Salvador Moncada

The Employment Precariousness Scale (EPRES): psychometric properties of a new tool for epidemiological studies among waged and salaried workers

Background Despite the fact that labour market flexibility has resulted in an expansion of precarious employment in industrialised countries, to date there is limited empirical evidence concerning its health consequences. The Employment Precariousness Scale (EPRES) is a newly developed, theory-based, multidimensional questionnaire specifically devised for epidemiological studies among waged and salaried workers. Objective To assess the acceptability, reliability and construct validity of EPRES in a sample of waged and salaried workers in Spain. Methods A sample of 6968 temporary and permanent workers from a population-based survey carried out in 2004–2005 was analysed. The survey questionnaire was interviewer administered and included the six EPRES subscales, and measures of the psychosocial work environment (COPSOQ ISTAS21) and perceived general and mental health (SF-36). Results A high response rate to all EPRES items indicated good acceptability; Cronbachs α coefficients, over 0.70 for all subscales and the global score, demonstrated good internal consistency reliability; exploratory factor analysis using principal axis analysis and varimax rotation confirmed the six-subscale structure and the theoretical allocation of all items. Patterns across known groups and correlation coefficients with psychosocial work environment measures and perceived health demonstrated the expected relations, providing evidence of construct validity. Conclusions Our results provide evidence in support of the psychometric properties of EPRES, which appears to be a promising tool for the measurement of employment precariousness in public health research.

Employment precariousness and poor mental health: evidence from Spain on a new social determinant of health.

Background. Evidence on the health-damaging effects of precarious employment is limited by the use of one-dimensional approaches focused on employment instability. This study assesses the association between precarious employment and poor mental health using the multidimensional Employment Precariousness Scale. Methods. Cross-sectional study of 5679 temporary and permanent workers from the population-based Psychosocial Factors Survey was carried out in 2004-2005 in Spain. Poor mental health was defined as SF-36 mental health scores below the 25th percentile of the Spanish reference for each respondents sex and age. Prevalence proportion ratios (PPRs) of poor mental health across quintiles of employment precariousness (reference: 1st quintile) were calculated with log-binomial regressions, separately for women and men. Results. Crude PPRs showed a gradient association with poor mental health and remained generally unchanged after adjustments for age, immigrant status, socioeconomic position, and previous unemployment. Fully adjusted PPRs for the 5th quintile were 2.54 (95% CI: 1.95–3.31) for women and 2.23 (95% CI: 1.86–2.68) for men. Conclusion. The study finds a gradient association between employment precariousness and poor mental health, which was somewhat stronger among women, suggesting an interaction with gender-related power asymmetries. Further research is needed to strengthen the epidemiological evidence base and to inform labour market policy-making.

The Copenhagen Psychosocial Questionnaire II (COPSOQ II) in Spain—A Tool for Psychosocial Risk Assessment at the Workplace

AIMS To describe the second version of the Spanish Copenhagen Psychosocial Questionnaire and to present evidence of its validity and reliability. METHODS The original Danish long COPSOQ II questionnaire was adapted to the labor market, cultural, and linguistic setting of Spain and included in the 2010 Spanish Psychosocial Risks Survey. Analysis involved the assessment of psychometric characteristics and associations among psychosocial scales and health scales. Medium and short versions were derived from the long one. RESULTS The long questionnaire was configured with 24 dimensions (92 items); medium-length questionnaire with 20 dimensions (69 items); and short questionnaire with 14 dimensions (28 items). All scales showed acceptable reliability and concordance between versions. Most associations among psychosocial scales and Mental Health, Stress, and Burnout scales were in the expected direction, except the scale of Influence, that showed some incongruent associations. CONCLUSION Results support the validity and reliability of Spanish COPSOQ II questionnaires as tools for psychosocial risk assessment at the workplace, however, better scales should be developed specially for the dimension of Influence.

Employment Precariousness in Spain: Prevalence, Social Distribution, and Population-Attributable Risk Percent of Poor Mental Health

As a consequence of labor market flexibilization, nonstandard employment has expanded and standard employment has declined. In many cases, these transformations are best described as an evolution toward precarious employment, which is considered a major determinant of health and health inequalities. Using the Employment Precariousness Scale (EPRES), this study aims to determine the prevalence of precarious employment in the waged and salaried workforce in Spain, to describe its distribution across social groups defined by occupational class, gender, age, and immigrant status, and to estimate the proportion of cases of poor mental health potentially attributable to employment precariousness. Data are from the Psychosocial Work Environment Survey conducted in 2004–5 on a representative sample of the Spanish workforce. Findings indicate a high prevalence of employment precariousness, affecting nearly 6.5 million workers, with almost 900,000 of them exposed to high precariousness. These estimates are higher than the proportion of fixed-term employment reported in regular statistical sources but may today be an underestimation, given the current economic crisis. Additionally, a significant proportion of cases of poor mental health are potentially attributable to employment precariousness. Both the proportion of cases of poor mental health attributable to and the prevalence of employment precariousness were highly unequally distributed across the study sample, indicating that this may be a significant contributor to social inequalities in mental health.

Psychosocial work environment and its association with socioeconomic status. A comparison of Spain and Denmark.

Aims: The purpose of this study was to describe psychosocial work environment inequalities among wage earners in Spain and Denmark. Methods: Data came from the Spanish COPSOQ (ISTAS 21) and the Danish COPSOQ II surveys both performed in 2004—05 and based on national representative samples of employees with a 60% response rate. Study population was 3,359 Danish and 6,685 Spanish women and men. Only identical items from both surveys were included to construct 18 psychosocial scales. Socioeconomic status was categorized according to the European Socioeconomic Classification System. Analysis included ordinal logistic regression and multiple correspondence analysis after categorizing all scales. Results: A relationship between socioeconomic status and psychosocial work environment in both Denmark and Spain was observed, with wider social inequalities in Spain for many scales, describing a strong interaction effect between socioeconomic status and country. Conclusions: Socioeconomic status is related to psychosocial work environment and some adverse psychosocial conditions tend to cluster in lower socioeconomic status groups in both Spain and Denmark. This effect could be modified by a country’s characteristics, such as economic and labour market structures, normative regulations and industrial relations including work organization. Hence, preventive strategies to reduce social inequalities in working conditions should consider the combination of actions at the macro and micro levels.

Sickness leave, administrative category and gender: results from the "Casa Gran' project

Objective: The aim of this study was to analyse the variations of sickness leave rates among the Barcelona city council civil servants by administrative category and gender Methods: The study was a retrospective cohort including all people who worked for more than six months for the City Council of Barcelona from 1 January 1984 to 31 December 1993. The cohort was composed of 11,647 men and 9,001 women who contribute to a total of 134,928.7 person/years of follow-up. The study population was classified into administrative categories. Sickness leaves were classified into short episodes (less than 11 days) and long episodes (more than 10 days). Age-specifi c rates of long and short episodes of sickness leave were computed in a gender-specifi c analysis. Results : Among men, rate ratios of long spells increased constantly from the middle technician category to the unskilled worker category for the three oldest age groups. This social pattern was not as clear for younger workers. Among women, rate ratios of long spells showed far fewer differences than among men. The social gradient was evident for the three youngest age groups, with the exception of the unskilled workers. The oldest age group showed similar differences between all categories. Short spells followed a different pattern for men and women. Conclusions: Women had generally higher rates than men did, and manual categories had higher rates than non-manual ones, which was more evident for men and long episodes. The relationship between incidence rates and gender could be due to the different contents of the jobs performed by men and women, the infl uence of gender-based work segregation, and the unequal share of the reproductive workload between men and women, information which was not available for this study.

Diferencias de género en la influencia del trabajo doméstico sobre la salud

Resumen Objetivo Analizar la influencia de la carga del trabajo domestico en la salud de la poblacion ocupada de Catalunya teniendo en cuenta su posible impacto diferencial en hombres y mujeres. Sujetos y metodos La poblacion de estudio fueron los 2.164 hombres y 1.215 mujeres entrevistadas en la Encuesta de Salud de Catalunya (ESCA) de 1994, que realizaban un trabajo remunerado, vivian en pareja y eran cabeza de familia o pareja del cabeza de familia. La variable dependiente fue el estado de salud percibida que se dicotomizo para el analisis bivariado y multivariado. La carga de trabajo domestico se midio a traves del numero de personas en el hogar (2,3,4 o mas de 4), la convivencia con menores de 15 anos y la convivencia con mayores de 65 anos. Las variables de ajuste fueron la edad y la clase social ocupacional. El analisis se realizo por separado para hombres y mujeres y se contrasto la existencia de asociaciones mediante el calculo de odds ratios (OR) crudas, ajustadas por edad y por todas las variables predictoras con sus correspondientes intervalos de confianza al 95% (IC95%). Resultados Mientras en los hombres no se observo relacion entre la carga de trabajo domestico y el estado de salud, en las mujeres el riesgo de mal estado de salud aumentaba al hacerlo el numero de personas en el hogar de modo que la OR ajustada asociada a vivir en hogares de mas de cuatro personas fue 2,35 (IC95% = 1,33–4,15), en relacion a vivir unicamente con la pareja. Vivir con mayores de 65 anos tuvo un efecto protector en las mujeres (OR ajustada = 0,63; IC95% = 0,39–1,03). Conclusion El riesgo de mal estado de salud asociado a la sobrecarga representada por el trabajo domestico en las mujeres con un trabajo remunerado apunta la necesidad de aumentar los recursos comunitarios para el cuidado de los ninos, asi como de incrementar la participacion de los hombres en las tareas domesticas. Futuras encuestas de salud deberian incluir informacion sobre el numero de personas de diferentes grupos de edad que viven en el hogar sobre todo en edades extremas.

Psychosocial risk exposures and labour management practices. An exploratory approach

Aim: The purpose was to explore the relationship between psychosocial risk exposures and labour management practices (LMP), as indicators of work organization and pertinent features for primary preventive intervention. Methods: Cross-sectional study of a representative sample of salaried working population in Spain (n = 7,612). Information was obtained in 2004-2005 using a standardized questionnaire administered through personal interviews at the household. Questions on working conditions were used to establish LMP indicators and the psychosocial exposures data were obtained on the basis of the Copenhagen Psychosocial Questionnaire (COPSOQ) I (ISTAS21). A multivariate description was performed through multiple correspondence analysis, and associations between LMPs and psychosocial exposures were assessed by ordinal logistic analysis adjusting for age and sex. Results: Correspondence analysis showed a good-bad coherent pattern regarding both psychosocial dimension and LMPs, though several LMPs categories were placed in the centre. Among the 14 possible associations of each psychosocial scale with LMP variables, several scales showed significant associations with more than eight LMP variables. Most relevant results referred to the LMP variable ‘‘Consultative and delegative participation in methods’’. Conclusions: In line with previous research, psychosocial exposures were associated with LMP. LMP may constitute a step on a pathway from work organization to health. Our exploratory work suggested that good psychosocial exposures were related to participatory working methods, being hired with a permanent labour contract, not being made to feel easily replaceable, having superiors with non-authoritarian and non-aggressive manners, not being threatened with dismissal, upward functional mobility, being paid according to the number of working hours and occupation, working between 31 and 40 hours per week and in regular morning shifts. Hence, the more these features became part of LMP in the workplace, the better the psychosocial work environment would be.

Measuring precarious employment in times of crisis: the revised Employment Precariousness Scale (EPRES) in Spain

OBJECTIVE This study examines the psychometric properties of the revised Employment Precariousness Scale (EPRES-2010) in a context of economic crisis and growing unemployment. METHODS Data correspond to salaried workers with a contract (n=4,750) from the second Psychosocial Work Environment Survey (Spain, 2010). Analyses included acceptability, scale score distributions, Cronbachs alpha coefficient and exploratory factor analysis. RESULTS Response rates were 80% or above, scores were widely distributed with reductions in floor effects for temporariness among permanent workers and for vulnerability. Cronbachs alpha coefficients were 0.70 or above; exploratory factor analysis confirmed the theoretical allocation of 21 out of 22 items. CONCLUSION The revised version of the EPRES demonstrated good metric properties and improved sensitivity to worker vulnerability and employment instability among permanent workers. Furthermore, it was sensitive to increased levels of precariousness in some dimensions despite decreases in others, demonstrating responsiveness to the context of the economic crisis affecting the Spanish labour market.

COPSOQ International Network: Co-operation for research and assessment of psychosocial factors at work

Abstract COPSOQ is a comprehensive questionnaire on psychosocial factors at work which is internationally widely used since approx. 10 years for risk assessments in organisations. The International COPSOQ-Network was established in 2009 by scientific and empirical users of the COPSOQ. Main aim is the international scientific exchange concerning the use of COPSOQ. A second goal lies in the coordination of research and further development of the questionnaire (content and measurement qualities), to facilitate international comparison studies. Further information: www.copsoq-network.org