Bryan Cleal

Hazard scenarios of truck drivers’ occupational accidents on and around trucks during loading and unloading

Recent epidemiological studies have shown that there is a clear need for efforts to prevent non-traffic occupational injuries among truck drivers. The objective of the present study was to establish the hazard scenarios for truck drivers during loading/unloading through analyses of text descriptions of accident processes. Focus was on accidents that were primarily related to movement/operation on and around the truck, which are particular to truck drivers. Special emphasis was placed on falls from heights, as this was shown to be the most frequent type of accident and a major cause of fractures among truck drivers. Analyses of text descriptions of 136 accidents, including 63 cases of fall from height, collected in one company over a period of three years, revealed that: (a) the major triggering factors for falls from heights on and around the truck were stepping off the edge at height (33.3%), wrong footing (27.0%), and loss of balance/control of wagon (15.9%); (b) the major triggering factors for accidents on and around the truck in general were slip/trip (44.1%) and defect/malfunction (14.7%). The present study identified four target areas for improving prevention of occupational accidents of truck drivers in connection with movement/operation on and around trucks during loading/unloading: (1) improvement of the procedures for unloading to reduce the risk of fall from the back-hatch lift, (2) improvements of shoes and housekeeping to reduce the risk of slip/trip, (3) improvement of truck maintenance, and (4) reconciliation of views on causes of accidents between employers and truck drivers as a first step for a dialogue for improving safety in the goods-transport branch.

Work, Diabetes and Obesity: A Seven Year Follow-Up Study among Danish Health Care Workers

Objectives The rise in prevalence of diabetes is alarming and research ascribes most of the increase to lifestyle. However, little knowledge exists about the influence of occupational factors on the risk for developing diabetes. This study estimates the importance of work and lifestyle as risk factors for developing diabetes mellitus among healthcare workers and explores the association of work factors and obesity, which is a risk factor for diabetes. Methods Questionnaire-based prospective cohort study among 7,305 health care workers followed for seven years in the Danish National Diabetes Register. We used bivariate comparisons to give an unadjusted estimate of associations, followed by adjusted survival analysis and logistic regression models to estimate the influences of potential risk factors related to job, health and lifestyle on diabetes and obesity. Results During seven years of follow up, 3.5% of participants developed diabetes, associated with obesity (HR  =  6.53; 95% CI 4.68–9.10), overweight (HR  =  2.89; CI 2.11–3.96) age 50–69 y (HR  =  2.27; 95% CI 1.57–3.43) and high quality of leadership (HR  =  1.60; CI 1.19–2.16). Obesity at baseline was most common among the youngest employees, and was mainly associated with developing diabetes (OR  =  3.84; CI 2.85–5.17), impaired physical capacity and physical inactivity. In the occupational setting, obesity was associated with shift work, severe musculoskeletal pain, low influence, but also by good management, fewer role conflicts and a positive work-life balance. Looking only at non-smokers, removed the influence of age and pain. However, non-smokers also had higher depression scores and more role conflicts. Conclusions Confirming obesity as the strongest risk factor for developing diabetes, the present study identified few occupational risk factors. However, obesity, the key risk factor for diabetes, had a more variable relation with work than did diabetes.

Online Peer-to-Peer Communities in the Daily Lives of People With Chronic Illness: A Qualitative Systematic Review

This qualitative systematic review investigated how individuals with chronic illness experience online peer-to-peer support and how their experiences influence daily life with illness. Selected studies were appraised by quality criteria focused upon research questions and study design, participant selection, methods of data collection, and methods of analysis. Four themes were identified: (a) illness-associated identity work, (b) social support and connectivity, (c) experiential knowledge sharing, and (d) collective voice and mobilization. Findings indicate that online peer-to-peer communities provide a supportive space for daily self-care related to chronic illness. Online communities provided a valued space to strengthen social ties and exchange knowledge that supported offline ties and patient–doctor relationships. Individuals used online communities to exchange experiential knowledge about everyday life with illness. This type of knowledge was perceived as extending far beyond medical care. Online communities were also used to mobilize and raise collective awareness about illness-specific concerns.

Why do people with suboptimal health avoid health promotion at work

OBJECTIVES To explore why people who have active work and who experience suboptimal health avoided using a multipurpose in-house health promotion service in the Danish police. METHODS Data were first collected via an electronic survey (N=6060) and subsequently via 25 telephone interviews targeting nonusers who perceived their health to be suboptimal. RESULTS Many nonusers with suboptimal health wished to change health behaviors, but did not use the service. Reasons were both individual (eg, laziness) and organizational (eg, delivery of the service). CONCLUSIONS Although many reported barriers are more individual in nature, increased information and accessibility could serve to increase participation.

Exploring the Experiences of People With Hypo- and Hyperthyroidism

Thyroid diseases evoke a complex range of psychological and physical symptoms. The psychosocial aspects of living with diseases causing hypo- or hyperthyroidism are poorly understood. In this article, we report the findings of a qualitative interview study in which we explored the lived experiences of 16 people with hypo- or hyperthyroidism. We purposefully selected participants from Danish outpatient clinics according to their diagnosis (Hashimoto’s thyroiditis or Graves’ disease with or without orbitopathy), age (18 to 65 years), and duration of treatment (more than 6 months). We used interpretative phenomenological analysis (IPA) as a theoretical frame and analytical approach and identified three superordinate themes: losing control over mental and physical states, ambiguous signs of disease, and negotiating sickness. We discuss the findings in the context of the recent literature on chronic illness and argue that these themes play an important role in the conceptualization and management of thyroid diseases.

Diabetes and work: 12-year national follow-up study of the association of diabetes incidence with socioeconomic group, age, gender and country of origin

Aims: To investigate the extent and socioeconomic distribution of incident diabetes among the Danish working-age population. Methods: The Danish National Diabetes Register was linked with socioeconomic and population-based registers covering the entire population. We analysed the 12-year diabetes incidence using multivariate Poisson regression for 2,086,682 people, adjusting for gender, 10-year age groups, main population groups defined by country of origin, and seven socioeconomic groups: professionals, managers, technicians, workers skilled at basic level, unskilled workers, unemployed and pensioners. Results: The crude 12-year incidence of diabetes was 5.8%. The saturated multivariate model, adjusted for gender, age, country of origin and socioeconomic status; showed a relative risk (RR) for diabetes incidence of 1.44 for male (reference: female), 3.95 for the age range of 50–59 years (reference: 30–39 years), 2.07 for unskilled workers (reference: professionals) and 2.15 for people from countries of ‘non-Western origin’ (reference: Danish origin). Conclusions: Diabetes incidence increases with age, male gender and low socioeconomic status; and also among people from countries of ‘non-Western origin’. The results indicate that getting a more senior workforce will substantially increase the proportion of workers with diabetes, especially among already vulnerable groups.

The Relationship Between Self-Efficacy and Help Evasion

Objective. To examine the relationship between self-efficacy and not wanting help to change health behaviors. Method. All employees in the Danish police department were invited to respond to an electronic questionnaire. All respondents expressing a desire to change health behaviors in relation to smoking (n = 845), alcohol (n = 684), eating (n = 4431), and physical activity (n = 5179) and who subsequently responded to questions on self-efficacy were included. Results. Both the bivariate and multiple regression analyses showed that all four specific self-efficacy scores were positively related to reporting that one did not want help. Conclusion. A high belief in one’s own ability to change lifestyle behaviors in relation to smoking, alcohol, eating, and physical activity may lead to avoidance of help offers in a workplace setting.

Hospital contacts due to injuries among male drivers working for road goods-transport contractors in Denmark

OBJECTIVES To establish a detailed picture of injury pattern among professional goods-transport drivers in Denmark. METHODS For each calendar year over the period of 1995-2003, the age-standardized hospital contact ratios (SHRs) for injury were calculated for male drivers working for road goods-transport contractors in Denmark. The reference population was the male skilled/semiskilled subpopulation of the general workforce in Denmark. RESULTS No differences in the rate of injury-related hospital contact could be found between male goods-transport drivers and the reference population between 1995 and 1999. However, in the following period of 2000-2003, elevated rates of injury-related hospital contact were noted among goods-transport drivers, compared with the reference population. Furthermore, the injury-related SHR of goods-transport drivers showed a significant increase throughout the period of 1995-2003. Injuries to ankles/feet/toes were prominent among goods-transport drivers. Compared with the reference population, male goods-transport drivers had elevated rates of superficial injuries, dislocations/sprains/strains, fractures, and concussion. The superficial injuries were sustained most frequently in the ankles/feet/toes, open wounds in head/neck, dislocations/sprains/strains in ankles/feet/toes, and fractures in wrists/hands/fingers and ankles/feet/toes. CONCLUSION There is a clear need for efforts to prevent work injuries among goods-transport drivers. Special attention should be paid to preventing fractures in wrists/hands/fingers and ankles/feet/toes, dislocations/sprains/strains in ankles/feet/toes, open wounds in head/neck, and concussion.

Help Preferences Among Employees Who Wish to Change Health Behaviors

Objective. To examine the help preferences of employees in the Danish police who had acknowledged that they wished to change health behaviors. In addition, we explored whether preferences varied with age, gender, chronic health concerns, positive expectations of good health, and past experiences of in-house health promotion services (i.e., wellness service). Methods. Respondents to an electronic questionnaire who acknowledged wishing to change health behaviors in relation to smoking (n = 845), alcohol (n = 684), eating (n = 4,431), and physical activity (n = 5,179) were asked to choose up to three help alternatives on a predefined list. Results. In descending order, smokers preferred help from nicotine gum, no help, and help and support from family and friends. Alcohol consumers preferred no help or help and support from family and friends or “other” forms. Employees who wanted to change eating habits preferred a free fruit bowl, free nutritional guidance, and healthy food at work. Employees who wanted to change physical activity patterns preferred exercise at work, offers of free exercise, and exercise in a social/collegial context. Conclusion. Wishing to change health behaviors is not always accompanied by perceiving a need for assistance. The no-help option was selected fairly frequently and mostly in relation to alcohol and smoking. A fruit bowl was the most preferred option for help, followed by exercise at work and free exercise. Help from traditional health services was ranked low, possibly reflecting that they are primarily viewed as a solution for stopping disease rather than promoting health.

Diabetes and depression in Denmark 1996-2010: national data stratified by occupational status and annual income

To assess the socio‐economic distribution of comorbid depression and diabetes among the Danish workforce using national registry data.