Perceived job demands relate to self-reported health complaints

BACKGROUND: Illness and illness behaviour are important problems in the Dutch workforce. Illness has been associated with job demands, with high demands relating to poorer health. It has not been reported whether subjective health complaints relate to job demands. AIMS: To investigate whether perceived (physical and mental) workload and specific job demands are associated with self-reported health complaints. METHODS: Cross-sectional study of a random sample of 983 male employees working in manufacturing industry. Job demands and health complaints were investigated using the self-completed Basic Occupational Health Questionnaire. The relationship between demands and health complaints were studied using logistic regression analysis with health complaints as the outcome variable. RESULTS: The questionnaires of 867 workers (88%) were suitable for analysis. The prevalence of health complaints was high. Physical workload was related to musculoskeletal symptoms. Standing work predicted pain in the legs and thoracic as well as low back pain, while sedentary work predicted low back pain. Heavy lifting predicted low back pain and pain in the extremities. Regular bending predicted low back pain and pain in the legs. Repetitive movements predicted pain in the arms and thoracic as well as low back pain. Mental workload was associated with fatigue and chest pain. Working under time pressure and working behind schedule were not related to self-reported health complaints. CONCLUSIONS: Perceived physical job demands matched with self-reported musculoskeletal complaints, whereas perceived mental job demands were unrelated to specific complaints.     

Job satisfaction and short-term sickness absence among Dutch workers

BACKGROUND: Sickness absence is a considerable economic and social problem. Short-term sickness absence is known to be associated with behavioural attitudes. The correlation between sickness absence and job satisfaction has been studied infrequently and with contradictory results. AIMS: This study investigated the correlation between short-term sickness absence and both global and specific job satisfaction. We defined short-term sickness absence as spells of up to 42 days. METHODS: A random sample of 898 Dutch workers from a variety of economic sectors and companies received a self-report questionnaire on their first day of sick leave. The questionnaire measured global and specific job satisfaction. In our regression analysis, we controlled for the confounding factors of age, gender, educational level, perceived workload, job autonomy and decision latitude. The duration of an absence spell was defined as the amount of calendar days between sick leave and return to work. RESULTS: Global job satisfaction did not correlate significantly with the duration of short-term sickness absence. While increasing physical job demands predicted longer absence, increasing job autonomy and educational level predicted shorter absence. Satisfaction with colleagues predicted longer duration absence. CONCLUSION: Global job satisfaction did not correlate with the duration of short-term absence spells, but specific satisfaction with colleagues was associated with longer sickness spells.     

Occupational and social variation in subjective health complaints

OBJECTIVES: Occupational and social factors are thought to be important determinants of health inequality. The aim of this study was to examine the relationships between occupation, lifestyle and subjective health complaints (SHC). METHODS: SHC and self-reported sickness absence were recorded in a cross-sectional study of 662 individuals aged between 16 and 67 from five occupational groups: blue-collar, school/education, health service, white-collar and service. Differences in SHC and sickness absence were investigated. A model of sociodemographic, lifestyle and work-related factors was tested to examine associations with SHC. RESULTS: Few differences in SHC and sickness absence were found when educational level, age and gender were controlled for. Female health service workers did, however, show significantly higher prevalence of pseudoneurological complaints compared with white-collar workers. Male blue-collar workers had significantly higher frequency of sickness absence than white-collar workers; otherwise, there were no significant differences in frequency and duration of sickness absence. The model explained very little of the variance of SHC (R(2)(adj) = 0.15) and occupational group was not significantly associated with health. Physical workload and sleep quality showed significant relationships with SHC for both genders. Education, however, was a significant factor for women only. CONCLUSIONS: The differences in health found between major occupational groups in this sample were mainly explained by gender differences. Sociodemographic, lifestyle and work-related factors explained little of the variance in SHC, suggesting that factors such as psychological demands, perceived job stress, coping and other psychological factors might be of stronger importance for SHC.     

Identifying workers at risk of sickness absence by questionnaire

BACKGROUND: Sickness absence is an important economic problem, because of high costs and lost productivity. Determining factors associated with increased risk of sickness absence may lead to the development of preventive measures. AIMS: To determine whether self-report questionnaires can identify those employees at risk of sickness absence METHODS: Prospective study of 238 healthy administrative workers. Participants completed a questionnaire proven to be valid and consistent. The questionnaire consisted of 116 items about health, work and working conditions. Sickness absence was followed-up for a period of 1 year. RESULTS: The questionnaires of 191 workers (80%) were suitable for analysis. The number of reported health complaints was significantly (P < 0.01) associated with sickness absence (OR 2.18; 95% CI 1.32-3.61). Concentration problems were correlated with more frequent absences, and both nervous complaints and coping problems with longer duration. Age (OR 0.96; 95% CI 0.93-0.99; P = 0.02) and job insecurity (OR 0.68; 95% CI 0.47-0.98; P = 0.04) were negatively associated with sickness absence. Psychosocial and physical work factors were not associated with sickness absence. CONCLUSIONS: Questionnaires on health and work can identify employees at future risk of sickness absence. Workers who report multiple health complaints, especially concentration problems, nervous complaints or coping problems, may be at increased risk of sickness absence.     

The connection between age,job control and sickness absences among Finnish food workers

METHODS: The relationship between sickness absence and job control among industrial food workers of different ages (n = 114) was studied. RESULTS: The number of absence spells, particularly short absence spells, was higher among younger workers, as expected. Using multivariate analysis, low job control was associated with an increased number of all absence spells (P < 0.02). CONCLUSIONS: Job control may be an important factor in determining sickness absence among industrial workers.     

Health complaints and sickness absence in Norway, 1996-2003

BACKGROUND: From 1996 to 2003, the total number of sickness absence days increased by 65% in Norway. AIM: To investigate if this could be explained by a corresponding increase in the prevalence of self-reported health complaints in the same period. METHODS: Representative samples of the Norwegian working population in 1996 (n = 838) and 2003 (n = 637) answered the subjective health complaints (SHC) questionnaire. The single items of the SHC questionnaire were matched with the corresponding sickness absence statistics from the National Insurance Administration in 1996 and 2003. RESULTS: The main finding was a poor concordance between the change in prevalence of health complaints and the change in the prevalence of sickness absence for diagnoses corresponding to these complaints. The prevalence of health complaints in Norway was high and relatively stable from 1996 to 2003. The only complaints that increased in prevalence during the period were allergy and severe asthma. Sickness absence for health complaints, however, showed a general increase. The diagnoses with the largest percentage increase in sickness absence were sleep problems, tiredness, anxiety and palpitation, although the absolute number of individuals with sickness absence for these complaints was small. CONCLUSIONS: The increased sickness absence in Norway from 1996 to 2003 cannot be explained by an increase in health complaints in the general population in the same period. The increase in sickness absence is most likely to be explained by multifactorial causes, such as changes in working life and health expectations.     

Predicting job loss in those off sick

BACKGROUND: Evidence shows incapacity benefit claimants (those off sick >26 weeks) are at greatest risk of long-term job loss. AIM: To develop a screening tool to select those at risk of job loss, defined as failure to return to work among those off sick. The screening tool was for use in the Job Retention and Rehabilitation Pilot of the Department for Work and Pensions. METHODS: A literature review identified risks for long-term incapacity and job loss as multifactorial. Potential predictors for return to work were then assembled into a set of questions and tested by a prospective study in general practice surgeries and a retrospective study of occupational health records of local authority employees referred for sickness absence management, using univariate and multivariate logistic regression analysis. RESULTS: Univariate logistic regression analysis of the retrospective study produced odds ratios with 95% confidence intervals for each question (where P 相似文献   

Importance of psychosocial work factors on general health outcomes in the national French SUMER survey

AIM: To examine the associations between psychosocial work factors and general health outcomes, taking into account other occupational risk factors, within the national French working population. METHODS: The study was based on a large national sample of 24 486 women and men of the French working population who filled in a self-administered questionnaire in 2003 (response rate: 96.5%). Psychosocial work exposures included psychological demands, decision latitude, social support, workplace bullying and violence from the public. The three health indicators studied were self-reported health, long sickness absence (>8 days of absence) and work injury. Adjustment was made for covariates: age, occupation, work status, working hours, time schedules, physical, ergonomic, biological and chemical exposures. Men and women were studied separately. RESULTS: Low levels of decision latitude, and of social support, and high psychological demands were found to be risk factors for poor self-reported health and long sickness absence. High demands were also found to be associated with work injury. Workplace bullying and/or violence from the public also increased the risk of poor health, long sickness absence and work injury. CONCLUSION: Psychosocial work factors were found to be strong risk factors for health outcomes; the results were unchanged after adjustment for other occupational risk factors. Preventive efforts should be intensified towards reducing these psychosocial work exposures.     

Work demands,job insecurity and sickness absence from work. How productive is the new,flexible labour force?

BACKGROUND: We investigate one aspect of productivity--sickness absence--and ask whether job insecurity and high work demands are associated with increased sickness absence and, if so, whether mental or physical health mediates this association. We further investigate if having control at work modifies these associations. METHODS: We used cross-sectional survey data from 2,248 employees aged 40-44 years living in two cities of south-eastern Australia. Logistic regressions were used to compare the associations between job insecurity and demands among those with short (1-3 days) or long-term (> 3 days) sickness absence with those who had no sickness absence in the last four weeks. The mediating effects of mental and physical health were assessed by evaluating changes in the magnitude of the association between these work conditions and sickness absence. RESULTS: High job insecurity (OR = 3.28; 95% CI 1.54-6.95) and high work demands (OR = 1.62; 95% CI 1.13-2.30) were significantly associated with long-term, but not with short-term, sickness absence. These associations were unaffected by job control. Depression and anxiety explained 61% of the association between high work demands and long-term sickness absence and 30% of the association between job insecurity and long-term sickness absence. CONCLUSION: Difficult working conditions may reduce productivity by contributing to longer absences from work. IMPLICATIONS: Reforms intended to improve economic performance should address any potential health costs of insecurity or intensification, which could inadvertently decrease productivity, possibly through their impact on mental health.     

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.     

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.     

Influence of change in psychosocial work characteristics on sickness absence: The Whitehall II Study

OBJECTIVES: To study the influence of change in self perceived psychosocial work characteristics on subsequent rates of sickness absence. METHODS: Prospective cohort study of British civil service employees. Job control, job demands, and work social supports were measured in 1985/88 and in 1991/93. Analyses included 3817 British civil servants with sickness absence records at baseline (1985-89) and for two follow up periods, early (1994-95) and later follow up (1996-98). RESULTS: Change in work characteristics predicted subsequent incidence of long spells of sickness absence (>7 days) in the early follow up period after adjustment for covariates including baseline work characteristics, health status, and sickness absence. Adjusted rate ratios were 1.23 (95% CI 1.03 to 1.46) for decreased compared with stable decision latitude; 1.17 (95% CI 1.01 to 1.36) for increased compared with stable job demands and 0.79 (95% CI 0.67 to 0.93) for increased compared with stable work social support. These associations were also seen in a sub-sample who did not change employment grade. In the later follow up period, associations between work change and long spells of sickness absence were similar for decision latitude, less pronounced for job demands, and no longer apparent for social supports. Changes in work characteristics were not associated with subsequent short spells of sickness absence (相似文献   

Long-term sickness absence - risk indicators among occupationally active residents of a Danish county

This study aims to identify risk factors and their prevalence in long-term sickness absence. The study is designed as a case-referent study which comprises 481 participants who have experienced a sickness absence lasting >10 weeks and a reference group of 1326 individuals in active employment. Multivariate analysis identified the following significant risk factors for men: (i) age >50 years [odds ratio (OR) = 2.4]; (ii) short period of education (OR = 2.3); (iii) unemployment within the last 3 years (OR = 1.7); (iv) heavy-duty work (OR = 2.1); (v) monotonous, repetitive work (OR = 1.7); (vi) lack of job satisfaction (OR = 2.1); and (vii) much back pain during the last 3 years (OR = 2.1). The following risk factors were identified for women: (i) leaving school without graduation (OR = 2.6); (ii) unemployment within the last 3 years (OR = 1.5); (iii) heavy-duty work (OR = 2.8); (iv) lack of influence on own job situation (OR = 2.1); and (v) much back pain within the last 3 years (OR = 1.8). It is concluded that the identification of working environment risk factors constitutes a case for improvement of the working environment which may be instrumental in reducing long-term sickness absence.     

Psychological workload and body weight: is there an association? A review of the literature

BACKGROUND: According to Karasek's Demand/Control Model, workload can be conceptualized as job strain, a combination of psychological job demands and control in the job. High job strain may result from high job demands combined with low job control. Aim To give an overview of the literature on the association between obesity and psychological workload. METHOD: We carried out a review of the associations between psychological workload and body weight in men and women. In total, 10 cross-sectional studies were identified. RESULTS: The review showed little evidence of a general association between psychological workload and body mass index. Only weak positive associations were found, and only between elements of psychological workload and overall body weight. For body fat distribution, two out of three studies showed a positive association in men, but the associations became insignificant after adjustment for education. For women, there was no evidence of a consistent association. CONCLUSION: The reviewed articles were not supportive of any associations between psychological workload and either general or abdominal obesity. Future epidemiological studies in this field should be prospective or experimental, and should examine how chronic work stress affects eating and to what extent initial body weight is a predictor for individual differences in perceived psychological workload.     

Psychosocial factors and work related sickness absence among permanent and non-permanent employees

STUDY OBJECTIVE: To examine the association between psychosocial work factors and work related sickness absence among permanent and non-permanent employees by sex. DESIGN: A cross sectional survey conducted in 2000 of a representative sample of the European Union total active population, aged 15 years and older. The independent variables were psychological job demands and job control as measures of psychosocial work environment, and work related sickness absence as the main outcome. Poisson regression models were used to compute sickness absence days' rate ratios. SETTING: 15 countries of the European Union. PARTICIPANTS: A sample of permanent (n = 12 875) and non-permanent (n = 1203) workers from the Third European Survey on Working Conditions. RESULTS: High psychological job demands, low job control, and high strain and passive work were associated with higher work related sickness absence. The risks were more pronounced in non-permanent compared with permanent employees and men compared with women. CONCLUSIONS: This work extends previous research on employment contracts and sickness absence, suggesting different effects depending on psychosocial working conditions and sex.     

Job characteristics,physical and psychological symptoms,and social support as antecedents of sickness absence among men and women in the private industrial sector

Most longitudinal studies on the relationship between psychosocial health resources and risks, and the employees' subsequent sickness absences have been conducted in the public sector. The purpose of this study was to find out psychosocial antecedents of sickness absenteeism in the private industrial sector. The effects of job characteristics (job autonomy and job complexity), physical and psychological symptoms, and social support (from coworkers and supervisors) on sickness absenteeism were investigated. The number of long (4-21 days) and very long (>21 days) sickness absence episodes of 3895 persons (76% men and 24% women, mean age 44 years) was obtained from the health registers of a multinational forest industry corporation in 1995-1998. A questionnaire survey on the working conditions and health of the workers was carried out in 1996. The follow-up time of the sickness absences was 1-year 9-month. Job autonomy was found to be associated with long and very long episodes in men (rate ratio (RR) in the lowest autonomy group approximately 2 times higher than the highest autonomy group), and with very long episodes of absence in women (2-3 times higher RR between the low vs. the high category). Low job complexity predicted men's very long absences (RR 1.4). Long and very long episodes were associated with physical and psychological symptoms (RR 1.2-1.7) among men and women. Lack of coworkers' support increased the frequency of very long sickness absence among men (RR 1.4), and lack of supervisor's support among women (RR 1.6). Also, some interaction effects of social support variables were observed among both genders. We conclude that the studied psychosocial factors are associated with subsequent sickness absence, and that the associations are partly gender-specific. The results showing which variables are related to employees' sickness absenteeism in the private industrial sector can be applied in human resource management and health service planning.     

High physical and psychosocial load at work and sickness absence due to neck pain

OBJECTIVES: This study investigates the relationship between physical and psychosocial load at work and sickness absence due to neck pain. METHODS: A prospective cohort study with a follow-up period of 3 years (1994-1998) was performed among a working population. At the beginning of the study, physical load at work was quantified by means of video recordings. Work-related psychosocial variables were measured by means of the Job Content Questionnaire. The frequency of sickness absence due to neck pain with a minimal duration of 3 days was assessed on the basis of company registrations during the follow-up period. Altogether 758 workers were included in the analyses. Possible confounding by individual characteristics, physical load, and psychosocial load was studied. RESULTS: Work-related neck flexion and neck rotation, low decision authority, and medium skill discretion showed statistically significant increased risks for sickness absence due to neck pain (adjusted rate ratios ranging from 1.6 to 4.2). High quantitative job demands, low skill discretion, and low job security showed nonsignificant increased risks for sickness absence due to neck pain (adjusted rate ratios of 2.0, 1.6 and 1.7, respectively). Work-related sitting, conflicting job demands, supervisor support, and co-worker support did not increase sickness absence due to neck pain. CONCLUSION: Work-related neck flexion, neck rotation, low decision authority, and medium skill discretion are risk factors for sickness absence due to neck pain. There are indications that high job demands, low skill discretion, and low job security are also risk factors for sickness absence due to neck pain.     

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.     

Effect of change in the psychosocial work environment on sickness absence: a seven year follow up of initially healthy employees

STUDY OBJECTIVE: To investigate the impact of changes in psychosocial work environment on subsequent sickness absence. DESIGN: Analysis of questionnaire and sickness absence data collected in three time periods: 1990-1991, before the recession; 1993, worst slump during the recession; and 1993-1997, a period after changes. SETTING: Raisio, a town in south western Finland, during and after a period of economic decline. PARTICIPANTS: 530 municipal employees (138 men, 392 women) working during 1990-1997 who had no medically certified sick leaves in 1991. Mean length of follow up was 6.7 years. MAIN RESULTS: After adjustment for the pre-recession levels, the changes in the job characteristics of the workers during the recession predicted their subsequent sick leaves. Lowered job control caused a 1.30 (95% CI = 1.19, 1.41) times higher risk of sick leave than an increase in job control. The corresponding figures in relation to decreased social support and increased job demands were 1.30 (95% CI = 1.20, 1.41) and 1.10 (95% CI = 1.03, 1.17), respectively. In some cases there was an interaction with socioeconomic status, changes in the job characteristics being stronger predictors of sick leaves for employees with a high income than for the others. The highest risks of sick leave (ranging from 1.40 to 1.90) were associated with combined effects related to poor levels of and negative changes in job control, job demands and social support. CONCLUSION: Negative changes in psychosocial work environment have adverse effects on the health of employees. Those working in an unfavourable psychosocial environment before changes are at greatest risk.     

Physicians as clinical directors: working conditions, psychosocial resources and self-rated health

BACKGROUND: Physicians in clinical directors' positions fulfil their commitments in demanding work environments characterized by organizational changes and economic cutbacks. Little is known about the self-rated health of this group. AIM: To investigate whether self-rated health was associated with psychosocial working conditions, professional networks, job support, social networks and social support, sick leave and salary in Swedish physicians working as clinical directors. METHODS: A self-reported questionnaire was sent to 373 clinical directors. Odds ratios (ORs) were used for estimating the bivariate association between self-rated health and psychosocial resources. RESULTS: A total of 274 clinical directors agreed to participate in the study. The response rate was 73%. The clinical directors exposed to high job demands had a significantly higher probability of low self-rated health [OR = 3.4 and 95% confidence interval (CI) = 1.6-7.0] than those who were not in this situation. Furthermore, participants who were exposed to high job demands had an increased risk of low self-rated health (OR = 3.8 and 95% CI = 1.8-8.1) irrespective of available social support inside or outside work. High average working hours more than doubled the risk of low self-rated health (OR = 2.2 and 95% CI = 1.1-4.4). CONCLUSION: The job demands on physicians in clinical directors' positions may exceed ordinary means of support with consequent adverse effects on self-rated health. More research is needed to investigate the interaction between job demands and support systems in this group of health care workers.