teeism and low productivity (Tennant, 2001). In the Netherlands, occupational health surveys are conducted every three to five years, querying workers from various occupational and demographic groups about health complaints, health care treatment, working conditions, and work demands. With increasing age, a general increase in health and stress complaints was seen for almost all item categories, although the relationship to age was only modest. In general, women reported relatively higher complaint levels than men in almost all survey domains (Lusk, 1997). The high levels of perceived job stress by older American workers, reported in the Health and Retirement Survey, were shown in Chapter 2.

In Great Britain in 1997, mental and behavioral disorders such as stress-related symptoms were one of the most prevalent types of claim for incapacity benefit. Incapacity benefit figures reveal the number of people of working age who are unavailable for work because of ill health (Griffiths, 2000). As part of the British Labour Force Survey, a stratified random sample of 40,000 people who were working or who had worked were surveyed in 1990. When surveyed again in 1995, the prevalence rates for most illness or disorder categories had fallen, but rates of work-related stress, anxiety, depression, and musculoskeletal disorders had increased (Griffiths, 2000). Compared to younger workers, twice as many cases of psychological ill health (stress, depression, and anxiety) were reported by workers between 45 years and retirement age. However, very few cases were found in the postretirement population. This pattern was consistent between two surveys. There is some but not full support for the hypothesis that older persons who are working and also serving as caregivers have more role conflict and role overload (Edwards et al., 2002).

The relationship between job stressors and mental health also has been documented for health workers (Sutherland and Cooper, 1992). In Japan, Shigemi and colleagues (2000) conducted a prospective cohort study to investigate the effect of job stressors on mental health, using the General Health Questionnaire. It was found that workers who complained of perceived job stressors had a greater risk of mental illness or disorder than those not reporting job stressors. Specific items from the job stressors questionnaire, such as “poor relationship with superior” and “too much trouble at work” were particularly associated with higher mental health risk. While such studies do not prove that perceived job stressors cause mental illness or disorder, they point to direction for further research on the causes and potential interventions for such problems.

Depression

Several studies have examined depressive disorders and symptoms in the workplace, and an estimated 1.8 to 3.6 percent of the U.S. workforce



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