The Experts below are selected from a list of 4338 Experts worldwide ranked by ideXlab platform
Töres Theorell - One of the best experts on this subject based on the ideXlab platform.
-
Demand-control-support among female and male managers in eight Swedish companies
Stress and Health, 2001Co-Authors: Peggy Bernin, Töres TheorellAbstract:This work is part of the Swedish project ‘Managers and Stress’. In the report the Swedish version of the Demand–Decision Latitude model was used, which made it possible to compare data with an earlier population study. A total of 179 male and 56 female managers were included. The demands and Decision Latitude scores were significantly higher than in the population study. Social support buffers high demands but surprisingly the managers did not report higher support than the participants in the population. Psychological demands and skill discretion differed significantly between companies. The hypotheses that psychological demands and Decision Latitude differ between female and male managers had to be rejected. The period of extensive changes which has taken place in working-life, especially in the government sector, probably influenced the results. The results did not indicate higher stress in those managers working in the companies that were the most extensive ‘downsizers’. Copyright © 2001 John Wiley & Sons, Ltd.
-
Decision Latitude, job strain, and myocardial infarction: a study of working men in Stockholm. The SHEEP Study Group. Stockholm Heart epidemiology Program.
American Journal of Public Health, 1998Co-Authors: Töres Theorell, Akizumi Tsutsumi, Johan Hallquist, Christina Reuterwall, Christer Hogstedt, Peeter Fredlund, Nils Emlund, Jeffrey V. JohnsonAbstract:OBJECTIVES: This study examined the role of Decision Latitude and job strain in the etiology of a first myocardial infarction. METHODS: Eligible case patients were all full-time working men 45 to 64 years of age who suffered a first myocardial infarction during the period January 1992 to January 1993 in the greater Stockholm region. Referents were selected from the general population. Participation rates were 82% (case patients) and 75% (referents). RESULTS: Both inferred and self-reported low Decision Latitude were associated with increased risk of a first myocardial infarction, although this association was weakened after adjustment for social class. A decrease in inferred Decision Latitude during the 10 years preceding the myocardial infarction was associated with increased risk after all adjustments, including chest pain and social class. The combination of high self-reported demands and low self-reported Decision Latitude was an independent predictor of risk after all adjustments. CONCLUSIONS: Both negative change in inferred Decision Latitude and self-reported job strain are important risk indicators in men less than 55 years of age and in blue-collar workers.
-
Is the effect of job strain on myocardial infarction risk due to interaction between high psychological demands and low Decision Latitude? Results from Stockholm Heart Epidemiology Program (SHEEP).
Social Science & Medicine, 1998Co-Authors: Johan Hallqvist, Töres Theorell, Christina Reuterwall, Finn Diderichsen, Anders AhlbomAbstract:The objectives are to examine if the excess risk of myocardial infarction from exposure to job strain is due to interaction between high demands and low control and to analyse what role such an interaction has regarding socioeconomic differences in risk of myocardial infarction. The material is a population-based case-referent study having incident first events of myocardial infarction as outcome (SHEEP: Stockholm Heart Epidemiology Program). The analysis is restricted to males 45-64 yr of age with a more detailed analysis confined to those still working at inclusion. In total, 1047 cases and 1450 referents were included in the analysis. Exposure categories of job strain were formed from self reported questionnaire information. The results show that high demands and low Decision Latitude interact with a synergy index of 7.5 (95% C.I.: 1.8-30.6) providing empirical support for the core mechanism of the job strain model. Manual workers are more susceptible when exposed to job strain and its components and this increased susceptibility explains about 25-50% of the relative excess risk among manual workers. Low Decision Latitude may also, as a causal link, explain about 30% of the socioeconomic difference in risk of myocardial infarction. The distinction between the interaction and the causal link mechanisms identifies new etiologic questions and intervention alternatives. The specific causes of the increased susceptibility among manual workers to job strain and its components seem to be an interesting and important research question.
-
On Cardiovascular Health in Women
Women Work and Health, 1991Co-Authors: Töres TheorellAbstract:An increasing proportion of working men and women in Sweden regard their work as psychologically demanding. At the same time, most physical stressors are becoming less frequent (Statistics Sweden, 1982). Several studies in this field have indeed focused on psychosocial job factors that could be positively affected by interventions in work organization or social climate. Studies have shown that psychological job demands increase the risk of illness only when the workers have poor resources for “Decision Latitude” (possibility to influence Decisions) and social support (see Johnson, 1986; Karasek, 1979; Karasek & Theorell, 1989; Theorell, 1989). Furthermore, recent studies (Johnson, 1986; Johnson, Hall, & Theorell, 1989) have shown that three environment dimensions—demands, Decision Latitude, and social support—probably interact in a multiplicative way in the promotion of illness processes. Theories (Karasek, Russell, & Theorell, 1982; Karasek & Theorell, 1989; Theorell, 1989) have been developed that propose or argue that job strain (a combination of high demands and low Decision Latitude) inhibits those mechanisms that protect the person against stress and at the same time increases the general arousal level. Such theories are close to those that have been developed using the individual’s response to stressors as a basis for formulations (see, for instance, Chapter 3, in this volume; Kahn, 1974.)
-
DEMOCRACY AT WORK AND ITS RELATIONSHIP TO HEALTH
Research in Occupational Stress and Well-being, 1Co-Authors: Töres TheorellAbstract:This chapter departs from a specific Swedish perspective on structural changes which took place during the 1990s in Sweden. Before this period Sweden had a long period of improving democracy at work. From the start of the 1990s a number of structural changes were – according to national surveys – associated with increasing psychological demands at work. According to the same sources this was followed during the three last years of the 1990s by a reduced Decision Latitude. The prevalence of work-related psychological problems started to rise when Decision Latitude started to decrease. A discussion of concepts related to work democracy is followed by a review of the literature on work democracy and health. Finally, strategies for improving democracy and possible health promoting effects of such improvement are discussed.
Stefan Diestel - One of the best experts on this subject based on the ideXlab platform.
-
differential effects of Decision Latitude and control on the job demands strain relationship a cross sectional survey study among elderly care nursing staff
International Journal of Nursing Studies, 2011Co-Authors: Klaus-helmut Schmidt, Stefan DiestelAbstract:Abstract Background According to the influential Job Demands–Control (JD-C) model developed by Karasek (1979; Karasek and Theorell, 1990), job strain is expected to result from high job demands and low job control as well as an interaction between both job characteristics. Previous research, however, has found such an interaction only rarely or inconsistently.It has been suggested that the conceptualization of the control variable (formerly referred to as Decision Latitude) may be particularly responsible for the lack of supportive findings. Objectives The present study aimed at clarifying this issue by contrasting a focused measure of control with a traditional measure of Decision Latitude in their relations to job strain of health care workers. The measure of Decision Latitude encompassed a wide range of job characteristics including control, task variety, and learning opportunities. Design A cross-sectional questionnaire survey was conducted with job satisfaction, psychosomatic complaints and emotional exhaustion as criterion measures of job strain. Setting A supra-regional organization for residential elderly care with 11 nursing homes located in a federal state in Germany. Participants Questionnaires were distributed to the whole nursing staff, of which 379 filled in the questionnaire during normal working hours (68% participation rate). Methods In addition to confirmatory factor analyses, descriptive statistics, and bivariate correlations, hierarchical multiple regression analyses were performed for testing the corresponding interaction effects. Results Findings confirmed the assumption that the focused measure of control and the traditional measure of Decision Latitude represent distinct, yet correlated factors. Furthermore, findings revealed a significant interaction effect between job demands and control on all outcomes considered. By way of contrast, there was no equivalent interaction effect between job demands and Decision Latitude. In line with the JD-C model, the adverse influence of increasing demands on job satisfaction, psychosomatic complaints and emotional exhaustion were reduced with increasing job control. Conclusions Extending the opportunities of health care workers to control work scheduling and the way of performing given tasks can make them less vulnerable against the adverse effects of high job demands.
-
Differential effects of Decision Latitude and control on the job demands–strain relationship: A cross-sectional survey study among elderly care nursing staff
International Journal of Nursing Studies, 2011Co-Authors: Klaus-helmut Schmidt, Stefan DiestelAbstract:Abstract Background According to the influential Job Demands–Control (JD-C) model developed by Karasek (1979; Karasek and Theorell, 1990), job strain is expected to result from high job demands and low job control as well as an interaction between both job characteristics. Previous research, however, has found such an interaction only rarely or inconsistently.It has been suggested that the conceptualization of the control variable (formerly referred to as Decision Latitude) may be particularly responsible for the lack of supportive findings. Objectives The present study aimed at clarifying this issue by contrasting a focused measure of control with a traditional measure of Decision Latitude in their relations to job strain of health care workers. The measure of Decision Latitude encompassed a wide range of job characteristics including control, task variety, and learning opportunities. Design A cross-sectional questionnaire survey was conducted with job satisfaction, psychosomatic complaints and emotional exhaustion as criterion measures of job strain. Setting A supra-regional organization for residential elderly care with 11 nursing homes located in a federal state in Germany. Participants Questionnaires were distributed to the whole nursing staff, of which 379 filled in the questionnaire during normal working hours (68% participation rate). Methods In addition to confirmatory factor analyses, descriptive statistics, and bivariate correlations, hierarchical multiple regression analyses were performed for testing the corresponding interaction effects. Results Findings confirmed the assumption that the focused measure of control and the traditional measure of Decision Latitude represent distinct, yet correlated factors. Furthermore, findings revealed a significant interaction effect between job demands and control on all outcomes considered. By way of contrast, there was no equivalent interaction effect between job demands and Decision Latitude. In line with the JD-C model, the adverse influence of increasing demands on job satisfaction, psychosomatic complaints and emotional exhaustion were reduced with increasing job control. Conclusions Extending the opportunities of health care workers to control work scheduling and the way of performing given tasks can make them less vulnerable against the adverse effects of high job demands.
Isabelle Niedhammer - One of the best experts on this subject based on the ideXlab platform.
-
Psychometric properties of the French version of the Karasek Job Content Questionnaire: a study of the scales of Decision Latitude, psychological demands, social support, and physical demands in the GAZEL cohort
International Archives of Occupational and Environmental Health, 2002Co-Authors: Isabelle NiedhammerAbstract:Objectives: The objective of this study was to explore the psychometric properties of the French version of the Karasek Job Content Questionnaire (JCQ) for the recommended scales of psychological demands, Decision Latitude, social support, and physical demands. Internal consistency, factorial validity, and convergent validity were examined in a large occupational cohort of men and women. Methods: This study was based on the GAZEL cohort composed of workers aged 40–50 years for men and 35–50 years for women employed by the French national electric and gas company Electricité De France-Gaz De France (EDF-GDF) in 1989. This cohort has been followed up since 1989 by means of yearly self-administered questionnaires and by the collection of data provided by the company. Results: The study population included the 11,447 GAZEL subjects, 8,277 men and 3,170 women, who were working and who answered the French version of the JCQ in 1997. Cronbach's alpha coefficients higher than 0.65 supported the internal consistency of the JCQ scales and subscales. The results of exploratory factor analysis were consistent with the expected dimensions. Physical demands, supervisor support, and co-worker support were clearly found. However, for Decision Latitude, ' repetitive work ' and ' learn new things ' displayed low factor loadings. For psychological demands, low factor loadings were observed for ' conflicting demands ', ' wait on others ', and ' no excessive work '. Confirmatory factor analysis supported the instrument construct in six latent factors: psychological demands, skill discretion, Decision authority, supervisor support, co-worker support, and physical demands, although the items mentioned earlier displayed low standardized factor loadings. The associations between the JCQ scales and gender, age, educational level, occupational grade, and job satisfaction were explored using analysis of variance and chi-square test, and supported the convergent validity. Conclusion: Although our results of factor analysis could invite the revision of the two scales of Decision Latitude and psychological demands, this study provided evidence of the validity of the French version of the four JCQ scales of psychological demands, Decision Latitude, social support, and physical demands among a large population consisting of French working men and women.
-
Psychometric properties of the French version of the Karasek Job Content Questionnaire: a study of the scales of Decision Latitude, psychological demands, social support, and physical demands in the GAZEL cohort
International Archives of Occupational and Environmental Health, 2002Co-Authors: Isabelle NiedhammerAbstract:Objectives: The objective of this study was to explore the psychometric properties of the French version of the Karasek Job Content Questionnaire (JCQ) for the recommended scales of psychological demands, Decision Latitude, social support, and physical demands. Internal consistency, factorial validity, and convergent validity were examined in a large occupational cohort of men and women. Methods: This study was based on the GAZEL cohort composed of workers aged 40–50 years for men and 35–50 years for women employed by the French national electric and gas company Electricite De France-Gaz De France (EDF-GDF) in 1989. This cohort has been followed up since 1989 by means of yearly self-administered questionnaires and by the collection of data provided by the company. Results: The study population included the 11,447 GAZEL subjects, 8,277 men and 3,170 women, who were working and who answered the French version of the JCQ in 1997. Cronbach's alpha coefficients higher than 0.65 supported the internal consistency of the JCQ scales and subscales. The results of exploratory factor analysis were consistent with the expected dimensions. Physical demands, supervisor support, and co-worker support were clearly found. However, for Decision Latitude, 'repetitive work' and 'learn new things' displayed low factor loadings. For psychological demands, low factor loadings were observed for 'conflicting demands', 'wait on others', and 'no excessive work'. Confirmatory factor analysis supported the instrument construct in six latent factors: psychological demands, skill discretion, Decision authority, supervisor support, co-worker support, and physical demands, although the items mentioned earlier displayed low standardized factor loadings. The associations between the JCQ scales and gender, age, educational level, occupational grade, and job satisfaction were explored using analysis of variance and chi-square test, and supported the convergent validity. Conclusion: Although our results of factor analysis could invite the revision of the two scales of Decision Latitude and psychological demands, this study provided evidence of the validity of the French version of the four JCQ scales of psychological demands, Decision Latitude, social support, and physical demands among a large population consisting of French working men and women.
-
Psychosocial work environment and cardiovascular risk factors in an occupational cohort in France.
Journal of Epidemiology & Community Health, 1998Co-Authors: Isabelle Niedhammer, Marcel Goldberg, Annette Leclerc, Simone David, Isabelle Bugel, Marie-france LandreAbstract:STUDY OBJECTIVE: Concordant results have been reported in several studies for the effects of job stress on cardiovascular disease, but the potential mechanisms of these effects have seldom been explored. The aim of this study was therefore to examine, in women and men, the cross sectional relations between psychosocial work variables (psychological demands, Decision Latitude, and social support) and cardiovascular risk factors (hypertension, hyperlipidaemia, diabetes, overweight, smoking, and alcohol consumption). PARTICIPANTS: The original cohort comprised 20,625 volunteers (men aged from 40 to 50 and women from 35 to 50) employed by the French Company Electricite De France-Gaz De France and followed up yearly since 1989. The study was restricted to the 13,226 volunteers in the cohort who were still working and answered a self administered questionnaire on psychosocial work factors in 1995. DESIGN: Data were based on replies to this questionnaire. Three psychosocial work environment exposure scores were used to assess psychological demands, Decision Latitude, and social support at work respectively. The main outcome measures were the prevalence of hypertension, hyperlipidaemia, and diabetes within the previous 12 months, overweight, smoking, and alcohol consumption. MAIN RESULTS: Psychosocial work factors were significantly associated with hypertension, hyperlipidaemia, overweight, smoking, and alcohol consumption, but not with diabetes. In men, low Decision Latitude was associated with hypertension, high Decision Latitude and high social support with overweight, low Decision Latitude with alcohol consumption. Moreover, the risk of hyperlipidaemia increased in men exposed to both high psychological demands and low social support. In women, low Decision Latitude was related to hyperlipidaemia, high psychological demands with overweight, high psychological demands and high Decision Latitude with smoking, and low social support with alcohol consumption. CONCLUSIONS: These cross sectional results underline the potential effects of psychosocial work characteristics on cardiovascular risk factors and the differences between the effects of job stress in men and women, and confirm the direct mechanisms (through physiological variables) and indirect mechanisms (through behavioural risk factors) potentially involved in the relation between psychosocial work characteristics and cardiovascular disease.
-
Psychosocial work environment and cardiovascular risk factors in an occupational
1998Co-Authors: Isabelle Niedhammer, Marcel Goldberg, Annette Leclerc, Simone David, Isabelle Bugel, Marie-france LandreAbstract:Study objective?Concordant results have been reported in several studies for the effects of job stress on cardiovascular dis ease, but the potential mechanisms of these effects have seldom been explored. The aim of this study was therefore to examine, in women and men, the cross sectional relations between psychosocial work variables (psychological demands, Decision Latitude, and social support) and cardiovascular risk factors (hypertension, hyperlipidaemia, diabetes, overweight, smoking, and alcohol consumption). Participants?The original cohort com prised 20 625 volunteers (men aged from 40 to 50 and women from 35 to 50) employed by the French Company Elec tricite De France - Gaz De France and followed up yearly since 1989. The study was restricted to the 13 226 volunteers in the cohort who were still working and answered a self administered question naire on psychosocial work factors in 1995. Design?Data were based on replies to this questionnaire. Three psychosocial work environment exposure scores were used to assess psychological demands, Decision Latitude, and social support at work respectively. The main outcome measures were the prevalence of hyper tension, hyperlipidaemia, and diabetes within the previous 12 months, over weight, smoking, and alcohol consump tion. Main results?Psychosocial work factors were significantly associated with hyper tension, hyperlipidaemia, overweight, smoking, and alcohol consumption, but not with diabetes. In men, low Decision Latitude was associated with hypertension, high Decision Latitude and high social sup port with overweight, low Decision Latitude with alcohol consumption. Moreover, the risk of hyperlipidaemia increased in men exposed to both high psychological de mands and low social support. In women, low Decision Latitude was related to hyper lipidaemia, high psychological demands with overweight, high psychological de mands and high Decision Latitude with smoking, and low social support with alcohol consumption. Conclusions?These cross sectional re sults underline the potential effects of psychosocial work characteristics on car diovascular risk factors and the differ ences between the effects of job stress in men and women, and confirm the direct mechanisms (through physiological vari ables) and indirect mechanisms (through behavioural risk factors) potentially in volved in the relation between psycho social work characteristics and cardiovascular disease. (J Epidemiol Community Health 1998;52:93-100)
Klaus-helmut Schmidt - One of the best experts on this subject based on the ideXlab platform.
-
differential effects of Decision Latitude and control on the job demands strain relationship a cross sectional survey study among elderly care nursing staff
International Journal of Nursing Studies, 2011Co-Authors: Klaus-helmut Schmidt, Stefan DiestelAbstract:Abstract Background According to the influential Job Demands–Control (JD-C) model developed by Karasek (1979; Karasek and Theorell, 1990), job strain is expected to result from high job demands and low job control as well as an interaction between both job characteristics. Previous research, however, has found such an interaction only rarely or inconsistently.It has been suggested that the conceptualization of the control variable (formerly referred to as Decision Latitude) may be particularly responsible for the lack of supportive findings. Objectives The present study aimed at clarifying this issue by contrasting a focused measure of control with a traditional measure of Decision Latitude in their relations to job strain of health care workers. The measure of Decision Latitude encompassed a wide range of job characteristics including control, task variety, and learning opportunities. Design A cross-sectional questionnaire survey was conducted with job satisfaction, psychosomatic complaints and emotional exhaustion as criterion measures of job strain. Setting A supra-regional organization for residential elderly care with 11 nursing homes located in a federal state in Germany. Participants Questionnaires were distributed to the whole nursing staff, of which 379 filled in the questionnaire during normal working hours (68% participation rate). Methods In addition to confirmatory factor analyses, descriptive statistics, and bivariate correlations, hierarchical multiple regression analyses were performed for testing the corresponding interaction effects. Results Findings confirmed the assumption that the focused measure of control and the traditional measure of Decision Latitude represent distinct, yet correlated factors. Furthermore, findings revealed a significant interaction effect between job demands and control on all outcomes considered. By way of contrast, there was no equivalent interaction effect between job demands and Decision Latitude. In line with the JD-C model, the adverse influence of increasing demands on job satisfaction, psychosomatic complaints and emotional exhaustion were reduced with increasing job control. Conclusions Extending the opportunities of health care workers to control work scheduling and the way of performing given tasks can make them less vulnerable against the adverse effects of high job demands.
-
Differential effects of Decision Latitude and control on the job demands–strain relationship: A cross-sectional survey study among elderly care nursing staff
International Journal of Nursing Studies, 2011Co-Authors: Klaus-helmut Schmidt, Stefan DiestelAbstract:Abstract Background According to the influential Job Demands–Control (JD-C) model developed by Karasek (1979; Karasek and Theorell, 1990), job strain is expected to result from high job demands and low job control as well as an interaction between both job characteristics. Previous research, however, has found such an interaction only rarely or inconsistently.It has been suggested that the conceptualization of the control variable (formerly referred to as Decision Latitude) may be particularly responsible for the lack of supportive findings. Objectives The present study aimed at clarifying this issue by contrasting a focused measure of control with a traditional measure of Decision Latitude in their relations to job strain of health care workers. The measure of Decision Latitude encompassed a wide range of job characteristics including control, task variety, and learning opportunities. Design A cross-sectional questionnaire survey was conducted with job satisfaction, psychosomatic complaints and emotional exhaustion as criterion measures of job strain. Setting A supra-regional organization for residential elderly care with 11 nursing homes located in a federal state in Germany. Participants Questionnaires were distributed to the whole nursing staff, of which 379 filled in the questionnaire during normal working hours (68% participation rate). Methods In addition to confirmatory factor analyses, descriptive statistics, and bivariate correlations, hierarchical multiple regression analyses were performed for testing the corresponding interaction effects. Results Findings confirmed the assumption that the focused measure of control and the traditional measure of Decision Latitude represent distinct, yet correlated factors. Furthermore, findings revealed a significant interaction effect between job demands and control on all outcomes considered. By way of contrast, there was no equivalent interaction effect between job demands and Decision Latitude. In line with the JD-C model, the adverse influence of increasing demands on job satisfaction, psychosomatic complaints and emotional exhaustion were reduced with increasing job control. Conclusions Extending the opportunities of health care workers to control work scheduling and the way of performing given tasks can make them less vulnerable against the adverse effects of high job demands.
G Marangi - One of the best experts on this subject based on the ideXlab platform.
-
Occupational injuries and sickness absence: association with job demand, Decision Latitude, and life style in 2174 workers in the Veneto Region
Medicina Del Lavoro, 2008Co-Authors: Giuseppe Mastrangelo, Stefano Mattioli, Alberto Baldasseroni, D Bontadi, E Capodicasa, V. Marzia, Maddalena Mazzi, P. Patané, Paola Torri, G MarangiAbstract:BACKGROUND: Stress was the most frequent (26,9%) health problem reported in a survey on the perception of working and health conditions in 5000 workers in the Veneto Region. OBJECTIVES: The aim of the study was to investigate in the Veneto Region the association between occupational stress and events occurred in the previous 12 months: occupational accidents, or sickness absence for 10 or more consecutive days. METHODS: Perceived occupational stress is correlated, according to Karasek's model, to high job demand (JD) and low Decision Latitude (DL). Using Karasek's questionnaire (to which questions on smoking and alcohol consumption were added), we examined 2174 subjects working in 30 companies with between 10 and 500 employees, who belonged to the occupational categories of industry and services that are more prevalent in the Veneto Region. The questionnaire was administered by the occupational physician during health surveillance. The subjects were classified on the basis of current exposure to psychosocial factors or, for subjects reporting an event, their exposure at that time. We identified the tertiles of JD and DL; data were submitted to the analysis of multiple logistic regression, estimating odds ratio (OR) and 95% confidence interval (CI). The population attributable risk (PAR) was calculated using the formula (pc (OR-1)/OR), where pc is the fraction of exposed cases. RESULTS: An elevated risk of occupational accidents was found in subjects with regular consumption of alcohol (OR = 2.0; IC = 1.2-3.5), in smokers smoking 10-20 (2.3; 1.3-3.8) or>20 cigarettes/day (3.8; 1.8-7.9), in the highest tertile of JD (2.29; 1.35-3.89) and in the lowest tertile of DL (1.6; 1.0-2.6). PAR was 37.6% for occupational factors (high JD and low DL), 44.5%for non-occupational factors (cigarette smoking and alcohol consumption), and 82.1% overall. The risk of sickness absence increased in subjects smoking 10-20 cigarettes (1.63 = 1.1-2.40), in the highest tertile of JD (1.5; 1.0-2.2) and in the lowest tertile of DL (1.6; 1.1-2.2). PAR was 26.1% for occupational factors (high JD and low DL), 7.6% for non-occupational factors (smoking), and 30.4% overall. While the risk of sick absence increased mainly with the reduction of DL, the risk of occupational accidents increased with increasing JD and, to a lesser extent, with decreasing DL. The current approach to accident prevention is based only on technical and administrative aspects, in spite of the fact that 80% of accidents are not attributable to malfunctioning of machinery. Injury prevention should address technical, personal and psychosocial risk factors together as a whole. Language: it
-
Occupational injuries and sickness absence: association with job demand, Decision Latitude, and life style in 2174 workers in the Veneto Region
La Medicina del lavoro, 2008Co-Authors: Giuseppe Mastrangelo, Stefano Mattioli, Alberto Baldasseroni, D Bontadi, E Capodicasa, V. Marzia, Maddalena Mazzi, P. Patané, Paola Torri, G MarangiAbstract:Stress was the most frequent (26,9%) health problem reported in a survey on the perception of working and health conditions in 5000 workers in the Veneto Region. The aim of the study was to investigate in the Veneto Region the association between occupational stress and events occurred in the previous 12 months: occupational accidents, or sickness absence for 10 or more consecutive days. Perceived occupational stress is correlated, according to Karasek's model, to high job demand (JD) and low Decision Latitude (DL). Using Karasek's questionnaire (to which questions on smoking and alcohol consumption were added), we examined 2174 subjects working in 30 companies with between 10 and 500 employees, who belonged to the occupational categories of industry and services that are more prevalent in the Veneto Region. The questionnaire was administered by the occupational physician during health surveillance. The subjects were classified on the basis of current exposure to psychosocial factors or, for subjects reporting an event, their exposure at that time. We identified the tertiles of JD and DL; data were submitted to the analysis of multiple logistic regression, estimating odds ratio (OR) and 95% confidence interval (CI). The population attributable risk (PAR) was calculated using the formula (pc (OR-1)/OR), where pc is the fraction of exposed cases. An elevated risk of occupational accidents was found in subjects with regular consumption of alcohol (OR = 2.0; IC = 1.2-3.5), in smokers smoking 10-20 (2.3; 1.3-3.8) or >20 cigarettes/day (3.8; 1.8-7.9), in the highest tertile of JD (2.29; 1.35-3.89) and in the lowest tertile of DL (1.6; 1.0-2.6). PAR was 37.6% for occupational factors (high JD and low DL), 44.5%for non-occupational factors (cigarette smoking and alcohol consumption), and 82.1% overall. The risk of sickness absence increased in subjects smoking 10-20 cigarettes (1.63 = 1.1-2.40), in the highest tertile of JD (1.5; 1.0-2.2) and in the lowest tertile of DL (1.6; 1.1-2.2). PAR was 26.1% for occupational factors (high JD and low DL), 7.6% for non-occupational factors (smoking), and 30.4% overall. While the risk of sick absence increased mainly with the reduction of DL, the risk of occupational accidents increased with increasing JD and, to a lesser extent, with decreasing DL. The current approach to accident prevention is based only on technical and administrative aspects, in spite of the fact that 80% of accidents are not attributable to malfunctioning of machinery. Injury prevention should address technical, personal and psychosocial risk factors together as a whole.
