Use of benzodiazepine drugs and perceived job stress in a cohort of working men and women in Belgium. Results from the BELSTRESS-study

Effects of an App-Based Intervention Program to Reduce Substance Use, Gambling, and Digital Media Use in Adolescents and Young Adults: A Multicenter, Cluster-Randomized Controlled Trial in Vocational Schools in Germany

Vocational students are a risk group for problematic substance use and addictive behaviors. The study aim was to evaluate the effects of an app-based intervention on tobacco, e-cigarettes, alcohol, and cannabis use as well as gambling and digital media-related behaviors in the vocational school setting. A total of 277 classes with 4591 students (mean age 19.2 years) were consecutively recruited and randomized into an intervention (IG) or waitlist control group (CG). Students from IG classes received access to an app, which encouraged a voluntary commitment to reduce or completely abstain from the use of a specific substance, gambling, or media-related habit for 2 weeks. Substance use, gambling, and digital media use were assessed before and after the intervention in both groups with a mean of 7.7 weeks between assessments. Multi-level logistic regression models were used to test group differences. Intention-to-treat-results indicated that students from IG classes had a significantly larger improvement on a general adverse health behavior measure compared to CG (OR = 1.24, p = 0.010). This difference was mainly due to a significantly higher reduction of students' social media use in the IG (OR = 1.31, p < 0.001). Results indicate that the app "Meine Zeit ohne" is feasible for the target group and seems to have a small but measurable impact on students' health behavior.

An Exploratory Study on the Relation between Companies’ Food Integrity Climate and Employees’ Food Integrity Behavior in Food Businesses

Given the need to prevent food fraud within the international food supply chain and the current lack of research on food integrity, in this paper, the relation between the organizational food integrity climate and employees’ food integrity behavior is examined to understand the role of the individual or psychological dimension in food integrity. The construct of food integrity behavior was introduced and defined, and the conceptual model of the food integrity climate in relation to food integrity behavior was elaborated along with study variables and hypotheses. In the proposed model, the potential moderating role of employees’ psychological well-being (i.e., burnout and job stress) was analyzed, and two mediating variables were also proposed (i.e., knowledge and motivation) which both could explain how the prevailing food integrity climate might influence employees’ food integrity behavior. Data was collected through convenience sampling in four Belgian food companies with a total of 118 participating employees through a self-assessment questionnaire. Based on the statistical analysis, it was concluded that a well-developed organizational food integrity climate promotes positive employees’ food integrity behavior. Specifically, results of this semi-quantitative study demonstrated that the companies’ food integrity climate is positively related to the employees’ food integrity behavior both directly and indirectly, and that food integrity knowledge is a partial mediator in the relation between food integrity climate and food integrity behavior, while food integrity motivation is a full mediator. Study limitations and implications are also discussed.

Increased use of analgesics in midlife women but no association with mental stress: observations from the Prospective Population Study of Women in Gothenburg

Background

The study is part of the ongoing Prospective Population Study of Women in Gothenburg, Sweden, initiated in 1968–1969 with the aim of characterising a total population of women who were representative of middle-aged females. The aim of the present study was to investigate the prevalence of actual analgesic use (prescribed and self-medication) and the possible association with perceived mental stress among women aged 38 and 50 years, respectively, in the Population Study of Women.

Methods

Two different cohorts of population-based samples of 38- and 50-year-old women examined in 2004–2005 and 2016–2017, respectively, were eligible participants. The women were representative for their age cohort at the time of the examinations. Use of medicines and especially analgesics, as well as perceived mental stress, was registered. Changes in medicine use among 38- and 50-year-old women between 2004 and 2005 and 38- and 50-year-old women in 2016–2017 were studied. Data were analysed using logistic regression. Use of analgesics and mental stress were analysed controlling for lifestyle factors, use of other medicines and pain.

Results

The overall sample size across the time periods was 1,073 individuals. The frequency of analgesic use in 38- and 50-year-old women was about 26% in 2004–2005 and 58% in 2016–2017. 28% of women who reported high mental stress in 2004–2005 used analgesics, compared to 60% in 2016–2017. There were no associations between self-perceived mental stress and the use of analgesics.

Conclusion

The higher use of analgesics among midlife women in 2016–2017 is in line with global findings and could be due to increased availability in Sweden of over the counter medicines. The impact of mental stress on analgesic use found previously by other researchers was not confirmed. However, medicine use as a potential coping strategy is an important public health issue that needs to be further explored.

Psychosocial job strain and polypharmacy: a national cohort study

Objectives:

Psychosocial job strain has been associated with a range of adverse health outcomes. The aim of this study was to examine the association between psychosocial job strain and prospective risk of polypharmacy (the prescription of ≥5 medications) and to evaluate whether coping strategies can modify this risk.

Methods:

Cohort study of 9703 working adults [mean age 47.5 (SD 10.8) years; 54% female] who participated in the Swedish Longitudinal Occupational Survey of Health (SLOSH) at baseline in 2006 or 2008. Psychosocial job strain was represented by job demands and control, and measured by the Swedish version of the demand–control questionnaire. The outcome was incidence of polypharmacy over an eight-year follow-up period. Information on dispensed drugs were extracted from the Swedish Prescribed Drug Register. Logistic regression was used to estimate the association of job strain status with polypharmacy, adjusted for a range of confounders.

Results:

During the follow-up, 1409 people developed polypharmacy (incident rate: 20.6/1000 person-years). In comparison to workers with low-strain jobs (high control/low demands), those with high-strain jobs (low control/high demands) had a significantly higher risk of incident polypharmacy (OR 1.40, 95% CI 1.04–1.89). The impact of high-strain jobs on developing polypharmacy remained among those with covert coping strategies (ie, directed inwards or towards others) but not among those with open coping strategies (ie, primarily directed toward the stressor).

Conclusions:

Workers in high-strain jobs may be at an increased risk of polypharmacy. Open coping strategies may reduce the negative impact of psychosocial job strain on risk of polypharmacy.

Layoffs and the mental health and safety of remaining workers: a difference-in-differences analysis of the US aluminium industry

BACKGROUND

Relatively few studies have examined the effects of layoffs on remaining workers, although the effects of layoffs and downsizing events may extend beyond those employees who lose their jobs.

METHODS

We examined the effects of layoffs on mental healthcare utilisation and injury risk among workers at 30 US plants between 2003 and 2013. We defined layoffs as reductions in the hourly workforce of 20% or more at each plant. Using a difference-in-differences approach, we compared the change in outcomes during layoffs versus the same 3-month period 1 year previously, accounting for secular trends with control plants.

RESULTS

Our study population included 15 502 workers and 7 layoff events between 2003 and 2013. Layoffs were associated with only minor decreases in injuries (-0.006, 95% CI -0.013 to 0.001). The probability of outpatient visits related to mental health increased by 1% during layoffs (0.010, 95% CI 0.003 to 0.017), and the probability of mental health-related prescriptions increased by 1.4% (0.014, 95% CI -0.0006 to 0.027). Among women, the increase in outpatient visits was more pronounced (0.017, 95% CI 0.003 to 0.031). Increased prescription utilisation appeared attributable primarily to opioid use (0.016, 95% CI 0.005 to 0.027).

CONCLUSION

Our results indicate an association between layoffs and remaining workers' mental health and safety, although changes mental healthcare utilisation may reflect both changes in underlying mental health and changes in care-seeking. Future research on concordance of service utilisation and underlying health may yield valuable insight into the experiences employed workers in the wake of layoffs.

Effort-reward imbalance and long-term benzodiazepine use: longitudinal findings from the CONSTANCES cohort

OBJECTIVES

To examine the association between effort-reward imbalance and incident long-term benzodiazepine use (LTBU).

METHODS

We included 31 077 employed participants enrolled in the French population-based CONSTANCES cohort between 2012 and 2014 who had not undergone LTBU in the 2 years before enrolment. LTBU was examined using drug reimbursement administrative databases. The effort-reward imbalance was calculated in quartiles. We computed ORs (95% CIs) for LTBU according to effort-reward imbalance over a 2-year follow-up period. We adjusted for age, gender, education, occupational grade, income, marital status, tobacco smoking, risk of alcohol use disorder, depressive symptoms and self-rated health.

RESULTS

Over the 2-year follow-up, 294 (0.9%) participants experienced incident LTBU. In the univariable analysis, effort-reward imbalance was associated with subsequent LTBU with ORs of 1.79 (95% CI 1.23 to 2.62) and 2.73 (95% CI 1.89 to 3.95) for the third and fourth quartiles, respectively, compared with the first quartile. There was no interaction between effort-reward imbalance and any of the considered variables other than tobacco smoking (p=0.033). The association remained significant in both smokers and non-smokers, with higher odds for smokers (p=0.031). In the fully adjusted model, the association remained significant for the third and fourth quartiles, with ORs of 1.74 (95% CI 1.17 to 2.57) and 2.18 (95% CI 1.50 to 3.16), respectively. These associations were dose dependent (p for trend <0.001).

CONCLUSIONS

Effort-reward imbalance was linked with incident LTBU over a 2-year follow-up period after adjustment for sociodemographic and health-related factors. Thus, screening and prevention of the risk of LTBU should be systematised among individuals experiencing effort-reward imbalance, with special attention paid to smokers.

Exposure to work stress and use of psychotropic medications: a systematic review and meta-analysis

BACKGROUND

There is good evidence that job stressors are prospectively related to mental health problems, particularly depressive symptoms. This review aimed to examine whether job stressors were also related to use of psychotropic medications.

METHODS

Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses approach, we examined seven electronic databases that indexed literature from a wide range of disciplines. Inclusion criteria were (1) the study included a job stressor or psychosocial working condition as an exposure, and (2) psychotropic medication was an outcome. All effect-size estimates were considered but needed to present either a SE or 95% CIs to be included in meta-analyses. Data were pooled between studies using the relative risk (RR) or odds ratio (OR) and 95% CIs.

RESULTS

There were 18 unique studies with non-overlapping exposures eligible for inclusion in the quantitative meta-analysis. High job demands were associated with a statistically significant increased risk of psychotropic medication use (RR 1.16, 95% CI 1.02 to 1.31). There was also an elevated RR in relation to work-family conflict (RR 1.26, 95% CI 1.03 to 1.48). In studies reporting OR, high job demands were associated with an OR of 1.39 (95% CI 1.06 to 1.71).

CONCLUSIONS

The findings of this review highlight the need for policy and programme attention to reduce harmful exposure to psychosocial job stressors. Health-service use measures should be considered as outcomes and may represent more severe mental health conditions.

Work-Related Stressors and Increased Risk of Benzodiazepine Long-Term Use: Findings From the CONSTANCES Population-Based Cohort

Objectives. To examine whether stressful job exposure to the public could be associated with having long-term benzodiazepine use.Methods. From the participants included between 2012 and 2016 in the French population-based CONSTANCES cohort, 13 934 men and 19 261 women declared a daily job exposure to the public and rated the frequency of stressful exposure. We examined benzodiazepine long-term use by using drug reimbursement administrative registries. Logistic regressions provided odds ratios (ORs) of benzodiazepine long-term use, with stratification for gender and adjustment for age, education, and area deprivation index. Occupational grade, job strain, depression, self-rated health, and alcohol use disorder were additional stratification variables.Results. Benzodiazepine long-term use was positively associated with stressful exposure to the public ("often or always" vs "rarely or never") in men (OR = 2.2; 95% confidence interval [CI] = 1.8, 2.8) and women (OR = 1.6; 95% CI = 1.4, 1.9), with dose-dependent relationships (P trends < .001). Adjustments and analyses in subgroups without other individual or environmental vulnerability factors led to similar results.Conclusions. Stressful job exposure to the public increases the risk of benzodiazepine long-term use. Prevention programs aiming at reducing the burden of benzodiazepine long-term use would benefit in targeting this specific population.

Characterizing the Interrelationships of Prescription Opioid and Benzodiazepine Drugs With Worker Health and Workplace Hazards

OBJECTIVE

Prescription opioid and benzodiazepine drug use, which has risen significantly, can affect worker health. Exploration of the scientific literature assessed (1) interrelationships of such drug use, occupational risk factors, and illness and injury, and (2) occupational and personal risk factor combinations that can affect their use.

METHODS

The scientific literature from 2000 to 2015 was searched to determine any interrelationships.

RESULTS

Evidence for eight conceptual models emerged based on the search yield of 133 articles. These models summarize interrelationships among prescription opioid and benzodiazepine use with occupational injury and illness. Factors associated with the use of these drugs included fatigue, impaired cognition, falls, motor vehicle crashes, and the use of multiple providers.

CONCLUSION

Prescription opioid and benzodiazepine drugs may be both a personal risk factor for work-related injury and a consequence of workplace exposures.

Gender differences in the use of alcohol and prescription drugs in relation to job insecurity. Testing a model of mediating factors

BACKGROUND

The results of several studies suggest that economy-related stressors are less distressing for women compared with men. This study proposed to examine the relationship of perceived job insecurity with the use of licit drugs using a theoretical model that considered antecedents and mediators of this association, in order to identify differences between working men and women.

METHODS

Using information from the Catalan Health Survey (2010-2014), we selected working individuals aged 16-64 who were primary providers of household income (N=5315). The outcomes were two measures of alcohol consumption (heavy drinking and binge drinking) and the use of hypnotics/sedatives. As antecedents of the exposure to job insecurity we considered the type of contractual relationship and occupational class. The mediating factors were poor mental health, household structure and the hours of housework per week. The theoretical model was assessed using path analysis where the moderating effect of gender was considered in all the associations.

RESULTS

No differences in the prevalence of job insecurity were found between men and women (17%). Job insecurity (Odds ratio [OR]=1.35, 95% confidence interval [CI]=1.23-1.48) and house workload (OR=1.01, 95% CI=1.00-1.02) were positively associated with poor mental health, with no significant interactions with gender. Poor mental health was significantly associated with binge drinking (OR=1.23, 95% CI=1.13-1.33) and with the use of hypnotics/sedatives (OR=1.71, 95% CI=1.53-1.91). House workload showed a direct negative association with binge drinking (OR=0.99, 95% CI=0.98-1.00), while those in households with no children were more likely to be binge drinkers, with no significant interactions with gender. An alternative model had better fitting results for heavy drinking.

CONCLUSION

No gender differences were found in the association of job insecurity with mental health nor with the use of substances among primary providers of household income, emphasising the importance of social roles when assessing differences in mental health among men and women.

Polysubstance use patterns and trajectories in vocational students--a latent transition analysis

BACKGROUND

The transition from late adolescence to early adulthood (16-20 years) represents a time of exploration and self-discovery for many young people. As such, it is often associated with experimentation in substance use. Vocational students in particular report high substance use. Thus, the aim of this study is to examine patterns and trajectories of their substance use behavior.

METHODS

On two occasions (interval 18 months), we investigated 5214 students (M=19.39 years; 54% male) from 49 vocational schools in seven German federal states. We identified classes of substance use and trajectories via latent transition analysis, controlling for gender, age, and socio-economic status. Additionally, we investigated work-related (job demands/stress/satisfaction) and psychopathological (depressive symptoms) predictors of substance use via multinomial regressions.

RESULTS

We found three latent stages of substance use: low use (baseline: 43%/follow-up: 44%), mainly alcohol use (50%/45%), and polysubstance use (7%/11%). Over time, 10% of alcohol users at baseline transitioned to polysubstance use at follow-up, while there were smaller transition rates (2-9%) between the other stages. Compared to low use, polysubstance use at follow-up was predicted by high job stress (aOR=1.45, 1.07-1.96) at baseline.

CONCLUSIONS

High alcohol use is associated with bidirectional transitions in young adults. Hence, future research needs to identify mechanisms of change to identify protective factors. Regarding vocational practice, early stress management seems to be a viable path to prevent polysubstance use in vocational students.

Gender differences in psychotropic use across Europe: Results from a large cross-sectional, population-based study

BACKGROUND

In many epidemiological studies, women have been observed to consume psychotropic medication more often than men. However, the consistency of this relationship across Europe, with differences in mental health care (MHC) resources and reimbursement policies, is unknown.

METHODS

Questions on 12-month psychotropic use (antidepressants, benzodiazepines, antipsychotics, mood stabilizers) were asked to 34,204 respondents from 10 European countries of the EU-World Mental Health surveys. Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) criteria were used to determine 12-month prevalence of mood/anxiety disorders using the Composite International Diagnostic Interview (v3.0).

RESULTS

For all participating countries, women were significantly more likely than men to use psychotropic medication within the previous 12 months (overall-OR=2.04, 95% CI: 1.81-2.31). This relationship remained significant after adjusting for common sociodemographic factors (age, income level, employment status, education, marital status) and country-level indicators (MHC provision, private household out-of-pocket expenditure, and Gender Gap Index). In multivariable gender-stratified risk-factor analysis, both women and men were more likely to have taken psychotropic medication with increasing age, decreasing income level, and mental health care use within the past 12 months, with no significant differences between genders. When only including participants with a mental disorder, gender differences overall were still significant with any 12-month mood disorder but not with any 12-month anxiety disorder, remaining so after adjusting for sociodemographic characteristics and country-level indicators.

CONCLUSIONS

Women use psychotropic medication consistently more often than men, yet reasons for their use are similar between genders. These differences also appear to be contingent on the specific mental disorder.

Working conditions and psychotropic drug use: cross-sectional and prospective results from the French national SIP study

Prospective studies exploring the associations between a large range of occupational factors and psychotropic drug use among national samples of workers are seldom. This study investigates the cross-sectional and prospective associations between occupational factors, including a large set of psychosocial work factors, and psychotropic drug use in the national French working population. The study sample comprised 7542 workers for the cross-sectional analysis and 4213 workers followed up for a 4-year period for the prospective analysis. Psychotropic drug use was measured within the last 12 months and defined by the use of antidepressants, anxiolytics or hypnotics. Three groups of occupational factors were explored: classical and emergent psychosocial work factors, working time/hours and physical work exposures. Weighted Poisson regression analyses were performed to adjust for covariates. In the cross-sectional analysis, psychological demands, low social support and hiding emotions were associated with psychotropic drug use. Job insecurity for men and night work for women were associated with psychotropic drug use. In the prospective analysis, hiding emotions and physical exposure were predictive of psychotropic drug use. Dose-response associations were observed for the frequency/intensity of exposure and repeated exposure to occupational factors. This study underlines the role of psychosocial work factors, including emergent factors, in psychotropic drug use. Prevention policies oriented toward psychosocial work factors comprehensively may be useful to reduce this use.

Use of psychotropic drugs in Lombardy in time of economic crisis (2007-2011): a population-based study of adult employees

Over years, there has been an increase in the prescription of psychotropic drugs (PDs), particularly antidepressants (ADs). The aim of the study was to evaluate the consumption of PDs in adult employees in a productive area of Italy and the possible changes induced by the "economic crisis". The study is a retrospective survey in all adult employees in Lombardy, Northern Italy, aged >18 years in the period 2007-2011, classified by gender, age class, nationality, education and province. During the 5-year period, there were 3,554,860 employed adults in Lombardy, of whom 277,865 (7.8%) used PDs. The use of PDs (particularly ADs) was associated with being an Italian woman aged >55 years with a basic education, a blue collar job, and an unstable working position. In 39% of cases, the use of PDs was limited to one trimester. The increase in the number of prescriptions of PDs after the economic crisis was the same as before it. The increase in PD use can be attributed more to ADs and anti-epileptic drugs with anxiolytic properties. Although continuously increasing, the use of AD fluctuated and was greater during the fall and winter. The increase involved all the provinces in Lombardy in a similar manner.

Psychotropic medication claims among religious clergy

This study examined psychotropic medication claims in a sample of Protestant clergy. It estimated the proportion of clergy in the sample who had a claim for psychotropic medication (i.e., anti-depressants and anxiolytics) in 2005 and examined associations between sociodemographic characteristics, occupational distress and having a claim. Protestant clergy (n = 749) from nine denominations completed a mail survey and provided access to their pharmaceutical records. Logistic regression models assessed the effect of sociodemographic characteristics and occupational distress on having a claim. The descriptive analysis revealed that 16 % (95 % Confidence interval [CI] 13.3 %-18.5 %) of the clergy in the sample had a claim for psychotropic medication in 2005 and that, among clergy who experienced frequent occupational distress, 28 % (95 % CI 17.5 %-37.5 %) had a claim. The regression analysis found that older clergy, female clergy, and those who experienced frequent occupational distress were more likely to have a claim. Due to recent demographic changes in the clergy population, including the increasing mean age of new clergy and the growing number of female clergy, the proportion of clergy having claims for psychotropic medication may increase in the coming years. To the best of our knowledge, this is the first study to examine the use of psychotropic medication among clergy.

Prevalence of alcohol and other psychoactive substances in injured drivers: comparison between Belgium and The Netherlands

STUDY OBJECTIVE

To compare the prevalence of alcohol and (il)licit drugs in seriously injured drivers in Belgium (BE) and the Netherlands (NL).

METHODS

Injured car and van drivers admitted to the emergency departments of five hospitals in Belgium and three in the Netherlands from January 2008 to May 2010 were included. Blood samples were taken and analysed for ethanol (with an enzymatic method) and 22 other psychoactive substances (UPLC-MS/MS or GC-MS).

RESULTS

In total 535 injured drivers were included in the study (BE: 348; NL: 187). More drivers were found positive for alcohol and drugs in Belgium (52.6%) than in the Netherlands (33.9%). Alcohol (≥0.1 g/L) was the most prevalent substance in both countries (BE: 42.5%; NL: 29.6%). A similar prevalence was found for amphetamine (BE: 2.6%; NL: 2.2%) and cocaine (BE: 2.3%; NL: 2.1%). In the Netherlands almost no positive findings for cannabis were recorded (0.5%). No driver tested positive for benzodiazepines in the Netherlands compared to 7.3% in Belgium. More injured drivers tested positive for Z-drugs (BE: 1.8%; NL: 0.5%) and medicinal opioids (BE: 3.3%; NL: 0.5%) in Belgium.

CONCLUSIONS

The prevalence of alcohol in seriously injured drivers was 12% higher found in Belgium than in the Netherlands. The prevalence of drugs was similar in both countries except for THC and medicinal drugs, particularly benzodiazepines, with a much higher prevalence in Belgium. In comparison to previous survey there were differences in the prevalence of THC, benzodiazepines and combinations of drugs. Possible explanations are the different matrix used, a bias in study population, or in case of illicit opiates and benzodiazepines a different consumption pattern in the two countries. Alcohol is still the most prevalent substance among the injured driver population and this increased the last 15 years.

Workplace bullying and psychotropic drug use: the mediating role of physical and mental health status

OBJECTIVES

The association between workplace bullying and psychotropic drug use is not well established. This study was aimed at exploring the association between workplace bullying, and its characteristics, and psychotropic drug use and studying the mediating role of physical and mental health.

METHODS

The study population consisted of a random sample of 3132 men and 4562 women of the working population in the south-east of France. Workplace bullying, evaluated using the validated instrument elaborated by Leymann, and psychotropic drug use, as well as covariates, were measured using a self-administered questionnaire. Covariates included age, marital status, presence of children, education, occupation, working hours, night work, physico-chemical exposures at work, self-reported health, and depressive symptoms. Statistical analysis was performed using logistic regression analysis and was carried out separately for men and women.

RESULTS

Workplace bullying was strongly associated with psychotropic drug use. Past exposure to bullying increased the risk for this use. The more frequent and the longer the exposure to bullying, the stronger the association with psychotropic drug use. Observing bullying on someone else at the workplace was associated with psychotropic drug use. Adjustment for covariates did not modify the results. Additional adjustment for self-reported health and depressive symptoms reduced the magnitude of the associations, especially for men.

CONCLUSIONS

The association between bullying and psychotropic drug use was found to be significant and strong and was partially mediated by physical and mental health.

[The contribution of work and other social determinants to the onset of psychotropic drug use among workers in Canada]

OBJECTIVES

This study aims to examine the contribution of work and other social determinants to the onset of psychotropic drug use among workers over an 8-year period.

METHODS

The study is based on a secondary analysis of the longitudinal data of the National Population Health Survey (NPHS) of Statistics Canada carried out between 1994-1995 and 2002-2003. A panel of 7,338 people aged 15 to 55 and employed at cycle 1 was selected. To establish the incidence rate, we included those participants identified at cycle 1 as not using psychotropic drugs. Overall, 7,020 people in 1,347 local communities did not use psychotropic drugs at cycle 1 and constituted the group at risk in the study. Discrete time survival multilevel regression models were used.

RESULTS

The onset of psychotropic drug use was estimated at 3.5% over the 8-year period studied. With the exception of the number of hours worked, occupations and other work characteristics measured in the NPHS do not show a significant contribution. Being a woman, age, physical health, smoking and stressful childhood events support an increased risk of psychotropic drug use, whereas certain personality traits decreased the risk of psychotropic drug use.

CONCLUSIONS

The work factors measured in the NPHS seem to play a limited role in the incidence of psychotropic drug use. More research is needed to better capture patterns of workers' psychotropic drug use over time.

The effects of becoming an entrepreneur on the use of psychotropics among entrepreneurs and their spouses

AIMS

Entering entrepreneurship (i.e. becoming an entrepreneur) is known to be a demanding activity with increased workload, financial uncertainty and increased levels of stress. However, there are no systematic studies on how entering entrepreneurship affects the people involved.

METHODS

The authors investigated prescriptions of psychotropics for 6,221 first-time entrepreneurs from 2001-2004 and their 2,381 spouses in the first two years after becoming entrepreneurs in a matched case-control study using linked data from three Danish national registries: The Danish database for Labor Market Research, the Danish Entrepreneurship database and the Danish Prescription database.

RESULTS

Entrepreneurs were more likely to fill prescriptions at pharmacies for sedatives/hypnotics (adjusted odds ratio (AOR): 1.45 [95% CI: 1.26-1.66], p < .0001). However, they were less likely to fill prescriptions for antidepressants (AOR: 0.74 [95% CI: 0.59-0.92] p = 0.007). Spouses of these entrepreneurs were also more likely to fill prescriptions for sedatives/hypnotics (AOR: 1.36 [95% CI: 1.10-1.67], p = 0.005). No difference in prescription of antidepressants was found for spouses.

CONCLUSIONS

This study showed that there was a significant relation between entering entrepreneurship and receiving prescriptions for sedative/ hypnotics both among the entrepreneurs themselves and their spouses, suggesting that entering entrepreneurship may be associated with increased stress for both the entrepreneurs and their families.

Psychosocial work environment, interpersonal violence at work and psychotropic drug use among correctional officers

The aims of this study were to establish the prevalence of psychotropic drug use, measure the association between job strain, extrinsic efforts-rewards ratio, interpersonal violence and psychotropic drug use among officers working in correctional facilities in the province of Quebec in Canada. This study also examined if interpersonal violence at work is an intermediate factor in the causal chain between psychosocial risk factors at work and psychotropic drug use. A cross-sectional study was performed which included 1288 Quebec correctional officers. The participants answered a self-administered questionnaire in 2007 assessing psychological demands, decision latitude, extrinsic efforts, rewards, overcommitment, intimidation, psychological harassment, social support in the actual job, psychotropic drug use during the month preceding the questionnaire and sociodemographic variables. Binomial regressions were performed for the principal associations and a bootstrap analysis was performed in order to evaluate interpersonal violence as an intermediate factor between psychosocial risk factors at work and psychotropic drug use. The prevalence of psychotropic drug use among correctional officers was 14.7%. The prevalence ratios (PR) for the associations between job strain, extrinsic efforts-rewards ratio, social support from colleagues and supervisors, intimidation and psychological harassment adjusted for age and gender were respectively 1.4 (95% CI 0.9-2.2), 1.6 (95% CI 1.2-2.2), 1.7 (95% CI 1.3-2.3), 1.4 (95% CI 0.9-2.4) and 1.5 (95% CI 1.1-2.0). The value of the indirect effect evaluating psychological harassment as an intermediate factor was not statistically significant (value=0.0087, 95% CI -0.0033 to 0.0207). An imbalanced extrinsic efforts-rewards ratio, low social support from colleagues and supervisors and psychological harassment at work were separately associated with psychotropic drug use among correctional officers. Psychological harassment was not found to be an intermediate factor.

[Chronic psychotropic drugs use in the Canadian labor force: what are the contributions of occupation and work organization conditions?]

BACKGROUND

This study aims to better understand the contributions of occupation and work organization conditions to the development of chronic psychotropic drugs use among workers in Canada.

METHODS

The study is based on a secondary analysis of the longitudinal data of the National Population Health Survey (NPHS) of Statistics Canada which includes five cycles from 1994-1995 to 2002-2003. A panel of 6585 people from 15 to 55 years old and employed at cycle 1 and nested in 1413 neighbourhoods was selected. Multilevel models of regression were estimated on three levels: repeated measures (level 1=24,785 observations) were nested in the individuals (level 2=6585 individuals) and the individuals nested in the local communities (level 3=1413 neighborhoods).

RESULTS

The prevalence of multiple episodes (two episodes and more between cycle 1 and cycle 5) of psychotropic drugs use was 6.7% (95%CI=6.0-7.4%). Only occupation and the number of working hours showed a significant contribution. Family and individual variables like marital status and personality traits (locus of control and sense of coherence) had a significant contribution, in addition to time, gender, age, physical health, number of cigarettes and stressful childhood events.

CONCLUSION

Work contributes weakly to the risk of chronic psychotropic drugs use, whereas individual characteristics make a much more important contribution to the phenomenon.

Overstretched and Unreciprocated Commitment: Reviewing Research on the Occupational Health and Safety Effects of Downsizing and Job Insecurity

Over the past two decades, a leading business practice has been often-repeated rounds of downsizing and restructuring (also referred to as reorganization, re-engineering, and a host of other euphemistic terms) by large private and public sector employers. Frequently associated with other practices such as outsourcing, privatization, and the increased use of temporary workers, downsizing/restructuring has increased the level of job insecurity among workers as well as leading to changes in work processes (including work intensification and multi-tasking) and management behavior. How has downsizing/restructuring and increased job insecurity affected the occupational health, safety, and well-being of workers, and what measures have employers, unions, and governments taken to address any adverse effects? The authors reviewed international studies of the occupational health and safety (OHS) effects of downsizing/restructuring and increased job insecurity undertaken over the past 20 years. After imposing quality filters, they obtained 86 studies. Analysis revealed that 73 (85%) of the studies found poorer OHS outcomes (using a range of measures). Studies were examined to see whether they provided clues as to the reasons for negative outcomes.

Benzodiazepine use among employees of a private company

This study aimed to identify variables associated to the consumption of benzodiazepine among workers of a private company in the VIII Region, Chile. This is a cross-sectional and correlative study. Study population: 40 employees of a private company. The instruments included a questionnaire on socio-demographic variables and a benzodiazepine questionnaire. There was no record of benzodiazepine consumption at the moment of the study. Twenty percent (20%) of the interviewees had already used benzodiazepine in the past, whereas, half of them (10%) in the last year. The bivariate analysis of the last year consumption of benzodiazepine with work hours variables showed no significant relation (p=0.073). No association was found between benzodiazepine consumption and socio-demographic variables among the study participants.

Interventions in relation to occupational burnout: the population-based health 2000 study

OBJECTIVE

To study participation in occupational and individual-focused interventions in relation to burnout.

METHODS

We used data from a questionnaire, structured interview, national register of psychopharmacological prescriptions, and the Composite International Diagnostic Interview in a nationally representative Finnish sample of 3276 employees (30 to 64 years).

RESULTS

When compared with employees free of burnout, the odds ratio of severe burnout for participation in occupational interventions was 0.41 (95% confidence interval [CI] = 0.26 to 0.65) and in individual-focused interventions 5.36 (95% CI = 3.14 to 9.17). Antidepressant prescriptions were 2.53 (95% CI = 1.04 to 6.15) times more common among those with severe burnout than among those without burnout after adjustment for depressive and anxiety disorders.

CONCLUSIONS

Employees with burnout were less often targets of occupational interventions but participated more in individual-focused interventions when compared with other employees. The use of antidepressants among employees with severe burnout was not fully explained by coexisting depressive or anxiety disorders.