Booster Shots

Oddities, musings and news from the health world

Category: workplace

To avoid the yawns, the best time to start work is between 9 a.m. and 2 p.m.

June 8, 2010 |  6:00 am

Night It takes people working around the clock to keep modern society functioning. But studies show people who work night or graveyard shifts pay a price. Working at night is linked to disrupted sleep patterns and an increased risk for several types of health problems, including obesity, heart disease and cancer. The fatigue that results from working odd hours increases the rate of accidents and mood disorders, too.

A new study shows just how sensitive humans are to work shifts. Using a mathematical model, researchers found that the total duration of sleep ranges from 4.5 hours to 8 hours depending on the start time of a person's work shift. The maximum estimated sleep duration occurs among people who start shifts between 9 a.m. and 2 p.m., said the researchers, from Washington State University's branch in Spokane. The minimum estimated sleep duration occurs when the shift starts between 8 p.m. and midnight.

Minimum on-the-job fatigue occurs when a shift starts at 9 a.m. and maximum fatigue occurs when the shift starts at 11 p.m. Workers who start shifts just after midnight fare better than workers who start at 11 p.m. probably because starting work after midnight allows those individuals to sleep before work. Shifts that start just before midnight do not allow for a sufficient pre-shift sleep because the timing conflicts with the body's circadian rhythm. Early evening is a time of day when the body is geared to be alert.

The take-home message of the study is that employers may want to avoid scheduling work shifts that start between 8 p.m. and midnight. The study was presented Tuesday at the Associated Professional Sleep Societies meeting.

-- Shari Roan

Photo credit: Jay L. Clendenin  /  Los Angeles Times

Book Review: 'Difficult Personalities' by Helen McGrath and Hazel Edwards

April 17, 2010 |  1:26 pm

Difficult PersonalitiescoverMost people have at least one person in their lives they consider "difficult." This is the co-worker, in-law, neighbor or friend who's bullying, controlling, hypercritical or so anxious they can't make a decision.

Interactions with them can be challenging, frustrating, even perilous, depending on the role they play in your life. A new book, "Difficult Personalities," by Helen McGrath, a clinical psychologist and adjunct university professor in Melbourne, Australia, and writer Hazel Edwards, offers advice on managing this kind of behavior in other people -- and in yourself.

The authors share insights into what's behind various personality traits, typical behavior, positive aspects of the types and practical strategies you can use to deal with them or cope with your own tendencies.

Their approach changes depending on the behavior. With worriers and perfectionists, they suggest offering understanding, empathy and a reality check. With inflexible and over-controlling people they suggest an assertive, rational and sometimes reassuring manner. They describe pragmatic ways to confront and defuse (or avoid) negative, bossy or "superior" people. And for dealing with bullies, con artists and sociopaths, they focus on concrete steps to identify the behaviors and protect yourself.

But for the most part, McGrath and Edwards advise an approach toward other people -- and ourselves -- that is respectful and compassionate, recognizing that we all have flaws and annoying traits. To that end, they include chapters on getting on top of anxiety, practicing rational thinking, managing anger, negotiating conflict and maintaining strong romantic partnerships.

They base much of their material, they say, on the "Diagnostic and Statistical Manual of Mental Disorders," the widely used American Psychiatric Assn. reference book. They also draw on the Myers-Briggs Type Indicator psychological test to discuss ways to manage differences between introverts and extroverts, thinkers and feelers, and planners and "optionizers." 

-- Anne Colby

Photo: "Difficult Personalities," Helen McGrath and Hazel Edwards, the Experiment, $14.95


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The doctor is in -- but not for long

February 23, 2010 |  1:00 pm

Clock In the public perception, medical doctors are among the hardest-working, most dedicated professionals in the workforce, routinely toiling through 12- or 15-hour days.

Some doctors undoubtedly do work that much. But the trend in the United States is for doctors to work less, not more. Today's physicians work, on average, 51 hours a week -- a figure, I'm guessing, is not uncommon in a great many other professions (teaching, law, journalism).

A study released Tuesday in the Journal of the American Medical Assn. surveyed doctors' work hours from 1976 to 2008. About 1997, doctors began working less, with hours declining nearly 7.2% between 1997 to 2007. The drop was seen across all types of doctors: men, women, young, old, hospital-based, self-employed, resident and non-resident. However, older doctors still tend to work more hours than younger doctors.

It's not clear why doctors are working less, but the decline in pay-per-hour is likely one cause. Average doctor fees, adjusted for inflation, decreased by 25% between 1995 and 2006. Doctors today "may have less incentive" to work, the authors of the paper note.

The trend has implications for society. Doctor shortages are already felt in some parts of the country and are predicted to become more acute in coming years. And, the paper notes, a 5.7% decrease in hours among a workforce of 630,000 doctors is equivalent to the loss of nearly 36,000 doctors.

-- Shari Roan

Photo credit: Juan Carlos Hernandez  /  Bloomberg News

Researchers say it's official: TGIF, baby!

January 15, 2010 |  6:00 am

People are happier and feel better on the weekends, according to new research. Now that may be obvious to you. Indeed, this is the type of study that we at Booster Shots call "one for the duh files." However, on closer examination, the study reveals some interesting observations about leisure time.

For example, everyone is happier on the weekend -- even people who love their jobs and no matter what type of profession one is in or how much one is paid. The study found that people love the freedom associated with weekends and even feel better physically. Perhaps the most surprising finding is that people say they feel more competent during the weekend than they do while at their day-to-day jobs.

Researchers based their findings on responses from 74 volunteers age 18 to 62. Participants monitored their experiences three times daily for 21 consecutive days using simple forms or pagers.

The study reinforces what is known as the "self-determination theory," which means that well-being is based on one's personal needs for autonomy, competence and social relationships. People can tap into those needs more readily on the weekend. Conversely, they may experience time pressures, work demands and unpleasant relationships while at work.

"Far from frivolous, the relatively unfettered time on weekends provides critical opportunities for bonding with others, exploring interests and relaxing -- basic psychological needs that people should be careful not to crowd out with overwork," the lead author of the study, Richard Ryan, from the University of Rochester, said in a news release. The study was published in the January issue of Journal of Social and Clinical Psychology.

The research reaffirms how important leisure time is to well-being. But, the authors note, it also shows that work really can be a bummer. "These results point to possibilities for improving wellness both through enhancing need satisfactions at work and providing more time for adults that is free from work," the authors wrote.

So, it's true. Down time is really up time. Enjoy your weekend. And if you're working, I'm truly sorry.

-- Shari Roan

Photo credit: Luis Sinco  /  Los Angeles Times

Health crimes and punishments: Employers -- and employees -- can decide

November 4, 2009 | 12:18 pm

Turns out, those employer wellness programs are not the benignly helpful initiatives that some Americans might have perceived them to be. Sure, they encourage workers to act in their own best health interests, but they're now also having an impact on those who don't. Ultimately, they could ... well, who knows.

StubsAnd that's the point of today's Los Angeles Times story on healthcare overhaul. It begins:

"Who could object to rewarding people who quit smoking, lose weight or start to exercise? The American Cancer Society and the American Heart Assn., for starters.

"Some companies are charging lower insurance premiums to workers who meet benchmarks for healthy living. The Senate's healthcare overhaul legislation would expand the trend.

"But instead of cheering the proposal, some patient advocacy and health groups are worried that it could mean higher rates for less-fit Americans, possibly pricing them out of their employers' insurance plans."

That story: Insurance discounts for healthy habits spur debate in Washington

But it's open enrollment time, and the debate is more than theoretical. It's personal and now faced by millions of Americans of varying states of health. Another recent L.A. Times story notes that some companies won't let workers sign up for health insurance until they sign up for risk assessments that were once optional. It says:

"If the assessment discovers manageable problems, you may be encouraged to join a fitness or smoking cessation program. Do that and you're likely to get bigger financial incentives -- somewhere in the neighborhood of $100 to $500 annually.

"But if you don't, your employer might restrict your health insurance choices to plans that demand higher deductibles and offer fewer services and benefits, which could cost you hundreds of dollars."

That story: This open enrollment period, expect rewards and penalties

Don't like the approach? You could take a stand. And pay for it, of course.

Not wild about helping to pay, in a roundabout way, for your smoking colleague's medical costs? Here's your chance to get just a little bit even and benefit from your own, perhaps wiser, choices.

Either way, the trend's increasing prominence suggests each of us should ask what such "incentives" might ultimately entail -- for good or ill.

Here's a recent Washington Post look at the issue. And an NPR story on Safeway's incentive programs.

-- Tami Dennis

Photo: Stop smoking -- or you might face limited healthcare choices.

Credit: John MacDougall / AFP / Getty Images

Meth use among L.A. workforce twice the national average

June 19, 2009 | 12:00 pm


Drug use by employees continues to be a major problem for employers. But new statistics show the picture is changing in Los Angeles.

Data from Quest Diagnostics show that cocaine use has decreased in recent years while amphetamine use is up. In particular, the rate of positive workplace drug tests for methamphetamine in Los Angeles is more than twice the national average: 23 positive tests per 10,000 people versus 11 per 10,000 nationwide.

Positive tests for cocaine were found in 27 per 10,000 workers in Los Angeles compared with 39 per 10,000 workers nationwide. Overall, screening shows a decline in positive drug tests in Los Angeles from 320 per 10,000 workers in 2006 to 269 per 10,000 last year. Nationwide, 380 per 10,000 workers tested positive for drug in 2006 compared with 360 per 10,000 last year.

The data are from the annual Quest Diagnostics Drug Testing Index, based on 5.7 million urine drug tests performed by the company.

-- Shari Roan

Photo: A pipe used to smoke crystal meth. Credit: Ann Heisenfelt / AP

You can retire from the job, but not necessarily its effects

June 9, 2009 | 12:33 pm

Workers It matters whether someone spends his or her working years as a manager or a person to be managed. And it matters long after the job becomes a description tacked onto the word "retired."

UC Davis researchers assessed the connection. From the news release:

"Retirement-aged Americans who held higher-status jobs — such as chief executives, financial managers and management analysts — tend to have the lowest rates of hypertension, while those who had lower-status jobs tend to have the highest rates."

We suspected as much. 

Here's the abstract from the study, published in the June issue of Journal of Occupational and Environmental Medicine.

-- Tami Dennis

Photo: If you're worried about your blood pressure, a promotion or two might be the way to go. Credit: Los Angeles Times

Barring smokers from employment isn't right, researchers say

January 21, 2009 |  4:00 pm

Smoker1Smoking bans in public buildings, workplaces, even at some outdoor venues are now commonplace. And becoming more common is the practice of barring smokers from employment. But this approach is unfair and may have unintended consequences that do more harm than good, say researchers in an essay published today in the journal Tobacco Control.

Policies prohibiting the hiring of smokers have become much more popular in the past year, a co-author of the report, Dr. Michael Siegel, said today in an interview. One U.S. company, for example, has stopped hiring smokers, has made smoking outside the workplace a fireable offense and even has extended its smoking ban to employees' spouses. Siegel, a professor at Boston University School of Public Health, is a tobacco-control advocate. But he and co-author Brian Houle, of the University of Washington, fear the widespread adoption of such policies may make smokers nearly unemployable, cause them to lose their health insurance and affect their health and that of their families.

Moreover, they say, refusing to hire smokers is discriminatory and may lead to the adoption of other selective employment practices, such as not hiring people who are overweight or who have high cholesterol.

"People have thought about the positive benefits of these programs," says Siegel, such as the fact that they may reduce absenteeism and increase productivity. "But we don't think people have thought through the negative consequences. We're looking at this from a broader public-health perspective."

Tobacco-control advocates are divided over the merits of barring smokers from the workplace. Some fear that speaking out against the employment bans will get them branded as "traitors to the cause," Siegel said.

"Smoking is a very powerful addiction," he said. "Tobacco-control practitioners have naturally become very frustrated that it's so difficult to get people to quit. The problem is that we can't let that frustration cloud our vision about what is appropriate and what is not appropriate. This represents employment discrimination. And I believe, from a public-health perspective, we need to shun that."

Employers typically favor positive approaches to encourage healthy employee behavior, such as free smoking-cessation classes. But Siegel predicts that workplace bans will become more popular as employers look for every approach to cut healthcare costs. About half of all states have laws that protect employees from being fired or not hired because they smoke. But other states have no such protections.

-- Shari Roan

Photo credit: Karen Bleier/AFP/Getty Images

More academic wisdom on the workplace

November 28, 2008 |  9:00 am

On Tuesday we wrote about a study that found that employees who worked for bad bosses were more likely to suffer from angina and heart attacks than those who worked for good bosses. Not good news!

Some other workplace psychology tidbits:

From the University of Alberta, as per a university news release: "Secret to workplace happiness? Remember what you love about the job." The study, published in the Journal of Gerontological Nursing, tested a "Spirit at Work" program aimed at fostering morale and sense of purpose in a healthcare setting. "Urging employees to simply rethink their jobs was enough to drop absenteeism by 60% and turnover by 75%," the news release states.

"Employees will feel -- and act -- engaged when their employer creates conditions that permit them to do so," states another release, this one from the journal Industrial and Organizational Psychology. No kidding! It's a thumb-sucker enough of a subject to warrant, in addition to the paper, "a set of 13 commentaries taking differing positions on the issue."

One more workplace finding -- from the Psychology of Women Quarterly -- reports (again from a release) that "employees who are sexually harassed experience less job satisfaction and lower job performance." Who would have imagined that?

All of these items may have a -- may we say obvious? -- flavor to them -- until you stop to consider how many organizations appear to ignore the obvious. In any case, they're more thoughtful than that: The harassment paper quantifies the effect of harassment, for example -- that's what you have to do sometimes to get people to act -- and the "Spirit" one actually tests a program. (Just because something looks good on paper doesn't mean it will work.)

And the creating-engagement-at-work paper discusses the precise factors that contribute to a feeling of engagement. Engagement is not the same as satisfaction, the researchers note. Certainly that makes sense to me. There have been days when I would be quite satisfied to sit around making pigs out of pushpins and pink erasers and checking L.A. Observed every hour or so.

But -- uh -- they were rare, of course. Aberrations, really. And very long ago.

-- Rosie Mestel

Bad boss? Your heart may feel the heat

November 25, 2008 | 10:33 am

Anyone who's been in the job market long enough has sooner or later worked for a bad boss -- the kind, perhaps, who makes you start awake at 3 in the morning to fret about the day ahead or the horrible day that just happened.

A new study suggests such bosses may increase the risk of a heart attack among employees, a finding that fits with other research on the effect of stress and powerlessness on physical health. (See, for example, the famous Whitehall II study.)

The latest study, published online today in the journal Occupational and Environmental Medicine, tracked 3,122 working Swedish men ages 19 and 70 at the study's start. Their health was checked between 1992 and 1995 and their heart health outcomes tracked all the way up to 2003. At the start of the study the men were also asked to rate their managers' leaderships skills for such issues as -- per the paper -- "consideration for individual employees, provision of clarity in goals and role expectations, supplying information and feedback, ability to carry out changes at work successfully, and promotion of employee participation and control."

During the period of time that was monitored, there had been 74 cases of ischemic heart disease (problems caused by narrow heart arteries, such as angina and heart attacks). Higher leadership scores were associated with a lower heart disease risk -- and the longer an employee worked at the same job with a good manager the lower his risk became. And vice versa.

The researchers do note the possibility that the heart outcomes may have more to do with the personality of the people doing the rating -- after all, the bad-boss-good-boss perceptions were made by the employees themselves.

But, they write in their paper, "if the association is causal, this study suggests that interventions aimed at improving the psychosocial work environment and preventing ischaemic heart disease among employees could focus on concrete managerial behaviors, such as the provision of clear work objectives, information and sufficient control in relation to responsibilities."

Of course, one can think of other good reasons management might want to improve workforce leadership skills -- such as making a workplace more pleasant (even if people aren't going to have heart attacks) and enhancing team performance. 

-- Rosie Mestel


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