Associations of effort-reward imbalance at work and reported symptoms in different groups of male and female public transport workers

This study tests associations between stressful working conditions in terms of effort-reward imbalance and reported physical symptoms in public transport workers. We hypothesize that bus- and subway drivers suffer from relatively highest level of ill health as compared to repair service workers and administrative personnel, and that a substantial part of this association is due to the imbalance experienced between high effort and low reward. 1337 employees participated in the present study. Measures of effort-reward imbalance were constructed from a large battery of standardized Likert-scaled items, and factor-based symptom scales were computed. After adjustment for relevant confounders multivariate logistic regression analysis revealed significantly elevated prevalence odds ratios in bus- and subway drivers suffering from effort-reward imbalance (in four out of five factor based symptoms scores). Similar, but less pronounced effects were observed in repair service personnel while elevated risk in administrative personnel suffering from effort-reward imbalance was observed only with regard to one symptom score: gastro-intestinal symptoms. In conclusion, stressful working conditions as defined by effort-reward imbalance are associated with high rates of reported symptoms in public transport workers, especially so in professional drivers. In view of long-term costs and reduced quality of life associated with high rates of reported symptoms, these results call for improved worksite health promotion in specific target groups of public transport workers.