Joost van der Gulden

The use of the ICF to describe work related factors influencing the health of employees.

Purpose: There are many models describing the responses of the human organism to work. However, the description of the effects on a personal level is rather limited. For this purpose the authors propose to use the concepts and the terminology of the ICF – the International Classification of Functioning, Disability and Health. Method: This article starts with a description of a model from occupational medicine, the Van Dijk model. Subsequently an overview of the health state of employees is presented, including the external and personal factors that may influence participation in work. Results: The schematic representation of the external and personal factors presented in this article is an expansion of the ICF-scheme. The scheme can be useful to describe problems of persons related to the working situation, and to identify the points of application of care for different professionals. Although the scheme does not have the intention to be complete, it might be useful in the development, execution and evaluation of programmes designed to prevent absenteeism in general or in specific groups, and to stimulate the return of people with absence due to illness. It is shown that the items of the Van Dijk model can be described using specific terms of the ICF. Conclusion: With the elaboration of the ICF scheme and the model of Van Dijk, expanded with ICF terms, the gap between the terminology used by professionals in health care, and the terminology used by professionals in occupational medicine is partly filled.

Work characteristics and determinants of job satisfaction in four age groups: university employees’ point of view

PurposeTo investigate (a) differences in work characteristics and (b) determinants of job satisfaction among employees in different age groups.MethodsA cross-sectional questionnaire was filled in by 1,112 university employees, classified into four age groups. (a) Work characteristics were analysed with ANOVA while adjusting for sex and job classification. (b) Job satisfaction was regressed against job demands and job resources adapted from the Job Demands-Resources model.ResultsStatistically significant differences concerning work characteristics between age groups are present, but rather small. Regression analyses revealed that negative association of the job demands workload and conflicts at work with job satisfaction faded by adding job resources. Job resources were most correlated with more job satisfaction, especially more skill discretion and more relations with colleagues.ConclusionsSkill discretion and relations with colleagues are major determinants of job satisfaction. However, attention should also be given to conflicts at work, support from supervisor and opportunities for further education, because the mean scores of these work characteristics were disappointing in almost all age groups. The latter two characteristics were found to be associated significantly to job satisfaction in older workers.

Organic dust toxic syndrome in swine confinement farming

BACKGROUND Pig farmers are exposed to organic dust with pro-inflammatory capacities. This makes it likely that they suffer from organic dust toxic syndrome (ODTS). No studies that included unexposed control populations are available so far. METHODS The prevalence of ODTS was established by the use of questionnaires in a group of 239 pig farmers and 311 rural controls working in nonagricultural occupations. RESULTS Pig farmers suffered more often from ODTS than controls (6.4% vs. 2.6%, P < 0.05). Organic dust toxic syndrome was associated with symptoms of atopy (prevalence odds ratio (POR) 3.1, 95% confidence interval (CI) 1.2-8.0) and with the use of wood-shavings as bedding (POR 4.3, 95% CI 1.2-15.6). An inverse association with the number of years worked as pig farmer was found (up to 5 years vs. more than 5 years; POR 5.0, 95% CI 0.8-32.9). CONCLUSIONS The prevalence of ODTS was elevated among pig farmers when compared to nonfarming, rural controls.

Using intervention mapping (IM) to develop a self-management programme for employees with a chronic disease in the Netherlands.

BackgroundEmployees with a chronic disease often encounter problems at work because of their chronic disease. The current paper describes the development of a self-management programme based on the Chronic Disease Self-Management programme (CDSMP) of Stanford University to help employees with a chronic somatic disease cope with these problems at work. The objective of this article is to present the systematic development and content of this programme.MethodsThe method of intervention mapping (Bartholomew 2006) was used to tailor the original CDSMP for employees with a chronic somatic disease. This paper describes the process of adjusting the CDSMP for this target group. A needs assessment has been carried out by a literature review and qualitative focus groups with employees with a chronic disease and involved health professionals. On the basis of the needs assessment, the relevant determinants of self-management behaviour at work have been identified for the target population and the objectives of the training have been formulated. Furthermore, techniques have been chosen to influence self-management and the determinants of behaviour and a programme plan has been developed.ResultsThe intervention was designed to address general personal factors such as lifestyle, disease-related factors (for example coping with the disease) and work-related personal factors (such as self-efficacy at work). The course consists of six sessions of each two and a half hour and intents to increase the self management and empowerment of employees with a chronic somatic disease.ConclusionIntervention mapping has been found to be a useful tool for tailoring in a systematic way the original CDSMP for employees with a chronic somatic disease. It might be valuable to use IM for the development or adjusting of interventions in occupational health care.

Hand eczema among healthcare professionals in the Netherlands: prevalence, absenteeism, and presenteeism

Healthcare professionals have a high risk of developing hand eczema. Hand eczema can interfere with their work.

Hands4U: a multifaceted strategy to implement guideline-based recommendations to prevent hand eczema in health care workers: design of a randomised controlled trial and (cost) effectiveness evaluation.

BackgroundWorkers in wet work occupations have a risk for developing hand eczema. Prevention strategies exist, but compliance to the proposed recommendations is poor. Therefore, a multifaceted implementation strategy (MIS) is developed to implement these recommendations to reduce hand eczema among health care workers performing wet work.Methods/DesignThis study is a randomised controlled trial in three university hospitals in the Netherlands. Randomisation to the control or intervention group is performed at department level. The control group receives a leaflet containing the recommendations only. The intervention group receives the MIS which consists of five parts: 1) within a department, a participatory working group is formed to identify problems with the implementation of the recommendations, to find solutions for it and implement these solutions; 2) role models will help their colleagues in performing the desired behaviour; 3) education to all workers will enhance knowledge about (the prevention of) hand eczema; 4) reminders will be placed at the department reminding workers to use the recommendations; 5) workers receive the same leaflet as the control group containing the recommendations. Data are collected by questionnaires at baseline and after 3, 6, 9 and 12 months. The primary outcome measure is self-reported hand eczema. The most important secondary outcome measures are symptoms of hand eczema; actual use of the recommendations; sick leave; work productivity; and health care costs.Analyses will be performed according to the intention to treat principle. Cost-effectiveness of the MIS will be evaluated from both the societal and the employers perspective.DiscussionThe prevention of hand eczema is important for the hospital environment. If the MIS has proven to be effective, a major improvement in the health of health care workers can be obtained. Results are expected in 2014.Trial registration numberNTR2812

Screening Manual and Office Workers for Risk of Long-term Sickness Absence: Cut-off Points for the Work Ability Index

OBJECTIVES The aim of this study was to investigate the Work Ability Index (WAI) as a tool to screen for risk of different durations of long-term sickness absence (LTSA) among manual and office workers. METHODS The prospective study comprised a cohort of 3049 (1710 manual and 1339 office) workers participating in occupational health surveys between 2010-2012. The survey date was set as baseline and incident LTSA episodes of different duration (>14, >28, >42, >60, and >90 days) were retrieved from an occupational health register in the year following the survey. Baseline WAI scores were associated with LTSA episodes occurring (no/yes) during one-year follow-up by logistic regression analysis in a random sample (N=1000) of the cohort. Predictions of LTSA risk were then validated among the workers not included in the random sample. RESULTS The odds of LTSA episodes at follow-up decreased with increasing baseline WAI scores (ie, better work ability). The WAI accurately predicted the risk of future LTSA episodes >28, >42, >60 days, but over-predicted the risk of LTSA episodes >14 and >90 days. The WAI discriminated between workers at high and low risk of LTSA episodes of all durations. Office workers had higher WAI scores than manual workers. Consequently, false-negative rates were higher among office workers and false-positive rates were higher among manual workers at each WAI cut-off point. CONCLUSION The WAI could be used to screen both manual and office workers for risk of LTSA episodes lasting >28, >42, >60 days. WAI cut-off points depend on the objectives of screening and may differ for manual and office workers.

Age differences in the associations between sick leave and aspects of health, psychosocial workload and family life: a cross-sectional study

Objectives To investigate differences in associations between sick leave and aspects of health, psychosocial workload, family life and work–family interference between four age groups (<36, 36–45, 46–55 and 55+ years). Design A cross-sectional study; a questionnaire was sent to the home addresses of all employees of a university. Setting A Dutch university. Participants 1843 employees returned the questionnaire (net response: 49.1%). The age distribution was as follows: <36: 32%; 36–45: 26%; 46–55: 27% and 55+: 12%. Primary outcomes Frequent sick leave (FSL, ≥3 times in the past 12 months) and prolonged sick leave (PSL, >2 weeks in total in the past 12 months). Differences between the age groups in independent variables and outcomes were investigated. Logistic regression analysis was used to calculate associations between various variables and the sick leave outcomes. Interaction terms were included to detect differences between the age groups. Results Age differences were found for many work- and family-related characteristics but not in the mean scores for health-related aspects. Presence of chronic disease was reported more frequently with increasing age. The 55+ age group had almost two times less chance of FSL, but 1.6 times more chance of PSL than the <36 age group. Age moderates the associations between career opportunities, partners contribution in domestic tasks and sex, and FSL. Job security and pay, support from supervisor, challenging work and being breadwinner have different associations with PSL. However, life events in private lives and perceived health complaints are important in all age groups. FSL and PSL have some determinants in common, but there are differences between the outcomes as well. Conclusions Age should be treated as a variable of interest instead of a control variable. Employers and occupational physicians need to be aware that each phase in life has specific difficulties that can lead to FSL and PSL.

Hands4U : the effects of a multifaceted implementation strategy on hand eczema prevalence in a healthcare setting. Results of a randomized controlled trial

Healthcare workers have an increased risk of developing hand eczema. A multifaceted implementation strategy was developed to implement a guideline to prevent hand eczema among healthcare workers.

Hands4U: the effectiveness of a multifaceted implementation strategy on behaviour related to the prevention of hand eczema—a randomised controlled trial among healthcare workers

Objectives To investigate the effects of a multifaceted implementation strategy on behaviour, behavioural determinants, knowledge and awareness of healthcare workers regarding the use of recommendations to prevent hand eczema. Methods The Hands4U study is a randomised controlled trial. A total of 48 departments (n=1649 workers) were randomly allocated to the multifaceted implementation strategy or the control group (minimal implementation strategy). Within the departments designated to the multifaceted implementation strategy, participatory working groups were set up to enhance the implementation of the recommendations for hand eczema. In addition, working group members were trained to become role models, and an education session was given within the department. Outcome measures were awareness, knowledge, receiving information, behaviour and behavioural determinants. Data were collected at baseline, with a 3- and 6-month follow-up. Results Statistically significant effects were found after 6 months for awareness (OR 6.30; 95% CI 3.41 to 11.63), knowledge (B 0.74; 95% CI 0.54 to 0.95), receiving information (OR 9.81; 95% CI 5.60 to 17.18), washing hands (B −0.40; 95% −0.51 to −0.29), use of moisturiser (B 0.29; 95% CI 0.20 to 0.38), cotton under gloves (OR 3.94; 95% CI 2.04 to 7.60) and the overall compliance measure (B 0.14; 95% CI 0.02 to 0.26), as a result of the multifaceted implementation strategy. No effects were found for behavioural determinants. Conclusions The multifaceted implementation strategy can be used in healthcare settings to enhance the implementation of recommendations for the prevention of hand eczema. Trial registration number NTR2812.