Interest in presenteeism, attending work while ill, has flourished in light of its consequences for individual well-being and organizational productivity. Our goal was to identify its most significant causes and correlates by quantitatively summarizing the extant research. Additionally, we built an empirical model of some key correlates and compared the etiology of presenteeism versus absenteeism. We used meta-analysis (in total, K = 109 samples, N = 175,965) to investigate the correlates of presenteeism and meta-analytic structural equation modeling to test the empirical model. Salient correlates of working while ill included general ill health, constraints on absenteeism (e.g., strict absence policies, job insecurity), elevated job demands and felt stress, lack of job and personal resources (e.g., low support and low optimism), negative relational experiences (e.g., perceived discrimination), and positive attitudes (satisfaction, engagement, and commitment). Moreover, our dual process model clarified how job demands and job and personal resources elicit presenteeism via both health impairment and motivational paths, and they explained more variation in presenteeism than absenteeism. The study sheds light on the controversial act of presenteeism, uncovering both positive and negative underlying mechanisms. The greater variance explained in presenteeism as opposed to absenteeism underlines the opportunities for researchers to meaningfully investigate the behavior and for organizations to manage it. (PsycINFO Database Record

/pdf/going-to-work-ill-a-meta-analysis-of-the-correlates-of-7150vzqiec.pdf

Going to work ill: A meta-analysis of the correlates of presenteeism and a dual-path model

High-risk human papillomavirus (HPV) is an established cause of head and neck carcinomas arising in the oropharynx. The presence of HPV has also been reported in some carcinomas arising in the sinonasal tract, but little is known about their overall incidence or their clinicopathologic profile. The surgical pathology archives of The Johns Hopkins Hospital were searched for all carcinomas arising in the sinonasal tract from 1995 to 2011, and tissue microarrays were constructed. p16 immunohistochemical analysis and DNA in situ hybridization for high-risk types of HPV were performed. Demographic and clinical outcome data were extracted from patient medical records. Of 161 sinonasal carcinomas, 34 (21%) were positive for high-risk HPV DNA, including type 16 (82%), type 31/33 (12%), and type 18 (6%). HPV-positive carcinomas consisted of 28 squamous cell carcinomas and variants (15 nonkeratinizing or partially keratinizing, 4 papillary, 5 adenosquamous, 4 basaloid), 1 small cell carcinoma, 1 sinonasal undifferentiated carcinoma, and 4 carcinomas that were difficult to classify but exhibited adenoid cystic carcinoma-like features. Immunohistochemistry for p16 was positive in 59/161 (37%) cases, and p16 expression strongly correlated with the presence of HPV DNA: 33 of 34 (97%) HPV-positive tumors exhibited high p16 expression, whereas only 26 of 127 (20%) HPV-negative tumors were p16 positive (P<0.0001). The HPV-related carcinomas occurred in 19 men and 15 women ranging in age from 33 to 87 years (mean, 54 y). A trend toward improved survival was observed in the HPV-positive group (hazard ratio=0.58, 95% confidence interval [0.26, 1.28]). The presence of high-risk HPV in 21% of sinonasal carcinomas confirms HPV as an important oncologic agent of carcinomas arising in the sinonasal tract. Although nonkeratinizing squamous cell carcinoma is the most common histologic type, there is a wide morphologic spectrum of HPV-related disease that includes a variant that resembles adenoid cystic carcinoma. The distinctiveness of these HPV-related carcinomas of the sinonasal tract with respect to risk factors, clinical behavior, and response to therapy remains to be clarified.

/pdf/human-papillomavirus-related-carcinomas-of-the-sinonasal-4y3le54w5w.pdf

Human papillomavirus-related carcinomas of the sinonasal tract.

Objectives/Hypothesis

To examine the incidence and survival of patients with sinonasal squamous cell carcinoma (SNSCC) between the years of 1973 and 2009 using the Surveillance, Epidemiology, and End Result (SEER) database.



Study Design

Retrospective cohort study using a national database.



Methods

The SEER registry was utilized to calculate incidence and survival trends for patients with SNSCC between 1973 and 2009. Patient data were then analyzed according to age, sex, and race.



Results

A total of 4,994 cases of SNSCC were identified, composed of 64.44% males and 35.56% females. Incidence trend analysis revealed a significant decrease in yearly rates from 1973 to 2009 for the overall population, females, whites, blacks, and “others” (P   .05) were found when comparing survival between the last three decades. Differences in long-term survival were noted between whites, blacks, and “others,” with whites displaying the highest 20-year survival. Males and females were found to have similar long-term survival curves, with 20-year survival of 30.68% and 26.35%, respectively.



Conclusions

The overall incidence of SNSCC is declining. However, survival has not significantly improved in the last 3 decades. Race seems to influence the overall survival of this tumor. Future studies need to be conducted to investigate these dynamic trends related to SNSCC.



Level of Evidence

2b. Laryngoscope, 124:76–83, 2014

Epidemiology of sinonasal squamous cell carcinoma: A comprehensive analysis of 4994 patients

Sinonasal cancer (SNC) has been related to occupational exposures, but the relative risk associated to specific jobs and/or carcinogen exposures other than wood and leather dust is generally based on small or inadequate sample sizes and the range of observed estimates is large. This paper is aimed at investigating such relationship through a systematic review of the literature followed by a meta-analysis of studies meeting specific inclusion criteria. Systematic search was made with PubMed, Google Scholar and Scopus engines using related keywords. Occupational exposures include wood and leather dust, formaldehyde, nickel and chromium compounds, textile industry, farming and construction. Meta-analysis of published studies after 1985 with a case-control or cohort design was performed, firstly using the fixed-effect model. Heterogeneity was assessed with the Q statistical test and quantified by the I2 index. When the heterogeneity hypothesis appeared relevant, the random-effect model was chosen. Sources of heterogeneity were explored using subgroup analyses. Out of 63 reviewed articles, 28 (11 cohort, 17 case-control) were used in the meta-analysis. Heterogeneity among studies was observed and random-effects models were used. Exposure to wood dust results associated with SNC (RRpooled = 5.91, 95% CI: 4.31-8.11 for the case-control studies and 1.61, 95% CI: 1.10-2.37 for the cohort studies), as well as to leather dust (11.89, 95% CI: 7.69-18.36). The strongest associations are with adenocarcinomas (29.43, 95% CI: 16.46-52.61 and 35.26, 95% CI: 20.62-60.28 respectively). An increased risk of SNC for exposures to formaldehyde (1.68, 95% CI: 1.37-2.06 for the case control and 1.09, 95% CI: 0.66-1.79 for the cohort studies), textile industry (2.03, 95% CI: 1.47-2.8), construction (1.62, 95% CI: 1.11-2.36) and nickel and chromium compounds (18.0, 95% CI: 14.55-22.27) was found. Subset analyses identified several sources of heterogeneity and an exposure-response relationship was suggested for wood dust (p = 0.001). By confirming the strength of association between occupational exposure to causal carcinogens and SNC risk, our results may provide indications to the occupational etiology of SNC (not only wood and leather dusts). Future studies could be focused on specific occupational groups to confirm causative agents and to define appropriate preventive measures.

/pdf/occupational-exposure-and-sinonasal-cancer-a-systematic-1nnjzq0g3c.pdf

Occupational exposure and sinonasal cancer: a systematic review and meta-analysis.

More than 70 benign and malignant sinonasal tumours and tumour-like conditions have been described. However, sinonasal tumours are rare, and sinonasal cancers comprise only 3% of all head and neck cancers and 1% of all malignancies, with a peak incidence in the 5th to 7th decades and with a male preponderance. The early symptoms and imaging findings of sinonasal tumours are similar to rhinosinusitis with runny and stuffy nose, lacrimation and epistaxis and therefore neglected both by the patients and doctors. When late symptoms such as anosmia, visual disturbances, cranial neuropathy (Cn II, IV, V, VI) or facial swelling appear, the patient is referred to sinonasal endoscopy or imaging. At the time of correct diagnosis more than half of the tumours have reached an advanced stage with a poor prognostic outcome. Even if imaging is performed in the early stages, a radiologist inexperienced with sinonasal anatomy and tumour features may easily interpret early signs of a malignant tumour as rhinosinusitis or a lesion that does not require follow-up. This article presents the imaging findings in some of the most common benign and malignant sinonasal tumours, and the TNM classification and staging of sinonasal carcinomas.

Imaging of sinonasal tumours

, et al. Department of Epidemiology, Local Health Unit TO3, Italy—Objectives: In spite of the high prevalence of low back pain (LBP) and presenteeism previously observed among nurses, no study has assessed the risk of presenteeism speciﬁcally due to LBP in nursing staff. Therefore, aim of the present study was to assess prevalence and risk factors of presenteeism due to LBP among hospital nursing personnel. Methods: 174 female nurses underwent a clinical interview and ﬁlled in a questionnaire on sociodemographics, LBP symp-toms and associated sickness absence, mental symp-toms, burnout and on exposure to workplace organiza-tional, psychosocial and ergonomic factors; 111 subjects affected by LBP were included in the analysis. The effect of sociodemographic and workplace characteristics on presenteeism was examined through multivariate Pois-son robust regression models. Results: Prevalence of presenteeism due to LBP was 58%, with wide differ-ences between registered nurses and nursing aides (p=0.001). Only a few workplace factors were signiﬁ-cantly associated with presenteeism, including frequent stooping, which decreased the risk of presenteeism, and good working climate and procedural justice, which increased it. Conclusions: Presenteeism due to LBP was very high among registered nurses and was inﬂu-enced only by workplace, but not by sociodemographic characteristics. Presenteeism due to LBP among regis-tered nurses should be closely monitored, and effort should be made to reduce it to prevent future work disability associated with LBP.(J Occup Health 2013; 55: 276–283)

Low Back Pain and Associated Presenteeism among Hospital Nursing Staff

Objectives: Sino-nasal cancer has been consistently associated with exposure to wood dust, leather dust, nickel and chromium compounds; for other occupational hazards, the findings are somewhat mixed. The aim of this study was to investigate the risk of sino-nasal epithelial cancer (SNEC) by histological type with prior exposure to suspected occupational risk factors and, in particular, those in metalworking. Methods: Between 1996 and 2000, incident cases were collected on a monthly basis from hospitals throughout the Piedmont region of Italy by the regional Sino-nasal Cancer Registry. A questionnaire on occupational history, completed by 113 cases and 336 hospital controls, was used to assign exposure to occupational hazards. The relationship between SNEC and cumulative exposure to these hazards was explored using unconditional logistic regression to statistically adjust for age, sex, smoking and co-exposures, allowing for a 10-year latency period. Results: The risk of adenocarcinoma was significantly increased with ever-exposure to wood dust (odds ratio; OR = 58.6), and to leather dust (OR = 32.8) and organic solvents (OR = 4.3) after controlling for wood dust, whereas ever-exposure to welding fumes (OR = 3.7) and arsenic (OR = 4.4) significantly increased the risk for squamous cell carcinoma. For each of these hazards, a significant increasing trend in risk across ordered cumulative exposure categories was found and, except for arsenic, a significantly increased risk with ever-exposure at low intensity. Treating cumulative exposure on a continuous scale, a significant effect of textile dusts was also observed for adenocarcinoma. For a mixed group of other histological types, a significant association was found with wood dust and organic solvents. Conclusions: Some occupational risk factors for SNEC were confirmed, and dose–response relationships were observed for other hazards that merit further investigation. The high risk for adenocarcinoma with low-intensity exposure to wood dust lends support for a reduction in the occupational threshold value.

A case-control study on occupational risk factors for sino-nasal cancer

https://oem.bmj.com/content/oemed/66/7/448.full.pdf

Objectives Sinonasal inverted papilloma (IP) is an uncommon benign tumour characterised by frequent recurrence and, in approximately 10% of cases, by neoplastic transformation. IP aetiology is unknown but human papillomavirus is detectable in about one quarter of tumours. As some occupational hazards have been reported to be possible risk factors for IP, the aim of this study was to assess risk for sinonasal IP associated with prior exposure to suspected occupational risk factors for sinonasal malignancies. Methods Between 1996 and 2007, data on incident cases were collected from hospitals throughout the Piedmont region of Italy by the regional sinonasal cancer registry. A questionnaire on occupational history, completed by 127 cases and 337 hospital controls, was used to assign previous exposure to a list of 17 occupational hazards. The relationship between IP and cumulative exposure to these hazards was explored using unconditional logistic regression to statistically adjust for age, sex, area of residence, smoking and co-exposures. Results The risk of IP was significantly increased for ever exposure to welding fumes (OR 2.14) and organic solvents (OR 2.11) after controlling for potential confounders. For organic solvents only, a significant association with continuous cumulative exposure and a significant trend in risk across ordered cumulative exposure categories was found. Conclusions The present study revealed a significant association and a significant dose–response relationship between occupational exposure to organic solvents and IP. The lack of a dose–response relationship for welding fumes suggests that the observed association with ever exposure should be interpreted with caution.

https://oem.bmj.com/content/oemed/early/2013/06/04/oemed-2013-101384.full.pdf

Occupational risk factors for sinonasal inverted papilloma: a case–control study

In 2007, the Health Councillorship of the Piedmont region announced, in convention with the Psychology Department of the University of Turin, of the creation of "Workgroup for Safeguard of Organizational Wellbeing" composed by psychologists, occupational doctors, and superintendents for Prevention and Protection services. This group is aimed at promoting pilot experiences in the Health Units in order to prevent and combat psychosocial discomfort and to sustain workers' wellbeing. A complex intervention started in January 2009 and involved the personnel from Services for the Organization and Development of Human Resources, Personnel Services, Services for Occupational Medicine, Services of Communication, Quality Services, belonging to all of the Health Units from Piedmont, and of some structures operating within the national health service, for a total of 23 work groups. Based on the results produced and/or from the shared reflections in the classroom between the 23 groups, four main themes were singled out, corresponding to different levels and fields of interventions, in order to favour the contrast of psychosocial distress and to promote a culture of wellbeing, were adopted taking into account needs and cultural specificity of different Units' realities. The activities embarked on, inside every main theme represent, in the expectations of all the participants, good practices that could be spread to the different Local Health Units.

[Organizational wellbeing in the health sector: the Piemonte Region experience].

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Papers

Low Back Pain and Associated Presenteeism among Hospital Nursing Staff

A case-control study on occupational risk factors for sino-nasal cancer

A case-control study on occupational risk factors for sino-nasal cancer

Occupational risk factors for sinonasal inverted papilloma: a case–control study

[Organizational wellbeing in the health sector: the Piemonte Region experience].