Prospective associations between psychosocial work exposures and general practitioner consultations in France

The literature is lacking on the associations between psychosocial work exposures and health outcomes as assessed using ‘objective’ data sources, especially those related to primary care use. The objectives of this study in a large population-based sample were to explore the prospective associations between psychosocial work exposures and the number of general practitioner (GP) consultations, as assessed using an ‘objective’ data source, over a follow-up of 2 years. The study was based on the data of the three waves of the national French ESPS survey (2010, 2012 and 2014) which were linked to the data of national health insurance system. Psychosocial work exposures were assessed using ten items that included proxies of the job strain and effort-reward imbalance models: quantitative demands, freedom at work, possibilities for learning new things, colleague support, recognition at work, salary satisfaction, job insecurity, tension with the public, temporary contract, and redundancy plan. GP consultations were derived from the national health insurance system. The studied outcome was the number of GP consultations over a 2-year period following each survey wave. The prospective associations between psychosocial work exposures and the number of GP consultations were studied using mixed effect negative binomial models before and after adjustment for covariates. The study included a study sample of 8771 workers aged 18–65. Low possibilities for learning new things, low colleague support, low recognition at work, low salary satisfaction, and job insecurity were prospectively associated with the number of GP consultations over follow-up. The associations were slightly weakened after adjustment for covariates and the number of GP consultations within the 6 months preceding survey wave. A dose-response association was observed between the number of psychosocial work exposures and the number of GP consultations. Almost all of these associations were found to be the same for men and women. Five of the ten studied psychosocial work exposures were associated prospectively with the number of GP consultations as assessed by ‘objective’ data source, avoiding any reporting bias. More research is needed to confirm our results using prospective design and outcomes from ‘objective’ data sources.