Ahlberg-Hulten G (1), Theorell T (2), Waldenstrom M (1), MUSIC-Norrtalje Study Group. (1) Department of Occupational Medicin, Karolinska Hospital, Stockholm, Sweden; (2) National Institute of Psychosocial factors and Health (IPM), Stockholm, Sweden.
Aim: In the Music Norrtalje, a case-referent study of low back and neck-shoulder pain, one of the aims has been to explore the relationship between psychosocial work environment variables and locomotor disorder, Recent national surveys have shown that women working in health care and service in Sweden have been experiencing increasing job strain during the period 1981-1991, and there is reason to hypothesize that this trend could have continued during the present retrospective study period 1991-1995.
Method: The interview dealt with possibility to take part in long term and daily planning of work, need of continuing education and possibilities to get support form workmates and superiors. After this part of the interview the respondent was asked whether there had been substantial changes in these conditions during the past five years. In the randomly selected referent group a selection of the occupation groups with the largest numbers of participants resulted in seven groups with in total 657 referents, 404 women and 253 men. The groups were education (n=61 wmen/16 men), health care (n=74/8), child minding and home care (n=105/6), administration and office (87/34), commercial (n=38/33), transport and communication (n=16/46) and manufacture and machine (n=23/110).
Results: On the whole 76% reported at least one substantial change in the working situation during the past five years. In all occupational groups, except for transport and communication, there were more subjects who reported an increase than who reported a decrease in the use of professional knowledge and experience. In total 34% had experienced a greater need now than before to keep their professional knowledge up to date while only 18% had experienced a decreased need of obtaining new knowledge. Health care personnel and persons working in transport and communication had the least improvement in possibilities to participate in both daily and long term planning. The degree of impediments hindering required work to be performed had decreased for 26%, not changed for 38%, and increased for 36%. Persons with education work and health care personnel reported the most increase and personnel with manufacturing and machine work the lease. Lack if clarity had increased for 17% - for persons in educational work as much as 37%. Lack of staff as an impediment for performing required work had increased for all groups, especially for health care (40%), educational work (39.5%), and child minders and home care (35%). However, these three groups also reported the most increase in possibilities to get support from workmates (32-36%). Within commercial work, transport & communication and manufacturing work it was more usual to have experienced a decrease of support form work mates than an increases, though 64% reported no change.
Conclusion: Decrease in staff in the public sector due to financial constraints seems to have resulted in increased impediments to perform required work. Decreased social support was reported in transport and manufacturing work whereas the opposite pattern was observed in health care, education, child minding and home care.