Occupational stress and professional exhaustion syndrome (burnout) in workers from the petroleum industry: a systematic review

Dias, Fernanda Monteiro; Santos, Jacqueline Fernandes de Cintra; Abelha, Lucia; Lovisi, Giovanni Marcos

Fernanda Monteiro Dias

Universidade Federal do Rio de Janeiro, Instituto de Estudos em Saúde Coletiva, Rio de Janeiro, RJ, Brasil.

Jacqueline Fernandes de Cintra Santos

Universidade Federal do Rio de Janeiro, Instituto de Estudos em Saúde Coletiva, Rio de Janeiro, RJ, Brasil.

Lucia Abelha

Universidade Federal do Rio de Janeiro, Instituto de Estudos em Saúde Coletiva, Rio de Janeiro, RJ, Brasil.

Giovanni Marcos Lovisi

Universidade Federal do Rio de Janeiro, Instituto de Estudos em Saúde Coletiva, Rio de Janeiro, RJ, Brasil.

Contato: Fernanda Monteiro Dias E-mail: nandamdias@gmail.com

The authors declare that there is no conflict of interest and that this article has not been presented at any scientific meeting.

Authors' contributions: Dias FM: data collection, analysis and interpretation, manuscript writing; Santos JFC: design, data collection, involvement in the manuscript writing and significant contribution in its critical review; Abelha L: substantial contribution to the project and important contribution to the critical review; Lovisi GM: project design, involvement in the data analysis and interpretation in addition to the final approval of the version to be published. This article is based on Fernanda Monteiro Dias's master's thesis entitled "Síndrome do esgotamento profissional (burnout) em trabalhadores da indústria de petróleo: uma revisão sistemática", defended at IESC/UFRJ in April of 2015.

✓ Is the hypothesis/aim/objective of the study clearly described?

✓ Are the main outcomes to be measured clearly described in the Introduction or Methods section?

✓ Are the characteristics of the patients included in the study clearly described?

✓ Are the distributions of principal confounders in each group of subjects to be compared clearly described?

✓ Are the main findings of the study clearly described?

✓ Does the study provide estimates of the random variability in the data for the main outcomes?

✓ Have the characteristics of patients lost to follow-up been described?

✓ üHave actual probability values been reported?

✓ Were those subjects who were prepared to participate representative of the entire population from which they were recruited?

✓ If any of the results of the study were based on "data dredging", was this made clear?

✓ In trials and cohort studies, do the analyses adjust for different lengths of follow-up of patients, or in case-control studies, is the time period between the intervention and outcome the same for cases and controls?

✓ Were the statistical tests used to assess the main outcomes appropriate?

✓ üWere the measures used accurate?

✓ Were the participants in the different groups recruited from the same population?

✓ Were the participants in the different groups recruited during the same time period?

✓ Did the analysis include an appropriate adjustment for the confounding variables?

✓ Were the participant losses considered during the study?

Authors	Country of publication/year	Study design	Location of study completion	Sample size	Study objective	Score from the study quality analysis()*
Sutherland and Copper²2. Sutherland VJ, Cooper CL. Stress in the offshore oil and gas exploration and production industries: an organizational approach to stress control. Geneva: International Labour Office; 1996.	United Kingdom/1996	Cross-sectional	Platform	310	To identify sources of stress that can be reduced or eliminated by an organizational change	16
Hellesoy, Gronhaug and Kvitastein⁴4. Hellesoy O, Gronhaug K, Kvitastein O. Burnout: conceptual issues and empirical findings from a new research setting. Scand J Mgmt. 2000;16(3):233-47.	Norway-North Sea/2000	Cross-sectional	Platform	2061	To estimate the frequency of burnout in the offshore environment and to analyze its dimensions in this context	17
Wong et al.¹¹11. Wong TW, Chen W-Q, Yu T-S, Lin Y-Z, Cooper CL. (2002). Perceived sources of occupational stress among Chinese offshore oil installation workers. Stress & Health. 2002;18(5):217-26.	China/2002	Cross-sectional	Platform	561	To explore sources of occupational stress observed among workers.	16
Chen, Wong and Yu²¹21. Chen WQ, Wong TW, Yu TS. Mental health issues in Chinese offshore oil workers. Occup Med. 2009;59(8):545-9.	China/2009	Cross-sectional	Platform	561	To explore the association between mental health and occupational stress and to identify ways of coping with diseases	16
Ljosa and Lau¹²12. Ljosa CH, Lau B (2009). Shiftwork in the Norwegian petroleum industry: overcoming difficulties with family and social life - a cross sectional stud. J Occup Med Toxicol. 2009;4(22):	Norway/2009	Cross-sectional	Platform and refinery	1697	Association between the regime of onshore and offshore shift work, and problems in the domestic and social life of the workers.	17
Ljosa, Tyssen and Lau²⁰20. Ljosa CH, Tyssen R, Lau B. Mental distress among shift workers in Norwegian offshore petroleum industry--relative influence of individual and psychosocial work factors. Scand J Work Environ Health. 2011;37(6):551-5.	Norway/2011	Cross-sectional	Platform	1336	To investigate the association between psychosocial and individual factors and mental distress among workers.	18
Menezes et al.²²22. Menezes MCR, Pires MLN, Benedito-Silva A, Tufik S. Sleep parameters among offshore workers: an initial assessment in the Campos Basin, Rio De Janeiro, Brazil. Chronobiol Int. 2004;21(6):889-97.	Bacia de Campos, Rio de Janeiro, Brazil/2004	Cross-sectional	Platform	179	To evaluate sleep parameters among workers and to investigate their association	15
Silva Júnior and Ferreira¹³13. Silva Júnior DI, Ferreira MC.A predição do burnout em trabalhadores off-shore-oil. Estudos. 2009;36(1/2):75-93.	Brazil/2009	Cross-sectional	Platform	355	To investigate the predictive power of environmental stress factors in the three burnout dimensions	15
Oenning, Carvalho e Lima²³23. Oenning N, Carvalho L, Lima V. Fatores de risco para absenteísmo com licença médica em trabalhadores da indústria de petróleo. Rev Saúde Pública. 2014;48(1):103-12.	Brazil/2014	Retrospective cohort	Refinery	782	To identify risk factors for absenteeism from sick leave among workers from a petroleum company	16

			Main results
Authors	Instruments used	Sources of occupational stress	Psychosocial factors and associated physical symptoms	Main conclusions
Sutherland and Copper²2. Sutherland VJ, Cooper CL. Stress in the offshore oil and gas exploration and production industries: an organizational approach to stress control. Geneva: International Labour Office; 1996.	Technical report containing three questionnaires designed by the authors.	• Lack of career prospects;	• Concern with family/ domestic issues while at work;	• A stress control program becomes effective when it is directed to the specific problems and sources of stress identified in certain groups of people;
		• Insecurity regarding work conditions;	• 34% of the sample are smokers and 16% reported being high alcohol consumers.	• Stress management must run hand-in-hand with company management;
		• Lack of stimulus;		• The sources of stress that were most associated with dissatisfaction at work were: lack of career prospects (25.3%), underutilization and low demand (27%) and shift work (8%).
		• Physical and climatic conditions at work;
		• Unpredictable and excessive workload;
		• Air transport to platform;
		• Necessity to adapt to new technologies.
Hellesoy, Gronhaug and Kvitastein⁴4. Hellesoy O, Gronhaug K, Kvitastein O. Burnout: conceptual issues and empirical findings from a new research setting. Scand J Mgmt. 2000;16(3):233-47.	Questionnaire adapted based on the Maslach burnout inventory (MBI) to the offshore context.	• Dangerous conditions;	• Feeling of not having a close relationship with colleagues (lack of social support and assistance coping);	• Lesser frequency of burnout in married individuals and greater frequency of in young unmarried individuals;
		• Shift work;	• Worry in regards to family while at work;	• Low frequency of burnout compared with other professions ("Helping professions");
		• Air transport to platform;	• Alienation;	• Association of negative emotions with coping focused on emotion.
		• Fire and explosion risks.	• Lack of focus and motivation;
			• Sleeping problems.
Wong et al.¹¹11. Wong TW, Chen W-Q, Yu T-S, Lin Y-Z, Cooper CL. (2002). Perceived sources of occupational stress among Chinese offshore oil installation workers. Stress & Health. 2002;18(5):217-26.	OSS (Occupational Stress Scale) adapted based on questionnaires designed by Cooper.	• Noise;	• Not being able to exercise ones role in the family while on the platform;	• The results found in Chinese workers were different from those found in the previous study conducted in the United Kingdom: the only widely reported stress factor was the home/domestic interface; there were few reports regarding problems in relation to the structural and organizational climate.
		• Vibration;	• Lack of career prospects.
		• Safety;
		• Feeling of putting oneself and others at risk by making a mistake.
Chen, Wong and Yu²¹21. Chen WQ, Wong TW, Yu TS. Mental health issues in Chinese offshore oil workers. Occup Med. 2009;59(8):545-9.	General Health Questionnaire (GHQ);	• Noise;	• Home/work interface;	• Occupational stress significantly associated with a worsening state of mental health of the worker;
	Occupational Stress Scale.	• Vibration;	• Lack of social support and assistance coping.	• Coping in terms of focusing on the problem was positively associated with improved mental health and that regarding focusing on emption was associated with mental health problems.
		• Lack of lighting and ventilation;
		• Shift work;
		• Adverse weather conditions;
		• Confinement.
Ljosa and Lau¹²12. Ljosa CH, Lau B (2009). Shiftwork in the Norwegian petroleum industry: overcoming difficulties with family and social life - a cross sectional stud. J Occup Med Toxicol. 2009;4(22):	Coping with Shift Work Questionnaire (CSQ).	• Shift work;	• Problems in social and domestic life;	• Coping by focusing on the problem and social support was associated with a small number of reports involving problems in social and family life; self- criticism was associated with a greatest number of reported problems;
		• Family separation.	• Lack of social support as a coping strategy.	• Ambiguity in relation to positive and negative aspects of shift work comparing the refineries and platforms.
Ljosa, Tyssen and Lau²⁰20. Ljosa CH, Tyssen R, Lau B. Mental distress among shift workers in Norwegian offshore petroleum industry--relative influence of individual and psychosocial work factors. Scand J Work Environ Health. 2011;37(6):551-5.	Hopkins symptom checklist (HSLC5);	• Shift work arrangements;	• Problems at home interfering at work;	• Mental distress identified using the HSLC is greater among men and associated with a low level of support and a high level of interference from family problems.
	The General Nordic Questionnaire for Psychological and Social Factors at Work (QPS Nordic).	• Isolation;	• Lack of social support.
		• Extreme weather conditions;
		• Risks of accidents;
		• Shift work, especially nightshifts.
Menezes et al.²²22. Menezes MCR, Pires MLN, Benedito-Silva A, Tufik S. Sleep parameters among offshore workers: an initial assessment in the Campos Basin, Rio De Janeiro, Brazil. Chronobiol Int. 2004;21(6):889-97.	Questionnaire designed by the authors.	• Irregular sleep patterns;	• Difficulties sleeping: poor quality sleep, difficulties getting to sleep, disturbed sleep, feeling tired after sleep;	• Sleeping problems and feelings of sadness are mostly reported by workers on the night shift compared to those on the day shift.
		• Work by turns.	• Nightmares and sleepwalking.
Silva Júnior and Ferreira¹³13. Silva Júnior DI, Ferreira MC.A predição do burnout em trabalhadores off-shore-oil. Estudos. 2009;36(1/2):75-93.	Scale for Evaluating Environmental Stress factors in the Offshore Context (EACOS) adapted from the MBI (specifically for professionals who have no contact with customers and validated for Brazilian workers in the offshore context by Silva Júnior).	• Being submitted to rules and discipline;	• Long periods away from the family;	• Identification of the three predicting dimensions for burnout;
		• Shift work;	• Relationship and performance problems.	• Younger workers are more prone to burnout;
		• Adverse working conditions;		• Suggestions for measures that can contribute towards reducing burnout among workers.
		• Feeling of insecurity (access to medical attention on the platform is precarious).
Oenning, Carvalho e Lima²³23. Oenning N, Carvalho L, Lima V. Fatores de risco para absenteísmo com licença médica em trabalhadores da indústria de petróleo. Rev Saúde Pública. 2014;48(1):103-12.	Secondary data obtained from electronic medical records at the occupational health service.	• Heavy physical workload;	• Hypertension;	• Female, being a smoker or ex-smoker, being dissatisfied with work and reporting abnormal sleep were significantly associated with absenteeism from work due to illness;
		• Discomfort regarding the working "positions".	• Musculoskeletal diseases;	• Individuals with sleep problems are more likely to miss work.

[1] Contato: Fernanda Monteiro Dias E-mail: nandamdias@gmail.com

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Occupational stress and professional exhaustion syndrome (burnout) in workers from the petroleum industry: a systematic review

Abstract

Introduction:

Objective:

Methods:

Results:

Conclusion: