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Incorporating work organisation into occupational health research: an invitation for dialogue
  1. L A MacDonald1,
  2. A Härenstam2,
  3. N D Warren3,
  4. L Punnett4
  1. 1
    National Institute for Occupational Safety and Health, Cincinnati, OH, USA
  2. 2
    Department of Work Science, Göteborg University, Sweden
  3. 3
    Division of Public Health and Population Sciences, University of Connecticut Health Center, Farmington, CT, USA
  4. 4
    Department of Work Environment, University of Massachusetts Lowell, Lowell, MA, USA
  1. Dr L MacDonald, National Institute for Occupational Safety and Health, 4676 Columbia Parkway, Cincinnati, OH 45226, USA; lmacdonald{at}cdc.gov

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The last decade has seen a lively debate emerge about the proper scope of public health research and the value of examining broad social and environmental factors as interacting determinants of morbidity and mortality.1 2 In occupational health and safety, the broader socio-ecological system of most obvious interest is that of the organisations in which workers are employed. However, occupational health researchers have been slow to incorporate broader workplace features into their exposure assessment protocols and epidemiological study designs. The dominant exposure paradigm remains largely confined to the characterisation of risk factors at the job level (fig 1, arrow B). While application of this paradigm has contributed much to our understanding of the association between work and worker health and safety, failure to consider the organisational factors and conditions that are antecedents to job-level hazards could limit our ability to design and implement effective and sustainable hazard controls (affecting arrows A, C, D in fig 1). Examples of this broader perspective already exist within systems safety and macroergonomics models37 but we suggest that the importance of the organisational context is relevant for all exposure domains—including chemical hazards. We seek to stimulate dialogue within the occupational health community about the organisational context in which worker injury and illness occurs—and its implications for aetiological research and hazard control.

Figure 1 Conceptual pathways that link organisational characteristics with workplace health and safety hazards and worker health outcomes. The box “work organisation” potentially represents multiple levels above the job level.

The investigative foci in occupational health and the organisational sciences differ significantly, from job-level to organisational-level.8 While each contributes to our understanding of how working …

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