NFA: Videnskabelige artikler

Implementation of a coordinated and tailored return-to-work intervention for employees with mental health problems [Epub ahead of print]

Fri, 10 Feb 2012 00:00:00 +0100

Purpose:Interventions to promote return to work (RTW) after sickness absence are often complex, involving numerous stakeholders and thus prone to implementation problems. To understand the outcomes of such interventions, researchers need to look beyond effectiveness data and incorporate systematic process evaluations. This article presents findings from a process evaluation of a coordinated and tailored RTW-intervention for employees with mental health problems. The purpose was to elucidate the implementation process and identify barriers for the feasibility and sustainability of the intervention. Methods: The evaluation draws on comprehensive data from observations of and documents from the intervention, a two-waved survey among participants (n = 76), two group interviews with the intervention team, three group interviews with municipal social insurance officers (SIOs), and ten individual interviews with participants. Results: We identified several barriers to the feasibility and sustainability of the intervention: (1) the inclusion criteria were perceived as too narrow by those responsible for recruitment (SIOs); (2) waiting lists occurred; (3) participants had more severe mental health problems than expected; (4) key stakeholders had divergent expectations of the timeframe for RTW; (5) the SIOs felt insufficiently informed about the intervention; (6) the global financial downturn resulted in many participants losing their job, which impeded workplace-based RTW-efforts. Conclusions: This study points out important pitfalls in implementing RTW-interventions, pertaining to specification of the target population, consideration of contextual constraints, and ensuring cooperation between key stakeholders. Thorough assessment of local context and stakeholder needs and concerns is likely to improve the feasibility and sustainability of future RTW-interventions.

Bullying at work and onset of a major depressive episode among Danish female eldercare workers [Epub ahead of print]

Tue, 07 Feb 2012 00:00:00 +0100

Objective: The aim of this study was to analyze whether exposure to workplace bullying among 5701 female employees in the Danish eldercare sector increases the risk of onset of a major depressive episode (MDE).Methods: Participants received questionnaires in 2004-2005 and again in 2006-2007. MDE was assessed with the Major Depression Inventory. We examined baseline bullying as a predictor of onset of MDE at follow-up using multiple logistic regression. We further conducted a cross-sectional analysis at the time of follow-up among participants who at baseline were free of bullying, MDE, and signs of reduced psychological health. Finally, we analyzed reciprocal effects, by using baseline bullying and baseline MDE as predictors for bullying and MDE at follow-up.Results: Onset rates of MDE in the groups of no, occasional, and frequent bullying were 1.5%, 3.4%, and 11.3%, respectively. Odds ratios (OR) for onset of MDE were 2.22 [95% confidence interval (95% CI) 1.31-3.76] for occasional bullying and OR 8.45 (95% CI 4.04-17.70) for frequent bullying, after adjustment for covariates. In the cross-sectional analysis, OR were 6.29 (95% CI 2.52-15.68) for occasional bullying and 20.96 (95% CI 5.80-75.80) for frequent bullying. In the analyses on reciprocal effects, both baseline bullying [occasional: OR 2.12 (95% CI 1.29-3.48) and frequent: OR 6.39 (95% CI 3.10-13.17)] and baseline MDE [OR 7.18 (95% CI 3.60-14.30] predicted MDE at follow-up. However, only baseline bullying [occasional: OR 7.44 (95% CI 5.94-9.31) and frequent: OR 11.91 (95% CI 7.56-18.77)] but not baseline MDE [OR 0.93 (95% CI 0.47-1.84)] predicted bullying at follow-up.Conclusions: Workplace bullying increased the risk of MDE among female eldercare workers. MDE did not predict risk of bullying. Eliminating bullying at work may be an important contribution to the prevention of MDE.

Effetcs of a 17q21 chromosome gene variant, tobacco smoke and furred pets on infant wheeze

Fri, 03 Feb 2012 00:00:00 +0100

The first common genetic factor identified for pediatric asthma by genome-wide association is the chromosome 17q21 locus, harbouring the ORMDL3 gene. ORMDL3 is involved in facilitation of endoplasmic reticulum-mediated inflammatory responses, believed to underlie its asthma association. We investigated associations between the rs7216389 polymorphism in the 17q21 locus affecting ORMDL3 expression and the risk for recurrent wheeze and interactions with exposure to tobacco smoke and furred pets during pregnancy and infancy using a birth cohort of 101?042 infants. Rs7216389 was significantly associated with recurrent wheeze risk among 18-month-old infants. There was a 1.35-fold higher risk of recurrent wheeze among homozygous variant allele carriers compared with homozygous wild-type allele carriers. There was significant interaction between rs7216389 and domestic furred pets, with a positive association between pets and wheeze among homozygous wild-type carriers and a negative association among homozygous variant allele carriers. There was no interaction between rs7216389 and tobacco smoke exposure.

Association between 8-oxo-7,8-dihydroguanine excretion and risk of lung cancer in a prospective study

Fri, 03 Feb 2012 00:00:00 +0100

Oxidative damage to guanine (8-oxoGua) is one of the most abundant lesions induced by oxidative stress anddocumented mutagenic. 8-Oxoguanine DNA glycosylase 1 (OGG1) removes 8-oxoGua from DNA by excision.The urinary excretion of 8-oxoGua is a biomarker of exposure, reflecting the rate of damage in the steadystate. The aim of this study was to investigate urinary 8-oxoGua as a risk factor for lung cancer. In a nestedcase-cohort design we examined associations between urinary excretion of 8-oxoGua and risk of lung canceras well as potential interaction with the OGG1 Ser326Cys polymorphism in a population-based cohort of25,717 men and 27,972 women aged 50-64 years with 3-7 years follow-up. We included 260 cases with lungcancer and a subcohort of 263 individuals matched on sex, age, and smoking duration for comparison. Urine collectedat entry was analysed for 8-oxoGua by HPLC with electrochemical detection. There was no significant effectof smoking or OGG1 genotype on the excretion of 8-oxoGua. Overall the incidence rate ratio (IRR) (95%confidence interval) of lung cancerwas 1.06 (0.97-1.15) per doubling of 8-oxoGua excretion. The association betweenlung cancer risk and 8-oxoGua excretion was significant among men [IRR: 1.17 (1.03-1.31)], neversmokers[IRR: 9.94 (1.04-94.7)], and former smokers [IRR: 1.19 (1.07-1.33)]. There was no significant interactionwith the OGG1 genotype, although the IRR was 1.14 (0.98-1.34) among subjects homozygous for Cys326.The association between urinary 8-oxoGua excretion and lung cancer risk among former and never-smokerssuggests that oxidative stress with damage to DNA is important in this group.

Cytotoxicity, oxidative stress and expression of adhesion molecules in human umbilical vein endothelial cells exposed to dust from paints with or without nanoparticles [Epub ahead of print]

Fri, 27 Jan 2012 00:00:00 +0100

Nanoparticles in primary form and nanoproducts might elicit different toxicological responses. We compared paint-related nanoparticles with respect to effects on endothelial oxidative stress, cytotoxicity and cell adhesion molecule expression. Primary human umbilical vein endothelial cells were exposed to primary nanoparticles (fine, photocatalytic or nanosized TiO2, aluminium silicate, carbon black, nano-silicasol or axilate) and dust from sanding reference- or nanoparticle-containing paints. Most of the samples increased cell surface expressions of vascular cell adhesion molecule-1 (VCAM-1) and intracellular adhesion molecule-1 (ICAM-1), but paint sanding dust samples generally generated less response than primary particles of TiO2 and carbon black. We found no relationship between the expression of adhesion molecules, cytotoxicity and production of reactive oxygen species. In conclusion, sanding dust from nanoparticle-containing paint did not generate more oxidative stress or expression of cell adhesion molecules than sanding dust from paint without nanoparticles, whereas the primary particles had the largest effect on mass basis.

The Danish national return-to-work program - aims, content, and design of the process and effect evaluation [Epub ahead of print]

Thu, 19 Jan 2012 00:00:00 +0100

The Danish national return-to-work (RTW) program aims to improve the management of municipal sickness benefit in Denmark. A study is currently ongoing to evaluate the RTW program. The purpose of this article is to describe the study protocol. The program includes 21 municipalities encompassing approximately 19 500 working-age adults on long-term sickness absence, regardless of reason for sickness absence or employment status. It consists of three core elements: (i) establishment of multidisciplinary RTW teams, (ii) introduction of standardized workability assessments and sickness absence management procedures, and (iii) a comprehensive training course for the RTW teams. The effect evaluation is based on a parallel group randomized trial and a stratified cluster controlled trial and focuses on register-based primary outcomes - duration of sickness absence and RTW - and questionnaire-based secondary outcomes such as health and workability. The process evaluation utilizes questionnaires, interviews, and municipal data. The effect evaluation tests whether participants in the intervention have a (i) shorter duration of full-time sickness absence, (ii) longer time until recurrent long-term sickness absence, (iii) faster full RTW, (iv) more positive development in health, workability, pain, and sleep; it also tests whether the program is cost-effective. The process evaluation investigates: (i) whether the expected target population is reached; (ii) if the program is implemented as intended; (iii) how the beneficiaries, the RTW teams, and the external stakeholders experience the program; and (iv) whether contextual factors influenced the implementation.The program has the potential to contribute markedly to lowering human and economic costs and increasing labor force supply. First results will be available in 2013. The trial registrations are ISRCTN43004323, and ISRCTN51445682.

Bi-directional associations between psychological arousal, cortisol, and sleep

Thu, 19 Jan 2012 00:00:00 +0100

The aim was to elucidate the possible bi-directional relation between daytime psychological arousal, cortisol, and self-reported sleep in a group of healthy employees in active employment. Logbook ratings of sleep (Karolinska Sleep Questionnaire), stress, and energy, as well as positive and negative experiences in work and private life, were collected together with salivary cortisol over 3 days (n = 265). Higher bedtime ratings of stress and problems during the day were associated with morning ratings of poor sleep. Poorer morning ratings of sleep were associated with higher ratings of stress and problems during the day. The results underpin the possibility that arousal and poor sleep might create a self-reinforcing vicious circle that negatively affects a person's well-being.

Risk factors for ischaemic heart disease mortality among men with different occupational physical demands. A 30-year prospective cohort study

Thu, 19 Jan 2012 00:00:00 +0100

[Open access] Objectives: Men with high physical work demands have elevated cardiovascular strain, which may lead to enhanced atherosclerosis. Theoretically, the impact of risk factors for ischaemic heart disease (IHD) may thus depend on physical work demands. The authors investigated this hypothesis. Design: Prospective 30-year follow-up. Setting: The Copenhagen Male Study. Participants: 5249 gainfully employed men aged 40-59 years; 311 men with cardiovascular disease/diabetes were excluded. Primary and secondary outcome measures: IHD and all-cause mortality. Results: 579 men (11.8%) died due to IHD and 2628 (53.7%) from all-cause mortality. Similarities and differences in risk predictors were found between men with low (n=1219), medium (n=2636) and high (n=846) physical work demands. After control for potential confounders, high physical fitness conferred a reduced risk of IHD mortality only among men with high physical work demands (HR: 0.48, 95% CI 0.24 to 0.96), a moderate/high level of leisure-time physical activity was associated with reduced risk of IHD mortality only among men with moderate and high physical work demands. High systolic blood pressure and smoking were risk factors in all groups. Similar, but less pronounced differences in risk factors for all-cause mortality between groups were found. Conclusions: The risk factors for IHD and all-cause mortality, low physical fitness and low leisure-time physical activity are not identical for men with different physical work demands. Preventive initiatives for IHD should be tailored to the physical work demands.

Strenght training increases the size of the satellite cell pool in type I and II fibres of chronically painful trapezius muscle in females

Thu, 19 Jan 2012 00:00:00 +0100

While strength training has been shown to be effective in mediating hypertrophy and reducing pain in trapezius myalgia, responses at the cellular level have not previously been studied. This study investigated the potential of strength training targeting the affected muscles (SST, n = 18) and general fitness training (GFT, n = 16) to augment the satellite cell (SC) and macrophage pools in the trapezius muscles of women diagnosed with trapezius myalgia. A group receiving general health information (REF, n = 8) served as a control. Muscle biopsies were collected from the trapezius muscles of the 42 women (age 44 ± 8 years; mean ± SD) before and after the 10 week intervention period and were analysed by immunohistochemistry for SCs, macrophages and myonuclei. The SC content of type I and II fibres was observed to increase significantly from baseline by 65% and 164%, respectively, with SST (P < 0.0001), together with a significant correlation between the baseline number of SCs and the extent of hypertrophy (r = -0.669, P = 0.005). SST also resulted in a 74% enhancement of the trapezius macrophage content (P < 0.01), accompanied by evidence for the presence of an increased number of actively dividing cells (Ki67+) post-SST (P < 0.001). GFT resulted in a significant 23% increase in the SC content of type II fibres, when expressed relative to myonuclear number only (P < 0.05). No changes in the number of myonuclei per fibre or myonuclear domain were detected in any group. These findings provide strong support at the cellular level for the potential of SST to induce a strong myogenic response in this population.

Airway effects of repeated exposures to ozone-initiated limonene oxidation products as model of indoor air mixtures

Thu, 19 Jan 2012 00:00:00 +0100

Repeated low-level indoor air exposure to volatile organic compounds (VOCs) may influence the report-ing of sensory irritation in the eyes and airways. The ozone-initiated reaction products of limonene, an abundant VOC, were used as a model of indoor air mixtures to study upper airway (sensory) irritation, bronchoconstrictive and alveolar level effects after repeated exposures. Mice were exposed 1 h/day for 10 consecutive days to: air, limonene (52 ppm/289 mg/m3); ozone (0.1 ppm/0.2 mg/m3); a reaction mixture of limonene (52 ¡À 8 ppm) and ozone (0.5, 2.5 and 3.9 ppm) resulting in ¡«0.05 ppm residual ozone. Neither the limonene nor the ozone exposures alone showed consistent effects on the respiratory parameters. In the limonene/ozone groups, the respiratory rate decreased concentration-dependently with an extrap-olated no-effect-level of ¡«0.3 ppm admixed ozone. Both sensory irritation and airflow limitation were conspicuous effects of the mixtures; sensory irritation appeared rapidly and airflow limitation developed slowly during each exposure. The effects of these parameters did not change with increasing number of exposures. No firm conclusion could be drawn about alveolar level effects. Cells in bronchoalveolar lavage were unchanged irrespective of exposure to air, ozone, and limonene with and without ozone. In con-clusion, the study indicated that repeated exposures to ozone-initiated limonene mixtures did not cause sensitization of sensory irritation and airflow limitation. Bronchoalveolar lavage after exposures to ozone, and limonene with and without ozone, respectively, did not show airway inflammation.

Changed activation, oxygenation, and pain response of chronically painful muscles to repetitive work after training interventions: a randomized controlled trial

Thu, 19 Jan 2012 00:00:00 +0100

[Open access] The aim of this randomized controlled trial was to assess changes in myalgic trapezius activation, muscle oxygenation, and pain intensity during repetitive and stressful work tasks in response to 10 weeks of training. In total, 39 women with a clinical diagnosis of trapezius myalgia were randomly assigned to: (1) general fitness training performed as leg-bicycling (GFT); (2) specific strength training of the neck/shoulder muscles (SST) or (3) reference intervention without physical exercise. Electromyographic activity (EMG), tissue oxygenation (near infrared spectroscopy), and pain intensity were measured in trapezius during pegboard and stress tasks before and after the intervention period. During the pegboard task, GFT improved trapezius oxygenation from a relative decrease of -0.83 ± 1.48 µM to an increase of 0.05 ± 1.32 µM, and decreased pain development by 43%, but did not affect resting levels of pain. SST lowered the relative EMG amplitude by 36%, and decreased pain during resting and working conditions by 52 and 38%, respectively, without affecting trapezius oxygenation. In conclusion, GFT performed as leg-bicycling decreased pain development during repetitive work tasks, possibly due to improved oxygenation of the painful muscles. SST lowered the overall level of pain both during rest and work, possibly due to a lowered relative exposure as evidenced by a lowered relative EMG. The results demonstrate differential adaptive mechanisms of contrasting physical exercise interventions on chronic muscle pain at rest and during repetitive work tasks.

Health, work, and personal-related predictors of time to return to work among employees with mental health problems [Epub ahead of print]

Thu, 19 Jan 2012 00:00:00 +0100

Purpose: To identify health-, personal- and work-related factors predictive of return to work (RTW) in employees sick-listed due to common mental health problems, such as, stress, depression, burnout, and anxiety. Methods: We distributed a baseline questionnaire to employees applying for sickness absence benefits at a large Danish welfare Department (n = 721). A total of 298 employees returned the questionnaire containing information on possible predictors of RTW. We followed up all baseline responders for a maximum of one year in a national registry of social transfer payments, including sickness absence benefits. Results: At baseline, about 9% of respondents had quit their job, 10% were dismissed and the remaining 82% were still working for the same employer. The mean time to RTW, measured from the first day of absence, was 25 weeks (median = 21) and at the end of follow-up (52 weeks) 85% had returned to work. In the fitted Cox model we found that fulfilling the DSM-IV criteria for depression predicted a longer time to RTW (HR: 0.61, CI: 0.45-0.84), whereas a better self-rated health predicted a shorter time to RTW (HR: 1.18, CI: 1.03-1.34). Employees working in the municipal (HR: 0.62, CI: 0.41-0.94) and private sector (HR: 0.65, CI: 0.44-0.96) returned to work slower compared to employees working in the governmental sector. Gender, education, cohabitation, size of workplace, low-back and upper-neck pain and employment at baseline did not predict RTW. Conclusion: Our results indicate that time to RTW is determined by both health- and work-related factors.

Job strain in relation to body mass index: pooled analysis of 160 000 adults from 13 cohort studies [Epub ahead of print]

Thu, 19 Jan 2012 00:00:00 +0100

Background: Evidence of an association between job strain and obesity is inconsistent, mostly limited to small-scale studies, and does not distinguish between categories of underweight or obesity subclasses.Objectives: To examine the association between job strain and body mass index (BMI) in a large adult population.Methods: We performed a pooled cross-sectional analysis based on individual-level data from 13 European studies resulting in a total of 161 746 participants (49% men, mean age, 43.7 years). Longitudinal analysis with a median follow-up of 4 years was possible for four cohort studies (n =42 222).Results: A total of 86 429 participants were of normal weight (BMI 18.5-24.9 kg m-2), 2149 were underweight (BMI < 18.5 kg m-2), 56 572 overweight (BMI 25.0-29.9 kg m-2) and 13 523 class I (BMI 30-34.9 kg m-2) and 3073 classes II/III (BMI = 35 kg m-2) obese. In addition, 27 010 (17%) participants reported job strain. In cross-sectional analyses, we found increased odds of job strain amongst underweight [odds ratio 1.12, 95% confidence interval (CI) 1.00-1.25], obese class I (odds ratio 1.07, 95% CI 1.02-1.12) and obese classes II/III participants (odds ratio 1.14, 95% CI 1.01-1.28) as compared with participants of normal weight. In longitudinal analysis, both weight gain and weight loss were related to the onset of job strain during follow-up.Conclusions: In an analysis of European data, we found both weight gain and weight loss to be associated with the onset of job strain, consistent with a 'U'-shaped cross-sectional association between job strain and BMI. These associations were relatively modest; therefore, it is unlikely that intervention to reduce job strain would be effective in combating obesity at a population level.

Muscle activation strategies during strenght training with heavy loading versus repetitions to failure [Epub ahead of print]

Thu, 19 Jan 2012 00:00:00 +0100

Going to failure - or not, have probably been one of the most debated issues during the history of strength training. However, few studies have directly compared the physiological effect of failure versus non-failure strength training. The purpose of this study was to evaluate muscle activation strategies with electromyography during heavy repetitions versus repetitions to failure with lighter resistance. 15 healthy untrained females performed a set with heavy loading (3 Repetition maximum) and a set of repetitions to failure with lower resistance (~15 RM) during lateral raise with elastic tubing. Electromyographic (EMG) amplitude and median power frequency (MPF) of specific shoulder and neck muscles was analysed and the Borg CR10 scale was used to rate perceived loading immediately after each set of exercise. During the failure set normalized EMG was significantly lower during the first repetition and significantly higher during the latter repetitions compared with the heavy 3 RM set (P<0.05). Normalized EMG for the examined muscles increased throughout the set to failure in a curvilinear fashion - e.g. for the trapezius from 86% to 124% MVC (P<0.001) - and reached a plateau during the final 3-5 repetitions before failure. MPF for all examined muscles decreased throughout the set to failure in a linear fashion, indicating progressively increasing fatigue. In conclusion, going to complete failure during lateral raise is not necessary to recruit the entire motor unit pool in untrained women - i.e. muscle activity reached a plateau 3-5 repetitions from failure with an elastic resistance of approximately 15 RM. Further, strengthening exercises performed with elastic tubing seems to be an efficient resistance exercise and a feasible and practical alternative to traditional resistance equipment.

Scapular muscle activity from selected strengthening exercises performed at low and high intensity [Epub ahead of print]

Thu, 19 Jan 2012 00:00:00 +0100

A balanced level of muscle strength between the different parts of the scapular muscles is important to optimize performance and prevent injuries in athletes. Emerging evidence suggests that many athletes lack balanced strength in the scapular muscles. Evidence based recommendations are important for proper exercise prescription. This study determines scapular muscle activity during strengthening exercises for scapular muscles performed at low and high intensities (Borg-CR10 level 3 and 8). Surface electromyography (EMG) from selected scapular muscles was recorded during seven strengthening exercises and expressed as a percentage of the maximal EMG. Seventeen women (aged 24-55 years) without serious disorders participated. Several of the investigated exercises - press-up, prone flexion, one-arm row and prone abduction at Borg 3 and press-up, push-up plus and one-arm row at Borg 8 - predominantly activated the lower trapezius over the upper trapezius (activation difference ([DELTA]) 13-30%). Likewise, several of the exercises - push-up plus, shoulder press and press-up at Borg 3 and 8 - predominantly activated the serratus anterior over the upper trapezius ([DELTA]18-45%). The middle trapezius was activated over the upper trapezius by one-arm row and prone abduction ([DELTA]21-30%). While shoulder press and push-up plus activated the serratus anterior over the lower trapezius ([DELTA]22- 33%), the opposite was true for prone flexion, one-arm row and prone abduction ([DELTA]16- 54%). Only the press-up and push-up plus activated both the lower trapezius and the serratus anterior over the upper trapezius. In conclusion, several of the investigated exercises both at low and high intensities predominantly activate the serratus anterior and lower and middle trapezius, respectively, over the upper trapezius. These findings have important practical implications for exercise prescription for optimal shoulder function. For example, both workers with neck pain and athletes at r

Evaluation of muscle activity during a strandardized resistance training bout in novice individuals [Epub ahead of print]

Thu, 19 Jan 2012 00:00:00 +0100

Momentary fatigue is an important variable in resistance training periodization programs. Although several studies have examined neuromuscular activity during single repetitions of resistance training, information is lacking in regard to neuromuscular fatigue indices throughout a full resistance training bout. The purpose of this study was to evaluate muscle activity during a shoulder resistance training bout with 15 repetitions maximum (RM) loadings in novice individuals. 12 healthy sedentary women (age = 27-58 years; weight = 54-85 kg; height = 160-178 cm) were recruited for this study. Normalized electromyographic activity (nEMG) and median power frequency (MPF) of the upper, medial and lower trapezius, the medial deltoid, infraspinatus and serratus anterior was measured during 3 sets of 15 RM during the exercises front raise, reverse flyes, shrugs and lateral raise. For the majority of exercises nEMG activity was high (>60% of MVC). From the first to the last repetition of each set nEMG - averaged for all muscles - increased 10.0+0.4% (P<0.05) and MPF decreased -7.7+0.5 Hz (P<0.05). By contrast, nEMG and MPF was unchanged from first to third set (averaged for all muscles: 38.1+23.6% vs 47.6+28.8% and 88.4+21.3 Hz vs 82.1+18.1 Hz respectively). In conclusion, during a shoulder resistance training bout in novice individuals using 15 RM loading muscle activity of the upper, medial and lower trapezius, the medial deltoid, infraspinatus and serratus anterior increased and median power frequency decreased within each set - indicating momentary neuromuscular fatigue. By contrast, no such change was observed between the three sets. This indicates that momentary neuromuscular fatigue in shoulder resistance training is induced more efficiently within a set than between sets.

Modern indoor climate research in Denmark from 1962 to 2010. An eyewitness report

Thu, 19 Jan 2012 00:00:00 +0100

Modern, holistic indoor climate research started with the formation of an interdisciplinary 'Indoor Climate Research Group' in 1962 at the Institute of Hygiene, University of Aarhus, Denmark. After some years, other groups started similar research in Denmark and Sweden, and later - after the First International Indoor Air Symposium in Copenhagen 1978 - this research spread to many countries and today it is carried out globally by probably 2000 scientists. This paper recounts the history of Danish indoor climate research, focusing on the three decades from the early 1960s to the founding of the Indoor Air journal in 1991. The aim of this paper is to summarize what was learned in those earlier years and to call to the attention of researchers in this area the need of multidisciplinary research, mingling epidemiological fact-finding field studies with climate chamber studies and laboratory investigations.

Salivary cortisol and sleep problems among civil servants [Epub ahead of print]

Thu, 19 Jan 2012 00:00:00 +0100

Objective: The present study used information from a field study conducted among 4489 civil servants (70% women) in Denmark in 2007. The purpose was to examine the association between sleep problems and salivary cortisol by using a cross-sectional design with repeated measures in a subsample three-month later. Methods: Sleep problems during the past night and the past 4 weeks were assessed by a self-administered questionnaire on overall sleep quality, disturbed sleep, sleep length and awakening problems. Saliva samples were collected in a single day, using cotton tubes, 30 min after awakening and again at 2000 h. A subsample of 387 participants collected saliva samples three-month later at awakening, +20 min and +40 min after awakening and at 2000 h. We adjusted for confounders related to sampling time, life style and personal characteristics, socioeconomic status and work aspects. Results: Sleep problems during the past four weeks were associated with low morning and evening saliva cortisol concentrations: [3.1% per score of disturbed sleep ( p = .009); and 4.7% per score of awakening problems ( p < .001)]. Whereas sleep problems were not related with slope (the morning to evening change in cortisol levels). Awakening problems predicted lower cortisol (7.51% per score; p = .003) three-month later. Cortisol awakening response (CAR) and slope three-month later were significantly associated with disturbed sleep (7.84% and 8.24%) and awakening problems (6.93). Area under the curve (AUCmorning) increased with disturbed sleep (3.77%).

Lean production - An evaluation of the possibilities for an employee supportive lean practice [Epub ahead of print]

Mon, 09 Jan 2012 00:00:00 +0100

Lean is a contested concept. It has been praised for empowering employees, and it has been criticized for intensifying work and impairing the health and well-being of employees. This article is reviewing the literature on the relations between lean and employees, and suggests ways for the development of an employee-supportive lean practice. There is good evidence of lean's adverse consequences for low-skilled employees in the auto industry and other assembly type manufacturing work, but there are also examples of more positive outcomes. It is important to emphasize that, not only lean thinking, but also the context and implementation of lean have consequences for employee outcomes. Research is still needed to demonstrate it in real life, but this analysis of lean thinking, context, and implementation suggests possibilities for developing a lean practice that is genuinely employee-supportive.

PPARgamma-PGC-1alpha activity is determinant of alcohol related breast cancer

Mon, 09 Jan 2012 00:00:00 +0100

Alcohol is a risk factor for postmenopausal breast cancer. One of several proposed mechanisms is that alcohol-related breast cancer is caused by increased sex hormone levels. PPAR? inhibits aromatase transcription in breast adipocytes. We reproduced previously found allele-specific effects of the wildtype Pro-allele of PPARG Pro(12)Ala in alcohol related breast cancer. In transiently transfected cells, transcriptional activation by PPAR? and the PPAR?-PGC-1a complex was inhibited by ethanol. PPAR? 12Ala-mediated transcription activation was not enhanced by PGC-1a, resulting in allele-specific transcription activation by the PPAR? 12Pro-PGC-1a complex. Our results suggest that PPAR? and PGC-1a activity is an important determinant of alcohol related breast cancer.

Genetic variations in multiple myeloma I: effect on risk of multiple myeloma [Epub ahead of print]

Mon, 09 Jan 2012 00:00:00 +0100

[Open access] Few risk factors have been established for the plasma cell disorder multiple myeloma, but some of these like African American ethnicity and a family history of B-cell lymphoproliferative diseases suggest a genetic component for the disease. Genetic variation represents the genetic basis of variability in a population. The complex interplay between environment and genes for the development of cancer may therefore be influenced by genetic variations. A genetic variation may change the function of the gene, and if the genetic variation is associated with the risk of disease, that particular gene may be involved in the pathogenesis of disease. Genes of interest are genes involved in the normal development and function of the plasma cell and genes that protect us against exposures from the environment, for example, genes involved in the metabolism of xenobiotics, metabolism of folate and methionine, as well as genes involved in inflammation and DNA repair. Identification of genes with potential influence on cancer risk may help us to establish relevant laboratory studies on exposure and dose-response assessment and may help us to test the hypothesis in epidemiological studies. Knowledge of individual at high risk of cancer may offer promising insight for the prevention of cancer.

The working environment in small firms: Responses from owner-managers [Epub ahead of print]

Mon, 09 Jan 2012 00:00:00 +0100

Limited research has been conducted on owner-managers' responses to the working environment (occupational health and safety). This should be understood in the light of the way owner-managers develop identity from their business, and a better understanding is needed to develop preventive programmes that fit the owner-managers' interpretation of the working environment. Qualitative interviews were carried out with the owner-managers or the managers responsible for the working environment in 23 small firms from the construction and metal industries. The interviews were analysed for attitudes on the working environment, understanding of risk, responsibility for the working environment, and attitudes towards regulation. The analysis revealed both a great heterogeneity of views on the working environment and groups of owners who share important characteristics. Most owner-managers take a positive approach to the working environment, but also try to 'talk risk down', criticize regulation as bureaucracy and push a part of the employer responsibility on to the employees. They try to follow what they experience as a generally acceptable standard for the working environment among the stakeholders in the sector, but some owner-managers also tend to neglect the working environment. The reason for the down grading of risk and the push to share responsibility can be found in the close social relationships and the identity work processes of the owner-managers with their business. They try to act as decent people and thus avoid personal guilt and blame if employees should get injured.

Low heart rate variability is associated with extended pain-related sick leave among employed care-seekers

Thu, 05 Jan 2012 00:00:00 +0100

Objective: To examine the association between autonomic regulation and length of pain-related sick leave in subjects receiving a cognitive behavioural therapy-based return to work intervention.Methods: Sixty-five persons (29 men, 36 women) on pain-related sick leave participated in the study. Electrocardiograms were recorded in the clinic during supine rest, passive head-up tilt, standing, and seated rest, and in the home during seated rest and sleep. Spectral components of heart rate variability were derived from short-term (5 min) segments of electrocardiogram recordings. The number of days on sick leave was obtained from register data for 3 months before to 6 months after seeking care at the primary healthcare clinic.Results: Extended sick leave (>?121 days) compared with short sick leave (

Effects of classroom acoustics and self-reported noise exposure on techers' well-being [Epub ahead of print]

Thu, 05 Jan 2012 00:00:00 +0100

Beyond noise annoyance and voice problems, little is known about the effects that noise and poor classroom acoustics have on teachers' health and well-being. The aim of this field study was therefore to investigate the effects of perceived noise exposure and classroom reverberation on measures of well-being. Data on self-reported noise exposure, job satisfaction, fatigue after work, and interest in leaving the job were obtained from 283 teachers at 10 schools in Copenhagen, Denmark. In addition, the schools' acoustical working environment was classified as "low reverberation time (RT)" (3 schools, RT = 0.41-0.47 s), "medium RT" (3 schools, RT = 0.50-0.53 s), or "high RT" (4 schools, RT = 0.59-0.73 s). Significant associations were found between high RT and noise exposure, and, respectively, low job satisfaction, lack of energy after work, and interest in leaving the job. Noise exposure was also associated with lack of motivation and sleepiness. The results demonstrate the importance of good classroom acoustic conditions for teachers' well-being.

Effort reward imbalance is associated with vagal withdrawal in Danish public sector employees

Thu, 05 Jan 2012 00:00:00 +0100

Objectives: The current study analyzed the relationship between psychosocial work environment assessed by the Effort Reward Imbalance Model (ERI-model) and heart rate variability (HRV) measured at baseline and again, two years later, as this relationship is scarcely covered by the literature.Methods: Measurements of HRV during seated rest were obtained from 231 public sector employees. The associations between the ERI-model, and HRV were examined using a series of mixed effects models. The dependent variables were the logarithmically transformed levels of HRV-measures. Gender and year of measurement were included as factors, whereas age, and time of measurement were included as covariates. Subject was included as a random effect.Results: Effort and effort reward imbalance were positively associated with heart rate and the ratio between low frequency (LF) and high frequency power (HF) and negatively associated with total power (TP) and HF. Reward was positively associated with TP.Conclusion: Adverse psychosocial work environment according to the ERI-model was associated with HRV, especially in the form of vagal withdrawal and most pronounced in women.

Work-related violence and incident use of psychotropics

Thu, 05 Jan 2012 00:00:00 +0100

Although the mental health consequences of domestic violence are well documented, empirical evidence is scarce regarding the mental health effects of violence in the workplace. Most studies have used data from small occupation-specific samples, limiting their generalizability. This article examines whether direct exposure to work-related violence is associated with clinically pertinent mental health problems, measured by purchases of psychotropics (antidepressants, anxiolytics, hypnotics), in a cross-occupational sample of 15,246 Danish employees free from using psychotropics at baseline. Self-reported data on work-related violence were merged with other data on purchases of medications through a national registry to estimate cause-specific hazard ratios during 3.6 years (1,325 days) of follow-up in the years 1996-2008. Outcomes were examined as competing risks, and analyses were adjusted for gender, age, cohabitation, education, income, social support from colleagues, social support from supervisor, and influence and quantitative demands at work. Work-related violence was associated with purchasing antidepressants alone (hazard ratio = 1.38, 95% confidence interval: 1.09, 1.75) or in combination with anxiolytics (hazard ratio = 1.74, 95% confidence interval: 1.13, 2.70) but not with purchasing anxiolytics or hypnotics only. The frequency of violent episodes and risk of caseness were unrelated. Work-related violence is associated with increased risk of clinically pertinent mental health problems. Reducing levels of work-related violence may help to prevent mental disorders in the working population.

Associations between psychosocial work environment and hypertension among non-western immigrant and Danish cleaners [Epub ahead of print]

Tue, 03 Jan 2012 00:00:00 +0100

Introduction: Non-Western cleaners have reported better psychosocial work environment but worse health compared with their Danish colleagues. The aim of this study was to compare the association between psychosocial work environment and hypertension among non-Western immigrant cleaners and Danish cleaners. Methods: Two hundred and eighty-five cleaners from nine workplaces in Denmark participated in this cross-sectional study. The cleaners were identified as non-Western immigrants (n= 137) or Danes (n= 148). Blood pressure was measured in a seated position, and psychosocial work environment was assessed by the Copenhagen Psychosocial Questionnaire (COPSOQ). In each population, multivariate logistic regressions were applied testing for an association between each of the COPSOQ scales and hypertension. Results: Models adjusted for age, sex, BMI, smoking, workplace and physical work exertion showed that high Trust regarding management (OR = 0.50) and high Predictability (OR = 0.63) were statistically significantly associated with low prevalence of hypertension in the Danish population. In the immigrant population, no significant associations were found. Analyses on interaction effects showed that associations between Meaning of work and hypertension were significantly different among the two populations (p < 0.05). Conclusions: Psychosocial work factors were associated with hypertension among Danes, but not among non-Western immigrants. This divergent association between psychosocial work environment and hypertension between Danes and non-Western immigrant cleaners may be explained by different perceptions of psychosocial work environment.

Perceived psychological pressure at work, social class, and risk of stroke. A 30-year follow-up in Copenhagen male study

Tue, 20 Dec 2011 00:00:00 +0100

Objective: Investigate if the association between perceived psychological work pressure and risk of stroke is modified by socioeconomic status.Methods: Thirty-year follow-up of 4943 middle-aged men without cardiovascular disease.Results: In the higher social classes (I, II, and III), perceived regular exposure to psychological work pressure was common and a significant predictor of stroke; almost 10% of the stroke events could be attributed to this exposure in the higher social classes; among lower social classes (IV and V), perceived psychological pressure was no predictor at all.Conclusions: Regular psychological work pressure is a highly prevalent and independent risk factor for stroke among men in higher social classes. In contrast, no association to stroke risk was found among low social class men

Mobning - en traumatisk oplevelse?

Tue, 20 Dec 2011 00:00:00 +0100