Occupational health check-ups and health-promoting programs and asthma

BackgroundThe focus in occupational health check-ups is in work and health, but they offer also a possibility to assess health behavior and give guidance e.g. on weight control. We wanted to study whether having occupational health checks-up, receiving physicians' advice to change health behavior or participation in health promotion programs had an effect on obesity in a five-year follow-up from 1998 to 2003 in asthmatic and non-asthmatic workers.MethodsAltogether 23,220 individuals aged 20-54years were picked up from a randomized Finnish population sample. Univariate and multivariate logistic regression analysis was used to calculate the risk for obesity in 2003. The variables used in the modelling were gender, age, smoking, asthma, depression, and physical workload.ResultsBoth asthmatic and non-asthmatic workers gained weight during the follow-up. Of the asthmatics 48 and 47% of the non-asthmatics had occupational health-check-up in the last 5years. Of the asthmatics 18 and 14% of the non-asthmatics had received physician's advice to change their health behavior (p30) in 2003 were gender (men OR 1.19), older age (OR 1.25), smoking (OR 1.07) or depression (OR 1.44).ConclusionsResults show that having occupational health checks-up or receiving physicians' advice to change health behavior or participation in health promotion programs did not stop gain of weight during a five-year follow-up. Asthmatic workers did not differ from non-asthmatics. Male gender, older age, smoking, and depression were associated with obesity but not the physical workload.Peer reviewe

Occupational health check-ups and health-promoting programs and asthma

BackgroundThe focus in occupational health check-ups is in work and health, but they offer also a possibility to assess health behavior and give guidance e.g. on weight control. We wanted to study whether having occupational health checks-up, receiving physicians' advice to change health behavior or participation in health promotion programs had an effect on obesity in a five-year follow-up from 1998 to 2003 in asthmatic and non-asthmatic workers.MethodsAltogether 23,220 individuals aged 20-54years were picked up from a randomized Finnish population sample. Univariate and multivariate logistic regression analysis was used to calculate the risk for obesity in 2003. The variables used in the modelling were gender, age, smoking, asthma, depression, and physical workload.ResultsBoth asthmatic and non-asthmatic workers gained weight during the follow-up. Of the asthmatics 48 and 47% of the non-asthmatics had occupational health-check-up in the last 5years. Of the asthmatics 18 and 14% of the non-asthmatics had received physician's advice to change their health behavior (p30) in 2003 were gender (men OR 1.19), older age (OR 1.25), smoking (OR 1.07) or depression (OR 1.44).ConclusionsResults show that having occupational health checks-up or receiving physicians' advice to change health behavior or participation in health promotion programs did not stop gain of weight during a five-year follow-up. Asthmatic workers did not differ from non-asthmatics. Male gender, older age, smoking, and depression were associated with obesity but not the physical workload.Peer reviewe

Asthma diagnosed in late adulthood is linked to work disability and poor employment status

Background: Age at asthma onset is associated with severity and outcomes of the disease. Objective: We studied if age at asthma diagnosis is related to employment and outcomes in working career. Patients and methods: A questionnaire was sent to 2613 adults with asthma in Tampere, Finland, and a follow-up questionnaire was sent after six years. Asthmatics were divided into groups based on their employment status: working full-time or work disability. Logistic regression was used to study the association of age at asthma diagnosis with employment status at baseline and with the risk of exiting full-time work during follow-up period. Results: In cross-sectional analysis, asthma diagnosed in late adulthood (50 + years) was associated with higher OR for having work-disability compared to childhood onset asthma (OR [95% CI] 3.60 [1.43-9.06]). During follow-up, asthma diagnosed in late adulthood was associated with higher OR for exiting full time work compared to childhood-onset asthma (OR 10.87 [3.25-36.40]). Conclusions: Asthma diagnosed in late adulthood is a higher risk for poor employment than asthma diagnosed earlier in life. Adult-onset of asthma is an important factor in view of work ability and early rehabilitation procedures.Peer reviewe

Correlates of employment status in individuals with asthma : a cross-sectional survey

Background: This study aims to elucidate factors that among adults with asthma are associated with working full-time. Methods: This cross-sectional survey of 2613 working-age adults with asthma included questions on asthma history, symptoms and use of asthma medication, socioeconomic factors and health behavior. Full-time workers were compared to groups according to employment status: unemployed, work disability and retired due to age. Results: Adults with asthma working full time were younger and more often nonmanual workers, experienced less asthma symptoms, used less asthma medication and smoked less than subjects with work disability. After adjusting for age, gender, smoking and professional status, having frequent symptoms of asthma during last month was associated with an increase in the risk of unemployment (OR 2.3, 95% CI 1.3-4.2) and with an increase in the risk of work disability (OR 4.4, 95% CI 2.3-8.2). Conclusions: Among adults with asthma, full-time work was associated with younger age, less symptomatic asthma despite of less medication, nonmanual work and less smoking. Having more severe symptoms of asthma was associated with undesirable employment status such as unemployment or work disability. Possibilities to change from manual to nonmanual work may be important in preventing work disability and early exit from work.Peer reviewe

Employment status and changes in working career in relation to asthma : a cross-sectional survey

Background: Asthmatics confront inconveniences in working life that make it more difficult to pursue a sustainable career, such as unemployment and work disability. Ways of dealing with these inconveniences may be career changes. More needs to be known about the backgrounds and consequences of career changes among asthmatics, especially their relation to asthma or a change in asthma symptoms. The aim of this study was to compare earlier career changes of adults with asthma who are working full time to those who have drifted away from active working life because of work disability, unemployment or early retirement. The frequency of having changed tasks, work place or occupation, whether the changes had been driven by asthma and furthermore, whether the changes had affected their asthma symptoms were investigated. Methods: In this population-based survey study, all patients with reimbursement rights for asthma aged 20-65 years in the city of Tampere (total population 190,000), Finland (n = 2613) were recruited. The questionnaire was sent in October 2000 and the response rate was 79%. The questionnaire included questions e.g. on changing tasks, work place and occupation, whether these changes were driven by asthma or associated with change of asthma symptoms. The respondents were divided into four groups: working full-time, work disability, unemployed and retired due to age. We applied ANOVA with Dunnet's post-test (variances were not equal between the groups) for a continued variable age and Chi-squared tests for categorical variables. Logistic regression models were built using unemployed vs. full-time work or work disability vs. full-time work as an outcome variable. A p-value of Results: Adults with asthma working full time had more often made changes in their career, but not as often driven by asthma as those with current work disability. The reason for changing work place compared to full-time workers (24.9%) was more often mainly or partly due to asthma among those with work disability (47.9%, p <0.001) and the unemployed (43.3%, p = 0.006). Of those who made career changes because of asthma, a major proportion (over 67%) reported relief in asthma symptoms. Changing tasks (OR 5.8, 95% CI 1.9-18.0, for unemployment vs. full-time work), work place (OR 2.8, 95% CI 1.1-7.0, for work disability vs. full-time work and OR 2.6, 95% CI 1.3-5.4, for unemployment vs. full-time work) or occupation (OR 2.7, 95% CI 1.2-6.0, for unemployment vs. full-time work) mainly because of asthma was associated with an elevated risk for undesirable employment status even after adjusting for age, gender, smoking and professional status. Conclusions: Career changes that were made mainly because of asthma were associated with undesirable employment status in this study. However, asthma symptoms were relieved after career changes especially among those who reported asthma to be the reason for the change. In addition to proper treatment and counselling of asthma patients towards applicable area of work or study, it may be beneficial to support early career changes in maintaining sustainable working careers among adults with asthma.Peer reviewe

Asthma trigger perceptions are associated with work disability

Objective: To study the association between perceptions of various triggers of asthma and employment status. Methods: A questionnaire was administered to all those adults living in the city of Tampere, Finland, who were entitled to special reimbursement for asthma medication by the Social Insurance Institution (n = 2613). The response rate was 79%. The study population (n = 1657) consisted of individuals who worked full-time (n = 967), were unemployed (n = 197), had all-cause work disability (n = 334), or were retired due to old age (n = 159). Given a list of potential asthma triggers, the respondents were asked how often (never/sometimes/often) the trigger caused or worsened their asthma symptoms during leisure time. Results: After adjusting for background variables (age, sex, smoking, and professional status), frequency of asthma symptoms, and the use of asthma medication during the last year, any individual trigger identified as asthma-relevant was associated with having work disability (vs. working full-time). The highest odds ratio (OR) was found for vehicle exhaust (OR 5.0, CI 2.2-11.4). We found similar but less consistent associations between asthma trigger perceptions and unemployment. No elevated ORs were found regarding asthma trigger perceptions for old-age retirement. Conclusions: Perceptions of asthma triggers are associated with all-cause work disability. Our findings suggest that asthmatics have excess trigger perceptions that are not explained by asthma alone. Asthmatics need to be informed that inaccurate trigger perceptions may develop, and how they are induced, because unnecessary trigger avoidance may interfere with work life.Peer reviewe

FireFit : Pelastajien hyvä fyysisen toimintakyvyn arviointikäytäntö (1.vaihe)

Sisäasianministeriön pelastajien työssä selviytymistä selvittävän työryhmän väliraportin (2005) mukaan pelastajien terveyden ja fyysisen toimintakyvyn ylläpitäminen vaatii ripeitä toimia. Kehittämisen kohteiksi koettiin erityisesti fyysisen toimintakyvyn arviointikäytäntöjen yhtenäistäminen, kuntotestauksen laadun parantaminen, työterveyshuollon asiantuntemuksen käytön lisääminen sekä terveellisiin elintapoihin kannustavan toiminnan kehittäminen. FireFit-hankkeen tavoitteena oli kehittää pelastajille yhtenäinen ja laadukas tietokonepohjainen fyysisen toimintakyvyn arviointimenetelmä, johon sisältyisi mittaustulosten käsittelyn ohella myös palautteenantoja seurantamahdollisuus. Tavoitteena oli kokeilla menetelmän toimivuutta Keski- ja Länsi-Uudenmaan pelastuslaitosten ja heidän työterveyshuoltojensa toiminnassa. Järjestelmän teknisenä ratkaisuna käytettiin AinoActive Oy:n testausjärjestelmää, jonka Puolustusvoimien käyttöön kehitettyä rakennetta (MilFit) muutettiin pelastusalalle soveltuvaksi (FireFit). Hankkeeseen osallistuvilla pelastuslaitoksilla koulutettiin tutkimuksen alussa yhteensä 10 testaajaa käyttämään FireFit-ohjelmaa. Tämän jälkeen testaajat keräsivät FireFit-tietokantaan molempien pelastuslaitosten pelastajilta (N=86) seuraavat tiedot: 1) submaksimaalisella polkupyöräergometritestillä arvioitu maksimaalinen hapenkulutus, 2) tulokset savusukellusohjeen mukaisesti suoritetuista lihaskuntotesteistä, 3) vyötärön ympärysmitta ja painoindeksi, 4) tulokset selän sivutaivutus- ja dynaamisen tasapainon testistä sekä 5) suoritusaika, sykintätaajuus ja kuormittuneisuus tiedot ns. Oulun mallin mukaisesta savusukellustestiradasta. Lisäksi pelastajat vastasivat kyselytutkimukseen, jossa kartoitettiin tietoja elintavoista sekä arvioita koetusta työkyvystä ja koetusta terveydestä. Kerättyjen testitulosten perusteella hahmoteltiin perusteita ns. Pelastajan indeksille. Kehittämishankkeen aikana toteutettiin myös FireFit-ohjelmassa käytetyn submaksimaalisen polkupyöräergometritestin luotettavuustutkimus kannettavalla hengityskaasuanalysaattorilla (N=20). Fyysisten toimintakykytestien suorittaminen ja tulosten kerääminen FireFit-järjestelmällä onnistui parhaiten, mikäli testaajat olivat motivoituneita testaamaan ja pelastuslaitoksen johto antoi tukensa, sitoutui toimintaan sekä jossain määrin valvoi testausaikataulun toteutumista. Palautteen antamiseksi testaajat kokivat tarvitsevansa lisää koulutusta. FireFit-ohjelman ensimmäiseen versioon valitut fyysisen toimintakyvyn testit ja kehon koostumuksen arviointimenetelmät olivat yhteydessä ikään, koettuun työkykyyn ja terveyteen. Tästä linjasta poikkesi tasapainotesti, jonka luotettava käyttö vaatii lisää tutkimusta. Polkupyöräergometritestin luotettavuustutkimus osoitti FireFit-ohjelmalla suoritetun submaksimaalisen testin yliarvioivan maksimaalista hapenkulutusta keskimäärin 1,4% verrattuna mitattuun hapenkulutukseen. Tämä ero pieneni keskimäärin 0,2%:iin, mikäli pelastajan mitattu maksimaalinen sykintätaajuus oli tiedossa. FireFit-ohjelmaan valitut fyysiset toimintakykytestit kuvasivat turvallisesti ja luotettavasti pelastajien fyysistä toimintakykyä, työkykyä ja terveyttä. FireFit-ohjelmalla suoritettu submaksimaalinen polkupyöräergometritesti osoittautui riittävän tarkaksi menetelmäksi pelastajien maksimaalisen hapenkulutuksen arvioimiseksi. Ikään sidotun ns. "Pelastajan indeksin" muodostamiseksi tulisi kerätä lisää fyysisten toimintakykytestien tuloksia eriikäisiltä pelastajilta. FireFit-ohjelmaan tulisi jatkossa kehittää toimiva testaajien koulutusjärjestelmä sekä luoda helppokäyttöinen palaute- ja seurantajärjestelmä

Pelastajien motorinen toimintakyky ja liikkuvuus: FireFit – Fyysisen toimintakyvyn arviointi-, palautteenanto- ja seurantajärjestelmän kehittämisen 3. vaihe

Pelastajilla on paljon tuki- ja liikuntaelinten sairauksia, vammoja ja oireita. Motorisen toimintakyvyn ja liikkuvuuden arviointiin ja siitä johdettuun harjoitteluun tulee kiinnittää huomiota vammojen ehkäisemiseksi. FireFit – Pelastajien fyysisen toimintakyvyn arviointijärjestelmän kehittämishankkeessa 3 kehitettiin FireFit-järjestelmän testaus-, palautteenanto-, harjoittelu- ja seurantaosien sisältöä. Hanke on jatkoa kehittämishankkeille 1 ja 2, joissa luotiin järjestelmän perusta sekä yksilöllinen palaute- ja harjoittelujärjestelmä. Tutkimuksen tuloksia ja suosituksia voidaan soveltaa FireFit-järjestelmän sekä pelastuslaitoksen ja työterveyshuollon toiminnan ja yhteistyön kehittämiseen

FireFit - Pelastajien hyvä fyysisen toimintakyvyn arviointikäytäntö

Työterveyslaitoksen vetämänä toteutettiin FireFit-Pelastajien hyvä fyysisen toimintakyvyn arviointikäytäntö, kehittämishanke vuosina 2006-2007. Siinä luotiin pohja fyysisen toimintakyvyn arviointikäytännölle ja -järjestelmälle