• Isabelle Niedhammer, Allison Milner, Thomas Coutrot, Béatrice Geoffroy-Perez, Anthony D LaMontagne, and Jean-François Chastang.
• From the INSERM, Univ Angers, Univ Rennes, EHESP, Irset (Institut de recherche en santé, environnement et travail)-UMR_S 1085, Epidemiology in Occupational Health and Ergonomics (ESTER) Team (Niedhammer, Chastang), Angers, France; Centre for Health Equity, Melbourne School of Population and Global Health (Milner, LaMontagne), University of Melbourne, Melbourne, Victoria, Australia; DARES, Ministère du Travail (Coutrot), Paris, France; Santé publique France (Geoffroy-Perez), Saint-Maurice, France; and Institute for Health Transformation, School of Health and Social Development (LaMontagne), Deakin University, Geelong, Victoria, Australia.
• Psychosom Med. 2021 Jan 1; 83 (1): 62-70.

ObjectiveThe objectives were to examine the prospective associations between psychosocial work factors of the job strain model and all-cause mortality in a national representative cohort of French employees using various measures of time-varying exposure.MethodsThe study was based on a sample of 798,547 men and 697,785 women for which data on job history from 1976 to 2002 were linked to mortality data from the national death registry. Psychosocial work factors from the validated job strain model questionnaire were imputed using a job-exposure matrix. Three time-varying measures of exposure were explored: current, cumulative, and recency-weighted cumulative exposure. Cox proportional hazards models were performed to study the associations between psychosocial work factors and mortality.ResultsWithin the 1976-2002 period, 88,521 deaths occurred among men and 28,921 among women. Low decision latitude, low social support, job strain, isostrain, high strain, and passive job were found to be risk factors for mortality. The model using current exposure was the best relative-quality model. The associations of current exposure to job strain and mortality were found to have hazard ratios of 1.30 (95% confidence interval [CI] = 1.24-1.36) among men and 1.15 (95% CI = 1.06-1.25) among women. The population fractions of mortality attributable to job strain were 5.64% (95% CI = 4.56%-6.71%) among men and 4.13% (95% CI = 1.69%-6.71%) among women.ConclusionsThis study supports the role of the psychosocial work factors of the job strain model on all-cause mortality. Preventive intervention to improve the psychosocial work environment may help to prevent mortality in working populations.Copyright © 2020 by the American Psychosomatic Society.

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