Correction to: Fractions of cardiovascular diseases and mental disorders attributable to psychosocial work factors in 31 countries in Europe.

Whilst working on an update of our study published in 2014 (orginal article), we have discovered an error in the measure of effort-reward imbalance (ERI) in this study, leading to errors in Table 3 for (1) the prevalence of exposure to ERI, and (2) the fractions of cardiovascular diseases and mental disorders attributable to ERI, attributable fractions (AF) being calculated from exposure prevalence and relative risk.

Physical working conditions as covered in European monitoring questionnaires.

BACKGROUND: The prevalence of workers with demanding physical working conditions in the European work force remains high, and occupational physical exposures are considered important risk factors for musculoskeletal disorders (MSD), a major burden for both workers and society. Exposures to physical workloads are therefore part of the European nationwide surveys to monitor working conditions and health. An interesting question is to what extent the same domains, dimensions and items referring to the physical workloads are covered in the surveys. The purpose of this paper is to determine 1) which domains and dimensions of the physical workloads are monitored in surveys at the national level and the EU level and 2) the degree of European consensus among these surveys regarding coverage of individual domains and dimensions. METHOD: Items on physical workloads used in one European wide/Spanish and five other European nationwide work environment surveys were classified into the domains and dimensions they cover, using a taxonomy agreed upon among all participating partners. RESULTS: The taxonomy reveals that there is a modest overlap between the domains covered in the surveys, but when considering dimensions, the results indicate a lower agreement. The phrasing of items and answering categories differs between the surveys. Among the domains, the three domains covered by all surveys are "lifting, holding & carrying of loads/pushing & pulling of loads", "awkward body postures" and "vibrations". The three domains covered less well, that is only by three surveys or less, are "physical work effort", "working sitting", and "mixed exposure". CONCLUSIONS: This is the first thorough overview to evaluate the coverage of domains and dimensions of self-reported physical workloads in a selection of European nationwide surveys. We hope the overview will provide input to the revisions and updates of the individual countries' surveys in order to enhance coverage of relevant domains and dimensions in all surveys and to increase the informational value of the surveys.

Psychosocial work exposures among European employees: explanations for occupational inequalities in mental health.

BACKGROUND: Social inequalities in mental health have been demonstrated but understanding the mechanisms remains unclear. This study aims at exploring the role of psychosocial work factors in explaining occupational inequalities in mental health among European employees. METHODS: The study sample covered 33,443 employees coming from the European Working Conditions Survey 2010. Mental health was measured by the WHO-5 well-being index and socioeconomic position by occupation. Twenty-five psychosocial work factors were constructed including job demands, job influence and development, role stressors, social support, quality of leadership, discrimination, violence at work, working hours, job promotion, job insecurity and work-life imbalance. Multilevel linear regressions and bootstrap analyses were performed. RESULTS: Occupational differences were observed for poor mental health and almost all psychosocial work factors. Factors related to job demands, influence and development at work, social relationships and leadership, working hours and other factors contributed to explain the occupational inequalities in mental health. In particular, factors related to influence and development contributed substantially. Among men, workplace violences were found to contribute little whereas among women these factors did not play a role. CONCLUSIONS: Future prevention interventions should have a broad and comprehensive focus in order to reduce social inequalities in mental health.

Association between socio-demographic, psychosocial, material and occupational factors and self-reported health among workers in Europe.

BACKGROUND: The aim of this study was to explore the associations between socio-demographic, psychosocial, material and occupational factors and self-reported health (SRH) in the European working population. Another objective was to examine whether these associations varied according to occupation and country. METHODS: This study was based on data from the European quality of life survey 2007 including 17,005 workers from 31 European countries. SRH was measured using a single item. Factors were classified into four different groups: socio-demographic, psychosocial, material and occupational factors. The associations between these factors and SRH were examined using multilevel logistic regression analyses including interaction tests. RESULTS: When all four groups of factors were studied together, age, occupation, urbanization level, origin, trust level, social exclusion, material deprivation, financial and neighbourhood problems, access to medical services, quality of public services, psychological job demands, job reward, work-life imbalance and dangerous/unhealthy working conditions were associated with poor SRH. Almost no differences were found in these associations according to occupation and country. CONCLUSION: Various factors were associated with poor SRH. This study gave a first European overview of the associations between socio-demographic, psychosocial, material and occupational factors and SRH in Europe and could provide better advice to policy-makers at a European level.

Psychosocial working conditions and psychological well-being among employees in 34 European countries.

PURPOSE: The aim of this study was to explore the associations between psychosocial working conditions and psychological well-being among employees in 34 European countries. Another objective was to examine whether these associations varied according to occupation and country. METHODS: The study was based on data from the European Working Conditions Survey 2010 including 33,443 employees, 16,512 men and 16,931 women, from 34 European countries. Well-being was measured by the WHO-5 well-being index. Twenty-five psychosocial work factors were constructed including job demands, role stressors, work hours, job influence and freedom, job promotion, job insecurity, social support, quality of leadership, discrimination and violence at work, and work-life imbalance. The associations between these factors and well-being were examined using multilevel logistic regression analyses. Different models were performed including interaction tests. RESULTS: When all 25 psychosocial work factors were studied simultaneously in the same model with adjustment variables, 13 showed a significant association with poor well-being among both genders: quantitative demands, demands for hiding emotions, low possibilities for development, low meaning of work, low role conflict, low quality of leadership, low social support, low sense of community, job insecurity, low job promotion, work-life imbalance, discrimination, and bullying. The association with low sense of community on poor well-being was particularly strong. CONCLUSIONS: A large number of psychosocial work factors were associated with poor well-being. Almost no country and occupational differences were found in these associations. This study gave a first European overview and could be useful to inform cross-national policy debate.

Fractions of cardiovascular diseases and mental disorders attributable to psychosocial work factors in 31 countries in Europe.

OBJECTIVES: The aim of this study was to evaluate the fractions of cardiovascular diseases and mental disorders attributable to three psychosocial work factors, job strain, effort-reward imbalance (ERI) and job insecurity, in 31 countries in Europe. METHODS: The prevalence of exposure (Pe) to job strain, ERI and job insecurity was calculated using the sample of 29,680 workers from 31 countries of the 2005 European Working Conditions Survey. Relative risks (RR) were obtained from three published meta-analyses. Pe and RR estimates were used to calculate attributable fractions (AF). RESULTS: Pe estimates were 26.90, 20.44 and 14.11% for job strain, ERI and job insecurity in Europe, and significant differences were observed between countries. The job strain and ERI AFs for cardiovascular diseases were, respectively, 4.46% (significantly different from zero for Europe and all countries, but without any differences between countries) and 18.21% (not significantly different from zero for Europe and without differences between countries). The significant job strain and job insecurity AFs for mental disorders were 18.16 and 4.53% in Europe, without any significant difference between countries. The significant ERI AF for mental disorders was 14.81%, and significant differences were found between countries; the 3 highest AFs were observed in Greece, Slovenia and Turkey, and the 3 lowest in Bulgaria, Ireland and Latvia. CONCLUSION: This study is the first one to provide fractions of cardiovascular diseases and mental disorders attributable to three psychosocial work factors for the whole Europe and to explore the differences between 31 countries. These results may be useful to guide European and national prevention policies as well as to evaluate the economic costs of diseases attributable to these exposures.

Dimensional comparability of psychosocial working conditions as covered in European monitoring questionnaires.

BACKGROUND: In most countries in the EU, national surveys are used to monitor working conditions and health. Since the development processes behind the various surveys are not necessarily theoretical, but certainly practical and political, the extent of similarity among the dimensions covered in these surveys has been unclear. Another interesting question is whether prominent models from scientific research on work and health are present in the surveys--bearing in mind that the primary focus of these surveys is on monitoring status and trends, not on mapping scientific models. Moreover, it is relevant to know which other scales and concepts not stemming from these models have been included in the surveys. The purpose of this paper is to determine (1) the similarity of dimensions covered in the surveys included and (2) the congruence of dimensions of scientific research and of dimensions present in the monitoring systems. METHOD: Items from surveys representing six European countries and one European wide survey were classified into the dimensions they cover, using a taxonomy agreed upon among all involved partners from the six countries. RESULTS: The classification reveals that there is a large overlap of dimensions, albeit not in the formulation of items, covered in the seven surveys. Among the available items, the two prominent work-stress-models--job-demand-control-support-model (DCS) and effort-reward-imbalance-model (ERI)--are covered in most surveys even though this has not been the primary aim in the compilation of these surveys. In addition, a large variety of items included in the surveillance systems are not part of these models and are--at least partly--used in nearly all surveys. These additional items reflect concepts such as "restructuring", "meaning of work", "emotional demands" and "offensive behaviour/violence & harassment". CONCLUSIONS: The overlap of the dimensions being covered in the various questionnaires indicates that the interests of the parties deciding on the questionnaires in the different countries overlap. The large number of dimensions measured in the questionnaires and not being part of the DCS and ERI models is striking. These "new" dimensions could inspire the research community to further investigate their possible health and labour market effects.

Psychosocial work factors and long sickness absence in Europe.

BACKGROUND: Studies exploring a wide range of psychosocial work factors separately and together in association with long sickness absence are still lacking. OBJECTIVES: The objective of this study was to explore the associations between psychosocial work factors measured following a comprehensive instrument (Copenhagen psychosocial questionnaire, COPSOQ) and long sickness absence (> 7 days/year) in European employees of 34 countries. An additional objective was to study the differences in these associations according to gender and countries. METHODS: The study population consisted of 16 120 male and 16 588 female employees from the 2010 European working conditions survey. Twenty-five psychosocial work factors were explored. Statistical analysis was performed using multilevel logistic regression models and interaction testing. RESULTS: When studied together in the same model, factors related to job demands (quantitative demands and demands for hiding emotions), possibilities for development, social relationships (role conflicts, quality of leadership, social support, and sense of community), workplace violence (physical violence, bullying, and discrimination), shift work, and job promotion were associated with long sickness absence. Almost no difference was observed according to gender and country. CONCLUSIONS: Comprehensive prevention policies oriented to psychosocial work factors may be useful to prevent long sickness absence at European level.

Social inequalities in psychological well-being: a European comparison.

The objective was to explore the educational differences in psychological well-being, measured using the WHO-5 Index, among 15,362 men and 20,272 women in 31 European countries. Relative Index of Inequality, multilevel logistic regression analyses and interaction tests were performed. Within Europe, large cross-national differences in the prevalence of poor well-being were observed. In almost all countries, the prevalence of poor well-being was higher in low educational groups, but the magnitude of these inequalities was much larger in some countries than in others. The highest social differences in well-being were observed in the European Union candidates countries among both genders. Future health promotion programs should consider strategies that target lower educational groups.

Social differences in self-reported health among men and women in 31 countries in Europe.

AIMS: The aim of this study was to examine educational differences in self-reported health (SRH) among men and women in Europe. METHODS: The study was based on a sample of 15,362 men and 20,272 women from the nationally representative European Quality of Life Survey conducted in 31 European countries in 2007. SRH was measured using a single item and dichotomised into good (very good, good) and poor (fair, bad, very bad) health. Education was classified into seven categories according to the International Standard Classification of Education. Relative index of inequality, multilevel logistic regression analyses, and interaction tests were conducted. RESULTS: Educational differences in SRH were found in almost all countries. After adjustment for covariates, no differences were found in Austria, Denmark, or the Netherlands. The highest differences were observed for both genders in Ireland and Macedonia. Women had significant larger educational differences in SRH than men in Portugal but significant lower differences in Czech Republic and Lithuania. CONCLUSIONS: The study underlined that the magnitude of educational differences in SRH varied according to gender and country.

Psychosocial work factors and sickness absence in 31 countries in Europe.

BACKGROUND: The studies on the associations between psychosocial work factors and sickness absence have rarely included a large number of factors and European data. The objective was to examine the associations between a large set of psychosocial work factors following well-known and emergent concepts and sickness absence in Europe. METHODS: The study population consisted of 14,881 male and 14,799 female workers in 31 countries from the 2005 European Working Conditions Survey. Psychosocial work factors included the following: decision latitude, psychological demands, social support, physical violence, sexual harassment, discrimination, bullying, long working hours, shift and night work, job insecurity, job promotion and work-life imbalance. Covariates were as follows: age, occupation, economic activity, employee/self-employed status and physical, chemical, biological and biomechanical exposures. Statistical analysis was performed using multilevel negative binomial hurdle models to study the occurrence and duration of sickness absence. RESULTS: In the models, including all psychosocial work factors together and adjustment for covariates, high psychological demands, discrimination, bullying, low-job promotion and work-life imbalance for both genders and physical violence for women were observed as risk factors of the occurrence of sickness absence. Bullying and shift work increased the duration of absence among women. Bullying had the strongest association with sickness absence. CONCLUSION: Various psychosocial work factors were found to be associated with sickness absence. A less conservative analysis exploring each factor separately provided a still higher number of risk factors. Preventive measures should take psychosocial work environment more comprehensively into account to reduce sickness absence and improve health at work at European level.

[Basic questionnaire and methodological criteria for Surveys on Working Conditions, Employment, and Health in Latin America and the Caribbean]. / Cuestionario básico y criterios metodológicos para las Encuestas sobre Condiciones de Trabajo, Empleo y Salud en América Latina y el Caribe.

This article aimed to present a basic questionnaire and minimum methodological criteria for consideration in future Surveys on Working Conditions, Employment, and Health in Latin America and the Caribbean. A virtual and face-to-face consensus process was conducted with participation by a group of international experts who used the surveys available up until 2013 as the point of departure for defining the proposal. The final questionnaire included 77 questions grouped in six dimensions: socio-demographic characteristics of workers and companies; employment conditions; working conditions; health status; resources and preventive activities; and family characteristics. The minimum methodological criteria feature the interviewee's home as the place for the interview and aspects related to the quality of the fieldwork. These results can help improve the comparability of future surveys in Latin America and the Caribbean, which would in turn help improve information on workers' heath in the region.

Changes in psychosocial work exposures among employees between 2005 and 2010 in 30 countries in Europe.

OBJECTIVE: The aim was to assess the changes in psychosocial work factors among European employees between 2005 and 2010. METHODS: The study samples came from the European Working Conditions Survey, involving 23,580 and 32,516 employees in 2005 and 2010, respectively, from 30 European countries. The psychosocial work factors studied were based on job strain and effort-reward imbalance models, and more recent factors. Multilevel linear and logistic regression models were used. Differences according to occupations and countries were tested. RESULTS: Results were mixed with improvement for some factors and decline for other factors. Some countries and occupations were more likely to be affected by negative changes, especially low-skilled employees. CONCLUSION: Prevention policies at the workplace should take into account that the degradation of some psychosocial work factors may be sharper for some countries and occupations.

Cuestionario básico y criterios metodológicos para las Encuestas sobre Condiciones de Trabajo, Empleo y Salud en América Latina y el Caribe / Basic questionnaire and methodological criteria for Surveys on Working Conditions, Employment, and Health in Latin America and the Caribbean / Questionário básico e critérios metodológicos para as Pesquisas sobre Condições de Trabalho, Emprego e Saúde na América Latina e Caribe

Resumen: El objetivo de este trabajo es presentar un cuestionario básico y criterios metodológicos mínimos, para ser considerados en futuras Encuestas sobre Condiciones de Trabajo, Empleo y Salud (ECTES) en América Latina y el Caribe. Para ello, se llevó a cabo un proceso de consenso, tanto virtual como presencial, con la participación de un grupo internacional de expertos que, para definir la propuesta, partieron de las encuestas disponibles en la región hasta 2013. El cuestionario final incluyó 77 preguntas agrupadas en seis dimensiones: características sociodemográficas del trabajador y la empresa; condiciones de empleo; condiciones de trabajo; estado de salud; recursos y actividades preventivas; y características familiares. Entre los criterios metodológicos mínimos destacan el domicilio de la persona entrevistada como lugar de la entrevista y los relacionados con la calidad del trabajo de campo. Estos resultados pueden ayudar a mejorar la comparabilidad de las futuras ECTES en América Latina y el Caribe, lo que contribuiría a mejorar la información en salud laboral en la región.

Abstract: This article aimed to present a basic questionnaire and minimum methodological criteria for consideration in future Surveys on Working Conditions, Employment, and Health in Latin America and the Caribbean. A virtual and face-to-face consensus process was conducted with participation by a group of international experts who used the surveys available up until 2013 as the point of departure for defining the proposal. The final questionnaire included 77 questions grouped in six dimensions: socio-demographic characteristics of workers and companies; employment conditions; working conditions; health status; resources and preventive activities; and family characteristics. The minimum methodological criteria feature the interviewee's home as the place for the interview and aspects related to the quality of the fieldwork. These results can help improve the comparability of future surveys in Latin America and the Caribbean, which would in turn help improve information on workers' heath in the region.

Resumo: O objetivo deste trabalho é apresentar um questionário básico e critérios metodológicos mínimos, para serem considerados em futuras pesquisas sobre Condições de Trabalho, Emprego e Saúde (ECTES) na América Latina e Caribe. Para tal, foi realizado um processo de consenso, tanto virtual como presencial, com a participação de um grupo internacional de expertos que, para definir a proposta, partiram das pesquisas disponíveis na região até 2013. O questionário final incluiu 77 perguntas agrupadas em seis dimensões: características sociodemográficas do trabalhador e a empresa; condições de emprego; condições de trabalho; estado de saúde; recursos e atividades preventivas; assim como características familiares. Entre os critérios metodológicos mínimos destacam-se o domicílio da pessoa entrevistada como lugar da entrevista e os relacionados com a qualidade do trabalho de campo. Estes resultados podem ajudar a melhorar a comparabilidade das futuras ECTES na América Latina e Caribe, o que contribuiria para melhorar a informação sobre saúde do trabalhador na região.