Aims Firstly, to bring readers up to date with the current organization and delivery of OH to uniformed personnel in the Armed Forces. Secondly, to review the research that has led to an improvement in OH services and the ways in which the Armed Forces are responding to the various challenges.

Methods A description of the type and delivery of OH to the Armed Forces is followed by a review of the relevant contemporaneous literature from both open publications and research dissertations.

Results Although there are some similarities with civilian OH, the principal requirement to prepare and sustain service personnel for operations on land, sea and air adds considerable complexity to the task. Research undertaken by Armed Forces OH professionals has added to the evidence base and enabled attrition in all aspects of the Armed Forces to be reduced.

Conclusions To meet the challenges of the 21st century, Armed Forces OH practitioners must continue to provide the best evidence-based advice to enhance force preparation and sustainment. All consultations in the Armed Forces involve an OH consideration from the simplest consultations through to the input from specialist OH practitioners. While the assessment of fitness to work in home bases and on deployed operations remains the primary output of OH, the provision of support to command policy, procurement and research are also key to the ability to operate worldwide.

Aims To provide a measure of the incidence of work-related mental ill-health reported by specialist psychiatrists and occupational physicians to UK voluntary reporting schemes during the period 2002–05. Additionally, an investigation of determinants, notably factors identified by reporters as precipitants in cases of work-related mental ill-health was undertaken.

Methods The study used data collected by The Health and Occupation Reporting Network (THOR) from 2002 to 2005. Cases were analysed by age, gender, industry and precipitating event.

Results Estimated annual average incidence rates and 95% confidence intervals of work-related mental ill-health diagnoses reported to THOR between 2002 and 2005 by psychiatrists were 89 (78, 101) per million and by occupational physicians were 1589 (1443, 1735) per million. For both groups of reporters, anxiety and depression continued to make up the largest proportion of diagnoses. The majority of cases were attributed to factors such as workload and difficulties with other workers. There was some suggestion that the type of factors associated with the mental ill-health case reports varied between industrial sectors.

Conclusions Work-related anxiety and depression and stress continue to constitute a significant proportion of all work-related mental ill-health diagnoses in the UK, with workload and interpersonal relationships reported as significant risk factors. Further investigations may determine whether guidance for employers and employees on work-related mental ill-health would benefit from being more industry specific.

Aims To explore the association of mental health with occupational stress, coping styles and their interaction among Chinese offshore oil platform workers.

Methods A cross-sectional survey was conducted among 561 Chinese offshore oil platform workers. They were sent a self-administered questionnaire exploring their socio-demographic characteristics, occupational stress, coping styles and mental health. Hierarchical multiple regression was used to assess the main and interactive effects of occupational stress and coping styles on mental health.

Results After controlling for age, educational level, marital status and years of offshore working, poor mental health was significantly positively associated with occupational stress, ‘internal behaviour’ coping methods and the interaction between occupational stress and internal behaviour coping.

Conclusions The results of this study suggest that the mental health of Chinese offshore oil platform workers is associated with occupational stress, some coping styles and interactions of occupational stress and some coping styles.

Aims To compare perceptions of illness, fitness to return to work and time to return to work among employees with those of their occupational physicians (OPs).

Methods A cross-sectional study of employees off sick for >2 weeks, with the return to work date ascertained at 3 months. Employees and their OPs completed similar questionnaires that included the Brief Illness Perception Questionnaire.

Results Of total, 84 employees (76% response rate) and nine OPs participated. Employees reported a greater impact on their life (P < 0.01), a longer duration of illness (P < 0.01), more symptoms (P < 0.01), more concern about their illness (P < 0.01), more emotional impact of their illness (P < 0.01) and that their illness was more serious (P < 0.01) than did the OPs. They attributed their illness to work more often than their OPs (P < 0.05) and predicted more accurately when they would be fit to return to work (P < 0.01). Employees who returned to work believed that their illness was shorter lasting (P < 0.01), more treatable (P < 0.01), more controllable (P < 0.05), less serious (P < 0.01), had less emotional impact (P < 0.01), perceived fewer symptoms (P < 0.05) and had less concern (P < 0.05) than those who failed to return to work.

Conclusions Employees had more negative perceptions about their illness than OPs. Positive perceptions were associated with an earlier return to work. Unhelpful negative beliefs about illness need to be addressed by OPs.

Aims To assess the relative impact of health, work characteristics and perceptions of work on absence and performance.

Methods Cross-sectional survey of two public sector organizations (n = 505). Data were analysed using multivariate linear regression to assess the individual and combined influence of each class of independent variables on the following: days sickness absence, spells of sickness absence, VAS performance and presenteeism.

Results Characteristics of work were weakly associated with days absence and performance. Perceptions of work were more strongly associated with performance than absence. Measures of mental health, rather than physical health, had the greatest influence on ability to work. Poor health had a greater impact on work performance than work absence. When considered together, health variables accounted for the largest proportion of explained variance in both absence and performance when compared with characteristics of work and work perceptions.

Conclusions Using absence as a marker of health-associated compromise at work may lead to an underestimation of the impact of health on work. This study demonstrates the need to manage the impact of health problems on the workforce not only from a bio-medical perspective but also in terms of the psychological pressures and the social context in which employees work.

Aims To ascertain if a multidimensional prevention programme combining physical training, patient transfer technique and stress management prevents sickness absence and LBP in NA students.

Methods The study was a 14-month cluster randomized controlled study. The participants were NA students from 37 randomly selected classes located at two schools of health and social care in Copenhagen, Denmark. The participants completed a comprehensive questionnaire regarding sickness absence, LBP and psychosocial factors on commencement and after completion of the study.

Results Of 766 female NA students, 668 (87%) completed the baseline questionnaire. Sickness absence during the study period increased in both groups but the increase was significantly lower in the intervention group than the control group, mean (standard deviation) number of days 12 (20) versus 18 (34), P < 0.05. The intervention group reported no change in the mean level of general health perception, energy/fatigue or psychological well-being at follow-up, while the control group reported a decline on those scales. There were no significant differences in the prevalence of LBP at follow-up between the intervention and control group.

Conclusions Compared to the control group, the intervention group had significantly less sickness absence. The intervention had no preventive effect on LBP prevalence.

Aims To study the effects of work demands and job control on the autonomic nervous system recovery among the media personnel.

Methods From the cross-sectional postal survey of the employees in Finnish Broadcasting Company (n = 874), three age cohorts (n = 132) were randomly selected for an analysis of HRV in 24 h electrocardiography recordings.

Results In the middle-aged group, those who experienced high job control had significantly better vagal recovery than those with low or moderate control (P < 0.01). Among young and ageing employees, job control did not associate with autonomic recovery.

Conclusions High job control over work rather than low demands seemed to enhance autonomic recovery in middle-aged media workers. This was independent of poor health habits such as smoking, physical inactivity or alcohol consumption.

Aims To investigate the relationship between the HSE MS and the following stress-related work outcomes: ‘job satisfaction’, job-related anxiety and depression and errors/near misses.

Methods An anonymous cross-sectional questionnaire was distributed by either e-mail or post to all employees within a community-based Health and Social Services Trust. Respondents completed the HSE Indicator Tool, a job-related anxiety and depression scale, a job satisfaction scale and an aggregated measure of the number of errors/near misses witnessed. Associations between the HSE Indicator Tool responses and stress-related work outcomes were analysed with regression statistics.

Results A total of 707 employees completed the questionnaire, representing a low response rate of 29%. Controlling for age, gender and contract type, the HSE MS (as measured by the HSE Indicator Tool) were positively associated with job satisfaction and negatively associated with ‘job-related anxiety’, ‘job-related depression’ and ‘witnessed errors/near misses’.

Conclusions This study provides empirical evidence to support the use of the MS approach in tackling workplace stress.

Aims To assess GPs’ training, knowledge and application of the DWP's sickness certification guidelines.

Methods A structured questionnaire was sent to GPs within a (former) primary care trust (PCT). It probed demographics, training and knowledge of sickness certification guidelines. Case histories and structured questions were used to assess current practice.

Results In this group of 113 GPs, there was a low awareness and use of the DWP's guidelines and Website relating to sickness certification. The majority of the GPs (63%) had received no training in sickness certification, and the mean length of time for those who had received training was 4.1 h. Most GPs also felt that patients and GPs have equal influence on the duration of sickness certification.

Conclusions This evidence of variable practice indicates that GPs should have more guidance and education in sickness certification. Closer sickness certification monitoring through existing GP computer systems may facilitate an improvement in practice that benefits patients and employers. The DWP, medical educators and PCTs may all have an additional role in further improving sickness certification practice.

Aims To determine the attitudes of occupational physicians in the UK towards EBG, what prevents them from practising EBM and their workplace Internet access.

Methods Self-administered questionnaires were posted to 357 physicians chosen randomly from the Society of Occupational Medicine membership list. Responders were stratified according to occupational medicine professional grade. The data were analysed using Cronbach's alpha, analysis of variance, chi-square and Kruskal–Wallis test.

Results A total of 259 occupational physicians responded giving a response rate of 73%. The attitude questionnaire showed good reliability. Occupational medicine specialists were more positive towards EBG than general practitioners. Overall, the respondents were more positive towards EBG than physicians in previous studies. The most common barriers to practising EBM were lack of time and limited availability of guidelines. The majority of respondents had workplace Internet access.

Conclusions UK occupational physicians have a positive attitude towards EBG. However, this study has identified a need to make EBG more readily accessible to them. In addition, occupational physicians require adequate time to practise EBM in their daily work. Educational workshops should be developed to enhance their literature search techniques, critical appraisal skills and application of EBM in clinical practice. Online training programmes should be considered to take advantage of their Internet access.