Introduction

Work is necessary to provide people with the means to live healthily, but since time immemorial, it has also been obvious that work can harm people's health through occupational accidents and the wear and tear of heavy and repetitive physical labour. It is far less obvious, but not necessarily less important, that work can also harm through chemical, social and psychological exposures. In this chapter, we will discuss how psychosocial factors at work can impact on people's health, and how such factors have been conceptualised and measured by researchers in this field. For decades, technological development has meant that fewer people work in agriculture, that factories acquire more modern machinery, and that increasing numbers of people work in office and service occupations – for example as salespersons, computer programmers, call centre operators and nurses. As described in Chapter 4, this is also increasingly true in India. Related to this is a decrease in physical work injuries. At the same time, the development of vaccines, antibiotics and good hygiene practices have helped to reduce the relative burden of infectious diseases. In contrast, cardiovascular disease, diabetes and cancer have become more salient as causes of death (Lonzano et al., 2012) and disability more globally (Murray et al., 2012). These are diseases which are known to be affected by health behaviours and are also believed to be stress related. Mental and substance use disorders, while contributing relatively little to premature mortality, are now the leading cause of years lived with disability worldwide, with depressive disorders contributing about 40% of this burden of ill health (Whiteford et al., 2013). These disorders are also commonly held to be stress related, and thus likely to be affected by the psychosocial work environment. A 2006 study, part of the World Health Organization (WHO) Global Burden of Disease studies, reported that 8% of depression globally can be attributed to environmental factors, in particular occupational stress (Prüss-Üstün and Corvalán, 2006).

It can therefore be argued that psychosocial factors are likely to have gained in relative importance for public health, at least in industrialised welfare states. The situation is less clear in developing countries, where a large proportion of the population still works in agriculture and physically demanding factory work, and where issues such as malnutrition, lack of clean water and poor access to healthcare are still salient for substantial parts of the population.