Job stress and occupational accidents in the Pró-saúde study, Brazil

The objective of this study was to investigate the association between job stress and the occurrence of occupational accidents using multilevel modeling in order to take into account clustering of participants at their workplaces. Analyses were based on 3572 university employees ≤70 years of age (~82% of the eligible population) during the second phase of data collection of a longitudinal study (Estudo Pró-Saúde). The period of recall for accidents was the 12-month before answering the self-reported questionnaire. Psychosocial stress at work was approached considering the interplay between high psychological demand and low control over the labor process. These dimensions were taken by means of the summarized version of the Karasek scale, which also contains information about the social support at work. Isolated dimensions of job stress (demand and control), the ratio between scores of psychological demand and control over the work process (ratio D/C) and social support at work were measured at individual level and at the level of the workplace. The total prevalence of accidents in the 12-month period was 26%. Results indicate that high psychological demands measured at the individual level was an important factor associated to the occurrence of occupational accidents, particularly among those with scores above the population average, independently of the level of control that the subject might have over the work process. Social support at work was inversely associated to the prevalence of occupational accidents. At the workplace level, this association was characterized by a curvilinear relationship more evident among female worker.