Mechanical and psychosocial work exposures: the construction and evaluation of a gender-specific job exposure matrix (JEM)

Objectives: The aim of this study was to (i) construct and evaluate a gender-specific job exposure matrix (JEM) for mechanical and psychosocial work exposures and (ii) test its predictive validity for low-back pain. Methods: We utilized data from the Norwegian nationwide Survey of Living Conditions on work environment in 2006 and 2009. We classified occupations on a 4-digit level based on the Norwegian version of the International Standard Classification of Occupations (ISCO-88). The mechanical and psychosocial exposure information was collected by personal telephone interviews and included exposures that were known risk factors for low-back pain. We evaluated the agreement between the individual- and JEM-based exposure estimates, with kappa, sensitivity and specificity measures. We assessed the JEM`s predictive validity by testing the associations between low-back pain and the individual- and JEM-based exposure. Results: The results showed an overall fair-to-moderate agreement between the constructed JEM and individual work exposures. The JEM performed considerably better for mechanical work exposures compared with psychosocial work exposures. The predictive validity of the mechanical and psychosocial JEM showed a consistently lower but predominantly reproducible association with low-back pain for both genders. Conclusions: The mechanical estimates and psychosocial stressors, such as psychological demands, monotonous work and decision latitude...