Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Via del Vespro, 129 90127, Palermo, Italy.
IDEWE, External Service for Prevention and Protection at Work, Interleuvenlaan 58, 3001, Heverlee, Belgium.
BMC Public Health. 2022 Jun 8;22(1):1145. doi: 10.1186/s12889-022-13558-2.
The main purpose of this longitudinal study was to elucidate the impact of external job mobility, due to a change of employer, on mental health.
A cohort of Belgian employees from the IDEWE occupational medicine registry was followed-up for twenty-seven years, from 1993 to 2019. The use of drugs for neuropsychological diseases was considered as an objective indicator of mental health. The covariates were related to demographic, physical, behavioural characteristics, occupational and work-related risks. Propensity scores were calculated with a Cox regression model with time-varying covariates. The PS matching was used to eliminate the systematic differences in subjects' characteristics and to balance the covariates' distribution at every time point.
The unmatched sample included 11,246 subjects, with 368 (3.3%) that changed their job during the baseline year and 922 (8.2%) workers that left their employer during the follow-up. More than half of the matched sample were males, were aged less than 38 years old, did not smoke, were physically active, and normal weighted, were not exposed to shift-work, noise, job strain or physical load. A strong association between job mobility and neuropsychological treatment was found in the matched analysis (HR = 2.065, 95%CI = 1.397-3.052, P-value < 0.001) and confirmed in the sensitivity analysis (HR of 2.012, 95%CI = 1.359-2.979, P-value < 0.001). Furthermore, it was found a protective role of physical activity and a harmful role of job strain on neuropsychological treatment.
Our study found that workers with external job mobility have a doubled risk of treatment with neuropsychological medication, compared to workers without job mobility.
本纵向研究的主要目的是阐明由于雇主变更导致的外部工作流动对心理健康的影响。
对 IDEWE 职业医学登记处的比利时员工队列进行了二十七年的随访，从 1993 年到 2019 年。使用神经心理疾病药物被视为心理健康的客观指标。协变量与人口统计学、身体、行为特征、职业和与工作相关的风险有关。使用时变协变量的 Cox 回归模型计算倾向评分。PS 匹配用于消除研究对象特征的系统差异，并在每个时间点平衡协变量的分布。
未匹配样本包括 11246 名受试者，其中 368 名（3.3%）在基线年内更换了工作，922 名（8.2%）工人在随访期间离开雇主。匹配样本的一半以上是男性，年龄小于 38 岁，不吸烟，身体活跃，体重正常，未接触轮班工作、噪音、工作压力或体力负荷。在匹配分析中发现工作流动与神经心理治疗之间存在很强的关联（HR=2.065，95%CI=1.397-3.052，P 值<0.001），并在敏感性分析中得到证实（HR 为 2.012，95%CI=1.359-2.979，P 值<0.001）。此外，还发现身体活动具有保护作用，工作压力具有神经心理治疗的有害作用。
我们的研究发现，与没有工作流动的工人相比，有外部工作流动的工人接受神经心理药物治疗的风险增加了一倍。
