| This dissertation is based on two studies of work and health that used questionnaires as the primary means of gathering information on work exposures and health effects. These studies were the World Health Organization (WHO) World Health Survey (WHS) and the United for Health Survey (UHS).; The objective of the WHS analyses was to assess the patterns of respiratory symptoms within countries and across world regions grouped by level of economic development. Multilevel models were used to examine associations between broadly defined occupational categories and the prevalence of two respiratory disease outcomes: asthma and shortness of breath. There were 308,218 participants from 70 countries. The employed had lower asthma and shortness of breath prevalence than the unemployed across all countries. The differences in asthma prevalence among 9 broad occupational groups varied substantially among countries, depending on their level of income. In general, middle income countries, mostly from Eastern Europe, had lower prevalences of respiratory disease compared to the low and high income countries.; The objective of the UHS analyses was to examine agreement between individual reports and expert ratings of hazardous workplace exposure, and further compare these exposure associations with individual health outcomes. Detailed questionnaires on self-reported health status (blood pressure, musculoskeletal and respiratory symptoms) and exposures to 9 different physical (dust, chemical, musculoskeletal) and social (job strain components) hazards were collected from 1282 participants in 14 work sites distributed among 4 industries.; There was generally poor agreement between the self-reported and expert assessments of workplace exposure. When individuals were compared to expert ratings, the more advantaged groups tended to over-estimate exposures compared to those conventionally considered disadvantaged. The one important exception was that lower-wage workers were more likely to over-estimate than higher-wage workers.; Self-reported exposures were positively associated with both musculoskeletal and respiratory health outcomes. Expert-rated exposures were positively associated with musculoskeletal outcomes and negatively associated with respiratory outcomes. Blood pressure was not associated with job strain in any assessments.; In both datasets, multilevel (mixed) models helped with the analyses of individual information nested within group level data and gave information about clustering of health symptoms and exposures. |
