[A systematic review of working hours and mental health burden]

Determining the effect of environmental factors, work postures and mental workload on musculoskeletal disorders in rescue workers and accidents of one of the water and sewage companies in Iran

BACKGROUND

Musculoskeletal disorders are one of the most important problems faced by ergonomists today.

OBJECTIVE

This study was conducted with the aim of investigating the effect of weather conditions, working conditions and mental workload on musculoskeletal disorders of rescuers and water and sewage company accidents in hot and cold seasons.

METHODS

The present study was a longitudinal study that was performed on all employees of rescue and disaster teams of Shiraz Water and Sewerage Company in Iran (184 people) by census. Demographic and Nordic questionnaires, NASA Load Index (NASA-TLX), work environment assessment with temperature screening checklist and workplace ergonomic risk factor (WERA) assessment method were performed by the researcher. The collected data were analyzed using SPSS version 23 software and parametric and non-parametric statistical tests.

RESULTS

The results showed that the highest and lowest prevalence of musculoskeletal disorders related to knee and back in winter and thigh in summer with prevalence of 57.1, 55.4 and 6% . The comparison of exposure to heat stress factors in summer and winter seasons showed that the temperature factors and work clothes of the workers in both seasons are in worse conditions than other factors (P <  0968). The results of the mental workload of people in two seasons showed that the highest and lowest mental workload is related to physical changes in the winter season and frustration in the summer season, and this relationship was significant (P <  0.001). Using multiple logistic regression model, the potential risk factors for musculoskeletal injuries including age, height, BMI, level of education and work experience in both hot and cold seasons were compared. The results showed that in summer, work experience (OR = 1.16 (1.06-1.28.)) and height (OR = 1.03(0.98-1.08) had a direct effect on the prevalence of pain and discomfort arranged in the back areas. One year of increase in work experience significantly increases the chance of a disorder in the back by 16% and a one centimeter increase in height increases the chance of a disorder in the lumbar region by 3%, although this relationship is significant.

CONCLUSION

It is recommended that suitable solutions such as using appropriate and up-to-date mechanical tools, reducing activity time, increasing rest time, increasing the number of personnel in order to reduce mental workload, using work clothes suitable for the season and type of work, and ergonomics training for workers are on the agenda of company officials. Water and sewage should be placed.

[Job stress and mental health at work]

In Japan, a study on mental health in workplace has expanded from tertiary to secondary and primary preventions of mental health disorders among employees. Recent movements suggest a trend of bringing numerous topics outside the industrial health, including those with perspectives from categories generally known as primordial prevention, such as enhancement of working life quality or improvement of work environment.First, according to the aforementioned trends, the present paper made an effort to organize the terms and concepts related to mental health disorders, which included the foundation for research and practice in this area as well as the outcomes of discussions on the tertiary and secondary preventions.Second, the primary models of work-related stress, along its impact on mental health, and the scales for assessing workers' mental health issues were discussed, which have been used in numerous studies since the 1990s. The introduction of those models and scales contributed immensely to the expansion of this field's research areas. However, a number of significant factors, most of which have social or cultural implications, can influence the connection between stress at workplace and health problems. Therefore, conducting large-scale study or systematic reviews targeting domestic cases exclusively is necessary to obtain evidence for establishing highly versatile measures against mental health problems in Japan.Third, in this regard, several noteworthy large-scale research projects in Japan are highlighted as a hope for encouraging such studies in this field. However, the occupational health practitioners' effort to understand the actual workplace situations where they attend to and to put the understanding into practice has been and will remain an indispensable attribute for them in the future.

Suicidal behaviors in the entertainment industry: a preliminary exploration of the interplay between work scheduling, social support, and wellbeing in Australia

OBJECTIVE

Workers of the Australian entertainment industry exhibit disproportionately high rates of impaired psychological wellbeing and suicidal behaviors, with such rates being exacerbated by the negative impact of working long and odd hours (Work Scheduling Impact; WSI). Nonetheless, stable and secure social support networks may buffer the risks associated with such systemic difficulties.

METHODS

The responses of 1302 Australian entertainment industry workers (50.3% females, M_age 38.39 years) on the Multidimensional Scale of Perceived Social Support, the Short Form Health Survey, WSI, and suicidal behaviors questions were examined via moderation analyses.

RESULTS

Higher social support and lower WSI appeared to reduce the suicidal ideation of those experiencing poorer mental health, while lower WSI further enhanced social support's positive effect.

CONCLUSIONS

Findings highlight the likely detrimental effect of WSI regarding the suicidal ideation reported by vulnerable Australian entertainment industry workers and stress the importance of the social support they experience.

PUBLIC HEALTH IMPLICATIONS

Interventions attempting to increase social support could improve inherent conditions associated with the Australian entertainment industry. Similarly, the negative effect of working long and odd hours on workers' mental health and suicidal behaviors indicates the need to regulate the industry appropriately.

Seafarers' mental health status and life satisfaction: Structural equation model

Background

A variety of factors influence seafarers' health. Such factors might affect their satisfaction with life.

Aims

To examine the relationships between seafarers' mental health status and satisfaction with life by using a structural equation method.

Methods

In this survey, 470 seafarers were selected via convenience sampling method from two shipping companies. Validated questionnaires including Satisfaction with Life Scale (SWLS), generalized anxiety disorder-7 (GAD-7), Post-traumatic Stress Disorder-8 (PTSD-8), Patient Health Questionnaire-9 (PHQ-9), General Health Questionnaire-12 (GHQ-12), Perceived Health status and Depression-Anxiety-Stress scale-21 (DASS-21) were used to assess different aspects of well-being and life satisfaction. The stratified path analysis method was applied to analyze the data.

Results

439 seafarers (200 officers and 237 non-officers) with a mean age of 34.5 (SD: 8.05) participated in the current study. The GHQ score directly affected satisfaction with life in both officers (β = 0.35) and non-officers (β = 0.40). Also, perceived health status directly and indirectly affected satisfaction with life among officers (β = 0.19) and non-officers (β = 0.06). While officers working days per month indirectly impacted satisfaction with life through the general anxiety disorder, perceived health status, depression, anxiety, stress and current mental health. In non-officers, generalized anxiety disorder had the most potent indirect effects on satisfaction with life through perceived health status and current mental health.

Conclusion

Perceived health status, directly and indirectly, affected seafarers' satisfaction with life. Measures should be taken in order to improve seafarers' perceived health status and its effects on satisfaction with life.

Association Between Overtime-Working Environment and Psychological Distress Among Japanese Workers: A Multilevel Analysis

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Objective:

The study aims to examine the association between overtime-working environment (OWE) and individual psychological distress among Japanese workers.

Methods:

Data of 7786 workers from 101 companies in Japan were analyzed. Psychological distress was assessed through a 29-item questionnaire. The OWE was evaluated by calculating the proportion of workers whose monthly overtime was 45 hours or more in a workplace. Multilevel logistic regression was used.

Results:

As 10% increase in the OWE was associated with a 16% higher risk of individual psychological distress after adjustment of individual covariates, including overtime working hours. Cross-level interaction showed that the risk was varied depending on individual overtime working hours.

Conclusions:

OWE was associated with the psychological distress of workers. It is necessary to create a non-OWE at workplaces to prevent psychological distress for workers.

Objective and subjective working hours and their roles on workers' health among Japanese employees

This study investigated the correlation between objective and subjective working hours (OWH and SWH, respectively) and their relation to the workers' health. The study included 6,806 workers of a Japanese company (response rate=86.6%). OWH were collected as the monthly data during fiscal year 2017 from the company record. SWH were self-reported as the weekly data during the past month in November 2017. Both OWH and SWH corresponded to the same period of one month (October 2017). Additionally, the data for the annual health checkup in fiscal year 2017 and self-reported mental health in November 2017 were collected. The results indicated that the longer OWH was related to more underestimation of SWH. The analyses of covariance adjusted for the selected variables showed that irrespective of OWH or SWH, significant relationships were found for stress responses but not for body mass index, aspartate and alanine aminotransferase, fasting blood glucose, hemoglobin A1c, high-density lipoprotein cholesterol, or triglyceride. However, significant relationships with only OWH were noted for systolic and diastolic blood pressure, low-density lipoprotein cholesterol, gamma-glutamyl transpeptidase, and positive work-related state of mind. The present findings show that SWH should be used carefully when assessing the health effects of long working hours.

The effect of changes in overtime work hours on depressive symptoms among Japanese white-collar workers: A 2-year follow-up study

OBJECTIVE

The purpose of this study was to investigate the effect of changes in overtime work hours on depressive symptoms among Japanese white-collar workers.

METHODS

Participant data were collected from a company's annual mental health survey in June 2013 and June 2014. The participants comprised 922 workers who responded to the survey in both the years and had records of monthly working hours in the past 2 years. We obtained information on monthly working hours from personnel records from June 2012 to May 2014. Depressive symptoms were measured by the Brief Job Stress Questionnaire. Changes in overtime work hours were measured by creating a five-category variable for each monthly average of overtime work hours in the past year: (a) stable short, (b) decreased, (c) stable medium, (d) increased, and (e) stable long groups. Analysis of covariance was conducted to estimate the degree of depressive symptoms of each group for changes in overtime work hours.

RESULTS

Significant differences among the groups were observed (F = 3.67, P = 0.006). In the Bonferroni multiple comparison test, significantly lower depressive symptoms were observed in the decreased group (point estimate = 9.56) compared to the stable short (10.76), stable medium (10.71), and increased groups (10.99). There was no significant difference between the decreased group and the stable long group (10.98).

CONCLUSIONS

A decrease in overtime work hours may prevent the deterioration of mental health. This knowledge could support the necessity of mental health measures through decreasing overtime work hours proposed by national policy in Japan.

Long working hours and depressive symptoms: moderating effects of gender, socioeconomic status, and job resources

PURPOSE

Systematic reviews and meta-analyses have found inconsistent associations between working hours and depressive symptoms. The purpose of this study was to investigate the possible moderators of this association, using data from a large-scale cross-sectional survey.

METHODS

A total of 16,136 Japanese employees (men 83.5%; women 16.5%) responded to a self-administered questionnaire inquiring about overtime working hours during the previous month and depressive symptoms (Center for Epidemiologic Studies Depression scale), as well as moderating factors including gender, age, marital status, socioeconomic status, commuting time, sleeping hours per day, job control and worksite social support (Job Content Questionnaire), neuroticism (Eysenck's Personality Questionnaire Revised), and social desirability (Social Desirability Scale) (response rate, 85%). We conducted sequential regression analyses to investigate the main effects and interaction effects of all moderating variables.

RESULTS

The association between overtime working hours and depressive symptoms was significantly moderated by gender (interaction effect: β = 0.03), age (β = - 0.02), manager (β = 0.03), sleeping hours (β = - 0.02), job control (β = - 0.03), and neuroticism (β = 0.02). Among workers engaged in 80 + hours of overtime, higher depressive symptoms were reported by women, younger employees, non-managers, employees with low job control, low worksite social support, and high neuroticism. A significant main effect of long overtime working hours on depressive symptoms was also observed even after controlling for all independent variables (β = 0.02).

CONCLUSIONS

Long overtime working hours is associated with depressive symptoms. We also found significant heterogeneity in the association according to employee characteristics, which may explain the inconsistent findings in previous literature.

Association between long work hours and depressive state: a pilot study of propensity score matched Japanese white-collar workers

Although long work hours have been associated with various physical health problems, studies of their association with mental health have yielded inconsistent results, due to differences in study settings, study outcome and/or unmeasured background factors. In this study, we used a propensity score method to evaluate the association between work hours and depressive state. A total of 467 Japanese white-collar workers were surveyed and divided into long and regular work hour groups according to overtime work records. Propensity score matching was performed based on 32 individual background and workplace factors, yielding 74 pairs of propensity-matched subjects. CES-D score, an indicator of depressive state, did not differ significantly among the two groups (p=0.203). However, work motivation, work control, social support and emotional stability correlated with CES-D score. These findings suggest that work control and social support factors are more associated with depressive state than control of work hours. These results also suggest that it is possible to use propensity score matching to evaluate the association between work hours and mental health in occupational study settings. Further studies, in larger populations, are required to determine the association between work hours and mental health parameters.

Psychological Health Problems Among Adolescent Workers and Associated Factors in Istanbul, Turkey

BACKGROUND

Work and work environment have a critical influence on adolescent workers' health. They are subjected to more risks than adults. The aim of this study is to examine psychological health outcomes in adolescent workers in the areas of depression, somatization, anxiety, hostility, and negative self-concept, and to investigate any related factors.

METHODS

This is a descriptive and cross-sectional study. Research samples were collected from adolescent workers between 15 and 18 years old attending a 1-day mandatory education course at vocational training centers, working 5 days per week in small enterprises. Data were collected using the following instruments: Brief Symptom Inventory, Multidimensional Scale of Perceived Social Support, and Descriptive Characteristics of Children's Assessment Form.

RESULTS

The investigation covers 837 young workers, of whom 675 were males and 162 were females. The majority of the families had low incomes (68.1%). Overall, 33.5% of the adolescents had been hospitalized because of health problems. Their average weekly working hours were 78.1 ± 10.7. Almost 50% of adolescent workers scored above the mean average in the Brief Symptom Inventory, indicating serious pschological health symptoms.Those who scored high for hostility, depression, negative self-concept, anxiety, and somatization were between 45.4% and 48.9% of the sample. Logistic regression analysis was conducted to determine the underlying factors: a perception of "feeling very bad" health conditions was 2.07-fold whereas the rate of "no annual leave" was 0.73-fold, and both were found to be effective on psychological problems.

CONCLUSION

In this study, it seems likely that psychological health problems are the result of multiple adverse factors including working conditions, annual leave, and health considerations.

Exhausting Physicians Employed in Hospitals in Japan Assessed by a Health Questionnaire

OBJECTIVE

Japanese physicians employed and working in general hospitals have become busier since 2005, as they had to teach and guide the increased number of medical residents graduated from medical schools. Working hours and chronic fatigue of employed physicians were surveyed compared with independent physicians working in their own out-patient clinics and with usual employed men in Japan, and their mental health was assessed.

METHODS

(1) 75 employed physicians in hospitals were surveyed of their working hours a week and compared with (2) 48 independent general practitioners (GP) who work in their own out-patient clinics. (3) 47 employed physicians aged 40s and 50s out of (1) were compared with group (4) or 277 men of the same age employed in an automobile company. A symptom check list questionnaire, the Total Health Index (THI), was used to assess their stress and mental health status. The THI has 130 questions including physical symptoms, mental complaints, lifestyle and habits. 130 items have been grouped into 12 scales: vague complaints, respiratory symptoms, depression, and 9 other scales.

RESULTS

The average weekly working hours of employed physicians of (1) and GPs of (2) were 55.7 h and 51.3 h, respectively, and those who worked 60 h or more a week were 44.0% and 27.0%, respectively. They had significantly higher average scale scores than GPs with respect to vague complaints, irregular daily life, mental instability, depression, neurotics and psychosomatics scales. They also had significantly higher yes response rates for question items, "envy for richer friends", "feel my life is going badly", and other items than the GPs. 47 employed physicians of group (3) and 277 men workers of group (4) worked for 57.0 h and 46.0 h a week, respectively, in average, and 51.1% and 6.2% of group (3) and (4), respectively, worked for 60 h or more a week. The average scale scores of physicians of (3) were highly significantly poorer than group (4) in many scales of THI. Physicians employed also had significantly higher yes response rates for question items "feel too heavy work load", "stressed state", "irritated", "depressed", "lack of sleep", and "low back pain". Most of the physicians of group (3) were exhausted due to the hard work, showing a sharp contrast to group (4).

CONCLUSIONS

Physicians employed in hospitals work for 57.0 h a week on average, although usual labors of the same age in a large farm work for 46.0 h a week. Physicians employed were exhausted or burnout and under poorer mental condition.

Gender differences of the influential factors on the mental health condition of teachers in the A university

The purpose of this research was to investigate the gender differences of the influential factors on the mental health condition among university teachers in the A university in Japan. A questionnaire survey was mailed to 924 university teachers in Japan, with a survey return rate of 43.8% (N=405). The General Health Questionnaire 28 (GHQ-28), Multidimensional Scale of Perceived Social Support (MSPSS), the Japanese version of the Brief Coping Orientation to Problems Experienced (COPE) and the Work Situation Questionnaire (WSQ) developed by the authors were administered to subjects. The GHQ-28 total score and all of sub-score of the woman was significantly higher than men. In the correlated factor of mental health, level of job satisfaction and job control, social support of significant others was observed in the both sexes. However, gender differences was observed in the coping style. Some copings including self-distraction and self-blame were related to the men, but the woman was related to the substance use. University teachers had some gender differences in the factors affecting their mental health condition. In order to improve university teacher's mental health condition, it is necessary to increase their level of job satisfaction and feeling of job control in the workplace. Especially, it was considered women's coping using substance use was important.

Work stress and risk factors for health management trainees in canakkale, Turkey

AIM

This study aims to investigate the general mental health situation, work-related stress and risk factors of health management trainees.

METHODS

This cross-sectional study was conducted on Health Management Musters students (N=96) in Canakkale Onsekiz Mart University Health Sciences Institute, May-June 2014. A total of 58 students who voluntarily participated in the study were reached (60.42%). Participants completed a 22-question sociodemographic survey form and a 12-item General Health Questionnaire in a face-to-face interview. Data were analyzed using the SPSS software version 20.0.

RESULTS

The average age of participants was 36.4±6.2 (Min:24-Max:62) years. Thirty five of the participants were female (60.3%), 23 were male (39.7%). The number of people using cigarettes and alcohol were 23 (39.7%) and 9 (15.8%) respectively. In our study group according to GHQ scale 32 people (55.2%) were in the group at risk of depression. Eighty-six percent of participants reported experiencing work stress. The most frequently reported sources of stress were superiors (56.8%), work itself (41.3%), and work colleagues (25.8%). There was no significant difference between those at risk of depression and those not at risk in terms of gender, marital status, educational level, age, work-related factors (daily work, computer use, duration of sitting at desk), sleep duration, presence of chronic disease, substance use (cigarettes, alcohol), regular exercise, regular meals, fast-food consumption, sufficient family time and vacations (p>0.05).

CONCLUSIONS

Our study results indicated that majority of participants reported experiencing work stress with more than half at high risk of developing depression. The most reported risk factors were superiors, the work itself and colleagues in the present study. Psychosocial risk factors at work environment should be investigated in terms of psychological, sociological and ergonomics in more detail to reduce the risk of health management trainees experiencing work stress and mental health problems.

Buffering effects of job resources on the association of overtime work hours with psychological distress in Japanese white-collar workers

PURPOSE

The purpose of the present study was to investigate the buffering effects of job resources, utilizing the job demands-control (or demand-control-support) and effort-reward imbalance models (i.e., job control, workplace social support, and extrinsic reward), on the association of overtime work hours with psychological distress in Japanese employees.

METHODS

A total of 1,198 participants (valid response rate = 93.7 %) from five branches of a manufacturing company in Japan completed a self-administered questionnaire comprising the scales assessing job resources, psychological distress, and demographic characteristics. We obtained the information on working hours in the most recent month from the personnel records of the surveyed company. Multiple logistic regression analyses were conducted. In a series of analyses, interaction term of overtime work hours with each job resource was included in the model.

RESULTS

Significant interaction effect of overtime work hours with job control was observed. Among the low job control group, the long overtime (80 h or more) subgroup had a significantly higher prevalence odds ratio of psychological distress compared to the short overtime (44 h or less) subgroup. No significant association of overtime work hours with psychological distress was found among the high job control group. On the other hand, there was no significant interaction effect of overtime work hours with workplace social support or extrinsic reward.

CONCLUSIONS

The present findings suggest that high job control has an effect on reducing psychological distress in relation to overtime work hours in Japanese employees.

Heavy overtime work and depressive disorder among male workers

BACKGROUND

The association between overtime and depression is unclear and very few studies have examined the association between heavy overtime work, i.e. working more than 60 h per week, and depression.

AIMS

To examine the association between heavy overtime work and the onset of depressive disorder among male workers.

METHODS

A 1-year follow-up cohort study of male workers in a manufacturing company in Japan, between 2008 and 2009. Working hours, depressive disorder, assessed by the Center for Epidemiologic Studies Depression (CES-D) Scale (score ≥16 points), and covariates were measured at baseline and at follow-up. Participants who had depressive disorder at baseline were excluded.

RESULTS

At follow-up, 1194 participants aged between 18 and 71 years were analysed. Multiple logistic regression analysis revealed that the odds ratio for the new onset of depressive disorder was 4.5 (95% CI 1.8-11.1) times higher for employees working >60 h per week than for those working ≤50 h per week, when adjusted for age, lifestyle factors, work-related characteristics and socio-demographic characteristics at baseline and working hours at follow-up. However, the correlation between working 50.1 to 60 h per week and depressive disorder was not significant. The trend test of depressive disorder among groups by working hours was significant (P < 0.01).

CONCLUSIONS

Heavy overtime work is a risk factor for the new onset of depressive disorder in this population of male workers. Working >60 h per week may be the cut-off to screen for high-risk groups who need preventive action against depressive disorder.

Effects of personality on overtime work: a cross-sectional pilot study among Japanese white-collar workers

Background

As detailed associations between personality and long work hours are unclear, we assessed associations between personality dimensions and overtime work among Japanese white-collar workers.

Methods

From records of hours worked over 12 months by 267 office workers in an organization within the service industry, average overtime work hours per month and occurrence of excessive overtime was determined for each worker. Excessive overtime was defined as >  45 overtime work hours per month for at least one month. Responses to a questionnaire assessing socio-demographic and workplace-related factors and the Big Five personality test were analyzed. Associations between personality factors and overtime work were assessed by multivariate logistic regression analysis.

Results

Low Extraversion was associated with excessive overtime work (OR 2.02, 95%CI 1.02 – 4.02, P =  0.04).

Conclusions

It is suggested that workers with low Extraversion can’t share work when busy to avoid excessive overtime. Personality factors should be considered in studies evaluating work time. Moreover, strengthening communication among workers with low Extraversion may reduce excessive overtime work and associated health problems.

Combined effects of working hours, income, and leisure time on suicide in all 47 prefectures of Japan

This study describes an ecological study that evaluated the combined effects of working hours, income, and leisure time on suicide in all 47 prefectures of Japan. In men, the age-adjusted rate of suicide (per 100,000 population) was significantly correlated with working hours (r=0.587, p<0.0001) as well as significantly and negatively correlated with income (r=-0.517, p=0.0002) and times for the leisure activities of self-education (r=-0.447, p=0.0016) and hobbies (r=-0.511, p=0.0002). In addition, a stepwise multiple regression analysis identified time for leisure social activities as a determining factor in suicide rate, even after adjusting for working hours and income. However, the impact of time for leisure social activities on suicide rate was smaller than that of working hours and income. In contrast, none of these factors affected suicide rate in women. These results suggest that increasing leisure time may be useful for preventing suicide among men in Japan.

Non-work-related personal events contribute to depressive symptoms in Japanese discretionary workers

In Japan, the number of workers with depressive symptoms has increased recently, and long working hours are considered one of the main contributing factors. Currently, the number of workers engaging in discretionary work is small but is expected to increase, as a diverse method of employment is believed to contribute to workers' well-being. However, the factors related to discretionary workers' depressive symptoms are unclear. This study aimed to identify the factors associated with depressive symptoms in discretionary workers. The subjects were 240 male discretionary workers in a Japanese insurance company. A cross-sectional study was performed using a questionnaire that includes demographic characteristics, living and working conditions, work-related and non-work-related stressful events, and the Center for Epidemiologic Studies Depression Scale (CES-D). Depressive symptoms were assessed as more than 16 points on the CES-D. Multiple logistic regression models were employed to estimate odd ratios (OR) with 95% confidence intervals (95% CI) of depressive symptoms in relation to possible factors. Thirty-six subjects (15.5%) showed depressive symptoms. The depressive symptoms were significantly related to age (p = 0.04), presence of child(ren) (p = 0.02), and length of employment (p = 0.01), but unrelated to working hours. Subjects who reported "financial matters" (OR = 4.50, 95% CI = 1.89-10.72) and "own event" such as divorce or illness (OR = 2.93, 95% CI = 1.13-7.61) were more likely to show depressive symptoms. In conclusion, mental health measures for discretionary workers should focus on addressing financial difficulties and consultations and assistance in personal health and family issues.

Using Bayesian networks to analyze occupational stress caused by work demands: preventing stress through social support

Occupational stress is a major health hazard and a serious challenge to the effective operation of any company and represents a major problem for both individuals and organizations. Previous researches have shown that high demands (e.g. workload, emotional) combined with low resources (e.g. support, control, rewards) are associated with adverse health (e.g. psychological, physical) and organizational impacts (e.g. reduced job satisfaction, sickness absence). The objective of the present work is to create a model to analyze how social support reduces the occupational stress caused by work demands. This study used existing Spanish national data on working conditions collected by the Spanish Ministry of Labour and Immigration in 2007, where 11,054 workers were interviewed by questionnaire. A probabilistic model was built using Bayesian networks to explain the relationships between work demands and occupational stress. The model also explains how social support contributes positively to reducing stress levels. The variables studied were intellectually demanding work, overwork, workday, stress, and social support. The results show the importance of social support and of receiving help from supervisors and co-workers in preventing occupational stress. The study provides a new methodology that explains and quantifies the effects of intellectually demanding work, overwork, and workday in occupational stress. Also, the study quantifies the importance of social support to reduce occupational stress.

Relationship between long working hours and depression in two working populations: a structural equation model approach

OBJECTIVES

To test the hypothesis that relationship reported between long working hours and depression was inconsistent in previous studies because job demand was treated as a confounder.

METHODS

Structural equation modeling was used to construct five models, using work-related factors and depressive mood scale obtained from 218 clerical workers, to test for goodness of fit and was externally validated with data obtained from 1160 sales workers. Multiple logistic regression analysis was also performed.

RESULTS

The model that showed that long working hours increased depression risk when job demand was regarded as an intermediate variable was the best fitted model (goodness-of-fit index/root-mean-square error of approximation: 0.981 to 0.996/0.042 to 0.044). The odds ratio for depression risk with work that was high demand and 60 hours or more per week was estimated at 2 to 4 versus work that was low demand and less than 60 hours per week.

CONCLUSIONS

Long working hours increased depression risk, with job demand being an intermediate variable.

Burnout syndrome in seafarers in the merchant marine service

PURPOSE

As seafarers face a wide range of psychosocial stressors on board, they may be endangered to develop burnout syndrome. This study aims to investigate respective indicators.

METHODS

In a cross-sectional study, 251 seafarers were asked about demographic data and job-related stressors. Particularly, the subscale emotional exhaustion (EE) of the Maslach Burnout Inventory and the Epworth Sleepiness Scale were used to assess the respective risks of job-related burnout and daytime sleepiness among seafarers. The statistical analysis was carried out using multiple logistic regression.

RESULTS

Within the whole study group, the EE score was elevated in 10.8 %. A higher EE score was found in 10.7 % of officers, in 4.5 % of lower crew ranks and in 25.0 % of the galley staff (p = 0.05). Furthermore, long working days were associated with an elevated EE score [OR 3.83 (CI 1.46-10.03)]. Emotional exhaustion was associated with a subjective perception of enough sleep on board [OR 3.33 (CI 1.17-9.46)], lack of care taken by the shipboard superiors and/or the shipping company [OR 1.19 (CI 1.04-1.36)], with high responsibility for work organisation of those involved in leadership [OR 1.46 (CI 1.20-1.78)] and with social problems due to the long periods of separation from their families [OR 1.19 (CI 1.02-1.39)], taking into account relevant demographic parameters.

CONCLUSIONS

Compared with the majority of on-shore occupations, the burnout risk in seafaring seems to be moderate. To reduce the EE among seafarers, it is recommended to extend the sleeping time, to avoid long working hours, to improve the superiors' communication and leadership skills, to diminish the superiors' stress load caused by organisational duties and to support low-price telecommunication possibilities at home.

Long working hours and symptoms of anxiety and depression: a 5-year follow-up of the Whitehall II study

BACKGROUND

Although long working hours are common in working populations, little is known about the effect of long working hours on mental health.

METHOD

We examined the association between long working hours and the onset of depressive and anxiety symptoms in middle-aged employees. Participants were 2960 full-time employees aged 44 to 66 years (2248 men, 712 women) from the prospective Whitehall II cohort study of British civil servants. Working hours, anxiety and depressive symptoms, and covariates were measured at baseline (1997-1999) followed by two subsequent measurements of depressive and anxiety symptoms (2001 and 2002-2004).

RESULTS

In a prospective analysis of participants with no depressive (n=2549) or anxiety symptoms (n=2618) at baseline, Cox proportional hazard analysis adjusted for baseline covariates showed a 1.66-fold [95% confidence interval (CI) 1.06-2.61] risk of depressive symptoms and a 1.74-fold (95% CI 1.15-2.61) risk of anxiety symptoms among employees working more than 55 h/week compared with employees working 35-40 h/week. Sex-stratified analysis showed an excess risk of depression and anxiety associated with long working hours among women [hazard ratios (HRs) 2.67 (95% CI 1.07-6.68) and 2.84 (95% CI 1.27-6.34) respectively] but not men [1.30 (0.77-2.19) and 1.43 (0.89-2.30)].

CONCLUSIONS

Working long hours is a risk factor for the development of depressive and anxiety symptoms in women.

Mental health, suicidal ideation, and related factors among workers from medium-sized business establishments in northern Japan: comparative study of sex differences

A questionnaire survey was conducted among 3,233 workers (2,442 males and 791 females) from 17 medium-sized business establishments in northern Japan with respect to GHQ-12 score, suicidal ideation, sociodemographic characteristics, work-associated factors, and attitude toward mental health resources. Sex differences were assessed for each questionnaire item, and logistic regression analyses were performed separately for males and females. Significant correlations between common mental disorder (CMD: GHQ-12 score≥3) and the following factors were found for both sexes: short sleep, irregular working schedule, working in specific businesses, and attitude toward mental health resources. Associations between CMD and excess workload were significant only in male workers. While correlations between suicidal ideation and demand for mental health resources were observed in both sexes, significant correlations were observed between suicidal ideation and use of mental health resources for female workers alone. These results suggest that screening of a high-risk population and provision of mental health resources contribute to suicide prevention as a part of mental health promotion measures in medium-sized business establishments. They also suggest the need for identification of business/job type-specific stressors while considering sex differences in lifestyle factors, working environment, and help-seeking behavior.

Association between long working hours and sleep problems in white-collar workers

The purpose of this study is to examine the association between long work hours and sleep disturbance among white-collar workers. We evaluated 1510 male white-collar full-time employees, between the ages of 18 and 59 years, using a comprehensive sleep quality questionnaire, the Pittsburgh Sleep Quality Index (PSQI). All subjects worked in a light metal products factory in Japan. The mean number of monthly overtime work hours was determined using data from the previous 6 months from timecard records. Subjects were divided into five groups based on quintiles of the mean number of monthly overtime work hours: <26 h month(-1); ≥26 but <40; ≥40 but <50; ≥50 but <63; and >63. Leisure time physical activity, drinking habits just before sleep, presence of family/partner and health status were used as confounding factors in the multiple regression model. The prevalence of short sleep hours, impairment of sleep efficiency and daytime dysfunction among seven components of PSQI increased, in a dose-response relationship, with overtime work hours. The prevalence of high global score (>5.5 points) was highest in workers with overtime hours ≥50 h week(-1). The odds ratios after adjustment for confounding factors for high global score using less than 26 h as a reference group were 1.67 for workers with ≥50 h and <63 h, and 1.87 for workers with 63 h and more. To conclude, the present results suggest that long work hours correlate with reduced sleep quality in a dose-response manner.

Influences of income and employment on psychological distress and depression treatment in Japanese adults

OBJECTIVES

Psychological distress is a health issue of critical importance, especially in people of working age in developed countries, including Japan. This study examined the relationships of income and employment arrangement with psychological distress and treatment of depression in a national sample of Japanese adults.

METHODS

Data for 10,959 men and 11,655 women 25-59 years of age, obtained from the Comprehensive Survey of the Living Conditions of People on Health and Welfare in 2007, were examined. Health outcomes were psychological distress measured by the Japanese version of the K6, subjective complaints and medical treatment of depression. Explanatory variables included marital status, employment arrangement, and household income. The relationships between health outcomes and explanatory variables were examined using multiple logistic regression analyses.

RESULTS

Lower income and unemployment were associated with a higher prevalence of psychological distress and treatment of depression. The association between psychological distress and income showed a threshold: the lowest income quintile had an especially high prevalence, while other quintiles had similar prevalences. The prevalence of depression treatment in those with psychological distress was significantly lower in the highest income quintile than in all the other income groups, and the prevalence was also significantly lower in employed than in unemployed respondents.

CONCLUSIONS

This study showed clear relationships of lower income and unemployment with psychological distress and depression treatment. It has been suggested that people with higher socioeconomic status and full-time work may be reluctant to consult professionals and receive medical treatment, despite their psychological distress. Comprehensive mental health interventions are required to prevent psychological distress in all socioeconomic strata of the population.

Associations between lifestyle factors, working environment, depressive symptoms and suicidal ideation: a large-scale study in Japan

To improve the management of depression and the prevention of suicide, we investigated associations between lifestyle, working environment, depressive symptoms and suicidal ideation. Variables measured included job stressors, working hours, overtime work, smoking status, alcohol consumption, sleep, exercise, meals, and family factors. Original items were used to measure working on holidays, number of confidants, use of stress reduction techniques, and suicidal ideation. A total of 4,118 employees (2,834 men, 1,284 women) in eleven cities and districts across Japan were analyzed. On stepwise multivariate logistic regression analysis, variables associated with depressive symptoms were exposure to high job stress, problem drinking, a feeling of insufficient sleep, absence of confidants, and no use of stress reduction techniques in both sexes. Further, problem drinking and absence of confidants were associated with suicidal ideation in both sexes. The prevalence of workers who had no confidants and who did not use stress reduction techniques was unexpectedly high. Given their clear association with depressive symptoms, greater attention to these factors should improve measures aimed at the prevention of suicide.

Long working hours and sleep disturbances: the Whitehall II prospective cohort study

STUDY OBJECTIVE

To examine whether exposure to long working hours predicts various forms of sleep disturbance; short sleep, difficulty falling asleep, frequent waking, early waking and waking without feeling refreshed.

DESIGN

Prospective study with 2 measurements of working hours (phase 3, 1991-1994 and phase 5, 1997-1999) and 2 measurements of subjective sleep disturbances (phase 5 and phase 7, 2002-2004).

SETTING

The Whitehall II study of British civil servants.

PARTICIPANTS

Full time workers free of sleep disturbances at phase 5 and employed at phases 5 and 7 (n = 937-1594) or at phases 3, 5, and 7 (n = 886-1510).

MEASUREMENTS AND RESULTS

Working more than 55 hours a week, compared with working 35-40 hours a week, was related to incident sleep disturbances; demographics-adjusted odds ratio (95% CI) 1.98 (1.05, 3.76) for shortened sleeping hours, 3.68 (1.58, 8.58) for difficulty falling asleep; and 1.98 (1.04, 3.77) for waking without feeling refreshed. Repeat exposure to long working hours was associated with odds ratio 3.24 (1.45, 7.27) for shortened sleep, 6.66 (2.64, 16.83) for difficulty falling asleep, and 2.23 (1.16, 4.31) for early morning awakenings. Some associations were attenuated after adjustment for other risk factors. To a great extent, similar results were obtained using working hours as a continuous variable. Imputation of missing values supported the findings on shortened sleep and difficulty in falling asleep.

CONCLUSION

Working long hours appears to be a risk factor for the development of shortened sleeping hours and difficulty falling asleep.

The interrelationships between working conditions, job satisfaction, burnout and mental health among hospital physicians in Japan: a path analysis

A growing number of physicians are leaving their hospitals because of painful working conditions in hospitals throughout Japan. We set out to analyze the interrelationships between working conditions, job satisfaction, burnout and mental health among Japanese physicians. A cross-sectional survey was conducted in 2007 for hospital physicians throughout Japan. A path analysis based on structural equation modeling was utilized for examining the interrelationships between work control, on-call duty volume, job satisfaction (the Japan Hospital Physicians Satisfaction Scale), burnout (the Japanese version of the Maslach Burnout Inventory) and mental health (the General Health Questionnaire). Of 336 physicians who received a solicitation E-mail, 236 participated in our study (response rate, 70%). Sixty physicians (25.4%) were women with a mean age of 41 yr. In the path analysis, burnout and poor mental health were related directly to job dissatisfaction and short sleeping time, while they were related indirectly to poor work control and heavy on-call duty. In the multi-group path analysis of both genders, sleeping time was related to job satisfaction more likely among female physicians but less among male physicians. Healthcare policy makers need to implement immediate, extensive and decisive measures to improve work condition and to reduce overwork among hospital physicians.

[Study of U.S. regulations on determination of work-relatedness of mental health disturbance and cerebrovascular and cardiac diseases]

Recently, work-relatedness of mental health disturbance, cerebrovascular and ischemic heart diseases has been generously recognized in the determination of workers' compensation, in administrative or civil suits in Japan. Companies that operate overseas enterprises need to investigate legislature and court opinions in countries and regions in which they operate. In this study, we studied legislative materials concerning mental health, and cerebrovascular and cardiac diseases by reviewing official documents published on homepages provided by governmental and academic bodies in the United States. Our main findings are as follows: 1. In the United States, the state authorities have wide powers. The areas where federal employment statutes are directly applied are limited to the employment conditions of the federal government or some interstate commerce. However, almost all employers in every state are required to record and report occupational injuries and illnesses, based on which, nationwide statistics are maintained. 2. The occupational injury and illness recording criteria are clearly stated in the 2001 revision of Code of Federal Regulations(CFR). During the process of amendment, various opinions were raised concerning mental illnesses. In the final ruling, employers are required to record mental illnesses when "the employee voluntarily provides the employer with an opinion from appropriate health care providers stating that the employee has a mental illness that is work related" (29CFR1904.5(b)(2)(ix)). 3. No specific criteria were found concerning cerebrovascular and ischemic heart disorders, except for the statement that injury or illness is considered if an event or exposure in the work environment significantly aggravates a pre-existing injury or illness(29CFR1904.5(a)). 4. According to the safety and health statistics(2004), around 3,000 cases(0.3 cases per 10,000 full-time workers)of mental disorders were reported in private industry workplaces. On the other hand, less than 500 cases of cerebrovascular and ischemic heart disorders were recorded. In the U.S., where significant numbers of work related mental disorders are reported, the necessity of mental health programs in workplaces is emphasized by state governments. It seems to be necessary to take care not to perform actions which might be considered as disturbance of privacy or discrimination due to disability in carrying out management measures, reflecting peoples' attitudes and legislation concerning these items. Few cases of work related cerebrovascular or ischemic heart disorders are reported in the U.S. However, recently, a reference review was published and a conference was held on this problem. Therefore it might become topical in the near future.