Objectively measured work load, health status and sickness absence among Danish ambulance personnel. A longitudinal study

Background: Reviews show that ambulance personnel (AP) have an increased risk of work-related health problems especially musculoskeletal disorders. Because of the unpredictable character of the AP’s work environment, standard measures of work environment exposures are imprecise. The aim of this presentation is to examine the associations between objectively measured work load taken from the company register, health and long-term sickness absence (LTSA) in 1-year follow up period.

Methods: Data is taken from the first round of MARS – Men, accidents, risk and safety, a two wave panel study of AP workers in Denmark (n = 1606) collected in winter 2010/11. The response rate to the questionnaire was 62% in the baseline. The respondents were asked about health status, physical (DMQ) and psychosocial work environment factors (COPSOQ). Information from the company register about work load (e.g. mean number of work tasks) for each participant from the year prior to baseline was linked to the questionnaire data. Information on LTSA was taken from the national register DREAM and analysed using Cox regression.

Results: Preliminary results show that mean number of work tasks was associated with lower levels of self-rated health (OR: 1.79), higher levels of musculoskeletal pain (OR: 1.16) but was unrelated to mental health. In addition, increasing work load was associated with higher levels of emotional demands and work pace (p < 0.000). The objective measure of work load was also associated with self-reported sickness absence and LTSA even when adjusting for baseline health. 7 % of the participants were sick-listed for at least 4 consecutive weeks in the follow up period. AP’s with mean number of work tasks higher than median had more than two-fold risk of being sick-listed (HR: 2.17 (95% CI: 1.35-3.51)).

Conclusions: This study is one of the first to study the association between objectively measured work load among AP and their association with health, (self-reported) work environment and sickness absence. The results show that increasing work load is associated with adverse health and work environment and higher levels of sickness absence. The study should initiate discussions of maximum work load among AP’s in order to prevent work-related health problems in this group.

Main messages:
• Objectively measured work load among ambulance workers is associated with lower levels of health, more adverse work environment and higher levels of sickness absence