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SICKNESS ABSENCE AND JOB LOSS
In the modern flexible economy, temporary contracts of employment are issued commonly. Concerns have been expressed about this: on the one hand, that fear of job loss may be harmful to health, and on the other that actual job loss may be more frequent in those with everyday illnesses. To investigate this second issue, Virtanen et al1 conducted a cohort study of 60 000 temporary and permanent public sector workers (the Finnish Public Sector Cohort Study). Data were collected on employment contract, sickness absence, job termination, unemployment, and disability pensioning in 1997–2000. Several associations were observed. Among women, a high rate of sickness absence increased the odds of later job termination by 1.5–1.7 fold in temporary workers relative to permanent staff. The effect was less apparent in men. However, among both sexes, temporary staff members with high rates of sickness absence were more likely than permanent contract counterparts to be unemployed three years on. The authors conclude that in relative terms permanent contracts protect against unemployment, even in those with higher sickness absence.
EVALUATING A NEW MODEL FOR AIR POLLUTION
In investigating the problem of air pollution compromises are forced by the availability of good data. Until recently, because of this, studies of particulate matter (PM) and mortality have been restricted to a comparatively small number of locations. The current regulatory need to measure PM offers a chance to extend inquiries to more centres, but this comes with a cost—regulatory measurements tend to be collected every sixth day, rather than daily as in the most comprehensive datasets. New strategies for analysis have been proposed to cover this situation. In this issue, Roberts and Martin2 use a model of “moving total mortality count” to investigate associations between PM and daily mortality in the hundred-city US NMMAPS database. Their model avoids the traditional need to select a lag of PM at which effects are analysed. The findings provide further evidence of an impact on public health: a 10 μ/m3 increase in PM was associated with a 0.12% increase in total mortality and a 0.17% increase in cardiovascular and respiratory mortality.
JOB LOSS IN NURSES
The shortage of nursing personnel is a serious worry in many countries. Populations are growing older and the need for nursing care is rising. Disturbingly, however, the nursing workforce is also ageing, and young entrants are becoming scarcer. Thus, factors that affect labour turnover are important to understand and if possible to modify. Fochsen et al3 have assessed the impact of physical workload on job leaving in a cohort of Swedish nursing personnel. During a three year follow up, aches and pains in the neck, shoulders, and knees were predictors of leaving nursing care. Those who seldom used mechanical transfer devices for assisted lifting were also more likely leavers, leading the authors to suggest that better ergonomic conditions could be a way to assist job retention.
WORK STRAIN AND SMOKING
Evidence on job strain and smoking habits is contradictory, with some studies suggesting higher job strain in current smokers and other studies showing no effect. To add to the debate and to clarify the relation in a general population sample, John et al4 have conducted a cross-sectional survey of 2500 working adults from northern Germany. Face to face computer aided interviews were conducted. Work strain (high work demand with low job control) and nicotine dependence were assessed according to standardised criteria. The authors found that although current smoking was unrelated to job strain the odds of nicotine dependence were raised 1.6-fold after allowing for other factors.