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Objectives: Sleep quality of firefighters can be negatively affected by occupational stressors. A cross-sectional investigation was conducted to understand how work-related stress, post-traumatic stress, burnout and depression collectively contribute to sleep quality., Methods: Professional firefighters in Northern Iran completed a survey comprised of demographic information, the Pittsburgh Sleep Quality Index, HSE's Stress Indicator Tool, the Posttraumatic Stress Disorder Checklist, Maslach's Burnout Inventory, and the Beck Depression Inventory during a work rest break. Data were analysed using structural equation modelling., Results: Mean age of the 2339 firefighters who completed the survey was 32.30 (5.74) years. Most experienced poor sleep quality, scoring above the established cut-off of 5. Levels of work-related stress, post-traumatic stress, burnout and depression were high. Fit indices of the final theoretical model were all adequate: the obtained and adjusted goodness-of-fit indices were 0.925 and 0.917 respectively. Comparative, and incremental fit indices were 0.946 and 0.948 respectively. Root mean squared error of approximation was 0.061. Post-traumatic stress was directly and indirectly related to sleep quality through eight paths, modulated by burnout variables and depression. Work-related stress was negatively related to sleep quality through four paths modulated, by burnout variables and depression., Conclusions: The findings illustrate the complex relationships of work-related stress and post-traumatic stress and sleep quality. High levels of poor sleep quality in this occupation emphasise the need to develop targeted and sustainable interventions to manage occupational stressors, burnout and depression to improve sleep quality in firefighters., Competing Interests: Declarations Ethics approval The Research Ethics Committee of Birjand University of Medical Sciences (BUMS) granted ethics approval for this study (No. IR.BUMS.REC.1401.195). The study was completed in accordance with the World Medical Association Declaration of Helsinki. Conflict of interest The authors declare that they have no competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. We formally declare that those authors who reside in a nation or region currently under international sanctions (i.e., Iran) are academics and scientists are not employed by the government of that country under sanctions; and all these authors are preparing articles in their “personal capacity”., (© 2024. The Author(s).)

Objective: This study investigates anxiety risk and work-related factors among platform workers. The recent growth in the platform industry is a worldwide trend, with delivery workers in Korea representing typical platform workers., Methods: This cross-sectional study used the 6th Korean Working Conditions Survey to assess anxiety risk among 532 delivery workers compared to general employees. It identified associations between work-related factors and anxiety, including job demands and autonomy, legal protection, and emotional labor., Results: Delivery workers exhibited significantly higher anxiety (odds ratio [OR] = 1.67 95% confidence interval [CI] = 1.23-2.28) and work-related anxiety (OR = 2.17 95% CI = 1.48-3.18) risk than the general workforce, and a significantly higher risk of having unfavorable work environment factors. Their anxiety risk was significantly associated with work-related factors, such as long shifts, quick return, time pressure, job stress, absence of union, work-family conflict, and emotional labor., Conclusions: This study identified high levels of anxiety among Korean delivery workers and associated occupational factors. It highlights the importance for industry and government interventions to enhance mental health support, mitigate poor employment conditions, and ensure legal safeguards., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Mental health in the workplace is a growing concern for enterprises and policy makers. MENTUPP is a multi-level mental health intervention implemented in small and medium size enterprises from three work sectors in nine countries. This pilot study aimed to evaluate the feasibility, delivery, and instruments for the MENTUPP intervention to inform the planning of a clustered randomized controlled trial., Methods: We administered items from the Copenhagen Psychosocial Questionnaire and the Danish Work Environment Cohort Study measuring psychosocial workplace factors. The questionnaire was answered by 382 participants at baseline, of which 98 participants also answered after six months at follow-up. We calculated mean scores of 19 psychosocial factors at baseline and conducted repeated measures ANOVAs to assess differences in eight psychosocial factors at follow-up. We also examined whether outcomes differed between work sectors and job positions at follow-up., Results: The construction sector and workers with no or a lower leadership role reported more negative working environment factors at baseline. We observed a statistically significant decline in social support from colleagues and social community at work, and a marginally significant decline in justice at work. For the rest of the constructs, we did not observe statistically significant changes., Conclusions: We found significant differences in psychosocial work environment factors among work sectors and job positions at baseline. Contrary to our hypotheses, three psychosocial work environment factors decreased at follow-up. Possible explanations are the utilization of specific psychosocial factors as resources to cope with psychosocial stressors, high participant expectations that were not met by the intervention, insufficient time for structural changes, or the intervention prompting critical evaluations of the work environment. These findings will inform the design and implementation of the forthcoming clustered randomized controlled trial, where they will also be further investigated to validate their significance., (© 2024. The Author(s).)

Objectives: The literature is nonexistent on the assessment of overall fractions of diseases attributable to multiple dependent psychosocial work factors. The objectives of the study were to calculate the overall fractions of coronary heart diseases (CHD) and depression attributable to multiple dependent psychosocial work factors in 35 European countries., Methods: We used already published fractions of CHD and depression attributable to each of the following psychosocial work factors: job strain, effort-reward imbalance, job insecurity, long working hours, and workplace bullying. We took all exposures and their correlations into account to calculate overall attributable fractions. Wald tests were performed to test differences in these overall attributable fractions between genders and between countries., Results: The overall fractions of CHD and depression attributable to all studied psychosocial work factors together were found to be 8.1% [95% CI: 2.0-13.9] and 26.3% [95% CI: 16.2-35.5] respectively in the 35 European countries. There was no difference between genders and between countries., Conclusion: Our study showed that the overall fractions attributable to all studied psychosocial work factors were substantial especially for depression. These overall attributable fractions may be particularly useful to evaluate the burden and costs attributable to psychosocial work factors, and also to inform policies makers at European level., (© 2024. The Author(s).)

Purpose: The current study addressed work-related stress and burnout experienced by health care workers (HCWs) in Cairo University isolation hospital and its impact on the cognitive domain of their executive functioning., Methods: Arabic validated questionnaires of Beverly Potter for sources of work-related burnout and Maslach Burnout Inventory Human Services Survey for evaluation of burnout degree of 81 HCWs were used. Wisconsin Card Sorting Test was used to examine the HCWs cognitive executive functioning during hospital work and 2 weeks after home isolation., Results: A high degree of work-related stress was evident by a high score on Beverly questionnaire with a mean ± SD of (132.08 ± 12.573). A high degree of burnout was marked with a mean ± SD of (28.48 ± 6.622) for Emotional Exhaustion module, (31.85 ± 5.439) Personal Achievement, and (17.52 ± 6.707) Depersonalization. Health care workers experienced impairment of executive functioning in the form of increased total errors of Wisconsin Card Sorting Test during hospital shifts compared to 2 weeks after. There is a positive significant correlation between work-related stress level and Maslach Burnout Inventory and the total errors of Wisconsin Card Sorting Test results during the hospital stay (p =  < 0.001), as well as 2 weeks after (p =  < 0.001).This cognitive decline manifested in increased errors during HCWs' clinical work., Conclusions: Health care workers on the front line experienced a high degree of work-related stress in addition to burnout in the form of Emotional Exhaustion, Depersonalization, and reduced Personal Achievement. They also suffered from impaired cognitive executive functioning due to such stressful exposure., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Introduction: The implications of work-related stress among manufacturing workers were often unrecognised. The purpose of this study is to determine the effectiveness of the workplace health promotion (WHP) program in reducing depression, anxiety, and stress levels, as well as improving the overall quality of life among Malaysian manufacturing workers., Methods: The study used a randomised controlled trial (RCT) design and included 88 employees from a food and beverage manufacturing factory in Klang Valley, Malaysia. The intervention group received a comprehensive WHP program based on organisational and individual stress management programs that included (i) healthy mental health module, (ii) anxiety management technique, (iii) mindfulness for stress and (iv) stress at work. The module was delivered through the Occupational Stress Management Course and Employee Assistance Program. The control group received no further intervention other than a general brochure on stress. The study period consisted of an intervention period of 3 months followed by a post-intervention period of 3 months. Measurements were recorded at baseline and at 3 month post-intervention. Outcome measures included the self-perceived depression, anxiety, and stress (DASS-21), participant's quality of life (WHOQOL), coping skills (COPE-28) and job characteristics (JCQ)., Results: The intervention group demonstrated a significant reduction in self-perceived stress, anxiety, and depression scores three months post intervention (p ≤ 0.001). All domains of health-related quality of life and coping skills related to social support and problem-solving were significantly improved in the intervention group following the intervention (p < 0.001). In the control group, no significant changes were observed in all the parameters., Conclusion: WHP program shows promising results in improving mental health status, quality of life and coping skills among the manufacturing workers., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objectives: Several studies show that severe social stressors, e.g., in the form of exposure to workplace bullying in humans, is associated with negative mental health effects such as depression and anxiety among those targeted. However, the understanding of the underlying biological mechanisms that may explain the relationship between exposure to bullying and such negative health outcomes is scarce. The analyses presented here focus on understanding the role of the β 2 -adrenergic receptors (ADRB2) on this association., Methods: First, a resident-intruder paradigm was used to investigate changes in circulating norepinephrine (NE) in rat serum induced by repeated social defeat and its relationship with subsequent social behavior. Second, the direct effects of the stress-hormones NE and cortisol, i.e., synthetic dexamethasone (DEX), on the ADRB2 expression (qPCR) and monocyte chemoattractant protein-1 (MCP-1) release (immunoassay) was examined in cultured EL-1 cells. Third, in a probability sample of 1052 Norwegian employees, the 9-item short version of the Negative Acts Questionnaire-Revised (S-NAQ) inventory, Hopkins Symptom Checklist and genotyping (SNP TaqMan assay) were used to examine the association between social stress in the form of workplace bullying and anxiety moderated by the ADRB2 genotype (rs1042714) in humans., Results: The present study showed a clear association between reduced social interaction and increased level of circulating NE in rats previously exposed to repeated social defeat. Parallel cell culture work, which was performed to examine the direct effects of NE and DEX on ADRB2, demonstrated ADRB2 downregulation and MCP-1 upregulation in cultured EL-1 cells. Genotyping with regard to the ADRB2 genotype; rs1042714 CC vs CG/GG, on human saliva samples, showed that individuals with CC reported more anxiety following exposure to bullying behaviors as compared to the G carriers., Conclusion: We conclude that workplace bullying promotes anxiety and threaten well-being through an ADRB2 associated mechanism., (© 2021. The Author(s).)

Aim: The adverse impacts of exposure to work intensity on mental health have been widely studied. However, there is a lack of research examining who is most vulnerable in terms of position on the mental health distribution. The current study aims to: (a) initially estimate the average impacts of work intensity on workers' mental health in Australia, and then (b) estimate the extent to which this effect varies across the mental health distribution., Materials and Methods: The current study uses data from waves 2005--2017 of the Household Income and Labour Dynamics in Australia (HILDA) survey. It first employs Average Treatment Effect (ATE) to provide a baseline/average treatment effect for the whole population, and then applies Quantile Regression fixed effects models for various quantiles on the mental health distribution., Discussion and Conclusion: The baseline estimates show that there are significantly negative effects of work intensity on mental health for the whole population, but importantly the quantile fixed effect estimates show that these adverse effects are substantially stronger for those with the poorest mental health (i.e. at the bottom of the distribution). When ATE alone is estimated, the significant effect is averaged over the mental health distribution, missing important information regarding the heterogeneity of the effect. The findings have important implications for understanding and reducing mental health inequality, particularly inequality driven by workplace stress. First, they align with existing research demonstrating the importance of reducing psychosocial job stressors. Second, given workers with mental health problems were most susceptible to the adverse effects of work intensity, there is a need to offer additional support (and be sensitive of workloads) for this group in particular., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Purpose: To evaluate job satisfaction and perceived stress among radiology technicians in relation to sociodemographic and occupational risk factors., Methods: A total of 207 radiology technicians were included in this questionnaire-based study. The questionnaire elicited items on sociodemographic and occupational characteristics along with Minnesota Satisfaction Questionnaire (MSQ) and Perceived Stress (PSS) scales to assess job satisfaction and the perceived stress, respectively., Results: Multivariate analysis revealed that more years in practice (B: - 4.80, BCa 95% CI - 7.26 to - 2.47), being uncomfortable with working in a radiation environment (B: - 6.30, BCa 95% CI - 9.62 to - 2.61) and the use of public transport to get to work (B: - 3.62, BCa 95% CI - 6.53 to - 1.03) were significant predictors of poorer job satisfaction, whereas break time (B: 8.54, BCa 95% CI 4.63-12.14) and following scientific literature (B: 8.32, BCa 95% CI 3.37-12.89) significantly predicted the better job satisfaction. Being satisfied with the current job (p < 0.015) and high-income class (p = 0.005) were associated with lower perceived stress levels, while higher perceived stress level (B: - 0.48, BCa 95% CI - 0.66 to - 0.32) was also a significant predictor of poorer job satisfaction., Conclusion: In conclusion, our findings revealed job satisfaction and perceived stress of radiology technicians to be at moderate levels and to be negatively correlated with each other. Our findings emphasize the importance of continuing education, in-service refresh training and continuing practice of regularly updating self-knowledge along with balance workload, income and safety at work to improve job satisfaction among radiology technicians., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objective: To investigate an association between quality-adjusted life years (QALY) and work-related stressors (job strain, effort/reward imbalance, and poor support from supervisor and coworkers), and estimate loss in QALY caused by these stressors., Methods: A cross-sectional study investigated data from a third-wave survey (in December 2017) of a 2-year prospective cohort study of Japanese workers. At baseline (first-wave survey), 5000 participants were recruited from workers who registered with an internet survey company. A total of 2530 participants responded to the second-wave survey 1 year later. Participants were then further recruited to the third-wave survey. An online questionnaire collected information regarding health-related quality of life (measured by EQ-5D-5L), job strain, supervisor and coworker support (Brief Job Stress Questionnaire), effort/reward imbalance (Effort/reward Imbalance Questionnaire), and demographic variables (age, sex, education, occupation, work contract, smoking, and alcohol drinking). Multiple linear regression analysis of the QALY score calculated from responses to EQ-5D-5L was employed on standardized scores of the work-related stressors and adjusted for demographic variables (SPSS version 26)., Results: Data of 1986 participants were analyzed. Job strain (unstandardized coefficient, b =  - 0.013, p < 0.01) and effort/reward imbalance (b =  - 0.011, p < 0.01) and coworker support (b = 0017, p < 0.01) were significantly associated with QALY score in the fully adjusted model., Conclusion: Job strain, effort/reward imbalance, and poor coworker support may be associated with a reduced QALY score among workers. A substantial impairment in QALY associated with the work-related stressors indicates that workplace interventions targeting work-related stressors may be cost-effective., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Purpose: There is limited empirical evidence regarding mental health in workplace settings in Africa. Gold mining is a major industry in Ghana, and this study investigated mental health-related symptoms and the factors contributing to such symptoms among employees in the Ghanaian., Methods: A cross-sectional survey design study was used to collect data from employees working in the mining industry across five gold mines in Ghana. All mining employees were invited to participate in the survey. Sociodemographic and work characteristic data (including job content) was collected alongside measures of recent mental health-related symptoms (Kessler-10). Questionnaires were administered in English. Data were analysed using descriptive statistics and logistic regression models., Results: Of 1165 participants (response rate: 78%), 87% were male and 13% were female. The majority of the participants were in the 25-34 age category. Psychological distress was categorized as low (62.6%), moderate (24.3%), high (10.0%) and very high (3.2%). Shift type (working 12 h or more), physical working conditions and financial factors were significantly associated with psychological distress. Job resources and job demands was not significantly associated with levels of psychological distress., Conclusion: This is the first study to explore mental health in the Ghanaian gold mining industry. The findings identify workplace factors associated with psychological distress in the mining industry in Ghana and support the importance of promoting mental health as part of workplace health and safety strategy to improve mental health across the mining population., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Studies of previous pandemics indicate that healthcare workers have a high risk of developing symptoms related to mental health, especially depression, anxiety, and stress., Objective: To identify mental disorder symptoms among Brazilian healthcare workers during the Sars-Cov-2 pandemic and compare findings in different work categories., Methods: This was an online cross-sectional study. Information related to the pandemic and mental disorder symptoms was collected. The Depression, Anxiety, and Stress Scale and the Impact of Event Scale-revised were used. Associations were estimated by the chi-square test. The mean scores were compared among work categories with ANOVA (α = 5%) and the prevalence of symptoms was estimated., Results: 1,609 healthcare workers participated in the survey [mean age: 36.9 (SD = 11.6) years, women = 83.6%]. There was no association between work category and changes in mental health during the pandemic (p = 0.288) or prevalence of unsafe feeling (p = 0.218). A significant relationship was observed between maintaining work activities during the pandemic and work category (p < 0.001). Physicians had the lowest out-of-work prevalence (9.5%) while dentists had the highest (32.3%). Physicians and nurses showed the highest prevalence of in-person work routine. Psychologists presented the highest prevalence of remote work (64.0%) while dentists had the lowest (20.2%). A high prevalence of depression (D), anxiety (A), and stress (S) symptoms was observed in all professional categories (D: 57.2, 95% CI 48.3-66.1%; A: 46.20%, 95% CI = 37.2-55.2%; S: 55.80%, 95% CI = 46.8-64.8%), with physicians (D = 38.4%, A = 25.80%, S = 37.90%), psychologists (D = 50.2%, A = 39.0%, S = 43.1%), and nurses (D = 50.0%, A = 40.9%, S = 49.0%) having significantly lower scores. Psychologists had the lowest pandemic-related psychological impact (42.70%, 95% CI 36.8-48.6%)., Conclusion: Extreme changes in the work routine of dentists and psychologists and an overall high prevalence of mental symptoms due to the pandemic were found. Researchers should focus on gathering information that can identify workers at increased risk of mental illness to guide discussions and develop actions to minimize the harm of the pandemic. In addition, we suggest that healthcare and support systems urgently adopt mental health care measures with specialized professionals to protect the psychological well-being of the healthcare community.

Purpose: This study aimed to test if work unit characteristics (WUCs) reported by call-center managers were directly related to the psychological distress reported by call-handlers or if these associations were mediated by the psychosocial working conditions (PWC)., Methods: Managers of 105 call-centers were interviewed about their call-center's WUCs by occupational physicians. 2719 female call-handlers from these call-centers completed self-reported questionnaires to evaluate PWC (Karasek, Siegrist, and other specific workplace stressors) and psychological distress (GHQ12 score). A two-level analysis tested the relationships between the 14 WUCs and GHQ12 score, with and without adding PWC as confounders. Unchanged coefficients between WUCs and GHQ12 score were assumed to flag a direct association between WUCs and psychological distress. In the case of changed coefficients, the mediated proportion was estimated using multiple mixed models., Results: Five out of fourteen WUCs were related to GHQ12 score: outbound-call type, call-center size, number of activity parameters displayed on the screen, the existence of a fixed break, and the assigned role of the supervisor being the monitoring/supervision of call-handler activities. After adding PWC, the association remained statistically significant only for outbound calls. For the other WUCs, the proportion of mediation by stressor ranged from 56 to 66%. Mediation was mostly through job demand, lack of reward and ethical conflict dimensions., Conclusion: The main results were that (1) associations exist between the WUCs reported by managers and the psychological distress reported by call-handlers, and (2) that most of these associations are mediated by psychosocial working conditions.

Purpose: To assess the prevalence of poor mental health and of exposure to psychosocial risks among the working population in Spain in 2005, 2010 and 2016; to analyse the associations between workplace psychosocial exposures and mental health problems according to gender and occupation., Methods: Three representative samples of the Spanish working population were analysed, in 2005 (n = 7,023), 2010 (n = 4,979), and 2016 (n = 1,807). Prevalence ratios between mental health and the five dimensions - job demands, job control, social support, employment insecurity and insecurity over working conditions-were estimated using multilevel mixed-effects Poisson regressions. All the analyses were separated by gender and occupation., Results: In 2016, there were improvements in job control, job demands and social support, and deteriorations in employment insecurity and insecurity over working conditions. The risk of poor mental health among manual workers rose if they were exposed to high demands, low social support and high employment insecurity; among non-manual workers, the risk increased if they were exposed to high demands, low control, low social support and high insecurity over working conditions. There were no differences according to gender., Conclusion: The new findings shed light on the evolution of the working conditions and health of the wage-earning population in Spain over the last 11 years. The stratification by gender and occupational group is relevant, since it allows a detailed analysis of the social disparities in the associations between psychosocial risks and mental health. The most vulnerable groups can be identified and preventive measures developed at source.

Purpose: Job stress has proven to be a relevant cause of stress for adults, but its effect on the development of metabolic alterations in individuals with obesity is still poorly explored. We aimed to investigate the association between job stress and metabolically unhealthy obesity (MUO) phenotype in participants with obesity at the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) baseline assessment., Methods: This study analyzed data collected at the baseline examination between 2008 and 2010. A total of 2371 individuals with obesity were included. Two metabolic phenotypes were characterized based on the US National Health and Nutrition Examination Survey criteria. The job stress scale was based on the Brazilian version of the Swedish Demand-Control-Support Questionnaire. The association between job stress domains and MUO phenotype was assessed by binary logistic models., Results: In our sample, 1297 (54.7%) participants were women, mean age was 49.6 ± 7.1 years and 1696 (71.5%) had MUO. Low skill discretion was associated with MUO after adjustment for age, sex and race. However, in fully-adjusted models, the MUO phenotype was not associated with high job demand (odds ratio [OR] = 1.05; 95% confidence interval [95%CI] 0.82-1.35), low skill discretion (OR = 1.26; 95%CI 0.95-1.68), low decision authority (OR = 0.94; 95%CI 0.70-1.25) nor low social support (OR = 0.93; 95%CI 0.71-1.20)., Conclusion: We found a significant association between low skill discretion and an adverse metabolic profile in models adjusted for age, sex and race. No associations were significant between job stress domains and the metabolic profile of individuals with obesity in full models.

Objective: The current study's main objective was to measure the prevalence of psychological distress and its associated factors among Egyptian physicians during the COVID-19 pandemic. Perceived stressors and coping strategies were also explored., Methods: A cross-sectional study on 714 physicians was carried out using an online administered questionnaire. The questionnaire included sociodemographic and occupational data, data related to the current pandemic, Kessler psychological distress scale, and the brief resilient coping scale. Multivariable logistic regression analysis was performed to identify significant predictors., Results: About 50% of physicians had severe psychological distress. Among studied physicians, the significant predictors were being female, having a pre-existing illness, having an elderly family member, and being in close contact with a case (AOR 1.6, 1.6, 1.4 and 1.7, respectively). Meanwhile, significant occupational predictors were less experienced and frontline physicians (AOR 2.0 and 1.8, respectively). The most distressful concern was fear for families and personal health and safety, while religious coping was the most effective coping strategy., Conclusion: During the current pandemic, Egyptian physicians have a high prevalence of psychological distress. Frontline, low-experienced, female, previously ill physicians are more likely to have severe psychological distress. Therefore, psychological preparedness and psychological support services should be implemented and made easily accessible during pandemics.

Objective: Surface-acting emotional labor (SaEL) is the requirement to hide or suppress felt emotions to achieve acceptable job performance. It is a common feature of jobs featuring interactions with the public, such as customers or patients. Resulting emotional inauthenticity is associated with psychological strain, but there have been few prospective studies of mental health outcomes., Methods: A self-administered questionnaire was distributed in 24 skilled nursing facilities at baseline and 23 facilities 2 years later. Permanent full-time and part-time employees in all jobs were eligible to participate. Respondents in these analyses provided survey information on the frequency of SaEL at baseline and depressive symptoms on both occasions. Those without depression at baseline were deemed at risk. Multivariable logistic regression modeling estimated adjusted odds ratios (aOR) for SaEL, other job features, and demographic characteristics., Results: A total of 939 eligible participants had no depression at baseline; 15% developed depressive symptoms. About two-thirds were direct care providers, including 38% nursing and medical assistants. Adjusted for potential confounders, workers with intermediate and high SaEL had a higher risk (aORs around 2). Symptom onset was also predicted by high work-family conflict, younger age and low decision latitude at work., Conclusions: In this prospective study of long-term care workers, those who reported experiencing high SaEL at the time of the baseline survey were at higher risk of developing depressive symptoms 2 years later. Both exposure and outcome could have suffered some misclassification. Future studies should examine a broader range of strategies for coping with emotional labor demands.

Purpose: European policy measures have led to an increased net labour participation of older employees. Yet, via different routes (for instance disability schemes) employees still often leave the labour market early. Mental health may be an important factor hindering labour participation. Aims of this study are twofold: first, to examine the relationship between mental health-particularly depressive complaints-and indicators of labour participation among older employees over a 2-year follow-up period and second, to explore the impact of different work contexts when studying this relation., Methods: A subsample of older employees (aged > 45 years; n = 1253) from the Maastricht Cohort Study was studied. Depressive complaints were assessed using the Hospital Anxiety and Depression scale. Logistic and Cox regression analyses covered 2 years of follow-up and were also stratified for relevant work-related factors., Results: Employees with mild depressive complaints showed statistically significantly higher risks for poor mental workability (HR 2.60, 95% CI 1.14-5.92) and high psychological disengagement levels (HR 2.35, 95% CI 1.21-4.57) over time compared to employees without depressive complaints. Within various work contexts, for instance in which employees perform physically demanding work or have high psychological job demands, significantly stronger associations were found between depressive complaints and poor mental workability over time., Conclusions: This study shows strong longitudinal associations between depressive complaints and indicators of labour participation, also within different work contexts over time. Results provide valuable input for developing preventive measure aiming to enhance sustainable labour participation of older employees.

Purpose: Occupational stress in police call handlers is researched less frequently than in operational or frontline police, despite the role's unique challenges. Occupational stress is potentially manageable, thus improved understanding of its contributors and consequences is important for effective intervention. We aimed to compare levels and sources of organisational stress in police contact and dispatch personnel with UK benchmarks. Second, to test whether different typologies of stress were associated with physical health, mental health and substance use. Finally, to examine whether non-organisational factors (socio-demographic factors and family interference with work (FIW)) predicted organisational stress typologies., Methods: A sample (n = 720) of police and civilian staff in a UK police call and dispatch centre were surveyed., Results: The strongest sources of stress were competing and high demands, low control, insufficient managerial support and ambiguity surrounding workplace change-all of which indicated need for 'urgent action' according to UK benchmarks. Substance use and particularly mental health difficulties were higher than published norms. A latent profile analysis grouped respondents into a low-stress group and two high-stress profiles. As stress increased across profiles, this corresponded with worse physical and mental health and higher substance use. FIW predicted membership of both high-stress profiles., Conclusion: Despite non-operational roles, police contact and despatch personnel can experience high occupational stress which is associated with physical and mental health difficulties and substance use. Organisational-level interventions which address lack of control, conflicting role demands as well as enhance management support and communication around change might be most effective in this group.

Objective: Need for recovery is a predictor of work stress and health problems, but its underlying factors are not yet well understood. We aimed to identify hearing-related, work-related, and personal factors influencing need for recovery in hearing-impaired employees., Methods: We retrospectively identified hearing-impaired employees (N = 294) that were referred to the Amsterdam University Medical Center between 2004 and 2019. Routinely obtained healthcare data were used, including a survey and hearing assessments. A directed acyclic graph was constructed, revealing the hypothesized structure of factors influencing need for recovery as well as the minimal set of factors needed for multiple regression analysis., Results: Four variables were included in the regression analysis. In total, 46.1% of the variance in need for recovery was explained by the factors feeling that something should change at work (B = 19.01, p < 0.001), self-perceived listening effort (B = 1.84, p < 0.001), personal adaptations scale score (B = - 0.34, p < .001), and having a moderate/poor general health condition (B = 20.06, p < 0.001). Although degree of hearing loss was associated with self-perceived listening effort, the direct association between degree of hearing loss and need for recovery was not significant., Conclusions: The results suggest that the way employees perceive their hearing loss and how they cope with it directly influence need for recovery, rather than their measured degree of hearing loss. Additionally, general health condition was found to be an independent factor for need for recovery. The results should be confirmed by future, longitudinal research.

Purpose: Research shows that psychosocial factors play a significant role in the emergence of musculoskeletal complaints (MSC). The aim of this study was to determine the long-term effects on unspecific MSC by a combined physiotherapy and coaching intervention compared to physiotherapy alone. The coaching intervention focussed on enabling better strategies for coping with work stressors., Methods: The participants of a previous randomized controlled intervention were invited to participate again in a third follow-up survey 22 months after the end of the intervention. In 2014, 65 nurses completed a 10-week personalised physiotherapy. Additionally, the intervention group (n = 33) passed five individual coaching sessions, plus an opening and closing session. 44 nurses (IG: n = 24; CG: n = 20) passed again a physical examination as well as another questionnaire assessment in 2016. The primary outcome was MSC, secondary outcomes were work ability and work-related well-being. Due to missing data, multiple imputations were conducted using the mice package in R. Data were analysed by ANOVA with two-way repeated measures, t tests for independent samples and Chi-squared tests., Results: In respect of MSC, stronger improvement of movement in the vertebral column was observed in the IG compared to the CG. No differences between the IG and CG regarding other long-term effects were observed., Conclusions: The results suggest that the combined intervention of work-related coaching and physiotherapy had only a marginally stronger long-term effect with respect to MSC than physiotherapy alone.

Purpose: There is increasing interest in the use of heart rate variability (HRV) as an objective measurement of mental stress in the surgical setting. To identify areas of improvement, the aim of our study was to review current use of HRV measurements in the surgical setting, evaluate the different methods used for the analysis of HRV, and to assess whether HRV is being measured correctly., Methods: A systematic review was performed according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). 17 studies regarding HRV as a measurement of mental stress in the surgical setting were included and analysed., Results: 24% of the studies performed long-term measurements (24 h and longer) to assess the long-term effects of and recovery from mental stress. In 24% of the studies, artefact correction took place., Conclusions: HRV showed to be a good objective assessment method of stress induced in the workplace environment: it was able to pinpoint stressors during operations, determine which operating techniques induced most stress for surgeons, and indicate differences in stress levels between performing and assisting surgery. For future research, this review recommends using singular guidelines to standardize research, and performing artefact correction. This will improve further evaluation of the long-term effects of mental stress and its recovery.

Purpose: There is no review on the effect of work-related stressors on mental health of young workers. We systematically reviewed epidemiological evidence on this relationship., Methods: The review searched eight databases: Embase, PubMed, Web of Science, Cinahl, Cochrane Library, Informit, PsycINFO, and Scopus from their respective start dates until May 2017. Studies that have examined a mental health outcome in relation to a work-related stressor as exposure in young workers were included. The review was reported based on the PRISMA statement., Results: Three cross-sectional studies and six longitudinal cohort studies were included. Cross-sectional evidence showed that adverse work conditions including working overtime, job boredom, low skill variety, low autonomy, high job insecurity, and lack of reward were associated with poor mental health of young workers. Longitudinal evidence showed that high job demands, low job control, effort-reward imbalance, and low work support (men only) were associated with poor mental health. There was evidence on the contemporaneous relationship between two or more adverse work conditions and poor mental health., Conclusions: Although more research (particularly high-quality longitudinal studies) is warranted in this area, our review indicates that work-related stressors have a negative impact on the mental health of young workers. The current review suggests that workplace interventions and policy are required to improve the quality of work for young workers.

Purpose: Little is known about the work environmental risk factors for opioid use disorder (OUD) in working populations. The purpose of this study is to examine whether adverse physical and psychosocial working conditions are associated with OUD in a working population of the United States (US)., Methods: Among the participants of the National Survey of Midlife Development in the United States (MIDUS) II Study (2004-2006), 2134 workers (1059 men and 1075 women; mean age, 51 years) were chosen for this study. OUD was measured with self-administered questions in line with the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSD-5). Physical demands (physical efforts, heavy lifting, and crouching/stooping/kneeling) and psychosocial work stressors (skill discretion, decision authority, job control, psychological job demands, supervisor and coworker support at work, job insecurity, and work hours) were measured with a standard questionnaire., Results: The prevalence of OUD was 3.8%. In multivariate analyses, low skill discretion, high psychological job demands, job strain (a combination of low control and high demands), and high physical job demands were significantly associated with OUD. The multivariate prevalence ratios for OUD by job strain and frequent heavy lifting were 1.98 (1.27-3.10) and 2.23 (1.22-4.10), respectively. Job strain was more strongly associated with OUD in men, while high physical job demands were more strongly associated with OUD in women., Conclusion: This study implies that adverse physical and psychosocial working conditions may be important risk factors for OUD in US working populations. Future longitudinal and mechanistic studies are urgently warranted.

Objectives: Individuals with reduced nocturnal blood pressure (BP) dipping are at increased risk of cardiovascular disease compared to persons with normal BP dipping. Although the relation of work-related factors and BP has been studied extensively, very little is known of the association between work-related factors and 24-h BP patterns in aging workers. We examined the cross-sectional relation of work-related risk factors, including occupational status, work-time mode, job demands and job control, with ambulatory BP in aging workers, focusing on nocturnal BP dipping., Methods: 208 workers (mean age 62 ± 3 years; 75% women) from two Finnish population-based cohort studies underwent 24-h ambulatory BP monitoring. Work-related factors were inquired using a questionnaire. Nocturnal BP dipping was calculated as [1 - (asleep BP/awake BP)] × 100., Results: Shift workers demonstrated a higher nocturnal diastolic BP dipping than regular day workers (19% vs. 17%, p = 0.03) and had a significantly higher systolic awake BP than regular day workers (136.5 mmHg vs. 132.5 mmHg, p = 0.03). Participants with high job demands demonstrated a smaller nocturnal systolic BP dipping than participants with low job demands (14% vs. 16%, p = 0.04). We did not observe significant differences in nocturnal systolic or diastolic BP dipping between groups categorized by occupational status or job control., Conclusions: Although shift workers have a higher daytime BP than regular daytime workers, they exhibit greater nighttime BP dipping. Participants with high job demand had smaller nighttime BP dipping than participants with low job demand. Job control or occupation did not affect the 24-h ambulatory BP profile of aging workers.

Purpose: The aim of this study was to identify gender- and age-specific occupational stress associated with depressive symptoms among Korean employees., Methods: Data of 73,014 employees aged 18 and above who had undergone comprehensive health examinations at Kangbuk Samsung Hospital Health Screening Center, South Korea, in January 2012 and who were followed up until December 2017 were collected, and 63,959 (participation rate: 87.59%, men: 50,413, women: 13,546) were finally analyzed. A Cox proportional hazards model was used to estimate the hazard ratios and 95% confidence intervals of the relationship between occupational stress and depressive symptoms. In light of gender and age differences in the association between occupational stress and depressive symptoms, interaction and stratification by gender and age groups were tested., Results: During 238,630 person-years of follow-up, case-level depressive symptoms developed in 4227 participants (an incident rate of 1.8%). There were gender differences in the relationship between job stress and incident depressive symptoms. For men, high job demand, job insecurity, lack of reward, and discomfort in their organizational climate were associated with incident depressive symptoms in all age groups. Insufficient job control was associated with the development of depressive symptoms only in midlife and organizational injustice only in early adulthood. For women, the results for high job demand, organizational injustice, and discomfort in an organizational climate were associated with the onset of depressive symptoms from early adulthood to the midlife decade., Conclusion: The results suggest gender and age differences in the relationship between occupational stress and incident depressive symptoms.

Introduction: Up to date, there has been little research about the acute stress load of emergency physicians of the Helicopter Emergency Medical Service (HEMS). Therefore, this study investigates the physiological stress level between an air-rescue day, a clinic day, and a day off (control day). Furthermore, phases of activity and resting were compared to assess the activity of the autonomic nervous system (ANS)., Methods: In this field study (within-subjects design), heart rate variability (HRV) and self-perceived stress levels were monitored on an air-rescue day, a clinic day, and a control day of 20 HEMS EPs [three females, 17 males; age: mean (M) = 44.95, standard deviation (SD) = 4.80]., Results: When comparing the activity phases, significant differences were found for HR and HRV. The highest HR was found on the air-rescue day during the phase of landing at the operation site with M = 107.30 bpm (SD = 22.66 bpm), which was significantly higher than during activity phases of the clinic day (M = 88.28 bpm, SD = 11.81 bpm) and the control day (M = 83.28 bpm, SD = 14.83 bpm). The SDNN is significantly higher on the air-rescue day for the phase before the alarm (M = 72.23 ms, SD = 38.60 ms), the phase of the alarm (M = 77.52 ms, SD = 40.52 ms), and the average of all phases (M = 60.04 ms, SD = 34.07 ms) than on the clinic day (M = 38.42 ms, SD = 15.16 ms) and the control day, where the lowest value was reached (M = 39.11 ms, SD = 17.65 ms). The highest LF/HF was found during activity phases of the clinic day with M = 1281.84% (SD = 587.33%), which was significantly higher than the first five phases of the emergency operations and the average of all phases of the emergency operations of the air-rescue day, where a maximum of M = 896.57 ms (SD = 681.79 ms) during the phase before the alarm and a minimum of M = 764.69 ms (SD = 372.28 ms) during the phase of landing at the operation site. The lowest LF/HF for all testing days was found during the activity phases of the control day with M = 693.74% (SD = 404.73%). Overall, 60 observations were analyzed. In the psychological assessment, on average, the EPs shows lower values than the norm sample., Discussion: In the comparison of the activity phases, significant effects were found on the clinic day and during the phases of the emergency operations of the air-rescue day for the HR and HRV. Hereby, a significant activation of the EPs ANS and an outweigh of the sympathetic nervous system could be shown, whereby the subjective stress load was reported mainly as low. For the resting phases, no significant differences were found between all testing days. We interpret this as a good sign for the ability of regeneration between the phases of high stress load.

Purpose: The study had three aims. We investigated, first, how six recovery experiences (i.e., detachment, relaxation, control, mastery, meaning, and affiliation) during off-job time suggested by the DRAMMA model (Newman et al. in J Happiness Stud 15(3):555-578. https://doi.org/10.1007/s10902-013-9435-x, 2014) are related to well-being (i.e., vitality, life satisfaction, and work ability). Second, we examined how age related to these outcomes, and third, we investigated whether age moderated the relationships between recovery experiences and well-being outcomes., Methods: A sample of 909 Finnish teachers responded to an electronic questionnaire (78% women, average age 51 years). The data were analyzed with moderated hierarchical regression analyses., Results: Detachment from work, relaxation, control, and mastery were associated with higher vitality. Detachment, relaxation, meaning, and affiliation were related to higher life satisfaction. Older age was related to lower work ability, but not to vitality or life satisfaction. Older teachers benefited more from control and mastery during off-job time than did younger teachers in terms of vitality, whereas younger teachers benefited more from relaxation in terms of all well-being outcomes., Conclusions: Detachment, relaxation, control, mastery, meaning, and affiliation during off-job time were related to higher well-being, supporting the DRAMMA model. Age moderated the relationships between control, mastery, and relaxation and vitality and life satisfaction. The role of aging in recovery from work needs further research.

Objective: To examine three levels of need for recovery (NFR) after work in relation to effort from work demands, demand compensatory strategies, effort-moderating or -reversing resources, and health including health behaviors. A further purpose was to examine occupational characteristics determining NFR., Methods: 5000 engineers, carpenters, nurses, and home care nurses were invited to participate. NFR k-means clusters were calculated from 1289 participants. The effect from three levels of NFR regarding demands, compensatory strategies, resources at work, health, and health behaviors was examined using analysis of variance (ANOVA) and post hoc analysis. Prevalence ratios (PRs) of suboptimal health for three levels of NFR were calculated using Poisson regression. Linear stepwise multiple regression predictors explaining NFR were examined also occupation wise., Results: NFR centroids at 5.8/33, 13.1/33, and 21.0/33 points were identified. ANOVA showed corresponding effects from NFR levels on work demands and compensatory strategies. The inversed proportion concerned levels of resources at work. Only the low NFR cluster negated regular health effects. The other two cluster groups also repeatedly worked while ill and presented PRs concerning health effects from 1.9 to 3.9 when compared to the low NFR group. Making good quality work, recovery opportunities, and thinking of work when off work were the most important predictors of NFR among 1289 participants with also occupation-wise interpretable profiles., Conclusions: Three levels of NFR meant corresponding levels of work demands, work-demand compensatory strategies, and unfavorable health behaviors. An inversed proportion of resources related to the same levels of NFR. Low NFR meant no regular health effects which could guide limit values regarding salutary NFR. Important predictors of NFR were resources making a good quality work, recovery opportunities, and reversely effort from rumination when off work. Occupation-wise predictors could guide interventions.

Purpose: To examine cross-sectional and longitudinal associations between content-related emotional demands at work and exhaustion, and to investigate if these associations were modified by other psychosocial work characteristics., Methods: In 2007, 4489 Danish public service employees participated in the PRISME study by completing postal questionnaires, and 3224 participated in the follow-up in 2009. Content-related emotional demands were measured by a scale (scored 1 to 5) based on five work-content-related items, and exhaustion was measured with the general exhaustion scale from the Copenhagen Burnout Inventory (CBI) (scored 1 to 5). The cross-sectional and longitudinal associations with exhaustion were analysed in the same model and adjusted for effects of potential confounders. Effect modifications were examined separately for self-reported emotional enrichment, meaningful work, job control, social support at work and quantitative demands., Results: Exhaustion increased with increasing emotional demands, both cross-sectionally and longitudinally. However, although statistically significant, the effect was small. In the longitudinal analysis, a one unit increase in emotional demands was associated with a 0.03 unit (95% CI: 0.01-0.06) increase in exhaustion. We found statistically significant effect modification for three of six potentially modifying work characteristics. The effect of emotional demands on exhaustion was lower for participants with high levels of emotional enrichment (cross-sectionally and longitudinally), high levels of meaningful work (longitudinally), and higher for high levels of quantitative demands (cross-sectionally)., Conclusions: Increasing content-related emotional demands were associated with increasing levels of exhaustion, cross-sectionally and longitudinally. This effect was reduced if the work was experienced as emotionally enriching and meaningful.

Purpose: The effort-reward imbalance (ERI) model includes extrinsic and intrinsic aspects of work stress. The single components, ERI and overcommitment (OC), are known to be associated with mental health. The aim of this study was to test whether OC is a mediator of the association between ERI and mental health., Methods: Longitudinal analyses were conducted using data from the Third German Sociomedical Panel of Employees on German employees aged 40-54 years. The short version of the ERI questionnaire was used to measure ERI and OC at baseline (2013). Outcomes were mental health problems and self-rated mental health (5-Item Mental Health Inventory) in 2015. Multivariate regressions were conducted controlling for sociodemographics, health-related behaviour, job-related aspects, and mental health at baseline., Results: A total of 912 men and 1148 women were included in the final analysis. Baseline OC was positively associated with follow-up mental health problems and negatively with self-rated follow-up mental health. While there was no direct effect of ERI on mental health, ERI affected mental health problems (b = 0.14; 95% CI 0.03 to 0.25) and self-rated mental health (b = - 1.15; 95% CI - 1.79 to - 0.57) indirectly through OC., Conclusions: OC was associated with reduced mental health. There was no association between ERI and mental health that was independent of OC. OC could therefore be interpreted as a mediator between ERI and mental health. Future studies are needed to test the causality of this association.

Purpose: Despite its importance a comprehensive assessment of health functioning has rarely been included in epidemiological investigations of work-related health outcomes. In this study, we analyzed associations of a health-adverse psychosocial work environment with a comprehensive set of subjective and objective measures of health functioning that cover the three domains of affective, cognitive, and physical functioning., Methods: Baseline data from the French CONSTANCES cohort study were used with a sample of 24,327 employed men and women aged 45-60. Psychosocial work environment was measured by the short version of the effort-reward imbalance (ERI) questionnaire. Measures of health functioning were depressive symptoms, semantic fluency, verbal memory, walking speed, standing balance and lung function., Results: First, we replicated main psychometric properties of the ERI questionnaire in the French cohort. Second, ERI scales revealed consistent associations with depressive symptoms, but less consistent links to cognitive and physical function. Among men, we observed an association of stressful work with reduced lung function., Conclusions: This study demonstrated consistent associations of stressful work in terms of effort-reward imbalance with affective functioning in a large sample of male and female employees. Relationships with physical functioning were less consistent and restricted to men, and cognitive functioning was only marginally associated with stressful work. We also established the psychometric properties of the French short version of the ERI questionnaire, thus offering a tool for guiding and harmonizing further research in this field.

Purpose: Work-related psychosocial risks are an increasingly important issue in occupational safety and health (OSH) policy. In Germany, as in many other European countries, employers are legally required to carry out workplace risk assessments (WRAs) and to account for psychosocial factors when doing this. The aim of this study was to expand the still scarce and sketchy empirical evidence on the extent to which employers comply with these obligations, as well as on possible determinants of compliance behaviour., Methods: Survey data from 6500 German companies were used to calculate the prevalence of workplace risk assessments that include psychosocial factors. Furthermore, multinomial logistic regressions were performed to explore which company characteristics influence the chance of psychosocial risk assessment occurrence., Results: The prevalence of psychosocial risk assessments was 21%. Next to company size (OR = 5.7, 95% CI 3.0-11.0), availability of safety specialist assistance (OR = 3.5, 95% CI 2.6-4.6), availability of occupational health specialist assistance (OR = 3.4; 95% CI 2.6-4.4) and inspection by OSH authority (OR = 3.4, 95% CI 2.4-4.7) were the strongest predictors of psychosocial risk assessment occurrence. Smaller (but still significant) effect sizes were found for the level of knowledge about legal OSH requirements, training of managers in OSH, economic situation of the company, presence of a works council, positive view on the benefit of OSH, affiliation with the production sector and magnitude of psychosocial risks within the company., Conclusions: The study results indicate large deficiencies in the implementation of psychosocial risk assessments, especially for small companies. Findings suggest that enhancing companies' utilisation of professional OSH experts and strengthening the advisory and control capacities of the OSH inspection authorities in the area of psychosocial risks would be beneficial for improving the current situation.

Objectives: To examine the associations between exposure to work-related violence and threats and subsequent PTSD among males and females in four high-risk occupations in human service work. Furthermore, we examined the modifying effect of coping style and self-efficacy., Methods: Questionnaire data were collected in 2011 and in 2015 from 2678 employees working in psychiatric wards, in the elder sector, in special schools and in the Prison and Probation Service (PPS). Exposure to work-related violence and threats was measured in 2011, while PTSD was measured in 2011 and 2015 by the Impact of Event Scale-Revised. To assess the associations, logistic regression was conducted, adjusted for bullying, sexual harassment, negative acts, conflicts at work, other private traumas and baseline PTSD., Results: There was an association between work-related threats and PTSD in 2011 and 2015. Furthermore, there was an association between work-related violence and PTSD in 2011. The associations were strongest in the PPS. Male staff had a higher risk for PTSD. Neither coping style nor self-efficacy did modify the associations between exposure to work-related violence and threats and subsequent PTSD., Conclusion: The prevention of PTSD following work-related violence and threats should first of all be based on reducing the risk of work-related violence. In addition, supervisors should be trained to detect symptoms of PTSD after exposure to traumatic events.

Purpose: Only a few studies have investigated the impact of negative aspects of social relations on cognitive function, and they have shown mixed results. Conflicts at work are part of the negative aspects of social relations, but the impact of experiencing conflicts at work has not yet been investigated as a risk factor for dementia. Therefore, we investigated whether experiencing prolonged or serious conflicts with a supervisor or colleagues at work was associated with incident dementia in old age., Methods: We analyzed data of 6,436 men and women from the third survey of the Copenhagen City Heart Study. At baseline in 1991-1994, the participants reported whether they had ever had a prolonged or serious conflict at work. The participants were followed until 2014. We used Poisson regression to estimate incidence rate ratios (IRR) and their 95% confidence intervals (CI)., Results: After adjusting for potential confounders, the IRR for dementia was 1.53 (95% CI 0.77-3.03) among participants who had reported having prolonged or serious conflicts both with a supervisor and colleagues compared with participants who had never had such conflicts. In separate analyses stratified by sex, the IRRs were 2.14 (95% Cl 0.97-4.71) for men and 0.98 (95% Cl 0.29-3.32) for women., Conclusions: Our findings did not support an overall association between experiencing prolonged or serious conflicts at work and incident dementia. However, because of the large differences in the point estimates for men and women, future research could aim at investigating potential sex differences regarding the association between conflicts at work and dementia.

Purpose: This study aimed to examine effects of persistence or change in job insecurity on psychological distress (PD) among Japanese community dwellers., Methods: The sample comprised 889 men and 762 women aged 25-50 years who were employed and completed both wave 1 (2010) and wave 2 (2012) surveys of the Japanese Study on Stratification, Health, Income, and Neighborhood (J-SHINE). Job insecurity, a perception of threat of job loss, was self-reported in both waves to define persistence and change of the status. Logistic regression analysis was performed to compare PD (K6 score ≥ 5) at wave 2 for employees whose job security changed or who remained insecure with that of those who remained secure., Results: Persistent job insecurity was associated with PD (for men, OR 1.64, 95% CI 1.03-2.63; for women OR 1.65, 95% CI 1.02-2.65), after adjustment for confounders. Additionally, change from secure to insecure perception was also associated with PD in men, while change from insecure to secure was associated with PD in women. Regardless of gender, these effects were observable among workers with children but not among those without children., Conclusions: Persistent job insecurity and change in job insecurity has adverse effects on PD, especially for workers with children. Gender differences in the effects of change in job security on PD might be explained by the social norms of gender roles and labor market gender segregation. Policy makers should consider dependent family and gender inequalities when developing policies to reduce job insecurity and its negative health effects.

Purpose: Many companies target international markets to expand their business. Companies need to manage international teams with a wide variety of skills, knowledge and values to run their business effectively; however, there are many issues of acculturation stress. Not only business travellers and expatriates, but also immigrant workers have issues adjusting to foreign culture. The aim of the present study is to identify the stress factors affecting foreign-born workers via a systematic review., Methods: The systematic review was conducted using PubMed, PsycINFO, Embase and Cochrane Library databases. Articles on the subject of workers living abroad, such as immigrants, expatriates and business travellers, were included. The risk of bias in the included articles was assessed using the Cochrane Collaboration's tool for assessing risk of bias for randomised controlled trials (RCTs), RoBANS for non-RCT studies, and CASP for qualitative studies., Results: For the systematic review, 45 out of 14,994 articles were analysed. Six components, communication, cultural differences in the workplace, daily life, relationships with family and colleagues, financial problems and social inequality, were extracted., Conclusion: Foreign-born workers are suffering from acculturation and occupational stress. The results of the present study can help greatly with understanding of the stress structure of working abroad.

Purpose: To investigate whether chronic psychosocial work stressors (low job control, high job demands, job strain, low supervisor and coworker support, job insecurity, and long work hours) are longitudinally associated with suicidal ideation in a working population., Methods: Five-hundred seventy-eight workers (aged 34-69) were chosen for this analysis from those who participated in both project 1 (2004-2006 at baseline) and project 4 (2004-2009 at follow-up) of the Midlife Development in the United States II study. The median time interval between the two projects was 26 months (range 2-62 months)., Results: About 11% of the workers reported suicidal ideation at follow-up, while 3% of them reported moderate/severe suicidal ideation at follow-up. After controlling for age, marital status, race, family history of suicide, and suicidal ideation at baseline, low skill discretion and job strain (a combination of low job control and high job demands) were associated with total suicidal ideation. After excluding those with suicidal ideation at baseline from analysis and further controlling for other work stressors, job strain was strongly associated with moderate/severe suicidal ideation: ORs, 4.29 (1.30-14.15) for quartile-based job strain and 3.77 (1.21-11.70) for median-based job strain. Long work hours (> 40 h/week vs. ≤ 40 h/week) also increased the likelihood for moderate/severe suicidal ideation: OR 4.06 (1.08-15.19)., Conclusions: Job strain and long work hours were longitudinally associated with moderate/severe suicidal ideation. Increasing job control and ensuring optimal level of work demands, including 40 h or less of work per week may be an important strategy for the prevention of suicide in working populations.

Purpose: We investigated prospective associations between mental illness and psychosocial employment quality using a nationally representative sample of the French working population by gender, primary diagnosis, and age of onset., Methods: 6234 employed French adults (aged 20-74 years) were followed from 2006 to 2010. All respondents provided data on 26 indicators of psychosocial employment quality drawn from the Job-Strain Model, other job stressors, and indicators of working time stressors (i.e., shift work, night work, and long working hours)., Results: We performed 272 statistical tests, of which 37 were significant following adjustment for age, poor socio-economic position during childhood, unemployment status at wave one, and anxiety or depression at wave two. Females with a lifetime diagnosis of any mental illness reported higher psychological and emotional demands at work, whilst males reported low decision latitude, tensions with the public, and work-life imbalance. In both genders a lifetime diagnosis of any mental illness was associated with role and ethical conflict. A lifetime diagnosis of major depression appeared to have stronger associations for females, whilst substance use disorder was associated with poorer psychosocial employment quality in males. Adolescent-onset mental illness might be associated with poorer psychosocial employment quality among men more so than among women., Conclusions: Results suggest that people with a history of mental illness who obtain employment tend to be employed in jobs characterized by poor psychosocial quality. Employment quality should be considered in vocational rehabilitation policies and practices aimed at optimizing employment participation in this population.

Purpose: Randomized controlled trials (RCTs) of interventions aimed at reducing work-related stress indicate that cognitive behavioural therapy (CBT) is more effective than other interventions. However, definitions of study populations are often unclear and there is a lack of interventions targeting both the individual and the workplace. The aim of this study was to determine whether a stress management intervention combining individual CBT and a workplace focus is superior to no treatment in the reduction of perceived stress and stress symptoms and time to lasting return to work (RTW) in a clinical sample., Methods: Patients with work-related stress reactions or adjustment disorders were randomly assigned to an intervention group (n = 57, 84.2% female) or a control group (n = 80, 83.8% female). Subjects were followed via questionnaires and register data. The intervention contained individual CBT and the offer of a workplace meeting. We examined intervention effects by analysing group differences in score changes on the Perceived Stress Scale (PSS-10) and the General Health Questionnaire (GHQ-30). We also tested if intervention led to faster lasting RTW., Results: Mean baseline values of PSS were 24.79 in the intervention group and 23.26 in the control group while the corresponding values for GHQ were 21.3 and 20.27, respectively. There was a significant effect of time. 10 months after baseline, both groups reported less perceived stress and improved mental health. 4 months after baseline, we found significant treatment effects for both perceived stress and mental health. The difference in mean change in PSS after 4 months was - 3.09 (- 5.47, - 0.72), while for GHQ it was - 3.91 (- 7.15, - 0.68). There were no group differences in RTW., Conclusions: The intervention led to faster reductions in perceived stress and stress symptoms amongst patients with work-related stress reactions and adjustment disorders. 6 months after the intervention ended there were no longer differences between the groups.

Objectives: The objectives of the study were to construct a job-exposure matrix (JEM) for psychosocial work factors of the job strain model, to evaluate its validity, and to compare the results over time., Methods: The study was based on national representative data of the French working population with samples of 46,962 employees (2010 SUMER survey) and 24,486 employees (2003 SUMER survey). Psychosocial work factors included the job strain model factors (Job Content Questionnaire): psychological demands, decision latitude, social support, job strain and iso-strain. Job title was defined by three variables: occupation and economic activity coded using standard classifications, and company size. A JEM was constructed using a segmentation method (Classification and Regression Tree-CART) and cross-validation., Results: The best quality JEM was found using occupation and company size for social support. For decision latitude and psychological demands, there was not much difference using occupation and company size with or without economic activity. The validity of the JEM estimates was higher for decision latitude, job strain and iso-strain, and lower for social support and psychological demands. Differential changes over time were observed for psychosocial work factors according to occupation, economic activity and company size., Conclusions: This study demonstrated that company size in addition to occupation may improve the validity of JEMs for psychosocial work factors. These matrices may be time-dependent and may need to be updated over time. More research is needed to assess the validity of JEMs given that these matrices may be able to provide exposure assessments to study a range of health outcomes.

Purpose: To examine the effectiveness of an intervention in the workplace designed to reduce job insecurity among employees affected by organizational change., Methods: Supervisors were randomly allocated to an intervention (IG) or waiting-list-control group (CG) and the intervention was administered over a period of 3 months, comprising six group sessions. N = 103 supervisors and their team members (mean age 41.80 ± 9.60 years, 60.19% male) provided data prior to (t0) and 3 months post-intervention (t1) by means of questionnaires and hair samples. Job insecurity (COPSOQ), mental health (HADS) and somatic health (GBB, hair cortisol concentration) were measured., Results: Job insecurity was reduced to a marginally significant degree in the IG compared to the CG at t1 (B = - 5.78, p = .06, CI [- 11.73, 0.17]). Differential effects for supervisors and team members were not found. No effects on health could be observed overall in the IG, but supervisors in the IG reported a significant decrease in exhaustion tendency (B = - 0.92, p = 0.01, CI [- 1.64, - 0.20]) and a non-significant trend towards higher levels of anxiety (B = 2.98, p = 0.10, CI [- 0.57, 6.54]) compared to team members., Conclusions: This is the first study to provide some evidence for the effectiveness of an intervention that aimed at reducing job insecurity during organizational change. Health-related effects were observed in supervisors but not in team members. Further intervention studies are needed to add to the current knowledge base.

Objectives: Emerging cross-sectional research has identified lack of supportive leadership behavior (SLB) as a risk factor for workforce health. However, prospective evidence is hitherto lacking. SLB denotes support in difficult situations, recognition and feedback on work tasks. This study aims to determine the effect of SLB on suboptimal self-rated health (SRH) after 10 years considering potential moderators such as ages, sex, occupation and job strain., Methods: The sample included 884 employed participants drawn from the population-based prospective MONICA/KORA Study. SLB, SRH, as well as job strain were assessed by questionnaire. Logistic regressions estimated odds ratios (ORs) and corresponding 95% confidence intervals (CIs) for the effect of SLB at baseline on suboptimal SRH at follow-up. Analyses were adjusted for age, gender, lifestyle (alcohol, smoking, physical activity), socioeconomic status as well as for SRH and job strain at baseline., Results: Lack of SLB was associated with suboptimal SRH at baseline [OR 2.00, (95% CI 1.19-3.46)] and at follow-up [OR 2.33, (95% CI 1.40-3.89)]. Additional adjustment for job strain did not substantially alter this association [OR 2.06, (95% CI 1.20-3.52)]. However, interactions between SLB and job strain as well as gender became evident, indicating moderating influences on the association between SLB and SRH., Conclusion: Lack of supportive leadership was associated with suboptimal SRH at 10 years' follow-up in men, even if SRH at baseline and other risk factors were taken into account. This effect is likely to be moderated by job strain.

Background: Numerous epidemiological studies among health care staff have documented associations of adverse psychosocial working conditions with poorer health-related outcomes, a reduced quality of patient care and intentions to leave the profession. The evidence for physician assistants in Germany remains limited though., Methods: We surveyed a total of 994 physician assistants between September 2016 and April 2017. Psychosocial working conditions were measured by the established effort-reward imbalance (ERI) questionnaire and by a questionnaire specifically developed to capture psychosocial working conditions among physicians. Health outcomes (i.e., self-rated health, depression, anxiety), self-rated quality of care and the intention to leave the profession were assessed by established measures. We ran multivariable logistic regression analyses., Results: The prevalence of work stress in terms of ERI equalled 73.77%. Work stress according to the ERI model was associated with significantly poorer self-rated health [odds ratio (OR) 3.62], elevated symptoms of depression (OR 8.83) and anxiety (OR 4.95), poorer quality of care (OR for medical errors 4.04; OR for interference of work with patient care 3.88) and an increased intention to leave one's current profession (OR 3.74). The PA-specific questionnaire showed similar, albeit weaker, associations (all ORs > 1.22)., Conclusions: Our results are in line with previous findings among health care staff and provide specific and novel evidence for physician assistants. Interventions aiming at the improvement of working conditions seem needed given their potential adverse consequences in terms of employee health, quality of care, and personnel policy.