Fractions of cardiovascular diseases, mental disorders, and musculoskeletal disorders attributable to job strain.

Objectives: The aim of this study was to evaluate fractions of diseases attributable to job strain defined using Karasek's model among the French working population for cardiovascular diseases (CVD), mental disorders, and musculoskeletal disorders (MSD).

Methods: Job strain was defined as the combination of high psychological demands and low decision latitude. The prevalence of exposure (P (e)) was estimated using the representative national sample of 24,486 employees of the French SUMER survey. Relative risks (RR) were estimated from a literature review (1990-2008) using the same inclusion criteria for the three health outcomes. P (e) and RR estimates were used to calculate attributable fractions (AF).

Results: P (e) estimates were 19.6% for men, 28.2% for women, and 23.2% for men and women combined. The literature review led to a selection of 13 studies for CVD, 7 studies for mental disorders, and 11 studies for MSD. RR estimates were 0.63-2.45 for CVD (morbidity and mortality), 1.2-3.3 for mental disorders, and 0.94-2.3 for MSD. AF estimates for CVD morbidity were 4.9-21.5% for men, 0-15.9% for women, and 6.5-25.2% for men and women combined, for CVD mortality 7.9-21.5% for men, 2.5% for women, and 6.5-25.2% for men and women combined, for mental disorders 10.2-31.1% for men, 5.3-33.6% for women, and 6.5% for men and women combined, and for MSD 0-19.6% for men, 0-26.8% for women, and 3.4-19.9% for men and women combined.

Conclusion: This study is the first one to provide fractions of diseases attributable to job strain for three health outcomes in France on the basis of a systematic review of the literature. These results could contribute to the estimation of the economic cost of diseases attributable to job strain.