[Assessment of job strain and its consequencies in a large public organisation. Findings from the SEMM Study].

The demand-control model originally developed by Robert Karasek is in Italy the preferred tool to investigate perceived work stress due to work-related organizational constrains. We wish to report the comprehensive results of the SEMM Study, carried on a wide sample of civil servants. N. 5271 women and 2601 men, employed at the Municipality of Milan in the years 1991-1996 were enrolled into the study. The overall participation rate was high in both gender group (75% or more), indicating a good compliance of employees for health prevention programmes carried out in work settings. Each participant, who has given consent, in addition to the medical examinations and biological tests related to the investigation of work exposures, underwent to a structured procedure to measure cardiovascular risk factors, according to the methods developed in the WHO MONICA Project, job strain adopting the Job Content Questionnaire (JCQ), and the Baecke Questionnaire to investigate major quotes of physical activity. In this contest the JCQ has shown an acceptable level of internal and external consistency as well as of acceptance, measured by employees compliance. Psychological job demand and decision latitude can be assessed with two different JCQ revisions available in Italian, which were validated with the contribution of the author, at different complexity, but with comparable results of weighted scores. For a comprehensive assessment of the working conditions social support at work is also of relevance. In the work public sector considered, the JCQ major scores resulted to be valid descriptors of key aspects of the work organization. The concurrent assessment of sick leaves, known marker of burnout, allows to identify work- and individual-related determinants and, in a specific work setting, to give indications for coping actions which may improve workers' integration. In addition, the assessment of cardiovascular risk factors, carried out with standardised and then reliable methods, allow to measure overall global CVD risk and to identify unhealthy behaviours that can be addressed with specific preventive programmes.