Effort-reward imbalance in police work: associations with the cortisol awakening response

Job-related stress associated with work-related upper extremity musculoskeletal disorders (UEMDs) in municipal waste collectors: the moderation and mediation effect of job support

Background

Since the policy of “keeping trash off of the ground” in Taiwan, long-term exposure to repetitive motion in waste collection process results in high risk of upper extremity musculoskeletal disorders (UEMDs). Thus, we assessed the moderation and mediation effects of job-related stress and job support on work-related UEMDs among municipal waste collectors.

Methods

A cross-sectional study was conducted in two cities located at northern Taiwan during 2018–2019. 626 municipal waste collectors voluntarily participated and anonymously filled out a structured questionnaire. The moderation and mediation effects of effort-reward imbalance (ERI) and social support on UEMDs were analyzed by Haye’s Process Macro Model.

Results

Prevalence of UEMDs in municipal waste collectors were 43.4% for neck, 56.0% for shoulder, 24.1% for upper back, and 33.1% for hand/wrist. There was high prevalence of shoulder (72.2%), neck (48%), and upper back (30%) in female workers compared to male, most significantly in shoulders. In univariate and multivariate analysis, high ERI and low job support were significantly associated with ORs of 3.11 (95% CI:1.58–6.13) for elbow, 2.79 (95% CI:1.39–5.56) for shoulder, 3.39 (95% CI:1.64–7.00) for upper back and 3.83 (95% CI:1.98–7.41) for hand/wrist. Prevalent UEMDs were positively associated with high ERI in municipal waste collectors but negatively with job support. The moderation effects of ERI and job support on UEMDs, of which the measured synergy index exceeded one, were 18.24 for shoulder, 3.32 for elbow, and 2.45 for hand/wrist, but mediation effects were not significant.

Conclusions

This study found municipal waste collectors with work-related upper extremity disorders were significantly associated with work-related psychological risk factors. Therefore, waste collection cannot only to be improved by semi-automatic and automatic processes but immediate intervention programs for the reduction of psychological risk factors is needed promptly.

The relationship between occupational stress and job burnout in coal miners: Interactions between GCCR and SLC6A4 gene polymorphisms and the environment

OBJECTIVE

To understand the current situation of job burnout among coal miners in Xinjian. The effects of occupational stress, GCCR and SLC6A4 gene polymorphisms, and gene-environment interactions on job burnout in coal miners were analyzed. This study provides a scientific basis for formulating health strategies to combat job burnout in the future.

METHODS

The job burnout scale and job content questionnaire (JCQ) were used to investigate the general situation of job burnout among coal miners and its influencing factors. The imLDR^TM multiple SNP typing kit was used to type 300 samples (150 samples from the burnout case group and 150 from the control group). The relationship between the occurrence of job burnout, and the GCCR and SLC6A4 genes was analyzed.

RESULTS

There were significant differences in the rate of burnout among miners of different sexes, ages, working years, shifts, working types, and marital status (P < 0.05). The difference in occupational stress between the different job burnout groups was statistically significant (P < 0.05). The GG genotype at rs41423247 increased the risk of burnout (OR=3.224, 95% CI:1.425-7.294). Similarly, compared to the TT genotype at rs11080122, the CC genotype increased the susceptibility of job burnout (OR =2.614, 95% CI:1.047-6.527). The results of gene-environment interaction regression analyses showed that the interaction between rs41423247, rs17209237, and occupational stress increased the risk of job burnout (OR = 5.049, 95% CI = 2.371-10.750).

CONCLUSION

In addition to demographic characteristics, occupational stress was also a risk factor for job burnout. The interaction between rs41423247 and rs17209237 of the GCCR gene and occupational stress increased the risk of job burnout.

Prevalence of mental health problems and associated factors among front-line public health workers during the COVID-19 pandemic in China: an effort-reward imbalance model-informed study

BACKGROUND

Poor mental health status and associated risk factors of public health workers have been overlooked during the COVID-19 pandemic. This study used the effort-reward imbalance model to investigate the association between work-stress characteristics (effort, over-commitment, reward) and mental health problems (anxiety and depression) among front-line public health workers during the COVID-19 pandemic in China.

METHODS

A total of 4850 valid online questionnaires were collected through a self- constructed sociodemographic questionnaire, the adapted ERI questionnaire, the 9-item Patient Health Questionnaire (PHQ-9) and the 7-item General Anxiety Disorder Scale (GAD-7). Hierarchical logistic regression analysis was conducted to investigate the association between ERI factors and mental health problems (i.e., depression and anxiety), with reward treated as a potential moderator in such associations.

RESULTS

The data showed that effort and over-commitment were positively associated with depression and anxiety, while reward was negatively associated with depression and anxiety. Development and job acceptance were the two dimensions of reward buffered the harmful effect of effort/over-commitment on depression and anxiety, whereas esteem was non-significant.

CONCLUSIONS

This study confirmed the harmful effects of effort and over-commitment on mental health among public health workers during the COVID-19 pandemic in China. Such effects could be alleviated through an appropriate reward system, especially the development and job acceptance dimensions of such a system. These findings highlight the importance of establishing an emergency reward system, comprising reasonable work-allocation mechanism, bonuses and honorary titles, a continuous education system and better career-development opportunities.

Roles of effort and reward in well-being for police officers in Singapore: The effort-reward imbalance model

RATIONALE

Despite the growing body of research on the effort-reward imbalance (ERI) model, evidence is scarce for the generalizability of the model across various national and occupational contexts. Also, studies that examine a wider variety of health and well-being outcomes of ERI are warranted, especially in vocations in which effort and stress is known to be high and reward is usually limited - such as policing.

OBJECTIVE

The current study examined the relationship between the ERI perception and four employee well-being outcomes (self-reported physical health, sickness absence, job satisfaction, and work-life effectiveness) among a sample of police officers in Singapore.

METHODS

Cross-sectional survey data collected from a large representative sample of uniformed police officers from Singapore were used (N = 8729). Missing data were handled with the multiple imputation method and logistic regression analyses were used to test hypotheses.

RESULTS

In line with the theory, employees characterized by high intrinsic effort and low reward (ERI > 1) reported significantly elevated odds ratios of poor physical health (OR = 1.25), job dissatisfaction (OR = 1.53), and work-life ineffectiveness (OR = 1.31). Contrary to expectations, an unusual relationship was observed such that police officers who were overcommitted exhibited lower odds ratios of the suboptimal outcomes. Interestingly, police officers in the low effort-low reward condition exhibited the worst outcomes, whereas officers in the high effort-high reward condition reported optimal outcomes. Findings were generally consistent across genders and age groups.

CONCLUSIONS

This research bolsters the core proposition of the ERI model and emphasizes the importance of social and occupational contexts in the study of ERI.

Occupational Stress in Spanish Police Officers: Validating the Effort-Reward Imbalance Questionnaire

The Effort-Reward Imbalance Questionnaire (hereinafter, ERIQ) has been largely used worldwide to assess job stress, but it has not yet been applied in Spanish police. The objective of this study was to examine the construct validity and the internal consistency of the ERIQ in police officers. A cross-sectional study was carried out, using a nonprobability sampling (quota). A total of 217 Spanish police officers participated, 192 men (88.47%) and 25 women (11.53%). The mean age was 41 years (SD = 7.51). These police officers completed the ERIQ together with some other questionnaires (DECORE-21, MBI, GHQ and STAI) in order to provide evidence for validity based on the relationships to other constructs. A confirmatory factor analysis was performed and a matrix of correlations with the rest of constructs was created. The results showed an appropriate fit to the original model consisting of three scales. In addition, the scales of the ERIQ presented the expected relationship with the other constructs. The ERIQ is a valid instrument for assessing occupational stress in Spanish police officers and can improve the interventions in this professional group.

Physician Stress and Burnout

Tens (or hundreds) of thousands of Americans die each year as a result of preventable medical errors. Changes in the practice and business of medicine have caused some to question whether burnout among physicians and other healthcare providers may adversely affect patient outcomes. A clear consensus supports the contention that burnout affects patients, albeit with low-quality objective data. The psychological and physical impact on physicians and other providers is quite clear, however, and the impact on the physician workforce (where large shortages are projected) is yet another cause for concern. We have all heard the airplane safety announcement remind us to "Please put on your own oxygen mask first before assisting others." Unfortunately, like many airline passengers (very few of whom use oxygen masks correctly when they are needed), physicians often do not recognize symptoms of burnout or depression, and even less often do they seek help. We detail the causes and consequences of physician burnout and propose solutions to increase physician work satisfaction.

Subclinical Markers of Cardiovascular Disease Among Police Officers: A Longitudinal Assessment of the Cortisol Awakening Response and Flow Mediated Artery Dilation

OBJECTIVE

To examine the association of the cortisol awakening response (CAR) with change in brachial artery flow-mediated dilation (FMD%) in police officers over a 7-year period.

METHODS

Baseline CAR was obtained from four saliva samples taken 15 minutes apart immediately after awakening. Analysis of covariance was used to compare the change in FMD% (FMD%Follow-up-FMD%Baseline) across tertiles of area under the cortisol curve with respect to increase (AUCI). Regression analysis was use to assess trend.

RESULTS

Officers (n = 172; 81% men) had a mean ± SD age of 41 ± 7.6 years. Men in the lowest AUCI tertile (ie, atypical waking cortisol pattern) had a significantly larger 7-year mean decline in FMD% (mean ± SE: -2.56 ± 0.64) compared with men in the highest tertile (-0.89 ± 0.69) (P = 0.0087).

CONCLUSIONS

An awakening cortisol AUCI predicted worsening of FMD% approximately 7 years later among male officers.