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Brønholt RLL, Hansen MB, Islamoska S, Christensen U, Grynderup MB, Nabe-Nielsen K. Physical and psychosocial work factors as explanations for social inequalities in self-rated health. Int Arch Occup Environ Health 2020; 94:335-346. [PMID: 32975659 DOI: 10.1007/s00420-020-01582-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 09/09/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVE We investigated the contribution of physical and psychosocial work factors to social inequalities in self-rated health (SRH) in a sample of Danish 40 and 50 years old occupationally active women and men. METHODS In this longitudinal study, the study population consisted of 3338 Danish women and men. Data were collected by postal questionnaires in 2000 (baseline) and 2006 (follow-up). The independent variable, socioeconomic position (SEP), was assessed by the highest achieved educational level at baseline. We conducted gender-stratified parallel multiple mediation analyses. In the mediation analyses, SEP was categorised as SEP I, II, III, VI and V among men. Among women, SEP was dichotomised into SEP I-IV and V. The outcome, SRH, was assessed at baseline and follow-up. A wide range of physical and psychosocial work factors were included as potential mediators. RESULTS We found a social gradient in SRH across all levels of SEP among men. Among women, we only found a poorer SRH among those with the lowest SEP. Mediation analyses showed that work factors together accounted for 56% of the social inequalities in SRH among men and 44% among women. In both genders, ergonomic exposures and job insecurity seemed to play the major role for social inequalities in SRH. For women only, we also found noise to contribute to the social inequalities in SRH. CONCLUSION Physical and psychosocial work factors partially explained social inequalities in SRH among both genders. Improvement of the working environment can potentially contribute to the reduction of social inequalities in health.
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Affiliation(s)
| | - Matilde Bøgelund Hansen
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen K, Denmark
| | - Sabrina Islamoska
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen K, Denmark
| | - Ulla Christensen
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen K, Denmark
| | | | - Kirsten Nabe-Nielsen
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen K, Denmark.
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Nordentoft M, Rod NH, Bonde JP, Bjorner JB, Cleal B, Larsen AD, Madsen IE, Magnusson Hanson LL, Nexo MA, Pedersen LRM, Sterud T, Xu T, Rugulies R. Effort-reward imbalance at work and weight changes in a nationwide cohort of workers in Denmark. Am J Ind Med 2020; 63:634-643. [PMID: 32285977 PMCID: PMC7317465 DOI: 10.1002/ajim.23110] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 03/23/2020] [Accepted: 03/27/2020] [Indexed: 12/14/2022]
Abstract
Objective To investigate the relation between effort‐reward imbalance (ERI) at work and subsequent weight changes. Methods We included participants from a population‐based cohort of workers in Denmark (mean age = 47 years, 54% women) with two (n = 9005) or three repeated measurements (n = 5710). We investigated the association between (a) ERI (ie, the mismatch between high efforts spent and low rewards received at work) at baseline and weight changes after a 2‐year follow‐up (defined as ≥5% increase or decrease in body mass index (BMI) vs stable), and (b) onset and remission of ERI and subsequent changes in BMI. Using multinomial logistic regression we calculated risk ratios (RR) and 95% confidence intervals (CI), adjusted for sex, age, education, cohabitation, migration background, and follow‐up time. Results After 2 years, 15% had an increase and 13% a decrease in BMI. Exposure to ERI at baseline yielded RRs of 1.09 (95% CI: 0.95‐1.25) and 1.04 (95% CI: 0.90‐1.20) for the increase and decrease in BMI, respectively. There were no differences between sex and baseline BMI in stratified analyses. The onset of ERI yielded RRs of 1.04 (95% CI: 0.82‐1.31) and 1.15 (95% CI: 0.84‐1.57) for subsequent increase and decrease in BMI. The RRs for the remission of ERI and subsequent increase and decrease in BMI were 0.92 (95% CI: 0.71‐1.20) and 0.78 (95% CI: 0.53‐1.13), respectively. Of the ERI components, high rewards were associated with a lower risk of BMI increase. Conclusion ERI was not a risk factor for weight changes. Future studies may investigate whether this result is generalizable to other occupational cohorts and settings.
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Affiliation(s)
- Mads Nordentoft
- National Research Centre for the Working Environment Copenhagen Denmark
| | - Naja Hulvej Rod
- Section of Epidemiology, Department of Public Health University of Copenhagen Copenhagen Denmark
| | - Jens Peter Bonde
- Department of Occupational and Environmental Medicine Bispebjerg‐Frederiksberg Hospital Copenhagen Denmark
| | - Jakob Bue Bjorner
- National Research Centre for the Working Environment Copenhagen Denmark
- Optum Patient Insights Lincoln Rhode Island
- Section of Social Medicine, Department of Public Health University of Copenhagen Copenhagen Denmark
| | - Bryan Cleal
- Steno Diabetes Center Copenhagen Gentofte Denmark
| | | | - Ida E.H. Madsen
- National Research Centre for the Working Environment Copenhagen Denmark
| | | | | | | | - Tom Sterud
- The National Institute of Occupational Health Oslo Norway
| | - Tianwei Xu
- National Research Centre for the Working Environment Copenhagen Denmark
- Section of Epidemiology, Department of Public Health University of Copenhagen Copenhagen Denmark
- Stress Research Institute Stockholm University Stockholm Sweden
| | - Reiner Rugulies
- National Research Centre for the Working Environment Copenhagen Denmark
- Section of Epidemiology, Department of Public Health University of Copenhagen Copenhagen Denmark
- Department of Psychology University of Copenhagen Copenhagen Denmark
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Burr H, Berthelsen H, Moncada S, Nübling M, Dupret E, Demiral Y, Oudyk J, Kristensen TS, Llorens C, Navarro A, Lincke HJ, Bocéréan C, Sahan C, Smith P, Pohrt A. The Third Version of the Copenhagen Psychosocial Questionnaire. Saf Health Work 2019; 10:482-503. [PMID: 31890332 PMCID: PMC6933167 DOI: 10.1016/j.shaw.2019.10.002] [Citation(s) in RCA: 149] [Impact Index Per Article: 29.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 09/20/2019] [Accepted: 10/23/2019] [Indexed: 10/25/2022] Open
Abstract
INTRODUCTION A new third version of the Copenhagen Psychosocial Questionnaire (COPSOQ III) has been developed in response to trends in working life, theoretical concepts, and international experience. A key component of the COPSOQ III is a defined set of mandatory core items to be included in national short, middle, and long versions of the questionnaire. The aim of the present article is to present and test the reliability of the new international middle version of the COPSOQ III. METHODS The questionnaire was tested among 23,361 employees during 2016-2017 in Canada, Spain, France, Germany, Sweden, and Turkey. A total of 26 dimensions (measured through scales or single items) of the middle version and two from the long version were tested. Psychometric properties of the dimensions were assessed regarding reliability (Cronbach α), ceiling and floor effects (fractions with extreme answers), and distinctiveness (correlations with other dimensions). RESULTS Most international middle dimensions had satisfactory reliability in most countries, though some ceiling and floor effects were present. Dimensions with missing values were rare. Most dimensions had low to medium intercorrelations. CONCLUSIONS The COPSOQ III offers reliable and distinct measures of a wide range of psychosocial dimensions of modern working life in different countries; although a few measures could be improved. Future testing should focus on validation of the COPSOQ items and dimensions using both qualitative and quantitative approaches. Such investigations would enhance the basis for recommendations using the COPSOQ III.
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Affiliation(s)
- Hermann Burr
- Division 3 Work and Health, Federal Institute of Occupational Safety and Health (BAuA), Berlin, Germany
| | - Hanne Berthelsen
- Center for Work Life and Evaluation Studies (CTA) and the Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Salvador Moncada
- Union Institute of Work, Environment and Health (ISTAS), Barcelona, Spain
| | - Matthias Nübling
- Freiburg Research Centre for Occupational Sciences (FFAW), Freiburg, Germany
| | | | - Yucel Demiral
- Department of Public Health, Dokuz Eylul University, Izmir, Turkey
| | - John Oudyk
- Occupational Health Clinics for Ontario Workers (OHCOW), Hamilton, Canada
| | | | - Clara Llorens
- Union Institute of Work, Environment and Health (ISTAS), Barcelona, Spain
- Research Group on Psychosocial Risks, Organization of Work and Health (POWAH), Autonomous University of Barcelona, Barcelona, Spain
| | - Albert Navarro
- Research Group on Psychosocial Risks, Organization of Work and Health (POWAH), Autonomous University of Barcelona, Barcelona, Spain
- Biostatistics Unit, Faculty of Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Hans-Joachim Lincke
- Freiburg Research Centre for Occupational Sciences (FFAW), Freiburg, Germany
| | | | - Ceyda Sahan
- Department of Public Health, Dokuz Eylul University, Izmir, Turkey
| | - Peter Smith
- Institute for Work and Health (IWH), Toronto, ON, Canada
- Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Anne Pohrt
- Institut für Medizinische Psychologie, Charité-Universitätsmedizin Berlin, Berlin, Germany
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Leineweber C, Eib C, Bernhard-Oettel C, Nyberg A. Trajectories of effort-reward imbalance in Swedish workers: Differences in demographic and work-related factors and associations with health. WORK AND STRESS 2019. [DOI: 10.1080/02678373.2019.1666434] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
| | - Constanze Eib
- Stress Research Institute, Stockholm University, Stockholm, Sweden
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | | | - Anna Nyberg
- Stress Research Institute, Stockholm University, Stockholm, Sweden
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Rantonen O, Alexanderson K, Clark AJ, Aalto V, Sónden A, Brønnum-Hansen H, Hougaard CØ, Rod NH, Mittendorfer-Rutz E, Kivimäki M, Oksanen T, Salo P. Antidepressant treatment among social workers, human service professionals, and non-human service professionals: A multi-cohort study in Finland, Sweden and Denmark. J Affect Disord 2019; 250:153-162. [PMID: 30856492 DOI: 10.1016/j.jad.2019.03.037] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 03/01/2019] [Accepted: 03/04/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND Social workers have an elevated risk for mental disorders, but little is known about their antidepressant treatment. AIMS To examine any and long-term antidepressant treatment among social workers in Finland, Sweden and Denmark. METHODS We linked records from drug prescription registers to three prospective cohorts: the Finnish Public Sector study, years 2006-2011, and nation-wide cohorts in Sweden and Denmark, years 2006-2014, including a total of 1.5 million employees in (1) social work, (2) other social and health care professions, (3) education and (4) office work. We used Cox proportional hazards models to estimate hazard ratios for any and long-term (>6 months) antidepressant treatment among social workers compared to the three reference occupational groups and carried out meta-analyses. RESULTS During follow-up, 25% of social workers had any prescriptions for antidepressants (19-24% reference occupations) and 20% for long-term treatment (14-19% reference occupations). The pooled effects for any and long-term treatment showed that probabilities were 10% higher in social workers compared to other health and social care professionals and 30% higher compared to education and non-human service professionals. Probabilities for any treatment in the three countries were relatively similar, but for long-term treatment social workers in Finland had a greater risk compared with other human service professions. LIMITATIONS There were differences between the cohorts in the availability of data. Specific diagnoses for the antidepressant treatment were not known neither adherence to treatment. CONCLUSION Social workers have a higher risk for any and long-term antidepressant treatment than other human and non-human service professionals.
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Affiliation(s)
- O Rantonen
- Finnish Institute of Occupational Health, Helsinki, Finland; Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Psychology, University of Turku, Turku, Finland.
| | - K Alexanderson
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
| | - A J Clark
- Department of Public Health, Section of Epidemiology, University of Copenhagen, Copenhagen, Denmark
| | - V Aalto
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - A Sónden
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
| | - H Brønnum-Hansen
- Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen, Denmark
| | - C Ø Hougaard
- Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen, Denmark
| | - N H Rod
- Department of Public Health, Section of Epidemiology, University of Copenhagen, Copenhagen, Denmark
| | - E Mittendorfer-Rutz
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
| | - M Kivimäki
- Finnish Institute of Occupational Health, Helsinki, Finland; Department of Epidemiology and Public Health, University College London, London, United Kingdom; Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - T Oksanen
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - P Salo
- Finnish Institute of Occupational Health, Helsinki, Finland; Department of Psychology, University of Turku, Turku, Finland
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Kokkinen L, Kouvonen A, Buscariolli A, Koskinen A, Varje P, Väänänen A. Human service work and long-term sickness absence due to mental disorders: a prospective study of gender-specific patterns in 1,466,100 employees. Ann Epidemiol 2019; 31:57-61.e1. [DOI: 10.1016/j.annepidem.2018.12.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 12/15/2018] [Accepted: 12/28/2018] [Indexed: 10/27/2022]
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Sick leave and work-related accidents of social workers in Germany: an analysis of routine data. Int Arch Occup Environ Health 2018; 92:175-184. [PMID: 30374699 PMCID: PMC6341039 DOI: 10.1007/s00420-018-1370-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 10/21/2018] [Indexed: 12/02/2022]
Abstract
Purpose The study aimed to explore the prevalence of sick leave and the risk of work-related accidents among German social workers and to describe causes and time trends in sick leave and accident claims. Methods A retrospective analysis of routine data was carried out. Aggregated sick leave data of 195,100 social workers from four health insurance funds and 3037 accident claims of social workers from an accident insurance institution were analysed. Causes of accidents were examined by statistics of the German Social Accident Insurance (DGUV). Sick leave rates per 100 insured person-years were calculated. Relative risks (RR) of accidents were calculated in a multivariate analysis for three occupational groups (social workers and therapists, caregivers in sheltered workshops and teachers in residential institutions) and compared to other health and welfare service workers. Results Mental disorders caused about one-fifth of the sick leave days of social workers. Sick leave due to mental disorders slightly increased in 2015 compared to 2012 (+ 3% and + 18%). Among the three subgroups of social workers, caregivers in sheltered workshops (RR 1.30; 95% CI 1.14–1.49) and teachers in residential institutions (RR 1.41; 95% CI 1.17–1.70) were at an increased risk of accidents at the workplace. Accidents were mostly caused by slipping (30%) and by violence (22%). Conclusions This study confirms that sick leave of social workers is frequently caused by mental disorders. Future studies could further examine differences between practice fields, long-term effects of work hazards and effective workplace interventions. Electronic supplementary material The online version of this article (10.1007/s00420-018-1370-z) contains supplementary material, which is available to authorized users.
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Burr H, d’Errico A. Priority, methodological and conceptual issues regarding epidemiological research of occupational psychosocial risk factors for poor mental health and coronary heart disease. ACTA ACUST UNITED AC 2018. [DOI: 10.3280/sl2018-150009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Rantonen O, Alexanderson K, Pentti J, Kjeldgård L, Hämäläinen J, Mittendorfer-Rutz E, Kivimäki M, Vahtera J, Salo P. Trends in work disability with mental diagnoses among social workers in Finland and Sweden in 2005-2012. Epidemiol Psychiatr Sci 2017; 26:644-654. [PMID: 27608540 PMCID: PMC6999035 DOI: 10.1017/s2045796016000597] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 07/23/2016] [Indexed: 11/06/2022] Open
Abstract
Aims Social workers report high levels of stress and have an increased risk for hospitalisation with mental diagnoses. However, it is not known whether the risk of work disability with mental diagnoses is higher among social workers compared with other human service professionals. We analysed trends in work disability (sickness absence and disability pension) with mental diagnoses and return to work (RTW) in 2005-2012 among social workers in Finland and Sweden, comparing with such trends in preschool teachers, special education teachers and psychologists. METHODS Records of work disability (>14 days) with mental diagnoses (ICD-10 codes F00-F99) from nationwide health registers were linked to two prospective cohort projects: the Finnish Public Sector study, years 2005-2011 and the Insurance Medicine All Sweden database, years 2005-2012. The Finnish sample comprised 4849 employees and the Swedish 119 219 employees covering four occupations: social workers (Finland 1155/Sweden 23 704), preschool teachers (2419/74 785), special education teachers (832/14 004) and psychologists (443/6726). The reference occupations were comparable regarding educational level. Risk of work disability was analysed with negative binomial regression and RTW with Cox proportional hazards. RESULTS Social workers in Finland and Sweden had a higher risk of work disability with mental diagnoses compared with preschool teachers and special education teachers (rate ratios (RR) 1.43-1.91), after adjustment for age and sex. In Sweden, but not in Finland, social workers also had higher work disability risk than psychologists (RR 1.52; 95% confidence interval 1.28-1.81). In Sweden, in the final model special education teachers had a 9% higher probability RTW than social workers. In Sweden, in the final model the risks for work disability with depression diagnoses and stress-related disorder diagnoses were similar to the risk with all mental diagnoses (RR 1.40-1.77), and the probability of RTW was 6% higher in preschool teachers after work disability with depression diagnoses and 9% higher in special education teachers after work disability with stress-related disorder diagnoses compared with social workers. CONCLUSION Social workers appear to be at a greater risk of work disability with mental diagnoses compared with other human service professionals in Finland and Sweden. It remains to be studied whether the higher risk is due to selection of vulnerable employees to social work or the effect of work-related stress in social work. Further studies should focus on these mechanisms and the risk of work disability with mental diagnoses among human service professionals.
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Affiliation(s)
- O. Rantonen
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - K. Alexanderson
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - J. Pentti
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - L. Kjeldgård
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - J. Hämäläinen
- Department of Social Sciences, University of Eastern Finland, Kuopio, Finland
| | - E. Mittendorfer-Rutz
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - M. Kivimäki
- Finnish Institute of Occupational Health, Helsinki, Finland
- Department of Epidemiology and Public Health, University College London Medical School, London, UK
- Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - J. Vahtera
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland
| | - P. Salo
- Finnish Institute of Occupational Health, Helsinki, Finland
- Department of Psychology, University of Turku, Turku, Finland
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Nielsen MBD, Madsen IEH, Aust B, Burr H, Rugulies R. Effort-reward imbalance at work and the risk of antidepressant treatment in the Danish workforce. J Affect Disord 2016; 196:248-51. [PMID: 26943941 DOI: 10.1016/j.jad.2016.02.038] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2015] [Revised: 09/09/2015] [Accepted: 02/13/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND Previous studies have shown that high effort-reward imbalance (ERI) at work is a risk factor for the onset of self-reported depressive symptoms. In this study, we examined whether ERI predicts risk of treatment with antidepressant medication in a representative sample of the Danish workforce. METHODS We linked survey data on ERI and covariates of 4541 participants from the Danish Work Environment Cohort Study 2000 with the Danish National Prescription Registry that includes all legally purchased prescription drugs at pharmacies in Denmark since 1995. Participants with a history of antidepressant treatment or with self-reported depressive symptoms at baseline were excluded. Using Cox proportional hazard analyses we examined the prospective association between ERI at baseline and incident antidepressant treatment while adjusting for potential confounders. Time of follow-up was 5 years. RESULTS A total of 309 (6.8%) participants started antidepressant treatment during follow-up. Exposure to ERI at baseline was not related to risk of antidepressant treatment (hazard ratio: 0.91, 95% CI=0.81-1.03 after adjustment for potential confounders). LIMITATIONS The use of antidepressant treatment as an indicator for onset of depression might have led to misclassification, because (a) antidepressants are also used to treat other conditions than depression and (b) a considerable proportion of individuals with depression are not treated with antidepressants. CONCLUSIONS ERI did not predict incident antidepressant treatment, contradicting previous findings on ERI and self-reported depression. To clarify the association of ERI with risk of depression, we recommend further prospective studies using non-self-reported measures of ERI, clinical assessments of depression, or both.
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Affiliation(s)
- Maj Britt D Nielsen
- National Research Centre for the Working Environment, Copenhagen, Denmark; COWI A/S, Kongens Lyngby, Denmark
| | - Ida E H Madsen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Birgit Aust
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Hermann Burr
- Federal Institute of Occupational Safety and Health (BAuA), Berlin, Germany
| | - Reiner Rugulies
- National Research Centre for the Working Environment, Copenhagen, Denmark; Department of Public Health, University of Copenhagen, Denmark; Department of Psychology, University of Copenhagen, Denmark.
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Psychobiological Pathways from Work Stress to Reduced Health: Naturalistic and Experimental Studies on the ERI Model. ALIGNING PERSPECTIVES ON HEALTH, SAFETY AND WELL-BEING 2016. [DOI: 10.1007/978-3-319-32937-6_7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Mc Carthy VJC, Perry IJ, Harrington JM, Greiner BA. Co-occurrence of protective health behaviours and perceived psychosocial job characteristics. Prev Med Rep 2015; 2:812-7. [PMID: 26844155 PMCID: PMC4721423 DOI: 10.1016/j.pmedr.2015.09.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Little is known about the association between positive job characteristics of older workers and the co-occurrence of protective health behaviours. This study aims to investigate the association between perceived psychosocial job characteristics and the adoption of protective health behaviours. A population-based cross-sectional study was performed on a sample of 1025 males and females (age-range 50–69-years) attending a primary healthcare clinic. Perceived job characteristics (job demands: quantitative and cognitive demands; resources: possibility for development and influence at work) were determined using the Copenhagen Psychosocial Questionnaire. Each scale is presented in tertiles. Protective health behaviours were; consumption of five or more portions of fruit and vegetables a day, moderate alcohol, non/ex-smoker, and high and moderate physical activity. Each participant was scored 0–4 protective health behaviours. The majority of the sample had three protective health behaviours. Higher levels of influence at work and cognitive demands were associated with higher self-reported physical activity, but not with any number of protective health behaviours. Conversely, higher quantitative and higher cognitive demands were associated with reporting any number of protective health behaviours or above average number of protective health behaviours respectively. The findings on protective health behaviours were inconsistent in relation to the different measures of perceived psychosocial job characteristics and were largely confined to physical activity and diet. Older workers showed positive associations between work demands and PHBs. No association was found between job strain and PHBs. Higher educated and women had more PHBs. The co-occurrence of PHBs needs to be promoted in the workplace to further address disease and mortality. Engaging in health behaviours in the workplace can benefit populations at large.
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Affiliation(s)
- Vera J C Mc Carthy
- Department of Epidemiology and Public Health, Western Gateway Building, University College Cork, College Road, Cork, Ireland
| | - Ivan J Perry
- Department of Epidemiology and Public Health, Western Gateway Building, University College Cork, College Road, Cork, Ireland
| | - Janas M Harrington
- Department of Epidemiology and Public Health, Western Gateway Building, University College Cork, College Road, Cork, Ireland
| | - Birgit A Greiner
- Department of Epidemiology and Public Health, Western Gateway Building, University College Cork, College Road, Cork, Ireland
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Effort-Reward Imbalance at Work and Risk of Long-Term Sickness Absence in the Danish Workforce. J Occup Environ Med 2013; 55:454-9. [DOI: 10.1097/jom.0b013e31827dba5b] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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14
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Cheng Y, Chen IS, Chen CJ, Burr H, Hasselhorn HM. The influence of age on the distribution of self-rated health, burnout and their associations with psychosocial work conditions. J Psychosom Res 2013; 74:213-20. [PMID: 23438711 DOI: 10.1016/j.jpsychores.2012.12.017] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2012] [Revised: 12/11/2012] [Accepted: 12/13/2012] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Self-rated health (SRH) and burnout are commonly used health indicators. This study was designed to examine the age-specific patterns of SRH and burnout and their correlations with self-reported disease symptoms, and to investigate the moderating effects of age on the associations of psychosocial work conditions with these two health measures. METHODS Study subjects were 20,454 male and 16,875 female employees from 2 representative surveys conducted in 2007 and 2010 in Taiwan. SRH was assessed by a single item and burnout was assessed by the general burnout subscale of the Copenhagen Burnout Inventory (CBI). Psychosocial work conditions including working hours, psychological and physical job demands, job control, job insecurity and workplace justice were assessed by a validated questionnaire. RESULTS Older workers were at higher risk for poor SRH which was correlated with the presence of multiple disease symptoms. In contrast, employees aged 30-40 years had higher burnout which was strongly correlated with emotional disturbance. Among all the examined work factors, low workplace justice was found to be the most predominant predictor for poor SRH and high burnout, and the associations were more profound in younger workers than in older workers. CONCLUSION SRH and burnout were differentially related to age, and there were evidences of moderating effects of age on the associations between psychosocial work conditions and health. Researchers and health practitioners should pay attention to the influence of age when using the measures of SRH and burnout as indicators to detect health risk in association with adverse psychosocial work conditions.
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Affiliation(s)
- Yawen Cheng
- Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taiwan.
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Rugulies R, Aust B, Madsen IEH, Burr H, Siegrist J, Bültmann U. Adverse psychosocial working conditions and risk of severe depressive symptoms. Do effects differ by occupational grade? Eur J Public Health 2012; 23:415-20. [PMID: 22683769 DOI: 10.1093/eurpub/cks071] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Depression is a major concern for public health. Both adverse working conditions and low socio-economic position are suspected to increase risk of depression. In a representative sample of the Danish workforce we investigated (i) whether adverse psychosocial working conditions, defined by the effort-reward imbalance (ERI) model, predicted onset of severe depressive symptoms after 5-year follow-up and (ii) whether the effect of ERI was differential across occupational grades. METHODS A cohort of 2701 Danish employees filled in a questionnaire on work and health in 2000 and 2005. ERI was measured with four effort and seven reward items. Depressive symptoms were assessed with the five-item Mental Health Inventory. Participants scoring ≤ 52 points were defined as cases. We used logistic regression to investigate the association of ERI and occupational grade in 2000 with onset of severe depressive symptoms in 2005. Analyses were adjusted for socio-demographics, health behaviours, survey method, self-rated health, sleep disturbances and non-severe depressive symptoms at baseline. RESULTS High ERI predicted onset of severe depressive symptoms at follow-up, after adjustment for co-variates and occupational grade (OR = 2.19, 95% CI = 1.12-4.25). Participants with high ERI and low occupational grade showed a considerably higher OR (2.43, 95% CI = 1.07-5.53) compared to participants with low/medium ERI and low grade (OR = 1.45, 95% CI = 0.72-2.92), high ERI and high grade (OR = 1.26, 95% CI = 0.59-2.70) and low/medium ERI and high grade (reference group). CONCLUSION Adverse psychosocial working conditions predicted onset of severe depressive symptoms. The effect was stronger among employees of lower occupational grades compared to those of higher grades.
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Affiliation(s)
- Reiner Rugulies
- National Research Centre for the Working Environment, Copenhagen, Denmark
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Larsman P, Kadefors R, Sandsjö L. Psychosocial work conditions, perceived stress, perceived muscular tension, and neck/shoulder symptoms among medical secretaries. Int Arch Occup Environ Health 2012; 86:57-63. [DOI: 10.1007/s00420-012-0744-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2011] [Accepted: 01/19/2012] [Indexed: 12/17/2022]
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Abstract
Occupational stress is a well researched topic leading to the development of strong, viable models of workplace stress. However, there is a gap in the literature with respect to the applicability of this research to specific cultural groups, in particular those of immigrant status. The present paper reviews the extant literature regarding occupational stress from a multicultural perspective, evaluates the usefulness for existing models in the multicultural context, and discusses current issues with respect to increasing multiculturalism in the work environment. The authors conclude that workforce diversity is emerging as a pressing issue of organizational life and consequently, that future research needs to continue investigating whether current knowledge regarding workplace stress is fitting with the multicultural diversity of the present-day working population.
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Affiliation(s)
- Romana Pasca
- University of Northern British Columbia, 3333 University Way, Prince George, BC V2N 4Z9, Canada
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Klein J, Grosse Frie K, Blum K, von dem Knesebeck O. Psychosocial stress at work and perceived quality of care among clinicians in surgery. BMC Health Serv Res 2011; 11:109. [PMID: 21599882 PMCID: PMC3119178 DOI: 10.1186/1472-6963-11-109] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2010] [Accepted: 05/20/2011] [Indexed: 11/30/2022] Open
Abstract
Background Little is known about the association between job stress and job performance among surgeons, although physicians' well-being could be regarded as an important quality indicator. This paper examines associations between psychosocial job stress and perceived health care quality among German clinicians in surgery. Methods Survey data of 1,311 surgeons from 489 hospitals were analysed. Psychosocial stress at work was measured by the effort-reward imbalance model (ERI) and the demand-control model (job strain). The quality of health care was evaluated by physicians' self-assessed performance, service quality and error frequency. Data were collected in a nationwide standardised mail survey. 53% of the contacted hospitals sent back the questionnaire; the response rate of the clinicians in the participating hospitals was about 65%. To estimate the association between job stress and quality of care multiple logistic regression analyses were conducted. Results Clinicians exposed to job stress have an increased risk of reporting suboptimal quality of care. Magnitude of the association varies depending on the respective job stress model and the indicator of health care quality used. Odds ratios, adjusted for gender, occupational position and job experience vary between 1.04 (CI 0.70-1.57) and 3.21 (CI 2.23-4.61). Conclusion Findings indicate that theoretical models of psychosocial stress at work can enrich the analysis of effects of working conditions on health care quality. Moreover, results suggest interventions for job related health promotion measures to improve the clinicians' working conditions, their quality of care and their patients' health.
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Affiliation(s)
- Jens Klein
- University Medical Center Hamburg-Eppendorf, Center for Psychosocial Medicine, Department of Medical Sociology and Health Economics, Martinistr. 52, 20246 Hamburg, Germany.
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Gillen M, Cisternas MG, Yen IH, Swig L, Rugulies R, Frank J, Blanc PD. Functional recovery following musculoskeletal injury in hospital workers. Occup Med (Lond) 2010; 60:532-9. [PMID: 20682740 DOI: 10.1093/occmed/kqq110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Hospital workers are at high risk of work-related musculoskeletal disorders (WRMSDs), but outcomes following such injuries have not been well studied longitudinally. AIMS To ascertain functional recovery in hospital workers following incident WRMSDs and identify predictors of functional status. METHODS Cases (incident WRMSD) and matched referents from two hospitals were studied at baseline and at 2 year follow-up for health status [SF-12 physical component summary (PCS)], lost workdays, self-rated work effectiveness and work status change (job change or work cessation). Predictors included WRMSD and baseline demographics, socio-economic status (SES), job-related strain and effort-reward imbalance. Logistic regression analysis tested longitudinal predictors of adverse functional status. RESULTS The WRMSD-associated risk of poor (lowest quartile) PCS was attenuated from a baseline odds ratio (OR) of 5.2 [95% confidence interval (CI) 3.5-7.5] to a follow-up OR of 1.5 (95% CI 1.0-2.3) and was reduced further in multivariate modelling (OR = 1.4; 95% CI 0.9-2.2). At follow-up, WRMSD status did not predict significantly increased likelihood of lost workdays, decreased effectiveness or work status change. In multivariate modelling, lowest quintile SES predicted poor PCS (OR = 2.0; 95% CI 1.0-4.0) and work status change (OR = 2.5; 95% CI 1.1-5.8). High combined baseline job strain/effort-reward imbalance predicted poor PCS (OR = 1.7; 95% CI 1.1-2.7) and reduced work effectiveness (OR = 2.6; 95% CI 1.6-4.2) at follow-up. CONCLUSIONS Baseline functional deficits associated with incident WRMSDs were largely resolved by 2 year follow-up. Nonetheless, lower SES and higher combined job strain/effort-reward imbalance predicted adverse outcomes, controlling for WRMSDs.
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Affiliation(s)
- M Gillen
- University of California, San Francisco, CA 94143-0608, USA
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