Health promotion in a Swedish industrial setting. Measures taken by occupational health services to enhance employee´s physical and mental well-being.
Gisela Rose
Abstract
Health examinations are an important part of the preventive work of the occupational health care at Swedish companies. They also create contactbetween the employees and the health care staff and are an invaluable source of knowlege about the work environment.
The aim of this study was to investigate the value (potential benefits and potential unwanted side effects) of health examinations carried out by occupational health care teams at a Swedish company and to analyse if, among potentially healthy employees, there is a correlation between psychological well-being and cardiovascular risk factors, and if there is a gender difference. A further aim was to investigate whether reported stressful life events, especially work-related life events, had any associations with mood and mental strain and risk fators for cardiovascular disease.
In an evaluation of an extensive health examination programme it was conclude that guidance base on information about lifestyle factors and biological markers that reflect lifestyle like body weight, blood pressure, serum lipids and serum liver transaminases mostly were important as a support for a better lifestyle, as observed when a follow-up was made after two years. Other laboratory examinations should only be carried out when suspicion of disease is present. To many persons the health examination was a starting point for a better lifestyle.
The possibility of a negative effect on psychological well-being from health examinations was examined with a prospective controlled study using two well-known questionnaires for determination of health-related quality of life and psychological well-being and with an interview study with unstructured, open-ended interviews of ten women and ten men. There were no signs of deteriorated psychological well-being after the health examination.
Among 150 potentially healthy employees associations were observed between psychological well-being and risk factors for cardiovascular disease, detected at a health examination, e.g. between depressed mood and elevated blood pressure in men. Women reported significantly worse psychological well-being but had a significantly better cardiovascular risk factor profile than men. Those women who felt best also had the best risk factor profile.
Further analyses of the correlations between risk factors for cardiovascular disease and psychological as well as psychosocial factors on one hand and stressful life events on the other have been carried out within the scope of the so called Coeur study. Negative life events, work-related as well as not work-related, were significantly correlate with depressed mood and mental strain, but not with elevation of cardiovascular risk factors. A higher proportion of white-collar than blue-collar workers was affected by work-related life events, while blue-collar workers liad a higher prevalence of cardiovascular risk factors. Depressed mood and mental strain were related to increased tobacco consumption and increased alcohol consumption.
ISBN 91-628-2815-0
Occupational Health Care Centre of Volvo and Department of Primary Health Care, Göteborg University, Göteborg, Sweden