Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) participant's profile regarding self-rated health: a multiple correspondence analysis.

BACKGROUND: Self-rated health (SRH) - one of the most common health indicators used to verify health conditions - can be influenced by several types of socioeconomic conditions, thereby reflecting health inequalities. This study aimed to evaluate the participant profiles regarding the association between self-rated health and social and occupational characteristics of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). METHODS: Cross-sectional design, including 11,305 individuals. Self-rated health was categorized as good, fair, and poor. The relationship between socio-demographic, psychosocial work environment, health-related variables, and self-rated health was analyzed by multiple correspondence analysis (stratified by age: up to 49 years old and 50 years old or more). RESULTS: For both age strata, group composition was influenced by socioeconomic conditions. Poor SRH was related to lower socioeconomic conditions, being women, black self-declared race/ethnicity, being non-married/non-united, low decision authority, low skill discretion, and obesity. CONCLUSION: To promote health, interventions should focus on reducing existing socioeconomic, race, and gender inequalities in Brazil.

Job Strain and Late-Life Cognition: Findings From the Puerto Rican Elderly Health Conditions Study.

Objectives: We examined associations between job strain and cognitive aging in a sample of older Puerto Ricans. Methods: Members of the Puerto Rican Elderly: Health Conditions study, aged 60-100 years at baseline, participated. Job strain indicators were quantified from O*NET (n = 1632) and a matrix of Job Content Questionnaire scores (JCQ; n = 1467). Global cognition was assessed twice across 4 years. Results: Controlling for age, sex, depressive symptoms, financial problems, hypertension, diabetes, childhood economic hardship, low job control and high job strain were consistently associated with greater cognitive decline. Adding education attenuated these associations. High education strengthened the JCQ job control-cognitive change link. Discussion: Low job control and high job strain may accelerate cognitive aging in this population. However, it may be more difficult to disentangle the intersecting roles of education and job strain in cognitive aging among older Puerto Ricans relative to older adults from contiguous United States or Europe.

Effects of Job Content and Physical Activity on Body Mass Index among Obese Managers of the Mexican Manufacturing Industry.

Mental health disorders resulting from work stressors are increasing in the Mexican manufacturing industry and worldwide. Managerial positions in these contexts are highly stressful, and although physical activity may reduce the negative effects of work stress, the relationships between these two aspects regarding their effects on the body mass index (BMI) of obese managers are scarcely studied. This article aims to study such relationships by using the Job Content Questionnaire (JCQ) dimensions with the Baecke's physical activity questionnaire dimensions and analyzing their effects on the BMI. A sample of 255 managers from the Mexican industry, with a (BMI > 30) participated by answering the surveys and providing their weight, their height, and certain sociodemographic information. The research hypotheses were tested using WarpPLS® 6.0 for structural equation modeling. The results for three models featuring acceptable reliability to estimate the direct, indirect, and total effects are presented. The first model showed a medium explanatory power, the variable of job decision-making authority having the greatest direct effect on BMI. The second model showed a medium explanatory power, and the variable of physical activity during leisure-time observed the unique direct effect on BMI. Finally, although the integrating model showed a small explanatory power, both work stress and the physical activity exerted observed direct effects on BMI reduction.

Associations of alternative operationalizations of job strain with health and well-being outcomes in the same multioccupational worker sample.

OBJECTIVES: The main goal of this study was to evaluate, in a large, occupationally diverse sample of Colombian workers, the association between alternative methods of operationalizing job strain and various health and well-being measures using the original Job Content Instrument (Job Content Questionnaire). We examine whether the specific way job strain is operationalized can explains differing variance in the outcomes. METHODS: A cross-sectional survey was conducted using self-report instruments. A total of 168 496 workers affiliated with the Colombian General System of Occupational Hazards answered a questionnaire that evaluated demographics, job demands and control, stress symptoms, general and mental health, vitality, job satisfaction, and diagnosis of hypertension. Hierarchical linear and logistic regression analyses were conducted. Seven different formulations of job strain were used as predictors. RESULTS: Results Differences in operationalization of job strain explained similar and significant percentages of variance in outcomes used in this study. Definition of job strain as cases found within the most extreme quartiles of high demands and low control explained more variance than alternative characterizations of job strain. Job strain definitions were predictive of hypertension, although did not explain additional variance in the model. CONCLUSIONS: The effect of psychological demands and control on health and well-being appears to be additive and not multiplicative. A definition of job strain that takes into account those most at risk in the sample appears have a better predictive value than alternative formulations.

Use of assessment scales, turnover and job strain in nursing staff: A study in a Colombian hospital.

AIM: To evaluate the association between job strain and socio-demographic characteristics, social support, job insecurity, use of patient assessment scales, and turnover of nursing staff in a Colombian hospital. BACKGROUND: Nursing is an occupation with high probability of job strain. Use of patient assessment scales and turnover of nursing staff could increase exposure to psychosocial risk. METHOD: A cross-sectional study of 222 nurses was conducted. A survey and the Job Content Questionnaire were used to obtain data at the individual level and free lists and institutional records were used at the hospital unit level. The associations of interest were evaluated with a logistic regression model with robust variance estimator. RESULTS: Many nurses (50.9%) nurses reported job strain, which was positively associated with high use of patient assessment scales (OR = 2.73; 95% CI = 1.35-5.51) but negatively associated with social support (OR = 0.89; 95% CI = 0.80-0.98). Turnover was not statistically associated with job strain. CONCLUSION: Job strain among nurses was associated with a high use of patient assessment scales, but not with turnover of nursing staff. IMPLICATIONS FOR NURSING MANAGEMENT: The findings of this study suggest possible opportunities for managers to improve nursing processes, the work conditions of nursing staff, and the quality of institutions.

Occupational stress and job dissatisfaction with health work.

OBJECTIVE: The purpose of this study is to evaluate the association between psychosocial aspects at work and dissatisfaction among health workers in five cities in Bahia, Brazil. METHODS: The evaluation was based on different models proposed to measuring occupational stress and possible combinations between them: demand-control model (DCM) and effort-reward imbalance (ERI). We conducted a cross-sectional epidemiological study including 3084 health workers. The analysis considered the association between partial/full/partial (combined) occupational stress models (the variable "exposure") and job dissatisfaction (the variable "outcome"). RESULTS: Dissatisfaction rate was 26%. Full DCM and ERI models were better than partial ones to investigate job dissatisfaction. After adjustments, the combined models presented more robust measures of prevalence ratio than models evaluated separately (PR 2.93; CI 2.26-3.80). CONCLUSIONS: The combination of models has shown greater capacity to identify situations of job dissatisfaction and provided more potential information to support actions for workers' health.

Occupational stress and job dissatisfaction with health work

Abstract Objective: The purpose of this study is to evaluate the association between psychosocial aspects at work and dissatisfaction among health workers in five cities in Bahia, Brazil. Methods: The evaluation was based on different models proposed to measuring occupational stress and possible combinations between them: demand-control model (DCM) and effort-reward imbalance (ERI). We conducted a cross-sectional epidemiological study including 3084 health workers. The analysis considered the association between partial/full/partial (combined) occupational stress models (the variable "exposure") and job dissatisfaction (the variable "outcome"). Results: Dissatisfaction rate was 26%. Full DCM and ERI models were better than partial ones to investigate job dissatisfaction. After adjustments, the combined models presented more robust measures of prevalence ratio than models evaluated separately (PR 2.93; CI 2.26-3.80). Conclusions: The combination of models has shown greater capacity to identify situations of job dissatisfaction and provided more potential information to support actions for workers' health. (AU)

Shift work, job strain, and metabolic syndrome: Cross-sectional analysis of ELSA-Brasil.

BACKGROUND: Shift work and psychosocial stressors may contribute to higher metabolic syndrome (MetS) incidence. Few studies investigated whether the presence of both factors simultaneously has a synergic effect on risk of MetS. METHODS: This cross-sectional analysis used baseline data (2008-2010) for 10 960 current workers from ELSA-Brasil. Multiple logistic regression was used to estimate independent associations between shift work and job strain and MetS. An interaction between these factors was tested by including a multiplicative term in the final model. RESULTS: Exposure to three-shifts a week (that is, three 12 h shifts of work followed by 36 h of rest) and high job-strain were independently associated with greater risk of MetS. We found no indication (P > 0.05) of interaction between working in shifts and job strain on MetS. CONCLUSIONS: Efforts to reduce job strain and shift work should be considered as part of a primary prevention strategy to reduce the risk of MetS.

Work Environment, Stress, and Driving Anger: A Structural Equation Model for Predicting Traffic Sanctions of Public Transport Drivers.

Public transport is an effective and sustainable alternative to private vehicle usage, also helping to reduce the environmental impact of driving. However, the work environment of public transport operators is full of adverse conditions, which, together with their high mileage, may increase the occurrence of negative safety outcomes such as traffic accidents, often preceded by risky road behaviors enhanced by stress, anger, and difficult operating conditions. The aims of this study were, first, to determine the association between work-related psychosocial factors and individual characteristics of public transport drivers and the rate of traffic sanctions they are subject to; and second, to assess the mediation of driving anger in this relationship. A sample of professional drivers (57.4% city bus, 17.6% taxi, and 25% inter-urban bus male operators) was used for this cross-sectional study, responding to a five-section survey including demographic data and driving-related factors, psychosocial work factors including job stress, driving stress, risk predisposition, and driving anger. The results of this study showed significant associations between work-related factors: measures of stress and self-reported rates of traffic fines. Second, it was found that driving anger mediates the associations between driving stress, risk predisposition, and traffic sanctions; and partially mediates the association between driving experience, hourly intensity, and job stress. This study supports the idea that traffic penalties reported by public transport rates are preceded by work-related, personality, and other individual factors that, when combined with driving anger, enhance the occurrence of road misbehavior that may affect overall road safety.

Using Gamma and Quantile Regressions to Explore the Association between Job Strain and Adiposity in the ELSA-Brasil Study: Does Gender Matter?

This paper explores the association between job strain and adiposity, using two statistical analysis approaches and considering the role of gender. The research evaluated 11,960 active baseline participants (2008-2010) in the ELSA-Brasil study. Job strain was evaluated through a demand-control questionnaire, while body mass index (BMI) and waist circumference (WC) were evaluated in continuous form. The associations were estimated using gamma regression models with an identity link function. Quantile regression models were also estimated from the final set of co-variables established by gamma regression. The relationship that was found varied by analytical approach and gender. Among the women, no association was observed between job strain and adiposity in the fitted gamma models. In the quantile models, a pattern of increasing effects of high strain was observed at higher BMI and WC distribution quantiles. Among the men, high strain was associated with adiposity in the gamma regression models. However, when quantile regression was used, that association was found not to be homogeneous across outcome distributions. In addition, in the quantile models an association was observed between active jobs and BMI. Our results point to an association between job strain and adiposity, which follows a heterogeneous pattern. Modelling strategies can produce different results and should, accordingly, be used to complement one another.

Interaction between demand-control and social support in the occurrence of common mental disorders / Interação entre demanda-controle e apoio social na ocorrência de transtornos mentais comuns

ABSTRACT OBJECTIVE To analyze the interaction between the psychosocial aspects of work and the occurrence of common mental disorders among health workers. METHODS This is a cross-sectional study conducted with a representative sample of workers of the primary health care of five municipalities of the State of Bahia, Brazil, in 2012. The variable of outcome were the common mental disorders evaluated by the SRQ-20, and the variables of exposure were high demand (high psychological demand and low control over the work) and low social support in the workplace. Interaction was checked by the deviation of the additivity of the effects for the factors studied from the calculation of excess risk from interaction, proportion of cases attributed to interaction, and the synergy index. RESULTS The global prevalence of common mental disorders was 21%. The group of combined exposure has shown higher magnitude (high demand and low social support), reaching 28% when compared to the 17% in the situation of no exposure (low demand and high social support). CONCLUSIONS The results strengthen the hypothesis of interaction between the factors investigated, directing to the synergy of the effects.

RESUMO OBJETIVO Analisar a interação entre aspectos psicossociais do trabalho e a ocorrência de transtornos mentais comuns entre trabalhadores da saúde. MÉTODOS Estudo transversal conduzido em amostra representativa de trabalhadores da atenção básica de cinco municípios da Bahia em 2012. As variáveis desfecho foram os transtornos mentais comuns avaliados pelo SRQ-20, as de exposição foram a alta exigência (alta demanda psicológica e baixo controle sobre o próprio trabalho) e o baixo apoio social no trabalho. A interação foi verificada pelo afastamento da aditividade dos efeitos para fatores estudados a partir do cálculo do excesso de risco devido à interação, proporção de casos atribuída à interação e índice de sinergia. RESULTADOS A prevalência global de transtornos mentais comuns foi de 21%. Apresentou maior magnitude no grupo de exposição combinada (alta exigência e baixo apoio social), chegando a 28% quando comparada a 17% na situação de nenhuma exposição (baixa exigência e alto apoio social). CONCLUSÕES Os resultados fortalecem a hipótese de interação entre os fatores investigados, com direção para a sinergia dos efeitos.

Work-family conflict, lack of time for personal care and leisure, and job strain in migraine: Results of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

BACKGROUND: Work-family conflict and time scarcity may affect health. We investigated the association between these issues and migraine, taking into account job strain. METHODS: Baseline data from ELSA-Brasil (6,183 women; 5,664 men) included four indicators of work-family conflict: time- and strain-based interference of work with family (TB-WFC, SB-WFC), interference of family with work (FWC) and lack of time for personal care and leisure (LOT). Migraine was classified according to International Headache Society criteria. RESULTS: Among women, definite migraine was associated with SB-WFC (odds ratio [OR] = 1.28; 95% confidence interval [CI] 1.06-1.55), FWC (OR = 1.32; 1.00-1.75), and LOT (OR = 1.30; 1.08-1.58). Probable migraine was associated with SB-WFC (OR = 1.17; 1.00-1.36). High psychological job demands and low social support interacted with LOT in association with definite migraine. Among men, probable migraine was associated with LOT (OR = 1.34; 1.09-1.64), and there were interactions between job strain and WFC for probable migraine. CONCLUSIONS: Balancing the demands of professional and domestic spheres could be highly relevant in the management of migraines. Am. J. Ind. Med. 59:987-1000, 2016. © 2016 Wiley Periodicals, Inc.

Estresse no trabalho e hipertensão arterial em profissionais de enfermagem da rede municipal de saúde de Belo Horizonte, Minas Gerais, Brasil / Job strain and arterial hypertension in nursing professionals from the municipal healthcare network in Belo Horizonte, Minas Gerais, Brazil

Resumo Objetivo: analisar a associação entre estresse no trabalho e hipertensão arterial (HA). Método: estudo transversal com amostra probabilística de 273 profissionais de enfermagem da rede municipal de saúde de Belo Horizonte, Minas Gerais, Brasil, desenvolvido entre setembro de 2008 e janeiro de 2009. O estresse no trabalho foi mensurado com o modelo de demanda-controle e a hipertensão arterial por meio do autorrelato de diagnóstico médico da doença ou uso de medicação anti-hipertensiva. Razões de prevalência (RP) de HA e seus respectivos intervalos de confiança de 95% (IC 95%) foram ajustados pela técnica de regressão multivariada de Poisson. Resultados: dos profissionais estudados, 42,1% eram enfermeiros e 57,8%, técnicos ou auxiliares de enfermagem. A HA foi diagnosticada em 16,9%. Sexo feminino (RP = 0,56), avançar da idade (p de tendência linear < 0,001), renda familiar de 4 ou mais salários mínimos (RP = 0,39) e o estresse no trabalho (RP = 2,53) permaneceram independentemente associadas à HA após o ajuste multivariado dos dados. Conclusões: o estresse no trabalho está associado à HA em profissionais de enfermagem da rede municipal de saúde de Belo Horizonte. Este achado deve ser levado em consideração na formulação de políticas públicas que envolvem a promoção da saúde desses trabalhadores.

Abstract Objective: to assess the association between job strain and arterial hypertension (AH). Method: cross-sectional study with random sample of 273 nursing professionals from the municipal healthcare network in Belo Horizonte, Minas Gerais, Brazil, conducted between September 2008 and January 2009. Job strain was measured using the demand-control model and hypertension by self-report medical diagnosis of the disease or use of antihypertensive medication. Prevalence ratios (PR) of AH and their respective 95% confidence intervals (95% CI) were adjusted by Poisson multivariate regression. Results: among the professionals studied, 42.1% were nurses and 57.8% were nursing technicians or assistants. The AH was diagnosed in 16.9%. Female sex (PR = 0.56), increasing age (p of linear trend < 0.001), household income of 4 or more minimum wages (PR = 0.39) and job strain (PR = 2.53) were independently associated to AH after the multivariate adjustment. Conclusions: job strain is associated with AH among nursing professionals from the municipal healthcare network in Belo Horizonte. This finding must be considered in the formulation of public policies involving the health promotion of these workers.