Musculoskeletal Pain and Depressive Symptoms as Predictors of Trajectories in Work Ability Among Finnish Firefighters at 13-Year Follow-Up

Objective: To identify work ability trajectories among Finnish firefighters during a 13-year follow-up. We examined whether baseline musculoskeletal pain and depressive symptoms (DPS) predicted membership of the trajectories.
Methods: We studied 411 male firefighters who responded to a questionnaire at both baseline and at least one of two follow-ups. The outcome variable was perceived work ability (0 to 10). The predictors were musculoskeletal and depressive symptoms. Covariates included age, diseases, lifestyle habits, and work-related factors.
Results: One fourth of the firefighters belonged to the Diminished work ability trajectory. Musculoskeletal and depressive symptoms, lifestyle risks and diseases, and, in separate analyses, low back pain, were strong predictors of this.
Conclusions: When planning preventive actions and workplace health promotion among firefighters, even one site musculoskeletal pain and mild signs of depression should be taken into account. Prevention of adverse lifestyle habits is also essential.

Source: Punakallio, Anne PhD; Lusa, Sirpa PhD; Luukkonen, Ritva PhD; Airila, Auli MSc; Leino-Arjas, Päivi MD. Journal of Occupational & Environmental Medicine: April 2014 - Volume 56 - Issue 4 - p 367–375.
http://dx.doi.org/10.1097/JOM.0000000000000139

 

La reconstruction professionnelle après un burnout

Pour continuer à s'intégrer dans une vie professionnelle et sociale, un cadre victime de burnout (épuisement professionnel) doit se reconstruire. L'analyse sociologique du parcours de reconstruction post-burnout permet de montrer que les étapes traversées par les victimes sont identiques. Cette même analyse met en évidence les places respectives de la centralité et du sens du travail qui ont un rôle essentiel dans l'identité professionnelle. Cet article propose aux médecins du travail et/ou aux gestionnaires de ressources humaines une trame et une grille de questions à envisager avec la victime pour l'accompagner dans sa reconstruction et permettre de retrouver son identité professionnelle.

Source: http://www.rst-sante-travail.fr/rst/pages-article/ArticleRST.html?ref=RST.TF%20216

Work-related gender differences in physician-certified sick leave

A prospective study of the general working population in Norway
Objectives: This study aimed to examine gender differences in physician-certified sick leave and the extent to which these differences can be explained by work-related psychosocial and mechanical risk factors.
Methods: Randomly drawn from the general population in Norway, the cohort comprised working men and women aged 18–69 years (N=12 255, response rate at baseline = 60.9%). Eligible respondents were interviewed in 2009 and registered with an active employee relationship of ≥100 actual working days in 2009 and 2010 (N=3688 men and 3070 women). The study measured 11 work-related psychosocial factors and 11 mechanical exposures, and outcomes of interest were physician-certified general sick leave (GSL) >0 days and long-term sick leave (LTSL) ≥40 working days during 2010.
Results: Women reported a significantly higher level of exposure to 9 of the 11 psychosocial factors evaluated. For mechanical factors, the reporting was mixed. After controlling for age, educational level, sick leave during 2009, housework, working hours and family status, a 1.7-fold risk for GSL and LTSL were found among women. In comparison with the initial model, adjusting for psychosocial factors reduced the excess risk by 21% and 27% for GSL and LTSL, respectively. The total effect of mechanical factors was negligible. Differences between occupations held by women and men explained an additional one-tenth of the excess risk for LTSL among women.
Conclusions: Work-related psychosocial factors contributed significantly to a higher level of GSL and LTSL among women. The most important factors were demands for hiding emotions, emotional demands, and effort–payment imbalance.

Source: Sterud T. Scand J Work Environ Health. 2014
http://dx.doi.org/10.5271/sjweh.3427

Les facteurs influençant le retour au travail après une dépression

Le point de vue et le rôle des acteurs syndicaux
En 2005, l'Organisation mondiale de la Santé (OMS) stipulait que dans moins d'une décennie, la dépression constituerait une des premières causes d'incapacité avec les maladies cardiovasculaires (World Health Organization, 2005). En effet, on constate une augmentation des prestations d'invalidité attribuables aux troubles mentaux, notamment la dépression. Celles-ci sont à l'origine de plus de 40% de toutes les réclamations d'assurance-salaire (MSSS, 2005). Le retour au travail des employés qui ont dû s'absenter en raison d'une dépression est parfois complexe car il implique plusieurs acteurs. À notre connaissance, peu d'études se sont intéressées au point de vue des acteurs syndicaux quant aux facteurs qui facilitent et qui gênent le retour au travail de personnes aux prises avec une dépression, ainsi qu'à leur rôle dans le processus de retour au travail de ces employés.
L'objectif de cette étude était de mieux comprendre le rôle des acteurs syndicaux dans le retour au travail de personnes ayant vécu une dépression, ainsi que les facteurs qui facilitent et qui gênent ce retour selon leur point de vue. Les questions principales étaient: dans votre rôle d'acteur syndical, qu'avez-vous fait à l'intérieur du processus de retour au travail d'employés qui ont eu une dépression? Selon vous, qu'est-ce qui aide les personnes ayant vécu une dépression à retourner au travail? Qu'est-ce qui nuit ou rend plus difficile leur retour au travail?

Source: http://www.irsst.qc.ca/-publication-irsst-retour-au-travail-apres-une-depression-r-805.html

Is temporary employment a risk factor for work disability due to depressive disorders and delayed return to work?

The Finnish Public Sector Study
Objectives: Research on temporary employment as a risk factor for work disability due to depression is mixed, and few studies have measured work disability outcome in detail. We separately examined the associations of temporary employment with (i) the onset of work disability due to depression, (ii) the length of disability episodes, and (iii) the recurrence of work disability, taking into account the possible effect modification of sociodemographic factors.
Methods: We linked the prospective cohort study data of 107 828 Finnish public sector employees to national registers on work disability (>9 days) due to depression from January 2005 to December 2011.
Results: Disability episodes were longer among temporary than permanent employees after adjustment for age, sex, level of education, chronic somatic disease, and history of mental/behavioral disorders [cumulative odds ratio (COR) 1.37, 95% confidence interval (95% CI) 1.25–51). The association between temporary employment and the length of depression-related disability episodes was more pronounced among participants with a low educational level (COR 0.95, 95% CI 1.54–2.48) and older employees (>52 years; COR 3.67, 95% CI 2.83–4.76). The association was weaker in a subgroup of employees employed for ≥50% of the follow-up period (95% of the original sample). Temporary employment was not associated with the onset or recurrence of depression-related work disability.
Conclusions: Temporary employment is associated with slower return to work, indicated by longer depression-related disability episodes, especially among older workers and those with a low level of education. Continuous employment might protect temporary employees from prolonged work disability.

Source: Ervasti J, Vahtera J, Virtanen P, Pentti J, Oksanen T, Ahola K, Kivimäki M, Virtanen M. Scand J Work Environ Health. 2014.
http://dx.doi.org/10.5271/sjweh.3424

Remain in Work—What Work-Related Factors Are Associated With Sustainable Work Attendance

A General Population-Based Study of Women and Men
Objective: To analyze if organizational climate and work commitment, demand and control, job strain, social support, and physical demands at work are associated with remain in work (RIW), that is, work attendance without sick leave over 15 days per year.
Methods: This Swedish cross-sectional study was based on 4013 workers (aged 19 to 64 years), randomly selected from a general population. Data were collected (2008) through postal questionnaire and registers.
Results: Fair organizational climate, the combination of fair organizational climate and fair work commitment, high control, and low physical demands were associated with RIW for women and men.
Conclusions: This study adds to the rather scarce research findings on factors that promote RIW by identifying work organizational factors and physical prerequisites as being important. Preventive work to create a healthy work environment could be directed at improving organizational climate and reducing physical demands.

Source : Holmgren, Kristina PhD; Löve, Jesper PhD; Mårdby, Ann-Charlotte PhD; Hensing, Gunnel PhD. Journal of Occupational & Environmental Medicine: March 2014 - Volume 56 - Issue 3 - p 235–242.
http://dx.doi.org/10.1097/JOM.0000000000000096

Travailler avec une maladie chronique

Les 10 recommandations de la Déclaration de Bruxelles
Pendant deux ans, les représentants de 28 pays européens - dont l'Anact et l'Aract Aquitaine pour la France - ont travaillé sur le thème du maintien dans l'emploi des personnes atteintes d'une maladie chronique évolutive. Venant conclure ces travaux, la "déclaration de Bruxelles" présente 10 recommandations à destination des employeurs et des gouvernements.

Source: http://www.anact.fr/web/actualite/essentiel?p_thingIdToShow=36337649

Développement d’un indice radiologique représentatif de la fonction de l’épaule chez des travailleurs souffrant de rupture de la coiffe des rotateurs

Les problèmes chroniques de douleur et de perte de fonction de l'épaule touchent jusqu'à 20 % des adultes (Pope, Croft et coll., 1997). La proportion serait encore plus élevée chez les adultes âgés de plus de 50 ans. Au Québec, la Commission de la santé et de la sécurité au travail du Québec (CSST) rapporte que, pour les années 2003 à 2006, les lésions à l'épaule représentaient 39% des 32 549 lésions inflammatoires dues à un travail répétitif ou à un traumatisme. Les lésions à l'épaule ont requis en moyenne 75,4 jours d'absence du travail et 4 533 $ en indemnités de remplacement du revenu (IRR) par travailleur. En comparaison, les lésions au membre inférieur représentaient moins de 10 % des lésions rapportées et ont requis en moyenne 39,5 jours d'absence et des IRR de 2 439 $ par travailleur (CSST, 2007). Ces chiffres montrent non seulement l'importance du problème, mais aussi que les lésions à l'épaule nécessitent proportionnellement plus de temps pour retrouver une fonction adéquate et permettre un retour durable au travail. Ceci témoigne de l'importance d'identifier rapidement les personnes à risque de développer des problèmes de fonction à l'épaule afin de les orienter vers des programmes de réadaptation efficaces et adaptés.

Source: http://www.irsst.qc.ca/-publication-irsst-indice-radiologique-representatif-fonction-de-epaule-r-812.html

Workplace strength training prevents deterioration of work ability among workers with chronic pain and work disability

A randomized controlled trial
Objective Imbalance between work demands and individual resources can lead to musculoskeletal disorders and reduced work ability. The aim of this study was to evaluate the effect of two contrasting interventions on work ability among slaughterhouse workers with chronic pain and work disability.
Methods Sixty-six slaughterhouse workers with upper-limb chronic pain and work disability were randomly allocated to 10 weeks of either strength training for the shoulder, arm, and hand muscles (3 times per week, 10 minutes per session) or ergonomic training (usual care control group) from September to December 2012. The outcome measure was the change from baseline to 10-week follow-up in the work ability index (WAI).
Results A priori hypothesis testing showed a group×time interaction for WAI (P<0.05). Compared with the ergonomic training group, WAI increased 2.3 [95% confidence interval (95% CI) 0.9–3.7] in the strength training group corresponding to a moderate effect size (Cohen's d 0.52). Within-group changes indicated that between-group differences were mainly caused by a reduction in WAI in the ergonomic group. Of the 7 items of WAI, item 2 (work ability in relation to the demands of the job) and item 7 (mental resources) increased following strength training compared with ergonomic training (P<0.05).
Conclusions Implementation of strength training at the workplace prevents deterioration of work ability among manual workers with chronic pain and disability exposed to forceful and repetitive job tasks. Thus, strength training performed at the workplace may in fact be regarded as a complex biopsychosocial intervention modality that reaches further than the specific physiological benefits of training per se.

Source: Sundstrup E, Jakobsen MD, Brandt M, Jay K, Persson R, Aagaard P, Andersen LL. Scand J Work Environ Health.
http://dx.doi.org/10.5271/sjweh.3419

Santé mentale au travail

Projet-pilote pour passer d'une approche individuelle de réadaptation à une approche organisationnelle de prévention
Les problèmes de santé mentale au travail représentent actuellement l'une des plus importantes causes d'absence du travail, et ce phénomène a connu une croissance marquée au cours des dernières années. Nos travaux antérieurs ont révélé que la majorité des travailleurs qui se sont absentés en raison d'un problème de santé mentale font référence aux difficultés vécues dans le cadre de leur activité professionnelle comme facteur ayant contribué à la détérioration de leur état de santé et de leur arrêt de travail, d'où l'importance d'orienter les pratiques de retour au travail vers la modification des facteurs de l'organisation du travail. L'objectif général de ce projet est de tracer le passage d'une démarche individuelle de soutien au retour au travail et au maintien en emploi des travailleurs qui se sont absentés en raison d'un problème de santé mentale à une démarche organisationnelle visant la prévention des problèmes de santé mentale dans le milieu de travail. Ce projet s'inscrit dans le prolongement d'une étude visant la conception, l'implantation et l'évaluation d'une démarche de soutien au retour au travail réalisée dans un centre de santé et de services sociaux (St-Arnaud et coll., 2011).

Source: http://www.irsst.qc.ca/-publication-irsst-sante-mentale-au-travail-r-807.html

Outcomes of the introduction of a standardized fitness-for-duty evaluation of commercial truck drivers on the incidence of low back injuries and workers' compensation costs

OBJECTIVE: To determine the incidence of low back injuries and associated workers' compensation costs before and after the introduction of a standardized fitness-for-duty evaluation of commercial truck drivers who present for their comprehensive Department of Transportation (DOT) physical examination. METHODS: Trained physical therapists administered questionnaires and performed functional testing of commercial truck drivers scheduled for their DOT examination. The results were communicated to providers performing DOT examinations. Incidence rates of low back injury and associated workers' compensation costs 3 years before and 3 years after the intervention (1999 to 2006) were determined. RESULTS: There was a 54% reduction in the low back pain incidence rate and an associated 45% reduction in workers' compensation costs from 1999 to 2006. CONCLUSIONS: This intervention was associated with a reduced incidence of low back injuries and reduced associated workers' compensation costs in this population.

Source: Berestnev KV, Moffitt GL, Vancil DS, McKenzie J. J. Occup. Environ. Med. 2014.
http://dx.doi.org/10.1097/JOM.0000000000000122

Are work disability prevention interventions effective for the management of neck pain or upper extremity disorders?

A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration
Purpose We conducted a systematic review to critically appraise and synthesize literature on the effectiveness of work disability prevention (WDP) interventions in workers with neck pain, whiplash-associated disorders (WAD), or upper extremity disorders. Methods We searched electronic databases from 1990 to 2012. Random pairs of independent reviewers critically appraised eligible studies using the Scottish Intercollegiate Guidelines Network criteria. Scientifically admissible studies were summarized and synthesized following best-evidence synthesis methodology. Results Of the 6,359 articles retrieved, 16 randomized controlled trials were eligible for critical appraisal and five were admissible. We found that a return-to-work coordination program (including workplace-based work hardening) was superior to clinic-based work hardening for persistent rotator cuff tendinitis. Workplace high-intensity strength training and workplace advice had similar outcomes for neck and shoulder pain. Mensendieck/Cesar postural exercises and strength and fitness exercises had similar outcomes for non-specific work-related upper limb complaints. Adding a brief job stress education program to a workplace ergonomic intervention was not beneficial for persistent upper extremity symptoms. Adding computer-prompted work breaks to ergonomic adjustments and workplace education benefited workers' recovery from recent work-related neck and upper extremity complaints. Conclusions At present, no firm conclusions can be drawn regarding the effectiveness of WDP interventions for managing neck pain, WAD, and upper extremity disorders. Our review suggests a return-to-work coordination program is more effective than clinic-based work hardening. Also, adding computer-prompted breaks to ergonomic and workplace interventions benefits workers' recovery. The current quality of evidence does not allow for a definitive evaluation of the effectiveness of ergonomic interventions.

Source: Varatharajan S, Côté P, Shearer HM, Loisel P, Wong JJ, Southerst D, Yu H, Randhawa K, Sutton D, van der Velde G, Mior S, Carroll LJ, Jacobs C, Taylor-Vaisey A. J. Occup. Rehabil. 2014.
http://dx.doi.org/10.1007/s10926-014-9501-1

The return-to-work process of individuals sick-listed because of whiplash-associated disorder

A three-year follow-up study in a Danish cohort of long-term sickness absentees
BACKGROUND: The chronic course of whiplash-associated disorder (WAD) has implications for both the individual and society. It has been shown that up to 50% of patients have not yet returned to work six months after a whiplash injury. We wanted to study the return-to-work (RTW) process in individuals sick-listed for more than eight weeks in six Danish municipalities. RTW in individuals sick-listed due to WAD was compared to that in those sick-listed for other musculoskeletal disorders (MSD). METHODS: Information about long-term sick-listed individuals in six Danish municipalities was retrieved from an existing database. Data on public transfer income were collected and the RTW process was followed on a weekly basis. Multivariate logistic regression analysis of RTW was done four times during the first three years after the start of sick-listing. RESULTS: One hundred and four individuals were sick-listed due to WAD and 3,204 individuals were sick-listed due to other MSDs. After 6 months, the RTW was significantly lower in the WAD group. OR for RTW in the WAD group was 0.29 (0.18-0.49) compared to the MSD group. The RTW process for both groups stabilised after two years of follow-up; 44% returned to work in the WAD group as compared to 58% in the MSD group. CONCLUSION: Sick-listed individuals with whiplash-associated disorder are less likely to return to work than individuals who are sick-listed because of other musculoskeletal disorders. In both groups, RTW stabilised after two years of follow-up.

Source : Biering-Sørensen S, Møller A, Stoltenberg CD, Holm JW, Skov PG. BMC Public Health. 2014; 14(1): 113.
10.1186/1471-2458-14-113

Les documents de la conférence «Safer and healthier work at any age» sont disponibles en ligne

Une conférence portant sur la sécurité et la santé au travail des travailleurs âgés s'est tenue au Parlement européen en décembre.
La manifestation était organisée dans le cadre d'un projet pilote du Parlement européen mené par l'EU-OSHA à la demande de la Commission européenne, lequel a pour objectif d'améliorer les connaissances au sujet des politiques et programmes actuels, de stimuler l'échange de meilleures pratiques et d'examiner plus en détail les moyens d'améliorer la santé et la sécurité des travailleurs âgés.

Source: https://osha.europa.eu/fr/teaser/safer-and-healthier-work-at-any-age-conference-materials-available-online

Plan cancer 2014-2019 : priorité au retour à l'emploi

François Hollande a présenté le 4 février 2014 le 3e plan cancer, couvrant la période 2014-2019. Le maintien et le retour à l'emploi des personnes atteintes de cancer font partie des axes d'action prioritaires.
Parmi les personnes qui sont en activité lors du diagnostic d'un cancer, trois personnes sur dix ont perdu leur emploi ou l'ont quitté deux ans après. Le 3e plan cancer 2014-2019 se fixe pour objectif d'augmenter de 50% les chances de retour à l'emploi à l'horizon 2020.
Pour celles qui conservent leur emploi, la conciliation avec l'activité professionnelle est très difficile : difficultés à combiner vie professionnelle et traitement thérapeutique ; retentissement de la maladie et des traitements en termes de fatigue, douleur, troubles du sommeil et de la concentration..., voire sentiment de marginalisation et mesures discriminatoires.

Source: http://www.preventica.com/actu-enbref-plan-cancer-retour-emploi-14-19-1050214.php

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