Taking account of sex and gender in occupational health studies poses statistical challenges. Other sociodemographic variables, such as racialization, class, and age, also affect the relations between workplace exposures and health and interact with sex and gender. Our objective was to perform a critical review of conventional and emerging statistical tools, examining whether each analysis takes account of sociodemographic variables (1) in a way that contributes to identification of critical occupational determinants of health (2) while taking account of relevant population characteristics to reflect intersectional approaches to health and (3) using sample sizes and population characteristics available to researchers. A two-step search was conducted: (1) a scientific watch concerning the statistical tools most commonly used in occupational health over the past 20 years; (2) a screening of the 1980–2022 literature with a focus on emerging tools. Our examination shows that regressions with adjustment for confounders and stratification fail to reveal the sociodemographic mechanisms that interact with occupational health problems, endangering the identification of occupational risks. Multilevel (notably MAIHDA) analyses, decision tree, cluster, and latent analyses are useful methods to consider when seeking to orientate prevention. Researchers should consider methods that adequately reveal the mechanisms connecting sociodemographic variables and occupational health outcomes.

Work-related musculoskeletal disorders (WMSD) represent a major public health problem and economic burden to employers, workers and health insurance systems. This systematic review had two objectives: (1) to analyze the cost-benefit results of organizational-level ergonomic workplace-based interventions aimed at preventing WMSD, (2) to explore factors related to the implementation process of these interventions (obstacles and facilitating factors) in order to identify whether economic results may be due to a successful or unsuccessful implementation. Systematic review. Studies were searched in eight electronic databases and in reference lists of included studies. Companion papers were identified through backward and forward citation tracking. A quality assessment tool was developed following guidelines available in the literature. An integration of quantitative economic results and qualitative implementation data was conducted following an explanatory sequential design. Out of 189 records, nine studies met selection criteria and were included in our review. Out of nine included studies, grouped into four types of interventions, seven yielded positive economic results, one produced a negative result and one mixed results (negative cost-effectiveness and positive net benefit). However, the level of evidence was limited for the four types of interventions given the quality and the limited number of studies identified. Our review shows that among the nine included studies, negative and mixed economic results were observed when the dose delivered and received by participants was low, when the support from top and/or middle management was limited either due to limited participation of supervisors in training sessions or a lack of financial resources and when adequacy of intervention to workers’ needs was low. In studies where economic results were positive, implementation data showed strong support from supervisors and a high rate of employee participation. Studies investigating the determinants of financial outcomes of prevention related to implementation process are very seldom. We recommend that in future research economic evaluation should include information on the implementation process in order to permit the interpretation of economic results and enhance the generalizability of results. This is also necessary for knowledge transfer and utilization of research results for prevention-oriented decision-making in occupational health and safety.

Work stress has become a major occupational risk factor in industrialized countries and an important economic issue. The objective was to estimate the annual costs of coronary heart diseases (CHD) and mental disorders (MD) attributable to job strain exposure according to Karasek’s model in France for the year 2003 from a societal perspective.

Adverse psychosocial work factors are recognized as a significant source of psychological distress, resulting in a considerable socioeconomic burden. The impact of occupational health standards that aim to reduce these adverse work factors, such as the Quebec Healthy Enterprise Standard (QHES), is of great interest for public health. The aim of this study was to evaluate, for the first time, the effect of QHES interventions targeting adverse psychosocial work factors on the prevalence of these factors and of psychological distress among ten Quebec organizations. These outcomes were assessed by questionnaire using validated instruments before (T1, n = 2849) and 2–3 years following (T2, n = 2560) QHES implementation. Beneficial effects of interventions were observed for two adverse psychosocial work factors: low rewards (ratio of prevalence ratios (PRs) = 0.77, 95% CI = 0.66–0.91) and low social support at work (ratio of PRs = 0.89, 95% CI = 0.77–1.03). Moreover, beneficial effects of interventions were also observed on the prevalence of high psychological distress (ratio of PRs = 0.86, 95% CI = 0.75–0.998). Psychosocial interventions implemented in the context of this standard improved the psychosocial work environment and had beneficial effects on workers’ mental health.

Background: This study aimed to estimate the annual burden of cardiovascular diseases and depression attributable to five psychosocial work exposures in 28 European Union countries (EU28) in 2015. Methods: Based on available attributable fraction estimates, the study covered five exposures, job strain, effort–reward imbalance, job insecurity, long working hours and workplace bullying; and five outcomes, coronary/ischemic heart diseases (CHD), stroke, atrial fibrillation, peripheral artery disease and depression. We estimated the burden attributable to each exposure separately and all exposures together. We calculated Disability-Adjusted Life Years (DALY) rate per 100 000 workers in each country for each outcome attributable to each exposure and tested the differences between countries and between genders using the Wald test. Results: The overall burden of CHD attributable to the five studied psychosocial work exposures together was estimated at 173 629 DALYs for men and 39 238 for women, 5092 deaths for men and 1098 for women in EU28 in 2015. The overall burden of depression was estimated at 355 665 DALYs for men and 305 347 for women (respectively 3931 and 912 deaths). The three highest burdens in DALYs in EU28 in 2015 were found for depression attributable to job strain (413 938 DALYs), job insecurity (223 200 DALYs) and workplace bullying (209 306 DALYs). Significant differences between countries were observed for DALY rates per 100 000 workers. Conclusions: Such results are necessary as decision tools for decision-makers (governments, employers and trade unions) when defining public health priorities and work stress preventive strategies in Europe.

Purpose: Although awareness is growing of the importance of employee mental health and the value of inclusive work practices, less is known about how to support employees with mental illness (MI). We aimed to explore organizational strategies and work practices that promote retention and support of employees living with MI in relation to past theory-driven research by building and extending current theory.Design/methodology/approach: We adopted a qualitative case-study approach focussed on organizations that have taken steps towards promoting workplace inclusion for employees with MI. Five diverse Canadian organizations were recruited based on their efforts to build psychologically safe and healthy workplaces, and actively support employees with MI. Data collection in each organization consisted of onsite observation and interviews with workplace stakeholders, including employees with MI, their co-workers, supervisors/managers and human resource professionals. Thirty interviews were conducted from across the five organizations. Data analysis was informed by interpretive description to identify challenges and opportunities.Findings: Two key themes were noted in depictions of supportive workplaces: (1) relationship-focussed workplaces and (2) flexible, inclusive work practices.Originality/value: These practices highlight how organizations support employees with MI. Despite our focus on organizations working towards inclusion, the stigma associated with MI and the rigidity of some workplace processes continue to limit support and retention. Our findings suggest that organizations should focus on communication processes, support mechanisms, how they reinforce flexibility, inclusion and oversight of employees with MI.