Advancing mediation analysis in occupational health research

In recent years, mediation analysis has become a popular means to identify and quantify pathways linking an exposure to an outcome, thereby elucidating how a particular exposure contributes to the occurrence of a specific outcome. When a mediator is a modifiable risk factor, this opens up new opportunities for interventions to block (part) of the exposure`s effect on the outcome. Recent examples in Scandinavian Journal of Work Environment Health have addressed the mediating effect of wellbeing on the association between type of office and job satisfaction (1) and examined whether workplace social capital contributes to the association between organizational changes and employee exit from work (2). Mediation analysis requires a specific study design ensuring that the temporal sequence of exposure, mediator, and outcome supports the argument for causation. A good illustration presented by Halonen and colleagues (3) used the Swedish Longitudinal Occupational Survey of Health (SLOSH) with bian nual waves to investigate whether depressive symptoms mediated the association between effort–reward imbalance and subsequent neck-shoulder pain. The longitudinal design allowed for a mediation analysis whereby exposure was measured two years before the mediator, and the mediator was assessed two years before the outcome of interest. When exposure and mediator are self-reported, without assurance that the mediator occurred after the exposure (eg, years of education in school preceding ...
Source: Scandinavian Journal of Work, Environment and Health - Category: Occupational Health Tags: Editorial Source Type: research