Heavy workloads linked to mental health, MSD treatment in health-care workers

In Brief

  • Health-care workers with heavy workloads have higher levels of both mental health and musculoskeletal disorders (MSDs), according to a study of British Columbia (B.C.) acute-care hospitals.
  • In hospitals in the northern region of B.C., health-care workers have lower rates of either mental health or musculoskeletal disorders than in other regions.

Why was this study done?

This study assessed the impact of different factors – such as workers’ job status, workload or type of hospital – that might affect musculoskeletal or mental health problems among nurses and support staff. Health planners, hospital managers and others could use this information to develop approaches to reduce the rates of these disorders.

How was the study done?

The researchers studied records for more than 21,000 health-care workers from 65 hospitals for each year between 1996 and 2000. The workers’ employment records were linked with their health records, Census information and hospital data on staffing and services. Researchers analyzed results based on three levels: 1: Health: the evidence of treatment for MSDs or mental health disorders in any given year. 2: Worker-related factors: gender, age, type of job, years of experience and neighbourhood income. 3: Hospital-level factors: hospital size, types of services (such as extended care, specialty, etc.), health region in B.C. and workload.

What did the researchers find?

Workers with the heaviest workloads had greater odds of treatment for both mental health and musculoskeletal disorders. (Workloads were based on both inpatient days and surgical cases per 1,000 employee hours.)

The overall rate of treatment for mental health conditions ranged from 12 to 14 per cent in different years. For MSDs the rate was 42 to 44 per cent. The rate of both disorders: -increased with age -was higher among women than men -was higher among those from neighbourhoods with lower average incomes. Workers with fewer than 15 years experience or who were registered nurses (versus support staff) had lower rates. Workers in large and specialty hospitals showed increased odds of mental health conditions. Health-care workers in the northern region had lower odds of treatment for both types of disorders. In general, the northern population is younger, more physically active and has less chronic pain.

What are some strengths and weaknesses of the study?

Researchers gathered detailed information on large numbers of health-care workers from different sources. They were able to link employment, health, benefit and compensation claim information. One weakness is that workload indicators were for an entire hospital, rather than for individual departments. This may have resulted in some misclassification.

Publication Information


Regions, hospitals and health outcomes over time: A multi-level analysis of repeat prevalence among a cohort of health-care workers


Cole D, Koehoorn M, Ibrahim S, Hertzman C, Ostry A, Xu F, Brown J


Health & Place, 2009: vol. 15, no. 4, pp. 1046-1057