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University of Applied Sciences

Faculty of Life Sciences

Master in Public Health

Evaluation of psychosocial risk factors at the workplace:

A pilot study in a mid-size company in Chile

Master Thesis

Date of submission:

Wednesday, 25 November 2015

Submitted by:

Felipe Weinberg

Matriculation number:

2 1 4 0 2 1 1

Examination supervisor:

Prof. Dr. York F. Zöllner

Secondary supervisor:

Prof. Dr. Wolf Polenz

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Summary

Introduction: Psychosocial risk factors in the workplace are equivalent to other occupational risks, to which long-term exposure can cause damage to one’s health. These risks lead to stress and are the precursors of health issues such as cardiovascular and musculoskeletal diseases and mental health and behavioural problems.

The Spanish CoPsoQ-istas21 questionnaire model is an international assessment tool for psychosocial risk factors. Although Chile is associated with positive economic development and workplace health, recent epidemiological and economic changes, as well as routine hazards in the workplace, have contributed to unresolved physical and psychosocial health problems.

The objective of this cross-sectional pilot study is to measure and analyse the psychosocial risk factors in a mid-size company in Chile. El Pangue is a mid-size enterprise, which represents the industrial economic sector and is a good example of a typical Chilean business organisation. Method: This is a pilot cross-sectional study that included the 57 employees of El Pangue. The CoPsoq-istas21 intermediate version for companies with 25 or more employees was used as the evaluation tool. This measure places participants into categories (unfavourable, intermediate, and favourable) by calculating a scale value from the average of the weights associated with the response options. The percentage of participants in an unfavourable category for a particular psychosocial dimension indicates the proportion of people who have high levels of exposure to that psychosocial risk.

Results: Results are organised by risk factor and department. The total response rate was 86%. The pace of work was the most frequently occurring psychosocial risk factor, with 68% of participants falling in an unfavourable category. The second and third most common risk factors were insufficient social support from peers and insecurity over working conditions, respectively. The psychosocial dimensions of vertical trust, demands for concealing emotions, recognition, and justice were the least problematic areas of potential risk, and can be seen as strengths of the company.

Discussion: Quantitative demands of work presented the highest level of risk, likely because of the industrial nature of the company. Problems with interpersonal relations and leadership reflect concerns about culture and support in the organisation. Dissatisfaction regarding job insecurity and working conditions likely reflect the economic fluctuations that are affecting El Pangue.

Conclusion: The study generates a baseline of risks that might influence workers’ health, speculates potential origins of each risk within the company, and proposes interventions to address the origins of these risk factors.

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Acknowledgments

I have worked hard in this study; nevertheless the success and final outcome of this project would not have been possible without the generous support and help of many persons.

I would like to extend my sincere thanks to all of them.

I am highly indebted to my supervisors and professors for their guidance, support and time. I would like to express my gratitude towards my parents and close friends, for their kindness, their

invaluable emotional co-operation and their encouragement.

I would like to offer my special gratitude and thanks to El Pangue and all their employees for giving me the opportunity to work on this project with them.

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Table of contents

Summary ... I Acknowledgments ... II List of figures and tables ... VI Acronyms and abbreviations ... IX

Chapter 1 - Introduction ... 1

1.1 Introduction ... 1

1.2 Conceptual framework ... 2

1.3 Project description ... 5

1.4 Reasons for the selection of the topic ... 5

Chapter 2 - Research objectives ... 7

Chapter 3 - Study background ... 8

3.1 The CoPsoQ questionnaire ... 8

3.2 The Spanish CoPsoQ-istas21 version 2 Questionnaire ... 9

3.3 Chile workplace health ... 9

3.4 Situation in small and mid-size private companies in Chile ... 11

3.5 Pilot study in Industria Maderera Elaboradora y Exportadora El Pangue Limitada ... 12

Chapter 4 - Materials and methods ... 16

4.1 Design ... 16 4.2 Study tool ... 16 4.3 Data collection ... 21 4.4 Data analysis ... 21 4.5 Study ethics ... 21 4.6 Project plan ... 22 Chapter 5 - Results ... 24 5.1 Response rate ... 24 5.2 Working conditions ... 25

5.3 Psychosocial risk factors ... 35

5.3.1 Exposure to risk factors in El Pangue ... 35

5.3.2 Location of exposures ... 36

5.3.3 Exposures dimension by dimension... 38

5.3.4 Work pace ... 38

5.3.5 Social support from peers ... 39

5.3.6 Insecurity with working conditions ... 40

5.3.7 Role conflicts... 41

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5.3.9 Job insecurity... 44 5.3.10 Role clarity ... 45 5.3.11 Predictability ... 46 5.3.12 Quantitative demands ... 47 5.3.13 Double shifts ... 48 5.3.14 Influence at work ... 50 5.3.15 Emotional demands ... 51 5.3.16 Quality of leadership ... 52

5.3.17 Social support from superior ... 53

5.3.18 Possibilities of development ... 54

5.3.19 Meaning of work ... 55

5.3.20 Justice ... 56

5.3.21 Recognition ... 58

5.3.22 Demands for concealing emotions ... 59

5.3.23 Vertical trust ... 60

5.4 Health and satisfaction ... 62

5.4.1 General Health ... 62 5.4.2 Mental Health ... 62 5.4.3 Stress ... 62 5.4.4 Burnout ... 63 5.4.5 Work satisfaction ... 63 Chapter 6 - Discussion ... 64

6.1 Data quality and limitations ... 64

6.2 Stakeholders involved and response rate ... 65

6.3 Working conditions and psychosocial risk factors... 65

6.3.1 Psychological demands of work ... 66

6.3.2 Work-family conflict ... 68

6.3.3 Work organisation and job contents ... 69

6.3.4 Interpersonal relations and leadership ... 71

6.3.5 Work-individual interface ... 73

6.3.6 Values at workplace level ... 75

6.4 Health and satisfaction ... 76

Chapter 7 - Conclusions and outlook ... 78

7.1 Conclusions ... 78

7.2 Future recommendations ... 80

References ... 81

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Annexes ... 92

Annex 1 - Agreement between researcher and El Pangue for the pilot study assessment of psychosocial risks at workplace ... 92

Annex 2 - Informative letter to employees for informed consent ... 95

Annex 3 - Psychosocial risk factors questionnaire for El Pangue ... 98

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List of figures and tables

Chart 1 - El Pangue export by country in 2014 14

Chart 2 - El Pangue import and export US$ 15

Chart 3 - Project Gantt chart 22

Chart 4 - Employees salary distribution 33

Chart 5 - Employees salary composition 33

Chart 6 - Work pace, risk by department 39

Chart 7 - Social support from peers, risk by department 40

Chart 8 - Insecurity with working conditions, risk by department 41

Chart 9 - Role conflicts, risk by department 42

Chart 10 - Social community at work, risk by department 43

Chart 11 - Job insecurity, risk by department 44

Chart 12 - Role clarity, risk by department 46

Chart 13 - Predictability, risk by department 47

Chart 14 - Quantitative demands, risk by department 48

Chart 15 - Double shifts, risk by department 49

Chart 16 - Influence at work, risk by department 51

Chart 17 - Emotional demands, risk by department 52

Chart 18 - Possibilities of development, risk by department 55

Chart 19 - Meaning of work, risk by department 56

Chart 20 - Justice, risk by department 57

Chart 21 - Recognition, risk by department 58

Chart 22 - Demands for concealing emotions, risk by department 60

Chart 23 - Vertical trust, risk by department 61

Figure 1 - Tentative psychosocial pathways 4

Figure 2 - Workplace organisation, stress and health 4

Figure 3 - El Pangue organisation 13

Figure 4 - El Pangue departments’ organisation 13

Table 1 - Emerging and changing psychosocial risk factors and hazards 2 Table 2 - Psychosocial hazards related to content and context of work 3

Table 3 - CoPsoQ principles and theoretical considerations 8

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Table 5 - Definition of psychosocial dimensions 19

Table 6 - Working conditions and sociodemographic questions 20

Table 7 - Health and satisfaction questions 21

Table 8 - Response rate by department 24

Table 9 - Response rate by job 25

Table 10 - Response rate by age rage 25

Table 11 - Functional mobility response rate 26

Table 12 - Direct consultation participation response rate 26

Table 13 - Employment relationship response rate 27

Table 14 - Length of employment response rate 27

Table 15 - Weekly working hours’ response rate 28

Table 16 - Work schedule response rate 28

Table 17 - Working time adaptability for clock-in/clock-out 29

Table 18 - Working time adaptability for personal or family issues 29

Table 19 - Working time adaptability for breaks 29

Table 20 - Response rate of worked Saturdays 30

Table 21 - Response rate of worked Sundays 30

Table 22 - Change in attendance requirement response rate 31

Table 23 - Overtime response rate 31

Table 24 - Domestic/family work response rate 32

Table 25 - Resources at work 32

Table 26 - Correspondence wage/labour 34

Table 27 - Job promotion response rate 34

Table 28 - Psychosocial risk factors exhibited in El Pangue 35

Table 29 - Exposures by department 36

Table 30 - Exposures by job 37

Table 31 - Work pace, questions’ response distributions 38

Table 32 - Social support from peers, questions’ response distributions 39 Table 33 - Insecurity with working conditions, questions’ response distributions 40

Table 34 - Role conflicts, questions’ response distributions 42

Table 35 - Social community at work, questions’ response distributions 43

Table 36 - Job insecurity, questions’ response distributions 44

Table 37 - Role clarity, questions’ response distributions 45

Table 38 - Predictability, questions’ response distributions 46

Table 39 - Quantitative demands, questions’ response distributions 47

Table 40 - Double shifts, questions’ response distributions 48

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Table 42 - Emotional demands, questions’ response distributions 51 Table 43 - Quality of leadership, questions’ response distributions 53 Table 44 - Social support from superior, questions’ response distributions 54 Table 45 - Possibilities of development, questions’ response distributions 54

Table 46 - Meaning of work, questions’ response distributions 56

Table 47 - Justice, questions’ response distributions 57

Table 48 - Recognition, questions’ response distributions 58

Table 49 - Demands for concealing emotions, questions’ response distributions 59

Table 50 - Vertical trust, questions’ response distributions 60

Table 51 - General health response rate 62

Table 52 - Mental Health response rate 62

Table 53 - Stress response rate 63

Table 54 - Burnout response rate 63

Table 55 - Work satisfaction response rate 63

Table 56 - Psychosocial risk factors exposure, origin and preventive measures matrix 66

Table 57 - Matrix analysis for work pace 67

Table 58 - Matrix analysis for quantitative demands 67

Table 59 - Matrix analysis for emotional demands 67

Table 60 - Matrix analysis for demands for concealing emotions 68

Table 61 - Matrix analysis for double shifts 69

Table 62 - Matrix analysis of influence at work 69

Table 63 - Matrix analysis for possibilities for development 70

Table 64 - Matrix analysis for meaning of work 70

Table 65 - Matrix analysis for social support from peers 71

Table 66 - Matrix analysis for social community at work 72

Table 67 - Matrix analysis for quality leadership 72

Table 68 - Matrix analysis for social support from superior 72

Table 69 - Matrix analysis for role conflicts 73

Table 70 - Matrix analysis for role clarity 73

Table 71 - Matrix analysis for predictability 73

Table 72 - Matrix analysis for insecurity with working conditions 74

Table 73 - Matrix analysis for job insecurity 74

Table 74 - Matrix analysis for recognition 75

Table 75 - Matrix analysis for justice 75

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Acronyms and abbreviations

CoPsoQ Copenhagen psychosocial questionnaire

CoPsoQ-istas21 Copenhagen psychosocial questionnaire, Spanish version 2 for companies with 25 or more employees

El Pangue Industria Maderera Elaboradora y Exportadora El Pangue Limitada

HR Human resource

ISTAS Union Institute of Work, Environment and Health

M Management department

OECD Organisation for Economic Co-operation and Development SENCE National Training and Employment Service

SF36 Short Form-36

WD Wood drying department

WM Wood moulding department

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Chapter 1 - Introduction

1.1 Introduction

Psychosocial risk factors at work are those characteristics of working conditions and workplace organisation for which evidence, based on a sociological frameworks and tentative pathways, displays effects on health (Martikainen, Bartley & Lahelma, 2002, p. 1092). Psychosocial risk factors are considered equivalent to other occupational risks (Declaration on Occupational Health for All, 1994, p. 3), to which long-term exposure can cause damage to health (Schneiderman, Ironson & Siegel, 2005, p. 6). The relationship between exposure to psychosocial risks at work and health problems is strong and indubitable (Martín et al., 2007, p. 95).

The interaction between the meso-level of psychosocial and individual psychological factors, plays a psychological and physiological role in biology and health behaviour as stress (Martikainen, Bartley & Lahelma, 2002, p. 1092). Under certain circumstances, this can become a harmful element, especially when it becomes a chronic stressor and there are no clear elements to identify and address the situation. Stress becomes the mediator mechanism by which exposure to psychosocial risk factors can cause diseases. (Slavich & Irwin, 2014, p. 10 - 16).

For the most part, psychosocial risks in the workplace have much to do with the organisation of the work, commonly based on the fundamental separation between the design and execution of responsibilities and duties, between being and not-being at work (Moncada et al., 2009. p. 5). Furthermore, in addition to providing sustenance, work can enhance creative and social skills, but can also relegate workers to alienated beings, appendages of machinery or processes, deprived of opportunities for learning and without working autonomy (Moncada et al., 2009. p. 5). This is especially demonstrated in the primary and secondary economic sector, where mostly unskilled workers are allocated monotonous tasks, are underprivileged and are cut-down from developing opportunities (Wunsch, Caselli & Vallin, 2005, p. 296). This is in addition to the physical hazards and psychological risk factors frequent in primary and secondary work environments (Hämmig & Bauer, 2013, p. 12).

In terms of the prevention of occupational risks and promotion of health, psychosocial factors represent the exposure to risks, the workplace conditions and organisation, the source of the risk and the stress being the precursors to and the originator of diseases (Moncada et al., 2007, p. 1), thus establishing a close link between psychosocial stress and the deterioration of the health.

There are many diseases and stress-related disorders that can be related to psychosocial risk factors (Nieuwenhuijsen, Bruinvels & Frings-Dresen, 2010, p. 277), but it is important to highlight it for both its prevalence and for the economic impact on the productive sectors; cardiovascular diseases

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(Pikhart & Pikhartova, 2015, p. 6 – 11; Strike & Steptoe, 2004, p. 337) and especially mental health problems (Stansfeld & Candy, 2006, p. 443 & 454).

1.2 Conceptual framework

The modern economy has evolved towards a post-Fordist production model, which is characterised by rapid technological change, increased economic globalisation and demographic transition, which affects the workplace (Stolk et al., 2012, p.14). These have contributed to concerns, over recent decades, about psychological risk factors and hazards at work and their associated risk on occupational health and safety (Stolk et al., 2012, p.11 & 14).

The so-called psychosocial hazards were defined by Cox and Griffiths (1995) as ‘those conditions design, organisation and management of the work, with their social and environment contexts, which have the potential to cause psychological, physical and social harm’ (Stolk et al., 2012, p.15; Antoniou & Cooper, 2005, p. 178). Many of these psychosocial risk factors and emerging hazards in the changing world of the workplace are summarised in Table 1, below.

Table 1 - Emerging and changing psychosocial risk factors and hazards

Areas of psychosocial risk and hazards Emerging and changing psychosocial risks and hazards

New forms of employment contracts and job insecurity

Precarious contracts in the context of an unstable labour market

Increased vulnerability of workers’ in the context of globalisation

New forms of employments contracts Feelings of job insecurity

Lean production and outsourcing

The ageing workforce Risk for the ageing workforce

Work intensification Long working hours

Work intensification

High emotional demands at work High emotional demands at work

Poor work-life balance Poor work-life balance

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In workplace health promotion and health protection, psychosocial risk factors are the ones provoked by organisation of the work, to which the response and impact on health can be physiological, emotional, cognitive or behavioural changes (Moncada et al., 2014, p. 21). In some circumstances it can cause the development of diseases and stress-related disorders (Slavich & Irwin, 2014, p. 10 - 16; Nieuwenhuijsen, Bruinvels, & Frings-Dresen, 2010, p. 277). Greater or fewer numbers of psychosocial risk factors and hazards in the content and context of work can be taxonomically represented in work characteristics and conditions that define hazards, as Table 2 shows.

Table 2 - Psychosocial hazards related to content and context of work

Work characteristics Examples of conditions defining hazards Content of work

Job content Lack of variety, meaningless work, under use

of skills

Workload and work pace Work overload or under load, machine pacing, time pressure

Work schedule Shift work, inflexible work schedules,

unpredictable hours

Environment and equipment Inadequate equipment, poor environmental conditions

Context of work

Control Low participation in decision-making, lack of

control

Organisational culture and function Poor communication, lack of definition Interpersonal relationships at work Social or physical isolation, interpersonal

conflict

Role in the organisation Role ambiguity

Career development Career stagnation and uncertainty, job insecurity, low social value to work

Home-work interface Conflicting demands of work and home

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The ten psychosocial hazards represented above could have damaging consequences on mental and physical health. This can be either via direct or indirect pathways, where the complex and problematic interaction between the workers and their environment, and the underlying cognitive and emotional negative experiences, causes work stress (Stolk et al., 2012, p. 21). In this manner the tentative pathways between psychosocial hazards, risk factors and health, can be schematically illustrated as shown in Figure 1. It shows how changes in social structures, excessive demands and psychological changes may affect health and well-being, either via psychobiological routes or through changing lifestyles and behaviours (Martikainen, Bartley & Lahelma, 2002, p. 1092).

Figure 1 - Tentative psychosocial pathways

Source: Based on Martikainen, Bartley & Lahelma, 2002, p. 1092

Psychosocial factors, workplace organisation, stress and health, all share a similar reaction mechanism that is related to the development of self-esteem and self-efficacy. In this way labour activity promotes or hinders people from exercising their abilities, from experiencing control and interacting with others to perform their duties well, and facilitates or hinders the satisfaction of their needs for well-being (Moncada et al., 2014, p. 21).

At work, psychosocial risk factors are: exposure to risk, workplace organisation, the source of risk factors and stress that is the precursor and originator of disease (Moncada et al., 2007, p. 1). This interaction is illustrated in Figure 2.

Figure 2 - Workplace organisation, stress and health

Macro level social structure Meso level social formations Meso level psychosocial factors Individual psychological factors Biology Behaviour Health Work organization Risk source Psychosocial factors Risk exposure Stress

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Workplace exposure to psychosocial risk factors has been recognised as one of the most significant causes of absenteeism (Catalina-Romero et al., 2015, p. 210; Moncada et al., 2014, p. 22). Furthermore, workplace psychosocial risk factors have been linked especially with highly prevalent health problems (Nieuwenhuijsen, Bruinvels & Frings-Dresen, 2010, p. 277), such as cardiovascular diseases (Belkic et al., 2004, p. 85; Moncada et al., 2014, p. 22), mental health disorders (Stansfeld & Candy, 2006, p. 443; Moncada et al., 2014, p. 22) and musculoskeletal diseases (Innes, 2005, p. 1; Kopec & Sayre, 2004, p. 1263; Moncada et al., 2014, p. 22).

Psychosocial factors are also related to other health problems, such as immune, gastrointestinal, dermatological and endocrinal diseases (Moncada et al., 2014, p. 22). Similarly, psychosocial risk factors are related to behavioural health risks such as smoking, alcohol and narcotic abuse, sedentary lifestyles and excessive weight (Siegrist & Rödel, 2006, p. 475 - 477; Moncada et al., 2014, p. 22).

1.3 Project description

This project was planned as a cross-sectional pilot study for Industria Maderera Elaboradora y Exportadora El Pangue Limitada in Santiago of Chile, hereafter referred to as “El Pangue”. The study goal was to evaluate the psychological risk factors in the workplace, and to generate possible hypotheses and provide potential solutions to improve workers’ well-being.

The Copenhagen psychosocial questionnaire (CoPsoQ) was selected as the ideal method because of its international legitimacy in evaluating the psychosocial risk factor in the workplace (Pejtersen et al., 2010, p. 19; Thorsen & Bjorner, 2010, p. 31). Finally, the Spanish CoPsoQ-istas21 (version 2 for companies with 25 or more employees) was selected as the questionnaire method to be used in this pilot study. This is a reproducible tool (Moncada et al., 2014, p. 103 - 105), with international prestige (Moncada et al., 2014, p. 12) and is valid in Chile. Furthermore it has good psychometric properties with which to measure psychosocial risk factors at work (Alvarado et al., 2012, p. 1154, 1160 & 1161).

The planning and execution was carried out by the investigator with organisational help from the company. The cost of the execution was shared with the company.

Preparation started in August 2015, with execution and evaluation taking place in September and October 2015 in Santiago. The project ended in November 2015.

1.4 Reasons for the selection of the topic

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- The CoPsoQ is an internationally accepted tool for the evaluation of psychosocial risk at work (Pejtersen et al., 2010, p. 19; Thorsen & Bjorner, 2010, p. 31).

- The CoPsoQ-istas21 is a validated, reliable, accepted and recognised tool in Chile (Alvarado et al., 2012, p. 1154, 1160 & 1161).

- The CoPsoQ-istas21 results are reproducible (Moncada et al., 2014, p. 103 - 105). - The CoPsoQ-istas21 is a publicly and freely available tool (Moncada et al., 2014, p. 5). - Personal connections with the company’s management allowed access to the company. - Management’s disposition permitted a psychosocial assessment to be carried out in the

company.

- Company management expressed genuine concern and interest in improving the workers’ situation within the company.

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Chapter 2 - Research objectives

As a pilot study, the main purpose was to evaluate, analyse and generate hypotheses about the possible origin of psychosocial risk factors related to the working conditions and the organisation at El Pangue.

The main objective of the study was to understand the psychosocial risk factors in the workplace in order to postulate meaningful health promotion activities and organisational changes to reduce these psychosocial risk factors and to improve employees’ well-being. With this in mind, the aim of this pilot cross-sectional study was the identification, location and measurement of exposure to psychosocial risk factors and other related issues in the working conditions at El Pangue.

To achieve these objectives, psychosocial risks will be analysed in this study following the methodology proposed by the CoPsoQ-istas21 version 2 Spanish questionnaire model.

At the end of this study, a psychosocial risk assessment report containing the investigation’s results was delivered to El Pangue. The company’s management was responsible for distributing the results to employees.

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Chapter 3 - Study background

3.1 The CoPsoQ questionnaire

There is a crucial relationship between workplace environment, workers’ well-being and health (Schabracq, Winnubst & Cooper, 2003, p. 1). Additionally, the psychosocial work environment is one of the most significant issues in the modern world, along with economic development and structural adjustment (Kristensen et al., 2005, p. 438; SAPRIN, 2004, p. 109). There is a growing need, born in the psychosocial work environment field, to standardise and validate an assessment tool that can be applied to all types of workplaces. This is what led to the development of the Copenhagen questionnaire (Kristensen et al., 2005, p. 439).

The CoPsoQ was developed by the National Research Centre on the Working Environment of Denmark (Kristensen et al., 2005, p. 438). It was based on general stress theory (Moncada et al., 2014, p. 14 & 23), which integrates two main models (Moncada et al., 2014, p. 22): the Demand/Control Model (Karasek & Theorell, 1990) and the Effort/Reward Model (Siegrist, 1996), and on the basis of subsequent theoretical considerations, as listed in Table 3.

Table 3 - CoPsoQ principles and theoretical considerations

1- Theory-based, but not theory-specific 2- Different levels of dimensions analysis 3- Different workplace dimensions

4- Cover potential workplace stressors and supporters 5- Comprehensive design

6- Generic questionnaire 7- User-friendly

Source: Adapted from Kristensen et al., 2005, p. 438

The Copenhagen Psychosocial Questionnaire is a psychosocial risk factors assessment tool, and its results and evaluations can be related to workers’ health (Burr, et al., 2010, p. 59). The development of this tool allowed for a standardized evaluation of a complex topic of psychosocial risk factors at

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work (Moncada et al., 2014, p. 171). It aims to improve psychosocial conditions in the workplace (Moncada et al., 2014, p. 5).

Furthermore, the CoPsoQ questionnaire is a reference tool for international organisations, for example (Moncada et al., 2014, p. 12): The World Health Organisation (Leka, 2010, p. 11 & 12), the European Agency for Safety and Health at Work (UE-OSHA, 2012, p. 6), the Institute of Work, Health and Organisations (Leka et al., 2008, p. 95 - 99) and The European Foundation for the Improvement of Living and Working Conditions (Schütte et al., 2014, p. 898).

The CoPsoQ is designed to evaluate any type of job in any economic sector and can be used to evaluate all jobs within the same organisation, whether the organisation is private or public (Moncada et al., 2014, p. 17).

3.2 The Spanish CoPsoQ-istas21 version 2 Questionnaire

The CoPsoQ-istas21 version 2 is a Spanish adaptation of the Copenhagen Psychosocial Questionnaire (Moncada et al., 2014, p. 5). It is an internationally recognised tool that is referenced in psychosocial workplace studies and psychosocial science (Moncada et al., 2014, p. 12; Kristensen et al., 2005, p. 438).

This tool was validated in Chile in the course of a government initiative carried out by the Public Health School of the University of Chile and with international collaboration from the Union Institute of Work, Environment and Health (ISTAS) team led by Dr. Salvador Moncada (Alvarado et al., 2012, p. 1160 - 1161).

The CoPsoQ-istas21 questionnaire is not only a tool that can help improve the prevention efforts that benefit workers by performing risk identification, locating problems and designing appropriate solutions. It cal also expand the range of knowledge for an organisation looking to understand what constitutes a risk (Kristensen et al., 2005, p. 446 - 449).

3.3 Chile workplace health

Chile is the only country in South America that is a member of the Organisation for Economic Co-operation and Development (OECD) and it is one of the most stable and secure countries in the region (Chile country profile - Overview, 2015). It has a highly competitive, open-market and liberal economy (The World Factbook, 2015). The economic growth in the last few decades has generated new occupational health and safety challenges (Ramírez Pérez & Lee Maturana, 2011, p. 432), such as: increased workloads and working hours, a still unequal income distribution and a low participation of women in the workforce (Rocha et al., 2013, p. 343 - 347; OECD, 2013, p. 8 - 9).

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Although a large part of the employed population is covered by the national social insurance system for work-related injury and illness, there is still a small group of workers without any health insurance coverage. Although the traditional risks are mostly covered by obligatory insurance, the demographic, epidemiological and economic changes have generated new and unresolved problems (Salinas & Vio, 2002; Rocha et al., 2013, p. 346).

There is a long history of workplace health problems in Chile. One of the most important events concerning this was the enactment of Law No. 16,744 in 1968 (Ley 16.744, 1968), which set up a legal framework to regulate the monetary and social rights of workers. This legal regulatory and institutional framework of occupational health actively engages many sectors of society such as businesses, workers, and public and private institutions.

The country policies of work and health are based on occupational medicine and on targeting public health criteria, which has enabled a steady progress in occupational health that is reflected in the significant reduction of occupational accidents in the last 50 years (Alvarado, Suazo & Quinteros, 1999, p. 52 - 54; Muñoz et al., 2014, p. 7 - 8). As consequence, preventive and surveillance measures have been developed under the paradigm of a causal relationship between risk factors at work and diseases. This mostly concerns taking actions to reduce or eliminate the exposure of workers to physical risks. This way of dealing with occupational diseases largely explains the success that has been obtained in respect to physical illnesses, which have decreased to a relatively low-level in Chile, as well as work-related diseases and accidents (Oyanedel et al., 2014, p. 147; Moncada et al., 2009, p. 9). However, applying the same concepts and paradigms of physical health to mental health has presented difficulties. For this reason, mental health at work has followed a different and slower process. It persists as one of the major health problems of the population and one of the bigger challenges to be solved, and it has become more and more common among the economically active population (Moncada et al., 2009, p. 9; Saavedra & von Mühlenbrock, 2009, p. 299 - 301).

In Chile, mental health problems and diseases are a national priority (Saavedra & von Mühlenbrock, 2009, p. 293 & 294; Minoletti & Zaccaria, 2005, p. 355 - 357). For example, in primary care for disorders that appear over an individual’s lifetime, or in the case of major depressive disorders that arise over any 12 month time period, the measures are 23.6 percent and 10.9 percent (Salvo, 2014, p. 1158). The impact quality on life is high. In 2007, a study suggested that neuropsychiatric conditions rank first out of the causes of a disability-adjusted life year, with a percent of 23.2 (Salvo, 2014, p. 1158). Another indicator of the mental health problem is higher absenteeism and Chile’s general absenteeism rate is 53 percent higher than the OECD average (English, 2015. p. 21). Problems are also translated into a significant investment of resources from the Social Security (Salvo, 2014, p. 1159). Introducing social protection for workers and their right for a healthy and

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safe workplace was a priority of the Government, especially the Health Ministry and the Superintendent of Social Security of Chile (MINSAL, 2011, p. 71 - 76 & 176 - 179).

3.4 Situation in small and mid-size private companies in Chile

Small and mid-size companies in Chile generate a good proportion of the jobs (Ministro Larroulet, 2012), stimulate the economy in the country and participate in internal and external markets (Alvarez & Crespi, 2001, p. 363). In Chile, there are around 1.5 million micro and small enterprises responsible for 49.3 percent of private employment (Hormazábal et al., 2013, p. 11).

In Chile, 98 percent of the existing companies can be categorised as small and medium-sized enterprises and in terms of employment 7 out of 10 new jobs are generated by small and mid-size private enterprises (Ministro Larroulet, 2012). But in 2011, small and medium-sized enterprises only generate 45.4 percent of the economic contribution in the country (Arellano & Carrasco, 2014, p. 24).

Chile has different realities and working conditions in regard to age, the gender of the workers and company size (Durán, 2014, p. 3, 8 - 12). These differences manifest themselves in lower chances of participation in the decision-making processes in the company, in exposure to certain risks, social coverage, in a low-level of autonomy and insecurity, and an in instability among other things (Carrasco & Vega, 2012, p. 4).

A National Survey done in the years 2009-2010 on 9,503 people over the age of 15 years, concerning conditions of employment, labour and health (Carrasco & Vega, 2012, p. 4), revealed the deficiencies in those aspects that affect the quality of working life (Carrasco & Vega, 2012, p. 4). It highlighted an emerging concern for psychosocial risk factors, which play a central role in the health and welfare of workers (Carrasco & Vega, 2012, p. 56). Almost a third of the interviewed workers could not decide for themselves they would rest or take a pause in their work, they could not influence the amount of work done in their work day, nor change the order of their tasks (Carrasco & Vega, 2012, p. 17). These aspects reveal a low autonomy and control over work by the worker (Carrasco & Vega, 2012, p. 57). Additionally, their participation in the various areas of labour organisation was low (Carrasco & Vega, 2012, p. 24 - 26). A low-level of input is also seen in their organisational and decision making processes at work. These are aspects that limit the quality of working life considerably (Carrasco & Vega, 2012, p. 58).

Another study done in Chile looking at 233 workers in five different economic sectors and published in 2011, measured the job climate, job satisfaction and other psychosocial factors in relationship to Burnout syndrome (Ramírez Pérez & Lee Maturana, 2011, p. 431 - 436). The result of the study was that psychosocial risk factors in the workplace are directly related to disease (Ramírez Pérez & Lee Maturana, 2011, p. 441).

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As a final example, another Chilean study, published in 2015, evaluated the correlation between psychosocial risk factors at work and perceived stress in the workers of a Chilean electric energy company (Güilgüiruca et al., 2015, p. 57). Using the CoPsoQ-istas21 questionnaire validated for Chilean workplaces (Alvarado et al., 2012, p. 1160 - 1161; Güilgüiruca et al., 2015, p. 57). This study came to the conclusion that workers’ perception of stress is related to the increase of psychosocial risk factors at work, which can be principally attributed to the workplace organisation (Güilgüiruca et al., 2015, p. 64).

It is possible to say, with a certain degree of confidence, that small and medium-sized enterprises in Chile are an important pillar of the country’s economy and that psychosocial risk factors are a hazard present in organisations. It is important to evaluate different organisations and economic sectors in such a way as to understand possible psychosocial risks variables in Chilean companies, in order to develop new health promotion activates and workplace policies for the future.

3.5 Pilot study in Industria Maderera Elaboradora y Exportadora El Pangue Limitada

El Pangue can be categorised as a private mid-size company (Ley-20416, 2010, p. 1). The company has a long history in the country and its business focus is the export of industrial wood mouldings and wooden shutters to North America and Australia (Maderera El Pangue Ltda., n.d.; El Pangue, n.d.). El Pangue represents the industrial economic sector and is a good example of a Chilean business organisation.

The company was founded in 1988 in Santiago of Chile as a family-owned business. It was later restructured, in 1977, to a Limited Liability Company. Its commercial address is Phillips 451, Of. 704, Santiago, Chile. El Pangue has two main manufacturing locations: one in Camino La Capilla de Nos N° 4, San Bernardo Santiago, and one in Santa Rosa Oriente Parcela N° 38, Constitución. The first site is where the main manufacturing processes are carried out and produces two types of final products: wood mouldings and wooden shutters. Both of these products are produced in two product lines with different internal organisation. At the second site, wood drying is carried out, with the objective of delivering dry wood to Santiago. This site also has its own organisational system. The total working population are mostly blue-collar workers, with 57 employees total (56 males and 1 female).

The organisation of the company is illustrated in Figure 3. It is important to highlight that the general management has supervisory and authoritarian control directly over all organisational levels. Workers have low capacity for influence at work, with no possibilities for personal and/or labour development and no participation in the decision making processes of the organisation. Furthermore, as an industrial company, most of the processes are monotonous and meaningless to the workers, who are just appendages of the machines. In addition to this, woodworking manufacturing companies

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have many health hazards such as: possible lacerations; amputations; blindness; musculoskeletal; skin and respiratory diseases and even death. Most of them are tied to the dangerous industrial processes of woodworking and the high physical demand in coping with the machines and the technology (Spellman & Bieber, 2011, p. 81 - 88).

Figure 3 - El Pangue organisation

The company is organised into four departments as is shown in Figure 4. These four departments are organised individually and only the management department runs the three others. As a consequence, there is an authoritarian leadership organisation and the blue-collar workers have little feeling of social community and/or commitment to the workplace.

Figure 4 - El Pangue departments’ organisation

General Management

Management and administration

Blue-collar workers

Management

Wood drying

Wood

moulding

Wooden

shutters

RO L

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Inside each of the departments there are many different roles; some of them are not assigned exclusively, but rather are interchanged among the general management. This job variation and mobility is done according to the different purchase orders and capacity planning. This can cause possible role conflicts, with low role definition and with job performance insecurity, which creates a stressful workplace (Olivares-Faúndez et al., 2014, p. 111; Emberland & Knardahl, 2015, p. 300). Economic information about El Pangue is available online (Maderera El Pangue Ltda., n.d.), and is shown in Charts 1 and 2. It is possible to conclude that the market for the company is almost exclusively mono-market, as represented by the 79 percent of exports to the United States of America in 2014. The monomarket of El Pangue could be a business risk factor within international market cycles and crises. This idea is reinforced by the variation of the total exports by year, as Chart 2 shows, where 50 percent of exports lost are directly correlated (temporally) with the 2007-8 economic crisis (Crash course, 2013). This may explain the difficulties of small and medium-sized exporting companies in gaining high market recognition, as they have fewer resources to ensure a good market position and less capital to deal with economic crises (Poblete & Amorós, 2013, p. 100). This insecurity of the working conditions and the company’s continuity adds an extra psychosocial risk factor to the workplace (Alvarado et al., 2012, p. 1155).

Chart 1 - El Pangue export by country in 2014

Source: Adapted from Maderera El Pangue Ltda., n.d. 79%

21%

Export by country in 2014

Industria Maderera Elaboradora y Exportadora El Pangue Limitada

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Chart 2 - El Pangue import and export US$

Source: Adapted from Maderera El Pangue Ltda., n.d.

As a conclusion, El Pangue is a suitable company to evaluate psychosocial risk factors in the workplace, as there are enormous possibilities to improve workers’ health and well-being, and to promote future health promotion activities and organisational changes.

$0 $500.000 $1.000.000 $1.500.000 $2.000.000 $2.500.000 $3.000.000 $3.500.000 2000 2002 2004 2006 2008 2010 2012 2014

Import and Export US $

Industria Maderera Elaboradora y Exportadora El Pangue Limitada

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Chapter 4 - Materials and methods

4.1 Design

This is pilot cross-sectional study, non-experimental design, with descriptive and correlational scopes. The sample includes all the employees of El Pangue, with a total of 57 employees, 56 of them men and 1 woman. The company of El Pangue was recruited through a familial relationship between the researcher and the management of the company

The company agreed to the implementation of the pilot study for psychosocial risk factors evaluation using the method CoPsoQ-istas21 (Spanish questionnaire version 2 for companies with 25 or more employees) and the agreement was signed on September 14th of 2015, in Santiago de Chile. A sample copy of the agreement is shown in Annex 1.

The agreement includes the following main features:

1. The creation of a working group within the company.

2. The authorisation to perform an evaluation in the whole company.

3. Information about the survey processes, anonymity and data management.

4.2 Study tool

CoPsoQ-istas21 is the Spanish adaptation of the Copenhagen Psychosocial Questionnaire, which is also validated in Chile (Alvarado et al., 2012, p. 1154). This Spanish version of the CoPsoQ is a public domain instrument with unauthorised modification and commercial use prohibited (Moncada et al., 2014, p. 17).

The questionnaire is confidential and anonymous. The questionnaire is answered individually and in the final report employees cannot be identified (Moncada et al., 2014, p. 7).

The final goal of the tool is prevention-oriented: through the location and assessment of risk exposures, a design for preventive measures can be made (Moncada et al., 2014, p. 5). Risk factors identify psychosocial domains and dimensions at the lowest complexity level and are listed in Table 4. The definition of each of the psychosocial dimensions are summed up in Table 5 and their corresponding domains are summarised below:

- Psychological demands of work: Refers to quantitative aspects and work tasks. Represented by the volume of work, time to perform tasks, cognitive and emotional tasks (Güilgüiruca et al., 2015, p. 60; Alvarado et al., 2012, p. 1155).

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- Work-family conflict: Refers to the level of exposure to double tasks associated with the household and work areas (Güilgüiruca et al., 2015, p. 61; Alvarado et al., 2012, p. 1155). - Work organisation and job contents: Refers to the autonomy and significance of the work,

to learning and development possibilities. Reflects the influence and/or autonomy of the worker in his job (Güilgüiruca et al., 2015, p. 60; Alvarado et al., 2012, p. 1155).

- Interpersonal relations and leadership: Refers to interpersonal relationships between workers and leadership. It includes feelings of community, attitudes toward leadership, predictability, and social support (Güilgüiruca et al., 2015, p. 60; Alvarado et al., 2012, p. 1155; Moncada et al., 2014, p. 32).

- Work-individual Interface: Refers to the perception of job security and continuity, as well as the level of job status (Güilgüiruca et al., 2015, p. 61; Alvarado et al., 2012, p. 1155). - Values at workplace level: Refers to the concept of social capital where individuals with

different levels of power in the organisation collaborate to do the job well (Moncada et al., 2014, p. 36).

The CoPsoQ-istas21, version for companies with 25 or more employees questionnaire has 109 short questions, most of them using a Likert scale (Moncada et al., 2014, p. 15). 25 questions on working conditions are listed in Table 6, 69 psychosocial risk factors questions are shown in Table 4 and 15 health and satisfaction questions are shown in Table 7. The health and satisfaction questions include the evaluation of mental health with the Short Form-36 (SF36), the stress scale developed by Sven Setterlind (Moncada et al., 2014, p. 39) and burnout scale version of the Copenhagen Burnout Inventory (Moncada et al., 2014, p. 40), all of them part of the CoPsoQ-istas21 tool.

The questionnaire has adaptations for El Pangue incorporated into it. These adaptations take into account the departments and jobs, the salary range updated in Chilean Pesos and the exclusion of the gender question to ensure anonymity. The result is a questionnaire of 108 questions. Annex 3 shows a sample copy of the questionnaire.

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Table 4 - CoPsoQ-istas21 Psychosocial Domains and Dimensions

Psychosocial domains Psychosocial dimensions Number of questions Psychological demands of work Quantitative demands

Work pace

Emotional demands Demands for concealing emotions

4 3 4 4

Work-family conflict Double-shifts 4

Work organisation and job contents Influence at work

Possibilities for development Meaning of work

4 4 3 Interpersonal relations and

leadership

Social support from peers Social support from supervisor Quality of leadership

Social community at work Predictability Role clarity Role conflicts 3 3 4 3 2 4 4 Work-individual interface Recognition

Job insecurity

Insecurity with work conditions

3 2 4 Values at workplace level Justice

Vertical trust

4 3

Total 69

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Table 5 - Definition of psychosocial dimensions

Psychosocial dimensions Definition Quantitative demands

Work pace

Emotional demands

Demands for concealing emotions

Psychological demands derived from the amount of work Psychological demands due to work intensity

The demands of non-engagement in emotional situations at work that may involve a transfer of feelings and emotions Neutral appearance regardless of the behaviour of others

Double-shift Synchronous requirements in family and home and in the workplace

Influence at work

Possibilities for development

Meaning of work

Power over decisions in day to day activity

Development opportunities at work for gaining new knowledge and learning new skills

Work's relationship with other values different from being employed and earn income

Social support from peers Social support from supervisor Quality of leadership

Social community at work Predictability

Role clarity Role conflicts

Getting assistance from colleagues to perform the job well Getting assistance from superiors to perform the job well Quality of human resources management

A “group feeling” at work

Having the adequate information at the right time to perform and adapt to the job properly

Knowledge about tasks, objectives, resources and autonomy Contradictory requirements at work that can create

professional or ethical conflicts Recognition

Job insecurity

Insecurity with work conditions

Respect and fair treatment from the management at work Insecurity about employment and unemployment

Concern for future working conditions Justice

Vertical trust

Equal treatment at work

Correct behaviour from the management and workers Source: Adaptation from Moncada et al., 2014, p. 128 – 137

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Table 6 - Working conditions and sociodemographic questions Sociodemographic characteristics Gender Age Removed 1

Department and jobs Department Job

1 1

Task design Functional mobility

Direct participation

1 1

Employment Employment relationship

Length of employment

1 1

Job promotion Job promotion 1

Workday Working days

Schedule

Weekly working hours Working time adaptability

Attendance requirement regarding working hours Housework Work resources 2 1 1 3 2 1 3 Salary Salary Salary composition Work-salary relationship 1 1 1 Total 25 - 1

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Table 7 - Health and satisfaction questions Health and satisfaction General health

Mental health Stress Burnout Work satisfaction 1 5 4 4 1 Total 15

Source: Adaptation from Moncada et al., 2014, p. 146 4.3 Data collection

The questionnaire was given to each employer in a closed envelope by the General Manager Secretary. El Pangue allowed each participant free working time to answer the questionnaire. Also, the voluntary participation was rewarded with $10,000 Chilean Pesos, approximately equivalent to €14 Euros. This amount was given in cash to each participant after the submission of the questionnaire into a closed box, which was put at their disposition outside the main office. The fieldwork was supervised by the investigator.

4.4 Data analysis

The data was organised, managed and analysed with the CoPsoq-istas21 2.0.17.2 software and Microsoft Excel 365 for Windows. Evaluation results are shown as total numbers and percentages, and are presented in three different units of analysis: within the whole company, different jobs and different departments. Information is ranked in three colours: red having the worst health tertile, yellow with an intermediate tertile and green with the most favourable health tertile. These percentages represent the proportion of employees exposed to more severe risk for that psychosocial dimension, and were calculated by the CoPsoq-istas21 2.0.17.2 software. The software determines the risk level by adding the points of the questions that comprise each scale, and taking the average of the weights for the response options (e.g., giving more or less weight for a person who indicates in a question that they are dissatisfied by that particular aspect of working life). The response distribution of each risk factor offers a visual representation of the proportion of employees who are in each tertile.

4.5 Study ethics

In the planning and execution of this pilot study, the required ethical and privacy factors were taken into account. These were also in agreement with the company and in the informative letter for the employees, as Annexs 1 and 2 show. The major features are:

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- El Pangue’s managers and the deputy manager of the workers joint committee accepted the participation and evaluation of psychosocial risk factors at workplace.

- An informative letter for each employee, including information about protection of anonymity and that participation was voluntary and that there were no costs to withdrawing. - Participation in the study was not obligatory.

- An economic reward for the study participation was accepted by all stakeholders. - The questionnaire was answered by the employees individually in a private room.

- It was agreed that this pilot study is confidential, anonymous and that individuals cannot be identified.

- The original questionnaires were destroyed after the data analysis and delivery of the final report.

- It was agreed with company managers and the workers’ joint committee, to disclose information about accidents and absenteeism with no possible individual identification. - The company agreed to disclose organisational information without the identification of

employees.

- Only freely available economic information about the company was allowed to be used in this study.

- Any type of study publication must have received prior authorisation from the company managers and stakeholders.

4.6 Project plan

The study covered a period of three months from the end of August 2015 to November 2015. The study plan was divided in four phases which are represented in Chart 3.

Chart 3 - Project Gantt chart

Project phase

Duration in Weeks

August September October November

1- Project Planning 4 2- Data Collection 5 3- Data Processing 4 4- Evaluation and

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Phase 1 – Project planning

The first 4 weeks were used to prepare the study, including the literature review, selection and preparation of the measurement instrument and arranging of organisational issues within the company.

Phase 2 – Data collection

Field work started on September the 7th and ended on October the 2nd, 2015. The agreement with the company was signed on September the 14th 2015, in Santiago de Chile; a sample copy of the agreement is shown in Annex 1. On the same day an information letter was given to each employee; a sample of the letter is presented in Annex 2.

The adaptation of the questions was conducted within the company between September the 9th and the 16th, 2015.

The questionnaire was completed by employees in the workplace, during working hours, in a private room at the company installations, between September the 17th and the 25th 2015.

Phase 3 – Data processing

This phase was done in-house by the investigator with the use of the CoPsoQ-istas21 2.0.17.2 software, SPSS version 19 and Microsoft excel 365.

Phase 4 – Evaluation and reporting

The pilot study assessment and report was carried out in this phase. Critical aspects of the study were evaluated using the following questions:

1. Were all parties and stakeholders successfully involved? 2. Were the objectives of the study were achieved?

3. Are the results and data quality relevant, significant and accurately represented? 4. Are there any possible confounding issues and/or biases?

5. What influence might the study have?

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Chapter 5 - Results

In this chapter, the study results are presented in four main sections: response rate by departments and jobs, working conditions, psychosocial risk factors and health and satisfaction in El Pangue. The raw data is available in Annex 4.

5.1 Response rate

The response rate in El Pangue was 86.0 percent (49 workers answered out of the 57 who were given the questionnaire). All categories have a response rate equal to or greater than 60.0 percent. The tables that follow show the response rate for the Units: Departments and Jobs. The response rate by department is shown in Table 8.

The Jobs Response rate is represented in absolute numbers and percentages according to the minimum number of workers needed for the job. This value represents the number of workers who had performed the job in the past three months. For example, in supervision and management this is 120.0 percent [N = 6]. This shows that one employee performed two or more tasks. Jobs Response rates are listed in Table 9.

Table 8 - Response rate by department

Department Response rate Total employees *

Management 100.0 % [N=3] 6.1 % N=3

Wood Drying 100.0 % [N=8] 16.3 % N=8

Wood Moulding 77.8 % [N=14] 28.3 % N=18

Wooden Shutters 85.7 % [N=24] 49.0 % N=28

Total 86.0 % [N=49] 100 % N=57

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Table 9 - Response rate by job

Job Response rate Job Response rate

General Management M 100.0 % [N=1] Quality control WM 100.0 % [N=2]

Secretary M 100.0 % [N=1] Packing WM 200.0 % [N=4] Supervision and Administration WD, WM and WS 120.0 % [N=6] Mechanical maintenance WM 100.0 % [N=1]

Boilermaker WD 100.0 % [N=3] Crane operator WM 100.0 % [N=1]

Stacker WD 100.0 % [N=4] Wood moulding WS 157.1 % [N=11]

Crane operator WD 100.0 % [N=1] Plywood operator WS 180.0 % [N=9] Swing saw operator WM 150.0 % [N=3] Painting and pasting WS 87.5 % [N=7] Wood trimmer WM 66.7 % [N=2] Quality control WS 75.0 % [N=6] Wood brushing WM 200.0 % [N=4] Mechanical maintenance WS 100.0 % [N=1] Finger joint operator WM 75.0 % [N=3] Crane operator WS 200.0 % [N=4]

Wood moulding WM 133.3 % [N=4] No answer 0.0 % [N=0]

Painting WM 100.0 % [N=2]

Departments: M: Management; WD: Wood Drying; WM: Wood Moulding; WS: Wooden Shutters

5.2 Working conditions

This first section presents the results of working conditions that are sources of risk factors. The sociodemographic characteristic expressed by the age range is shown in Table 10.

Table 10 - Response rate by age rage

Q1 - How old are you? Response rate

Under 31 6.1 % [N=3]

Between 31 and 45 18.4 % [N=9]

Older than 45 75.5% [N=37]

No answer 0.0 % [N=0]

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Characteristics relating to task design characteristics examined as functional mobility in Table 11 and direct consultation participation in Table 12 are presented below.

Table 11 - Functional mobility response rate

Q4 - Do you perform tasks in different positions? Response rate

Usually not 22.9 % [N=11]

Yes, generally high-level tasks 4.2 % [N=2]

Yes, generally low-level tasks 4.2 % [N=2]

Yes, generally of the same level 43.8 % [N=21]

Yes, either high, low or the same level tasks 22.9 % [N=11]

I do not know 2.1 % [N=1]

No answer 2.1 % [N=1]

Total [N=49]

Table 12 - Direct consultation participation response rate

Q5 - In the last year, did your managers consult with you about improving the way production is carried out?

Response rate

Always + Often 33.3 % [N=16]

Sometimes 29.2 % [N=14]

Only once + never 37.5 % [N=18]

No answer 0.0 % [N=1]

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Characteristics related to the work are depicted in Tables 13 and 14, which represent the Employment Relationship and Length of Employment at El Pangue.

Table 13 - Employment relationship response rate

Q8 - What kind of employment relationship do you have with the Pangue?

Response rate Permanent contract 89.8 % [N=44] Temporary contract 41.1 % [N=2] No contract 6.1 % [N=3] No answer 0.0 % [N=0] Total [N=49]

Table 14 - Length of employment response rate

Q7 - How long have you worked at El Pangue? Response rate

Less than 30 days 2.0 % [N=1]

Between 1 and 6 months 10.2 % [N=5]

More than 6 months and up to 2 years 4.1 % [N=2]

More than 2 years and up to 5 44.9 % [N=22]

More than 5 years and up to 10 8.2 % [N=4]

More than 10 years 30.6 % [N=15]

No answer 0.0 % [N=0]

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Characteristics relating to the workday with the weekly hours worked and work schedule are depicted in Tables 15 and 16.

Table 15 - Weekly working hours’ response rate

Q17 - How many hours do you usually work for El Pangue in a week? Response rate 30 hours or less 4.1 % [N=2] 31 to 35 hours 0.0 % [N=0] 36 to 40 hours 4.1 % [N=2] 41 to 45 hours 79.6 % [N=39]

More than 45 hours 12.2 % [N=6]

No answer 0.0 % [N=0]

Total [N=49]

Table 16 - Work schedule response rate

Q12 - What is your work schedule? Response rate

Morning and afternoon 95.9 % [N=47]

Rotating shifts including nights 4.1 % [N=2]

No answer 0.0 % [N=0]

Total [N=49]

Working time adaptability is shown in Tables 17 to 19, with the clock-in/clock-out time frames, the possibility of leaving work in case of personal or family issues and the adaptability for taking breaks.

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Table 17 - Working time adaptability for clock-in/clock-out

Q13 - What is the time frame for clocking-in/clocking-out? Response rate

Working time is set with no possibility for changes 83.7 % [N=41] May choose between several fixed working schedules 0.0 % [N=0]

Up to 30 minutes 8.2 % [N=4]

From half an hour to an hour 4.1 % [N=2]

More than an hour 4.1 % [N=2]

No answer 0.0 % [N=0]

Total [N=49]

Table 18 - Working time adaptability for personal or family issues

Q14 - If you have personal or family issues, can you leave your job for at least one hour?

Response rate

Always + Often 55.1 % [N=27]

Sometimes 10.2 % [N=5]

Only once + Never 34.7 % [N=17]

No answer 0.0 % [N=0]

Total [N=49]

Table 19 - Working time adaptability for breaks

Q20 - Can you decide when to take a break? Response rate

Always + often 34.7 % [N=17]

Sometimes 30.6 % [N=15]

Seldom + Never/hardly ever 34.7 % [N=17]

No answer 0.0 % [N=0]

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The Working Days section shows the number of weekend days worked in a month. Results are shown in Tables 20 and 21.

Table 20 - Response rate of worked Saturdays

Q10 - Do you usually work on Saturdays? Response rate

Never 40.8 % [N=20]

On exceptional occasions 32.7 % [N=16]

Once a month 10.2 % [N=5]

Twice a month 4.1 % [N=2]

Three or more Saturdays each month 12.2 % [N=6]

No answer 0.0 % [N=0]

Total [N=49]

Table 21 - Response rate of worked Sundays

Q11 - Do you usually work on Sundays? Response rate

Never 89.8 % [N=44]

On exceptional occasions 6.1 % [N=3]

One Sunday a month 0.0 % [N=0]

Two Sundays a month 0.0 % [N=0]

Three or more Sundays each month 4.1 % [N=3]

No answer 0.0 % [N=0]

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Attendance requirements with regard to working hours, including a measure of how often the clock-in/clock-out times are changed as well as actual work days is shown in Table 22 and the extra hours worked is displayed in Table 23.

Table 22 - Change in attendance requirement response rate

Q16 - How often does the company change the time for starting and leaving work or the actual working?

Response rate

Always + Often 6.3 % [N=3]

Sometimes 6.3 % [N=3]

Only once + Never 87.5 % [N=42]

No answer 0.0 % [N=1]

Total [N=49]

Table 23 - Overtime response rate

Q18 - How many times a month do you work at least an extra half an hour (overtime, additional hours…)?

Response rate

Never 74.5 % [N=35]

Exceptionally 12.8 % [N=6]

1 - 5 times in a month 2.1 % [N=1]

6 - 10 times in a month 4.3 % [N=2]

11 times in a month or more 6.4 % [N=3]

No answer 4.3 % [N=2]

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Domestic/family work done by the respondent is shown in Table 24.

Table 24 - Domestic/family work response rate

Q15 - What part of family/domestic work do you do? Response rate

I am the responsible one and do most of the family and household tasks

16.3 % [N=8]

Approximately half of family and household tasks 18.4 % [N=9] Around one fourth of family and household tasks 28.4 % [N=14]

Only occasional household tasks 16.3 % [N=10]

None or almost none 16.3 % [N=8]

No answer 0.0 % [N=0]

Total [N=49]

Responses regarding the resources needed to do the work well are listed in Table 25.

Table 25 - Resources at work

Always + often Sometimes Seldom +

Never/hardly ever No answer Q19a - Your department or section is understaffed 15.9 % [N=7] 18.2 % [N=8] 65.9 % [N=29] [N=5] Q19b - Planning is realistic 68.2 % [N=30] 11.4 % [N=5] 20.5 % [N=9] [N=5] Q19c - You work with adequate technology and it operates correctly? 72.1 % [N=31] 14.0 % [N=6] 14.0 % [N=6] [N=6]

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The characteristics relating to salary and salary composition are shown in Charts 4 and 5. The correspondence between wage and labour in represented in Table 26.

Chart 4 - Employees salary distribution

Chart 5 - Employees salary composition 1 20 15 5 1 3 1 1 1 0 1 0 2 4 6 8 10 12 14 16 18 20 ≤ €300 €301 - €450 €451 - €600 €601 - €750 €751 - €900 €901 - €1,200 €1,201 - €1,500 €1,501 - €1,800 €1,801 - €2,100 ≥ €2,101 Not answer Fixed salary 78% Fixed and variable salary 20% Variable salary 2%

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Table 26 - Correspondence wage/labour

Q6 - Does your job correspond to your professional category and salary?

Response rate

Yes 58.7 % [N=27]

No, my job is of a higher professional category than my salary 17.4 % [N=8] No, my job is of a lower professional category than my salary 6.5 % [N=3]

Do not know 17.4 % [N=8]

No answer 6.5 % [N=3]

Total [N=49]

Job promotion within at El Pangue is shown in Table 27.

Table 27 - Job promotion response rate

Q9 - Have you been promoted to a higher professional category since your recruitment?

Response rate

No 75.0 % [N=36]

Yes, once 18.8 % [N=9]

Yes, twice 2.1 % [N=1]

Yes, three or more times 4.2 % [N=2]

No answer 2.1 % [N=1]

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Medium risk: between acceptable and tolerable limit. High risk: above

The risk of asbestos workers (dotted line) is derived by linear extrapolation of asbestos-induced death due to lung cancer or mesothelioma in asbestos workers (excluding mining

• shall reference values refer to exposure duration ?.. Risk reduction

Pilot studies: In the two comparable German cities Dortmund (1) and Duisburg (2), parents with children aged zero to three were asked to complete a