345 Which psychosocial risk factors at work contribute to the onset of stress-related disorders? a systematic review and meta-analysis

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IntroductionPsychosocial risk factors at work are known to contribute to the onset of stress-related disorders (SRDs). Evidence about work-related psychosocial risk factors is necessary to select and implement preventive workplace interventions. The aim of our review was to identify psychosocial risk factors at work which are associated with the onset of SRDs, updating a prior review with evidence up until 2008.MethodsA systematic literature search was conducted for the period January 2008 to October 2014 in Medline, Embase and PsycINFO. Inclusion criteria were: prospective study design, exposure of workers to psychosocial risk factors, and an SRD outcome. Data from the studies included were pooled with the results of a previous systematic review. The quality of the evidence was assessed using an adapted GRADE procedure.ResultThe updated review consisted of twelve studies. The search yielded 5300 articles. Five articles met the inclusion criteria and were added to the seven of the previous review.Evidence of high quality was found for the risk factors of ‘effort-reward imbalance’, ‘high psychological demands’, ‘low decision authority’, ‘low co-worker support’, ‘low supervisor support’, ‘low procedural justice’ and ‘low relational justice’, while evidence of moderate quality was found for ‘high emotional demands’ contributing to the onset of an SRD.‘Effort-reward imbalance’ and ‘low procedural justice’ exhibited the largest association with SRDs, with Odds Ratios of 2.0 (95% CI: 1.81 to 2.22) and 1.8 (95% CI: 1.60 to 1.98), respectively.DiscussionSeveral psychosocial work-related risk associated with the onset of SRDs were established, confirming prior findings. Awareness of these risk factors could be the starting point for the selection of preventive interventions to reduce work-related SRDs.

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