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      Psychosocial risk factors, job characteristics and self-reported health in the Paris Military Hospital Group (PMHG): a cross-sectional study

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          Abstract

          Objectives

          To investigate the associations between psychosocial risk factors and self-reported health, taking into account other occupational risk factors.

          Design

          Cross-sectional survey using a self-administered questionnaire.

          Setting

          The three military hospitals in Paris, France.

          Participants

          Surveys were distributed to 3173 employees (1807 military and 1336 civilian), a total of 1728 employees completed surveys. Missing data prohibited the use of 26 surveys.

          Primary and secondary outcome measures

          The authors used Karasek's model in order to identify psychosocial factors (psychological demands, decisional latitude, social support) in the workplace. The health indicator studied was self-reported health. Adjustments were made for covariates: age, gender, civil or military status, work injury, ergonomic score, physical and chemical exposures, and occupational profile. Occupational profile was defined by professional category, department, work schedule, supervisor status and service-related length in the hospital.

          Results

          Job strain (defined as high psychological demands and low decisional latitude) (adjusted OR 2.1, 95% CI 1.5 to 2.8, p<0.001) and iso-strain (job strain with low social support) were significantly associated with moderate or poor self-reported health. Among covariates, occupational profile (p<0.001) and an unsatisfactory ergonomic score (adjusted OR 2.3 95% CI 1.6 to 3.2, p<0.001) were also significantly associated with moderate or poor self-reported health.

          Conclusions

          The results support findings linking moderate or poor self-reported health to psychosocial risk factors. The results of this study suggest that workplace interventions that aim to reduce exposure to psychological demands as well as to increase decisional latitude and social support could help improve self-reported health.

          Article summary

          Article focus
          • Health professionals reported frequently distress at work due to work overloads and the constant confrontation with illness.

          • We wanted to investigate the associations between psychosocial risk factors and self-reported health in a military hospital group.

          Key messages
          • Job strain and iso-strain were found to be associated with poor self-reported health.

          • Self-reported health is a unique indication that succeeds in estimating the multidimensional nature of health. It is a relevant synthetic indicator of actual health status.

          Strengths and limitations of this study
          • One of the strong points is that this study simultaneously explore psychosocial risk factors and occupational risk factors.

          • The nature of the studied population and different response rates between civilian and military staff limit the generalisation of the results to healthcare workers in non-military settings.

          Related collections

          Most cited references30

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          Night work and risk of breast cancer.

          Melatonin shows potential oncostatic activity and is acutely suppressed by light exposure. Some evidence suggests an association between night work and breast cancer risk, possibly through the melatonin pathway. In a cohort of premenopausal nurses, we prospectively studied the relation between rotating night shift work and breast cancer risk. Total number of months during which the nurses worked rotating night shifts was first assessed at baseline in 1989 and periodically updated thereafter. We used Cox proportional hazards models to calculate relative risks (RRs) and 95% confidence intervals (CIs). Among 115,022 women without cancer at baseline, 1,352 developed invasive breast cancer during 12 years of follow up. Women who reported more than 20 years of rotating night shift work experienced an elevated relative risk of breast cancer compared with women who did not report any rotating night shift work (multivariate RR = 1.79; 95% CI = 1.06-3.01). There was no increase in risk associated with fewer years of rotating night work. Our results suggest a modestly elevated risk of breast cancer after longer periods of rotating night work. Additional studies are warranted to rule out small sample size or uncontrolled sources for confounding as alternative explanations.
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            • Record: found
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            • Article: not found

            On cross-sectional questionnaire studies of relationships between psychosocial conditions at work and health--are they reliable?

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              • Record: found
              • Abstract: found
              • Article: not found

              Job strain and autonomic indices of cardiovascular disease risk.

              Despite the epidemiological evidence linking job strain to cardiovascular disease, more insight is needed into the etiologic mechanisms. This, in turn, would help to more precisely identify risk. We measured Job Strain using the Job Content Questionnaire, 8/day diary reports, and nationally standardized occupational code linkage, as well as autonomic regulation utilizing heart rate variability including spectral-derived components and QT interval variability in 36 healthy mid-aged males with varying strain jobs. The subjects wore Holter-monitors for 48 hr; this included a work and rest day. Job strain (P = 0.02) and low decision latitude (P = 0.004) were associated with a reduction in cardiac vagal control (HFP) persisting throughout the 48 hr. Job strain was also associated with elevations in sympathetic control during working hours (P = 0.003). The disturbed cardiovascular regulatory pattern associated with job strain may help explain the increased risk of cardiovascular diseases linked with occupational exposure.
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                Author and article information

                Journal
                BMJ Open
                BMJ Open
                bmjopen
                bmjopen
                BMJ Open
                BMJ Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2044-6055
                2012
                31 July 2012
                : 2
                : 4
                : e000999
                Affiliations
                [1 ]HIA Bégin, Centre de Médecine de Prévention des Armées, Saint-Mandé, France
                [2 ]Centre d'Epidémiologie et de Santé Publique des Armées, HIA Bégin, Saint-Mandé, France
                [3 ]Département de Psychiatrie, HIA Percy, Clamart, France
                [4 ]Direction Centrale du Service de Santé des Armées, Vincennes, France
                Author notes
                [Correspondence to ] Dr Jean-François Ferrand; ferrand.jeff@ 123456wanadoo.fr
                Article
                bmjopen-2012-000999
                10.1136/bmjopen-2012-000999
                4400733
                22855624
                de5368e9-9a2e-4e42-b484-49c22b05e3f3
                Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions

                This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.

                History
                : 2 March 2012
                : 29 June 2012
                Categories
                Occupational and Environmental Medicine
                Research
                1506
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                Medicine
                Medicine

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