The lack of communication and agreement by Dutch GPs and OPs in medical diagnosis and management of employees long-term sick listed due to mental health problems are indicators of sub-optimal medical treatment and return-to-work strategies.

Effective interventions to prevent work stress and to improve health, well-being, and performance of employees are of the utmost importance. This quasi-experimental intervention study presents a specific method for diagnosis of psychosocial risk factors at work and subsequent development and implementation of tailored work stress interventions, the so-called DISCovery method. This method aims at improving employee health, well-being, and performance by optimizing the balance between job demands, job resources, and recovery from work. The aim of the study is to quantitatively assess the effectiveness of the DISCovery method in hospital care. Specifically, we used a three-wave longitudinal, quasi-experimental multiple-case study approach with intervention and comparison groups in health care work. Positive changes were found for members of the intervention groups, relative to members of the corresponding comparison groups, with respect to targeted work-related characteristics and targeted health, well-being, and performance outcomes. Overall, results lend support for the effectiveness of the DISCovery method in hospital care.

Incidence rates of third party workplace violence in Europe have increased, but little is known about the causes thereof. It has been suggested that the growth of the service sector and the intensification of work could be responsible for the increase. This study aimed to identify trends in the prevalence of physical workplace violence across Europe, as well as to uncover factors explaining these trends. Three cross-sectional waves (1995, 2000, and 2005) of the European Working Conditions Survey were used, involving 58,520 workers and covering 15 European member states. Logistic regression analyses were performed to investigate associations between work characteristics and violence prevalence. Workplace violence increased significantly during the study interval. Although violence was clearly related to specific characteristics of the labour market (gender, age, sector, etc.) and the work environment (client contact frequency, time pressure, control, and computer work), recent changes in the European labour market composition and work environment could not explain the increase in violence. In jobs characterized by high levels of computer work in particular, violence appears to be an emerging risk. Our results suggest that the nature (and perhaps quality) of client contact is changing, leading to higher violence risks.

Objectives-To achieve a coherent programme of topics for research in occupational health and safety, with well founded priorities and to relate them to perceived gaps and needs in The Netherlands. Methods-In the first phase ofthe study 33 key informants were interviewed. In the second phase questionnaires were sent to 150 Dutch experts (including the key informants). Four groups were recruited, originating from: occupational health and safety services; scientific research institutes; governmental and other administrative bodies; and companies. Using the Delphi technique, the experts were asked to prioritise several topics, which were placed under different headings. In the third phase five workshops were organised to elaborate on the highly prioritised topics. Results-The response rates were 86% for the first and 81% for the second questionnaire. In the second round consistency was reached and consensus proved to be satisfactory, so that the Delphi process was stopped. There were surprisingly few differences in opinion between the four groups. The most important heading was "design/implementationlevaluation of measures", in which the topic cost-benefit analysis of measures had the highest score. "Assessment of relations between exposure and effect" was the second most important heading. Under this heading, topics on work stress were generally judged to be more important than topics on musculoskeletal disorders, which in turn had higher scores than topics on safety and biological, chemical, and physical hazards. The headings "occupational rehabilitationlsociomedical guidance" and "occupational health care/ occupational health services" had about the same priority, closely following the heading "assessment of relations between exposure and effect".Conclusions-The general agreement on priorities should provide a sufficiently broad basis for decision makers to initiate a long term programme for occupational health research and development in The Netherlands.(Occup Environ Med 1997;54:504-5 10)