Effects of psychosocial determinants of health at work on well-being over time: a systematic review of the literature with narrative synthesis

The temporal question is central to the research on the psychosocial determinants, because of the possibility of studying and deepening the dynamics of this complex web of interactions, which is only possible through longitudinal studies and the use of sophisticated statistical analyses. In order to update the existing information on this field of research using an epidemiological approach, scientific information on the effects of the psychosocial determinants associated with work on the health and Well-being of workers over time was collected and systematized Searches were performed to the databases Medline via PubMed, Embase, PsycInfo, Google Scholar and journals publishing in this area according selection criteria. The selection was performed by two of the authors independently Seven longitudinal studies were identified that met the inclusion criteria and more than 50% of previously defined quality criteria.A narrative synthesis was performed because the studies selected were very heterogeneous regarding the sample size, the observation period, the spacing of the observation moments, the total observation period and the methods of statistical analysis, among others High values of job demands were consistently associated over time with the decrease in well-being and that the control varied inversely with the well-being, but not in a significant way. High supervisor support was associated with high well-being in only three of the four studies that analysed this dimension, but co-workers support only revealed a significant and positive association with well-being in one of two studies. The dimensions of the Work-Family Conflict (Strain-Based Conflict and Time-Based Conflict) had direct effects on the simultaneous analyzes but in one of the studies the cross-lagged effects showed a paradoxical effect in which, being associated with negative effects on the well-being in the concomitant analysis, were associated with an increase in well-being 6 months later in the cross-lagged analysis, which the authors attributed to recovery effects. The work-family facilitation did not reveal any association with well-being over timeN/

Health Examination Surveys and Human Biomonitoring – the added value of combined studies

Health Examination Surveys (HES) are health surveys where information collected by questionnaire is complemented with information obtained through physical measurements, such as blood pressure and anthropometric measurements, and through clinical analysis of biological samples. Between 2000 and 2017, 15 European countries have conducted a national HES and in many countries smaller, regional or disease specific surveys have been carried out. Portugal is one of the countries that has recently conducted a first National Health Examination Survey (INSEF), which collected interview and anthropometric data and blood samples in a nationally representative sample of 4911 individuals aged between 25 and 74 years old. Human Biomonitoring (HBM) is a scientific approach used to assess individual human exposure to environmental chemicals by measuring substances, their metabolites or reaction products in biological specimens. Many countries have established HBM programs to monitor the chemical exposures of their populations. HES and HBM studies are very similar in terms of the infrastructure and procedures necessary for their implementation, as in either type of studies data is collected through fieldwork, which constitutes one of the largest expenditures for such studies. Combined studies could then result in more costeffective ways to conduct health and environmental monitoring. Some countries, like the USA, Canada, Germany, Belgium and France have already recognized the potential to combine these two types of studies and have successfully implemented surveys with both components. However, in practice, the opportunity for adding an HBM module to a health study and vice versa is rarely used. Reasons for this may be multifarious and may differ from country to country, and between different study settings. Within the HBM4EU project the advantages and obstacles of combined studies are being evaluated and feasibility studies will be conducted in order to identify practical/logistic, financial and scientific benefits and short comings.No âmbito do projeto HBM4EU, da qual fazem parte a Fundação para a Ciência e Tecnologia, I.P. (FCT), o Instituto Nacional de Saúde Dr. Ricardo Jorge, I.P. (INSA), a Direção Geral de Saúde (DGS) e a Agência Portuguesa do Ambiente, I.P. (APA), em parceria com a Faculdade de Medicina, Universidade de Lisboa (FMUL) e a Escola Superior de Tecnologia da Saúde Lisboa (ESTeSL), Instituto Politécnico de Lisboa.N/

Avaliação da exposição da população portuguesa a substâncias químicas perigosas

Sónia Namorado, investigadora do Departamento de Epidemiologia do INSA e uma das coordenadoras da Iniciativa Europeia em Biomonitorização Humana (HBM4EU) a nível nacional.Apresentação dos resultados do estudo INSEF-ExpoQuim, nomeadamente os referentes à exposição da população portuguesa a cádmio, bisfenóis e hidrocarbonetos aromáticos policíclicos (PAHs). O conhecimento científico atual suporta a afirmação que a exposição a determinadas substâncias químicas ambientais pode causar efeitos adversos na saúde ou mesmo doença. Para avaliar o risco para a saúde humana é importante medir a quantidade dessas substâncias químicas no nosso organismo. Isto pode ser feito com recurso à biomonitorização humana, que consiste na medição da quantidade de uma determinada substância química em amostras biológicas como sangue, urina, unhas ou cabelo, e pode ser utilizada para a avaliação da exposição interna total a uma substância química resultante de todas as fontes e vias de exposição. No âmbito da Iniciativa Europeia de Biomonitorização Humana (HBM4EU), Portugal contribuiu com o estudo INSEF-ExpoQuim, um estudo epidemiológico transversal realizado entre os participantes no primeiro Inquérito Nacional de Saúde com Exame Físico (INSEF 2015) com o objetivo de caracterizar a exposição da população adulta portuguesa a substâncias químicas. Os resultados apresentados serão discutidos numa perspetiva de avaliação de risco, de apoio à tomada de decisão e de definição de prioridades a nível nacional para a realização de estudos futuros.O INSEF-ExpoQuim foi cofinanciado no âmbito da Iniciativa Europeia em Biomonitorização Humana (projeto HBM4EU), que recebeu financiamento do programa Horizonte 2020 da Comissão Europeia (acordo de subvenção nº 733032).N/

Exposição ambiental e ocupacional da população portuguesa a metais e seus determinantes

A União Europeia reconheceu o papel relevante da biomonitorização humana (BMH) na geração do conhecimento para a avaliação dos efeitos cumulativos da exposição a químicos, tendo em conta as várias vias e fontes de exposição e, neste sentido, cofinanciou a Iniciativa Europeia de Biomonitorização Humana (2017-2022), projeto que envolveu 116 instituições de 30 países e teve como objetivo utilizar a biomonitorização humana para avaliar a exposição humana a substâncias químicas, com vista a uma melhor compreensão dos impactos associados na saúde e à melhoria da avaliação dos riscos químicos. No âmbito desta iniciativa, Portugal participou no estudo realizado para avaliação da exposição da população geral a químicos selecionados como prioritários (Estudos Alinhados do HBM4EU), entre os quais o cádmio, e no estudo ocupacional para avaliação da exposição a crómio hexavalente. Nesta comunicação serão apresentados os resultados portugueses, nomeadamente dados da exposição a cádmio na população geral e da exposição a crómio em trabalhadores.O estudo INSEF-ExpoQuim e o estudo ocupacional do crómio foram financiados no âmbito da Iniciativa Europeia de Biomonitorização Humana (HBM4EU) que recebeu financiamento do programna de investigação e inovação Horizonte 2020 da União Europeia (acordo de subvenção 733032) e das instituições participantes.N/

Job exposure matrices and human biomonitoring

Em epidemiologia ocupacional é importante conhecer e caracterizar a exposição aos fatores de risco e estabelecer o nexo de causalidade com as alterações na saúde. De entre as várias formas de avaliar a exposição no local de trabalho, contam-se as matrizes de exposição ocupacional (MEO). Uma MEO consiste num sistema de classificação da exposição, para uma ou mais substâncias ou agentes, em distintas ocupações e por ramos específicos de atividade. As MEO requerem estimativas qualificadas, sistemáticas e detalhadas das potenciais exposições e podem ser construídas com informação primária ou secundária. No essencial, trata- se de reconstruir, com o rigor possível, a exposição a que os trabalhadores estiveram sujeitos durante a sua vida profissional. Embora os dados da biomonitorização humana (BMH) sejam frequentemente usados para efeitos de validação de MEO, podem igualmente ser usados para o seu desenvolvimento. Este trabalho pretende descrever a abordagem baseada em matrizes de exposição ocupacional na avaliação da exposição ocupacional e o contributo dos dados de biomonitorização humana nessa avaliação. As MEO constituem, sem dúvida, um importante instrumento a ser utilizado quer em estudos populacionais, quer em Saúde Ocupacional, potenciando vários estudos e monitorizações, com destaque para a biomonitorização humana.In occupational epidemiology, it is important to know and characterize exposure to risk factors and establish the causal link with changes in health. Among the various ways of assessing exposure in the workplace are job exposure matrices (JEM). A JEM consists of an exposure classification system, for one or more substances or agents, in different occupations and by specific branches of activity. A JEM requires qualified, systematic and detailed estimates of potential exposures and can be constructed with primary or secondary information. Essentially, it is a question of reconstructing, as rigorously as possible, the exposure to which workers were subjected during their professional lives. Although human biomonitoring (HBM) data are often used for JEM validation purposes, they can also be used for the development of JEM. This work intends to describe the technical development of occupational exposure matrices, as an exposure assessment tool, and the role that human biomonitoring can play in this development. JEM are undoubtedly an important instrument to be used both in population studies and in occupational health, enhancing several studies and monitoring, especially human biomonitoring.info:eu-repo/semantics/publishedVersio

Assessment of Portuguese firefighters’ lifestyle: results from an online survey

Firefighters are an occupational group exposed to multiple agents, such as heat, fatigue, noise and chemical substances. Exposure to these agents can have a severe impact on their health. In addition, lifestyle behaviors may also affect their health and well-being. As such, the aim of this study was to assess health-related lifestyle behaviors in Portuguese firefighters. Data was obtained via an online survey using an adapted version of the FANTASTIC Lifestyle Assessment Inventory that included questions on relationships with family and friends, physical activity, nutrition, tobacco and alcohol consumption, sleep and stress, career and shifts. The access link to the survey was disseminated through collaboration with the National School of Firefighters. Data was collected between April 24th and May 27th 2021. From the 861 participating firefighters, the majority were men and had less than 40 years old. Around half were married and were firefighters for more than ten years. The majority referred to have people to talk about important things and to give and receive affection. Regarding physical activity the majority did not practice physical activity in the professional context. Only a quarter reported to have healthy eating habits and the majority reported the consumption of high-calorie foods and to be exceeding their ideal weight. More than a third reported smoking and around 16% reported driving motor vehicles after consuming alcohol. Around 40% reported to consume more than 3 caffeine drinks per day. Around a tenth reported to almost never have good quality sleep and only around 78% reported to have difficulties sleeping. About 43% didn’t have capacity to manage stress in their day to day life and about 57% were not able to relax in their free time. Around 40% reported not being happy with their work and a third reported to do periodic medical exams.This work was developed within the project “Leadership process and firefighters occupational health: Development of an intervention program” funded by Foundation for Science and Technology (PCIF/SSO/0054/2018).N/

Relation between depression and chronic physical disease and healthcare utilisation in the Portuguese

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Health studies: opportunities for the development of Human Biomonitoring in Europe

Introduction: Human Biomonitoring (HBM) and health studies are very similar in terms of the infrastructure and procedures necessary for their implementation, as in either type of studies data is collected through fieldwork, which constitutes one of the largest expenditures for such studies. Thus, combined studies could result in more cost-effective ways to conduct health and environmental monitoring. As such, within the HBM4EU project an inventory of the health studies available which could include an HBM component was performed. Methods: An online questionnaire was developed to collect information on recently conducted, ongoing and planned health studies, which could be linked to an HBM study. The link to the questionnaire was distributed with the help of the National Hub Contact Points of the HBM4EU project. Results: From the 58 different studies included in this inventory, half were longitudinal and presented the possibility of introducing an HBM component in the future. Most of the studies for which data was reported had public funding, either from the government or from public grants (national or European). The vast majority of the studies included the collection of biological samples and the most frequently stored samples were blood, plasma, serum or DNA. More than 50% of the studies reported that the measurement of chemicals was already performed or was planned to be performed. The most frequently measured chemicals were phthalates, bisphenols and cadmium. Conclusions: In vast majority of the studies included in the inventory biological samples are collected and stored, posing the opportunity to use them in HBM studies for the analyses of chemicals of interest. About 50% of these studies already had ethical approval to measure chemicals from collected samples. Funding: HBM4EU has received funding from the European Union’s Horizon 2020 research and innovation programme (grant agreement 733032).HBM4EU has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 733032.N/

Health Impact Assessment on the Adoption of Recommendations regarding Urban Operations in the Reconversion of Industrial Areas with Contaminated Soils: results from the screening and scoping phases

Trabalho desenvolvido no âmbito do Programa de Treino em Health Impact Assessment nos termos do Acordo de Colaboração Bienal (BCA) entre a Organização Mundial da Saúde (OMS) e o Ministério da Saúde de Portugal, coordenado pelo Instituto Nacional de Saúde Doutor Ricardo Jorge (INSA).Em 2017 foi produzido um conjunto de recomendações em matéria de operações urbanísticas na reconversão de áreas industriais com solos contaminados. Estas recomendações incluem várias fases de preparação de um projeto de planeamento urbano. A adoção plena destas recomendações nas operações de reconversão de áreas industriais em urbanas poderá ter impacte na saúde humana. Como tal, foi proposto uma avaliação de impacte na saúde (Health Impact Assessment - HIA) com o objetivo de analisar o impacte da adoção das recomendações nas operações de reconversão. Foi implementado um estudo urbanístico na reconversão de áreas industriais com solos contaminados. Este trabalho foi realizado no âmbito do Programa de Treino em Health Impact Assessment e descreve as etapas de screening e scoping que foram desenvolvidas utilizando as ferramentas propostas pelo Instituto de Saúde Pública da Irlanda. Foram realizados focus groups com elementos de instituições públicas da área da saúde humana para preencher as ferramentas. Com base numa revisão da literatura, foi desenvolvido um modelo conceptual de exposição para identificar as principais vias de exposição e os efeitos na saúde associados a serem avaliados no âmbito do HIA. A análise efetuada na fase de screening, realizada considerando os possíveis impactes na saúde, levou a que se continuasse o desenvolvimento deste HIA. O modelo conceptual de exposição desenvolvido na fase de scoping permitiu identificar como principal via de exposição da população residente a exposição por inalação de compostos voláteis.In 2017 a set of recommendations regarding urban operations in the reconversion of industrial areas with contaminated soils were produced. These recommendations included several phases of preparation of the urban planning project. The full adoption of these recommendations in all reconversion operations from industrial into urban areas may have impacts on the human health. A Health Impact Assessment (HIA) was proposed with the aimto analyze the impact on human health of the adoption of these recommendations in urbanization operations in the reconversion of industrial areas with contaminated soils. The present work is included in a training programme in Health Impact Assessment and describes the screening and scoping phases developed using the tools proposed by the Institute of Public Health in Ireland. Several focus groups with elements from public institutions with competences in the human health area were conducted to fill the screening and scoping tools. Based on a literature review, a comprehensive causal pathway was developed to identif y main exposure routes and respective health ef fects to be evaluated in the HIA scope. Results from the screening, considering the possible health impacts, lead to the fur ther development of the HIA. The conceptual exposure model developed in the scoping allowed to identif y as main exposure pathway for the resident population the inhalation of volatile compounds.info:eu-repo/semantics/publishedVersio

Psychological distress – prevalence and associated factors in the portuguese population in 2015: results from the National Health Examination Survey

O distress psicológico é um constructo multifatorial que se relaciona com o mau funcionamento psicológico e pior qualidade de vida. Este estudo examina a associação entre o distress psicológico (avaliado através do instrumento Mental Health Inventory 5), sexo, idade, estado civil, escolaridade e ocupação. Utilizamos dados do 1º Inquérito Nacional de Saúde com Exame Físico (INSEF) realizado em Portugal em 2015, com uma amostra probabilística de 4911 indivíduos com idade compreendida entre os 25 e os 74 anos. A regressão de Poisson foi utilizada para estimar a razão de prevalência (RP) de distress psicológico de acordo com as diferentes variáveis. Todas as estimativas foram ponderadas para as diferentes probabilidades de seleção e distribuição da população por região geográfica, faixa etária e sexo. O distress psicológico foi reportado por 22,5% [IC 95%: 20,7-24,5] da população. A prevalência foi mais elevada nas mulheres (30,5%, RP=2,20 [1,74-2,80]), grupos etários mais velhos (28,4%, RP=1,80 [1,28-2,53]), nos viúvos (46,2%, RP=2,06 [1,71-2,46]) e nos desempregados (28,6%, RP=1,54[1,27-1,86]). O distress psicológico era menos prevalente nos indivíduos com níveis mais elevados de escolaridade. Os resultados sugerem que grupos populacionais específicos estão provavelmente mais em risco de desenvolver problemas de saúde mental: mulheres; viúvos; indivíduos entre os 45 e os 74 anos e desempregados.Psychological distress is a multi-factorial construct that relates to poor psychological function and worst quality of life. This study examines the association between psychological distress (evaluated using the Mental Health Inventory 5) and sex, age, civil status, education and professional activity. We used data from the first Portuguese Health Examination Survey (INSEF) conducted in Portugal in 2015, with a probabilistic sample of 4911 individuals aged 25-74 years old. Poisson regression was used to estimate prevalence ratios (PR) of psychological distress according to the different variables. All estimates were weighted to account for different selection probabilities and to match the population distribution in terms of geographic region, age group and sex. Psychological distress was reported by 22.5% [95%CI: 20.7-24.5] of the population. Women (30.5%, PR=2.20 [1.74-2.80]), older age groups (28.4%, PR=1.80 [1.28-2.53]), widows (46.2%, PR=2.06 [1.71-2.46]) and unemployed individuals (28.6%, PR=1.54 [1.27-1.86]) were more likely to report psychological distress. Prevalence of psychological distress was lower among individuals with higher levels of education. INSEF results suggest that specific population groups are probably more at-risk of developing mental health problems: women; widows and unemployed individuals between 45 and 74 years old.info:eu-repo/semantics/publishedVersio