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Objective This study investigates the impact of physical workload factors and occupational class on working life expectancy (WLE) and working years lost (WYL) in a sample of older Finnish workers. Methods A 70% random sample of Finns in 2004 was linked to a job exposure matrix for physical workload factors and register information on occupational class and labor market status until 2014. Transitions between being at work, time-restricted work disability, unemployment, economic inactivity, disability retirement, retirement and death were estimated. A multistate Cox regression model with transition-specific covariates was used to estimate the WLE and WYL at age 50 up to 63 years for each occupational class and physical workload factor for men and women (N=415 105). Results At age 50, male and female manual workers had a WLE of 10.13 and 10.14 years, respectively. Among both genders, manual workers had one year shorter WLE at age 50 than upper non-manual employees. This difference was largely attributable to unemployment (men: 0.60, women: 0.66 years) and disability retirement (men: 0.28, women: 0.29 years). Self-employed persons had the highest WLE (11.08 years). Men and women exposed to four or five physical workload factors had about one year lower WLE than non-exposed workers. The difference was primarily attributable to ill-health-related reasons, including disability retirement (men: 0.45 years, women: 0.53 years) and time-restricted work disability (men: 0.23, women: 0.33 years). Conclusions Manual workers and those exposed to physical workload factors had the lowest WLE. The differences in WYL between exposure groups can primarily be explained by ill-health-based exit routes.

OBJECTIVES: This study aims to investigate the extent to which low job control and heavy physical workload in middle age explain educational differences in all-cause and ischemic heart disease (IHD) mortality while accounting for important confounding factors. METHODS: The study is based on a register-linked cohort of men who were conscripted into the Swedish military at around the age of 18 in 1969/1970 and were alive and registered in Sweden in 2005 (N=46 565). Cox proportional hazards regression models were built to estimate educational differences in all-cause and IHD mortality and the extent to which this was explained by physical workload and job control around age 55 by calculating the reduction in hazard ratio (HR) after adjustments. Indicators of health, health behavior, and other factors measured during conscription were accounted for. RESULTS: We found a clear educational gradient for all-cause and IHD mortality (HR 2.07 and 2.47, respectively, for the lowest compared to the highest education level). A substantial part was explained by the differential distribution of the confounding factors. However, work-related factors, especially high physical workload, also played important explanatory roles. CONCLUSION: Even after accounting for earlier life factors, low job control and especially high physical workload seem to be important mechanistic factors in explaining educational inequalities in all-cause and IHD mortality. It is therefore important to find ways to reduce physical workload and increase job control in order to decrease inequalities in mortality.

Waste management workers experience high stress and physical strain in their work environment, but very little empirical evidence supports effective health management practices for waste management workers. Hence, this study investigated the effects of worker characteristics and biometric indices on workers’ physical and psychological loads during waste-handling operations. A biometric measurement system was installed in an industrial waste management facility in Japan to understand the actual working conditions of 29 workers in the facility. It comprised sensing wear for data collection and biometric sensors to measure heart rate (HR) and physical activity (PA) based on electrocardiogram signals. Multiple regression analysis was performed to evaluate significant relationships between the parameters. Although stress level is indicated by the ratio of low frequency (LF) to high frequency (HF) or high LF power in HR, the results showed that compared with workers who did not handle waste, those who did had lower PA and body surface temperature, higher stress, and lower HR variability parameters associated with higher psychological load. There were no significant differences in HR, heart rate interval (RRI), and workload. The psychological load of workers dealing directly with waste was high, regardless of their PA, whereas others had a low psychological load even with high PA. These findings suggest the need to promote sustainable work relationships and a quantitative understanding of harsh working conditions to improve work quality and reduce health hazards.

Background Demands of physical work are related to musculoskeletal disorders, and hence, important to assess. The Physical Workload Questionnaire (PWQ) is based on 26 items related to physical workload. The PWQ has been translated into Norwegian, but its psychometric properties have not yet been tested. The aim of this study was to assess the validity and reliability of the PWQ among patients with musculoskeletal disorders. Methods A cross-sectional study with a test-retest design was conducted to assess construct validity (structural validity and hypothesis testing) and reliability (internal consistency and test-retest reliability) among employed patients with musculoskeletal disorders. Exploratory factor analysis was performed to assess the structural validity and number of items to be included in the Norwegian version of the PWQ. Hypothesis testing was assessed by 14 a priori hypotheses (“known” group, convergent and discriminant validity). Internal consistency was evaluated using Cronbach’s alpha and test-retest reliability by Intraclass Correlation Coefficient (ICC 2.1 ), Standard Error of Measurement (SEM agreement ) and Smallest Detectable Change (SDC 95% ind). Results In total, 115 patients with a mean age (SD) of 46 (9) years were included, of which 48 were included in the reliability analyses. Exploratory factor analysis resulted in two subscales: “Heavy physical work” (15 items, range 0–100) and “Long-lasting postures and repetitive movements” (7 items, range 0–100). No floor or ceiling effects were seen in the subscales. Twelve of the 14 (85%) predefined hypotheses were confirmed. The internal consistency with Cronbach’s alpha was 0.94 and 0.85 on subscales 1 and 2, respectively. Test-retest reliability analyses demonstrated an ICC 2.1 of 0.96 (95% CI 0.88, 0.98) and 0.92 (95% CI 0.81, 0.96), SEM of 6.9 and 10.0 and SDC 95% ind of 19.2 and 27.7 of subscales 1 and 2, respectively. Conclusions The Norwegian version of the PWQ demonstrated good validity and reliability and can be used to evaluate physical workload in patients with musculoskeletal disorders.

PurposeThis study investigated the association between menstrual symptoms and the intention to leave work among female nurses in Japan.MethodsThis cross-sectional study investigated female nurses (n = 317) at two university hospitals. The items measured were their characteristics (e.g., age, body mass index), “intention to leave” work, somatic symptoms related with menstruation, self-reported menstrual characteristics (e.g., pain), physical workloads (e.g., working hours and night shifts) and psychological workloads, measured with the Copenhagen Burnout Inventory (CBI), and the Job Content Questionnaire (JCQ). Participants with at least four somatic symptoms (e.g., cold, fatigue) which are present during their menstrual cycles were considered to have “somatic symptoms associated with menstruation.” We also measured serum ovarian and gonadotropin-releasing hormones.ResultsApproximately 40% of women answered “intention to leave” work, and 17% had “somatic symptoms associated with menstruation.” Multiple logistic regression analysis suggested that nurses reporting “somatic symptoms associated with menstruation” were more likely to have “intention to leave” work: the adjusted odds ratios (AOR, 95% confidence interval [CI]) were 2.15 (1.12–4.11) in the personal-burnout model, 2.23 (1.16–4.31) in the work-related burnout model, 2.91 (1.52–5.56) in the client-related burnout model; 2.96 (1.50–5.82) in the JCQ model. There was no association between serum and gonadotropin hormones and the intention to leave.ConclusionSomatic symptoms with menstruation were associated with intention to leave work among female Japanese nurses. Intervention for somatic symptoms with menstruation might support nurses to continue work.

Background The prevalence of workers with demanding physical working conditions in the European work force remains high, and occupational physical exposures are considered important risk factors for musculoskeletal disorders (MSD), a major burden for both workers and society. Exposures to physical workloads are therefore part of the European nationwide surveys to monitor working conditions and health. An interesting question is to what extent the same domains, dimensions and items referring to the physical workloads are covered in the surveys. The purpose of this paper is to determine 1) which domains and dimensions of the physical workloads are monitored in surveys at the national level and the EU level and 2) the degree of European consensus among these surveys regarding coverage of individual domains and dimensions. Method Items on physical workloads used in one European wide/Spanish and five other European nationwide work environment surveys were classified into the domains and dimensions they cover, using a taxonomy agreed upon among all participating partners. Results The taxonomy reveals that there is a modest overlap between the domains covered in the surveys, but when considering dimensions, the results indicate a lower agreement. The phrasing of items and answering categories differs between the surveys. Among the domains, the three domains covered by all surveys are “lifting, holding & carrying of loads/pushing & pulling of loads”, “awkward body postures” and “vibrations”. The three domains covered less well, that is only by three surveys or less, are “physical work effort”, “working sitting”, and “mixed exposure”. Conclusions This is the fırst thorough overview to evaluate the coverage of domains and dimensions of self-reported physical workloads in a selection of European nationwide surveys. We hope the overview will provide input to the revisions and updates of the individual countries’ surveys in order to enhance coverage of relevant domains and dimensions in all surveys and to increase the informational value of the surveys.

Feedback on cognitive workload may reduce decision-making mistakes. Machine learning-based models can produce feedback from physiological data such as electroencephalography (EEG) and electrocardiography (ECG). Supervised machine learning requires large training data sets that are (1) relevant and decontaminated and (2) carefully labeled for accurate approximation, a costly and tedious procedure. Commercial over-the-counter devices are low-cost resolutions for the real-time collection of physiological modalities. However, they produce significant artifacts when employed outside of laboratory settings, compromising machine learning accuracies. Additionally, the physiological modalities that most successfully machine-approximate cognitive workload in everyday settings are unknown. To address these challenges, a first-ever hybrid implementation of feature selection and self-supervised machine learning techniques is introduced. This model is employed on data collected outside controlled laboratory settings to (1) identify relevant physiological modalities to machine approximate six levels of cognitive-physical workloads from a seven-modality repository and (2) postulate limited labeling experiments and machine approximate mental-physical workloads using self-supervised learning techniques.

Objectives This study aims to (i) evaluate relative risks, excess fraction of cases, and rate advancement periods for total hip replacement (THR) due to primary osteoarthritis in relation to lifelong cumulative physical workload and (ii) describe temporal trends in the proportion employed in the most highly exposed industries from 1986—2006. Methods In a cohort study of the Danish working population, we assessed cumulative physical workload by combining year-by-year register information on employment industry with an industry exposure matrix that provided point scores (0—2) of physical workload. Cumulative physical workload was expressed as point-years corresponding to the pack-year concept of smoking. We retrieved register information on first-time THR during 1996—2006 and used a logistic regression technique to fit discrete time hazards models adjusting for age and other factors. We calculated excess fraction of cases and rate advancement periods. Results Total numbers of point-years ranged from 0—86. For men, an exposure—response relation was observed reaching an odds ratio of 1.33 [95% confidence interval (95% CI) 1.17—1.53] for the highest exposure category (35—86 point-years) compared to 0 point-years. The excess fraction of cases was 18%, and THR took place up to 3.4 years earlier with increasing exposure. For women, no exposure—response relation was found. Conclusions At the population level, cumulative physical workload increased the risk of THR among men, with surgery being performed slightly earlier in life. The proportion employed in the most highly exposed industries remained constant.

ObjectiveFew earlier studies on cumulative exposure to high physical workload and shoulder diseases have been reported. This study aimed to investigate the association between cumulative exposure to heavy lifting and working with hands above shoulder level and diagnosed shoulder diseases across four Nordic countries.Material and MethodsA meta-analysis was performed using four national register-based cohorts: the Finnish SLFF, the Norwegian Nor-Work, the Swedish SWIP and the Danish DOC*X. Exposures to heavy lifting and working with hands above shoulder level were assessed using a gender-specific European job exposure matrix (EuroJEM) for physical workload assigned to occupational codes. Participants born 1933-1985 with at least 10 years of employment were followed until first patient visit due to shoulder disease (ICD-10 codes M75), death, emigration, or end of follow-up. Cumulative exposure was calculated as years exposed from age 25-35, categorised as 0, 1-5, 6-10 and >10 years. Discrete time hazard models were used to study associations between cumulative exposures and shoulder diseases in each cohort. Meta-analyses were performed using a random effect model.ResultsThe relative risks of shoulder diseases increased with number of years exposed to heavy lifting and working with hands above shoulders until 6-10 years of exposure. In men the risks were similar in size for 6-10 years (pooled HR 1.65[1.41;1.94] for lifting, 1.57[1.37;1.81] for hands above shoulders) and >10 years of exposure. Among women, those exposed to heavy lifting (pooled HR 1.51[1.33;1.72]) and working with hands above shoulder (HR 1.48[1,27;1.72]) for 6-10 years had the highest risks.ConclusionReducing prolonged exposure to heavy lifting and working with hands above shoulder level has a high potential to prevent shoulder diseases in both genders.FundingThe study is part of the Exposome Project for Health and Occupational Research (EPHOR) funded by the European Union’s Horizon 2020 research and innovation programme.

ObjectiveThis study aims to investigate the impact of occupational heavy physical workload on life-course labor market participation expressed by working life expectancy and working years lost among men and women in Sweden.Material and MethodsData from the SWIP (Swedish Work, Illness, and labor market Participation) cohort of the registered Swedish population in 2005 born from 1945 to 1975 were utilized (circa three million individuals). The multi-state Estimated Labor Market Affiliation (ELMA) method was used to estimate working life expectancy and working years lost due to unemployment, sickness absence due to musculoskeletal diagnoses, sickness absence due to other causes, other time outside of work, disability pension, early old-age pension, and death over a 15-year period (2006-2020), while adjusting for confounders. Physical workload was assessed through a job exposure matrix (JEM).ResultsWe found that men and women with low occupational physical workload have a longer working life expectancy (26.86 years for men and 25.77 years for women at age 30) compared to those in medium (24.29 years for men and 22.65 years for women at age 30) or high levels (24.50 years for men and 22.54 years for women at age 30) of physical workload. Those in high physical workload jobs lost more working time to musculoskeletal-related sickness absence, sickness absence due to other causes, unemployment, and death, while those in medium physical workload jobs lost more time due to disability pension and early old age pension.ConclusionThat those in low physical workload jobs could expect a longer working life while those with medium and high levels of physical workload could expect a similar length of working life indicates that any elevated level of physical workload can reduce labor market participation.FundingThe Swedish Research Council for Health, Working Life, and Welfare supported this research (Forte 2021-01548 and 2023-01561).