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Health@Work 2020
HC 1: Introduction to Health @work
Why study health and work now?
- Ageing workforce (retirement age is going up) → more workers with health problems.
- Flexible labour market (it will be difficult to find permanent job contracts like our
parents now) → may challenge the mental health of younger workers.
Will a 55-year old construction worker with shoulder pain develop low back pain due to his
work? → No, it depends on the work capacity of the worker.
3.000 workers die every year because of factors at work in the Netherlands.
Costs due to productivity losses at work are the most expensive for the society.
HC 2: Model workload and ICF model
Relatie tussen werk en gezondheid.
Hoe kan werk gezondheid beïnvloeden?
- Een gevaarlijk beroep kan ervoor zorgen dat je gewond raakt → negatieve invloed op
gezondheid.
+ Als je werk je gelukkig maakt (leuke collega’s) → positieve invloed op gezondheid.
→ werk kan gezondheid positief en negatief beïnvloeden.
Gezondheid ook invloed op werk.
● Productiviteit: positief of negatief.
● Ziekteverzuim: sommige kunnen en andere niet terug naar hun werk.
Health @work:
- How can work and health influence each other?
- Theoretical models for work and health:
- Model Workload.
- International Classification of Functioning, Disability and Health (ICF).
Work <-> Health
1. Model Work load: Work → Health
a. Work as a starting point for explaining health.
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b.
i. External workload = all characteristics of work and working
environment that evoke (oproepen) health (physical or psychological)
responses.
1. Consists of 4 elements; Work demands, very broad (not strict):
a. Task content refers to the things the persons needs to
do during the day.
b. Working conditions.
c. Working relations are the people you work with; Are
they supportive? Friendly? Are there any arguments or
conflicts that can lead to stress symptoms? Or are
these relationships good, leading to work pleasure and
happiness?.
d. Employment terms consists of possibilities to develop
yourself (career opportunities), payments and benefits
besides your salary (travel allowance), free time (work
schedule, compensation for night/weekend work, or
amount of holidays) and a course payment, are you
happy with the salary.
ii. Job control (decision latitude) = ability of worker to reduce the
external load through:
1. Change in working conditions.
2. Use of tools/ mechanical aids.
3. Method of work or sequence.
iii. Physical work capacity = the full range of physical & psychosocial
characteristics of the worker at a certain moment. Physical work
capacity is always a health complaint (klacht), a temporary health
complaint, not an expression of characteristics from work (heavy
lifting). The health complaint is because of the work. So it is ‘low back
pain’ and not heavy lifting.
Can you handle your job emotionally, physically and socially?
- Physically
- Attitudes
- Knowledge
- Skills
iv. Physical workload refers to short term health effects because of
work and not to the workload itself, as this is captured by external
workload. Physical workload comprises the effects of work on your
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body. Physical workload = all temporary and short-term physical
responses.
1. Temporary: effects fully disappear after recovery (e.g. couple
of hours, new working day).
2. Caused by work demands.
= short-term (health) effects like sweating, increased heart rate
or back pain for one day.
= caused by work!
v. Health effects = long-term health effects (still present after recovery
period), chronic, recurrent or permanent effects of workload and
caused by work demands. Think of burn out or chronic low back pain.
c. Example waitress:
i. External workload:
1. Task content = lifting plates, walking, cleaning tables with wet
towel.
2. Working conditions = temperature cold or hot, party with noise/
earplugs?, plates heavy?, busy days with time pressure?
3. Working relations = relations with colleagues, relation with
supervisor, relation with clients.
4. Employment terms = career opportunities: manager? Live far
from work: travel allowance? Salary: tips? Holidays?
ii. Job control (decision latitude):
1. Waitress can adapt her work: her external workload consists of
lots of walking and lifting heavy plates. This may lead to
fatigue, but when her colleagues help her, or if she can take a
break when she starts to feel tired, or when she has a tool
available for piles of heavy plates (e.g., a trolley), she may be
less tired. The health effects of the external workload are then
reduced.
2. If the waitress has Job control she can do/use things to be not
tired from work.
3. When the waitress does not have job control over working
conditions, method of work or tools, she will become tired
much quicker. Example when the boss does not allow the
working conditions she wants, when there is no time for a
break or when there are no tools available.
iii. Physical work capacity: Negative
1. Physical; not strong enough.
2. Emotional; inadequate coping.
3. Cognitive; calculation speed.
When waitress is not strong enough to lift plates with heavy meals and
drinks on it, her physical capacity is not balanced with the external
workload. Also, when she finds it difficult to cope with customers who
are angry or upset, she might develop stress symptoms sooner
compared to colleagues that can cope with stress more easily.
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→ Physical work capacity can change over time! It can become better
(training) or worse.
Job control + External work load
● Job control: adapt external work load?
● Lifting heavy plates: no help from colleague/trolley.
○ No job control → high external work load.
● Lifting heavy plates: ask strong colleague to help.
○ Job control → low external work load.
● You need to know what the job control is!
When studying the effects of the external factors on health, you need to know if someone
has the power to alter the external load.
Lifting heavy plates
● Physical work load: back pain for 1 day.
● But: lifting continues during whole summer.
○ Back pain won’t disappear: negative health effect.
Balance in the model 1: do not forget work capacity!
Balance in the model 2: do not forget work capacity!
How can we intervene?
1. Reduce external load.
a. E.g. tools, more resting times, higher rewards.
2. Enhance job control.
a. Give worker more power to adapt job.
3. Work capacity.