Associations between psychosocial work environment and hypertension among non-Western immigrant and Danish cleaners

Introduction

Non-Western cleaners have reported better psychosocial work environment but worse health compared with their Danish colleagues. The aim of this study was to compare the association between psychosocial work environment and hypertension among non-Western immigrant cleaners and Danish cleaners.

Methods

Two hundred and eighty-five cleaners from nine workplaces in Denmark participated in this cross-sectional study. The cleaners were identified as non-Western immigrants (n?=?137) or Danes (n?=?148). Blood pressure was measured in a seated position, and psychosocial work environment was assessed by the Copenhagen Psychosocial Questionnaire (COPSOQ). In each population, multivariate logistic regressions were applied testing for an association between each of the COPSOQ scales and hypertension.

Results

Models adjusted for age, sex, BMI, smoking, workplace and physical work exertion showed that high Trust regarding management (OR?=?0.50) and high Predictability (OR?=?0.63) were statistically significantly associated with low prevalence of hypertension in the Danish population. In the immigrant population, no significant associations were found. Analyses on interaction effects showed that associations between Meaning of work and hypertension were significantly different among the two populations (p?Conclusions Psychosocial work factors were associated with hypertension among Danes, but not among non-Western immigrants. This divergent association between psychosocial work environment and hypertension between Danes and non-Western immigrant cleaners may be explained by different perceptions of psychosocial work environment.     

Comparison between the first and second versions of the Copenhagen Psychosocial Questionnaire: psychosocial risk factors for a high need for recovery after work

Purpose

The Copenhagen Psychosocial Questionnaire (COPSOQ I) was developed as a tool to assess a broad range of psychosocial work environment factors and was recently revised (COPSOQ II). The research question in this study was: Do COPSOQ II-scales predict a high need for recovery (NFR) after work better than COPSOQ I-scales?

Methods

A cross-sectional questionnaire study was conducted in 990 subjects (84.5% response), employed in the public sector. Psychosocial factors were assessed by COPSOQ I and COPSOQ II. Multivariate logistic regression analysis was used to calculate the odds ratios for the presence of a high NFR, controlled for gender, age, physical workload and other relevant occupational and non-occupational factors. Analyses were performed for COPSOQ I and COPSOQ II separately.

Results

In both COPSOQ versions, ‘quantitative demands’ (p < 0.001) and ‘job insecurity’ (p < 0.005) were significantly associated with a high NFR. Additionally, in the COPSOQ I model, ‘demands for hiding emotions’ (p < 0.05) and ‘degrees of freedom’ (p < 0.05), and in the COPSOQ II model ‘emotional demands’ (p < 0.05) and ‘commitment to the workplace’ (p < 0.005) were significant as well. ‘Degrees of freedom’ was omitted by the developers in the revised COPSOQ II. Reintroducing it into the COPSOQ II model did not alter the existing associations, but pointed out ‘degrees of freedom’ to be an additional important dimension (p < 0.05). The COPSOQ II model with ‘degrees of freedom’ included also had the best data fit.

Conclusions

The results suggested the COPSOQ II to be better predictive than COPSOQ I for a high NFR, but also indicated that ‘degrees of freedom’ should be included into the COPSOQ II when studying the NFR as outcome parameter.     

Psychosocial work conditions, perceived stress, perceived muscular tension, and neck/shoulder symptoms among medical secretaries

Purpose

Unfavorable psychosocial working conditions are hypothesized to lead to perceived stress, which, in turn, can be related to an increased risk of development of neck/shoulder symptoms through increased and sustained muscle activation. The aim of the present study was to test this hypothesized process model among medical secretaries, a female-dominated profession characterized by a high amount of visual display unit use and a high prevalence of neck/shoulder symptoms.

Methods

In this cross-sectional study, a questionnaire survey was conducted among medical secretaries (n = 200). The proposed process model was tested using a path model framework.

Results

The results indicate that high work demands were related to high perceived stress, which in turn was related to a high perceived muscle tension and neck/shoulder symptoms. Low influence at work was not related to perceived stress, but was directly related to a high perceived muscle tension.

Conclusions

In general, these cross-sectional results lend tentative support for the hypothesis that adverse psychosocial work conditions (high work demands) may contribute to the development of neck/shoulder symptoms through the mechanism of stress-induced sustained muscular activation. This process model needs to be further tested in longitudinal studies.     

Stress,Lebenszufriedenheit und Gesundheitswahrnehmung

Objective

The study examines the impact of stress experiences among members of the professional fire brigade. It was assumed that members who feel burdened show a lower life satisfaction, evaluate their health condition worse, and experience themselves as less confident and active.

Method

In a cross-sectional study, 102 members of the fire department Berlin-Süd were evaluated using the so-called Copenhagen Psychological Questionnaire (COPSOQ), a standardized questionnaire for detecting occupational stress.

Results

It became apparent that stress burdens are primarily less due to firefighting operations but rather relate to everyday activities at the station. Members with high stress levels show a significantly lower life satisfaction and experience themselves as less active and confident. Members with little behavioral and cognitive stress symptoms described themselves as more confident. In the same manner, cognitive stress symptoms correlate with perceived activity. Surprisingly, firefighters with a high stress level describe their health condition in more positive terms than those who are not stressed.     

A one-item workability measure mediates work demands, individual resources and health in the prediction of sickness absence

Objectives

The study tested the hypothesis that a one-item workability measure represented an assessment of the fit between resources (the individuals’ physical and mental health and functioning) and workplace demands and that this resource/demand fit was a mediator in the prediction of sickness absence. We also estimated the relative importance of health and work environment for workability and sickness absence.

Methods

Baseline data were collected within a Danish work and health survey (3,214 men and 3,529 women) and followed up in a register of sickness absence. Probit regression analysis with workability as mediator was performed for a binary outcome of sickness absence. The predictors in the analysis were as follows: age, social class, physical health, mental health, number of diagnoses, ergonomic exposures, occupational noise, exposure to risks, social support from supervisor, job control and quantitative demands.

Results

High age, poor health and ergonomic exposures were associated with low workability and mediated by workability to sickness absence for both genders. Low social class and low quantitative demands were associated with low workability and mediated to sickness absence among men. The mediated part was from 11 to 63 % of the total effect for the significant predictors.

Conclusion

Workability mediated health, age, social class and ergonomic exposures in the prediction of sickness absence. The health predictors had the highest association with both workability and sickness absence; physical work environment was higher associated with the outcomes than psychosocial work environment. However, the explanatory value of the predictors for the variance in the model was low.     

The Portuguese long version of the Copenhagen Psychosocial Questionnaire II (COPSOQ II) – a validation study

Background

Psychosocial risks are now widely recognised as one of the biggest challenges for occupational safety and health (OSH) and a major public health concern. The aim of this paper is to investigate the Portuguese long version of the Copenhagen Psychosocial Questionnaire II (COPSOQ II), in order to analyse the psychometric properties of the instrument and to validate it.

Methods

The Portuguese COPSOQ II was issued to a total of 745 Portuguese employees from both private and public organisations across several economic sectors at a baseline and then 2 weeks later. Methodological quality appraisal was based on COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) recommendations. An analysis of the psychometric properties of the long version of COPSOQ II (internal consistency, intraclass correlation coefficient, floor and ceiling effects, response rate, missing values, mean and standard deviation, exploratory factor analysis) was performed to determine the validity and reliability of the instrument.

Results

The COPSOQ II had a response rate of 60.6% (test) and a follow-up response rate of 59.5% (retest). In general, a Cronbach’s alpha of the COPSOQ scales (test and retest) was above the conventional threshold of 0.70. The test-retest reliability estimated by the intraclass correlation coefficient (ICC) showed a higher reliability for most of the scales, above the conventional 0.7, except for eight scales. The proportion of the missing values was less than 1.3%, except for two scales. The average scores and standard deviations showed similar results to the original Danish study, except for eight scales. All of the scales had low floor and ceiling effects, with one exception. Overall, the exploratory factor analysis presented good results in 27 scales assuming a reflective measurement model. The hypothesized factor structure under a reflective model was not supported in 14 scales and for some but not all of these scales the explanation may be a formative measurement model.

Conclusion

The Portuguese long version of COPSOQ II is a reliable and valid instrument for assessing psychosocial risks in the workplace. Although the results are good for most of the scales, there are those that should be evaluated in greater depth in future studies. This instrument may contribute to the promotion of a healthy working environment and workforce, providing clear benefits for companies and employees.

     

Preliminary Evidence for a Classroom Based Psychosocial Intervention for Disaster Exposed Children with Posttraumatic Stress Symptomatology

Background

In 2004, a firework factory in a residential area of a large Danish city exploded. The children at the local school were screened for symptoms of posttraumatic stress disorder (PTSD) 16 months and 3½ years after the incident. A large proportion of the children still suffered from a substantial number of symptoms 3½ years after the incident. Thus, a treatment program designed to target PTSD symptoms in trauma-exposed children was established.

Objectives

The first aim of this study was to provide preliminary evidence that a classroom-based psychosocial intervention program for children with posttraumatic stress would be associated with reductions in symptoms. The second aim was to evaluate the usefulness of the Darryl, a cartoon-based PTSD screening instrument.

Methods

One hundred and eight children participated in the treatment program, all of whom fulfilled at least two out of the three DSM-IV PTSD symptom clusters. The children were screened for PTSD symptoms at baseline and 1 month after treatment using Darryl.

Results

There was a statistically significant reduction in PTSD symptoms from pre-treatment to post-treatment. Furthermore, a logistic regression analysis revealed that being female, being young, and having a high PTSD score at baseline predicted a probable PTSD diagnosis post-treatment.

Conclusion

The present study provides preliminary evidence of feasibility and that the treatment program described may help to alleviate PTSD symptoms children with chronic PTSD symptoms. Furthermore, the results indicated that the Darryl instrument is a useful screening tool for assessing PTSD symptoms in this sample of children.     

Wie geht es Kita-Leitungen?

Background

The main aim of the study is a classification of the heads of childcare centres?? fields of work, of experienced stress factors and resources during the actual working process, as well as of potential solutions and developments in health promotion for heads of childcare centres

Materials and method

The key aspect is a qualitative interview survey carried out with the heads of 35 childcare centres. This is supplemented by a survey with the COPSOQ with 255 kindergarten teachers and heads of childcare centres.

Results

The results of the qualitative interviews are presented in more detail. Thus it appears that specific fields of work can be identified which not only give rise to multiple stress factors but also offer resources among heads of childcare centres. Of those, human resource management comes first, together with educational management, public relations, administration, sickness/absentee management and work organisation. In general, the interviewed heads of childcare centres evaluated their overall work experience as being feasible and satisfying, despite considerable stress factors.

Conclusion

A clear orientation within the specific fields of work facilitates the strategic combination of educational quality development with health promotion in the childcare centre setting and is thus effective in the long term.     

Musculoskeletal symptoms and psychosocial work environment,among Swedish commercial pilots

Purpose

The associations between psychosocial work conditions and health in pilots are understudied, and therefore, the associations between the psychosocial work conditions and musculoskeletal problems among Swedish commercial pilots were investigated.

Methods

In 2010, a self-administered questionnaire study was performed among pilots in one Swedish commercial airline: 354 pilots participated (61 %). Musculoskeletal symptoms and the psychosocial work conditions measured by the demand control social support model were investigated. Odds ratios (OR) with 95 % confidence interval (95 % CI) were expressed per change of one unit on the interquartile score scale.

Results

Pilots on long-haul flights had less elbow symptoms (OR 0.34, 95 % CI 0.14–0.85), and women had more hand symptoms (OR 2.90, 95 % CI 1.11–7.52). There were associations between high work demands and symptoms from the neck (OR 2.04, 95 % CI 1.45–2.88), shoulders (OR 1.46, 95 % 1.05–2.03), elbows (OR 1.79, 95 % CI 1.10–2.90) and low back (OR 1.42, 95 % CI 1.02–1.96) in pilots. Low social support was associated with symptoms from the neck (OR 1.87, 95 % 1.35–2.58), shoulders (OR 1.56, 95 % CI 1.14–2.14) and low back (OR 1.63, 95 % CI 1.18–2.24). Low supervisor support was associated with neck (OR 1.67, 95 % CI 1.22–2.27), shoulders (OR 1.38, 95 % CI 1.02–1.87) and low back symptoms (OR 1.48, 95 % CI 1.09–2.01). The associations were mainly found among first officers.

Conclusions

Musculoskeletal symptoms in pilots can be affected by poor psychosocial work conditions such as high demands and low social support, especially for first officers. The psychosocial aspects of organisational changes in commercial airlines should be taken into consideration.     

Occupational noise exposure,psychosocial working conditions and the risk of tinnitus

Purpose

The purpose of this study was to evaluate the influence of occupational noise (current and cumulative doses) and psychosocial work factors (psychological demands and decision latitude) on tinnitus occurrence among workers, using objective and non-self-reported exposure measures to prevent reporting bias.

Methods

In a cross-sectional study, we analyzed data from a Danish survey from 2009 to 2010 that included 534 workers from children day care units and 10 manufacturing trades. Associations between risk factors (current noise exposure, cumulative noise exposure and psychosocial working conditions) and tinnitus were analyzed with logistic regression.

Results

We found no statistically significant associations between either current [OR 0.95 (95% CI 0.89; 1.01)] or cumulative [OR 0.93 (95% CI 0.81; 1.06)] occupational noise exposure and tinnitus. Likewise, results for psychosocial working conditions showed no statistically significant association between work place decision latitude [OR 1.06 (95% CI 0.94; 1.13)] or psychological demands [OR 1.07 (95% CI 0.90; 1.26)] and tinnitus.

Conclusions

Our results suggest that current Danish occupational noise levels (in combination with relevant noise protection) are not associated with tinnitus. Also, results indicated that the psychosocial working conditions we observed in this cohort of mainly industrial workers were not associated with tinnitus. Therefore, psychosocial working conditions comparable to those observed in this study are probably not relevant to take into account in the evaluation of workers presenting with tinnitus.

     

Psychosocial work factors and long sickness absence in Europe

Background:

Studies exploring a wide range of psychosocial work factors separately and together in association with long sickness absence are still lacking.

Objectives:

The objective of this study was to explore the associations between psychosocial work factors measured following a comprehensive instrument (Copenhagen psychosocial questionnaire, COPSOQ) and long sickness absence (>7 days/year) in European employees of 34 countries. An additional objective was to study the differences in these associations according to gender and countries.

Methods:

The study population consisted of 16 120 male and 16 588 female employees from the 2010 European working conditions survey. Twenty-five psychosocial work factors were explored. Statistical analysis was performed using multilevel logistic regression models and interaction testing.

Results:

When studied together in the same model, factors related to job demands (quantitative demands and demands for hiding emotions), possibilities for development, social relationships (role conflicts, quality of leadership, social support, and sense of community), workplace violence (physical violence, bullying, and discrimination), shift work, and job promotion were associated with long sickness absence. Almost no difference was observed according to gender and country.

Conclusions:

Comprehensive prevention policies oriented to psychosocial work factors may be useful to prevent long sickness absence at European level.     

Psychosocial working conditions and psychological well-being among employees in 34 European countries

Purpose

The aim of this study was to explore the associations between psychosocial working conditions and psychological well-being among employees in 34 European countries. Another objective was to examine whether these associations varied according to occupation and country.

Methods

The study was based on data from the European Working Conditions Survey 2010 including 33,443 employees, 16,512 men and 16,931 women, from 34 European countries. Well-being was measured by the WHO-5 well-being index. Twenty-five psychosocial work factors were constructed including job demands, role stressors, work hours, job influence and freedom, job promotion, job insecurity, social support, quality of leadership, discrimination and violence at work, and work-life imbalance. The associations between these factors and well-being were examined using multilevel logistic regression analyses. Different models were performed including interaction tests.

Results

When all 25 psychosocial work factors were studied simultaneously in the same model with adjustment variables, 13 showed a significant association with poor well-being among both genders: quantitative demands, demands for hiding emotions, low possibilities for development, low meaning of work, low role conflict, low quality of leadership, low social support, low sense of community, job insecurity, low job promotion, work-life imbalance, discrimination, and bullying. The association with low sense of community on poor well-being was particularly strong.

Conclusions

A large number of psychosocial work factors were associated with poor well-being. Almost no country and occupational differences were found in these associations. This study gave a first European overview and could be useful to inform cross-national policy debate.     

The psychosocial work environment and mental health of teachers: a comparative study between the United Kingdom and Hong Kong

Purpose

There is limited research on teachers’ psychosocial work environment and mental health, and most has been conducted in predominantly Western countries that share a number of important common characteristics that distinguish them from countries in many other regions of the world. Within the framework of the effort–reward imbalance (ERI) theoretical model, the relationship between the psychosocial work environment and mental health of teachers in the United Kingdom (UK) and Hong Kong (HK) was investigated.

Methods

Full-time qualified teachers from both the UK and HK (N = 259) participated in the research. They were asked to fill in a set of questionnaires that measured their perceived stress, mental health, psychosocial work environment and demographic information.

Results

Perceived stress was found to predict teachers’ mental health. Overcommitment, the intrinsic component of the ERI model, predicted mental health among HK teachers. There were significant differences in the psychosocial variables between UK and HK teachers.

Conclusion

The results showed support for the ERI model and in particular for the relationship between stress and mental health and demonstrated the role of overcommitment in the teaching profession. Some implications are discussed for combating cultural differences in managing the psychosocial work environment of teachers.     

Sick building syndrome (SBS) and sick house syndrome (SHS) in relation to psychosocial stress at work in the Swedish workforce

Purpose

Medical symptoms called sick building syndrome (SBS) and sick house syndrome (SHS) are usually investigated separately: in this study, SBS and SHS were explored simultaneously. The significance of personal factors, perceptions of air quality, and psychosocial work situation in explaining SBS and SHS were investigated.

Methods

A random sample of 1,000 subjects (20–65 year) received a postal questionnaire including questions on personal factors, medical symptoms, and the psychosocial demand-control-support model. The response rate was 70 % (n = 695), of which 532 were occupationally active.

Results

In logistic regression models, atopy, poor air quality at work, and low social support, especially low supervisor support, were associated with both SBS and SHS when age, gender, smoking, and BMI were introduced. The general work-related symptoms (headache, tiredness, nausea, and sensation of a cold) were also related to low control over work.

Conclusions

The perception of poor physical environmental conditions is associated with common medical symptoms that are both work and home related. The associations between medical symptoms and poor air quality are still present, even when controlling for the psychosocial environment.     

Predictors of work ability in occupations with psychological stress

Aim

This study aimed to detect health- and work-related predictors of poor and good work ability in teachers (TE) and office workers (OW).

Method

Work ability and its influence factors were analyzed in 100 female TE and 60 female OW aged between 25 and 60 years. The work ability was evaluated with the work ability index questionnaire and the health status with the vitality measurement system®. In addition, cardiac risk factors, burnout risk, as well as the working demands and effort-reward ratio were taken into account. Predictors of work ability were analyzed by using a CHAID analysis. The number of complaints represents the best predictor to divide both occupational groups into subgroups with different work abilities (criterion variable).

Results

Poor work ability is caused by many complaints and cardiovascular risk factors. By contrast, excellent work ability is associated with few complaints, the occupation “office workers,” a younger vital functional age, and the absence of burnout symptoms, which means in comparison with OW, TE have a 1.6 times higher risk for impaired work ability. Furthermore, the absence of burnout symptoms is a resource of TE, whereas OWs tend to have a younger vital functional age compared to their calendrical age. Although this analysis is able to explain 61.2% of the influence on impaired work ability, research for further causes must be undertaken.

Conclusion

The results reflect the positive effect of a high educational level and a challenging job on the preservation of good work ability. Moreover, they draw the attention to the psychological and psychosocial strains of TE. TEs are exposed more frequently to feeling overstrained; this probably effects a higher retirement rate due to illness.     

The prospective relationship between work stressors and cardiovascular disease, using a comprehensive work stressor measure for exposure assessment

Purpose

The currently used instruments which measure the psychosocial work environment have been criticized. We analyzed the association between work stressors and cardiovascular disease, using the Maastricht Cohort Study Work Stressor Score (MCS-WSS), a comprehensive measure which has been associated with work strain.

Methods

At baseline 11,489 employees of the Maastricht Cohort Study were participating. This prospective cohort study started in 1998 in the Netherlands and includes a heterogeneous population of employees. The psychosocial work environment, cardiovascular risk factors and the occurrence of cardiovascular disease were measured with questionnaires at various time points during follow-up, the last follow-up was in 2008. For a subsample of employees, CVD extracted from medical records was available. The MCS-WSS consists of items from emotional demands, psychological demands, role clarity, career possibilities, working overtime, job insecurity, cognitive demands, skills discretion and decision authority. Each item has its own contribution in inducing work strain, represented by its own weighting factor. The association between a high exposure to work stressors at baseline and cardiovascular morbidity was assessed with Cox regression analyses. Analyses were adjusted for age, gender, educational level, smoking, body mass index, alcohol consumption and leisure physical activity.

Results

During a median follow-up of 49 months, 309 employees developed incident cardiovascular disease. Overall, no significant associations were found between a high exposure to work stressors at baseline and cardiovascular morbidity.

Conclusions

The results of this study indicate that high exposure to work stressors has no considerable impact on cardiovascular disease.     

The influence of psychosocial work characteristics on the need for recovery from work: a prospective study among computer workers

Purpose

To investigate the influence of high job demands, low job control, and high social support on need for recovery (NFR) among computer workers.

Methods

Data was obtained from a longitudinal cohort study, including 5 consecutive measurements, with an in-between period of 6 months. General estimating equations analyses were performed to assess the risk for high NFR 6 months later. Odds ratios (ORs) for high NFR were calculated for high job demands, low job control and low social support, separately. Likewise, ORs were calculated for combinations of job demands and job control, as well as for combinations of job demands, job control and social support.

Results

High job demands resulted in an increased risk for high NFR 6 months later, particularly in older workers. Low social support showed also an increased risk for future high NFR, but this was not the case for low job control. Furthermore, a combination of high job demands and low job control, as well as a combination of high job demands, low job control and low social support demonstrated an increased risk for future high NFR where older workers showed higher risks.

Conclusion

This study demonstrated that adverse psychosocial work characteristics predicted future NFR among computer workers.     

Do psychosocial job demands and job resources predict long-term sickness absence? An analysis of register-based outcomes using pooled data on 39,408 individuals in four occupational groups

Purpose

To investigate whether psychosocial job demands (work pace and quantitative demands) and job resources (influence at work and quality of leadership) predict long-term sickness absence (LTSA) for more than three consecutive weeks in four occupational groups.

Methods

Survey data pooling 39,408 respondents were fitted to a national register containing information on payments of sickness absence compensation. Using multi-adjusted Cox regression, respondents were followed for an 18-month follow-up period to assess risk of LTSA.

Results

In the entire study population, low and medium levels of influence at work and low quality of leadership predicted a significantly increased risk of LTSA, whereas medium levels of quantitative demands predicted a significantly reduced risk of LTSA. For employees working with clients and for office workers, low and medium influence at work associated with a significantly increased risk of LTSA. For employees working with clients, low quality of leadership predicted a significantly increased risk of LTSA. For manual workers, low influence at work predicted a significantly increased risk of LTSA and medium quantitative demands were associated with a significantly reduced risk of LTSA. For employees working with customers, medium quantitative demands predicted a significantly reduced risk of LTSA. Finally, in predicting LTSA, we found significant interaction effects between job demands and job resources.

Conclusions

The study indicates that a lack of job resources—particularly influence at work—are more important predictors of LTSA than high job demands.     

A new quantitative approach to measure perceived work-related stress in Italian employees

Objective

We propose a method for a reliable quantitative measure of subjectively perceived occupational stress applicable in any company to enhance occupational safety and psychosocial health, to enable precise prevention policies and intervention and to improve work quality and efficiency.

Materials and Methods

A suitable questionnaire was telephonically administered to a stratified sample of the whole Italian population of employees. Combined multivariate statistical methods, including principal component, cluster and discriminant analyses, were used to identify risk factors and to design a causal model for understanding work-related stress.

Results

The model explained the causal links of stress through employee perception of imbalance between job demands and resources for responding appropriately, by supplying a reliable U-shaped nonlinear stress index, expressed in terms of values of human systolic arterial pressure. Low, intermediate and high values indicated demotivation (or inefficiency), well-being and distress, respectively. Costs for stress-dependent productivity shortcomings were estimated to about 3.7% of national income from employment.

Conclusions

The method identified useful structured information able to supply a simple and precise interpretation of employees’ well-being and stress risk. Results could be compared with estimated national benchmarks to enable targeted intervention strategies to protect the health and safety of workers, and to reduce unproductive costs for firms.     

The incremental effect of psychosocial workplace factors on the development of neck and shoulder disorders: a systematic review of longitudinal studies

Background

To systematically analyse evidence on the incremental effect of work-related psychosocial risk factors on the development of neck and shoulder disorders, as reported in longitudinal studies.

Methods

A systematic literature search was conducted in three data bases (MEDLINE, EMBASE, and PsychINFO) until May 2009. The quality assessment leading to a methodological quality score of the included studies was conducted by two independent reviewers using a standardised checklist. Criteria for the evaluation of evidence were established. Heterogeneity analyses were conducted.

Results

Altogether 18 prospective longitudinal studies were included in the analysis. Potential psychosocial risk factors were mainly based on the job demand control (support) model by Karasek (1998). Study results were too heterogeneous to deduce pooled risk estimates. But the weight of evidence was strong for an incremental effect of job demands, job control, social support, and job strain, on the development of neck and/or shoulder disorders.

Conclusion

While we found evidence for an incremental effect of different psychosocial work factors (in addition to the effect of physical job factors), these results have to be interpreted carefully in order to support the notion that psychological factors can have an independent causal influence on the development of musculoskeletal disorders. Nevertheless, our findings are important for the development of preventive strategies, as they stress the need for preventive approaches that tackle both physical and psychosocial factors. Future research is warranted to consolidate and strengthen the results of this review.