Beruflich Dokumente
Kultur Dokumente
Applied Ergonomics
journal homepage: www.elsevier.com/locate/apergo
Academic Medical Center, University of Amsterdam, Coronel Institute of Occupational Health, PO Box 22660, 1100 DE Amsterdam, The Netherlands
Arbouw, Dutch Health & Safety Institute in the Construction Industry, Harderwijk, The Netherlands
a r t i c l e i n f o
a b s t r a c t
Article history:
Received 6 January 2012
Accepted 11 January 2013
We assessed psychosocial work environment, the prevalence of mental health complaints and the
association between these two among bricklayers and construction supervisors. For this cross-sectional
study a total of 1500 bricklayers and supervisors were selected. Psychosocial work characteristics were
measured using the Dutch Questionnaire on the Experience and Evaluation of Work and compared to the
general Dutch working population. Mental health effects were measured with scales to assess fatigue
during work, need for recovery after work, symptoms of distress, depression and post-traumatic stress
disorder. The prevalence of self-reported mental health complaints was determined using the cut-off
values. Associations between psychosocial work characteristics and self-reported mental health complaints were analysed using logistic regression.
Total response rate was 43%. Compared to the general working population, bricklayers experienced
statistically signicant worse job control, learning opportunities and future perspectives; supervisors
experienced statistically signicant higher psychological demands and need for recovery. Prevalence of
self-reported mental health effects among bricklayers and supervisors, respectively, were as follows:
high need for recovery after work (14%; 25%), distress (5%, 7%), depression (18%, 20%) and post-traumatic
stress disorder (11%, 7%). Among both occupations, high work speed and quantity were associated with
symptoms of depression. Further, among construction supervisors, low participation in decision making
and low social support of the direct supervisor was associated with symptoms of depression.
The ndings in the present study indicate psychosocial risk factors for bricklayers and supervisors. In
each occupation a considerable proportion of workers was positively screened for symptoms of common
mental disorders.
2013 Elsevier Ltd and The Ergonomics Society. All rights reserved.
Keywords:
Construction industry
Work environment
Psychosocial factors
Common mental disorders
1. Introduction
The physically demanding nature of the construction trade and
the resulting health effects have been extensively studied
(Holmstrm et al., 1995; Schneider, 2001). However, the world of
work has changed over the years and has led to several new or
increasingly prevalent psychosocial risks, such as new forms of
employment and an intensication of work (European Agency on
Safety and Health at Work, 2007). The construction industry has
become more stressful in recent years (Campbell, 2006). Therefore,
the inuence of psychosocial risk factors should be considered
when dealing with construction workers (Alavinia et al., 2007,
0003-6870/$ e see front matter 2013 Elsevier Ltd and The Ergonomics Society. All rights reserved.
http://dx.doi.org/10.1016/j.apergo.2013.01.004
749
electricians etc). The remaining workforce (30e45%) is in managerial roles, including managers and supervisors (Grootenboer and
van der Schaaf, 2012; National Guidance Research Forum, 2012).
In this cross-sectional study, we aimed to get insight into the psychosocial work environment of two very distinct construction professions adequately, the occupation of bricklayer as an example of a
manual occupation and the construction supervisor as an example
of a managerial occupation. The bricklayer has a repetitive job with
high physical demands, whereas the construction supervisor is
responsible for site management and has a job with particular high
mental demands. In the present study we focused on psychosocial
job characteristics which are known risk factors for work-related
depression and stress: high work speed and work quantity, high
mental demands, low social support, little job control, and having
experienced or witnessed a serious accident (de Roos and Sluiter,
2004; Nieuwenhuijsen et al., 2010). Furthermore, we were interested in the specic stressor lack of future perspective, which
might play a role among construction workers, particularly since the
economic recession caused many construction workers to loose
their jobs or nd themselves in uncertain circumstances
(International Labour Ofce (ILO), 2009). The stressor lack of job
variety is often mentioned for occupations involving monotonous
work, which might play a role among the bricklayers specically
(Beereboom, 2005). Therefore, we decided to include job variety as a
psychosocial work characteristic of interest.
The objectives of the present study are to assess the following:
i) the magnitude of psychosocial work characteristics;
ii) the prevalence of self reported mental health effects (fatigue
during work, need for recovery after work, distress, depression and post-traumatic stress disorder (PTSD);
iii) the psychosocial factors that are associated with mental
health in the different occupations.
2. Methods
2.1. Sample and sample size
A priori, the prevalence of self-reported symptoms was estimated at a maximum of 30% and in order to obtain the prevalence of
symptoms with 5% precision, a sample size of 318 was calculated. In
a pilot questionnaire survey, a 40% response rate in a population of
bricklayers and supervisors was achieved (Boschman et al., 2011b).
In total, 750 bricklayers and 750 construction supervisors were
randomly selected from a Dutch registry comprised of all employed
Dutch construction workers. The random selection was performed
by the independent data manager of the registry, frequently
assisting in selecting samples for research purposes. Among the
bricklayers were both those working in the construction of new
buildings as in renovation. Among the construction supervisors
were those working in ground, road and water construction and in
commercial and industrial building. Furthermore, the selection was
not restricted based on the type of construction supervisor (main or
assisting supervisor).
There was an overall response rate of 39% among the bricklayers
(n 262) and 46% among the construction supervisors (n 310).
All respondents were active in their current occupation during the
past twelve months. A more detailed description of the characteristics of the respondents is presented in Table 1.
2.2. Procedure
The survey was conducted from December 2009 to January
2010. All participants received a sealed envelope at their home
750
Table 1
Characteristics of respondents.
Bricklayers
Construction supervisors
Male/female
Age (years)
24 (1e47, 13)
16 (1e42, 10)
13 (1e42.0, 10)
17 (1e46, 12)
39 (5e55, 6)
47 (5e70, SD 8)
Years employed in
construction
Years employed in
present occupation
Years employed at
present company
Working hours per week
751
752
high mental demands, low social support, little job control, and
having experienced or witnessed a serious accident) (de Roos and
Sluiter, 2004; Nieuwenhuijsen et al., 2010). For PTSD, only the
association between the emotional demand of experiencing or
witnessing an accident and PTSD was determined. Statistical signicance was set at an alpha level of 0.05. We corrected for multiple
analyses by using the Bonferroni correction. The IBM SPSS Statistics
19.0 software was used for analysing the data.
3. Results
need for recovery after work scale was exceeded by 13.6% (35/257)
of the bricklayers. On the IES 10.9% (28/258) of the bricklayers
exceeded the cut-off value. Of the bricklayers, 4.7% (12/255) were
classied as distressed and 17.6% (44/250) scored positive on the
depression screener.
Among the supervisors there was a higher need for recovery
than among the reference population. A total of 24.6% (74/301) of
the supervisors exceeded the cut-off value on the need for recovery
after work scale. The prevalence of PTSD, symptoms of distress and
symptoms of depression were 6.9% (21/304), 6.8% (20/295) and
19.6% (59/300), respectively.
Table 2
Psychosocial work demands among bricklayers and construction supervisors compared to the general Dutch working population (2003e2007).
Job demands
Work speed and quantity
Mental demands
Job control
Task autonomy
Participation in decision making
Recovery opportunities
Social support
Relationship with colleagues
Relationship with direct supervisor
Job variety
Variety in work
Opportunities to learn
Future perspective
Future perspective
a
Reference populationa
Bricklayers
Mean (SD)
Mean (SD)
42.8 (14.7)
72.3 (17.4)
Bricklayers compared to
reference population
Supervisors
42.8 (14.1)
62.1 (17.6)
49.6 (13.0)
75.5 (15.6)
41.8 (18.4)
46.6 (19.8)
n.a.
49.4 (18.0)
49.1 (20.4)
39.5 (14.9)
34.2 (17.0)
32.1 (19.6)
45.7 (15.0)
21.3 (13.2)
21.4 (16.2)
18.2 (14.0)
21.5 (18.7)
23.4 (13.8)
22.5 (18.0)
37.6 (19.9)
48.7 (22.2)
39.9 (17.1)
52.6 (21.2)
25.7 (13.9)
34.8 (19.0)
32.6 (34.8)
48.6 (33.5)
29.1 (29.2)
Mean (SD)
Supervisors compared to
reference population
data provided by SKB Questionnaire Services; better: score is signicantly lower (p < 0.002) than reference population; worse: score is signicantly higher (p < 0.002) than
reference population; n.s.: not signicantly different (p > 0.002) from reference population; n.a.: not applicable, no reference value available.
753
Table 3
Need for recovery and fatigue during work among bricklayers and construction supervisors compared with the general Dutch working population (2003e2007).
Mental health effects
Reference populationa
Bricklayers
Mean (SD)
Mean (SD)
26.8 (28.9)
22.8 (16.0)
21.7 (27.3)
20.3 (16.9)
Supervisors
Mean (SD)
31.0 (30.4)
23.8 (14.1)
a
data provided by SKB Questionnaire Services; n.s.: not signicantly different (p > 0.002) from reference population; less: score is signicantly lower (p < 0.002) than
reference population; higher: score is signicantly higher (p < 0.002) than reference population.
PTSD
Distress
Depression
Bricklayers
Construction supervisors
% (95% CI)
Relative
frequency
% (95% CI)
Relative
frequency
10.8 (7.1e14.7)
4.7 (2.1e7.3)
17.6 (12.9e22.3)
28/258
12/255
44/250
6.9 (4.1e9.8)
6.8 (3.9e9.7)
19.6 (15.2e24.2)
21/304
20/295
59/300
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Table 5
The association between high versus low psychosocial load and symptoms of depression, distress, and PTSD. Statistically signicant associations are in bold (p < 0.001).
Job demands
High work speed and quantity
Bricklayers
Construction supervisors
High mental demands
Bricklayers
Construction supervisors
Job control
Low task autonomy
Bricklayers
Construction supervisors
Low participation in decision making
Bricklayers
Construction supervisors
n.t.
n.t.
n.t.
n.t.
n.t.
n.t.
n.t.
n.t.
Social support
Low social support colleagues
Bricklayers
Construction supervisors
Low social support direct supervisor
Bricklayers
Construction supervisors
n.t.
n.t.
n.t.
n.t.
N (n 253)
3.0 (0.6e15.9) (n 294)
n number of cases included in analysis; n.t. not tested; N no estimation of OR and condence interval possible.
Alavinia et al. (2009) found that lack of job control, lack of support
and dissatisfaction with work were signicantly related to sick
leave. Holmstrm et al. (1992a,b) found that psychosocial factors
such as quantitative work demands, were signicantly associated
with low back pain. We found that, although bricklayers and construction supervisors both work in the construction industry, the
psychosocial work environment for bricklayers and supervisors
differs greatly when compared to the general working population.
While bricklayers experience lack of learning opportunities, job
control and future perspectives, supervisors experience high psychological demands. Monitoring job-specic aspects of the psychosocial work environment might therefore be a proper strategy
to improve working conditions for constructions workers. In a
longitudinal study design the effects on mental health of such a
strategy, based on signalling psychosocial risk factors and consecutive preventive actions, could be evaluated.
The construction supervisor is believed to be at risk for stressrelated disorders and other mental health problems (Beswick
et al., 2007; Boschman et al., 2011a; Strobel and von Krause,
1997), but based on the ndings in the present study, there is a
need to monitor the mental health of both bricklayers and construction supervisors. Moreover, workers with symptoms indicative of mental health disorders should be offered interventions to
improve their mental well-being in an early stage. When screening for common mental health disorders in construction workers,
it seems preferable not to differentiate between occupations.
However, when assessing job-specic psychosocial risk factors, the
type of construction occupation should be taken into account.
Authors contributions
JB is responsible for data collection, statistical analysis and
drafted the manuscript. All authors conceived and designed the
study, read and corrected draft versions of the manuscript and
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Horowitz, M., Wilner, N., Alvarez, W., 1979. Impact of Event Scale: a measure of
subjective stress. Psychosom. Med. 41, 209e218.
Hu, B.S., Liang, Y.X., Hu, X.Y., Long, Y.F., Ge, L.N., 2000. Posttraumatic stress disorder
in co-workers following exposure to a fatal construction accident in China. Int. J.
Occup. Environ. Health 6, 203e207.
International Labour Ofce (ILO), 2009. The Many Facets of the Crisis - The Crisis in
the Construction Industry. World of Work - The magazine of the ILO. 16e17.
Kaerlev, L., Kolstad, H.A., Hansen, A.M., Thomsen, J.F., Kaergaard, A., Rugulies, R.,
Mikkelsen, S., Andersen, J.H., Mors, O., Grynderup, M.B., Bonde, J.P., 2011. Are
risk estimates biased in follow-up studies of psychosocial factors with low
base-line participation? BMC Public Health 11, 539.
Karasek, R.A., 1979. Job demands, job decision latitude, and mental strain: Implications for job redesign. Admin. Sci. Q. 24, 285e308.
Kim, H.C., Park, S.G., Min, K.B., Yoon, K.J., 2009. Depressive symptoms and selfreported occupational injury in small and medium-sized companies. Int.
Arch. Occup. Environ. Health 82, 715e721.
Kolstad, H.A., Hansen, A.M., Kaergaard, A., Thomsen, J.F., Kaerlev, L., Mikkelsen, S.,
Grynderup, M.B., Mors, O., Rugulies, R., Kristensen, A.S., Andersen, J.H.,
Bonde, J.P., 2011. Job strain and the risk of depression: is reporting biased? Am. J.
Epidemiol. 173, 94e102.
Laitinen-Krispijn, S., Bijl, R.V., 2002. Werk, psyche en ziekteverzuim. Aard en
omvang van psychische stoornissen, ziekteverzuim en zorggebruik in de beroepsbevolking. Trimbosinstituut, Utrecht.
Meijman, T.F., Schaufeli, W., 1996. Psychische vermoeidheid en arbeid (Psychological fatigue and work). in Dutch. De Psycholoog, 236e242.
National Guidance Research Forum, 2012. Construction Occupations. http://www2.
warwick.ac.uk/fac/soc/ier/ngrf/lmifuturetrends/sectorscovered/construction/
occupations/.
National Institute for Public Health and Environment (RIVM), 2011.
Depressie. Ministerie van Volksgezondheid, Welzijn en Sport. http://www.
nationaalkompas.nl/gezondheid-en-ziekte/ziekten-en-aandoeningen/
psychische-stoornissen/depressie/hoe-vaak-komt-depressie-voor/.
Netherlands Center for Occupational Diseases (NCvB), 2011. Beroepsziekten in Cijfers (Occupational diseases in gures). in Dutch. Nederlands Centrum voor
Beroepsziekten/Coronel Instituut voor Arbeid en Gezondheid, AMC/Universiteit
van Amsterdam, Amsterdam.
Nieuwenhuijsen, K., Bruinvels, D., Frings-Dresen, M., 2010. Psychosocial work
environment and stress-related disorders, a systematic review. Occup. Med.
(Lond) 60, 277e286.
Schneider, S.P., 2001. Musculoskeletal injuries in construction: a review of the literature. Appl. Occup. Environ. Hyg. 16, 1056e1064.
SKB Questionnaire Services, 2010. Reference Values Questionnaire on the Experience and Evaluation of Work (QEEW).
Sluiter, J.K., de Croon, E.M., Meijman, T.F., Frings-Dresen, M.H.W., 2003. Need for
recovery from work related fatigue and its role in the development and prediction of subjective health complaints. Occup. Environ. Med. 60, 62e70.
Sluiter, J.K., van der Beek, A.J., Frings-Dresen, M.H., 1999. The inuence of work
characteristics on the need for recovery and experienced health: a study on
coach drivers. Ergonomics 42, 573e583.
Stattin, M., Jrvholm, B., 2005. Occupation, work environment, and disability pension: a prospective study of construction workers. Scand. J. Public Health 33,
84e90.
Stocks, S.J., McNamee, R., Carder, M., Agius, R.M., 2010. The incidence of medically
reported work-related ill health in the UK construction industry. Occup. Environ. Med. 67, 574e576.
Strobel, G., von Krause, J., 1997. Psychische Belastung von Bauleitern (Psychological
Demands for Construction Supervisors). in German. Schriftenreihe der Bundesanstalt fr Arbeitsschtz und Arbeitsmedizin, Dortmund/Berlin.
Twisk, J.W.R., 2007. Inleiding in de toegepaste biostatistiek (Introduction in applied
biostatistics). in Dutch. Elsevier Gezondheidszorg, Reed Business Information
bv, Maarssen.
van der Doef, M., Maes, S., 1999. The job demand-control (-support) model and
psychological well-being: a review of 20 years of empirical research. Work &
Stress 13, 87e114.
van der Molen, H.F., 2004. World at work: bricklayers and bricklayers assistants.
Occup. Environ. Med. 61, 89e93.
van der Ploeg, E., Mooren, T.T., Kleber, R.J., van der Velden, P.G., Brom, D., 2004.
Construct validation of the Dutch version of the impact of event scale. Psychol.
Assess. 16, 16e26.
van Veldhoven, M., 1996. Psychosocial job demands and job stress: psychosociale
arbeidsbelasting en werkstres (in Dutch). Swets & Zeitlinger, Lisse, thesis.
van Veldhoven, M., Broersen, S., 2003. Measurement quality and validity of the
need for recovery scale. Occup. Environ. Med. 60 (Suppl 1), i3ei9.
van Veldhoven, M., Meijman, T.F., Broersen, J.P.J., Fortuin, R.J., 2002. Het meten van
psychosociale arbeidsbelasting met een vragenlijst: de vragenlijst beleving en
beoordeling van de arbeid (VBBA) (The measurement of psychosocial job
demands with a questionnaire: the questionnaire on the experience and
evaluation of work (QEEW)). SKB Vragenlijst Services.
van Veldhoven, M.J., Sluiter, J.K., 2009. Work-related recovery opportunities: testing
scale properties and validity in relation to health. Int. Arch. Occup. Environ.
Health 82, 1065e1075.
Whooley, M.A., Avins, A.L., Miranda, J., Browner, W.S., 1997. Case-nding instruments for depression. Two questions are as good as many. J. Gen. Intern. Med.
12, 439e445.