Postal work - work organizational changes as tools to improve health

Sammanfattning: Postal work is performed in very different settings, and the works are e.g., drivers, letter carriers, postal sorters, and counter clerks. A finding that a small group of parcel sorters with a good psychosocial work situation had much lower health complaints than comparable workers with a worse psychosocial situation at work, indicated that it might be possible to improve mental and physical health among postal employees by improving work organization.The theoretical framework for this thesis is the demands-control-support (DCS) model by Karasek, Theorell, and Johnson. Two cross-sectional studies were performed with questionnaires. In a study on 144 workers at a postal terminal it was found associations between low support from superiors and high psychological work demands, on one hand and gastrointestinal and sleep problems on the other. In another study on 655 postal workers in 6 different occupations, high psychological work demands and low skill discretion was associated with low-back pain, and low social support at work with neck pain. In this study, the associations differed significantly between men and women.A follow-up study on the postal terminal (136 persons) was performed 8 and 12 months after an organizational change took place. The changes were aimed at improving the shift system, and psychosocial work situation. Authority over decision and skill discretion increased, and sick-leave decreased during the follow up period. Changes in contact with superiors, team-mates, and skill discretion were associated with changes in gastrointestinal and sleep complaints. In another follow up study, 82 individuals were studied before and 1 year after improvement of the psychosocial work environment. Musculoskeletal complaints were significantly reduced in the intervention group but not in the control group. Increased support from superiors was associated with less symptoms. Younger age and higher authority over decisions at baseline was associated with reduced symptoms at follow-up.The main findings of this thesis are that there are significant associations between psychosocial work situation among postal workers and psychosomatic and musculoskeletal symptoms, and that it is possible to reduce symptoms and sick-leave, by changes of organization, and improvement of the psychosocial work situation