Prevalence of Self-Reported Work-Related Injuries and Their Association with Psychological Symptoms in General Working Population of Taiwan

Objectives This study investigated the prevalence of self-reported work-related injuries across occupational groups and examined their association with the risk of psychological symptoms in general working population of Taiwan. Methods Data from a national survey conducted in 2013 of a representative sample of general working people of Taiwan was analyzed, consisting of 12,528 male and 8396 female workers aged 25~65 years. Information about work-related injuries including work-related disease occurred over the previous 12 months prior to the survey was obtained by a standardized questionnaire. The presence of psychological symptoms was assessed by the Brief Symptom Rating Scale (BSRS). Also obtained were participants’ socio-demographic characteristics, working hours, job control, psychological job demands, physical job demands and job insecurity. Results Over a year, 14.91 % of male and 11.53 % of female working people had experienced work-related injuries. Workers with lower educational level, manual workers, the self-employed as well as employers of small enterprise were at higher risks for work-related injuries. Findings from multivariate logistic regression analyses with adjustment of gender, age, working hours and psychosocial work conditions showed that employees with experiences of work-related injuries over the past year were at a substantially higher risk for psychological symptoms (OR = 2.42) as compared to employees who had no experiences of work-related injuries. Conclusion A sizable proportion of workers are affected by work-related injuries and these workers are at higher risk for psychological symptoms. The psychosocial consequences of work-related injuries deserve further investigation and interventions.     

Effects of work-related factors and work-family conflict on depression among Japanese working women living with young children

Objective In a Japanese metropolis, we examined the effects of work-related factors and work-family conflict on depressive symptoms among working women living with young children. Methods Data was derived from women (n=501) who lived with at least one preschool child and worked for 20 hours or more per week. As work-related factors, we chose job pressure, skill underutilization, dissatisfaction with personal income, inflexible work schedule, job insecurity, and relationships in the workplace. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale. The effects of work-related factors and work-family conflict on depressive symptoms were explored by hierarchical regression analysis. Results Work-related factors except job pressure were significantly correlated with depressive symptoms. Multiple regression analyses revealed that women who had more frequent work-family conflict and more work-related stressors such as bad relationships in the workplace, job insecurity, and underutilization of skills were likely to have more depressive symptoms. Conclusions Among women workers with young children, work-family conflict and various work-related factors such as perceived bad relationships at work, job insecurity, and underutilization of skills had a significant relationship with depressive symptoms. Much more research is needed to explore ways to support working mothers.     

The contribution of gender-role orientation, work factors and home stressors to psychological well-being and sickness absence in male- and female-dominated occupational groups

The associations of work stress, types of work and gender-role orientation with psychological well-being and sickness absence were investigated in a questionnaire survey of 588 male and female nurses and 387 male and female accountants. We hypothesised that health might be impaired among women working in the male-dominated occupation (accountancy), and men in the female-dominated occupation (nursing), but that effects might be moderated by job strain (perceptions of high demand and low control), work and home hassles, and traditional male (instrumentality) and female (expressivity) psychological characteristics. Responses were analysed from 172 female and 61 male nurses, and from 53 female and 81 male commercial accountants. Female accountants were more likely than other groups to have high anxiety scores on the Hospital Anxiety and Depression Scales, while male nurses had the highest rates of sickness absence. Male nurses and female accountants also reported more work-related hassles than did female nurses and male accountants. Men and women in the same occupation did not differ in job strain or job social support, but nurses reported greater job strain than accountants, due to higher ratings of demands and lower skill utilisation. After adjusting for age, sex, occupation, paid work hours and a measure of social desirability bias, risk of elevated anxiety was independently associated with higher job strain, lower job social support, more work hassles, more domestic responsibility, lower instrumentality and higher expressivity. The association between sex and anxiety was no longer significant after instrumentality had been entered into the regression model. Sickness absence of more than three days over the past 12 months was independently associated with higher job strain, more work hassles, lower instrumentality and higher expressivity. The results suggest that when men and women occupy jobs in which they are in the cultural and numerical minority, there may be adverse health effects that are gender-specific. Psychological traits related to socially constructed gender roles may also be relevant, and mediate in part the differences in psychological well-being between men and women.     

An investigation into the effects of vacations on the health status in male white-collar workers

There are many stress factors in occupational settings, and the lack of vacations could be one of factors in the context of work stress. The authors have been studying the relationship between workload and employee health. This time, an investigation into the effects of leisure vacations on worker health status using male white-collar employees aged 20–60 years engaged in a manufacturing company was conducted. The subjects were questioned on work stress factors including vacations and modifiers in their occupational settings, and on psychological and physiological stress reactions; that is, how often they were able to take leisure vacations every year, their average working hours a day and work stress factors from the Demand-Control-Support model. The questions also examined other factors concerning the employees such as type-A behavior and lifestyles as modifiers, diseases of the employees, physical complaints, feelings about sleep, perceived stress, job and life satisfaction, and stress reactions as measured by physiological examination. Correlation and logistic regression analysis were conducted with the 551 eligible subjects. The results were as follows: Leisure vacation was decreasingly related to some of psychological stress reactions after adjustment was made for working hours and for modifiers. Less vacation was increasingly related to the workers’ diseases especially among the employees aged 20–34, though the association was not statistically significant. Vacations did not show obvious association with physiological measures. These findings demonstrate the effectiveness and possibility of leisure vacation in controlling fatigue and maintaining the health of workers. Vacation should always be taken into consideration as a stress factor in a survey of the health problems of white-collar workers.     

Job strain and risk of cardiovascular events in treated hypertensive Japanese workers: hypertension follow-up group study

In Japan, Karoshi, which means "death from overwork", has become a focus of social concern. However, no previous study has examined long working hours and job strain simultaneously in relation to incidence of cardiovascular events (CVE) in Japanese workers. We prospectively evaluated the relation between job strain or long working hours and risk of CVE in treated hypertensives during the years 1994-2000. In this study, we followed a sample of 1,615 participants (908 men and 707 women) aged 40-65 yr who were working more than 5 working hours per day. Participants completed questions about work-related conditions and lifestyle variables at baseline, and were free of diagnosed cardiovascular disease, stroke or cancer. Job strain (the combination of job demands and job control) was assessed using a simple questionnaire developed with reference to Karasek's model. The main outcome measure was incidence of CVE. During the mean follow-up period of 5.6 yr, we documented 38 cases of initial CVE. Analyses were conducted using the Cox proportional hazard model. We found a significant association between incidence of CVE and job strain categories, but not long working hours. Multivariate relative risks for CVE in active jobs and high strain jobs overall were 2.89 (95% CI: 1.33-6.28) and 2.45 (95% CI: 0.87-6.93); for men 2.94 (95% CI: 1.29-6.73) and 1.86 (95% CI: 0.51-6.75), and for women 3.97 (95% CI: 0.34-46.88) and 9.05 (95% CI: 1.17-69.86), respectively. In conclusion, active jobs and high strain jobs were associated with increased risk of CVE for treated hypertensive workers.     

Work and family life of childrearing women workers in Japan: comparison of non-regular employees with short working hours, non-regular employees with long working hours, and regular employees

This study assessed the working and family life characteristics, and the degree of domestic and work strain of female workers with different employment statuses and weekly working hours who are rearing children. Participants were the mothers of preschoolers in a large Japanese city. We classified the women into three groups according to the hours they worked and their employment conditions. The three groups were: non-regular employees working less than 30 h a week (n=136); non-regular employees working 30 h or more per week (n=141); and regular employees working 30 h or more a week (n=184). We compared among the groups the subjective values of work, financial difficulties, childcare and housework burdens, psychological effects, and strains such as work and family strain, work-family conflict, and work dissatisfaction. Regular employees were more likely to report job pressures and inflexible work schedules and to experience more strain related to work and family than non-regular employees. Non-regular employees were more likely to be facing financial difficulties. In particular, non-regular employees working longer hours tended to encounter socioeconomic difficulties and often lacked support from family and friends. Female workers with children may have different social backgrounds and different stressors according to their working hours and work status.     

A systematic review of working hours and mental health burden]

There is growing concern over the possible increase in mental health problems among Japanese workers. This trend is generally regarded as a reflection of Japan's prolonged economic depression and changes in working environment. In fact, claims for compensation for industrial accidents related to mental health diseases have been rapidly increasing in recent years. Working hours, personal-relationships, support from supervisors/co-workers, job demand, job control, and payment are known to affect workers mental health. In 2004, the Government announced a guideline to combat overwork and mental health problems at work places. This guideline articulates that long overtime working is a major indicator, and workers who work over 100 h overtime in a month should be encouraged to see an occupational physician. This guideline takes into account the practicalities of occupational health at work places and the empiric knowledge that long working hours might associate with workers mental health status. It may be reasonable to assume that long working hours affect workers health status both psychologically and physiologically, interacting with a variety of occupational factors, particularly job stress. However, the association between working hours and workers mental health status has not been fully clarified. The present article aimed to provide a systematic review of the association between working hours and mental health problems. The authors conducted a systematic review of the published literature on the association between working hours and mental health problems using PubMed. Of 131 abstracts and citations reviewed, 17 studies met the predefined criteria. Ten of these are longitudinal studies, and the others are cross-sectional studies. Seven of the 17 studies report statistically significant associations between working hours and mental health problems, while the others report no association. In addition, comparison among these studies is difficult because a variety of measurements of working hours were used. The present review found inconsistent results in the association between working hours and mental health burden.     

Can labour contract differences in health and work-related attitudes be explained by quality of working life and job insecurity?

Study aim

We hypothesise that due to a lower quality of working life and higher job insecurity, the health and work-related attitudes of temporary workers may be less positive compared to permanent workers. Therefore, we aimed to (1) examine differences between contract groups (i.e. permanent contract, temporary contract with prospect of permanent work, fixed-term contract, temporary agency contract and on-call contract) in the quality of working life, job insecurity, health and work-related attitudes and (2) investigate whether these latter contract group differences in health and work-related attitudes can be explained by differences in the quality of working life and/or job insecurity.

Methods

Data were collected from the Netherlands Working Conditions Survey 2008 (N?=?21,639), and Hypotheses were tested using analysis of variance and cross-table analysis.

Results

Temporary work was associated with fewer task demands and lower autonomy and was more often passive or high-strain work, while permanent work was more often active work. Except for on-call work, temporary work was more insecure and associated with worse health and work-related attitude scores than permanent work. Finally, the quality of working life and job insecurity partly accounted for most contract differences in work-related attitudes but not in health.

Conclusions

Especially agency workers have a lower health status and worse work-related attitudes. Job redesign measures regarding their quality of working life and job insecurity are recommended.     

Risk Factors for Work-related Fatigue in Students With School-Year Employment

PurposeTo explore potential risk factors for acute and chronic work-related fatigue in students working at a paid job while pursuing school studies. Although work-related fatigue was identified as a potential hazard for youth health, academic achievement, and occupational safety, very few studies have specifically addressed its correlates and possible predictors.MethodsCross-sectional data from an ongoing prospective cohort study of health risk behaviors in adolescents was used to identify factors associated with increased levels of acute and chronic fatigue in 209 students aged 17–18 years working during the school year. Multiple stepwise regression analyses were performed with acute and chronic fatigue levels as dependent variables, and demographic, work, and health factors as potential explanatory variables.ResultsAverage hours worked per week by students was 14.7 hours. It was observed that higher psychological distress, poorer health perception, greater sleep debt, and higher exposure to physical work factors were associated with higher levels of acute fatigue. Also, it was observed that higher psychological distress, poorer health perception, higher exposure to physical work factors, and holding multiple jobs were associated with higher levels of chronic fatigue. The number of hours worked weekly was associated with neither acute nor chronic work-related fatigue.ConclusionsFindings suggest that prevention strategies devised to minimize work-related fatigue in students should consider exposure to physical work factors. Results also re-emphasize the importance of obtaining sufficient sleep so as to prevent high levels of acute work-related fatigue.     

Job control, job demands, social support at work and health among adolescent workers

OBJECTIVE: To evaluate physical and psychological dimensions of adolescent labor (such as job demands, job control, and social support in the work environment), and their relation to reported body pain, work injuries, sleep duration and daily working hours. METHODS: A total of 354 adolescents attending evening classes at a public school in Sao Paulo, Brazil, answered questionnaires regarding their living and working conditions (Karasek's Job Content Questionnaire, 1998), and their health status. Data collection took place in April and May 2001. Multiple logistic regression analysis was used to determine relations among variables. RESULTS: Psychological job demands were related to body pain (OR=3.3), higher risk of work injuries (OR=3.0) and reduced sleep duration in weekdays (Monday to Thursday) (p<0.01). Lower decision authority in the workplace (p=0.03) and higher job security (p=0.02) were related to longer daily working hours. CONCLUSIONS: It was concluded that besides physical stressors, psychological factors are to be taken into account when studying adolescent working conditions, as they may be associated with negative job conditions and health effects.     

Combined effects of job strain and social isolation on cardiovascular disease morbidity and mortality in a random sample of the Swedish male working population

This study examined the impact of psychosocial work organization on cardiovascular disease (CVD) morbidity and the nine-year cumulative mortality incidence for a random sample of the male Swedish working population (N = 7219). A multiplicative measure was constructed to model the combined effects of psychological job demands, work-related social support and work control. Highly strained and isolated workers had a higher age-adjusted prevalence ratio for CVD morbidity and a higher age-adjusted risk ratio for CVD mortality when compared with those working under less strained and more collective conditions. Blue-collar workers showed the greatest risk for both morbidity and mortality when groups with highly isolated and strained conditions were compared to those in more collective and less strained conditions. Strained and isolated workers also had a substantially higher probability of developing and dying of CVD at a younger age than did those in less adverse environments.     

Epidemiology of job stress and health in Japan: review of current evidence and future direction.

With the increasing concern about job stress, there is a growing body of literature addressing psychosocial job stress and its adverse effects on health in Japan. This paper reviews research findings over the past 15 years concerning the assessment of job stress, the relationship of job stress to mental and physical health, and the effects of worksite stress reduction activities in Japan. Although studies were conducted in the past using ad-hoc job stress questionnaires, well-established job stressor scales have since been translated into Japanese, their psychometric properties tested and these scales extensively used in recent epidemiologic studies. While the impact of overtime and quantitative job overload on mental health seems moderate, job control, skill use and worksite support, as well as qualitative job demands, had greater effects on psychological distress and drinking problems in cross-sectional and prospective studies. These job stressors also indicated a strong association with psychiatric disorders, including major depression, even with a prospective study design. Long working hours were associated with a higher risk of myocardial infarction, diabetes mellitus and hypertension. There is evidence that the job demands-control model, as well as the use of new technology at work, is associated with higher levels of blood pressure and serum lipids among Japanese working populations. Fibrinolytic activity, blood glucose levels, immune functions and medical consultation rates were also affected by job stressors. It is further suggested that Japanese workers tend to suppress expression of positive feelings, which results in apparently higher psychological distress and lower job satisfaction among Japanese workers compared with workers in the U.S. Future epidemiologic studies in Japan should focus more on a prospective study design, theoretical models of job stress, job stress among women, and cultural difference and well-designed intervention studies of various types of worksite stress reduction.     

Psychosocial burden among offshore drilling platform employees

Conditions of work on offshore drilling platforms are particularly hard due to extreme environmental situations created both by nature and technological processes. Oil drilling workers employed on the open sea are potentially exposed to permanently high stress. Apart from the obvious objective factors affecting drilling platform employees, a great role in the general work-related stress level is played by the working conditions and work-related psychosocial factors, defined according to Karask's concept as demands, control, and social support. A total of 184 drill platform workers were examined using objective and subjective research methods. The level of subjective stress among drilling platform workers is lower than the level of objective stress and the stress resulting from prognoses related with specificity of work in extremely hard conditions (audit). The examinations of drilling platform workers reveal a positive role of stress in psychological adaptation, being a special case of the "work ethos" and attachment to the firm. In such investigations of work-related stress on drilling platforms, which are very specific workplaces, a multi-aspect character, sociological and economic aspects, organizational culture conditions in the firm, and a tendency to conceal ailments and the stress experienced should be taken into account. It is important to apply measures referring to at least three different types of evidence (objective demands, subjective stress, health problems reported). Otherwise, the result reflecting work-related stress may not be objective and far from the truth.     

Quality of life of coal dust workers without pneumoconiosis in mainland China

The purpose of this cross-sectional study was to evaluate the quality of life (QOL) of coal dust workers without pneumoconiosis in mainland China. Three hundred five coal dust workers and 200 non-dust workers without pneumoconiosis from five coal mines in Shanxi province were enrolled in this study. The Chinese World Health Organization Quality of Life-brief version (WHOQOL-BREF) questionnaire was used. Socio-demographic, working, and health factors were also collected. Multiple stepwise regression analysis was used to identify significant factors related to the four domain scores of WHOQOL-BREF. All functional domains of the Chinese WHOQOL-BREF were significantly worse in coal dust workers compared to non-dust workers except for psychological health. For the physical domain of QOL, educational level, working hours, and work danger were the significant factors. In the psychological domain, types of job, welfare satisfaction, work danger, hobbies, smoking, one-child family, and marital status were the predictive factors. Working hours, welfare satisfaction, educational level, and birthplace were the predictive factors for the social domain of QOL. Finally, the predictors for the environmental domain of QOL were types of job, working hours, welfare satisfaction, work danger, self-reported social status, smoking, and drinking. Coal dust workers without pneumoconiosis had worse QOL than non-dust workers but their subjective feelings were positive. There were four distinct models for the various domains of QOL. Corresponding health policies could be developed to improve their QOL.     

Occupation-specific screening for future sickness absence: criterion validity of the trucker strain monitor (TSM)

Background: Monitoring psychological job strain may help occupational physicians to take preventive action at the appropriate time. For this purpose, the 10-item trucker strain monitor (TSM) assessing work-related fatigue and sleeping problems in truck drivers was developed. Objectives: This study examined (1) test–retest reliability, (2) criterion validity of the TSM with respect to future sickness absence due to psychological health complaints and (3) usefulness of the TSM two-scales structure. Methods: The TSM and self-administered questionnaires, providing information about stressful working conditions (job control and job demands) and sickness absence, were sent to a random sample of 2000 drivers in 1998. Of the 1123 responders, 820 returned a completed questionnaire 2 years later (response: 72%). Results: The TSM work-related fatigue scale, the TSM sleeping problems scale and the TSM composite scale showed satisfactory 2-year test–retest reliability (coefficient r=0.62, 0.66 and 0.67, respectively). The work-related fatigue, sleeping problems scale and composite scale had sensitivities of 61, 65 and 61%, respectively in identifying drivers with future sickness absence due to psychological health complaints. The specificity and positive predictive value of the TSM composite scale were 77 and 11%, respectively. The work-related fatigue scale and the sleeping problems scale were moderately strong correlated (r=0.62). However, stressful working conditions were differentially associated with the two scales. Conclusions: The results support the test–retest reliability, criterion validity and two-factor structure of the TSM. In general, the results suggest that the use of occupation-specific psychological job strain questionnaires is fruitful.     

High strain and low social support at work as risk factors for being the target of third-party workplace violence among healthcare sector workers

Introduction:Healthcare workers are particularly vulnerable to third-party workplace violence. The experience of work-related stress, by threatening the psychological balance of healthcare workers, making them less effective in managing the relationship with patients and their family members, may significantly contribute to third-party violence.Objective:To investigate whether stress-related psychosocial situations at work as defined by the widely known Demand-Control model, and the level of work-related social support, act as risk factors for third-party violence among healthcare workers. Specifically, we explored whether the risk of violence is higher in situations associated with higher levels of work-related stress (i.e., active or passive situations, and especially the high strain situation) when compared to a work situation related to lower levels of stress (i.e., low strain situation). We also explored whether the risk of violence is lower at higher levels of social support.Method:Cross-sectional study on 633 healthcare workers. Psychosocial work situations and third-party workplace violence have been operationalized by using well validated scales.Results:Logistic regressions including a number of relevant covariates (e.g., gender, job role, night shift work) revealed that, compared to a low strain situation, an active or passive situation had an increased risk for workplace violence. However, the highest risk was observed for a high strain situation (i.e., the situation associated with the highest level of work-related stress). High social support acted as a protective factor.Conclusion:Healthcare workers’ experience of stress at work may make them more vulnerable to third-party violence. Ensuring better psychosocial working conditions may contribute to the prevention of workplace violence and its consequences.Key words: Third-party workplace violence, job strain, low social support, demand-control model, healthcare workers     

Age-related differences in work injuries: a multivariate, population-based study

BACKGROUND: Many population-based studies find that the rate of work injuries is higher among adolescent and young adult workers compared to older adults. The present study examines age-related differences in work injuries, with an emphasis on adjusting for the potential confounding effects of job characteristics. METHODS: Age-related differences in work injuries were examined in a representative sample of 56,510 working Canadians aged 15 years and over. Respondents reported work-related injuries and job characteristics (e.g., occupation) in the past 12 months. Total hours worked in the past year were computed for each worker and accounted for in the logistic regressions. Analyses were stratified by gender. RESULTS: For men, adjusting for job characteristics substantially reduced, but did not eliminate the elevated risk status of adolescent and young adult workers. For women, only young adult women showed an elevated risk of work injury with job characteristics controlled. CONCLUSIONS: This is one of the few multivariate studies specifically examining contributors to age-related differences in work injuries in a population-based sample of workers. The substantial reduction in age-work injury association in the fully adjusted model suggests that differences in the types of jobs young workers hold play a critical role in their high-risk status.     

Prevalence of common infections among employees in different work schedules

This study examined the prevalence of common infections among employees in different work schedules. Self-administered questionnaire data from the Maastricht Cohort Study on "Fatigue at Work" (n = 12,140) were used. Job title was used as a matching variable between day and shift workers to control for their different work environment. We used a multilevel analysis of a two-level structure, in which the individual employees (level 1) were nested within job titles (level 2), adjusted for demographics, longstanding disease, health behavior, work-related factors, fatigue and sleep quality. Results from the multilevel analyses showed that, compared to day work, shift work was associated with a higher risk for common infections, with the highest risk in three-shift workers. Compared to day work, shift work was further associated with differences in health, health behavior, sleep, fatigue and perceived job characteristics, factors that may influence the occurrence of infections and should be taken into account in future studies as well.     

The role of educational level and job characteristics on the health of young adults

The mediating effect of job characteristics in the socioeconomic status (SES)-health relationship has not been well studied in the young adult population. The early health trajectory is important to study since the health trajectories of young people shape their health in later years. The purpose of this study was to determine whether the education defined SES-health relationship is mediated through job characteristics, controlling for healthy lifestyle factors in young adults. We hypothesize that accounting for differences in job quality would reduce the education-health gradient. Using a sample of 10,215 Canadian workers aged 20-29 years, we used multivariable logistic regressions to examine the associations of sociodemographic, work, and lifestyle factors with two health outcomes, self-perceived health and work-related injury. The key findings indicate that job characteristics partly explain the education gradient observed in work-related injuries, and to a lesser extent in self-perceived health for working young adults. Our results show that increased physical exertion and working in sales and service or manual occupations were job characteristics which were independently associated with work-related injuries, while low work-related social support and irregular shift work were associated with poor self-perceived health. Lifestyle factors have a greater association with the education-self-perceived health relationship. This pattern of findings suggests that work factors related to education have a more specific effect on occupational health early in the health trajectory. These findings have potential practical implications since policies to reduce poor health must be targeted at appropriate age groups, as workers need to be healthy in their younger years in order to stay in the workforce as they age.     

High job strain and ambulatory blood pressure in middle-aged men and women from the Belgian job stress study

OBJECTIVE: The aim of this study was to assess whether job strain is associated with 24-hour ambulatory blood pressure measurements within a subsample of the Belgian Job Stress Project (BELSTRESS) population. METHODS: A group of 89 middle-aged male and female workers perceiving high job strain and an equally large group of workers perceiving no high job strain wore an ambulatory blood pressure monitor for 24 hours on a regular working day. RESULTS: Mean ambulatory blood pressure at work, at home, and while asleep was significantly higher in workers with job strain as compared with others. The associations between job strain and ambulatory blood pressure were independent from the covariates. CONCLUSIONS: Within this study, high job strain was an important independent risk factor for higher ambulatory blood pressure at work, at home, and during sleep in a group of men and women.