title: Organisational downsizing and work stress: testing synergistic health effects in employed men and women.
abstract: OBJECTIVE
  To systematically study the separate and combined effects of organisational downsizing and work related stress on a measure of health in "survivors of layoffs".
  
  
  METHODS
  Using Rothman's approach, separate and combined effects of the two exposures in estimating the risk of poor self rated health (work related symptoms) are analysed in a large sample of male and female employees.
  
  
  METHODS
  0.1% cross sectional sample of the German working population.
  
  
  METHODS
  12 240 men and 10 319 women, aged 16 to 59 years, surveyed in 1998-1999.
  
  
  RESULTS
  Compared with the reference group, the group of participants who were simultaneously exposed to downsizing and work related stress (effort-reward imbalance) exhibited odds ratios (OR) of three or more work related symptoms that were by far higher (OR 4.41 in men and OR 5.37 in women) than those associated with single exposures. Altogether 21% (men) and 31% (women) of the effect size of the combined exposure was attributable to synergistic interaction.
  
  
  CONCLUSIONS
  Although reduced health associated with organisational downsizing is partly attributable to an increase in work related stress these findings show an additional synergy effect produced by the combined exposure to both conditions.
authors: Department of Medical Sociology, University of Duesseldorf, PO Box 10 10 07, D-40001 Duesseldorf, Germany. dragano@uni-duesseldorf.de
authors: Nico
authors: N
authors: Dragano
authors: Pablo Emilio
authors: PE
authors: Verde
authors: Johannes
authors: J
authors: Siegrist
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D004651:Employment; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology / Q000209:etiology*; D016017:Odds Ratio; D020415:Personnel Downsizing / Q000523:psychology*; D012737:Sex Factors; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000453:epidemiology / Q000209:etiology*