A team that supports workers over the long term
At Laval University in Quebec City, a team of occupational health researchers—including researcher Chantal Brisson—has been studying the effects of the psychosocial work environment on health since the 1990s.
The strength of their research lies in their methodology: rather than measuring stress at a single point in time, these studies follow the same individuals over several years. This is what makes it possible to distinguish a mere coincidence from a solid link.
This research is based on a central model in occupational health, that of job strain (Karasek’s model): the combination of high psychological demands and low decision-making latitude—that is, little control over how one does one’s job.
Work-Related Stress and Blood Pressure
A study published inthe *American Journal of Public Health* (Guimont et al., 2006) followed 6,719 office workers in Quebec City for seven and a half years.
The results showed that among men repeatedly exposed to workplace stress, systolic blood pressure was, on average, nearly 2 mmHg higher than among those who were not exposed. Among women, the association followed the same pattern, though the effects were less pronounced.
Two millimeters of mercury may seem like a small amount for an individual. But hypertension is one of the leading cardiovascular risk factors, and what matters here is the effect of cumulative exposure over time on the entire workforce.
Returning to Work After a Heart Attack: A Risky Move
This is one of the team’s most significant studies. Published in JAMA in 2007 (Aboa-Éboulé et al.), it followed 972 people aged 35 to 59 who had returned to work after a first heart attack for an average of nearly six years.
People exposed to chronic workplace stress had twice the risk of a new coronary event: recurrent heart attack, unstable angina, or death from cardiac causes. This finding remained valid after adjusting for 26 other coronary risk factors
In an editorial accompanying the article, Swedish researcher Kristina Orth-Gomér of the Karolinska Institute called for greater consideration of workplace stress in clinical practice.
For occupational health professionals, the message is clear: preparing to return to work after a cardiac event is not just a medical matter. The work conditions that await the individual also matter.
Taking Action on Organizational Structure: The Hospital as a Case Study
The team did not stop at simply identifying the problem. They tested a participatory intervention in an acute-care hospital, comparing it to a control hospital (Bourbonnais et al., *Occupational and Environmental Medicine*).
The starting point. Among healthcare workers, the initial assessment revealed psychosocial risk factors clearly associated with psychological distress:
| Mail carrier at work | Prevalence of Psychological Distress |
|---|---|
| Low recognition | 2.9 times higher |
| Imbalance Between Effort and Recognition | 2.7 times higher |
| High psychological demands | 2.3 times higher |
| Lack of support from supervisors and coworkers | 1.4 times higher |
The Method. A team comprising all relevant stakeholders identified 56 problem areas and developed solutions focused on teamwork, staffing levels, work organization, training, communication, and ergonomics.
The Results. After one year, several risk factors had decreased at the hospital in question, as had sleep disturbances and work-related burnout. Three years later, the effect was confirmed: nearly all risk factors had improved, and burnout had decreased significantly. In the control hospital, by contrast, social support and autonomy had deteriorated.
The authors conclude that the intervention is effective in the long term and consider the participatory approach “highly transferable” to other organizations.
How This Research Impacts Businesses
1. Stress at work is also a matter of physical health. These studies demonstrate this through objective measurements of heart health and blood pressure taken over several years.
2. The duration of exposure matters. These studies link the observed effects to repeated or chronic exposure. Identifying stressful situations early on allows for action to be taken before their effects take hold.
3. Returning to work after a heart condition warrants special attention. Adjusting the workload, restoring flexibility, and providing follow-up are all part of a successful return to work.
4. Organizational changes can make a difference. Experience in hospitals shows that a participatory approach—involving management, supervisors, and employees—produces measurable and lasting results.
The main lesson from this research is encouraging: risks related to work organization are not inevitable. They can be measured, understood, and reduced.
Sources and References
• Guimont, C., Brisson, C., et al. (2006). Effects of job strain on blood pressure: a prospective study of male and female white-collar workers. American Journal of Public Health. Abstract: NBC News.
• Aboa-Éboulé, C., Brisson, C., et al. (2007). Job strain and risk of acute recurrent coronary heart disease events. JAMA, 298(14), 1652–1660. Abstract: ScienceDaily.
• Bourbonnais R., Brisson C., Vinet A., et al. (2006). Development and implementation of a participatory intervention to improve the psychosocial work environment and mental health in an acute care hospital. Occupational and Environmental Medicine, 63(5).
• Bourbonnais R., Brisson C., Vinet A., Vézina M., Abdous B., Gaudet M. (2006). Effectiveness of a participatory intervention on psychosocial work factors to prevent mental health problems in a hospital setting. Occupational and Environmental Medicine, 63(5), 335–342.
• Bourbonnais R., Brisson C., Vézina M. (2011). Long-term effects of an intervention on psychosocial work factors among healthcare professionals in a hospital setting. Occupational and Environmental Medicine, 68(7), 479.
