Manuel Parra

Job strain, bullying and violence at work and asthma in Peruvian cleaners—a cross-sectional analysis

Abstract Objectives: An increased asthma prevalence was found in cleaners. Many of them work in precarious employment conditions, potentially leading to stress, a known risk factor for asthma. We aimed to analyze whether asthma in cleaners might partly be explained by psychosocial working conditions. Methods: The study population of this cross-sectional study included 199 cleaners employed at regional public health services in Puno Province (Peru). They were compared to 79 unexposed workers from Lima, Peru (response 83%). Both groups answered the short version of the European Working Condition Survey and a modified version of the European Community Respiratory Health screening questionnaire. After multiple imputation, the association between psychosocial working conditions and asthma (wheeze without cold or use of asthma medication) was assessed. Results: The 12-months prevalence of asthma was 22% among cleaners versus 5% among unexposed workers (pChi2 = .001). Cleaners were more likely than unexposed workers to work with temporary or sub-contracts, have a high employment insecurity, high strain working conditions and low social support (all pChi2 < .05). Twenty-six percent vs. 10% reported a high bullying score; 39% vs. 8% had experienced violence at work (both pChi2 < .001). High bullying score (adjusted Odds Ratio 5.6; 95% Confidence Interval 1.5–21.4) and violence (2.4; 1.1–5.4) were the main predictors of asthma. Taking these factors into account, being a cleaner was not statistically significantly associated with the outcome (3.5; 0.9–13.8). Conclusions: Poor psychosocial working conditions of cleaners may partly explain the high prevalence of asthma. The underlying mechanism might be a stress-induced inflammatory immune response.

Working Conditions, Workplace Violence, and Psychological Distress in Andean Miners: A Cross-sectional Study Across Three Countries

BACKGROUNDnPsychosocial working conditions are well-known determinants of poor mental health. However, studies in mining populations where employment and working conditions are frequently precarious have, to our knowledge, only focused on occupational accidents and diseases.nnnOBJECTIVESnThe aim of this study was to assess psychosocial working conditions and psychological distress in Andean underground miners.nnnMETHODSnThe study population consisted of 153 Bolivian miners working in a silver mining cooperative, 137 Chilean informal gold miners, and 200 formal Peruvian silver miners employed in a remote setting. High work demands, minimal work control, minimal social support at work, and workplace exposure to violence and bullying were assessed using the Spanish short form of the European Working Condition Survey. A general health questionnaire score >4 was used as cutoff for psychological distress. Associations between psychosocial work environment and psychological distress were tested using logistic regression models controlling for potential confounding and effect modification by country.nnnFINDINGSnPrevalence of psychological distress was 82% in the Bolivian cooperative miners, 29% in the Peruvian formal miners, and 22% in the Chilean informal miners (pχ(2) < 0.001). 55% of the miners had suffered violence during the 12-months before the survey. Workplace demands were high (median 12.5 on a scale from 7-14), as was social support (median 5.5 on a scale from 3-6). After adjustment for country and other relevant exposure variables and considering interactions between country and job strain, miners in active (odds ratio [OR], 6.8; 95% confidence interval [CI] 2.1-22.7) and high strain jobs (OR, 7.2; 95% CI, 1.7-29.9) were at increased odds of distress compared with those in low strain jobs. Violence at work also contributed to increased odds of distress (OR, 1.86; 95% CI, 1.1-3.1).nnnCONCLUSIONSnPsychological distress is associated with the psychosocial work environment in Andean underground miners. Interventions in mining populations should take the psychosocial work environment into account.

1516 Psychological distress, effort-reward imbalance and work-family interactions in ecuadorian petroleum workers

Introduction Work in oil industry often has workers living transiently in camps for 1–2 weeks periods. This is a challenge for workers’ personal-family life. The objective was to evaluate relationship of psychosocial factors and work-family interactions with psychological distress in Ecuadorian petroleum workers living transiently in camps, comparing to those who stay in cities. Methods 350 workers invited to answer a self-administered questionnaire (response 88%; October 2015 to January 2016). Psychological distress assessed through General Health Questionnare – 12 items (GHQ-12; dichotomized GHQ-score, GHQcase=cutu2009off 4/5). Psychosocial factors: Effort-Reward Imbalance (ERI) Questionnaire, short version (ERI and Overcommitment (OC) sub-scales, cut-off upper tertile). Work and family-personal life interaction evaluated with Work-Home Interaction – Nijmegen questionnaire (SWING; 4 dimensions, scores rescaled to 0–3, cut-off upper tertile). Other variables were socio-demographics and commuting time from house or camp to workplace. Result Higher prevalences of GHQcases were found in workers who perceived higher ERI (38.1% vs 18.2%, p<0.001) and OC levels (33.6% vs 20.0%, p<0.05), compared to lower tertiles). GHQcases were also more prevalent in urban workers (31.5%, p=0.001) and when commuting time was >15u2009min (31.5%, p<0.05). Negative interactions from work to family and viceversa were associated with higher prevalences of GHQcases (p<0.05), while positive interactions were associated with lower ones (p<0.001). Adjusted Odds Ratios (95%u2009CI) for GHQcase showed significant associations with ERI [2.34; (1.13–4.84)] and residing in cities while working [3.36; (1.38–8.16)]. Positive influences from domestic-personal life to work were associated with lower risk of psychological distress [0.25 (0.10–0.61)]. Discussion Perception of imbalance between effort and reward is associated with lower mental health. If skills and learnings acquired in domestic life are allowed to be displayed in work, workers seem to experience better mental health. Workers living transiently in camps exhibited better mental health in this group.

1361 Association between perceived demands and barriers and work-related strain in school-teachers in chuquisaca, bolivia

Introduction Teaching environments can influence performance and health of teachers. In Latin America little research was done to explore teaching conditions and health. The objective was to assess demands and barriers for teaching and work-related strain in school-teachers in Chuquisaca, Bolivia. Methods Cross-sectional study was conducted in sixty randomly selected schools (August to November 2015). All teachers (1062) were invited to participate (response 56%). Teaching demands and barriers were explored through a set of questions previously used by UNESCO-OREALC (4-points Likert scales). Demands included sociocultural differences, indiscipline, learning problems, desertion, and repetition. Barriers explored about lack of student families and colleagues support, poor social and economic conditions, lack of pedagogical support and leadership of the director. A validated version of the irritation index (7-points Likert scale) was used to explore work-related strain (emotional and cognitive irritation). Scores for demands, barriers and irritation were added and dichotomized in lower (1u2009st and 2nd) and upper (3rd) tertiles. Crude and adjusted odds ratios with 95% confidence intervals for work-related strain were estimated through logistic regression models. Missing data was imputed using chained equations imputation method. Sensitive analysis was performed using imputed and non-imputed data. Results Most of teachers were female (72%), in public schools (81%), exclusively in primary level (48%). About one-third of teachers (37%) have bachelor or postgraduate training (37%). Teaching in primary level (adjusted OR 2.21; 95%u2009CI: 1.4 to 3.6) and high academic barriers (1.73; 1.1–2.8), were statistically significant risk factors for work-related strain. University graduated teachers had lower risk (0.6; 0.4–0.9). Discussion Structural barriers seem to play an important role in work-related strain in teachers, while they are able to cope with pedagogical demands. Comprehensive actions need to be taken considering families and social resources in order to take care of teachers’ physical and mental health for a better performance.

1510 Precarious employment conditions and its association with heart rate variabilityin mexican hospital workers

Introduction Psychosocial working conditions such as employment precariousness or an imbalance between effort and reward at the workplace might result in cardiovascular diseases. One marker of cardiovascular effects is Heart Rate Variability (HRV). The objective of this study was to analyse the relation between precarious employment and HRV in health and administrative workers employed at a hospital in Mexico City. Methods In this cross-sectional study, 206 hospital employees without known cardiovascular diseases participated (response 90%). An interview-based questionnaire assessed sociodemographics, employment conditions, employment precariousness (EPRES) and lifestyle factors. HRV was measured over 10u2009min in sitting posture. Standard Deviation (SDNN) of the RR intervals over a five minutes was calculated (IBM SPSS 24). Results Healthcare personnel (n=106) was less likely to be active smokers (9% vs 29%) than administrative workers. Healthcare workers reported lower employment duration (24% vs 7% duration <5 years), working more hours per week (19% vs 7% working ≥60u2009hours/week), and more shift work (22% vs 11%) than the comparison group. They were more affected by temporality of the contract (27% vs 7%) and were less likely to suffer from economic deprivation (46% vs 69%; all pChi 2 <0.05) than office workers. Mean SDNN did not differ between healthcare workers (49,93±SD 31,91) and administrative workers (54,26±41,50; pt-Test=0,33). This was confirmed after adjusting for potential confounders. The only significant work-related predictor of SDNN was shift work (Beta: −16,68; 95%u2009CI: −30,69 to −2,67). Discussion Although Mexican healthcare professionals frequently suffer from precarious employment conditions, shift work was the main predictor for lower HRV in our study population.

Prevalence of musculoskeletal disorders among school teachers from urban and rural areas in Chuquisaca, Bolivia: a cross-sectional study

BackgroundMusculoskeletal disorders (MSD) are important health problems in working populations. The study aimed to determine the prevalence of MSD among school teachers from urban and rural areas in Chuquisaca, Bolivia.MethodsA cross-sectional study was conducted in 60 randomly selected schools. In total, 1062 teachers were invited to participate (response 58%). The Spanish version of the Standardized Nordic questionnaire was used assessing the 12-months and 7-days prevalence of MSD as well as the 12-months prevalence of work limiting pain. Prevalence were calculated for the different parts of the body; as summary measures, MSD in any part of the body and in ≥3 parts of the body were assessed. Crude and adjusted odds ratios with 95% confidence intervals were calculated using logistic regression models adjusting for age, sex, teaching level and school type.ResultsPrevalence of MSD in any part of the body was 86% during the last 12xa0months, 63% during the last 7xa0days and 15% for work limiting pain. MSD was most common in the neck (12-months prevalence 47%) and least common in the wrist/hands (26%). In the adjusted model, teachers working in rural areas presented significantly higher odds than teachers from urban schools for work-limiting pain during the last 12-months considering any part of the body (aOR 2.2; 95% CI 1.1–4.1), and for ≥3 parts of the body (aOR 3.7; 95% CI 1.3–10.6).ConclusionThe prevalence of MSD is high in School teachers, even more in teachers working in rural areas. It is needed to identify risk factors for MSD in teachers in order to propose appropriate strategies to control and reduce it.

P182 Intervention in occupational health in a community of chilean shellfish divers through an ecohealth approach

Introduction Artisanal shellfish divers in southern Chile are vulnerable workers lacking social security, working in dangerous conditions in the sea. For several years serious and fatal accidents affected them. Measures implemented by local authorities and fishermen have improved this situation. However, long-term effects are the current concern; in 2012–2014, a study about working and health conditions of divers was carried out. Main results showed high prevalence of sensorineural hearing loss and attention deficits associated with long-term exposure. Intervention activities are needed for prevention. Objective To develop an intervention program to prevent long-term effects on health of shellfish divers in southern Chile through an ecohealth approach. Methods Based on the pillars of ecohealth approach for solving health problems (community participation, gender equality and transdisciplinary), workshops for social dialogue are being implemented since 2015 to obtain a participative diagnosis and to identify the resources for management with community leaders, workers, governmental and nongovernmental organisations. Results Twenty-five people participated in the first workshop (response: 29%; women: 20%). The main strengths identified were the active participation of fishermen’s unions, the intersectoral support network and research applied for solving problems. Weaknesses were low participation of women and experienced divers and environmental factors. The main challenges are to improve access to social security, improve environmental and working conditions and following rise awareness about long-term effects based on research. Conclusions Interventions in occupational health, using the ecohealth approach allows the participation of the community in diagnosing and solving their health problems. Acknowledgments We thank EKOSANTÉ, a Latin American, Caribbean and Canadian collaboration in ecohealth, for the grant for this intervention project and the Centre for International Health CIHLMU funded by the German Academic Exchange Service (DAAD) via its exceed program financed by the German Federal Ministry for Cooperation and Development (BMZ) for funding the initial research project.

O03-6 Job strain, bullying and violence at work and asthma in peruvian cleaners

Epidemiological studies indicate that cleaners are at increased risk of asthma. Many cleaners work in precarious employment conditions potentially leading to stress, a known risk factor for asthma. Therefore, we aimed to analyse whether the high prevalence of asthma in cleaners might partly be explained by psychosocial working conditions. The study population of this cross-sectional study included 199 cleaners employed at regional public health services in Puno province (Peru). They were compared to 79 unexposed workers from Lima, Peru (response 83%). Both groups answered the short version of the European Working Condition Survey and a modified version of the European Community Respiratory Health screening questionnaire. After multiple imputation, the association between type of job, employment conditions, job strain and control, social support, bullying, violence, distress and asthma (wheeze without cold or use of asthma medication) was assessed. The 12-months prevalence of asthma was 22% among cleaners compared to 5% among unexposed workers (pChi2 = 0.001). Cleaners were more likely than unexposed workers to be female, be non-smokers, work with temporary contracts and as subcontractors, have a high employment insecurity, high strain working conditions and low social support (all pChi2 < 0.05). Twenty six percent vs. 10% reported a high bullying score; 39% vs. 8% had experienced violence during the 12-months prior to the study (both pChi2 < 0.001). High bullying score (adjusted Odds Ratio 5.6; 95% Confidence Interval 1.5–21.4) and violence at the workplace (2.4; 1.1–5.4) were main predictors of asthma. Taking these factors into account, being a cleaner was no longer statistically significantly associated with the outcome (3.5; 0.9–13.8). The poor psychosocial working conditions of cleaners may partly explain the high prevalence of asthma in this group. The underlying mechanism might be a stress-induced inflammatory immune response.