Study of the validity of a job-exposure matrix for the job strain model factors: an update and a study of changes over time

Exploring the employment determinants of job insecurity in the French working population: Evidence from national survey data

Studies are lacking on the employment determinants of job insecurity, that may be helpful to determine highly exposed groups and to assess the feasibility of constructing job-exposure matrices (JEMs) for this occupational exposure. The objectives were to explore the employment determinants of job insecurity in a nationally representative sample of the French working population. The study was based on the cross-sectional data of the 2013 national French working conditions survey including a sample of 28,293 employees, 12,283 men and 16,010 women. Job insecurity was assessed using one single item related to the fear of job loss in the next 12 months. Gender, age, and educational level were studied as well as the following employment variables: temporary/permanent work contract, full/part time work, job seniority, occupation, economic activity of the company, public/private sector, and company size. The associations with job insecurity were studied using bivariate and multivariate analyses. One quarter of the study sample was exposed to job insecurity, without any difference between genders. Lower age and lower educational levels were associated with job insecurity. Employees who had a temporary work contract, lower job seniority, who were working in low-skilled occupational groups, in manufacturing (for both genders) and construction (among men), and in the private sector had a higher prevalence of exposure to job insecurity. The two major employment variables associated with job insecurity were temporary work contract (prevalence ratios>2) and private sector (prevalence ratios>1.4) for the whole sample and for both men and women. Our findings suggested that intervention/prevention measures could be oriented towards specific highly exposed groups of the working population, especially those exposed to temporary work contract and/or working in the private sector. Our study also underlined that constructing JEMs for job insecurity may be possible and could be a useful tool for large-scale occupational health studies.

Constructing and validating an occupational job strain index based on five Norwegian nationwide surveys of living conditions on work environment

BACKGROUND

It has been claimed that Nordic register data are a "goldmine" for research. However, one limitation is the lack of information on working conditions. Job exposure matrices (JEMs) are one solution to this problem. Thus, the three aims of this study were (i) to investigate the reliability of an occupation-based psychosocial JEM, i.e., a Job Strain Index (job strain or JSI abbreviated), (ii) to examine the construct and criterion-related validity of this measure of job strain (iii) and assesses the concurrent and the predictive validity of an occupation-based Job Strain Index for use in analyses of Norwegian register data.

METHOD

The study utilized five waves of the nationwide Norway Survey of Living Conditions in the Work Environment with a total sample of 43,977 individuals and register data with a total sample of 1,589,535 individuals. Job strain was composed of items belonging to the two dimensions of Karasek's DC model, job demands and job control (1979). The reliability of the JSI and its dimensions and components were investigated by measuring the degree of agreement (Cohen's kappa), sensitivity, specificity, and internal consistency (Cronbach's alpha). Construct validity was assessed by confirmatory factor analysis, and criterion-related validity was measured by concurrent validity and predictive validity. The selected concurrent criteria were self-reported survey information on long-term sick absence, anxiety, depression, and sleeping difficulty. The predictive criteria were register information on receipt of disability benefits, mortality, and long-term sick leave.

RESULTS

Agreement between individual and occupation-based job strain and components was fair to poor. The sensitivity and specificity of occupation-based job strain and its components varied from acceptable to low. The consistency of the items comprising job demand and job control was clearly acceptable. Regarding concurrent validity, significant associations between (both individual and occupational) job strain, and long-term sick leave and sleeping difficulty were observed for both genders. Occupation-based job strain indicated an elevated risk for anxiety and depression among men, but not among women. As for predictive reliability, significant associations between occupation-based job strain and all three health outcomes were observed for both men and women.

CONCLUSION

Our occupation-based JSI serves as a reliable and valid indicator of psychosocial job exposure that can be used in analyses of Norwegian register data where individual information on such conditions is missing.

Study of the variation of the 12-month prevalence of exposure to workplace bullying across national French working population subgroups

OBJECTIVES

The studies are lacking on the variation of the prevalence of exposure to workplace bullying according to subgroups of national working populations. The objectives were to assess the 12-month prevalence of bullying in the national French working population, to describe the reported reasons for bullying, and to study its variation according to various employment variables.

METHODS

The study was based on the data of the 2013 national French working conditions survey. The study sample included 25,769 employees aged 15-65 working in the same job within the last 12 months. The 12-month prevalence of bullying was assessed using a 9-item questionnaire. Employment variables included: occupation, economic activity of the company, public/private sector, company size, permanent/temporary work contract, and full/part-time work. The analyses were performed using statistical methods for weighted survey data.

RESULTS

The 12-month prevalence of bullying was 26.7% and 28.7% for men and women, respectively. The most prevalent forms of bullying were criticisms, exclusion, and deprivation of right of expression. The leading reasons for being bullied were related to occupation, age, and gender. The prevalence of bullying was higher among the younger employees, the employees working in medium/large companies (including the public sector), and among employees working full time. Though significant, the variations according to occupations and economic activities of the company were small.

CONCLUSION

Workplace bullying appeared as a widespread phenomenon in France. More attention should be given to young employees and the employees working in medium/large companies. Preventive measures should also target the whole working population comprehensively.

Nursing Home, Ward and Worker Level Determinants of Perceived Quantitative Work Demands: A Multi-Level Cross-Sectional Analysis in Eldercare

Introduction

Perceived quantitative demands at work have been associated with poor mental and physical health, long-term sickness absence and subsequent early retirement. Identifying modifiable determinants of perceived quantitative demands at different levels of the organization is key to developing effective interventions. The aim of the study was to identify determinants of perceived quantitative demands at work and examine the extent to which they occur at different levels of the eldercare organisation (i.e. the worker, ward and nursing home levels).

Methods

We collected data on 383 eldercare workers in 95 wards at 20 nursing homes in Denmark using workplace observations and questionnaires to workers and their managers. Perceived quantitative work demands were assessed using two items from the Copenhagen Psychosocial Questionnaire, II. We identified contributions to overall variability from the three organisational levels using variance components analysis, and examined associations between determinants at these three levels and quantitative demands.

Results

Almost all (90.9%) the variability in perceived quantitative demands occurred between eldercare workers (within wards). Determinants significantly associated with lower quantitative demands were: having a job as a care helper, working fixed evening shifts, being born outside Denmark, having lower influence at work, higher quality of leadership and lower emotional demands. None of the investigated physical factors (e.g. resident handlings, push/pull tasks, step-count) were associated with perceived quantitative demands.

Conclusion

We found that the variability in perceived quantitative demands occurred primarily between eldercare workers within wards. Our study indicates that psychosocial work environment factors are the strongest modifiable determinants of perceived quantitative demands in eldercare, while organisational factors related to job position, shift, and resident-staff ratio also play a role. Interventions should test if changes in these determinants can reduce perceived quantitative demands at work in eldercare.

Shift and Night Work and All-Cause and Cause-Specific Mortality: Prospective Results From the STRESSJEM Study

The literature remains sparse and inconclusive about the impact of shift and night work on mortality, and still more on specific causes of death. The objectives were to explore the prospective associations between exposure to shift and night work and all-cause and cause-specific mortality. The study was based on a large national representative French prospective cohort of 1,511,456 employees followed up from 1976 to 2002. Exposure to shift and night work relied on a job-exposure matrix, and 3 time-varying measures (current, cumulative, and recency-weighted cumulative exposure) were constructed. Mortality and causes of death were provided by the national registry, and all-cause, cardiovascular, cancer and preventable mortality, and suicide were studied. Cox proportional hazards models were performed to study the associations between shift and night work and mortality. During follow-up, 22,105 deaths occurred for all-cause mortality. In the study of mortality until the end of last job during follow-up, shift and/or night work were associated with all-cause, cardiovascular, cancer and preventable mortality, and suicide (except night without shift work with cancer mortality and suicide) among men. Shift work (especially shift without night work) was associated with all-cause, cancer and preventable mortality among women. The results were similar for current, cumulative, and recency-weighted cumulative exposure. Associations were found for more detailed causes of death: cerebrovascular diseases for both genders, ischemic heart diseases, respiratory cancers, smoking-related mortality, and external causes of death among men, and breast cancer among women. In the study of mortality until the end of follow-up, some additional associations were found among women between night work and all-cause and preventable mortality, and suicide, suggesting long-term or delayed exposure effects. The study may, however, be underpowered to detect all the exposure-outcome associations, especially among women. More research and prevention are needed to reduce mortality among shift and night workers.

Psychosocial factors at work from the job strain model and preventable mortality in France: The STRESSJEM prospective study

The study aimed to explore the prospective associations between psychosocial factors at work from the job strain model and preventable mortality, including smoking- and alcohol-related mortality as well as external causes of death. The study was based on prospective data and relied on a sample of 1,511,456 individuals for which data on job history, mortality and causes of death were linked over the 1976-2002 period. Exposures were the factors from the job strain model imputed through a job-exposure matrix. Various time-varying measures of exposure were used including current exposure and two measures of cumulative exposure. Preventable mortality was defined using the OECD/Eurostat list of preventable causes of death. The associations between exposures and outcomes were studied using Cox proportional hazards models. Effect modification by gender was also assessed. Over the study period, 57,264 preventable deaths occurred before the age of 75 years. Low decision latitude, low social support, job strain, iso-strain, passive job, and high strain were associated with preventable mortality, and associations of stronger magnitude were found for job strain and isostrain among men. Stronger associations were observed for alcohol-related mortality than for smoking-related mortality and external causes of death. The fractions of preventable mortality attributable to current exposure to job strain and isostrain were significant among men only (5.1% and 3.3%). Psychosocial factors at work from the job strain model may play a role on preventable mortality. Intensifying research and prevention towards the psychosocial work environment may be helpful to reduce risky health-related behaviours and related mortality.

Identification of socio-demographic, occupational, and societal factors for guiding suicide prevention: A cohort study of Swiss male workers (2000-2014)

INTRODUCTION

We modeled suicidal rate among Swiss working-age males, considering three groups of factors at socio-demographic, occupational, and societal levels jointly. Our goal was twofold: to verify the effect of occupation after adjustment for non-occupational factors and to identify protective and risk factors relevant for suicide prevention in working male adults.

METHODS

The study population included all men aged [18-65] years at the 2000 population census and followed up within the Swiss National Cohort (SNC). The risk of suicide was modeled using Poisson regression.

RESULTS

The cohort comprised 1,534,564 men and 4371 deaths by suicide. Suicide rate varied significantly according to age, civil status, nationality, highest education achieved, and socio-professional category at socio-demographic level; occupation, occupational activity branch, weekly working hours, and home-to-work commute time at occupational level; calendar period of death, region, religious affiliation, and volunteering activity at societal level. After adjustment for non-occupational factors, agricultural and fishery laborers, military and civil security workers, and health and social workers were identified as high-risk groups with respect to suicide.

CONCLUSION

This study evidenced a complex web of factors at socio-demographic, occupational, and societal levels behind the suicide in Swiss male workers and identified the most at-risk groups, deserving targeted prevention efforts.

Psychosocial Work Factors of the Job Strain Model and All-Cause Mortality: The STRESSJEM Prospective Cohort Study

OBJECTIVE

The objectives were to examine the prospective associations between psychosocial work factors of the job strain model and all-cause mortality in a national representative cohort of French employees using various measures of time-varying exposure.

METHODS

The study was based on a sample of 798,547 men and 697,785 women for which data on job history from 1976 to 2002 were linked to mortality data from the national death registry. Psychosocial work factors from the validated job strain model questionnaire were imputed using a job-exposure matrix. Three time-varying measures of exposure were explored: current, cumulative, and recency-weighted cumulative exposure. Cox proportional hazards models were performed to study the associations between psychosocial work factors and mortality.

RESULTS

Within the 1976-2002 period, 88,521 deaths occurred among men and 28,921 among women. Low decision latitude, low social support, job strain, isostrain, high strain, and passive job were found to be risk factors for mortality. The model using current exposure was the best relative-quality model. The associations of current exposure to job strain and mortality were found to have hazard ratios of 1.30 (95% confidence interval [CI] = 1.24-1.36) among men and 1.15 (95% CI = 1.06-1.25) among women. The population fractions of mortality attributable to job strain were 5.64% (95% CI = 4.56%-6.71%) among men and 4.13% (95% CI = 1.69%-6.71%) among women.

CONCLUSIONS

This study supports the role of the psychosocial work factors of the job strain model on all-cause mortality. Preventive intervention to improve the psychosocial work environment may help to prevent mortality in working populations.

Comparing self-reported and O*NET-based assessments of job control as predictors of self-rated health for non-Hispanic whites and racial/ethnic minorities

The Occupational Information Network (O*NET) database has been used as a valuable source of occupational exposure information. Although good agreement between O*NET and self-reported measures has been reported, little attention has been paid to O*NET's utility in racially/ethnically diverse samples. Because O*NET offers job-level information, if different racial groups have different experiences under the same job title, O*NET measure would introduce systematic measurement error. Using the General Social Survey data (n = 7,041; 437 occupations), we compared self-report and O*NET-derived measures of job control in their associations with self-rated health (SRH) for non-Hispanic whites and racial/ethnic minorities. The correlation between self-report and O*NET job control measures were moderate for all gender-race groups (Pearson's r = .26 - .40). However, the logistic regression analysis showed that the association between O*NET job control and SRH was markedly weaker for racial/ethnic minorities than for non-Hispanic whites. The self-reported job control was associated with SRH in similar magnitudes for both groups, which precluded the possibility that job control was relevant only for non-Hispanic whites. O*NET may not capture job experience for racial/ethnic minorities, and thus its utility depends on the racial/ethnic composition of the sample.

Descriptive study of workplace demand, control and bullying among migrant and Australian-born workers by gender: does workplace support make a difference?

OBJECTIVE

The objective of this study is to examine the relationship between bullying in migrants and Australians and types of workplace Iso-strain, by gender.

DESIGN AND SETTING

Two descriptive cross-sectional surveys of the Australian working population.

PARTICIPANTS

Australian-born workers of Caucasian ancestry (n=1051, participant response rate=87.3%) and workers born in New Zealand (n=566), India (n=633) and the Philippines (n=431) (participant response rate=79.5%).

PRIMARY AND SECONDARY OUTCOMES MEASURES

Using logistic regression, we examined whether self-reported assessment of various forms of bullying in the workplace was associated with Iso-strain (job with high demands and low control and without social support), gender and migrant status.

RESULTS

The prevalence of workplace bullying within the previous year was 14.5%. Sexual harassment, though rare (n=47, 1.8%), was reported by more women than men (83% vs 17%, χ²=19.3, p<0.0001) and more Australia or New Zealand born workers compared to India or the Philippines workers (75.5% vs 25.5%, χ²=4.6, p=0.032). Indian-born women had lower adjusted OR for being bullied and for being intimidated compared to other women. Independent of migrant status, Iso-strain (1), (low support from boss) and Iso-strain (2), (low support from colleagues) predicted being bullied. Women were more likely to be in an Iso-strain (1) job than men (18.7% vs 13.6%, p=0.013) and had twice the risk of being both verbally abused and intimidated compared to men (OR 9 vs OR 5.5, p<0.0001).

CONCLUSION

Workplace bullying was more likely for women than men. There were few differences between workers from different migrant groups. Iso-strain was the strongest predictor of workplace bullying. Workplaces should encourage supportive and collegiate work environments.

Developing a Job Exposure Matrix of Work Organization Hazards in the United States: A Review on Methodological Issues and Research Protocol

Background

Most job exposure matrices (JEMs) have been developed for chemical and physical hazards in the United States (US). In addition, the overall validity of most JEMs of work organization hazards using self-reported data in the literature remains to be further tested due to several methodological weaknesses.

Methods

This paper aims to review important methodological issues with regard to a JEM of work organization hazards using self-report data and to present a research protocol for developing a four-axis (job titles, hazards, sex, and time) JEM of major work organization hazards using the US General Social Survey-Quality of Work-Life (GSS-QWL) data (2002–2018; N = 7,100 workers).

Results

Five methodological weaknesses in existing JEMs of work organization hazards using self-report data were identified: having only two axes (hazard and occupation), using psychometrically weak items and scales, including scales having little interoccupational variability, unresolved optimal minimum numbers of subjects per occupation, and low accessibility. The methodological weaknesses were successfully addressed in the proposed research protocol.

Conclusion

The work organization JEM to be developed will significantly facilitate and strengthen occupational epidemiological studies on work organization hazards and major health outcomes, improve national and occupational surveillance of work organization hazards, and promote interventions for a healthy work environment in the US.

Psychosocial work exposures of the job strain model and cardiovascular mortality in France: results from the STRESSJEM prospective study

Objectives:

The study aims to explore the prospective associations of the psychosocial work exposures of the job strain model with cardiovascular mortality, including mortality for ischemic heart diseases (IHD) and stroke, using various time-varying exposure measures in the French working population of employees.

Methods:

The study was based on a cohort of 798 547 men and 697 785 women for which job history data from 1976 to 2002 were linked to mortality data and causes of death from the national death registry. Psychosocial work exposures from the validated job strain model questionnaire were assessed using a job-exposure matrix (JEM). Three time-varying measures of exposure were studied: current, cumulative, and recency-weighted cumulative exposure. Cox proportional hazards models were used to examine the associations between psychosocial work exposures and cardiovascular mortality.

Results:

Within the 1976–2002 period, there were 19 264 cardiovascular deaths among men and 6181 among women. Low decision latitude, low social support, job strain, iso-strain, passive job, and high strain were associated with cardiovascular mortality. Most of these associations were also observed for IHD and stroke mortality. The comparison between the different exposure measures suggested that current exposure may be more important than cumulative (or past) exposure. The population fractions of cardiovascular mortality attributable to job strain were 5.64% for men and 6.44% for women.

Conclusions:

Psychosocial work exposures of the job strain model may play a role in cardiovascular mortality. The estimated burden of cardiovascular mortality associated with these exposures underlines the need for preventive policies oriented toward the psychosocial work environment.

Working conditions and depression in the French national working population: Results from the SUMER study

OBJECTIVES

The objectives were to explore the associations between various types of occupational exposures and depression in the French national working population, most of the studies in the literature focussing on a limited number of exposures and on symptom scales.

METHODS

The study was based on a nationally representative sample of 25 977 employees, 14 682 men and 11 295 women. Depression was measured using the PHQ-9 instrument and algorithm. Occupational exposures included factors related to both the psychosocial and physical work environment. Weighted logistic regression analyses were performed to study the associations between exposures and outcome with adjustment for covariates among men and women separately.

RESULTS

The prevalence of depression was higher for women than for men (5.70% versus 3.78%). The final models showed that low decision latitude, low reward, bullying, work-family and ethical conflicts for both genders, and high psychological demands, low social support, and long working hours among women were risk factors for depression. No occupational exposure of physical, biomechanical, chemical and biological nature was associated with depression. Sensitivity analyses confirmed the robustness of the results.

CONCLUSIONS

Significant associations were found between psychosocial work exposures and depression, and there were some differences in these associations between genders. This study is one of the first to provide a comprehensive overview of occupational exposures in association with depression. More prevention towards the psychosocial work environment is needed to improve mental health of working populations.

Prospective associations of psychosocial work exposures with mortality in France: STRESSJEM study protocol

INTRODUCTION

Although evidence has been provided on the associations between psychosocial work exposures and morbidity outcomes in the literature, knowledge appears much more sparse on mortality outcomes. The objective of STRESSJEM is to explore the prospective associations between psychosocial work exposures and mortality outcomes among the national French working population. In this paper, we describe the study protocol, study population, data sources, method for exposure assessment, data analysis and future plans.

METHODS AND ANALYSIS

Data sources will include: the data from the national SUMER survey from DARES on the evaluation of psychosocial work exposures and the data from the COSMOP programme from Santé publique France linking job history (DADS data from INSEE) and mortality according to causes of death (data from the national death registry, INSERM-CépiDc). A sample of 1 511 456 individuals will form the studied prospective cohort for which data are available on both job history and mortality over the period 1976-2002. Psychosocial work exposures will be imputed via a job-exposure matrix using three job title variables that are available in both the SUMER and COSMOP data sets. Our objectives will be to study the associations between various psychosocial work exposures and mortality outcomes. Psychosocial work exposures will include the job strain model factors as well as other psychosocial work factors. Various measures of exposure over time will be used. All-cause and cause-specific mortality will be studied.

ETHICS AND DISSEMINATION

Both the SUMER survey and the COSMOP programme have been approved by French ethics committees. Dissemination of the study results will include a series of international peer-reviewed papers and at least one paper in French. The results will be presented in national and international conferences. This project will offer a unique opportunity to explore mortality outcomes in association with psychosocial work exposures in a large national representative sample of the working population.

Physical work demands and psychosocial working conditions as predictors of musculoskeletal pain: a cohort study comparing self-reported and job exposure matrix measurements

OBJECTIVES

Determining exposure to occupational factors by workers' job titles is extensively used in epidemiological research. However, the correspondence of findings regarding associations to health between job exposure matrices (JEMs) and individual-level exposure data is largely unknown. We set out to examine the prospective associations of physical work demands and psychosocial working conditions with musculoskeletal pain, comparing JEMs with individual-level self-reported exposures.

METHODS

We analysed data of 8132 participants from the Work Environment and Health in Denmark cohort study. Using random intercept multilevel modelling, we constructed age-specific and sex-specific JEMs estimating predicted exposures in job groups. We analysed associations between working conditions (individual and JEM level) at baseline and musculoskeletal pain at follow-up using multilevel modelling stratified by sex, adjusting for age, education and baseline pain.

RESULTS

Any consistent associations present in the individual-level analysis were also found in the JEM-level analysis. Higher pain levels at follow-up was seen for employees with higher baseline physical work demands, women exposed to violence and men with lower decision authority, whether measured at the individual or JEM level. Higher JEM-level quantitative demands were associated with less pain, but no association was seen at the individual level.

CONCLUSIONS

We found predominately comparable prospective associations between working conditions and pain, whether using JEMs or individual level exposures, with the exception of quantitative demands. The results suggest that, with few notable exceptions, findings obtained using JEMs may be comparable with those obtained when using self-reported exposures.