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  • Mental health

2011

CIS 12-0358 Flintrop J., eds.
Mental health promotion in the workplace - A good practice report
Mental health promotion (MHP) includes all the actions that contribute to good mental health. Its primary aim is to focus on what maintains and improves our mental wellbeing. It is important to highlight that optimally effective MHP should include a combination of both risk management and health promotion. This good practice report includes information on how to integrate MHP into a comprehensive approach to enhancing and promoting the safety, health and wellbeing of employees at work. Several case studies based on innovative and creative approaches are included.
European Agency for Safety and Health at Work, Gran Vía 33, 48009 Bilbao, Spain, Sep. 2011. 41p. Illus. 30 ref.
Mental_health_promotion_in_the_workplace_[INTERNET_FREE_ACCESS] [en inglés]

CIS 12-0356 Liira J., Karlsbakk J., Joensuu M., Sidorov P., Novikova I., Ketinka O., Loginova T., Bojko E., Lehtinen S.
Psychological workload and return to work
Collection of articles on occupational stress, mental health and work aptitude of relevance to Nordic countries and Russia. Contents: Norwegian language training of young Russians with disabilities; psychological load, education and social systems, and return to work after a long sickness absence; strategy for occupational burnout prevention among physicians in Russia; evaluation of the psycho-physiological and functional status of young people in a northern region of Russia. Other topics addressed: Other topics brief reports on OSH conferences during 2011 in Istanbul, Turkey, Riga, Latvia and Saint Petersburg, Russia.
Barents - Newsletter on Occupational Health and Safety, 2011, Vol.14, No.3, p.63-91 (whole issue). Illus. Bibl.ref.
Psychological_workload_[INTERNET_FREE_ACCESS] [en inglés]

CIS 12-0353 Kai Y., Nagamatsu T., Yamaguchi Y., Tokushima S.
Effect of leisure-time physical activity and commuting by walking on depressive symptoms among Japanese workers
The objective of this study was to investigate the prospective association of leisure-time physical activity and commuting to work by walking with depressive symptoms among Japanese workers. It was based on one-year follow-up longitudinal survey data collected from 634 Japanese individuals (536 men) aged 20-60 years working at an information technology company and exhibiting no depressive symptoms at baseline. The duration of leisure-time physical activity and commuting by walking were measured using an online self-report questionnaire. Findings suggest that leisure-time physical activity plays an important role in the prevention of depressive symptoms among Japanese workers, independent of job stress, whereas commuting to work by walking has no anti-depressive effect.
Bulletin of the Physical Fitness Research Institute, Apr. 2011, Vol.109, p.1-8. 30 ref.
Effect_of_leisure-time_physical_activity_[INTERNET_FREE_ACCESS] [en inglés]

CIS 12-0078 Vézina M., Cloutier E., Stock S., Lippel K., Fortin E., Delisle A., St-Vincent M., Funes A., Duguay P., Vézina S., Prud'homme P.
Quebec survey on working and employment conditions and occupational health and safety (EQCOTESST) - Summary report
Enquête québécoise sur des conditions de travail, d'emploi et de santé et sécurité du travail (EQCOTESST) - Rapport sommaire [en francés]
This report presents the main findings of a survey carried out among a random sample of 5000 workers aged 15 years or more in Quebec, Canada. Data were collected by means of phone interviews. Topics addressed included: conditions of work; non-occupational factors; violence, bullying and sexual harassment; state of health; musculoskeletal diseases; occupational accidents; mental health. Findings are discussed.
Institut de recherche Robert-Sauvé en santé et en sécurité du travail du Québec (IRSST), 505 boul. de Maisonneuve Ouest, Montreal (Quebec) H3A 3C2, Canada, 2011. v, 39p. 33 ref.
Enquête_québécoise_sur_des_conditions_de_travail_[INTERNET_FREE_ACCESS] [en francés]
Quebec_survey_on_working_and_employment_[INTERNET_FREE_ACCESS] [en inglés]

CIS 12-0174 Lehmann A., Burkert S., Daig I., Glaesmer H., Brähler E.
Subjective underchallenge at work and its impact on mental health
The objective of this study was to investigate the relation between subjective underchallenge at work and the degree of depressiveness and life satisfaction. It involved a representative sample of 1178 German workers (52.5% men, average age 40.4 years) who responded to a questionnaire on satisfaction with life, state of heath and a ten-item scale developed for the purpose of this study. The association between subjective underchallenge at work, life satisfaction and depressiveness was examined by means of path analyses. A significant positive association was found between subjective underchallenge at work and depressiveness, mediated by life satisfaction. This association was not moderated by income but by level of education. Participants with a medium educational level displayed a weaker association than participants with either a high or a low educational level. Not only work overload but also feeling underchallenged at work can have a negative impact on mental health and well-being.
International Archives of Occupational and Environmental Health, Aug. 2011. Vol.84, No.6, p.655-664. Illus. 59 ref.
Subjective_underchallenge_at_work_[INTERNET_FREE_ACCESS] [en inglés]

CIS 12-0165 Leinonen T., Pietiläinen O., Laaksonen M., Rahkonen O., Lahelma E., Martikainen P.
Occupational social class and disability retirement among municipal employees - The contribution of health behaviors and working conditions
This study examined, on the one hand, the associations between occupational social class and disability retirement due to all causes, musculoskeletal diseases, and mental disorders and, on the other hand, the contribution of health behaviors and working conditions to these associations. A total of 6516 middle-aged municipal employees from the Helsinki Health Study cohort baseline surveys in 2000-2002 were followed up until the end of 2010 for disability retirement. Social class was categorized into managers and professionals, semi-professionals, routine non-manual employees and manual workers. Cox regression analysis was used to calculate hazard ratios and their 95% confidence intervals. The risk of disability retirement was generally higher among those in lower social classes with a strong gradient for all causes, an even stronger gradient for musculoskeletal diseases, and a weaker non-linear association for mental disorders. These associations were largely mediated through physical workload among both women and men and hazardous exposures particularly among men. In mental disorders, job control also mediated the association. Strenuous desktop work and job demands widened the social class differences particularly among men and in mental disorders. The contribution of health behaviors was modest. Implications of these findings are discussed.
Scandinavian Journal of Work, Environment and Health, Nov. 2011, Vol.37, No.6, p.464-472. 42 ref.
Occupational_social_class_[BUY_THIS_ARTICLE] [en inglés]
ILO_LABORDOC_[INTRANET_ACCESS] [en inglés]

CIS 12-0330 Driesen K., Jansen N.W., van Amelsvoort L.G., Kant I.
The mutual relationship between shift work and depressive complaints - A prospective cohort study
The aim of this study was to examine longitudinally the mutual relationship between shift work and depressive complaints. Data from the ongoing Maastricht cohort study (1998-2008) were used. Firstly, the impact of shift work on the development of depressive complaints was studied. Secondly, the impact of depressed mood on changes in shift work at one-year follow-up was studied. Analyses were stratified for gender and age. Overall, the impact of shift work on the development of depressed mood over a ten-year period was small. Retrospective analyses found higher odds of depressed mood and depressive disorder among former or current male shift workers than among those never having done shift work. Results lacked significance when correcting for demographic and work-related factors. Implications of these and other findings are discussed.
Scandinavian Journal of Work, Environment and Health, Sep. 2011, Vol.37, No.5, p.402-410. 47 ref.
The_mutual_relationship_[BUY_THIS_ARTICLE] [en inglés]
ILO_LABORDOC_[INTRANET_ACCESS] [en inglés]

CIS 12-0154 Carey M.G., Al-Zaiti S.S., Dean G.E., Sessanna L., Finnell D.S.
Sleep problems, depression, substance use, social bonding, and quality of life in professional firefighters
Little attention has been given to factors contributing to firefighters' well-being. The purpose of this descriptive study was to examine such contributing factors in a sample of 112 professional firefighters. Overall, many firefighters reported sleep deprivation (59%), binge drinking behavior (58%), poor mental well-being (21%), current nicotine use (20%), hazardous drinking behavior (14%), depression (11%), poor physical well-being (8%), caffeine overuse (5%) and poor social bonding (4%). Small-to-medium correlations were identified between sleep deprivation, depression, physical/mental well-being and drinking behaviors. High-risk behaviors that impact psychosomatic well-being are prevalent in professional firefighters, which require environmental and individual-based health promotion interventions.
Journal of Occupational and Environmental Medicine, Aug. 2011, Vol.53, No.8, p.928-933. Illus. 31 ref.
Sleep_problems_[BUY_THIS_ARTICLE] [en inglés]

CIS 12-0153 Bennett J.B., Broome K.M., Schwab-Pilley A., Gilmore P.
A web-based approach to address cardiovascular risks in managers - Results of a randomized trial
The objective of this study was to examine whether a Web-based health and leadership development programme designed specifically for managers was associated with changes in self-reported and biometric indicators of cardiovascular disease within the context of a randomized control trial. A total of 145 managers from eight organizations participated in a six-month Internet-based programme or a control condition. They completed pre- and posttest assessments that included both self-reported attitudes (on diet, exercise, and mental health) and biometric measures (body weight, waist circumference). The intervention was associated with improvements in dietary attitudes, dietary self-efficacy, and exercise, and reductions in distress symptoms. Women in the program reduced their waist circumference significantly more than controls. The programme showed promise for reducing cardiovascular disease risk factors. Similar results across diverse organizations suggest the program may be useful across industry types.
Journal of Occupational and Environmental Medicine, Aug. 2011, Vol.53, No.8, p.911-918. Illus. 40 ref.
A_web-based_approach_[BUY_THIS_ARTICLE] [en inglés]

CIS 12-0348 Greubel J., Kecklund G.
The impact of organizational changes on work stress, sleep, recovery and health
The study objective was to investigate the impact of various types of organizational changes, as well as anticipation of such changes, on work-related stress, sleep, recovery and health. It was hypothesized that impaired sleep and recovery increase the adverse health consequences of organizational changes. The data consisted of cross sectional questionnaire data from a random sample of 1,523 employees in the Swedish police force. It could be shown that extensive organizational changes including downsizing or a change in job tasks were associated with a small increase in work stress, disturbed sleep, incomplete recovery and health complaints. However, less extensive organizational changes such as relocation did not affect these outcome variables. Anticipation of extensive organizational changes had almost the same effect as actual changes. Furthermore a moderating effect of sleep and work stress on gastrointestinal complaints and depressive symptoms was found.
Industrial Health, May 2011, Vol.49, No.3, p.353-364. Illus. 37 ref.
The_impact_of_organizational_changes_[INTERNET_FREE_ACCESS] [en inglés]

CIS 12-0131 Butterworth P., Leach L.S., Strazdins L., Olesen S.C., Rodgers B., Broom D.H.
The psychosocial quality of work determines whether employment has benefits for mental health: Results from a longitudinal national household panel survey
This study used longitudinal data to investigate whether the benefits of having a job depend on its psychosocial quality (levels of control, demands and complexity, job insecurity, and unfair pay), and whether poor quality jobs are associated with better mental health than unemployment. It involved the analysis of seven sets of annual data (2001 to 2007) from 7,155 respondents of working age. Longitudinal regression models evaluated the concurrent and prospective association between employment circumstances and mental health. Overall, unemployed respondents had poorer mental health than those who were employed. However the mental health of those who were unemployed was comparable or superior to those in jobs of the poorest psychosocial quality. This pattern was evident in prospective models. The health benefits of becoming employed were dependent on the quality of the job. Moving from unemployment into a high quality job led to improved mental health, however the transition from unemployment to a poor quality job was more detrimental to mental health than remaining unemployed. Implications of these findings are discussed.
Occupational and Environmental Medicine, Nov. 2011, Vol.68, No.11, p.806-812. Illus. 48 ref.
The_psychosocial_quality_of_work_[BUY_THIS_ARTICLE] [en inglés]

CIS 12-0342 Bourbonnais R., Brisson C., Vézina M.
Long-term effects of an intervention on psychosocial work factors among healthcare professionals in a hospital setting
This case-control study assessed the long-term effects of a workplace intervention aimed at reducing adverse psychosocial work factors (psychological demands, decision latitude, social support and effort-reward imbalance) and mental health problems among health care professionals in an acute care hospital. Pre-intervention and 3-year post-intervention measures were collected by telephone interviews with validated instruments. Three years after the intervention, all adverse psychosocial factors except one were reduced in the experimental group, and the improvement was statistically significant for five out of the nine factors. In addition, all health indicators improved. In the control hospital, three work factors improved significantly but two deteriorated significantly: decision latitude and social support. All health problems deteriorated, although not significantly, in the control hospital. Moreover, three years after the intervention, the mean of all adverse factors except one (psychological demands) and all health indicators was significantly more favourable in the experimental than the control hospital, after adjusting for pre-intervention measures. These results support the long-term effectiveness of the intervention.
Occupational and Environmental Medicine, July 2011, Vol.68, No.7, p.479-486. Illus. 43 ref.
Long-term effects of an intervention_[BUY_THIS_ARTICLE] [en inglés]

CIS 12-0001 Coutu M.F., Durand M.J., Marchand A., Labrecque M.E., Berbiche D., Cadieux G.
Presence and evolution of generalized anxiety disorder maintenance factors in workers undergoing rehabilitation for persistent pain of musculoskeletal origin
Présence et évolution des facteurs de maintien du trouble de l'anxiété généralisée chez des travailleurs en réadaptation pour une douleur persistante d'origine musculo-squelettique [en francés]
The objective of this study was to better understand the nature of the anxious manifestations of workers with persistent musculoskeletal disorders (MSDs), together with the extent of their problems, using a recognized model to document the presence, intensity and variation over time of generalized anxiety disorder (GAD). Close to forty workers participated in the study, half of whom showed symptoms of GAD. They were valuated at baseline and at various stages of their return to work by means of self-administered questionnaires. All the maintenance factors diminished significantly during the rehabilitation program. At the end, only 21% of the participants still presented GAD. The psychosocial factors already recognized in the MSD field do not seem to be significantly associated with the factors comprising the GAD model. However, the perception of benefiting from a safe work environment is associated with less risk of presenting GAD symptoms. The factors associated with returning to work or not are: usefulness of worry, fear of movement, dramatization of pain and the perceptions of benefiting from ergonomics and disability management.
Institut de recherche Robert-Sauvé en santé et en sécurité du travail du Québec (IRSST), 505 boul. de Maisonneuve Ouest, Montreal (Quebec) H3A 3C2, Canada, 2011. viii, 42p. Illus. Approx. 120 ref.
Présence_et_évolution_des_facteurs_[INTERNET_FREE_ACCESS] [en francés]

CIS 11-0899 Ford M. T, Cerasoli C.P., Higgins J.A., Decesare A.L.
Relationships between psychological, physical, and behavioural health and work performance: A review and meta-analysis
The relationships between health and job performance problems have received increased attention in business and scientific communities. This paper attempts to synthesize theoretical and empirical work in this arena. First, the theoretical links between health and work performance are presented. This is followed by a meta-analysis of the relations between psychological, physical, and behavioural health variables and work performance criteria. Meta-analytic results from 111 independent samples obtained from a search of the literature indicate that psychological health, in the form of psychological well-being, depression, general anxiety and life satisfaction, is a moderate-to-strong correlate of work performance. Associations between physical health, particularly somatic complaints and hypertension, and performance were weak-to-moderate. Regarding health behaviour, alcohol consumption and smoking were weakly and sleep problems moderately associated with performance problems. Other findings are discussed.
Work and Stress, 2nd quarter 2011, p.185-204. Approx. 65 ref.

CIS 11-0526 Wang L.J., Chen C.K., Hsu S.C., Lee S.Y., Wang C.S., Yeh W.Y.
Active job, healthy job? Occupational stress and depression among hospital physicians in Taiwan
The objective of this study was to assess the levels and association of occupational stress and depression rate among physicians, and to compare physicians' occupational stress with that of Taiwanese employees in other occupations. The subjects were physicians employed at 14 participating regional hospitals. Self-administered questionnaires capturing data on demographics, occupational characteristics, occupational stress measured using Job Content Questionnaire and health status measured using Taiwanese Depression Questionnaire were sent to eligible physicians. Results revealed that the depression rate (13.3%) was higher than that found in the general population (3.7%) of Taiwan. The mean scores of the dimensions "work demands" and "job control" were both much higher than for most occupations in Taiwan. Higher depression scores were found in subjects with higher work demands, 8-10 days of being on duty per month and more frequent alcohol consumption, while lower depression scores were found in subjects working in the east Taiwan area, with higher job control and with greater workplace social support. Gender, smoking and working hour were not independently correlated with depression, but the interaction of gender and job control also had an independent effect on depression.
Industrial Health, 2011, Vol.49, p.173-184. Illus. 52 ref.
Active_job.pdf [en inglés]

CIS 11-0592 Samson L.
Questions concerning mental health: What prevention means exist against so-called psychosocial hazards?
La santé mentale en questions? Quelle prévention possible des risques dits psychosociaux? [en francés]
This article addresses some of the workplace conditions that can affect mental health, in particular decision latitude, emotions, social support and ethical conflicts.
Préventique-Sécurité, Mar.-Apr. 2011, No.116, p.78-81. Illus. 10 réf.

CIS 11-0589 Greubel J., Kecklund G.
The impact of organizational changes on work stress, sleep, recovery and health
The study objective was to investigate the impact of various kinds of organizational changes, as well as anticipation of such changes, on work-related stress, sleep, recovery and health. It was hypothesized that impaired sleep and recovery increase the adverse health consequences of organizational changes. In this cross-sectional study, data were collected by means of questionnaires from a random sample of 1,523 employees in the Swedish police force. It was found that extensive organizational changes including downsizing or a change in job tasks were associated with a small increase in work stress, disturbed sleep, incomplete recovery and health complaints. However, less extensive organizational changes such as relocation did not affect these outcome variables. Anticipation of extensive organizational changes had almost the same effect as actual changes. The implications of these and other findings are discussed.
Industrial Health, 2011, Vol.49, p.353-364. Illus. 37 ref.
The_impact.pdf [en inglés]

CIS 11-0362 Stanislavoviene J., Pajarskiene B., Jankauskas R., Veniute M.
The psychosocial factors at work related to depression among female white-collar workers in Vilnius (Lithuania)
The aim of this study was to establish which psychosocial factors at work are related to depression among female white-collar workers in Vilnius, Lithuania. The data was collected in a case-control study in 2002-2004. The cases were selected from patients treated at Vilnius mental health centers. The controls were randomly selected from employed Vilnius residents. A descriptive statistic and logistic regression was applied. Three psychosocial factors and possible confounders within the evaluated model were statistically reliable: adjusted odds ratios for uneven work, job control and family esteem were 2.17, 10.81 and 2.13 respectively.
International Journal of Occupational Medicine and Environmental Health, 2011, Vol.24, No.2, p.166-176. 36 ref.

CIS 11-0374 Lilley R., LaMontagne A.D., Firth H.
Combined exposures to workplace psychosocial stressors: Relationships with mental health in a sample of NZ cleaners and clerical workers
A combined measure of two common psychosocial stressors, called job pressure has previously been shown to be strongly associated with poor mental health in high status workers. This study tests the generalizability of this association to lower status workers. A national random cross-sectional sample of 596 cleaners and clerical workers was obtained from the New Zealand electoral roll by occupational title. Cross-sectional data on job stressors, demographics, and mental health were collected by computer-assisted telephone interviews. Combined exposure to low job control, high job demands and job insecurity (high job pressure) was associated with markedly elevated odds (13-fold or higher) of poor mental health after adjustment for age, sex, occupation, and education.
American Journal of Industrial Medicine, 2011, Vol.54, p.405-409. 25 ref.

CIS 11-0445 van Hooff M.L.M., Geurts S.A.E., Beckers D.G.J., Kompier M.A.J.
Daily recovery from work: The role of activities, effort and pleasure
This study examines the effect of work and non-work activities and the perception of these activities on the daily recovery process using a 5-day diary study. Results indicate that pleasure in both domains increases the effects on recovery and, in the work domain, the combination of unpleasant and effortful work activities is negatively related to recovery. Findings indicate the importance of becoming involved in pleasant activities in both work and non-work domains.
Work and Stress, Jan.-Mar. 2011, Vol.25, No.1, p.55-74. Illus. 40 ref.

CIS 11-0444 Schat A.C.H., Frone M.R.
Exposure to psychological aggression at work and job performance: The mediating role of job attitudes and personal health
The purpose of this study was to investigate the relations between psychological aggression at work and two forms of job performance (task performance and contextual performance) and potential mediators of these relations. A model was developed and tested in which overall job attitudes (job satisfaction and organizational commitment) and overall personal health (physical and psychological health) fully mediate the relations between exposure to psychological aggression at work and both task performance and contextual performance. Data were obtained from a random sample of 2376 United States workers by means of phone interviews by trained interviewers, and the model was tested using structural equation modeling. The results supported the hypothesized model, demonstrating that exposure to psychological aggression at work negatively predicted both task performance and contextual performance, and that these relations were explained by decrements in job attitudes and health associated with exposure to psychological aggression at work.
Work and Stress, Jan.-Mar. 2011, Vol.25, No.1, p.23-40. Illus. 51 ref.

CIS 11-0335 Morrison J.
The role of the GP in keeping people in work
This editorial argues in favour of improved cooperation between general practitioners (GPs) and occupational health specialists and employers in the United Kingdom, in particular for the early identification of patients with psychological distress who are vulnerable to the risk of becoming permanently dependant on sickness benefits, while the most favourable decision would be to facilitate their return to work.
Occupational Medicine, 2011, Vol.61, p.74-75. 16 ref.
The_role_of_the_GP.pdf [en inglés]

CIS 11-0442 MacFarlane E., Simpson P., Benke G., Sim M.R.
Suicide in Australian pesticide-exposed workers
Epidemiological research has observed that workers with exposure to anticholinesterase pesticides, and particularly those with a history of acute overexposure, may be at increased risk of depression. However, there is little published research about the risk of suicide in relation to pesticide exposure. A nested case-control study was performed within a retrospective cohort study of pesticide-exposed workers. Ninety male suicide deaths and 270 male controls were matched by age bands, state of residence and live status. Cholinesterase inhibition was determined using subject-specific biomonitoring records collected at the time of exposure. This study did not find an elevated suicide risk associated with use of any major class of pesticide and there was little evidence that overexposure was associated with increased risk of suicide.
Occupational Medicine, 2011, Vol.61, p.259-264. 29 ref.

2010

CIS 12-0343 North C.S., Pfefferbaum B., Hong B.A., Gordon M.R., Kim Y.S., Lind L., Pollio D.E.
The business of healing: Focus group discussions of readjustment to the post-9/11 work environment among employees of affected agencies
Between one and two years after the September 11, 2001 terrorist attacks, 12 focus groups were conducted with 85 employees of companies directly affected by the 9/11 attacks on New York City, to discuss mental health issues surrounding return to the workplace after the disaster. Risk communication, tension between workplace productivity and employees' emotional needs and post-disaster work space were topics discussed in the focus groups. Employees identified many effective responses by their companies after 9/11 relating to these areas of concern as well as gaps in response.
Journal of Occupational and Environmental Medicine, July 2010, Vol.52, No.7, p.713-718. 38 ref.
The_business_of_healing_[INTERNET_FREE_ACCESS] [en inglés]

CIS 11-0896 Hilton M.F., Whiteford H.A.
Associations between psychological distress, workplace accidents, workplace failures and workplace successes
This study investigates associations between psychological distress and workplace accidents, workplace failures and workplace successes. The Health and Work Performance Questionnaire (HPQ) was distributed to employees of 58 large employers in Australia. A total of 60,556 full-time employees were eligible for analysis. The HPQ probed whether the respondent had, in the past 30-days, a workplace accident, success or failure. Psychological distress was quantified using the Kessler 6 (K6) scale and categorised into low, moderate and high psychological distress. Three binomial logistic regressions were performed with the dependent variables being workplace accident, success or failure. Covariates in the models were K6 category, gender, age, marital status, education level, job category, physical health and employment sector. Moderate and high psychological distress significantly increased the odds ratio (OR) for a workplace accident to 1.4 for both levels of distress. Moderate and high psychological distress significantly increased the OR (OR 2.3 and 2.6, respectively) for a workplace failure and significantly decreased the OR for a workplace success (OR 0.8 and 0.7, respectively). Implications of these findings are discussed.
International Archives of Occupational and Environmental Health, Dec. 2010, Vol.83, No.8, p.923-933. 50 ref.
Associations_between_psychological_distress.pdf [en inglés]

CIS 11-0895 van Oostrom S.H., Heymans M.W., de Vet H.C., van Tulder M.W., van Mechelen W., Anema J.R.
Economic evaluation of a workplace intervention for sick-listed employees with distress
The objective of this study was to evaluate the cost effectiveness, cost utility and cost benefit of a workplace intervention compared with usual care for sick-listed employees with distress. An economic evaluation was conducted alongside a randomised controlled trial. Employees with distress and who were sick-listed for 2-8 weeks were randomised to a workplace intervention (n=73) or to usual care (n=72). The workplace intervention is a stepwise process involving the sick-listed employee and their supervisor, aimed at formulating a consensus-based plan for return to work (RTW). The effect outcomes were lasting RTW and quality-adjusted life years (QALYs). Healthcare utilisation was measured over 12 months. Cost effectiveness analyses (CEA) and cost utility analyses (CUA) were conducted from the societal perspective and cost benefit analyses (CBA) from the employer perspective. Bootstrapping techniques were used to estimate cost and effect differences, and cost effectiveness and cost utility ratios. Cost effectiveness planes were presented and subgroup analyses were performed. CEA and CUA revealed no statistically significant differences in lasting RTW, QALYs or costs. The CBA indicated a statistically significant higher cost of occupational health services in the workplace intervention group. The workplace intervention was not cost effective according to the CEA, CUA and CBA. Widespread implementation of the workplace intervention for sick-listed employees with distress is not recommended because there is no economic benefit compared with usual care.
Occupational and Environmental Medicine, Sep. 2010, Vol.67, No.9, p.603-610. Illus. 37 ref.

CIS 11-0748 Platt B., Hawton K., Simkin S., Mellanby R.J.
Systematic review of the prevalence of suicide in veterinary surgeons
There is preliminary evidence to suggest that veterinary surgeons are a group at risk of suicide. The objective of this study was to conduct a systematic review of studies of rates and methods of suicide in this profession. A systematic search of the international research literature was performed in May 2008. The data from the 19 studies of the prevalence of suicide in the veterinary profession were extracted by two independent reviewers and analysed. Between 0 and 43% of veterinary surgeon deaths were due to suicide. In all but one of the 15 studies presenting risk of suicide in veterinary surgeons with a comparison population, an elevated risk was found. The better quality studies with the lowest risk of bias indicated that in the United Kingdom, the rate of suicide in the veterinary profession was at least three times the general population rate. Studies of the methods of suicide veterinary surgeons use suggest that self-poisoning and firearms are particularly common. There appears to be an elevated risk of suicide for veterinary surgeons in several countries. Access to means of suicide influences the methods used and may contribute to increased risk.
Occupational Medicine, Sep. 2010, Vol.60, No.6, p.436-446. Illus. 33 ref.
Systematic_review.pdf [en inglés]

CIS 11-0717 Arimura M., Imai M., Okawa M., Fujimura T., Yamada N.
Sleep, mental health status, and medical errors among hospital nurses in Japan
Medical error involving nurses is a critical issue since nurses' actions will have a direct and often significant effect on the prognosis of their patients. To investigate the significance of nurse health in Japan and its potential impact on patient services, a questionnaire-based survey was conducted among nurses working in hospitals, with the specific purpose of examining the relationship between shift work, mental health and self-reported medical errors. Multivariate analysis revealed significant associations between the shift work system, General Health Questionnaire (GHQ) scores and nurse errors: the odds ratios for shift system and GHQ were 2.1 and 1.1, respectively. It was confirmed that both sleep and mental health status among hospital nurses were relatively poor, and that shift work and poor mental health were significant factors contributing to medical errors.
Industrial Health, Nov. 2010, Vol.48, No.6, p.811-817. 25 ref.
Sleep_mental_health.pdf [en inglés]

CIS 11-0715 Tanaka K., Otsubo T., Tanaka M., Kaku A., Nishinoue N., Takanao T., Kamata N., Miyaoka H.
Similarity in predictors between near miss and adverse event among Japanese nurses working at teaching hospitals
Near miss-based analysis has been recently suggested to be more important in the medical field than focusing on adverse events, as in the industrial field. To validate the utility of near miss-based analysis in the medical fields, this study investigated whether or not predictors of near misses and adverse events were similar among nurses at teaching hospitals. Of the 1,860 nurses approached, 1,737 (93.4%) were included in the final analysis. Potential predictors provided for analysis included gender, age, years of nursing experience, frequency of alcohol consumption, work place, ward rotation, frequency of night shifts, sleepiness during work, frequency of feeling unskilled, nurses' job stressors, working conditions, and depression. Ordinal logistic analysis showed that predictors of near misses and adverse events were markedly similar. Parameters that were significantly related to both near misses and adverse events were years of experience, frequency of night shifts, internal ward, and time pressure.
Industrial Health, Nov. 2010, Vol.48, No.6, p.775-782. 36 ref.
Similarity_in_predictors.pdf [en inglés]

CIS 11-0331 Rehkopf D.H., Kuper H., Marmot M.G.
Discrepancy between objective and subjective measures of job stress and sickness absence
The aim of this study was to examine possible differences in the association of externally and self-assessed measures of work environment with sickness absence. The study population included 6997 middle-aged men and women from the Whitehall II cohort, whose work characteristics were examined at baseline (1985-1988) through both an external evaluation and self-report, with a follow-up of up to 13 years of sickness absence reporting from administrative records. The primary exposure of interest was the discrepancy between measures of work stress for fast job pace, conflicting demands and decision latitude. External measures of job characteristics were more strongly associated with higher rates of sickness absence compared with self-assessed measures, for both lower frequency of fast work pace and lower conflicting demands. Individuals who self-reported higher frequencies of fast work pace and conflicting demands than were reported through external assessment had higher rates of short-term sickness absence. There was no difference in rates of sickness absence found for decision latitude. Implications of these findings are discussed.
Scandinavian Journal of Work, Environment and Health, Nov. 2010, Vol.36, No.6, p.449-457. Illus. 27 ref.

CIS 11-0330 Netterstrøm B., Blønd M., Nielsen M., Rugulies R., Eskelinen L.
Development of depressive symptoms and depression during organizational change - A two-year follow-up study of civil servants
In 2007, Denmark went through a major reorganization, where most of its 275 municipalities and 14 counties merged into larger units. This study aimed to examine the development of depressive symptoms and incident depression among employees affected by this organizational change. A total of 685 civil servants employed in the administration of five municipalities and two counties participated in the study. They answered a postal questionnaire eight months prior to and 16 months after the reorganization regarding working conditions, psychosocial work environment factors, and depressive symptoms, based on the Major Depression Inventory (MDI). During the follow-up period in 2006-2008, 295 employees had experienced a merger with other workplaces (hereafter the merger group), 259 had got a new job (the new job group), and 131 who experienced no change in workplace served as the control group. The three groups were compared for mean score of MDI and incident cases of depression using general linear models and logistic regression analyses. After adjustment of the MDI for age, occupation, supervisor function and department at baseline in 2006, no significant differences in increase in MDI were found between the groups. The incidence of depression in the merger group was not significantly higher than the control group.
Scandinavian Journal of Work, Environment and Health, Nov. 2010, Vol.36, No.6, p.445-448. 21 ref.

CIS 11-0439 Madsen I.E., Diderichsen F., Burr H., Rugulies R.
Person-related work and incident use of antidepressants: Relations and mediating factors from the Danish work environment cohort study
Previous Danish studies have shown that employees who work with people are at increased risk of hospitalization with a diagnosis of depression. This study examines whether person-related work is associated with incident use of antidepressants, and whether this association is mediated by several work environment exposures. Self-reported data from 4958 participants in the Danish work environment cohort study in 2000 were linked with the use of antidepressants between 2001 and 2006. Compared to employees doing non-person-related work, the use of antidepressants was increased statistically significantly for healthcare workers and statistically non-significantly for educational workers. The use of antidepressants was not elevated for social or customer service workers, or those doing other types of person-related work. The increased risks of antidepressant-use for healthcare and educational workers were attenuated when adjusted for emotional demands at work. Implications of these findings are discussed.
Scandinavian Journal of Work, Environment and Health, Nov. 2010, Vol.36, No.6, p.435-444. 63 ref.

CIS 11-0183 Durand M.J., Corbière M., Briand C., Coutu M.F., St-Arnaud L., Charpentier N.
The factors related to prolonged work absences due to a transitory mental disorder - Development of a measurement tool
Les facteurs reliés aux absences prolongées du travail en raison d'un trouble mental transitoire- Développement d'un outil de mesure [en francés]
The objective of this study was to evaluate the obstacles to the return-to-work of persons having experienced mental health problems and extended absenteeism, and to design a diagnosis tool in the form of a physician-administered questionnaire, entitled "Diagnosis of the work handicap situation" (DWHS). A prototype of the DWHS was evaluated by clinicians. Findings are discussed.
Institut de recherche Robert-Sauvé en santé et en sécurité du travail du Québec (IRSST), 505 boul. de Maisonneuve Ouest, Montreal (Quebec) H3A 3C2, Canada, 2010. vi, 49p. Illus. 126 ref. Available only in downloadable electronic version (PDF format), free of charge.
R-674.pdf [en francés]

CIS 11-0138 Kojima R., Fujisawa D., Tajima M., Shibaoka M., Kakinuma M., Shima S., Tanaka K., Ono Y.
Efficacy of cognitive behavioral therapy training using brief e-mail sessions in the workplace: A controlled clinical trial
This case-control study was conducted to evaluate the effects of cognitive behavioral therapy (CBT) training in improving depression and self-esteem in workers. A total of 261 white-collar workers were assigned to either an intervention group (137) or to a control group (124). The intervention group was offered participation in a group session with CBT specialists and three e-mail sessions with occupational health care staff. Between-group differences in the change in Center for Epidemiologic Studies Depression Scale (CES-D) and Self-Esteem Scale from baseline to three months after the end of training were assessed by analysis of covariance. All subjects in the intervention group completed the group session and 114 (83%) completed the three e-mail sessions. CES-D score decreased by 2.21 points in the intervention group but increased by 0.12 points in the control group. However, between-group difference in change of self-esteem scores was not significant. Implications of these findings are discussed.
Industrial Health, July 2010, Vol.48, No.4, p.495-502. Illus. 24 ref.
Efficacy_of_cognitive_behavioral_therapy.pdf [en inglés]

CIS 11-0067 Paterson J.L., Dorrian J., Pincombe J., Grech C., Dawson D.
Mood change and perception of workload in Australian midwives
Twenty midwives in an Australian metropolitan hospital completed logbooks assessing daily fluctuations in subjective mood and workload. Participants also provided information about history of psychopathology and sleep quality. Workload factors significantly predicted mood at work. Specifically, when participants felt that their work was more demanding and frustrating and required more effort, or when they felt that they could not accomplish all that was expected, mood was negatively influenced. This supports the connection between workload and negative mood change in healthcare. Given the potential for mood to influence a multitude of functions relevant to safety, performance and psychosocial wellbeing it is important to understand the factors which influence mood, particularly in light of the current shortfall in the Australian healthcare workforce.
Industrial Health, July 2010, Vol.48, No.4, p.381-389. Illus. 39 ref.
Mood_change.pdf [en inglés]

CIS 10-0509 Arial M., Gonik V., Wild P., Danuser B.
Association of work related chronic stressors and psychiatric symptoms in a Swiss sample of police officers; a cross-sectional questionnaire study
The objectives of this cross-sectional study were to identify work-related stressors associated with psychiatric symptoms in a Swiss sample of policemen and to develop a model for identifying officers at risk for developing mental health problems. A total of 354 male police officers answered a questionnaire assessing a wide spectrum of work related stressors. Psychiatric symptoms were assessed using the "TST questionnaire". Logistic regression with backward procedure was used to identify a set of variables collectively associated with high scores for psychiatric symptoms. A total of 42 (11.9%) officers had a high score for psychiatric symptoms. All potential stressors considered (lack of support, self perception of bad quality work, inadequate work schedule, high mental/intellectual demands, age and physical environment) were significantly associated with a high score for psychiatric symptoms. Implications of these findings are discussed.
International Archives of Occupational and Environmental Health, Mar. 2010, Vol.83, No.3, p.323-331. 34 ref.

CIS 10-0500 Allen H., Hyworon Z., Colombi A.
Using self-reports of symptom severity to measure and manage workplace depression
The aim of this study was examine the impact of depression on health and productivity loss. Structural equation models of health risk appraisal data of 39,097 individuals involving 41 measures of contextual characteristics, depression severity, health and job performance were used. Findings are discussed. The results link depression to large health and productivity deficits. They call for public-private collaboration, parity in mental and physical health benefits, and resource allocation that is proportionate across the depression spectrum and facilitated by symptom severity screening.
Journal of Occupational and Environmental Medicine, Apr. 2010, Vol.52, No.4, p.363-374. Illus. 32 ref.

CIS 10-0450 Johansson B., Rask K., Stenberg M.
Piece rates and their effects on health and safety - A literature review
The purpose of this literature survey was to analyze relevant research articles about piece rate wages and their effects on safety and health. A total of 75 research articles were examined extensively and 31 of these were found relevant and had sufficient quality to serve the purpose of this study. The findings of these relevant articles are summarized and analyzed in the survey. Since the late 1980s, there has been a change of research focus regarding piece rates and their effects on safety and health. More recent research shows a clear interest for health, musculoskeletal injuries, physical workload, pains and occupational injuries. The previous interest in risk behaviour, security and accidents is still there, but no longer dominates the research scene. Although research is still sparse and fragmented, much of the accumulated knowledge about the effects of piece rate work tells us that piece rates in many situations have a negative effect on safety and health. Indeed 27 of the 31 studied articles found negative effects of piece rates on different aspects of safety and health. Further research is needed to address specific questions.
Applied Ergonomics, July 2010, Vol.41, No.4, p.607-614. 31 ref.

CIS 10-0449 Shibaoka M., Takada M., Watanabe M., Kojima R., Kakinuma M., Tanaka K., Kawakami N.
Development and validity of the Japanese version of the organizational justice scale
Organizational justice has recently attracted attention as a predictor of employee mental and physical health. However, the lack of a Japanese translation of the original English-language organizational justice scale (OJS) has precluded its application in Japan. The present study aimed to develop a Japanese version of the measure of organizational justice. A total of 229 employees responded to the Japanese version of the OJS (OJS-J), the effort-reward imbalance (ERI) model and the Kessler Psychological Distress Scale (K10). To assess construct validity, job satisfaction was recorded using the visual analog scale (VAS). Exploratory factor analysis supported the four-factor structure model of OJS-J. Correlation coefficients between the OJS-J and ERI, K10 and VAS were statistically significant, indicating a reasonable degree of construct validity. Obtained internal consistency was markedly high and test-retest reliability as analyzed with an intra-class correlation coefficient was 0.91. These results suggest that the OJS-J is a reliable and valid measure that may be suitable for use as a predictor of employee health in Japanese workplaces.
Industrial Health, Jan. 2010, Vol.48, No.1, p.66-73. Illus. 20 ref.
Development_and_validity.pdf [en inglés]

CIS 10-0447 Nishitani N., Sakakibara H.
Job stress factors, stress response, and social support in association with insomnia of Japanese male workers
The aim of the present study was to examine the relation of insomnia with job stress factors, stress response and social support. A self-completed questionnaire survey was conducted in 212 male Japanese workers at a synthetic fibre plant. With regard to insomnia, subjects were asked the first five of the eight questions on the Athens Insomnia Scale (AIS). Job stress factors, stress response and social support were assessed using the Job Stress Questionnaire. Multiple regression analyses showed that psychological job stress factors of poor appropriateness of work and high qualitative workload were associated with insomnia. The psychological stress response of depression and physical stress responses were also related with insomnia. Depression was also related to appropriateness of work. The present results showed that insomnia was closely related with the psychological job stress factor of appropriateness of work and the psychological response of depression. These mutual relationships between insomnia and poor mental health need be investigated further.
Industrial Health, Mar. 2010, Vol.48, No.2, p.178-184. 32 ref.
Job_stress_factors.pdf [en inglés]

CIS 10-0446 Layte R., Maître B., Whelan C.T.
Living conditions, social exclusion and mental well-being
Over the past two decades, the concept of social exclusion has increasingly replaced the concept of poverty within the EU policy discussion on social vulnerability and disadvantage. It has been shown that unequal access to the labour market and poor living conditions negatively affect social participation and social contact, which in turn impact on the quality of life of Europe's citizens and lead to a sense of social exclusion. The second European Quality of Life Survey (EQLS), conducted by the European Foundation in 2007, offers a wide-ranging view of the diverse social realities in Europe today. This report looks at the relationships between living conditions, social exclusion and mental well-being.
European Foundation for the Improvement of Living and Working Conditions, Wyattville Road, Loughlinstown, Dublin 18, Ireland, 2010. viii, 70p. Illus. 81 ref.
Living_conditions.pdf [en inglés]

CIS 10-0256 Solomon G.M., Janssen S.
Health effects of Gulf oil spill
This article identifies four main health hazards associated with the Gulf of Mexico oil spill: vapours from oil chemicals and dispersants in the air; skin damage from direct contact with tar balls or contaminated water; potential cancer or other long-term health risks from consumption of contaminated seafood; mental health problems of depression, anxiety, and self-destructive behaviour due to stress. It is too soon to know if there will be any long-term respiratory effects. Seafood safety is probably the biggest concern right now with the new fishery re-openings, particularly for vulnerable populations such as pregnant women, children and subsistence fish consumers. The authors ask the Food and Drug Administration to review their methods of assessing seafood safety and to make all their data on seafood safety publicly available.
Journal of the American Medical Association, 8 Sep. 2010, Vol.304, No.10, p.1118-1119. 10 ref.

CIS 10-0295 Kawai K., Yamazaki Y, Nakayama K.
Process evaluation of a web-based stress management program to promote psychological well-being in a sample of white-collar workers in Japan
The article describes the evaluation of a web-based stress management programme designed to improve psychological well-being. A total of 168 employees participated in the intervention. The pre-test was conducted at the time of registration and the post-test upon the completion of the programme. To facilitate analysis, a model was build based on the programme impact theory and a path analysis was conducted. It was found that the majority of participants evaluated the program positively in all sessions. Participant evaluations directly predicted changes in psychological well-being. It is concluded that programmes where participants feel enjoyment and enhance their self-rated capability to cope with stress can be effective.
Industrial Health, May 2010, Vol.48, No.3, p.265-274. Illus. 36 ref.

2009

CIS 11-0366 Vézina M., eds.
Matrix for the identification of psychosocial risks at work
Grille d'identification des risques psychosociaux au travail [en francés]
Occupational health professionals are increasingly concerned by the extent of work-related mental health problems. A growing number of cases relate to psychological distress, burnout, depression or, more generally, to occupational stress. Within this context, an important need has arisen for a tool allowing a simple evaluation of the probability of high psychosocial risks in certain occupational settings, thus allowing judging whether a further investigation of the case is warranted. This document presents a simple quantitative tool which also includes educational features, aimed at assisting professionals in identifying actions to be implemented or targets to be reached within the enterprise.
Institut national de santé publique du Québec, 94, avenue Wolfe, Quebec G1V 5B3, Canada, 2009. 38p.
Grille_d'identification.pdf [en francés]

CIS 10-0592 Hilton M.F., Scuffham P.A., Sheridan J., Cleary C.M., Vecchio N., Whiteford H.A.
The association between mental disorders and productivity in treated and untreated employees
This large cross-sectional study investigates associations between employee work productivity, psychological distress, and the treatment of mental disorders. A total of 60556 Australian employees completed the Health and Work Performance Questionnaire (HPQ). The HPQ quantified treatment seeking behaviour for depression, anxiety or other mental disorders. The HPQ also evaluated the level of psychological distress and employee productivity measures. The productivity of employees without psychological distress and who have not been in treatment of a mental disorder was 20%, while that of successfully treated employees for a mental disorder was 17%. It is concluded that the treatment of mental disorders resulting in normalization of symptoms is associated with employees' productivity returning to values approaching those of employees without a history of a mental disorder.
Journal of Occupational and Environmental Medicine, Sep. 2009, Vol.51, No.9, p.996-1003. Illus. 49 ref.

CIS 10-0231 Documento de información técnica sobre las enfermedades que plantean problemas para su posible inclusión en la lista de enfermedades profesionales que figura como anexo de la Recomendación sobre la lista de enfermedades profesionales, 2002 (núm. 194)
Technical backgrounder on the problematic diseases in the proposed list to replace the list annexed to the List of Occupational Diseases Recommendation, 2002 (No. 194) [en inglés]
Document technique sur les maladies problématiques inscrites sur la liste proposée en remplacement de la liste des maladies professionnelles figurant dans l'annexe à la recommandation (nº 194) sur la liste des maladies professionnelles, 2002 [en francés]
This report was prepared as a background for discussion at a meeting of experts on the revision of the ILO list of occupational diseases held in Geneva, Switzerland, 27-30 October 2009 (see ISN 110721). It addresses a number of occupational diseases that raise specific issues: diseases caused by radiofrequency radiation; malaria; extrinsic allergic alveolitis caused by the inhalation of organic dusts; carpal tunnel syndrome; mental and behavioural disorders; formaldehyde; hepatitis B virus and hepatitis C virus; crystalline silica. In each case, the report includes general information on the disease or diseases caused by the agent, the exposure at work, the scientific background and the diagnosis criteria, as well as the list of countries specifically including the disease in the national list of occupational diseases.
ILO Publications, International Labour Office, 1211 Genève 22, Switzerland, 2009. iv, 32p.
MERLOD/2009/5/EN.pdf [en inglés]
MERLOD/2009/5/FR.pdf [en francés]
MERLOD/2009/5/ES.pdf [en español]

CIS 09-1420 OSH in figures: Stress at work - Facts and figures
According to the fourth European Survey of Working Conditions, carried out in 2005 in all Member States of the European Union, stress was experienced by an average 22% of working Europeans. In 2002, the annual economic cost of work-related stress in 15 EU countries was estimated at EUR 20 billion. Contents of this report on stress at work in Europe: introduction; prevalence of stress at work; stress by age; stress by gender; stress by sector and occupation; stress by employment status; expert survey on emerging psychosocial risks; cost of stress-related health problems; legislation.
European Agency for Safety and Health at Work, Gran Vía 33, 48009 Bilbao, Spain, 2009. 132p. Illus. 76 ref.

CIS 09-1416 Merecz D., Drabek M., Mościcka A.
Aggression at the workplace - Psychological consequences of abusive encounter with coworkers and clients
The aim of the study was to evaluate the consequences of workplace aggression from coworkers and the public among nurses and public service workers in a Polish locality. Data on violent incidents, burnout, physical health, mental health and work satisfaction were obtained by means of questionnaires and subjected to multiple regression models. It was found that employees experiencing workplace aggression were less satisfied with work, showed symptoms of burnout and their general health was poorer. The effect of aggression by coworkers was stronger than that by the public. Aggression from the public usually resulted in compassion of peers, and it was perceived as the organizational problem that should be solved, while dealing with an aggressive co-worker was usually perceived as the employee's own problem, resulting in isolation and a sense of unfairness.
International Journal of Occupational Medicine and Environmental Health, 3rd quarter 2009, Vol.22, No.3, p.243-260. 25 ref.

CIS 09-1414 Tei-Tominaga M., Akiyama T., Miyake Y., Sakai Y.
The relationship between temperament, job stress and overcommitment: A cross-sectional study using the TEMPS-A and a scale of ERI
This cross-sectional study examined the relationship between temperament, job stress, and overcommitment. Self-administered questionnaires were obtained from 730 employees of a Japanese IT services company. Data were subjected to a hierarchical regression analysis. Findings showed that depressive and anxious temperaments attenuated the influence of working hours on stress, and influenced the effects of effort and rewards independently.
Industrial Health, Sep. 2009, Vol.47, No.5, p.509-517. 34 ref.
http://www.jniosh.go.jp/en/indu_hel/pdf/IH_47_5_509.pdf [en inglés]

CIS 09-1413 Urakawa K., Yokoyama K.
Sense of coherence (SOC) may reduce the effects of occupational stress on mental health status among Japanese factory workers
To examine if sense of coherence (SOC) can reduce the adverse effects of job stress on mental health status, self-administered questionnaires were distributed among 740 workers in a manufacturing industry (participation rate 62.8%). Logistic regression analyses revealed that for both men and women, mental health status was adversely related to job demand whereas it was positively associated with SOC. Similarly, the mental health status was affected adversely by managerial work in males, whereas was positively by co-workers support in females. Other findings are discussed.
Industrial Health, Sep. 2009, Vol.47, No.5, p.503-508. 29 ref.
http://www.jniosh.go.jp/en/indu_hel/pdf/IH_47_5_503.pdf [en inglés]

CIS 09-1412 Shimazu A., Schaufeli W.B.
Is workaholism good or bad for employee well-being? The distinctiveness of workaholism and work engagement among Japanese employees
The aim of the present study was to demonstrate the empirical distinctiveness of workaholism and work engagement by examining their relationships with well-being in a sample of 776 Japanese employees. Questionnaires were used to measure workaholism, work engagement and well-being. Structural equation modeling showed that workaholism was positively associated with ill-health and negatively associated with life satisfaction and job performance. In contrast, work engagement was negatively associated with ill-health and positively associated with life satisfaction and job performance.
Industrial Health, Sep. 2009, Vol.47, No.5, p.495-502. Illus. 45 ref.
http://www.jniosh.go.jp/en/indu_hel/pdf/IH_47_5_495.pdf [en inglés]

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