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Preview: Occupational Medicine - current issue

Occupational Medicine Current Issue





Published: Sat, 26 Aug 2017 00:00:00 GMT

Last Build Date: Sat, 26 Aug 2017 03:49:27 GMT

 



Fake Silk: The Lethal History of Viscose Rayon

2017-08-26

BlancPaul David. Published by Yale University Press, New Haven, CT, 2017. ISBN: 978-0-300-20466-7. Price: £30.00. 328 pp.



Health and Safety in a Changing World

2017-08-26

Edited by DingwallRobert, FrostShelley. Published by Routledge, Abingdon and New York, 1st edition, 2017. ISBN: 978-1-138-22521-3. Price: £34.99 (paperback). 164 pp.



The effects of arts, trades and professions on health and longevity

2017-08-26

Charles Turner ThackrahThe first edition was published in early 1831 with the title The Effects of the Principal Arts, Trades and Professions and of Civic States and Habits of Living on Health and Longevity: with a particular reference to The Trades and Manufactures of Leeds: and suggestions for the removal of many of the agents, which produce disease and shorten the duration of life. The most widely available version is the second edition of 1832. Published by Longman, Rees, Orme, Brown, Green and Longman, with Simkin and Marshall in London and Baines and Newsome in Leeds. This contained some additional material and corrections. The title was shortened by the omission of ‘particular reference… of Leeds’. A reprint of this edition, with an introductory essay by Andrew Meiklejohn on Thackrah’s life was produced for the Society of Occupational Medicine by W. H. Smith in 1989.



Organizational occupational health interventions: what works for whom in which circumstances?

2017-08-26

According to the EU Framework Directive 89/391/EEC, organizations have a legal obligation to ‘ensure the safety and health of workers in every aspect related to work’ and the European Framework Agreement of 8 October 2004 specifies that this includes psychosocial issues. The directive does not provide information on how to manage the psychosocial work environment and therefore the European Commission called upon the social partners to develop their own strategies [2]. As a result, national policies have been developed across Europe, e.g. the Management Standards in the UK [3], WorkPositive in Ireland [4], SOBANE (Screening, Observation, Analysis and Expertise) in Belgium [5], START in Germany [6] and the INAIL (National Institute for Insurance against Accidents at Work) methodology for the assessment and management of work-related stress in Italy [2,7,8]. All of these strategies apply a stepwise participatory approach to organizational-level occupational health interventions (OOHIs) aimed at improving employee health and well-being through changing the way work is organized, designed and managed [8].



Revalidation, appraisal and multisource feedback for occupational physicians

2017-08-26

It is a regulatory requirement for all doctors working in the UK to have annual formative appraisals in which they discuss their practice and performance. Since December 2012, there has also been a requirement for UK doctors to revalidate every 5 years. Revalidation is a summative process by which doctors demonstrate that they remain up to date and fit to practice. The UK General Medical Council (GMC) document Good Medical Practice (GMP) outlines core ethical guidance for doctors [1]. Appraisal is structured to demonstrate compliance with the key principles and values set out in GMP. Doctors are required to provide supporting information about their practice, continuing education and professionalism as part of the appraisal process. Revalidation is largely determined by the outcome of annual appraisal. There is therefore a tension between the formative input from appraisal and the summative output of revalidation.



Occupational medicine in the Middle East

2017-08-26

The Middle East consists primarily of countries in the Arabian Peninsula with similar culture and geography, but with considerable differences in stage of development, industrialization and provisions for occupational health. Middle-Eastern countries such as Saudi Arabia and Oman have a much longer history compared with the United Arab Emirates (UAE) and Qatar which were established as independent nations as recently as 1971. Many of these countries are located in desert environments, rich in oil and gas, and with less infrastructure for agriculture (cultivation of date palms being a notable exception). Most are relatively stable with fast developing economies although some, such as Iraq and Yemen, are in the midst of experiencing or recovering from recent wars. Saudi Arabia has the unique experience of having a regular influx of large numbers of Muslim visitors who travel to Mecca for pilgrimage. This has an impact on workers in the transport, catering and hospitality industry. Middle-Eastern countries have large diverse groups of expatriate workers, mainly from Africa and Asia. In the UAE and Qatar, they constitute >80% of the total population. This creates a major challenge especially for occupational medicine provision. Some countries in the region have attracted bad publicity in the social media and the press in regards to their facilities and support for expatriate workers. Physical and mental health and social and adjustment problems are reported wherever individuals seek employment in countries distant from their homes, leaving their families behind. Any difference between countries is often a matter of scale, with conflicting and confusing cultural and occupational practices, and biased attitudes and beliefs being major contributors to workplace health and safety problems.



In this issue of Occupational Medicine

2017-08-26

Occupational medicine involves a series of activities aimed at worker protection. We consider how to prevent work-related illness and injury and develop standards for particular roles so the right people are doing the job. When working, we look at the demands and resources that workers have to do the job and consider how we can help and support workers who develop problems which are caused by or impact on work. Thus, the whole (well not quite the whole) of occupational medical practice is present in this issue as these aspects of practice, particularly with regards to public sector and emergency service workers, are studied.






Reply

2017-08-26

Dear Sir,



Why I became an Occupational Physician

2017-08-26

Growing up in India, while the next door oil-fired furnace kept my lungs supplied with smoke, my dad’s engineer colleagues home-tutored me and inspired my numeracy skills. Over my school days, I kept up an interest in industry, visiting fireclay factories, fertilizer works, heavy engineering companies, railway yards, ship and navy yards. While in high school, suffering from teenage exuberance, on a few occasions, I have travelled not just on the footplate (strongly recommended for Rail Physicians) but also on the buffers of overcrowded trains (definitely not recommended). In that environment, industrial (and non-industrial) injuries and illnesses were never far away.






Golden Jubilee Travel Fellowship 2016

2017-08-26

While undertaking higher specialist training in occupational medicine in the UK, I developed a particular interest in the management of psychological ill-health in the workplace, probably as a result of this constituting three quarters of my workload. I attended a talk on the management of ‘sick doctors’ in the UK by the Practitioner Health Programme (PHP) and was intrigued by the support and resources available for ‘struggling’ medical colleagues and the role occupational medicine played. It, however, made me think what fellow medical colleagues had for ‘support’ around the world; in particular, in Nigeria where I studied and trained as a doctor at Obafemi Awolowo University Teaching Hospitals, Ile-Ife over 25 years ago.



The MRC breathlessness scale

2017-08-26

The symptom of breathlessness is a common feature of both respiratory and cardiac problems and is subjective and difficult to quantify thereby causing problems for researchers wanting to assess interventions and compare treatments. In order to develop a measure of the effect of breathlessness on everyday life, data which had been collected from studies on pneumoconiosis in Welsh coal miners were used to develop a series of questions about the disability resulting from breathlessness [1]. This was then developed into the familiar Medical Research Council (MRC) breathlessness/dyspnoea scale and was published in 1959 [2]. A respiratory questionnaire has also been developed by the MRC and is published along with guidance for interviewers, the latest version being published in 1986 [3]. The respiratory questionnaire was specifically designed for large epidemiological studies of between 100 and 1000 patients and is explicitly not for individual use [3].



Occupational Medicine Calendar

2017-08-26

2017DateEventContact AddressVenueOctober 1–410th International Symposium on Biological Monitoring in Occupational and Environmental healthhttp://www.centercongressi.com/isbm10Naples. ItalyOctober 3–6WOS 9th International Conference on the prevention of accidents at workhttp://www.wos2017.net/Prague, Czech RepublicOctober 10–11Workplace Health 2017, organised by The At Work Partnership Ltdinfo@atworkpartnership.co.ukWarwickshire, UKOctober 19Trent Occupational Medicine Symposium 2017http://trentoccupationalmedicine.org.uk/programme/Belfry, NottinghamNovember 1–410th European Public Health Conference 2017. Sustaining resilient and healthy communitieshttp://www.ephconferences.euStockholm, SwedenNovember 15-17ALAMA Autumn Conference 2017http://www.alamaconferences.co.uk/alamawinchester/programme.htmlWinchester, UKDecember 28–3010th International Joint Conference on Occupational Health for Healthcare Workers: Health & wellbeing in the health care sector; addressing current threats to workerswww.ohhcw2017.orgKhon Kaen, Thailand2018April 29 – May 2Annual American Occupational Health Conference (103rd AOHC)http://www.acoem.org/educational_conferences.aspxNew Orleans. LAApril 29 – May 432nd International Congress on Occupational Health. ICOHhttp://www.icoh2018.orgDublin, IrelandMay 6–10American Aerospace Medical Association Annual Meetinghttps://www.asma.org/scientific-meetings/asma-annual-scientific-meeting/future-annual-meetingsDallas, Texas2019April 28 – May 1Annual American Occupational Health Conference (104th AOHC)http://www.acoem.org/educational_conferences.aspxAnaheim, CAMay 5–9American Aerospace Medical Association Annual Meetinghttps://www.asma.org/scientific-meetings/ asma-annual-scientific-meeting/ future-annual-meetingsLas Vegas, Navada



Job-specific mandatory medical examinations for the police force

2017-08-08

Abstract
Background
Mandatory medical examinations (MMEs) of workers should be based on the health and safety requirements that are needed for effectively performing the relevant work. For police personnel in the Netherlands, no job-specific MME exists that takes the specific tasks and duties into account.
Aims
To provide the Dutch National Police with a knowledge base for job-specific MMEs for police personnel that will lead to equitable decisions from an occupational health perspective about who can perform police duties.
Methods
We used a stepwise mixed-methods approach in which we included interviews with employees and experts and a review of the national and international literature. We determined the job demands for the various police jobs, determined which were regarded as specific job demands and formulated the matching health requirements as specific as possible for each occupation.
Results
A total of 21 specific job demands were considered relevant in different police jobs. These included biomechanical, physiological, physical, emotional, psychological/cognitive and sensory job demands. We formulated both police-generic and job-specific health requirements based on the specific job demands. Two examples are presented: bike patrol and criminal investigation.
Conclusions
Our study substantiated the need for job-specific MMEs for police personnel. We found specific job demands that differed substantially for various police jobs. The corresponding health requirements were partly police-generic, and partly job-specific.



Systematic review: Factors associated with return to work in burnout

2017-08-03

Abstract
Background
Professional burnout predicts sick leave and even permanent withdrawal from the labour force. However, knowledge of the barriers to and facilitators of return to work (RTW) in such burnout is limited.
Aims
To identify factors associated with RTW of burned-out individuals to inform occupational health care (OHC) RTW policy.
Methods
A systematic search of peer-reviewed quantitative and mixed-method studies published from January 2005 to July 2016 in English and Finnish in ARTO, CINAHL (EBSCO), Medic, PsycINFO (ProQuest), PubMed, Scopus and Web of Science databases, followed by a manual search. We included studies that identify burnout with valid burnout measures and measure the degree of RTW or sick leave as outcomes. We excluded studies with heterogeneous samples without subgroup analyses of RTW in burnout cases.
Results
We included 10 studies (three experimental and seven observational) of the initial 1345 identified. The studies reported work-related factors; enhanced communication (positive association) and low control at work (negative association) and individual-related factors; male gender (positive association), covert coping (negative association), high over-commitment to work (positive association) and burnout-related factors; unimpaired sleep (positive association), duration of sick leave over 6 months (negative association) and part-time sick leave (positive association) associated with RTW in burnout. Associations between burnout rehabilitation and RTW, and the level of symptoms and cognitive impairment and RTW remained unclear.
Conclusions
Few quantitative studies, of varied methodological quality, explore factors associated with RTW in burnout. Further research is needed to build an evidence base and develop guidelines for supportive OHC actions.



Systematic review: Lost-time injuries in the US mining industry

2017-08-02

Abstract
Background
The mining industry is associated with high levels of accidents, injuries and illnesses. Lost-time injuries are useful measures of health and safety in mines, and the effectiveness of its safety programmes.
Aims
To identify the type of lost-time injuries in the US mining workforce and to examine predictors of these occupational injuries.
Methods
Primary papers on lost-time injuries in the US mining sector were identified through a literature search in eight health, geology and mining databases, using a systematic review protocol tailored to each database. The Critical Appraisal Skills Programme (CASP), Framework of Quality Assurance for Administrative Data Source and the Cochrane Collaboration ‘Risk of bias’ assessment tools were used to assess study quality.
Results
A total of 1736 articles were retrieved before duplicates were removed. Fifteen articles were ultimately included with a CASP mean score of 6.33 (SD 0.62) out of 10. Predictors of lost-time injuries included slips and falls, electric injuries, use of mining equipment, working in underground mining, worker’s age and occupational experience.
Conclusions
This is the first systematic review of lost-time injuries in the US mining sector. The results support the need for further research on factors that contribute to workplace lost-time injuries as there is limited literature on the topic. Safety analytics should also be applied to uncover new trends and predict the likelihood of future incidents before they occur. New insights will allow employers to prevent injuries and foster a safer workplace environment by implementing successful occupational health and safety programmes.



Employment characteristics of a complex adult congenital heart disease cohort

2017-07-29

Abstract
Background
Due to advances in surgical techniques and subsequent management, there have been remarkable improvements in the survival of patients with congenital heart disease. In particular, larger numbers of patients with complex disease are now living into adulthood and are entering the workforce.
Aims
To establish the types of employment complex adult congenital heart disease (ACHD) patients are engaged in, based on the largest cohort of patients with a single-ventricle circulation in the UK.
Methods
Records of all patients with a univentricular (Fontan) circulation at the Queen Elizabeth Hospital were reviewed. Employment status was categorized according to the Standard Occupational Classification criteria (2010).
Results
A total of 210 patient records were reviewed. There was the same proportion of professionals in our cohort compared to the rest of the UK (20% versus 20%). There were greater proportions working in the caring, leisure and other service occupations (15% versus 9%), the elementary occupations (17% versus 11%), sales and customer service occupations (14% versus 8%) and administrative and secretarial occupations (12% versus 11%). The reverse trend was observed for associate professions and technical occupations (7% versus 14%), skilled trades (10% versus 11%), process, plant and machine operatives (3% versus 6%) and managers, directors and senior officials (2% versus 10%).
Conclusions
The data show that ACHD patients with a single ventricle are engaged in a diverse range of occupations. It is essential that early education and employment advice are given to this cohort to maximize future employment potential.



Comparison of clinic models for patients with work-related asthma

2017-07-26

Abstract
Background
Work-related asthma (WRA) is a prevalent occupational lung disease that is associated with undesirable effects on psychological status, quality of life (QoL), workplace activity and socioeconomic status. Previous studies have also indicated that clinic structure may impact outcomes among patients with asthma.
Aims
To identify the impact of clinic structure on psychological status, QoL, workplace limitations and socioeconomic status of patients with WRA among two different tertiary clinic models.
Methods
We performed a cross-sectional analysis between two tertiary clinics: clinic 1 had a traditional referral base and clinical staffing while clinic 2 entirely comprised Worker’s Compensation System referrals and included an occupational hygienist and a return-to-work coordinator. Beck Anxiety and Depression II Inventories (BAI and BDI-II), Marks’ Asthma Quality of Life Questionnaire (M-AQLQ) and Work Limitation Questionnaire (WLQ) were used to assess outcomes for patients with WRA.
Results
Clinic 2 participants had a better psychological status across the four instruments compared with clinic 1 (for Beck ‘Anxiety’: P < 0.001 and ‘Depression’: P < 0.01, ‘Mood’ domain of M-AQLQ: NS and ‘Mental Demands’ domain of WLQ: P < 0.01). Clinic 2 had a greater proportion of participants with reduced income.
Conclusions
Our study indicates that clinic structure may play a role in outcomes. Future research should examine this in larger sample sizes.



Late boosting phenomenon in TST conversion among health care workers

2017-07-26

Abstract
Background
Available information is insufficient to guide determination of whether tuberculin skin test (TST) conversions of health care workers (HCWs) within 2 years of two-step testing are related to occupational exposures or to other causes, including late boosting.
Aims
To describe the epidemiologic factors of TST conversion in HCWs, comparing early TST conversion (≤2 years after two-step testing) with late conversion to possibly distinguish late boosting phenomenon from occupational TST conversion.
Methods
Retrospective analysis of a database of TSTs of HCWs from 1 January 1998, through 31 May 2014, in the United States Midwest.
Results
In total, 40142 HCWs had 197932 tests over the 16 years, with 123 conversions (conversion rate: 0.3%; 95% CI 0.3–0.4%). Among 61 HCWs with a negative two-step TST, 30 (49%) were found to have early TST conversion within 2 years; 31 (51%) had late conversion, with likely occupational exposure but no identifiable community risks. Persons with early conversion were more likely to be born outside the USA (89% versus 57%; P < 0.05), had a higher rate of prior bacille Calmette-Guérin (BCG) vaccination (89% versus 52%; P < 0.05) and had no identifiable risk factors for conversion (63% versus 58%; P < 0.05).
Conclusions
Early conversions among HCWs after negative two-step TST are associated with various nonoccupational factors, including international birth and BCG vaccination history. Therefore, conversion is not a reliable indicator of recent tuberculosis contact in this population, and two-step TST is insufficient to discount a delayed boosting response for HCWs.



Job demands, resources and mental health in UK prison officers

2017-07-25

Abstract
Background
Research findings indicate that working as a prison officer can be highly stressful, but the aspects of work that predict their mental health status are largely unknown.
Aims
To examine, using elements of the demands–resources model, the extent to which work pressure and several potential resources (i.e. control, support from managers and co-workers, role clarity, effective working relationships and positive change management) predict mental health in a sample of UK prison officers.
Methods
The Health and Safety Executive Management Standards Indicator Tool was used to measure job demands and resources. Mental health was assessed by the General Health Questionnaire-28. The effects of demands and resources on mental health were examined via linear regression analysis with GHQ score as the outcome.
Results
The study sample comprised 1267 prison officers (86% male). Seventy-four per cent met ‘caseness’ criteria for mental health problems. Job demands, poor interpersonal relationships, role ambiguity and, to a lesser extent, low job control and poor management of change were key predictors of mental health status.
Conclusions
The findings of this study can help occupational health practitioners and psychologists develop structured interventions to improve well-being among prison officers.



Occupational rhinoconjunctivitis caused by the common indoor plant, Hoya compacta

2017-07-21

Abstract
Background
Allergic reactions to the common house plant Hoya compacta (HC) have not previously been described.
Aims
To confirm HC as the cause of rhinoconjunctivitis in three horticultural workers.
Methods
Greenhouse working conditions were reproduced in our challenge chamber.
Results
All three cases developed rhinoconjunctivitis when working with HC plants. A control challenge was performed in two cases with iceberg lettuce causing no symptoms. Nasal volume measured by acoustic rhinometry (AR) fell after all three active challenges, but also after one of the control challenges.
Conclusions
Our study confirms that HC may cause occupational rhinoconjunctivitis and asthma through a Type I hypersensitivity reaction. Specific inhalation challenges, nasal nitric oxide measurement and AR may be useful additional tools in supporting such diagnoses for occupational physicians to consider.



The economic impact of workplace wellness programmes in Canada

2017-06-20

Abstract
Background
The economic benefits of workplace wellness programmes (WWPs) are commonly cited as a reason for employers to implement such programmes; however, there is limited evidence outside of the US context exploring their economic impact. US evidence is less relevant in countries such as Canada with universal publicly funded health systems because of the lower potential employer savings from WWPs.
Aims
To conduct a systematic review of the Canadian literature investigating the economic impact of WWPs from an employer perspective. The quality of that evidence was also assessed.
Methods
We reviewed literature which included analyses of four economic outcomes: return on investment calculations; cost-effectiveness or cost-benefit analyses; valuations of productivity, turnover, absenteeism and/or presenteeism costs; and valuations of health care utilization costs. We applied the British Medical Journal (BMJ) Economic Evaluation Working Party Checklist to evaluate the quality of this evidence.
Results
Eight studies met the inclusion criteria. Although the studies showed that WWPs generated economic benefits from an employer perspective (largely from productivity changes), none of the reviewed studies were in the high-quality category (i.e. fulfilled at least 75% of the checklist criteria) and most had severe methodological issues.
Conclusions
Though the Canadian literature pertaining to the economic impact of WWPs spans over three decades, robust evidence on this topic remains sparse. Future research should include a comparable control group, a time horizon of over a year, both direct and indirect costs, and researchers should apply analytical techniques that account for potential selection bias.



Preventing occupational injury among police officers: does motivation matter?

2017-06-20

Abstract
Background
Injury prevention is an important issue for police officers, but the effectiveness of prevention initiatives is dependent on officers’ motivation toward, and adherence to, recommended health and safety guidelines.
Aims
To understand effects of police officers’ motivation to prevent occupational injury on beliefs about safety and adherence to injury prevention behaviours.
Methods
Full-time police officers completed a survey comprising validated psychometric scales to assess autonomous, controlled and amotivated forms of motivation (Treatment Self-Regulation Questionnaire), behavioural adherence (Self-reported Treatment Adherence Scale) and beliefs (Safety Attitude Questionnaire) with respect to injury prevention behaviours.
Results
There were 207 participants; response rate was 87%. Hierarchical multiple regression analyses demonstrated that autonomous motivation was positively related to behavioural adherence, commitment to safety and prioritizing injury prevention. Controlled motivation was a positive predictor of safety communication barriers. Amotivation was positively associated with fatalism regarding injury prevention, safety violation and worry.
Conclusions
These findings are consistent with the tenets of self-determination theory in that autonomous motivation was a positive predictor of adaptive safety beliefs and adherence to injury prevention behaviours.



Mortality from multiple sclerosis in British military personnel

2017-06-20

Abstract
Background
While analysing trends in occupational mortality in England and Wales, we noticed an unexpectedly elevated proportion of deaths from multiple sclerosis (MS) among men in the armed forces.
Aims
To document and explore possible explanations for the observed excess.
Methods
We analysed data on underlying cause of death and last full-time occupation for 3688916 deaths among men aged 20–74 years in England and Wales during 1979–2010, calculating proportional mortality ratios (PMRs) standardized for age. We compared PMRs for MS in the armed forces with those for each main social class, and in selected other occupations. We also compared PMRs for MS with those for motor neurone disease (MND).
Results
The overall PMR for MS in the armed forces during 1979–2010 was 243 (95% CI 203–288). The excess was apparent in each of three separate decades of study (PMRs, ranging from 220 to 259), and across the entire age range. PMRs for MS were not elevated to the same extent in comparator occupations, nor in any of the main social classes. There was no parallel increase in PMRs for MND.
Conclusions
These findings suggest that the high proportional mortality from MS in British military personnel is unlikely to have occurred by chance, or as an artefact of the method of investigation. However, the only military cohort study with published results on MS does not support an increased risk. It would be useful to analyse data on MS from other established military cohorts, to check for evidence of a hazard.



Designing smartphone mental health applications for emergency service workers

2017-05-23

Abstract
Background
Emergency service workers are often exposed to trauma and have increased risk of a range of mental health (MH) conditions. Smartphone applications have the potential to provide this group with effective psychological interventions; however, little is known about the acceptability and preferences regarding such initiatives.
Aims
To describe the preferences and opinions of emergency service workers regarding the use of smartphone MH applications and to examine the impact of age on these preferences.
Methods
Participants were recruited from four metropolitan Fire and Rescue NSW stations and responded to questionnaire items covering three key domains: current smartphone use, potential future use and preferences for design and content as well as therapeutic techniques.
Results
Overall, approximately half the sample (n = 106) claimed they would be interested in trying a tailored emergency-worker MH smartphone application. There were few differences between age groups on preferences. The majority of respondents claimed they would use an app for mental well-being daily and preferred terms such as ‘well-being’ and ‘mental fitness’ for referring to MH. Confidentiality, along with a focus on stress, sleep, exercise and resiliency were all considered key features. Behavioural therapeutic techniques were regarded most favourably, compared with other therapies.
Conclusions
Emergency workers were interested in utilizing smartphone applications focused on MH, but expressed clear preferences regarding language used in promotion, features required and therapeutic techniques preferred.



Temporary work and depressive symptoms in South Korean workers

2017-05-09

Abstract
Background
In many countries, including South Korea, labour market changes have led to an increase in unstable, temporary jobs. There is evidence that workers in such jobs may experience poorer mental health than those in more stable employment.
Aims
To investigate the association between temporary employment and depressive symptoms in South Korean workers.
Methods
We analysed data from the 2010–2014 Korean Welfare Panel Study (KOWEPS). Employment type was categorized into workers paid per day of labour (day labourers), those on short-term contracts (fixed-term workers) and permanent workers. The association between employment type and depressive symptoms, measured using the Center for Epidemiological Studies Depression scale (CES-D 11), was examined using the generalized estimating equation model.
Results
A total of 3756 workers aged 20–59 were included in the 2010 baseline population. Day labourers had the highest mean CES-D 11 score, followed by fixed-term workers and permanent workers. With the day labourer group as reference, fixed-term workers (β: −1.5027, P < 0.001) and permanent workers (β: −2.1848, P < 0.001) showed statistically significant decreases in depression scores.
Conclusions
Compared with day labourers, fixed-term workers and permanent workers had progressively lower depression scores. The findings of this study suggest that mental health inequalities based on employment type exist in South Korea.