Psychosocial work environment and mental health among construction workers
Highlights
► Bricklayers experience a lack of learning opportunities, job control and future perspectives. ► Supervisors experience high psychological job demands and high need for recovery. ► A substantial part of the population is at risk for common mental disorders. ► Psychosocial work factors should be assessed job-specific. ► Job-specific screening for common mental disorders is not necessary.
Introduction
The physically demanding nature of the construction trade and the resulting health effects have been extensively studied (Holmström et al., 1995; Schneider, 2001). However, the world of work has changed over the years and has led to several new or increasingly prevalent psychosocial risks, such as new forms of employment and an intensification of work (European Agency on Safety and Health at Work, 2007). The construction industry has become more stressful in recent years (Campbell, 2006). Therefore, the influence of psychosocial risk factors should be considered when dealing with construction workers (Alavinia et al., 2007, Alavinia et al., 2009; Holmström et al., 1992a; Holmström et al., 1992b). Several theories have been developed which link psychosocial risk factors at work to consequences for the mental health of workers. The job-demand-control theory of Karasek is one of them (Karasek, 1979). The extended model of job demands, control, and support states that high demands, low control and low social support have the most negative effects on employee wellbeing (van der Doef and Maes, 1999). The central job demand in the model is a high quantitative workload. However, in the construction industry other job demands may be important predictors as well, besides doing too much work in too little time and working long hours (Beswick et al., 2007). Also commuting, having responsibility for the safety of others at work, engaging in dangerous job, the transient nature of the job and the ‘hire and fire’ culture are reported in the literature as stressors (Beswick et al., 2007). Furthermore, the financial crisis of 2008 had a great impact on employment in the construction industry worldwide. The International Labour Organization (ILO) calculated that at least 5 million construction workers had lost their jobs during 2008, and the recession continues (International Labour Office (ILO), 2009). Consequences of the recession include job insecurity and minimal job opportunities.
Some of the before mentioned psychosocial risk factors and their effects on construction workers have been studied (Alavinia et al., 2007; Holmström et al., 1992a; Holmström et al., 1992b). The construction industry, however, consists of many different jobs, each with its own specific demands and requirements. Examining the psychosocial risk factors for all construction workers ignores the diversity of experiences within the industry. When studying the psychosocial work environment among construction workers, it is important to consider the situation for a specific job or trade (Cremers, 2004). The nature and specific characteristics of the psychosocial work environment among construction occupations remain unknown.
Adverse psychosocial work environments may lead to stress-related disorders (Nieuwenhuijsen et al., 2010) or depression (Bonde, 2008) and could affect musculoskeletal health as well (Eatough et al., 2012). Although the relationship between adverse psychosocial work environments and musculoskeletal disorders has been studied among construction workers, studies focussing on mental health problems in this population are rare. Available evidence on the size and scope of the problem seems conflicting. In the Netherlands for example, the incidence of occupational mental health disorders reported by the occupational physician has increased in the construction industry from 11.2% in 2007 to 16.1% in 2010 (Netherlands Center for Occupational Diseases (NCvB), 2011). The industry had the second-highest incidence in 2010, after healthcare and social services. On the other hand, Stocks et al. (2010) found a lower incidence (4%) of mental illness among construction workers in the UK compared to all other employment sectors (as reported by clinical specialists from 2004 to 2008). Compared to other diseases or conditions, mental illness had the lowest incidence among construction workers. However, differences exist among the various construction occupations; Stattin and Järvholm (2005) found considerable variation in the risk for disability pension due to psychiatric disorders among different occupations within the construction industry.
Aside from the individual burden of common mental health disorders, work functioning in the construction industry may be critically reduced when the workers suffer from mental illness. This may lead to a higher risk of accidents and injuries on the job (Beseler and Stallones, 2010; Kim et al., 2009). Bentley et al. (2006) studied the key risk factors for slips, trips and falls. They found that such accidents are partially caused by time pressures and the need to divide attention between concurrent visual tasks, such as inspecting work progress and walking on difficult terrain. Among the other key risk factors were fatigue and poor risk perception. In other words, construction workers need psychological and mental capacities to remain concentrated and alert and to manage the variety of on-site hazards throughout the work day. These capacities are likely to be impaired when the worker suffers from mental health complaints.
A detailed assessment of both the psychosocial work environment and the prevalence of common mental health disorders in the construction industry allows for a more comprehensive understanding of the size and scope of psychosocial risk factors and mental health effects among construction occupations. Increased insight into the psychosocial and mental health risk factors of construction work can contribute substantially to selecting the most relevant interventions or actions for the workers.
The construction industry consists of over 80 different jobs. A high proportion (about 55–70%) of the workforce is made up of workers with manual skills (such as bricklayers, carpenters, electricians etc). The remaining workforce (30–45%) is in managerial roles, including managers and supervisors (Grootenboer and van der Schaaf, 2012; National Guidance Research Forum, 2012). In this cross-sectional study, we aimed to get insight into the psychosocial work environment of two very distinct construction professions adequately, the occupation of bricklayer as an example of a manual occupation and the construction supervisor as an example of a managerial occupation. The bricklayer has a repetitive job with high physical demands, whereas the construction supervisor is responsible for site management and has a job with particular high mental demands. In the present study we focused on psychosocial job characteristics which are known risk factors for work-related depression and stress: high work speed and work quantity, high mental demands, low social support, little job control, and having experienced or witnessed a serious accident (de Roos and Sluiter, 2004; Nieuwenhuijsen et al., 2010). Furthermore, we were interested in the specific stressor ‘lack of future perspective’, which might play a role among construction workers, particularly since the economic recession caused many construction workers to loose their jobs or find themselves in uncertain circumstances (International Labour Office (ILO), 2009). The stressor ‘lack of job variety’ is often mentioned for occupations involving monotonous work, which might play a role among the bricklayers specifically (Beereboom, 2005). Therefore, we decided to include job variety as a psychosocial work characteristic of interest.
The objectives of the present study are to assess the following:
- i)
the magnitude of psychosocial work characteristics;
- ii)
the prevalence of self reported mental health effects (fatigue during work, need for recovery after work, distress, depression and post-traumatic stress disorder (PTSD);
- iii)
the psychosocial factors that are associated with mental health in the different occupations.
Section snippets
Sample and sample size
A priori, the prevalence of self-reported symptoms was estimated at a maximum of 30% and in order to obtain the prevalence of symptoms with 5% precision, a sample size of 318 was calculated. In a pilot questionnaire survey, a 40% response rate in a population of bricklayers and supervisors was achieved (Boschman et al., 2011b).
In total, 750 bricklayers and 750 construction supervisors were randomly selected from a Dutch registry comprised of all employed Dutch construction workers. The random
Psychosocial work characteristics
In Table 2 scores on psychosocial work characteristics are presented as well as the comparison of the score to the general Dutch working population. Compared with the general Dutch working population, the bricklayers experienced a lack in job control, learning opportunities and future perspectives. On the other hand, the bricklayers appraised their relationship with colleagues better than the general population. With regard to work speed and quantity, 17% of the bricklayers exceeded the cut-off
Findings
The psychosocial work environment of bricklayers and construction supervisors differed on the following aspects compared to the general working population: the bricklayers experienced worse job control, learning opportunities and future perspective. Among the construction supervisors it was found that their mental demands are higher compared to the general working population. Among both occupations, high job demands are associated with symptoms of depression. Low participation in decision
Authors' contributions
JB is responsible for data collection, statistical analysis and drafted the manuscript. All authors conceived and designed the study, read and corrected draft versions of the manuscript and approved the final manuscript. HM, JS and MF-D obtained funding for this study. JS and MF-D were the co-principal investigators.
Acknowledgements
This study is partly granted by Arbouw, Dutch Health & Safety Institute in the Construction Industry.
References (54)
- et al.
Understanding the link between psychosocial work stressors and work-related musculoskeletal complaints
Appl. Ergon.
(2012) - et al.
Impact of work-related factors, lifestyle, and work ability on sickness absence among Dutch construction workers
Scand. J. Work Environ. Health
(2009) - et al.
Influence of work-related factors and individual characteristics on work ability among Dutch construction workers
Scand. J. Work Environ. Health
(2007) The Bricklayer
(2005)- et al.
Investigating risk factors for slips, trips and falls in New Zealand residential construction using incident-centred and incident-independent methods
Ergonomics
(2006) - et al.
Safety knowledge, safety behaviors, depression, and injuries in Colorado farm residents
Am. J. Ind. Med.
(2010) - et al.
An Analysis of the Prevalence and Distribution of Stress in the Construction Industry
(2007) Psychosocial factors at work and risk of depression: a systematic review of the epidemiological evidence
Occup. Environ. Med.
(2008)- et al.
Occupational demands and health effects for bricklayers and construction supervisors: a systematic review
Am. J. Ind. Med.
(2011) - et al.
Response rate of bricklayers and supervisors on an internet or a paper-and-pencil questionnaire
Int. J. Ind. Ergon.
(2011)
Validation study of a distress screener
J. Occup. Rehabil.
Sickness absence and early retirement on health grounds in the construction industry in Ireland
Occup. Environ. Med.
Monitor Arboconvenanten: kengetallen en grenswaarden
Tijdschrift voor Bedrijfs- en Verzekeringsgeneeskunde
De Schok Verwerkings Lijst
Nederlands Tijdschrift voor de Psychol.
Perceived job insecurity and health: the Michigan recession and recovery study
J. Occup. Environ. Med.
Occupational Stress in the Construction Industry
Stress in the European Construction Sector: Up-to-the-minute?
Stressful work, psychological job strain, and turnover: a 2-year prospective cohort study of truck drivers
J. Appl. Psychol.
Depressie als beroepsziekte: Identificatie van werkgebonden psychosociale risicofactoren uit de landelijke registratie en een systematisch literatuuronderzoek
Tijdschrift voor Bedrijfs- en Verzekeringsgeneeskunde
Expert Forecast on Emerging Psychosocial Risks Related to Occupational Safety and Health
Vitaliteit: van feit tot beleid: Inventariserend onderzoek
Musculoskeletal disorders in construction workers
Occup. Med.
Low back and neck/shoulder pain in construction workers: occupational workload and psychosocial risk factors. Part 1: relationship to low back pain
Spine (Phila Pa. 1976 )
Low back and neck/shoulder pain in construction workers: occupational workload and psychosocial risk factors. Part 2: relationship to neck and shoulder pain
Spine (Phila Pa. 1976 )
Monitoring working conditions and health of older workers in Dutch construction industry
Am. J. Ind. Med.
Impact of Event Scale: a measure of subjective stress
Psychosom. Med.
Posttraumatic stress disorder in co-workers following exposure to a fatal construction accident in China
Int. J. Occup. Environ. Health
Cited by (0)
- 1
JKS and MF-D were the co-principal investigators on this project.