title: Primary care visits to occupational health physicians and nurses in Finland.
abstract: OBJECTIVE
  In Finland, 91% of employer-arranged occupational health services (OHS) include primary care for employees. Occupational health (OH) physicians and OH nurses carry the main responsibility for primary care in OHS. This study analyses work- and health-related factors associated with primary care visits to OH physicians and OH nurses.
  
  
  METHODS
  This population-based cross-sectional survey encompassed 1636 randomly selected working employees aged 25-64 covered by OHS which included primary care. The associations between factors and visits during the previous 6 months were tested by Poisson regression analysis.
  
  
  RESULTS
  The proportion of employees who visited OH physicians or OH nurses was 57%. Men visited OH nurses more often than women, but the number of visits to OH physicians was similar. Long-standing illnesses impairing work ability, work-related symptoms, and type of OHS provision were associated with visits to both OH physicians and nurses. Moderate psychological stress was associated with visits to OH physicians. Among men, the requirement of obtaining a sick-leave certificate on the first day of absence was associated with visits. Less possibilities to influence one's work was associated with visits to OH nurses, and among women also to OH physicians. Poor support from supervisors and co-workers had non-significant or inverse associations.
  
  
  CONCLUSIONS
  The wide use of OHS and both the type and similarities between factors associated with visits may signify that both OH physicians and OH nurses are likely to encounter work-related health problems through primary care in OHS.
authors.affiliation: Finnish Institute of Occupational Health, Helsinki, Finland. annukka.kimanen@sll.fimnet.fi
authors.forename: Annukka
authors.initials: A
authors.lastname: Kimanen
authors.forename: Maria
authors.initials: M
authors.lastname: Rautio
authors.forename: Pirjo
authors.initials: P
authors.lastname: Manninen
authors.forename: Kimmo
authors.initials: K
authors.lastname: Räsänen
authors.forename: Päivi
authors.initials: P
authors.lastname: Husman
authors.forename: Kaj
authors.initials: K
authors.lastname: Husman
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D005387:Finland; D006801:Humans; D008297:Male; D009726:Nurses; D009784:Occupational Diseases / Q000175:diagnosis / Q000628:therapy; D016272:Occupational Health; D054538:Occupational Health Physicians; D009786:Occupational Health Services / Q000458:organization & administration; D009819:Office Visits / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000458:organization & administration; D018582:Sick Leave; D013315:Stress, Psychological / Q000175:diagnosis; D011795:Surveys and Questionnaires; D014938:Work Capacity Evaluation; D000078329:Workforce