Niedhammer Isabelle, Sultan-Taïeb Hélène, Chastang Jean-François, Vermeylen Greet, Parent-Thirion Agnès
INSERM, U1018, CESP Centre for Research in Epidemiology and Population Health, Epidemiology of Occupational and Social Determinants of Health Team, 16 Avenue Paul Vaillant Couturier, 94807, Villejuif Cedex, France,
Int Arch Occup Environ Health. 2014 May;87(4):403-11. doi: 10.1007/s00420-013-0879-4. Epub 2013 Apr 27.
The aim of this study was to evaluate the fractions of cardiovascular diseases and mental disorders attributable to three psychosocial work factors, job strain, effort-reward imbalance (ERI) and job insecurity, in 31 countries in Europe.
The prevalence of exposure (Pe) to job strain, ERI and job insecurity was calculated using the sample of 29,680 workers from 31 countries of the 2005 European Working Conditions Survey. Relative risks (RR) were obtained from three published meta-analyses. Pe and RR estimates were used to calculate attributable fractions (AF).
Pe estimates were 26.90, 20.44 and 14.11% for job strain, ERI and job insecurity in Europe, and significant differences were observed between countries. The job strain and ERI AFs for cardiovascular diseases were, respectively, 4.46% (significantly different from zero for Europe and all countries, but without any differences between countries) and 18.21% (not significantly different from zero for Europe and without differences between countries). The significant job strain and job insecurity AFs for mental disorders were 18.16 and 4.53% in Europe, without any significant difference between countries. The significant ERI AF for mental disorders was 14.81%, and significant differences were found between countries; the 3 highest AFs were observed in Greece, Slovenia and Turkey, and the 3 lowest in Bulgaria, Ireland and Latvia.
This study is the first one to provide fractions of cardiovascular diseases and mental disorders attributable to three psychosocial work factors for the whole Europe and to explore the differences between 31 countries. These results may be useful to guide European and national prevention policies as well as to evaluate the economic costs of diseases attributable to these exposures.
本研究旨在评估欧洲31个国家中，归因于三种社会心理工作因素（工作压力、付出-回报失衡和工作不安全感）的心血管疾病和精神障碍的比例。
利用2005年欧洲工作条件调查中31个国家的29680名工人样本，计算工作压力、付出-回报失衡和工作不安全感的暴露患病率（Pe）。相对风险（RR）来自三项已发表的荟萃分析。Pe和RR估计值用于计算归因比例（AF）。
欧洲工作压力、付出-回报失衡和工作不安全感的Pe估计值分别为26.90%、20.44%和14.11%，各国之间存在显著差异。心血管疾病的工作压力和付出-回报失衡归因比例分别为4.46%（欧洲和所有国家均显著不同于零，但各国之间无差异）和18.21%（欧洲不显著不同于零，各国之间无差异）。欧洲精神障碍的显著工作压力和工作不安全感归因比例分别为18.16%和4.53%，各国之间无显著差异。精神障碍的显著付出-回报失衡归因比例为14.81%，各国之间存在显著差异；最高的三个归因比例出现在希腊、斯洛文尼亚和土耳其，最低的三个出现在保加利亚、爱尔兰和拉脱维亚。
本研究首次提供了整个欧洲归因于三种社会心理工作因素的心血管疾病和精神障碍比例，并探讨了31个国家之间的差异。这些结果可能有助于指导欧洲和国家的预防政策，以及评估这些暴露所致疾病的经济成本。
