Psychosocial workplace factors and alcohol-related morbidity: a prospective study of 3 million Swedish workers

Abstract

Background Psychosocial workplace factors may be associated with alcohol-related morbidity, but previous studies have had limited opportunities to take non-occupational explanatory factors into account. The aim of this study is to investigate associations between job control, job demands and their combination (job strain) and diagnosed alcohol-related morbidity while accounting for several potentially confounding factors measured across the life-course, including education. Methods Job control, job demands and job strain were measured using the Swedish job exposure matrix measuring psychosocial workload on the occupational level linked to over 3 million individuals based on their occupational titles in 2005 and followed up until 2016. Cox regression models were built to estimate associations with alcohol-related diagnoses recorded in patient registers. Results Low job control was associated with an increased risk of alcohol-related morbidity, while high job demands tended to be associated with a decreased risk. Passive and high-strain jobs among men and passive jobs among women were also associated with an increased risk of alcohol diagnoses. However, all associations were found to be weakened in models adjusted for other factors measured prospectively over the life-course, especially in models that included level of education. Conclusion The associations between low job control and high job demands, and the risk of alcohol-related morbidity reflect underlying socioeconomic differences to some extent. Lower job control, however, remained associated with a higher risk of alcohol-related morbidity.

Job demands and job control and their associations with disability pension—a register-based cohort study of middle-aged and older Swedish workers

“…Details of the construction and its validity are described in a previous publication (Fredlund et al 2000 ), but external validation has not been possible. However, results in several recent studies using this JEM (Almroth et al 2021 ; Almroth et al 2022a , b ) were consistent with similar studies from other countries.…”

Job control, job demands and job strain and suicidal behaviour among three million workers in Sweden

“…One explanation could be that women in these occupations may have greater access to lethal means. However, in previous studies of the same population, we have also found that this group of women has an increased risk of both depression and alcohol-related morbidity,11 12 indicating that there may be unique risk factors of this specific group. Additionally, the medium-low control group tended to be more disadvantaged from baseline regarding childhood factors, mental health, education and sick leave.…”

“…Beyond such a specific circumstance, one of the most common ways of quantifying work-related psychosocial stress is the demand-control model 8. Some studies have found that the combination of low job control and high job demands (job strain) is related to adverse psychological outcomes,5 9 but job control tends to be the more consistent predictor of alcohol related morbidity,10 11 depression12 13 and suicide ideation14 in many studies. Some experts even argue that it may be job control which is driving observed associations between job strain and psychiatric outcomes 15 16…”

Ist Stress am Arbeitsplatz ein Thema für den kardiologischen Alltag? Evidenz, Erkennung und Therapie aversiver Stressbedingungen im Arbeitsumfeld

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