Matteo Ronchetti

The relevance of socio-demographic and occupational variables for the assessment of work-related stress risk

BackgroundWork-related stress is widely recognized as one of the major challenges to occupational health and safety. The correlation between work-related stress risk factors and physical health outcomes is widely acknowledged. This study investigated socio-demographic and occupational variables involved in perceived risk of work-related stress.MethodsThe Italian version of the Health and Safety Executive Management Standards Indicator Tool was used in a large survey to examine the relationship between work-related stress risks and workers’ demographic and occupational characteristics. Out of 8,527 questionnaires distributed among workers (from 75 organizations) 6,378 were returned compiled (74.8%); a set of mixed effects models were adopted to test single and combined effects of the variables on work-related stress risk.ResultsFemale workers reported lower scores on control and peer support and more negative perceptions of relationships and change at work than male workers, most of them with full-time contracts. Age, job seniority, and educational level appeared positively correlated with control at work, but negatively with job demands. Fixed-term workers had positive perceptions regarding job demands and relationships, but more difficulties about their role at work than permanent workers. A commuting time longer than one hour and shift work appeared to be associated with higher levels of risk factors for work-related stress (except for role), the latter having more negative effects, increasing with age.ConclusionsThe findings suggest that the assessment and management of work-related stress risk should consider specific socio-demographic and occupational risk factors such as gender, age, educational level, job status, shift work, commuting time, job contracts.

Hard and soft law approaches to addressing psychosocial risks in Europe: lessons learned in the development of the Italian approach

Psychosocial risks in the workplace have been identified as some of the most significant emerging risks, particularly since issues such as work-related stress, which is closely linked to psychosocial risks, are widely recognised as major challenges in modern occupational safety and health. This paper presents the policy framework and key initiatives that have been implemented for the management of psychosocial risks in the workplace in Europe. It discusses several approaches and initiatives, both from a hard and soft law perspective, that have been implemented at European Union and national level. Within this context, it discusses the key issues that pertain to the development of national approaches, focussing as an example on the Management Standards for work-related stress developed in the UK and their recent adaptation in Italy. The Italian approach is discussed in detail as an example that may highlight key process elements in the development of psychosocial risk management policies, and promote good practice in this area through lessons learned. It is concluded that it is more pressing now than ever for a critical evaluation of efforts employed so far to address psychosocial risks to be conducted, and an approach at European level to be developed that will allow both flexibility and a certain level of benchmarking across members states. Such an approach can be supported by European bodies, responsible for surveillance and promotion of good practice, working in collaboration with similar national bodies.

WHO/ILO work-related burden of disease and injury: Protocol for systematic reviews of exposure to long working hours and of the effect of exposure to long working hours on stroke.

BACKGROUND The World Health Organization (WHO) and the International Labour Organization (ILO) are developing a joint methodology for estimating the national and global work-related burden of disease and injury (WHO/ILO joint methodology), with contributions from a large network of experts. In this paper, we present the protocol for two systematic reviews of parameters for estimating the number of deaths and disability-adjusted life years from stroke attributable to exposure to long working hours, to inform the development of the WHO/ILO joint methodology. OBJECTIVES We aim to systematically review studies on occupational exposure to long working hours (called Systematic Review 1 in the protocol) and systematically review and meta-analyse estimates of the effect of long working hours on stroke (called Systematic Review 2), applying the Navigation Guide systematic review methodology as an organizing framework, conducting both systematic reviews in tandem and in a harmonized way. DATA SOURCES Separately for Systematic Reviews 1 and 2, we will search electronic academic databases for potentially relevant records from published and unpublished studies, including Medline, EMBASE, Web of Science, CISDOC and PsychINFO. We will also search electronic grey literature databases, Internet search engines and organizational websites; hand-search reference list of previous systematic reviews and included study records; and consult additional experts. STUDY ELIGIBILITY AND CRITERIA We will include working-age (≥15 years) workers in the formal and informal economy in any WHO and/or ILO Member State, but exclude children (<15 years) and unpaid domestic workers. For Systematic Review 1, we will include quantitative prevalence studies of relevant levels of occupational exposure to long working hours (i.e. 35-40, 41-48, 49-54 and ≥55 h/week) stratified by country, sex, age and industrial sector or occupation, in the years 2005-2018. For Systematic Review 2, we will include randomized controlled trials, cohort studies, case-control studies and other non-randomized intervention studies with an estimate of the relative effect of a relevant level of long working hours on the incidence of or mortality due to stroke, compared with the theoretical minimum risk exposure level (i.e. 35-40 h/week). STUDY APPRAISAL AND SYNTHESIS METHODS At least two review authors will independently screen titles and abstracts against the eligibility criteria at a first stage and full texts of potentially eligible records at a second stage, followed by extraction of data from qualifying studies. At least two review authors will assess risk of bias and the quality of evidence, using the most suited tools currently available. For Systematic Review 2, if feasible, we will combine relative risks using meta-analysis. We will report results using the guidelines for accurate and transparent health estimates reporting (GATHER) for Systematic Review 1 and the preferred reporting items for systematic reviews and meta-analyses guidelines (PRISMA) for Systematic Review 2. PROSPERO registration number: CRD42017060124.

1337 Investigating the effectiveness of organisationallevel interventions for the management of work-related stress through a process evaluation: an italian case study

Introduction Evaluating the effects of organisational level interventions, as those related to work related-stress, is broadly recognised crucial to identify the key steps needed to ensure the efficacy of interventions. The Italian Workers’ Compensation Authority (INAIL) developed a methodology for management of risks associated to work related-stress as an organisational integrated approach useful for OSH professional and companies. This study provides a process evaluation of organizational-level work related stress management interventions in a public administration using the INAIL’s methodology. Methods An Italian Public Administration (more than 4, 000 employees) has carried out a process of risk assessment and management of work-related stress using the INAIL’s approach and tools, with the methodological support of a research team form INAIL. Our support ensured that some key aspects of the process were implemented such as: specific training, the active involvement of workers, and OSH professionals, and raise the awareness of management on the importance of organisational level interventions in managing stress at work. According to the literature, we analysed intervention process using two methodological approaches: quantitative and qualitative. Results Some aspects resulted valuable for the effectiveness of the interventions: the active role played by OSH professionals in implementing the process; 2) the high participation of workers with a 75% of response rate in the risk assessment (3200 questionnaires); 3) The direct involvement of the management; 4) a bottom-up approach through the active involvement of workers by the means of focus groups in identifying concrete actions based on the assessment findings in collaboration with OSH professional and managers. Discussion This study investigates the ways of implementing an effective integrated approach for assessing and managing work related stress using the INAIL’s methodology through a process evaluation of organizational-level interventions. Findings contributes to the international debate on how to verify the effectiveness of processes of intervention planning and implementation.

Young Workers’ Access to and Awareness of Occupational Safety and Health Services: Age-Differences and Possible Drivers in a Large Survey of Employees in Italy

Young workers are in particular need of occupational safety and health (OSH) services, but it is unclear whether they have the necessary access to such services. We compared young with older workers in terms of the access to and awareness of OSH services, and examined if differences in employment conditions accounted for age-differences. We used survey data from Italy (INSuLA 1, 2014), with a sample of 8000 employed men and women aged 19 to 65 years, including 732 young workers aged under 30 years. Six questions measured access to services, and five questions assessed awareness of different OSH issues. Several employment conditions were included. Analyses revealed that young workers had less access and a lower awareness of OSH issues compared with older workers. For instance, odds ratios (OR) suggest that young workers had a 1.44 times higher likelihood [95%—confidence interval 1.21–1.70] of having no access to an occupational physician, and were more likely (2.22 [1.39–3.38]) to be unaware of legal OSH frameworks. Adjustment for selected employment conditions (company size, temporary contract) substantially reduced OR’s, indicating that these conditions contribute to differences between older and younger workers. We conclude that OSH management should pay particular attention to young workers in general and, to young workers in precarious employment, and working in small companies in particular.

O09-5 The italian survey on perception of health at work: the association of working conditions and occupational risks perception with workers’ health

Background The last decades have seen significant developments in the economic, political, technological and social landscape as well as in the nature of work that has been re-shaped under these impacts. All these changes have had a high impact on workers’ health and have lead to several improvements in occupational health and safety (OSH) policy framework at European and national level. The Italian Workers’ Compensation Authority (INAIL) carried out a national survey (Insula project) to investigate the employer’s perception related to working conditions, occupational risk exposure and their impact on mental and physical health. This study aimed to provide secondary analysis of INSuLa data to investigated factors mainly associated to workers’ health in a national wide representative sample of workers. Methods A questionnaire has been developed and administered to a sample of 8,000 workers (representative of the Italian working population in companies with more than 5 employees) through CATI interview; a set of logistic and linear regression models were adopted to test effects of the variables on mental and physical health. Results mental and physical health resulted to be positively linked with peer support (p<0.01, exp(B)=1.26) and job satisfaction (p<0.05, exp(B) = 1.23) and negatively linked with workplace violence and harassment (p<0.001, exp(B) = 1.57); the perception of OSH risks (p < 0.001, exp(B) = 0.75) and work-related stress risk exposure (p < 0.05, exp(B) = 0.98) reported negative relationships with mental and physical health and a positive relationship with depression. working conditions (p<0.05) – except for organisational change – were negative related with depression. Conclusions This study offers a secondary analysis of Insula project that represents a unique case in Italy in terms of the sample’s dimensions and workforce representativeness. Findings suggest specific prevention strategies to protect the health conditions of Italian workers and may offer useful information to drive national policy implementation in the OSH field.