A systematic review of the “reversed” effect
Objectives Work represents an important role in society, and the nature and consequences of job stress have garnered significant research interest. In recent years, considerable effort has been made to elucidate the occupational stressor–strain relationship, or the interplay between unfavorable working conditions (stressor) and worker well-being (strain). In line with Bandura's notion of “reciprocal determinism”, a reciprocal occupational stressor–strain relationship is now increasingly postulated, where variables exert mutual influences on each other over time. The objective of this study was to determine the extent of empirical support for three specific “reversed” (strain-to-stressor) effects, guided by the Demand–Control–Support model.
Methods A systematic literature review was conducted (1996–2012 inclusive) through a search of databases. After relevant studies were identified, a methodological quality appraisal was performed based on four key criteria: sample size, measurement, non-spuriousness, and non-response bias. Subsequently, a quantitative synthesis of evidence from high-quality studies was performed by calculating a standardized index of convergence for each reversed effect.
Results Twenty-three qualifying studies were found and evidence from ten high-quality studies ultimately contributed to the synthesis. Moderately strong evidence in support of a positive strain-to-job demands effect was found, but there was no evidence in support of either a strain-to-job control or a strain-to-workplace social support effect
Conclusions In conjunction with available evidence on the corresponding “normal” (stressor-to-strain) effect, this review gives credence to the possibility of a reciprocal stressor–strain relationship involving job demands and worker well-being.
Source: Tang, K. Scand J Work Environ Health. 2014; 40 (5): 441-456.
A Case-Control Pilot Study
Study Objective: This research examined the impact of daylight exposure on the health of office workers from the perspective of subjective well-being and sleep quality as well as actigraphy measures of light exposure, activity, and sleep-wake patterns.
Methods: Participants (N = 49) included 27 workers working in windowless environments and 22 comparable workers in workplaces with significantly more daylight. Windowless environment is defined as one without any windows or one where workstations were far away from windows and without any exposure to daylight. Well-being of the office workers was measured by Short Form-36 (SF-36), while sleep quality was measured by Pittsburgh Sleep Quality Index (PSQI). In addition, a subset of participants (N = 21; 10 workers in windowless environments and 11 workers in workplaces with windows) had actigraphy recordings to measure light exposure, activity, and sleep-wake patterns.
Results: Workers in windowless environments reported poorer scores than their counterparts on two SF-36 dimensions—role limitation due to physical problems and vitality—as well as poorer overall sleep quality from the global PSQI score and the sleep disturbances component of the PSQI. Compared to the group without windows, workers with windows at the workplace had more light exposure during the workweek, a trend toward more physical activity, and longer sleep duration as measured by actigraphy.
Conclusions: We suggest that architectural design of office environments should place more emphasis on sufficient daylight exposure of the workers in order to promote office workers' health and well-being.
Source: Boubekri M, Cheung IN, Reid KJ, Wang CH, Zee PC. Impact of windows and daylight exposure on overall health and sleep quality of office workers: a case-control pilot study. J Clin Sleep Med. 2014; 10 (6): 603-611.
L’équipe de recherche VISAGE a lancé un outil Web interactif de sensibilisation aux réalités de la violence en milieu de travail qui a été développé en collaboration avec l’Association paritaire pour la santé et la sécurité du travail, secteur « affaires municipales » (APSAM) et l’Association paritaire pour la santé et la sécurité du travail, secteur « affaires sociales » (ASSTSAS).
Ce projet vise les trois objectifs suivants :
- Aider les travailleurs à reconnaître plusieurs formes de violence verbale et physique au travail.
- Sensibiliser les travailleurs à l’importance de parler avec leurs collègues et leurs proches des actes de violence dont ils ont été victimes ou témoins dans leur milieu de travail.
- Augmenter la probabilité que les travailleurs déclarent ces actes de violence à leur employeur.
Selon un sondage réalisé auprès de 2889 travailleurs québécois en 2012, 67 % d’entre eux ont déclaré avoir été victimes ou témoins de différents types de violence au travail.
Entre 2005 et 2013, pour les salariés de France métropolitaine, les changements organisationnels ont repris et les contraintes de rythme de travail se sont accrues, après la relative stabilisation enregistrée entre 1998 et 2005. Cette intensification a été plus marquée dans la fonction publique que dans le secteur privé. L'usage de l'informatique dans le travail poursuit sa progression à un rythme rapide. D'ailleurs, le contrôle ou suivi informatisé du travail est la contrainte de rythme qui s'est le plus diffusée.
Sur la même période, les marges de manœuvre tendent à se réduire pour toutes les catégories socioprofessionnelles, sauf pour les ouvriers non qualifiés. Les salariés signalent des possibilités de coopération plus importantes avec leurs collègues ou leur hiérarchie, ce qui est susceptible d'atténuer les effets de l'intensification. Néanmoins les tensions sont plus fréquentes avec les collègues ou les clients et usagers. De même, les salariés sont plus nombreux à vivre au travail des situations exigeantes sur le plan émotionnel (être en contact avec des personnes en situation de détresse, devoir calmer des gens).
United States, 2008–2012
Cardiovascular disease accounts for one in three deaths in the United States each year, and coronary heart disease and stroke account for most of those deaths. To try to prevent 1 million heart attacks and strokes by 2017, the U.S. Department of Health and Human Services launched the Million Hearts initiative, promoting proven and effective interventions in communities and clinical settings. In workplace settings, cardiovascular disease can be addressed through a Total Worker Health program, which integrates occupational safety and health protection with health promotion. To identify workers likely to benefit from such a program, CDC analyzed data from the National Health Interview Survey (NHIS) for the period 2008–2012 to estimate the prevalence of a history of coronary heart disease or stroke (CHD/stroke) among adults aged <55 years by selected characteristics, employment status, occupation category, and industry of employment. The results of that analysis showed that 1.9% of employed adults aged <55 years reported a history of CHD/stroke, compared with 2.5% of unemployed adults looking for work, and 6.3% of adults not in the labor force (e.g., unemployed adults who stopped looking for work, homemakers, students, retired persons, and disabled persons). Workers employed in service and blue collar occupations were more likely than those in white collar occupations to report a history of CHD/stroke. Two industry groups also had significantly higher adjusted prevalence ratios (aPRs) for CHD/stroke: Administrative and Support and Waste Management and Remediation Services and Accommodation and Food Service. Workers in these occupation and industry groups might especially benefit from a Total Worker Health approach to reducing the risk for CHD/stroke.
Identification of groups with multiple disadvantages
Job quality indexes are constructed on the basis of such aspects of working conditions as earnings, prospects, working time, and intrinsic job quality. Occupations where job quality is consistently low are labelled ‘occupations with multiple disadvantages'. This report uses data from the fifth European Working Conditions Survey to identify such occupations. It finds that workers in mid-skilled manual and lowskilled occupations do quite poorly when it comes to earnings, prospects and intrinsic job quality, and they report relatively low levels of both physical and mental well-being. However, their working time quality is generally good. In contrast, workers in high-skilled occupations do relatively well on almost all job quality indicators, except working time.
Results of a randomized controlled trial
Objective: The primary purpose of this randomized controlled trial (RCT) was to evaluate the efficacy of internet-based problem-solving training (iPST) for employees in the educational sector (teachers) with depressive symptoms. The results of training were compared to those of a waitlist control group (WLC).
Methods: One-hundred and fifty teachers with elevated depressive symptoms (Center for Epidemiologic Studies Depression Scale, CES-D ≥16) were assigned to either the iPST or WLC group. The iPST consisted of five lessons, including problem-solving and rumination techniques. Symptoms were assessed before the intervention began and in follow-up assessments after seven weeks, three months, and six months. The primary outcome was depressive symptom severity (CES-D). Secondary outcomes included general and work-specific self-efficacy, perceived stress, pathological worries, burnout symptoms, general physical and mental health, and absenteeism.
Results: iPST participants displayed a significantly greater reduction in depressive symptoms after the intervention (d=0.59, 95% CI 0.26–0.92), after three months (d=0.37, 95% CI 0.05–0.70) and after six months (d=0.38, 95% CI 0.05–0.70) compared to the control group. The iPST participants also displayed significantly higher improvements in secondary outcomes. However, workplace absenteeism was not significantly affected.
Conclusion: iPST is effective in reducing symptoms of depression among teachers. Disseminated on a large scale, iPST could contribute to reducing the burden of stress-related mental health problems among teachers. Future studies should evaluate iPST approaches for use in other working populations.
Source: Ebert DD, Lehr D, Boß L, Riper H, Cuijpers P, Andersson G, Thiart H, Heber E, Berking M. Scand J Work Environ Health. 2014
Foreign-born workers and work-related injuries in Australia
Higher rates of work-related injuries (WRI) have been reported among foreign-born workers in many countries, but little is known about the situation in Australia, which initially had large waves of European followed by Asian migration and where the recruitment of skilled migrants has dominated recently. The aim of the study was to examine WRI among foreign-born workers in Australia. This was a two phase mixed methods study. The first stage used the 2005/6 and 2009/10 Australian national Multi-Purpose Household Survey (MPHS) information on WRI occurring in the previous year (N = 36,702). Logistic regression examined the relationship between WRI and country of birth, adjusting for period of arrival in Australia, age, sex, industry and working conditions. Next, 92 purposively sampled foreign-born workers participated in individual interviews (n = 17) or focus groups (n = 75). Workers were sampled via community organisations, trade unions or churches. A concurrent thematic analysis was conducted. Analysis of the MPHS showed that country of birth was generally not associated with a higher reporting of WRI and compared with Australian-born workers, those from Oceania reported less WRI. Key themes from the interviews suggest that understanding of Occupational Health and Safety (OH&S) differed by community integration and cohesiveness. Precarious work, cultural factors and the demands of production may preclude workers from reporting incidents. Quantitative findings from the MPHS point to higher risks related to area of work rather than country of birth. However qualitative findings suggest there may be some under-reporting of WRI among migrants to Australia.
Source: Reid A, Lenguerrand E, Santos I, Read U, Lamontagne AD, Fritschi L, Harding S. Safety Sci. 2014; 70: 378-386.
Objective: This study aimed to assess relationships between perceptions of organizational practices and policies (OPP), social support, and injury rates among workers in hospital units.
Methods: A total of 1230 hospital workers provided survey data on OPP, job flexibility, and social support. Demographic data and unit injury rates were collected from the hospitals' administrative databases.
Results: Injury rates were lower in units where workers reported higher OPP scores and high social support. These relationships were mainly observed among registered nurses. Registered nurses perceived coworker support and OPP as less satisfactory than patient care associates (PCAs). Nevertheless, because of the low number of PCAs at each unit, results for the PCAs are preliminary and should be further researched in future studies with larger sample sizes.
Conclusions: Employers aiming to reduce injuries in hospitals could focus on good OPP and supportive work environment.
Source: Tveito, T. H.; Sembajwe, G.; Boden, L. I.; Dennerlein, J. T.; Wagner, G. R.; Kenwood, C.; Stoddard, A. M.; Reme, S. E.; Hopcia, K.; Hashimoto, D.; Shaw, W. S.; Sorensen, G. Journal of Occupational & Environmental Medicine: August 2014, Volume 56, Issue 8, p. 802–808.
A meta-analysis of observational studies
Background: Observational studies suggest that shift work may be associated with diabetes mellitus (DM). However, the results are inconsistent. No systematic reviews have applied quantitative techniques to compute summary risk estimates.
Objectives: To conduct a meta-analysis of observational studies assessing the association between shift work and the risk of DM.
Methods: Relevant studies were identified by a search of PubMed, Embase, Web of Science and ProQuest Dissertation and Theses databases to April 2014. We also reviewed reference lists from retrieved articles. We included observational studies that reported OR with 95% CIs for the association between shift work and the risk of DM. Two authors independently extracted data and assessed the study quality.
Results: Twelve studies with 28 independent reports involving 226 652 participants and 14 595 patients with DM were included. A pooled adjusted OR for the association between ever exposure to shift work and DM risk was 1.09 (95% CI 1.05 to 1.12; p=0.014; I2=40.9%). Subgroup analyses suggested a stronger association between shift work and DM for men (OR=1.37, 95% CI 1.20 to 1.56) than for women (OR=1.09, 95% CI 1.04 to 1.14) (p for interaction=0.01). All shift work schedules with the exception of mixed shifts and evening shifts were associated with a statistically higher risk of DM than normal daytime schedules, and the difference among those shift work schedules was significant (p for interaction=0.04).
Conclusions: Shift work is associated with an increased risk of DM. The increase was significantly higher among men and the rotating shift group, which warrants further studies.
Source: Yong Gan and others. Shift work and diabetes mellitus: a meta-analysis of observational studies, Occupational and Environmental Medicine, 16 July 2014.
What Is the Role of Positive Mental Health?
Objective: To examine whether positive mental health (PMH)—a positively focused well-being construct—moderates the job stress–distress relationship.
Methods: Longitudinal regression was used to test two waves of matched, population-level data from a sample of older, working Australian adults (n = 3291) to see whether PMH modified the relationship between work stress and later psychological distress.
Results: Time 1 work stress was positively associated with distress at both time points. Positive mental health was negatively associated with work stress at both time points. Positive mental health modified the impact of work stress on psychological distress. This effect only occurred for those with the highest levels of PMH.
Conclusions: Positive mental health may help protect workers from the effect of workplace stress but only in a small proportion of the population. Therefore, to improve workplace mental health, workplaces need to both prevent stress and promote PMH.
Source: Page, Kathryn M.; Milner, Allison J.; Martin, Angela; Turrell, Gavin; Giles-Corti, Billie; LaMontagne, Anthony D. Journal of Occupational & Environmental Medicine: August 2014, Volume 56, Issue 8, p. 814-819.
Objective: To examine how various predictors and subgroups of respondents contribute to the prediction of health care and productivity costs in a cohort of employees.
Methods: We selected 1548 employed people from a cohort study with and without depressive and anxiety symptoms or disorders. Prediction rules, using the RuleFit program, were applied to identify predictors and subgroups of respondents, and to predict estimations of subsequent 1-year health care and productivity costs.
Results: Symptom severity and diagnosis of depression and anxiety were the most important predictors of health care costs. Depressive symptom severity was the most important predictor for productivity costs. Several demographic, social, and work predictors did not predict economic costs.
Conclusions: Our data suggest that from a business perspective it can be beneficial to offer interventions aimed at prevention of depression and anxiety.
Source: Geraedts, Anna S.; Fokkema, Marjolein; Kleiboer, Annet M.; Smit, Filip; Wiezer, Noortje W.; Majo, Maria Cristina; van Mechelen, Willem; Cuijpers, Pim; Penninx, Brenda W. J. H. Journal of Occupational & Environmental Medicine: August 2014, Volume 56, Issue 8, p. 794–801.
Recent scholarship on work suggests that information and communication technology (ICT) use may be significantly altering job conditions in ways that are indicative of work intensification, which, in turn, contributes to employee strain and distress. This article uses structural equation modelling and OLS regression techniques to analyse 2002 survey data drawn from a nationally representative sample of US employees in order to assess the pathways through which ICT use may influence levels of employee strain and distress. It is found that use is linked to higher levels of employee strain and distress via a work intensification process that is indicated by faster-paced work and greater levels of interruptions and multitasking. However, there is also evidence that both work and personal ICT use may mitigate these influences. While the findings do suggest that ICT use can have negative implications for contemporary workers, as a whole the results support a more nuanced view that points to both costs and benefits associated with ICT use.
Source: Noelle Chesley, Work, Employment & Society, August 2014; Vol. 28, No. 4.
Issues and Policies
Despite relative affluence, workplace stress is a prominent feature of the US labour market. To the extent that job stress causes poor health outcomes – either directly through increased blood pressure, fatigue, muscle pain, etc. or indirectly through increased rates of cigarette smoking – policy to lessen job stress may be appropriate. Focusing predominantly on the United States, this report reviews the literature on a variety of economic concerns related to job stress and health. Areas in which economists may provide valuable insights regarding job stress include empirical selection concerns in identifying the effect of stress on health; measurement error with respect to stress; the existence and magnitude of compensating differentials for stress; and the unique "job lock" effect in the United States created by a system of employer-provided health insurance. This report concludes with a brief discussion of US policies related to job stress.
A causal approach for Europe
This paper estimates the causal effect of perceived job insecurity – i.e. the fear of involuntary job loss – on health in a sample of men from 22 European countries. We rely on an original
instrumental variable approach based on the idea that workers perceive greater job security in countries where employment is strongly protected by the law, and relatively more so if employed in industries where employment protection legislation is more binding, i.e. in industries with a higher natural rate of dismissals. Using cross-country data from the 2010 European Working Conditions Survey, we show that when the potential endogeneity of job insecurity is not accounted for, the latter appears to deteriorate almost all health outcomes.
When tackling the endogeneity issue by estimating an IV model and dealing with potential weak-instrument issues, the health-damaging effect of job insecurity is confirmed for a limited
subgroup of health outcomes, namely suffering from headaches or eyestrain and skin problems. As for other health variables, the impact of job insecurity appears to be insignificant at conventional levels.
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