The overall fractions of coronary heart diseases and depression attributable to multiple dependent psychosocial work factors in Europe.

OBJECTIVES: The literature is nonexistent on the assessment of overall fractions of diseases attributable to multiple dependent psychosocial work factors. The objectives of the study were to calculate the overall fractions of coronary heart diseases (CHD) and depression attributable to multiple dependent psychosocial work factors in 35 European countries. METHODS: We used already published fractions of CHD and depression attributable to each of the following psychosocial work factors: job strain, effort-reward imbalance, job insecurity, long working hours, and workplace bullying. We took all exposures and their correlations into account to calculate overall attributable fractions. Wald tests were performed to test differences in these overall attributable fractions between genders and between countries. RESULTS: The overall fractions of CHD and depression attributable to all studied psychosocial work factors together were found to be 8.1% [95% CI: 2.0-13.9] and 26.3% [95% CI: 16.2-35.5] respectively in the 35 European countries. There was no difference between genders and between countries. CONCLUSION: Our study showed that the overall fractions attributable to all studied psychosocial work factors were substantial especially for depression. These overall attributable fractions may be particularly useful to evaluate the burden and costs attributable to psychosocial work factors, and also to inform policies makers at European level.

Update of the fractions of cardiovascular diseases and mental disorders attributable to psychosocial work factors in Europe.

OBJECTIVES: The objectives of this study were to provide the fractions of cardiovascular diseases and mental disorders attributable to five psychosocial work exposures, i.e. job strain, effort-reward imbalance, job insecurity, long working hours, and bullying in Europe (35 countries, including 28 European Union countries), for each one and all countries together, in 2015. METHODS: The prevalences of exposure were estimated using the sample of 35,571 employees from the 2015 European Working Conditions Survey (EWCS) for all countries together and each country separately. Relative risks (RR) were obtained via literature reviews and meta-analyses already published. The studied outcomes were: coronary/ischemic heart diseases (CHD), stroke, atrial fibrillation, peripheral artery disease, venous thromboembolism, and depression. Attributable fractions (AF) for each exposure and overall AFs for all exposures together were calculated. RESULTS: The AFs of depression were all significant: job strain (17%), job insecurity (9%), bullying (7%), and effort-reward imbalance (6%). Most of the AFs of cardiovascular diseases were significant and lower than 11%. Differences in AFs were observed between countries for depression and for long working hours. Differences between genders were found for long working hours, with higher AFs observed among men than among women for all outcomes. Overall AFs taking all exposures into account ranged between 17 and 35% for depression and between 5 and 11% for CHD. CONCLUSION: The overall burden of depression and cardiovascular diseases attributable to psychosocial work exposures was noticeable. As these exposures are modifiable, preventive policies may be useful to reduce the burden of disease associated with the psychosocial work environment.

Burden of cardiovascular diseases and depression attributable to psychosocial work exposures in 28 European countries.

BACKGROUND: This study aimed to estimate the annual burden of cardiovascular diseases and depression attributable to five psychosocial work exposures in 28 European Union countries (EU28) in 2015. METHODS: Based on available attributable fraction estimates, the study covered five exposures, job strain, effort-reward imbalance, job insecurity, long working hours and workplace bullying; and five outcomes, coronary/ischemic heart diseases (CHD), stroke, atrial fibrillation, peripheral artery disease and depression. We estimated the burden attributable to each exposure separately and all exposures together. We calculated Disability-Adjusted Life Years (DALY) rate per 100 000 workers in each country for each outcome attributable to each exposure and tested the differences between countries and between genders using the Wald test. RESULTS: The overall burden of CHD attributable to the five studied psychosocial work exposures together was estimated at 173 629 DALYs for men and 39 238 for women, 5092 deaths for men and 1098 for women in EU28 in 2015. The overall burden of depression was estimated at 528 549 DALYs for men and 344 151 for women (respectively 7862 and 1823 deaths). The three highest burdens in DALYs in EU28 in 2015 were found for depression attributable to job strain (546 502 DALYs), job insecurity (294 680 DALYs) and workplace bullying (276 337 DALYs). Significant differences between countries were observed for DALY rates per 100 000 workers. CONCLUSIONS: Such results are necessary as decision tools for decision-makers (governments, employers and trade unions) when defining public health priorities and work stress preventive strategies in Europe.

Integration of sex and gender in interventions by students in ergonomics.

This article aims to analyse the integration of sex and gender (s/g) by ergonomics students during their internship at the master's degree level, following training sessions on s/g issues in the workplace. This exploratory research used a descriptive mixed-methods design, encompassing evaluation of students' intention to use the content from the training (n = 13 students), and a multiple case study (n = 5 ergonomics interventions). The results show that while students found the training relevant, they only minimally integrated s/g in their interventions and when they did, it was primarily from an anthropometric and physiological perspective. In addition to discussing the training format limitations, the article discusses barriers to this integration: combining learning about s/g issues with learning about activity analysis is challenging; employers' and workers' organisations may be reluctant to approach s/g issues; and it is difficult for an ergonomist to integrate these issues when the employer's request does not specify it.Practitioner summary: This article aims to analyse the integration of s/g by ergonomics students during their internships. Findings show that they only minimally considered s/g. The discussion examines s/g training, organisational obstacles to inclusion of s/g during interventions, and how ergonomists can consider s/g in their practice.

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

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

A Comparison of Healthcare Use and Costs for Workers with Psychiatric Disabilities Employed in Social Enterprises Versus Those Who Are Not Employed and Seeking Work.

Because of work's contribution to recovery, governments have moved to improve employment rates of people with severe mental disorders (SMDs). Social enterprises (SEs) have been identified as a means to achieve employment. In Ontario, Canada, the Ministry of Health and Long-Term Care (MOHLTC) have provided SEs government subsidies. Public funding arrangements create a potential trade-off for governments that must decide how to distribute constrained budgets to meet a variety of public needs. In Ontario, the government is potentially faced with choosing between supporting employment versus healthcare services. This study addresses the question, are there significant differences in service use and costs from the MOHLTC's perspective for people with SMDs working in SEs versus those who are not working and looking for work? Our results indicate there is a significant difference in healthcare use between the two groups suggesting there could be less healthcare use associated with SE employment.

Economic evaluations of ergonomic interventions preventing work-related musculoskeletal disorders: a systematic review of organizational-level interventions.

BACKGROUND: Work-related musculoskeletal disorders (WMSD) represent a major public health problem and economic burden to employers, workers and health insurance systems. This systematic review had two objectives: (1) to analyze the cost-benefit results of organizational-level ergonomic workplace-based interventions aimed at preventing WMSD, (2) to explore factors related to the implementation process of these interventions (obstacles and facilitating factors) in order to identify whether economic results may be due to a successful or unsuccessful implementation. METHODS: Systematic review. Studies were searched in eight electronic databases and in reference lists of included studies. Companion papers were identified through backward and forward citation tracking. A quality assessment tool was developed following guidelines available in the literature. An integration of quantitative economic results and qualitative implementation data was conducted following an explanatory sequential design. RESULTS: Out of 189 records, nine studies met selection criteria and were included in our review. Out of nine included studies, grouped into four types of interventions, seven yielded positive economic results, one produced a negative result and one mixed results (negative cost-effectiveness and positive net benefit). However, the level of evidence was limited for the four types of interventions given the quality and the limited number of studies identified. Our review shows that among the nine included studies, negative and mixed economic results were observed when the dose delivered and received by participants was low, when the support from top and/or middle management was limited either due to limited participation of supervisors in training sessions or a lack of financial resources and when adequacy of intervention to workers' needs was low. In studies where economic results were positive, implementation data showed strong support from supervisors and a high rate of employee participation. CONCLUSION: Studies investigating the determinants of financial outcomes of prevention related to implementation process are very seldom. We recommend that in future research economic evaluation should include information on the implementation process in order to permit the interpretation of economic results and enhance the generalizability of results. This is also necessary for knowledge transfer and utilization of research results for prevention-oriented decision-making in occupational health and safety.

[Respiratory cancers attributable to occupational exposures: what is the cost to society in France]. / Cancers des voies respiratoires attribuables aux expositions professionnelles : quels coûts pour la société française ?

OBJECTIVE: To estimate the social cost of respiratory cancers attributable to occupational risk factors in France in 2010. METHODS: We estimated the number of cases of respiratory cancers attributable to each identified occupational risk factor according to the attributable fractions method. We also estimated direct (costs of hospital stays, drugs, outpatient care) and indirect costs (production losses) related to morbidity (absenteeism and presenteeism) and mortality (years of lost production). Production losses for paid work and unpaid domestic activities were taken into account. RESULTS: The social cost of respiratory cancers (lung, larynx, sinonasal, pleural mesothelioma) attributable to exposure to asbestos, chromium, diesel engine exhaust, polycyclic aromatic hydrocarbons, painting occupations (unidentified carcinogen), crystalline silica, wood and leather dust in France in 2010 was estimated to be between €960 and 1,866 million. The cost of lung cancer represents between €804 and 1,617 million. The three risk factors with the greatest impact are asbestos (€530 to 890 million), diesel engine exhaust (€227 to 394 million), and crystalline silica (€116 to 268 million). CONCLUSION: These results provide a conservative estimate of the public health and economic burden of respiratory cancers attributable to occupational risk factors from a societal perspective.

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

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

Costs of presenteeism and absenteeism associated with psychological distress among male and female older workers: a cross-sectional study.

OBJECTIVE: We estimated, for women and men: 1) the associations between psychological distress and the prevalences of presenteeism and absenteeism, 2) average hours lost annually per person and 3) costs from the employers' economic perspective. METHODS: Participants were 1292 Canadian white-collar workers. Psychological distress, presenteeism and absenteeism were assessed with validated questionnaires. The average annual hours of productivity loss and related costs were estimated using generalized linear models with a negative binomial distribution and a log link. RESULTS: High psychological distress in women and men was associated with presenteeism costs ($6944 and $8432) and absenteeism costs ($2337 and $2796 per person). The association between psychological distress and annual hours lost to presenteeism was twice stronger for men than women. CONCLUSION: Productivity losses associated with psychological distress are high in women and men older workers.

The annual costs of cardiovascular diseases and mental disorders attributable to job strain in France.

BACKGROUND: Work stress has become a major occupational risk factor in industrialized countries and an important economic issue. The objective was to estimate the annual costs of coronary heart diseases (CHD) and mental disorders (MD) attributable to job strain exposure according to Karasek's model in France for the year 2003 from a societal perspective. METHODS: We produced attributable fraction estimates which were applied to the number of cases (morbidity and mortality) and the costs of CHD and MD. Relative risk estimates came from a systematic literature review of prospective studies. We conducted meta-analyses based on this selection of studies. Prevalence of exposure to job strain came from the national SUMER survey conducted in France in 2003. Costs included direct medical costs and indirect costs: production losses due to sick leaves and premature deaths. RESULTS: Between 8.8 and 10.2% of CHD morbidity was attributable to job strain, and between 9.4 and 11.2% of CHD mortality was attributable to this exposure for men. Between 15.2 and 19.8% of MD was attributable to job strain for men, and between 14.3 and 27.1% for women. As a whole, between 450 000 and 590 000 cases of diseases and 910-1130 deaths were attributable to job strain for men. From 730 000 to 1 380 000 cases of diseases and from 150 to 280 deaths were attributable to job strain for women. The total number of sick leave days amounted from 5 to 6.6 million days for men, and from 8.5 to 16 million days for women. The total costs of CHD and MD attributable to job strain exposure ranged from 1.8 to 3 billion euros for the year 2003 (0.12-0.19% GDP). Medical costs accounted for 11% of the total costs, value of life costs accounted for 13-15% and sick leave costs for 74-77%. The cost of CHD was estimated at 113-133 million euros and the cost of MD was between 1.7 - 2.8 billion euros in 2003. CONCLUSION: This study on the economic burden of diseases attributable to job strain in France provides relevant insights for policy-makers when defining public health priorities for prevention policies.

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

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

Implementation process evaluation of an ergonomic train the trainer program: How to learn from mechanisms and the temporal structure of processes?

In implementation process evaluation, the analysis of the temporal structure of processes is key for understanding the successive interactions between the flow of practitioners' actions and evolving workplace reactions and context. However, capturing the temporal structure of processes in data analysis is a methodological challenge, and available literature to overcome this challenge is scarce, especially for workplace ergonomic interventions. The aim of this paper was to perform an implementation process evaluation of an ergonomic train the trainer program taking into account the temporal structure of processes. We provided a method for qualitative data analysis based on a three-stage strategy: 1) producing the timeline of the implemented intervention, 2) identifying influential factors, 3) identifying determinant mechanisms (sequence of influential factors that intervened in the implementation process). This method allowed us to identify six determinant mechanisms positioned on the timeline of the intervention. Obstacles and levers were identified as a sequence of interrelated causes and consequences rather than isolated factors. We recommended success strategies for practitioners, while also shedding light on how organizations can better be prepared to undertake the intervention and their required actions to attain targeted intervention objectives.

How to carry out participatory research that takes account of sex and gender issues: a scoping review of guidelines targeting health inequities.

OBJECTIVE: Conducting participatory research (PR) aimed at improving health implies considering inequitable power relations, including those related to sex/gender (S/G). This necessitates specific skills and methods and may be challenging especially since guidelines are scarce. Our objective was to perform a scoping review to provide a typology of existing guidelines for researchers on how to take account of S/G in the context of PR in public health, with a focus on occupational and environmental health. METHODS: All steps of the research were conducted with the collaboration of an advisory committee, following PR principles. Nineteen documents were retained from 513 references identified in nine scientific databases and grey literature between 2000 and 2020. Data on recommendations were extracted and coded qualitatively. Cluster analysis based on similarities in recommendations proposed in the documents identified four types: (1) empowerment-centered; (2) concrete action-centered; (3) macrosystem-centered; and (4) stakeholder-centered. SYNTHESIS: Many sources gave pointers on how to include S/G during data collection and analysis or during the dissemination of findings, but there was a dearth of suggestions for building partnerships with stakeholders and producing sustainable S/G sociopolitical transformations. Occupational health PR showed less similarities with other public health subfields including environmental health PR. Power relationships with workplace stakeholders generated specific obstacles related to S/G integration that require further attention. Intersectionality and reflexive practices emerged as overarching themes. CONCLUSION: This review provides helpful guidelines to researchers at different stages of planning PR, ranging from familiarizing themselves with S/G approaches to anticipating difficulties in their ongoing S/G-transformative PR.

RéSUMé: OBJECTIF: Les recherches participatives (RP) visant l'amélioration de la santé doivent tenir compte de rapports de pouvoir inéquitables, incluant ceux liés au sexe/genre (S/G). Cela peut s'avérer difficile vu les compétences requises et la rareté de recommandations. Notre objectif consistait à réaliser une revue de portée menant à une typologie des recommandations existantes pour les chercheurs.euses sur l'intégration du S/G en contexte de RP en santé publique, particulièrement en santé environnementale ou au travail. MéTHODOLOGIE: Un comité d'encadrement a participé à chaque étape de l'étude. Nous avons retenu 19 documents parmi 513 références identifiées dans neuf bases de données scientifiques et la littérature grise (2000­2020). L'extraction et le codage qualitatif des recommandations a mené à une analyse de clusters basée sur les similitudes identifiant quatre types centrés sur : 1) pouvoir d'agir; 2) actions concrètes; 3) macro-système; et 4) parties prenantes. SYNTHèSE: Plusieurs sources indiquaient comment intégrer le S/G pendant la collecte/analyse des données ou la diffusion des résultats. Peu de recommandations touchaient l'aspect S/G au niveau des partenariats avec des parties prenantes ou des transformations sociopolitiques durables. Les recommandations en santé au travail étaient moins similaires aux autres sous-domaines de santé publique. Les relations de pouvoir en milieu de travail engendrent des obstacles spécifiques liés à l'intégration du S/G et nécessitent une attention particulière. L'intersectionnalité et les pratiques réflexives sont apparues comme des thèmes primordiaux. CONCLUSION: Les recommandations repérées aideront des chercheurs.euses à différents stades de leur parcours d'intégration du S/G dans une RP en cours, allant de la familiarisation à l'anticipation de difficultés.

How Can Quantitative Analysis Be Used to Improve Occupational Health without Reinforcing Social Inequalities? An Examination of Statistical Methods.

Taking account of sex and gender in occupational health studies poses statistical challenges. Other sociodemographic variables, such as racialization, class, and age, also affect the relations between workplace exposures and health and interact with sex and gender. Our objective was to perform a critical review of conventional and emerging statistical tools, examining whether each analysis takes account of sociodemographic variables (1) in a way that contributes to identification of critical occupational determinants of health (2) while taking account of relevant population characteristics to reflect intersectional approaches to health and (3) using sample sizes and population characteristics available to researchers. A two-step search was conducted: (1) a scientific watch concerning the statistical tools most commonly used in occupational health over the past 20 years; (2) a screening of the 1980-2022 literature with a focus on emerging tools. Our examination shows that regressions with adjustment for confounders and stratification fail to reveal the sociodemographic mechanisms that interact with occupational health problems, endangering the identification of occupational risks. Multilevel (notably MAIHDA) analyses, decision tree, cluster, and latent analyses are useful methods to consider when seeking to orientate prevention. Researchers should consider methods that adequately reveal the mechanisms connecting sociodemographic variables and occupational health outcomes.

Issue with Evaluating Costs Over Time in a Context of Medical Guideline Changes: An Example in Myocardial Infarction Care Based on a Longitudinal Study from 1997 to 2018.

BACKGROUND: Cost studies appear sporadically in the scientific literature and are rarely revised unless drastic technological advancements occur. However, health technologies and medical guidelines evolve over time. It is unclear if these changes render obsolete prior estimates. We examined this issue in a cost study in the context of patients' first myocardial infarction (MI), a clinical area prone to such continuous evolution in care. METHODS: We conducted a longitudinal cost analysis based on a Quebec cohort. Quebec health administrative databases were used to identify incident MI cases using diagnostic codes from the international classification of diseases (ICD-9 and ICD-10). Physician fees and hospitalization costs (ie, costs incurred by the hospital center) were derived from administrative databases and a university hospital's finance department. All costs were converted to 2019 Canadian dollars. Nonparametric bootstraps were used to estimate 95% confidence intervals (CI) of the average costs of an episode of care. Generalized linear regressions were used to examine temporal trends of cost. RESULTS: Our study sample consists of 261 patients hospitalized for a first MI. The average total cost for this first event was estimated at $5782 (95% CI: $5293 - $6373). Though total costs remained stable over time, physician fees increased by 123% ($1240 vs $2761) whereas total hospital length of stay dropped by 17% (6.6 vs 5.5 days) over the 21-year period. CONCLUSION: Patients' first MI hospitalization impose an economic burden on the healthcare system. Though overall costs remained stable, our results suggest that some cost components varied over time.

Fractions of cardiovascular diseases, mental disorders, and musculoskeletal disorders attributable to job strain.

OBJECTIVES: The aim of this study was to evaluate fractions of diseases attributable to job strain defined using Karasek's model among the French working population for cardiovascular diseases (CVD), mental disorders, and musculoskeletal disorders (MSD). METHODS: Job strain was defined as the combination of high psychological demands and low decision latitude. The prevalence of exposure (P (e)) was estimated using the representative national sample of 24,486 employees of the French SUMER survey. Relative risks (RR) were estimated from a literature review (1990-2008) using the same inclusion criteria for the three health outcomes. P (e) and RR estimates were used to calculate attributable fractions (AF). RESULTS: P (e) estimates were 19.6% for men, 28.2% for women, and 23.2% for men and women combined. The literature review led to a selection of 13 studies for CVD, 7 studies for mental disorders, and 11 studies for MSD. RR estimates were 0.63-2.45 for CVD (morbidity and mortality), 1.2-3.3 for mental disorders, and 0.94-2.3 for MSD. AF estimates for CVD morbidity were 4.9-21.5% for men, 0-15.9% for women, and 6.5-25.2% for men and women combined, for CVD mortality 7.9-21.5% for men, 2.5% for women, and 6.5-25.2% for men and women combined, for mental disorders 10.2-31.1% for men, 5.3-33.6% for women, and 6.5% for men and women combined, and for MSD 0-19.6% for men, 0-26.8% for women, and 3.4-19.9% for men and women combined. CONCLUSION: This study is the first one to provide fractions of diseases attributable to job strain for three health outcomes in France on the basis of a systematic review of the literature. These results could contribute to the estimation of the economic cost of diseases attributable to job strain.

Integrative prevention and coordinated action toward primary, secondary and tertiary prevention in workplaces: A scoping review.

BACKGROUND: Integrated approaches are valued in several occupational health strategic programmatic orientations. A better understanding of the use of integrative prevention in coordinating measures is needed to develop its use in workplaces. OBJECTIVE: Identify workplace integrative prevention approaches and definitions of prevention (primary, secondary and tertiary) in the literature. METHODS: A scoping review was conducted following Arksey and O'Malley (2005). The literature search was carried out in three databases without date restrictions. In order to be retained, the articles needed to address at least two levels of prevention using an integrative approach in a workplace setting. A qualitative analysis was conducted. RESULTS: The review yielded 16 published articles between 1995 and 2017. The articles addressed mental health, musculoskeletal disorder prevention and comprehensive approaches. Integrative prevention approaches are diverse and are not always named as such. Prevention definitions are not homogenous. CONCLUSIONS: This review identified some of the integrative prevention characteristics aimed at coordinated action for prevention in the workplace and to clarify measures taken at different levels of prevention. Further studies are needed to elaborate on the implementation of integrative prevention in the workplace.

Impacts of considering sex and gender during intervention studies in occupational health: Researchers' perspectives.

The aim of this article is to examine the impacts of incorporating sex and gender (s/g) analysis in integrated knowledge translation (iKT) initiatives in the field of ergonomics and occupational health. The article presents findings based on a retrospective analysis of twelve intervention-research (IR) studies, including a thematic content analysis of in-depth interviews conducted with 15 researchers involved in these IRs. The findings offer an overview of various categories of impacts, such as changes in partners' views, in workplace settings and conditions, in practices and policies, and in economic outcomes. In these types of IR, health effects measurement is not the main objective, and direct health outcomes are difficult to assess. Explicitly talking about sex/gender led more often to system-level changes but less often to workplace-level changes, compared to interventions where sex/gender was not identified as a specific object of the intervention.