摘要：Objectives. We sought to describe work organization attributes for employed immigrant Latinas and determine associations of work organization with physical health, mental health, and health-related quality of life. Methods. We conducted a cross-sectional survey with 319 employed Latinas in western North Carolina (2009–2011). Measures included job demands (heavy load, awkward posture, psychological demand), decision latitude (skill variety, job control), support (supervisor control, safety climate), musculoskeletal symptoms, mental health (depressive symptoms), and mental (MCS) and physical component score (PCS) health-related quality of life. Results. Three fifths reported musculoskeletal symptoms. Mean scores for depression, MCS, and PCS were 6.2 (SE = 0.2), 38.3 (SE = 0.5), and 42.8 (SE = 0.3), respectively. Greater job demands (heavy load, awkward posture, greater psychological demand) were associated with more musculoskeletal and depressive symptoms and worse MCS. Less decision latitude (lower skill variety, job control) was associated with more musculoskeletal and depressive symptoms. Greater support (supervisor’s power and safety climate) was associated with fewer depressive symptoms and better MCS. Conclusions. Work organization should be considered to improve occupational health of vulnerable women workers. Additional research should delineate the links between work organization and health among vulnerable workers. Immigrant and low-income workers constitute a vulnerable population that is at significant risk for occupational injury and illness. These workers often have the most demanding jobs in the most dangerous industry sectors (e.g., agriculture, construction). 1-5 When they work in less hazardous sectors, such as manufacturing, they generally work in industries such as poultry and meat processing, which have substantial hazards and few protections. 6-7 These manufacturing hazards include exposure to toxicants (e.g., cleaners, solvents), exposure to biological materials (e.g., feces, dander), repetitive motion injuries, slips and falls, and lacerations and amputation from sharp tools and machinery. Although addressing conventional risk factors (e.g., chemical and mechanical exposures) remains important for improving the health of immigrant and low-income workers, greater attention is being given to how work organization affects their health and safety. 5,8 The National Institute for Occupational Safety and Health (NIOSH) 9 defines “work organization ” as the processes and organizational practices that influence job design. Work organization domains include the timing of when work is performed, such as shifts and hours worked, seasonality, and flexibility; the physical and psychological demands of work; the control or decision latitude workers have, including variation in effort and choice in performing work; and style of supervision and support, including supervisor support and control and work safety climate. 10,11 Work organization has most often been considered in its effects on job satisfaction and health of white-collar workers. Although work organization is believed to be particularly influential in the health and safety of vulnerable workers, little research has examined work organization and health outcomes for vulnerable populations such as immigrant workers. 5,8,12 Even less research has focused on work organization among immigrant women. For example, recent analyses of work organization and health among US immigrant workers in agriculture 13-15 and construction 16-18 have shown that, among agricultural workers, job demands are associated with poorer physical health 13 ; high worker control is associated with better mental health 14 ; and poor safety climate is associated with greater musculoskeletal discomfort. 15 Among construction workers, poor work safety climate is associated with poor work safety behavior. 16 However, participants in these studies have been almost exclusively male. Recent analyses of work organization and health among immigrant poultry processing workers have included a substantial number of women. 19-22 These analyses showed that management practices, such as poor safety commitment, and job design, such as authority, variety, psychological workload, frequent awkward posture, and repetitive movement, are associated with risk of recent musculoskeletal problems, respiratory problems, and self-reported injury or illness. 19-21 In a similar way, organizational hazards, including low job control and high psychological demand, are associated with increased risk for epicondylitis, rotator cuff syndrome, and back pain. 22 However, these analyses have not focused on women or on gender differences. A qualitative analysis of female immigrant household domestic workers in Spain reported that such work organization factors as job control affect health. 23,24 The job demand–control–support model 10,11 provides a framework for examining the association of work organization and health among women immigrant manual workers. This model posits that jobs with greater physical and psychological demand or stressors will result in poorer health. However, jobs with greater control or decision latitude can result in better health and can offset the effects of demand leading to poor health. Finally, support of peers and supervisors, including perceived safety climate 25 (how workers perceive supervisors’ valuing safety over production) reduces occupational injury and buffers the effects of job demands. The place of work organization in the health of immigrant women is particularly important. These women have major family, child care, and domestic responsibilities that they need to integrate into their work responsibilities. 12,26 Immigrant women are also extremely vulnerable to workplace physical and sexual harassment, as they often do not speak English, do not know their rights, and may lack proper work documents. 27-29 This analysis had 2 goals. The first was to delineate work organization attributes of full-time employed immigrant Latinas with manual occupations. The work organization attributes included indicators of job demands, decision latitude, and support. The second goal was to determine the associations of work organization attributes with health characteristics of these women, including physical health, mental health, and health-related quality of life. We tested 3 hypotheses: (1) greater job demands will be associated with poorer physical health, mental health, and health-related quality of life; (2) greater decision latitude will be associated with better physical health, mental health, and health-related quality of life; and (3) greater job support (higher perceived supervisor control, better job safety climate) will be associated with better physical health, mental health, and health-related quality of life.
