the workplace. In light of this, we aimed to explore obesity in the workplace and its contributing factors. Methodology An online survey was distributed via official work emails. The survey assessed demographic variables and work environment-related factors, such as physical and mental well-being, lack of time, and social and personal habits. The total sample included 380 full-time employees, of which 16.67% were excluded for not meeting the inclusion criteria. Data were analyzed by using descriptive and inferential statistics. Results Of note, 79.87% of the participants reported an increase in weight after getting employed. The average weight gain was 10.4 kg for 8.2 years of experience. The physical and mental items and time-related items had the highest average scores of 3.24 and 3.44, respectively. The multivariable logistic regression showed a significant association between work experience (p = 0.0259) and time (p = 0.0363), as well as physical and mental domains (p = 0.0007). Conclusions Based on our findings, greater work experience, a lack of time, and negative mental and physical well-being are risk factors for weight gain among employees.

Decoding Employee ambidexterity: Understanding drivers, constraints, and performance implications for thriving in the evolving work landscapes - A scoping review

Employee ambidexterity (EA) is becoming increasingly recognised as a significant factor in enhancing individual and organisational performance across diverse industries. Ambidexterity refers to the capacity to exploit and explore organisational resources simultaneously. Scholars from diverse industry sectors have been motivated to delve deeper into the topic of EA due to its growing popularity. The objective of conducting a scoping review was to scrutinise the existing literature and identify the key drivers and constraints that impact EA to thrive in the changing work landscape. The insights gained from this review can assist decision-makers in formulating effective strategies to cultivate the ambidexterity skills of their workforce and achieve desirable outcomes. This review adheres to the PRISMA-ScR protocol. Articles were obtained from databases including Scopus, Web of Science, and EBSCOhost (Academic Search Complete, Business Source Complete). The body of literature concerning EA is in its nascent stage. 23 articles assessing EA's performance outcomes were identified using targeted search terms and thorough screening. After conducting a thorough thematic analysis using the iterative categorisation (IC) technique, tailored for scoping a review, we successfully identified twenty-nine factors contributing to the enhancement of EA, meticulously organised into five distinct categories: organisational factors, social connectedness, employee behaviour, employee personality, and work environment related factors. Similarly, we discovered four factors that impede EA: functional tenure, team identification, bounded discretion, and conscientiousness. Our findings underscore the profound impact of employee ambidexterity on distinct types of performance. Among the sixteen types of performance reported to be enhanced by EA, ten are linked to individual performance, while six are tied to organisational performance. Notably, our analysis revealed that nearly all studies have relied on cross-sectional research methods except for one. However, we advocate for the exploration of longitudinal studies as they hold the promise of offering a more comprehensive understanding of EA. The paper presents valuable insights into how to cultivate ambidextrous capabilities in the workforce for unparalleled success in today's rapidly evolving work environment. Additionally, it identifies several intriguing avenues for future research that could further elucidate and bridge existing knowledge gaps.

Engage and enjoy-investigating predictors of employee engagement and work satisfaction in equine veterinary professionals.

Individuals working in the field of veterinary care are regularly affected by their profession. High levels of responsibility to often provide life-saving health care to animals combined with having to manage owners' expectations and irregular working hours can cause considerable levels of work-related stress among professionals in equine veterinary practice. On the positive side, research also shows that working in the veterinary profession can have a positive impact on personal wellbeing and feelings of fulfillment. A limited number of studies has investigated work satisfaction and engagement among veterinarians across the globe, and none specifically in the equine veterinary work field. The aim of the current study was to identify relevant predictors of employee engagement and work satisfaction in relation to demographic and work environment related factors in the equine veterinary profession. A cross-sectional study design was used to investigate work satisfaction and employee engagement among equine veterinary professionals from the UK, the US and the Netherlands using an online survey. Results suggest that levels of work engagement and satisfaction in the veterinary profession may be gauged using four factors. These factors encompass Pride and purpose (the extent to which personal core values align with the mission of the employer, i.e., the veterinary practice), Company culture and relationship with management (the manner in which staff members interact with each other and the management), Working conditions and compensation (formal employment conditions relating to responsibilities and rewards and levels of collegiality) and Team culture and learning possibilities (encouragement to pursue personal and professional growth). Findings underline the importance of being particularly mindful of inexperienced colleagues, those with demanding family commitments and, where feasible, of providing employees with a modicum of autonomy in order to ensure a satisfied equine veterinary workforce.

Development of the core of an ICF-based instrument for the assessment of work capacity and guidance in return to work of employees on sick leave: a multidisciplinary modified Delphi study

BackgroundSeveral occupational health disciplines are involved in return to work guidance, implying that good interdisciplinary collaboration is important. A shared conceptual framework and a common language for the assessment of work capacity and guidance in return to work is expected to be at the benefit of appropriate and sustainable employability of sick employees. The International Classification of Functioning, Disability and Health (ICF) can be considered a shared conceptual framework and is also promising in terms of a common language. The purpose of the current study is to reach multidisciplinary consensus among occupational health professionals on the content of an ICF-based instrument for the assessment of work capacity and guidance in return to work.MethodsTo obtain multidisciplinary consensus we conducted a modified Delphi study among twelve occupational health experts, including four occupational physicians, four insurance physicians and four labour experts. The study included two e-mail rounds and two virtual meetings. In the consecutive rounds the experts assessed ICF items as well as a list of non-ICF-based work-related environmental factors on their relevance for the assessment of the work capacity and guidance in return to work together with their interpretability.ResultsThe four consecutive Delphi rounds resulted in 20 items that are minimally needed for the assessment of the work capacity and return to work possibilities of employees on sick leave. The final list included six items on personal functioning, seven items on social functioning and seven items on physical functioning.ConclusionsThis set of items forms the core of an ICF-based instrument, which is expected to facilitate interdisciplinary and intradisciplinary communication because of the use of a shared conceptual framework. As such, it should be of help in the guidance in return to work of employees on sick leave and contribute to appropriate and sustainable employability.

Factors relevant to work participation from the perspective of adults with developmental dyslexia: a systematic review of qualitative studies

BackgroundThis review is focused on workers with developmental dyslexia (DD). In this review DD is considered an expression of neurodiversity, a consequence of a natural variant of the brain. Evidence was synthesized to explore which factors workers with DD consider relevant for their participation in work and whether these factors reflect shifts in the concepts of health and sustainable employability. The factors were classified according to the International Classification of Functioning, Disability and Health (ICF), adapted for occupational health.MethodsA systematic review of qualitative studies was performed. Two search strings were used to determine the population and the context of work. The factors were classified using a recently proposed rearrangement of the ICF scheme that places participation in a central position and incorporates preliminary lists of work-related environmental factors and personal factors.ResultsFifty-one factors were found that appeared in 35% or more of the included studies and that were relevant to work participation according to the workers themselves. These factors were dispersed over all ICF categories. In the category Functions and Structures (11 factors), most of the factors had negative connotations. In the category Activities (9 factors), all the factors cause difficulties, except speaking (which is ambiguous). In the category Participation (4 factors), the formal relationships are important for the degree of participation. Overall, more than half of the factors are environmental (18) or personal (9) and they both hinder and facilitate work participation.ConclusionsThe results of this review give an indication for the importance of the biopsychosocial model as a relevant approach for people with a disability in the world of work. This review also adds data for the usefulness of the proposals for the reconsideration of the ICF scheme. The data has not (yet) returned any visible trends revealing that the concept of neurodiversity is common in organizations.

Burnout among nurses working in COVID-19 pandemic

Nurses are at high risk of burnout because of the characteristic of their work that expends most of the time in delivering care to the patients. This study aimed to describe burnout among nurses working during corona virus disease 2019 (COVID-19) using nurses' demographic characteristics. This observational cross-sectional study involved 149 nurses from some hospitals and public health centers in Semarang using an online questionnaire from May 1 to June 15, 2020. Primary data were collected using Maslach Burnout Inventory including emotional exhaustion, depersonalization, and reduced personal accomplishment. Univariate and multivariate analyses were performed. The study showed that 63.6% of nurses in the COVID-19 unit were at high levels of emotional exhaustion, 56.3% of them were at high levels of depersonalization, and 46.7% of them are at high levels of reduced personal accomplishment. Education was the only demographic factor that was significantly related to emotional exhaustion and depersonalization (p<0.05) with a weak correlation. The work environment and the reduced anxiety-related factors were not significantly correlated with the reduced personal accomplishment with a very weak correlation, while the nurses’ unit was significantly correlated with depersonalization (p<0.05) with a very weak correlation. The results found that burnout develops among nurses due to the work environment-related factors such as the unit of work, corona-infected patients, personal protective equipment usage, and the specific characteristics of the workplace. Nurses’ characteristics affect their ability to manage the workload even in a pandemic. Nurses need optimal supports to build their self-efficacy. The organizational efforts play an important role in strengthening nurses to prevent burnout.

Perceived Stress of Special Education Teachers in the Context of the Person-Environment Relationship

Background: The teachers of learners with special needs are confronted with higher demands, enormous challenges and low reward or motivation. Hence, stress among the teachers is inevitable with a resultant effect on behavioural and learning outcomes of learners with special needs. Unfortunately, factors that contribute to perceived stress among teachers of learners with special needs, particularly in Southwest Nigeria, are yet to be established. Objective: To establish the relationship of some personal and environment-related factors as determinants of stress among teachers of learners with special needs. Methods: A total of 118 participants were randomly selected from special schools in South west Nigeria. A descriptive survey of both a quantitative and qualitative research design was adopted. Based on the person-environment fit theory, four research questions were raised and answered. A structured questionnaire and semi-structured interview were used for data collection. Quantitative data were analysed with descriptive statistics and inferential statistics at a 0.05 level of significance, while qualitative data were thematically analysed. Results: The study found a significant positive relationship between the student-teacher relationship and perceived stress and an inverse relationship of work experience and work motivation with perceived stress among the participants. An unfavourable working environment and lack of motivation were identified by the participants as major sources of stress. Conclusion: The study concluded that work environment-related factors triggered stress among teachers of learners with special needs.

FACTORS INFLUENCING WORK ENGAGEMENT AMONG CANCER SURVIVORS IN MALAYSIA

This study investigated the antecedents of work engagement of Malaysian employees who were cancer survivors. Work engagement refers to a positive, fulfilling, work-related state of mind characterizing employees who work hard and persist despite difficulties. Employees with high levels of work engagement are deeply involved in what they do and are happily absorbed in their work. This study was aimed to examine the individual and work environment-related factors that influence work engagement. A quantitative research paradigm was adopted, with a cross-sectional design using data collected from cancer survivors registered at the Hospital Kuala Lumpur. The 270 participants in this study were randomly selected by inclusive criteria sampling. A validated instrument was tested in a pilot study. Partial Least Square-Structural Equation Model (PLS-SEM) was used to test the direct effects of work engagement. It was found that the level of all the tested variables (work engagement, employee resilience, social support, and quality of working life) among the participants were high. This study highlights the importance of resilience and social support in improving work engagement among cancer survivors in Malaysia.

Work environment-related factors and nurses\u2019 health outcomes: a cross-sectional study in Lebanese hospitals

BackgroundWorldwide, studies show a relationship between nurses’ health and some work environment factors; however, data on nurses’ health and self-perceived workload and nursing task allocation are lacking, particularly for Lebanese nurses. We assessed the relationship of several work environment factors: overall workload and specific temporal, physical, mental, effort, frustration, and performance demands (NASA Task Load Index), staffing resources and adequacy and leadership (Practice Environment Scale of Nursing Work Index), teamwork climate (Safety Attitudes Questionnaire), and nursing task allocation (Basel Extent of Rationing of Nursing Care)) with self-reported musculoskeletal, cardiovascular, skin, and mental health diseases (Work Ability Index) and emotional exhaustion (Maslach Burnout Inventory) among Lebanese nurses.MethodsA cross-sectional self-report survey was distributed to all 289 registered nurses (RNs) in the medical, surgical, and pediatric units in two Lebanese university-affiliated hospitals; 170 RNs had complete data. Adjusted multivariable logistic regression models were used to estimate the association between work environment factors and health outcomes.ResultsThe most prevalent outcomes were musculoskeletal disease (69%), emotional exhaustion (59%), and mental health problems (56%); 70% of RNs had ≥2 and 35.29% had ≥4 co-occurring health problems. Musculoskeletal disease was associated with higher overall (OR = 1.36 (95%CI = 1.03, 1.80)), temporal (OR = 1.30 (95%CI = 1.09, 1.55)), and physical demands (OR = 1.20 (95%CI = 1.03, 1.49)), higher task allocation to RNs (OR = 1.11 (95%CI = 1.01, 1.23)) and lower teamwork climate (OR = 0.60 (95%CI = 0.36, 0.98). Higher odds of mental/emotional problems were associated with higher overall, temporal, frustration, and effort demands, and lower teamwork climate, performance satisfaction, and resources adequacy (increased odds ranging from 18 to 88%). Work environment indicators were associated with higher co-occurrence of health problems.ConclusionsResults show elevated health burden and co-morbidity among Lebanese RNs and highlight the value of comprehensive approaches that can simultaneously improve several work environment factors (namely self-perceived workload, teamwork,, resources, and nursing task allocation) to reduce this burden.

Work Schedule Irregularity and the Risk of Work-Related Injury among Korean Manual Workers.

Work schedules comprise various variables and generate health and safety outcomes, including work-related injury, which causes socioeconomic problems, such as productivity loss and damage to worker health. We investigated the association between work schedule irregularity and the incidence of work-related injury among South Korean manual workers using data from the 5th Korean Working Conditions Survey. In total, 18,330 manual workers were included. A multivariate logistic regression analysis was performed to understand the association between work schedule and work-related injury and the influence of sufficient safety information and work schedule on work-related injury. We calculated the influence of an irregular work schedule on occupational injury after controlling for personal and work environment-related factors. The adjusted odds ratio (OR) for work-related injury was 1.66 (95% confidence interval (CI) 1.32–2.09) for an irregular work schedule. The interaction had an additive effect when the work schedule was irregular, even when sufficient safety information was provided. Manual workers had a higher incidence of injury (2.1%). Even in adjusted analyses, work schedule irregularity conferred greater risks of work injury, particularly when not working the same number of days weekly (OR 1.52, 95% CI 1.21–1.90). Policymakers and health professionals need to consider the impact of work schedule irregularity on worker safety and health.

Work-Focused Health Care: The Role of Physical Therapists.

Musculoskeletal disorders (MSDs) are characterized by pain and reduced physical functioning that often results in decreased quality of life. Work-related musculoskeletal disorders (WRMDs) are health problems in which working conditions (ie, physically demanding or repetitive activities or a poor work environment) significantly contribute to the onset or progression of the disorder, but are not necessarily the sole cause. Even if work-related environmental factors do not directly cause MSDs, the symptoms can be work relevant (ie, the work can influence the symptoms, or the symptoms can affect the ability to work). WRMDs are burdensome to patients, employers and society as they are associated with high rates of disability, absenteeism, presenteeism, loss of productivity, longer recovery timeframes and workers' compensation costs. In this Point of View, we argue that physical therapists treating patients with MSDs should adopt a work-focused approach. There is ample evidence showing that being employed is associated with better health.1 Physical therapists can improve the health-related quality of life for patients with MSDs through adopting a work-focused approach and promoting participation in work.

Experiences and Needs of Nursing Staff Caring for Double Care Demanding Patients: A Qualitative Study

Nursing staff has a key role in the multidisciplinary care for patients with combined mental (psychiatric and/or psychogeriatric) and physical problems (DCD-patients). This study explores the experiences and needs of DCD-nursing staff in Dutch mental healthcare (MH) and nursing home (NH) settings, to identify factors to provide optimal care for DCD-patients. A qualitative approach was used, consisting of five semi-structured focus group interviews with DCD-staff (n=28) from MH- and NH-settings in the Netherlands. Five levels of factors were identified: (1) Patient-related factors (complexity of combined care needs, and complexity of behavioral problems); (2) Informal care-related factors (misapprehension of DCD-complexity, and involvement of volunteers); (3) Professional care-related factors (competences and attitudes, well-matched multidisciplinary team, and collaborative care between MH- and NH-settings); (4) Living and work environment-related factors (staff availability and continuity, and facility requirements); and (5) Organization-related factors (clear DCD-care policy, and provision of specific training and coaching). DCD-staff stressed the importance of team-efficacy, depending on commitment, mutual trust, and good communication- and collaboration skills; of experiencing a psychologically and physically safe work-environment; and of empowerment through the acknowledgment of the specificity of DCD-care and the teams’ specific qualities regarding DCD-care. These findings can be used to optimize DCD-care.

Exploration of Mistreatment and Burnout Among Resident Physicians: a Cross-Specialty Observational Study.

Resident physician mistreatment and burnout are widespread issues in medical training, but the association between the two remains unclear. This study examines the prevalence and types of mistreatment among resident physicians in core specialties and its association with burnout syndrome as well as feelings of depression/anxiety. A cross-sectional, survey-based observational study of medical residents was conducted at the University of California, Davis Medical Center in 2014. Current residents (PGY2 or higher) in the internal medicine, family medicine, obstetrics/gynecology, surgery, and pediatrics programs completed anonymous questionnaires addressing topics such as workplace mistreatment, feelings of depression/anxiety, and stress management. Burnout was measured using the Maslach Burnout Inventory. Forty-four out of 105 residents (41.9%) witnessed mistreatment of their co-residents while 26 residents (24.8%) disclosed personal accounts of mistreatment. Seventy-one percent of residents met the criteria for burnout. Residents who had been personally mistreated were almost eight times more likely to report burnout (OR 7.6, 95% CI = 1.7-34.4) and almost four times more likely to report symptoms of anxiety and depression (OR 3.8, 95% CI = 1.6-9.1). Public belittlement or humiliation was the most common type of mistreatment. Encountering mistreatment was associated with higher rates of burnout, as well as depression/anxiety. While it is uncertain if mistreatment in the workplace has a causative impact on burnout syndrome, the findings reveal the need to address work-related environmental factors that may contribute to both resident physician mistreatment and burnout.

Communication failures in surgery in the Asia Pacific region: a systematic review

Introduction Communication failure among healthcare professionals causes preventable surgical morbidity and mortality. Asia- Pacific region has its own cultural norms and customs sometimes causing perplexities and acting as a barrier in communication in a surgical setup. This systematic review summarizes the communication failures in surgery in countries belonging to the Asia-Pacific Region. Methods Data were obtained by a stepwise process using electronic databases such as MEDLINE, EMBASE and Google Scholar. MeSH subheading 'Surgery' and MeSH terms such as anaesthesia, operating rooms and communication were used. Results The literature search yielded 447 articles. Additional five articles were selected from the references. Twelve eligible articles were selected for the final analysis. The causes of communication failure were identified in four domains. Those were failures in communication in teamwork, individual factors, work environment related factors and technical factors. Conclusions Professional power, hierarchical approach, gender-based discriminations and not being open for constructive criticism leading to communication failures were seen in Asia-Pacific region. Debriefing on areas in communication errors and implementations such as creating awareness through nontechnical skills education, protocols, checklists, and introducing other methods to minimize the failure rates perhaps need to be done in this region.

Ageing at the level of telomeres in association to residential landscape and air pollution at home and work: a review of the current evidence

Studies suggest that leukocyte telomere length is an index of systemic ageing. Here, we discuss telomere length as a marker of biological ageing in relation to residential landscape (greenness), residential air pollution and work-related exposures. Telomere lengths are memories of cumulative oxidative and inflammatory stress, and show to have inverse associations with the risk of non-communicable diseases. For this reason, telomeres are considered as markers of biological ageing. Studies at birth, in children, young adulthood, and elderly show that residential green space, lower traffic exposure and long-term lower exposure to particulate air pollution are associated with longer telomeres. Work-related exposures including exposure to toxic metals, polycyclic aromatic hydrocarbons and particulate matter are associated with shorter telomeres for a given age. In contrast to chronic exposures, evidence is present of the observation that recent exposure is associated with longer telomeres. Our overview shows that the magnitude of residential and work-related environmental factors on telomere length are often as important as many classical lifestyle factors.

Elaboration of the contextual factors of the ICF for Occupational Health Care.

Many work-related items are not included in the current classification of environmental factors from the International Classification of Functioning, Disability and Health (ICF). Furthermore, personal factors are not classified and the ICF only provides a very limited list of examples. These facts make the ICF less useful for occupational health care and for research in the field of occupation and health. The objective of this discussion paper is to introduce an elaboration of contextual factors, focussing on factors that influence work participation. During the last 12 years, we developed two concept lists from the bottom up. These lists are based on our experiences in teaching and research, suggestions from students and other researchers, and factors found in the literature. In the fall of 2015 a scoping literature review was done to check for missing factors in these two concept lists. An elaboration of contextual factors, consisting of a list of work-related environmental factors and a list of personal factors. Important contextual factors that influence work participation are identified. Researchers, teachers, students, occupational and insurance physicians, allied health care professionals, employers, employees, and policy makers are invited to use the elaboration and to make suggestions for improvement. The elaboration and the suggestions received can be used in the ICF revision process. The development of an ICF ontology must be given priority, to give room to this elaboration, which will increase the applicability of the ICF and enable mapping with other terminologies and classifications.

Fostering functioning of workers: A new challenge for prevention in occupational health.

Given large changes in working conditions and society, occupational health care has to prioritize its efforts towards fostering health and functioning of workers and as such promote work participation. This requires that more emphasis is given on the application of biopsychological models in the care of workers. Although a biopsychological approach is often mentioned as essential part of occupational health care, it's application is often hampered in practice, by practical barriers and lack of practical knowledge. This is illustrated by a study that uncovered facilitating and hindering factors in the implementation process of a preventive strategy, proven effective in reducing the risk of long term sickness absence. To facilitate the use of biopsychological models in occupational health care, it is shown that setting up a training curriculum is possible, based on the International Classification of Functioning, Disability and Health (ICF) grafted on available training in evidence based practice skills is possible. Furthermore, there is a need for elaboration of the personal factors relevant for workers and the relevant work-related environmental factors to support practical application of ICF in occupational health care. A paradigm shift in occupational health care can facilitate widespread implementation of the biopsychosocial approach in occupational health and may stimulate occupational health professionals to further integrate this approach in their dailypractice.

Predictors of job satisfaction among individuals with disabilities: An analysis of South Korea's National Survey of employment for the disabled

This study aims to explore the influences of personal, vocational, and job environment related factors that are associated with job satisfaction of individuals with disabilities in South Korea. Data for wage-based working employees from a nationwide survey were obtained, which resulted in a total number of 417 participants. The six hypotheses and mediation effects of personal and work related environmental factors were tested using the structural equation modeling drawn from existing research evidence. Results revealed that (a) life satisfaction and job related environments directly influenced job satisfaction; (b) the relationship between personal experience and job satisfaction was mediated by life satisfaction for both mild/moderate and severe/profound disabilities group; and (c) the mediating role of job environment between vocational preparedness and job satisfaction was only observed for individuals with mild/moderate disabilities. Summary of findings and implications for future research and practices are discussed.

Determinants of the occupational environment and heavy vehicle crashes in Western Australia: A case–control study

ObjectiveTo determine the association between a heavy vehicle driver's work environment, including fatigue-related characteristics, and the risk of a crash in Western Australia. MethodsThis case–control study included 100 long-haul heavy vehicle drivers who were involved in a police-reported crash in WA and 100 long-haul heavy vehicle drivers recruited from WA truck stops, who were not involved in a crash in the previous 12 months. Driver demographics and driving details, work environment, vehicle and sleep-related characteristics were obtained using an interviewer-administered questionnaire. Drivers were tested for obstructive sleep apnoea using an overnight diagnostic device. Conditional multiple logistic regression analysis was undertaken to determine work environment-related factors associated with crash involvement. ResultsAfter accounting for potential confounders, driving a heavy vehicle with an empty load was associated with almost a three-fold increased crash risk compared to carrying general freight (adjusted OR: 2.93, 95% CI: 1.17–7.34). Driving a rigid heavy vehicle was associated with a four-fold increased risk of crashing compared to articulated heavy vehicles (adjusted OR: 4.08, 95% CI: 1.13–14.68). The risk of crashing was almost five times higher when driving more than 50% of the trip between midnight and 5.59am (adjusted OR: 4.86, 95% CI: 1.47–16.07). Furthermore, the risk of crashing significantly increased if the time since the last break on the index trip was greater than 2h (adjusted OR: 2.18, 95% CI: 1.14–4.17). Drivers with more than 10 years driving experience were 52% less likely to be involved in a crash (adjusted OR: 0.48, 95% CI: 0.23–0.99). ConclusionThe results provide support for an association between a driver's work environment, fatigue-related factors, and the risk of heavy vehicle crash involvement. Greater attention needs to be paid to the creation of a safer work environment for long distance heavy vehicle drivers.

Work Environment-Related Factors in Obtaining and Maintaining Work in a Competitive Employment Setting for Employees with Intellectual Disabilities: A Systematic Review.

Background People with an intellectual disability value work as a significant part of their lives, and many of them want to participate in regular paid employment. Current estimates show that the number of people with ID who have some form of paid employment are very low, ranging from 9 to 40 % across different countries, despite legislations. This review examines papers published in the past 20 years in an attempt to answer the following research question: ‘What work environment-related factors contribute to obtaining or maintaining work in competitive employment for people with an intellectual disability?’ Method The databases of PubMed, PsycINFO, CINAHL, Embase and Web of Science were searched for relevant papers published between 1993 and 2013. All papers were independently screened by two researchers. Methodological quality of the studies was evaluated, and data on work environment-related factors stimulating employment for people with intellectual disabilities were extracted and grouped into categories. Results A total of 1932 articles were retrieved. After extensive screening for relevance and quality, 26 articles were included in this review. Four themes/categories with work environment-related factors that could influence work participation were distinguished. Five studies were conducted on employers’ decisions and opinions. Eight focused on job content and performance, and eight on workplace interaction and culture. Five studies evaluated support by job coaches. Conclusion Despite ongoing legislation to promote participation of people with intellectual disabilities in the paid workforce, research in this area is still extremely scarce. In the past 20 years, very few studies have focused on work environment-related factors that can enhance competitive work for people with intellectual disabilities. This review shows that relevant work environment-related factors for obtaining and maintaining work in competitive employment include supporting the employers by paying specific attention to: employer’s decisions, job content, integration and work culture and job coaches. Electronic supplementary materialThe online version of this article (doi:10.1007/s10926-015-9586-1) contains supplementary material, which is available to authorized users.