Development of a European job exposure matrix (EuroJEM) for psychosocial exposures and their association with diagnosed depression in register-based cohorts

OBJECTIVE: This study developed a European job exposure matrix (EuroJEM) for psychosocial work factors in order to examine their prospective associations with diagnosed depression in three register-based Nordic cohorts. METHODS: National, gender-specific psychosocial JEM from Finland, Norway, and Sweden were evaluated for similarities in exposures, exposure definitions, and occupational coding. The EuroJEM harmonized two exposures: quantitative job demands and decision authority. Disagreements on exposure categories across the national JEM were addressed among experts. Associations between exposures and diagnosed depression were examined across three register-based cohorts. RESULTS: The EuroJEM provides gender-specific exposure categories, based on the proportion of workers exposed, for 371 ISCO-88 (COM – European version of the International Standard Classification of Occupations) occupational codes. All associations were similar across the three cohorts, except for medium-high / high likelihood of exposure to high job demands among women. The pooled hazard ratios (pHR) for depression among workers with a medium-high / high likelihood of exposure to low decision authority had pHR of 1.50 [95% confidence interval (CI) 1.33–1.68] among men and 1.28 (95% CI 1.22–1.35) among women. High strain jobs had pHR of 1.19 (95% CI 1.15–1.24) and 1.07 (95% CI 1.01–1.14) and active jobs 0.79 (95% CI 0.72–0.87) and 0.86 (95% CI 0.79–0.94) among men and women, respectively. The associations between job demands and depression were less clear, especially among women. CONCLUSION: We found consistent associations between diagnosed depression and EuroJEM-based psychosocial exposures. Especially decision authority and job strain indicate a good performance of this JEM. The performance for job demands may be suboptimal.