In a longitudinal cohort study, organizational climate and long-term effects of exposure to nasty teasing (aggression) at work were investigated. The baseline consisted of a representative sample of Danish employees in 1995 with a response rate of 80% (N = 5,652). Of these, 4,647 participated in the follow-up in 2000 (response rate 84%). In 1995, 6.3% were subjected to nasty teasing with no significant gender difference. At baseline, we found significant associations among nasty teasing, a negative organizational climate, and psychological health effects. In the follow-up analyses, associations were found between exposure to nasty teasing at baseline and psychological health problems at follow-up, even when controlled for organizational climate and psychological health at baseline and nasty teasing at follow-up. Stratified for gender, the follow-up associations were significant for women but not for men. Low coworker support and conflicts at baseline and teasing at follow-up mediated the effects on men.
Depression is a major concern for public health. Both adverse working conditions and low socio-economic position are suspected to increase risk of depression. In a representative sample of the Danish workforce we investigated (i) whether adverse psychosocial working conditions, defined by the effort-reward imbalance (ERI) model, predicted onset of severe depressive symptoms after 5-year follow-up and (ii) whether the effect of ERI was differential across occupational grades.
A cohort of 2701 Danish employees filled in a questionnaire on work and health in 2000 and 2005. ERI was measured with four effort and seven reward items. Depressive symptoms were assessed with the five-item Mental Health Inventory. Participants scoring = 52 points were defined as cases. We used logistic regression to investigate the association of ERI and occupational grade in 2000 with onset of severe depressive symptoms in 2005. Analyses were adjusted for socio-demographics, health behaviours, survey method, self-rated health, sleep disturbances and non-severe depressive symptoms at baseline.
High ERI predicted onset of severe depressive symptoms at follow-up, after adjustment for co-variates and occupational grade (OR = 2.19, 95% CI = 1.12-4.25). Participants with high ERI and low occupational grade showed a considerably higher OR (2.43, 95% CI = 1.07-5.53) compared to participants with low/medium ERI and low grade (OR = 1.45, 95% CI = 0.72-2.92), high ERI and high grade (OR = 1.26, 95% CI = 0.59-2.70) and low/medium ERI and high grade (reference group).
Adverse psychosocial working conditions predicted onset of severe depressive symptoms. The effect was stronger among employees of lower occupational grades compared to those of higher grades.
Although depression is common, prevalence estimates of antidepressant use among the workforce and undisputed evidence relating psychosocial work characteristics to depression is scarce. This study cross-sectionally assesses the prevalence of antidepressant use among employed in Sweden and Denmark and prospectively examines associations between work characteristics and antidepressant use.
Data on work demands, influence and learning possibilities was collected 2005-2006 from two representative samples of employed aged 20-59 years from Sweden (n=4351) and Denmark (n=8064) and linked to purchases of antidepressants through national prescription drug registries. Standardized 12-month prevalences were calculated. Cox regressions on work characteristics and incident use were performed separately and estimates pooled.
Employed Swedish residents had higher standardized prevalence than Danish, 6.0% compared to 5.0%. Working fast and conflicting demands were associated with incident use when estimates were pooled, but adjustment for baseline health attenuated these estimates. Emotionally disturbing situations were related to any incident use, and more strongly to use >179 defined daily dosages/year, even after adjustment for various covariates.
Statistics based on national prescription drug registries are influenced by, e.g., treatment seeking behaviours and other reasons for prescription than depression. Selective drop-out may also affect prevalence estimates.
The study indicates that use of antidepressants among the workforce is relatively high and that employed Swedish residents had higher prevalence of antidepressant use than Danish. Relationships between work characteristics and antidepressant use were, however, similar with emotional demands showing the strongest association, indicating that particular groups of employees may be at increased risk.
To determine the effect of job insecurity based on repeated measurements on ischemic heart disease (IHD) and on antihypertensive medication.
The study population consists of 12,559 employees aged 18-59 years of the Danish Work Environment Cohort Study. With an open cohort design, data from up to four representative waves were linked to four registers. Poisson regression with time-dependent covariates was used to estimate the rate ratio (RR) with confidence interval (CI) of perceived job insecurity associated with first-time IHD hospitalization or mortality 1991-2010 (n = 561 cases) and incident dispensing of prescribed antihypertensive medications 1996-2010 (n = 2,402 cases).
Participants with perceived job insecurity filled more antihypertensive prescriptions (age-, gender-, and calendar year-adjusted RR 1.23, 95 % CI 1.12-1.33) and had a borderline significant higher IHD incidence (RR 1.23, 95 % CI 0.98-1.55). In a subanalysis, the risk of antihypertensive medication dispensed was only significant among employees with worries about both unemployment and poor reemployment opportunities. After explorative stratifications by age, gender, and occupational status, perceived job insecurity was associated with more dispensing of antihypertensive medications to participants less than 50 years of age.
In a country with high social security and active labor market policy, employees with the feeling of an insecure job have a modestly increased risk to fill an antihypertensive prescription. Further studies on health risks of job insecurity should consider improved exposure assessment, earlier outcomes such as medication in order to increase statistical power, and identification of vulnerable population groups.
Cites: Int J Occup Med Environ Health. 2014 Aug;27(4):536-4625008851
Cites: J Epidemiol Community Health. 2010 Jan;64(1):75-8119854752
Cites: Int Arch Occup Environ Health. 2015 Apr;88(3):311-924997610
Correlation between relative rates of hospital treatment or death due to ischaemic heart disease (IHD) and of IHD-related medication among socio-occupational and economic activities groups in Denmark, 1996-2005.
The aim of the present work was to establish whether or not prescribed medication is a usable risk indicator for work-related ischaemic heart disease (IHD), in Denmark.
Weighted Spearman rank correlation coefficients (rho) were used to evaluate the agreement between Standardised Hazard Ratios (SHR) for hospital treatment or death due to IHD and SHR for purchase of prescriptions for medicine that may prevent IHD from (re)occurring, among socio-occupational and economic activities groups in Denmark. The SHR were based on a 10-year prospective follow-up of 2 million people in Danish national registers 1996-2005.
We found approximately 7 times more cases of medicine usage (N = 411 651) than we did for hospital treatment or death (N = 55 684). The correlations between the 2 types of SHR were strong (rho = 0.94 for the socio-occupational groups; rho = 0.74 for the economic activities groups). We observed, however, one markedly contradictive result; the industrial group entitled 'general practitioner, dentists etc.' was associated both with significantly high rates of medicine usage (SHR = 1.15, 95% CI: 1.12-1.19) and significantly low rates of hospital treatment or death due to IHD (SHR = 0.80, 95% CI: 0.71-0.91).
Apart from a few caveats, the strong correlations obtained in the present study signify that purchase of a prescription for IHD-related medication is a usable risk indicator for IHD in the working population of Denmark. The usage of medicine data in addition to or instead of the use of death or hospital data in epidemiological studies on work-related IHD risk will bring about a tremendous increase in statistical power.
The Copenhagen Psychosocial Questionnaire (COPSOQ) comprises dimensions (emotional demands, demands of hiding emotions, meaning of work, quality of leadership, and predictability) that are not in the job strain or the effort-reward imbalance (ERI) models. The study aim was to investigate whether these dimensions explain changes in vitality and mental health over and above the job strain and ERI models.
A cohort of 3552 employees in 2000 were followed up in 2005 (cohort participation of 51%). Regression analyses were carried out with mental health and vitality as dependent variables. A significance level of 0.01 was applied when comparing regression models.
Regarding mental health, both the full COPSOQ-ERI model (p = 0.005) and the full job strain-COPSOQ model (p = 0.01) were significantly better than the ERI and the job strain models. Regarding vitality, none of the full COPSOQ models (i.e. with new COPSOQ dimensions together with job strain or ERI respectively) was significantly better than the ERI (p = 0.03) or the job strain (p = 0.04) models. Emotional demands and low meaning of work predicted poor mental health and low vitality.
In relation to mental health, new psychosocial risk factors have the potential to add to the predictive power of the job strain and ERI models. The current practice of including only items from the ERI and job strain models in public health studies should be reconsidered. Theories regarding the status of, for example, emotional demands and meaning of work should be developed and tested.
Does affective organizational commitment and experience of meaning at work predict long-term sickness absence? An analysis of register-based outcomes using pooled data on 61,302 observations in four occupational groups.
To investigate whether experience of low meaning at work (MAW) and low affective organizational commitment (AOC) predicts long-term sickness absence (LTSA) for more than 3 consecutive weeks and whether this association is dependent on the occupational group.
Survey data pooling 61,302 observations were fitted to the DREAM register containing information on payments of sickness absence compensation. Using multiadjusted Cox regression, observations were followed for an 18-month follow-up period to assess the risk for LTSA.
Low levels of MAW and AOC significantly increased the risk for LTSA during follow-up. Subgroup analyses showed that associations were statistically significant for employees working with clients and office workers but not for employees working with customers and manual workers. Further analyses showed that associations between MAW and LTSA varied significantly across the four occupational groups.
Meaning at work and affective organizational commitment significantly predict LTSA. Promoting MAW and AOC may contribute toward reducing LTSA in contemporary workplaces.
Does affective organizational commitment and experience of meaning at work predict risk of disability pensioning? An analysis of register-based outcomes using pooled data on 40,554 observations in four occupational groups.
The aim of this study is to investigate whether experience of meaning at work (MAW) and affective organizational commitment (AOC) predict risk of disability pensioning in four occupational groups.
Survey data from 40,554 individuals were fitted to a national register (DREAM) containing information on payments of disability pension. Using multi-adjusted Cox-regression, observations were followed in the DREAM-register to assess risk of disability pensioning.
Low levels of MAW significantly increased risk of disability pensioning during follow-up referencing high levels of MAW. Respondents with medium levels of AOC had a significantly reduced risk of disability pensioning, when compared to respondents with high levels of AOC. Furthermore, results indicate an interaction effect between AOC and MAW in predicting risk of disability pension.
AOC and MAW are significantly associated with risk of disability pensioning. Promoting MAW and managing AOC in contemporary workplaces may contribute towards reducing risk of disability pensioning.
Emotionally demanding work has been associated with increased risk of common mental disorders. Because emotional demands may not be preventable in certain occupations, the identification of workplace factors that can modify this association is vital. This article examines whether effects of emotional demands on antidepressant treatment, as an indicator of common mental disorders, are buffered by good leadership.
We used data from two nationally representative work environment studies, the Danish Work Environment Cohort Study (n = 6,096) and the Swedish Longitudinal Occupational Survey of Health (n = 3,411), which were merged with national registers on antidepressant purchases. All individuals with poor self-reported baseline mental health or antidepressant purchases within 8.7 months before baseline were excluded, and data analysed prospectively. Using Cox regression, we examined hazard ratios (HRs) for antidepressants in relation to the joint effects of emotional demands and leadership quality. Buffering was assessed with Rothman's synergy index. Cohort-specific risk estimates were pooled by random effects meta-analysis.
High emotional demands at work were associated with antidepressant treatment whether quality of leadership was poor (HR = 1.84, 95 % CI 1.32-2.57) or good (HR = 1.70, 95 % CI 1.25-2.31). The synergy index was 0.66 (95 % CI 0.34-1.28).
Our findings suggest that good leadership does not substantially ameliorate any effects of emotional demands at work on employee mental health. Further research is needed to identify possible preventive measures for this work environment exposure.
Cites: AJS. 2002 Jan;107(4):1065-9612227382
Cites: Int Arch Occup Environ Health. 2002 Apr;75(4):259-6611981660
The aim of the current study was to investigate whether Workplace Health Promotion (WHP) is available for workers with poor health status (overweight, musculoskeletal disorders, sickness absence and poor self-rated health) or health behaviour (smoking, poor diet and sedentarism) and whether they participate in WHP. In total, 9835 workers responded to questions regarding availability to 6 different types of WHP through The Danish Work Environment Cohort Study in 2010. Logistic regression analyses adjusted for age, gender and industry were performed to calculate odds ratios for availability and participation of WHP among groups with different health behaviours and health status. In general, poor health behaviours were associated with reduced availability of and participation in WHP. In contrast, poor health status was generally associated with higher availability of WHP and increased participation. However, poor self-rated health was associated with lower availability of several types of WHP and reduced participation. In general, workers with health challenges that are visible to others had WHP available, whereas workers with less visible health challenges had WHP less frequently available. Health challenges visible to others were associated with higher participation in WHP, whereas poor health behaviour and reduced self-rated health were associated with reduced participation in WHP programmes.