{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T18:13:24Z","timestamp":1791051204894,"version":"4.1.0"},"reference-count":53,"publisher":"BMJ","issue":"12","license":[{"start":{"date-parts":[[2022,12,26]],"date-time":"2022-12-26T00:00:00Z","timestamp":1672012800000},"content-version":"unspecified","delay-in-days":25,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2022,12,7]]},"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The stress and anxiety associated with the predisposition of ageing workers to severe COVID-19 illness, once occupationally infected, jeopardise their mental health. This study aimed to investigate the association between individual level, work environment exposure factors and perceived workplace safety with a decline in mental health of ageing workers from different industry sectors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Observational study, prevalence assessment of survey added to longitudinal cohort data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>The Survey of Health, Ageing and Retirement in Europe (SHARE) from 27 countries in Europe and Israel participating in the COVID-19 survey (summer 2020) and having prepandemic waves\u2019 SHARE data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Workers aged 50\u201370 (n=6449) who attended their workplaces at least partially after the pandemic broke out.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary outcome measure<\/jats:title>\n                    <jats:p>Perceived decline in mental health compared with preoutbreak status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Multilevel analyses demonstrated that 24.5% (95% CI 23.5% to 25.5%) of ageing workers in Europe experienced mental health decline associated with national-level self-reported COVID-19 burden. Workplace safety perception was the strongest predictor, as each one-point increase in unsafe perception was associated with 60% of mental health decline (OR=1.6, 95% CI 1.47 to 1.74), explaining 30% of increased reported mental health symptoms of ageing workers. Safety perception mediates the mental health outcomes of the work environment, such as workplace contagion risk and work location. Female gender (OR=1.77, 95% CI 1.55 to 2.02), financial difficulties (OR=1.19, 95% CI 1.1 to 1.28), higher vulnerability index (comorbidities, age &gt;60) (OR=1.11, 95% CI 1.05 to 1.18), pre-existing mental problems (OR=1.78, 95% CI 1.55 to 2.04) and increased national burden of COVID-19 (OR=1.01, 95% CI 1.0 to 1.02) were associated with declines in mental health, whereas exclusively working on-site was protective.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Vulnerable subgroups for mental health declines among ageing workers were revealed, which warrant their screening and employers\u2019 evaluation of workplace conditions of ageing workers to prevent mental health-related implications. Workplace interventions should aim to reduce work environment influences on infection risk and mental distress.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2022-064590","type":"journal-article","created":{"date-parts":[[2022,12,26]],"date-time":"2022-12-26T10:41:55Z","timestamp":1672051315000},"page":"e064590","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Ageing workers\u2019 mental health during COVID-19: a multilevel observational study on the association with the work environment, perceived workplace safety and individual factors"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8132-6464","authenticated-orcid":false,"given":"Lilah","family":"Rinsky-Halivni","sequence":"first","affiliation":[{"name":"Takemi Program in International Health, Department of Global Health and Population, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA"},{"name":"Braun School of Public Health, Faculty of Medicine, The Hebrew University, Jerusalem, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuli","family":"Brammli-Greenberg","sequence":"additional","affiliation":[{"name":"Braun School of Public Health, Faculty of Medicine, The Hebrew University, Jerusalem, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0301-0242","authenticated-orcid":false,"given":"David C","family":"Christiani","sequence":"additional","affiliation":[{"name":"Environmental Health, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,12,26]]},"reference":[{"key":"2025121513031161000_12.12.e064590.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30854-0"},{"key":"2025121513031161000_12.12.e064590.2","doi-asserted-by":"publisher","DOI":"10.1002\/ajim.23222"},{"key":"2025121513031161000_12.12.e064590.3","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1038\/s43587-021-00114-7","article-title":"SARS-CoV-2, COVID-19 and the ageing immune system","volume":"1","author":"Bartleson","year":"2021","journal-title":"Nat Aging"},{"key":"2025121513031161000_12.12.e064590.4","doi-asserted-by":"publisher","DOI":"10.1136\/oemed-2020-106844"},{"key":"2025121513031161000_12.12.e064590.5","unstructured":"Mustard C . What research can do: estimating the role of workplaces in COVID-19 transmissions. at work. 101, 2020."},{"key":"2025121513031161000_12.12.e064590.6","unstructured":"Czaja SJ , Moen P . US Technology for adaptive aging. In: Technology and employment. National Academies Press, 2004."},{"key":"2025121513031161000_12.12.e064590.7","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-044965"},{"key":"2025121513031161000_12.12.e064590.8","doi-asserted-by":"publisher","DOI":"10.1186\/s12939-021-01541-z"},{"key":"2025121513031161000_12.12.e064590.9","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph18010346","article-title":"Vulnerable workers and COVID-19: insights from a survey of members of the International Commission for occupational health","volume":"18","author":"Tamin","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"2025121513031161000_12.12.e064590.10","doi-asserted-by":"publisher","DOI":"10.1136\/oemed-2020-106774"},{"key":"2025121513031161000_12.12.e064590.11","doi-asserted-by":"publisher","DOI":"10.1136\/oemed-2020-106731"},{"key":"2025121513031161000_12.12.e064590.12","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsr2019953"},{"key":"2025121513031161000_12.12.e064590.13","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(20)30264-3"},{"key":"2025121513031161000_12.12.e064590.14","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m1642"},{"key":"2025121513031161000_12.12.e064590.15","doi-asserted-by":"crossref","unstructured":"Smith PM , Oudyk J , Potter G . The association between the perceived adequacy of workplace infection control procedures and personal protective equipment with mental health symptoms: a cross-sectional survey of Canadian health-care workers during the COVID-19 pandemic. Can J Psychiatry 2020:0706743720961729.doi:10.1177\/0706743720961729","DOI":"10.1177\/0706743720961729"},{"key":"2025121513031161000_12.12.e064590.16","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph17217857","article-title":"COVID-19-related mental health effects in the workplace: a narrative review","volume":"17","author":"Giorgi","year":"2020","journal-title":"Int J Environ Res Public Health"},{"key":"2025121513031161000_12.12.e064590.17","doi-asserted-by":"publisher","DOI":"10.1186\/s12992-019-0540-4"},{"key":"2025121513031161000_12.12.e064590.18","doi-asserted-by":"crossref","first-page":"639","DOI":"10.5271\/sjweh.3922","article-title":"The deterioration of mental health among healthcare workers during the COVID-19 outbreak: a population-based cohort study of workers in Japan","volume":"46","author":"Sasaki","year":"2020","journal-title":"Scand J Work Environ Health"},{"key":"2025121513031161000_12.12.e064590.19","doi-asserted-by":"crossref","unstructured":"Atzendorf J , Gruber S . The mental well-being of older adults after the first wave of COVID-19, 2021.doi:10.2139\/ssrn.3808100","DOI":"10.2139\/ssrn.3808100"},{"key":"2025121513031161000_12.12.e064590.20","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2020.19686","article-title":"Prevalence of depression symptoms in US adults before and during the COVID-19 pandemic","volume":"3","author":"Ettman","year":"2020","journal-title":"JAMA Netw Open"},{"key":"2025121513031161000_12.12.e064590.21","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1002\/da.23071","article-title":"COVID stress syndrome: concept, structure, and correlates","volume":"37","author":"Taylor","year":"2020","journal-title":"Depress Anxiety"},{"key":"2025121513031161000_12.12.e064590.22","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1016\/j.jad.2022.05.038","article-title":"Association between workplace and mental health and its mechanisms during COVID-19 pandemic: a cross-sectional, population-based, multi-country study","volume":"310","author":"Zhang","year":"2022","journal-title":"J Affect Disord"},{"key":"2025121513031161000_12.12.e064590.23","first-page":"1","article-title":"Survey of health, ageing and retirement in Europe (share) wave 3","volume":"7","author":"B\u00f6rsch-Supan","year":"2020","journal-title":"Release version"},{"key":"2025121513031161000_12.12.e064590.24","first-page":"1","article-title":"Survey of health, ageing and retirement in Europe (share) wave 4","volume":"7","author":"B\u00f6rsch-Supan","year":"2020","journal-title":"Release version"},{"key":"2025121513031161000_12.12.e064590.25","first-page":"1","article-title":"Survey of health, ageing and retirement in Europe (share) wave 5","volume":"7","author":"B\u00f6rsch-Supan","year":"2020","journal-title":"Release version"},{"key":"2025121513031161000_12.12.e064590.26","first-page":"1","article-title":"Survey of health, ageing and retirement in Europe (share) wave 6","volume":"7","author":"B\u00f6rsch-Supan","year":"2020","journal-title":"Release version"},{"key":"2025121513031161000_12.12.e064590.27","doi-asserted-by":"crossref","unstructured":"B\u00f6rsch-Supan A . Survey of health, ageing and retirement in Europe (share) wave 7. Release version 2020;7.doi:10.6103\/SHARE.w7.711","DOI":"10.1007\/978-3-319-69892-2_348-1"},{"key":"2025121513031161000_12.12.e064590.28","doi-asserted-by":"crossref","unstructured":"B\u00f6rsch-Supan A . Survey of health, ageing and retirement in Europe (share) wave 8. Release version 2021;1.doi:10.6103\/SHARE.w8.100","DOI":"10.1007\/978-981-287-080-3_243-1"},{"key":"2025121513031161000_12.12.e064590.29","doi-asserted-by":"crossref","unstructured":"B\u00f6rsch-Supan A . Survey of health, ageing and retirement in Europe (share) wave 8 COVID-19 survey 1. Release version 2021.doi:10.6103\/SHARE.w8ca.100","DOI":"10.1007\/978-981-287-080-3_243-1"},{"key":"2025121513031161000_12.12.e064590.30","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyt088"},{"key":"2025121513031161000_12.12.e064590.31","unstructured":"Brugiavini A , Orso CE , Genie MG . Combining the retrospective interviews of wave 3 and wave 7: the third release of the share job episodes panel. Munich center for the economics of aging (MeA), Munich, share working paper series, 2019: 36\u20132019."},{"key":"2025121513031161000_12.12.e064590.32","unstructured":"Collecting survey data among the 50+ population during the COVID-19 outbreak . The survey of health, ageing and retirement in Europe (share). survey research methods, 2020."},{"key":"2025121513031161000_12.12.e064590.33","doi-asserted-by":"crossref","first-page":"1233","DOI":"10.1007\/s00420-021-01722-x","article-title":"Fitness for work during the COVID-19 disease: principles and suggested assistive tool for protecting workers during the pandemic era","volume":"94","author":"Sahar Kostis","year":"2021","journal-title":"Int Arch Occup Environ Health"},{"key":"2025121513031161000_12.12.e064590.34","doi-asserted-by":"publisher","DOI":"10.1037\/0022-3514.51.6.1173"},{"key":"2025121513031161000_12.12.e064590.35","doi-asserted-by":"publisher","DOI":"10.1016\/j.euroneuro.2005.04.012"},{"key":"2025121513031161000_12.12.e064590.36","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1097\/JOM.0000000000002080","article-title":"The importance of small business safety and health climates during COVID-19","volume":"63","author":"Brown","year":"2021","journal-title":"J Occup Environ Med"},{"key":"2025121513031161000_12.12.e064590.37","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1080\/10803548.2007.11076721","article-title":"Workplace safety perceptions and perceived organizational support: do supportive perceptions influence safety perceptions?","volume":"13","author":"Gyekye","year":"2007","journal-title":"Int J Occup Saf Ergon"},{"key":"2025121513031161000_12.12.e064590.38","doi-asserted-by":"publisher","DOI":"10.1007\/s10926-020-09908-9"},{"key":"2025121513031161000_12.12.e064590.39","doi-asserted-by":"crossref","unstructured":"Lo S , Christiani DC . Is \u201cEnough\u201d Really Enough? How Protected Are Our Most Vulnerable Workers\u2014Those That Support Our Country\u2019s Economy and Infrastructure? Harv public health rev 2021;33.","DOI":"10.54111\/0001\/GG6"},{"key":"2025121513031161000_12.12.e064590.40","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph191811588","article-title":"The impact of working from home on mental health: a cross-sectional study of Canadian worker's mental health during the third wave of the COVID-19 pandemic","volume":"19","author":"Bodner","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"2025121513031161000_12.12.e064590.41","doi-asserted-by":"crossref","first-page":"619","DOI":"10.5271\/sjweh.3983","article-title":"Working from home: mismatch between access and need in relation to work-home interference and fatigue","volume":"47","author":"Astrid","year":"2021","journal-title":"Scand J Work Environ Health"},{"key":"2025121513031161000_12.12.e064590.42","first-page":"1","article-title":"The relationship between telework from home and employee health: a systematic review","volume":"22","author":"Lunde","year":"2022","journal-title":"J BMC public health"},{"key":"2025121513031161000_12.12.e064590.43","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph19052602","article-title":"Telework and mental health during COVID-19","volume":"19","author":"Mendon\u00e7a","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"2025121513031161000_12.12.e064590.44","doi-asserted-by":"publisher","DOI":"10.1136\/oemed-2020-106945"},{"key":"2025121513031161000_12.12.e064590.45","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1108\/JCRE-08-2020-0031","article-title":"Work environment transformation in the post COVID-19 based on work values of the future workforce","volume":"23","author":"Pataki-Bitt\u00f3","year":"2021","journal-title":"Journal of Corporate Real Estate"},{"key":"2025121513031161000_12.12.e064590.46","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-042270"},{"key":"2025121513031161000_12.12.e064590.47","doi-asserted-by":"crossref","DOI":"10.1016\/j.ijnurstu.2021.104002","article-title":"Global prevalence of mental health problems among healthcare workers during the Covid-19 pandemic: a systematic review and meta-analysis","volume":"121","author":"Saragih","year":"2021","journal-title":"Int J Nurs Stud"},{"key":"2025121513031161000_12.12.e064590.48","doi-asserted-by":"publisher","DOI":"10.1136\/jech-2021-216715"},{"key":"2025121513031161000_12.12.e064590.49","doi-asserted-by":"crossref","unstructured":"Brugiavini A , Buia R , Simonetti I . Occupation and working outcomes during the coronavirus pandemic. SSRN Journal 2021:1\u201320.doi:10.2139\/ssrn.3781534","DOI":"10.2139\/ssrn.3781534"},{"key":"2025121513031161000_12.12.e064590.50","doi-asserted-by":"crossref","first-page":"245","DOI":"10.5271\/sjweh.3956","article-title":"The COVID-19 pandemic: one year later - an occupational perspective","volume":"47","author":"Burdorf","year":"2021","journal-title":"Scand J Work Environ Health"},{"key":"2025121513031161000_12.12.e064590.51","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61415-9"},{"key":"2025121513031161000_12.12.e064590.52","doi-asserted-by":"crossref","first-page":"e365","DOI":"10.1016\/S2468-2667(21)00069-4","article-title":"Mental health and social interactions of older people with physical disabilities in England during the COVID-19 pandemic: a longitudinal cohort study","volume":"6","author":"Steptoe","year":"2021","journal-title":"Lancet Public Health"},{"key":"2025121513031161000_12.12.e064590.53","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph18189702","article-title":"Total Worker Health\u00ae and Small Business Employee Perceptions of Health Climate, Safety Climate, and Well-Being during COVID-19","volume":"18","author":"Brown","year":"2021","journal-title":"Int J Environ Res Public Health"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2022-064590","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T21:03:20Z","timestamp":1765832600000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2022-064590"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12]]},"references-count":53,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2022,12,26]]},"published-print":{"date-parts":[[2022,12]]}},"alternative-id":["10.1136\/bmjopen-2022-064590"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2022-064590","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12]]}}}