Risk of first musculoskeletal disorder in Danish occupational fishermen – a register-based study

Abstract Background Occupational fishery increase risk of musculoskeletal disorders due to a combination of heavy workloads and strenuous settings. Scarce and inconsistent knowledge exists on work-related risk factors despite high prevalence is evident. The aim was to determine work-related risk factors for the first diagnosis of musculoskeletal disorders in Danish occupational fishermen. Methods This study was a register-based cohort study. We extracted data the from Nationwide Danish registers on work affiliation and health data for all persons registered as occupational fishermen between 1994 and 2017. Job titles were retrieved from the Danish Occupational Cohort with eXposure (DOC*X). Time-to-event analysis using cox regression with age as timescale was applied. Results Among 15.739 fishermen, forty percent (n = 6.218 cases) experienced first musculoskeletal disorder during 82.2 million person-years of follow-up. Adjusted gender-stratified analysis showed that male fishermen, who worked less than 5 years and more than 15 years had the highest significant risks of MSD (HR 2.40 (95%CI: 2.06, 2.80), HR: 2.40 (95%CI: 1.76, 2.35)) respectively, compared to working more than 20 years. In males, more years in workforce, a captain education and working part time significantly protected against first MSD, while shifting trades above three times increased risk. Women had estimates with greater uncertainties due to their small numbers in the industry. Conclusions A high incidence of musculoskeletal disorders was found in Danish occupational fishermen between 1994-2017. Findings suggest a bimodal relationship between occupational fishermen seniority level and their risk of musculoskeletal disorder, where highest risk was seen at five years in trade, afterwards from lower estimate slowly increasing with accumulating years until highest occupational seniority, compared to more than twenty years in trade. Continued development actions of preventive measures are suggested. Key messages Persons who are working large proportions of their work-life within occupational fishery significantly increase the risk of experiencing first musculoskeletal disorder. High incidence of musculoskeletal disorder cases within Danish occupational fishery was shown, therefor further preventive actions towards work-related risk factors is necessary.


Background:
Poor working conditions might lead to mental illness.

Methods:
We performed a systematic review with meta-analyses as an update of a review published in 2013. We registered the study protocol with PROSPERO (registration number: CRD42020170032) and searched for epidemiological studies in MEDLINE, PsycINFO, and Embase. Two reviewers carried out independently all review steps including title-abstract screening, full-text screening, risk-of-bias assessment and data extraction. Discordances were solved by consensus. We determined the certainty of evidence using the GRADE-approach. Results: Ten cohort studies with acceptable study quality examined the relationship between high job strain and the incidence of depression. In the ''classic'' demand-control-model, 'high strain' (combination of high demands and low control) is compared with 'low strain' (combination of low demands and high job control). For high strain, the risk of depression was elevated by 73%, the pooled effect estimate for the risk of depression was 1.73 (95% CI 1.32-2.27. In a dichotomous analysis (without dividing job strain into the four dimensions mentioned above), there was a doubled risk of depression with high job strain (pooled effect estimate = 1.99, 95% CI 1.68-2.35). We found comparable risk estimates for men and women. The GRADE assessment revealed a high certainty of evidence of the association between job strain and depression. We also found a considerably increased risk of anxiety disorder among individuals prone to high job strain.

Conclusions:
This systematic review finds a clear association between high job strain (high demands in combination with low control) and depression as well as anxiety disorders. Acknowledgment: This study was financially supported by SUVA (Schweizerische Unfallversicherungsanstalt). Key messages: High job strain (high demands, low control) is clearly associated with depression and anxiety disorders.
The GRADE assessment revealed a high certainty of evidence of the association between job strain and depression.

Background:
Healthcare systems are facing major challenges due to population ageing, increased need for care, and economic challenges combined with staff shortage. The existing need for longer work careers combined with increasing turnover rates in healthcare highlights the need to understand working hours in association with work capacity and sustainable work careers. We aimed to investigate the concurrent changes in part-time work and sickness absence (SA) among healthcare employees without any SA spell >14 days at baseline.

Methods:
Annual working hour and SA data from 23 hospital districts and cities in Finland for 2008-2019 (172 922 employees with at least one work shift in any year). The sample was restricted to 20274 employees with 31 work shifts/year in 3 consequent years during the follow-up and without any SA spell >14 days at baseline in 2008. Part-time work/year (yes/no), SA months/ year, and nightwork/year (% of nightwork of all shifts) as time varying covariate were used in the group-based trajectory models examining the concurrent changes. Models for age groups (in 2008 and categorized into < 25 years of age, !25 and <40 years, !40 and <55 years, and >55 years) will be considered later.

Conclusions:
These initial findings indicate that while most employees work full-time without SA, those who transfer from working fulltime to part-time during follow-up from 2009 to 2019 seem to have low SA. Thus, part-time work may promote work capacity, and accompanied by part-time work disability benefits, offer a tool for employers to support sustainable working life and to keep older employees at work. Key messages: Part-time work may provide possibility to maintain work participation. An important public health message is to provide possibilities for part-time work accompanied with partial work disability benefits to support sustainable working life.

Background:
Occupational fishery increase risk of musculoskeletal disorders due to a combination of heavy workloads and strenuous settings. Scarce and inconsistent knowledge exists on workrelated risk factors despite high prevalence is evident. The aim was to determine work-related risk factors for the first diagnosis of musculoskeletal disorders in Danish occupational fishermen.

Methods:
This study was a register-based cohort study. We extracted data the from Nationwide Danish registers on work affiliation and health data for all persons registered as occupational fishermen between 1994 and 2017. Job titles were retrieved from the Danish Occupational Cohort with eXposure (DOC Ã X). Time-to-event analysis using cox regression with age as timescale was applied.
Results: Among 15.739 fishermen, forty percent (n = 6.218 cases) experienced first musculoskeletal disorder during 82.2 million person-years of follow-up. Adjusted gender-stratified analysis showed that male fishermen, who worked less than 5 years and more than 15 years had the highest significant risks of MSD (HR 2.40 (95%CI: 2.06, 2.80), HR: 2.40 (95%CI: 1.76, 2.35)) respectively, compared to working more than 20 years. In males, more years in workforce, a captain education and working part time significantly protected against first MSD, while shifting trades above three times increased risk. Women had estimates with greater uncertainties due to their small numbers in the industry.

Conclusions:
A high incidence of musculoskeletal disorders was found in Danish occupational fishermen between 1994-2017. Findings suggest a bimodal relationship between occupational fishermen seniority level and their risk of musculoskeletal disorder, where highest risk was seen at five years in trade, afterwards from lower estimate slowly increasing with accumulating years until highest occupational seniority, compared to more than twenty years in trade. Continued development actions of preventive measures are suggested.

Key messages:
Persons who are working large proportions of their worklife within occupational fishery significantly increase the risk of experiencing first musculoskeletal disorder. High incidence of musculoskeletal disorder cases within Danish occupational fishery was shown, therefor further preventive actions towards work-related risk factors is necessary.

Background:
Precarious employment (PE) is a well-known social determinant of health and health inequalities, yet the effect of PE on mortality has not been explored sufficiently and high-quality longitudinal studies are lacking. When studying this effect, several methodological factors must be considered, one of them being the immortal time bias or prevalent user bias. A framework that helps us overcome these biases is the target trial. Therefore, the aim of this study is to estimate the causal effect of switching from precarious to standard employment (SE) on the 12-year risk of all-cause mortality among precariously employed workers aged 20-55 in Sweden.

Methods:
We emulated the target trial as a series of 11 target trials (starting at any year between 2005 and 2016), such that each individual may participate in multiple trials using Swedish register data (N = 251274). We classified individuals as: a) workers that at baseline (start) move from PE to SE and then followed while in SE or b) continuation of PE over follow-up. All-cause mortality was measured from 2006 to 2017. We pooled data for all 11 emulated trials and used pooled logistic regression to estimate intention-to-treat effects via hazard ratios and standardized survival curves.

Results:
The following results are preliminary. Individuals that continued on PE were 185,480 and those that initiated SE were 65,794. Over the 12-year follow-up, 1553 individuals died. The estimated observational analogue of the intentionto-treat 12-year survival difference for all cause-mortality between workers that continued on PE and those that initiated SE was of -0.2%, and the HR:0.82, 95%CI:0.72-0.94.

Conclusions:
The following conclusions are preliminary. According to our results, we find indication that shifting from PE to SE decreased the risk of death. Our study highlights the crucial role of decent employment conditions for health.

Key messages:
Changing from precarious to more decent employment conditions decreases the risk of death by any cause in a cohort of Swedish workers. This study provides evidence that precarious employment has also an effect on any cause mortality.

Background:
Subjects with lower socioeconomic status (SES) are exposed to higher levels of environmental stressors. The cumulative effects of chronic stressors on cardiometabolic health can be evaluated using the allostatic load (AL) score. Despite the accepted social gradient, clear relationships between social determinants and cardiometabolic health in populations with different sociocultural contexts have been rarely explored. This study aimed to compare the relationships of social determinants with AL in different socioeconomic contexts: unstable Venezuela (VE) and stable Czechia (CZ). Methods: 25-64 years old subjects from two cross-sectional populationbased samples from CZ (2013-2014, n = 1579, 56% females) and VE (2014-2017, n = 1652, 70% females). The AL score