Conflict between the work and family domains and exhaustion among vocationally active men and women

Exhaustion is consistently found to be more prevalent in women than in men. Women suffer from job strain more often, which may constitute a partial explanation for this phenomenon, but experienced shortcomings in combining work and family demands may also contribute to ill health. The aim of this study was to investigate, and analyse by gender, how work-related and family-related factors, as well as the interface between them, i.e. work-to-family conflict (WFC) and family-to-work conflict (FWC), are related to exhaustion. The study was cross-sectional with self-administered questionnaires assessing exposures and outcome with previously well-validated instruments. The participants were 2726 men and 2735 women, aged 45-64, vocationally active, and residing in Malmö, Sweden. Sixteen percent of the women and 8% of the men considered themselves exhausted. WFC, FWC, job strain, and low job support were all strongly correlated to exhaustion in both genders. In the multivariate analyses, adjusting for other work and family risk factors, WFC and FWC remained statistically significant risk factors for exhaustion in both men and women. Job strain, low job support, and having a somatic disorder were also independently associated with exhaustion. While WFC was more prevalent among men, it was more strongly associated with exhaustion in women than in men. In women, WFC and FWC contributed to a larger part of the explanatory power of the model, which amounted to 22% of the variance in women and 14% in men. The results imply that the concept of 'work stress' should be regarded in a wider context in order to understand gender related issues of exhaustion among vocationally active individuals

Psychosocial working conditions and exhaustion in a working population sample of Swedish middle-aged men and women

BACKGROUND: Exhaustion is a concept of interest for both occupational health research and stress-disease theory research. The aim of the present study was to explore associations between chronic stressors, in terms of psychosocial working conditions, and exhaustion in a Swedish middle-aged population sample. METHODS: A vocationally active population sample of the Malmö Shoulder and Neck Study cohort, comprising 2555 men and 2466 women between 45 and 64 years of age, was used. Psychosocial working conditions, assessed by means of the demand-control-support model, were measured longitudinally with a 1-year interval. Exhaustion was assessed by the SF-36 vitality scale and measured at follow-up, yielding a cross-sectional study design. RESULTS: Exhaustion was twice as common in women as in men. High psychological job demands, low job control and low job support were independently associated with exhaustion in both men and women. These associations remained after controlling for a variety of potential confounders and mediators, including socio-demographic factors, lifestyle factors, musculoskeletal pain, disease, other work-related factors (including physical workload) and non-work-related factors. High demands in combination with low control (job strain), and job strain combined with low job support (iso-strain), increased the risk for exhaustion. CONCLUSION: Psychosocial working conditions seem to contribute to exhaustion in middle-aged men and women. Future research should include exploration of exhaustion as a possible mediator between work stress and disease, as well as exploration of other chronic stressors, including non-work-related stressors, regarding their effects on exhaustion in men and women

Sleeping Problems as a Risk Factor for Subsequent Musculoskeletal Pain and the Role of Job Strain:Results from a One-Year Follow-Up of the Malm Shoulder Neck Study Cohort

BACKGROUND: The role of sleeping problems in the causal pathway between job strain and musculoskeletal pain is not clear. Purpose: To investigate the impact of sleeping problems and job strain on the one-year risk for neck, shoulder, and lumbar pain. METHOD: A prospective study, using self-administered questionnaires, of a healthy cohort of 4,140 vocationally active persons ages 45-64, residing in the city of Malmo. RESULTS: At follow-up, 11.8% of the men and 14.8% of the women had developed pain. The odds ratios (OR) for pain at follow-up and sleeping problems at baseline were 1.72 (95% CI: 1.13-2.61) in men and 1.91 (1.35-2.70) in women. Regarding exposure to job strain, ORs were 1.39 (0.94-2.05) for men and 1.63 (1.18-2.23) for women. These statistically significant risks remained so when controlled for possible confounding. A modest synergistic effect was noted in women with concurrent sleeping problems and job strain, but not in men. CONCLUSION: One in 15-20 of all new cases of chronic pain in the population could be attributed to sleeping problems. No evidence was found for a causal chain with job strain leading to musculoskeletal pain by the pathway of sleeping problems

Gender and regional differences in perceived job stress across Europe

Background: Over the last 20 years stress at work has been found to be predictive of several conditions such as coronary heart disease, high blood pressure and non- specific sick leave. The Karasek demand/ control/ strain concept has been the most widely used in prospective epidemiological studies. Objectives: To describe distribution in Karasek's demand/ control ( DC) dimensions as well as prevalence of strain in samples from different parts of Europe grouped into three regions ( South, Middle, Sweden), adjusting for occupation. To describe gender differences in Karasek's DC dimensions along with strain prevalence and assess the regional stability of those differences in different occupational groups. Design: The Job stress, Absenteeism and Coronary heart disease in Europe ( JACE) study, a Concerted Action ( Biomed I) of the European Union, is a multicentre prospective cohort epidemiological study: 38,019 subjects at work aged 35 - 59 years were surveyed at baseline. Standardised techniques were used for occupation coding ( International Standardised Classification of Occupations) and for the DC model ( Karasek scale): five items for the psychological demand and nine items for the control or decision latitude dimensions, respectively. Results: A total of 34,972 subjects had a complete data set. There were important regional differences in the Karasek scales and in prevalence of strain even after adjustment for occupational class. Mean demand and control were higher in the Swedish centres when compared to two centres in Milano and Barcelona ( Southern region) and values observed in four centres ( Ghent, Brussels, Lille and Hoofddorp) in Middle Europe were closer to those observed in the Southern cities than to those obtained in the Swedish cities. Clerks ( ISCO 4) and, more specifically, office clerks ( ISCO 41) exhibited the smallest regional variation. In a multivariate model, the factor ` region' explained a small fraction of total variance. In the two Southern centres as well as in the four Middle European centres, men perceived marginally less job- demand as compared to women whereas the reverse was observed in the two Swedish centres. Differences were larger for control: men appeared to perceive more control at work than did women. In a multivariate model, gender explained a small fraction whereas occupational level explained a large fraction of the variance. Conclusions: In this standardised multicentre European study Karasek's DC model showed large gender and occupational differences whereas geographic region explained a small fraction of the total DC variance, notwithstanding large differences in labour market and working conditions as pointed out by the European Commission as recently as 2000