Stephanie Boini

Effect of occupational safety and health education received during schooling on the incidence of workplace injuries in the first 2 years of occupational life: a prospective study

Objectives This study aimed to determine the effect of occupational safety and health (OSH) education during formal schooling on the incidence of workplace injuries (WIs) in young people starting their careers. We hypothesised that young people who had received OSH education during their schooling would have fewer WIs than those who received no OSH education. Secondary objectives focused on the effect of ‘first aid at work’ training during schooling and the conditions encountered on arrival in the company (occupational hazard information, safety training and job task training) on WI occurrence. Design Prospective cohort study. Participants From 2009 to 2012, French apprentices and students at the end of their schooling and starting their careers were included. Outcomes Occurrence of WIs. Methods At the time of inclusion, information about school courses and personal characteristics were collected, and subsequent half-yearly contacts gathered information relating to work and personal data. During the 2-year follow-up, WIs were directly reported by participants and were identified by searching the French National Health Insurance Funds’ databases listing compulsory WI declarations. Results 755 participants reported holding 1290 jobs. During follow-up, 158 WIs were identified, corresponding to an incident rate of 0.12 (0.10 to 0.14) WIs per full-time worker. Subjects who reported having received OSH education at school had two times less WIs than those declaring not having received OSH education (incidence rate ratio (IRR) 0.51, 0.00 to 0.98). A lower WI risk was observed for participants who received the ‘first aid at work’ training (IRR=0.68, 0.00 to 0.98). The conditions on arrival in company were not associated with WIs occurrence. Conclusion In France, the OSH education provided to apprentices and students is mostly broader than the specific risks related to future jobs. Our results highlight the advantages of reinforcing this approach.

0342 Perception of psychosocial factors at work according to age

The objective was to explore the effects of age on the perception of psychosocial factors (PSF) SUMER, a cross-sectional survey, was designed to characterise occupational exposures in a large representative sample of French employees. In 2010, 26 762 males and 20 019 females, aged 18 to 65, filled in the Karasek (skill discretion and decision authority, job demands, social support from colleagues and supervisors) and Siegrist (esteem, job security, job promotion) questionnaires. Additionally, participants were interviewed by occupational physicians about their work situation and occupational exposures. Graphical representations were used to characterise the PSF scores according to age. Then, breakpoints were identified using multiple change-point models. Finally, seniority, and working conditions were included as dependent factors in piecewise linear models with age, separately in men and women. The graphical representations highlighted that perceptions were different for young and old workers compared to the middle-range age in both genders. These trends were confirmed statistically for young (breakpoint at 30 years) and for older workers (breakpoint at 55 years) mostly for the Siegrist scores. When seniority was taken into account, the effect of age on PSF scores was intensified for young newly hired (less than 3 years of experience) for the Karasek scores. Results confirmed that young, and to a lesser extent, senior workers have different perceptions of PSF compared to middle-age group. Particularly, the effect of age was strengthened in young newly hired workers. Given the well-known impact of the PSF on health, OSH prevention should pay attention to these groups of workers.

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.