Impact of the psychosocial work environment on registered absence from work: A two-year longitudinal study using the IPAW cohort

During the Intervention Project on Absence and Well-being (IPAW), a 5-year project conducted in Denmark, we investigated psychosocial work environment factors as independent predictors of the number of absence days per year. The present two-year longitudinal study used the IPAW cohort, but was not intended to study intervention effects, which will be reported later. Data were derived from baseline questionnaires and employers' registers of absence for 1919 participants (1305 women, 614 men, mainly in low-skilled jobs) in different occupations from 52 workplaces. These workplaces included municipal care, municipal technical services and a large pharmaceutical company. Analyses were performed by Poisson regression accounting for over-dispersion. After controlling for age, family type, health behaviours and physical work environment variables, we found that high levels of decision authority predicted low absence rates in both women and men. We tested two new psychosocial constructs developed for this study: Predictability (relating to being informed on future events at work) and Meaning of Work (relating to how meaningful and useful the work is perceived to be). Higher Predictability was a significant predictor of lower absence rates in men. This study adds to the body of evidence that the psychosocial working environment influences absence and should therefore be considered to be an important target for intervention.     

Impact of the psychosocial work environment on registered absence from work: A two-year longitudinal study using the IPAW cohort

During the Intervention Project on Absence and Well-being (IPAW), a 5-year project conducted in Denmark, we investigated psychosocial work environment factors as independent predictors of the number of absence days per year. The present two-year longitudinal study used the IPAW cohort, but was not intended to study intervention effects, which will be reported later. Data were derived from baseline questionnaires and employers’ registers of absence for 1919 participants (1305 women, 614 men, mainly in low-skilled jobs) in different occupations from 52 workplaces. These workplaces included municipal care, municipal technical services and a large pharmaceutical company. Analyses were performed by Poisson regression accounting for over-dispersion. After controlling for age, family type, health behaviours and physical work environment variables, we found that high levels of decision authority predicted low absence rates in both women and men. We tested two new psychosocial constructs developed for this study: Predictability (relating to being informed on future events at work) and Meaning of Work (relating to how meaningful and useful the work is perceived to be). Higher Predictability was a significant predictor of lower absence rates in men. This study adds to the body of evidence that the psychosocial working environment influences absence and should therefore be considered to be an important target for intervention.     

Reciprocal relationships between psychosocial work characteristics and sleep problems: A two-wave study

Sleep problems are common and impair the health and productivity of employees. Work characteristics constitute one possible cause of sleep problems, and sleeping poorly might influence wellbeing and performance at work. This study examines the reciprocal associations between sleep problems and psychosocial work characteristics. The participants were 1744 full-time employed individuals (56% women; mean age 38 years in 2007) from the Young Finns study who responded to questionnaires on work characteristics (conceptualised by the demand–control model and effort–reward imbalance model) and sleep problems (Jenkins Sleep Scale) in 2007 and 2012. Cross-lagged structural equation models are used to examine the associations. The results show that low control and low rewards at baseline predicted sleep problems. Baseline sleep problems predicted higher effort, higher effort–reward imbalance, and lower reward. Sleep problems also predicted lower odds for belonging to the low (rather than high) job strain group and active jobs group. The association between work characteristics and sleep problems appears to be reciprocal, with a stressful work environment increasing sleep problems, and sleep problems influencing future work characteristics. The results emphasise the importance of interventions aimed at both enhancing sleep quality and reducing psychosocial risks at work.     

Editorial: Cognitive science,occupational stress and organizational health

A number of studies have shown that musculoskeletal symptoms are related to the physical and psychosocial work environments. Workers with musculoskeletal symptoms are often advised to cope by such measures as changing working technique, using lifting equipment and discussing health and environmental problems with supervisors and colleagues. Intervention studies at the individual level, however, have shown that such advice has limited effects in reducing the prevalence of musculoskeletal symptoms. The hypothesis for this study was that negative social and organizational factors may prevent workers from implementing such coping strategies. All 103 motor vehicle mechanics surveyed in 12 different garages responded to a questionnaire on coping with musculoskeletal symptoms and the psychosocial work environment. Positive and significant relationships were shown between how mechanics coped with their musculoskeletal symptoms and such psychosocial factors as work demands, social support, control, manager's involvement in health and safety work, and whether the garages had regular meetings between management and workers. Achieving positive results from preventive work through back schools and other ergonomic interventions seems to require that an organization with positive attitudes towards health and safety work be created before such interventions are implemented.     

How the psychosocial work environment of motor vehicle mechanics may influence coping with musculoskeletal symptoms

A number of studies have shown that musculoskeletal symptoms are related to the physical and psychosocial work environments. Workers with musculoskeletal symptoms are often advised to cope by such measures as changing working technique, using lifting equipment and discussing health and environmental problems with supervisors and colleagues. Intervention studies at the individual level, however, have shown that such advice has limited effects in reducing the prevalence of musculoskeletal symptoms. The hypothesis for this study was that negative social and organizational factors may prevent workers from implementing such coping strategies. All 103 motor vehicle mechanics surveyed in 12 different garages responded to a questionnaire on coping with musculoskeletal symptoms and the psychosocial work environment. Positive and significant relationships were shown between how mechanics coped with their musculoskeletal symptoms and such psychosocial factors as work demands, social support, control, manager's involvement in health and safety work, and whether the garages had regular meetings between management and workers. Achieving positive results from preventive work through back schools and other ergonomic interventions seems to require that an organization with positive attitudes towards health and safety work be created before such interventions are implemented.     

Psychosocial work environment and psychosomatic health of nurses in Hungary

The main goal of this preliminary study was to detect the relative effects of sociodemographics, socio-economic factors and some variables of psychosocial work environment on an overall index of psychosomatic symptoms as an indicator of psychosomatic health in a sample of female Hungarian nurses. The participants were registered nurses and student nurses chosen at random from public hospitals ( n =420). Self-administered questionnaires contained various items on psychosomatic symptoms, sociodemographics, socio-economic variables, work schedule, the frequency of stressful situations and emotionally provoking problems at work, and social support from peers. Multiple regression models revealed that the frequency of stressful situations and emotionally provoking problems, and the lack of social support from peers, i.e. measures of psychosocial work environment, proved to be the only significant contributors to psychosomatic health complaints, after controlling for other variables in both registered and student nurses.     

Psychosocial work environment and psychosomatic health of nurses in Hungary

The main goal of this preliminary study was to detect the relative effects of sociodemographics, socio-economic factors and some variables of psychosocial work environment on an overall index of psychosomatic symptoms as an indicator of psychosomatic health in a sample of female Hungarian nurses. The participants were registered nurses and student nurses chosen at random from public hospitals ( n =420). Self-administered questionnaires contained various items on psychosomatic symptoms, sociodemographics, socio-economic variables, work schedule, the frequency of stressful situations and emotionally provoking problems at work, and social support from peers. Multiple regression models revealed that the frequency of stressful situations and emotionally provoking problems, and the lack of social support from peers, i.e. measures of psychosocial work environment, proved to be the only significant contributors to psychosomatic health complaints, after controlling for other variables in both registered and student nurses.     

Work and other factors influencing coronary health and sickness absence

Two major problems encountered in studies of the impact of work on health are the determination of which diseases and health states may be affected, and the separation of work from other factors affecting health. The greatest burden of ill-health may be due to the psychosocial work environment, rather than exposure to traditionally studied environmental agents. A common concern is with coronary heart disease (CHD). The author and his colleagues have been studying CHD, mental health and sickness absence, this last as a measure which combines social, psychological and physical functioning. Two longitudinal studies were conducted on civil servants, with the major aim of investigating the effect on health of occupational and other socioeconomic influences on white-collar workers. It was found that the lowest risk of CHD was in administrators, and the highest risk in the lower socioeconomic groups. Type A behaviour was higher in higher grades of worker. Lower-grade workers had less healthy lifestyle habits. It may not be possible to separate the effect of work from other influences on an individual, and it could be that the point of intervention should be not the individual but the environment.     

Psychosocial work environment and mental health among travelling salespeople

Travelling salespeople have a rather unusual working environment, with long periods of absence from their firm and a low level of social contacts with colleagues. Furthermore, they are exposed to high demands in their work, which may conflict with a normal family life. In this paper a cross-sectional study of psychosocial work environment and mental health of Danish travelling salespeople is described. A sample of 1,306 travelling salespeople filled in a questionnaire (response rate 68%). The results indicate that poor mental health is associated with a number of demand indicators: number of working hours per week, number of customers per week, non-day work, and a high level of perceived job demands. On the other hand, the number of hours spent with customers per week is positively associated with mental health. The authors did not find the expected associations between poor mental health and several factors such as number of hours away from firm, nights away from home, and a low degree of perceived support from colleagues and superiors. It is concluded that the main stressors of travelling salespeople are long working hours, many customers, non-day work and high perceived psychological demands in general.     

Psychosocial work environment and mental health among travelling salespeople

Travelling salespeople have a rather unusual working environment, with long periods of absence from their firm and a low level of social contacts with colleagues. Furthermore, they are exposed to high demands in their work, which may conflict with a normal family life. In this paper a cross-sectional study of psychosocial work environment and mental health of Danish travelling salespeople is described. A sample of 1,306 travelling salespeople filled in a questionnaire (response rate 68%). The results indicate that poor mental health is associated with a number of demand indicators: number of working hours per week, number of customers per week, non-day work, and a high level of perceived job demands. On the other hand, the number of hours spent with customers per week is positively associated with mental health. The authors did not find the expected associations between poor mental health and several factors such as number of hours away from firm, nights away from home, and a low degree of perceived support from colleagues and superiors. It is concluded that the main stressors of travelling salespeople are long working hours, many customers, non-day work and high perceived psychological demands in general.     

The Danish psychosocial work environment and symptoms of stress: the main, mediating and moderating role of sense of coherence

The aim of this cross-sectional study was to explore the main, mediating and moderating role of sense of coherence (SOC) on stress symptoms and on the association between perceived psychosocial work environment and stress symptoms. The sample includes 2053 Danish employees from 52 workplaces. Hierarchical regression models were applied for each measure of stress. The results strongly supported the presence of a main effect for SOC. People with high levels of SOC experienced fewer stress symptoms. A mediating effect of SOC was also supported. Thus, SOC in part explained the association between work environment and stress symptoms. In addition, some support for a moderating effect of SOC was found, suggesting that people with higher SOC coped more efficiently with work environmental strain that people with lower SOC. Taken together the regression models explained 11-32% of the variance in stress symptoms. The results suggest that measures of individual factors such as SOC should be included in analyses of the effects of work environmental factors on stress and well-being.     

The contribution of the psychosocial work environment to sickness absence in human service workers: Results of a 3-year follow-up study

We investigated to what extent psychosocial work characteristics predict sickness absence in a cohort of 890 human service professionals (84% women), followed-up for 3 years. We measured 16 different psychosocial work characteristics at baseline and analysed their associations with number of sickness absence days at follow-up using multivariate Poisson regression. In addition, we computed a psychosocial work environment index, summarizing eight psychosocial scales. Participants with exposure to violence and threats, high emotional demands, high demands for hiding emotions, low influence at work, low meaning of work, low quality of management, and role conflicts had an increased number of sickness absence days at follow-up, after adjustment for numerous confounders. Adjusting for sickness absence history caused little change in most effect estimates. Scoring in the most adverse quartile of the psychosocial work environment index was associated with a 71% increase in sickness absence days. Improving the psychosocial work environment index and eliminating exposure to violence and threats would have prevented 32% of all sickness absence days in the study population. In particular we found that exposure to violence was a strong predictor of absence. This study shows that a wide range of psychosocial work characteristics contribute to sickness absence in human service workers. Improving the psychosocial work environment might help to reduce sickness absence in this population.     

The Danish psychosocial work environment and symptoms of stress: The main,mediating and moderating role of sense of coherence

The aim of this cross-sectional study was to explore the main, mediating and moderating role of sense of coherence (SOC) on stress symptoms and on the association between perceived psychosocial work environment and stress symptoms. The sample includes 2053 Danish employees from 52 workplaces. Hierarchical regression models were applied for each measure of stress. The results strongly supported the presence of a main effect for SOC. People with high levels of SOC experienced fewer stress symptoms. A mediating effect of SOC was also supported. Thus, SOC in part explained the association between work environment and stress symptoms. In addition, some support for a moderating effect of SOC was found, suggesting that people with higher SOC coped more efficiently with work environmental strain that people with lower SOC. Taken together the regression models explained 11–32% of the variance in stress symptoms. The results suggest that measures of individual factors such as SOC should be included in analyses of the effects of work environmental factors on stress and well-being.     

Risk factors for neck and back pain in a working population in Sweden

The relationship between lifestyle, ergonomie and psychosocial workplace factors and musculo-skeletal pain was examined in this cross-sectional study. A total of 22180 employees undergoing screening examinations at their occupational health-care service filled in a series of questionnaires concerning their health, lifestyle and working situation. Of these 31% reported having had neck pain and 18% had seen a health professional for such pain during the previous year. Similarly, 39% reported having had back pain and 16% had seen a professional during the year. Odds ratios were calculated to estimate the relative risk of the various exposure factors. Although not eating regularly and smoking increased the risk for both neck and back pain somewhat, not exercising and consuming alcohol did not increase the risk for these musculoskeletal pains. Lifting, monotonous work tasks, vibration and uncomfortable work postures were the most important ergonomie factors (odds ratios from 1.01 to 2.95). Sitting, however, did not increase the risk for either neck or back pain. A 'poor' psychosocial work environment, as compared to a 'good' one, increased the risk for both neck and back pain (odds ratios from 1.62 to 3.01). Work content and social support were of particular relevance. Finally, a combination of a 'poor' psychosocial work environment and exposure to one of the ergonomic variables produced the highest risk factors (odds ratios from 2.42 to 3.61). Although the conclusions that may be drawn are limited by the cross-sectional nature of this study, the results seem to underscore the complex aetiology of musculoskeletal pain and especially the importance of psychosocial variables. Prevention programmes should therefore be broad-based and include psychosocial as well as ergonomic measures.     

Regulations,policies and practices concerning work stress in five European countries

Abstract

A comparative inventory of regulations, policies and practices in The Netherlands, Sweden, UK, Germany and France with regard to the prevention of work stress was carried out. In each country data were collected by means of interviews with key informants and through exploring relevant documents and literature. It was found that Sweden, The Netherlands and the UK—those countries with framework legislation in the field of health and safety—recognize stress as an important health and safety topic, whereas Germany and France do not yet recognize stress as an important policy issue. However, even in the first group of countries less attention is being paid towards psychosocial work characteristics when compared with traditional health and safety issues, such as noise, machine safety and toxic agents. There is a clear lack of well-documented (national) ‘examples of good preventive practice’, even in Sweden and The Netherlands. Recommendations are being formulated concerning type of legislation, guidance and information, monitoring and risk assessment, costs and benefits, examples of good practice and European networking.     

Relationships between bullying, psychosocial work environment and individual stress reactions

It is frequently assumed that a poor psychosocial working environment will create conditions that encourage bullying. However, few studies have examined this assumption while comparing work environment ratings of bullied and non-bullied employees who work in the same organization and/or department. The objectives of this study were therefore, first, to investigate relationships between bullying and other psychosocial work environment factors within a particular organizational setting and, second, to investigate if bullied employees reported higher levels of stress than non-bullied employees. A total of 186 blue-collar employees from a Danish manufacturing company participated in the study (response rate of 93%). Results showed significant differences in bullied and non-bullied employees' ratings of psychosocial factors such as job control, management style, role clarity, social climate, social contact and work centrality. In order to investigate assumptions that a poor psychosocial work environment creates conditions that encourage bullying, a number of analyses compared the company's manufacturing departments with either high, medium or low levels of bullying. Results showed significant departmental differences. Yet, when bullied employees were removed from the statistical analyses, with regard to the perceived psychosocial environment these same departments could be differentiated only on the basis of rated job demands and management style. The results therefore bring into question the assumption that a generally poor work environment contributes to bullying. None the less, they do suggest that management style may directly or indirectly have contributed to a higher level of bullying. Also, bullied employees reported significantly more symptoms of psychological stress and mental fatigue than non-bullied employees.     

Relationships between bullying,psychosocial work environment and individual stress reactions

It is frequently assumed that a poor psychosocial working environment will create conditions that encourage bullying. However, few studies have examined this assumption while comparing work environment ratings of bullied and non-bullied employees who work in the same organization and/or department. The objectives of this study were therefore, first, to investigate relationships between bullying and other psychosocial work environment factors within a particular organizational setting and, second, to investigate if bullied employees reported higher levels of stress than non-bullied employees. A total of 186 blue-collar employees from a Danish manufacturing company participated in the study (response rate of 93%). Results showed significant differences in bullied and non-bullied employees’ ratings of psychosocial factors such as job control, management style, role clarity, social climate, social contact and work centrality. In order to investigate assumptions that a poor psychosocial work environment creates conditions that encourage bullying, a number of analyses compared the company's manufacturing departments with either high, medium or low levels of bullying. Results showed significant departmental differences. Yet, when bullied employees were removed from the statistical analyses, with regard to the perceived psychosocial environment these same departments could be differentiated only on the basis of rated job demands and management style. The results therefore bring into question the assumption that a generally poor work environment contributes to bullying. None the less, they do suggest that management style may directly or indirectly have contributed to a higher level of bullying. Also, bullied employees reported significantly more symptoms of psychological stress and mental fatigue than non-bullied employees.     

The relationship between perceived employability and subsequent health

Being capable of getting new employment may enable an employee to cope with turbulent situations or deteriorating job conditions. Individuals who have higher perceived employability are likely to appraise a situation at work more favourably, and consequently experience better health and well-being. The aim of the present study was to investigate the relationship between perceived employability and subsequent health, while controlling for baseline health, background factors, and work environment exposures. The study is based on 53 items in the National Working Life Cohort in Sweden from two data collections (2004 and 2005), comprising 1918 individuals. Forced entry hierarchical regression analysis showed that, after controlling for demographics, psychological demands, control, and ergonomic exposures, perceived employability was positively associated with global health and mental well-being, but unrelated to physical complaints. When baseline health status was added, perceived employability was still a significant predictor of two out of three outcome variables. Individuals with higher perceived employability had a tendency to report better health and well-being a year later. It is concluded that how an employee perceives his or her possibilities in regard to acquiring new employment is relevant for well-being at a later stage. Perceived employability, which has been little studied before, is therefore a useful concept in health promotion, both at the individual and at the organizational level.     

The moderating role of social support in Karasek's job strain model

The potential stressfulness of an event may depend on how it is appraised by the individual, although up to now there have been no longitudinal studies on the relationship between lay beliefs concerning work stress and perceived strain. This longitudinal study examines how lay theories of work stress at baseline were related to perceived mental strain at follow up. The present paper builds on an earlier study (Furnham, ), using a longitudinal design and a much larger population of the British workforce (N=2270). Lay beliefs were assessed by a scale consisting of 36 items. Factor analysis gave a solution with five factors on perceived causes and four factors of perceived alleviation of work stress. Linear multiple regression analysis revealed significant relations between lay beliefs of work stress at baseline and perceived mental strain as well as job stress 14 months later. The effect sizes were small but of a similar magnitude to those that have been found, for example, in occupational stress-reducing interventions. A problem with the factor analytic approach was the discrepancies between the factor solutions and the relative importance of the perceived causes of work stress. The results from the study suggest that subjective beliefs about work stress merits further analysis as potentially mediating between ‘objective’ working conditions and stress outcomes.     

Regulations, policies and practices concerning work stress in five European countries

A comparative inventory of regulations, policies and practices in The Netherlands, Sweden, UK, Germany and France with regard to the prevention of work stress was carried out. In each country data were collected by means of interviews with key informants and through exploring relevant documents and literature. It was found that Sweden, The Netherlands and the UK—those countries with framework legislation in the field of health and safety—recognize stress as an important health and safety topic, whereas Germany and France do not yet recognize stress as an important policy issue. However, even in the first group of countries less attention is being paid towards psychosocial work characteristics when compared with traditional health and safety issues, such as noise, machine safety and toxic agents. There is a clear lack of well-documented (national) 'examples of good preventive practice', even in Sweden and The Netherlands. Recommendations are being formulated concerning type of legislation, guidance and information, monitoring and risk assessment, costs and benefits, examples of good practice and European networking.