Occupational hazards and early retirement: German National Cohort (NAKO) baseline distributions

Abstract Background Despite measures to ensure occupational safety, harmful workplace conditions that negatively impact worker health persist. The baseline assessment of the German National Cohort (NAKO) provides a basis for determining the prevalence of occupational hazards and early retirement (due to health reasons). Methods From 2014 to 2017, the NAKO examined 205,141 participants aged 20-69 years at 18 study centers across Germany. Working participants were asked about exposure to airborne particulates, occupational noise, evening and night work, sick days, presenteeism, and personal safety equipment use (respiratory masks, hearing protection). The assessment also included questions on retirement. We examined the distributions descriptively. Results A total of 84.2% (n = 172,766) participants were ever employed. Of these participants, 7.9% reported ever working in a job with dust or air particulate exposure where a respiratory mask was required for at least one year. However, nearly one-third (31.6%) of the particulate-exposed workers reported not having worn a mask. 11.4% worked at least a year in a job that required hearing protection, but 27.2% of noise-exposed workers did not comply with this safety measure. Over half of the workers sometimes worked between 6 and 10 pm, and 18.7% sometimes worked at night (11 pm to 6 am) in the last three months. On average, participants used 10.5 sick days in the previous year, and the 12-month prevalence of going to work sick at least one day (presenteeism) was 64.9%. Nearly one-fourth (24.4%; n = 9043) of retirees reported early retirement due to health reasons. Conclusions Hazardous working conditions were common, and there was only partial compliance with the use of available personal safety equipment and measures. The NAKO provides a basis for examining the distribution of occupational exposures in Germany, and future prospective data will permit an evaluation of the effectiveness of preventative regulations. Key messages The NAKO cohort provides essential information on the prevalence of hazardous working conditions in Germany. In the future, trend observations from the prospective data can help evaluate the efficacy of preventive regulations.


Background:
Cardiovascular diseases represent the main cause of mortality worldwide. While cardiovascular risk (CVR) has decreased in grown adults and elderly in the last years due to innovative therapies and prevention, it seems to be rising among young adults. The aim of our study was to map the 10-year CVR in healthcare workers (HCWs) at the teaching hospital Policlinico Umberto I of Rome and identify possible determinants in order to design and implement preventive strategies.

Methods:
A cross-sectional study was carried out between January 2019 and July 2020. 525 HCWs aged 20-40 years were recruited. All participants underwent, after informed consent, medical history collection, physical examination and blood tests. CVR was measured using Framingham Risk Score (FRS) and CUORE score (CVR score developed by the Italian National Institute of Health). Univariate, bivariate and multivariate analysis were performed. Results: CVR evaluated with FRS correlated positively with age (b = 0.104, p < 0.001), being a shift worker (b = 0.06, p = 0.037), and negatively with female gender (b = -0.757, p < 0.001). No differences were found between being a doctor or a nurse. CVR evaluated with CUORE score correlated positively with age (b = 0.698, p < 0.001), and negatively with female gender (b = -0.332, p < 0.001) and being a doctor (b = -0.220, p < 0.001). Inferential analysis showed low correlation between FRS and CUORE Score (R2 = 0.340).

Conclusions:
Our study demonstrates that females have a lower CVR among HCWs. On the contrary, 15% of male HCWs show a CVR above the average. FRS and CUORE score indicate that advancing age determines an increase in CVR. There is a low correlation between the scores used, in fact CUORE score underestimates the CVR of shift workers while it is known that this particular category is at higher risk.

Background:
Despite measures to ensure occupational safety, harmful workplace conditions that negatively impact worker health persist. The baseline assessment of the German National Cohort (NAKO) provides a basis for determining the prevalence of occupational hazards and early retirement (due to health reasons).

Methods:
From 2014 to 2017, the NAKO examined 205,141 participants aged 20-69 years at 18 study centers across Germany. Working participants were asked about exposure to airborne particulates, occupational noise, evening and night work, sick days, presenteeism, and personal safety equipment use (respiratory masks, hearing protection). The assessment also included questions on retirement. We examined the distributions descriptively.

Results:
A total of 84.2% (n = 172,766) participants were ever employed. Of these participants, 7.9% reported ever working in a job with dust or air particulate exposure where a respiratory mask was required for at least one year. However, nearly one-third (31.6%) of the particulate-exposed workers reported not having worn a mask. 11.4% worked at least a year in a job that required hearing protection, but 27.2% of noiseexposed workers did not comply with this safety measure. Over half of the workers sometimes worked between 6 and 10 pm, and 18.7% sometimes worked at night (11 pm to 6 am) in the last three months. On average, participants used 10.5 sick days in the previous year, and the 12-month prevalence of going to work sick at least one day (presenteeism) was 64.9%. Nearly one-fourth (24.4%; n = 9043) of retirees reported early retirement due to health reasons.