Exposure to psychosocial risk factors in the context of work: a systematic review

Fernandes, Cláudia; Pereira, Anabela

doi:10.1590/S1518-8787.2016050006129

Acessibilidade / Reportar erro

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

Review • Rev. Saúde Pública 50 • 2016 • https://doi.org/10.1590/S1518-8787.2016050006129 copy

Exposure to psychosocial risk factors in the context of work: a systematic review

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

OBJECTIVE

To analyze the scientific literature about the effects of exposure to psychosocial risk factors in work contexts.

METHODS

A systematic review was performed using the terms “psychosocial factors” AND “COPSOQ” in the databases PubMed, Medline, and Scopus. The period analyzed was from January 1, 2004 to June 30, 2012. We have included articles that used the Copenhagen Psychosocial Questionnaire (COPSOQ) as a measuring instrument of the psychosocial factors and the presentation of quantitative or qualitative results. German articles, psychometric studies or studies that did not analyze individual or work factors were excluded.

RESULTS

We included 22 articles in the analysis. Individual factors, such as gender, age, and socioeconomic status, were analyzed along with work-related factors such as labor demands, work organization and content, social relationships and leadership, work-individual interface, workplace values, justice and respect, personality, health and well-being, and offensive behaviors. We analyzed the sample type and the applied experimental designs. Some population groups, such as young people and migrants, are more vulnerable. The deteriorated working psychosocial environment is associated with physical health indicators and weak mental health. This environment is also a risk factor for the development of moderate to severe clinical conditions, predicting absenteeism or intention of leaving the job.

CONCLUSIONS

The literature shows the contribution of exposure to psychosocial risk factors in work environments and their impact on mental health and well-being of workers. It allows the design of practical interventions in the work context to be based on scientific evidences. Investigations in specific populations, such as industry, and studies with more robust designs are lacking.

Psychosocial Impact; Occupational Risks; Working Environment; Professional Autonomy; Job Satisfaction; Mental Health; Occupational Health

Criteria

Inclusion	Exclusion
Use of COPSOQ for measuring psychosocial risks Presentation/analysis of quantitative/qualitative data about individual or work-related factors Studies published between January 1, 2004 and June 30, 2012.	No use of COPSOQ for measuring psychosocial risks No presentation/analysis of quantitative/qualitative data about individual or work-related factors Outside the research period Psychometric study^a Repeated Another language^b

	Author/Publishing year	Sample/Activity sector	Country	Methodology of the study	Main results	Individual factors and work-related factors ** Studied dimensions psychosocial factors Scale [subscale]
1	Albertsen et al.¹1. Albertsen K, Rugulies R, Garde AH, Burr H. The effect of the work environment and performance-based self-esteem on cognitive stress symptoms among Danish knowledge workers. Scand J Public Health. 2010;38(3 Suppl):81-9. DOI:10.1177/1403494809352104 (2010)	n = 349 knowledge industry workers (i.e., employees of communication or knowledge exchange)	Denmark	Correlational Longitudinal (12 months)	Positive correlations were observed between the baseline of the quantitative requirements, conflicts and lack of role clarity, lack of recognition and cognitive stress symptoms. Influence and social support by the management are negatively associated with cognitive stress symptoms. Social support from colleagues did not present any significant relationship.	Self-esteem [cognitive stress] ** Labor demands [quantitative demands] Social relationships and leadership [transparency of labor role, labor role conflict, rewards/recognition, social support from colleagues] Health and well-being [cognitive stress]
2	Aust et al.² (2010)	n = 399 hospital workers (nurses, midwives, assistants, laboratory technicians, others)	Denmark	Controlled intervention in workplace Longitudinal study (16 months)	The psychosocial environment deteriorated after the intervention, especially in the scales related to interpersonal relationship at work and leadership. There was no decrease in the scales that assessed the labor demands. The negative effects found in the scales of COPSOQ are partly because of the disappointment of workers with unrealized expectations.	Expectations ** Social relationships at work and leadership Labor demands
3	Burr et al.⁵ (2010)	n = 3,552 active workers	Denmark	Correlational	The COPSOQ scales had more positive results than those of ERI and of models of tension at work. Mental health deteriorated with more emotional demands and improved with more meaningful work. Regarding mental health, the new psychosocial risk factors have the potential to increase the predictive value of previous models (e.g., ERI).	Vitality, mental health ** Global index of exposure to risk factors Labor demands [emotional demands, demands to hide emotions] Work organization and content [meaning of work] Social relationships at work and leadership [predictability, quality of leadership] Work-individual interface Workplace values Personality Health and well-being Offensive behavior
4	Fuss et al.⁷ (2008)	n = 296 hospital doctors	Germany	Correlational	The interference of work in family was prevalent as part of the work-family conflict (when compared the sample with the population of the studied country in general). No significant gender differences were found. The work-family conflict was significantly correlated with burnout and with physical and cognitive symptoms of stress. Low levels of work-family conflict were correlated with greater job satisfaction, better perception of health in general, greater capacity for work, and higher levels of satisfaction with life. Organization and factors of interpersonal relationship at work were identified as significant predictors of work-family conflict. The function being studied showed differences for the country’s population in general, especially higher levels of stress and quality of life and lower levels of well-being in general.	Physical health Mental health Burnout Satisfaction with life Ability to work Gender ** Work-individual interface [work/family conflict; family/work conflict] Work organization and content Social relationships and leadership [social support from colleagues, social support from superiors]
5	Ghaddar et al.⁸ (2011)	n = 7,429 prison workers	Spain	Correlational	Quantitative and emotional demands, work-home conflict, low influence at work, low autonomy, low social support from colleagues, and stress had statistically significant negative associations with the ability to work. The association between age and ability to work was measured by work experience.	Ability to work, work experience Age ** Labor demands [quantitative demands, emotional demands] Work organization and content [influence at work] Social relationships and leadership [social support from colleagues] Work-individual interface [work-home conflict] Health and well-being [stress]
6	Holst et al.⁹ (2012)	n = 342 musicians of symphony orchestras	Denmark	Correlational	Women reported greater labor demands and higher levels of stress symptoms than men. Individuals in a given function are more susceptible to risk because of the pace, content and organization of work. The increase in labor demands, work organization and content, interpersonal relationships, leadership and work-home interface were significantly correlated with the increase in symptoms of stress.	Physiological stress Sex Function ** Labor demands Work organization and content Health and well-being [stress]
7	Kiss et al.¹¹ (2012)	n = 990 public sector workers	Not available	Correlational	Quantitative demands, job insecurity, demands for hiding emotions, emotional demands, and commitment to the workplace were significantly associated with lower levels of recovery after work.	Recovery after work ** Labor demands [quantitative demands, emotional demands, demands to hide emotions] Work organization and content [commitment to the workplace] Work-individual interface [job insecurity]
8	Kolstrup et al.¹² (2008)	n = 67 farmers in the dairy area and pig raising	Sweden	Correlational	No significant relationships were found between the psychosocial work environment and the development of musculoskeletal injuries. The probability of the physical work environment leading to musculoskeletal injuries is higher than the probability associated with the psychosocial work environment.	Musculoskeletal injuries ** Global index of exposure to risk factors [labor demands, work organization and content, social relationships and leadership, work-individual interface, workplace values, personality, health and well-being, offensive behaviors]
9	Kristensen et al.¹⁴ (2010)	n = 2,331 hospital workers	Denmark	Correlational Longitudinal (12 months)	Absences from work by illness increase with the decrease in the socioeconomic status (few exceptions). The social gradient in the absence from work by illness presented different durations and patterns.	Perception of overall health Absence from work by illness Function Socioeconomic status
10	Larsman et al.¹⁵ (2006)	n = 148 female workers that use computer and are 45 years old or older	Denmark, Netherlands, Sweden and Switzerland	Correlational	The labor demands influence the musculoskeletal injuries because of their mediating effect on stress. The effect of labor demands can be attributed to stress mechanisms.	Stress, musculoskeletal injuries Age ** Labor demands [quantitative demands, pace of work] Health and well-being [stress]
11	Li et al.¹⁸ (2010)	n = 3,088 nursing female workers	China	Correlational Longitudinal (12 months)	Increased emotional demands, decrease in work meaning, decrease in commitment to the workplace, and decrease in satisfaction were associated with the intention of leaving the job permanently. An unfavorable psychosocial work environment predicts the intention of leaving the job permanently.	Intention of leaving the job permanently Sex ** Work demands [emotional demands] Work organization and content [meaning of work, commitment to the workplace] Work-individual interface [work satisfaction]
12	Llorens et al.²⁰ (2010)	n = 7,612 active workers with salary	Spain	Correlational	Exposure to psychosocial risks was associated with management practices. Exposure to good psychosocial environment was associated with participatory working methods, permanent employment contracts, not having the perception of being easily replaced, having superiors little authoritarian and little aggressive, not being inconsiderately treated, possibility of promotion, being paid according to the hours worked and function, working between 31 and 40 hours a week, and working regular shifts.	Management practices ** Global index of exposure to risk factors [labor demands, work organization and content, social relationships and leadership, work-individual interface, workplace values, personality, health and well-being, offensive behaviors]
13	Mache et al.²¹ (2009)	n = 203 doctors	Germany	Correlational	The perceptions of working conditions differ significantly depending on the ownership of the work. Labor satisfaction does not vary among different types of ownership of the work. The work demands and the available resources are associated with work satisfaction. The type of ownership of the work is not associated with work satisfaction.	Work satisfaction, ownership of the work ** Labor demands Work organization and content [influence at work] Work-individual interface [work satisfaction]
14	Moncada et al.²³ (2010)	n = 10,044, in which: Danish workers (3,359), Spanish workers (6,685)	Spain, Denmark	Correlational	A relationship between socioeconomic status and work psychosocial environment was observed. Strong correlations between socioeconomic status and home country.	Socioeconomic status ** Global index of exposure to risk factors [labor demands, work organization and content, social relationships and leadership, work-individual interface, workplace values, personality, health and well-being, offensive behaviors]
15	Nielsen et al.²⁴ (2009)	n = 1,737, in which: nursing staff (791), assistants (410), cleaning staff (255), dairy workers (281)	Not available	Correlational	Specific model for analyzed group. There is an association between psychosocial factors and low physical health (back pain). Differentiation between typically female occupations in replacement for women working conditions.	Physical health complaints, mental health complaints, behavioral stress, back pain, groups, sex ** Global index of exposure to risk factors [labor demands, work organization and content, social relationships and leadership, work-individual interface, workplace values, personality, health and well-being, offensive behaviors]
16	Nübling et al.²⁵ (2010)	n = 889 geriatrics technicians – home work (412), geriatric nursing staff (313), other geriatric workers (164)	Germany	Correlational	The degree of negativity in the evaluation of psychosocial factors associated with the work demand were directly related to the amount of hours worked per week and the number of calls within period of prevention, i.e., during the “period of prevention”.	Working hours, “To be called”, “period of prevention”^a ** Labor demands
17	Nyberg et al.²⁶ (2011)	n = 554 hotelier staff	Sweden, Poland, Italy	Correlational	Significant positive correlations were observed between destructive leadership at organizational level and weak psychosocial well-being at individual level.	Leadership, psychosocial well-being ** Social relationships and leadership [quality of leadership] Health and well-being
18	Olesen et al.²⁸ (2012)	n = 285, in which: migrant workers (137), Dutch workers (148)	Netherlands	Correlational	Low prevalence of hypertension in the resident population. Significant association between meaning of work and hypertension, though with different standards for residents and migrants.	Blood pressure, migration ** Work organization and content [meaning of work]
19	Rugulis et al.²⁹ (2010)	n = 3,188 active workers with salary	Netherlands	Correlational	The psychosocial environment predicts the absence from work for medically prescribed disease.	Sick leave ** Global index of exposure to risk factors [labor demands, work organization and content, social relationships and leadership, work-individual interface, workplace values, personality, health and well-being, offensive behaviors]
20	Sandsjö et al.³⁰ (2006)	n = 146 female workers that use computer and are 45 years old or older	Denmark, Netherlands, Sweden, and Switzerland	Correlational	Although there are differences between groups regarding working conditions, such differences had no scale to constitute standards concerning musculoskeletal injuries.	Musculoskeletal injuries Age ** Global index of exposure to risk factors [labor demands, work organization and content, social relationships and leadership, work-individual interface, workplace values, personality, health and well-being, offensive behaviors]
21	Schenk et al.³¹ (2007)	n = 111 administrative staff and nursing staff	Not available	Correlational	There is no evidence that different mechanisms lead to low back pain in both analyzed professions. General recommendations regarding prevention and treatment of back injury for the professions under study were not found.	Musculoskeletal injuries (low back pain), profession ** Global index of exposure to risk factors [labor demands, work organization and content, social relationships and leadership, work-individual interface, workplace values, personality, health and well-being, offensive behaviors]
22	Sharipova et al.³² (2010)	n = 8,134 health care workers	Denmark	Correlational	No significant differences were found in the exposure to physical violence at the workplace by gender. Younger employees have higher risk of exposure to physical violence related to work. Workers exposed to high emotional demands at work showed a risk increased in more than twice regarding physical violence. Different components of the workplace seem to have an influence on the risk of exposure to violence related to work – e.g., type of institution. Lower rates of violence were found in workplaces with good quality of leadership, without role conflicts, and with high levels of commitment to the workplace.	Type of institution Gender, age ** Work demands [emotional demands] Work organization and content [commitment to the workplace] Social relationships and leadership [work roles conflicts, quality of leadership] Offensive behavior

Faculdade de Saúde Pública da Universidade de São Paulo Avenida Dr. Arnaldo, 715, 01246-904 São Paulo SP Brazil, Tel./Fax: +55 11 3061-7985 - São Paulo - SP - Brazil
E-mail: revsp@usp.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Correspondence: Cláudia Fernandes. Centro de Apoio Tecnológico à Indústria Metalomecânica – CATIM. Rua dos Plátanos, 197 4100-414 Porto, Portugal. E-mail: claudia.fernandes@catim.pt