Physical and psychosocial working conditions as predictors of 5-year changes in work ability among 2078 employees in Germany

OBJECTIVE

To examine 5-year prospective associations between working conditions and work ability among employees in Germany.

METHODS

A cohort study (2011/2012-2017), based on a random sample of employees in employments subject to payment of social contributions aged 31-60 years (Study on Mental Health at Work; S-MGA; N = 2,078), included data on physical and quantitative demands, control (influence, possibilities for development, control over working time), relations (role clarity and leadership quality) and work ability (Work Ability Index, WAI; subscale 'subjective work ability and resources'). Data were analysed using linear regression.

RESULTS

Physical demands and control were associated with small 5-year changes in work ability (ΔR² = 1%). Among the subgroup of employees with ≥ 25 sickness days, possibilities for development, control and quality of leadership were associated with changes in work ability (ΔR² = 8%).

CONCLUSIONS

The impact of working conditions on long term changes in work ability seems to be negligible. However, in vulnerable subpopulations experiencing poor health, working conditions may be associated to a larger extent to work ability over this time span.

The Demand-Control Model as a Predictor of Depressive Symptoms-Interaction and Differential Subscale Effects: Prospective Analyses of 2212 German Employees

Testing assumptions of the widely used demand–control (DC) model in occupational psychosocial epidemiology, we investigated (a) interaction, i.e., whether the combined effect of low job control and high psychological demands on depressive symptoms was stronger than the sum of their single effects (i.e., superadditivity) and (b) whether subscales of psychological demands and job control had similar associations with depressive symptoms. Logistic longitudinal regression analyses of the 5-year cohort of the German Study of Mental Health at Work (S-MGA) 2011/12–2017 of 2212 employees were conducted. The observed combined effect of low job control and high psychological demands on depressive symptoms did not indicate interaction (RERI = −0.26, 95% CI = −0.91; 0.40). When dichotomizing subscales at the median, differential effects of subscales were not found. When dividing subscales into categories based on value ranges, differential effects for job control subscales (namely, decision authority and skill discretion) were found (p = 0.04). This study does not support all assumptions of the DC model: (1) it corroborates previous studies not finding an interaction of psychological demands and job control; and (2) signs of differential subscale effects were found regarding job control. Too few prospective studies have been carried out regarding differential subscale effects.

Appreciation and job control predict depressive symptoms: results from the Study on Mental Health at Work

OBJECTIVE

Depressive symptoms are a leading cause of disability retirement and sick leave. The aim of this study was to assess the risk of depressive symptoms in German employees and its associations with factors from both the occupational and the non-occupational domain and gender.

METHODS

In the second wave of the German Study of Mental Health at Work (SMGA), a representative sample of 2640 German employees (52% women) was studied. Depressive symptoms were assessed with the PHQ-9 questionnaire. Psychosocial occupational and non-occupational conditions were assessed with quantitative interviews. In this cross-sectional sample, the association of these factors with depressive symptoms was examined using logistic regression models.

RESULTS

Factors from both the occupational and the non-occupational domain were associated with risk of depressive symptoms. Low appreciation from superior (OR_men 2.1 (95% CI 1.2-3.7); OR_women 3.2 (95% CI 2.1-4.8)), low job control (OR_men 2.9 (95% CI 1.6-5.4); OR_women 1.6 (95% CI 1.0-2.5)), and critical life events (OR_men 3.0 (95% CI 1.6-5.4); OR_women 2.3 (95% CI 1.5-3.7)) had the strongest association with risk of depressive symptoms. The association with quantitative demands was stronger in caregivers than in non-caregivers. The results indicated possible differences in the associations of working conditions between men and women, and between family caregivers and non-caregivers.

CONCLUSION

Factors from both work and private life are associated with depressive symptoms, especially appreciation, job control, and critical life events. Gender differences, with respect to appreciation and influence at work, suggest a more gender sensitive approach to psychosocial occupational health research and interventions.

Working conditions as risk factors for early exit from work-in a cohort of 2351 employees in Germany

Objectives

We would assess the possible impact of a range of physical and psychosocial working conditions on early exit from paid employment (i.e., before retirement age) in a representative employee population in Germany.

Methods

We analysed a cohort from the German Study on Mental Health at Work (S-MGA) with a baseline of 2351 employees in 2011/12, sampled randomly from the register of integrated employment biographies (IEB) at the Institute for Employment Research (IAB). Follow-up ended mid-2015. Early Exit comprised episodes of either pensioning, long-term sickness absence or unemployment ≥ 18 months. Total follow-up years were 8.422. Working conditions were partly assessed by the Copenhagen Psychosocial Questionnaire (COPSOQ). Through Cox regressions, associations of baseline working conditions with time to event of exit were estimated—adjusting for baseline age, gender, poverty, fixed-term contract and socioeconomic position.

Results

In multiple regressions, awkward body postures (HR = 1.24; 95% CI = 1.07–1.44), heavy lifting (1.17; 1.00–1.37) and high work pace (1.41; 1.16–1.72) were associated with exit. The estimated attributable fraction of exit for being exposed to less than optimal work environment was 25%. Regarding specific exit routes, repetitive movements (1.25; 1.03–1.53) increased the risk for the long-term sickness absence; work pace (1.86; 1.22–2.86) and role clarity (0.55; 0.31–1.00) were associated to unemployment; and control over working time (0.72; 0.56–0.95) decreased the risk of the early retirement.

Conclusions

Work environment seems to be important for subsequent early exit from work. Physical and psychosocial demands seem to be associated to exit to a stronger extent than resources at work.