Table 3

Summary of observational studies of associations between work factors and ill health: non-health care workers

StudyCountryDesignParticipantsResponse rateWork factorsOutcomesResults
Bacharach et al, 199129USACross sectional430 public sector engineers79%Role conflict, time pressureEmotional exhaustion (MBI)High role conflict (B=0.24) associated with emotional exhaustion
Carayon et al, 199530USAProspective148 public sector office workers71%Job demands, content and control, social support, task clarity and job future ambiguityWorker strain, including anxiety and depression (McNair)Predictors of worker strain at one and two years were task clarity and job future ambiguity
Driscoll et al, 199531USACross sectional4900 public sector workers70%Job demands, control and social supportAnxiety and depression (NIOSH Generic Job Stress Questionnaire)High demand and low support associated with anxiety (ORs 1.46 and 2.01) and depression (ORs 2.02 and 1.69)
Ferrie et al, 199832UKProspective10308 public sector workers80%Job insecurityPsychological distress (GHQ-30)Non-significant association
Frese, 199933GermanyLongitudinal90 male blue collar workers35–66%Work intensity, uncertainty, organisational problems, environmental problems, social pressure, social supportAnxiety, depressionSocial pressure and support associated with anxiety/depression (r=0.21/0.20 and −0.21/−0.27)
Frone et al, 199534USALongitudinal795 employed adults67%Work pressure, lack of autonomy, role ambiguityDepression (CES-D)Work pressure, lack of autonomy, role ambiguity all associated with depression (Bs=0.10, p<0.01; 0.19, p<0.001; 0.18, p<0.001, respectively)
Fusilier et al, 198735USACross sectional312 police officers and fire fighters65%Role conflict and ambiguity, social supportDepression (Caplan)Low social support associated with depression (B=−0.24, p<0.01)
Karasek, 1979: Study 136SwedenLongitudinal1896 working males92% and 85%Decision latitude and job demandsDepression (amended from American Health Survey), absenteeismDecision latitude negatively associated with depression and absenteeism (OR=−1.29, p<0.05 and −1.44, p<0.01). Job demands associated with depression (OR=1.45, p<0.001)
Study 2USACross sectional911 working males76%As aboveAs aboveDecision latitude negatively associated with depression and absenteeism (OR=−1.41, p<0.01 and –2.04, p<0.001); job demands associated with depression (OR=1.20, p<0.05)
Karasek, 199037SwedenCross sectional8504 white collar workers87%Changes in control over workDepression and absenteeismDecreased control associated with depression (p<0.01) and with absenteeism in men (p<0.01) but not women
LaRocco et al, 198038USACross sectional636 male workersNot reportedSupervisor support, participation, future ambiguity, under-utilisation, workload, role conflictAnxiety and depression (Cobb and Kasl)Supervisor support buffers the adverse effect of low participation on depression (p<0.1, significant ) and of future ambiguity on anxiety (p<0.01)
Niedhammer et al, 199839FranceProspective1155292%Psychological demands, decision latitude and social supportDepression (CES-D)High psychological demand, low decision latitude and social support associated with subsequent depression. For men, OR of 1.8, 1.4 and 1.6 respectively and for women, OR of 1.4, 1.4 and 1.3 respectively.
Payne and Fletcher, 198340UKCross sectional148 teachers74%Workload demands, discretionAnxiety and depression (CCEI)Association with workload demands (betas=0.117 for anxiety and 0.176 for depression) and negative association with discretion (betas=−0.222 for anxiety and –0.121 for depression)
Reifman et al, 199141USACross sectional and longitudinal200 married, professional women>90%Social support at work , control over work, role ambiguity, workloadDepression (SCL-90)Cross sectionally, association with social support at work (r=0.37), role ambiguity (r=0.35) and workload (r=0.29). No associations one year later
Romanov et al, 199642FinlandProspective15530 employeesNot reportedConflict at workPsychiatric morbidity (hospital discharge registry)Positive association (RR 2.18, CI95 1.34, 3.54)
Rubenowitz et al, 198343SwedenCross sectional25 departments of 5 companies. Numbers not reported85–90%Perceived participation (individual, group, representative)AbsenteeismNegative association for individual participation (r=−0.53)
Shields, 199944CanadaProspective3830 working population80%Long working hoursDepression (Composite International Diagnostic Interview)>35 hours per week associated with depression in women (OR=2.2) but not men
Smulders and Nijuis, 199945The NetherlandsCross sectional and prospective1755 male public sector workers70%Job control and job demandsAbsence rate and absence frequencyCross sectionally, job control associated with low absence frequency (beta=0.10, p<0.01) and job demand associated with low absence rate (beta=−0.08, p<0.05)
Sparks and Cooper, 199946UKCross sectional7099 from 13 occupationsNot reportedWork control, career achievement, organisational climate, job factors, home/work interface, work relationshipsMental health (OSI)All associated (r=0.22 to −0.28, p<0.001)
Stansfeld et al, 199547UKCross sectional10314 public sector employees73%Job variety and skill use, control, social support, work pace, conflicting demandsPsychological distress (GHQ-30)All significantly associated (intertile trend p values < 0.001)
Stansfeld et al, 199848UKProspective7372 public sector workers72%Job demands, decision latitude, social support and effort-reward imbalancePsychological functioning (SF-36)Low support and effort-reward imbalance associated with poor psychological functioning (OR=1.2 for men and 1.4 for women; 1.8 for men and 2.3 for women respectively). In men, low decision latitude (OR=1.2) and in women, high job demand (OR=2.0) were associated with poor psychological functioning