Ville Aalto’s research while affiliated with Finnish Institute of Occupational Health and other places

Background In Northern latitudes, winter is the darkest time of the year, and depressive episodes during winter are prevalent. Although changing weather patterns due to climate change are projected to result in warmer and wetter and, thus, even darker winters, research on the impact of winter-time natural light and precipitation on mental health is scarce. We examined associations of exposure to solar radiation and precipitation with psychotropic medication and antidepressant purchases in winter months. Methods Of the 251,268 eligible participants from the Finnish public sector study, aged ≥18 years, 72% were women. Associations for municipality-level 4-week average solar radiation and precipitation with register-based medication purchases from 1999 to 2016 were analyzed using random effects method with Poisson regression. A 6-month washout period with no purchases was applied to each purchase. Confounding by region and year, and effect modifications by sex, age, and socioeconomic status were examined. Results No association was observed for an increase in 4-week average of solar radiation by standard deviation (585 kJ/m ² ) with any psychotropic medications (incidence rate ratio: 0.99; 95% confidence interval: 0.98, 1.00) or antidepressants (1.00; 0.99, 1.01). No difference in any psychotropic medication or antidepressant purchases in participants exposed to high solar radiation (≥2000 kJ/m ² ) compared with those with the lowest exposure (<500 kJ/m ² ) was observed. No associations were observed for precipitation. Conclusion No evidence linking higher solar radiation exposure to reduced psychotropic medication purchases, nor higher precipitation exposure to increased medication purchases in winter was observed. Further research is needed to validate and expand upon these findings.

Employee turnover is a challenge for public sector employers. In this study, we used machine learning to develop and validate models to predict actualized turnover of Finnish public sector workers. The development cohort data (N=52 291) included 158 variables from 2018. We defined overall turnover (regardless of reason) and net turnover (excluding workers in retirement age) through eligibility to a follow-up survey in 2020. The validation cohort included 9030 hospital workers who responded to survey in 2017, with turnover assessed in 2019. Area under the curve (AUC) value was 0.75 (95% CI: 0.74-0.76) for overall turnover and 0.75 (95% CI 0.73-0.76) for net turnover. The validation yielded similar AUC values. Key predictors of turnover were younger age, shorter job tenure, and turnover intentions totaling over 70% of the net gain. Work-related exposures, of which low threat of lay-off and satisfaction with challenges at work were most important, had considerably lower predictive power (about 1% each). These results may offer insights for public sector employers in their efforts to reduce employee turnover.

Aim: The aim of this study was to determine the association between neighbourhood socioeconomic disadvantage and teaching staff's risk of workplace violence and whether workplace psychosocial resources can act as effect modifiers. Methods: Primary school teaching staff in the six largest cities in Finland responded to a survey in 2018 and were linked to information on school neighbourhood disadvantage obtained from the national grid database (n = 3984). Results: After adjustment for confounders, staff working in schools located in the most disadvantaged neighbourhoods had a 1.2-fold (95% confidence interval 1.07-1.35) risk of encountering violence or threat of violence compared with staff working in the most advantaged neighbourhoods. The association was less marked in schools with strong support from colleagues (risk ratio 1.14, 95% confidence interval (95% CI) 0.98-1.32 for high support versus 1.23, 95% CI 1.07-1.43 for low/intermediate support), a strong culture of collaboration (1.08, 95% CI 0.93-1.26 versus 1.31, 95% CI 1.12-1.53), high leadership quality (1.12, 95% CI 0.96-1.31 versus 1.29, 95% CI 1.08-1.54), and high organizational justice (1.09, 95% CI 0.91-1.32 versus 1.29, 95% CI 1.09-1.52). Conclusions: The association between school neighbourhood and teaching staff's risk of violence was weaker in schools with high workplace psychosocial resources, suggesting that targeting these factors might help in minimizing violence at schools, but future intervention studies are needed to confirm or refute this hypothesis.

Objective: This study aimed to investigate (i) the risk of work disability (>10-day sickness absence spell or disability pension) due to common mental disorders (CMD) among social workers compared with other health and social care, education, and non-human service professionals and (ii) whether the risk was mediated by job stress. Methods: A cohort of 16 306 public sector professionals in Finland was followed using survey data from baseline (2004 or if not available, 2008) on job stress [job strain or effort-reward imbalance (ERI)] and register data on work disability due to CMD from baseline through 2011. A Cox proportional hazards model was used to analyze the risk of work disability due to CMD between three occupation-pairs in a counterfactual setting, controlling for age, sex, job contract, body mass index, alcohol risk use, smoking, and physical inactivity. Results: Social workers' job stress was at higher level only when compared to education professionals. Thus, the mediation hypothesis was analyzed comparing social workers to education professionals. Social workers had a higher risk of work disability due to CMD compared with education professionals [hazard ratio (HR) 2.08, 95% confidence interval (CI) 1.58-2.74]. This HR was partly mediated by job strain (24%) and ERI (12%). Social workers had a higher risk of work disability than non-human service professionals (HR 1.54, 95% CI 1.13-2.09), but not compared with other health and social care professionals. Conclusions: Job stress partly mediated the excess risk of work disability among social workers only in comparison with education professionals.

Background We examined how reducing work-related psychosocial stressors affected long-term sickness absence of younger and older employees. Methods We used data from 43 843 public sector employees in Finland who participated in surveys in 2018 and 2020. We assessed psychosocial factors, such as job demands, job control, work effort, job rewards and worktime control. We obtained sickness absence data from registers for spells longer than 10 consecutive working days. We applied age-specific propensity score weighting and generalized linear models to estimate the effects of changes in psychosocial factors between 2018 and 2020 on sickness absence in 2020. Results Among employees under 50 years, increasing job rewards by 1 SD reduced the risk of sickness absence by 17% [risk ratio (RR) 0.83, 95% CI 0.72–0.96]. Among employees aged 50 years or older, decreasing job demands by 1 SD reduced the risk of sickness absence by 13% (RR 0.87, 95% CI 0.78–0.98), and increasing job control by 1 SD reduced the risk by 12% (RR 0.88, 95% CI 0.76–1.01). Changes in efforts and worktime control had no significant associations with sickness absence. Conclusions Reducing psychosocial stressors can lower the occurrence of long-term sickness absence, but the associations differ by age group. Younger workers benefit more from enhancing job rewards, while older workers benefit more from lowering job demands and increasing job control. To establish the causal impact of psychosocial risk reduction on sickness absence across age groups, future research should employ randomized controlled trials as the methodological approach.

Background Stressful events and uncertain times are known to pose occupational risks. COVID-19 pandemic brought many changes to work, work arrangements, and work environment. Prospective studies are needed to assess the potential effects of these changes on psychosocial work environment. Methods We followed a large cohort of Finnish public sector employees using biennial survey data from 2016 to 2022 (n = 22,688). Those who reported a change (over to remote work, other tasks, or team reorganization) in work due to the pandemic in 2020 were compared to those who did not report such a change. Sex-, age, and socioeconomic status -adjusted means for psychosocial factors were calculated in four timepoints separately for the groups of employees with and without changes. Multilevel modelling was applied to examine the change in psychosocial factors accounting for autocorrelation between observations. To examine the potential difference in trends between the groups, time x group interaction was tested. Results Transfer to working from home in 2020 (n = 10,587, 47%) was associated with increased work time control (b = 0.07; 95% CI 0.05, 0.08) and social capital (b = 0.03, 95% CI 0.01, 0.05) over time. A transfer to other work tasks in 2020 (n = 1660, 7%) was associated with suboptimal trend in work time control (b= -0.06; 95% CI -0.09, -0.03), and procedural justice (b= -0.05; 95% CI -0.10, 0.00), particularly in 2020 compared to those not exposed to such transfer. Team reorganization in 2020 ((n = 1067, 5%) was associated with suboptimal trend in work time control compared to those not exposed to team reorganization (b= -0.06; 95% CI -0.10, -0.02). Conclusions COVID-19 pandemic induced changes at work were associated with mixed changes in the perceived psychosocial work environment. Key messages • COVID-19 -induced changes at work may have had unequal impacts on different groups of employees in the public sector. • Promoting the resilience of the most vulnerable employee groups needs attention in the future.

Aim: To determine the extent to which level of active commute mode use is associated with self-rated health and work ability. Methods: The data were sourced from the Finnish Public Sector Study survey in 2020 (n = 38,223). The associations between active commuting - assessed with the frequency of using active commute modes - and self-rated health and work ability were examined with negative binomial regression analyses. Passive commuting and low-to-moderate levels of active commuting were compared with active commuting, and the models were adjusted for sociodemographic factors, working time mode, and lifestyle risk factors. We also assessed separate associations between walking and cycling as a mode of commuting by additionally considering the commuting distance and the outcomes. Results: After adjustment, when using active commuters as a reference, passive commuters had a 1.23-fold (95% confidence intervals (CI) 1.19 to 1.29) risk of suboptimal self-rated health and a 1.18-fold (95% CI 1.13 to 1.22) risk of suboptimal work ability. More frequent and/or longer distance by foot and especially by bicycle, was positively associated with health and work ability. Never commuting by bicycle was associated with a 1.65-fold (95% CI 1.55 to 1.74) risk of suboptimal health and a 1.27-fold (95% CI 1.21 to 1.34) risk of suboptimal work ability when using high-dose bicycle commuting as a reference. Conclusions: Passive commuting was associated with suboptimal self-rated health and suboptimal work ability. Our results suggest that using active commute modes, particularly cycling, may be beneficial for employee health and work ability.

Sosiaalinen pääoma kuvaa yksilöiden ja yhteisöjen välisiä sosiaalisia verkostoja ja normeja ja niissä syntyvää luottamusta ja vastavuoroisuutta. Työyhteisöstä saatava sosiaalinen pääoma edistää työntekijöiden hyvinvointia ja ennaltaehkäisee sairastavuutta. Väestön ikääntyessä on tärkeää löytää keinoja työntekijöiden työkyvyn ylläpitoon, ja työpaikan sosiaalisen pääoman tukemisella voisi olla keskeinen rooli. Tässä tutkimuksessa tarkasteltiin, onko työyhteisön sosiaalisen pääoman väheneminen yhteydessä työntekijän koettuun heikentyneeseen työkykyyn. Työyhteisön sosiaalista pääomaa mitattiin sekä yksilön itsearviona että työtovereiden arviona. Tutkimuksessa käytettiin Työterveyslaitoksen Kuntasektorin seurantatutkimuksen aineistoa. Otokset muodostuivat sairaaloista ja kunnista vuosina 2012, 2015/2016 ja 2017/2018 kerätystä aineistosta ja sisälsivät 11 196 (yksilön sosiaalinen pääoma) sekä 9 579 (työyksikön sosiaalinen pääoma) vastaajaa. Tutkimus toteutettiin kokeellista asetelmaa jäljittelevänä pseudokokeellisena asetelmana, joka mahdollisti sosiaalisen pääoman ja työkyvyn muutosten ajallisten yhteyksien tarkastelun. Aineisto analysoitiin logistisella regressioanalyysilla, jossa tarkasteltiin miten työyhteisön sosiaalisen pääoman väheneminen ensimmäisen ja toisen aikapisteen välissä ennustaa työntekijän heikentynyttä työkykyä kolmannessa aikapisteessä. Analyyseissa kontrolloitiin ikä, sukupuoli, ammattiasema, siviilisääty, työaikamuoto sekä terveyskäyttäytymiseen ja terveydentilaan liittyviä tekijöitä. Yksilön sosiaalisen pääoman väheneminen ennusti työntekijän työkyvyn heikentymistä myös kovariaattien vakioinnin jälkeen. Muilta työyksikön jäseniltä mitattu sosiaalisen pääoman väheneminen ennusti heikentynyttä työkykyä vakioimattomassa analyysissa, mutta vakioinnin jälkeen tulos ei ollut tilastollisesti merkitsevä. Työyhteisön sosiaalisen pääoman väheneminen saattaa heikentää työntekijän työkykyä. Työyhteisön sosiaalisen pääoman tukemiseksi tulisi löytää keinoja työpaikoilla ja jatkotutkimuksissa.

Background and purpose: Amongst people of working age, the return to work (RTW) after anterior cruciate ligament (ACL) reconstruction is an important marker of success of surgery. We determined when patients are able to return to work after ACL reconstruction and identified factors that are associated with the timing of RTW. Patients and methods: We used logistic regression analyses to examine patient-related factors that may be associated with the length of RTW (above vs. below the median 59 days) after arthroscopic ACLR in a large cohort of patients working in the public sector in Finland (n = 803; n = 334 male, n = 469 female; mean age 41 years [SD 8.6]). Results: The mean length of RTW was 65 days (SD 41). Higher odds ratios (OR) were observed for age groups 40-49 and ≥ 50 years compared with ≤ 30 years old (OR 2.0, 95% confidence interval 1.3-3.1 and 2.0, 1.2-3.4, respectively); for lower level non-manual and manual work compared with higher level non-manual work (3.0, 2.0-4.3 and 4.9, 3.4-7.0, respectively); and for those who had been on sick leave > 30 days in the preceding year (2.0, 1.4-2.9). Sex, comorbid conditions, preceding antidepressant treatment and concomitant procedures were not associated with the length of RTW. Interpretation: Factors associated with prolonged sick leave beyond the median time of 59 days are higher age, lower occupational status, and preoperative sick leaves.

Introduction Bullying and violence at work are relatively common in Finnish public sector workplaces. Previous research has demonstrated their association with increased risk of poor health and well-being, but only few intervention studies exist. The aim of this protocol paper is to describe the development and assessment of the effectiveness of a workplace intervention aimed at reducing these harmful phenomena. Methods and analysis This protocol describes a two-wave quasi-experimental intervention. Each of the three participating Finnish public sector organisations (cities) will select four work units (a total of 450–500 employees) to participate in an intervention including 2–3 workshops for the work unit, 2–3 consultative meetings with the supervisor of the work unit, a follow-up meeting for the entire work unit (a maximum of 6-month time lag) and online meetings with the supervisor to monitor achievements and discuss about difficult cases, if any. Three age-matched, sex-matched and occupation-matched controls for each participants of the intervention group will be randomly selected, a total 1350–1500 individuals in the control group. For intervention and control groups, premeasurement is based on responses to a survey that was conducted in 2020. Postintervention measurement will be based on survey responses in 2022. Data will be analysed using latent change score modelling or difference-in-difference analysis. Ethics and dissemination Ethics approvals are from the Ethics committees of the Helsinki and Uusimaa hospital district and the Finnish institute of Occupational Health. Results will be made available to participating organisations and their employees, the funder and other researchers via open access article in a peer-reviewed journal and subsequent reporting of the results via social media channels and press release to the public.