Exposure to psychosocial work factors in 31 European countries

Leaders as the targets of workplace bullying - prevalence and outcomes

PURPOSE

Bullying of leaders is an underexplored topic in organizational research. To fill this knowledge gap, the aims of this study were to determine the prevalence of bullying of leaders and to examine whether holding a formal leadership position influences the relationships between exposure to bullying and the outcomes job satisfaction and depression.

METHODS

Data from two separate surveys were employed: (1) A cross-sectional occupation specific sample comprising 678 Norwegian child welfare social workers; (2) A nationally representative probability sample of 1,608 Norwegian employees with two time-points (6 months' time-lag).

RESULTS

Analyzing multiple indicators of workplace bullying, holding a formal leadership position had no impact on the initial risk of being bullied. Analyses of prospective data showed that leaders report a somewhat stronger increase in levels of bullying over time compared to non-leaders, although the effect size was small. With exception of a small buffering effect on the cross-sectional association between exposure to bullying behaviors and job satisfaction in the second sample, holding a leadership position had no effect on the strength of the association between bullying and outcomes.

CONCLUSION

The findings show that leaders have the same risk of being bullied and are influenced by bullying in roughly the same manner as non-leaders. Organizational measures and interventions against bullying should therefore consider leaders as a risk group in line with other employees.

Incidence and Severity of Sexual Harassment, and its Impact on Mental Health in a Cohort of International Humanitarian Field-Workers

To date, there have been no cohort studies of sexual harassment incidence and its relation to mental health within humanitarian field-workers. Research among numerous occupations suggests an association between workplace sexual harassment and several health complaints. This study examined the incidence and severity of sexual harassment and its association with changes in mental health in a cohort of international humanitarian aid field-workers (iHAWs). Four hundred and seventy-eight iHAWs filled in questionnaires about sexual harassment, depression, anxiety, and Post-Traumatic Stress Disorder (PTSD) as part of a larger study on health and well-being. Six percent of male and 18% of female iHAWs reported experiencing sexual harassment during their latest field assignment, with most reporting low levels of nonphysical forms of sexual harassment. Sexual harassment was predictive of negative changes in both depression and anxiety symptom severity between before and after an assignment for females; for males, it predicted negative changes in PTSD symptom severity. Sexual harassment did not predict utilization of mental healthcare services within 2 months after the end of assignment. The current findings are the first figures derived from a representative sample of iHAWs on the incidence of sexual harassment during a field assignment and show sexual harassment to be a relatively common and present issue. The findings are mostly in line with the extant literature and underscore the importance of attending to the issue of sexual harassment in the humanitarian sector.

Assessment of psychosocial work hazards and workplace deviant behaviours of teachers in rural community-based schools

This is a cross-sectional study that assessed the psychosocial work hazards and workplace deviant behaviours of teachers in rural community-based schools. A total of 254 primary school teachers participated in the study. Copenhagen Psychosocial Questionnaire (COPSOQ) and Work Deviance Behaviour Scale were employed to elicit the teachers' responses. The descriptive statistics (frequency and percentage), and Pearson's correlation (r) statistical analysis were used to analyse the data. The results showed that the primary school teachers experience elements of psychosocial work hazards. It was also indicated that primary school teachers rarely exhibit work deviant behaviours. There is a significant positive relationship between psychosocial work hazards and workplace deviant behaviours of primary school teachers in Enugu State. In conclusion, it was suggested that teachers experience psychosocial work hazards and exhibit workplace deviant behaviours in primary schools in Enugu State Nigeria. Therefore, professionals in workplaces including schools should design practicable interventions that would help to reduce workplace deviance among employees in different works of life. With this, these should be reflected in decision-making and policies implementations to rural communities and beyond.

High Emotional Demands at Work and Poor Mental Health in Client-Facing Workers

This study investigated the association between emotional demands and depression or anxiety in a wide range of jobs. We used data from the third Korean Working Conditions Survey (n = 50,032) for all occupational classifications, with no limitations placed on job title or employment type. Among the full set of regular paid workers in addition to self-employed, unpaid family workers, and informal employees such as independent contractors, 23,989 respondents worked with “customers, passengers, students, or patients” (i.e., clients). Emotional demands were evaluated using two questions: handling angry clients and needing to hide feelings for work performance. Any depression or anxiety over the last 12 months was taken to indicate poor mental health. Multivariable logistic regression modeling was performed to calculate adjusted ORs with 95% confidence intervals for the influence of emotional demands on mental health, adjusting for demographic factors (age, gender, education, income), occupational psychological demands, decision latitude, social support, weekly work hours and job insecurity. The prevalence of emotional demands was higher in self-employed and informal employees than in regular paid employees. The more frequent the exposure to the two emotional demands combined was, the higher the risk of depression or anxiety. High psychological demands, low social support, and low job security each further increased the risk of poor mental health. Emotional demands turned out to be widespread in the entire economy, were not limited to service or sales occupations, and were more evident in precarious work. The contribution of emotional demands and other preventable job stressors to the burden of depression or anxiety in society may be substantial.

Long-term trends in psychosocial working conditions in Europe-the role of labor market policies

Background

Employees have witnessed rising trend in work stress over the last few decades. However, we know a little about country differences in those trends. Our article fills this gap in the literature by examining heterogeneities in trends in working conditions by country groups defined by their amount of investment into labor market policy (LMP) programs. Additionally, we provide findings on differences in occupational inequalities between country groups.

Methods

We use comparative longitudinal data of the European Working Conditions Surveys including cross-sectional information on employees from 15 countries surveyed in Waves 1995, 2000, 2005, 2010 and 2015. Estimation results are provided by three-way multilevel models with employees nested within country-years nested within countries. Our work stress measure is the proxy version of job strain based on the demand-control model.

Results

Our regression results indicate that for employees in countries with the least LMP spending job strain increased by 10% from 1995 to 2015 compared to a smaller and insignificant change in middle- and high-LMP countries. In low-LMP countries, inequalities in job strain also widened during the studied period: the gap in job strain between the highest- and lowest-skilled increased by 60% from 1995 to 2015. This contrasts a stable gap in middle- and high-LMP countries.

Conclusions

Our results direct the attention to the vulnerable position of the least skilled and highlight that LMP investments may buffer some of the adverse impacts of globalization and technological changes and effectively improve the labor market situation of the least skilled.

Update of the fractions of cardiovascular diseases and mental disorders attributable to psychosocial work factors in Europe

OBJECTIVES

The objectives of this study were to provide the fractions of cardiovascular diseases and mental disorders attributable to five psychosocial work exposures, i.e. job strain, effort-reward imbalance, job insecurity, long working hours, and bullying in Europe (35 countries, including 28 European Union countries), for each one and all countries together, in 2015.

METHODS

The prevalences of exposure were estimated using the sample of 35,571 employees from the 2015 European Working Conditions Survey (EWCS) for all countries together and each country separately. Relative risks (RR) were obtained via literature reviews and meta-analyses already published. The studied outcomes were: coronary/ischemic heart diseases (CHD), stroke, atrial fibrillation, peripheral artery disease, venous thromboembolism, and depression. Attributable fractions (AF) for each exposure and overall AFs for all exposures together were calculated.

RESULTS

The AFs of depression were all significant: job strain (17%), job insecurity (9%), bullying (7%), and effort-reward imbalance (6%). Most of the AFs of cardiovascular diseases were significant and lower than 11%. Differences in AFs were observed between countries for depression and for long working hours. Differences between genders were found for long working hours, with higher AFs observed among men than among women for all outcomes. Overall AFs taking all exposures into account ranged between 17 and 35% for depression and between 5 and 11% for CHD.

CONCLUSION

The overall burden of depression and cardiovascular diseases attributable to psychosocial work exposures was noticeable. As these exposures are modifiable, preventive policies may be useful to reduce the burden of disease associated with the psychosocial work environment.

Assessment of the influence of psychosocial factors on musculoskeletal disorder symptom intensity

BACKGROUND

Previous studies have observed that psychosocial factors are associated with an increase in work-related musculoskeletal disorders (WMSDs) in European countries. However, the influence of psychosocial factors on the WMSD symptoms has not been studied in detail. Additionally, working conditions differ between developing and developed countries.

OBJECTIVE

In this study, the influence of psychosocial factors on WMSD symptoms among men and women in the footwear industry in northeastern Brazil is investigated.

METHODS

A questionnaire survey was conducted to evaluate workers' perceptions of psychosocial factors and WMSD symptoms. The influence of psychosocial factors on WMSD symptom trends was observed through ordinal logistic regression models.

RESULTS

It was found that different psychosocial factors are related to WMSD symptom intensification. Factors such as "job insecurity" and "low social support," which are not associated with the worsening of WMSD symptoms in developed countries, showed a noticeable influence in the sample analyzed.

CONCLUSION

These findings may be associated with differences in working conditions and economic problems in developing countries, suggesting that some psychosocial factors have a different effect on workers' perceptions in developing countries.

Study for the Design of a Protocol to Assess the Impact of Stress in the Quality of Life of Workers

(1) Background: Work stress is one of the most relevant issues in public health. It has a significant impact on health, especially the development of mental disorders, causing occupational imbalance. There is a growing interest in the development of tools with a positive effect on workers. To this end, wearable technology is becoming increasingly popular, as it measures biometric variables like heartbeat, activity, and sleep. This information may be used to assess the stress a person is suffering, which could allow the development of stress coping strategies, both at a professional and personal level. (2) Methods: This paper describes an observational, analytical, and longitudinal study which will be set at a research center in A Coruña, Spain. Various scales and questionnaires will be filled in by the participants throughout the study. For the statistical analysis, specific methods will be used to evaluate the association between numerical and categorical variables. (3) Discussion: This study will lay the foundation for a bigger, more complete study to assess occupational stress in different work environments. This will allow us to begin to understand how occupational stress influences daily life activity and occupational balance, which could directly enhance the quality of life of workers if the necessary measures are taken.

Cumulative disadvantage during employment careers - The link between employment histories and stressful working conditions

Accumulated evidence on health-adverse effects of stressful psychosocial and physical work environments is considered a major breakthrough in recent social epidemiological research. However, research on adverse health effects of repeated exposure over time is lacking. In this contribution we analyse associations of characteristics of adverse employment histories with stressful psychosocial and physical current working conditions. We use data from the French CONSTANCES study and restrict the sample to employed men and women aged 45-60 (n = 23652). Current working conditions are assessed by effort-reward imbalance as well as stressful physical working tasks and positions. Previous employment histories (between age 25 and 45) are retrospectively assessed and measured by indicators of precarious, discontinuous and disadvantaged working careers. We found consistent associations of precarious, discontinuous or disadvantaged careers with strenuous physical working conditions and with low occupational rewards. However, low effort rather than high effort was associated with adverse employment histories. Therefore, associations with the effort-reward ratio turned out to be inconsistent. By extending the scope of analysis beyond single time-point measures, we identified three types of adverse employment histories among employees between age 25 and 45 in a stress-theoretical framework, and we demonstrated their associations with employees' current adversity at work between the age of 45-60.

Work stress on rise? Comparative analysis of trends in work stressors using the European working conditions survey

Objective

The rapid transformation of labor markets has been accompanied by the belief of rising stress at work. However, empirical evidence on such trends based on reliable survey data is scarce. This study analyzes long-term trends in well-established measures of work stressors across Europe, as well as potential occupational differences.

Methods

We use repeated cross-sectional data of 15 European countries from waves 1995, 2000, 2005, 2010, and 2015 of the European Working Conditions Surveys. We apply three-way multilevel regressions (with employees nested in country-years, which are in turn nested in countries) to analyze trends in work stressors measured according to the demand-control and effort-reward imbalance models. Trends by occupational groups are also assessed.

Results

Our findings suggest that work stress generally increased from 1995 to 2015, and that the increase was mostly driven by psychological demands. People working in lower-skilled occupations had generally higher levels of job strain and effort-reward imbalance, as well as they tend to have a steeper increase in job strain than people working in higher-skilled occupations. Most of the change occurred from 1995 to 2005.

Conclusion

Our results indicate that work stress has been on rise since 1995, specifically for people working in disadvantageous occupations. This directs the attention to the vulnerable position of the least skilled and also to the use of preventive measures to counteract some of the disadvantages experienced by this occupational group.

Associations between change in labour market policies and work stressors: a comparative longitudinal survey data analysis from 27 European countries

BACKGROUND

Many studies have shown that work stressors have a negative impact on health. It is therefore important to gain an understanding of how work stressors can be reduced. Recent studies have shown that employees in countries with high investments into labour market policies less often report exposure to work stressors. Although these studies are indicative of an influence of the political level on work stressors, they are based on cross-sectional cross-country analyses where causal assumptions are problematic. The aim of this study is to extend the existing evidence by longitudinally testing whether changes in labour market policies are related to changes in work stressors.

METHODS

We used comparative longitudinal survey data from the European Working Conditions Survey (27 countries; for the years 2005, 2010, 2015). The measurement of work stressors is based on two established work stress models: effort-reward imbalance (ERI) and job demand-control (job strain). To measure labour market policies, we used information on active (ALMP) and passive labour market policies (PLMP). After excluding persons with missing data, 64,659 participants were eligible for the ERI and 67,114 for job strain analyses. Estimation results are provided by three-way multilevel models (individuals, country-years, country), which allow us to estimate longitudinal and cross-country macro-effects.

RESULTS

An increase in ALMP leads to a decrease of ERI. The analyses for the subcomponents 'effort' and 'reward' showed that mainly the 'reward' component is positively associated with ALMP. The association between ALMP and 'reward' shows that an increase in ALMP investments is related to an increase in rewards. Yet, no significant longitudinal associations between ALMP and job strain, and between PLMP and the work stressors, were observed.

CONCLUSIONS

The study extends the current knowledge with longitudinal information by showing that an increase in ALMP is associated with an increase in rewards and a decrease of ERI. These longitudinal analyses may support a causal interpretation. The findings of this study have important policy implications. Our main result suggests that investments into ALMP can lead to better working conditions.

Interventions as the centrepiece of psychosocial risk assessment – why so difficult?

Purpose

Due to the “European Union Framework Directive on Safety and Health at work” (Directive 89/391/EEC, 1989), every employer is obliged to avoid psychosocial hazards when designing work. Little is known empirically about the barriers that workplace actors experience while developing and implementing OSH measures that prevent psychosocial hazards. The purpose of this paper is to explore barriers, causes and attempts to overcome them and discusses them with reference to relevant theoretical concepts and models that help to explain how these barriers hinder the development and implementation of OSH measures.

Design/methodology/approach

Semi-structured interviews with workplace actors in charge of psychosocial risk assessment (PRA) were conducted in 41 business cases, and transcripts were analysed using a thematic analysis approach. Barriers, causes and attempts to overcome them were extracted inductively and discussed with reference to relevant theories and explanatory models.

Findings

The complex nature of psychosocial risks, hindering general beliefs, lack of a perceived scope for risk avoidance, lack of assumptions of responsibility among players on all hierarchical levels, discrepancies between formal responsibility and decision authority, and low reflexivity on processes of development and implementation of interventions were described as barriers. Causes and attempts to overcome these barriers were reflected upon by workplace actors.

Practical implications

Recommendations on the organisation of PRA will be given with respect to the reported results and relevant research in this field.

Originality/value

This qualitative study explores the barriers to developing and implementing OSH measures to eliminate psychosocial hazards, from the perspective of actors in charge of PRA, and why they might fail.

A psychosocial theory of sick leave put to the test in the European Working Conditions Survey 2010-2015

PURPOSE

In the present investigation a psychosocial theory of sick leave is proposed which integrates work-related determinants, health effects of particular work characteristics, and workers' health status. In addition, the theory explicitly formulates a series of mediators and moderators of the associations between work-related determinants and sick leave. On the basis of the theoretical assumptions and previous research findings, a series of research hypotheses are investigated with survey data.

METHODS

The study is based on data from the European Working Conditions Survey 2010 and 2015 (n = 59,790). The research hypotheses are investigated by means of generalised linear mixed models within the framework of hierarchical Bayesian regression models and Markov Chain algorithms. The theory is assessed by estimating three so-called hurdle models, which take into account the excess zeros usually observed in sick leave rates.

RESULTS

In general, the findings provide evidence of the adequacy of the theory explaining the observed variation of sick-leave rates. Several biomechanical and psychosocial characteristics of the working environment, occupation, age, and the subjective assessment of health status were found to be strongly associated with both the likelihood of being in sick leave and the length of sick-leave spells.

CONCLUSIONS

The theory and the findings of the present study may serve as a basis for the development and implementation of occupational health interventions aiming to reduce sick-leave rates in organisations.

Effects of workplace bullying on Chinese children's health, behaviours and school adjustment via parenting: study protocol for a longitudinal study

Background

Bullying in the workplace is a serious public health issue. As a chronic work stress, workplace bullying places the victims’ physical and mental health at risk which, in extreme cases, may lead to suicidal ideation. The high prevalence rate of workplace bullying has been reported and documented globally. However, a major limitation of the existing literature is that studies essentially focus on the consequences of workplace bullying on victims, including the psychological, physiological and socioeconomic impacts, and on the factors causing workplace bullying, but research on the impact of workplace bullying on the victims’ families is lacking. It is however evident that the consequences of workplace bullying have a spillover effect on the victims’ family members. Since many victims have children and given that children are particularly vulnerable to a negative family environment, examining the impacts of the type of parental stress induced by workplace bullying on children’s health including physical and psychological health (depression and self-esteem), externalizing problem behaviors (aggression, lying, disrespect) and school adjustment (academic performance and school conduct) is urgently needed. The overall aim of this study is to examine how health, externalizing problem behaviors and school adjustment of children whose parents are victims of workplace bullying may be associated with the impact that workplace bullying has on parenting practices.

Methods

It is a longitudinal study. Quantitative data will be collected from multi-informants, including currently employed Chinese parents, their children aged between 6 and 12 years old, and their class teachers at two time points, separated by a 1-year interval. One primary school will be recruited from each district of Hong Kong including participants with different socioeconomic backgrounds. At least 837 dyads (parents and children) from 18 primary schools will join the study.

Discussion

Workplace bullying not only affects victims but can also be harmful to their families as it alters the victims temper in the family environment. Results will be informative for the government and corporations to make concerted efforts and find strategies to prevent workplace bullying and to heighten the awareness of the importance of promoting safe and respectful workplaces for workers.

Workplace bullying among employees in Germany: prevalence estimates and the role of the perpetrator

OBJECTIVES

The aim of this study was to examine the prevalence of workplace bullying in Germany while also taking the perpetrator and severity level (measured by frequency) into account and considering the role of gender, age and socio-economic status.

METHODS

We used data from a large representative sample (N = 4143) of employees in Germany subject to social security contributions. Self-reported bullying was assessed for different combinations of perpetrators (co-workers, superiors) and according to severity, i.e., being exposed at all and to severe bullying (at least weekly).

RESULTS

Prevalence estimates varied from 2.9% for severe bullying by co-workers to 17.1% for overall bullying (i.e., without distinguishing by perpetrator, less severe bullying also included). Unskilled workers reported more bullying by both perpetrators than academics/managers. We also observed an age trend for severe bullying by superiors (i.e., bossing), with younger employees being more affected from bossing than elder. No gender differences were detected.

CONCLUSIONS

The findings indicate that it is crucial to consider type of perpetrator and severity of the behaviors when examining the prevalence of workplace bullying. The way bullying is defined and operationalized strongly contributes to the prevalence estimates. Differences between subgroups and associations or cause-effect relationships should be analyzed with these variations in mind.

Gender differences in paid employment after retirement : Psychosocial working conditions and well-being

BACKGROUND

An increasing number of persons continue to work after retirement age. This decision is often different between men and women as well as working histories, sectors and hierarchical positions; however, whether gender differences in working conditions and occupational well-being also exist in paid employment after retirement (PEAR) has not yet been investigated.

OBJECTIVE

This study aimed to examine gender differences in working conditions and well-being of workers in PEAR.

MATERIAL AND METHODS

In this study 784 employees (23.5% female) aged 65 years and older who were contracted by a Dutch temporary employment agency, participated in the baseline survey in 2011. Furthermore, a panel of 228 employees (25.9% female) participated again during a second wave in 2012. Job demands, job control, emotional exhaustion and job engagement were assessed at both time points by validated self-reporting measures.

RESULTS

Female employees worked fewer years in paid employment before 65 years of age, were more likely to be single, divorced or widowed, had a smaller income and worked less hours during PEAR than men. In the baseline analysis, females reported less job control and higher job stress than men. No gender differences were found on emotional exhaustion, engagement or job demands. Over the study period emotional exhaustion only increased in females. The longitudinal trend of job demands, control and engagement did not significantly differ between both sexes.

CONCLUSION

The results suggest that working conditions of PEAR are less favorable for women than for men. Furthermore, the longitudinal trend of emotional exhaustion seems to be more disadvantageous for women.

One's Workplace, Other's Home? Work and Health of Domestic Workers in Argentina

Background:

Domestic workers around the world work and eventually live in private homes where control of working conditions is difficult.

Objective:

The aim of this study was to compare working conditions and its impact on general and mental health in live-in and live-out domestic workers in Argentina.

Methods:

In a cross-sectional study, the Spanish version of the European Workings Condition Survey and an ad hoc questionnaire were applied to 201 domestic workers (response 94%). Twelve months’ prevalence of verbal or physical workplace violence was assessed. Poor general health was defined by general health self-assessed as poor or fair. Symptoms of common mental disorders (CMD) were considered present if Goldberg’s general health score was above 4. Data were analyzed using Chi square’s test and logistic regression models.

Findings:

Live-in workers formed 66% of the participants. They were more likely to take care of the elderly, iron and cook than live-out workers. Workplace violence was reported by 17% of live-in and 24% of live-out workers (p = 0.25). Overall prevalence of poor general health was 23%; 53% reported CMD. After adjustment, violence remained a statistically significant predictor of poor general health (Odds Ratio 7.3; 95% Confidence Interval 2.8–19.1) and CMD (3.2; 1.1–9.3).

Conclusions:

Working conditions of live-in and live-out domestic workers are different. However, exposure to workplace violence is common in both groups and affects general and mental health.

Effort-Reward Imbalance at Work and Incident Coronary Heart Disease: A Multicohort Study of 90,164 Individuals

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Background:

Epidemiologic evidence for work stress as a risk factor for coronary heart disease is mostly based on a single measure of stressful work known as job strain, a combination of high demands and low job control. We examined whether a complementary stress measure that assesses an imbalance between efforts spent at work and rewards received predicted coronary heart disease.

Methods:

This multicohort study (the “IPD-Work” consortium) was based on harmonized individual-level data from 11 European prospective cohort studies. Stressful work in 90,164 men and women without coronary heart disease at baseline was assessed by validated effort–reward imbalance and job strain questionnaires. We defined incident coronary heart disease as the first nonfatal myocardial infarction or coronary death. Study-specific estimates were pooled by random effects meta-analysis.

Results:

At baseline, 31.7% of study members reported effort–reward imbalance at work and 15.9% reported job strain. During a mean follow-up of 9.8 years, 1,078 coronary events were recorded. After adjustment for potential confounders, a hazard ratio of 1.16 (95% confidence interval, 1.00–1.35) was observed for effort–reward imbalance compared with no imbalance. The hazard ratio was 1.16 (1.01–1.34) for having either effort–reward imbalance or job strain and 1.41 (1.12–1.76) for having both these stressors compared to having neither effort–reward imbalance nor job strain.

Conclusions:

Individuals with effort–reward imbalance at work have an increased risk of coronary heart disease, and this appears to be independent of job strain experienced. These findings support expanding focus beyond just job strain in future research on work stress.

Effects of cognitive loading and force on upper trapezius fatigue

Background

Musculoskeletal disorders (MSDs) are particularly common in the shoulder/neck region for some tasks that involve low force exertions, for example computer work. It has been demonstrated that muscle activity may be stimulated by cognitively demanding tasks. There is a lack of studies on the relationship between qualitative levels of cognitive loading, level of muscle activity, and muscle fatigue.

Aims

To investigate the effects of quantitative levels of cognitive loading on conduction velocity changes and isometric endurance times for the upper trapezius.

Methods

Participants performed a combination of three levels of a cognitively demanding computer task (0, 1.59 and 3 Bits) while simultaneously performing either of two isometric endurance tests (20 and 40% MVC) for the upper trapezius.

Results

Information load had a significant effect (P < 0.05) on normalized conduction velocity slopes for the 40% but not for the 20% maximum voluntary contraction conditions. Information load had a highly significant effect on endurance times for both exertion levels (P < 0.01).

Conclusions

This study found that performing a high-difficulty cognitive task while simultaneously performing increasingly higher levels of static isometric shoulder abduction exertions, fatigued the trapezius muscle quicker than performing an equivalent exertion with low cognitive load. This is particularly relevant to workplaces with increasing levels of automation that require high levels of decision making and computer use.

[Respiratory cancers attributable to occupational exposures: what is the cost to society in France]

OBJECTIVE

To estimate the social cost of respiratory cancers attributable to occupational risk factors in France in 2010.

METHODS

We estimated the number of cases of respiratory cancers attributable to each identified occupational risk factor according to the attributable fractions method. We also estimated direct (costs of hospital stays, drugs, outpatient care) and indirect costs (production losses) related to morbidity (absenteeism and presenteeism) and mortality (years of lost production). Production losses for paid work and unpaid domestic activities were taken into account.

RESULTS

The social cost of respiratory cancers (lung, larynx, sinonasal, pleural mesothelioma) attributable to exposure to asbestos, chromium, diesel engine exhaust, polycyclic aromatic hydrocarbons, painting occupations (unidentified carcinogen), crystalline silica, wood and leather dust in France in 2010 was estimated to be between €960 and 1,866 million. The cost of lung cancer represents between €804 and 1,617 million. The three risk factors with the greatest impact are asbestos (€530 to 890 million), diesel engine exhaust (€227 to 394 million), and crystalline silica (€116 to 268 million).

CONCLUSION

These results provide a conservative estimate of the public health and economic burden of respiratory cancers attributable to occupational risk factors from a societal perspective.

Taking Account of Gender Differences When Designing Interventions in Occupational Health? Lessons from a Study of the "Healthy Enterprise" Standard in Québec: Les différences de genre sont-elles prises en compte lors de la conception des interventions de prévention en santé au travail? Résultats d une étude sur la norme "Entreprises en Santé" dans les entreprises au Québec

The literature shows substantial differences in occupational exposures between men and women, both between and within occupations, but remains very sparse on whether interventions are tailored to gender differences in the workplace. Our objective was to determine whether gender differences are taken into account when designing prevention interventions. This study is part of a project on the evaluation of interventions implemented in the framework of the "Healthy Enterprise" standard in Quebec organizations. Three sets of quantitative and qualitative data were collected in seven organizations and triangulated. Our results show that in the process of elaborating and implementing activities, the main objectives were to reach a maximum number of workers and meet the needs identified in a health and risk diagnosis. Activities were not tailored to the needs of specific subgroups of employees, such as gender or age. Not distinguishing men's and women's situations in this diagnosis may play a role in intervention design. Résumé La littérature montre des différences d'exposition au travail importantes entre les hommes et les femmes, y compris à catégories d'emploi identiques. Les études sur l'adaptation des interventions de prévention aux différences de genre dans les milieux de travail sont quasiment inexistantes dans la littérature. Notre objectif était de déterminer dans quelle mesure les différences de genre sont prises en compte lors de la conception des interventions de prévention. Cette étude fait partie d'un projet d'évaluation des interventions mises en œuvre dans le cadre de la norme «Entreprises en santéé au Québec. Trois séries de données quantitatives et qualitatives ont été collectées auprès de sept organisations et analysées par triangulation. Nos résultats montrent que lors du processus d'élaboration des activités, les principaux objectifs étaient d'atteindre un nombre maximal de travailleurs et de remplir les besoins identifiés dans le diagnostic des risques et de la santé des travailleurs. Le fait que la situation des hommes et des femmes n'ait pas été analysée séparément dans le diagnostic peut avoir joué un râle dans ce résultat. Les activités de prévention n'ont pas été conçues en tenant compte de sous-groupes de travailleurs en fonction du genre ou de l'âge.

Country differences of psychosocial working conditions in Europe: the role of health and safety management practices

BACKGROUND

In times of demographic change, maintaining health and employability of older employees is important. In this context, studies show that stressful working conditions differ by countries. Yet, it is unclear if specific national management practices to deal with these conditions contribute towards explaining country differences.

METHODS

This study combines two different data sources. The first one provides detailed information on psychosocial working conditions in 17 European countries, based on 12,284 employees from the Survey of Health, Ageing and Retirement in Europe (SHARE) and the English Longitudinal Study of Ageing (ELSA). We link this information to the second data source that provides information on health and safety management practices in each of the countries under study (collected among 17,477 managers at the level of companies in the Enterprise survey on new and emerging risks (ESENER)). We distinguish six different types of risk management procedures in the analysis.

RESULTS

Results show that levels of psychosocial risks are generally lower in countries with more developed management practices, in particular if national management practices are marked by (1) procedures to deal with work stress, (2) information about whom to address in case of work-related psychosocial problems, and (3) health and safety services provided by psychologists.

CONCLUSION

The findings underline the importance of a comprehensive psychosocial risk management approach in reducing work-related stress, as lower levels of psychosocial risks are linked to specific psychosocial risk management practices within companies, in particular those pointing to clear responsibilities and coordinated procedures in dealing with psychosocial risks.

The Contribution of Individual, Social and Work Characteristics to Employee Mental Health in a Coal Mining Industry Population

BACKGROUND

Evidence regarding the extent of mental health problems and the associated characteristics within an employee population is necessary to inform appropriate and tailored workplace mental health programs. Mental health within male dominated industries (such as mining) has received recent public attention, chiefly through observations regarding suicide in such populations in Australia and internationally. Currently there is limited empirical evidence regarding the mental health needs in the mining industry as an exemplar of a male dominated workforce, and the relative contribution to such problems of individual, socio-economic and workplace factors. This study aimed to investigate the mental health and associated characteristics among employees in the Australian coal mining industry with a specific focus on identifying modifiable work characteristics.

METHODS

A cross-sectional study was conducted among employees (n = 1457) across eight coal mines stratified by key mine characteristics (state, mine type and employee commute arrangements). Participants completed measures of psychological distress (K10+) and key variables across four categories (socio-demographic characteristics, health history, current health behaviours, work attitudes and characteristics).

RESULTS

Psychological distress levels within this sample were significantly higher in comparison with a community sample of employed Australians. The following factors contributed significantly to levels of psychological distress using hierarchical linear regression analysis: lower social networks; a past history of depression, anxiety or drug/alcohol problems; high recent alcohol use; work role (managers) and a set of work characteristics (level of satisfaction with work, financial factors and job insecurity; perception of lower workplace support for people with mental health problems.

CONCLUSION

This is the first study to examine the characteristics associated with mental health problems in the Australian coal mining industry. The findings indicate the salience of mental health needs in this population, and the associated interplay of personal, social and work characteristics. The work characteristics associated with psychological distress are modifiable and can guide an industry response, as well as help inform the understanding of the role of workplace factors in mental health problems in a male dominated workforce more generally.

Globalization, Work, and Cardiovascular Disease

Cardiovascular disease (CVD), a global epidemic, is responsible for about 30% of all deaths worldwide. While mortality rates from CVD have been mostly declining in the advanced industrialized nations, CVD risk factors, including hypertension, obesity, and diabetes, have been on the increase everywhere. Researchers investigating the social causes of CVD have produced a robust body of evidence documenting the relationships between the work environment and CVD, including through the mechanisms of psychosocial work stressors. We review the empirical evidence linking work, psychosocial stressors, and CVD. These work stressors can produce chronic biologic arousal and promote unhealthy behaviors and thus, increased CVD risk. We offer a theoretical model that illustrates how economic globalization influences the labor market and work organization in high-income countries, which, in turn, exacerbates job characteristics, such as demands, low job control, effort-reward imbalance, job insecurity, and long work hours. There is also a growing interest in “upstream” factors among work stress researchers, including precarious employment, downsizing/restructuring, privatization, and lean production. We conclude with suggestions for future epidemiologic research on the role of work in the development of CVD, as well as policy recommendations for prevention of work-related CVD.

Job strain, bullying and violence at work and asthma in Peruvian cleaners-a cross-sectional analysis

OBJECTIVES

An increased asthma prevalence was found in cleaners. Many of them work in precarious employment conditions, potentially leading to stress, a known risk factor for asthma. We aimed to analyze whether asthma in cleaners might partly be explained by psychosocial working conditions.

METHODS

The study population of this cross-sectional study included 199 cleaners employed at regional public health services in Puno Province (Peru). They were compared to 79 unexposed workers from Lima, Peru (response 83%). Both groups answered the short version of the European Working Condition Survey and a modified version of the European Community Respiratory Health screening questionnaire. After multiple imputation, the association between psychosocial working conditions and asthma (wheeze without cold or use of asthma medication) was assessed.

RESULTS

The 12-months prevalence of asthma was 22% among cleaners versus 5% among unexposed workers (pChi(2) = .001). Cleaners were more likely than unexposed workers to work with temporary or sub-contracts, have a high employment insecurity, high strain working conditions and low social support (all pChi(2) < .05). Twenty-six percent vs. 10% reported a high bullying score; 39% vs. 8% had experienced violence at work (both pChi(2) < .001). High bullying score (adjusted Odds Ratio 5.6; 95% Confidence Interval 1.5-21.4) and violence (2.4; 1.1-5.4) were the main predictors of asthma. Taking these factors into account, being a cleaner was not statistically significantly associated with the outcome (3.5; 0.9-13.8).

CONCLUSIONS

Poor psychosocial working conditions of cleaners may partly explain the high prevalence of asthma. The underlying mechanism might be a stress-induced inflammatory immune response.

Systematic comparative content analysis of 17 psychosocial work environment questionnaires using a new taxonomy

BACKGROUND

Many questionnaires have been developed to measure how psychosocial characteristics are perceived in a work environment. But the content validity of these questionnaires has rarely been questioned due to the absence of a reference taxonomy for characteristics of work environments.

OBJECTIVES

To propose an exhaustive taxonomy of work environment characteristics involved in psychosocial risks and to apply this taxonomy to questionnaires on workplace psychosocial factors.

METHODS

The taxonomy was developed by categorizing factors present in the main theoretical models of the field. Questionnaire items most frequently cited in scientific literature were retained for classification.

RESULTS

The taxonomy was structured into four hierarchical levels and comprises 53 categories. The 17 questionnaires analyzed included 927 items: 59 from the "physical environment" category, 116 from the "social environment" category, 236 from the "work activity" category, 255 from the "activity management" category, and 174 from the "organizational context" category.

CONCLUSIONS

There are major content differences among analyzed questionnaires. This study offers a means for selecting a scale on the basis of content.

Wellbeing and occupational risk perception among health care workers: a multicenter study in Morocco and France

Background

The study analyzes health care workers’ (HCWs) occupational risk perception and compares exposure to occupational risk factors in Moroccan and French hospitals.

Method

Across nine public hospitals from three Moroccan regions (north, center and south), a 49 item French questionnaire, based on the Job Content Questionnaire, and 4 occupational risks subscales, was distributed to 4746 HCWs. Internal consistency of the study was determined for each subscale. Confirmatory factor analysis was conducted on the Moroccan questionnaire. Psychosocial job demand, job decision latitude and social support scores analysis was used to isolate high strain jobs. Occupational risks and high strain perception correlation were analyzed by univariate and multivariate logistic regression. A comparative analysis between Moroccan and French (Nantes Hospitals) investigations data was performed.

Results

In Morocco, 2863 HCWs (60 %) answered the questionnaire (54 % women; mean age 40 years; mean work seniority 11 years; 24 % physicians; 45 % nurses). 44 % Moroccan HCWs are at high strain. Casablanca region (1.75 OR; CI: 1.34–2.28), north Morocco (1.66 OR; CI: 1.27–2.17), midwives (2.35 OR; 95 % CI 1.51–3.68), nursing aides (1.80 OR; 95 % CI: 1.09–2.95), full-time employment (1.34 OR; 95 % CI 1.06–1.68); hypnotics, sedatives use (1.48 OR; 95 % CI 1.19–1.83), analgesics use (1.40 OR; 95 % CI 1.18–1.65) were statistically associated to high strain. 44% Moroccan HCWs are at high strain versus 37 % French (Nantes) HCWs (p < 0.001).

Conclusion

Moroccan HCWs have high strain activity. Moroccan HCWs and more Moroccan physicians are at high strain than Nantes HCWs. Moroccan and French’s results showed that full time workers, midwives, workers using hypnotics, and analgesics are at high strain. Our findings underscore out the importance of implementing a risk prevention plan and even a hospital reform. Further research, with an enlarged study pool will provide more information on psychosocial risks (PSR) and HCWs’ health.

Linking Quality of Work in Midlife to Volunteering During Retirement: a European Study

There is increasing recognition that disadvantaged work and employment conditions over the life course, including psychosocial stress at work, have negative long-term effects on health at older ages. Yet, the question whether stress at work additionally influences the likelihood of participating in voluntary work during retirement still needs to be explored. This paper studies long-term influences of stressful work during adulthood (as defined by low control and low reward at work) on participation in voluntary work in older ages. Analyses are based on the Survey of Health Ageing and Retirement in Europe (SHARE), with detailed retrospective information on individual life courses collected among 11,751 retired men and women in 13 European countries. Results of multivariable analyses demonstrate that people who experienced stressful work are also less likely to participate in voluntary work during retirement. Importantly, these associations remain significant after controlling for important factors, including disability in older ages and disadvantaged socioeconomic circumstances. In conclusion, findings suggest that promoting good working conditions may not only increase health and well-being, but also encourage participation in productive activities after labour market exit.

Associations of neighborhood-level workplace violence with workers' mental distress problems: a multilevel analysis of Taiwanese employees

OBJECTIVE

Workplace violence is known to pose mental health risks. However, whether or not workplace violence in a surrounding area might further increase the risk of mental distress in workers has rarely been examined.

METHODS

The study subjects were 9,393 male and 7,716 female employees who participated in a nationwide survey in 2010. Their personal experiences of workplace violence over the past 1 year were ascertained by a standardized questionnaire. Also assessed were their psychosocial work characteristics and mental distress problems. Neighborhood-level workplace violence was computed based on aggregated data at the county level and was categorized into low-, medium-, and high-level categories. Multilevel logistic regression models were constructed to examine the associations between neighborhood-level workplace violence and individual-level mental distress problems, with adjustment of individual-level experience of workplace violence.

FINDINGS

The neighborhood-level prevalence of workplace violence ranged from 4.7 to 14.7% in men and from 6.4 to 14.8% in women across 22 counties. As compared with those who live in counties of the lowest tertile of workplace violence, female workers who lived in counties of the highest tertile of workplace violence had a 1.72-fold increased risk for mental distress problems after controlling for individual experience of workplace violence and other psychosocial work characteristics.

CONCLUSION

Neighborhood-level workplace violence was associated with poor mental health in female workers. Preventative strategies targeting workplace violence should pay attention to neighborhood factors and gender-specific effects that might influence societal tolerance of abusive work practices and workers' vulnerability to mental health impacts of workplace violence.

Psychosocial and occupational risk perception among health care workers: a Moroccan multicenter study

BACKGROUND

International studies on occupational risks in public hospitals are infrequent and only few researchers have focused on psychosocial stress in Moroccan Health Care Workers (HCWs). The aim of this study was to present and analyze Moroccan HCWs occupational risk perception. Across nine public hospitals from three Moroccan regions (northern, central and southern), a 49 item French questionnaire with 4 occupational risks subscales, was distributed to 4746 HCWs. This questionnaire was based on the Job Content Questionnaire. Psychosocial job demand, job decision latitude and social support scores analysis were used to isolate high strain jobs. Occupational risks and high strain perception correlation were analyzed by univariate and multivariate logistic regression.

RESULTS

2863 HCWs (60%) answered the questionnaire (54% women; mean age 40 years; mean work seniority 11 years; 24% physicians; 45% nurses). 44% of Moroccan HCWs were at high strain. High strain was strongly associated with two occupational categories: midwives (2.33 OR; CI 1.41-3.85), full-time employment (1.65 OR; CI 1.24-2.19), hypnotics and sedatives use (1.41 OR; CI 1.11-1.79), analgesics use (1.37 OR; CI 1.13-1.66).

CONCLUSION

Moroccan HCWs, physicians included, perceive their job as high strain. Moroccan HCWs use of hypnotics, sedatives and analgesics is high. Risk prevention plan implementation is highly recommended.

Threats of dismissal and symptoms of major depression: a study using repeat measures in the Swedish working population

BACKGROUND

Job insecurity is considered a profound work stressor. While previous research has indicated that job insecurity represents a substantial mental health burden, few studies have examined its relationship with symptoms of major depression. The aim of this study was to assess whether episodic and repeated self-reported threats of dismissal increase the risk of subsequent symptoms of major depression and whether symptoms of major depression are related to subsequent experience of threats of dismissal.

METHODS

The study is based on the Swedish Longitudinal Occupational Survey of Health (SLOSH) study, a cohort study with multiple repeated measurements. The sample consisted of 6275 participants who were in regular paid employment and who provided data in 2008, 2010 and 2012. Severity of depression was assessed with a brief Symptom Checklist scale and categorised according to symptoms of major depression or not.

RESULTS

Results based on generalised estimating equations logit models showed that prior threats of dismissal predicted symptoms of major depression OR 1.37; 95% CI 1.04 to 1.81) after adjustment for prior depression and major confounders. Especially related threats increased the risk of major depression symptoms (OR 1.74 CI 1.09 to 2.78). Major depression symptoms also increased the odds of subsequent threats of dismissal (OR 1.52, CI 1.17 to 1.98).

CONCLUSIONS

These findings support a prospective association between threats of dismissal and symptoms of major depression, in particular repeated exposure to threats of dismissal. The results also indicate that threats of dismissal are more likely to be reported by workers with symptoms of major depression.

Work characteristics and suicidal ideation in young adults in France

PURPOSE

Job insecurity, unemployment, and job strain can predict psychological distress and suicide risk. Young people, who are particularly at risk of suicide, may be especially vulnerable to the deterioration of labor market conditions as a result of the current economic crisis in Europe. We aimed to examine the effects of work and employment characteristics on suicidal ideation in a contemporary sample of young adults.

METHODS

Using data from a sample of French young adults surveyed in 2011 (TEMPO study, N = 1,214, 18-37 years old) and their parents who took part in a longitudinal cohort study, we used multiple logistic regression to examine the relationship between job insecurity, lifetime and recent unemployment and suicidal ideation in the past 12 months. Our analyses were adjusted for factors associated with suicidal risk including age, sex, educational attainment, living with a partner, insufficient social support, alcohol abuse, depression and parental history of depression.

RESULTS

Five percent of the sample reported suicidal ideation in the preceding 12 months. Controlling for all covariates, the likelihood of suicidal ideation was associated with job insecurity (OR 2.24, 95% CI 1.08-4.63), lifetime unemployment (OR 2.25, 95% CI 1.17-4.29), and recent unemployment (OR 2.10, 95% CI 1.04-4.25). After stratifying by educational attainment, the association between suicidal ideation and job insecurity was particularly notable for participants with low educational attainment (OR 9.28, 95% CI 1.19-72.33).

CONCLUSION

Young adults who have unstable and unfavorable employment characteristics are disproportionately likely to be suicidal, which should be monitored, particularly in times of economic downturn.

Assessment and Analysis of Workplace Violence in a Greek Tertiary Hospital

This study sought to assess workplace violence in a Greek tertiary hospital for the first time. The authors conducted a descriptive study with 175 participants and examined the characteristics of violent episodes, the responses of victims and the administration, and the perception of workplace safety in addition to the implications of these incidents. The vast majority of employees (83.4%) had experienced work-related violence; however, half of them (52%) had not reported the incident to the hospital administration. Verbal violence was the most common type of incident (98.6%). Nurses and other health care staff reported feeling safer than physicians (odds ratio [OR] = 4.47, 95% confidence interval [CI]: 1.94-10.28 and OR = 2.80, 95% CI: 1.64-8.74, respectively). A large proportion of victims (72.6%) suffered psychological consequences following the violent incident. This study reveals the high prevalence of workplace violence in a Greek tertiary hospital and underscores its negative impact on health care workers.

Proximal and distal determinants of stressful work: framework and analysis of retrospective European data

Background

While robust evidence on associations of stressful work with health exists, less research is available on determinants of stressful work in terms of respondents' characteristics (proximal factors) and in terms of national labour market policies (distal factors). In this article we analyse proximal (childhood circumstances and labour market disadvantage) and distal determinants (national compensation and integration policies) of stressful work in a comprehensive framework.

Methods

We use data from the third wave of the Survey of Health, Ageing and Retirement in Europe (SHARE), with retrospective information on individual life courses collected among 11181 retired men and women in 13 European countries (2008–2009). To test our hypotheses we estimate multilevel regression models.

Results

Results show that stressful work is related to disadvantaged circumstances during childhood. To some extent this association is explained by labour market disadvantage during adulthood. Additionally, well developed labour market integration policies are related to lower overall levels of stressful work at national level.

Conclusion

This analysis provides first evidence of important determinants of stressful work, both in terms of pre-employment conditions (childhood circumstances) and in terms of contextual macro-social policies.

Electronic supplementary material

The online version of this article (doi:10.1186/1471-2458-14-849) contains supplementary material, which is available to authorized users.

All part of the job? The contribution of the psychosocial and physical work environment to health inequalities in Europe and the European health divide

This study is the first to examine the contribution of both psychosocial and physical risk factors to occupational inequalities in self-assessed health in Europe. Data from 27 countries were obtained from the 2010 European Working Conditions Survey for men and women aged 16 to 60 (n = 21,803). Multilevel logistic regression analyses (random intercept) were applied, estimating odds ratios of reporting less than good health. Analyses indicate that physical working conditions account for a substantial proportion of occupational inequalities in health in both Central/Eastern and Western Europe. Physical, rather than psychosocial, working conditions seem to have the largest effect on self-assessed health in manual classes. For example, controlling for physical working conditions reduced the inequalities in the prevalence of"less than good health" between the lowest (semi- and unskilled manual workers) and highest (higher controllers) occupational groups in Europe by almost 50 percent (Odds Ratio 1.87, 95% Confidence Interval 1.62-2.16 to 1.42, 1.23-1.65). Physical working conditions contribute substantially to health inequalities across "post-industrial" Europe, with women in manual occupations being particularly vulnerable, especially those living in Central/Eastern Europe. An increased political and academic focus on physical working conditions is needed to explain and potentially reduce occupational inequalities in health.

Changes in Leadership Behaviors Predict Changes in Job Satisfaction and Well-Being in Low-Skilled Workers

The purpose of this longitudinal study of 255 members of the low-skilled workforce was to enhance insight into the nature of the relations between specific supervisor behavior (social support, positive feedback, task-related communication) and employee well-being. Data were analyzed using latent change models focusing on interindividual change and change–change associations over time. Our results indicated that interindividual differences in the intraindividual change in perceived supervisor behavior were related to changes in indicators of well-being across a 6-month period. These results provide further evidence for longitudinal associations between leader behavior and employee outcomes as well as the necessity of designing specific interventions for low-level managers.

A balancing act? Work-life balance, health and well-being in European welfare states

BACKGROUND

Recent analyses have shown that adverse psychosocial working conditions, such as job strain and effort-reward imbalance, vary by country and welfare state regimes. Another work-related factor with potential impact on health is a poor work-life balance. The aims of this study are to determine the association between a poor work-life balance and poor health across a variety of European countries and to explore the variation of work-life balance between European countries.

METHODS

Data from the 2010 European Working Conditions Survey were used with 24,096 employees in 27 European countries. Work-life balance is measured with a question on the fit between working hours and family or social commitments. The WHO-5 well-being index and self-rated general health are used as health indicators. Logistic multilevel models were calculated to assess the association between work-life balance and health indicators and to explore the between-country variation of a poor work-life balance.

RESULTS

Employees reporting a poor work-life balance reported more health problems (Poor well-being: OR = 2.06, 95% CI = 1.83-2.31; Poor self-rated health: OR = 2.00, 95% CI = 1.84-2.17). The associations were very similar for men and women. A considerable part of the between-country variation of work-life balance is explained by working hours, working time regulations and welfare state regimes. The best overall work-life balance is reported by Scandinavian men and women.

CONCLUSION

This study provides some evidence on the public health impact of a poor work-life balance and that working time regulations and welfare state characteristics can influence the work-life balance of employees.

Income inequality as a moderator of the relationship between psychological job demands and sickness absence, in particular in men: an international comparison of 23 countries

OBJECTIVES

The aim of this study was to investigate whether more sickness absence is reported in countries with higher income inequality than elsewhere, and whether the level of income inequality moderates the association between psycho-social job demands and sickness absence.

METHODS

Our analysis is based on the Fifth European Working Conditions Survey that compared 23 European countries. We performed multi-level regression analysis. On the macro-level of analysis we included the Gini-Index as measure of inequality. On the micro-level of analysis we followed the Karasek-Theorell model and included three scales for psychological job demands, physical job demands, and decision latitude in the model. The model was stratified by sex.

RESULTS

We found that, in countries with high income inequality, workers report significantly more sickness absence than workers in countries with low income inequality. In addition we found that the level of income inequality moderates the relationship between psychological job demands and sickness absence. High psychological job demands are significantly more strongly related to more days of sickness absence in countries with low income inequality than in countries with high income inequality.

CONCLUSIONS

As the nature and causal pathways of cross-level interaction effects still cannot be fully explained, we argue that future research should aim to explore such causal pathways. In accordance with WHO recommendations we argue that inequalities should be reduced. In addition we state that, particularly in countries with low levels of income inequality, policies should aim to reduce psychological job demands.

Work, health, and welfare: the association between working conditions, welfare states, and self-reported general health in Europe

This article is the first to examine the association between self-reported general health and a wide range of working conditions at the European level and by type of welfare state regime. Data for 21,705 men and women ages 16 to 60 from 27 European countries were obtained from the 2010 European Working Conditions Survey. The influence of individual-level sociodemographic, physical, and psychosocial working conditions and of the organization of work were assessed in multilevel logistic regression analyses, with additional stratification by welfare state regime type (Anglo-Saxon, Bismarckian, Eastern European, Scandinavian, and Southern). At the European level, we found that "not good" general health was more likely to be reported by workers more exposed to hazardous working conditions. Most notably, tiring working positions, job strain, and temporary job contracts were strongly associated with a higher likelihood of reporting "not good" health. Analysis by welfare state regime found that only tiring or painful working conditions were consistently associated with worse self-reported health in all regimes. There was no evidence that the Scandinavian welfare regime protected against the adverse health effects of poor working conditions. The article concludes by examining the implications for comparative occupational health research.

Association of job strain with working hours, shift-dependent perceived workload, sleepiness and recovery

We explored the relationship of job strain with working hours, shift-dependent perceived workload, sleepiness and recovery. Nurses/nursing assistants (n = 95) were recruited from wards that belonged to either the top (high-strain group, HJS) or the bottom (low-strain group, LJS) job strain quartiles of a Job Content Questionnaire survey of employees in five health care districts and four cities in Finland. Three-week field measurements during naturally occurring shift schedules and a subset of pre-selected shift arrangements consisted of the Karolinska Sleepiness Scale, perceived workload and recovery. The HJS group (n = 42) had more single days off and quick returns than the LJS group (n = 53, p < 0.01), and both mental workload and physical workload were rated as higher (p < 0.01). During naturally occurring shift arrangements, severe sleepiness was more common in the HJS group only in quick returns (p = 0.04) and the HJS group recovered on average more poorly from work after all shifts (p = 0.01) and morning shifts (p = 0.02). During pre-selected shift arrangements, the differences between the groups were only minor. In conclusion, job strain-related differences in sleepiness and recovery were mostly attributable to differences in shift arrangements.