Why is it Important to Identify Mental Health Problems among Employees in Physically Demanding Jobs?

Research Paper Title

Physical working conditions and subsequent disability retirement due to any cause, mental disorders and musculoskeletal diseases: does the risk vary by common mental disorders?

Background

Physical work exposures and common mental disorders (CMD) have been linked to increased risk of work disability, but their joint associations with disability retirement due to any cause, mental disorders or musculoskeletal diseases have not been examined.

Methods

The data for exposures and covariates were from the Finnish Helsinki Health Study occupational cohort surveys in 2000-2002, 2007 and 2012.

The researchers used 12,458 observations from 6159 employees, who were 40-60 years old at baseline.

CMD were measured by the General Health Questionnaire (GHQ-12, cut-off point 3+).

Four self-reported work exposures (hazardous exposures, physical workload, computer and shift work) were combined with CMD and categorized as “neither”, “work exposure only”, “CMD only”, and “both”.

Associations with register-based disability retirement were assessed with Cox proportional hazards models for sample survey data adjusting for confounders over 5-year follow-up.

Additionally, synergy indices were calculated for the combined effects.

Results

Those reporting CMD and high physical workload had a greater risk of disability retirement due to any cause (HR 4.26, 95% CI 3.60-5.03), mental disorders (HR 5.41, 95% CI 3.87-7.56), and musculoskeletal diseases (HR 4.46, 95% CI 3.49-5.71) when compared to those with neither.

Synergy indices indicated that these associations were synergistic.

Similar associations were observed for CMD and hazardous exposures, but not for combined exposures to CMD and computer or shift work.

Conclusions

Identification of mental health problems among employees in physically demanding jobs is important to support work ability and reduce the risk of premature exit from work due to disability.

Reference

Halonen J.I., Mänty, M., Pietiläinen, O., Kujanpää, T., Kanerva, N., Lahti, J., Lahelma, E., Rahkonen, O. & Lallukka, T. (2020) Physical working conditions and subsequent disability retirement due to any cause, mental disorders and musculoskeletal diseases: does the risk vary by common mental disorders? Social Psychiatry and Psychiatric Epidemiology. doi: 10.1007/s00127-019-01823-6. [Epub ahead of print].

Workplace Injury: Musculoskeletal Conditions & Mental Illness

Research Paper Title

Prevalence of serious mental illness and mental health service use after a workplace injury: a longitudinal study of workers’ compensation claimants in Victoria, Australia.

Background

Serious mental illness is common among those who have experienced a physical workplace injury, yet little is known about mental health service use in this population.

This study aims to estimate the proportion of the workplace musculoskeletal injury population experiencing a mental illness, the proportion who access mental health services through the workers’ compensation system and the factors associated with likelihood of accessing services.

Methods

A longitudinal cohort study was conducted with a random sample of 615 workers’ compensation claimants followed over three survey waves between June 2014 and July 2015.

The primary outcome was receiving any type of mental health service use during this period, as determined by linking survey responses to administrative compensation system records for the 18 months after initial interview.

Results

Of 181 (29.4%) participants who met the case definition for a serious mental illness at one or more of the three interviews, 75 (41.4%) accessed a mental health service during the 18-month observation period.

Older age (OR=0.96, 95% CI 0.93 to 0.99) and achieving sustained return to work (OR=0.27, 95% CI 0.11 to 0.69) were associated with reduced odds of mental health service use.

Although not significant, being born in Australia was associated with an increased odds of service use (OR=2.23, 95% CI 0.97 to 5.10).

Conclusions

The proportion of injured workers with musculoskeletal conditions experiencing mental illness is high, yet the proportion receiving mental health services is low.

More work is needed to explore factors associated with mental health service use in this population, including the effect of returning to work.

Reference

Orchard, C., Carnide, N., Mustard, C. & Smith, P.M. (2020) Prevalence of serious mental illness and mental health service use after a workplace injury: a longitudinal study of workers’ compensation claimants in Victoria, Australia. Occupational and Environmental Medicine. pii: oemed-2019-105995. doi: 10.1136/oemed-2019-105995. [Epub ahead of print].