Typology of employers offering line manager training for mental health

BACKGROUND

Mental ill health has a high economic impact on society and employers. National and international policy advocates line manager (LM) training in mental health as a key intervention, but little is known about employer training provisions.

AIMS

To explore the prevalence and characteristics of organizations that offer LM training in mental health.

METHODS

Secondary analysis of existing longitudinal anonymised organizational-level survey data derived from computer-assisted telephone interview surveys collected in four waves (2020:1900 firms, 2021:1551, 2022:1904, 2023:1902) in England, before, during and after a global pandemic.

RESULTS

The proportion of organizations offering LM training in mental health increased pre- to post-pandemic (2020:50%, 2023:59%) but 41% do not currently provide it. Logistic regression confirmed that LM training is more likely to be offered by large-sized enterprises, organizations with a larger proportion of employees who are younger (aged 25-49), female, disabled and from ethnic minority communities. Sector patterns were inconsistent, but in 2023, organizations from the 'Hospitality' and 'Business Services' sectors were more likely to provide LM training than other sectors.

CONCLUSIONS

Continued efforts are needed to increase the proportion of employers offering LM training in mental health, particularly small- to medium-sized enterprises, and organizations with predominantly male, White and/or older workforces.

Relationship Between Occupational Safety and Health Policy Principles, Organizational Action on Work-related Stress and the Psychosocial Work Environment in Italy

Background

It is acknowledged that legislation acts as a motivator for organizational action on psychosocial risks. Our study aims to provide evidence on the relationship between key occupational safety and health (OSH) policy principles and organizational action on work-related stress, and, in turn, with reported employee job demands and resources and their experience of work-related stress. We focus on Italy where specific legislation and practices on work-related stress were introduced in 2008 which are underpinned by these key OSH policy principles.

Methods

Secondary analysis of the Italian samples from the employer ESENER-2 and employee 6th EWCS surveys was conducted, using path analysis in structural equation modeling (SEM) linking the two datasets.

Results

We found a strong statistically significant relationship between OSH policy principles and organizational action on work-related stress (C.I. = .62-.78 p < .001). The existence of an organizational action plan on work-related stress was found to be significantly associated with more reported job resources (C.I. = .02-.24, p < .05) but these were not found to be significantly associated with less work-related stress. No significant association was found between having an organizational action plan for work-related stress and reported job demands. However, job demands were significantly related to reported work-related stress (C.I. = .27-.47, p < .001).

Conclusions

Findings add support to the call for specific legislation on work-related psychosocial risks and highlight how an organizational OSH culture underpinned by key OSH principles, and awareness/competence development on psychosocial risk management can have a positive effect on organizational action. However, further support needs to be provided to organizations around developing primary prevention interventions at the organizational level with the aim of reducing job demands.

Where is the limit for overtime? Impacts of overtime on employees' mental health and potential solutions: A qualitative study in China

Although Labor Law of the People's Republic of China stipulates the overtime system, overtime is still widespread in the IT industry. Through qualitative interviews, we explored the impact of overtime on employees' mental health and life. The current study identified four main themes, namely overtime reasons, outcomes of overtime, influential factors and solutions to overtime challenges. Besides work-related reasons and cultural influence, it was found that employees may work overtime due to personal reasons, such as capability and personal qualities; the most frequent impacts reported were fatigue, depression, stress and interference with life; three predominant influential factors were timing of overtime, control and rewards; and overtime conditions could be improved in practical and emotional ways. The study's findings highlight the importance of the design of flexible working time arrangements for avoiding fatigue and improving employees' work-life balance, enhancement of schedule arrangement for avoiding daily work interruption and last-minute tasks, and optimization of rewarding systems for avoiding complaints and facilitating voluntary overtime. Results suggest that mental health and work-life balance can be promoted by organizational initiatives focusing on minimizing excessive job demands, increasing psychosocial resources, supporting boundary management, and enhancing perceived flexibility.

Occupational Safety and Health Staging Framework for Decent Work

The 2030 United Nations Goal 8 for sustainable development focuses on decent work. There is utility in identifying the occupational safety and health aspects of Goal 8, as they pertain to the four pillars of decent work: job creation, social protection, rights of workers, and social dialogue. A workgroup of the International Commission on Occupational Health and collaborators addressed the issue of decent work and occupational safety and health (OSH) with the objective of elaborating a framework for guidance for practitioners, researchers, employers, workers, and authorities. This article presents that framework, which is based on an examination of the literature and the perspectives of the workgroup. The framework encompasses the intersection of the pillars of decent (employment creation, social protection, rights of workers, and social dialogue) work with new and emerging hazards and risks related to various selected determinants: new technologies and new forms of work; demographics (aging and gender); globalization; informal work; migration; pandemics; and OSH policies and climate change. The OSH field will need an expanded focus to address the future of decent work. This focus should incorporate the needs of workers and workforces in terms of their well-being. The framework identifies a starting point for the OSH community to begin to promote decent work.

The impact of national legislation on psychosocial risks on organisational action plans, psychosocial working conditions, and employee work-related stress in Europe

Work-related psychosocial hazards are recognised as a key priority in the future of work. Even though European Union (EU) legislation requires employers to assess and manage all types of risks to workers' health and safety associated with all types of hazards in the work environment, it does not include clear reference to psychosocial risks and work-related stress. In several EU member states, there is now more specific legislation on psychosocial risks that clarifies employer responsibilities. The aim of this study is to explore whether the introduction of specific legislation on psychosocial risks and/or work-related stress is related to organisations implementing action plans to prevent work-related stress, and in turn, better psychosocial working conditions (job demands and resources), and less reported work-related stress in the workforce. It does so by comparing EU member states and candidate countries that have introduced more specific legislation to those that have not, conducting multilevel modelling analysis by linking two representative European-level datasets, the 2014 employer European Survey of Enterprises on New & Emerging Risks and the 2015 employee European Working Conditions Survey. Findings indicate that the presence of specific national stress legislation is associated with more enterprises having a work-related stress action plan. The existence of action plans was found to be associated with increased job resources but not decreased job demands. Furthermore, only in those countries with specific national legislation on stress, job resources were found to be associated with less reported stress through the existence of organisational action plans. Findings lend support to the argument for more specific legislation on psychosocial risks/work-related stress in the EU. However, they also raise questions on whether current interventions implemented at organisational level to deal with work-related stress may be geared more towards the development of individual resources and less towards better work organisation and job design.

Work-related Well-being in the Zimbabwean Banking Sector: A Job Demands-Resources Perspective

Background

Research on the impact of psychosocial risks on well-being at work remains scarce in low- and middle-income countries, especially in the banking sector. This study sought to examine the relationships between job demands, job resources, well-being, job satisfaction, and work engagement in the Zimbabwean banking sector.

Methods

An online survey was administered to 259 employees from five banks. Hierarchical multiple regression tested the relationships between job demands (quantitative demands, emotional demands, work pace, and work–family conflict), job resources (possibilities for development, social support from colleagues and supervisors, quality of leadership, and influence at work), well-being, work engagement, and job satisfaction. Interactions between all variables were tested.

Results

Job demands were negatively related to well-being, work engagement, and job satisfaction. Job resources had positive relationships with the same. Work pace had positive relationships with well-being and work engagement. Influence at work moderated the relationship between emotional demands and work pace with well-being. Possibilities for development moderated the relationship between work–family conflict and well-being. Work–family conflict moderated the relationship between social support from colleagues and job satisfaction. Emotional demands, work pace, and quantitative demands moderated the relationship between influence at work with job satisfaction and work engagement.

Conclusion

Job demands should be reduced where possible in order to enhance employee well-being, work engagement, and job satisfaction. The job resources that should be availed to facilitate a positive psychosocial work environment in the banking sector include social support from supervisors, influence at work, and possibilities for development.

The Role of Occupational Health Services in Psychosocial Risk Management and the Promotion of Mental Health and Well-Being at Work

The development and enhancement of occupational health services (OHS) at the national level is central to ensuring the sustainable health, well-being and work engagement of the working population. However, due to differences in national health, social security and occupational safety and health systems, the content, capacity, coverage and provisions of OHS vary considerably across national contexts. Obtaining a better understanding in terms of such similarities and variations internationally is essential as such comparative information can help inform evidenced-based decision-making on OHS at both policy and practice levels. This paper therefore reviews and analyses the key policies, standards and approaches in OH systems and services, using both academic and grey literature, across 12 industrialised countries (Australia, Canada, Finland, France, Germany, Ireland, Italy, Japan, The Netherlands, Poland, United Kingdom and the United States of America). It provides a detailed overview and categorization of OHS in these selected countries in terms of the legal and policy context, organisation and financing and coverage and staffing while specifically discussing variations aimed at psychosocial risk management and the promotion of mental health and well-being at work. It draws conclusions on key development needs of OHS internationally to ensure psychosocial risk management and mental health promotion are prioritised effectively in a preventive manner.

Developing a cost-estimation model for work-related stress: An absence-based estimation using data from two Italian case studies

Objectives:

This paper discusses the development of a cost-estimation model for work-related stress based on psychosocial risk exposure and absence from work. It presents findings from its implementation and evaluation in two organizations in Italy, using national-level tools developed by the Italian Workers’ Compensation Authority (INAIL). It also provides recommendations for the development of similar cost-calculation methods in other countries.

Methods:

The cost-estimation model was based on the human capital approach using an indirect cost indicator: loss of productivity due to days of absence attributable to work-related stress. Furthermore, the population attributable fraction (PAF) epidemiological measure was used to calculate the impact of exposure to work-related stress on the basis of data collected through validated tools developed by INAIL and salary cost data.

Results:

The developed model was implemented and evaluated in two organizations, the first in healthcare (N=1014) and the second in public administration (N=534). In the first case, it was found that absence related to work-related stress cost the organization €445 000. In the second case, the cost was €360 000.

Conclusions:

The proposed model provides an example of how organizations can incorporate well-established indicators associated with work-related stress (eg, various types of absence, psychosocial risk perception, loss of productivity on the basis of salary costs) in a practical way in cost estimations of work-related stress. Such cost estimation can be applied in other countries and organizations to establish the economic and business case of managing work-related stress.

Psychosocial Working Conditions and Well-Being of Migrant Workers in Spain

This study examines the relationship beween employment and psychosocial working conditions and well-being of native and migrant workers in the working population of Spain. Data from the 7th Spanish Survey of Working Conditions was used to conduct a confirmatory factor analysis (n = 8508) to identify the main latent variables that influenced well-being. Using structural equation modeling and multivariate analysis, we found different patterns and perceptions of well-being and working conditions in these two groups. We discuss the reasons for these differences and suggest directions for further research in this area.

Occupational stress and musculoskeletal symptoms in firefighters

OBJECTIVES

The aim of this study was to evaluate the potential association between occupational stress and musculoskeletal symptoms in firefighters.

MATERIAL AND METHODS

Data were collected among Cypriot firefighters through a battery of adapted questionnaires completed anonymously.

RESULTS

A total of 430 firefighters (a response rate of 68%) completed the survey (the age range: 21-60 years). A total of 11% of firefighters reported moderate to extremely severe stress through the <i>Copenhagen Psychosocial Questionnaire</i> and <i>Depression, Anxiety and Stress Scale</i>. A total of 40% of firefighters reported musculoskeletal symptoms, the most frequent being back pain. Multivariable-adjusted logistic regression models showed that occupational stress was associated with a 50% higher risk of musculoskeletal symptoms in firefighters after adjusting for age, smoking and obesity (OR = 1.52, p = 0.04). In addition, a positive dose-response relationship was found between occupational stress and musculoskeletal symptoms.

CONCLUSIONS

Occupational stress constitutes a significant risk for firefighters and is associated with higher prevalence of musculoskeletal symptoms at work. Int J Occup Med Environ Health. 2019;32(3):341-52.

Tailoring Psychosocial Risk Assessment in the Oil and Gas Industry by Exploring Specific and Common Psychosocial Risks

BACKGROUND

Psychosocial risk management [Psychosocial Risk Management Approach (PRIMA)] has, through the years, been applied in several organizations in various industries and countries globally. PRIMA principles have also been translated into international frameworks, such as PRIMA-EF (European framework) and the World Health Organization Healthy Workplace Framework. Over the past 10 years, an oil and gas company has put efforts into adopting and implementing international frameworks and standards for psychosocial risk management. More specifically, the company uses a PRIMA.

METHODS

This study explores available quantitative and qualitative risk data collected through the PRIMA method over the past 8 years in order to explore specific and common psychosocial risks in the petroleum industry.

RESULTS

The analyses showed a significant correlation between job resources and symptoms of work-related stress, there was a significant correlation between job demands and symptoms of work-related stress, and there were differences in psychosocial risk factors and symptoms of work-related stress onshore and offshore. The study also offers recommendations on how the results can further be utilized in building a robust system for managing psychosocial risks in the industry.

CONCLUSION

The results from the analyses have provided meaningful and important information about the company-specific psychosocial risk factors and their impact on health and well-being.

Examples of Holistic Good Practices in Promoting and Protecting Mental Health in the Workplace: Current and Future Challenges

Background

While attention has been paid to physical risks in the work environment and the promotion of individual employee health, mental health protection and promotion have received much less focus. Psychosocial risk management has not yet been fully incorporated in such efforts. This paper presents good practices in promoting mental health in the workplace in line with World Health Organization (WHO) guidance by identifying barriers, opportunities, and the way forward in this area.

Methods

Semistructured interviews were conducted with 17 experts who were selected on the basis of their knowledge and expertise in relation to good practice identified tools. Interviewees were asked to evaluate the approaches on the basis of the WHO model for healthy workplaces.

Results

The examples of good practice for Workplace Mental Health Promotion (WMHP) are in line with the principles and the five keys of the WHO model. They support the third objective of the WHO comprehensive mental health action plan 2013–2020 for multisectoral implementation of WMHP strategies. Examples of good practice include the engagement of all stakeholders and representatives, science-driven practice, dissemination of good practice, continual improvement, and evaluation. Actions to inform policies/legislation, promote education on psychosocial risks, and provide better evidence were suggested for higher WMHP success.

Conclusion

The study identified commonalities in good practice approaches in different countries and stressed the importance of a strong policy and enforcement framework as well as organizational responsibility for WMHP. For progress to be achieved in this area, a holistic and multidisciplinary approach was unanimously suggested as a way to successful implementation.

An exploration of workplace social capital as an antecedent of occupational safety and health climate and outcomes in the Chinese education sector

PURPOSE

It is widely acknowledged that teachers are at greater risk of work-related health problems. At the same time, employee perceptions of different dimensions of organizational climate can influence their attitudes, performance, and well-being at work. This study applied and extended a safety climate model in the context of the education sector in Hong Kong. Apart from safety considerations alone, the study included occupational health considerations and social capital and tested their relationships with occupational safety and health (OSH) outcomes.

METHODS

Seven hundred and four Hong Kong teachers completed a range of questionnaires exploring social capital, OSH climate, OSH knowledge, OSH performance (compliance and participation), general health, and self-rated health complaints and injuries. Structural equation modeling (SEM) was used to analyze the relationships between predictive and outcome variables.

RESULTS

SEM analysis revealed a high level of goodness of fit, and the hypothesized model including social capital yielded a better fit than the original model. Social capital, OSH climate, and OSH performance were determinants of both positive and negative outcome variables. In addition, social capital not only significantly predicted general health directly, but also had a predictive effect on the OSH climate-behavior-outcome relationship.

CONCLUSIONS

This study makes a contribution to the workplace social capital and OSH climate literature by empirically assessing their relationship in the Chinese education sector.

Examining psychosocial and physical hazards in the Ghanaian mining industry and their implications for employees' safety experience

INTRODUCTION

In addition to hazardous conditions that are prevalent in mines, there are various physical and psychosocial risk factors that can affect mine workers' safety and health. Without due diligence to mine safety, these risk factors can affect workers' safety experience, in terms of near misses, disabling injuries and accidents experienced or witnessed by workers.

METHOD

This study sets out to examine the effects of physical and psychosocial risk factors on workers' safety experience in a sample of Ghanaian miners. 307 participants from five mining companies responded to a cross sectional survey examining physical and psychosocial hazards and their implications for employees' safety experience.

RESULTS

Zero-inflated Poisson regression models indicated that mining conditions, equipment, ambient conditions, support and security, and work demands and control are significant predictors of near misses, disabling injuries, and accidents experienced or witnessed by workers. The type of mine had important implications for workers' safety experience.

Psychosocial risks: is risk management strategic enough in business and policy making?

BACKGROUND

In times of continuous change and volatile markets, organizations are increasingly characterized by downsizing, work intensification, and resource rationalization. This has resulted in diversification, and the emergence of new risks within the field of occupational health and safety, with an important impact. This paper focuses on one such type of risk in the modern workplace-psychosocial risks. The current study aimed to explore stakeholder perspectives, regarding the extent to which psychosocial risks are incorporated into strategic risk management practices, at both the business and policy level.

METHODS

Semi-structured interviews were conducted with 14 professionals, representing employer, expert, policy maker, and trade union stakeholder perspectives.

RESULTS

It was found that the majority of organizations do not sufficiently, if at all, understand and incorporate psychosocial risks into strategic decision making, whereby the key barrier related to practical difficulties of not knowing how to manage psychosocial risks adequately.

CONCLUSION

The study found that there is a need to close the gap between policy and practice on a number of levels. Future recommendations comprise a policy framework and infrastructure underpinned by educational initiatives, partnerships, and networks to drive a shift in attitudes toward recognizing the duality of the concept of risk (including both potential negative and positive outcomes) and moving beyond simple regulatory compliance.

Investigating the impact of psychosocial risks and occupational stress on psychiatric hospital nurses' mental well-being in Japan

A cross-sectional survey was conducted, with the aim to examine what stressors in the workplace and demographic factors were associated with signs and symptoms of poor well-being among psychiatric nurses. A structured questionnaire was distributed to nurses within six psychiatric hospitals in Japan. Information was collected on demographic information, work characteristics and two dimensions of well-being: feeling uptight and emotional exhaustion. Three hundred and sixty-one questionnaires were completed by participants. High rates of emotional exhaustion in psychiatric nurses were found to be predicted by young age, high psychological demands paired with low social support in the workplace, job strain (a proxy to occupational stress) and job strain paired with low social support. In addition, high rates of being tense/uptight were associated with high psychological job demand, low psychological job control, low social support in the workplace, high job strain and high job strain paired with low social support. The current study has found evidence of significant relationships between demographic factors and several work and organizational stressors and poor mental health among Japanese psychiatric nurses.

Occupational psychosocial health policies in Hong Kong schools: a review and exploration of key stakeholder perceptions

OBJECTIVES

It is widely acknowledged that teachers are suffering from work-related health problems. However, the implementation of relevant occupational safety and health (OSH) policies is complex and under-studied. This study reviews key legislation of relevance to psychosocial health and explores stakeholders' perceptions on their implementation in Hong Kong (HK) schools.

METHODS

The content of OSH legislation applicable to psychosocial health was systematically reviewed by the modified WHO checklist on legislation. Semi-structured interviews were then conducted with 38 key stakeholders. These were transcribed and subjected to Framework Analysis.

RESULTS

The review showed that there were several ambiguities in the legislation and the interviews found that awareness and understanding in relation to OSH issues and policies differed on the basis of the level of implementation bodies. The importance of management, trust, communication and interpersonal relationships was emphasised.

CONCLUSION

On the basis of the study it is concluded that implementation of psychosocial health policies in HK schools is poor and there appears to be a gap among stakeholder communication. Also, the content of these policies needs to be clarified so that it can be more conducive to implementation in practice. The improvement of OSH climate and social capital could foster a more effective implementation of OSH policies.

Perceptions of psychosocial hazards, work-related stress and workplace priority risks in developing countries

OBJECTIVES

During the last few decades, major global developments in the world of work include an international trend to shift production to developing countries, with wide variations in working conditions and exposure to traditional and emerging occupational risks, such as psychosocial risks. The latter have rarely been addressed or explored in developing and economically-emerging country contexts while we find an abundant body of research from industrialized countries. The research presented, which is part of a larger study, explored the perception of multi-disciplinary experts from different regions, as defined by the World Health Organization (WHO), of the nature of psychosocial hazards, and work-related stress, as well as their views on workplace priorities that require urgent attention.

METHODS

Semi-structured interviews were conducted with 29 experts from developing countries which were subjected to thematic analysis. A two-tiered Delphi survey was completed by 74 experts in the first round with 53 of these experts completing the survey in the second round.

RESULTS

Psychosocial hazards and work-related stress were mostly seen as interchangeable in terms of source and effect and all participants perceived them as concern to their workforce. Through the interviews and the Delphi surveys they allude to our contemporary understanding of psychosocial risks. Workplace risks of priority differed by region but primarily work-related stress, injury and accident prevention, and substance abuse and risk behaviors were reported to require urgent attention.

CONCLUSIONS

The current lack of awareness and research in the area of psychosocial risks and work-related stress hampers action in developing countries. International experts should support the exchange of information and the development of interventions in workplaces in developing countries with a view to integrating these emerging risks into comprehensive occupational health and safety policy frameworks to make such approaches more effective.

Occupational health and safety policy and psychosocial risks in Europe: the role of stakeholders' perceptions

INTRODUCTION

Psychosocial risks are now largely acknowledged throughout Europe as important challenges in occupational health and safety. However, there appear to be wide gaps in perception between experts and the general population on the nature and the relevance of psychosocial risks that have a potential impact on policy development and implementation in this area.

METHODS

This study investigated the level of knowledge among European stakeholders, of legislation on occupational safety and health, focusing particularly on psychosocial risk factors. 75 members of employers' associations, trade unions and government institutions from 21 countries in the European Union (EU) participated in the study. In addition, to further elaborate the findings of the survey, focus groups were organised during a 2-day stakeholder workshop.

RESULTS

The level of application of European Directive 89/391 for the assessment and management of psychosocial risks and work-related stress was largely reported by the stakeholders as inadequate. This opinion was more marked in the new EU27 countries than the older EU15, and the difference was significant as regards the impact of the Directive on the assessment and management of psychosocial risks. Overall, psychosocial risks and work-related stress were reported to be important occupational health and safety concerns; however there were important differences among stakeholders in different countries.

CONCLUSIONS

Despite the development of knowledge and activities on both the policy and practice levels in recent years, further work is still needed to harmonize stakeholder perceptions in this area in the various EU member states.

Work-place social capital and smoking cessation: the Finnish Public Sector Study

AIMS

To examine whether high social capital at work is associated with an increased likelihood of smoking cessation in baseline smokers.

DESIGN

Prospective cohort study.

SETTING

Finland.

PARTICIPANTS

A total of 4853 employees who reported to be smokers in the baseline survey in 2000-2002 (response rate 68%) and responded to a follow-up survey on smoking status in 2004-2005 (response rate 77%).

MEASUREMENTS

Work-place social capital was assessed using a validated and psychometrically tested eight-item measure. Control variables included sex, age, socio-economic position, marital status, place of work, heavy drinking, physical activity, body mass index and physician-diagnosed depression.

FINDINGS

In multi-level logistic regression models adjusted for all the covariates, the odds for being a non-smoker at follow-up were 1.26 [95% confidence interval (CI)=1.03-1.55] times higher for baseline smokers who reported high individual-level social capital than for their counterparts with low social capital. In an analysis stratified by socio-economic position, a significant association between individual-level social capital and smoking cessation was observed in the high socio-economic group [odds ratio (OR) (95% CI)=1.63 (1.01-2.63)], but not in intermediate [(OR=1.10 (0.83-1.47)] or low socio-economic groups [(OR=1.28 (0.86-1.91)]. Work unit-level social capital was not associated with smoking cessation.

CONCLUSIONS

If the observed associations are causal, these findings suggest that high perceived social capital at work may facilitate smoking cessation among smokers in higher-status jobs.

A European framework to address psychosocial hazards

Over the past decades, emphasis has been placed on the changing nature of work and new forms of risk that could negatively affect employee health and safety. These are mainly associated with new types of occupational hazards that have been termed psychosocial. Issues such as work-related stress, bullying and harassment are now receiving attention on a global basis and efforts have been made to address them at the workplace level. However, it has been acknowledged that despite developments of policy in this area, there still appear to be a broad science-policy gap and an even broader one between policy and practice. The WHO Network of Collaborating Centers in Occupational Health has, since the late 1990s, been supporting a dedicated program of work on psychosocial factors and work-related stress. Part of the Network's work is currently focusing on the translation of existing knowledge into practice in the area of psychosocial risk management. This program has identified that the optimum way forward lies in the development of a European framework for psychosocial risk management. This framework will serve as the basis for coordination of research activities and preventive action with an emphasis on evidence based interventions and best practice on an international basis.

Work factors related to psychological and health-related distress among employees with chronic illnesses

OBJECTIVE

This study examined specific psychosocial factors associated with psychological and health-related distress amongst employees reporting different chronic illnesses.

METHODS

The sample consisted of 1029 employees managing either musculoskeletal pain (n=324), arthritis and rheumatism (n=192), asthma (n=174), depression and anxiety (n=152), heart disease (n=96) or diabetes (n=91). Information on psychological distress, work limitations, illness management, disclosure, absence, presenteeism, support and demographic factors were obtained through self-administered questionnaires.

RESULTS

Both low psychological well-being and high health-related distress were associated with an increase in work limitations (beta=0.20, SE=.03; and beta=0.19, SE=.01, respectively), poorer management of illness symptoms at work (beta=-0.17, SE=.12; and beta=-0.13, SE=.02), high presentieesm (beta=0.19, SE=.25; and beta=0.14, SE=.05) and low workplace support (beta=-0.05, SE=.22; and beta=-0.12, SE=.05). Health-related distress was additionally associated with disclosure of illness at work (beta=0.18, SE=.08) and long-term sickness absence (beta=0.10, SE=.06).

CONCLUSIONS

To enable individuals to effectively manage both their illness and their work without serious repercussions, it is important for both healthcare professionals and employers alike, to improve the well-being of workers with chronic illness by supporting and facilitating their efforts to over-come health-related limitations at work.

Dealing with self-management of chronic illness at work: predictors for self-disclosure

This paper explores the role of self-management of chronic illness at work, as a predictor for self-disclosure. The study reports findings from a survey sent to all staff at a UK university, of which 610 employees reported managing a chronic illness: arthritis, musculoskeletal pain, diabetes, asthma, migraine, heart disease, irritable bowel syndrome and depression. The study found that discrete self-management factors predicted different levels of disclosure: partial self-disclosure (employees informing line managers about the presence of a chronic illness) and full self-disclosure (employees informing line managers how that chronic illness affected them at work). For partial disclosure, a greater reported experience of chronic illness by employees was positively associated with self-disclosure. For full-disclosure, employees were more likely to report disclosure to line managers if they had already disclosed to colleagues, and if they perceived receiving support from their line managers in relation to their chronic illness as important. Except for academics who were least likely to disclose, occupational groups did not emerge as significant predictors for either partial or full disclosure. Except for diabetes, chronic illness itself was not a significant predictor or barrier to self-disclosure. Our findings suggest that chronically ill employees adopt a disclosure strategy specifically related to different self-management needs of chronic illness at work.

Work limitations and employer adjustments for employees with chronic illness

This study measured work limitations and work adjustments among chronically ill employees with regard to three distinct job characteristics: physical work demands, cognitive work demands and social work demands. The study presents findings from an organizational-based survey, from which 610 respondents reported managing employees with a chronic illness. These included arthritis, musculoskeletal pain, diabetes, asthma, migraine, heart disease, irritable bowel syndrome and depression. The results indicate that depression had the largest impact in all three work demand categories, while musculoskeletal pain principally affected physical work demands and migraine and diabetes largely affected cognitive work demands. For other chronic illnesses, it was the generic symptoms of the illness (for example, fatigue) that resulted in a work limitation, rather than the specific nature of the illness itself. Employer work adjustments were available to those people with illnesses that required a physical work adjustment (for example, musculoskeletal pain). For other chronic illnesses, with the exception of depression, disclosing an illness was the strongest predictor for work adjustments in cognitive tasks and the provision of social support. Those with depression were least likely to receive a cognitive work adjustment, indicating either a low disclosure rate in this group or that employers' perceptions of depression may be a barrier to providing suitable work adjustments.

Psychosocial hazards and seafarer health: priorities for research and practice

This paper discusses the changing nature of work and the emergence and prevalence of psychosocial hazards. It addresses their effect on worker health with particular emphasis on the issue of work-related stress. It then considers how these hazards affect seafarer health in the light of current working conditions in the maritime sector. Finally, specific recommendations are made for future directions for research and practice in relation to these issues.