Wellbeing and occupational risk perception among health care workers: a multicenter study in Morocco and France

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Abstract

Background

The study analyzes health care workers’ (HCWs) occupational risk perception and compares exposure to occupational risk factors in Moroccan and French hospitals.

Method

Across nine public hospitals from three Moroccan regions (north, center and south), a 49 item French questionnaire, based on the Job Content Questionnaire, and 4 occupational risks subscales, was distributed to 4746 HCWs. Internal consistency of the study was determined for each subscale. Confirmatory factor analysis was conducted on the Moroccan questionnaire. Psychosocial job demand, job decision latitude and social support scores analysis was used to isolate high strain jobs. Occupational risks and high strain perception correlation were analyzed by univariate and multivariate logistic regression. A comparative analysis between Moroccan and French (Nantes Hospitals) investigations data was performed.

Results

In Morocco, 2863 HCWs (60 %) answered the questionnaire (54 % women; mean age 40 years; mean work seniority 11 years; 24 % physicians; 45 % nurses). 44 % Moroccan HCWs are at high strain. Casablanca region (1.75 OR; CI: 1.34–2.28), north Morocco (1.66 OR; CI: 1.27–2.17), midwives (2.35 OR; 95 % CI 1.51–3.68), nursing aides (1.80 OR; 95 % CI: 1.09–2.95), full-time employment (1.34 OR; 95 % CI 1.06–1.68); hypnotics, sedatives use (1.48 OR; 95 % CI 1.19–1.83), analgesics use (1.40 OR; 95 % CI 1.18–1.65) were statistically associated to high strain. 44% Moroccan HCWs are at high strain versus 37 % French (Nantes) HCWs ( p < 0.001).

Conclusion

Moroccan HCWs have high strain activity. Moroccan HCWs and more Moroccan physicians are at high strain than Nantes HCWs. Moroccan and French’s results showed that full time workers, midwives, workers using hypnotics, and analgesics are at high strain. Our findings underscore out the importance of implementing a risk prevention plan and even a hospital reform. Further research, with an enlarged study pool will provide more information on psychosocial risks (PSR) and HCWs’ health.

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Most cited references 33

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Work stress in the etiology of coronary heart disease--a meta-analysis.

Ari Väänänen, Marianna Virtanen, Marko Elovainio … (2006)

This study focused on estimating the relative risk of coronary heart disease (CHD) in association with work stress, as indicated by the job-strain model, the effort-reward imbalance model, and the organizational injustice model. A systematic review and meta-analysis of prospective cohort studies were carried out. Studies were eligible if they had published a quantitative estimate of the association between work stress and incident CHD or cardiovascular mortality by January 2006. Fourteen prospective cohort studies were identified. For a total of 83 014 employees, the age- and gender-adjusted relative ratio of CHD for high versus low job strain was 1.43 [95% confidence interval (95% CI) 1.15-1.84], but the ratio decreased to 1.16 (95% CI 0.94-1.43) after adjustment for risk factors and potential mediators. The age- and gender-adjusted risk ratio for a combination of high efforts and low rewards was 1.58 (95% CI 0.84-2.97) for 11 528 employees, and no reduction in the risk ratio was seen after further adjustments. For organizational injustice, the age- and gender-adjusted, and multiple-adjusted relative risks were 1.62 (95% CI 1.24-2.13) and 1.47 (95% CI 1.12-1.95), respectively, for a population of 7246 men and women. There was little standardization in the assessment of work stress within all three stress models, and significant heterogeneity in the effects of stress was observed between studies. Few studies were available for female samples. Observational data suggest an average 50% excess risk for CHD among employees with work stress. Further research is needed to confirm that a reduction in work stress will lead to a reduction in CHD risk.

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Epidemiological study to investigate potential interaction between physical and psychosocial factors at work that may increase the risk of symptoms of musculoskeletal disorder of the neck and upper limb.

I Vlachonikolis, P Buckle, Jason J. Devereux (2002)

To investigate potential interactions between physical and psychosocial risk factors in the workplace that may be associated with symptoms of musculoskeletal disorder of the neck and upper limb. 891 of 1514 manual handlers, delivery drivers, technicians, customer services computer operators, and general office staff reported on physical and psychosocial working conditions and symptoms of neck and upper limb disorders using a self administered questionnaire (59% return rate). Of the 869 valid questionnaire respondents, 564 workers were classified in to one of four exposure groups: high physical and high psychosocial, high physical and low psychosocial, low physical and high psychosocial, and low physical and low psychosocial. Low physical and low psychosocial was used as an internal reference group. The exposure criteria were derived from the existing epidemiological literature and models for physical and psychosocial work factors. The frequency and amplitude of lifting and the duration spent sitting while experiencing vibration were used as physical exposure criteria. Ordinal values of mental demands, job control, and social support with managers and coworkers were used as psychosocial exposure criteria. In the multivariate analyses, the highest and significant increase in risk was found in the high physical and high psychosocial exposure group for symptoms of hand or wrist and upper limb disorders after adjusting for years at the job, age, and sex. A potential interaction effect was found for the symptoms of the hand or wrist and upper limb disorders but not for the neck symptoms. This study showed that workers highly exposed to both physical and psychosocial workplace risk factors were more likely to report symptoms of musculoskeletal disorders than workers highly exposed to one or the other. The results suggest an interaction between physical and psychosocial risk factors in the workplace that increased the risk of reporting symptoms in the upper limbs. Psychosocial risk factors at work were more important when exposure to physical risk factors at work were high than when physical exposure was low. Ergonomic intervention strategies that aim to minimise the risks of work related musculoskeletal disorders of the upper limb should not only focus on physical work factors but also psychosocial work factors.

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Is job strain a major source of cardiovascular disease risk?

P A Landsbergis, Peter L Schnall, K Belkić … (2004)

Empirical studies on job strain and cardiovascular disease (CVD), their internal validity, and the likely direction of biases were examined. The 17 longitudinal studies had the highest validity ratings. In all but two, biases towards the null dominated. Eight, including several of the largest, showed significant positive results; three had positive, nonsignificant findings. Six of nine case-control studies had significant positive findings; recall bias leading to overestimation appears to be fairly minimal. Four of eight cross-sectional studies had significant positive results. Men showed strong, consistent evidence of an association between exposure to job strain and CVD. The data of the women were more sparse and less consistent, but, as for the men, most of the studies probably underestimated existing effects. Other elements of causal inference, particularly biological plausibility, corroborated that job strain is a major CVD risk factor. Additional intervention studies are needed to examine the impact of ameliorating job strain upon CVD-related outcomes.

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Author and article information

Contributors

Dominique Tripodi: dominique.tripodi@chu-nantes.fr

Journal

Journal ID (nlm-ta): J Occup Med Toxicol

Journal ID (iso-abbrev): J Occup Med Toxicol

Title: Journal of Occupational Medicine and Toxicology (London, England)

Publisher: BioMed Central (London )

ISSN (Electronic): 1745-6673

Publication date (Electronic): 4 May 2016

Publication date PMC-release: 4 May 2016

Publication date Collection: 2016

Volume: 11

Electronic Location Identifier: 20

Affiliations

[ ]Department of Occupational Medicine and Environment Health, HCWs Research Laboratory, 5 rue du doyen Boquien, Nantes University Hospital, Nantes, 44 093 France

[ ]“Lucian Blaga” University of Sibiu, 10 Victoriei Boulevard, Sibiu, 550024 Romania

[ ]Psychology Laboratory of Pays de la Loire (LPPL - UPRES EA 4638), Department of Psychology, University of Nantes, BP 81 227 44312 Nantes cedex 3, France

[ ]Cognition, Health, Socialization, EA6291 University of Reims Champagne-Ardenne, 57, rue Pierre-Taittinger, Reims, 51 096 France

[ ]Department of Public Health, Nantes University Hospital, 35 rue Saint Jacques, Nantes, 44 000 France

[ ]Laboratory of Ergonomics Epidemiology Health and Work, LEEST-UA InVS - IFR 132- UPRES EA 4336, University of Angers, Faculty of Medicine, University Hospital, 4 rue Larrey, 49933 Angers Cedex, France

[ ]Occupational Medicine Department, 6 rue Henri Le Guilloux, University Hospital of Rennes, Rennes, 35 000 France

[ ]Graduate School of Health Engineering and Project Management, 24 rue Lafontaine, Quartier Racine, Casablanca, 20 100 Morocco

[ ]Public Health Department, SMBH, Paris 13 University, 74 avenue Marcel Cachin, Bobigny, 93017 France

Article

Publisher ID: 110

DOI: 10.1186/s12995-016-0110-0

PMC ID: 4855316

PubMed ID: 27148391

SO-VID: 33a1c7e3-0bab-4aef-a835-52ed14f90506

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 15 April 2015

Date accepted : 21 April 2016

Funding

Funded by: European Social Fund through the Sectorial Operational Programme Human Resources Development 2007-2013

Award ID: POSDRU/CPP107/DMI1.5/S/76851

Award Recipient : Doina Ileana Giurgiu

Funded by: European Social Fund through the Sectorial Operational Programme Human Resources Development 2007-2013

Award ID: POSDRU/CPP107/DMI1.5/S/76851

Award Recipient : Doina Ileana Giurgiu

Funded by: Nature Science Foundation of Hubei Province

Award ID: 2015CFB262

Award Recipient : Dominique Tripodi

Custom metadata

ScienceOpen disciplines: Occupational & Environmental medicine

Keywords: occupational stress,risk exposure,high strain,public hospital,medication use

Data availability:

ScienceOpen disciplines: Occupational & Environmental medicine

Keywords: occupational stress, risk exposure, high strain, public hospital, medication use

Wellbeing and occupational risk perception among health care workers: a multicenter study in Morocco and France

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China Occupational Medicine

Most cited references 33

Work stress in the etiology of coronary heart disease--a meta-analysis.

Epidemiological study to investigate potential interaction between physical and psychosocial factors at work that may increase the risk of symptoms of musculoskeletal disorder of the neck and upper limb.

Is job strain a major source of cardiovascular disease risk?

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