Reducing stress in the workplace : an evidence review : full report

Job stress is a large and growing concern in Australia and internationally. This report presents a current snapshot on job stress concepts and measures, an overview of the evidence linking job stress to ill health, estimates of the size of the problem, the benefits of reducing job stress, a summary of the intervention research on ways to prevent and control job stress, an outline of international best practice in job stress intervention and resources for workplace stakeholders to support efforts to implement best practice

Reducing stress in the workplace: an evidence review: summary report

Job stress is a large and growing concern in Australia and internationally. This report presents a current snapshot on job stress concepts and measures, an overview of the evidence linking job stress to ill health, estimates of the size of the problem, the benefits of reducing job stress, a summary of the intervention research on ways to prevent and control job stress, an outline of international best practice in job stress intervention and resources for workplace stakeholders to support efforts to implement best practice

Occupational skill level and hazardous exposures among working Victorians

This paper examines the patterning of exposures to occupational hazards in relation to occupational skill level as a proxy for pay rate, testing the general hypothesis that exposures to occupational hazards increase in prevalence with decreasing skill level. A population-based telephone survey was conducted on a random sample of working Victorians (N = 1,101). A set of 10 indicators of exposure to occupational hazards were analysed individually and as a summary scale in multivariate regression models. A significant increasing trend in hazardous working conditions from the highest to lowest occupational skill level was observed, with those in lower skill level jobs twice as likely to be exposed as those at the highest skill level. This overall trend was driven primarily by higher exposure in the middle skill level group (technicians and skilled trades) as well as the lowest (labourers and elementary clerical), the two main bluecollar groups. Findings provided partial support for the hypothesised relationship

Persistent musculoskeletal pain and productive employment; a systematic review of interventions.

A systematic analysis of the literature was undertaken to determine which characteristics of workplace interventions are most effective in assisting people with persistent musculoskeletal pain (PMP) to remain productively employed. Databases of Medline, PsychINFO, CINAHL and Embase were searched using MeSH and other relevant terms. Studies that reported on interventions at, or involving, the workplace were included. Interventions were considered as either focused on the individual or multilevel. Outcome measures assessed included: job loss, productivity, sick leave, pain and cost benefit. A quality assessment was undertaken using GRADE criteria with development of impact statements to synthesise the results. Eighteen relevant articles (14 studies) were identified for inclusion in the review. No high-level evidence for workplace interventions to assist people with PMP were identified. Low numbers of participants and limited studies resulted in downgrading of evidence. However, individually focused interventions will probably reduce job loss and sick leave, but are unlikely to reduce pain. Multilevel focused interventions will probably result in decreased sick leave and provide some cost benefit. The evidence on productivity was limited and of poor quality. Further research is required because sustainable employment for individuals with PMP is important and understanding what works is necessary to ensure effective workplace interventions are developed

Job strain — Attributable depression in a sample of working Australians: Assessing the contribution to health inequalities

Background The broad aim of this study was to assess the contribution of job strain to mental health inequalities by (a) estimating the proportion of depression attributable to job strain (low control and high demand jobs), (b) assessing variation in attributable risk by occupational skill level, and (c) comparing numbers of job strain–attributable depression cases to numbers of compensated \u27mental stress\u27 claims. Methods Standard population attributable risk (PAR) methods were used to estimate the proportion of depression attributable to job strain. An adjusted Odds Ratio (OR) of 1.82 for job strain in relation to depression was obtained from a recently published meta-analysis and combined with exposure prevalence data from the Australian state of Victoria. Job strain exposure prevalence was determined from a 2003 population-based telephone survey of working Victorians (n = 1101, 66% response rate) using validated measures of job control (9 items, Cronbach\u27s alpha = 0.80) and psychological demands (3 items, Cronbach\u27s alpha = 0.66). Estimates of absolute numbers of prevalent cases of depression and successful stress-related workers\u27 compensation claims were obtained from publicly available Australian government sources. Results Overall job strain-population attributable risk (PAR) for depression was 13.2% for males [95% CI 1.1, 28.1] and 17.2% [95% CI 1.5, 34.9] for females. There was a clear gradient of increasing PAR with decreasing occupational skill level. Estimation of job strain–attributable cases (21,437) versus "mental stress" compensation claims (696) suggest that claims statistics underestimate job strain–attributable depression by roughly 30-fold. Conclusion Job strain and associated depression risks represent a substantial, preventable, and inequitably distributed public health problem. The social patterning of job strain-attributable depression parallels the social patterning of mental illness, suggesting that job strain is an important contributor to mental health inequalities. The numbers of compensated \u27mental stress\u27 claims compared to job strain-attributable depression cases suggest that there is substantial under-recognition and under-compensation of job strain-attributable depression. Primary, secondary, and tertiary intervention efforts should be substantially expanded, with intervention priorities based on hazard and associated health outcome data as an essential complement to claims statistics

Predictors of musculoskeletal discomfort: a cross-cultural comparison between Malaysian and Australian office workers

Prevalence and predictors associated with musculoskeletal disorders (MSDs) vary considerably between countries. It is plausible that socio-cultural contexts may contribute to these differences. We conducted a cross-sectional survey with 1184 Malaysian and Australian office workers with the aim to examine predictors associated with MSD discomfort. The 6-month period prevalence of self-reported MSD discomfort for Malaysian office workers was 92.8% and 71.2% among Australian workers. In Malaysia, a model regressing level of musculoskeletal discomfort against possible risk factors was significant overall (F [6, 370] = 17.35; p < 0.001) and explained 22% (r = 0.46) of its variance. MSD discomfort was significantly associated with predictors that included gender (b = 14), physical (b = 0.38) and psychosocial hazards (b= - 0.10), and work-life balance (b = - 0.13). In Australia, the regression model is also significant (F [6, 539] = 16.47; p < 0.001) with the model explaining 15.5% (r = 0.39) of the variance in MSD discomfort. Predictors such as gender (b = 0.14), physical (b= 24) and psychosocial hazards (b = - 0.17), were associated with MSD discomfort in Australian office workers. Predictors associated with MSD discomfort were similar, but their relative importance differed. Work-life balance was significantly associated with increased MSD discomfort for the Malaysian population only. Design and implementation of MSD risk management needs to take into account the work practices and culture of the target population

Estimates of mortality rates in people with diabetes and cardiovascular disease using administrative pharmaceutical data

Background Quantifying the mortality risk for people with diabetes is challenging because of associated comorbidities. The recording of cause specific mortality from accompanying cardiovascular disease in death certificate notifications has been considered to underestimate the overall mortality risk in persons with diabetes. Main Aim Develop a technique to quantify mortality risk from pharmaceutical administrative data and apply it to persons diagnosed with diabetes, and associated cardiovascular disease and dyslipidaemia before death. Methods Persons with diabetes, cardiovascular disease and dyslipidaemia were identified in a publicly available Australian Pharmaceutical data set using World Health Organization anatomic therapeutic codes assigned to medications received. Diabetes associated multi-morbidity cohorts were constructed and a proxy mortality (PM) event determined from medication and service discontinuation. Estimates of mortality rates were calculated from 2004 for 10 years and compared persons with diabetes alone and associated cardiovascular disease and dyslipidemia. Results This study identified 346,201 individuals within the 2004 calendar year as having received treatments for diabetes (n=51,422), dyslipidaemia (n=169,323) and cardiovascular disease including hypertension (n=280,105). Follow up was 3.3 x 106 person-years. Overall crude PM was 26.1 per 1000 person-years. PM rates were highest in persons with cardiovascular disease and diabetes in combination (47.5 per 100 person years). Statin treatments significantly improved the mortality rates in all persons with diabetes and cardiovascular disease alone and in combination over age groups >44 years (p<.001). Age specific diabetes PM rates using pharmaceutical data correlated well with Australian data from the National Diabetes Service Scheme (r=0.82) Conclusion Proxy mortality events calculated from medication discontinuation in persons with chronic conditions can provide an alternative method to estimate disease mortality rates. The technique also allows the assessment of mortality risk in persons with chronic disease multi-morbidity

An integrated workplace mental health intervention in a policing context: protocol for a cluster randomised control trial

BACKGROUND: In this paper, we present the protocol for a cluster-randomised trial to evaluate the implementation and effectiveness of a workplace mental health intervention in the state-wide police department of the south-eastern Australian state of Victoria. n. The primary aims of the intervention are to improve psychosocial working conditions and mental health literacy, and secondarily to improve mental health and organisational outcomes. METHODS/DESIGN: The intervention was designed collaboratively with Victoria Police based on a mixed methods pilot study, and combines multi-session leadership coaching for the senior officers within stations (e.g., Sergeants, Senior Sergeants) with tailored mental health literacy training for lower and upper ranks. Intervention effectiveness will be evaluated using a two-arm cluster-randomised trial design, with 12 police stations randomly assigned to the intervention and 12 to the non-intervention/usual care control condition. Data will be collected from all police members in each station (estimated at &gt;20 per station). Psychosocial working conditions (e.g., supervisory support, job control, job demands), mental health literacy (e.g., knowledge, confidence in assisting someone who may have a mental health problem), and mental health will be assessed using validated measures. Organisational outcomes will include organisational depression disclosure norms, organisational cynicism, and station-level sickness absence rates. The trial will be conducted following CONSORT guidelines. Identifying data will not be collected in order to protect participant privacy and to optimise participation, hence changes in primary and secondary outcomes will be assessed using a two-sample t-test comparing summary measures by arm, with weighting by cluster size. DISCUSSION: This intervention is novel in its integration of stressor-reduction and mental health literacy-enhancing strategies. Effectiveness will be rigorously evaluated, and if positive results are observed, the intervention will be adapted across Victoria Police (total employees ~16,500) as well as possibly in other policing contexts, both nationally and internationally.<br /