Psychosocial Work Stress and Health Risks - A Cross-Sectional Study of Shift Workers From the Hotel and Catering Industry and the Food Industry.

Purpose: Psychosocial work stress, and shift and night work are considered risk indicators for impaired health. Using the effort-reward (ER) model, it was possible to examine which relationships exist for shift workers between clusters (CL) of different levels of psychosocial work stress and overcommitment (OC) and cardiovascular or psychological health indicators, and which predictive value is evident in individual health indicators to explain the clusters.

Methods: The data were collected as part of an occupational health prevention program. The analysis sample consisted of 199 shift workers from alternating shift systems with and without night work (43%) (average age: 40 ± 12 years, men: 47%). Psychosocial work stress was recorded using the ER imbalance (ERI) questionnaire. To determine the clusters, ERI and OC were entered into a cluster analysis. Blood pressure, body mass index, waist-hip ratio, PROCAM score (risk of a heart attack within the next 10 years), sporting activity, and smoking were included as cardiovascular indicators, psychological wellbeing (GHQ-12) and inability to recovery (IR) (FABA) as psychological health indicators. Shift system, sex, and age were entered into the statistical analyses as control variables. Multinomial logistic regression models were used to identify health-related predictors to explain the ER-OC clusters.

Results: Three different ER-OC clusters emerged: low-stress: 36%, normal: 44%, risk: 20%. While normal psychosocial work stress is present in the low-stress and the normal CL, in the risk CL 28% of the shift workers show a health-endangering ERI and 48% show an excessive OC. No significant cluster-specific differences were determined for the cardiovascular health indicators. Rather, the known sex and age effects were confirmed and the shift system had no significant effect. Significantly more shift workers in the risk CL had impaired psychological health (18 vs. 1/6%) and an IR (52 vs. 0/12%) than in the low-stress and normal CL. IR turned out to be the strongest predictor of the explanation for the ER-OC clusters (49%).

Conclusion: IR could be assigned an independent diagnostic value for the assessment of psychosocial work stresses and discussed as a new component of occupational health screening concepts for shift workers. Independently of this, the health indicators signal an urgent need for occupational health prevention and care.