Objectives To explore whether a change in work schedule was associated with a change in the probability of prescribed sleep medication use. Methods A longitudinal study with annual questionnaire data (2008/2009–2021, except 2019) on work schedule (day work only, shift work without nights and shift work with nights) and prescribed sleep medication use from 2028 Norwegian nurses (mean age 31.7 years, 90.5% women at baseline) who participated in the ongoing Survey of Shift work, Sleep and Health (SUSSH). Associations were estimated using a random effects model, and a fixed effects regression model in which nurses were included as their own control to account for potential unobserved confounding. Results In both models, day work was associated with a more than 50% lower probability of sleep medication use compared with shift work with nights (adjusted OR (aOR) 0.50, 95% CI 0.27 to 0.93 in the random effects model, and an aOR 0.32, 95% CI 0.14 to 0.70 in the fixed effects regression model). Shift work without nights was associated with a non-statistically significant reduction in sleep medication use within nurses in the fixed effects regression model when compared with shift work with nights (aOR 0.66, 95% CI 0.37 to 1.20). Conclusions Day work was associated with a significant reduced probability of prescribed sleep medication use compared with shift work with nights. This indicates that quitting night work will improve sleep and thereby reduce hypnotic use.

Non-communicable diseases (NCDs) account for an estimated 71% of all deaths globally. In Norway, in 2015, 71% of all deaths were due to cardiovascular diseases, cancers and neurological disorders. NCDs are mostly chronic diseases where individuals live a long period with the disease, thus the disease becomes a part of everyday life. This perspective explores the NCD care model within the Norwegian health delivery system in relation to the integration of prevention, diagnosis, treatment and rehabilitation services of non-communicable diseases to the primary health care system, and also explores several best practices and lessons that can be adapted to minimize the critical gaps and areas of the non-communicable diseases care model in Sri Lanka.

Objectives: The objective of the study was to clarify the reasons why students who graduated from a Master's programme in international health were joining the programme. Another objective was to document how the Master's degree had influenced the careers of the graduates. Study design: An online survey of students who graduated from a Master's programme in international health, including oral science, between 2010 and 2015. Method: The study used an anonymous questionnaire that contained 28 items. Topics included information such as demographics, questions about the reasons for joining the Master's programme and the benefits and influence of the programme on the career of the students. Results: Of the 102 alumni who were invited to participate, 70 responded. The response rate was 69%, and we have no information about the non-responders. The results showed that the main reasons for students enrolling in the programme were to improve their competence and develop their career. Around 63% of the respondents reported that the programme had increased their competencies in the jobs they had, whereas 24% answered that their increased qualifications had enabled them to acquire new positions. Thus successfully completing the programme had a positive influence on the graduates' careers in international health. Most of the graduates, who were working, were typically employed at hospitals and universities. Several graduates had proceeded to gain further qualifications by now being enrolled in a PhD programme. Conclusions: Among the 70% of responders in this survey, the master's programme had benefitted the alumni and the programme had fulfilled their expectations. The programme had a positive influence on the alumni in areas such as increased competency, development of their careers, new positions and better salaries. (c) 2020 The Authors. Published by Elsevier Ltd on behalf of The Royal Society for Public Health. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

IntroductionIn 2007, an oil tank in an industrial area in Norway exploded and caused a prolonged malodorous pollution. Previous studies have shown that acute physical and psychological health complaints are prevalent in populations recently affected by industrial accidents. However, follow-up studies of human health effects after such accidents are limited, and knowledge about long-term health effects among workers exposed to malodourous emissions following a chemical accident is scarce. The aim of the study was to assess whether subjective health complaints among employees in the industrial area and clean-up workers declined over a four-year period after an oil tank explosion, a period that included removal of the malodorous pollution.MethodsA longitudinal survey from 2008 (1 ½ years after the explosion) to 2012 (5 ½ years after the explosion) was performed using the Subjective Health Complaints Inventory, a validated questionnaire. Data were analysed using a linear mixed effects model.ResultsIn 2008, exposed workers (n=147) had significantly more health complaints such as headache, tiredness, sleep problems, dizziness and depression, compared to unexposed controls living far away from the explosion site (n=137). In 2012, there was a reduction of subjective health complaints among the exposed workers, but they still had significantly more subjective neurological symptoms (p<0.01) than controls, adjusted for gender, age, smoking habits, educational level and proximity to the explosion.DiscussionIt is likely that the overall decrease of subjective health complaints among exposed workers could be due to decreased exposure to malodorous pollutants or time passed since explosion. However, the persistent subjective neurological complaints might be mediated by perceived pollution and health risk perception. Worry might have caused a chronic effect, manifested by a dysfunctional and persistent neuropsychological response. A possible implication is that quick clean-up of malodorous chemical spills is important to avoid persistent health effects.

Shift workers often experience circadian misalignment and problems adjusting adequately to their work schedules, which is manifested in the high prevalence rates of shift work disorder, insomnia and sleepiness in this group of workers compared to day workers. However, there exist large inter-individual differences in tolerance to shift work. We investigated whether frequency variation in single nucleotide polymorphisms capturing genetic variation in genes involved in the regulation of circadian rhythms (clock genes) was associated with insomnia, sleepiness, and shift work disorder in a sample of Norwegian nurses employed in various work schedules. Saliva samples from 691 female nurses participating in "the Survey on Shift work, Sleep and Health" were analysed for associations between genetic variations in clock genes and the nurses' survey responses. A total of 662 single nucleotide polymorphisms were analysed. After multiple testing correction, we did not observe any statistically significant associations between the genetic variants and insomnia, sleepiness, or shift work disorder.

The Ebola epidemic in West Africa presents a considerable occupational risk to the health personnel involved. The principal mode of virus transmission to health care personnel is through direct contact with the patient, although transmission by aerosols through the air may also occur. Many safety protocols have been suggested relating to personal protection and particularly respiratory protection. It is generally agreed that all health care workers should have easy access to personal protective equipment. However, the degree of respiratory safety escalates from a mask, to an adequate respirator, and finally to a whole body suit with integrated helmet and positive air pressure. Recent publications demonstrate a lack of consensus on the degree of safety necessary. The step from “safe enough” to being “absolutely safe” seems, in most countries, insurmountable because of costs and logistics.

OBJECTIVES:To further develop and validate a Dutch prognostic model for high sickness absence (SA).METHODS:Three-wave longitudinal cohort study of 2,059 Norwegian nurses. The Dutch prognostic model was used to predict high SA among Norwegian nurses at wave 2. Subsequently, the model was updated by adding person-related (age, gender, marital status, children at home, and coping strategies), health-related (BMI, physical activity, smoking, and caffeine and alcohol intake), and work-related (job satisfaction, job demands, decision latitude, social support at work, and both work-to-family and family-to-work spillover) variables. The updated model was then prospectively validated for predictions at wave 3.RESULTS:1,557 (77 %) nurses had complete data at wave 2 and 1,342 (65 %) at wave 3. The risk of high SA was under-estimated by the Dutch model, but discrimination between high-risk and low-risk nurses was fair after re-calibration to the Norwegian data. Gender, marital status, BMI, physical activity, smoking, alcohol intake, job satisfaction, job demands, decision latitude, support at the workplace, and work-to-family spillover were identified as potential predictors of high SA. However, these predictors did not improve the model's discriminative ability, which remained fair at wave 3.CONCLUSIONS:The prognostic model correctly identifies 73 % of Norwegian nurses at risk of high SA, although additional predictors are needed before the model can be used to screen working populations for risk of high SA.

Questionnaires are often used to study health problems in working populations. An association between self-reported symptoms and psychosocial strain has been suggested, but results from such studies are difficult to interpret, as a gender difference might be present. The knowledge in this area is not clear.To compare the prevalence of subjective health symptoms and their relation to psychosocial work strain among men and women in different age groups, all working as university staff.A cross-sectional survey was carried out among university personnel. The questionnaire included a subjective health complaint inventory consisting of 29 items about subjective somatic and psychological symptoms experienced during the last 30 days and psychosocial work factors. Regression analyses were performed.In total, 172 (86%) of 201 eligible employees participated. Women had a higher prevalence of musculoskeletal symptoms than men. Significant differences were found between the genders for headaches, neck pain and arm pain. There was a significant relationship between musculoskeletal symptoms and work strain for both genders. This was found for both men and women below 40 years and among men above the age of 40. No significant difference was found between genders regarding pseudoneurological, gastrointestinal, allergic and flu-like symptoms.More female than male university personnel reported musculoskeletal symptoms. The musculoskeletal symptoms were associated with high work strain in both genders, but, for women, this was limited to employees under the age of 40. The cause of this gender difference is unknown.

Background: Sickness absence is high in healthcare and contributes to nursing staff shortages reducing the efficiency and quality of patient care. Assessing the risk of sickness absence in working nurses opens opportunities for preventive strategies. Job satisfaction has attracted much attention in healthcare research and has been associated with sickness absence among nurses.Objectives: To investigate if job satisfaction scores are useful to identify working nurses at risk of future sickness absence.Design: Prospective cohort study with a baseline period from November 2008 to March 2009 and 1-year follow-up.Settings: Hospitals, nursing homes, and ambulant care settings in Norway.Participants: 2059 Norwegian nurses, of whom 1582 (77%) could be followed-up.Methods: Nurses received a questionnaire at baseline and after 1-year follow-up. The questionnaire contained the Job Satisfaction Index (JSI), a 5-item scale measuring overall job satisfaction, and asked for sickness absence in the last 12 months. Baseline JSI scores were included in a logistic regression model with self-rated sickness absence at 1-year follow-up as outcome variable. Predictions of sickness absence were calibrated by the Hosmer-Lemeshow goodness-of-fit test. The ability of JSI scores to discriminate between nurses with and without sickness absence was examined by receiver operating characteristic analysis and expressed as area under the curve (AUC).Results: Low job satisfaction was associated with higher odds of sickness absence (odds ratio [OR] = 1.05; 95% confidence interval [CI] 1.01-1.09) and high (>= 31 days) sickness absence (OR = 1.10; 95% CI 1.06-1.14). Calibration was acceptable, but job satisfaction neither discriminated between nurses with and without sickness absence (AUC = 0.54; 95% CI 0.51-0.58) nor between nurses with and without high (>= 31 days) sickness absence (AUC = 0.58; 95% CI 0.54-0.63).Conclusions: The results of this study indicated that job satisfaction was associated with sickness absence, though job satisfaction scores as measured with the JSI did not identify working nurses at risk of sickness absence. (C) 2012 Elsevier Ltd. All rights reserved.

BACKGROUND:Sickness absence is an important problem in healthcare that affects the quality of care. Sickness absence has been related to coping strategies. Problem-focused coping was shown to be associated with low sickness absence and emotion-focused coping with high sickness absence among postal workers. OBJECTIVES:This study investigated the relationship between coping styles and sickness absence in healthcare. DESIGN:Prospective study linking self-rated coping styles at baseline with the number of episodes of sickness absence during one year of follow-up. SETTING:Somatic hospital employing 1,153 persons. PARTICIPANTS:Convenience sample of 566 female nurses working in the hospital's clinical wards and outpatient clinic. Of these, 386 (68%) nurses had complete data for analysis. METHODS:The nurses completed a questionnaire at baseline with items on health, work, and coping styles. Three styles of coping were defined: problem-solving coping (i.e., looking for opportunities to solve a problem), social coping (i.e., seeking social support in solving a problem), and palliative avoidant coping (i.e., seeking distraction and avoiding problems). Sickness absence data were retrieved from the hospital's register in the following year. The association between the coping styles and the number of both short (1-7 days) and long (>7 days) episodes of sickness absence was assessed by Poisson regression analyses with age, work hours per week, general health, mental health, and effort-reward [ER] ratio as covariates. RESULTS:Problem-solving coping was negatively associated with the number of long episodes of sickness absence (rate ratio [RR] = 0.78, 95% confidence interval [CI] = 0.64-0.95). Social coping was negatively associated with the number of both short episodes (RR = 0.88, 95% CI = 0.79-0.97) and long episodes (RR = 0.79, 95% CI = 0.64-0.97) of sickness absence. After adjustment for the ER-ratio, the associations of coping with short episodes of sickness absence strengthened and associations with long episodes weakened, however, significance was lost for both types of sickness absence. Palliative avoidant coping was not associated with sickness absence among female hospital nurses. CONCLUSION:Problem-solving coping and social coping styles were associated with less sickness absence among female nurses working in hospital care. Nurse managers may use this knowledge and reduce sickness absence and understaffing by stimulating problem-solving strategies and social support within nursing teams.

UNLABELLED:Symptoms, signs, perceptions, and objective measures were studied in university buildings. Two problem buildings with a history of dampness and complaints were compared with two control buildings. Health investigations among university staff were performed at the workplace (n = 173) including tear film stability [non-invasive break-up time (NIBUT) and self-reported break-up time (SBUT)], nasal patency (acoustic rhinometry), nasal lavage fluid analysis [NAL: eosinophil cationic protein (ECP), myeloperoxidase (MPO), lysozyme and albumin] and atopy by total serum IgE and IgE antibodies (Phadiatop). Exposure assessment included inspections, thermal and atmospheric climate at 56 points modelled for all work sites. Multiple regressions were applied, controlling for age and gender. Exposure differences between problem buildings and controls were small, and variations between rooms were greater. Workers in the problem buildings had more general and dermal symptoms, but not more objective signs than the others. Adjusted day NIBUT and SBUT increased at higher night air temperatures, with B (95% CI) 0.6 (0.04-1.2) and 1.3 (-0.02 to 2.5), respectively. Higher relative humidity at mean day air temperature <22.1 degrees C was associated with adjusted NIBUT and SBUT, with B (95% CI) 0.16 (0.03-0.29) and 0.37 (-0.01 to 0.75), respectively. Air velocity below recommended winter values and reduced relative humidity in the range of 15-30% were associated with dry air and too low temperature.PRACTICAL IMPLICATIONS:Thermal climate in university buildings may be associated with both perceptions and physiological signs. Reduced night time air temperature, increased difference in air temperature between day and night, and fast changes in air temperature might impair indoor environment. This may have implication for energy-saving policies. It might be difficult to identify the exposure behind, and find the reason why, some buildings are defined as 'problem buildings'.

Background Dental assistants help the dentist in preparing material for filling teeth. Amalgam was the filling material mostly commonly used in Norway before 1980, and declined to about 5% of all fillings in 2005. Amalgam is usually an alloy of silver, copper, tin and mercury. Copper amalgam, giving particularly high exposure to mercury was used in Norway until 1994. Metallic mercury is neurotoxic. Few studies of the health of dental assistants exist, despite their exposure to mercury. There are questions about the existence of possible chronic neurological symptoms today within this working group, due to this exposure. The aim of this study was to compare the occurrence of neurological symptoms among dental assistants likely to be exposed to mercury from work with dental filling material, compared to similar health personnel with no such exposure. Methods All dental assistants still at work and born before 1970 registered in the archives of a trade union in Hordaland county of Norway were invited to participate (response rate 68%, n = 41), as well as a similar number of randomly selected assistant nurses (response rate 87%, n = 64) in the same age group. The participants completed a self-administered, mailed questionnaire, with questions about demographic variables, life-style factors, musculoskeletal, neurological and psychosomatic symptoms (Euroquest). Results The dental assistants reported significant higher occurrence of neurological symptoms; psychosomatic symptoms, problems with memory, concentration, fatigue and sleep disturbance, but not for mood. This was found by analyses of variance, adjusting for age, education, alcohol consumption, smoking and personality traits. For each specific neurological symptom, adjusted logistic regression analyses were performed, showing that these symptoms were mainly from arms, hands, legs and balance organs. Conclusion There is a possibility that the higher occurrence of neurological symptoms among the dental assistants may be related to their previous work exposure to mercury amalgam fillings. This should be studied further to assess the clinical importance of the reported symptoms.

UNLABELLED:The aim was to utilize data from a study of occupational indoor environments to analyze symptoms and physiological signs in relation to the home environment. A medical investigation was performed at the workplace among university staff (n = 173) from four university buildings in Bergen, in March 2004. Tear film break up time (BUT) was measured by two methods. Nasal patency was measured by acoustic rhinometry. Nasal lavage fluid analysis (NAL) included eosinophilic cationic protein (ECP); myeloperoxidase (MPO), lysozyme and albumin. Atopy was assessed by total serum IgE and specific IgE (Phadiatop). Totally 21%, 21%, 18%, 11%, and 27% had weekly ocular, nasal, facial dermal symptoms, headache and tiredness, respectively, 15% had a damp dwelling, and 20% had a cat or dog. Multiple linear or logistic regressions were applied, controlling for age gender, smoking, and environmental factors. Building dampness was associated with increased NAL-lysozyme (P = 0.02) and an increase of airway infections [odd ratio (OR) = 3.14, P = 0.04]. Pet keeping was associated with difficulties to concentrate (OR = 5.10, P = 0.001), heavy headedness (OR = 4.35, P = 0.004), four more days with tiredness per month (P = 0.04), and less airway infections (OR = 0.32; P = 0.02). In conclusion, pet keeping was associated with more central nervous system (CNS)-symptoms but less airway infections. Dampness in the dwelling may have inflammatory effects on the airway mucosa, possibly mediated via increased infection proneness.PRACTICAL IMPLICATIONS:The main health focus on pet keeping has been allergen exposure. Our study indicates that effects on airway infections and other types of symptoms should also be considered. The findings support the view that measures should be taken to reduce building dampness in dwellings.