Division of Preventive Medicine, University of Alberta, Edmonton, Canada.
Occup Med (Lond). 2012 Sep;62(6):435-43. doi: 10.1093/occmed/kqs134.
Although there have been many studies of work demands and self-reported job strain, few have examined incident physician-diagnosed mental ill-health (MIH) by detailed occupational group.
To investigate whether linkage of occupation from worker compensation claims to diagnoses from administrative health records can give credible information on occupation and incidence of MIH by diagnostic group and gender.
Information on occupation from all worker compensation claims 1995-2004 in Alberta, Canada were linked to administrative health records of MIH diagnoses. Relative risks for affective, substance use and psychotic disorders by four digit occupational codes were calculated for men and women aged 18-65 years in a log-binomial regression adjusting for age and stratifying by sex.
There were 327883 male and 88483 female compensation claims available for the analysis of incident cases. Affective disorders (5.2% men, 11.5% women) were much more common than substance use disorders or psychotic disorders (both ≤1%) in this population of working people. In men, the type of work appeared to either protect from or precipitate affective disorders, but no protective effect was seen for women. Substance use disorders clustered mainly in physically demanding occupations typically involving employment outside the urban areas. New onset psychotic disease was rare but seen in excess in painters, boilermakers and chefs.
Data linkage of occupation close to the time of new onset MIH can provide important insight into the relation between work and physician-diagnosed MIH and indicate areas in which intervention might be appropriate.
尽管已有许多关于工作要求和自我报告的工作压力的研究，但很少有研究通过详细的职业群体来研究新发的医生诊断的心理健康障碍（MIH）。
调查通过工人赔偿索赔将职业与行政健康记录中的诊断联系起来，是否可以提供有关职业和按诊断组和性别划分的新发 MIH 的可信信息。
将加拿大阿尔伯塔省 1995-2004 年所有工人赔偿索赔中的职业信息与 MIH 诊断的行政健康记录相联系。在对数二项式回归中，根据年龄和性别分层，对 18-65 岁的男性和女性，计算了四个数字职业代码的情感障碍、物质使用障碍和精神病障碍的相对风险。
共有 327883 名男性和 88483 名女性的赔偿索赔可用于分析新发病例。在该劳动人群中，情感障碍（男性 5.2%，女性 11.5%）比物质使用障碍或精神病障碍更为常见（均≤1%）。在男性中，工作类型似乎可以预防或引发情感障碍，但对女性没有保护作用。物质使用障碍主要集中在需要体力的职业中，这些职业通常涉及到城市以外的就业。新发病例的精神病很少见，但在油漆工、锅炉工和厨师中发病率过高。
在新发 MIH 发生时接近职业的数据联系，可以为工作与医生诊断的 MIH 之间的关系提供重要的见解，并指出干预可能适当的领域。
