Reported incidence and precipitating factors of work-related stress and mental ill-health in the United Kingdom (1996–2001)

The relationship between organisational stressors and mental wellbeing within police officers: a systematic review

BACKGROUND

Occupational stressors in police work increase the risk for officer mental health morbidities. Officers' poor mental wellbeing is harmful to the individual, can affect professionalism, organisational effectiveness, and public safety. While the impact of operational stressors on officers' mental wellbeing is well documented, no review has systematically investigated organisational stressor impacts. This study aimed to conduct a systematic review to assess the relationship between organisational stressors and police officer mental wellbeing.

METHODS

Systematic review conducted following PRISMA and Cochrane Collaboration guidelines. Literature search was undertaken from 1990 to May 2017 on four databases (EBSCOHOST Medline/SocINDEX/PsycINFO/OVID Embase) and grey literature. Included articles were critically appraised and assessed for risk of bias. Narrative and evidence syntheses were performed by specific mental health outcomes.

RESULTS

In total, 3571 results were returned, and 15 studies met the inclusion criteria. All included studies were published in English between 1995 and 2016, had cross-sectional study designs, spanned across four continents and covered 15,150 officers. Strong evidence of significant associations was identified for organisational stressors and the outcomes of: occupational stress, psychiatric symptoms/psychological distress, emotional exhaustion and personal accomplishment. The organisational stressors most often demonstrating consistently significant associations with mental health outcomes included lack of support, demand, job pressure, administrative/organisational pressure and long working-hours.

CONCLUSIONS

This review is the first to systematically examine organisational stressors and mental health in police officers. Organisational stressors that can be targeted by interventions and policy changes to secure officer wellbeing, a healthy work environment, and benefits to the organisation and the public are identified.

Trends in work-related mental disorders by sector in France

Background

Notifications of work-related mental disorders (WRMDs) are increasing while little data are available on trends by industrial sector.

Aims

To assess WRMD notifications and trends from 2001 to 2011 by industrial sector using data collected by the French National Network for Occupational Disease Vigilance and Prevention (RNV3P) network.

Methods

We calculated standardized notification ratios (SNRs) per sector. To analyse trends over time, we used odds ratios, analysed by logistic regression, including time as a discrete variable or as a continuous variable.

Results

We found higher than expected WRMD notifications in manufacturing; paper and book (SNR = 2.16; 95% CI [1.88-2.48]), chemical and pharmaceutical (SNR = 1.79; 95% CI [1.58-2.03]), textile and clothing (SNR = 1.27; 95% CI [1.04-1.54]). In the trade sectors, retail (SNR = 1.60; 95% CI [1.52-1.68]), motor vehicle and cycle trade and repair (SNR = 1.19; 95% CI [1.05-1.34]). In the services sector personal (SNR = 2.09; 95% CI [1.83-2.38]), information technology (SNR = 1.54; 95% CI [1.36-1.74]), financial and insurance (SNR = 1.42; 95% CI [1.31-1.53]), post and telecommunication (SNR = 1.44; 95% CI [1.30-1.60]), human health and social work (SNR = 1.29; 95% CI [1.24-1.34]). We found an increase in notifications in agriculture, post-telecommunication services and the human health/social work sectors and a decrease in chemical/pharmaceutical, metal, and paper and book manufacturing sectors (P < 0.05).

Conclusions

These results reveal trends in notifications for WRMDs by industrial sector. This highlights the importance of monitoring trends in WRMDs in specific worker subsets, using specialized networks such as the RNV3P.

Incidence of ill-health related job loss and related social and occupational factors. The "unfit for the job" study: a one-year follow-up study of 51,132 workers

Objective

The analysis of ill-health related job loss may be a relevant indicator for the prioritization of actions in the workplace or in the field of public health, as well as a target for health promotion. The aim of this study was to analyze the medical causes, the incidence, and the characteristics of employees medically unfit to do their job.

Methods

This one-year prospective study included all workers followed by occupational physicians in an occupational health service in the south of France. The incidence of unfitness for work have been grouped according to the main medical causes and analyzed. We performed a multivariate analysis in order to adjust the observed risk of job loss based on the age groups, sex, occupation and the activity sectors.

Results

A total of 17 occupational physicians followed up 51,132 workers. The all-cause incidence of being unfit to return to one’s job was 7.8‰ (n = 398). The two main causes of being unfit for one’s job were musculoskeletal disorders (47.2%, n = 188) and mental ill-health (38.4%, n = 153). Being over 50 years old (Odds ratio (OR) 2.63, confidence interval 95% CI [2.13–3.25]) and being a woman (OR 1.52, 95% CI [1.21–1.91]) were associated with the all-cause unfitness, independent of occupation and activity sector.

Conclusions

Identification of occupational and demographic determinants independently associated with ill-health related job loss may provide significant and cost-effective arguments for health promotion and job loss prevention.

Ill Health-Related Job Loss: A One-Year Follow-Up of 54,026 Employees

INTRODUCTION

The diagnoses of workers being unfit to work may be a relevant health indicator. Therefore, the aim of this study was to analyze the one-year incidence of an unfit to work diagnosis.

METHOD

This one-year prospective study included all workers undergoing annual work medical examination from occupational health services in Troyes, France.

RESULTS

Twenty-one occupational physicians followed 54,026 employees. The all-cause incidence of being unfit to return to work was 0.772%. The two main causes of being unfit to work were musculoskeletal disorders (61%) and psychopathologies (24%). The relative risk (RR) of being unfit to work, independent of the cause, was higher when employees were aged over 50 years (RR = 2.51), and female (RR = 1.51).

CONCLUSIONS

Prospective results from occupational physicians' medical records may provide significant and cost-effective directions to prioritize actions and target health promotion in the workplace.

Prevalence rates for depression by industry: a claims database analysis

PURPOSE

To estimate and interpret differences in depression prevalence rates among industries, using a large, group medical claims database.

METHODS

Depression cases were identified by ICD-9 diagnosis code in a population of 214,413 individuals employed during 2002-2005 by employers based in western Pennsylvania. Data were provided by Highmark, Inc. (Pittsburgh and Camp Hill, PA). Rates were adjusted for age, gender, and employee share of health care costs. National industry measures of psychological distress, work stress, and physical activity at work were also compiled from other data sources.

RESULTS

Rates for clinical depression in 55 industries ranged from 6.9 to 16.2 %, (population rate = 10.45 %). Industries with the highest rates tended to be those which, on the national level, require frequent or difficult interactions with the public or clients, and have high levels of stress and low levels of physical activity.

CONCLUSIONS

Additional research is needed to help identify industries with relatively high rates of depression in other regions and on the national level, and to determine whether these differences are due in part to specific work stress exposures and physical inactivity at work.

CLINICAL SIGNIFICANCE

Claims database analyses may provide a cost-effective way to identify priorities for depression treatment and prevention in the workplace.

Association of work-related stress with mental health problems in a special police force unit

OBJECTIVES

Law and order enforcement tasks may expose special force police officers to significant psychosocial risk factors. The aim of this work is to investigate the relationship between job stress and the presence of mental health symptoms while controlling sociodemographical, occupational and personality variables in special force police officers.

METHOD

At different time points, 292 of 294 members of the 'VI Reparto Mobile', a special police force engaged exclusively in the enforcement of law and order, responded to our invitation to complete questionnaires for the assessment of personality traits, work-related stress (using the Demand-Control-Support (DCS) and the Effort-Reward-Imbalance (ERI) models) and mental health problems such as depression, anxiety and burnout.

RESULTS

Regression analyses showed that lower levels of support and reward and higher levels of effort and overcommitment were associated with higher levels of mental health symptoms. Psychological screening revealed 21 (7.3%) likely cases of mild depression (Beck Depression Inventory, BDI≥10). Officers who had experienced a discrepancy between work effort and rewards showed a marked increase in the risk of depression (OR 7.89, 95% CI 2.32 to 26.82) when compared with their counterparts who did not perceive themselves to be in a condition of distress.

CONCLUSIONS

The findings of this study suggest that work-related stress may play a role in the development of mental health problems in police officers. The prevalence of mental health symptoms in the cohort investigated here was low, but not negligible in the case of depression. Since special forces police officers have to perform sensitive tasks for which a healthy psychological functioning is needed, the results of this study suggest that steps should be taken to prevent distress and improve the mental well-being of these workers.

Occupations, work characteristics and common mental disorder

BACKGROUND

The present study aimed to assess the prevalence of common mental disorders (CMDs) by occupation in a representative sample of the English adult population. Another aim was to examine whether the increased risk of CMD in some occupations could be explained by adverse work characteristics. Method We derived a sample of 3425 working-age respondents from the Adult Psychiatric Morbidity Survey 2007. Occupations were classified by Standard Occupational Classification group, and CMD measured by the Revised Clinical Interview Schedule. Job characteristics were measured by questionnaire, and tested as explanatory factors in associations of occupation and CMD.

RESULTS

After adjusting for age, gender, housing tenure and marital status, caring personal service occupations had the greatest risk of CMD compared with all occupations (odds ratio 1.73, 95% confidence interval 1.16-2.58). The prevalence of adverse psychosocial work characteristics did not follow the pattern of CMD by occupation. Work characteristics did not explain the increased risk of CMDs associated with working in personal service occupations. Contrary to our hypotheses, adding work characteristics individually to the association of occupation and CMD tended to increase rather than decrease the odds for CMD.

CONCLUSIONS

As has been found by others, psychosocial work characteristics were associated with CMD. However, we found that in our English national dataset they could not explain the high rates of CMD in particular occupations. We suggest that selection into occupations may partly explain high CMD rates in certain occupations. Also, we did not measure emotional demands, and these may be important mediators of the relationship between occupation type and CMDs.

The contribution of work and non-work factors to the onset of psychological distress: an eight-year prospective study of a representative sample of employees in Canada

OBJECTIVES

This study examined how occupation and work organization conditions contributed, over 8 yr, to the onset of psychological distress after adjusting for non-work and individual characteristics.

METHODS

The data came from the five cycles (Cycle 1=1994-1995, Cycle 5=2002-2003) of Statistics Canada's National Population Health Survey. A sample of 5,270 workers nested in 1,122 neighborhoods and aged 15 to 55 yr with no psychological distress at baseline was analyzed with discrete time survival multilevel regression models.

RESULTS

The onset of psychological distress decreased over time. Occupation was not significant, whereas social support at work decreased the risk. Substantial effects for non-work and individual factors were found, including neighborhood, social support outside the workplace, demographics, physical health, personality traits, and life habits.

CONCLUSIONS

This study found that work characteristics made a limited contribution to the onset of psychological distress, but social support in the workplace clearly proved to be an important protective factor. Enterprises must pay special attention to how colleagues and supervisors act to help workers complete tasks.

Mental health issues in Chinese offshore oil workers

BACKGROUND

Offshore oil platform work is regarded as a stressful occupation, and occupational stress has been shown to be an important risk factor for mental illness. Little, however, is known about the main and interactive effects of occupational stress and coping styles on the mental health of Chinese offshore oil platform workers.

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.

Depressive symptoms in Chinese factory workers in Nagasaki, Japan

The number of foreign workers in Japan, especially temporary workers, has been increasing recently. However, little is known about the mental health status of the foreign workers working temporarily in Japan. We examined the depressive symptoms in 81 Chinese factory workers and attempted to identify the determining factors. The subjects were requested to complete individual questionnaires on sociodemographic variables (sex, age group, and residence period in Japan), working condition variables (number of working days per week and working hours per day), health administration variables (health checkups and health education), a social support variable (interpreters at workplace), and health behavior variables (alcohol consumption, current smoking, and regular exercise). The 20-item Center for Epidemiologic Studies Depression scale (CES-D) was used to measure the depressive symptoms. Of all the subjects, 95% and 84% received health checkups and health education, respectively, at their workplaces. The results of multiple linear regression analysis showed that long working hours per day were significantly associated with high CES-D score. Further, we found that older age (30-49 yr) was marginally associated with high CES-D score. Health administration considering working time and age would be important for decreasing depressive symptoms among foreign workers.

Cost, effectiveness, and cost-effectiveness of a collaborative mental health care program for people receiving short-term disability benefits for psychiatric disorders

OBJECTIVE

To examine the cost, effectiveness, and cost-effectiveness of a collaborative mental health care (CMHC) pilot program for people on short-term disability leave for psychiatric disorders.

METHOD

Using a quasi-experimental design, the analyses were conducted using 2 groups of subjects who received short-term disability benefits for psychiatric disorders. One group (n = 75) was treated in a CMHC program during their disability episode. The comparison group (n = 51) received short-term disability benefits related to psychiatric disorders in the prior year but did not receive CMHC during their disability episode. People in both groups met screening criteria for the CMHC program. Differences in cost and days absent from work were tested using Student t tests and confirmed using nonparametric Wilcoxon rank sum tests. Differences in return to work and transition to long-term disability leave were tested using chi-square tests. The cost-effectiveness analysis used the net benefit regression framework.

RESULTS

The results suggest that with CMHC, for every 100 people on short-term disability leave for psychiatric disorders, there could be $50 000 in savings related to disability benefits along with more people returning to work (n = 23), less people transitioning to long-term disability leave (n = 24), and 1600 more workdays.

CONCLUSIONS

CMHC models of disability management based on our Canadian data may be a worthwhile investment in helping people who are receiving short-term disability benefits for psychiatric disorders to receive adequate treatment.

Incidence and suspected cause of work-related musculoskeletal disorders, United Kingdom, 1996–2001

BACKGROUND

Musculoskeletal conditions are the most common self-reported work-related disease, with high costs incurred from long-term disability. In the United Kingdom, occupational physicians and rheumatologists have been reporting new cases of work-related musculoskeletal disorders to voluntary surveillance schemes since 1996.

AIMS

To estimate population incidence rates for work-related musculoskeletal disorders reported by rheumatologists and occupational physicians by occupation and industry, in relation to tasks and movements suspected as causal.

METHODS

Estimated average annual incidence rates were calculated for nine main job categories and eight industrial groups; Labour Force Survey figures were used as the denominator for rheumatologists, and a special survey for the occupational physicians. These were then related to tasks and movements reported as causal.

RESULTS

Between October 1997 and the end of 2001, an estimated 2,599 new cases/year were reported by rheumatologists, and from January 1996, 5,278 cases/year by occupational physicians. Average annual rates overall were 94 per million for rheumatologists and 1,643 per million for occupational physicians (a 17-fold difference). Jobs at highest risk for the upper limb were primarily clerical, craft-related and machine work. Tasks associated with upper limb disorders and with neck and back problems were predominantly keyboard work and heavy lifting, and in craft-related occupations with gripping or holding tools.

CONCLUSIONS

Jobs at risk and the associate tasks were identified which should assist prevention, but the extent to which these factors were causal or aggravating previous injury requires further study. The much higher rates reported by occupational physicians reflect, in part, the type of industries they served.