In 2008 a deep economic crisis started in the US and rapidly spread around the world. The crisis severely affected the labor market and employees’ well-being. Hence, the aim of this work is to implement a systematic review of the principal studies that analyze the impact of the economic crisis on the health of workers. We conducted our search on the PubMed database, and a total of 19 articles were selected for review. All studies showed that the economic crisis was an important stressor that had a negative impact on workers’ mental health. Most of the studies documented that a rise in unemployment, increased workload, staff reduction, and wages reduction were linked to an increased rate of mood disorders, anxiety, depression, dysthymia, and suicide. Some studies showed that problems related to the crisis may have also affected the general health of workers by increasing the risk of such health problems as cardiovascular and respiratory diseases. Finally, some studies looked at the impact of the crisis on health care services. These studies demonstrated that the reduction in public expenditure on health care services, and the reduction of public hospital budgets due to the recession, led to organizational problems (eg, medical supply shortages).

Background The World Health Organization (WHO) and the International Labour Organization (ILO) are developing Joint Estimates of the work-related burden of disease and injury (WHO/ILO Joint Estimates), with contributions from a large network of experts. Evidence from mechanistic data suggests that exposure to long working hours may cause ischaemic heart disease (IHD). In this paper, we present a systematic review and meta-analysis of parameters for estimating the number of deaths and disability-adjusted life years from IHD that are attributable to exposure to long working hours, for the development of the WHO/ILO Joint Estimates. Objectives We aimed to systematically review and meta-analyse estimates of the effect of exposure to long working hours (three categories: 41–48, 49–54 and ≥55 h/week), compared with exposure to standard working hours (35–40 h/week), on IHD (three outcomes: prevalence, incidence and mortality). Data sources We developed and published a protocol, applying the Navigation Guide as an organizing systematic review framework where feasible. We searched electronic databases for potentially relevant records from published and unpublished studies, including MEDLINE, Scopus, Web of Science, CISDOC, PsycINFO, and WHO ICTRP. We also searched grey literature databases, Internet search engines and organizational websites; hand-searched reference lists of previous systematic reviews; and consulted additional experts. Study eligibility and criteria We included working-age (≥15 years) workers in the formal and informal economy in any WHO and/or ILO Member State but excluded children (aged < 15 years) and unpaid domestic workers. We included randomized controlled trials, cohort studies, case-control studies and other non-randomized intervention studies which contained an estimate of the effect of exposure to long working hours (41–48, 49–54 and ≥55 h/week), compared with exposure to standard working hours (35–40 h/week), on IHD (prevalence, incidence or mortality). Study appraisal and synthesis methods At least two review authors independently screened titles and abstracts against the eligibility criteria at a first stage and full texts of potentially eligible records at a second stage, followed by extraction of data from qualifying studies. Missing data were requested from principal study authors. We combined relative risks using random-effect meta-analysis. Two or more review authors assessed the risk of bias, quality of evidence and strength of evidence, using Navigation Guide and GRADE tools and approaches adapted to this project. Results Thirty-seven studies (26 prospective cohort studies and 11 case-control studies) met the inclusion criteria, comprising a total of 768,751 participants (310,954 females) in 13 countries in three WHO regions (Americas, Europe and Western Pacific). The exposure was measured using self-reports in all studies, an...

Our results provide further evidence on the health paradox of OPA, with higher CVD rates among workers with intense PA at work. Moreover, the protective effect on CVDs of SpPA is prominent in sedentary workers, but it attenuates and even reverses in moderate and strenuous OPA workers.

Aims The aim of this study was to investigate the independent associations of occupational (OPA) and sport physical activity (SpPA) and job strain on the incidence of coronary heart disease (CHD) events, and to explore their interplay. Methods The study sample included 3310 25–64-year-old employed men, free of CHD at baseline, recruited in three population-based and one factory-based cohorts. OPA and SpPA, and job strain were assessed by the Baecke and the Job Content Questionnaires, respectively. We estimated the associations between different domains of physical activity and job strain with CHD, adjusting for major risk factors using Cox models. Results During follow-up (median=14 years), 120 CHD events, fatal and non-fatal, occurred. In the entire sample, a higher CHD risk was found for high job strain (hazard ratio=1.55, 95% confidence interval: 1.05–2.31). The joint effect of low OPA and high job strain was estimated as a hazard ratio of 2.53 (1.29–4.97; reference intermediate OPA with non-high strain). With respect to intermediate OPA workers, in stratified analysis when SpPA is none, low OPA workers had a hazard ratio of 2.13 (95% confidence interval: 1.19–3.81), increased to 3.95 (1.79–8.78) by the presence of high job strain. Low OPA–high job strain workers take great advantage from SpPA, reducing their risk up to 90%. In contrast, the protective effect of SpPA on CHD in other OPA–job strain categories was modest or even absent, in particular when OPA is high. Conclusions Our study shows a protective effect of recommended and intermediate SpPA levels on CHD risk among sedentary male workers. When workers are jointly exposed to high job strain and sedentary work their risk further increases, but this group benefits most from regular sport physical activity.

IntroductionThe aim of the study is to investigate the interplay between job strain (JS) and occupational physical activity (OPA) in determining the risk of major cardiovascular diseases (CVD), in a working male population.Methodsn=1515 participants to three population-based (WHO-MONICA Brianza II and III survey and PAMELA) North Italian cohorts, 25–64 years old, employed and CVD-free at baseline, were available for the analyses. JS was investigated using the Job Content Questionnaire (MONICA-MOPSY short version), and dichotomized as high vs no-high strain. A habitual OPA score was derived from the Baecke Questionnaire (8 items) and categorised in tertiles. Age-adjusted hazard ratios (HRs) and 95% confidence intervals for incidence of CVD (first coronary heart disease or ischaemic stroke, fatal or non-fatal) events were estimated from Cox-proportional hazard models. A sensitivity analysis was carried out stratifying by sport PA levels.ResultIn a median 17 years of follow-up, n=102 first CVD events occurred. As compared to the intermediate OPA tertile, workers with low and high OPA showed higher HRs of 1.67 (95% CI: 0.96 to 2.92) and 2.01 (1.17–3.46), respectively. Stratifying by sport PA, the above reported HRs for low and high OPA workers increased to 2.32 (1.15; 4.69) and to 2.54 (1.09; 5.95) when sport PA was below and above the median, respectively. High vs non-high JS workers evidenced an HR of 1.27 (0.76–2.11). When adjusting for age, BMI, alcohol intake, smoking and sport PA, a joint effect was detected between OPA and JS, with the highest HR for workers in the low OPA and high JS category [2.70 (1.17; 6.26)] as compared to workers in the intermediate OPA and non-high JS.DiscussionWe observed a joint additive effect between sedentary work and high JS on the incidence of cardiovascular events.