Heidi Janssens

The relation between presenteeism and different types of future sickness absence

The Relation between Presenteeism and Different Types of Future Sickness Absence: Heidi JANSSENS, et al. Department of Public Health, Ghent University, Belgium—

The relation between psychosocial risk factors and cause-specific long-term sickness absence

BACKGROUND The aim was to study the impact of psychosocial risk factors on long-term sickness absence due to mental health problems (LSA-MH) or musculoskeletal disorders (LSA-MSD) in 2983 Belgian middle-aged workers. METHODS Data were collected from 1372 male and 1611 female workers in the Belstress III study. Considered psychosocial risk factors were job demands, job control, social support, job strain, efforts, rewards, effort-reward imbalance and bullying. Prospective registered sickness absence data were collected during 12 months follow-up; the causes for long-term sickness absence episodes of at least 15 consecutive days were obtained by contacting the general practitioner of the worker. Multiple logistic regression models were used to investigate the relationship between the psychosocial risk factors and LSA-MH and LSA-MSD. RESULTS Higher levels of rewards at baseline were independently and significantly associated with a lower risk for LSA-MH. Higher levels of control were associated with a lower risk for LSA-MSD during follow-up. Higher job demands and efforts were significantly related to a lower risk for LSA-MSD. Finally, bullying was significantly and independently related to both LSA-MH and LSA-MSD during the follow-up period. CONCLUSIONS These results suggest that psychosocial risk factors are related to LSA-MH and LSA-MSD, of which especially bullying seems to be a potent stressor.

Association between psychosocial characteristics of work and presenteeism: a cross-sectional study

OBJECTIVES This study aimed at investigating cross-sectional relationships between psychosocial characteristics of work and presenteeism in a sample of Belgian middle-aged workers. MATERIAL AND METHODS Data were collected from 1372 male and 1611 female workers in the Belstress III study. Psychosocial characteristics assessed by the use of self-administered questionnaires were: job demands, job control, social support, efforts, rewards, bullying, home-to-work conflict and work-to-home conflict. Presenteeism was measured using a single item question, and it was defined as going to work despite illness at least 2 times in the preceding year. Logistic regression models were used to investigate the relationship between psychosocial characteristics and presenteeism, while adjusting for several socio-demographic, health-related variables and neuroticism. An additional analysis in a subgroup of workers with good self-rated health and low neuroticism was conducted. RESULTS The prevalence of presenteeism was 50.6%. Overall results, adjusted for major confounders, revealed that high job demands, high efforts, low support and low rewards were associated with presenteeism. Furthermore, a significant association could be observed for both bullying and work-to-home conflict in relation to presenteeism. The subgroup analysis on a selection of workers with good self-rated health and low neuroticism generally confirmed these results. CONCLUSIONS Both job content related factors as well as work contextual psychosocial factors were significantly related to presenteeism. These results suggest that presenteeism is not purely driven by the health status of a worker, but that psychosocial work characteristics also play a role.

Comparison of two case-based learning conditions with real patients in teaching occupational medicine

Abstract Objective: To investigate the impact of three different training formats in occupational medicine (OM) on perceptions and performance of undergraduate students. Methods: A comparative study which included all fourth-year medical students was conducted over a three-year period. The year group in 2010 (211 students) received paper case studies followed by one small group session. The format used in 2011 actively engaged 188 students in the learning process by adding collaborative work and group discussions to the written information. In 2012, the approach comprised no longer constructed text cases but 212 students encountered real patients. Students’ perceptions were obtained by questionnaire. Their learning performance was assessed through review of written reports and score on oral presentations. Statistical differences in ratings were analyzed using Fisher’s exact and Kruskal–Wallis tests. Results: All three formats were found to equally achieve the stated learning objectives. The year groups with incorporation of active learning strategies and patient contacts had significant better test performance compared to those receiving only written case studies. Real patient students gave statistically significant higher rates for relevance, authenticity and appropriate difficulty level of the training than did students who discussed written case studies. Conclusion: Both approaches with augmented interaction in 2011 and 2012, improved performance and satisfaction among students. However, students valued the use of real patients higher than paper-form cases.

Development and evaluation of a new occupational medicine teaching module to advance self-efficacy and knowledge among medical students.

Objectives: Self-efficacy is defined as a persons beliefs in his or her abilities to successfully complete a task, and has been shown to influence student motivation and academic achievement. The purpose of this study was to evaluate the impact of a new European teaching module in occupational medicine on undergraduate students’ self-efficacy and knowledge in the subject matter. Methods: Pre-, in-between, and posttraining tests were used to assess self-efficacy and knowledge building of 261 third-year medical students on occupational health issues. Determinants of self-efficacy and knowledge were also identified. Repeated measurement data were analyzed with multilevel statistical procedures. Results: The level of self-efficacy and knowledge in occupational medicine increased after the training. Students who frequently attended the lectures scored significantly higher than sporadic attendees. There was no relation between the level of self-efficacy and the final knowledge score. Conclusions: Teaching with the new occupational medicine module was effective. Lecture attendance is an important determinant of self-efficacy and performance. Self-efficacy was not associated with knowledge score. Encouraging classroom participation may enhance student achievement.

Hair cortisol in relation to job stress and depressive symptoms

Background Measurement of hair cortisol concentration (HCC) may be used as a biomarker for chronic stress. However, the association between stress and HCC has rarely been investigated in a working population. Aims To explore associations between (i) HCC and various stress measures and (ii) HCC and symptoms of depression in Belgian workers. Methods Hair samples were collected from workers in two production companies and cortisol content was determined by liquid chromatography tandem mass spectrometry. Participants completed a questionnaire including socio-demographics, health behaviours and standardized measures for assessing stress. Results After excluding those workers suffering from a psychiatric or neuroendocrine disease and those treated with glucocorticoids, there were a total of 102 workers with both questionnaire, cortisol results and anthropometric measures. Median HCC was 5.73 pg/mg hair (interquartile range = 4.52-9.06). No significant associations were found between cortisol and the standardized measures related to several work psychosocial risk factors. A significantly lower mean HCC was found in shift workers compared with dayworkers, adjusted for age. Additionally, a significant higher mean HCC was found in workers with symptoms of depression compared with those without symptoms of depression, after adjustment for age. Conclusions HCC showed a limited applicability as a biomarker for job stress in this sample, although the results suggest this method may be a suitable marker for detecting early symptoms of depression. Further research is needed to investigate the applicability of HCC in the working environment and within job stress research.

Relationship between non-standard work arrangements and work-related accident absence in Belgium

The main objective of this study is to examine the relationship between indicators of nonstandard work arrangements, including precarious contract, long working hours, multiple jobs, shift work, and work‐related accident absence, using a representative Belgian sample and considering several sociodemographic and work characteristics.

Health Behaviours As a Mechanism in the Prospective Relation between Workplace Reciprocity and Absenteeism: A Bridge too Far ?

Background The persistent lack of evidence on causal mechanisms between social capital and health threatens the credibility of the social capital—health association. The present study aims to address this ongoing problem by investigating whether health behaviours (i.e. smoking, alcohol consumption, and physical activity) mediate the prospective relation between workplace reciprocity and future sickness absence. Methods A cohort of 24,402 Belgian employees was followed up during 12 months for sickness absence. Workplace reciprocity was measured with four indicators—colleague help, colleague interest, supervisor help, and supervisor concern. Three types of multilevel mediation models were applied. Results Overall, workplace reciprocity negatively related to high sickness absence (≥ 10 days) mainly independently from health behaviours. Uniquely, colleague interest positively related to smoking (OR = 1.058, 95% CI = 1.019, 1.098) and smoking in turn, positively related to sickness absence (OR = 1.074, 95% CI = 1.047, 1.101). No behavioural pathways could be identified between company-level reciprocity and sickness absence, and company-level health-related behaviours did not mediate the relation between company-level reciprocity and individual sickness absence. Conclusions These results suggest that both social capital and health behaviours are relevant for employee health, but health behaviours seem not to be the underlying explanatory mechanism between workplace reciprocity and health.

Reciprocity and depressive symptoms in belgian workers: a cross-sectional multilevel analysis

Objective: This study examines the multidimensional association between reciprocity at work and depressive symptoms. Methods: Data from the Belgian BELSTRESS survey (32 companies; N = 24,402) were analyzed. Multilevel statistical procedures were used to account for company-level associations while controlling for individual-level associations. Results: Different dimensions of individual reciprocity were negatively associated with depressive symptoms. On the company level, only vertical emotional reciprocity was negatively associated (&bgr; = −4.660; SE = 1.117) independently from individual reciprocity (&bgr; = −0.557; SE = 0.042). Complex interactions were found such that workplace reciprocity (1) may not uniformly benefit individuals and (2) related differently to depressive symptoms, depending on occupational group. Conclusions: This study extends the existing literature with evidence on the multidimensional, contextual, and cross-level interaction associations of reciprocity as a key aspect of social capital on depressive symptoms.

The relation between indicators of low employment quality and attendance behavior in countries of the European Union

Background Previous research demonstrated an association between low employment quality and lower sickness absence, which may be explained by presenteeism. Therefore, this study aimed exploring the relation between three indicators of employment quality (long working hours, precarious employment, job insecurity) and attendance behavior. Methods The association between employment quality and attendance behavior was investigated in 28.999 workers (mean age: 40.0 years, 53% males) of the fifth wave of the European Working Conditions Survey, using multilevel multinomial logistic regression analysis. Attendance behavior was operationalized as different combinations of sickness absence and presenteeism. Results Those working >48 h/week, had a higher risk to report presenteeism (with or without sickness absence). They had a lower risk to report sickness absence without presenteeism. Workers with a precarious contract had a lower risk to report absenteeism without presenteeism and the combination of both presenteeism and absenteeism. Finally, for workers perceiving job insecurity, the risk for presenteeism without sickness absence was significantly higher. Conclusions Several indicators of low employment quality were associated with attendance behavior, suggesting a complex behavioral mechanism in workers facing low job quality employment. Therefore, policy makers are recommended to re‐establish the indefinite contractual employment as the standard, avoiding long working hours.