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Johannes Siegrist - One of the best experts on this subject based on the ideXlab platform.
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Effort–Reward Imbalance and long-term benzodiazepine use: longitudinal findings from the CONSTANCES cohort
Journal of epidemiology and community health, 2019Co-Authors: Guillaume Airagnes, Cédric Lemogne, Sofiane Kab, Nicolas Hoertel, Marcel Goldberg, Morten Wahrendorf, Johannes Siegrist, Yves Roquelaure, Frédéric Limosin, Marie ZinsAbstract:Objectives To examine the association between Effort–Reward Imbalance and incident long-term benzodiazepine use (LTBU). Methods We included 31 077 employed participants enrolled in the French population-based CONSTANCES cohort between 2012 and 2014 who had not undergone LTBU in the 2 years before enrolment. LTBU was examined using drug reimbursement administrative databases. The Effort–Reward Imbalance was calculated in quartiles. We computed ORs (95% CIs) for LTBU according to Effort–Reward Imbalance over a 2-year follow-up period. We adjusted for age, gender, education, occupational grade, income, marital status, tobacco smoking, risk of alcohol use disorder, depressive symptoms and self-rated health. Results Over the 2-year follow-up, 294 (0.9%) participants experienced incident LTBU. In the univariable analysis, Effort–Reward Imbalance was associated with subsequent LTBU with ORs of 1.79 (95% CI 1.23 to 2.62) and 2.73 (95% CI 1.89 to 3.95) for the third and fourth quartiles, respectively, compared with the first quartile. There was no interaction between Effort–Reward Imbalance and any of the considered variables other than tobacco smoking (p=0.033). The association remained significant in both smokers and non-smokers, with higher odds for smokers (p=0.031). In the fully adjusted model, the association remained significant for the third and fourth quartiles, with ORs of 1.74 (95% CI 1.17 to 2.57) and 2.18 (95% CI 1.50 to 3.16), respectively. These associations were dose dependent (p for trend Conclusions Effort–Reward Imbalance was linked with incident LTBU over a 2-year follow-up period after adjustment for sociodemographic and health-related factors. Thus, screening and prevention of the risk of LTBU should be systematised among individuals experiencing Effort–Reward Imbalance, with special attention paid to smokers.
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Effort Reward Imbalance and long term benzodiazepine use longitudinal findings from the constances cohort
Journal of Epidemiology and Community Health, 2019Co-Authors: Guillaume Airagnes, Cédric Lemogne, Sofiane Kab, Nicolas Hoertel, Marcel Goldberg, Morten Wahrendorf, Johannes Siegrist, Yves Roquelaure, Frédéric Limosin, Marie ZinsAbstract:Objectives To examine the association between Effort–Reward Imbalance and incident long-term benzodiazepine use (LTBU). Methods We included 31 077 employed participants enrolled in the French population-based CONSTANCES cohort between 2012 and 2014 who had not undergone LTBU in the 2 years before enrolment. LTBU was examined using drug reimbursement administrative databases. The Effort–Reward Imbalance was calculated in quartiles. We computed ORs (95% CIs) for LTBU according to Effort–Reward Imbalance over a 2-year follow-up period. We adjusted for age, gender, education, occupational grade, income, marital status, tobacco smoking, risk of alcohol use disorder, depressive symptoms and self-rated health. Results Over the 2-year follow-up, 294 (0.9%) participants experienced incident LTBU. In the univariable analysis, Effort–Reward Imbalance was associated with subsequent LTBU with ORs of 1.79 (95% CI 1.23 to 2.62) and 2.73 (95% CI 1.89 to 3.95) for the third and fourth quartiles, respectively, compared with the first quartile. There was no interaction between Effort–Reward Imbalance and any of the considered variables other than tobacco smoking (p=0.033). The association remained significant in both smokers and non-smokers, with higher odds for smokers (p=0.031). In the fully adjusted model, the association remained significant for the third and fourth quartiles, with ORs of 1.74 (95% CI 1.17 to 2.57) and 2.18 (95% CI 1.50 to 3.16), respectively. These associations were dose dependent (p for trend Conclusions Effort–Reward Imbalance was linked with incident LTBU over a 2-year follow-up period after adjustment for sociodemographic and health-related factors. Thus, screening and prevention of the risk of LTBU should be systematised among individuals experiencing Effort–Reward Imbalance, with special attention paid to smokers.
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Effort-Reward Imbalance and long-term benzodiazepine use: longitudinal findings from the CONSTANCES cohort
Journal of Epidemiology and Community Health, 2019Co-Authors: Guillaume Airagnes, Cédric Lemogne, Sofiane Kab, Nicolas Hoertel, Marcel Goldberg, Morten Wahrendorf, Johannes Siegrist, Yves Roquelaure, Frédéric Limosin, Marie ZinsAbstract:Objectives - To examine the association between Effort-Reward Imbalance and incident long-term benzodiazepine use (LTBU). Methods - We included 31 077 employed participants enrolled in the French population-based CONSTANCES cohort between 2012 and 2014 who had not undergone LTBU in the 2 years before enrolment. LTBU was examined using drug reimbursement administrative databases. The Effort-Reward Imbalance was calculated in quartiles. We computed ORs (95% CIs) for LTBU according to Effort-Reward Imbalance over a 2-year follow-up period. We adjusted for age, gender, education, occupational grade, income, marital status, tobacco smoking, risk of alcohol use disorder, depressive symptoms and self-rated health. Results - Over the 2-year follow-up, 294 (0.9%) participants experienced incident LTBU. In the univariable analysis, Effort-Reward Imbalance was associated with subsequent LTBU with ORs of 1.79 (95% CI 1.23 to 2.62) and 2.73 (95% CI 1.89 to 3.95) for the third and fourth quartiles, respectively, compared with the first quartile. There was no interaction between Effort-Reward Imbalance and any of the considered variables other than tobacco smoking (p=0.033). The association remained significant in both smokers and non-smokers, with higher odds for smokers (p=0.031). In the fully adjusted model, the association remained significant for the third and fourth quartiles, with ORs of 1.74 (95% CI 1.17 to 2.57) and 2.18 (95% CI 1.50 to 3.16), respectively. These associations were dose dependent (p for trend
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measuring Effort Reward Imbalance in school settings a novel approach and its association with self rated health
Journal of Epidemiology, 2010Co-Authors: Li Shang, Tao Wang, Johannes SiegristAbstract:Background: We attempted to apply the model of Effort–Reward Imbalance (ERI) to school settings in order to measure students’ psychosocial stress and analyze its association with self-rated health in adolescents.Methods: A cross-sectional survey was conducted in Kunming, China among 1004 Chinese students (468 boys and 536 girls) in grades 7 through 12, using a 19-item Effort–Reward Imbalance questionnaire.Results: Satisfactory internal consistencies for the scales for Effort and Reward were obtained; the value for the scale for overcommitment was acceptable. Factor analysis replicated the theoretical structure of the ERI construct in this sample of Chinese students. All 3 scales were associated with an elevated odds ratio for diminished self-rated health, and the effect was strongest for the Effort–Reward ratio, as predicted by the theory. Sex and grade differences were also observed.Conclusions: The ERI questionnaire is a valid instrument for identifying sources of stressful experience, in terms of Effort–Reward Imbalance, among adolescents in school settings.
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Effort-Reward Imbalance, job strain and burnout among clinicians in surgery
Psychotherapie Psychosomatik medizinische Psychologie, 2010Co-Authors: Jens Klein, Johannes Siegrist, Kirstin Grosse Frie, Karl Blum, Olaf Von Dem KnesebeckAbstract:The aim of the study is to analyse the association between psychosocial stress at work and burnout among clinicians in surgery in Germany. For the conceptualisation of work stress the demand-control model (job strain) and the Effort-Reward Imbalance model (ERI) were used. Based on a stratified probability sample a mail survey of 1 311 clinicians from 489 hospitals was conducted. Burnout was measured by the Copenhagen Burnout Inventory. Results of logistic regressions show that both models are significantly associated with burnout (odds ratio job strain: 6.53 (95% confidence interval 4.50-9.46), odds ratio ERI: 5.39 (95% confidence interval 3.94-7.36). Clinicians who are exposed to both, job strain and ERI, have an additionally increased risk. The demand-control model and the Effort-Reward Imbalance model suggest theory-driven interventions for job related health promotion measures which aim for improved working conditions and a decrease of health risks among clinicians in surgery.
Jussi Vahtera - One of the best experts on this subject based on the ideXlab platform.
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Effort-Reward Imbalance Is Associated With Alcohol-Related Problems. WIRUS-Screening Study
Frontiers in psychology, 2019Co-Authors: Jens Christoffer Skogen, Jussi Vahtera, Mikkel Magnus Thørrisen, Tore Bonsaksen, Børge Sivertsen, Randi Wågø AasAbstract:There is ample evidence of associations between a perceived stressful working environment and several health-related outcomes. To better understand potential mechanisms behind these observations some studies have focused on the relationship between Effort-Reward Imbalance at work and alcohol consumption. So far, the findings have been inconsistent. One reason for this inconsistency might come from the focus on alcohol consumption per se, while disregarding other aspects such as adverse consequences related to the consumption of alcohol. The aim of the present study was to explore associations between perceived Effort and Reward, Effort-Reward Imbalance and overcommitment, and alcohol-related problems. Using data from the alcohol screening component in the Norwegian WIRUS-project (N = 5,080), we ascertained the perceived Effort, Reward, Effort-Reward Imbalance (ERI) and overcommitment using the Effort-Reward Imbalance questionnaire. Alcohol-related problems was determined using a cut-off ≥8 on the Alcohol Use Disorder Identification Test (AUDIT). Associations were estimated using crude and adjusted logistic regression models. Covariates were age, gender and education. We found associations between different aspects of ERI and overcommitment, and alcohol-related problems. Specifically, the main analysis indicated that there was an increased odds for alcohol-related problems among those who reported high levels of ERI in conjunction with high overcommitment [adjusted OR: 1.40 (CI 95% 1.10-1.78)] compared to those with low levels of ERI and low overcommitment. Our findings suggest that ERI and overcommitment is associated with increased likelihood of alcohol-related problems. These findings indicate that individual and work-related factors should be taken into account collectively when aiming to determine the impact of psychosocial work environment on alcohol-related problems. Due to the cross-sectional nature of the present study, we are not able to determine the direction of the associations, and future studies should aim to investigate this.
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Effort-Reward Imbalance, procedural injustice and relational injustice as psychosocial predictors of health: Complementary or redundant models?
Occupational and environmental medicine, 2007Co-Authors: Mika Kivimaki, Marko Elovainio, Jussi Vahtera, Marianna Virtanen, Johannes SiegristAbstract:Objective: Effort-Reward Imbalance at work is an established psychosocial risk factor but there are also newer conceptualisations, such as procedural injustice (decisions at work lack consistency, openness and input from all affected parties) and relational injustice (problems in considerate and fair treatment of employees by supervisors). The authors examined whether procedural injustice and relational injustice are associated with employee health in addition to, and in combination with, Effort-Reward Imbalance. Methods: Prospective survey data from two cohorts related to public-sector employees: the 10-Town study (n = 18 066 (78% women, age range 19–62) and the Finnish Hospital Personnel study (n = 4833, 89% women, age range 20–60). Self-rated poor health, minor psychiatric morbidity and doctor-diagnosed depression were assessed at baseline (2000–2) and at follow-up (2004). To determine incident morbidity, baseline cases were excluded. Results: In multivariate models including age, sex, occupational status and all three psychosocial factors as predictors, high Effort-Reward Imbalance and either high procedural injustice or high relational injustice were associated with increased morbidity at follow-up in both cohorts. After combining procedural and relational injustice into a single measure of organisational injustice, high Effort-Reward Imbalance and high injustice were both independently associated with health. For all outcome measures, a combination of high Effort-Reward Imbalance and high organisational injustice was related to a greater health risk than high Effort-Reward Imbalance or injustice alone. Conclusion: Evidence from two independent occupational cohorts suggests that procedural and relational components of injustice, as a combined index, and Effort-Reward Imbalance are complementary risk factors.
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Effort–Reward Imbalance and relational injustice at work predict sickness absence: The Whitehall II study
Journal of psychosomatic research, 2007Co-Authors: Jenny Head, Mika Kivimaki, Johannes Siegrist, Jane E. Ferrie, Jussi Vahtera, Martin J. Shipley, Michael G. MarmotAbstract:Objectives: Sickness absence is a major occupational health problem, but evidence for associations between potentially modifiable psychosocial work factors and sickness absence is still scarce. We studied the impact of relational justice and Effort-Reward Imbalance on subsequent rates of sickness absence. Methods: The Whitehall II prospective cohort study of British civil servants, 10,308 men and women, was established between 1985 and 1988. Indicators of Effort-Reward Imbalance and the relational component of organizational justice were constructed from questions included at baseline. Participants were classified into three groups (low, intermediate, and high) for both Effort-Reward Imbalance and relational justice. Short ( 7 days) spells of sickness absence during 1985-1989 and 1991-1995 were used to study immediate and longer term effects of work characteristics. Results: After adjustment for age, employment grade, and baseline health, men and women with low relational justice had increased risks of long spells of sickness absence of 14% and 28% in comparison to men and women experiencing high levels of justice. Similar effect sizes (25% and 21%) were found for high vs. low Effort-Reward Imbalance. Both work measures also predicted short spells of sickness absence. Effort-Reward Imbalance (men and women) and relational justice (women only) each predicted long spells of sickness absence independently of the other. Conclusions: Both relational justice and Effort-Reward Imbalance are important determinants of sickness absence. Workplace interventions to improve these aspects of working conditions have the potential to reduce levels of sickness absence. (c) 2007 Elsevier Inc. All rights reserved.
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Job strain, Effort-Reward Imbalance, and heavy drinking: a study in 40,851 employees.
Journal of occupational and environmental medicine, 2005Co-Authors: Anne Kouvonen, Mika Kivimaki, Sara J Cox, Kari Poikolainen, Tom Cox, Jussi VahteraAbstract:OBJECTIVE: The objective of this study was to examine the relationship of the job strain model and the Effort-Reward Imbalance model with heavy drinking. METHODS: Questionnaire survey data were obtained from 32,352 women and 8499 men employed in the Finnish public sector (participation 67%). Logistic regression analyses for all employees and for separate subgroups were undertaken by sex, adjusted for age, education, occupational position, marital status, job contract, smoking, and negative affectivity. Different cutoff points of heavy drinking were used for men and women. RESULTS: High job strain and high Effort-Reward Imbalance as global constructs were not associated with heavy drinking. However, some components of these models were associated with heavy drinking but the relationships were not all in the expected direction and they varied by sex, age, and occupational position. CONCLUSIONS: Stressful work conditions are not consistently associated with heavy drinking.
Michael G. Marmot - One of the best experts on this subject based on the ideXlab platform.
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Effort-Reward Imbalance and relational injustice at work predict sickness absence: The Whitehall II study
J PSYCHOSOM RES, 2007Co-Authors: Michael G. MarmotAbstract:Objectives: Sickness absence is a major occupational health problem, but evidence for associations between potentially modifiable psychosocial work factors and sickness absence is still scarce. We studied the impact of relational justice and Effort-Reward Imbalance on subsequent rates of sickness absence. Methods: The Whitehall II prospective cohort study of British civil servants, 10,308 men and women, was established between 1985 and 1988. Indicators of Effort-Reward Imbalance and the relational component of organizational justice were constructed from questions included at baseline. Participants were classified into three groups (low, intermediate, and high) for both Effort-Reward Imbalance and relational justice. Short (7 days) spells of sickness absence during 1985-1989 and 1991-1995 were used to study immediate and longer term effects of work characteristics. Results: After adjustment for age, employment grade, and baseline health, men and women with low relational justice had increased risks of long spells of sickness absence of 14% and 28% in comparison to men and women experiencing high levels of justice. Similar effect sizes (25% and 21%) were found for high vs. low Effort-Reward Imbalance. Both work measures also predicted short spells of sickness absence. Effort-Reward Imbalance (men and women) and relational justice (women only) each predicted long spells of sickness absence independently of the other. Conclusions: Both relational justice and Effort-Reward Imbalance are important determinants of sickness absence. Workplace interventions to improve these aspects of working conditions have the potential to reduce levels of sickness absence. (c) 2007 Elsevier Inc. All rights reserved.
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Effort–Reward Imbalance and relational injustice at work predict sickness absence: The Whitehall II study
Journal of psychosomatic research, 2007Co-Authors: Jenny Head, Mika Kivimaki, Johannes Siegrist, Jane E. Ferrie, Jussi Vahtera, Martin J. Shipley, Michael G. MarmotAbstract:Objectives: Sickness absence is a major occupational health problem, but evidence for associations between potentially modifiable psychosocial work factors and sickness absence is still scarce. We studied the impact of relational justice and Effort-Reward Imbalance on subsequent rates of sickness absence. Methods: The Whitehall II prospective cohort study of British civil servants, 10,308 men and women, was established between 1985 and 1988. Indicators of Effort-Reward Imbalance and the relational component of organizational justice were constructed from questions included at baseline. Participants were classified into three groups (low, intermediate, and high) for both Effort-Reward Imbalance and relational justice. Short ( 7 days) spells of sickness absence during 1985-1989 and 1991-1995 were used to study immediate and longer term effects of work characteristics. Results: After adjustment for age, employment grade, and baseline health, men and women with low relational justice had increased risks of long spells of sickness absence of 14% and 28% in comparison to men and women experiencing high levels of justice. Similar effect sizes (25% and 21%) were found for high vs. low Effort-Reward Imbalance. Both work measures also predicted short spells of sickness absence. Effort-Reward Imbalance (men and women) and relational justice (women only) each predicted long spells of sickness absence independently of the other. Conclusions: Both relational justice and Effort-Reward Imbalance are important determinants of sickness absence. Workplace interventions to improve these aspects of working conditions have the potential to reduce levels of sickness absence. (c) 2007 Elsevier Inc. All rights reserved.
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Do changes in Effort-Reward Imbalance at work contribute to an explanation of the social gradient in angina?
OCCUP ENVIRON MED, 2005Co-Authors: Michael G. MarmotAbstract:Aims: To determine whether an increase in Effort-Reward Imbalance over time increases the risk of angina, and whether such increases are associated with lower occupational position.Methods: Effort-Reward Imbalance (ERI) at work was measured in the Whitehall II occupational cohort of London based civil servants at baseline (1985-88) and in 1997. Coronary heart disease was measured in a self-reported health questionnaire by combining the Rose Angina Questionnaire with doctor diagnosed angina in 2001.Results: Among men, increase in ERI over time was associated with an increased risk of incident angina. Moreover, as increases in ERI were more common among lower grade civil servants, change in Imbalance, to some extent, contributed to explaining the social gradient in angina. Among women, increases in Imbalance were not associated with risk of angina, and therefore did not contribute to the explanation of the social gradient.Conclusions: Reductions in Effort-Reward Imbalance at work may reduce the risk of coronary heart disease among men.
Mika Kivimaki - One of the best experts on this subject based on the ideXlab platform.
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Effort Reward Imbalance
The Wiley Blackwell Encyclopedia of Health Illness Behavior and Society, 2014Co-Authors: Mika KivimakiAbstract:The concept of Effort–Reward Imbalance (ERI), describing a source of work-related stress, was developed by Johannes Siegrist of the University of Dusseldorf (Siegrist 1996, 2010). According to the ERI model, the experience of Imbalance between high Efforts spent at work and a perception of low Reward received in return is stressful, as this Imbalance violates core expectations about reciprocity. According to the ERI model, high demands at work and heavy obligations in private life (e.g., large debts) may lead to a high expenditure of Effort. The reason for high Efforts can also be intrinsic, reflecting an employee's excessive work-related commitment (“overcommitment”). Low Rewards refer to three factors: insufficient pay, low esteem (e.g., lack of help or acceptance by supervisors and colleagues), and poor career opportunities (no promotion prospects, job insecurity, and/or status inconsistency). Keywords: medical sociology; occupational health; psychosocial factors; stress; work
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Effort-Reward Imbalance, procedural injustice and relational injustice as psychosocial predictors of health: Complementary or redundant models?
Occupational and environmental medicine, 2007Co-Authors: Mika Kivimaki, Marko Elovainio, Jussi Vahtera, Marianna Virtanen, Johannes SiegristAbstract:Objective: Effort-Reward Imbalance at work is an established psychosocial risk factor but there are also newer conceptualisations, such as procedural injustice (decisions at work lack consistency, openness and input from all affected parties) and relational injustice (problems in considerate and fair treatment of employees by supervisors). The authors examined whether procedural injustice and relational injustice are associated with employee health in addition to, and in combination with, Effort-Reward Imbalance. Methods: Prospective survey data from two cohorts related to public-sector employees: the 10-Town study (n = 18 066 (78% women, age range 19–62) and the Finnish Hospital Personnel study (n = 4833, 89% women, age range 20–60). Self-rated poor health, minor psychiatric morbidity and doctor-diagnosed depression were assessed at baseline (2000–2) and at follow-up (2004). To determine incident morbidity, baseline cases were excluded. Results: In multivariate models including age, sex, occupational status and all three psychosocial factors as predictors, high Effort-Reward Imbalance and either high procedural injustice or high relational injustice were associated with increased morbidity at follow-up in both cohorts. After combining procedural and relational injustice into a single measure of organisational injustice, high Effort-Reward Imbalance and high injustice were both independently associated with health. For all outcome measures, a combination of high Effort-Reward Imbalance and high organisational injustice was related to a greater health risk than high Effort-Reward Imbalance or injustice alone. Conclusion: Evidence from two independent occupational cohorts suggests that procedural and relational components of injustice, as a combined index, and Effort-Reward Imbalance are complementary risk factors.
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Effort Reward Imbalance heart rate and heart rate variability the cardiovascular risk in young finns study
International Journal of Behavioral Medicine, 2007Co-Authors: Mirka Hintsanen, Marko Elovainio, Sampsa Puttonen, Mika Kivimaki, Tuomas Koskinen, Olli T Raitakari, Liisa KeltikangasjarvinenAbstract:Background: Work stress indicated by Effort—Reward Imbalance is hypothesized to cause autonomic arousal, which, if prolonged or frequent, could contribute to cardiovascular pathology. However, only limited empirical evidence on this mechanism is available. Purpose: This study examined associations between Effort-Reward Imbalance, heart rate (HR), and heart rate variability (HRV). Method: The participants were 457 women and 406 men (mean age 32.3 years) derived from the population-based Young Finns Study. Effort—Reward Imbalance was defined as the ratio between Effort and Reward, higher Efforts compared to Rewards indicating greater Imbalance. Results: In age-adjusted regression models, higher Effort-Reward Imbalance was associated with lower HRV, and lower Reward was associated with higher HR among women. These associations were not attenuated after additional adjustments for demographic characteristics and coronary risk factors. No significant associations of Effort—Reward Imbalance or its components with HR and HRV were found in men. Conclusion: Our finding of lower HRV and higher HR in young healthy women with high Effort—Reward Imbalance and low Rewards provides evidence of a potential mechanism that may link Effort-Reward Imbalance to the development of coronary heart disease (CHD) in women.
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Effort–Reward Imbalance and relational injustice at work predict sickness absence: The Whitehall II study
Journal of psychosomatic research, 2007Co-Authors: Jenny Head, Mika Kivimaki, Johannes Siegrist, Jane E. Ferrie, Jussi Vahtera, Martin J. Shipley, Michael G. MarmotAbstract:Objectives: Sickness absence is a major occupational health problem, but evidence for associations between potentially modifiable psychosocial work factors and sickness absence is still scarce. We studied the impact of relational justice and Effort-Reward Imbalance on subsequent rates of sickness absence. Methods: The Whitehall II prospective cohort study of British civil servants, 10,308 men and women, was established between 1985 and 1988. Indicators of Effort-Reward Imbalance and the relational component of organizational justice were constructed from questions included at baseline. Participants were classified into three groups (low, intermediate, and high) for both Effort-Reward Imbalance and relational justice. Short ( 7 days) spells of sickness absence during 1985-1989 and 1991-1995 were used to study immediate and longer term effects of work characteristics. Results: After adjustment for age, employment grade, and baseline health, men and women with low relational justice had increased risks of long spells of sickness absence of 14% and 28% in comparison to men and women experiencing high levels of justice. Similar effect sizes (25% and 21%) were found for high vs. low Effort-Reward Imbalance. Both work measures also predicted short spells of sickness absence. Effort-Reward Imbalance (men and women) and relational justice (women only) each predicted long spells of sickness absence independently of the other. Conclusions: Both relational justice and Effort-Reward Imbalance are important determinants of sickness absence. Workplace interventions to improve these aspects of working conditions have the potential to reduce levels of sickness absence. (c) 2007 Elsevier Inc. All rights reserved.
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Job strain, Effort-Reward Imbalance, and heavy drinking: a study in 40,851 employees.
Journal of occupational and environmental medicine, 2005Co-Authors: Anne Kouvonen, Mika Kivimaki, Sara J Cox, Kari Poikolainen, Tom Cox, Jussi VahteraAbstract:OBJECTIVE: The objective of this study was to examine the relationship of the job strain model and the Effort-Reward Imbalance model with heavy drinking. METHODS: Questionnaire survey data were obtained from 32,352 women and 8499 men employed in the Finnish public sector (participation 67%). Logistic regression analyses for all employees and for separate subgroups were undertaken by sex, adjusted for age, education, occupational position, marital status, job contract, smoking, and negative affectivity. Different cutoff points of heavy drinking were used for men and women. RESULTS: High job strain and high Effort-Reward Imbalance as global constructs were not associated with heavy drinking. However, some components of these models were associated with heavy drinking but the relationships were not all in the expected direction and they varied by sex, age, and occupational position. CONCLUSIONS: Stressful work conditions are not consistently associated with heavy drinking.
Jaana Pentti - One of the best experts on this subject based on the ideXlab platform.
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Effort-Reward Imbalance at work and risk of type 2 diabetes in a national sample of 50,552 workers in Denmark: A prospective study linking survey and register data.
Journal of psychosomatic research, 2019Co-Authors: Mads Nordentoft, Ida E. H. Madsen, Naja Hulvej Rod, Jens Peter Bonde, Jakob B. Bjorner, Bryan Cleal, Linda L. Magnusson Hanson, Mette Andersen Nexo, Line Rosendahl Meldgaard Pedersen, Jaana PenttiAbstract:Abstract Objective To examine the prospective relation between Effort-Reward Imbalance at work and risk of type 2 diabetes. Methods We included 50,552 individuals from a national survey of the working population in Denmark, aged 30–64 years and diabetes-free at baseline. Effort-Reward Imbalance was defined, in accordance with the literature, as a mismatch between high Efforts at work (e.g. high work pace, time pressure), and low Rewards received in return (e.g. low recognition, job insecurity) and assessed as a continuous and a categorical variable. Incident type 2 diabetes was identified in national health registers. Using Cox regression we calculated hazard ratios (HR) and 95% confidence intervals (95% CI) for estimating the association between Effort-Reward Imbalance at baseline and risk of onset of type 2 diabetes during follow-up, adjusted for sex, age, socioeconomic status, cohabitation, children at home, migration background, survey year and sample method. Results During 136,239 person-years of follow-up (mean = 2.7 years) we identified 347 type 2 diabetes cases (25.5 cases per 10,000 person-years). For each one standard deviation increase of the Effort-Reward Imbalance score at baseline, the fully adjusted risk of type 2 diabetes during follow-up increased by 9% (HR: 1.09, 95% CI: 0.98–1.21). When we used Effort-Reward Imbalance as a dichotomous variable, exposure to Effort-Reward Imbalance was associated with an increased risk of type 2 diabetes with a HR of 1.27 (95% CI: 1.02–1.58). Conclusion The results of this nationwide study of the Danish workforce suggest that Effort-Reward Imbalance at work may be a risk factor for type 2 diabetes.