Current Practices And Perceived Implementation Barriers For Working With Alcohol Prevention In Occupational Health Services: The WIRUS OHS Study
1OsloMet - Oslo Metropolitan University, Oslo, Norway; 2Norwegian Institute of Public Health, Bergen, Norway; 3Stavanger University Hospital, Stavanger, Norway; 4University of Stavanger, Stavanger, Norway; 5Diakonhjemmet Hospital, Oslo, Norway; 6Karolinska Institutet, Stockholm, Sweden; 7Presenter - Making Sense of Science, Stavanger, Norway
Background: The workplace may be a serviceable arena for targeting employees' alcohol problems, especially due to its impact on presenteeism and sick leave. However, little is known about the role occupational health services (OHS) play in targeting this public health problem.
Objectives: The aims of this study were to explore current practices of such preventive efforts in a sample of OHS professionals, investigate whether perceived implementation barriers are associated with such preventive efforts, and explore whether barriers display differential associations across different risk groups.
Methods: In a cross-sectional design, survey data were collected from 295 OHS professionals in Norway. Reported alcohol-preventive efforts were analysed by means of descriptive statistics and one-way analysis of variance (ANOVA). Associations between alcohol-preventive efforts and implementation barriers were explored by applying multiple hierarchical regression analyses.
Results: The OHS' were most focused on targeting problem drinkers or heavy drinkers (tertiary prevention), and more seldom working with those at risk (secondary prevention). Yet overall, alcohol-preventive efforts were quite limited. Barriers concerning the competence among OHS' and their resources were associated with alcohol-preventive efforts across all different risk groups, but barriers concerning employers and employees were not.
Conclusion: This study revealed that to increase the implementation of workplace primary preventive interventions targeting alcohol problems, presenteeism and sick leave, it is necessary to facilitate training of OHS professionals as well as ensuring sufficient time and resources for addressing this important public health challenge.
Is Alcohol Consumption Among Employees A Risk Factor For Presenteeism? A Systematic Review
1OsloMet - Oslo Metropolitan University, Oslo, Norway; 2VID Specialized University, Sandnes, Norway; 3University of Stavanger, Stavanger, Norway; 4Diakonhjemmet Hospital, Oslo, Norway; 5Presenter - Making Sense of Science, Stavanger, Norway
Background: Alcohol consumption is a major risk factor for disease, disability and mortality, as well as being associated with sickness absence. Presenteeism (reduced on-the-job productivity) is an important, but under-researched topic.
Objective: The aim of this review was to explore whether evidence in the research literature supports employees' alcohol consumption to be a risk factor for presenteeism in the workplace.
Methods: Primary observational studies, published 1990 or later in English or a Scandinavian language, were included. Tested associations in the included data were quality assessed and analyzed descriptively with frequency tables and cross tabulations. Associations' measurements were categorized by means of content analysis. 26 articles, containing 132 tested associations, were included in the review.
Results: The vast majority of the tested associations (77 %) indicated a positive relationship between alcohol consumption and presenteeism (i.e., higher consumption associated with higher presenteeism), and positive associations were considerably more likely than negative to be statistically significant (OR = 14.00, p <.001). Alcohol measurements based on hangovers and composite instruments were overrepresented among significant positive associations of moderate or high quality. However, negative associations (19 %) were, compared to positive, less likely to be of low quality (OR = 0.22, p <.01). Overall, the majority of tested associations were characterized by low quality.
Implications: Workplace interventions aimed at improving productivity could benefit from including an emphasis on alcohol consumption.
Conclusion: Evidence suggests alcohol consumption to be associated with presenteeism. However, due to the lack of longitudinal designs and low research quality, existing evidence may still be characterized as inconclusive regarding whether alcohol constitutes a risk factor for presenteeism. More robust and less heterogeneous research is needed.
How Much or How Often? Alcohol Consumption, Sickness Presenteeism, and impaired Daily Activities
1University of Stavanger, Norway; 2Oslo Metropoletan University, Oslo, Norway; 3Presenter - Making Sense of Science, Stavanger, Norway
Background: Harmful alcohol consumption constitutes a global public health issue. Studies conducted in developed countries have identified between 10 and 35% of employees as risky drinkers. Employees' alcohol consumption may influence their activity performance across domains, including the occupational and domestic spheres. Studies have found high levels of alcohol use to be associated with sickness presenteeism, i.e., reduced on-the-job productivity as well as impaired daily activities. Drinking frequency and drinking intensity (episodic heavy drinking or binge drinking) may have dissimilar effects on activity performance.
Aim: The aim of this study was to explore and compare the influence of two aspects of alcohol consumption (drinking frequency, i.e., “how often” and drinking intensity, i.e. “how much”) on sickness presenteeism and impaired daily activities.
Methods: Cross-sectional data from 3278 Norwegian employees were collected. Drinking frequency and intensity were measured with items from the Alcohol Use Disorders Identification Test (AUDIT), developed by the WHO. Frequency was measured by asking to rate how often they had consumed alcohol during the last year. Intensity was measured by asking how often during the last year they had had binge drinking episodes, i.e., six or more alcohol units on a single occasion. The two activity performance items were taken from the Work Productivity and Activity Impairment questionnaire (WPAI).
Results: Results showed that drinking intensity (how much) displayed significant associations with both sickness presenteeism and impaired daily activities. Drinking frequency (how often) did display a significant association with impaired daily activities, but to a lesser degree than drinking intensity.
Conclusion: Frequent drinking over time is a risk factor for long-term health complications. However, high-frequency drinking would not necessarily produce short-term impairments comparable to binge drinking episodes (how much each time).The study found also that drinking intensity displayed a stronger association with impaired daily activities than with sickness presenteeism.
Employee Perspectives Of A Workplace Health Programme
University of Southern Denmark, Denmark
Background:Risk of long-term sick leave increases with high physical occupational load while it decreases with high leisure time physical activity. Sønderborg Municipality in the Southern Region of Denmark has since 2008 offered a workplace health programme including various initiatives to promote a healthy lifestyle for employees. Elected health- and safety representatives are expected to act as health ambassadors and promote the health programme at the workplace. The aim of this study wasto understand how a workplace health programme is received and used by the employees.
Methodology: A comparative case study design was used with two different workplaces within the municipality serving as cases. Observations and interviews were done among employees from all layers of the workplaces and was analysed using Malteruds systematic text condensation.
Results: Preliminary findings indicate that health- and safety representatives appointed as ambassadors for the health programme is problematic. The representatives do not feel confident because they lack proper training in the ambassador tasks. On the other hand employees and management in both workplaces emphasize that changing workplace culture in a more healthy direction will require employee driven processes. Decisions about health from the management alone may even have the opposite effect on some employees.
Conclusion:From an employee perspective Sønderborg Municipality’s health programme has implementation challenges because the health- and safety representatives are poorly prepared and empowered to cover all the complex aspects of the health ambassador job.
Does It Work? Introducing Work Focus Into a Lifestyle Intervention for Persons With Morbid Obesity
1The Norwegian National Advisory Unit on Occupational Rehabilitation; 2Muritunet Rehabilitation Centre; 3Volda University College
Obesity is related to lower labor force participation, increased sickness absence and reduced productivity. This indicates that work rehabilitation may be important for persons with obesity. Despite this connection, work focus has not been a part of lifestyle interventions for persons with morbid obesity.
In our study, we wanted to examine whether introducing a work intervention in a lifestyle changing rehabilitation program affects the participants’ ability to work and their lifestyle. We also wanted to find out how the participants experienced their health, work ability and work capacity, quality of life, diet and self-efficacy before and during the intervention. We hypothesised that work focus would lead to higher work participation.
The study was designed as a randomized controlled study with an exploring prospective design. It included 178 participants, where 99 participants completed the whole intervention and formed the data-foundation. Of these, 20 were interviewed. The lifestyle group was randomized into two interventions, one with work intervention one without. The work intervention entailed lectures and individual guidance from a work consultant. Data material gathered at each stay consisting of forms, test (such as measurements of weight, BMI and aerobe capacity), journal and individual interviews. These were all collected at baseline, and at six and twelve months.
Results from this study was that there is only a small difference between the interventions regarding achieved work participation from the start to the end of the study. Most of the participants interpreted their intervention as a process of lifestyle change, rather than a process to improve their capacity to work.
However, the participants in the intervention with a work focus had in general better overall results, i.e. they had:
- Bigger weight loss.
- Higher work capacity (VO2 peak).
- Greater belief on their ability to meet work demands.
The Relationship between Occupational Physical Activity and Need for Recovery: A cross sectional analysis from the DPhacto cohort
1The National Research Center for the Working Environment, Denmark; 2The University of Sydney, Australia; 3University of Gävle, Sweden; 4University of Copenhagen, Denmark; 5University of Tampere, Finland
Sustainable employment is one of the greatest problems facing modern economies. As an intermediate measure of sustainable employment, a person’s Need For Recovery (NFR) refers to the extent that the work task induces a need to recuperate from work induced effort, and has been linked to employee wellbeing, sickness absence and employee turnover. In this study we sought to determine the relationship between objectively measured Occupational Physical Activity (OPA) and NFR, as well as identify any moderating effect of age on this relationship.
This was a cross-sectional analysis of the DPhacto cohort. Physical activity data was collected on 840 white and blue-collar workers using tri-axial accelerometery worn on the thigh for several days. NFR was collected utilising a shortened version of the Danish NFR scale. Analysis was conducted in R utilising linear regression modelling of compositional data and compositional isotemporal substitution modelling.
Preliminary results show a significant effect of the OPA composition on NFR (p<0.001). The effect of allocating 15 minutes of time to a particular activity (from all activities) was significant for sedentary behaviours (β=-0.018 ± 0.011), but not for standing (β=-0.011 ± 0.022), light physical activities (moving/slow walking; β=0.021 ± 0.041) or more vigorous activities (fast walking, running, cycling; β=0.030 ± 0.046)
Increasing sedentary behaviours seems to be associated with a decreased NFR. However, multivariate analyses investigating potential modifying effects of age still remain, and will be available for presentation at the conference.