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Objective: Evaluate the effect of the Quebec Healthy Enterprise Standard (QHES) on adverse physical and psychosocial work factors and work-related musculoskeletal problems (WMSP). Methods: Workers of ten organizations completed questionnaires before (n=2849) and 2-3 years following (n=2560) QHES implementation. Outcomes were assessed using validated instruments. Results: Workers exposed to adverse physical and psychosocial work factors had a higher prevalence of WMSP. After interventions, the prevalences of one adverse physical and three adverse psychosocial work factors were lower among workers exposed to interventions. Among men exposed to physical and psychosocial interventions, the lower prevalence of neck WMSP is compatible with a beneficial intervention effect. Other results generally showed few effects on WMSP. Conclusions: Results suggest that QHES implementation lead to a decrease in some adverse physical and psychosocial factors. Few effects were observed on WMSP.

Marginal structural models (MSMs) allow estimating the causal effect of a time‐varying exposure on an outcome in the presence of time‐dependent confounding. The parameters of MSMs can be estimated utilizing an inverse probability of treatment weight estimator under certain assumptions. One of these assumptions is that the proposed causal model relating the outcome to exposure history is correctly specified. However, in practice, the true model is unknown. We propose a test that employs the observed data to attempt validating the assumption that the model is correctly specified. The performance of the proposed test is investigated with a simulation study. We illustrate our approach by estimating the effect of repeated exposure to psychosocial stressors at work on ambulatory blood pressure in a large cohort of white‐collar workers in Québec City, Canada. Code examples in SAS and R are provided to facilitate the implementation of the test.

Marginal structural models (MSMs) allow estimating the causal effect of a time‐varying exposure on an outcome in the presence of time‐dependent confounding. The parameters of MSMs can be estimated utilizing an inverse probability of treatment weight estimator under certain assumptions. One of these assumptions is that the proposed causal model relating the outcome to exposure history is correctly specified. However, in practice, the true model is unknown. We propose a test that employs the observed data to attempt validating the assumption that the model is correctly specified. The performance of the proposed test is investigated with a simulation study. We illustrate our approach by estimating the effect of repeated exposure to psychosocial stressors at work on ambulatory blood pressure in a large cohort of white‐collar workers in Québec City, Canada. Code examples in SAS and R are provided to facilitate the implementation of the test.

Objective: Evaluate the effect of the Quebec Healthy Enterprise Standard (QHES) on adverse physical and psychosocial work factors and work-related musculoskeletal problems (WMSP). Methods: Workers of ten organizations completed questionnaires before (n=2849) and 2-3 years following (n=2560) QHES implementation. Outcomes were assessed using validated instruments. Results: Workers exposed to adverse physical and psychosocial work factors had a higher prevalence of WMSP. After interventions, the prevalences of one adverse physical and three adverse psychosocial work factors were lower among workers exposed to interventions. Among men exposed to physical and psychosocial interventions, the lower prevalence of neck WMSP is compatible with a beneficial intervention effect. Other results generally showed few effects on WMSP. Conclusions: Results suggest that QHES implementation lead to a decrease in some adverse physical and psychosocial factors. Few effects were observed on WMSP.