Introduction Work-related psychosocial exposures are highly prevalent in European countries and are associated with various health outcomes, especially mental disorders and cardiovascular diseases (CVD). Evaluations of the economic burden of psychosocial work exposures are however very seldom in the literature.

Objective To estimate the annual costs of depression and CVD attributable to work-related psychosocial exposures in 28 European Union countries (EU28).

Methods This study will follow the top-down cost-of-illness (COI) approach, which estimates the economic burden of health conditions in a population from a societal perspective, starting from the total costs of diseases. We will estimate the fractions of these costs that are attributable to work-related psychosocial exposures (attributable fractions, AFs). AF estimates require data on the prevalence of exposure in the whole population, and on the relative risk of developing the disease when exposed to the risk factor. Relative risk estimates will come from a systematic literature review. Prevalence of exposure estimates will derive from an analysis of the 2015 European Working Conditions Survey data. Work-related psychosocial exposures will include the factors from the job strain model, effort-reward imbalance model, and other models/concepts depending on the availability of data.

Results Our evaluation of costs will include: (1) direct healthcare costs as reimbursed by public healthcare systems: outpatient visit fees to physicians and other health professionals, hospitalisations, emergency room visits and medication, (2) direct healthcare costs as out-of-pocket payments paid by patients, depending on the extent of the public healthcare system in each country, (3) indirect costs due to sickness absences at work, to disability leave, early retirement and premature death, and the cost of presenteeism when available.

Conclusion This study will provide original and relevant insights on a macro-level for policy-makers and stakeholders when defining public health priorities and preventive strategies in European countries regarding work stress prevention.