Update of the fractions of cardiovascular diseases and mental disorders attributable to psychosocial work factors in Europe

Int Arch Occup Environ Health. 2022 Jan;95(1):233-247. doi: 10.1007/s00420-021-01737-4. Epub 2021 Jun 28.


Objectives: The objectives of this study were to provide the fractions of cardiovascular diseases and mental disorders attributable to five psychosocial work exposures, i.e. job strain, effort-reward imbalance, job insecurity, long working hours, and bullying in Europe (35 countries, including 28 European Union countries), for each one and all countries together, in 2015.

Methods: The prevalences of exposure were estimated using the sample of 35,571 employees from the 2015 European Working Conditions Survey (EWCS) for all countries together and each country separately. Relative risks (RR) were obtained via literature reviews and meta-analyses already published. The studied outcomes were: coronary/ischemic heart diseases (CHD), stroke, atrial fibrillation, peripheral artery disease, venous thromboembolism, and depression. Attributable fractions (AF) for each exposure and overall AFs for all exposures together were calculated.

Results: The AFs of depression were all significant: job strain (17%), job insecurity (9%), bullying (7%), and effort-reward imbalance (6%). Most of the AFs of cardiovascular diseases were significant and lower than 11%. Differences in AFs were observed between countries for depression and for long working hours. Differences between genders were found for long working hours, with higher AFs observed among men than among women for all outcomes. Overall AFs taking all exposures into account ranged between 17 and 35% for depression and between 5 and 11% for CHD.

Conclusion: The overall burden of depression and cardiovascular diseases attributable to psychosocial work exposures was noticeable. As these exposures are modifiable, preventive policies may be useful to reduce the burden of disease associated with the psychosocial work environment.

Keywords: Attributable fraction; Cardiovascular diseases; Depression; Europe; Exposure prevalence; Job stress; Mental disorders; Psychosocial work factors.

MeSH terms

  • Cardiovascular Diseases* / epidemiology
  • Europe / epidemiology
  • Female
  • Humans
  • Male
  • Mental Disorders* / epidemiology
  • Mental Disorders* / psychology
  • Occupational Diseases* / epidemiology
  • Occupational Diseases* / psychology
  • Stress, Psychological / epidemiology
  • Stress, Psychological / psychology
  • Workplace / psychology

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