Combined exposures to workplace psychosocial stressors: Estimating the contribution to poor mental health in a sample of working Australians

The evidence linking individual stressors to mental health outcomes is relatively strong, but less is known about combined job stressor exposures and associated health outcomes. We assessed exposure to five job stressors singly and in combination, and associations between these measures and SF-12 mental health in a population-based sample of working Australians (N = 981). Prevalence and effect size estimates were combined to estimate the burden of poor mental health attributable to the measured job stressors. Job pressure combines job strain and insecurity. Measures of job quality were computed by summing exposures (yes/no) for three (low control, high demands, and high insecurity), four (plus long working hours), and five stressors (plus unwanted sexual advances at work). Exposure to one of the five stressors in our job quality measure was the norm (42%), with exposure to two (31%) or three (11%) stressors relatively common as well. Increasing job pressure showed a stepwise increase in the odds of poor mental health, and improved model fit over modelling job strain and insecurity independently. The 5-stressor measure of job quality also showed stepwise increasing odds of poor mental health and improved model fit compared to modelling the 5 stressors individually. Population attributable risk estimates suggest that half or more of poor mental health in this working population sample could be attributable to poor psychosocial working conditions. Psychosocial working conditions could be a major determinant of population mental health, thus policy and practice initiatives to improve psychosocial working conditions could have major population health benefits.