Susanna Toivanen

BACKGROUND Spending time outdoors can reduce stress, and integrating short, regular outdoor office work into daily routines may be an innovative approach to alleviating workplace stress, which is a growing global concern. OBJECTIVE To evaluate the feasibility of an outdoor office work intervention with stress monitoring among office workers, to examine its associations with perceived and physiological stress and document facilitators and barriers using digital tools. METHODS In a 2–week pilot study (2022) of office workers in Sweden, participants worked indoors during week 1 (baseline) and outdoors for ≥30 min per day during week 2 (intervention). During work hours, an online digital questionnaire collected daily perceived stress ratings (1–10 scale), while heart rate variability (HRV) was recorded using the Firstbeat Bodyguard 3. Facilitators and barriers to outdoor office work were documented through photographs using the Stanford Our Voice Discovery Tool app. Stress data were analysed with linear mixed model (random intercept for participant). Photographs were coded using a reflexive thematic analysis. RESULTS The protocol was found to be feasible with high data completeness (93%-88%) and adherence to the study protocol (89%). Seven participants provided 10 days of repeated stress measures over the 2-week study period. Mean perceived stress decreased from then baseline week through the end of the outdoor office intervention week, with mean change of −1.0 (95% CI −1.7 to −0.3; P=.01). For HRV, frequency–domain measures decreased during the intervention compared with baseline: very low frequency (VLF) −19.7 ms² (95% CI −38.2 to −1.2; P=.037) and the low frequency (LF) decreased compared with baseline: −98.8 ms² (95% CI −187.6 to −10.0; P=.03). Photo analysis of 70 images yielded five themes—State of Being, Nature Environment, Comfort or Convenience, Current Norms, and Urban Settings—each containing specific elements acting as facilitators or barriers to outdoor office work. CONCLUSIONS Overall, this small pilot study’s design using digital tools, and high data completeness and adherence support the feasibility of this intervention in real–world office settings, though some adjustments are required. The reduction in perceived stress in the week where participants were working outdoors suggests that outdoor office work may be a promising strategy for addressing work–related stress and worthy of further exploration. However, HRV indices indicate decreased autonomic system variability and possibly increased physiological stress. Though likely multi-faceted, contextual factors identified through analysis of photographs may help explain this discrepancy.

Background: Perceived stress in the workplace is a growing concern, with modern office environments often contributing through noise, crowding, and lack of privacy. To support office workers’ well-being and recovery during the workday, new ways of working—such as spending time outdoors—are being explored. Objective: This explorative pilot study aims to investigate whether engaging in at least 30 min of outdoor office work each day for five consecutive working days could reduce self-rated stress levels among office workers. Methods: A within-subjects design was employed. During the first week, eight participants followed their regular office routine. In the second week, the same participants were instructed to spend a minimum of 30 min each day performing office work outdoors. Results: In the second week, participants worked outdoors for an average of 322 min per week (≈64 min/day), primarily in urban nature settings. Self-rated stress levels were 15% lower than in the first week, a statistically significant reduction by paired-sample t-test, though not by the Wilcoxon test. Conclusions: Daily outdoor work is feasible among office workers and may reduce self-rated stress levels, warranting larger studies with more diverse participants and environments.

Studies on the association between work-family conflict and self-reported health are mostly cross-sectional; few studies have investigated the effect of education on this association. To investigate association between work-family conflict, family-work conflict, lack of time for self-care and leisure due to family and work demands, and self-rated health trajectories, examining sex differences and the modifying effect of education on these associations. Data from active workers (women = 4,283; men = 3,851) from the three waves and annual follow-up (2008-2020) of the Longitudinal Study of Adult Health were analyzed using multinomial logistic models. Work-family conflict, family-work conflict, and lack of time were associated with worse self-rated health trajectories in both sexes. However, among women who reported a lack of time for self-care and leisure, education was a modifying factor. The odds of a fair or poor self-reported health trajectory were higher among women with a high education level who reported a lack of time “sometimes” or “often” than in women with a low education level. Work-family conflict dimensions were associated with worse self-reported health trajectories among both women and men. Education only modified this effect among women.

Background: Workers exposed to gender harassment and illegitimate tasks may experience adverse mental health outcomes such as depression and burnout. However, the longitudinal effects and the complex interrelationships between these variables remain largely unexplored. We therefore investigated...

Background Smoking cessation is not an easy accomplishment. However, the benefits are several for those who do it, such as cardiovascular risk reduction 1 year after quitting smoking. This study aimed to verify the factors related to smoking cessation in civil servants of The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Methods This study had a longitudinal design using data from a prospective cohort of civil servants (ELSA-Brasil). Our variable of interest was smoking cessation. The relationship between socio-demographic characteristics, job stress, health-related variables, legislation, and smoking cessation was analyzed by Cox proportional hazard models. The analyses were stratified by gender. Second-hand smoke exposure, age, education, excessive alcohol consumption, common mental disorder, and smoking control law were the variables considered in the final model. Results Information of 2020 women and 2429 men was analyzed. Individuals without second-hand smoke exposure, with up to 49 years of age, with higher education, without excessive alcohol consumption, without common mental disorders, and who initiated smoking in 1989 or after the smoking control law had a higher risk of stopping smoking. The risks magnitudes were higher for women. Conclusions Our study reinforces the necessity of alcohol consumption regulation, the relevance of Public Health Policies, and the need for more smoking cessation measures focused on men, on people with mental disorders, alcoholism, and older adults. Also, our results did not show significant risks regarding the psychosocial working environment.

Background: The aim of this paper was to investigate if job demands, decision authority, and workplace violence mediate the association between employment in the health and social care industry and register-based sickness absence. Methods: Participants from the Swedish Longitudinal Occupational Survey of Health who responded to questionnaires in 2006–2016 (n = 3951) were included. Multilevel autoregressive cross-lagged mediation models were fitted to the data. Employment in the health and social care industry at one time point was used as the predictor variable and register-based sickness absence >14 days as the outcome variable. Self-reported levels of job demands, decision authority, and exposure to workplace violence from the first time point were used as mediating variables. Results: The direct path between employment in the health and social care industry and sickness absence >14 days was, while adjusting for the reverse path, 0.032, p = 0.002. The indirect effect mediated by low decision authority was 0.002, p = 0.006 and the one mediated by exposure to workplace violence was 0.008, p = 0.002. High job demands were not found to mediate the association. Conclusion: Workplace violence and low decision authority may, to a small extent, mediate the association between employment in the health and social care industry and sickness absence.

The safety and health of many workers employed in micro-enterprises (with less than 10 employees) is poor, and legal arrangements related to working environments remain a considerable challenge in these enterprises. The aim of this study is to gain a deeper understanding of how Swedish occupational safety and health (OSH) inspectors perceive themselves as inspectors and their role as bureaucratic regulators when meeting micro-enterprises. In the study, 11 Swedish inspectors were interviewed and asked to reflect on their role as inspectors, how they perceive themselves as inspectors and what their role is as bureaucratic regulators when inspecting micro-enterprises. The qualitative content analysis revealed one theme—a balancing act—and three categories: one inspector, many roles; interactions with micro-entrepreneurs; and exercise the profession as an inspector. The results showed that OSH inspectors experience challenges in meeting the requirements of street-level bureaucracy while addressing the needs of micro-enterprises. In conclusion, OSH inspectors need organisational support to develop inspection models and enforcement styles tailored to micro-enterprises, as this could ease their work and contribute to better inspection outcomes. The implications of this study include a need for increased competence about working environment issues in micro-enterprises, development of enforcement styles among the inspectors, emphasis of the importance of specific governmental projects for OSH and development of models in this enterprise group. Additionally, development of micro-enterprise managers’ competence and ability to handle issues related to the working environment and health were also important.

Background: Precarious employment is a risk factor for poor mental health, particularly among young adults. Knowledge about how young people maintain their mental health while in a precarious employment situation is scarce. The aim of the study was to explore the meaning of precarious employment for young adults in Sweden and their strategies for maintaining good mental health.Methods: In-depth interviews were conducted with 15 individuals (9 men and 6 women) aged 20–39 years in a precarious employment situation. Contact persons at union offices and at specific job-coaching organizations collaborating with the Swedish public employment agency in the city of Malmö were gate openers to reach informants. Analysis was based on constructivist grounded theory, implying an emergent design where data collection and analysis go hand in hand.Results: All informants had completed secondary school in Sweden, and one third had studied at the university level. A majority currently had jobs; however, they were mostly employed on an hourly basis and only a few had temporary full-time jobs. The analysis resulted in a core category “Diverting blame to stay sane,” which summarized an emergent coping process involving individual resources and resources represented by the individuals’ social capital. The developed theoretical model contained four main categories, “Facing reality,” “Losing control,” “Adapting,” and “Fighting back,” related to the core category.Conclusions: The results implied a process where the challenges created by loss of employment-based rights required a coping process where the individual’s social capital plays an important role. However, social capital is to a large extent determined by contextual factors, underlining the strong health equity aspect of precarious employment.

Background Precarious employment is a risk factor for poor mental health, particularly among young adults. Knowledge about how young people maintain their mental health while in a precarious employment situation is scarce. The aim of the study was to explore the meaning of precarious employment for young adults in Sweden and their strategies for maintaining good mental health.Methods In-depth interviews were conducted with 15 individuals (9 men and 6 women) aged 20–39 years in a precarious employment situation. Contact persons at union offices and at specific job-coaching organizations collaborating with the Swedish public employment agency in the city of Malmö were gate openers to reach informants. Analysis was based on constructivist grounded theory, implying an emergent design where data collection and analysis go hand in hand.Results All informants had completed secondary school in Sweden, and one third had studied at the university level. A majority currently had jobs; however, they were mostly employed on an hourly basis and only a few had temporary full-time jobs. The analysis resulted in a core category “Diverting blame to stay sane,” which summarized an emergent coping process involving individual resources and resources represented by the individuals’ social capital. The developed theoretical model contained four main categories, “Facing reality,” ”Losing control,” “Adapting,” and “Fighting back,” related to the core category.Conclusions The results implied a process where the challenges created by loss of employment-based rights required a coping process where the individual’s social capital plays an important role. However, social capital is to a large extent determined by contextual factors, underlining the strong health equity aspect of precarious employment.

Purpose The aim of the study is to examine to what extent human service work and family caregiving is associated with emotional exhaustion and sickness absence, and to what extent combining human service work and family caregiving is associated with additional odds. Methods Data were derived from participants in paid work from the Swedish Longitudinal Occupational Survey of Health, year 2016 (n = 11 951). Logistic regression analyses were performed and odds ratios and 95% confidence intervals estimated for the association between human service work and family caregiving, respectively, as well as combinations of the two on one hand, and emotional exhaustion and self-reported sickness absence on the other hand. Interaction between human service work and family caregiving was assessed as departure from additivity with Rothman’s synergy index. Results Human service work was not associated with higher odds of emotional exhaustion, but with higher odds of sickness absence. Providing childcare was associated with higher odds of emotional exhaustion, but lower odds of sickness absence, and caring for a relative was associated with higher odds of both emotional exhaustion and sickness absence. There was no indication of an additive interaction between human service work and family caregiving in relation to neither emotional exhaustion nor sickness absence. Conclusions We did not find support for the common assumption that long hours providing service and care for others by combining human service work with family caregiving can explain the higher risk of sickness absence or emotional exhaustion among employees in human service occupations.