Marchand A, Blanc M-E
Ecole de relations industrielles, université de Montréal, C.P. 6128, succursale Centre-Ville, Montréal, Québec, H3C 3J7 Canada.
Rev Epidemiol Sante Publique. 2010 Apr;58(2):89-99. doi: 10.1016/j.respe.2009.10.010. Epub 2010 Feb 26.
This study aims to better understand the contributions of occupation and work organization conditions to the development of chronic psychotropic drugs use among workers in Canada.
The study is based on a secondary analysis of the longitudinal data of the National Population Health Survey (NPHS) of Statistics Canada which includes five cycles from 1994-1995 to 2002-2003. A panel of 6585 people from 15 to 55 years old and employed at cycle 1 and nested in 1413 neighbourhoods was selected. Multilevel models of regression were estimated on three levels: repeated measures (level 1=24,785 observations) were nested in the individuals (level 2=6585 individuals) and the individuals nested in the local communities (level 3=1413 neighborhoods).
The prevalence of multiple episodes (two episodes and more between cycle 1 and cycle 5) of psychotropic drugs use was 6.7% (95%CI=6.0-7.4%). Only occupation and the number of working hours showed a significant contribution. Family and individual variables like marital status and personality traits (locus of control and sense of coherence) had a significant contribution, in addition to time, gender, age, physical health, number of cigarettes and stressful childhood events.
Work contributes weakly to the risk of chronic psychotropic drugs use, whereas individual characteristics make a much more important contribution to the phenomenon.
本研究旨在更好地了解职业和工作组织条件对加拿大工人使用慢性精神药物的影响。
该研究基于对加拿大统计局全国人口健康调查（NPHS）纵向数据的二次分析，该调查涵盖了1994 - 1995年至2002 - 2003年的五个周期。选取了一个由6585人组成的样本，这些人年龄在15至55岁之间，在第1周期时就业，并分布在1413个社区中。在三个层面上估计了多级回归模型：重复测量（第1层 = 24,785个观测值）嵌套于个体（第2层 = 6585个个体），个体又嵌套于当地社区（第3层 = 1413个社区）。
精神药物多次使用（第1周期和第5周期之间有两次及以上使用）的患病率为6.7%（95%CI = 6.0 - 7.4%）。只有职业和工作小时数显示出显著影响。除了时间、性别、年龄、身体健康状况、吸烟数量和童年压力事件外，家庭和个体变量如婚姻状况和人格特质（控制点和连贯感）也有显著影响。
工作对慢性精神药物使用风险的影响较弱，而个体特征对这一现象的影响更为重要。
