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BackgroundPrevious research has reported that sexual harassment can lead to reduced mental health. Few studies have focused on sexual harassment conducted by clients or customers, which might occur in person-related occupations such as eldercare work, social work or customer service work. This study examined the cross-sectional association between sexual harassment by clients or customers and depressive symptoms. We also examined if this association was different compared to sexual harassment conducted by a colleague, supervisor or subordinate. Further, we investigated if psychosocial workplace initiatives modified the association between sexual harassment by clients or customers and level of depressive symptoms.MethodsWe used data from the Work Environment and Health in Denmark cohort study (WEHD) and the Work Environment Activities in Danish Workplaces Study (WEADW) collected in 2012. WEHD is based on a random sample of employed individuals aged 18–64. In WEADW, organizational supervisors or employee representatives provided information on workplace characteristics. By combining WEHD and WEADW we included self-reported information on working conditions and health from 7603 employees and supervisors in 1041 organizations within 5 occupations. Data were analyzed using multilevel regression and analyses adjusted for gender, age, occupation and socioeconomic position.ResultsExposure to workplace sexual harassment from clients or customers was statistically significantly associated with a higher level of depressive symptoms (2.05; 95% CI: 0.98–3.12) compared to no exposure. Employees harassed by colleagues, supervisors or subordinates had a higher mean level of depressive symptoms (2.45; 95% CI: 0.57–4.34) than employees harassed by clients or customers. We observed no statistically significant interactions between harassment from clients and customers and any of the examined psychosocial workplace initiatives (all p > 0.05).ConclusionsThe association between sexual harassment and depressive symptoms differed for employees harassed by clients or customers and those harassed by colleagues, supervisors or subordinates. The results underline the importance of investigating sexual harassment from clients or customers and sexual harassment by colleagues, supervisors or subordinates as distinct types of harassment. We found no modification of the association between sexual harassment by clients or customers and depressive symptoms by any of the examined psychosocial workplace initiatives.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-017-4669-x) contains supplementary material, which is available to authorized users.

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Background Sexual harassment is a complex phenomenon and our knowledge is hampered by a lack of consensus on the definition and measurement. However, workplaces need reliable instruments that provide a nuanced understanding of sexual harassment and input for action to mitigate negative consequences. The aim of this project is to help workplaces prevent and manage sexual harassment, which include developing a new and comprehensive instrument to monitor sexual harassment (Inventory of Workplace Sexual Harassment). In this abstract, we explain the process of designing the questionnaire. Methods The design process follows three steps: (1) Identification of a theoretical and conceptual framework, (2) item development and (3) field testing. First, we identified relevant theoretical and conceptual frameworks, which we discussed with an expert group consisting of researchers and stakeholders (employer and trade unions). Second, we developed items based on expert inputs and previous surveys. We adapted the first version of the questionnaire following a feedback round with the expert group. Third, we will complete field testing in 2019-2020. Field testing encompasses cognitive interviews (n = 15) and in-depth interviews with men and women exposed to sexual harassment to assess clarity and relevance (in 2019), and a pilot study at 15 workplaces to assess prevalence and usability (in 2020). Results Based on the theoretical and conceptual model from Fitzgerald et al, we developed a preliminary version, consisting of 22 items that cover three domains: (1) unwanted sexual attention, (2) gender harassment and (2) sexual coercion. The survey draws on questions from SEQ-DoD and Bergen Sexual Harassment Scale. Results from field testing will be available for the conference. Conclusions The Inventory of Workplace Sexual Harassment will provide a comprehensive and validated measurement of workplace sexual harassment and will help workplaces prevent and manage sexual harassment. Key messages Sexual harassment is a complex and multifaceted phenomenon, but our knowledge is hampered by a lack of consensus on the definition and measurement. This study contributes with a new instrument measuring the prevalence of workplace sexual harassment and tools for prevention and management of sexual harassment.