title: Job strain and other work conditions: relationships with psychological distress among civil servants in Rio de Janeiro, Brazil.
abstract: BACKGROUND
  In developing countries, traditional sources of employment and work practices have changed rapidly and work environment has appeared as an important factor associated with an increased prevalence of mental disorders in these countries.
  
  
  OBJECTIVE
  To investigate the association between job strain and other work characteristics with psychological distress, and to estimate the contextual effects of different working environments on psychological distress, using cross-sectional data from an occupational cohort.
  
  
  METHODS
  The subjects were 3,574 non-faculty civil servants working at university campuses in Rio de Janeiro, Brazil (Pró-Saúde Study). Psychological distress was measured by the 12-item General Health Questionnaire. Work characteristics were measured by the modified version of the Karasek model and through questions about night shift work and occupational status.
  
  
  RESULTS
  After adjusting for age, education, income and other work characteristics, low social support at work and high job strain were associated with psychological distress. For low social support, the association was stronger in men (Prevalence Ratio = 2.02; 95% Confidence Interval 1.6-2.6) than in women (PR = 1.46; 95% CI 1.2-1.4). High job strain was similarly significant in both women (PR = 1.43; 95% CI 1.2-1.7) and men (PR = 1.30; 95% CI 1.0-1.7). Men having a routine non-manual work presented 29% more psychological distress than those undertaking professional roles. Night shift work did not show significant association with psychological distress. In the multilevel analysis, the prevalence of psychological distress did not vary significantly across work units.
  
  
  CONCLUSIONS
  Job strain and poor support at work seem important psychological stressors in the workplace in Brazil. Our findings are comparable to those found in more developed countries, providing additional evidence of an association between an adverse psychosocial work environment and psychological distress, being thus useful for policymakers in planning and promoting healthier and happier working force necessary for economic development.
authors.affiliation: Department of Epidemiology, Institute of Social Medicine, State University of Rio de Janeiro, Rua São Francisco Xavier 524, 7 degrees andar, Rio de Janeiro, RJ, 20550-900, Brazil. lopes@ims.uerj.br
authors.forename: Claudia S
authors.initials: CS
authors.lastname: Lopes
authors.forename: Ricardo
authors.initials: R
authors.lastname: Araya
authors.forename: Guilherme L
authors.initials: GL
authors.lastname: Werneck
authors.forename: Dóra
authors.initials: D
authors.lastname: Chor
authors.forename: Eduardo
authors.initials: E
authors.lastname: Faerstein
mesh_terms: D001938:Brazil / Q000453:epidemiology; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D057217:Economic Development; D004651:Employment / Q000523:psychology; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D009784:Occupational Diseases / Q000453:epidemiology / Q000523:psychology; D015995:Prevalence; D012737:Sex Factors; D012944:Social Support; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000453:epidemiology* / Q000523:psychology; D011795:Surveys and Questionnaires; D014937:Work / Q000523:psychology*; D014940:Work Schedule Tolerance; D016526:Workload / Q000523:psychology; D017132:Workplace / Q000523:psychology