Job strain and chronic obstructive pulmonary disease exacerbations: an individual-participant meta-analysis.

To the Editor:Chronic obstructive pulmonary disease (COPD) is a major cause of mortality and disability worldwide (1). The clinical course of COPD is characterised by exacerbations, which can be minor and manageable at home or in primary care, or severe, leading to hospitalisation or even death. Known causes of exacerbations include tobacco smoke, air pollution, dusts and fumes, and respiratory infections (1, 2). One less well understood risk factor is stress, which could plausibly lead to COPD exacerbations as it can trigger inflammation (3, 4) and is associated with increased smoking (5), which are both implicated in COPD pathology (2). Work is an important source of stress in the age groups in which COPD is typically diagnosed (1, 6). However, we are not aware of previous investigations of work-related stress and the risk of COPD exacerbations.In this study, we examined the associations between job strain (the most widely studied conceptualisation of work-related stress) and severe COPD exacerbations using individual-level data from 10 prospective cohort studies from the Individual Participant Data Meta-analysis in Working Populations (IPD-Work) Consortium (7). Job strain is defined as a combination of high demands (excessive amounts of work) and low control (having little influence on what tasks to

Maintenance of subjective health during a merger:the role of experienced change and pre-merger social support at work in white- and blue-collar workers

Prospective research on psychosocial effects on employees' health associated with organizational mergers has been scarce. The first aim of this study was to explore the subjective health effects (exhaustion and functional incapacity) of an organizational merger among employees who had experienced a change in their own job position differently (improved, unaltered, and declined). Secondly, the effects of pre-merger social support (organizational, supervisor, and coworkers) at work on the experienced change in job position and on subjective health were examined. The merger took place in 1999 between two multinational firms of equal size. The study is based on two surveys (n = 2,225) carried out in 1996 and in 2000 in the Finnish part of the company. The data on age, sex, pre-merger sickness absence (1996-98) and subjective health status (1996) were used as covariates. The results indicate that all sources of social support had a significant effect on the experience of change in one's job position. A decline in job position strongly increased the risk of poor subjective health after the merger. Weak organizational support was associated with impaired subjective health, especially in blue-collar workers, while weak supervisor support impaired functional capacity in white-collar workers, In turn, strong co-workers' support increased the risk of poor subjective health among blue-collar workers when their job position declined. We conclude that negative changes experienced in one's job position and lack of upper-level social support at work create a potential risk for health impairment in different employee groups in merging enterprises. (C) 2003 Elsevier Ltd. All rights reserved

Organisational merger and psychiatric morbidity: a prospective study in a changing work organisation

Background Prospective studies on the relationship between organisational merger and mental health have been conducted using subjective health indicators. The objective of this prospective occupational cohort study was to examine whether a negative change during an organisational merger is an independent predictive factor of psychiatric morbidity. Method Survey data on organisational characteristics, health and other factors were collected prior to (1996) and after the merger (2000); register data on psychiatric morbidity were collected at baseline (1/1/1994e30/9/ 2000) and during the follow-up (1/10/2000e31/12/ 2005). Participants were 6511 (77 % men) industrial employees aged 21e65 years with no register-based diagnosed psychiatric events prior to the follow-up (the Still Working Study). During the follow-up, 252 participants were admitted to the hospital due to psychiatric disorders, were prescribed a psychotropic drug or attempted or committed suicide. Results A negative self-reported change in the work organisation during the merger was associated with increased risk of postmerger psychiatric event (HR 1.60, 95 % CI 1.19 to 2.14). This association was independent of mental health-related factors measured before the merger announcement, such as demographic characteristics, occupational status, personal orientation to life, self-rated health, self-reported psychiatric morbidity or chronic disease. Conclusion A negative change in work organisation during an organisational merger may elevate the risk for postmerger psychiatric morbidity

Maintenance of subjective health during a merger: the role of experienced change and pre-merger social support at work in white- and blue-collar workers

Prospective research on psychosocial effects on employees' health associated with organizational mergers has been scarce. The first aim of this study was to explore the subjective health effects (exhaustion and functional incapacity) of an organizational merger among employees who had experienced a change in their own job position differently (improved, unaltered, and declined). Secondly, the effects of pre-merger social support (organizational, supervisor, and coworkers) at work on the experienced change in job position and on subjective health were examined. The merger took place in 1999 between two multinational firms of equal size. The study is based on two surveys (n = 2,225) carried out in 1996 and in 2000 in the Finnish part of the company. The data on age, sex, pre-merger sickness absence (1996-98) and subjective health status (1996) were used as covariates. The results indicate that all sources of social support had a significant effect on the experience of change in one's job position. A decline in job position strongly increased the risk of poor subjective health after the merger. Weak organizational support was associated with impaired subjective health, especially in blue-collar workers, while weak supervisor support impaired functional capacity in white-collar workers, In turn, strong co-workers' support increased the risk of poor subjective health among blue-collar workers when their job position declined. We conclude that negative changes experienced in one's job position and lack of upper-level social support at work create a potential risk for health impairment in different employee groups in merging enterprises. (C) 2003 Elsevier Ltd. All rights reserved

Are intrinsic motivational factors of work associated with functional incapacity similarly regardless of the country?

Background: Many psychosocial models of wellbeing at work emphasise the role of intrinsic motivational factors such as job autonomy, job complexity, and innovativeness. However, little is known about whether the employees of multinational enterprises differ from country to country with regard to intrinsic motivational factors, and whether these factors are associated with wellbeing similarly in the different countries. The purpose of this study was to examine the level of intrinsic motivational factors and their impact on functional incapacity in different countries in a multinational corporation. Methods: In 2000, data were collected from a globally operating corporation with a questionnaire survey. The participants were 13 795 employees (response rate 59%; 56% under age 45; 80% men; 61% blue collar employees), who worked in similar industrial occupations in five countries (Canada, China, Finland, France, and Sweden). Results: The Chinese employees reported higher autonomy and lower complexity at work than the employees from the other countries. After adjustment for age, sex, socioeconomic status, and physical work environment, job autonomy, and job complexity at work were associated with functional incapacity in most countries, whereas in China the impact was significantly stronger. In Finland and in China employees with low innovativeness at work were more prone to functional incapacity than corresponding employees in other countries. Conclusions: The level of intrinsic motivational factors varied between the Chinese employees and those in other countries. In line with theoretical notions, the relation between intrinsic motivational factors of work and functional incapacity followed a similar pattern in the different countries. However, these country specific results show that a culture specific approach to employee wellbeing should also be applied

Gezond reorganiseren. Hoe te reorganiseren met behoud van welbevinden van medewerkers?

Reorganisaties zijn niet meer weg te denken uit onze hedendaagse economie. Iedere medewerker krijgt vroeg of laat met een reorganisatie te maken, in welke vorm dan ook. Door te reorganiseren proberen organisaties hun prestaties te vergroten. Het is een manier om zich voor te bereiden op of aan te passen aan een veranderende omgeving. Een reorganisatie is een organisatieverandering die ingrijpender is dan een ‘alledaagse verandering’ en die ten minste een sector of een volledige organisatie aantast. Het gaat om meer dan alleen veranderingen in werkwijzen (1). Reorganisaties zijn een grote uitdaging voor werkgevers en medewerkers. Veranderingen worden doorgevoerd terwijl tegelijkertijd ook het dagelijks werk gewoon door moet gaan