Employmentweb_low

policies and interventions
along with economic and health policies designed to alleviate
poverty in poor countries. at the same time, those employment
arrangements that deliver healthier and better quality working
conditions must also be pursued centrally and be well integrated
with other policies aimed at ameliorating public health inequalities
(stahl, Wismar, ollila, lahtinen, & leppo, 2006; labonte &
schrecker, 2007).
case study 94: IStAS’ participatory approach to the psychosocial work environment to reduce health inequalities in
Spain. - salvador Moncada i lluís, clara llorens serrano, Fernando rodrigo, ariadna Font corominas and ariadna galtés
the spanish psychosocial work environment combines poor psychosocial working conditions (e.g., 14.5% and 17.6% of
workers in high strain in 1995 and 2000 respectively), elevated exposures to psychosocial hazards (e.g., high prevalence of
exposures to low influence, low possibilities for development, low control over working time and high job insecurity) and large
occupational health inequalities (e.g., poor mental health outcomes are associated with precarious employment arrangements)
(Moncada, llorens, gimeno, & Font, 2007; benach et al., 2007). Historically, main causes of the unhealthy spanish psychosocial
work environment include lack of awareness on occupational health problems, employers’ resistance to attaining healthier
workplaces via the implementation of organisational changes, the weakness of unions with low density levels and sometimes a
lack of concern for health and safety issues, the deregulation of working conditions within an economic structure with many
small- and medium-size firms in which, due to the international division of labour, competitiveness is increasingly based on
precarious working conditions stemming from labour management practices characterised by employer demands of high
availability regarding working time and employment arrangements, as well as taylorism (see case study 59) and the presence
of a number of “myths” (e.g. that “stress” would be directly linked with individual personality issues or that we lack valid methods
for assessing psychosocial hazards). the implementation of the spanish Health and safety act in 1996, however, represented an
opportunity to highlight psychosocial hazards, making it mandatory for employers to evaluate and prevent workplace
occupational hazards, as well as to recognise the participatory rights of health and safety representatives. in 2008, the 70,000
union health and safety representatives constitute a key workplace organisation asset for improving occupational health
(Menéndez, benach, & vogel, 2008; 2009).
the Union institute of Work, environment and Health (istas) is a non-profit, self-managed technical trade union
foundation supported by the spanish trade Union confederation “comisiones obreras” (cc.oo.) whose aim is to improve
working conditions, occupational health and safety and environmental protection in spain. a concrete example of the istas
approach is action to improve the psychosocial work environment. istas uses a participatory strategy that empowers
workers and helps safety representatives provoke changes in work organisation, pressing employers to negotiate and thus
improve the psychosocial work environment and workers’ health. one of the key istas activities is to provide safety
representatives with an adequate level of information, training and advice, so they can implement preventive interventions
in the workplace (garcía, lópez-Jacob, dudzinski, gadea, & rodrigo, 2007). the overall strategy includes eight general steps
that are summarised below.
1. promote actively union’s participation to endorse primary prevention, that is, the trade union decision to work towards
developing the highest level of participatory rights in workplace health and safety in order to achieve prevention at the
source,. this includes proposals regarding bargaining and co-management in all phases of the prevention process.
2. develop alliances and collaborative agreements with scientific, administrative and technical institutions, including
national (e.g. spanish Universities, occupational Health and safety institutes, and regional governments) and international
(the danish national research centre for the Working environment) institutions.
3. adapt a valid and participatory method for assessing workplace psychosocial hazards. istas adapted the
copenhagen psychosocial Questionnaire (copsoQ) (Kristensen, Hannerz, Høgh, & borg, 2005) in cooperation with other
institutions (see above), attaining a valid, reliable and practical method for analysing psychosocial workplace hazards in
spain - copsoQ (istas21) (Moncada, llorens, navarro, & Kristensen, 2005; Moncada, llorens, Font, galtés, & navarro,
2008). although a complete evaluation is still in process, it is estimated that no less than 2,000 firms are already using this
scientific, participatory, action-based approach. all istas materials are of public domain, including information on istas21.
also, it is estimated that around 15,000 downloads have been made from istas web site.
4. promote specific workplace experiences. risk assessment processes were implemented in 50 spanish workplaces
in order to adapt the istas21 (copsoQ) prevention processes to the spanish context. in all cases, three-party working teams
(i.e. managers, occupational health professionals and workers’ representatives) were established.
5. achieve agreements with labour authorities. an agreement was reached so that the catalan government established
349