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Objectives: The literature is nonexistent on the assessment of overall fractions of diseases attributable to multiple dependent psychosocial work factors. The objectives of the study were to calculate the overall fractions of coronary heart diseases (CHD) and depression attributable to multiple dependent psychosocial work factors in 35 European countries., Methods: We used already published fractions of CHD and depression attributable to each of the following psychosocial work factors: job strain, effort-reward imbalance, job insecurity, long working hours, and workplace bullying. We took all exposures and their correlations into account to calculate overall attributable fractions. Wald tests were performed to test differences in these overall attributable fractions between genders and between countries., Results: The overall fractions of CHD and depression attributable to all studied psychosocial work factors together were found to be 8.1% [95% CI: 2.0-13.9] and 26.3% [95% CI: 16.2-35.5] respectively in the 35 European countries. There was no difference between genders and between countries., Conclusion: Our study showed that the overall fractions attributable to all studied psychosocial work factors were substantial especially for depression. These overall attributable fractions may be particularly useful to evaluate the burden and costs attributable to psychosocial work factors, and also to inform policies makers at European level., (© 2024. The Author(s).)

The study aimed to explore the prospective associations between psychosocial factors at work from the job strain model and preventable mortality, including smoking- and alcohol-related mortality as well as external causes of death. The study was based on prospective data and relied on a sample of 1,511,456 individuals for which data on job history, mortality and causes of death were linked over the 1976-2002 period. Exposures were the factors from the job strain model imputed through a job-exposure matrix. Various time-varying measures of exposure were used including current exposure and two measures of cumulative exposure. Preventable mortality was defined using the OECD/Eurostat list of preventable causes of death. The associations between exposures and outcomes were studied using Cox proportional hazards models. Effect modification by gender was also assessed. Over the study period, 57,264 preventable deaths occurred before the age of 75 years. Low decision latitude, low social support, job strain, iso-strain, passive job, and high strain were associated with preventable mortality, and associations of stronger magnitude were found for job strain and isostrain among men. Stronger associations were observed for alcohol-related mortality than for smoking-related mortality and external causes of death. The fractions of preventable mortality attributable to current exposure to job strain and isostrain were significant among men only (5.1% and 3.3%). Psychosocial factors at work from the job strain model may play a role on preventable mortality. Intensifying research and prevention towards the psychosocial work environment may be helpful to reduce risky health-related behaviours and related mortality., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Studies evaluating the effects of multiple occupational exposures on sleep are very rare. We assessed the associations between a wide range of occupational exposures and sleep problems and investigated the cumulative effects of these exposures on this outcome. We used data from the French 2016 Working Conditions survey conducted on a nationally representative sample of workers, including 20,430 employees aged 15-65 yr (8,579 men, 11,851 women). Sleep problems were defined by either sleep disturbances or sleep medication, almost daily or several times a week. Occupational exposures included 21 psychosocial work factors grouped into five dimensions, four factors related to working time/hours and four factors related to the physical work environment. Unadjusted and adjusted weighted robust Poisson regression analyses were performed. Almost all psychosocial work exposures were associated with sleep problems, whereas the only significant working time/hours factor associated with sleep problems was night work among women. Some gender differences in the exposure-outcome associations were found. The prevalence ratio of sleep problems increased with the number of exposures for most dimensions of psychosocial work factors. Physical work exposures were associated with sleep problems, and there was a linear association between the number of these occupational exposures and sleep problems in both genders, although the trend did not reach statistical significance among women. Workplace preventive strategies targeting the work environment comprehensively may be effective in improving sleep among working populations. More attention should be given to multiple exposures in the workplace., (© 2020 European Sleep Research Society.)

Objectives The study aims to explore the prospective associations of the psychosocial work exposures of the job strain model with cardiovascular mortality, including mortality for ischemic heart diseases (IHD) and stroke, using various time-varying exposure measures in the French working population of employees. Methods The study was based on a cohort of 798 547 men and 697 785 women for which job history data from 1976 to 2002 were linked to mortality data and causes of death from the national death registry. Psychosocial work exposures from the validated job strain model questionnaire were assessed using a job-exposure matrix (JEM). Three time-varying measures of exposure were studied: current, cumulative, and recency-weighted cumulative exposure. Cox proportional hazards models were used to examine the associations between psychosocial work exposures and cardiovascular mortality. Results Within the 1976-2002 period, there were 19 264 cardiovascular deaths among men and 6181 among women. Low decision latitude, low social support, job strain, iso-strain, passive job, and high strain were associated with cardiovascular mortality. Most of these associations were also observed for IHD and stroke mortality. The comparison between the different exposure measures suggested that current exposure may be more important than cumulative (or past) exposure. The population fractions of cardiovascular mortality attributable to job strain were 5.64% for men and 6.44% for women. Conclusions Psychosocial work exposures of the job strain model may play a role in cardiovascular mortality. The estimated burden of cardiovascular mortality associated with these exposures underlines the need for preventive policies oriented toward the psychosocial work environment.

Background: Our study aimed to explore the associations between psychosocial work exposures, as well as other occupational exposures, and suicide ideation in the French national working population. An additional objective was to study the cumulative role of occupational exposures in this outcome., Methods: The study was based on a nationally representative sample of the French working population of 20,430 employees, 8579 men and 11,851 women (2016 French national Working Conditions survey). Occupational exposures included 21 psychosocial work factors, 4 factors related to working time/hours and 4 factors related to the physical work environment. Suicide ideation within the last 12 months was the outcome. The associations between exposures and outcome were studied using weighted logistic regression models adjusted for covariates., Results: The 12-month prevalence of suicide ideation was 5.2% among men and 5.7% among women. Among the occupational exposures, psychosocial work factors were found to be associated with suicide ideation: quantitative and cognitive demands, low influence and possibilities for development, low meaning at work, low sense of community, role conflict, job insecurity, temporary employment, changes at work, and internal violence. Some rare differences in these associations were observed between genders. Linear associations were observed between the number of psychosocial work exposures and suicide ideation., Conclusions: Psychosocial work factors were found to play a major role in suicide ideation, and their effects were cumulative on this outcome. More research on multiple and cumulative exposures and suicide ideation and more prevention towards the psychosocial work environment are needed.

Objectives: The objectives of the study were to construct a job-exposure matrix (JEM) for psychosocial work factors of the job strain model, to evaluate its validity, and to compare the results over time., Methods: The study was based on national representative data of the French working population with samples of 46,962 employees (2010 SUMER survey) and 24,486 employees (2003 SUMER survey). Psychosocial work factors included the job strain model factors (Job Content Questionnaire): psychological demands, decision latitude, social support, job strain and iso-strain. Job title was defined by three variables: occupation and economic activity coded using standard classifications, and company size. A JEM was constructed using a segmentation method (Classification and Regression Tree-CART) and cross-validation., Results: The best quality JEM was found using occupation and company size for social support. For decision latitude and psychological demands, there was not much difference using occupation and company size with or without economic activity. The validity of the JEM estimates was higher for decision latitude, job strain and iso-strain, and lower for social support and psychological demands. Differential changes over time were observed for psychosocial work factors according to occupation, economic activity and company size., Conclusions: This study demonstrated that company size in addition to occupation may improve the validity of JEMs for psychosocial work factors. These matrices may be time-dependent and may need to be updated over time. More research is needed to assess the validity of JEMs given that these matrices may be able to provide exposure assessments to study a range of health outcomes.

Background: Explanations of social inequalities in sickness absence are lacking in the literature. Our objectives were to evaluate the contribution of various occupational exposures in explaining these inequalities in a national representative sample of employees., Methods: The study was based on the cross-sectional sample of the SUMER 2010 survey that included 46 962 employees, 26 883 men and 20 079 women. Both sickness absence spells and days within the last 12 months, as health indicators, were studied. Occupation was used as a marker of social position. The study included both psychosocial work factors (variables related to the classical job strain model, psychological demands, decision latitude, social support and understudied variables related to reward, job insecurity, job promotion, esteem, working time/hours and workplace violence) and occupational exposures of chemical, biological, physical and biomechanical nature. Weighted age-adjusted Poisson and negative binomial regression analyses were performed., Results: Strong occupational differences were found for sickness absence spells and days and for exposure to most work factors. Psychosocial work factors contributed to explain occupational differences in sickness absence spells, and the contributing factors were: decision latitude, social support, reward, shift work and workplace violence. Physical exposure, particularly noise, and biomechanical exposure were also found to be contributing factors. Almost no work factor was found to contribute to occupational differences in sickness absence days., Conclusion: Preventive measures at the workplace oriented towards low-skilled occupational groups and both psychosocial work factors and other occupational exposures may be beneficial to reduce sickness absence spells and occupational differences in this outcome., (© The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.)

Background: The 2008 economic crisis may have had an impact on mental health but the studies on this topic are sparse, in particular among the working population. However, mental health at work is a crucial issue involving substantial costs and consequences. The aim of the study was to assess changes in behaviors and indicators of mental health in the French working population between 2006 and 2010, and to explore the differential changes according to age, origin, occupation, activity sector, public/private sector, self-employed/employee status and work contract., Methods: The data came from the prospective national representative Santé et itinéraire professionnel (SIP) survey, including a sample of 5600 French workers interviewed in 2006 and 2010. The behaviors and indicators of mental health studied were excessive alcohol consumption, smoking, sleep problems (sleep disorders and/or insufficient sleep duration), psychotropic drug use (antidepressants, anxiolytics and/or hypnotics), and poor self-reported health. Generalized estimating equations were used to analyze changes in behaviors and indicators of mental health, and the analyses were adjusted for age. Covariates (age, origin, occupation, activity sector, public/private sector, self-employed/employee status and type of contract) were added separately to assess differential changes., Results: Increases in excessive alcohol consumption among women, sleep problems among men, and smoking, insufficient sleep duration and poor self-reported health for both genders were observed in the French working population between 2006 and 2010. Some differential changes were observed, negative changes being more likely to affect young workers and workers with a permanent contract., Conclusion: Prevention policies should consider that behavior and indicators of mental health may deteriorate in times of economic crisis, especially among some sub-groups of the working population, such as young workers and workers with a permanent contract. These changes might foreshadow a forthcoming increase in mental disorders., (Copyright © 2017 Elsevier Masson SAS. All rights reserved.)

Objectives: Social inequalities in mental health have been observed, but explanations are still lacking. The objectives were to evaluate the contribution of a large set of psychosocial work factors and other occupational exposures to social inequalities in mental health in a national representative sample of employees., Methods: The sample from the cross-sectional national French survey SUMER 2010 included 46,962 employees: 26,883 men and 20,079 women. Anxiety and depression symptoms were measured using the Hospital Anxiety and Depression scale. Occupation was used as a marker of social position. Psychosocial work factors included various variables related to the classical job strain model, psychological demands, decision latitude, social support, and other understudied variables related to reward, job insecurity, job promotion, esteem, working time/hours, and workplace violence. Other occupational exposures of chemical, biological, physical, and biomechanical nature were also studied. Weighted age-adjusted linear regression analyses were performed., Results: Occupational gradients were found in the exposure to most psychosocial work factors and other occupational exposures. Occupational inequalities were observed for depressive symptoms, but not for anxiety symptoms. The factors related to decision latitude (and its sub-dimensions, skill discretion, and decision authority), social support, and reward (and its sub-dimensions, job promotion, job insecurity, and esteem) contributed to explain occupational inequalities in depressive symptoms. Decision latitude played a major role in the explanation. Workplace violence variables contributed among men only. Other exposures of physical and biomechanical nature also displayed significant contributions., Conclusions: Comprehensive prevention policies at the workplace may help to reduce social inequalities in mental health in the working population.

Objectives: The objective was to explore the associations between psychosocial work factors and first depressive episode. Additional objectives included the study of the frequency and duration of exposure, and the evaluation of the induction period between exposures and outcome and of the reversibility of the effects., Methods: The study was based on a sample of 13,648 men and women from the 2006 national representative French SIP survey. Retrospective evaluation was performed for depressive episode for the whole life history, for psychological demands, skill discretion, social support, tension with the public, reward and work-life imbalance for each job, and within each job before and after each major change, and for time-varying covariates. The outcome was the first depressive episode. Statistical analysis was performed using weighted discrete time logistic regression model., Results: High psychological demands and low social support were risk factors for first depressive episode for both genders. The risk increased with the frequency of exposure to these factors. Associations were found with the frequency of exposure to tension with the public among women and to work-life imbalance among men. The risk increased with the duration of exposure to psychological demands and low social support for both genders, however, these associations become non-significant when recent exposure was taken into account. Past exposure older than 2 years was not associated with the outcome., Conclusion: Associations between psychosocial work factors and first depressive episode were observed, including dose-response associations. However, after removal of the exposure, the risk may be reduced after 2 years.

Prospective studies exploring the associations between a large range of occupational factors and psychotropic drug use among national samples of workers are seldom. This study investigates the cross-sectional and prospective associations between occupational factors, including a large set of psychosocial work factors, and psychotropic drug use in the national French working population. The study sample comprised 7542 workers for the cross-sectional analysis and 4213 workers followed up for a 4-year period for the prospective analysis. Psychotropic drug use was measured within the last 12 months and defined by the use of antidepressants, anxiolytics or hypnotics. Three groups of occupational factors were explored: classical and emergent psychosocial work factors, working time/hours and physical work exposures. Weighted Poisson regression analyses were performed to adjust for covariates. In the cross-sectional analysis, psychological demands, low social support and hiding emotions were associated with psychotropic drug use. Job insecurity for men and night work for women were associated with psychotropic drug use. In the prospective analysis, hiding emotions and physical exposure were predictive of psychotropic drug use. Dose-response associations were observed for the frequency/intensity of exposure and repeated exposure to occupational factors. This study underlines the role of psychosocial work factors, including emergent factors, in psychotropic drug use. Prevention policies oriented toward psychosocial work factors comprehensively may be useful to reduce this use., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Introduction: This study was designed to investigate the associations between psychosocial work factors, using well-known theoretical models and emerging concepts, and self-reported health in the national population of French employees., Methods: This study was based on the data of the French national representative SUMER 2010 survey. The sample included 46,962 employees, 26,883 men and 20,079 women, with an 87% participation rate. Self-reported health was measured by means of a single question and was analysed as a binary variable. Psychosocial work factors included factors related to job strain and effort-reward imbalance models, workplace violence and working hours. Associations between psychosocial work factors and self-reported health were studied using weighted logistic regression models adjusted for covariates (age, occupation, economic activity, and other types of occupational exposure)., Results: Low decision latitude (skill discretion and decision authority), high psychological demands, low social support (from supervisors for men), low reward (low esteem and low job promotion for both genders and job insecurity for men), bullying and verbal abuse for both genders were associated with self-reported health., Conclusions: This study emphasizes the role of psychosocial work factors as risk factors for poor self-reported health and suggests that the implementation of preventive measures to reduce exposure to psychosocial work factors should be an objective for the improvement of health at work.

Background: Little is known about associations between emergent psychosocial work factors and mental health., Aims: To explore associations between classical and emergent psychosocial work factors and depression and anxiety symptoms in employees in France., Methods: A national cross-sectional study (the SUrveillance Médicale des Expositions aux Risques professionnels (SUMER) survey) assessed psychosocial work factors including psychological demands, decision latitude, social support, reward and its sub-dimensions (esteem, job security and job promotion), bullying, verbal abuse, physical violence and sexual assault, long working hours, shift and night work, unsociable work days, predictability and demands for responsibility. We also measured depression and anxiety symptoms using the Hospital Anxiety and Depression scale. We used gender-stratified generalized linear models to adjust for age, occupation and economic activity., Results: A total of 26883 men and 20079 women participated (response rate 87%). Low decision latitude, high psychological demands, low social support, low reward, bullying and verbal abuse were associated with depression and anxiety in both genders (β coefficients from 0.14 to 1.40). In men, low predictability was associated with both depression and anxiety (β = 0.12 [95% confidence interval (CI) 0.01, 0.24] and 0.19 [95% CI 0.06, 0.32]) and long working hours were associated with anxiety (β = 0.48 [95% CI 0.27, 0.69]). The strongest associations were observed for bullying, reward (especially esteem) and psychological demands. Using a less conservative approach, we found more factors to be significantly associated with mental health symptoms., Conclusions: Most psychosocial work factors studied are associated with depression and/or anxiety symptoms. Comprehensive prevention policies may help to reduce exposure to psychosocial work factors, including emergent ones, and improve mental health at work., (© The Author 2014. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)

Background: The literature has been extensive on the associations between psychosocial work factors and mental health. Nevertheless, the studies using prospective design, various concepts and more than one measurement point in time for these factors and diagnostic interview to assess mental disorders remain seldom in the literature. This study is an attempt to fill the gap in this topic., Methods: The study was based on a national representative sample of 4717 workers of the French working population (SIP survey), interviewed in 2006 and reinterviewed again in 2010 and free of mental disorders at baseline. Psychosocial work factors, measured in both 2006 and 2010, included: psychological demands, decision latitude, social support, reward, emotional demands, role conflict, ethical conflict, tensions with the public, job insecurity and work-life imbalance. Other occupational factors related to working time/hours and physical work environment were also studied. Major depressive (MDD) and generalized anxiety disorders (GAD) were measured using a standardised diagnostic interview (MINI). Covariates were age, occupation, marital status, having a child under 3 y, social support outside work and stressful life events. Multivariate analyses were performed using weighted logistic regression models., Results: Using models taking all occupational factors into account simultaneously, low reward and job insecurity predicted MDD. Psychological demands, low reward, emotional demands and job insecurity were predictive of GAD. The more frequent the exposure to job insecurity, the higher the risk of MDD and GAD, and the more frequent the exposure to psychological demands and low reward, the higher the risk of GAD. No effect was observed for repeated exposure to occupational factors., Conclusions: Classical and emergent psychosocial work factors were predictive factors of depression and anxiety with dose-response associations in terms of frequency of exposure. More attention may be needed on emergent psychosocial work factors and frequent exposure to these factors.

Purpose: The aim of the study was to assess the changes in psychosocial work factors in the French working population between 2006 and 2010 and to examine potential differential changes according to age, occupation, public/private sector, work contract and self-employed/employee status., Methods: The study sample included 5,600 workers followed up from 2006 to 2010 from the national representative Santé et Itinéraire Professionnel (SIP) survey. Psychosocial work factors included decision latitude, psychological demands, social support, reward, overcommitment, long working hours, predictability, night- and shift work, emotional demands, role conflict, ethical conflict, tensions with the public, job insecurity and work-life imbalance, and were measured using scores. Linear regressions were used to analyse the change in the scores of these factors adjusted for age and initial score. All analyses were stratified by gender., Results: Psychosocial work factors worsened between 2006 and 2010: decision latitude, social support, reward, role conflict and work-life imbalance for both genders, and psychological demands, emotional demands, ethical conflict and tensions with the public for women. Differential changes according to age, occupation, public/private sector, work contract and self-employed/employee status were observed suggesting that some groups may be more likely to be exposed to negative changes especially the younger, low- and high-skilled and public sector workers., Conclusion: Monitoring exposure to psychosocial work factors over time may be crucial, and prevention policies should take into account that deterioration of psychosocial work factors may be sharper among subgroups such as younger, low- and high-skilled and public sector workers.

Purpose: The aim of this study was to explore the associations between psychosocial working conditions and psychological well-being among employees in 34 European countries. Another objective was to examine whether these associations varied according to occupation and country., Methods: The study was based on data from the European Working Conditions Survey 2010 including 33,443 employees, 16,512 men and 16,931 women, from 34 European countries. Well-being was measured by the WHO-5 well-being index. Twenty-five psychosocial work factors were constructed including job demands, role stressors, work hours, job influence and freedom, job promotion, job insecurity, social support, quality of leadership, discrimination and violence at work, and work-life imbalance. The associations between these factors and well-being were examined using multilevel logistic regression analyses. Different models were performed including interaction tests., Results: When all 25 psychosocial work factors were studied simultaneously in the same model with adjustment variables, 13 showed a significant association with poor well-being among both genders: quantitative demands, demands for hiding emotions, low possibilities for development, low meaning of work, low role conflict, low quality of leadership, low social support, low sense of community, job insecurity, low job promotion, work-life imbalance, discrimination, and bullying. The association with low sense of community on poor well-being was particularly strong., Conclusions: A large number of psychosocial work factors were associated with poor well-being. Almost no country and occupational differences were found in these associations. This study gave a first European overview and could be useful to inform cross-national policy debate.

Objectives: The aim of this study was to evaluate the fractions of cardiovascular diseases and mental disorders attributable to three psychosocial work factors, job strain, effort-reward imbalance (ERI) and job insecurity, in 31 countries in Europe., Methods: The prevalence of exposure (Pe) to job strain, ERI and job insecurity was calculated using the sample of 29,680 workers from 31 countries of the 2005 European Working Conditions Survey. Relative risks (RR) were obtained from three published meta-analyses. Pe and RR estimates were used to calculate attributable fractions (AF)., Results: Pe estimates were 26.90, 20.44 and 14.11% for job strain, ERI and job insecurity in Europe, and significant differences were observed between countries. The job strain and ERI AFs for cardiovascular diseases were, respectively, 4.46% (significantly different from zero for Europe and all countries, but without any differences between countries) and 18.21% (not significantly different from zero for Europe and without differences between countries). The significant job strain and job insecurity AFs for mental disorders were 18.16 and 4.53% in Europe, without any significant difference between countries. The significant ERI AF for mental disorders was 14.81%, and significant differences were found between countries; the 3 highest AFs were observed in Greece, Slovenia and Turkey, and the 3 lowest in Bulgaria, Ireland and Latvia., Conclusion: This study is the first one to provide fractions of cardiovascular diseases and mental disorders attributable to three psychosocial work factors for the whole Europe and to explore the differences between 31 countries. These results may be useful to guide European and national prevention policies as well as to evaluate the economic costs of diseases attributable to these exposures.

Objective: The aim was to assess the changes in psychosocial work factors among European employees between 2005 and 2010., Methods: The study samples came from the European Working Conditions Survey, involving 23,580 and 32,516 employees in 2005 and 2010, respectively, from 30 European countries. The psychosocial work factors studied were based on job strain and effort-reward imbalance models, and more recent factors. Multilevel linear and logistic regression models were used. Differences according to occupations and countries were tested., Results: Results were mixed with improvement for some factors and decline for other factors. Some countries and occupations were more likely to be affected by negative changes, especially low-skilled employees., Conclusion: Prevention policies at the workplace should take into account that the degradation of some psychosocial work factors may be sharper for some countries and occupations.

Background: The studies on the associations between psychosocial work factors and sickness absence have rarely included a large number of factors and European data. The objective was to examine the associations between a large set of psychosocial work factors following well-known and emergent concepts and sickness absence in Europe., Methods: The study population consisted of 14,881 male and 14,799 female workers in 31 countries from the 2005 European Working Conditions Survey. Psychosocial work factors included the following: decision latitude, psychological demands, social support, physical violence, sexual harassment, discrimination, bullying, long working hours, shift and night work, job insecurity, job promotion and work-life imbalance. Covariates were as follows: age, occupation, economic activity, employee/self-employed status and physical, chemical, biological and biomechanical exposures. Statistical analysis was performed using multilevel negative binomial hurdle models to study the occurrence and duration of sickness absence., Results: In the models, including all psychosocial work factors together and adjustment for covariates, high psychological demands, discrimination, bullying, low-job promotion and work-life imbalance for both genders and physical violence for women were observed as risk factors of the occurrence of sickness absence. Bullying and shift work increased the duration of absence among women. Bullying had the strongest association with sickness absence., Conclusion: Various psychosocial work factors were found to be associated with sickness absence. A less conservative analysis exploring each factor separately provided a still higher number of risk factors. Preventive measures should take psychosocial work environment more comprehensively into account to reduce sickness absence and improve health at work at European level.

Background: Although psychosocial work factors are recognized as major occupational risk factors, little information is available regarding the prevalence of exposure to these factors and the differences in exposure between countries., Aims: To explore the differences in various psychosocial work exposures between 31 European countries., Methods: The study was based on a sample of 14,881 male and 14,799 female workers from the 2005 European Working Conditions Survey. Eighteen psychosocial work factors were studied: low decision latitude (skill discretion and decision authority), high psychological demands, job strain, low social support, iso-strain, physical violence, sexual harassment, bullying, discrimination, work-family imbalance, long working hours, high effort, job insecurity, low job promotion, low reward and effort-reward imbalance. Covariates were age, number of workers in household, occupation, economic activity, self-employed/employee, public/private sector and part/full time work. Statistical analysis was performed using multilevel logistic regression analysis., Results: Significant differences in all psychosocial work factors were observed between countries. The rank of the countries varied according to the exposure considered. However, some countries, especially Denmark, Netherlands and Norway, displayed a significantly lower prevalence of exposure to four factors or more, while some Southern and Eastern countries, especially Czech Republic, Greece, Lithuania and Turkey, had a higher prevalence., Conclusions: Differences in psychosocial work exposures were found between countries. This study is the first to compare a large set of psychosocial work exposures between 31 European countries. These findings may be useful to guide prevention policies at European level.

Objective: To examine the associations between psychosocial exposures at work and depressive symptoms by using two independent French national databases., Methods: A job-exposure matrix of psychosocial work exposures was constructed from data collected by the national medical monitoring of occupational risks survey in 2003. Depressive symptoms came from the 2002 to 2003 decennial health survey. Data were linked by age, occupational group, and economic activity., Results: The crude and adjusted results showed small but significant and systematic associations between job strain and depressive symptoms among men. These associations were much weaker for psychological demands and decision latitude. No statistical associations were observed among women., Conclusion: The results suggest that, among men, using independent data on exposure and health, there is a robust association between job strain and depressive symptoms. They contribute to the debate about the causal nature of associations between psychosocial exposures at work and mental health.

Aim: To examine the associations between psychosocial work factors and general health outcomes, taking into account other occupational risk factors, within the national French working population., Methods: The study was based on a large national sample of 24 486 women and men of the French working population who filled in a self-administered questionnaire in 2003 (response rate: 96.5%). Psychosocial work exposures included psychological demands, decision latitude, social support, workplace bullying and violence from the public. The three health indicators studied were self-reported health, long sickness absence (>8 days of absence) and work injury. Adjustment was made for covariates: age, occupation, work status, working hours, time schedules, physical, ergonomic, biological and chemical exposures. Men and women were studied separately., Results: Low levels of decision latitude, and of social support, and high psychological demands were found to be risk factors for poor self-reported health and long sickness absence. High demands were also found to be associated with work injury. Workplace bullying and/or violence from the public also increased the risk of poor health, long sickness absence and work injury., Conclusion: Psychosocial work factors were found to be strong risk factors for health outcomes; the results were unchanged after adjustment for other occupational risk factors. Preventive efforts should be intensified towards reducing these psychosocial work exposures.

Psychosocial factors at work have been found to be associated with having potential risk for adverse health effects. The main instrument used to measure these factors and their impact is the Job Content Questionnaire (JCQ) by Karasek. The objective of this study was to evaluate the psychometric properties of the French version of the JCQ, and in particular to assess its internal coherence and consistency, as well as the factorial and convergent validity of psychological demands, decisional latitude and social support at work based upon the SUMER survey, which was the first French national survey of its kind to include the JCQ. The study was based on a sample of 24, 486 workers who answered the JCQ in 2003 (96.5% response rate). Internal consistency was satisfactory, as Cronbach's alpha coefficients were observed as being higher than 0.65. Confirmatory factor analysis showed that the best model was composed of 5 latent variables: demands and pressures, the two dimensions of latitude (utilization of skills and autonomous decision-making), and the two dimensions of support (from supervisors and from colleagues). Convergent validity tests confirmed the expected association with key variables, which were: age, work status, sector of activity, occupation, job satisfaction, perception of job stress, and intent to change job. This study demonstrated satisfactory psychometric properties of Karasek's JCQ scales for the French working population.