Influence of combined exposure to perceived risk at work and unstable employment on self-rated health: a comparison of two cross-sectional surveys in Europe and Korea

BMJ Open. 2020 Jan 2;10(1):e032380. doi: 10.1136/bmjopen-2019-032380.

Abstract

Objectives: The purpose of this study was to investigate the combined effect of exposure to perceived risk at work and unstable employment on self-rated health in both Korea and the European Union.

Design: Cross-sectional study.

Setting: We conducted the analyses using employees data from the third Korean Working Conditions Survey (KWCS) conducted in 2011 and the fifth European Working Conditions Survey (EWCS) conducted in 2010.

Participants: Employees of the third KWCS and the fifth EWCS from 35 European countries were the participants of the study.

Primary outcome measures: Employment status was divided into two categories: stable and unstable employment. Perceived risk regarding safety and health at work were assessed. Primary health outcomes were poor or moderate self-rated health. Exposures and health status were assessed via a questionnaire.

Results: Among Korean employees, the OR of poor self-rated health was 2.00 (95% CI: 1.80 to 2.22) for those with perceived risk at work, 1.18 (95% CI: 1.09 to 1.28) for those with unstable employment and 3.22 (95% CI: 2.72 to 3.81) for those with both perceived risk at work and unstable employment. Relative excess risk due to interaction (RERI) was 1.03 (95% CI: 0.48 to 1.58). Among European employees, the OR for poor self-rated health was 3.20 (95% CI: 2.93 to 3.49) for those with perceived risk at work, 1.04 (95% CI: 0.97 to 1.13) for those with unstable employment and 3.41 (95% CI: 2.93 to 3.98) for those with both perceived risk at work and unstable employment. The RERI was 0.18 (95% CI: -0.36 to 0.71).

Conclusions: Among Korean employees, a supra-additive interaction between perceived risk at work and unstable employment on poor self-rated health was observed. Conversely, a supra-additive interaction was not observed among European employees.

Keywords: interaction analysis; perceived risk at work; self-rated health; unstable employment.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Employment / psychology
  • Employment / statistics & numerical data*
  • Europe / epidemiology
  • Female
  • Health Status*
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Republic of Korea / epidemiology
  • Retrospective Studies
  • Sex Factors
  • Stress, Psychological / epidemiology*
  • Stress, Psychological / psychology
  • Surveys and Questionnaires