Relationships of demandingwork conditions with fatigueand psychotropic drug use:A community-based study
Lorhandicap group:N Chau, JF Ravaud, E Bourgkard, J Sanchez, M Choquet,JP Meyer, C Otero Sierra,JP Michaely, B Legras, F Guillemin,A Bhattacherjee, S Guillaume, A Dazord,L Méjean, N Tubiana-Rufi, Y Schléret, JM MurINRS, Département Epidémiologie en Entreprises, Vandoeuvre-lès-Nancy, Inserm U420, INRS, Inserm U472, Inserm U502-CERMES, IFR25-RFRH, Script-Inserm, EA 3444, LIM, Hôpital Robert Debré APHP, CTNERHI, ORSAS (France), and Indian Institute of Technology (India)
Investigation supported by the European Pole for Health
Epicoh 2004 – Melbourne, 13-15 October 2004
Objective
Demanding work conditions with multiple hazards can increase psychotropic drug use
Assessment of the relationships of demanding work conditions with regular psychotropic drug use among employed people
Epicoh 2004 – Melbourne, 13-15 October 2004
Materials and methodsThe sample: All subjects aged 15 or more from 8,000 households randomly selected from the Lorraine (north-eastern France)
Mailed self-administrated questionnaire: • socio-demographical characteristics, smoking habit, alcohol use • highly demanding occupational hazards • regular psychotropic drug use (fatigue, headache, sleeplessness, nervousness or anguish)
Epicoh 2004 – Melbourne, 13-15 October 2004
Study protocol
(a) A request of participation by means of a questionnaire to ascertain the number of people in the household
(b) Sending out standardized auto-questionnaires with a covering letter and a pre-paid envelope for reply
(c) Sending a reminding letter without questionnaire
(d) Sending questionnaires with a covering letter and a pre-paid envelope
Communications addressed to the households at one month intervals
The results were expressed in terms of adjusted odds ratios
Epicoh 2004 – Melbourne, 13-15 October 2004
Results
7,807 households contacted (193 communications lost, 2%)
3,460 households participated (44.3%) Every member participated for 86% of these
households
6,214 participants
The present study concerned the 2,826 employed people
Epicoh 2004 – Melbourne, 13-15 October 2004
Fig. 1. Distribution of the sample (n=6,214) and the Lorraine population (n=1,848,579 – Insee census) according to age (%)
0
2
4
6
8
10
12
14
15-1
9
20-2
4
25-2
9
30-3
4
35-3
9
40-4
4
45-4
9
50-5
4
55-5
9
60-6
4
65-6
9
70 o
r over
Sample Lorraine population
Epicoh 2004 – Melbourne, 13-15 October 2004
Men 56.6Age (yr) : mean (SD) 38.5 (10.2)Current smokers 34.4Excess alcohol use 8.9
Job category Executives, intellectual professionals, teachers18.2 Workmen 21.6 Foremen 4.8 Employees 35.5 Farmers, craftsmen, tradesmen 5.1 Technicians 6.0 Others 8.8
Table 1. Characteristics of the subjects (n = 2826): %
Epicoh 2004 – Melbourne, 13-15 October 2004
Table 2. Demanding occupational hazards: %
Noise 28.0Mental workload 26.3Artificial light 20.8Heat 18.7Standing about and
walking 18.5Pace 18.2Cold 16.0Wrong work posture 14.3Handling objects 13.2Physical workload 10.0Working in adverse
climates 6.2Hand tools with vibration5.1Workplace with vibration
3.9
Working on production line3.4Tasks at high level 3.3Shocks 2.3Machine tools 2.2Heat radiation 1.6Hammer 1.6Screwdriver 0.9
Number of hazards 0 40.1 1-2 40.2 3-4 12.2 5 or over 7.5
Epicoh 2004 – Melbourne, 13-15 October 2004
Fig. 2. Prevalence of psychotropic drug use (%)
3,84,37,1
21,5
30
0
5
10
15
20
25
30
35
All drugs
combined
Headache Nervousness
or anguish
Sleeplessness Fatigue
Epicoh 2004 – Melbourne, 13-15 October 2004
Table 3. Prevalence of psychotropic drug use according to age, sex, smoking habit and alcohol use: %
Age (yr) 15-29 33.9 30-39 27.1 40-49 30.3 NS (p = 0.064) 50-59 31.1 60 or over 28.6Sex Men 23.5 p < 0.001 Women 38.5Smoking habit Current smokers 32.0 NS Others 28.9Excess alcohol use Yes 30.0 NS No 30.0
Epicoh 2004 – Melbourne, 13-15 October 2004
Table 4. Psychotropic drug use for various job categories compared to executives, intellectual professionals, and teachers: OR adjusted on age
and sex and 95% CI
Executives, intellectual professionals, teachers 1.00
Workmen 1.98‡ (1.49-2.65)
Foremen 1.76† (1.12-2.76)
Employees 1.64‡ (1.27-2.13)
Farmers, craftsmen, tradesmen 1.68* (1.09-2.60)
Technicians 1.76† (1.12-2.76)
Others 1.21 (0.82-1.79)
*p < 0.05, †p<0.01, ‡p<0.001
Epicoh 2004 – Melbourne, 13-15 October 2004
Table 5. Relationship between the number of hazards NH and psychotropic drug use : 0R adjusted on age, sex and job and 95% CI
Number Fatigue Headache Sleeplessness Nervousness of subjects or anguish
NH=0 1134 1.0 1.0 1.0 1.0
NH=1 or over 1792 1.66* 1.39† 2.46‡ 2.00‡ (1.02-2.69) (1.12-1.73) (1.46-4.13) (1.36-2.91)
1-2 1137 1.48 1.25* 2.14† 1.67* (0.88-2.47) (1.00-1.57) (1.25-3.68) (1.12-2.51)
3-4 344 1.61 1.52† 3.43‡ 2.67‡ (0.85-3.07) (1.11-2.07) (1.74-6.75) (1.61-4.41)
5 or over 211 1.74 2.08‡ 2.65 5.98‡ (0.73-4.12) (1.36-3.17) (0.95-7.40) (2.71-13.17) *p < 0.05, †p<0.01, ‡p<0.001
Epicoh 2004 – Melbourne, 13-15 October 2004
Fig. 3. Relationship between the number of hazards NH and psychotropic drug use : 0R adjusted on age, sex and job and 95% CI
1.44(1.15-1.75)
1.66(1.26-2.20)
2.74(1.83-4.09)
0
0,5
1
1,5
2
2,5
3
NH 0 NH 1-2 NH 3-4 NH 5 orover
Epicoh 2004 – Melbourne, 13-15 October 2004
Conclusions
• Demanding work conditions may cause psychotropic drug use
• Prevention should reduce occupational hazards, particularly when their number is high