Text

Introduction: Physical and psychosocial exposures are well-established risk factors for fatigue, musculoskeletal pain, sickness absence and early retirement, placing a significant burden on workplaces and society. Traditionally, research and practice have focused on the health effects of single work exposures—such as prolonged standing or low autonomy—in isolation from each other. While this approach has been effective in addressing certain risks, it fails to reflect that exposures co-occur in time. For example, a worker may be standing, while bending the back forward, under low work autonomy at the same time. The combined effect of these co-occurring exposures in time may extend beyond the impact of each exposure individually. Thus, it might not only be important to know how much each exposures occur, but also to which extent they co-occur in time. This study aimed to develop a new conceptual framework for understanding how physical and psychosocial work exposures are co-dependent and co-occur in time, in which contexts, and how they influence worker health. This approach incorporates (a) how physical and psychosocial work exposures occur, (b) to which extent they co-occur in time, and (3) how they depend on context (e.g. work tasks).

Methods: The framework was developed through four separate participatory workshops, each involving a different group: (1) researchers; (2) occupational health practitioners and workplace representatives; (3) regulatory agency; and (4) social partners. These workshops focused on co-creating the conceptual foundations of the framework by integrating both research expertise, occupational health and safety (OHS) practice and regulatory insights, and knowledge from a range of workplaces across jobs.

Results: The resulting framework consisted of two parts: (a) “concept model” that outlines factors that can influence the co-dependency and co-occurrence of physical and psychosocial exposures and their effect on symptoms (e.g., fatigue), pain and sickness absence; and (b) “construct model” that outlines how physical and psychosocial work exposures are co-dependent and co-occur in time.

Discussion: This novel framework reorients occupational health research and practice toward the co-dependency and co-occurrence of ergonomic and psychosocial work exposures. It calls for analytical approaches, measurement tools, research data and designs that can investigate the co-dependent and co-occurrence of work exposures and their importance for worker health. Sensor-based data collection combined with task identification methods offers a promising path forward. For practitioners, the approach suggests a new way of conducting workplace risk assessments and preventive interventions.

Conclusions: This framework might advance occupational health research and practice by adding how physical and psychosocial work exposures co-depend and co-occur in time. We believe that the approach has potential to advance prevention strategies, inform policy, and ultimately lead to healthier and more sustainable work environments for all.