Anne Pohrt

Occupational exposure to respirable crystalline silica and chronic non-malignant renal disease: systematic review and meta-analysis

BackgroundWhile occupational exposure to respirable silica is known to lead to lung disease, most notably silicosis, its association with chronic kidney disease is unclear.ObjectivesThis review explores the association between occupational exposure to respirable silica and chronic non-malignant renal disease such as glomerulonephritis. The evidence has been collected and compiled. Possible sources of bias are thoroughly discussed.MethodsCohort studies with silica exposure and case–control studies of renal disease were searched in PubMed until January 2015. Two authors independently abstracted data; any disagreement was resolved by consulting a third reviewer. A meta-analysis was performed to evaluate the association to silica exposure.ResultsA total of 23 cohort and four case–control studies were included in the analysis. The meta-analysis of cohort studies yielded elevated overall SMRs for renal disease. Some studies, however, included dose–response analyses, most of which did not show a positive trend. The approaches and results of the case–control studies were very heterogeneous.ConclusionsWhile the studies of cohorts exposed to silica found elevated SMRs for renal disease, no clear evidence of a dose–response relationship emerged. The elevated risk may be attributed to diagnostic and methodological issues. In order to permit a reliable estimation of a possible causal link, exposed cohorts should be monitored for renal disease, as the information from mortality studies is hardly reliable in this field.

Arbeit und Gesundheit

ZusammenfassungHintergrundFragen zum Zusammenhang von Arbeitsfaktoren einerseits und psychischer und physischer Gesundheit der Beschäftigten andererseits sind in Deutschland aktuell und werden weiter aktuell bleiben.FragestellungInzwischen liegt hierzulande eine Reihe von Datensätzen vor, die Daten sowohl zu Arbeit als auch Gesundheit enthalten. Oft allerdings sind sie Wissenschaftler(inne)n, die in diesem Themenfeld tätig sind, nicht bekannt. Ziel des Beitrags ist, diese Datensätze systematisch vorzustellen.Material und MethodeInhalt und Hintergrunddaten umfassender, zugänglicher, aktueller und für die deutsche Erwerbsbevölkerung repräsentativer Datensätze wurden 13 Hauptkategorien und 97 Unterkategorien zugeordnet.ErgebnisVon 32 Datensätzen erfüllten 20 die Einschlusskriterien. 2537 Fragebogenitems wurden klassifiziert; 8 Datensätze haben den Schwerpunkt „Arbeit“, 4 den Schwerpunkt „Gesundheit“, 4 sind allgemeine Bevölkerungsstudien, und 4 sind europäische Studien mit deutschen Teilstichproben. Neben der tabellarischen Auflistung im Artikel steht Interessierten eine detaillierte Exceltabelle zu Verfügung (info-zentrum@baua.bund.de).SchlussfolgerungenDie vorliegende Übersicht zeigt Fülle und auch Potenziale der aktuellen Datenlage zu „Arbeit und Gesundheit“ in Deutschland auf. Potenziale schließen die Verknüpfungen von Datenquellen ein. Es mangelt allerdings noch an landesweiten Kohortenstudien über das gesamte Altersspektrum des Erwerbsalters mit umfassender Erfassung von Arbeit und Gesundheit. Deren Potenzial für Wissenschaft und Gesellschaft lässt sich aus Nordamerika, Großbritannien, den Niederlanden, Skandinavien und Japan ableiten.AbstractBackgroundIssues concerning the association of work with physical and psychological health among workers are and will remain relevant in Germany.ObjectivesCurrently, there are many data sets available covering both work and health aspects; however, they are often not known to the scientists in the field. The aim of this article is to present these data sets in a systematic overview.MethodsContent and background data of recent large and accessible data sets representative for the working population were classified into 13 main categories and 97 subcategories.ResultsOut of 32 data sets available 20 fulfilled the inclusion criteria. A total of 2537 items were classified: 8 data sets with the main topic “work”, 4 studies with a focus on “health”, 4 general population studies and 4 European studies with German subsamples. In addition to the table overview given in this article, those interested can obtain access to a detailed excel file via info-zentrum@baua.bund.de.ConclusionThis overview of data sets indicates the breadth and potential of current data concerning work and health in Germany. Among the potential s may be data linkage of different sources. What is lacking, however, is a nationwide cohort study covering work and health in detail and for all age groups of workers. The benefit of such investigations for science and society can be derived from North America and Canada, the UK, the Netherlands, Scandinavia and Japan.

Non-enhanced MR imaging for preinterventional assessment of the angioarchitecture in vein of Galen malformations

Background and purpose Endovascular treatment of vein of Galen malformations (VGMs) requires sufficient preceding MR imaging. Standardized, preinterventional, non-invasive imaging has not been established. Our study is the first to examine the role of a dedicated, standardized, non-invasive imaging protocol in the evaluation of VGM angioarchitecture by non-contrast MRI/MR angiography. Materials and methods We retrospectively evaluated a consecutive series of VGM patients who underwent a 1.5 T MRI protocol, including standard T2 weighted images (T2WI), arterial time of flight (TOF), and thin T2WI without flow compensation (T2OffPh). The primary outcome was the proportion of patients in whom VGM subtypes and all arterial feeders (anterior (AChA) and posterior (PChA) choroidal arteries, pericallosal arteries, basilar tip, and leptomeningeal supply) could be accurately identified compared with a DSA gold standard. Results A total of 26 VGM patients who underwent 108 studies were used in the statistical analysis. VGM subtype was best seen in axial T2OffPh (92.1%) and TOF (89.8%). AChA feeders were best seen in TOF (86.5%) and axial T2OffPh (72.2%). PChA feeders were best seen in TOF (95.1%) and axial T2OffPh (88.1%). Pericallosal feeders were best seen in axial T2OffPh (95.4%) and TOF (95.1%). Basilar tip feeders were best seen in TOF (90.6%) and axial T2OffPh (88.4%). Conclusion VGM angioarchitecture is best seen in TOF and axial T2OffPh. It can be used as an alternative to global angiographic series.

12-month trajectories of depressive symptoms among nurses—Contribution of personality, job characteristics, coping, and burnout

BACKGROUND Job related factors have been associated with higher risk for developing depression, but past studies lacked full consideration of individual factors such as personality and coping. We sought to evaluate associations of personality, coping, job characteristics, and burnout with 12-month trajectories of depressive symptoms among nursing workers. METHODS Cohort of nursing workers (N = 281) in a private hospital system, with baseline assessments of personality, job characteristics, and coping. Burnout and depression were measured at baseline and during monthly follow-ups. Linear mixed modeling was used to examine contributions to between- and within-individual variation in monthly depressive symptoms. RESULTS Personality trait of negative affectivity accounted for 36% of between-individual variation in depressive symptoms over 12 months, while job characteristics and coping explained an additional 5% and 8% of this variation, respectively. Exhaustion dimension of burnout was associated with between-individual variation in depressive symptoms (fixed effect β coefficient 2.44, p < 0.001), but not with within-individual variation in symptoms. Disengagement dimension of burnout was not associated with between-individual variation in depressive symptoms, but contributed to within-individual variation in depressive symptoms over time (fixed effect β coefficient 0.52, p = 0.01). LIMITATIONS Participants were nursing workers within a single hospital system. Participants who were excluded due to missing baseline data were more likely of non-white race, which may also limit the generalizability of our results. We used latent variables to represent certain job and coping characteristics, which may make our results less comparable with other studies examining the role of these factors in work-associated depression. CONCLUSIONS Future interventions to prevent depression in healthcare workers should consider multiple job and individual factors. Potential components include strategies to manage negative affectivity and reduce avoidant coping, such as cognitive reframing and mindfulness-based techniques, and organizational approaches to address burnout through augmentation of job resources.

Does age modify the association between psychosocial factors at work and deterioration of self-rated health?

Objectives Few epidemiological studies have examined whether associations of psychosocial working conditions with risk of poor health differ by age. Based on results from mostly cross-sectional studies, we test whether (i) psychosocial relational factors (social support) are more strongly associated with declining health of older than younger employees and (ii) psychosocial job factors (workpace, influence, possibilities for development) are more strongly associated with declining health of younger than older employees. Methods We extracted two cohorts from the Danish Work Environment Cohort Study (DWECS): the 2000-2005 and 2005-2010 cohorts. The participating 5281 employees with good self-rated health (SRH) at baseline were observed in 6585 5-year time windows. Using log-binomial regression analyses, we analysed whether psychosocial factors at work predicted 5-year deterioration of SRH. Effect modification by age was estimated by calculating relative excess risk due to interaction (RERI). Results High workpace among men, low influence at work as well as low social support from colleagues among women, and low possibilities for development and low social support from supervisors among both genders predicted 5-year decline in SRH. Of the 20 interaction analyses, only 1 was statistically significant and in the opposite direction of what was hypothesized (higher risk for declining SRH among middle-aged men with low possibilities for development compared to the young men with high possibilities for development). Conclusions Psychosocial working conditions predicted decline in SRH in this 5-year follow-up study. The model did not support our hypotheses about modifying effects by age.

The association of health and voluntary early retirement pension and the modifying effect of quality of supervision: Results from a Danish register-based follow-up study:

Objectives: The aims of this article are to (1) determine whether and to what extent general perceived health and quality of supervision predict voluntary early retirement pension (VERP) and (2) assess whether quality of supervision modifies the association between general perceived health and VERP. Methods: Employees aged 49–64 years who participated in the Danish Work Environment Cohort Study in 2000 were selected. Their questionnaire data about health and work were linked to register data on social transfer payments, among others VERP, from 2001 to 2012 in the Danish Register for Evaluation of Marginalization (N=1167). Cox proportional hazards analyses were performed to identify the prospective association of general perceived health and quality of supervision on VERP. Relative excess risks due to interaction (RERIs) were calculated to assess whether quality of supervision modified the association between health and VERP. Results: Employees with poor health at baseline had an increased risk of VERP during follow-up (hazard ratio [HR]=1.23; 95% confidence interval [CI] 1.02–1.49). Quality of supervision at baseline was not associated to VERP during follow-up (HR=1.04; 95% CI 0.90–1.21). There was no statistically significant interaction of poor health and poor quality of supervision with regard to risk of VERP (RERI=−0.33; 95% CI −1.79 to 1.14). Conclusions: This study did not support the notion that quality of supervision buffers the association between poor health and VERP. Future research is needed to determine whether other aspects of supervision, for example supervisors’ opportunities to effectuate workplace adjustments, may modify the association of poor health and VERP.

Zusammenhang von Arbeitsunfähigkeit und arbeitsbedingten psychischen Faktoren@@@Association between sick leave and work-related psychological factors: Analyse der BIBB/BAuA-Erwerbstätigenbefragung 2005/2006@@@Results from the BIBB/BAuA labour force survey 2005/2006

ZusammenfassungHintergrundDie Zahl der Krankheitstage durch psychische Störungen ist in den letzten Jahren deutlich angestiegen, weshalb psychische Faktoren aus der Arbeitsumwelt zunehmend in den Blickpunkt des Interesses geraten. Ziel dieser Arbeit war es, Assoziationen von arbeitsbedingten Faktoren wie Arbeitszufriedenheit und Arbeitsplatzunsicherheit mit dem Risiko für Arbeitsunfähigkeit und Langzeitarbeitsunfähigkeit zu analysieren.Material und MethodenDie Untersuchung erfolgte auf Basis der BIBB/BAuA-Erwerbstätigenbefragung 2005/2006. Mithilfe logbinomialer Regression wurden Schätzer für die Assoziation ermittelt.ErgebnisseSchlechte Arbeitszufriedenheit und subjektive Arbeitsplatzunsicherheit sind positiv mit dem Risiko für Arbeitsunfähigkeit assoziiert, objektive Kriterien der Arbeitsplatzunsicherheit sind jedoch negativ mit dem Risiko für Arbeitsunfähigkeit assoziiert.SchlussfolgerungAuf Basis dieser Ergebnisse lassen sich keine Kausalaussagen hinsichtlich des Zusammenhangs von Arbeitszufriedenheit (bzw. Arbeitsplatzunsicherheit) ableiten. Es zeigt sich jedoch eine starke und konsistente Assoziation, deren Ursachen in weiteren Untersuchungen betrachtet werden sollten.AbstractBackgroundSick leave due to mental illness has been increasing continuously in recent years: therefore, work-related psychological factors have come into focus. The aim of this study was to examine associations between work-related measures (e.g. job satisfaction and job insecurity) and the risk of (long-term) sick leave.MethodsData from the representative BIBB/BAuA labour force survey 2005/2006 and log-binomial regression were used to estimate associations.ResultsLow job satisfaction and perceived job insecurity are consistently associated with a higher risk for sick leave, whereas objective measures of job insecurity (private enterprise, self-employment) are associated with a lower risk.ConclusionsThe survey structure makes it impossible to infer a causal connection; however, the causes for the association between low job satisfaction, job insecurity and sick leave should be examined further.

Zusammenhang von Arbeitsunfähigkeit und arbeitsbedingten psychischen FaktorenAssociation between sick leave and work-related psychological factors

ZusammenfassungHintergrundDie Zahl der Krankheitstage durch psychische Störungen ist in den letzten Jahren deutlich angestiegen, weshalb psychische Faktoren aus der Arbeitsumwelt zunehmend in den Blickpunkt des Interesses geraten. Ziel dieser Arbeit war es, Assoziationen von arbeitsbedingten Faktoren wie Arbeitszufriedenheit und Arbeitsplatzunsicherheit mit dem Risiko für Arbeitsunfähigkeit und Langzeitarbeitsunfähigkeit zu analysieren.Material und MethodenDie Untersuchung erfolgte auf Basis der BIBB/BAuA-Erwerbstätigenbefragung 2005/2006. Mithilfe logbinomialer Regression wurden Schätzer für die Assoziation ermittelt.ErgebnisseSchlechte Arbeitszufriedenheit und subjektive Arbeitsplatzunsicherheit sind positiv mit dem Risiko für Arbeitsunfähigkeit assoziiert, objektive Kriterien der Arbeitsplatzunsicherheit sind jedoch negativ mit dem Risiko für Arbeitsunfähigkeit assoziiert.SchlussfolgerungAuf Basis dieser Ergebnisse lassen sich keine Kausalaussagen hinsichtlich des Zusammenhangs von Arbeitszufriedenheit (bzw. Arbeitsplatzunsicherheit) ableiten. Es zeigt sich jedoch eine starke und konsistente Assoziation, deren Ursachen in weiteren Untersuchungen betrachtet werden sollten.AbstractBackgroundSick leave due to mental illness has been increasing continuously in recent years: therefore, work-related psychological factors have come into focus. The aim of this study was to examine associations between work-related measures (e.g. job satisfaction and job insecurity) and the risk of (long-term) sick leave.MethodsData from the representative BIBB/BAuA labour force survey 2005/2006 and log-binomial regression were used to estimate associations.ResultsLow job satisfaction and perceived job insecurity are consistently associated with a higher risk for sick leave, whereas objective measures of job insecurity (private enterprise, self-employment) are associated with a lower risk.ConclusionsThe survey structure makes it impossible to infer a causal connection; however, the causes for the association between low job satisfaction, job insecurity and sick leave should be examined further.

Zusammenhang von Arbeitsunfähigkeit und arbeitsbedingten psychischen Faktoren

ZusammenfassungHintergrundDie Zahl der Krankheitstage durch psychische Störungen ist in den letzten Jahren deutlich angestiegen, weshalb psychische Faktoren aus der Arbeitsumwelt zunehmend in den Blickpunkt des Interesses geraten. Ziel dieser Arbeit war es, Assoziationen von arbeitsbedingten Faktoren wie Arbeitszufriedenheit und Arbeitsplatzunsicherheit mit dem Risiko für Arbeitsunfähigkeit und Langzeitarbeitsunfähigkeit zu analysieren.Material und MethodenDie Untersuchung erfolgte auf Basis der BIBB/BAuA-Erwerbstätigenbefragung 2005/2006. Mithilfe logbinomialer Regression wurden Schätzer für die Assoziation ermittelt.ErgebnisseSchlechte Arbeitszufriedenheit und subjektive Arbeitsplatzunsicherheit sind positiv mit dem Risiko für Arbeitsunfähigkeit assoziiert, objektive Kriterien der Arbeitsplatzunsicherheit sind jedoch negativ mit dem Risiko für Arbeitsunfähigkeit assoziiert.SchlussfolgerungAuf Basis dieser Ergebnisse lassen sich keine Kausalaussagen hinsichtlich des Zusammenhangs von Arbeitszufriedenheit (bzw. Arbeitsplatzunsicherheit) ableiten. Es zeigt sich jedoch eine starke und konsistente Assoziation, deren Ursachen in weiteren Untersuchungen betrachtet werden sollten.AbstractBackgroundSick leave due to mental illness has been increasing continuously in recent years: therefore, work-related psychological factors have come into focus. The aim of this study was to examine associations between work-related measures (e.g. job satisfaction and job insecurity) and the risk of (long-term) sick leave.MethodsData from the representative BIBB/BAuA labour force survey 2005/2006 and log-binomial regression were used to estimate associations.ResultsLow job satisfaction and perceived job insecurity are consistently associated with a higher risk for sick leave, whereas objective measures of job insecurity (private enterprise, self-employment) are associated with a lower risk.ConclusionsThe survey structure makes it impossible to infer a causal connection; however, the causes for the association between low job satisfaction, job insecurity and sick leave should be examined further.