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.

Musculoskeletal disorders and associated healthcare costs among family members of injured workers.

BACKGROUND: Research has infrequently looked beyond the injured worker when gauging the burden of occupational injury. OBJECTIVES: We explored the relationship between occupational injury and musculoskeletal disorders (MSDs) among family members of injured workers. DATA AND METHODS: We used 2005 and 2006 Truven Health Analytics databases, which contain information on workers' compensation and family healthcare claims. We used descriptive analyses, and negative binomial and two-part models. RESULTS: Family members of severely injured workers had a 15% increase in the total number of MSD outpatient claims and a 34% increase in the mean cost of MSD claims compared to family members of non-severely injured workers within 3 months after injury. Extrapolating cost results to the national level implies that severe occupational injury would be associated with between $29 and $33 million additional cost of family member outpatient MSD claims. CONCLUSION: Occupational injury can impose a formerly unrecognized health burden on family members of injured workers.

Development of the National Institute for Occupational Safety and Health Worker Well-Being Questionnaire.

OBJECTIVE: This article describes development of the National Institute for Occupational Safety and Health (NIOSH) Worker Well-Being Questionnaire (WellBQ). METHODS: The NIOSH WellBQ was developed through literature reviews and expert panel recommendations. We drew from a representative sample of the civilian, noninstitutionalized, US working population to pilot the questionnaire. Psychometric analyses were performed on data from 975 respondents to finalize items and optimize the NIOSH WellBQ's psychometric properties. RESULTS: The final questionnaire consists of 16 scales, 5 indices, and 31 single items across 5 domains: (1) work evaluation and experience; (2) workplace policies and culture; (3) workplace physical environment and safety climate; (4) health status; and (5) home, community, and society (experiences and activities outside of work). The instrument demonstrated adequate reliability and validity. CONCLUSIONS: The NIOSH WellBQ is a reliable and valid instrument that comprehensively measures worker well-being.

Association of Parent Workplace Injury With Emotional and Behavioral Problems in Children.

OBJECTIVE: Investigate associations between occupational injury to parents and the psychological well-being of their children. METHODS: We used multiple logistic regression to examine effects of occupational injury to parents on measures of psychological well-being among their children using National Health Interview Survey data from 2012 through 2016. RESULTS: Children of injured workers exhibited greater impairment than children of workers who had not sustained injuries for four of five measures of emotional and behavioral functioning that were hypothesized to differentiate these two child groups. A significant group difference was not observed for a sixth behavioral measure that was expected to be insensitive to parent occupational injury. CONCLUSION: Study findings heighten concern over downstream effects of occupational injury and signal need for more expansive investigation of these effects and mitigation strategies among children of injured workers.

Expanding the Paradigm of Occupational Safety and Health: A New Framework for Worker Well-Being.

OBJECTIVE: This article describes the National Institute for Occupational Safety and Health's (NIOSH) development of a conceptual framework for worker well-being. While well-being research is growing, there is a need to translate theoretical concepts into practical models for measurement and action. METHODS: Multidisciplinary literature reviews informed development of the worker well-being framework and major domains and subdomains. An expert panel helped prioritize constructs for measurement. RESULTS: The framework includes five domains and 20 subdomains and conceptualizes worker well-being as a subjective and objective phenomenon inclusive of experiences both within and beyond work contexts. CONCLUSION: Well-being is a positive and unifying concept that captures multiple factors that contribute to workers' health and quality of life. This work lays the foundation for larger well-being measurement efforts and will provide tools for NIOSH partners to help workers flourish.

Creating healthier workplaces: The American Psychological Association/National Institute of Occupational Safety and Health cooperative agreement. Introduction and historical overview.

This article introduces the special section on the American Psychological Association/National Institute for Occupational Safety and Health (APA/NIOSH) collaboration. The section includes an overview statement of National Institute for Occupational Safety and Health research by Linda Rosenstock and 5 competitively peer-reviewed articles submitted to the Journal of Occupational Health Psychology following their presentation in an earlier form at the 3rd APA/NIOSH conference in September 1995. This article provides a brief history of the APA/NIOSH collaboration forged at the turn of this decade.

Monitoring the changing organization of work: international practices and new developments in the United States.

Recent trends in the organization of work have raised concerns about their implications for safety and health in the workplace. Capacity for monitoring of these trends from an occupational safety and health perspective (also known as hazard surveillance) varies considerably across countries and regions. This forum article discusses current practices for monitoring the organization of work, noting strengths, limitations, and needs for improvement. Particular attention is given to the status of monitoring practices in the U.S., and new initiatives by the National Institute for Occupational Safety and Health (NIOSH) to improve upon these practices.

Work organization interventions: state of knowledge and future directions.

Changes taking place in the modern workplace, such as more flexible and lean production technologies, flatter management structures, and nontraditional employment practices fundamentally alter work organization factors and raise concerns about potentially negative influences on worker health and safety. These changes raise concerns about adverse effects on worker safety and health and call attention to the need for interventions to counter these effects. This forum article provides an overview of work organization intervention research, highlights gaps in the research literature, and sets forth an agenda for future intervention research. Research to date has focused primarily on individual-level interventions, with far less attention to interventions at the legislative/policy level, employer/organization level, and job/task level. Future research is recommended to establish the effectiveness of work organization interventions using improved methodological designs and giving increased attention to the circumstances within organizations that promote the adoption of such interventions.

Total worker health and work-life stress.

OBJECTIVE: Review relationships between work-life stress and health behaviors to advance understanding of pathways between occupational and individual risk factors and health and safety outcomes. METHODS: A background on the Total Worker Health concept is provided, and a review of research on the relationship between work-life stress and health behaviors is presented. RESULTS: Research evidence indicates that work-life stress serves as a negative occupational exposure relating to poor health behaviors, including smoking, poor food choices, low levels of exercise, and even decreased sleep time. CONCLUSION: The association between work-life stress and adverse health behaviors suggests that interventions at both the occupational (health protection) and individual (health promotion) level may be helpful in mitigating effects of work-life stress, consistent with the Total Worker Health approach. Further study is needed to investigate gains from an integrated prevention strategy.

Supplementary breaks and stretching exercises for data entry operators: a follow-up field study.

BACKGROUND: This study expanded previous NIOSH-IRS research examining the effects of rest breaks and stretching exercises on symptoms and performance in data-entry workers. METHODS: All workers spent 4 weeks with conventional breaks (two 15 min breaks per day) and 4 weeks with supplementary breaks (two 15 min breaks plus four 5 min breaks per day). One-half were assigned at random to a group instructed to perform brief stretching exercises during breaks. The remainder comprised the "no stretching" (control) group. RESULTS: 51 workers (stretch group n = 21; no stretch group n = 30) completed the study symptom questionnaires. Discomfort and eyestrain were significantly lower with supplementary breaks, and supplementary breaks attenuated accumulation of discomfort and eyestrain during work sessions. Data-entry speed was significantly faster with supplementary breaks so that work output was maintained, despite replacing 20 min of work time with break time. In the stretch group, workers reported stretching during only 25% of conventional breaks and 39% of supplementary breaks, and no significant effects of stretching on discomfort or performance were observed. CONCLUSIONS: These results provide further converging evidence that supplementary breaks reliably minimize discomfort and eyestrain without impairing productivity. Low compliance in performing stretches prevented valid assessment of stretching effects. Further research on stretching exercises and exercise compliance is warranted.

Long hours of work in the U.S.: associations with demographic and organizational characteristics, psychosocial working conditions, and health.

BACKGROUND: There are relatively few studies of large national databases that contain information on working hours and health. The current study involved an analysis of data from a quality of work life (QWL) module developed for the 2002 General Social Survey. This module collected work and health data from a representative sample of the U.S. population (N=1,744). METHODS: Descriptive analyses were conducted for five groups based on total hours worked per week: part-time (1-34 hr/week), full-time (35-40 hr/week), lower overtime (41-48 hr/week), medium overtime (49-69 hr/week), and higher overtime (70+ hr/week). Multiple logistic regression examined the association between these five categories and several measures of health and well-being. RESULTS: Compared to full-time workers, the three groups of overtime workers were more likely to be male, white, and middle-aged, with higher levels of education and income. They were also more likely to be self-employed, salaried, work as independent contractors, have more than one job, and work split/irregular/on-call shifts. Although overtime work was characterized by higher levels of job stress and perceptions of overwork, it was also associated with increased levels of participation in decision making and opportunities to develop special abilities. Several significant associations emerged between hours of work and measures of health and well-being, particularly for respondents in the higher overtime group (70+ hr/week). CONCLUSION: Overtime workers differ from their part-time and full-time counterparts in several important areas. Some of these differences tended to increase with the number of overtime hours worked, suggesting a linear relationship. However, caution is warranted before generalizing the results of this study to specific occupations or workplaces.

Long working hours, safety, and health: toward a National Research Agenda.

BACKGROUND: A significant and growing number of people work long hours. Research examining impacts is limited, but raises concerns about risks to the worker, the family, the employer, and the community. The purpose of this report, which is authored by the National Occupational Research Agenda (NORA) Long Work Hours Team, is to motivate and guide future research by proposing a framework for studying long work hours and discussing research gaps. METHODS: The NORA Long Work Hours Team examined research reports and literature reviews, and gathered input from a conference on long work hours organized by the Team and faculty from University of Maryland. RESULTS AND CONCLUSION: A framework is proposed for long work hours, including determinants, outcomes, and moderating factors of long work hours, suggesting that studies need to include more clear and complete descriptions of work schedules, worker characteristics, and the work environment, and need to consider a wider range of possible health, safety, social and economic outcomes for workers, families, employers, and the community. Additional studies are needed on vulnerable employee groups and those critical to public safety. More studies are also needed to develop interventions and test their effectiveness.

Occupational stress and work-related upper extremity disorders: concepts and models.

BACKGROUND: While research has suggested that interventions targeted at occupational stress (job stress) factors may improve clinical and work outcomes related to work-related musculoskeletal disorders, the emerging hypotheses relating occupational stress to work-related upper extremity disorders (WRUEDs) are not particularly well known among occupational health providers and researchers. METHODS: Generic job stress and health models and multivariable models of WRUEDs were described and evaluated. RESULTS: Models on occupational stress and health/WRUEDs offer unique perspectives on the role of occupational stressors on WRUEDs. However, the limited support for the structure and proposed mechanisms of these models suggest that investigations examining and validating proposed biobehavioral pathways are still needed. DISCUSSION: Difficulties in conceptualizing occupational stress have, in the past, hindered its systematic incorporation into occupational health research and prevention/intervention strategies. The present paper provides a common basis for researchers and practitioners with diverse backgrounds to understand job stress and its relation to WRUEDs in order to enhance future efforts. Given the present limitations in the field and the need for comprehensive approaches to WRUEDs, there is great potential for occupational health researchers and clinicians to advance knowledge in this area.

Stress e qualidade de vida no trabalho: perspectivas atuais da saúde ocupacional / Stress and quality of work life: perspectives of health

Este livro aborda tópicos importantes nas áreas de stress, saúde ocupacional e qualidade de vida, reunindo um grupo multidisciplinar de especialistas que fornecem análises aprofundadas sobre o tema. Pelo fato de o stress no trabalho Ter se formado em uma preocupação mundial, este livro assume uma perspectiva verdadeiramente internacional sobre o stress ocupacional e o bem-estar dos colaboradores. A obra apresenta temas do que é atualmente uma literatura em expansão que visa atender as causas, os efeitos e a prevenção do stress no local de trabalho. Começa com três capítulos sobre as diferentes fontes de stress ocupacional, abordando de fatores organizacionais a atributos dos próprios trabalhadores. Os cinco capítulos seguintes atualizam a compreensão sobre os efeitos adversos que o stress pode ter sobre os indivíduos, suas famílias e as organizações. O último grupo de capítulos do livro tem um tom mais positivo, avaliando os benefícios de ambientes de trabalho saudáveis e formas de superar a prevenir o stress no trabalho. Em suma, os capítulo destacam o conhecimento básico e os novos avanços no campo em rápida expansão de pesquisa na área do trabalho e stress. Com a leitura desta obra, os leitores vão obter informações que sirvam para alertar para as causas e os custos do stress ocupacional. O texto fornece incentivos e idéias para que as organizações no Brasil e em outros países comecem a pensar e a buscar formas de criar um ambiente menos estressante, garantindo, assim, a sua produtividade e a qualidade dos seus produtos sem prejuízos à saúde e ao bem-estar da sua força de trabalho.