title: [Occupational injuries and sickness absence: association with job demand, decision latitude, and life style in 2174 workers in the Veneto Region].
abstract: BACKGROUND
  Stress was the most frequent (26,9%) health problem reported in a survey on the perception of working and health conditions in 5000 workers in the Veneto Region.
  
  
  OBJECTIVE
  The aim of the study was to investigate in the Veneto Region the association between occupational stress and events occurred in the previous 12 months: occupational accidents, or sickness absence for 10 or more consecutive days.
  
  
  METHODS
  Perceived occupational stress is correlated, according to Karasek's model, to high job demand (JD) and low decision latitude (DL). Using Karasek's questionnaire (to which questions on smoking and alcohol consumption were added), we examined 2174 subjects working in 30 companies with between 10 and 500 employees, who belonged to the occupational categories of industry and services that are more prevalent in the Veneto Region. The questionnaire was administered by the occupational physician during health surveillance. The subjects were classified on the basis of current exposure to psychosocial factors or, for subjects reporting an event, their exposure at that time. We identified the tertiles of JD and DL; data were submitted to the analysis of multiple logistic regression, estimating odds ratio (OR) and 95% confidence interval (CI). The population attributable risk (PAR) was calculated using the formula (pc (OR-1)/OR), where pc is the fraction of exposed cases.
  
  
  RESULTS
  An elevated risk of occupational accidents was found in subjects with regular consumption of alcohol (OR = 2.0; IC = 1.2-3.5), in smokers smoking 10-20 (2.3; 1.3-3.8) or >20 cigarettes/day (3.8; 1.8-7.9), in the highest tertile of JD (2.29; 1.35-3.89) and in the lowest tertile of DL (1.6; 1.0-2.6). PAR was 37.6% for occupational factors (high JD and low DL), 44.5%for non-occupational factors (cigarette smoking and alcohol consumption), and 82.1% overall. The risk of sickness absence increased in subjects smoking 10-20 cigarettes (1.63 = 1.1-2.40), in the highest tertile of JD (1.5; 1.0-2.2) and in the lowest tertile of DL (1.6; 1.1-2.2). PAR was 26.1% for occupational factors (high JD and low DL), 7.6% for non-occupational factors (smoking), and 30.4% overall. While the risk of sick absence increased mainly with the reduction of DL, the risk of occupational accidents increased with increasing JD and, to a lesser extent, with decreasing DL. The current approach to accident prevention is based only on technical and administrative aspects, in spite of the fact that 80% of accidents are not attributable to malfunctioning of machinery. Injury prevention should address technical, personal and psychosocial risk factors together as a whole.
authors.affiliation: Dipartimento di Medicina Ambientale e Sanità Pubblica, Università degli Studi di Padova. giuseppe.mastrangelo@unipd.it
authors.forename: G
authors.initials: G
authors.lastname: Mastrangelo
authors.forename: S
authors.initials: S
authors.lastname: Mattioli
authors.forename: A
authors.initials: A
authors.lastname: Baldasseroni
authors.forename: D
authors.initials: D
authors.lastname: Bontadi
authors.forename: E
authors.initials: E
authors.lastname: Capodicasa
authors.forename: Vita
authors.initials: V
authors.lastname: Marzia
authors.forename: Maddalena
authors.initials: M
authors.lastname: Mazzi
authors.forename: P
authors.initials: P
authors.lastname: Patané
authors.forename: Paola
authors.initials: P
authors.lastname: Torri
authors.forename: G
authors.initials: G
authors.lastname: Marangi
authors.forename: Emanuela
authors.initials: E
authors.lastname: Fadda
authors.forename: G
authors.initials: G
authors.lastname: Priolo
authors.forename: L
authors.initials: L
authors.lastname: Scoizzato
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Maier
authors.forename: G
authors.initials: G
authors.lastname: Campo
authors.forename: L
authors.initials: L
authors.lastname: Marchiori
mesh_terms: D000041:Absenteeism; D000062:Accidents, Occupational / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology; D004868:Equipment Failure / Q000706:statistics & numerical data; D005260:Female; D006306:Health Surveys; D006801:Humans; D007558:Italy / Q000453:epidemiology; D007587:Job Description; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology*; D016273:Occupational Exposure; D012907:Smoking / Q000453:epidemiology; D013312:Stress, Physiological / Q000453:epidemiology