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Evaluation of the Validity of Job Exposure Matrix for Psychosocial Factors at Work
Authors:Svetlana Solovieva  Tiina Pensola  Johanna Kausto  Rahman Shiri  Markku Heli?vaara  Alex Burdorf  Kirsti Husgafvel-Pursiainen  Eira Viikari-Juntura
Institution:1. Centre of Expertise for Health and Work Ability, Finnish Institute of Occupational Health, Helsinki, Finland.; 2. Disability Prevention Centre, Finnish Institute of Occupational Health, Helsinki, Finland.; 3. National Institute for Health and Welfare, Helsinki, Finland.; 4. Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.; University of Pennsylvania, United States of America,
Abstract:

Objective

To study the performance of a developed job exposure matrix (JEM) for the assessment of psychosocial factors at work in terms of accuracy, possible misclassification bias and predictive ability to detect known associations with depression and low back pain (LBP).

Materials and Methods

We utilized two large population surveys (the Health 2000 Study and the Finnish Work and Health Surveys), one to construct the JEM and another to test matrix performance. In the first study, information on job demands, job control, monotonous work and social support at work was collected via face-to-face interviews. Job strain was operationalized based on job demands and job control using quadrant approach. In the second study, the sensitivity and specificity were estimated applying a Bayesian approach. The magnitude of misclassification error was examined by calculating the biased odds ratios as a function of the sensitivity and specificity of the JEM and fixed true prevalence and odds ratios. Finally, we adjusted for misclassification error the observed associations between JEM measures and selected health outcomes.

Results

The matrix showed a good accuracy for job control and job strain, while its performance for other exposures was relatively low. Without correction for exposure misclassification, the JEM was able to detect the association between job strain and depression in men and between monotonous work and LBP in both genders.

Conclusions

Our results suggest that JEM more accurately identifies occupations with low control and high strain than those with high demands or low social support. Overall, the present JEM is a useful source of job-level psychosocial exposures in epidemiological studies lacking individual-level exposure information. Furthermore, we showed the applicability of a Bayesian approach in the evaluation of the performance of the JEM in a situation where, in practice, no gold standard of exposure assessment exists.
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