Biomedical subjects

I Niedhammer

Publications and source records attributed to I Niedhammer.

At least 19 recordsLinked to original sources

PubMed2006

[The French version of the Leymann's questionnaire on workplace bullying: the Leymann Inventory of Psychological Terror (LIPT)].

BACKGROUND: Workplace bullying is considered as a major job stress factor and is associated with mental disorders. To date, there was no validated French version of the "Leymann Inventory of Psychological Terror" (LIPT), considered to be the instrument of reference. The objective of this study was to elaborate this French version and to explore its factorial, convergent and predictive validity. METHODS: The present study was based on a large sample of men and women of the working population asked to participate to a cross-sectional survey by a network of 143 occupational physicians in the South-East of France. This study included 7694 subjects, 3132 men and 4562 women, who responded to the anonymous self-questionnaire including the French version of the LIPT. This version was obtained by a standard forward/backward translation procedure. RESULTS: The LIPT allows to evaluate the 12-month prevalence of exposure to 45 forms of bullying. The analysis of an open question asking for other potentially missing forms of bullying underlined the satisfactory coverage of the LIPT. The study of the factorial validity showed a satisfactory coherence in the interpretation of the factors obtained. Leymann defined workplace bullying by the exposure to at least one form of bullying, weekly or more, and for at least six months. The convergent and predictive validity were increased when this definition was combined with the self-report of being exposed to bullying. CONCLUSION: This study is the first one elaborating and validating the French version of the LIPT by Leymann. This step of development and validation of the French version of questionnaires seems crucial to set up future high-quality studies, and to allow comparisons at the international level. Workplace bullying seems to be a serious problem in the French working life given the prevalence observed here (around 10%). Forthcoming studies should prefer using such validated questionnaire to better understand and prevent this occupational risk factor.

Adult↗

PubMed2006

[Psychometric properties of the French version of Karasek's "Job Content Questionnaire" and its scales measuring psychological pressures, decisional latitude and social support: the results of the SUMER].

Psychosocial factors at work have been found to be associated with having potential risk for adverse health effects. The main instrument used to measure these factors and their impact is the Job Content Questionnaire (JCQ) by Karasek. The objective of this study was to evaluate the psychometric properties of the French version of the JCQ, and in particular to assess its internal coherence and consistency, as well as the factorial and convergent validity of psychological demands, decisional latitude and social support at work based upon the SUMER survey, which was the first French national survey of its kind to include the JCQ. The study was based on a sample of 24, 486 workers who answered the JCQ in 2003 (96.5% response rate). Internal consistency was satisfactory, as Cronbach's alpha coefficients were observed as being higher than 0.65. Confirmatory factor analysis showed that the best model was composed of 5 latent variables: demands and pressures, the two dimensions of latitude (utilization of skills and autonomous decision-making), and the two dimensions of support (from supervisors and from colleagues). Convergent validity tests confirmed the expected association with key variables, which were: age, work status, sector of activity, occupation, job satisfaction, perception of job stress, and intent to change job. This study demonstrated satisfactory psychometric properties of Karasek's JCQ scales for the French working population.

Adult↗

PubMed2004

Incidence of shoulder pain in repetitive work.

AIMS: To determine the predictiveness of personal and occupational factors for the onset of shoulder pain in occupations requiring repetitive work. METHODS: A sample of 598 workers in five activity sectors completed a self administered questionnaire in 1993-94 and again three years later. Both questionnaires included questions about shoulder pain. The associations between various factors at baseline and subsequent shoulder pain were studied among subjects free from shoulder pain at baseline. RESULTS: The incidence of shoulder pain was associated with several independent risk factors: depressive symptoms, low level of job control, and biomechanical constraints. After adjustment for other risk factors, the presence of depressive symptoms predicted occurrence of shoulder pain. A low level of job control was also associated with the onset of shoulder pain in both sexes. For men, repetitive use of a tool was a strong predictor, while the two most important biomechanical risk factors for women were use of vibrating tools and working with arms above shoulder level. CONCLUSION: This study used a longitudinal approach to examine different sets of risk factors for shoulder pain simultaneously. The results confirm the role of several biomechanical constraints. Psychological symptoms and a low level of job control also play a role.

Adult↗

PubMed2003

Do psychosocial work factors and social relations exert independent effects on sickness absence? A six year prospective study of the GAZEL cohort.

STUDY OBJECTIVES: The objective of this prospective cohort study was to determine whether psychosocial work characteristics and social relations exert independent effects on the incidence of sickness absence in a population of middle aged French employees over six years of follow up. DESIGN: This study included 9631 men and 3595 women participating in the French GAZEL cohort. Social relations (social networks, personal social support, and social relations satisfaction) were measured in 1994 by self report. Psychosocial work characteristics (decision latitude, psychological demands, and social support at work) were ascertained in 1995. Sickness absence data were collected independently. The authors studied the incidence of short (>7 days), intermediate (7-21 days), and long (>21 days) spells of absence from 1995 to 31 December 2001. Rate ratios associated with psychosocial exposures, adjusted on sociodemographic characteristics, and health behaviours, were calculated by means of log-linear Poisson regression. SETTING: A cohort of 20000 employees of France's national gas and electricity company (the GAZEL study). MAIN RESULTS: Among men and women, levels of decision latitude and personal social support below the median predicted 17% to 24% increases in absence rates. Low satisfaction with social relations and low social support at work lead to a 10% to 26% excess in sick leaves among men. No interactive effects were found between the variables under study. CONCLUSIONS: The quality of the work environment and of social relations affect sickness absence over an extended period of follow up. This study supports the hypothesis of independent, not interactive effects.

Adult↗

PubMed2003

Psychosocial factors at work and self reported health: comparative results of cross sectional and prospective analyses of the French GAZEL cohort.

BACKGROUND: Psychosocial factors at work have been found to be significant contributors to health, especially cardiovascular health. AIMS: To explore the relation between psychosocial factors at work and self reported health, using cross sectional and prospective analyses for a large occupational cohort of men and women. METHODS: Psychosocial factors at work were evaluated using the Karasek questionnaire, designed to measure psychological demands, decision latitude, social support, and physical demands. Self reported health was used as health outcome. Covariates included chronic diseases, and sociodemographic, occupational, and behavioural factors. The cross sectional and prospective analyses concerned respectively 11 447 and 7664 workers. Men and women were analysed separately. RESULTS: Cross sectional analysis revealed significant associations between psychological demands, decision latitude, social support, and physical demands, and self reported health for both men and women. Prospective analysis showed that high psychological demands for both genders, low decision authority for men, and low social support and high physical demands for women were predictive of poor self reported health. These results were independent of potential confounding variables. CONCLUSIONS: Results highlight the predictive effects of psychosocial factors at work on self reported health in a one year follow up study. They also underline the need for longitudinal study design and separate analyses for men and women in the field of psychosocial factors at work.

Adult↗

PubMed2002

Socioeconomic position, health, and possible explanations: a tale of two cohorts.

OBJECTIVES: We examined whether the social gradient for measures of morbidity is comparable in English and French public employees and investigated risk factors that may explain this gradient. METHODS: This longitudinal study of 2 occupational cohorts-5825 London civil servants and 6818 French office-based employees-used 2 health outcomes: long spells of sickness absence during a 4-year follow-up and self-reported health. RESULTS: Strong social gradients in health were observed in both cohorts. Health behaviors showed different relations with socioeconomic position in the 2 samples. Psychosocial work characteristics showed strong gradients in both cohorts. Cohort-specific significant risk factors explained between 12% and 56% of the gradient in sickness absence and self-reported health. CONCLUSIONS: Our cross-cultural comparison suggests that some common susceptibility may underlie the social gradient in health and disease, which explains why inequalities occur in cultures with different patterns of morbidity and mortality.

Adult↗

PubMed2002

Psychosocial factors at work, personality traits and depressive symptoms. Longitudinal results from the GAZEL Study.

BACKGROUND: An association between stressful job conditions and depressive symptoms has been reported. This association could be explained by personality traits. AIMS: To examine the relationship between psychosocial factors at work and changes in depressive symptoms, taking into account personality traits. METHOD: The role of occupational characteristics, psychosocial stress and personality traits in predicting an increase of depressive symptoms was evaluated in 7729 men and 2790 women working at the French National Electricity and Gas Company, with a 3-year follow-up. RESULTS: In men, high decision latitude was predictive of a decrease in the Centre for Epidemiologic Studies - Depression scale (CES-D) scores. In both genders, high job demands and low social support at work were predictive of increased scores, irrespective of personality traits and covariates. CONCLUSIONS: Adverse psychosocial work conditions are predictors of depressive symptom worsening, independent of personality traits.

Depressive Disorder↗

PubMed2001

Socioeconomic, demographic, occupational, and health factors associated with participation in a long-term epidemiologic survey: a prospective study of the French GAZEL cohort and its target population.

The purpose of this paper is to examine personal and health factors, both at the beginning of the study and thereafter, associated with participation in the GAZEL cohort, set up in 1989 in a large French company. The authors used logistic regression to analyze the associations between participation and data available for both participants (n = 20,093) and nonparticipants (n = 24,829). Higher participation was associated with male sex, marriage, children, managerial status, and residence in particular regions. Among men, lower participation was associated with sick leave in the year before recruitment and afterwards. During follow-up, participation was negatively associated with several groups of diseases, especially those associated with alcohol consumption. The risk of upper respiratory and digestive tract and lung cancer during follow-up was higher among nonparticipants. The same phenomenon occurred among women, but less markedly, for cancers of the breast and genital organs. During follow-up, mortality among men was higher among nonparticipants, especially for alcohol-related diseases. The association among women was less strong. Among men, but not among women, diseases caused by alcohol, smoking, or dangerous behavior were the primary reason for the health differences observed between participants and nonparticipants. Overall, the most important determinants of participation were cultural factors and lifestyle behaviors.

Absenteeism↗

PubMed2001

Is there a link between subjective daytime somnolence and sickness absenteeism? A study in a working population.

A number of studies have highlighted the increasing incidence and financial cost of sleep-related disorders in the general population, but little research has been carried out on the impact of subjective daytime somnolence on health status. The existence of a survey of the health of employees of the French National Gas and Electricity Board has allowed us to investigate this question and measure the link between subjective daytime somnolence and sickness absenteeism, used here as a general health indicator. In order to evaluate the quality of sleep over the previous 3 months, a questionnaire was given to each participant. The association between subjective daytime somnolence and absence as a result of sickness was explored using the data of sickness absenteeism provided by the company's social security department during a 12-month follow-up period. Of our 1105 subjects, 6.7% reported severe subjective daytime somnolence of 3 days or more a week and 30% of our study population had at least one spell of sickness absence during the 12-month period of follow-up. A strong association was observed between subjective daytime somnolence and sickness absence, which remained significant even after adjustment for potential confounding variables (age, sex, employment grade, sleep symptoms and self-reported diseases). The odds-ratio for absence as a result of sickness during the follow-up period associated with subjective daytime somnolence of 3 days or more a week was 2.2 (95% CI: 1.3--3.8). Employees suffering from severe subjective daytime somnolence lose more working days for health reasons than their more alert colleagues. This may have long-term implications for employees' health.

Absenteeism↗

PubMed2001

Upper-limb disorders in repetitive work.

OBJECTIVES: A longitudinal study was conducted to determine the predictability of personal and occupational factors with respect to the incidence of upper-limb disorders in occupations requiring repetitive work. METHODS: A sample of 598 workers in five activity sectors completed a self-administered questionnaire; the workers were examined by an occupational health physician in 1993-1994 and 3 years later. Three disorders were considered, carpal tunnel syndrome (CTS), lateral epicondylitis and wrist tendinitis. RESULTS: The results of this longitudinal study indicated that the following three sets of risk factors independently affect the incidence of upper-limb disorders: (i) biomechanical constraints, (ii) psychosocial factors, and (iii) personal factors. The combination of risk factors differed between CTS, lateral epicondylitis, and wrist tendinitis. The presence of psychosomatic problems was a strong predictor of wrist tendinitis. Social support at work was also associated with the incidence of wrist tendinitis. The presence of depressive symptoms and other upper-limb disorders predicted the first occurrence of lateral epicondylitis. Age was associated only with epicondylitis. The results were consistent with those concerning the role of forceful movements of the elbow for epicondylitis and confirmed the role of forceful movements for CTS. CONCLUSIONS: This study considered different sets of risk factors simultaneously with a longitudinal approach, in a population with a high level of occupational exposure. The results indicate that three sets of risk factors independently affect the incidence of upper-limb disorders. In addition to biomechanical constraints, psychosocial and personal factors play a role.

Adult↗

PubMed2000

Validity of self-reported weight and height in the French GAZEL cohort.

OBJECTIVE: To examine the validity of self-reported weight and height and the resulting body mass index (BMI), and to explore the associations between demographic, socioeconomic, and health-related factors on the one hand and bias in self-reported weight and height on the other, in order to determine the groups most likely to exhibit bias. DESIGN: Prospective cohort study. SUBJECTS: 7350 middle-aged subjects, 5445 men and 1905 women, from the GAZEL cohort, who have been followed up since 1989 and work at the French national company Electricité De France-Gaz De France (EDF-GDF) in various occupations. MEASUREMENTS: Self-reported weight and height were based on information from yearly mailed questionnaires, and measured weight and height, used here as true values, were provided by occupational physicians from 1994 to 1997. Sex, age, marital status, education, occupation, history of ischemic heart disease, and treatment for cardiovascular risk factors were obtained from the mailed questionnaires or from data provided by the Company's personnel and medical departments. RESULTS: Strong correlations were found between measured and self-reported values, but self-reported weight and height displayed significant systematic errors. Weight was significantly underestimated for men (0.54 kg) and for women (0.85 kg), and height overestimated for men (0.38 cm) and women (0.40 cm). These biases led to significant underestimations of BMI (0.29 and 0.44 kg/m2 for men and women respectively). Consequently, the prevalence of overweight, defined as BMI > 26.9 kg/m2 for women and BMI > 27.2 kg/m2 for men, was also underestimated, by 13% for men and 17% for women. The five factors associated with bias in self-reported weight and height were: overweight status, end-digit preference, age, educational level and occupation. CONCLUSION: These findings suggest that self-reported weight and height should be treated with caution, because of biases leading to misclassification for overweight and obesity, especially in certain segments of the population.

Adult↗

PubMed2000

Individual and occupational determinants of low back pain according to various definitions of low back pain.

OBJECTIVES: To test associations between non-specific low back pain and several risk factors when definitions of low back pain vary. DESIGN/SETTING/PARTICIPANTS: A cross sectional study was set up in 1991, 725 workers from four occupational sectors answered a self administrated questionnaire including the Nordic questionnaire and questions about intensity of pain and individual and occupational factors. MAIN RESULTS: Prevalence of low back pain varied from 8% to 45% according to the definition used. Psychosomatic problems, bending or carrying loads were often associated to low back pain, whereas other risk factors were related to some specific dimensions of the disorder. CONCLUSIONS: Risk factors of low back pain vary with the definition. This could explain inconsistencies found in literature reviews. To be able to compare data, it seems important to be precise what definition is used and to use comparable questionnaires.

Adult↗

PubMed2000

How is sex considered in recent epidemiological publications on occupational risks?

OBJECTIVES: Although women account for almost half the working population in industrialised countries, a sex bias persists in publications on medical research in general and occupational health in particular. The objective was to review recent publications on how sex is considered in epidemiological studies of occupational health, and to answer the following questions: are men and women studied equally, what are the respective characteristics of the studies which comprise only men, only women, and both, and what strategy of data analysis is chosen by the authors to take account of the sex factor in mixed studies. MATERIALS: This review was based on publications in six journals during the year 1997, and included all the original articles reporting an epidemiological study of occupational health. RESULTS: In all, 348 articles were reviewed. In 40 articles (11%), the sex of the study population was not specified. In 177 articles (51%), the study population was mixed. In 108 (31%), the population consisted exclusively of men, and in only 23 (7%), exclusively of women. Even when study populations were mixed, they included fewer women than men. The sex composition of the population was related to the occupational risk factor considered, and also to health outcome. Industrial sector workers, and exposure to chemicals were more likely to be studied in samples of men. Mortality and health outcomes such as neoplasms and cardiovascular diseases were also more often studied among men. Surprisingly, study design differed significantly according to the sex of the population, and prospective studies, cohort studies, and exposed versus non-exposed studies were more often carried out in samples of men. Among the 177 mixed studies, sex was not investigated in over a quarter (27%). In 26 articles (15%), sex was not taken into account, but the authors attempted to justify this decision. In 46 mixed studies (26%), the results were adjusted for sex, and in 46 (26%), the authors gave separate results for men and women. In 11 studies (6%), more complete strategies of data analysis were chosen, including research for interactions or adjustment, followed by stratification. CONCLUSION: This review of recent publications in occupational health epidemiology showed that women are still less often studied than men, and that the sex factor is not investigated in many mixed studies. The results therefore underline the need for further research on occupational hazards among women, and on sex differences.

Epidemiologic Studies↗

PubMed2000

[Psychometric properties of the French version of the Effort-Reward Imbalance model].

BACKGROUND: Two main models are currently used to evaluate psychosocial factors at work: the Job Strain model developed by Karasek and the Effort-Reward Imbalance model. A French version of the first model has been validated for the dimensions of psychological demands and decision latitude. As regards the second one evaluating three dimensions (extrinsic effort, reward, and intrinsic effort), there are several versions in different languages, but until recently there was no validated French version. The objective of this study was to explore the psychometric properties of the French version of the Effort-Reward Imbalance model in terms of internal consistency, factorial validity, and discriminant validity. METHODS: The present study was based on the GAZEL cohort and included the 10 174 subjects who were working at the French national electric and gas company (EDF-GDF) and answered the questionnaire in 1998. A French version of Effort-Reward Imbalance was included in this questionnaire. This version was obtained by a standard forward/backward translation procedure. RESULTS: Internal consistency was satisfactory for the three scales of extrinsic effort, reward, and intrinsic effort: Cronbach's Alpha coefficients higher than 0.7 were observed. A one-factor solution was retained for the factor analysis of the scale of extrinsic effort. A three-factor solution was retained for the factor analysis of reward, and these dimensions were interpreted as the factor analysis of intrinsic effort did not support the expected four-dimension structure. The analysis of discriminant validity displayed significant associations between measures of Effort-Reward Imbalance and the variables of sex, age, education level, and occupational grade. CONCLUSION: This study is the first one supporting satisfactory psychometric properties of the French version of the Effort-Reward Imbalance model. However, the factorial validity of intrinsic effort could be questioned. Furthermore, as most previous studies were based on male samples working in specific occupations, the present one is also one of the first to show strong associations between measures of this model and social class variables in a population of men and women employed in various occupations.

Adult↗

PubMed1999

One-year predictive factors for various aspects of neck disorders.

STUDY DESIGN: A longitudinal epidemiologic study conducted over 12 months among active workers in different occupations. The study was primarily designed to evaluate intervention for prevention of low back and other spinal disorders. OBJECTIVE: To determine factors that predict incidence, recurrence, and persistence of neck disorders (ND), taking into account various dimensions of ND. SUMMARY OF BACKGROUND DATA: Neck pain is often supposed to have essentially the same risk factors as back pain; however, there is comparatively little data relevant to this issue. Moreover, there is a lack of prospective studies that take into account a diversity of predictive factors. METHODS: The Nordic questionnaire for the analysis of musculoskeletal symptoms was completed twice at a 12-month interval by 568 workers. Predictive factors were studied with logistic models for four dimensions of ND from the second questionnaire: 1) any ND in the past 6 months; 2) ND for more than 30 days; 3) treatment for ND; and 4) visit to a health care professional for ND. The predictive factors were obtained from the first questionnaire and included gender, age, occupational group, level of psychological distress and psychosomatic problems, and ND at baseline. RESULTS: Female gender and older age were predictors of ND. Headaches or pain in the head, psychological distress, and psychosomatic problems were predictors for all dimensions of ND. These effects were observed for both incidence and persistence of ND. CONCLUSIONS: The results emphasize the role of psychosomatic and psychological factors in the occurrence and course of ND for various dimensions of the disorder.

Adult↗

PubMed1998

Psychosocial work environment and cardiovascular risk factors in an occupational cohort in France.

STUDY OBJECTIVE: Concordant results have been reported in several studies for the effects of job stress on cardiovascular disease, but the potential mechanisms of these effects have seldom been explored. The aim of this study was therefore to examine, in women and men, the cross sectional relations between psychosocial work variables (psychological demands, decision latitude, and social support) and cardiovascular risk factors (hypertension, hyperlipidaemia, diabetes, overweight, smoking, and alcohol consumption). PARTICIPANTS: The original cohort comprised 20,625 volunteers (men aged from 40 to 50 and women from 35 to 50) employed by the French Company Electricité De France-Gaz De France and followed up yearly since 1989. The study was restricted to the 13,226 volunteers in the cohort who were still working and answered a self administered questionnaire on psychosocial work factors in 1995. DESIGN: Data were based on replies to this questionnaire. Three psychosocial work environment exposure scores were used to assess psychological demands, decision latitude, and social support at work respectively. The main outcome measures were the prevalence of hypertension, hyperlipidaemia, and diabetes within the previous 12 months, overweight, smoking, and alcohol consumption. MAIN RESULTS: Psychosocial work factors were significantly associated with hypertension, hyperlipidaemia, overweight, smoking, and alcohol consumption, but not with diabetes. In men, low decision latitude was associated with hypertension, high decision latitude and high social support with overweight, low decision latitude with alcohol consumption. Moreover, the risk of hyperlipidaemia increased in men exposed to both high psychological demands and low social support. In women, low decision latitude was related to hyperlipidaemia, high psychological demands with overweight, high psychological demands and high decision latitude with smoking, and low social support with alcohol consumption. CONCLUSIONS: These cross sectional results underline the potential effects of psychosocial work characteristics on cardiovascular risk factors and the differences between the effects of job stress in men and women, and confirm the direct mechanisms (through physiological variables) and indirect mechanisms (through behavioural risk factors) potentially involved in the relation between psychosocial work characteristics and cardiovascular disease.

Adult↗

PubMed1998

Psychosocial factors at work and sickness absence in the Gazel cohort: a prospective study.

OBJECTIVE: To test whether psychosocial factors at work are predictors of rates of sickness absence. METHODS: The study population consisted of middle aged men and women employed by the French national electricity and gas company (EDF-GDF) in various occupations and followed up since 1989 by annual self administered questionnaires and independent data obtained from the medical and personnel departments of EDF-GDF. The 1995 questionnaire provided information about three psychosocial work factors: psychological demands, decision latitude, and social support at work. Sick-ness absence data were provided by the company's social security department. The occurrence of spells and days of absence in the 12 months after completion of the 1995 questionnaire was studied. Potential confounding variables were age, smoking, alcohol, and marital status, assessed in the 1995 questionnaire, and educational level and occupation, assessed from data provided by the personnel department. This study was restricted to the 12,555 subjects of the initial cohort who were still working and answered the self administered questionnaire in 1995. RESULTS: Low levels of decision latitude were associated with more frequent and longer sickness absences among men and women. Low levels of social support at work increased the numbers of spells and days of absence among men only. These associations weakened after adjustment for potential confounding factors, but remained significant. CONCLUSION: The study indicates that psychosocial factors at work, especially decision latitude, are predictive of sickness absence.

Adult↗

PubMed1998

Psychosocial factors at work and subsequent depressive symptoms in the Gazel cohort.

OBJECTIVE: This study attempted to establish whether psychosocial factors at work are predictors of depressive symptoms in a prospective cohort of men and women employed in a wide variety of occupations by the French national company Electricité De France - Gaz De France (EDF-GDF). METHODS: This prospective cohort study followed the Gazel cohort by means of annual self-administered questionnaires and independent data obtained from the medical and personnel departments of the company. The self-administered questionnaire, in 1995, provided information about the psychosocial work environment characteristics, psychological job demands, decision latitude, and social support at work. Depressive symptoms were assessed by the Center for Epidemiologic Studies Depression (CES-D) Scale in the 1996 questionnaire. Potential confounding variables were age, marital status, and number of children, assessed in the 1995 questionnaire, stressful personal and occupational events during the previous 12 months, assessed in the 1996 questionnaire, and educational level, occupation and previous absenteeism for mental disorders, assessed from the independent data provided by EDF-GDF. The subjects were 11 552 workers (8422 men aged 46-56 years in 1995 and 3130 women aged 41-56 years) who answered the 1995 and 1996 questionnaires and were working during this period. RESULTS: High levels of psychological demands, low levels of decision latitude, and low levels of social support at work were significant predictors of subsequent depressive symptoms in both the men and the women. These results were unchanged after adjustment for potential confounding variables. CONCLUSIONS: The results strongly support the possibility that psychosocial factors at work are predictive of depressive symptoms.

Adaptation, Psychological↗