Effort-Reward Imbalance and Mental Health Problems in 1074 German Teachers, Compared with Those in the General Population.

High degrees of premature retirement among teachers warrant investigating the occupational burden and the mental health status of this profession. A sample of 1074 German teachers participated in this study. Two samples of the general population (N = 824 and N = 792) were used as comparison groups. Work distress was assessed with the Effort-Reward-Imbalance questionnaire, and mental health problems were measured with the General Health Questionnaire (GHQ-12). Teachers reported more effort-reward imbalance (M = 0.64) compared with the general population (M = 0.57), and they perceived more mental health problems (GHQ: M = 12.1) than the comparison group (M = 9.5). School type was not associated with work stress and mental health. Teachers with leading functions perceived high degrees of effort and reward, resulting in a moderate effort-reward ratio and no heightened mental health problems. Teachers working full time reported more effort than teachers working part time, but the reward mean values of both groups were similar. This results in a somewhat unfavourable effort-reward ratio of teachers working full time. Moreover, teachers working full time reported more mental health problems. The results support the appropriateness of the effort-reward conception, applied to the profession of teachers. The higher degree of effort-reward imbalance and the level of mental health problems warrant preventive measures. Copyright © 2014 John Wiley & Sons, Ltd.

Teachers' Health.

BACKGROUND: Almost 800,000 teachers were working in Germany in the 2012-13 school year. A determination of the most common medical problems in this large occupational group serves as the basis for measures that help maintain teachers' health and their ability to work in their profession. METHODS: We present our own research findings, a selective review of the literature, and data derived from the German statutory health insurance scheme concerning medical disability, long-term illness, and inability to work among teachers. RESULTS: Compared to the general population, teachers have a more healthful lifestyle and a lower frequency of cardiovascular risk factors (except hypertension). Like non-teachers, they commonly suffer from musculoskeletal and cardiovascular diseases. Mental and psychosomatic diseases are more common in teachers than in non-teachers, as are nonspecific complaints such as exhaustion, fatigue, headache, and tension. It is commonly said that 3-5% of teachers suffer from "burnout," but reliable data on this topic are lacking, among other reasons because the term has no standard definition. The percentage of teachers on sick leave is generally lower than the overall percentage among statutory insurees; it is higher in the former East Germany than in the former West Germany. The number of teachers taking early retirement because of illness has steadily declined from over 60% in 2001 and currently stands at 19%, with an average age of 58 years, among tenured teachers taking early retirement. The main reasons for early retirement are mental and psychosomatic illnesses, which together account for 32-50% of cases. CONCLUSION: Although German law mandates the medical care of persons in the teaching professions by occupational physicians, this requirement is implemented to varying extents in the different German federal states. Teachers need qualified, interdisciplinary occupational health care with the involvement of their treating physicians.

Predictors of mental health in female teachers.

OBJECTIVE: Teaching profession is characterised by an above-average rate of psychosomatic and mental health impairment due to work-related stress. The aim of the study was to identify predictors of mental health in female teachers. MATERIAL AND METHODS: A sample of 630 female teachers (average age 47 ± 7 years) participated in a screening diagnostic inventory. Mental health was surveyed with the General Health Questionnaire GHQ-12. The following parameters were measured: specific work conditions (teacher-specific occupational history), scales of the Effort-Reward-Imbalance (ERI) Questionnaire as well as cardiovascular risk factors, physical complaints (BFB) and personal factors such as inability to recover (FABA), sense of coherence (SOC) and health behaviour. RESULTS: First, mentally fit (MH(+)) and mentally impaired teachers (MH(-)) were differentiated based on the GHQ-12 sum score (MH(+): < 5; MH(-): ≥ 5); 18% of the teachers showed evidence of mental impairment. There were no differences concerning work-related and cardiovascular risk factors as well as health behaviour between MH(+) and MH(-). Binary logistic regressions identified 4 predictors that showed a significant effect on mental health. The effort-reward-ratio proved to be the most relevant predictor, while physical complaints as well as inability to recover and sense of coherence were identified as advanced predictors (explanation of variance: 23%). CONCLUSION: Contrary to the expectations, classic work-related factors can hardly contribute to the explanation of mental health. Additionally, cardiovascular risk factors and health behaviour have no relevant influence. However, effort-reward-ratio, physical complaints and personal factors are of considerable influence on mental health in teachers. These relevant predictors should become a part of preventive arrangements for the conservation of teachers' health in the future.

Oral health-related quality of life and oral status in a German working population.

The study aim was to identify predictors of impaired oral health-related quality of life (OHRQoL). Employees of five companies were offered a clinical full-mouth examination. Oral health-related quality of life was measured with the German version of the Oral Health Impact Profile (OHIP) and summarized as additive scores (OHIP-ADD) and as prevalence of negative impacts (OHIP-SC). Two logistic regression models were developed for the odds of increased scores of the target variables OHIP-ADD and OHIP-SC. The target variables were dichotomized, and for the OHIP-ADD, the cut-off point for having impaired OHRQoL was heuristically defined as OHIP-ADD > 34. For the OHIP-SC, the corresponding threshold was OHIP-SC > 0. In the model for the OHIP-ADD, female gender, impaired aesthetics, few posterior occluding pairs, and painful masticatory muscles proved to be significant independent variables. For the OHIP-SC, female gender, impaired aesthetics, painful masticatory muscles, joint sounds, missing mandibular teeth, and carious teeth were significant. This cross-sectional study showed that within the models for both OHIP-ADD and OHIP-SC the high-risk person for impaired OHRQoL is a woman with impaired aesthetics and painful masticatory muscles.

[Prevention in occupational health care--a societal challenge]. / Prävention im betrieblichen Setting--eine gesellschaftliche Aufgabe.

The metabolic syndrome, increasingly appearing amongst the elderly and recently in younger people with a most sudden increase in the age group < 30 years, is one of the main threats to European health in this century. Early diagnosis is the most efficient way to manage and to prevent metabolic syndrome from developing. Recent studies have convincingly demonstrated that lifestyle intervention, addressing diet and exercise, reduced the risk of developing diabetes and metabolic syndrome. The challenges today are to develop and implement efficient strategies to identify those on risk and to implement prevention management programs for clinical practice. Company medical officers could play an important role while identifying persons with increased risk for the metabolic syndrome, because they are addressing patients and healthy working persons but also reaching persons who normally are not reached by the health-care system. The occupational medical health promotion has the structural requirement to implement preventive intervention also by using its influence to establish healthy workplaces. Implementing managed prevention programs in the occupational medical care setting will enable prevention of the metabolic syndrome without consuming large resources. This process will be challenging and must be sustainable requiring many partners but resulting in a profitable chance for occupational health care.

Working conditions, adverse events and mental health problems in a sample of 949 German teachers.

OBJECTIVES: The aim of this study was (1) to explore in detail the working load of teachers, (2) to analyse the extent of negative or threatening school-related events teachers are confronted with, and (3) to evaluate mental health strain by applying the general health questionnaire (GHQ). METHODS: A sample of 949 teachers in 10 grammar schools (German: Gymnasien) and 79 secondary modern schools (German: Hauptschulen) was investigated applying (1) a questionnaire covering different aspects of the occupational burden and threatening school-associated events and (2) the general health questionnaire (GHQ-12). RESULTS: Based on what teachers indicated in the questionnaire, full-time teachers work more than 51 h weekly. More than 42% of our sample indicated verbal insults, almost 7% deliberate damage of personal belongings, and 4.4% threat of violence by pupils during the past 12 months. When applying the GHQ-12, we found that 29.8% of the sample report significant mental health problems. With respect to school types, teachers in secondary modern schools indicated more of such problems, while no effects regarding age, gender, or full/part-time teaching were observed. CONCLUSIONS: To be a teacher is a hard work and requires coping of considerable amount of adverse events. Based on the GHQ, nearly 30% of teachers suffer from significant mental health problems.

Burnout and effort-reward-imbalance in a sample of 949 German teachers.

OBJECTIVES: High rates of teachers' premature retirement initiated a research investigating their occupational burden. The aim of this study was to elaborate on and extend previous investigations exploring (1) teacher burnout and (2) the relationship between teachers' efforts and their rewards. METHODS: A sample of 949 German teachers in 10 Gymnasien (grammar schools) and 79 Hauptschulen (secondary modern schools) was investigated applying the Maslach Burnout Inventory (MBI-D) and the Effort Reward Imbalance Inventory (ERI). RESULTS: Compared with other studies investigating burnout in employees, we found high rates of burnout symptoms such as emotional exhaustion, depersonalisation, and low personal accomplishment. Male teachers showed significantly lower personal accomplishment and more depersonalization than female teachers. With respect to school types, teachers in Hauptschulen were more often affected by emotional exhaustion and showed more depersonalization. Part-time teachers felt less personal accomplishment than full-time teachers. The ERI cut off was exceeded by 21.6% of all teachers indicating that this subgroup is affected by an imbalance between too much effort and too little reward. With respect to the ERI, significant differences were found for school types, with a higher proportion of Hauptschulen teachers being above this cut off. CONCLUSIONS: At present, the working situation of teachers appears to be characterized by a perceived imbalance of effort and reward and is associated with a high risk of developing burnout symptoms.

Evaluation criteria for aircraft noise.

Based on extensive and detailed reviews the present paper suggests evaluation limits for aircraft noise for the prediction of noise effects and for the protection of residents living in the vicinity of (newly constructed or extended) civil airports. The protection concept provides graded assessment values: Critical Limits indicate noise loads that shall be tolerated only exceptionally during a limited time. Protection Guides are central assessment values for taking actions to reduce noise imission. Threshold values inform about measurable physiological and psychological reactions due to noise exposures where long term adverse health effects are not expected. Evaluation limits are provided for various protection goals. Apart from hearing damage, evaluation limits are provided for the avoidance of primary extraaural effects on communication and on sleep, for the avoidance of annoyance as a secondary effect and for the avoidance of suspected cardiovascular diseases. Such limits enable authorities to outline the areas around airports, where appropriate measures are mandatory to protect residents against the deleterious effects of noise. Protecting residents is a dynamic process that must be followed up. The evaluation limits must be repeatedly tested in view of new scientific findings and adapted, if necessary.

Trends of research and practice in "occupational risk prevention" as seen in Germany.

Hypothesis and scenarios of future developments in ORP and ORP research are derived. Based on an analysis of events in the past, on the content and process of research projects in the German "humanization" program, on literature analysis and expert interviews 19 anamnesis to diagnosis relationships are formulated concentrating on the following topics: 1. Innovation potentials and value systems of ORP research, 2. Fields and topics of ORP research of the future, 3. Service-oriented systems of actors in ORP, 4. Demands and limits for research transfer. So the creative potential of the ORP community in Germany was used to conclude on recommendations for ORP developments.