Effects of the Labour Inspectorate Authority's regulatory tools on psychosocial and biomechanical work factors in Norwegian home care services: a cluster randomised controlled trial

Bjørnar Finnanger Garshol, Stein Knardahl, Jan Shahid Emberland, Øivind Skare, Håkon A Johannessen, Bjørnar Finnanger Garshol, Stein Knardahl, Jan Shahid Emberland, Øivind Skare, Håkon A Johannessen

Abstract

Objectives: This study aimed to determine the effects of the Labour Inspectorate Authority's (LIA's) regulatory tools on psychosocial and biomechanical work factors in the Norwegian municipal home care services.

Methods: A cluster-randomised controlled trial conducted in the home care services with employee questionnaire data on work factors at baseline, and 6 and 12 months after the interventions. In total, 96 eligible municipalities were randomly assigned to either the control group or one of two interventions: (1) labour inspection visits, based on the LIA's standard inspections; and (2) guidance-through-workshops, where the participating services highlighted issues and trained labour inspectors provided guidance based on existing labour laws and regulations.

Results: No favourable intervention effect was observed for the inspection intervention. No effects were observed for most of the variables in the guidance intervention, although an effect was observed for the following psychosocial factors: decision control, control over work intensity and empowering leadership. However, after adjusting for multiple testing, none of the observed effects were statistically significant.

Conclusion: Labour inspections did not affect psychosocial and biomechanical work factors in the home care services. A favourable effect of the guidance intervention on psychosocial work factors was observed. However, this was not evident after adjusting for multiple testing. Further research is needed to elaborate on how labour inspections and other regulatory tools can impact psychosocial and biomechanical work factors.

Trial registration number: NCT03855163.

Keywords: Clinical Trial; Ergonomics; Health Personnel; Occupational Health; Psychology.

Conflict of interest statement

Competing interests: None declared.

© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Figures

Figure 1
Figure 1
Flowchart illustrating cluster allocation, intervention implementation and data collection, adapted from Indregard et al.

References

    1. Knardahl S, Johannessen HA, Sterud T, et al. . The contribution from psychological, social, and organizational work factors to risk of disability retirement: a systematic review with meta-analyses. BMC Public Health 2017;17:176. 10.1186/s12889-017-4059-4
    1. Knardahl S, Sterud T, Nielsen MB, et al. . Arbeidsplassen og sykefravær - Arbeidsforhold av betydning for sykefravær. Tidsskrift for velferdsforskning 2016;19:179–99. 10.18261/issn.2464-3076-2016-02-05
    1. Taibi Y, Metzler YA, Bellingrath S, et al. . A systematic overview on the risk effects of psychosocial work characteristics on musculoskeletal disorders, absenteeism, and workplace accidents. Appl Ergon 2021;95:103434. 10.1016/j.apergo.2021.103434
    1. Duchaine CS, Aubé K, Gilbert-Ouimet M, et al. . Psychosocial stressors at work and the risk of sickness absence due to a diagnosed mental disorder: a systematic review and meta-analysis. JAMA Psychiatry 2020;77:842–51. 10.1001/jamapsychiatry.2020.0322
    1. Tollånes MC, Knudsen AK, Vollset SE, et al. . Disease burden in Norway in 2016. Tidsskr Nor Laegeforen 2018;138. doi:10.4045/tidsskr.18.0274. [Epub ahead of print: 02 10 2018].
    1. Sterud T, Tynes T. Work-related psychosocial and mechanical risk factors for low back pain: a 3-year follow-up study of the general working population in Norway. Occup Environ Med 2013;70:296–302. 10.1136/oemed-2012-101116
    1. Johannessen HA, Tynes T, Sterud T. Effects of occupational role conflict and emotional demands on subsequent psychological distress: a 3-year follow-up study of the general working population in Norway. J Occup Environ Med 2013;55:605–13. 10.1097/JOM.0b013e3182917899
    1. Carneiro P, Braga AC, Barroso M. Work-related musculoskeletal disorders in home care nurses: study of the main risk factors. Int J Ind Ergon 2017;61:22–8. 10.1016/j.ergon.2017.05.002
    1. Sterling MR, Li J, Cho J, et al. . Prevalence and predictors of home health care workers' general, physical, and mental health: findings from the 2014‒2018 behavioral risk factor surveillance system. Am J Public Health 2021;111:2239–50. 10.2105/AJPH.2021.306512
    1. Bakke B, Degerud EMM, Gravseth HMU. Faktabok om arbeidsmiljø og helse 2021. Status og utviklingstrekk [Norwegain Fact Book on Work Environment and Health 2021 – Status and Recent Developments]. STAMI-rapport, 2021.
    1. Grønoset Grasmo S, Frostad Liaset I, Redzovic SE. Home health aides' experiences of their occupational health: a qualitative meta-synthesis. Home Health Care Serv Q 2021;40:148–76. 10.1080/01621424.2021.1921650
    1. Quinn MM, Markkanen PK, Galligan CJ, et al. . Occupational health of home care aides: results of the safe home care survey. Occup Environ Med 2016;73:237–45. 10.1136/oemed-2015-103031
    1. Ministry of Health and Care Services . Leve hele livet - En kvalitetsreform for eldre [Meld. St. 15 (2017-2018)] [Living a full life – a qualitiy reform for older people]. Oslo Ministry of Health and Care Services, 2018.
    1. Muramatsu N, Sokas RK, Chakraborty A, et al. . Slips, Trips, and falls among home care aides: a mixed-methods study. J Occup Environ Med 2018;60:796–803. 10.1097/JOM.0000000000001355
    1. Rydenfält C, Holgersson C, Östlund B, et al. . Picking low hanging fruit - A scoping review of work environment related interventions in the home care sector. Home Health Care Serv Q 2020;39:223–37. 10.1080/01621424.2020.1772936
    1. World Health Organization . Declaration on workers health - approved at the seventh meeting of who collaborating centers for occupational health. Stresa; 2006.
    1. International Labour Office . Global strategy on occupational safety and health–conclusions adopted by the International labour conference at its 91st session. Geneva; 2004.
    1. Andersen JH, Malmros P, Ebbehoej NE, et al. . Systematic literature review on the effects of occupational safety and health (OSH) interventions at the workplace. Scand J Work Environ Health 2019;45:103–13. 10.5271/sjweh.3775
    1. Tompa E, Kalcevich C, Foley M, et al. . A systematic literature review of the effectiveness of occupational health and safety regulatory enforcement. Am J Ind Med 2016;59:919–33. 10.1002/ajim.22605
    1. Johannessen HA, Løchting I, Bakke B. Effekter av myndighetstiltak på arbeidsmiljø og helse. En systematisk kunnskapsoppsummering [Effects of authorities’ efforts to improve work environment and health – a systematic literature review]. STAMI-rapport, 2017.
    1. Mischke C, Verbeek JH, Job J, et al. . Occupational safety and health enforcement tools for preventing occupational diseases and injuries. Cochrane Database Syst Rev 2013:CD010183. 10.1002/14651858.CD010183.pub2
    1. Indregard A-MR, Knardahl S, Emberland JS, et al. . Effectiveness of the labour inspection authority's regulatory tools for work environment and employee health: study protocol for a cluster-randomised controlled trial among Norwegian home-care workers. BMJ Open 2019;9:e031226. 10.1136/bmjopen-2019-031226
    1. Johannessen HA, Knardahl S, Emberland JS. Do regulatory tools instigate measures to prevent work-related musculoskeletal pain and mental distress? A process evaluation of a labour inspection authority trial in the home-care services
    1. Dallner M, Elo A, Gamberale F. Validation of the general Nordic questionnaire (QPSNordic) for psychological and social factors at work. Copenhagen: Nordic Council of Ministers [Nordiska ministerrådet], 2000.
    1. Wännström I, Peterson U, Åsberg M, et al. . Psychometric properties of scales in the general nordic questionnaire for psychological and social factors at work (QPs): confirmatory factor analysis and prediction of certified long-term sickness absence. Scand J Psychol 2009;50:231–44. 10.1111/j.1467-9450.2008.00697.x
    1. Statistics Norway . Samordnet levekårsundersøkelse 2009 – Tverrsnitt. Tema: Arbeidsmiljø (Coordinated living conditions survey 2009 - Cross sectional. focus: work environment). Oslo: Statistics Norway, 2010.
    1. Smedley J, Egger P, Cooper C, et al. . Manual handling activities and risk of low back pain in nurses. Occup Environ Med 1995;52:160–3. 10.1136/oem.52.3.160
    1. Borg G. Psychophysical scaling with applications in physical work and the perception of exertion. Scand J Work Environ Health 1990;16 Suppl 1:55–8. 10.5271/sjweh.1815
    1. J T, L B, T H, et al. . Different ways to estimate treatment effects in randomised controlled trials. Contemp Clin Trials Commun 2018;10:80–5. 10.1016/j.conctc.2018.03.008
    1. Benjamini Y, Hochberg Y. Controlling the false discovery rate: a practical and powerful approach to multiple testing. Journal of the Royal Statistical Society: Series B 1995;57:289–300. 10.1111/j.2517-6161.1995.tb02031.x
    1. World Medical Association . World Medical association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA 2013;310:2191–4. 10.1001/jama.2013.281053
    1. Weissbrodt R, Arial M, Graf M, et al. . Preventing psychosocial risks at work: an evaluation study of labour inspectorate interventions. Saf Sci 2018;110:355–62. 10.1016/j.ssci.2018.08.024
    1. Jespersen AH, Hasle P, Nielsen KT. The wicked character of psychosocial risks: implications for regulation. NJWLS 2016;6:23–42. 10.19154/njwls.v6i3.5526
    1. Weissbrodt R, Giauque D. Labour inspections and the prevention of psychosocial risks at work: a realist synthesis. Saf Sci 2017;100:110–24. 10.1016/j.ssci.2017.02.012
    1. Pinder J, Gibb A, Dainty A, et al. . Occupational safety and health and smaller organisations: research challenges and opportunities. Policy Pract Health Saf 2016;14:34–49. 10.1080/14773996.2016.1239357
    1. Mellor N, Mackay C, Packham C, et al. . ‘Management standards’ and work-related stress in Great Britain: progress on their implementation. Saf Sci 2011;49:1040–6. 10.1016/j.ssci.2011.01.010
    1. Gautun H. For få på jobb? Sykepleierbemanning I sykehjem OG hjemmesykepleien. Søkelys på arbeidslivet 2021;38:142–57. 10.18261/issn.1504-7989-2021-02-05
    1. Fielding S, Fayers P, Ramsay CR. Analysing randomised controlled trials with missing data: choice of approach affects conclusions. Contemp Clin Trials 2012;33:461–9. 10.1016/j.cct.2011.12.002
    1. Chirico F, Heponiemi T, Pavlova M, et al. . Psychosocial risk prevention in a global occupational health perspective. A descriptive analysis. Int J Environ Res Public Health 2019;16. doi:10.3390/ijerph16142470. [Epub ahead of print: 11 07 2019].
    1. Amundsen S, Martinsen Øyvind L. Empowering leadership: construct clarification, conceptualization, and validation of a new scale. Leadersh Q 2014;25:487–511. 10.1016/j.leaqua.2013.11.009

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