Are Workplace Psychosocial Factors Associated With Work-Related Injury in the US Workforce?

A method to assess bullying and harassment as an upstream determinant of construction worker mental health

BACKGROUND

Bullying and harassment in the workplace are increasingly recognized as hazardous exposures associated with poor mental health and suicidality. The construction sector has one of the highest rates of suicide among all occupations and is actively engaged in efforts to destigmatize mental health support. However, there has been less focus on reducing factors that may be contributing to poor well-being among construction workers.

METHODS

As a step toward addressing work-related determinants of mental health in construction, we collaborated with a large construction union to survey members about their experiences of abusive conduct. We adapted standardized questionnaires to better suit the sector, such as by assessing "hazing that went too far" and apprenticeship status. Additionally, we included questions on reporting of abuse, concern about the impacts of abuse, and an open-response to allow participants to share their perspectives.

RESULTS

We developed and tested a carefully-tailored survey of abusive conduct. The responses to the survey (over 3300, including 500 narrative responses) will facilitate data-driven interventions with the potential to prevent and address abuse. This paper describes the survey development process in collaboration with the union, domains of abuse that are relevant to the construction context, and the survey protocol.

CONCLUSION

Through a collaborative effort, we developed an instrument to understand abusive conduct in construction and benchmark success in reducing adverse experiences of bullying and harassment. We recommend its use throughout the sector to reduce exposure to this well-being hazard.

Health Management: Evaluating the Relationship between Organizational Factors, Psychosocial Risks at Work, Performance Management, and Hospital Outcomes

Introduction-Health system (HS) health organizations are complex and are in constant dynamic interaction with multiple elements, including political, environmental, societal, legal, and organizational factors, along with human components, such as human resources, patients, and other stakeholders. Objective-This research aimed to study three HS organizations, identifying and characterizing the elements of health organizations and the factors related to professionals, determining their influence on economic and financial performance results, as well as results related to the professionals and to the patients comprising the institutions. Method-A quantitative study was conducted in which data were collected through questionnaires from various sources to better understand and characterize the factors related to organizations, professionals, and patients (470 health professionals and 768 patients). To test the integrated evaluation model for health organizations, path analysis was used. Results-The results reveal that the organizational culture (OC) presents a positive relationship between the professional's quality of life (QL) and the performance management (PM) of the professionals, along with a negative relationship with the psychosocial work risks (PWR). There is also a relationship between the OC and patient satisfaction (PS), professional job satisfaction (PJS), and economic and financial results (EFR). In the relationship between the processes and the results, there are significant relationships between PM and PJS and PWR and PJS. In terms of the results, there is a significant relationship between the EFR and the PS. Conclusions-This study contributes to a deeper knowledge of the factors that influence the quality of health organizations and their results and produces recommendations for health organizations to address the current challenges.

Noise exposure and mental workload: Evaluating the role of multiple noise exposure metrics among surface miners in the US Midwest

This study examined associations between metrics of noise exposure and mental workload. In this cross-sectional study, five occupational noise metrics computed from full-shift dosimetry were evaluated among surface mine workers in the US Midwest. Mental workload was evaluated using a modified, raw NASA-TLX and clustered with a k-means clustering algorithm. Mixed effects logistic regression and Bayesian Kernel Machine Regression (BKMR) was utilized for analysis. Average noise exposure, the difference between peak and mean noise exposure, and the number of peaks >135 dB were each strongly associated with mental workload, while the kurtosis and standard deviation of noise throughout a shift were not. An exposure-response relationship between average noise exposure and mental workload may exist, with elevated risk of high mental workload beginning at 80 dBA. These results suggest that high noise exposure may be an independent risk factor of high mental workload, and impulse events and the difference between the peak and mean noise exposure may have interactive effects with average noise exposure.

Effect of Joint Exposure to Psychosocial and Physical Work Factors on the Incidence of Workplace Injuries: Results From a Longitudinal Survey

OBJECTIVE

To analyze the interaction between physical and psychosocial work factors regarding the workplace injuries incidence among 6900 workers out of a longitudinal survey.

METHODS

Based on responses to questionnaires, we obtained exposure groups respectively for physical factors and for psychosocial factors using hierarchical clustering. We performed multiple Poisson regression model with the workplace injuries incidence during 4 years of follow-up as the outcome and the clusters as the independent variables of interest.

RESULTS

High psychosocial exposure had a deleterious effect on workplace injuries incidence, which was no longer significant when adjusting for physical factors. The difference in model-based workplace injuries rates between high and low psychosocial exposures seemed to increase (non-significantly) with increasing physical exposure.

CONCLUSIONS

The risk of workplace injuries was highest among workers with high physical exposures regardless of the psychosocial exposures.

It Is Time to Implement Primary Prevention in the Workplace to Ameliorate the Ongoing U.S. Opioid Epidemic

The United States' opioid public health crisis continues having disastrous consequences on communities, including workers and employers. From May 2019 to May 2020, the largest number of drug overdose deaths was recorded over a twelve-month period. The "twindemics" of COVID-19 and opioids underscore the urgent need to address workers' physical and mental health. Although much has been written about the negative impacts of the opioid epidemic on the workplace, few initiatives have focused on primary prevention, addressing work-related root causes of opioid use disorders (e.g., injury, stress) that may lead to prescription or illicit opioid use. We suggest primary prevention efforts to address the connection between workplace hazards and opioid misuse, dependence, and addiction such as examining patterns of work injury and stress with records of opioid prescription. Government funding should be expanded to support primary prevention and research efforts to strengthen the evidence-base to support workplace primary prevention endeavors.

Low-grade systemic inflammation and the workplace

BACKGROUND

Psychosocial and physical stressors can elicit the stress response, co-ordinated by interactions between neuroendocrine and inflammatory processes. The central role of the immune system, specifically low-grade systemic inflammation, is sometimes overlooked in work-related stress research.

OBJECTIVE

To review evidence that work-related psychosocial and physical stressors can stimulate a low-grade systemic inflammation which, through interactions with the neurohormonal systems, may impact on the well-being and productivity of workers.

METHODS

Literature searches were performed by databases and by hand. Databases used included Interface - EBSCOhost Research Databases; PsycINFO; Academic Search Complete; Africa-Wide Information; CINAHL; E-Journals; MEDLINE and PsycARTICLES.

RESULTS

Psychosocial stressors, infections, poor indoor air quality, musculoskeletal injuries and chemicals can stimulate a low-grade systemic inflammation that may adversely affect workers' mental and physical health, as well as productivity. The psychological and physical effects caused by infection-induced inflammation are generally referred to as sickness behaviour and those caused by poor indoor air quality as sick building syndrome.

CONCLUSIONS

Stressor-induced low-grade systemic inflammation can be a causal factor in the physical and behavioural symptoms of work-related stress. It is therefore important that those involved with the health of workers be cognisant of inappropriate or chronic low-grade inflammation as a potential health hazard.

A Public Health Approach to Protecting Workers from Opioid Use Disorder and Overdose Related to Occupational Exposure, Injury, and Stress : APHA Policy Statement Number 202012, Issued October 24, 2020

Opioid overdose mortality, in combination with increased deaths from alcohol and suicide, is having a profound impact on American workplaces, compromising occupational health and safety and increasing workers' compensation and health insurance costs, absenteeism, and lost productivity. The President's Council of Economic Advisers estimates that more than 1 million workers are out of the workforce due to the opioid crisis. The impact on workers is equally profound, including job loss, divorce and family disruption, and potentially imprisonment, injury, illness, and death. Pain from occupational injuries and illnesses and stress are important pathways to opioid use disorder. Effective workplace programs that incorporate the public health approach to prevention offer a significant opportunity to prevent and respond to the opioid crisis. To date, the nation's efforts at combating the crisis have not included the necessary policy reforms to transform the workplace from a pathway to opioid misuse to a pathway to prevention, including education of workers, unions, employers, and health care providers and treatment and recovery of affected workers. Several key policy interventions are recommended to address this disconnect, including prevention of workplace injury, illness, and emotional distress; worker education and training; and replacement of stigmatizing, punitive workplace substance use programs with supportive programs. Increasing access to alternative pain treatment and preventing opioid misuse in workers' compensation systems are other key policy recommendations.

Approach for Assessing the Prevalence of Psychosocial Risks of Workers in the Greenhouse Construction Industry in South-Eastern Spain

This paper shows the prevalence of psychosocial risks for workers in the greenhouse construction industry in south-eastern Spain. Method: The assessment of the workers' psychosocial risks was carried out through simple random sampling, which uses a questionnaire containing 13 variables characterizing the companies, 14 variables characterizing the workers, and 15 questions proposed by the Mini Psychosocial Factors (MPFs) risk assessment method. A descriptive analysis and multiple correspondence analysis were performed on the sample data. Results: Greenhouse construction businesses in south-eastern Spain can generally be classified as small companies with an average annual turnover below EUR 2.0 million (69.3%), an average of 22.8 workers with an average age of 39.84 years old, most of whom are married, with an average of 1.76 children. The prevalence of workers at high risk was 2.9%, while 45.1% were at medium-high risk. Of the 12 psychosocial factors assessed using the MPF method, 7 of them presented a high level of worker risk: Mobbing (3.2%), Relationships (1.6%), Recognition (1.6%), Autonomy (12.9%), Emotional (8.0%), Control (4.8%), and Demands (3.2%). Lastly, the variables were grouped into four clusters, showing that larger companies are correlated with a medium (workers over 40 years of age or less than 25 years of age) to high (workers under 25 years of age) risk level in several of the psychosocial factors assessed for workers who are Spanish nationals, while in smaller companies, the workers are usually middle aged (between 25 and 40 years old) and from Eastern Europe or Africa, presenting either a low or high level of risk depending on the psychosocial factors and tasks performed. Impact of the results: The study reveals a lack of prevention management regarding psychosocial risks. Therefore, it is necessary to carry out new prevention programmes that optimise the psychosocial conditions of the workers, involving the workers, employers, and other social agents.

Opioids and the Workplace Prevention and Response Awareness Training: Mixed Methods Follow-Up Evaluation

The National Institute of Environmental Health Sciences Worker Training Program piloted an Opioids and the Workplace: Prevention and Response training tool and program in 2019. The pilot trainees (N = 97) were surveyed (n = 27) and interviewed (n = 6) six months posttraining, and those who downloaded the training tool from the Worker Training Program website (n = 87) were surveyed (n = 19) and interviewed (n = 1) two to six months postdownload, to evaluate the impact of the training program. Workplace policy and program-level actions were reported less frequently than individual-level actions by trainees, except for planning and conducting training and education. Barriers to taking actions included not being able to make changes on their own without supervisor support and lack of upper management support and approval. We found some evidence that the Opioids in the Workplace training program and materials contributed to helping workers introduce policies and programs related to opioids within their workplace or union.

Work Schedule Irregularity and the Risk of Work-Related Injury among Korean Manual Workers

Work schedules comprise various variables and generate health and safety outcomes, including work-related injury, which causes socioeconomic problems, such as productivity loss and damage to worker health. We investigated the association between work schedule irregularity and the incidence of work-related injury among South Korean manual workers using data from the 5th Korean Working Conditions Survey. In total, 18,330 manual workers were included. A multivariate logistic regression analysis was performed to understand the association between work schedule and work-related injury and the influence of sufficient safety information and work schedule on work-related injury. We calculated the influence of an irregular work schedule on occupational injury after controlling for personal and work environment-related factors. The adjusted odds ratio (OR) for work-related injury was 1.66 (95% confidence interval (CI) 1.32–2.09) for an irregular work schedule. The interaction had an additive effect when the work schedule was irregular, even when sufficient safety information was provided. Manual workers had a higher incidence of injury (2.1%). Even in adjusted analyses, work schedule irregularity conferred greater risks of work injury, particularly when not working the same number of days weekly (OR 1.52, 95% CI 1.21–1.90). Policymakers and health professionals need to consider the impact of work schedule irregularity on worker safety and health.