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Associations of job strain, isostrain, and job insecurity with cardiovascular risk factors and productivity in Mexican workers

Abstract

Occupational psychosocial factors have been associated in previous research with cardiovascular diseases and low productivity. The paucity of data from developing economies including Mexico hampers the development of worksite intervention efforts in those regions. This study assessed the prevalence of psychosocial job factors (job strain, isostrain, their subdomains, and job insecurity) and their cross-sectional associations with cardiovascular risk factors and productivity in a sample of 2,330 Mexican workers drawn from different companies.

Psychosocial and biological cardiovascular risk factors were evaluated by questionnaire and on-site physical examinations. Psychosocial job factors were ascertained by the Job Content Questionnaire. Sick-leave absenteeism data were collected from personnel records from the Mexican Institute of Social Security and presenteeism was assessed using the eight-item version of the Work Limitations Questionnaire. Associations between psychosocial job factors, biological cardiovascular risk factors, and productivity indicators were examined in multiple regression models, adjusting for physical workload and socio-demographic factors.

Overall, and in agreement with our hypotheses, psychosocial job factors had a negative impact on blood glucose, total blood cholesterol levels, smoking, leisure-time physical activity, and productivity indicators. Mixed associations were found between psychosocial job factors and overweight/obesity indicators and blood pressure. Social support (in particular supervisor support) was protective against high total blood cholesterol levels, overweight/obesity, and smoking, and promoted leisure-time physical activity.

Our study makes a unique contribution by evaluating within the same study population the effects of alternative operationalizations of psychological demands and decision latitude scales based on factor analysis and addressing the possibility that some of the original scales may have been interpreted as physical rather than psychosocial job factors. In fact, when considering fully adjusted models, the alternative versions predicted the outcomes better than the original versions, and showed better agreement to the literature and to our hypotheses than the original versions.

Taking into consideration the overall results of this study, which point to a harmful effect of psychosocial stressors on cardiovascular risk factors and a protective effect of social support on most outcomes, we conclude that interventions at the worksite level are needed to reduce psychosocial stressors and improve workers' cardiovascular health and productivity.

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