Psychosocial work conditions and registered sickness absence: a 3-year prospective cohort study among office employees

Purpose  

To investigate associations between a wide variety of psychosocial work conditions and sickness absence in a medium-sized company.     

Psychosocial work environment and incidence of severe depressive symptoms: prospective findings from a 5-year follow-up of the Danish work environment cohort study

The authors analyzed the impact of psychosocial work characteristics on the incidence of severe depressive symptoms among 4,133 (49% women) employees from a representative sample of the Danish workforce between 1995 and 2000. Psychosocial work characteristics at baseline included quantitative demands, influence at work, possibilities for development, social support from supervisors and coworkers, and job insecurity. Severe depressive symptoms were measured with the five-item Mental Health Inventory of the 36-item Short-Form Health Survey, with a cutoff point of 52. Women with low influence at work (relative risk (RR) = 2.17, 95% confidence interval (CI): 1.23, 3.82) and low supervisor support (RR = 2.03, 95% CI: 1.20, 3.43) were at increased risk for severe depressive symptoms after exclusion of cases at baseline and adjustment for sociodemographic factors, baseline depression score, and health behaviors. Further adjustments for socioeconomic position did not change the result substantially. Additional analyses showed that a one-standard deviation increase on the influence scale resulted in a 27% decreased risk of severe depressive symptoms. Among men, job insecurity predicted severe depressive symptoms (RR = 2.04, 95% CI: 1.02, 4.07). The findings indicate that the work environment influences the risk of developing severe depressive symptoms and that different factors play a role for men and women.     

The psychosocial work environment and alcohol dependence: a prospective study

Aims: To examine whether a stressful psychosocial work environment predicts alcohol dependence.

Methods: Alcohol dependence of participants in the Whitehall II occupational cohort of London based civil servants (1985–88) was measured in 1991–93 using the CAGE questionnaire. The psychosocial work environment was measured by self report questions on the job demand-support-control model and on the model of effort-reward imbalance. Potential mediators including physical illness and poor mental health (GHQ) were measured at follow up in 1989.

Results: Effort-reward imbalance at work was associated with alcohol dependence in men after adjustment for employment grade and other baseline factors related to alcohol dependence. Although effort-reward imbalance predicted future longstanding illness, poor mental health and negative aspects of close relationships, the association between effort-reward imbalance and alcohol dependence in men was only partially mediated through these health and social support measures. In women, low decision latitude was related to alcohol dependence to some extent, but alcohol dependence among women was more prevalent in higher occupational grades. Men with high job demands or with low work social supports had a slightly reduced risk of alcohol dependence. No association was found between objectively assessed demands, job control, and alcohol dependence in either men or women.

Conclusion: A stressful psychosocial work environment in terms of effort-reward imbalance was found to be a risk factor for alcohol dependence in men. In view of the public health importance of alcohol dependence in working populations these findings call for more emphasis on psychosocial factors in occupational health research and prevention.

     

Office design as a risk factor for disability retirement: A prospective registry study of Norwegian employees

Objectives:This aim of this study was to (i) examine differences in risk of subsequent disability retirement between employees working in cellular, shared, and open-plan offices and (ii) determine the contribution of gender, skill-level, work ability, medically certified sickness absence, leadership position, and personality traits (extroversion, agreeableness, conscientiousness, neuroticism, and openness) as confounders.Methods:Survey data on predictor variables combined with official objective registry data on disability retirement and sickness absence were extracted from a large Norwegian occupational cohort of office workers (N=6779, 53.5% women). Questionnaire data included the respondents’ office designs, comparing cellular, shared, and open-plan offices, demographic characteristics, workability, and personality factors. Objective data on disability retirement and medically certified sickness absence were extracted from the sickness and disability benefit register of the Norwegian Labor and Welfare Administration.Results:In the final fully adjusted model, employees working in shared [hazard rato (HR) 1.52, 95% confidence interval (CI) 1.08–2.16] and open-plan (HR 1.95, 95% CI 1.31–2.90) offices had significantly higher risk of subsequent disability retirement compared to employees in cellular offices. Gender, work ability, medically certified sickness absence, and conscientiousness had independent direct effects on risk of disability retirement.Conclusion:This study shows that open and shared workspace designs have detrimental effects by increasing risk of disability retirement among office workers, even when taking other known predictive factors into account.     

Psychosocial factors at work and sickness absence in the Gazel cohort: a prospective study

OBJECTIVE: To test whether psychosocial factors at work are predictors of rates of sickness absence. METHODS: The study population consisted of middle aged men and women employed by the French national electricity and gas company (EDF-GDF) in various occupations and followed up since 1989 by annual self administered questionnaires and independent data obtained from the medical and personnel departments of EDF-GDF. The 1995 questionnaire provided information about three psychosocial work factors: psychological demands, decision latitude, and social support at work. Sick-ness absence data were provided by the company's social security department. The occurrence of spells and days of absence in the 12 months after completion of the 1995 questionnaire was studied. Potential confounding variables were age, smoking, alcohol, and marital status, assessed in the 1995 questionnaire, and educational level and occupation, assessed from data provided by the personnel department. This study was restricted to the 12,555 subjects of the initial cohort who were still working and answered the self administered questionnaire in 1995. RESULTS: Low levels of decision latitude were associated with more frequent and longer sickness absences among men and women. Low levels of social support at work increased the numbers of spells and days of absence among men only. These associations weakened after adjustment for potential confounding factors, but remained significant. CONCLUSION: The study indicates that psychosocial factors at work, especially decision latitude, are predictive of sickness absence.

 

     

Psychosocial work characteristics and sickness absence in Japanese employees

Objectives: This study was undertaken to examine the association between sickness absence in Japanese employees and job demand/control and occupational class as psychosocial work characteristics. Methods: The study was cross-sectional in design with data collected from 20,464 male and 3,617 female employees, whose mean age was 40.9 years (SD ± 9.1 years) and 36.9 years (SD ± 10.8 years), respectively. The participants were asked to write the total number of sick leaves they had taken during the past year, and a comparison was made between the group with more than 6 days of sickness absence and the group with 0–6 days as a reference group. Job demands, job control, and worksite support from supervisors and colleagues were analyzed by the Job Content Questionnaire, and likewise by the Generic Job Stress Questionnaire of the National Institute for Occupational Safety and Health. Results: Both low job control and low support at the worksite were associated with a high frequency of sickness absence. But there was no clear relationship between job demands and sickness absence. The lowest sickness absence rate was found in male managers and the highest in male and female laborers. Conclusion: This is the first report of a large-scale survey of Japanese employees to show a high frequency of sickness absence associated with increased work stress and a socioeconomically low occupational class.     

Psychosocial work environment and well-being: a cross-sectional study at a thermal power plant in China

To investigate the effects of the job demand-control (DC) model and the effort-reward imbalance (ERI) model on worker's well-being, self-reports for psychosocial work conditions and well-being were made by a sample of 878 workers at a thermal power plant in China using the main dimensions of DC and ERI questionnaires. Logistic regression analyses were employed controlling for age, gender, and educational level, and negative and positive affection among others. Workers reporting high job demands and low job control or high efforts and low rewards had elevated risks of job dissatisfaction, psychosomatic complaints and depressive symptoms. Odds ratios were generally higher in workers reporting both high efforts and low rewards. Furthermore, low reward proved to be a stronger predictor of poor well-being when both job stress models were simultaneously adjusted. To some extent, interaction effects were found for social support, but no interaction effects were found for overcommitment. The findings indicate independent effects of both the DC model and the ERI model on well-being. Future work should explore the combined effects of these two models of psychosocial stress at work on health more thoroughly.     

Job demands, job resources, and work engagement of Japanese employees: a prospective cohort study

Purpose

Research on the prospective association of job demands and job resources with work engagement is still limited in Asian countries, such as Japan. The purpose of the present study was to investigate the prospective association of job demands (i.e., psychological demands and extrinsic effort) and job resources (i.e., decision latitude, supervisor support, co-worker support, and extrinsic reward), based on the job demands-control (JD-C) [or demand-control-support (DCS)] model and the effort-reward imbalance (ERI) model, with work engagement among Japanese employees.

Methods

The participants included 423 males and 672 females from five branches of a manufacturing company in Japan. Self-administered questionnaires, including the Job Content Questionnaire (JCQ), the Effort-Reward Imbalance Questionnaire (ERIQ), the nine-item Utrecht Work Engagement Scale (UWES-9), and demographic characteristics, were administered at baseline (August 2009). At one-year follow-up (August 2010), the UWES-9 was used again to assess work engagement. Hierarchical multiple regression analyses were conducted.

Results

After adjusting for demographic characteristics and work engagement at baseline, higher psychological demands and decision latitude were positively and significantly associated with greater work engagement at follow-up (β = 0.054, p = 0.020 for psychological demands and β = 0.061, p = 0.020 for decision latitude).

Conclusions

Having higher psychological demands and decision latitude may enhance work engagement among Japanese employees.     

Psychosocial work characteristics and incidence of newly diagnosed depression: a prospective cohort study of three different models

This study explored the association between psychosocial work characteristics and incidence of depression as indicated in three complementary models (the Job Strain Model, the Team Climate Model, and the Procedural Justice Model). Participants were 4815 Finnish hospital personnel (4278 women and 537 men) free from diagnosed depression at entry into the study. A baseline survey in 1998 measured psychosocial work characteristics, health-related behaviours, psychological distress, and doctor-diagnosed depression. The factor analysis of pooled questionnaire items on psychosocial work characteristics supported a five-factor solution with the following distinct dimensions: team climate, relational justice, procedural justice, job control, and job demands. Items in these dimensions were used as scales and job strain was modelled as a combination of job demands and job control. A follow-up survey in 2000 identified 225 incident cases of depression. After adjustment for age, sex and income, poor team climate, low procedural justice, and low relational justice were associated with a higher risk of new depression, the odds ratios (ORs) 1.58 (95% confidence interval (CI) 1.11-2.24), 1.45 (95% CI 1.03-2.04), and 1.39 (95% CI 1.00-1.96), respectively. After additional adjustment for lifestyle factors and exclusion of those with psychological distress at baseline, there was still an association between poor team climate and risk of depression (ORs 1.55 and 1.75, respectively). Job control, work demands, and job strain did not predict the 2-year incidence of depression, and the effects of all psychosocial work characteristics were attenuated when entered simultaneously in the model. In conclusion, work unit social factors seem to be predictive of subsequent doctor-diagnosed depression, but other aspects of psychosocial work environment may also be important.     

Occupation, work environment, and disability pension: a prospective study of construction workers

AIMS: This study investigated the importance of occupation and work environment for the risk of disability pension among construction workers in Sweden. METHODS: The data include around 389,000 construction workers who participated in health examinations from 1971 to 1992. During that period 68,000 participants received disability pension in some form. Between 1985 and 1992 questionnaires were used to collect data regarding hazards in the work environment. Some 87,000 participants answered that questionnaire, and almost 6,000 of these were in receipt of a disability pension. To analyse the risk of disability pension in different occupations, incidence rates (SIR) were calculated according to the person-year method. Logistic regression was used to calculate age-controlled odds ratios according to physical and psychosocial work environment factors. RESULTS: The results show considerable variation in risk for disability pension between different occupations within the construction industry. Furthermore, analysis of work environment factors indicated associations with physical, ergonomic, and psychosocial work environment factors. DISCUSSION: A considerable variation between occupations indicates that characteristics in the work situation are important when explaining the risk of disability pension. The results from this study indicate that improvements in working conditions are an important area of intervention in order to facilitate and prolong labour market participation among elderly people.     

Psychosocial work environment and registered absence from work: estimating the etiologic fraction

BACKGROUND: Evidence is growing that an adverse psychosocial work environment increases sickness absence, but little is known on the magnitude of this problem or the impact of specific factors. METHODS: Psychological demands, decision authority, skill discretion, social support from colleagues or supervisor, predictability, and meaning of work were assessed with questionnaires at baseline and sickness absence was followed-up in employers' registers for 1,919 respondents (response rate 75.2%, 68% women, mainly low-skilled jobs) from 52 Danish workplaces during a 2-year period. Etiologic fractions (EFs) were calculated with the most favorable quartiles as reference. RESULTS: In the fully adjusted model, the following EFs were found: decision authority: 12%; social support from supervisors: 8%; psychological demands: 6%; and predictability: 5%. In total, the seven psychosocial factors explained 29% of all sick-leave days. CONCLUSIONS: The results suggest that improving the psychosocial work environment among the less favorable 75% may prevent substantial amounts of absence.     

Need for recovery from work in relation to age: a prospective cohort study

Purpose  

To investigate the impact of increasing age on the need for recovery (NFR) over time among day workers     

Psychosocial work environment and mental health--a meta-analytic review

OBJECTIVES: To clarify the associations between psychosocial work stressors and mental ill health, a meta-analysis of psychosocial work stressors and common mental disorders was undertaken using longitudinal studies identified through a systematic literature review. METHODS: The review used a standardized search strategy and strict inclusion and quality criteria in seven databases in 1994-2005. Papers were identified from 24,939 citations covering social determinants of health, 50 relevant papers were identified, 38 fulfilled inclusion criteria, and 11 were suitable for a meta-analysis. The Comprehensive Meta-analysis Programme was used for decision authority, decision latitude, psychological demands, and work social support, components of the job-strain and iso-strain models, and the combination of effort and reward that makes up the effort-reward imbalance model and job insecurity. Cochran's Q statistic assessed the heterogeneity of the results, and the I2 statistic determined any inconsistency between studies. RESULTS: Job strain, low decision latitude, low social support, high psychological demands, effort-reward imbalance, and high job insecurity predicted common mental disorders despite the heterogeneity for psychological demands and social support among men. The strongest effects were found for job strain and effort-reward imbalance. CONCLUSIONS: This meta-analysis provides robust consistent evidence that (combinations of) high demands and low decision latitude and (combinations of) high efforts and low rewards are prospective risk factors for common mental disorders and suggests that the psychosocial work environment is important for mental health. The associations are not merely explained by response bias. The impact of work stressors on common mental disorders differs for women and men.     

Psychosocial work environment among immigrant and Danish cleaners

Introduction  

Non-Western cleaners have been shown to have poorer health than their Danish colleagues. One reason could be a poorer psychosocial work environment. However, it is unknown if differences in self-reported psychosocial work environment exist between non-Western and Danish workers within the same social class. The aim of this study was to investigate such differences among cleaners with the hypothesis that the non-Western compared with Danish cleaners would report a generally poorer psychosocial work environment.     

Organisational downsizing and musculoskeletal problems in employees: a prospective study

OBJECTIVES—To study the association between organisational downsizing and subsequent musculoskeletal problems in employees and to determine the association with changes in psychosocial and behavioural risk factors.
METHODS—Participants were 764 municipal employees working in Raisio, Finland before and after an organisational downsizing carried out between 1991 and 1993. The outcome measures were self reports of severity and sites of musculoskeletal pain at the end of 1993 and medically certified musculoskeletal sickness absence for 1993-5. The contribution of changes in psychosocial work characteristics and health related behaviour between the 1990 and 1993 surveys was assessed by adjustment.
RESULTS—After adjustment for age, sex, and income, the odds ratio (OR) for severe musculoskeletal pain between major and minor downsizing and the corresponding rate ratios for musculoskeletal sickness absence were 2.59 (95% confidence interval (95% CI) 1.5 to 4.5) and 5.50 (3.6 to 7.6), respectively. Differences between the mean number of sites of pain after major and minor downsizing was 0.99 (0.4 to 1.6). The largest contribution from changes in work characteristics and health related behaviour to the association between downsizing and musculoskeletal problems was from increases in physical demands, particularly in women and low income employees. Additional contributory factors were reduction of skill discretion (relative to musculoskeletal pain) and job insecurity. The results were little different when analyses were confined to initially healthy participants.
CONCLUSIONS—Downsizing is a risk factor for musculoskeletal problems among those who remain in employment. Much of this risk is attributable to increased physical demands, but adverse changes in other psychosocial factors may also play a part.


Keywords: ocupational health; musculoskeletal disorders; downsizing     

Psychosocial work environment exposures as risk factors for long-term sickness absence among Danish employees: results from DWECS/DREAM

OBJECTIVE: This study examines effects of psychosocial risk factors on long-term sickness absence, and investigates possible interactions between psychosocial and physical work environment risk factors. METHODS: A total of 5,357 employees were interviewed in 2000 regarding work environment and followed up during the proceeding 1.5 years regarding onset of long-term sickness absence. RESULTS: Long-term sickness absence among female employees was associated with role conflict, low reward, and poor management quality. Demands for hiding emotions and high emotional demands predicted long-term sickness absence among men. No significant interactions between psychosocial and physical exposures were found for female or male employees. CONCLUSIONS: The study suggests a potential for reducing long-term sickness absence through interventions targeted toward reducing role conflict, and improving reward and management quality among female employees, and through reducing emotional demands and demands for hiding emotions among male employees.