Psychosocial factors at the workplace have been implicated in the current epidemic of work-related illness manifested by 1) psychological disorders such as anxiety, burnout and depression, 2) musculoskeletal disorders and 3) cardiovascular disease in the form of hypertension and atherosclerotic heart disease.
Overview of Program: To ameliorate these health problems, a comprehensive program is needed for the improvement of the psychosocial well-being and musculoskeletal and cardiovascular health of working people through 1) srveillance, 2) early detection with referral for evaluation and treatment of individuals with early manifestations of disease, and 3) Interventions at the workplace intended to reduce exposures.
This proposed pilot program is intended to draw on the resources of the academically based California occupational and environmental health centers (COEH's) to initiate, coordinate and provide the training, research and services to accomplish these goals. The target population will be the employed labor force of several large corporations as well as public employees in Southern California who have access to the COEH at UCLA and UCI medical centers.
1) Service - A comprehensive plan of surveillance with detection of psychosocial exposures and incipient illness will be initiated in cooperation with interested corporations, health care providers, public agencies, and labor unions. Working people with identified health problems will be referred to COEH facilities for evaluation and treatment by COEH and medical center staff (including cardiologists). Secondary prevention/treatment programs will be conducted at the involved worksites utilizing staff (e.g., clinicians, occupational health psychologists (OHP)) trained in an understanding of the role of workplace psychosocial factors in the etiology of work-related diseases. Knowledge gained over time through ongoing surveillance and by working with employers and employees will be utilized to design primary prevention programs.
2) Training - The success of this initiative will require the development of an extensive training program for graduate students and professionals to enhance their awareness of the role of psychosocial work factors in the etiology of psychological and physical disorders, hypertension and cvd. (see article on Training pg ?) Programs for graduate students will provide them with skills in conducting surveillance, detecting psychosocial exposures, and obtaining a psychosocial work history from employed people. Training for professionals should provide similar skills but focus more heavily on the development of the appropriate clinical skills (e.g., taking a relevant history of workplace psychosocial exposures), necessary for the detection, evaluation and treatment of work-induced CVD.
3) Research - A research program will be carried out in parallel with the service component of the project, with the purpose of evaluating 1) the surveillance and treatment programs and 2) informing subsequent intervention and prevention programs for the target population aimed at reducing the burden of injuries and CVD. Observational studies of naturally occurring changes in the workplace can be conducted through ongoing surveillance at the workplace with reevaluation of psychosocial exposures and associated changes in workplace blood pressure.
4) Primary Prevention - Prevention programs will be developed that focus on changes in work organization and job characteristics. These programs will developed in close collaboration with management, employees and employee organizations. Interventions will be informed by knowledge of the workplace accumulated over time through ongoing surveillance of the workforce and implemented observational studies.