Work activity in food service: The significance of customer relations, tipping practices and gender for preventing musculoskeletal disorders.

Some evidence shows that food servers are exposed to an elevated risk of musculoskeletal disorders and injuries, and that their work activity varies by gender. Interviews of servers and observations of food service in Québec, Canada, were carried out in three restaurants and a questionnaire was administered to 64 workers from 44 other restaurants. The relationship with the customer has specific effects on work activity and transforms the physical, emotional and cognitive work. Strategies intended to speed service or otherwise related to the customer relationship can involve health risks. Women reported more direct food service (p < 0.01), a tendency to do more "housekeeping" tasks (p < 0.07) and fewer hours of work per week (p < 0.01). Women workers reported experiencing more sites of pain (p < 0.003). This exploratory study suggests that managing the server-customer relationship could be important in preventing musculoskeletal disorders in this population and that women are at particular risk.

Workplace psychological harassment: Gendered exposures and implications for policy.

This article reports on the results of an empirical study of working conditions including psychological harassment (workplace bullying) in the province of Québec, Canada, the first North American jurisdiction to regulate psychological harassment in its labor legislation. All empirical data provided in this article was drawn from the Québec Survey on Working, Employment and Occupational Health and Safety Conditions, conducted through 5071 telephone interviews of a representative sample of Québec workers, including the self-employed. Here we focus on employees, and provide bivariate and multivariate analyses. All analyses were stratified by gender. We provide a portrait of exposure to psychological harassment, and exposure to other psychosocial factors in the workplace associated with exposure to psychological harassment. Results show associations between exposure to psychological harassment and negative health measures including psychological distress, symptoms of depression, traumatic work accidents, musculoskeletal disorders and negative perception of health status. We report on steps taken by employees to put an end to the harassment. Gender similarities and differences in exposure, associated risk factors, health measures and strategies are presented and discussed in light of the legal context in which the study took place. We conclude with recommendations for prevention strategies that take into consideration the gender composition of the workplace.

Changes implemented during a workplace psychosocial intervention and their consistency with intervention priorities.

OBJECTIVES: To describe the changes implemented as part of a workplace psychosocial intervention. METHODS: The intervention was conducted in a public organization employing 1630 white-collar workers. The intervention was defined as all changes implemented to reduce adverse psychosocial work factors. A logbook was held to describe the changes implemented in the intervention group and in a comparable control group (N = 1282). RESULTS: Social support and reward were the psychosocial factors most targeted (41% to 83%). In comparison with the control group, the intervention group implemented four times more major changes and implemented changes, improving the employees' workload. CONCLUSIONS: Changes mainly targeted social support and reward. The intervention group implemented four times more major changes than the control group. The intervention group implemented changes targeting the workload, whereas no such changes were implemented in the control group.

Determinants of pain, functional limitations and health-related quality of life six months after total knee arthroplasty: results from a prospective cohort study.

BACKGROUND: Total knee arthroplasty (TKA) is an effective procedure. However, for some patients, the outcomes are not satisfactory. Identification of TKA determinants could help manage these patients more efficiently. The purpose of this study was to identify pre- and perioperative determinants of pain, functional limitations and health-related quality of life (HRQoL) 6 months after TKA. METHODS: 138 participants were recruited from 3 hospitals in Quebec City, Canada and followed up until 6 months after surgery. Data were collected through review of the subjects' medical files and structured telephone interviews before and 6 months after TKA. Pain and functional limitations were measured with the Western Ontario and McMaster Osteoarthritis Index (WOMAC) and HRQoL was measured with the SF-36 Health Survey. Independent variables included demographic, socioeconomic, psychosocial, clinical and surgical characteristics of participants as well as data on health services utilization. Stepwise multiple regression analysis was used to assess the strength of the associations between the independent variables and the WOMAC and SF-36 scores. RESULTS: Higher preoperative pain, cruciate retaining implants and the number of complications were significantly associated with worse pain 6 months after TKA (p < 0.05) and explained 11% of the variance of the WOMAC pain score. Higher preoperative functional limitations, being single, separated, divorced or widowed, being unemployed or retired and the number of complications were significantly associated (p < 0.05) with worse functional limitations 6 months after TKA and explained 16% of the variance of the WOMAC function score. Lower preoperative HRQoL, contralateral knee pain, higher psychological distress and comorbidities were significantly associated (p < 0.05) with worse HRQoL 6 months after TKA and explained 23% of the variance of the SF-36 physical functioning score. CONCLUSIONS: Several variables were found to be significantly associated with worse outcomes 6 months after TKA and may help identify patients at risk of poorer outcome. The identification of these determinants could help manage patients more efficiently and may help target patients who may benefit from extensive rehabilitation.

Obstacles to and facilitators of return to work after work-disabling back pain: the workers' perspective.

INTRODUCTION: Back pain entails considerable costs, particularly because many injured workers are absent from work for long periods. Factors that influence return to work among workers with back pain are still, however, not well understood. This qualitative study aimed at documenting affected workers' perspective on the: 1--difficulties caused by back pain, and 2--most important obstacles to and facilitators of return to work. METHODS: Two focus groups composed of workers having suffered from work-disabling back pain were held: a group of participants who had returned to work (n = 9) and a group of participants who had not returned or had recently returned to work (n = 10). The verbatim accounts of the discussions were transcribed and a content analysis was carried out that included a ranking of items. RESULTS: Difficulties caused by back pain were related to: (1) personal, (2) family, (3) social, (4) occupational, and (5) financial factors, and (6) health services. Obstacles to and facilitators of return to work were of 4 different types: (1) occupational factors, (2) factors associated with the utilization of health services, (3) clinical, and (4) personal factors. Persistent pain, lack of access to information or support groups, and lack of collaboration and understanding from employer were the most important obstacles identified, whereas knowledge of one's limits and physical training were perceived to be the most important facilitators of return to work, ahead of work-related factors. Differences between groups' perceptions were attributed mainly to control beliefs. CONCLUSIONS: Personal, clinical, occupational and health services factors are perceived by workers with back pain to play a crucial role in determining whether they return to work or not.

The impacts of pre-surgery wait for total knee replacement on pain, function and health-related quality of life six months after surgery.

OBJECTIVE: The purpose of the current study was to assess, in patients scheduled for primary total knee replacement (TKR), the effects of pre-surgery waiting time on pain and functional limitations related to the knee joint undergoing surgery, on health-related quality of life (HRQoL) and on contralateral knee pain 6 months after surgery. METHOD: A total of 141 patients scheduled for TKR were recruited from three hospitals in Quebec City, Canada, and followed up until 6 months after surgery. Pre-surgery wait, defined as the time between enrolment on the pre-surgery waiting list and surgery, was considered in four categories (≤3, >3-6, >6-9, >9 months). Pain and functional limitations were measured with the Western Ontario and McMaster Osteoarthritis Index (WOMAC). HRQoL was measured with the SF-36. RESULTS: Mean pre-surgery waiting time was 184 (SD: 120.8) days. Six months after TKR, a significant difference was seen between the four groups of pre-surgery wait in terms of HRQoL SF-36 role physical [F(3, 136) = 2.74, P = 0.046] and contralateral knee WOMAC pain [F(3, 136) = 5.78, P = 0.0009] scores. Participants with the longest pre-surgery wait (>9 months) showed the worst scores 6 months after TKR. CONCLUSIONS: Longer pre-surgery waiting time had a negative clinically important impact on HRQoL and contralateral knee pain 6 months after surgery.

Implementation of an organizational-level intervention on the psychosocial environment of work: comparison of managers' and employees' views.

OBJECTIVE: To compare employees' and managers' perceptions of implemented changes in an organizational-level workplace intervention. METHODS: Nine departments participated in an intervention aimed at reducing adverse psychosocial work environment factors. On the basis of a prior risk evaluation, department managers were responsible for decisions and implementation of the intervention, that is, work changes. These were recorded in logbooks, which were compared to employees' questionnaire ratings of the changes. RESULTS: For half of the changes, proportion of employees reporting that a specific change was implemented did not correspond with the amount of manager-reported changes. CONCLUSIONS: Evaluation of employees' and managers' perceptions of an organizational-level intervention is crucial, since these perceptions do not necessarily fully correspond. Employees perceived changes that were not reported by department managers and they also did not perceive exposure to all changes reported by the managers.

Effort-reward imbalance at work and recurrent coronary heart disease events: a 4-year prospective study of post-myocardial infarction patients.

OBJECTIVE: Prospective studies have shown that effort-reward imbalance (ERI) at work is associated with the incidence of a first coronary heart disease (CHD) event. However, it is unknown whether ERI at work increases the risk of recurrent CHD events. The objective of this study was to determine whether ERI at work and its components (effort and reward) increase the risk of recurrent CHD in post-myocardial infarction (post-MI) workers. METHODS: We carried out a prospective cohort study of 669 men and 69 women who returned to work after a first MI. ERI at work was assessed by telephone interview using validated scales of reward and psychological demands. The outcome was a composite of fatal CHD, nonfatal MI, and unstable angina. CHD risk factors were documented in medical files and by interview. The participants were followed up for a mean period of 4.0 years (1998-2005). RESULTS: During the follow-up, 96 CHD events were documented. High ERI and low reward were associated with recurrent CHD (respective adjusted hazard ratios [HRs] = 1.75, 95% confidence interval [CI] = 0.99-3.08, and HR = 1.77, 95% CI = 1.16-2.71). There was a gender interaction showing stronger effects among women (respective adjusted HRs for high ERI and low reward: HR = 3.95, 95% CI = 0.93-16.79, and HR = 9.53, 95% CI = 1.15-78.68). CONCLUSIONS: Post-MI workers holding jobs that involved ERI or low reward had increased risk of recurrent CHD.

Effort-reward imbalance at work and psychological distress: a validation study of post-myocardial infarction patients.

OBJECTIVES: To examine whether the psychometric properties of the effort-reward imbalance (ERI) at work scales could be replicated with post-myocardial infarction (post-MI) patients and to measure the criterion validity through its association with psychological distress. METHODS: A cross-sectional survey was conducted among 814 patients (739 men and 75 women) who had returned to work after their first MI and who were followed up by telephone at an average of 2.2 years after their baseline interview (1998-2000). The psychological demands scale of the Karasek Job Content Questionnaire was used to measure effort. Reward was measured with nine items from the original reward scale by Siegrist plus two proxy items. Exploratory and confirmatory factor analyses were used to test the theoretical structure of ERI. Using log-binomial regression models, we evaluated the association between ERI scales and psychological distress measured with the 14-item Psychiatric Symptom Index. RESULTS: ERI scales and subscales demonstrated adequate internal consistencies. Exploratory factor analysis using oblique (promax) rotation yielded a three-factor solution with items representative of extrinsic effort (Factor 1) and reward subscales (Factors 2 and 3). Confirmatory factor analysis demonstrated a good fit with the data. The internal consistencies and discriminant validities of the ERI scales were satisfactory. Furthermore, effort, reward, and ERI ratio were significantly associated with psychological distress (adjusted prevalence ratio [PR] = 1.71, 95% confidence interval [CI] = 1.26-2.31; PR = 1.63, 95% CI = 1.16-2.29; and PR = 1.70, 95% CI = 1.17-2.47, respectively). CONCLUSIONS: The psychometric properties of the ERI scales were generally reproduced among post-MI patients. The associations with psychological distress supported the criterion validity of the ERI scales in this population.

Long-term effects of an intervention on psychosocial work factors among healthcare professionals in a hospital setting.

OBJECTIVE: This study assessed the long-term effects of a workplace intervention aimed at reducing adverse psychosocial work factors (psychological demands, decision latitude, social support and effort-reward imbalance) and mental health problems among health care professionals in an acute care hospital. METHODS: A quasi-experimental design with a control group was used. Pre-intervention (71% response rate) and 3-year post-intervention measures (60% response rate) were collected by telephone interviews with validated instruments. RESULTS: Three years after the intervention, all adverse psychosocial factors except one were reduced in the experimental group, and the improvement was statistically significant for 5/9 factors: psychological demands, effort-reward imbalance, quality of work, physical load and emotional demands. In addition, all health indicators improved and 2/5 significantly: work-related and personal burnout. In the control hospital, three work factors improved significantly but two deteriorated significantly: decision latitude and social support. All health problem deteriorated, although not significantly, in the control hospital. Moreover, 3 years after the intervention, the mean of all adverse factors except one (psychological demands) and all health indicators was significantly more favourable in the experimental than the control hospital, after adjusting for pre-intervention measures. CONCLUSION: These results support the long-term effectiveness of the intervention. The reduction in many psychosocial factors in the experimental hospital may have clinical significance since most health indicators also improved in this hospital. These results support the whole process of the intervention given that significant improvements in psychosocial factors and health problems were observed in the experimental hospital but not in the control hospital.

Intervention study on psychosocial work factors and mental health and musculoskeletal outcomes.

Organizations are facing ever-stiffer competition in the current globalized economy, and employees are consequently being exposed to increasingly adverse psychosocial work factors. Psychosocial work factors, also called psychosocial stressors, refer to all organizational factors and interpersonal relationships in the workplace that may affect workers' health. Two well-defined and internationally recognized theoretical models are used to assess these factors: the Karasek demand-latitude-support model and the Siegrist effort-reward imbalance model. The Karasek and Siegrist models reflect specific components of the work environment for which there is empirical evidence of a deleterious effect on health. Preventive interventions targeting these factors are conducted in workplaces. However, few studies have rigorously documented these interventions and their effectiveness in reducing adverse work factors and improving health outcomes. Most previous intervention studies were limited by (1) a short follow-up that may not have provided sufficient time for effects to appear, (2) small sample sizes (N ≤ 100) that limited the statistical power and the possibility of detecting results and (3) rare assessment of the Siegrist model. The current paper presents the overall design and the main results of an intervention study on psychosocial work factors and related mental health and musculoskeletal outcomes. The study integrated (1) a development phase that aimed at identifying the changes needed to reduce psychosocial factors in the target population and the best ways to bring about these changes, (2) an implementation phase that systematically documented how the intervention was carried out and (3) an effectiveness phase that evaluated whether the intervention was successful in reducing adverse psychosocial work factors and health problems. In addition, the study used repeated measurements of psychosocial work factors and health indicators at baseline and six and 30 months post-intervention to assess short- and medium-term effects of the intervention.

Processes of task performance as measured by the Assessment of Motor and Process Skills (AMPS): A predictor of work-related outcomes for adults with schizophrenia?

OBJECTIVE: To determine whether the processes of task performance as measured by the Assessment of Motor and Process Skills (AMPS) would discriminate between the employment levels of adults with schizophrenia. PARTICIPANTS: Twenty adults with schizophrenia who were engaged either in competitive employment, supported employment, prevocational training, or non-vocational activities, participated in this exploratory study. METHODS: Each participant completed the AMPS, the Positive and Negative Syndrome Scale (PANSS), the Addiction Severity Index (ASI), and the Worker Role Interview (WRI) to gather data about their occupational performance, symptoms, drug / alcohol use, and psychosocial / environmental factors that might influence their work-related outcomes. RESULTS: Analysis revealed a moderate correlation between the level of employment and the global scores of the process skills scale in the AMPS. CONCLUSIONS: This should be seen as preliminary evidence that beyond the basic cognitive functions, processes of task performance may also be a predictor of work-related outcomes for this population. The results also highlighted the importance of considering personal causation and worker roles when assessing the work capacities of these clients. Finally, findings supported the four levels of employment used in this study, which appeared to form a continuum from non-vocational activities, prevocational training, supported employment, through to competitive employment.

[The association between psychosocial work demands and mental health problems in Quebec: a gender-based analysis]. / Contraintes psychosociales de travail et problèmes de santè mentale au Québec: une analyse différenciée selon le sexe.

OBJECTIVE: The objective of the study was to conduct a gender-based analysis of associations between certain psychosocial work demands and certain mental health problems in Québec. METHODS: The study comprised 2,877 workers, with a response rate of 78%. Data collection was conducted by means of computer-assisted interviews, mainly in person. The mental health problems retained in the model were: psychological distress, a major episode of depression, and a positive score on the global depression index. The psychosocial work demands measured were: level of decision latitude, of psychological job demands and of social support. A set of job and personal characteristics were also measured. FINDINGS: In all, 41% of Québec workers have a low level of decision authority and 46% experience low skill discretion at work. Moreover, 45% reported having little social support and 40% high psychological job demands. The findings show that 25% of the population studied had experienced a level of psychological distress during the month preceding the survey, and during the previous 12 months, 4% had had a major episode of depression and 6.4% a score on the global depression index indicating depression. These indicators seemed more marked among women compared to men. The findings of the multivariate analysis showed that among women, low skill discretion surprisingly appeared to be a protective factor against a major episode of depression. CONCLUSION: The reasons for these differences between the sexes are discussed and seem related to such factors as more unfavourable working conditions for women, as well as double workloads (home and work), and a relationship to work that differs from that of men.

The burden of wait for knee replacement surgery: effects on pain, function and health-related quality of life at the time of surgery.

OBJECTIVE: To examine the change in pain and function related to the knee scheduled for surgery, change in health-related quality of life (HRQoL) and change in contralateral knee pain during pre-surgery wait up until time of surgery. METHODS: One hundred and fifty-three patients scheduled for knee replacement were recruited from three hospitals in Québec City, Canada, and followed until surgery. Pre-surgery wait, defined as the time between enrolment on the pre-surgery wait list and surgery, was considered in five categories (< or =3, >3-6, >6-9, >9-12 and >12 months). Pain and functional limitations were measured with the Western Ontario and McMaster Osteoarthritis Index (WOMAC) and HRQoL was measured with the medical outcomes study 36-item short form health survey. RESULTS: Mean pre-surgery wait time was 183 (s.d. 121.9) days. Subjects having waited >9-12 months showed significant deterioration of the WOMAC pain (-9.9; 95% CI -19.2, -0.54) and function (-11.1; 95% CI -18.7, -3.4) scores. On the HRQoL SF-36 physical functioning scale, a significant deterioration was seen in subjects having waited >9-12 months (-11.3; 95% CI -18.4, -4.2) and >12 months (-7.1; 95% CI -12.9, -1.3). On the contralateral knee WOMAC pain score, a significant deterioration was observed in subjects having waited >6-9 months (-10.4; 95% CI -16.9, -3.9) and >12 months (-10.7; 95% CI -19.7, -1.7). CONCLUSION: Pre-surgery wait time has a negative significant impact on pain, function and HRQoL at the time of surgery. The magnitude of deterioration seen in this study may be clinically important. The effects of this pre-surgery deterioration on post-surgery outcomes need to be investigated.

Psychosocial work environment, interpersonal violence at work and psychotropic drug use among correctional officers.

The aims of this study were to establish the prevalence of psychotropic drug use, measure the association between job strain, extrinsic efforts-rewards ratio, interpersonal violence and psychotropic drug use among officers working in correctional facilities in the province of Quebec in Canada. This study also examined if interpersonal violence at work is an intermediate factor in the causal chain between psychosocial risk factors at work and psychotropic drug use. A cross-sectional study was performed which included 1288 Quebec correctional officers. The participants answered a self-administered questionnaire in 2007 assessing psychological demands, decision latitude, extrinsic efforts, rewards, overcommitment, intimidation, psychological harassment, social support in the actual job, psychotropic drug use during the month preceding the questionnaire and sociodemographic variables. Binomial regressions were performed for the principal associations and a bootstrap analysis was performed in order to evaluate interpersonal violence as an intermediate factor between psychosocial risk factors at work and psychotropic drug use. The prevalence of psychotropic drug use among correctional officers was 14.7%. The prevalence ratios (PR) for the associations between job strain, extrinsic efforts-rewards ratio, social support from colleagues and supervisors, intimidation and psychological harassment adjusted for age and gender were respectively 1.4 (95% CI 0.9-2.2), 1.6 (95% CI 1.2-2.2), 1.7 (95% CI 1.3-2.3), 1.4 (95% CI 0.9-2.4) and 1.5 (95% CI 1.1-2.0). The value of the indirect effect evaluating psychological harassment as an intermediate factor was not statistically significant (value=0.0087, 95% CI -0.0033 to 0.0207). An imbalanced extrinsic efforts-rewards ratio, low social support from colleagues and supervisors and psychological harassment at work were separately associated with psychotropic drug use among correctional officers. Psychological harassment was not found to be an intermediate factor.

The adverse effects of psychosocial constraints at work: a participatory study to orient prevention to mitigate psychological distress.

Studies conducted with the JDC (job demand-control) or ERI (effort-reward imbalance) models highlight the links between constraints in the psychosocial work environment and psychological distress. However, the underlying mechanisms are not very well understood. The present participatory qualitative study explored these mechanisms with a view to identifying both the processes at work in these relationships and some targets for problem prevention. This investigation was conducted with white-collar workers from a public service organisation within one Canadian province (Quebec) who participated in six discussion groups during an intervention designed to reduce psychosocial environment constraints. The data gathered in these groups was subjected to content analysis through thematic categorization. The findings indicate that psychosocial constraints take root in situations that adversely affect subjective dimensions relating to personal and professional experience. An interpretive model is proposed on the basis of these findings, which helps to elucidate the dynamic relationships that exist among the various aspects of work experience that can lead to psychological distress. From this model, some targets for problem prevention have emerged.

Waiting for total knee replacement surgery: factors associated with pain, stiffness, function and quality of life.

BACKGROUND: Recent evidences show that education and rehabilitation while waiting for knee replacement have positive effects on the patients' health status. Identification of factors associated with worse pain, function and health-related quality of life (HRQoL) while waiting for surgery could help develop pre-surgery rehabilitation interventions that target specifically these factors and prioritize patients that may benefit the most from them. The objectives of this study were to measure pain, stiffness, function and HRQoL in patients at enrolment on waiting lists for knee replacement and to identify demographic, clinical, socioeconomic and psychosocial characteristics associated with these outcomes. METHODS: This study is part of a broader study measuring the effects of pre-surgery wait in patients scheduled for knee replacement. From 02/2006 to 09/2007, 197 patients newly scheduled for total knee replacement were recruited from the waiting lists of three university hospitals in Quebec City, Canada. Pain, stiffness and function were measured with the Western Ontario and McMaster Osteoarthritis Index (WOMAC) and HRQoL was measured with the SF-36 Health Survey. Stepwise multiple regression analysis was used to assess the strength of the associations between the independent variables and the WOMAC and SF-36 scores. RESULTS: The scores of all eight HRQoL physical and mental domains of the SF-36 were significantly lower than aged matched Canadian normative data (p < 0.05). Contralateral knee pain, higher psychological distress, higher body mass index (BMI) and the use of a walking aid were significantly associated with worse function (p < 0.05) and contributed to 22% of the variance of the WOMAC function score (multiple r = 0.47). A higher BMI, the use of a walking aid, contralateral knee pain and advanced age were significantly associated with worse physical function (p < 0.05) and contributed to 17% of the variance of the SF-36 HRQoL physical functioning score (multiple r = 0.41). CONCLUSION: Patients waiting for knee replacement have poor function and HRQoL. Characteristics that were found to be associated with these outcomes could help develop pre-surgery rehabilitation program and prioritize patients that may benefit the most from them. Such programs could include interventions to reduce psychological distress, therapeutic exercises targeting both knees and weight loss management.

Job strain and risk of acute recurrent coronary heart disease events.

CONTEXT: There is evidence that job strain increases the risk of a first coronary heart disease (CHD) event. However, little is known about its association with the risk of recurrent CHD events after a first myocardial infarction (MI). OBJECTIVE: To determine whether job strain increases the risk of recurrent CHD events. DESIGN, SETTING, AND PATIENTS: Prospective cohort study of 972 men and women aged 35 to 59 years who returned to work after a first MI and were then followed up between February 10, 1996, and June 22, 2005. Patients were interviewed at baseline (on average, 6 weeks after their return to work), then after 2 and 6 years subsequently. Job strain, a combination of high psychological demands and low decision latitude, was evaluated in 4 quadrants: high strain (high demands and low latitude), active (high demands and high latitude), passive (low demands and low latitude), and low strain. A chronic job strain variable was constructed based on the first 2 interviews, and patients were divided into those exposed to high strain at both interviews and those unexposed to high strain at 1 or both interviews. The survival analyses were presented separately for 2 periods: before 2.2 years and at 2.2 years and beyond. MAIN OUTCOME MEASURE: The outcome was a composite of fatal CHD, nonfatal MI, and unstable angina. RESULTS: The outcome was documented in 206 patients. In the unadjusted analysis, chronic job strain was associated with recurrent CHD in the second period after 2.2 years of follow-up (hazard ratio [HR], 2.20; 95% CI, 1.32-3.66; respective event rates for patients exposed and unexposed to chronic job strain, 6.18 and 2.81 per 100 person-years). Chronic job strain remained an independent predictor of recurrent CHD in a multivariate model adjusted for 26 potentially confounding factors (HR, 2.00; 95% CI, 1.08-3.72). CONCLUSION: Chronic job strain after a first MI was associated with an increased risk of recurrent CHD.

Psychosocial work environment, interpersonal violence at work and mental health among correctional officers.

The main purpose of this study was to present changes occurring between 2002 and 2004 in the prevalence of psychosocial constraints and interpersonal violence at work among officers working in correctional facilities in Quebec. Results suggest that in the absence of specific organizational intervention aimed at improving a deleterious work situation, exposure to low decision latitude remained similar between 2002 and 2004, while exposure to high psychological demands improved somewhat, for both men and women. In 2000, rates of exposure of correctional officers in Quebec to high psychological demands, low decision latitude and the combination of high psychological demands and low decision latitude (job strain) were significantly higher than those obtained for the entire population of workers in Quebec in contact with the public. Exposure of correctional officers in Quebec to intimidation at work increased substantially between 2002 and 2004, among both men and women. Globally speaking, rates of exposure to intimidation by colleagues and superiors practically doubled between 2000 and 2004. Rates of exposure to intimidation among correctional officers in Quebec were particularly high in 2004 (71% among men 66% among women) compared to rates in another study conducted among federal correctional officers (48%) by Samak. The present study also showed that in 2004, correctional officers in Quebec were more likely to present signs of psychological distress linked with work when they were exposed to high psychological demands, low decision latitude, job strain and poor social support from superiors and colleagues. Psychological distress was also shown to be greater when reward at work was scarce and when there was an imbalance between effort and reward at work. Finally, in 2004, psychological distress among correctional officers was also associated with intimidation and psychological harassment at work.