Employmentweb_low

employment relations and health inequalities: a conceptual and empirical overvieW
of studies of psychosocial work stressors and mental health found
consistent evidence that low decision latitude, high job demands, low
social supports at work, job strain and effort-reward imbalance were
risk factors for subsequent mental health problems (Stansfeld &
Candy, 2006). Finally, evidence suggests that job stressors such as
high job demands, low job control, low social support, few rest break
opportunities (Bongers, Kremer, & Ter laak, 2002), and job strain
(rugulies & Krause, 2005) contribute to the development of
musculoskeletal disorders of the upper extremity (such as carpal
tunnel syndrome and tendonitis) and of the lower back, after taking
into account physical job demands. acute injuries have also been
associated with psychosocial stressors (Hanecke, Tiedemann,
nachreiner, & Grzech-Sukalo, 1998; Clarke, Sloane, & aiken, 2002).
another psychosocial characteristic of work linked to ill-health is
threat-avoidant vigilant work, which involves continuously
maintaining a high level of vigilance in order to avoid disaster, such
as death. This is a feature of a number of occupations at high risk for
CVD, e.g., truck drivers, air traffic controllers, and sea pilots (Belkic
et al., 2000). The strongest evidence for threat-avoidant vigilance
comes from studies of single occupations, where professional
drivers, particularly urban transport operators, emerge as the
occupation with the most consistent evidence of elevated risk of CVD
(Belkic, Emdad, & Theorell, 1998; Tuchsen, 2000).
although there appears to be some conceptual overlap between the
three work stress models, empirical evidence suggests that they each
independently influence health. From this perspective, an important
scientific question has been posed. are these observed associations
causal or are they a product of methodological problems associated
with epidemiological studies of psychosocial factors and health such as
reverse causality, reporting bias and residual confounding
In spite of these concerns, there are plausible biological pathways
which may mediate the association between work stress and health. In
the Whitehall II study, there was a dose-response association between
iso-strain (a combination of high demands, low control and low
support) and the metabolic syndrome, a cluster of physiological risk
factors which increase the risk of heart disease and diabetes
(Chandola, Brunner, & Marmot, 2006). Body mass index is another
potential intermediate factor that has been associated with job strain.
next, opportunistic studies of the effects of change in working
conditions can provide stronger evidence for a causal link. For
example, studies that have taken place in the context of downsizing
have shown an association between change in working conditions and
subsequent health. In the Whitehall II study, adverse changes in
Ethiopian Airlines' technicians at work.
Ethiopian Airlines (Ethiopia).
source: © ilo/m. crozet (2003)
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