Rosane Härter Griep

Job strain and unhealthy lifestyle: results from the baseline cohort study, Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

BackgroundUnhealthy lifestyle choices, such as smoking and sedentary behavior, are among the main modifiable risk factors for chronic non-communicable diseases. The workplace is regarded as an important site of potential health risks where preventive strategies can be effective. We investigated independent associations among psychosocial job strain, leisure-time physical inactivity, and smoking in public servants in the largest Brazilian adult cohort.MethodsWe conducted a cross-sectional analysis of baseline data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)—a multicenter prospective cohort study of civil servants. Our analytical samples comprised 11,779 and 11,963 current workers for, respectively, analyses of job strain and leisure-time physical activity and analyses of job strain and smoking. Job strain was assessed using the Brazilian version of the Swedish Demand-Control-Support Questionnaire; physical activity was evaluated using a short form of the International Physical Activity Questionnaire. We also examined smoking status and number of cigarettes smoked per day. The association reported in this paper was assessed by means of multinomial and logistic regression, stratified by sex.ResultsAmong men, compared with low-strain activities (low demand and high control), job strain showed an association with physical inactivity (odds ratio [OR] = 1.34; 95% confidence interval [CI] = 1.09–1.64) or with the practice of physical activities of less than recommended duration (OR = 1.44; 95% CI = 1.15–1.82). Among women, greater likelihood of physical inactivity was identified among job-strain and passive-job groups (OR = 1.47; 95% CI = 1.22–1.77 and OR = 1.42; 95% CI = 1.20–1.67, respectively). Greater control at work was a protective factor for physical inactivity among both men and women. Social support at work was a protective factor for physical inactivity among women, as was smoking for both genders. We observed no association between demand or control dimensions and smoking.ConclusionsJob strain, job control, and social support were associated with physical activity. Social support at work was protective of smoking. Our results are comparable to those found in more developed countries; they provide additional evidence of an association between an adverse psychosocial work environment and health-related behaviors.

Mortality differences between self-employed and paid employees : a 5-year follow-up study of the working population in Sweden

Objectives Analyse mortality differences between self-employed and paid employees with a focus on industrial sector, educational level and gender using Swedish register data. Methods A cohort of the total working population (4 776 135 individuals; 7.2% self-employed; 18–100 years of age at baseline 2003) in Sweden with a 5-year follow-up (2004–2008) for all-cause and cause-specific mortality (57 743 deaths). Self-employed individuals were categorised as sole proprietors or limited liability company (LLC) owners according to their enterprises legal form. Cox proportional hazards models were applied to compare mortality rates between sole proprietors, LLC owners and paid employees, adjusted for sociodemographic confounders. Results Mortality from cardiovascular diseases was 16% lower and from suicide 26% lower among LLC owners than among paid employees, adjusted for confounders. Within the industrial category, all-cause mortality was 13–15% lower among sole proprietors and LLC owners compared with employees in manufacturing and mining (MM) as well as personal and cultural services (PCS), and 11–20% higher in sole proprietors in trade, transport and communication and the welfare industry (W). A significant three-way interaction indicated 17–23% lower all-cause mortality among male LLC owners in MM and female sole proprietors in PCS, and 50% higher mortality in female sole proprietors in W than in employees in the same industries. Conclusions Mortality differences between self-employed individuals and paid employees vary by the legal form of self-employment, across industries, and by gender. Differences in work environment exposures and working conditions, varying market competition across industries and gender segregation in the labour market are potential mechanisms underlying these findings.

Factors associated with sedentary behavior among ELSA-Brasil participants: ecological model

The main objective was to identify the prevalence and factors associated with sedentary behavior (SB). The study comprising a total of 13,765 individuals of both sexes participating in the Longitudinal Study of Adult Health (ELSA-Brasil) assessed in the second wave (2012-2014). e SB was measured using questions related to sitting time during the week and weekend. e associated factors were assessed by face-to-face interviews, with blocks of questionnaires and anthropometric measurements. A hierarchical ecological model was built with all possible factors associated with SB: sociodemographic environment (age and level of education; economic status); behavioral environment (leisure time physical activity, commuting physical activity, beer consumption, current smoking); and biological environment (overweight, obesity and abdominal obesity). Crude and adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs) were estimated using logistic regression. Among men and women, higher education, current smoking and abdominal obesity were positively associated with SB, while being over 51 years old and being physically active were negatively associated with SB. The proposed ecological model explains the SB through the sociodemographic, behavioral and biological environment.

P2-105 Factors associated with short and long sickness absenteeism among healthcare workers

Introduction Sickness absenteeism is a complex and multifactorial phenomenon. The present paper studies the association between variables of different levels of determination and short/long sickness absenteeism reported by nursing staff. Methods Sectional study with 1509 workers (89.4% of all workers) from three public hospitals in Rio de Janeiro, Brazil. Sickness absence was assessed by means of the self-reported question: ‘‘How many whole days have you been off work due to health problems (diseases or healthcare or for examination) during the past year (12 months)?” and we defined short sickness absenteeism (1–9 days) and long (≥10 days). The logistic regression analysis used a conceptual model that consider distal (socio-economic conditions), intermediate I (occupational conditions), intermediate II (lifestyle characteristics) and proximal determinants (diseases and health conditions). Results The prevalence of short and long absenteeism were respectively 20.3% and 16.6%. In multivariate analysis, both types of absenteeism were associated with the role of practical nurse, musculoskeletal diseases, self-perceived poor/regular health and presence of minor psychological distress. In addition, short absenteeism was also associated with age and having more than one job, while long absenteeism was related to marital status and being a public servant. Conclusion The results indicated variables of different levels of determination were linked to sickness absenteeism. Sickness absenteeism seems to indicate a multiple and complex determination that cannot be explained exclusively by health conditions.