Abstract
Purpose
It is unknown whether immigrants working in the cleaning industry have a poorer health and work ability than cleaners from the native population. The main aim was to investigate differences in objective and self-reported health measures between immigrant and Danish cleaners.
Methods
Three hundred and fifty-one cleaners, consisting of 166 Danes (88% women) and 179 immigrants (74% women) (6 with unknown ethnicity), from 9 workplaces in Denmark participated in the study. Health and work ability were obtained by objective (e.g., BMI and blood pressure) and self-reported measures (e.g., work ability, self-rated health, and musculoskeletal symptoms). In order to investigate differences between Danish and immigrant cleaners, logistic regression analyses and General Linear Models were performed.
Results
When controlling for age, sex, workplace, job seniority, and smoking, more Danish compared with immigrant cleaners were current smokers (42% vs. 28%, p < 0.001 (not controlled for smoking)), had hypertension (46% vs. 26%, p < 0.05) and drank more alcohol (3.0 vs. 0.8 units per day, respectively, p < 0.001). Contrary, more immigrants compared with Danish cleaners were measured to be overweight (47% vs. 30%, p < 0.05), reported less than good work ability (57% vs. 42%, p < 0.01), considered it unthinkable/unsure to be able to perform work 2 years ahead (37% vs. 23%, p < 0.01), reported reduced self-rated health (46% vs. 38%, p < 0.01) and everyday pain in the neck/shoulder (28% vs. 11%, p < 0.01), wrist (18% vs. 7%, p < 0.01), and lower back (21% vs. 10%, p < 0.01). There were no differences in self-reported chronic diseases.
Conclusions
Although the health of the cleaners was alarmingly poor, the immigrant cleaners generally had a poorer self-reported health and work ability than the Danish cleaners. These findings highlight the need for occupational health actions among cleaners, particularly tailored to the immigrant subpopulation.
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References
Ahonen EQ, Benavides FG, Benach J (2007) Immigrant populations, work and health—a systematic literature review. Scand J Work Environ Health 33(2):96–104
Alavinia SM, van Duivenbooden C, Burdorf A (2007) Influence of work-related factors and individual characteristics on work ability among Dutch construction workers. Scand J Work Environ Health 33:351–357
Andersen LL, Kjær M, Søgaard K, Hansen L, Kryger AI, Sjøgaard G (2008) Effect of two contrasting types of physical exercise on chronic neck muscle pain. Arthr Care Res 59:84–91
Borg G (1970) Perceived exertion as an indicator of somatic stress. Scand J Rehabil Med 2–3:92–98
Borg V, Kristensen TS (2000) Social class and self-rated health: can the gradient be explained by differences in life style or work environment? Soc Sci Med 51:1019–1030
Borrell LN, Crawford ND, Dallo FJ (2007) Race/ethnicity and self-reported diabetes among adults in the National Health Interview Survey: 2000–2003. Public Health Rep 122:616–625
Carlsson AC, Wandell PE, De Faire U, Hellenius ML (2008) Prevalence of hypertension in immigrants and Swedish-born individuals, a cross-sectional study of 60-year-old men and women in Sweden. J Hypertens 26:2295–2302
Claessen H, Arndt V, Drath C, Brenner H (2009) Overweight, obesity and risk of work disability: a cohort study of construction workers in Germany. Occup Environ Med 66:402–409
DeSalvo KB, Bloser N, Reynolds K, He J, Muntner P (2006) Mortality prediction with a single general self-rated health question. J Gen Intern Med 21:267–275
Dotevall A, Rosengren A, Lappas G, Wilhelmsen L (2000) Does immigration contribute to decreasing CHD incidence? Coronary risk factors among immigrants in Goteborg, Sweden. J Intern Med 247:331–339
Gadd M, Johansson SE, Sundquist J, Wändell P (2006) Are there differences in all-cause and coronary heart disease mortality between immigrants in Sweden and in their country of birth? A follow-up study of total populations. BMC Public Health 6:102
Gamperiene M, Nygard JF, Sandanger I, Wμrsted M, Bruusgaard D (2006) The impact of psychosocial and organizational working conditions on the mental health of female cleaning personnel in Norway. J Occup Med Toxicol 1:24
Glerup H (2000) Vitamin D deficiency among immigrants. Ugeskr Laeger 162:6196
Han TS, Schouten JS, Lean ME, Seidell JC (1997) The prevalence of low back pain and associations with body fatness, fat distribution and height. Int J Obes Relat Metab Disord 21:600–607
Han TS, Sattar N, Lean M (2006) Assessment of obesity and its clinical implications. BMJ 333:695–698
Holtermann A, Jørgensen MB, Gram B, Christensen JR, Faber A, Overgaard K, Ektor-Andersen J, Mortensen OS, Sjøgaard G, Søgaard K (2010) Worksite interventions for preventing physical deterioration among employees in job-groups with high physical work demands: background, design and conceptual model of FINALE. BMC Public Health 10:120
Hunt SM, Bhopal R (2004) Self report in clinical and epidemiological studies with non-English speakers: the challenge of language and culture. Br Med J 58:618
Idler EL, Benyamini Y (1997) Self-rated health and mortality: a review of twenty-seven community studies. J Health Soc Behav 38:21–37
Ilmarinen J, Tuomi K, Klockars M (1997) Changes in the work ability of active employees over an 11-year period. Scand J Work Environ Health 23:49–57
Jørgensen MB, Rasmussen CDN, Ekner D, Søgaard K (2010) Successful reach and adoption of a workplace health promotion intervention study targeting a group of high-risk workers. A randomized controlled trial among cleaners. BMC Med Res Method 10:56
Juel K, Sorensen J, Bronnum-Hansen H (2008) Supplement: risk factors and public health in Denmark. Scand J Public Health 36:1–227
Kaleta D, Makowiec-Dabrowska T, Jegier A (2006) Lifestyle index and work ability. Int J Occup Med Environ Health 19:170–177
Koh-Banerjee P, Wang Y, Hu F, Spiegelman D, Willett W, Rimm E (2003) Changes in body weight and fat distribution as risk factors for diabetes in US men. Am J Epidemiol 157:272
Kronborg CN, Hallas J, Jacobsen IA (2009) Prevalence, awareness, and control of arterial hypertension in Denmark. J Am Soc Hypertens 3:19–24
Krüger D, Louhevaara V, Nielsen J, Schneider T (1997) Risk assessment and preventive strategies in cleaning work. Wirtschaftsverlag NW, Bremerhaven
Kuorinka I, Jonsson B, Kilbom A (1987) Standardized Nordic questionnaires for the analysis of musculoskeletal symptoms. Appl Ergonomics 18:233–237
Labriola M, Lund T (2007) Self-reported sickness absence as an indicator of future disability pension. Prospective findings from the DWECS/DREAM study 1990–2004. Eur J Public Health 17:47
Lauderdale DS, Rathouz PJ (2000) Body mass index in a US national sample of Asian Americans: effects of nativity, years since immigration and socioeconomic status. Int J Obes Relat Metab Disord 24:1188
Liira J, Matikainen E, Leino-Arjas P, Malmivaara A, Mutanen P, Rytkonen H, Juntunen J (2000) Work ability of middle-aged Finnish construction workers—a follow-up study in 1991–1995. Int J Ind Ergon 25:477–481
Mackenbach JP, Stirbu I, Roskam AJR, Schaap MM, Menvielle G, Leinsalu M, Kunst AE (2008) Socioeconomic inequalities in health in 22 European countries. N Engl J Med 358:2468
Marhold C, Linton SJ, Melin L (2001) A cognitive-behavioral return-to-work program: effects on pain patients with a history of long-term versus short-term sick leave. Pain 91:155–163
McLafferty S, Chakrabarti R (2009) Locating diversity: race, nativity and place in health disparities research. GeoJournal 74:107–113
Nygard CH, Arola H, Siukola A, Savinainen M, Luukkaala T, Taskinen H, Virtanen P (2005) Perceived work ability and certified sickness absence among workers in a food industry. Int Congr Ser 1280:296–300
Pedersen MT, Blangsted AK, Andersen LL, Jorgensen MB, Hansen EA, Sjogaard G (2009) The effect of worksite physical activity intervention on physical capacity, health, and productivity: a 1-year randomized controlled trial. J Occup Environ Med 51:759–770
Pohjonen T (2001) Age-related physical fitness and the predictive values of fitness tests for work ability in home care work. J Occup Environ Med 43:723–730
Reijneveld SA (1998) Reported health, lifestyles, and use of health care of first generation immigrants in The Netherlands: do socioeconomic factors explain their adverse position? Br Med J 52:298
Rugulies R, Aust B, Burr H, Bültmann U (2008) Job insecurity, labour market chances and decline in self-rated health in Denmark. Proceedings of 10th international congress of behavioral medicine, 27–30 Aug 2008, Tokyo, Japan, p 273
Sell L, Bultmann U, Rugulies R, Villadsen E, Faber A, Sogaard K (2009) Predicting long-term sickness absence and early retirement pension from self-reported work ability. Int Arch Occup Environ Health 82:1133–1138
Soares JJF, Grossi G (1999) Experience of musculoskeletal pain—comparison of immigrant and Swedish patients. Scand J Caring Sci 13:254–266
Sogaard K, Blangsted AK, Herod A, Finsen L (2006) Work design and the labouring body: examining the impacts of work organization on danish cleaners’ health. Antipode 38:579–602
Statistics Denmark (2010) Statistical yearbook 2010
Stronks K, Kunst AE (2009) The complex interrelationship between ethnic and socio-economic inequalities in health. J Public Health 31:324–325
Sundquist J, Johansson SE (1997) The influence of country of birth on mortality from all causes and cardiovascular disease in Sweden 1979–1993. Int J Epidemiol 26:279–287
Tunceli K, Li K, Williams LK (2006) Long-term effects of obesity on employment and work limitations among U.S. adults 1986 to 1999. Obesity 14:1637–1646
Tuomi K, Ilmarinen J, Eskelinen L, Jarvinen E, Toikkanen J, Klockars M (1991) Prevalence and incidence rates of diseases and work ability in different work categories of municipal occupations. Scand J Work Environ Health 17:67–74
Tuomi K, Ilmarinen J, Jahkola A, Katajarinne L, Tulkki A (1998) Work ability index, 2nd rev edn. Finnish Institute of Occupational Health, Helsinki, Finland
Ujcic-Voortman JK, Schram MT, Jacobs-van der Bruggen M, Verhoeff AP, Baan CA (2009) Diabetes prevalence and risk factors among ethnic minorities. Eur J Public Health 19(5):511–515
Unge J, Ohlsson K, Nordander C, Hansson GA, Skerfving S, Balogh I (2007) Differences in physical workload, psychosocial factors and musculoskeletal disorders between two groups of female hospital cleaners with two diverse organizational models. Int Arch Occup Environ Health 81:209–220
Ware JE, Sherbourne CD (1992) The Mos 36-item short-form health survey (SF-36). 1. Conceptual-framework and item selection. Med Care 30:473–483
Wiking E, Johansson SE, Sundquist J (2004) Ethnicity, acculturation, and self reported health. A population based study among immigrants from Poland, Turkey, and Iran in Sweden. J Epidemiol Community Health 58:574
Woods V, Buckle P (2006) Musculoskeletal ill health amongst cleaners and recommendations for work organisational change. Int J Ind Ergon 36:61–72
Yusuf S, Hawken S, Èunpuu S, Bautista L, Franzosi MG, Commerford P, Lang CC, Rumboldt Z, Onen CL, Lisheng L, Tanomsup S, Wangai P Jr, Razak F, Sharma AM, Anand SS (2005) Obesity and the risk of myocardial infarction in 27.000 participants from 52 countries: a case-control study. Lancet 366:1640–1649
Zock JP (2005) World at work: cleaners. Occup Environ Med 62:581
Acknowledgments
This project is a part of the FINALE program, supported by a grant from the Danish Working Environment Research Foundation, and The Ministry of Culture Committee on Sports Research, Denmark.
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The authors declare that they have no conflict of interest.
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Jørgensen, M.B., Rasmussen, C.D.N., Carneiro, I.G. et al. Health disparities between immigrant and Danish cleaners. Int Arch Occup Environ Health 84, 665–674 (2011). https://doi.org/10.1007/s00420-010-0607-2
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DOI: https://doi.org/10.1007/s00420-010-0607-2