Differential economic stability and psychosocial stress at work: associations with psychosomatic complaints and absenteeism.

Stressful working conditions are well known to have a negative impact on the worker's health. We investigated this association in a Belgian study with a psychosocial health perspective, including individual work characteristics as well as firms' features. These data come from the first measure of the Somstress study. This is a 4 year project, initiated in 1999 and conducted in four different firms. The objective of this article is to investigate the relationships between stress, working conditions and absenteeism, self-reported health and psychosomatic complaints. Firms were selected according to their degree of structural environment and job stability. Among the four work sites, one can be considered as stable, one unstable and the remaining ones in an in-between situation. Stress is generally measured according to one of the following models: the job demands control model (Karasek) and the effort-reward imbalance model (Siegrist). We used here both models, along with the social support at work (Karasek) and overcommitment (Siegrist). Sex, age and education are important health determinants. After adjustment for those three variables and additionally for the work instability, it appeared that poor health outcomes (measured by the self-rated health, depression (SCL-90), anxiety (SCL-90), somatisation (SCL-90), chronic fatigue (Vercoulen) and reported absenteeism) are mainly associated with a low control, low social support at work, high overcommitment and high level of imbalance. Inversely, job demands do not make any significant contribution in the logistic regression models for the above-mentioned health outcomes.