Quelle intervention au niveau organisationnel dans les entreprises pour prévenir ou réduire le burnout ?

Ce rapport présente les résultats de réflexions menées dans le cadre du projet STOBS-VD ; il rend compte de deux études quantitatives dont le but était de déterminer quel type d’intervention serait efficace pour prévenir l’épuisement professionnel (burnout) et dans quels secteurs d’activité. Les résultats indiquent qu’en Suisse, les secteurs « Banques, assurances », « Santé, social, médico-social », « Agences de sécurité et autres activités de soutien aux entreprises », « Transport, entreposage, poste » et « Hébergement et restauration » affichent les taux les plus élevés d’épuisement émotionnel et de stress au travail. La combinaison de ces deux facteurs constitue un risque accru du burnout professionnel. Les deux études ont consisté en une revue systématique et une méta-analyse de 13 études interventionnelles. Cette dernière a, quant à elle, confirmé l’efficacité des interventions organisationnelles pour prévenir le burnout. Un effet bénéfique modéré à fort a été mis en évidence, notamment pour la dimension de l’épuisement émotionnel. Cet effet a été renforcé par la combinaison des interventions menées au niveau organisationnel et individuel. Parmi les interventions évaluées, les interventions participatives ont démontré une meilleure efficacité préventive. Le rapport présente deux exemples d’interventions et discute leur applicabilité en Suisse

Prevalence of occupational burnout in Swiss workers: a systematic review and meta-analysis

Introduction: Occupational burnout (OB) has been associated with job dissatisfaction, lower productivity, intentions to leave the job, increased turnover and health-care costs, as well as other socioeconomic issues. Despite such negative consequences, the prevalence of burnout among Swiss workers remains unknown. Material and Methods: We interrogated international databases such as Medline (Pubmed), EMBASE, and PsycINFO, and 15 Swiss universities’ databases from 2010 up to July 6, 2021 to identify studies reporting the prevalence of OB and/or emotional exhaustion (EE) - the core OB dimension- in Swiss workers. Data were summarized descriptively and quantitatively using random effects meta-analysis. Results: We identified 23 studies that used different outcome assessment methods: hetero-assessment by physicians and self-reported, using a specific question or one burnout inventory scale (frequently used: Maslach Burnout Inventory (MBI) and Copenhagen Burnout Inventory (CBI)). We estimated the prevalence of clinical/severe burnout, overall burnout and emotional exhaustion (EE)] at 4%, 18% and 18%, respectively, with considerable heterogeneity (I-square >90%, p< 0.00). Conclusions: Despite between-study heterogeneity, our overall estimate of OB in Swiss workers is high enough to reinforce the current efforts to detect it better and earlier and reduce its negative consequences at individual and societal levels

Challenges in Quantifying 8-OHdG and 8-Isoprostane in Exhaled Breath Condensate

Exhaled breath condensate (EBC) has attracted substantial interest in the last few years, enabling the assessment of airway inflammation with a non-invasive method. Concentrations of 8-Hydroxydesoxyguanosine (8-OHdG) and 8-isoprostane in EBC have been suggested as candidate biomarkers for lung diseases associated with inflammation and oxidative stress. EBC is a diluted biological matrix and consequently, requires highly sensitive chemical analytic methods (picomolar range) for biomarker quantification. We developed a new liquid chromatography coupled to tandem mass spectrometry method to quantify 8-OHdG and 8-isoprostane in EBC simultaneously. We applied this novel biomarker method in EBC obtained from 10 healthy subjects, 7 asthmatic subjects, and 9 subjects with chronic obstructive pulmonary disease. Both biomarkers were below the limit of detection (LOD) despite the good sensitivity of the chemical analytical method (LOD = 0.5 pg/mL for 8-OHdG; 1 pg/mL for 8-isoprostane). This lack of detection might result from factors affecting EBC collections. These findings are in line with methodological concerns already raised regarding the reliability of EBC collection for quantification of 8-OHdG and 8-isoprostane. Precaution is therefore needed when comparing literature results without considering methodological issues relative to EBC collection and analysis. Loss of analyte during EBC collection procedures still needs to be resolved before using these oxidative stress biomarkers in EBC

Relationship Between Effort-Reward Imbalance, Over-Commitment and Occupational Burnout in the General Population: A Prospective Cohort Study

Objectives: To prospectively investigate the association between Effort-Reward Imbalance (ERI) and over-commitment and the scores of the burnout dimensions over a 4 years follow-up period considering potential confounders. Methods: Data stemmed from CoLaus|PsyCoLaus, a population-based cohort study including 575 participants (mean age 55 years, 50% men). Participants completed the Maslach Burnout Inventory-General Survey, ERI and over-commitment questionnaires at baseline (T1) and after a 4 years follow-up (T2), and provided demographic, behavioral, psychiatric, personality and social support information through self-reported questionnaires and semi-structured interviews. Serially adjusted linear regression models were used. Results: ERI and over-commitment were not associated longitudinally with any of the burnout dimensions when controlling for confounders. One standard deviation increases in the scores of exhaustion, cynicism and professional efficacy were associated with one standard deviation increase in the scores of the same burnout dimensions longitudinally, and these associations were independent of the effects of ERI and over-commitment. Conclusion: Future studies should re-examine the effect of ERI and over-commitment on workers' burnout, considering the effects of confounders

Methodological, political and legal issues in the assessment of the effects of nanotechnology on human health

Engineered nanomaterials (ENMs) raise questions among the scientific community and public health authorities about their potential risks to human health. Studying a prospective cohort of workers exposed to ENMs would be considered the gold standard for identifying potential health effects of nanotechnology and confirming the 'no effect' levels derived from cellular and animal models. However, because only small, cross-sectional studies have been conducted in the past 5 years, questions remain about the health risks of ENMs. This essay addresses the scientific, methodological, political and regulatory issues that make epidemiological research in nanotechnology-exposed communities particularly complex. Scientific challenges include the array of physicochemical parameters and ENM production conditions, the lack of universally accepted definitions of ENMs and nanotechnology workers, and the lack of information about modes of action, target organs and likely dose-response functions of ENMs. Standardisation of data collection and harmonisation of research protocols are needed to eliminate misclassification of exposures and health effects. Forming ENM worker cohorts from a combination of smaller cohorts and overcoming selection bias are also challenges. National or international registries for monitoring the exposures and health of ENM workers would be helpful for epidemiological studies, but the creation of such a registry and ENM worker cohorts will require political support and dedicated funding at the national and international levels. Public authorities and health agencies should consider carrying out an ENM awareness campaign to educate and engage all stakeholders and concerned communities in discussion of such a project