An urgent call to address work-related psychosocial hazards and improve worker well-being.

Work-related psychosocial hazards are on the verge of surpassing many other occupational hazards in their contribution to ill-health, injury, disability, direct and indirect costs, and impact on business and national productivity. The risks associated with exposure to psychosocial hazards at work are compounded by the increasing background prevalence of mental health disorders in the working-age population. The extensive and cumulative impacts of these exposures represent an alarming public health problem that merits immediate, increased attention. In this paper, we review the linkage between work-related psychosocial hazards and adverse effects, their economic burden, and interventions to prevent and control these hazards. We identify six crucial societal actions: (1) increase awareness of this critical issue through a comprehensive public campaign; (2) increase etiologic, intervention, and implementation research; (3) initiate or augment surveillance efforts; (4) increase translation of research findings into guidance for employers and workers; (5) increase the number and diversity of professionals skilled in preventing and addressing psychosocial hazards; and (6) develop a national regulatory or consensus standard to prevent and control work-related psychosocial hazards.

Vital Signs: Health Worker-Perceived Working Conditions and Symptoms of Poor Mental Health - Quality of Worklife Survey, United States, 2018-2022.

Introduction: Health workers faced overwhelming demands and experienced crisis levels of burnout before the COVID-19 pandemic; the pandemic presented unique challenges that further impaired their mental health. Methods: Data from the General Social Survey Quality of Worklife Module were analyzed to compare self-reported mental health symptoms among U.S. adult workers from 2018 (1,443 respondents, including 226 health workers) and 2022 (1,952, including 325 health workers). Logistic regression was used to examine associations between health workers' reported perceptions of working conditions and anxiety, depression, and burnout. Results: From 2018 to 2022, health workers reported an increase of 1.2 days of poor mental health during the previous 30 days (from 3.3 days to 4.5 days); the percentage who reported feeling burnout very often (11.6% to 19.0%) increased. In 2022, health workers experienced a decrease in odds of burnout if they trusted management (odds ratio [OR] = 0.40), had supervisor help (OR = 0.26), had enough time to complete work (OR = 0.33), and felt that their workplace supported productivity (OR = 0.38), compared with those who did not. Harassment at work was associated with increased odds of anxiety (OR = 5.01), depression (OR = 3.38), and burnout (OR = 5.83). Conclusions and implications for public health practice: Health workers continued to face a mental health crisis in 2022. Positive working conditions were associated with less burnout and better mental health. CDC's National Institute for Occupational Safety and Health has developed a national campaign, Impact Wellbeing, to provide employers of health workers with resources to improve the mental health of these workers.

Risking one's life to save one's livelihood: Precarious work, presenteeism, and worry about disease exposure during the COVID-19 pandemic.

The present study advances research on the negative consequences of precarious work experiences (PWE), which include perceptions of threats to one's job and financial security as well as a sense of powerlessness and inability to exercise rights in the workplace. Using the COVID-19 pandemic as a backdrop, we examine how PWE relate to sickness presenteeism and worry about work-related COVID-19 exposure. In a 12-week, four-wave study of workers working fully in-person, perceptions of powerlessness and job insecurity were associated with presenteeism (e.g., general presenteeism as well as attending work with known or possible COVID-19 infection) and concerns about disease exposure at work. Whereas powerlessness primarily operated at the between-person level of analysis, job insecurity's effects emerged at both levels of analysis. A sense of powerlessness at work also predicted sending children to school/daycare sick. In sum, the findings suggest that precarity related to being able to keep one's job and a sense of powerlessness at work contribute to concerns about the risk of COVID-19 exposure at work and, simultaneously, behaviors that may contribute to the health risks faced by others. This research provides added support to the argument that precarious work should be addressed in order to improve both worker well-being and public health. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Expanding the Focus of Occupational Safety and Health: Lessons from a Series of Linked Scientific Meetings.

There is widespread recognition that the world of work is changing, and agreement is growing that the occupational safety and health (OSH) field must change to contribute to the protection of workers now and in the future. Discourse on the evolution of OSH has been active for many decades, but formalized support of an expanded focus for OSH has greatly increased over the past 20 years. Development of approaches such as the National Institute for Occupational Safety and Health (NIOSH)'s Total Worker Health® concept and the World Health Organization (WHO)'s Healthy Workplace Framework are concrete examples of how OSH can incorporate a new focus with a wider view. In 2019, NIOSH initiated a multi-year effort to explore an expanded focus for OSH. This paper is a report on the outputs of a three-year cooperative agreement between NIOSH and The University of Texas School of Public Health, which led to subject matter expert workshops in 2020 and an international conference of global interest groups in 2021. This article traces the background of these meetings and identifies and assesses the lessons learned. It also reviews ten thematic topics that emerged from the meetings: worker health inequalities; training new OSH professionals; future OSH research and practice; tools to measure well-being of workers; psychosocial hazards and adverse mental health effects; skilling, upskilling and improving job quality; socioeconomic influences; climate change; COVID-19 pandemic influences; and strategic foresight. Cross-cutting these themes is the need for systems and transdisciplinary thinking and operationalization of the concept of well-being to prepare the OSH field for the work of the future.

Unstable sitting in the workplace--are there physical activity benefits?

The increasingly popular practice of using a stability ball (exercise/fitness ball) as a sitting surface runs counter to conventional human factors/ergonomics guidelines for seated workspace design. Employees sitting on stability balls in an office environment present safety risks that might be justifiable if the practice has a definitive benefit to the promotion of health. However, the published studies and best evidence to date call into question even the theoretical basis for this practice and do not suggest significant health benefits. First, biomechanical studies do not confirm the intended trunk muscle activation. Second, energy expenditure studies show a small (if any) increase in metabolic demand that is unlikely to be effective in combating sedentary work risk factors. Until studies demonstrate more conclusive benefits, the practice of stability ball sitting should be viewed skeptically as a general workplace recommendation in the interest of health or wellness.

Workplace psychosocial factors associated with work-related injury absence: a study from a nationally representative sample of Korean workers.

BACKGROUND: Little is known about the association between psychosocial factors and injury absence in the workplace. PURPOSE: This study aims to assess the association of comprehensive workplace psychosocial factors with work-related injury absence among Korean workers. METHODS: The data (n = 7,856) were derived from the First Korean Working Conditions Survey conducted in 2006 with a representative sample (n = 10,043) of the Korean working population. The survey instrument contained questions about hours of work, physical risk factors, work organization, and the effect of work on health/injury. Work-related injury absence was indicated by a dichotomous variable with at least 1 day absence during the preceding 12 months. Logistic regression models were used to calculate odds ratio and confidence interval (CI). Incremental adjustments for sociodemographic, health behavior, and occupational confounding variables were employed in the models. RESULTS: The overall 1-year prevalence of work-related injury absence in this study was 1.37 % (95 % CI, 1.11-1.63 %). Those who experienced violence at work (adjusted odds ratio (aOR), 7.05 (95 % CI, 2.69-18.5)), threat of violence at work (aOR, 4.25 (95 % CI, 1.32-13.64)), low job autonomy (aOR, 1.79 (95 % CI, 1.17-2.74)), and high job strain (aOR, 2.38 (95 % CI, 1.29-4.42) had an increased risk of injury absence, compared with their respective counterparts (p < 0.05). Among all job types, skilled workers in Korea were at a near fourfold risk of work absence due to occupational injuries, compared with managers in low-risk jobs. CONCLUSION: Workplace violence and increased job strain were two key workplace psychosocial factors associated with work-related injury absence.

Co-effect of Demand-control-support model and effort-reward imbalance model on depression risk estimation in humans: findings from Henan Province of China.

OBJECTIVE: To investigate the co-effect of Demand-control-support (DCS) model and Effort-reward Imbalance (ERI) model on the risk estimation of depression in humans in comparison with the effects when they are used respectively. METHODS: A total of 3 632 males and 1 706 females from 13 factories and companies in Henan province were recruited in this cross-sectional study. Perceived job stress was evaluated with the Job Content Questionnaire and Effort-Reward Imbalance Questionnaire (Chinese version). Depressive symptoms were assessed by using the Center for Epidemiological Studies Depression Scale (CES-D). RESULTS: DC (demands/job control ratio) and ERI were shown to be independently associated with depressive symptoms. The outcome of low social support and overcommitment were similar. High DC and low social support (SS), high ERI and high overcommitment, and high DC and high ERI posed greater risks of depressive symptoms than each of them did alone. ERI model and SS model seem to be effective in estimating the risk of depressive symptoms if they are used respectively. CONCLUSION: The DC had better performance when it was used in combination with low SS. The effect on physical demands was better than on psychological demands. The combination of DCS and ERI models could improve the risk estimate of depressive symptoms in humans.

Job strain, effort-reward imbalance and neck, shoulder and wrist symptoms among Chinese workers.

The purpose of this study was to examine the association between psychosocial job stress (by the Job Control-Demand (JCD) model and Effort-Reward imbalance (ERI) model) and musculoskeletal (MS) symptoms among workers in China. Overall, 3,632 male and 1,706 female workers from 13 factories/companies participated in this study. Perceived job stress was evaluated by the Chinese version of the Job Content Questionnaire (JCQ) and ERI Questionnaire. Neck, shoulder and wrist symptoms were assessed by self-report during the past year. Workers reporting high job demands and low job control or high effort and low rewards had moderately increased risk for all MS symptoms. Odds ratios (ORs) were higher in workers reporting both high effort and low rewards. The combination of high physical job demands with low job control showed significant associations with MS symptoms. The effects of psychological demands on symptoms in women, effort and effort-reward imbalance on symptoms among both genders were increased as the number of regions with symptoms increased. These results suggest that high job strain and ERI are associated with neck, shoulder and wrist symptoms in Chinese factory workers independent of individual factors, physical factors, and other psychological variables.

Organizational factors associated with work-related sleep problems in a nationally representative sample of Korean workers.

PURPOSE: The purpose of this study was to assess the association of organizational factors with work-related sleep problems (WRSP) among Korean workers. METHODS: The data were derived from the First Korean Working Conditions Survey conducted in 2006 with a representative sample of the Korean working population (n = 10,039). RESULTS: The overall prevalence of WRSP was 5.1% (95% confidence interval (CI) 4.7-5.5). Those who experienced sexual harassment at work (adjusted odds ratio (aOR) 3.47: 95% CI 1.77-6.81), discrimination due to sex (aOR 2.44: 95% CI 1.36-4.36) or age (aOR 2.22: 95% CI 1.52-3.23), violence at work (aOR 1.98: 95% CI 1.06-3.68), threat of violence (aOR 1.96: 95% CI 1.05-3.66), poor work-life balance (aOR 1.78: 95% CI 1.44-2.20), low job satisfaction (aOR 1.69: 95% CI 1.37-2.09), high cognitive (OR 1.64: 95% CI 1.32-2.03) and emotional (aOR 1.53: 95% CI 1.22-1.91) demands, job insecurity (aOR 1.32: 95% CI 1.07-1.63), and high work intensity (aOR 1.55: 95% CI: 95% CI 1.25-1.92) had an increased risk of WRSP compared to their respective counterparts (p < 0.01). Low social support was not significantly associated with WRSP (aOR 0.88: 95% CI 0.67-1.15). CONCLUSION: The results revealed that poor psychosocial working conditions may be related to a high prevalence of WRSP among representative Korean workers.

Evaluating the association of workplace psychosocial stressors with occupational injury, illness, and assault.

This research project characterizes occupational injuries, illnesses, and assaults (OIIAs) as a negative outcome associated with worker exposure to generalized workplace abuse/harassment, sexual harassment, and job threat and pressure. Data were collected in a nationwide random-digit-dial telephone survey conducted during 2003-2004. There were 2151 study interviews conducted in English and Spanish. Analyses included cross tabulation with Pearson's Chi-Square and logistic regression analyses. Three hundred and fifty-one study participants reported having an OIIA during the 12 months preceding the study. Occurrences of generalized workplace harassment (OR = 1.53; CI = 1.33-1.75, p ≤ 0.05); sexual harassment (OR = 1. 18; CI = 1.04-.34, p ≤ 0.05); and job pressure and threat (OR = 1.26; CI = 1.10-1.45, p ≤ 0.05) were significantly associated with reporting an OIIA. The psychosocial environment is significantly associated with an increased risk of OIIA. Further research is needed to understand causal pathways and to explore potential interventions.

Job satisfaction, common cold, and sickness absence among white-collar employees: a cross-sectional survey.

The purpose of this study is to examine the independent association of job satisfaction with common cold and sickness absence among Japanese workers. A total of 307 apparently healthy white-collar employees (165 men and 142 women), aged 22-69 (mean 36) yr, completed a questionnaire survey during April to June, 2002. Global job satisfaction was measured by a 4-item scale from the Japanese version of a generic job stress questionnaire with higher scores indicating greater satisfaction. Information about whether the employees had a common cold (within the past 6 months) and sickness absence (within the past 12 months) was self-reported. Hierarchical log-linear Poisson regression analysis controlling for confounders revealed that greater job satisfaction was inversely correlated with days (B = -0.116; p<0.001) and times (B = -0.058; p = 0.067) of common cold and days (B = -0.160; p<0.001) and times (B = -0.141; p<0.001) of sickness absence. Our findings suggested that poor job satisfaction is associated with both common cold and sickness absence.

Nurses, smoking, and immunity: a review.

Nurses regularly are exposed to a variety of occupational hazards. In addition to documented occupational hazards, exposure to smoking remains a major concern. This article reviews the prevalence of smoking among nurses working in the United States and discusses their reasons for smoking. Researchers conducted a state-of-the-art review on the effects of cigarette smoking and exposure to secondhand smoke (SHS) on the immune system. Smoking prevalence among nurses working in the United States ranged from 796-12%, and high work stress, poor work environment, shift work, and peer influence were suspected major risk factors influencing smoking behavior. A review of the effects of smoking on immunity revealed that both active smoking and exposure to SHS negatively affects immune function. When rehabilitation nurses stop smoking their health improves and nonsmokers are exposed to less SHS. Rehabilitation nurses are encouraged to share knowledge of the immunological benefits of smoking cessation with patients to facilitate nurse-led rehabilitation programs.

Is self-rated health associated with blood immune markers in healthy individuals?

BACKGROUND: Although self-rated health (SRH) has been established as a robust predictor of morbidity and mortality, the immunological mechanisms underpinning this relationship are poorly understood. PURPOSE: This study examined the association of SRH with humoral and cellular immune markers in healthy individuals who reported no physical illnesses. METHOD: A total of 116 healthy Japanese white-collar employees (79 women and 37 men) at a pharmaceutical company, aged 23-62 (mean 32) years, underwent a blood draw for the measurement of circulating immune (T, B, and natural killer) cells, inflammatory cytokines (interleukin-6 and tumor necrosis factor-alpha), and plasma immunoglobulin G (IgG) and completed a health survey including SRH. The question regarding SRH ranged from "very good" (coded 1) to "very poor" (coded 5). Hierarchical multiple regression analysis was carried out to calculate the relationship between SRH and immune markers. RESULTS: In this sample, poor SRH was positively correlated with B (CD19(+)) cell numbers (beta = 0.260, p < 0.05) and IgG levels (beta = 0.335, p < 0.01) even after adjusting for depressive symptoms, age, education, marital status, smoking, alcohol consumption, physical activity, body mass index, sex, and sex x SRH interaction. The interaction between SRH and sex on the immune markers was not significant. CONCLUSION: Although the connection between SRH and immune markers was not strong in this context, the results suggest that poor SRH may be associated with reduced humoral immune system capacity to respond to new/latent challenges. The results provide some support for the immunological basis of SRH in healthier individuals.

Job satisfaction is associated with elevated natural killer cell immunity among healthy white-collar employees.

Although the association of job satisfaction with health has been well documented, little is known about the biological mechanisms underlying this relationship. This study investigates the association of job satisfaction with cell-mediated immunity among Japanese white-collar daytime workers. A total of 306 healthy full-time employees (141 women and 165 men), aged 22-69 (mean 36) years, provided a blood sample for the measurement of circulating immune (natural killer (NK), B, and total T) cells and NK cell cytotoxicity (NKCC) and completed a questionnaire survey during April to June 2002. Job satisfaction was measured by a 4-item scale from the Japanese version of the generic job stress questionnaire with higher scores indicating greater satisfaction. Analyses were done separately for women and men using a hierarchical multiple linear regression model controlling for multiple confounders. The results revealed that greater job satisfaction was positively correlated with NKCC (ß = .207; p = .029) and the number of NK (CD3(-)CD56(+)) cells (ß = .261; p = .008) in women. In men, job satisfaction was marginally correlated with NKCC (ß = .165; p = .050) but was not correlated with the number of NK (CD3(-)CD56(+)) cells (ß = .142; p = .107). Job satisfaction did not correlate with numbers of T (CD3(+)CD56(-)) and B (CD19(+)) cells in both women and men. Our findings suggest an independent association between job satisfaction and NK cells but the association seems to be stronger in women than in men. Although the results provide a support for the biological plausibility of the job satisfaction-health relationship, additional research is required to determine whether greater job satisfaction contributes to recovery/maintenance of NK cell immunity and host defense over time.

Active and passive smoking and depression among Japanese workers.

OBJECTIVE: To assess the relation of passive and active smoking to depressive symptoms in 1839 men and 931 women working in a suburb of Tokyo in 2002. METHOD: Self-reported smoking history and exposure to passive smoking (no, occasional, or regular) at work and at home. Depressive symptoms according to the Center for Epidemiologic Studies Depression Scale, with a cut-off point of 16. RESULTS: Compared to never smokers unexposed to passive smoking, never smokers reporting regular and occasional exposure to passive smoking at work had increased depressive symptoms. The adjusted odds ratios (aORs) were 1.92 (95% confidence interval (CI) 1.14, 3.23) for regular exposure and 1.63 (95% CI 1.08, 2.47) for occasional exposure. Current smokers had significantly increased depressive symptoms (aOR ranging from 2.25 to 2.38) but former smokers had only marginal increases of depressive symptoms (aOR ranging from 1.43 to 1.55). Gender did not modify the effects of active/passive smoking on depressive symptoms. CONCLUSION: Passive smoking at work and current smoking appear associated with higher levels of depressive symptoms.

The prevalence and correlates of occupational injuries in small-scale manufacturing enterprises.

Workers involved in small-scale manufacturing businesses are known to comprise a high-risk population for occupational injury. The present study investigated the prevalence and correlates of occupational injury in this population. A self-administered questionnaire that solicited answers about occupational information including injury, demographic characteristics, health conditions and lifestyle factors was collected from a sample of 1,298 workers in 228 small-scale manufacturing enterprises (defined as fewer than 50 workers) aged 16-78 (mean 46) yr in Yashio city, Saitama, Japan (response rate 65.5%). The enterprises were randomly selected from the 2000 edition of the city commercial directory corresponding to the distribution of types of businesses in the city. Occupational injury was assessed by asking subjects, ;Have you ever been injured during your work, including minor scratches and cuts in the previous 1-yr period?' The possible response was either ;yes' or ;no.' The prevalence of study-defined occupational injury among the workers was 35.6% (male 43.0%, female 17.9%). Among job types, manufacturing (44.2%) and driving (43.5%) had high rates of occupational injuries. Similarly, occupational injuries were high in the papermaking (54.5%) and machinery (47.7%) industries. For males, younger age, current or former smoking, insomnia symptoms, and disease(s) currently under treatment were correlated with injury, whereas for females, being unmarried, higher educational status, and insomnia symptoms were the correlating factors. Occupational injury is common among small-scale manufacturing businesses, and is associated with multiple controllable factors. Countermeasures such as prohibiting smoking during work, sleep health education, job safety training for young/inexperienced workers are appropriate methods for eliminating or reducing injuries.

Impact of psychosocial job stress on non-fatal occupational injuries in small and medium-sized manufacturing enterprises.

BACKGROUND: Workers involved in manufacturing are known to comprise a high-risk population for occupational injury, and this risk is greater in small and medium-sized enterprises (SMEs). The purpose of this study was to examine the association between psychosocial job stress and occupational injuries among workers in SMEs. METHODS: One thousand forty-nine men and 721 women from 244 SMEs participated in this study. Perceived job stress was evaluated with the Japanese version of the generic job stress questionnaire, which covered 14 job stress variables. Occupational injury was assessed by self-report during the last 1-year period. RESULTS: Workers with high quantitative workload (odds ratio [OR] = 1.55 for men, 1.62 for women), high cognitive demands (OR = 1.70 for men, 1.53 for women), and low job satisfaction (OR = 1.33 for men, 1.93 for women) had a significantly increased risk of occupational injury in the multivariate model. High variance in workload (OR = 1.70) and high job future ambiguity (OR = 1.35) in men, and low job control (OR = 2.04) and high intragroup conflict (OR = 1.66) in women were significantly associated with occupational injury. In manufacturing/production workers, high quantitative workload (OR = 1.91), high variance in workload (OR = 2.02), and high depressive symptoms (OR = 1.55) were significantly associated with injury in men, while low social support from colleagues (OR = 2.36) or family (OR = 2.51) was related to injury in women. CONCLUSIONS: These data point to an independent relationship between psychosocial job stress and self-reported occupational injury in SMEs.

Sleep-related risk of occupational injuries in Japanese small and medium-scale enterprises.

A cross-sectional study evaluated the contribution of daily sleep habits to occupational injuries. A self-administered questionnaire solicited answers about sleep, symptoms of depression, occupational injury, demographics, presence of diseases and lifestyle factors from 2,903 workers between the ages of 16-83 (mean 45) yr in small and medium-scale enterprises. Eight sleep habits were queried and dichotomized: 1) less or more than 6 hr of daily sleep, 2) taking more or less than 30 min to fall asleep (Difficulty initiating sleep; DIS), 3) awakening during sleep more or less than 3 times/wk (Difficulty maintaining sleep; DMS), 4) early morning awakening more or less than 3 times/wk (EMA), 5) definitely/somewhat difficulty waking up or not, 6) sleeping very poorly/not so well at night or not, 7) definitely/somewhat insufficient nightly sleep or not, and 8) difficulty in breathing during sleep more than once/week or less. Occupational injury was assessed by asking subjects 'Have you ever been injured during your work, including minor scratches and cuts (Yes/No)?' Both sleep and injury were assessed over the previous one year period. One-third of workers answered that they had experienced injury. Workers with sleep features of DIS, sleeping poorly at night, insufficient sleep, and insomnia had a significantly higher prevalence for injury after adjusting for multiple confounders. The findings suggest that poor nocturnal sleep habits are associated with self-reported occupational injury.