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Logo of oenvmedOccupational and Environmental MedicineVisit this articleSubmit a manuscriptReceive email alertsContact usBMJ
Occup Environ Med. 2007 December; 64(12): e7.
PMCID: PMC2095350

Psychosocial 1 and Mental health

018 Sickness absence due to depressive symptoms

P. C. Koopmans1, C. A. M. Roelen2, J. W. Groothoff3. 1ArboNed Groningen; 2ArboNed Zwolle; 3University Medical Center Groningen, University of Groningen

ObjectivesThe impact of mental illness on overall health and productivity is substantial throughout the world. Depression is one of the most common mental disorders. According to the World Health Organization, depression will be the leading cause of illness‐related morbidity by the year 2010. The aim of this study was to determine the duration of sickness absence due to depressive symptoms in the Dutch working population.

MethodsIn this observational study of 15% of the Dutch working population, all absence episodes (n = 9910) starting between April 2002 and November 2005 diagnosed as depression by the occupational physician were selected. For these episodes, Kaplan‐Meier survival curves were computed.

ResultsThe mean (and median) duration of sickness absence due to depressive symptoms was 200 (179) days in men and 213 (201) days in women. Men more often returned to work and women more often reached the disability pension date. Older employees had longer absence durations. Depressive symptoms had an estimated rate of chronicity (1 year of absence) of 24%. Employees in educational and public services, commercial services and health care had the longest duration of absence due to depressive symptoms. Employees in large sized companies and men in the industrial sector had the shortest absence episodes.

ConclusionWorkers with a depressive disorder are absent for a long time. Explanations for the long duration are discussed. Persons with lower grade depressive moods may not report complaints at all and stay at work. If absent, they might have returned to work before they are invited to visit the occupational physician. It is possible that occupational physicians diagnose a depressive disorder in a later phase of illness when the symptoms are more apparent or after the worker is referred to a psychiatrist. The duration of absence due to depressive disorder exceeds the estimation of a depressive episode of 3 months in the general Dutch population. Social benefits in The Netherlands could have contributed to the relatively long absence duration. In order to prevent long‐term absenteeism, it is important to take active reintegration measures in an early stage of the absence episode.

Key wordsdepression; duration of sick‐leave; gender and age differences

019 Working conditions and health in call centres

B. Charbote. UMRESTTE, Université Claude Bernard Lyon

ObjectivesA transversal study was carried out to investigate working conditions and health in call centres.

Methods47 occupational physicians participated in the study. The study was proposed to the workers during the periodic occupational medical examination. Data were collected using a self‐completed questionnaire: descriptions of working conditions, perception of work and working conditions, and health. Two standardised questionnaires were used to assess work perception and mental health: Karasek and a General Health Questionnaire (GHQ‐12). The first step was a descriptive analysis of the work, perception and medical aspects. Association between working conditions and health was studied and a multivariate analysis was carried out.

Results2130 workers were recruited. Only 18 workers refused to participate. 72% of the participants were females, the mean age being 32.4 years; 91.2% were permanent employees; 81.5% worked full time and 70.4% had chosen to work in a call centre. The education level of the population studied is high, 68% of workers having followed higher education. In this population, the decision latitude score was 57.2 (±12.6), 58.8 (±13.1) among men and 56.7 (±12.3) among women. The psychological demand score was 23.3 (±4.0) in the whole population, with few gender variations. Almost 60% of workers had sick leave during the previous 12 months; the mean number of sick leave days was 13. According to the classical GHQ‐12 score, 746/2074 (36.0%) of workers had a moderate (score between 3 and 5) or high level (6 and more) of psychological distress. Almost 24% of workers had used psychoactive medications during the previous 12 months. Some occupational factors were found to increase the risk of psychological distress.

ConclusionThe mean score of decision latitude among call centres workers is close to the score usually observed in blue collar workers, whereas psychological demand is similar to that observed in executives and engineers. These factors may have led to the high level of psychological distress observed; scores conform to the findings of other studies in call centres. Occupational factors have been identified, providing some ways of prevention.

Key wordscall centre; health; working conditions

020 Effectiveness of a preventive coaching intervention for employees at risk for sickness absence due to psychosocial health complaints: results of a randomised controlled trial

S. F. A. Duijts, I. J. Kant, P. A. van den Brand, G. M. H. Swaen. Maastricht University

ObjectivesTo assess the effectiveness of a preventive coaching intervention on sickness absence due to psychosocial health complaints and on general wellbeing of employees.

MethodsThe study was carried out in three large companies in The Netherlands. Employees (n = 151) at risk for sickness absence were identified by means of a screening instrument called ‘Werkwijzer', and randomised. The intervention group (n = 76) received the preventive coaching program in a human resource context; the control group (n = 75) received usual care. Self‐administered questionnaires were sent to employees at 6 (T1) and 12 (T2) months follow‐up, and self‐reported and objective sickness absence data were gathered. The primary outcome measure of the trial is sickness absence due to psychosocial health complaints; secondary outcome measures are self‐rated health, psychological distress, anxious mood, coping, psychological work characteristics, need for recovery, fatigue and burnout.

ResultsThe results showed no effect of coaching on self‐reported sickness absence due to psychosocial health complaints. Based on objective data, a 14% reduction in sickness absence duration was achieved in the intervention group as compared to the control group (15.6 vs 18.1 days). Employees who participated in the coaching reported statistically significant and clinically relevant improved health, declined psychological distress, and demonstrated less burnout, less need for recovery and an increased satisfaction with life. Adverse significant effects were found for job insecurity and training possibilities.

ConclusionThis study shows that the coaching intervention has an effect on both objective duration of sick leave and general well‐being of employees. For implementation of the preventive strategy further research is warranted.

Key wordspreventive intervention; sickness absence; randomised controlled trial

021 Prevalence of common mental disorders and work disability according to occupational class in France

C. Cohidon. Department of Occupational Health, Institut de Veille Sanitaire

ObjectivesThe aims of the study were first to estimate the prevalence of the principal mental disorders according to occupational class and secondly to describe the work disability of such disorders in a representative sample of the French working population.

MethodsThe multicentric study “Santé mentale en population générale” was conducted in the French general population between 1999 and 2003. The sample consisted of about 36 000 persons aged 18 and over. They were selected by quota sampling stratified by age, sex, and occupational and educational levels with the general population of the centre as the sampling frame. For our study, the population was limited to people having a job. Data were collected face‐to‐face by trained interviewers. Mental health disorders were assessed using the Mini International Neuropsychiatric Interview (MINI) including mood disorders (major depressive disorder, dysthymia, lifetime manic episode) and anxiety disorders (generalised anxiety disorder, social phobia, agoraphobia and panic disorder). In addition, work disability was explored by two questions: Does this trouble interfere with your functioning at work? Did you break off your work because of this trouble?

ResultsAnxiety disorders are the most common disorders, with a prevalence of 17% in men and 25% in women. Mood disorders prevalence estimates are about 11% in men and 16% in women. The lowest occupational classes (clerks and workers) have consistently higher prevalence estimates of mental disorders. Farmers report consistently low prevalence (in men). Work disability is about 50%, varying from 41% (generalised anxiety) to 63% (agoraphobia). It varies according to occupational classes differently for men and women. In men, craftsmen and sales people are often the most disturbed in their job. In women results are less consistent. Women managers often have the most disruption to their job. Absenteeism is between 12% (generalised anxiety) and 37% (dysthymia). Whatever their gender, managers, in this population, were more likely to stop their job activity.

ConclusionThis study shows social and professional inequalities both in mood disorders prevalence and in the job consequences of such troubles in the French working population. Despite some methodological limitations, these results are interesting because they can be considered as the first national references.

Key wordsmental health; occupational class; work disability

022 The influence of work environment and job adjustment on risk of absence from work in mid‐pregnancy

P. Kristensen1, R. Nordhagen2, E. Wergeland3, T. Bjerkedal4. 1National Institute of Occupational Health; 2Norwegian Institute of Public Health, Oslo; 3Norwegian Labour Inspection Authority, Oslo; 4Institute of Epidemiology, Norwegian Armed Forces Medical Services, Oslo

ObjectivesWork participation is almost complete among women of childbearing age in Norway. A large proportion of those who are pregnant are on sick leave, though, and the possibility of job adjustment in order to help pregnant women stay in work has been emphasised. Our objective was to quantify the relation between work environment and absence from work in mid‐pregnancy, and to examine if job adjustment is associated with reduced absence.

MethodsThe population consisted of pregnant women in the Norwegian Mother and Child Cohort Study (MoBa). A total of 46 262 participants filled in questionnaires in week 17 (Q1) and in week 30 (Q2) in pregnancy. Pregnant women who were employed and not absent in week 17, and who gave information on key variables numbered 22 932. More than 2 weeks of absence from work in the period between questionnaires was considered the study outcome. All data were based on self‐report. Associations between the quality of work environment (physical, psychosocial) and absence risk were analysed and risk differences were estimated in multiple binomial regression. The influence of job adjustment (three categories: not needed, needed but not obtained, needed and obtained) on absence risk was also assessed in binomial regression.

ResultsDuring follow‐up, 7072 (30.8%) had been absent from work for >2 weeks. The absence risk was strongly associated with a number of background factors as well as physical work characteristics, psychosocial work characteristics, and work schedules in univariate analyses. In a model including several work environment characteristics, absence risk was increased in association with stress at work by 0.075 (95% CI 0.050 to 0.100), with monotony at work (0.081, 95% CI 0.057 to 0.105) and physical heavy work (0.091, 95% CI 0.064 to 0.117). Job adjustment (reference: adjustment needed but not obtained) was associated with a risk decrease of 0.108 (95% CI 0.091 to 0.125) in a model including all influential work characteristics.

ConclusionJob adjustment is associated with reduced absence from work in mid‐pregnancy.

Key wordspregnancy; sickness absence; work environment

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