OBJECTIVE: The objectives were to assess the prospective associations between work-related factors, including psychosocial and physical work factors and working time/hours factors, and sickness presenteeism alone or combined with sickness absence.
METHODS: The study relied on prospective data of a national representative sample of 16 129 employees followed up from 2013 to 2016 in France. Work-related factors were assessed in 2013 and included 20 psychosocial work factors, 4 working time/hours factors and 4 physical work factors. Sickness presenteeism was studied using two items in 2016: the presence and duration of sickness presenteeism within the last 12 months. Weighted Hurdle and multinomial logistic regression models were performed to study the prospective associations between work-related factors at baseline and sickness presenteeism (both presence and duration) and sickness absence at follow-up. Models were adjusted for covariates.
RESULTS: Almost all psychosocial and physical work factors were predictive of sickness presenteeism (ORs ranging from 1.30 to 2.07 for men, and from 1.16 to 2.30 for women) but only some of them predicted its duration. Dose-response associations were observed between multiple exposures to these factors and sickness presenteeism. These factors predicted more sickness presenteeism alone or combined with sickness absence than sickness absence alone. Gender differences were observed in these associations, as some associations were found to be stronger among women than among men.
CONCLUSIONS: There is a need to study sickness presenteeism and sickness absence combined. Prevention oriented towards the psychosocial and physical work environment may contribute to reduce sickness presenteeism and sickness absence.

BACKGROUND: Women with breast cancer face many barriers to return to work (RTW) after their cancer. The main objective of the FASTRACS-RCT is to evaluate the impact of the FASTRACS (Facilitate and Sustain Return to Work after Breast Cancer) intervention on the sustainable RTW of breast cancer patients, 12 months after the end of active treatment.
METHODS: FASTRACS-RCT is a prospective, national, multicentre, randomized, controlled and open-label study. A total of 420 patients with early breast cancer scheduled for surgery and (neo)adjuvant chemotherapy, will be randomly assigned (1:1 ratio) to: (i) the intervention arm comprising four steps over 6 months : Handing over the intervention tools; transitional medical consultation with the general practitioner (GP); pre-RTW visit with the company\'s occupational physician (OP); catch-up visit with a hospital-based RTW expert (if sick leave > 10 months) (ii) the control arm to receive usual care. The design of the FASTRACS intervention was informed by intervention mapping for complex interventions in health promotion planning, and involved patients and representatives of relevant stakeholders. Specific tools were developed to bridge the gap between the hospital, the GP, the OP and the workplace: a toolkit for breast cancer patients comprising a theory-based guide; specific checklists for the GP and the OP, respectively; and a theory-based guide for workplace actors (employer, manager, colleagues). The primary endpoint will associate sustainable RTW (full-time or part-time work at 50% or more of working time, for at least 28 consecutive days) and days off work. It will be assessed at 4, 8 and 12 months after the end of active oncological treatment. Secondary endpoints will include quality of life, anxiety, depression, RTW self-efficacy, physical activity, social support, job accommodations, work productivity, job status, and the usefulness and acceptability of the intervention\'s tools.
CONCLUSIONS: FASTRACS-RCT will be supplemented by a realist evaluation approach aimed at understanding the influence of context in activating the intervention\'s mechanisms and effects. If the expected impact of the intervention is confirmed, the intervention will be adapted and scaled-up for other cancers and chronic diseases to better integrate healthcare and work disability prevention.
BACKGROUND: NCT04846972 ; April 15, 2021.

BACKGROUND: Most studies about accidents and about PTSD, respectively, have been conducted either on blue-collar workers, or on the entire working population. There are very few such studies on white-collar workers.
OBJECTIVE: To examine diagnosis-specific sickness absence (SA) and disability pension (DP) after a work accident or PTSD, respectively, among white-collar workers in the private retail and wholesale industry.
METHODS: A prospective population-based cohort study of all 192,077 such workers aged 18-67 (44% women) in Sweden in 2012, using linked microdata from nationwide registers. We identified individuals who had secondary healthcare due to work-related accidents (n = 1114; 31% women) or to PTSD (n = 216; 79% women) in 2012-2016. Their average number of net days of diagnosis-specific SA (in SA spells > 14 days) and DP were calculated for 365 days before and 365 days after the healthcare visit.
RESULTS: 35% of the women and 24% of the men had at least one new SA spell during the 365 days after healthcare due to work accidents. Among women, the average number of SA/DP days increased from 14 in the year before the visit to 31 days the year after; among men from 9 to 21 days. SA days due to fractures and other injuries increased most, while SA days due to mental diagnoses increased somewhat. 73% of women and 64% of men who had healthcare due to PTSD had at least one new SA spell in the next year. Women increased from 121 to 157 SA/DP days and men from 112 to 174. SA due to stress-related disorders and other mental diagnoses increased the most, while DP due to stress-related diagnoses and SA due to musculoskeletal diagnoses increased slightly.
CONCLUSIONS: About a quarter of those who had secondary healthcare due to work accidents, and the majority of those with such healthcare due PTSD, had new SA in the following year. SA due to injury and mental diagnoses, respectively, increased most, however, SA/DP due to other diagnoses also increased slightly. More knowledge is needed on factors associated with having or not having SA/DP in different diagnoses after work accidents and among people with PTSD.

This article aims to explore the experience of long-term work disability (LWD) of users-workers in primary health care (PHC), understanding the therapeutic itineraries and the search for social protection, the elements that contribute to the incapacitation process and the strategies constructed for living with this condition. LWD is a multidimensional phenomenon, with a negative impact on the lives of workers, families and society. PHC has an important role in caring for people on leave from work. This is a qualitative, descriptive-exploratory study of the daily lives of people in situations of LWD. The comprehensive perspective guides the analysis of data co-produced in interviews and field observation. Cross-cutting themes such as social lack of protection, lack of communication and co-operation between key actors that enhance or mitigate LWD were recognised. The social support network proved to be important to access health care and to avoid social decadence. The Family Health Strategy, with technical support in Occupational Health, emerges with potential in the production of care for worker-users, although the fragility of maintaining long-term care.
O artigo objetiva explorar a experiência da incapacidade prolongada para o trabalho (IPT) de usuários-trabalhadores na atenção primária à saúde (APS), compreendendo os itinerários terapêuticos e de busca de proteção social, os elementos que contribuem para o processo de incapacitação e as estratégias construídas para viver com essa condição. A IPT é um fenômeno multidimensional, com impacto negativo na vida do trabalhador, da família e da sociedade. A APS tem papel relevante no cuidado de pessoas em afastamento do trabalho. Trata-se de uma pesquisa qualitativa de caráter descritivo-exploratório, apoiada no estudo do cotidiano de pessoas em situação de IPT. A perspectiva compreensiva orienta a análise dos dados coproduzidos em entrevistas e em observação de campo. Foram reconhecidos temas transversais, como a desproteção social e a falta de comunicação e cooperação entre os atores-chave que potencializam ou atenuam a IPT. A rede de apoio social mostrou-se importante para acessar a assistência à saúde e para evitar a decadência social. A Estratégia de Saúde da Família, com a retaguarda técnica em saúde do trabalhador, emerge com potencial na produção do cuidado aos usuários-trabalhadores, embora permaneça a fragilidade em manter a longitudinalidade do cuidado.

UNASSIGNED: Hair cortisol concentration (HCC) indicates chronic stress exposure, which is a risk factor in the pathogenesis of burnout and depression. However, findings on HCC are inconsistent. Similarly, intervention studies show mixed effects on HCC. The present study aimed to shed light on these inconsistencies, by additionally considering also hair cortisone.
UNASSIGNED: Twenty-five patients with a burnout-related depressive disorder receiving a multimodal inpatient treatment for clinical burnout and 17 matched healthy controls participated in this study. All participants provided 1 cm long hair samples at the beginning and end of the treatment. HCC and hair cortisone levels (HCNC) were determined. Meteorological data and duration of sick leave were considered as potential covariates. Burnout and depression were assessed with self-ratings, the latter also with examiner ratings.
UNASSIGNED: There were no significant group differences in glucocorticoid levels. Treatment led to a decrease in both depression severity and hair glucocorticoid concentration in inpatients, while lower HCNC in particular predicted a greater reduction in depression severity. Moreover, meteorological data and the duration of sick leave were also found to have an effect on hair glucocorticoid concentrations.
UNASSIGNED: These results suggest that multimodal inpatient treatment of clinical burnout considerably reduced stress on both a psychological and biological level. In parallel, hair glucocorticoids appear to be sensitive biomarkers for the evaluation of treatment success and prediction. Examining both HCC and HCNC in intervention studies may provide clearer results than the usual examination of HCC alone.

OBJECTIVE: Many adolescents, especially girls, report temporomandibular disorder (TMD) symptoms that may impact their daily life.
METHODS: At 19 different schools participating in the preventive program with dental nurses of FRAMM (Fluoride, Advise, Arena, Motivation, Food), at the Västra Götaland Region in Sweden, 15-year-old girls were invited to a cohort study about symptoms of TMD that also included headaches. Three hundred twenty-nine girls attended the study and answered a questionnaire regarding TMD symptoms and their consequences such as sick leave from school and consumption of analgesics. The girls were asked about the symptom\'s influence on their daily life, about their general health, use of regular medication, physical activity, and they answered the PHQ4 regarding experienced symptoms of anxiety and depression.
RESULTS: There was a significant correlation between TMD symptoms and sick leave with 31% of the girls having stayed home due to symptoms. Of the girls who answered affirmative in the screening questions (3QTMD), nearly half the group had stayed at home due to their symptoms, 24% had consulted a physician, 42% had used analgesics weekly and 59% reported that they felt the symptoms negatively affected their school performance. The girls who had regular medication had more TMD symptoms. Anxiety and depression were associated with TMD symptoms.
CONCLUSIONS: The study showed that TMD symptoms had a negative impact on the 15-year-old girls\' daily life resulting in sick leave from school, consumption of analgesics, and experiences of negative impacts on their behavior and performance at school.

BACKGROUND: Common mental health problems, such as stress, anxiety and depression, are highly prevalent among workers and often lead to long-term absenteeism and work disability. Effective elements found in previous researched interventions were to explicitly focus on return to work (RTW) and not solely on symptom reduction, to take into account the employees\' cognition towards RTW and to include the workplace environment. Based on these elements, a stepped-care approach was developed. The aim of this paper is to present the study design of a randomized controlled trial (RESTART), evaluating the effectiveness of the stepped-care approach on lasting RTW and the implementation process.
METHODS: RESTART is a randomized controlled trial with a 2 × 2 factorial design and a follow-up of one year. Employees eligible for this study are those who reported sick within 2 to 8 weeks with psychological distress based on a distress screener. Participants will be randomized to a group receiving a tailored e-Health app or usual care, as well as randomized to a group receiving a Participatory Approach (PA; conversational method) in the workplace or usual care. The PA will however only be provided in case of persistent sickness absence at 8 weeks. Measurements take place at baseline, after the e-Health intervention period (3 months), and after the PA intervention period (6 months) and 12 months. Primary outcome is lasting RTW, defined as full RTW in previous or equal work for at least four consecutive weeks. Secondary outcomes are (the severity of) stress-related symptoms, total number of sickness absence days, self-efficacy for RTW and self-reported health. A process evaluation including a realist evaluation will also be conducted.
CONCLUSIONS: Early intervention that focuses on RTW, the cognition towards RTW despite symptoms and involves the workplace environment, plays a crucial role in managing sickness absence among employees with psychological distress. If effective, the stepped-care approach is relevant for employees, employers and society as a whole.
BACKGROUND: ISRCTN: 90663076. Registered on 5 October 2023.

UNASSIGNED: Although work provides many benefits, occupational mental disorders, such as mental distress, depression, and stress-related illnesses have significantly increased.
UNASSIGNED: This study aims to identify and present the spatial distribution of the major mental and behavioral disorders that lead to sick leave in Brazil Northeastern states.
UNASSIGNED: This descriptive study with an ecological time series design aimed to identify the distribution of occupational mental and behavioral disorders in Brazil Northeastern states. Data collection included downloading information from the Observatório de Segurança e Saúde no Trabalho (SmartLab, Occupational Health and Safety Observatory) from 2012 to 2018. Data were analyzed using Python.
UNASSIGNED: Grants of sick leave according to the type of illness were recorded for nonaccident-related leave (B31) and accident-related leave (B91). Bahia had the highest number of cases reported for B31, as did Rio Grande do Norte for B91. Rio Grande do Norte and Alagoas stood out with the highest rates of sick leave due to mental and behavioral disorders. Phobic-anxiety disorders had the highest number of notifications. The building construction industry had the highest number of work-related notifications.
UNASSIGNED: This study has contributed to identifying the main occupational disorders. Public policies need to be implemented to tackle the public health crisis which directly impacts on domestic social and economic conditions.
UNASSIGNED: Mesmo diante dos benefícios que a atividade laboral proporciona, tem-se observado um aumento significativo no número de trabalhadores com sofrimento psíquico, depressão e doenças associadas ao estresse.
UNASSIGNED: Identificar e apresentar a distribuição espacial por estado do Nordeste dos principais transtornos mentais e comportamentais que geram afastamento da atividade laboral.
UNASSIGNED: Realizou-se um estudo descritivo com desenho ecológico de série temporal, cuja finalidade é identificar a distribuição de transtornos mentais e comportamentais em trabalhadores da região Nordeste. Para a coleta de dados, utilizou-se o Observatório de Segurança e Saúde no Trabalho (SmartLab) mediante o download das informações notificadas no período de 2012 a 2018. A análise foi realizada por meio da linguagem de programação Python.
UNASSIGNED: As concessões de auxílios por afastamento conforme o tipo de doença foram registradas para afastamentos não acidentários (B31) e acidentários (B91). A Bahia apresentou um maior número de casos notificados para B31, assim como o Rio Grande do Norte para B91. O Rio Grande do Norte e Alagoas se destacaram como os estados que concentram o maior percentual de casos de afastamento por transtornos mentais e comportamentais. Os transtornos fóbico-ansiosos obtiveram o maior número de notificações entre os estados. A atividade de construção de edifícios se revelou com os maiores números de notificações relacionadas ao trabalho.
UNASSIGNED: Este estudo contribuiu para a identificação dos principais transtornos que acometem os trabalhadores. É necessário que sejam adotadas políticas públicas no enfrentamento da crise de saúde pública que impacta diretamente as condições sociais e econômicas do país.

We aimed to investigate the associations of working hour characteristics based on the international and local definitions with sickness absence (SA) among airport security personnel. The payroll-based registry data of daily working hours for 2016-2019 at one airport was limited to those with ≥30 work shifts in a year (n=377-687 employees). The conditional Poisson model for incidence rate ratios (IRR) with 95% confidence intervals (CI) was used for analyses. Based on the international definitions, only a few associations were found: each one-unit increase in weekly working hours and the number of consecutive working days were associated with a lower likelihood of SA. The local definitions were more consistently associated with SA: Each one-unit increase in shift length and time between shifts, higher variation in shift length, and the number of consecutive evening and night shifts were associated with a higher likelihood of SA. To conclude, especially the local definitions of working hour characteristics seem to be important limits for short SA. Thus, high variability of shift lengths and prolonged shifts could be avoided to reduce the risk of SA. Overall, keeping the working hours within any of the recommendations among airport security personnel could support well-being and health.

BACKGROUND: Returning to work after long-term sick leave can be challenging, particularly in small- and medium-sized enterprises (SMEs) where support may be limited. Recognizing the responsibilities and challenges of SME employers, a web-based intervention (hereafter the SME tool) has been developed. The SME tool aims to enhance the employer\'s intention and ability to support the sick-listed employee. Based on the Self-Determination Theory, it is hypothesized that this intention is enhanced by intervening in the employer\'s autonomy, competences, and relatedness targeted at, e.g., communication with sick-listed employee, involvement of other stakeholders, and practical support. This is achieved by means of providing templates, communication videos, and information on legislation. This article describes the design of an effect and process evaluation of the SME tool.
METHODS: A randomized controlled trial (RCT) with a 6-month follow-up will be conducted with a parallel-group design with two arms: an intervention group and a control group. Sick-listed employees (≤ 8 weeks) of SMEs (≤ 250 employees) at risk of long-term sick leave and their employers will be recruited and randomly allocated as a dyad (1:1). Employers randomized to the intervention group receive unlimited access to the SME tool, while those in the control group will receive care as usual. The primary outcome is the satisfaction of the employee with the return to work (RTW) support provided by their employer. Secondary outcomes include social support, work performance, and quality of work life at the employee level and self-efficacy in providing RTW support at the employer level. Outcomes will be assessed using questionnaires at baseline and 1, 3, and 6 months of follow-up. Process evaluation measures include, e.g., recruitment and use of and perceived usefulness of the SME tool. Additionally, semi-structured interviews with employers, employees, and occupational physicians will explore the interpretation of the RCT results and strategies for the national implementation of the SME tool.
CONCLUSIONS: The SME tool is hypothesized to be valuable in addition to usual care helping employers to effectively support the RTW of their long-term sick-listed employees, by improving the employers\' intention and ability to support.
BACKGROUND: ClinicalTrials.gov, NCT06330415. Registered on February 14, 2024.