Elevated risk of depression and anxiety disorder by „high strain“ occupations: a systematic review

Abstract Background Poor working conditions might lead to mental illness. Methods We performed a systematic review with meta-analyses as an update of a review published in 2013. We registered the study protocol with PROSPERO (registration number: CRD42020170032) and searched for epidemiological studies in MEDLINE, PsycINFO, and Embase. Two reviewers carried out independently all review steps including title-abstract screening, full-text screening, risk-of-bias assessment and data extraction. Discordances were solved by consensus. We determined the certainty of evidence using the GRADE-approach. Results Ten cohort studies with acceptable study quality examined the relationship between high job strain and the incidence of depression. In the “classic” demand-control-model, ‘high strain’ (combination of high demands and low control) is compared with ‘low strain’ (combination of low demands and high job control). For high strain, the risk of depression was elevated by 73%, the pooled effect estimate for the risk of depression was 1.73 (95% CI 1.32-2.27. In a dichotomous analysis (without dividing job strain into the four dimensions mentioned above), there was a doubled risk of depression with high job strain (pooled effect estimate=1.99, 95% CI 1.68-2.35). We found comparable risk estimates for men and women. The GRADE assessment revealed a high certainty of evidence of the association between job strain and depression. We also found a considerably increased risk of anxiety disorder among individuals prone to high job strain. Conclusions This systematic review finds a clear association between high job strain (high demands in combination with low control) and depression as well as anxiety disorders. Acknowledgment: This study was financially supported by SUVA (Schweizerische Unfallversicherungsanstalt). Key messages High job strain (high demands, low control) is clearly associated with depression and anxiety disorders. The GRADE assessment revealed a high certainty of evidence of the association between job strain and depression.


Background:
Poor working conditions might lead to mental illness.

Methods:
We performed a systematic review with meta-analyses as an update of a review published in 2013. We registered the study protocol with PROSPERO (registration number: CRD42020170032) and searched for epidemiological studies in MEDLINE, PsycINFO, and Embase. Two reviewers carried out independently all review steps including title-abstract screening, full-text screening, risk-of-bias assessment and data extraction. Discordances were solved by consensus. We determined the certainty of evidence using the GRADE-approach. Results: Ten cohort studies with acceptable study quality examined the relationship between high job strain and the incidence of depression. In the ''classic'' demand-control-model, 'high strain' (combination of high demands and low control) is compared with 'low strain' (combination of low demands and high job control). For high strain, the risk of depression was elevated by 73%, the pooled effect estimate for the risk of depression was 1.73 (95% CI 1.32-2.27. In a dichotomous analysis (without dividing job strain into the four dimensions mentioned above), there was a doubled risk of depression with high job strain (pooled effect estimate = 1.99, 95% CI 1.68-2.35). We found comparable risk estimates for men and women. The GRADE assessment revealed a high certainty of evidence of the association between job strain and depression. We also found a considerably increased risk of anxiety disorder among individuals prone to high job strain.

Conclusions:
This systematic review finds a clear association between high job strain (high demands in combination with low control) and depression as well as anxiety disorders. Acknowledgment: This study was financially supported by SUVA (Schweizerische Unfallversicherungsanstalt). Key messages: High job strain (high demands, low control) is clearly associated with depression and anxiety disorders.
The GRADE assessment revealed a high certainty of evidence of the association between job strain and depression.

Background:
Healthcare systems are facing major challenges due to population ageing, increased need for care, and economic challenges combined with staff shortage. The existing need for longer work careers combined with increasing turnover rates in healthcare highlights the need to understand working hours in association with work capacity and sustainable work careers. We aimed to investigate the concurrent changes in part-time work and sickness absence (SA) among healthcare employees without any SA spell >14 days at baseline.

Methods:
Annual working hour and SA data from 23 hospital districts and cities in Finland for 2008-2019 (172 922 employees with at least one work shift in any year). The sample was restricted to 20274 employees with 31 work shifts/year in 3 consequent years during the follow-up and without any SA spell >14 days at baseline in 2008. Part-time work/year (yes/no), SA months/ year, and nightwork/year (% of nightwork of all shifts) as time varying covariate were used in the group-based trajectory models examining the concurrent changes. Models for age groups (in 2008 and categorized into < 25 years of age, 25 and <40 years, 40 and <55 years, and >55 years) will be considered later.

Conclusions:
These initial findings indicate that while most employees work full-time without SA, those who transfer from working fulltime to part-time during follow-up from 2009 to 2019 seem to have low SA. Thus, part-time work may promote work capacity, and accompanied by part-time work disability benefits, offer a tool for employers to support sustainable working life and to keep older employees at work. Key messages: Part-time work may provide possibility to maintain work participation. An important public health message is to provide possibilities for part-time work accompanied with partial work disability benefits to support sustainable working life.
Abstract citation ID: ckac130.093 Risk of first musculoskeletal disorder in Danish occupational fishermen -a register-based study