Work-related psychosocial factors and inflammatory markers: A systematic review and meta-analysis

J Psychosom Res. 2023 Jul:170:111349. doi: 10.1016/j.jpsychores.2023.111349. Epub 2023 May 2.


Objective: We conducted a systematic review and meta-analysis to evaluate the prospective effect of adverse work-related psychosocial factors on increases in inflammatory markers.

Methods: A systematic literature search was conducted in PubMed, Embase, PsycINFO, PsycARTICLES, and the Japan Medical Abstracts Society database. Studies were eligible for inclusion if they examined associations between work-related psychosocial factors and inflammatory markers (interleukin-6, tumor necrosis factor-alpha, and C-reactive protein), used longitudinal or prospective cohort designs, were conducted among workers, were original articles written in English or Japanese, and were published up to 2017 for the first search, October 2020 for the second, and November 2022 for the third. A meta-analysis was conducted using a random-effects model to assess the pooled effect size for the associations. A meta-regression analysis was used to estimate the association between length of follow-up and effect size. The ROBINS-I tool was used to assess risk of bias.

Results: Of the 11,121 studies identified in the first search, 29,135 studies from the second, and 9448 studies from the third, eleven were eligible for this review and meta-analysis. The pooled coefficient between adverse work-related psychosocial factors and inflammatory markers was significant and positive (β = 0.014, 95% confidence interval: 0.005-0.023). However, a clear association was only observed for interleukin-6, and all the studies included had serious risks of bias. Meta-regression showed the effect size decreased depending on the follow-up period.

Conclusion: This study revealed a weak positive association between adverse work-related psychosocial factors and increases in inflammatory markers.

Trial registration: PROSPERO CRD42018081553 (

Keywords: C-reactive protein; Interleukin-6; Meta-analysis; Psychosocial factor; Tumor necrosis factor-alpha; Workplace.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Humans
  • Interleukin-6*
  • Japan
  • Prospective Studies


  • Interleukin-6