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    Occupational risk factors for ischaemic heart disease : differences among males and females in the Māori and general populations of New Zealand : a thesis with publications presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Public Health (Epidemiology) at Massey University, Wellington, New Zealand
    (Massey University, 2021) Barnes, Lucy
    Occupation is a poorly characterised risk factor for cardiovascular disease, a leading cause of death worldwide, with females and indigenous peoples underrepresented in research. This thesis assessed associations between occupation/occupational exposures and cardiovascular risk factors and ischaemic heart disease (IHD), for males and females of the Māori and general populations of New Zealand. Two previous New Zealand Workforce Surveys (NZWS) in the general (NZWS; n=3003; 2004-2006) and Māori (Māori NZWS; n=2107; 2009-2011) populations were linked to Ministry of Health data in Statistics New Zealand’s Integrated Data Infrastructure. Age-adjusted logistic regression was used to assess associations between occupational groups and cardiovascular risk factors (high blood pressure, high deprivation, high cholesterol, diabetes, smoking and obesity). Cox proportional hazard regression, adjusted for age, deprivation and smoking, was used to assess associations between ever working in an occupational group and incident IHD, over a 7-14 year follow-up period. Associations with occupational exposures were also assessed. Cardiovascular risk factors were disproportionately experienced by blue-collar workers, particularly plant and machine operators and assemblers and elementary workers. In contrast, professionals were less likely to experience risk factors. Similarly, having ever worked as a plant and machine operator and assembler or elementary worker was positively associated with IHD for Māori females. Having ever worked as a technician and associate professional was inversely associated with IHD. Associations were not consistent between Māori and the general population or between males and females, with differences observed for clerks, agriculture and fishery workers and sales and service workers. Occupational exposure to dust, tools that vibrate, smoke or fumes, oils and solvents, and high frequency exposure to repetitive tasks, loud noise, working at high speeds and awkward grip or hand movements, common in blue-collar occupations, was positively associated with IHD. Associations were not consistent across all populations, with no positive associations observed among Māori males. In conclusion, this thesis shows a role of occupation in IHD risk, presenting an opportunity for IHD interventions, particularly for blue-collar occupations. However, findings suggest that occupational risk factors cannot be generalised across all populations and future research and intervention development therefore requires consideration of sex and ethnicity.
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    The Independent Newspapers Limited study: an investigation into occupational overuse syndrome within the newspaper industry : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University
    (Massey University, 1993) Pirie, Ross
    An investigation was undertaken into occupational overuse injuries. Overuse injuries are commonly associated with repetitive movements, sustained or constrained postures, and forceful movements. Other factors, such as work environment, amount of keyboard use, and the ergonomic status of the work area, have been identified as elements in the development of overuse injuries. These perspectives were used to provide research objectives in studying a sample of subjects working in the newspaper industry. Five hundred and seventy five respondents completed a questionnaire, which included a measure of the incidence and severity of overuse injuries, and questions aimed at discovering the effectiveness of different types of treatment and intervention strategies. Using a combination of descriptive and bivariate statistics, this data was analyzed. The analysis revealed low levels of reported muscular aches and pains. Of those subjects who did report some form of ache or pain, the majority answered that the level of their aches and pains had remained the same. As well, the image of the aetiology of overuse injuries which emerged, was in contradiction to much of the proceeding research in this area. The analysis also demonstrated that the treatment and intervention strategies being employed were ineffective. This was despite the fact that subjects often reported that they considered a particular strategy to be productive in managing their overuse injury. In the discussion section, the limitations of the questionnaire as a survey technique in this area of research was considered, and the possible effects these limitations have on the present study. This point has special relevance to the application of clinical models of overuse injury. It was concluded that the results demonstrated a need for research into effectively manipulating working conditions to counter-act the development, incidence and severity of overuse injuries. Such strategies as job enlargement and job rotation were suggested.
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    Interaction between physical and psychosocial work risk factors for low back symptoms : a study of prevalence, risk factors, and interaction between physical and psychosocial work risk factors for low back symptoms and its consequences (reduced activities and absenteeism) in a random sample of workers in New Zealand and in Indonesian coal mining workers : a thesis presented in fulfilment of the requirements for the degree of Doctor of Philosophy in Ergonomics at Massey University, Manawatu, New Zealand
    (Massey University, 2013) Widanarko, Baiduri
    The prevalence of low back symptoms (LBS) in developed and industrially developing countries (IDCs) is high, and there have only been a few studies in New Zealand and IDCs. It is well known that the risk factors for LBS include physical and psychosocial exposures, but the interaction between these is not well understood. Even less is known about prevalence of, and risk factors for, twopossible consequences of LBS (reduced activities and absenteeism). Hence, this thesis examines the prevalence, risk factors, and the interaction between physical and psychosocial work risk factors for LBS and its consequences in a developed country and an IDC. This was done in two cross-sectional studies of: A) a large random sample of workers in New Zealand, and; B) Indonesian coal mining workers. In telephone interviews of 3,003 participants (1,431 males and 1,572 females) aged 20-64 randomly selected from the New Zealand Electoral Roll, the 12-month period prevalence of LBS, reduced activities, and absenteeism due to LBS were 54%, 18%, and 9%, respectively. Risk factors of LBS for the whole population (males and females) increased with work in awkward or tiring positions and stressful jobs. Awkward or tiring positions at work, dissatisfaction with contact and cooperation with management, and stressful jobs were risk factors for women but not for men. The only risk factor for reduced activities was lifting. Risk factors for absenteeism were working in awkward or tiring positions and in a cold or damp environment. In a self-administered questionnaire among 1,294 Indonesian coal mining workers (1,252 males and 42 females), the 12-month period prevalence of LBS, reduced activities, and absenteeism due to LBS were 75%, 16%, and 13%, respectively. This study afforded an opportunity to examine selection bias due to a healthy worker effect. It showed that blue-collar work (as opposed to white-collar work) was a risk factor for LBS, after adjustment for a healthy worker effect and other potential confounders. The presence of LBS and smoking increased the risk of reduced activities and absenteeism. This study also indicated that those who were exposed to both high physical (awkward posture, whole-body vibration, using vibrating hand tools, and lifting) and high psychosocial (high effort, low reward, job dissatisfaction, and work stress) factors were most likely to report LBS and both consequences. High psychosocial exposure increased the likelihood of reporting LBS, but high physical exposure did so for reduced activities and absenteeism. Current smokers were more likely to report LBS consequences than nonsmokers. Permanent employment and night shift work increased the risk of LBS and its consequences. There was an interaction between physical and psychosocial exposures for LBS. The overall risk for LBS was greater than the sum of the individual risks due to physical and psychosocial factors (as indicated by departure from an additive model of risk). Thirty-nine percent of LBS cases among those who were exposed to high physical and high psychosocial risk factors were due to exposure to both factors. There were also interactions between the risk factors for reduced activities due to LBS, although not significant, whereas for absenteeism due to LBS it was not present. The implications of these findings for New Zealand workers are that LBS and its consequences could be reduced by using interventions designed to avoid or minimise exposure to physical and psychosocial work factors. In addition, environmental factors should also be improved in order to reduce the consequences of LBS. For Indonesian coal mining workers, addressing both physical and psychosocial factors in the workplace is likely to reduce up to 39% of LBS cases among workers exposed to both factors. This will in turn, reduce the risk of LBS consequences. The intervention strategy should also focus on permanent employment, night shift work, and smokers.
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    Workforce survey of occupational exposures and health effects in New Zealand : a thesis by publications presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Epidemiology at Massey University, Wellington, New Zealand
    (Massey University, 2011) Eng, Amanda Jane
    This thesis is based on the first workforce survey in New Zealand to assess occupational exposures and health in a random sample of the working population. The aims of this thesis were to: i) describe the prevalence and distribution of occupational exposures and workplace practices in the New Zealand working population; ii) identify gender and ethnic differences in occupational exposure; and iii) examine which occupational risk factors contribute to the risk of respiratory disease. Over a two year period 10,000 individuals aged 20-64 were randomly selected from the Electoral Roll and invited to take part in a telephone interview. The interview obtained information on lifetime work history, occupational exposures including dust/chemical exposures and certain physical and organisational factors, and selected health effects including respiratory symptoms. A total of 3,003 interviews were completed (37% response rate). Occupational exposure to dust/chemical and certain physical factors were disproportionately experienced by workers in the agricultural, trades, and manufacturing sectors, where prevalences were as high as 75%. However, exposures also occurred in other occupational groups not traditionally associated with hazardous exposures (for example the legislators and managers group). Substantial differences in exposure prevalence were observed between males and females and Maori and non-Maori workers. The occupations positively associated with current and adult-onset asthma included printers, bakers, and sawmill labourers, as well as several occupations that have not been previously associated with asthma (for example teachers and certain sales professionals). Finally, a positive association between work-related stress and asthma was identified. This thesis indicates that the traditional chemical and physical exposures are common in the New Zealand working population, and that emerging factors such as organisational and psychosocial exposures are also prevalent and relevant to occupational health. While the distribution of occupational exposures and risk factors for asthma were concentrated in certain occupational groups, they were also more widely spread across the workforce than previously assumed. Besides occupation, the demographic characteristics of a worker also appeared to determine their occupational exposure. The findings of this thesis illustrate that workforce surveys are a valuable tool for assessing a wide range of exposures in a wide range of workers, and therefore should be carried out on a regular basis.