Health Risk Behaviors and Morbidity among Hospital Staff - Comparison across Hospital Ward Medical Specialties in a Study of 21 Finnish Hospitals

By Virtanen, Marianna; Vahtera, Jussi et al. | Scandinavian Journal of Work, Environment & Health, May 2012 | Go to article overview

Health Risk Behaviors and Morbidity among Hospital Staff - Comparison across Hospital Ward Medical Specialties in a Study of 21 Finnish Hospitals


Virtanen, Marianna, Vahtera, Jussi, Batty, G. David, Tuisku, Katinka, Oksanen, Tuula, Elovainio, Marko, Ahola, Kirsi, Pentti, Jaana, Salo, Paula, Vartti, Anne-Marie, Kivimäki, Mika, Scandinavian Journal of Work, Environment & Health


Objective This study examined whether indicators of poor health and health risk behaviors among hospital staff differ between the ward specialties.

Methods Across 2 1 hospitals in Finland, 8003 employees (mean age 42 years, 87% women, 86% nurses) working in internal medicine, surgery, obstetrics and gynecology, pediatrics, intensive care, and psychiatry responded to a baseline survey on health and health risk behaviors (response rate 70%). Responses were linked to records of sickness absence and medication over the following 12 months.

Results Psychiatric staff had higher odds of smoking [odds ratio (OR) 2.58, 95% confidence interval (95% CI) 2.14-3.12], high alcohol use (OR 1.55, 95% CI 1.21-1.99), physical inactivity (OR 1.30, 95% CI 1.11-1.53), chronic physical disease (OR 1.19, 95% CI 1.04-1.36), current or past mental disorders (OR 1.81, 95% CI 1 .50-2. 1 7), and co-occurring poor health indicators (OR 2.65, 95% CI 2.08-3.37) as compared to those working in other specialties. They also had higher odds of sickness absence due to mental disorders (OR 1.40, 95% CI 1.02-1.92) and depression (OR 1.61, 95% CI 1.02-2.55) at follow-up after adjustment for baseline health and covariates. Personnel in surgery had the lowest probability of morbidity. No major differences between specialties were found in the use of psychotropic medication.

Conclusion The prevalence of hospital employees with an adverse health risk profile is higher in psychiatric wards than other specialties.

Key terms healthcare personnel; medication; mental health; prospective study; sickness absence.

Although studies on health inequalities between occupational groups has had important policy implications at all levels of society, recently there has been growing interest in horizontal comparisons of employees within the same organization (1). In hospital settings, there is some evidence to suggest differences in health and health behaviors between staff working in different specialties (2-21). Studies of physicians show elevated rates of "burnout", mental disorders, substance use, and suicide among psychiatrists, anesthesiologists, and physicians working in emergency or primary care although the association is not robust (2-14). In contrast, surgeons and pediatricians have reported lower rates of substance use (7), although this is not a universal finding (9, 10). Surgeons have also been shown to have higher (1 1) and lower (12) risk of death from ischemie heart disease when compared to other medical specialists. Studies of nurses suggest that psychiatric nurses report lower levels of work stress and burnout (15, 16) and higher levels of job autonomy (17) but also more emotional exhaustion (17) than their collaborators working in non-psychiatric settings. No difference was found in one study investigating suicidal behavior among psychiatric healthcare personnel and the general population (18). Other studies found nurses in non-emergency somatic medicine having higher levels of exhaustion than those working in emergency care (19), medical care nurses reporting higher workload than geriatric care nurses (20), and intensive care nursing staff having particularly high burnout rates (2 1 ). A major limitation of most studies in this field, however, is a reliance on small sample sizes and, with few exceptions (3, 5, 11, 12), exclusive use of cross-sectional self-report data. In addition, a broad range of health risks and their accumulation has not previously been investigated.

In this study of 8003 Finnish public hospital employees, we examined the association of medical specialty with employee lifestyle and morbidity. We also examined the onset of sickness absence and medication use by using record linkage to national health registers which has not, to our knowledge, previously been examined. Based on earlier evidence, we anticipated that employees working in psychiatry may have more health problems than those in other medical domains. …

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