Risk factors in the workplace

Ce document est réservé à l'usage exclusif de et ne peut faire l'objet d'aucune autre utilisation ou diffusion auprès de tiers. Tous droits réservés, Global-Watch ®

Scientific interpretation

When it’s a matter of workplace health, we know that risk factors are closely associated with mental health problems, musculoskeletal troubles and cardiovascular diseases, which can have major socio-economic impacts on organizations. This is one of the reasons why Quebec’s “Healthy Enterprise” standard was developed. This standard targets the improvement and maintenance of the health of people in the workplace. In 2018, Letellier and colleagues examined this standard to evaluate the effects on the prevalence of risk factors in the workplace and employees’ psychological distress within ten Quebec organizations.

Expert advisers

Marie-Claude Letellier, resident in public health and preventive medicine, Université Laval

MICHEL VÉZINA, emeritus professor, Université Laval, and medical adviser, INSPQ

CAROLINE BIRON, associate professor, Department of management, Université Laval


Étienne FOUQUET, research assistant, Université de Sherbrooke

MARIE-ÉLISE LABRECQUE, research professional, Université de Sherbrooke 

This initiative was made possible through a collaboration with the Université de Sherbrooke.

Quebec’s Healthy Enterprise standard


Quebec’s Healthy Enterprise standard is a voluntary standard whose focus is the improvement and maintenance of the health status of people in the workplace. This happens through the creation of conditions that foster overall health in the business, including a change to management processes with the aim of fostering the participation of employees and management.

Actions done as part of this standard target four areas of activity aimed at improving employees’ mental health and physical health: (i) living habits; ii) work–life balance; (iii) work environment; and (iv) management practices.

All types of organizations can choose one of the two following levels of commitment:

Healthy enterprise: The business clearly demonstrates its commitment to the health and well-being of its employees in an organized, planned manner in two of the four areas of activity (one of the two areas must be living habits) according to the needs of its employees as determined through data collection, and according to the priorities of the business.

Healthy enterpriseElite: The actions affecting all four areas of activity; health and well-being are incorporated to a greater degree in the corporate culture and management processes.

Actions done in the area of management practices include activities that target risk factors in the workplace. For this reason, implementing the Healthy Enterprise standard can help to reduce adverse exposure at work and improve employees’ mental health.


Risk factors in the workplace

Risk factors in the workplace are recognized as a major source of psychological distress and a key factor in the development of mental health problems. These risks can take the form of (1) increased psychological demands (high workload), (2) low level of latitude when it comes to decision making (low level of decision-making autonomy), (3) low social support at work (little support from managers and colleagues) and (4) a lack of recognition (low level of appreciation by managers or colleagues, low likelihood of promotion, job insecurity).

Psychological distress

Psychological distress is defined as a state of emotional suffering characterized by symptoms of anxiety and depression. It is linked to diagnosed mental health problems, which are associated with employee absenteeism.

Complete reference

Letellier, M. C., Duchaine, C. S., Aubé, K., Talbot, D., Mantha-Bélisle, M. M., Sultan-Taïeb, H., … & Brisson, C. (2018). Evaluation of the Quebec Healthy Enterprise Standard: Effect on Adverse Psychosocial Work Factors and Psychological Distress. International journal of environmental research and public health, 15(3), 426.


In total, 10 Quebec organizations took part in the study. They were from the public (7/10) and private (3/10) sectors.

To be eligible for the study, participating organizations had to be in the process of becoming certified for the Healthy Enterprise standard. Participants had to complete a questionnaire on their needs with regard to the four areas of activity and their health status at the beginning of the process (T1), and then 24 to 36 months later (T2). In this second questionnaire, participants had to say at what point they noticed changes in their work in relation to each of the standard’s four areas of activity.

For example, they had to indicate whether they had noticed changes related to their workload, their social relationships at work, their decision-making latitude and recognition at work. These questions provide an indicator of how well actions related to each area of the standard were implemented: that is, whether they were indeed implemented in each of the 10 organizations.


  • The size of the organizations varied from 103 to 1,467 employees. All employees (active and on leave) were invited by their employer to participate.
  • The final sample included 2,849 employees at T1 and 2,560 employees at T2, with response rates ranging from 63% to 90%, depending on the organization.
  • The age of participants was between 25 and 54 years.
  • Participants had management, professional, technician, clerical and manual labour positions.




The article confirms that significant psychological distress is associated with exposure to risk factors in the workplace. The Healthy Enterprise actions related to management practices had positive effects in reducing the distress of employees who are more exposed to changes in this area of activity. Therefore, this implies that actions in the workplace could reduce employees’ exposure to risk factors in the workplace and improve their mental health.


When it comes to risk factors in the workplace, following the implementation of the Healthy Enterprise standard, half of the organizations that are most exposed to actions related to management practices reported an improvement in social support and recognition. These same organizations also saw a reduction in the prevalence of psychological distress.

In organizations that were less exposed to actions related to management practices, the opposite trend was observed.


Despite these positive changes regarding social support and recognition in the five organizations that are most exposed to actions related to management practices, psychological demands and latitude in decision making were not affected.

This can be explained by the fact that organizations are more open to increasing social support and recognition through a certain number of social activities within the organization, rather than changing psychological demands and latitude in decision making.

In the end, these results suggest that organizational activities carried out in the area of management practices improved the psychosocial work environment and had beneficial effects on employees’ mental health.




Ensure that senior management makes a firm commitment in support of their employees’ health.

  • Commitment must come from senior management of the organization.
  • The organization’s values must be aligned with the objectives of prevention, promotion and organizational practices contributing to health in the workplace.

Create a health and wellness committee.

  • The committee is responsible for developing the organization’s health and wellness program that is linked to organizational issues and concerns.
  • The committee is also responsible for evaluating activities done as part of the program.

Do a needs assessment.

  • Collect employees’ suggestions on the problems they think are important to include in the program.
  • Collect data on living habits, work–life balance, the work environment and management practices.
  • Collect data on employee satisfaction and needs in relation to the visible commitment of managers in implementing the program.

Support the implementation and establishment of activities for prevention, promotion and organizational practices contributing to health in the workplace.

  • Put in place a calendar of events of the health and wellness committee.
  • Plan how communications will be done during activities.
  • Plan activities based on the available budget in a realistic way.

Be sure to evaluate the change and benefits of the program with the target population.

  • Obtain an assessment report following each activity that includes an employee satisfaction rate and the rate of achieving program objectives.
  • Conduct a qualitative assessment after doing the assessment report to ensure that the process meets expectations and the original objectives.

Have a policy for training managers in people management.

  • Put in place hiring criteria for managers that encourage people management skills.
  • Offer ongoing training to managers on promoting mental health.


This research clearly shows the importance of organizational approaches to improve employees’ mental health in the workplace. These approaches are therefore a priority, as they target all employees, unlike individual approaches that prove to be more complementary. Furthermore, beyond activities promoting support for employees, as well as recognizing their work, businesses must not neglect to take action on autonomy and workload, even if these are often more difficult to carry out, as they affect management rights and are based on respect.



Letellier, M.-C., Vézina, M., Biron, C. (2019). Risk factors in the workplace.Global-Watch scientific interpretation available at: www.global-watch.com


Trudel-Fitzgerald, C., Savard, J., et Ivers, H. (2013). Which symptoms come first? Exploration of temporal relationships between cancer-related symptoms over an 18-month period. Annals of Behavioral Medicine, 45(3), 329-337.

Pierre Breton
Author: Pierre Breton