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Master projects - Cohort 2017

Absence from home: Is it associated with mental distress?

Sánchez Gómez WJ
2017 MSc Thesis, LMU München.


Background: Mental disorders have the highest prevalence of all diseases throughout the world. The workplace is an important risk factor for development mental distress. The truck drivers are a vulnerable population for the development of mental distress due to their psychosocial working conditions. The aim of this study was to evaluate the statistical association of days absent from home and mental distress in truck driver from Peru.

Purpose: This study aims to determine the association of days of physical absence of the home and mental distress in truck drivers of heavy load in a company specialized in Peru.

Methods: Cross-sectional study. The study population consisted of 206 truck drivers (response rate 89%). Mental distress was assessed using a general health questionnaire score >4. Days of absence from home was assessed with specific question and the response subtracted to 30 to obtain the number of days that the worker has been absent from their home have also been considered demographic questions. Associations between days absent from home and psychological distress were tested using logistic regression models controlling for potential confounders.

Results: The prevalence of psychological distress was 35% for truck drivers with ≤ 19 days away from home, 38% among truck drive rs with ≥ 20 and ≤ 25 days and 51% for those > 26 days away from home (pChi2>0.05). This independence of distress from days away from home was confirmed in the multiple logistic regression model (Odds Ratio 1.75; 95% Confidence Interval (0.75-4.09). Odds of distress was lower among drivers with higher level of education (0.25; 0.07-0.94) and higher among those with a higher job security (2.13; 1.06-4.28).

Conclusions: The prevalence of mental distress was 42% compared to 29 % formal Peruvian miners. We found no association between days absent from home and mental distress in Peruvian truck drivers. The exposed, those with high security of employment contract had increased risk of mental distress being the highest level of education a risk factor for mental distress.

Association between the number of days away from home and work-family interaction in Ecuadorian petroleum workers

Cabal Álvarez NK
2017 MSc Thesis, LMU München


Background: In Ecuador, almost all petroleum industry is located in remote area in the Amazon region. Work is done 24-7 and workers need to stay far away from home for several workdays. The aim of this study was to identify the association between the number of days away from home and work-family interaction in workers employed in the oil fields of the Amazon region of Ecuador compared with city workers.

Methods: 350 workers (response 88%) were invited to participate in a self-administered cross-sectional questionnaires survey between October 2015 and January 2016. Outcome was assessed by the Work-Home Interaction-Nijmegen» (SWING) questionnaire, taking the median of each dimension as cut-off point. Exposure was defined by the number of days away from home every month. Other variables included were socio-demographics, working conditions and mental distress (GHQ-12 cut-off ≥5). Descriptive analyses were followed by multiple logistic regression models.

Results: The number of days away from home was a risk factor for negative home to work interaction: compared to those working in the city, adjusted Odds Ratio for workers with up to 16days absence from home was 1.89(95% Confidence Interval: 1.09-3.27) and 2.96 (1.43-6.15) for those with more than 16 days absence. Workers with mental distress showed increased negative interactions and decreased positive interactions in both directions.

Conclusions: Prolonged absence from home is a risk factor for negative interaction from family to work. Domestic roles and problems with spouse/family/friends could affect job performance and colleague relationships. Positive interactions need to be explained with other work conditions for future research.

Keywords: family relations, work schedule tolerance, work-family conflict, oil and gas industry, mental health, work.

Can I help you? Psychological working conditions and psychological distress in Call Center workers in Lima, Perú

Mondoñedo Acevedo D
2017 MSc Thesis, LMU München.


Background: Call-Center Workers serve customers ́ complaints and provide support to customers. They may therefore face adverse psychosocial working conditions which may cause psychological distress leading to depression and anxiety. The aim of this study was to assess job demand-control experienced by call-center employees in Lima, Peru and to determine its association with psychological distress (PD).

Methods: Between November 2015 and January 2016, 150 call-center workers were invited to answer an interview-based questionnaire during their work breaks (response 75%) of which 108 presented complete data. Questions included questions on job demand, job control and social support at workplace as well as the General Health Questionnaire (GHQ-12) to assess PD. High job demand; low job control and low social support were defined using the median of the sum scores as cut-off points. PD was considered present when the GHQ-12 score was above 4. Associations between demand, control, social support and PD were analyzed using chi-square test (x2) and crude and adjusted logistic regression models using EpiInfo version 3.5.2 software.

Results: The prevalence of PD was 54%. High demand (a OR 2.80; 95% CI 1.08-7.25) and low social support (aOR10.87; 95% CI 4.09-28.84) were statistically significant related to PD. Stratifying for social support, the association with demand only remained statistically significant for those with low social support.

Conclusions: This study indicates a high prevalence of PD distress in call-center workers. High demand and a lack of social support are potential explanatory factors were interventions might be targeted at.

Keywords: psychological distress, high demand, social support, mental health, psychosocial conditions, call-center workers.

Effort/Reward Imbalance and Work – Family Conflict related to Back Pain: a cross sectional study among Mexican female daycare workers

Herrera Reyna P
2017 MSc Thesis, LMU München.


Background: Back pain in daycare workers is very common; negative psychosocial working conditions might be a risk factor. We aimed at determining prevalence of back pain and the association between effort–reward imbalance (ERI), conflict work–family (CWF) with this musculoskeletal symptom in female daycare workers employed at an institution of the Mexican Social Security.

Methods: This cross-sectional study included 257 participants, 156 daycare (DCW) and 101 administrative workers (ADW), response 56%. 12-months prevalence of upper (UBP) and low back pain (LBP) were assessed with the Nordic Questionnaire; psychosocial risks at work with ERI (cut-off at the upper tertile of the effort-reward ratio 0.82) and CWF (cut-off at the upper tertile of the distribution) with SUSESO–ISTAS 21 questionnaires. After descriptive comparisons between daycare and administrative workers, logistic regression was used adjusting for occupation, noise and ergonomic conditions perceived, ERI, over-commitment and CWF.

Results: The 12-months prevalence of UBP in DCW was 40% and 52% for LBP. Compared to ADW, DCW were at greater risk of UBP (adjusted Odds Ratio 2.91; 95% Confidence interval 1.23 –6.91) and LBP (2.98; 1.30 –6.83). For LBP, CWF was an additional risk factor in the adjusted model (2.3; 1.26 –4.20) while ERI was only borderline significant (1.07; 0.88 –3.28). For UBP, noise perceived at work was borderline significant (1.07; 0.98 –3.98). Over-commitment was not associated.

Conclusions: The DCW are at risk to back pain, partly being explained by psychosocial burden, especially CWF. Intervention studies are warranted to improve psychosocial working conditions.

Key words: Effort-reward; ERI; work-family conflict; psychosocial risks at work; low-back pain; daycare workers; Latin-America; Mexico.

Effort-reward imbalance, overcommitment and hypertension: a cross-sectional study among Peruvian labor inspectors

Manrique Morales YP 
2017 MSc Thesis, LMU München.


Background: Labor inspectors monitor promotion and protection of health at the workplace. Nevertheless, their psychosocial working environment and its association with hypertension has not been analyzed. We therefore aimed to investigate the association between effort-reward imbalance (ERI), over commitment (OC) and hypertension in Peruvian labor inspectors.

Methods: Employing a cross-sectional design, 171 labor inspectors were investigated (response rate 78%). High risk of work-related stress and high OC were defined using the upper tertile of ERI and OC scale respectively. Blood pressure was measured once according to the recommendations of the American Heart Association. Hypertension was defined as ³ 140 mm Hg / ³ 90mm Hg. Socio-demographic and behavior risk factors were collected via self-administered anonymous questionnaires. Anthropometric measurements were taken using validated devices. The potential association between ERI, OC and hypertension were analyzed using logistic regression.

Results: ERI was associated with smokers (p=0.07) and elevated waist circumference (p=0.04). Higher OC was associated with age (0.08). 78% of the participants reported work-related stress (ERI > 1). The prevalence of hypertension was 27%. After adjusting for potential confounders neither ERI (OR 1.45;0.62-3.38) nor OC (OR 1.11;0.49-2.52)were associated with hypertension. Gender (women: OR 0.30; 0.14-0.68) and increasing age (40-49yrs: OR 4.19; 1.58-11.12); (50+:OR3.85; 1.28-11.59) were significant predictors of hypertension.

Conclusions: Psychosocial working conditions assessed in Peruvian labor inspectors with ERI questionnaire were not related to hypertension.

Keywords: Effort-reward imbalance, over commitment; work-related stress, hypertension, blood pressure, cardiovascular disease risk, Inspectors

Factors associated with low back pain in school teachers of Chiquinquirá-Colombia

Camargo ML
2017 MSc Thesis, LMU München.


Background: School teachers are a population potentially vulnerable to low back pain. There are few studies which have examined causative factors in Colombia.

Objective: We aimed to determine the association between work conditions (general, with students and psychosocial) and the prevalence of low back pain in primary and secondary teachers in Chiquinquirá, Colombia.

Methods: A cross-sectional study was conducted inviting 266 school teachers from eleven different schools; 226 teachers (85%) returned the questionnaires; after exclusions, 96 of primary and 87 of secondary were used for the analysis. Nordic questionnaire were used to assess seven days prevalence of musculoskeletal pain and Effort-Reward Imbalance questionnaire to assess the psychosocial work factors. To analyze data, the Chi-square test and the logistic regression model were used.

Results: Prevalence of low back pain during last seven days was 36% among primary teachers and 30 % among secondary teachers (pChi2 =0.43). According to Effort reward imbalance model, the results of multivariate logistic regression revealed that over-commitment (OR: 2.53, 95% CI: 1.04 -6.14) was positively associated with Low back pain. Other factors were not significantly associated.

Conclusions: While ergonomic factors and extracurricular activities were not associated with low back pain, our study showed that psychosocial factors contribute notably to musculoskeletal problems.

For this reason intervention studies should take into account such factors.

Key words: Musculoskeletal, low back pain, school teachers.

Prevalence and risk factors for hypertension in medical specialist from Third Level Hospital, Quito-Ecuador

Rosero Sánchez EP
2017 MSc Thesis, LMU München.


Background: The cardiovascular health condition and the degree of exposure to occupational stress of specialist physicians working in a hospital of high complexity is little well-known. Being the cardiovascular disease the main cause of morbidity and mortality in the world and hypertension its most important risk factor, evaluate these parameters is priority.

Methods: Using an internationally validated survey and standard measurement of blood pressure, we performed a cross-sectional study among 220 medical specialists, divided in two groups (critical areas and outpatient) and established association with age, sex, psychosocial factors (model of effort/ reward (ERI) and over commitment), body mass index (BMI), smoking, violence and working time. The objective was to determine the prevalence of hypertension in physicians studied and the possible associated risk factors

Results: Hypertension prevalence was 34.6% and BMI ≥ 25 kg/m2 in 55.9% without significant difference between both groups of physicians. Among participants, 22% reported having been a victim of physical violence by persons outside the hospital and 34% had ERI. After adjustment, only BMI ≥ 25 kg/m

2 (OR 3.32) and age (OR 2.35) were statistically significant for hypertension.

Conclusion: The prevalence of hypertension and BMI ≥25 kg/m2 is high with a direct association, while the psychosocial risk factors and violence need further studies. Additionally, other cardiovascular risk factors not considered in this study are necessary to establish a preventive health strategy.

Key words: Hypertension, psychosocial risk factors , medical specialist, third level hospital.

Prevalencia de síntomas depresivos asociados a horarios no convencionales en el trabajo entre pescadores industriales y pescadores artesanales, Manabí 2015

Luna Guerra MA
2017 MSc Thesis, LMU München


Abstract: Depression is a psychiatric disorder characterized by significant mood disorders such as sadness, guilt, loss of interest, anorexia, insomnia, which lasts for at least 2 weeks. The importance of studying depression is due to its high prevalence worldwide, 350 million people suffer this pathology.

Aim: To determine the prevalence of depressive symptoms associated with unconventional job schedules in industrial and artisanal fishermen in Manabí province.

Materials and Methods: We used PHQ9 questionnaire to diagnostic depressive symptomatology. Besides PHQ9 questionnaire the study had a psychosocial module named “working conditions and health in Latin America”, a reference survey of the Ludwig Maximilians Universität München in its second version. The study was applied in 233 fishermen (80% artisan response rate and 100% industrial) during the year 2015. The variables used in the study were: marital status, number of children, educational level and rest while working.

Results: Regardless of the type of sector in which fishermen work, the sector and the idiosyncrasies are the same, so the levels of schooling and the number of children were very similar and show no statistical difference. The greatest difference shows when comparing the age, in industrial fishermen the majority over the 40 years old and people with couple. When analyzing the initial objective the information shows that prevalence of depressive symptoms in artisanal fishers is 20% and of the artisanal fishermen of 36%.

Conclusion: Depressive symptoms may increase in people who have unconventional work schedules, and will increase depressive symptoms in the event that there is no rest program during the shift.

Key words: depressive symptoms, depression, fishermen, Manabí, Ecuador

Prevalencia de Síntomas Respiratorios en Trabajadores Bananeros Ecuatorianos

Piedra González JP
2017 MSc Thesis, LMU München.


Background: The banana harvest workers were exposed to pesticides, these were used to fight against “sigatoka negra” (Fungal banana disease). The present investigation pretends to compare the respiratory symptoms prevalence between banana harvest workers and packing workers.

Methods: This present study of transversal cut, was based in survey questionnaires (Spain national work conditions (INSHT)and Respiratory Health European Community in its short version , focused to 400 banana workers of Ecuadorian farmers from Guayas, Los Rios and El Oro provinces where 394 surveys were made (264 in harvest workers and 130 in packing workers) in a percentage of 99%. The groups were compared using statistics such us Chi2 a statistical test and crude adjusted logistic regression models to identify potential confounding variables.

Results: The wheeze at work prevalence in the harvest workers was of 15% (pChi2=0,01) in comparison with 6% of the packing group and the labor in capacity by a respiratory problem was of 17% (pChi2<0,001) in contrast with 3% of the packaging group. Likewise, the risk to get wheeze at work in harvest workers was 2.70 (ORc:IC = 95% 1,20–5,90) in the same way the labor incapacity was of 6,50 (ORc, IC 95%: 2,30 - 18,40) in contrast with the packing group.

Conclusion: The banana harvest workers were exposed to chemical substances; they got the highest risk to get respiratory diseases. This contributes as an evidence that pesticides increase the occupational respiratory diseases risk

Psychological risk, employment conditions and mental distress: a cross-sectional study in Peruvian miners

Cruz Timaná IN
2017 MSc Thesis, LMU München.


Introduction: Mental health problems constitute a heavy economic burden in many societies. Psychosocial factors at work are associated with common mental disorders. Few studies have focused on miners in terms of associating psychosocial factors with mental distress. This study aimed to evaluate the association between effort-reward imbalance, employment conditions and the prevalence of mental distress in Peruvian miners.

Methods: A cross-sectional study was carried out in a metalliferous underground mine in Peru between October and November 2015. A questionnaire was distributed to a sample from a population of about 600 miners (participants 440; response rate 73%). Socio-demographics and employment conditions were assessed. Effort-reward ratio was calculated and a value equal or above the upper tertile (value 99) was defined as ERI. Mental distress was defined as a score 3 or higher in general health questionnaire (GHQ-12). Variables were analyzed by using chi-square test and logistic regression. Epi Info software was used to analyze data.

Results: Prevalence of mental distress was 27%. Logistic regression analysis showed no association between effort-reward imbalance and mental distress. However, inadequate adjustment of work to social and family matters was associated to mental distress (OR 6.79, 1.60-28.90).

Conclusions: Workers with inadequate adjustment of work to social and family matters may be at increased risk of mental distress. Mental health needs to be approached based on strategic organizational support and family involvement.

Key words: psychological stress, mental health, depressive symptoms, mining, working conditions, work-family conflict

Psychosocial work environment and blood pressure: A cross sectional study in typist in Colombia

Hermida Gutiérrez TA
2017 MSc Thesis, LMU München.


Background/Objective: Hypertension has become a public health a worldwide challenge. It has been associated with psychosocial working conditions and with several chronic diseases. One of the job positions where poor psychosocial working condition might be present is a typist. We aimed to determine the prevalence of hypertension In Colombian typist population, associated with psychosocial factors at the work and identifying associated socio‐demographic characteristics and employment conditions.

Methods: Cross sectional interview-based questionnaire study and measurements (blood pressure, high, weigh) in 196 typist and 134 administrative workers from the same company in Colombia (response 100%). Logistic regression models adjust to type of work, job demand control, Effort-Reward-Ratio, social support, age, gender and overweight.

Results: The prevalence of hypertension in workers was 17.82%. The age of workers was from 20 to 39 years (76.3%). From the participants with high blood pressure, 31.2% had overweight, 21% reported high tension and 20% indicated active job (p 0.36). The most important associations in the logistic regression, was overweight (OR 4.6; 95% CI 2.1-9.9), age between 30 and 40 years (OR 2.75; 95% CI 1.1-6.5), high social support (OR 2.45; 95% CI 1.1-5.1) and active job (OR 3.36; 95% CI 1.1-10.2).

Conclusions: This study results indicate an increment of the prevalence of hypertension in Colombian young people, related to the epidemiological transition. It is an evidence of the need to shift the orientation of the country health programs to chronic diseases, such as the hypertension and overweight.

Psychosocial working conditions and mental health among teachers from Cuenca, Ecuador

Pando Bacuilima KE
2017 MSc Thesis, LMU München.


Background: In Latin America, there is limited research on teachers’ psychosocial working conditions and mental health. Globally, the emotional demands of working with children have been shown to contribute to mental health problems in teachers. The aim of this study was to investigate the association between Effort-Reward-Imbalance (ERI) and psychological distress in public and private school teachers of Cuenca city (Ecuador).

Methods: The study population of this cross-sectional study included a sample of 200 public (71% response) and 200 private (68% response) school teachers. Psychosocial working conditions were assessed with the ERI questionnaire and psychological distress with the General Health Questionnaire (GHQ-12). Public and private school teachers were compared by Chi2 tests. Associations between ERI (Effort-Reward-Ratio ≥ Upper Tertile = 1.06) and psychological distress (GHQ-12 ≥5) were analyzed by logistic regression analysis adjusting for potential confounders.

Results: The prevalence of psychological distress was 39% without statistically significant differences between public and private school teachers. After adjustment, ERI was

statistically significantly associated with psychological distress (Adjusted Odds Ratio 2.60; 95% Confidence Interval 1.5 - 4.6).

Conclusion: This is the first study indicating that ERI is associated with psychological distress in Ecuadorian school teachers independently of type of school. Intervention studies are warranted.

Key words: School teachers; effort reward imbalance; mental health

Working below skill level as risk factor for distress among Latin American migrants living in Germany – cross sectional study

Espinoza Castro BC
2017 MSc Thesis, LMU München.


Background: About 84.710 Latin Americans currently live in Germany. Knowledge about their work situation in relation to their skill level and its association with mental health is limited - mainly due to the difficult access to the population. Therefore, the aims of this study were to assess the frequency of working below skill level and its association with the prevalence of distress in Latin American migrants living in Germany.

Methodology: This study included a convenience sample of 282 Latin American migrants living in Germany. Participants were recruited by a short online (Facebook, personal contacts) or interview- based questionnaire from November 2015 to April 2016. Questions included skill level, job category (categorized by ISCO 2008 code), socio-demographics, violence at the workplace and distress assessed by Goldberg’s General Health Questionnaire using a cut-off of 4/5. Descriptive statistics were followed by logistic regression analyses adjusting for potential confounders.

Results: About half of the study population reported symptoms of distress (45%). 12-months prevalence of violence at the workplace was 14%. 62% of the population worked below skill level. After adjustment, working below skill level was a statistically significant risk factor for distress (Odds Ratio 2.80; 95% Confidence Interval: 1.58 –4.95).

Conclusion: Working below skill level is common in Latin American migrants in Germany and may result in poor psychosocial well-being.

Keywords: Latin American migrants, Germany, working bellow skill level, distress.