Dominique Chouaniere

Evaluation of the French version of EUROQUEST: a questionnaire for neurotoxic symptoms.

BACKGROUND EUROQUEST was designed to explore various neuropsychiatric symptoms caused by neurotoxic agents in occupational epidemiological studies. This paper was aimed at assessing (i) the internal consistency of the French version of EUROQUEST, (ii) its sensitivity to age, educational level and exposure, (iii) and its convergent validity by examining relationships between declared symptoms and results from psychometric tests on the same mental functions. DESIGN Data from four cross-sectional studies were selected: 180 workers exposed to toluene, mixed solvents or anaesthetic gas, and 588 non-exposed ones. The internal consistency of the questionnaire was assessed by computing Cronbachs alphas. Sensitivity to age, educational level and exposure were assessed with multiple linear regression models. Relationships between EUROQUEST scores and correspondent neuropsychological tests were assessed with Pearsons correlation coefficients. The relationships between EUROQUEST domain specific scores, age and educational level were evaluated for men and women from the Reference group. Most of the analyses were performed in men and women separately. RESULTS The results of the Cronbachs alphas computed for each EUROQUEST domain, showed a reasonable internal consistency for the questionnaire. For both women and men, memory problems and sleep disorders increased significantly with age. A significant association between EUROQUEST scores and exposure to neurotoxic agents was found for workers exposed to anaesthetic gas only. In addition, EUROQUEST memory symptoms from the Reference population were found to be correlated with two memory neuropsychological tests, both for men and women. CONCLUSION Our results showed a high internal consistency and a good convergent validity on assessed domains. Moreover, they showed a significant sensitivity to age, educational level and highlighted sensitivity to anaesthetic gas exposure.

O19-6 An interdisciplinary approach to evaluate complex prevention interventions

This project dealt with evaluation of complex occupational interventions on Psychosocial Risks (PSR) and Musculo Skeletal Disorders (MSD) targeting primary prevention and organisation. The project aimed to perform a relevant theoretical framework and to design recommendations, methods and tools for field practices. A multidisciplinary working group performed literature review on PSR/TMS evaluation and existing multidisciplinary models of evaluation. Moreover it carried out comparison of the evaluation theoretical models available in human and biological sciences „(psychology, sociology, ergonomics, economics, epidemiology, management and education sciences). In parallel, 50 prevention practitioners were requested to report evaluation practices, needs and expectations. Based on theoretical compilation and practitioners’ recommendations, a new evaluation approach was designed. Evaluation was considered from the point of view of each academic discipline according to ontology, epistemology, causation, method, tools, etc. Convergence and divergence between the disciplines were identified. Realistic evaluation was retained as integrative model of existing intervention models. The proposed method defined 4 different domains of evaluation, among those one on all potential effects of organisational interventions (listed in 6 headings and 39 sub headings) and another one on assessment of causality between intervention and effects. This evaluation approach was tested in 2015, by 27 out of the 50 practitioners in 32 interventions intended mainly to prevent PSR and/or MSD but also to reduce physical load or to promote quality of work life, etc. An 800-item form was filled out by testers in order to evaluate the method in substance and in form. Mixed analyses of this questionnaire allowed sharpening the evaluation approach. Edition in 2016 of a manuscript on theoretical aspects and a brochure for practitioners should contribute to promote extended and adequate evaluation, in order to improve field practices of PSR/TMS prevention interventions. This evaluation methodology could concern all complex interventions which intend to improve work organisation.

O01-4 Effect of change in psychosocial exposure on incidence of depressive and anxiety disorders

The objective of this study was to highlight the relationships between deterioration of a wide variety of psychosocial factors (PSF) and increase of mental health symptoms. About 5,500 workers from of the French cohort “Health and Career paths” were considered in this study. Mental health symptoms were assessed in 2006 and 2010 by the Mini International Neuropsychiatric Interview leading to diagnosis of Major Depressive Disorder (MDD) or Generalised Anxiety Disorder (GAD). The outcome considered here was the diagnosis of MDD/GAD in 2010. Seventeen self-reported PSF, evaluated in 2006 and 2010, explored six domains: labour intensity and working time (7 items), emotional demand (3), autonomy (2), social relationships at work (2), conflict of values (2), and job insecurity (1). For each PSF, four exposure groups were considered: exposed both in 2006 and 2010 (A), exposed in 2006 and not in 2010 (B), exposed in 2010 and not in 2006 (C), and never exposed (as reference). Changes in PSF exposure between 2006 and 2010, although small, were rather towards deterioration, in particular for the pressure at work and the lack of reward. In men without MDD/GAD in 2006, job insecurity and high volume of work were related to MDD/GAD diagnosis in 2010, whatever the exposure groups. MDD/GAD diagnosis in 2010 was associated with high complexity of work in group A, emotional discordance in group B and long working hours in group C. In women, job insecurity was highly associated to MDD/GAD diagnosis in 2010. Exposure to fear at work, work-family imbalance or lack of reward affected women, but not men. These results underlined, in the context of a 4-year follow-up, the relationships between several PSF, in addition to those of „Karasek and Siegrist models, and MDD/GAD diagnosis. Job insecurity and emotional discordance impaired mental health in both genders.

0078 Work organisational characteristics and psychological distress in French call-centres. Is there a direct effect?

Objectives In cross sectional studies, relationships between perceived stressors and self-reported health are suspected of mono-method bias related to negative affectivity. The purpose of this work was to test if work organisational characteristics (WOC) reported by managers were related to psychological distress (PD) reported by call-handlers, taking into account their perception of work conditions (perceived strain) and usual individual confounders. Method Managers of 107 call-centres were queried by occupational physicians on their call-centres’ WOC. 4002 call-handlers (2,929 women were considered here) of these call-centres completed self-reported questionnaires in order to evaluate perceived work strain (Karasek and Siegrist questionnaires) and PD (12-items General Health Questionnaire). A 2-level analysis tested the relationships between 14 WOC and PD score, with and without adding perceived strain as confounder, assuming that unchanged coefficients between WOC and PD score flag a direct effect of WOC on psychological distress. We also analysed perceived strain as an effect modificator for WOC using interactions. Results Five of 14 WOC were significantly related to the PD score: type of calls, call-centre size, number of activity parameters displayed on screen, instructions for client relationships, and required control role of supervisor. In adding perceived strain, the relationship only remained for the type of call. Conclusions Main results of this study are (1) existence of relationships between WOC reported by managers and psychological distress reported by call-handlers (2) most of effects of WOC are moderated by the perception of work strain.

Relationships between organizational workplace characteristics and perceived workplace strain in call-centers in France.

BACKGROUND Our objective was to study the associations between organizational workplace characteristics (OC) reported by call-center (CC) managers and workplace stressors reported by call-handlers. METHODS The managers of 107 CCs were interviewed by their occupational physicians using a questionnaire designed to specifically explore OC in the CCs. Four thousand two call-handlers from these CCs completed a self-report questionnaire including the Karasek and Siegrist work stressor questionnaires and two specific items on other workplace stressors. RESULTS Around one-third of the OC examined were associated with the demand/control ratio, the perception of demanding work and ethical conflicts, however, far fewer OC were associated with the effort/reward ratio. Most OC were associated with higher levels of job stressors. Some had strong, systematic negative associations with stressors (e.g., highly formatted instructions for the client relationship). CONCLUSIONS These findings could help in targeting job stressor prevention and health improvement strategies in CCs.