工作场所精神和行为障碍的职业暴露因素：FOREC 主题词表。
Occupational exposure factors for mental and behavioral disorders at work: The FOREC thesaurus.
机构信息
CHU Clermont-Ferrand, University Hospital of Clermont-Ferrand, Occupational Medicine, Clermont-Ferrand, France.
CHU Clermont-Ferrand, University Hospital of Clermont-Ferrand, Clinical Research and Innovation Direction, Clermont-Ferrand, France.
出版信息
PLoS One. 2018 Jun 21;13(6):e0198719. doi: 10.1371/journal.pone.0198719. eCollection 2018.
BACKGROUND
Mental disorders in the workplace are a major public health problem. Knowledge of the impact of the psychosocial work environment on mental and behavioral disorders can assist occupational physicians in the identification and description of occupational risk situations, and help to define priority actions. However, no classification for occupational exposure factors is currently available. We aimed to build a thesaurus of "Organizational, Relational, Ethical and other Contributing Factors" (FOREC) linked with the onset of mental and behavioral disorders.
METHODS
The French Agency for Food, Environmental and Occupational Health and Safety (ANSES) initiated and supervised a multidisciplinary working group consisting of the representatives of the main French occupational and public health actors. All decisions were accepted on a consensus basis. This collaborative work led to the classification of occupational exposure factors for mental and behavioral disorders in the workplace. To test this thesaurus in clinical practice, a French multicenter study was implemented. Patients were workers referred to the Occupational Disease Centers for mental health issues at work. Factors contributing to mental and behavioral disorders among workers were identified and coded retrospectively from the worker's point of view using the FOREC thesaurus.
RESULTS
We recruited 323 workers, aged 44.9±9.2 years, of which 31.3% were men. The most commonly encountered disorders were generalized anxiety disorders (106 workers, 32.8%) and moderate depressive episodes (86 workers, 26.7%). We identified 1357 factors, i.e. an average of 4.2 factors per worker. Among them, 575 (42.4%) were relational and 515 (37.9%) were organizational. All factors identified during consultations were described in the thesaurus.
CONCLUSIONS
We built the first thesaurus of "Organizational, Relational, Ethical and other Contributing Factors" (FOREC) that may help to generate profiles of mental and behavioral disorders at work. Encoding and describing these exposure factors, as well as using a worldwide standardized and shared terminology, will help to identify specific workplace prevention programs.
背景
工作场所中的精神障碍是一个主要的公共卫生问题。了解心理社会工作环境对精神和行为障碍的影响，可以帮助职业医生识别和描述职业风险情况，并有助于确定优先行动。然而，目前尚无职业暴露因素的分类。我们旨在构建一个与精神和行为障碍发病相关的“组织、关系、伦理和其他促成因素”（FOREC）词库。
方法
法国食品、环境和职业健康安全局（ANSES）发起并监督了一个由主要法国职业和公共卫生机构代表组成的多学科工作组。所有决定均基于共识。这项合作工作促成了工作场所精神和行为障碍职业暴露因素的分类。为了在临床实践中检验这个词库，我们进行了一项法国多中心研究。研究对象为因工作相关心理健康问题而被转诊至职业疾病中心的工人。从工人的角度，使用 FOREC 词库回顾性地识别和编码导致工人精神和行为障碍的因素。
结果
我们招募了 323 名年龄为 44.9±9.2 岁的工人，其中 31.3%为男性。最常见的疾病是广泛性焦虑障碍（106 名工人，32.8%）和中度抑郁发作（86 名工人，26.7%）。我们共识别出 1357 个因素，即每个工人平均 4.2 个因素。其中，575 个（42.4%）为关系因素，515 个（37.9%）为组织因素。咨询过程中识别出的所有因素均在词库中进行了描述。
结论
我们构建了第一个“组织、关系、伦理和其他促成因素”（FOREC）词库，这有助于生成工作场所精神和行为障碍的特征。对这些暴露因素进行编码和描述，以及使用全球标准化和共享的术语，将有助于确定特定的工作场所预防计划。
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