10970274, 2022, 10, Downloaded from https://onlinelibrary.wiley.com/doi/10.1002/ajim.23414 by Spanish Cochrane National Provision (Ministerio de Sanidad), Wiley Online Library on [21/12/2022]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License Received: 7 November 2021 | Revised: 5 July 2022 | Accepted: 7 July 2022 DOI: 10.1002/ajim.23414 RESEARCH ARTICLE Delegation and consultation on operational and tactical issues: Any difference in their potentialities for a healthier psychosocial work environment? Clara Llorens‐Serrano MSoc1,2,3 | Sergio Salas‐Nicás PhD3 | Albert Navarro‐Giné PhD3,4 | Salvador Moncada Lluís PhD2 1 Sociology Department, Faculty of Sociology and Political Sciences, Autonomous University Abstract of Barcelona (UAB), Cerdanyola del Vallès, Background: Despite the growing number of studies on direct participation labor‐ Spain 2 Union Institute of Work, Environment and management practices, little is known about the role of their different discretionary Health (ISTAS), Reference Centre on Work degrees (delegation or consultation) and topics in their relationship with the Organization and Health, Barcelona, Spain psychosocial work environment by occupational groups. 3 Research Group on Psychosocial Risks, Organization of Work and Health (POWAH), Methods: Cross‐sectional study on the relationship between direct participation and Autonomous University of Barcelona (UAB), work‐related psychosocial risks (using COPSOQ‐ISTAS21 v3) on a representative sample Cerdanyola del Vallès, Spain 4 of the salaried and wage‐earning employees in Spain (n = 1807). Prevalence ratios were Biostatistics Unit, Faculty of Medicine, Autonomous University of Barcelona (UAB), calculated using adjusted Poisson regression models, controlling for 10 other labor‐ Cerdanyola del Vallès, Spain management practices, sex, and age, and stratified by occupational group. Correspondence Results: The use of direct participation was either associated consistently with a Clara Llorens‐Serrano, MSoc, Sociology healthier psychosocial work environment (mostly in manual occupations, which Department, Faculty of Sociology and Political presented twice as many positive associations as nonmanual occupations, and of Sciences, Autonomous University of Barcelona, Edifici B, Cerdanyola del Vallès greater strength, mostly in the control and social support dimensions) or there were 08193. no significant associations (mostly among nonmanual occupations and in relation to Email: cllorens@istas.ccoo.es and clara.llorens@uab.cat work pace). More frequent and stronger associations were observed when consultation and delegation were used in combination. If used separately, Funding information Instituto de Salud Carlos III, consultation achieved better results among manual occupations and delegation Grant/Award Number: PI15/00161 among nonmanual occupations. Direct participation topics were not important for results in manual occupations whereas results were better on tactical (vs. operational) issues in nonmanual occupations. Conclusions: Direct participation does not change power structure, but it may be a useful intervention at the company level to reduce work‐related psychosocial exposures and associated diseases among workers in manual occupations, and consequently for decreasing occupational exposures and health inequalities. KEYWORDS direct participation, employees' involvement, occupational class inequalities, psychosocial work environment, work organization This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. © 2022 The Authors. American Journal of Industrial Medicine Published by Wiley Periodicals LLC 800 | wileyonlinelibrary.com/journal/ajim Am J Ind Med. 2022;65:800–812. 10970274, 2022, 10, Downloaded from https://onlinelibrary.wiley.com/doi/10.1002/ajim.23414 by Spanish Cochrane National Provision (Ministerio de Sanidad), Wiley Online Library on [21/12/2022]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License LLORENS‐SERRANO ET AL. | 801 1 | INTRODUCTION discretion or powers (i.e., consultation or delegation) and different topics or scope (i.e., operational or tactical issues), which may A considerable body of evidence has identified psychosocial risks as determine their relationship with working conditions.27–29 However, features of work organization that may harm workers' health and relevant comparative evidence on different forms of direct participa- well‐being.1 Research is prolific on the relationship between tion and working conditions is scarce, with debates being more psychosocial risks and cardiovascular and mental illnesses, two of conceptual than empirical.30 the most challenging illnesses in occupational health and safety and According to degrees of discretion, that is, the extent to which public health in general, especially in Western societies.2–4 Using the managers let workers be involved in decisions, direct participation demand‐control‐social support5,6 and effort‐reward imbalance models,7 could be categorized as delegation, when management grants exposure to these risks at the workplace has been related to anxiety decision‐making capacity to workers and as consultation, when 8,9 10,11 and depression and myocardial infarction or stroke, among management encourages workers to make their opinions known many other health disorders. Furthermore, longitudinal studies and but reserves the capacity to accept or reject them.31 Delegative direct meta‐analyses with large databases have been able to rule out chance participation practices (mostly semi‐autonomous workgroups but 12 associations. also individual self‐management) underpin labor‐management mod- Additionally, scientific literature has shown major occupational els, such as the humanization and democratization of work, socio- class disparities on psychosocial exposures, connected with other technical systems, and high involvement or learning organizations, socioeconomic and sociodemographic factors,13 in a segmented labor mostly associated with a healthier working environment. Team or market derived from the unequal implementation of labor‐ individual autonomy to make decisions in enlarged and enriched jobs management practices.14–16 Moreover, recent studies on trends in is considered one of the key factors for exerting influence in and over psychosocial working conditions in the European Union and United work, in giving better chances for using abilities, learning, and States have observed persistent inequalities by occupational groups. developing on the job, in increasing the opportunities for cooperation In the European Working Conditions Survey (EWCS) data from 1995 and for being recognized as a professional.32–34 Some research to 2015, salaried and wage‐earning employees in lower‐skilled critical of “high‐performance” management warns of its negative occupations not only had higher levels of job strain and effort‐ effects, mostly referring to individual delegation among nonmanual reward imbalance on average, but they also experienced a steeper jobs. Despite its rhetorical support for workers' personal and increase in job strain than employees in higher‐skilled occupations in developmental needs,35,36 inside the “self‐management” paradigm, the original 15 European Union countries (EU‐15) during that period. while workers may enjoy considerable discretion regarding how they The persistent low job control for low‐skilled manual jobs during the carry out their duties, their workload is overburdened, and their 20‐year period of the survey reflected a decrease in skill discretion performance is under constant scrutiny, their autonomy being partial 17 (skill use) and persistent low decision authority. Similarly, job and contradictory.28,37,38 On the other hand, consultative direct control remained at higher levels for the management and participation practices have been studied as part of “lean” production, professional groups and at low levels for service and blue‐collar jobs, high performance, and “new public management,” and they have also consistent with the findings from the 2002–2014 NIOSH Quality of been associated with excessive demands in terms of effort and 18 Work Surveys for the US population. commitment, increased peer competitiveness, and work intensifica- This public health literature also points to organizational tion among manual and nonmanual jobs.21,39–44 Nevertheless, some interventions at the workplace to minimize psychosocial job scholars have suggested that consultative direct participation exposures as a step to promote workers' health.19,20 Along this line, practices are crucial for achieving positive effects on working the research to date suggests that various aspects of labor‐ conditions (i.e., influence, using skills and learning new ones, management practices, such as working time arrangements, working coworker support or management recognition) when lean production methods, job design, employment relationship, and salary structures, is implemented.45–50 are modifiable work features at the origin of workplace psychosocial Regarding direct participation scope, that is, the topics about exposures.21–25 However, it still remains a vast area to explore.26 which managers allow workers to decide themselves or to take part More than 40 years of public health research supports the in decisions, direct participation may address operational issues (i.e., harmfulness of Taylorism toward physical and mental health21 due to job or task‐related topics, pertaining to concrete job performance) or division, fragmentation, and standardization of work, which in turn tactical issues (i.e., technology, work organization, or productive are associated with low control, high work pace, lack of social system design). As far as strategic content (i.e., production goals, support, and low recognition at work. In contrast, scholars have investment strategies, or restructuring), participation, if any, is mainly debated the relationship between direct participation practices and reserved to workers' representatives.27,28 Direct participation studies working conditions, with few studies on psychosocial risks. which considered scope typically involved delegation on operational Direct participation practices have been defined in the literature matters and consultation on tactical issues, as reflected, for example, as labor‐management practices that involve some kind of in the typology used by Eurofound from 2013 onwards.51,52 This decentralization in decision‐making from management toward work- study focuses on direct participation practices and its results ers, either individually or in groups, entailing different degrees of suggested that all forms are associated with better working 10970274, 2022, 10, Downloaded from https://onlinelibrary.wiley.com/doi/10.1002/ajim.23414 by Spanish Cochrane National Provision (Ministerio de Sanidad), Wiley Online Library on [21/12/2022]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License 802 | LLORENS‐SERRANO ET AL. conditions. For instance, Gallie and Zhou,51 using European level four‐stage stratified design. The stratification was based on data, showed lower levels of work intensity, increased informal geographical area and size of municipality and stages corresponded learning, and higher possibilities to experience management support to municipality, census tract, household, and salaried and wage‐ when consultation on tactical issues, or delegation about operational earning employee. The selection of households was made by random issues (or both direct participation forms) were implemented in routing and that of individuals by random numbers. Fieldwork was companies. Llorens et al.,53 working with Spanish data, found no carried out between October and December 2016, using a CAPI association with quantitative demands and more frequent and questionnaire distributed during personal interviews at the inter- stronger positive associations with control, social support and viewees' homes. Participation was voluntary and all participants rewards, when using delegative and consultative direct participation provided informed oral consent. Data were rigorously anonymized practices simultaneously and among manual jobs. Felstead et al.,54 before analysis. The response rate before substitution was 70.1%. using data from the UK, found these practices associated with skill Inclusion criteria were having worked for at least 1 h in a paid job, utilization and with lower required effort and work exhaustion. during the week before the interview, age between 16 and 65, and Moreover, Dhondt et al.,55 using data from Denmark, Ireland, The residence in Spain. Fourteen individuals in CEO positions were Netherlands, Finland, Sweden, and the UK, showed high work excluded from this study. As a result, the final sample size was intensity being associated with less delegation and not associated n = 1793. with consultation, which, in turn, was positively associated with well‐ being. Furthermore, these studies suggest that direct participation practices may reduce occupational class differences in working 2.2 | Measures 30,51,53,56,57 conditions. Therefore, direct participation was mostly studied in combination 2.2.1 | Independent, adjustment, and stratification with other labor‐management practices as part of one labor‐ variables management model (lean, high‐performance management, high involvement management, among others). Only some studies Four variables were created for direct participation (see Table 1 and assessed direct participation practices and their relationships with Supporting Information: Appendix 1), two indicators were created as working conditions comparing specific degrees of discretion (i.e., independent variables: one on operational issues and the other on consultation, delegation, or both) while mixing the scope (i.e., tactical issues, both distinguishing between different degrees of operational or tactical); very few others linked direct participation discretion (consultation, delegation, or combination of the two). This practices to work‐related psychosocial risks, distinguishing between allowed for an empirical discussion not only about the relationship occupational groups; and even fewer have used an assessment between work‐related psychosocial risks and different degrees of instrument validated in the field of occupational health. discretion in using direct participation practices, but also on the The potential of different degrees of discretion and scope in relationship with the different topics addressed by them. direct participation practices to promote a better psychosocial work Ten other labor‐management practices variables on working environment at the company level across different occupational hours, employment relationship, promotion, salary, and staffing (see groups, is still unclear.58 Consequently, the present study aims to Table 1 and Supporting Information: Appendix 1) were considered expand the empirical evidence about the role of specific features of potential confounding factors in addition to sex and age. They were direct participation practices as social determinants of psychosocial chosen by a multidisciplinary panel of experts comprising sociologists, exposures and health promoting practices, which may differ among economists, lawyers, and epidemiologists and were taken from an occupational groups. earlier study, which used data from the Spanish Psychosocial Risks Survey carried out in 2005 to investigate the associations between these variables and the psychosocial work environment.60 2 | M E TH O D S Occupational group was used as the stratification variable, measured with the 2011 National Classification of Occupations 2.1 | Study design and population (CNO‐11) at the one‐digit level (nine categories) and then dichoto- mized into manual and nonmanual occupations.61 2.1.1 | Population‐based cross‐sectional study All research procedures were approved by the Ethics Committee on 2.2.2 | Dependent variables Animal and Human Experimentations of the Autonomous University of Barcelona (CEEAH/3445) and by ISTAS' Research Ethics Commit- The survey included the COPSOQ‐ISTAS21 v3,59 the Spanish tee. Data were obtained from the 3rd Spanish Psychosocial Risks adaptation of the Copenhagen Psychosocial Questionnaire (COPSOQ Survey (ERP 2016),59 administered to a representative sample of the v3), an internationally validated instrument for the assessment of salaried and wage‐earning employees in Spain (n = 1807). A random work‐related psychosocial risks.62 The COPSOQ questionnaire sample was obtained covering the entire national territory through a allows for the operationalization of the most prominent work‐ 10970274, 2022, 10, Downloaded from https://onlinelibrary.wiley.com/doi/10.1002/ajim.23414 by Spanish Cochrane National Provision (Ministerio de Sanidad), Wiley Online Library on [21/12/2022]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License LLORENS‐SERRANO ET AL. | 803 T A B L E 1 Study variables among study population (ERP 2016; TABLE 1 (Continued) Percentages) Salaried workers Salaried workers Salaried workers Salaried workers in manual in nonmanual in manual in nonmanual occupations (57.4) occupations (42.6) occupations (57.4) occupations (42.6) Schedule determination** Sociodemographic variables Always 12.3 21.3 Sex** Sometimes 11.6 16.5 Women 56.7 44.2 Never 76.1 62.2 Men 43.3 55.8 Salary covers unexpected needs** Age Always 32.9 56.2 <30 33.6 26.8 Sometimes 34.2 23.9 30–45 27.6 27.8 Never 32.9 19.8 >45 38.8 45.4 Salary fairness regarding performance* Indicators of labor management practices Always 39.8 50.8 Direct participation (DP) on operative issues (way of doing one's Sometimes 27.6 22.9 work)** Never 32.6 26.3 Delegation without 8 9.3 consultation Staffing levels* Consultation without 7.6 8.5 Enough 66.2 54.7 delegation Shortage 33.8 45.3 Delegation and 38.9 52.3 Work planning consultation Realistic 69.6 71.8 No direct participation 45.6 30 practices Unrealistic 30.4 28.2 Direct participation on tactical issues (purchase of new tools or Promotion on boss favoritism technology)* Yes 35 32 Delegation without 2.4 3 No 65 68 consultation Promotion on meeting availability demands Consultation without 8.6 10.5 delegation Yes 50.2 47.8 Delegation and 19.2 25.2 No 49.8 52.2 consultation Exposure to work‐related psychosocial risks No direct participation 69.9 61.3 practices Demands Employment contract** High work pace 31 30.1 Permanent (indefinite) 64.2 77.8 Control Temporary 28.7 20.1 Low influence** 45.5 23 (fixed term) Low possibilities for 45 17.2 No contract 7.1 2.1 (skills) development** Seniority (company)** Social support <5 57.7 37.7 Low support from 33 23 colleagues** 5–10 17.4 19. Low support from 42.2 26.5 >10 24.8 42.4 supervisor** Overtime Rewards Always 16.5 20 Low recognition** 42.9 27 Sometimes 25 23.7 *p ≤ 0.05. Never 58.5 56.3 **p ≤ 0.001. (Continues) 10970274, 2022, 10, Downloaded from https://onlinelibrary.wiley.com/doi/10.1002/ajim.23414 by Spanish Cochrane National Provision (Ministerio de Sanidad), Wiley Online Library on [21/12/2022]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License 804 | LLORENS‐SERRANO ET AL. related psychosocial risk theories, including the most relevant risks, stratifying by occupational group. All analyses were conducted psychosocial domains. For this study, six dimensions were selected considering the sample design by using the “svy” command of the as indicators of central components of the demand‐control‐social STATA statistical package, version 12.0. support (DCS) and effort‐reward (ER) models and considered dependent variables: work pace, influence, possibilities for development, social support from colleagues and supervisor and recognition. Each one 3 | RESULTS was measured on a scale comprising between two and four 5‐point Likert‐type items. For the analysis, the answers to the questions were Direct participation practices were associated with a better psycho- added and standardized with scores ranging from 0 to 100. The social work environment, after adjusting for other labor‐management scores were then dichotomized considering the 25% (or the closest practices, sex, and age, and after stratifying the population by possible) at most risk as “poor” and the rest at “good” for health in occupational group. Significant associations, always positive, were each psychosocial dimension (see Table 1 and Supporting more frequent and stronger among manual occupations compared to Information). nonmanual ones (23 vs. 11 out of 36 observations). Regarding direct participation practices characteristics, in both occupational groups, when consultation and delegation were used in 2.3 | Statistical analysis combination, the associations with psychosocial work environment were always positive, more frequent (16 out of 24 observations) and Sampling weights were calculated to account for the probability of a stronger (Tables 2 and 3). When they were used separately, a worker being selected according to the sampling design, and to different picture emerged: among manual occupations (Table 2), comply with the sex and occupational group distribution of the associations with a better psychosocial work environment were Spanish salaried and wage‐earning employees, taken from the survey stronger and more frequent when using consultation (9 vs. 4 out of the active population (EPA) for the last quarter of 2015. of 12 observations), while in nonmanual occupations (Table 3), they Robust Poisson regression models were fitted to estimate were stronger and more frequent when delegation was used (4 vs. 1 adjusted prevalence ratios (PR) with their respective 95% confidence out of 12). intervals (95% CIs), to establish possible associations between Among workers in manual occupations (Table 2), the frequency different direct participation practices and work‐related psychosocial of associations with work‐related psychosocial risks were similar for TABLE 2 Prevalence ratios (PR) between psychosocial work factors and direct participation practices. Salaried workers in MANUAL occupations. Direct Participation on operative issues Direct Participation on tactical issues Delegation Consultation Delegation Consultation without Delegation and without without Delegation and without delegation consultation consultation delegation consultation consultation PR 95% CI PR 95% CI PR 95% CI PR 95% CI PR 95% CI PR 95% CI Demands Work pace 0.74 0.46 1.19 1.33 0.92 1.90 1.05 0.77 1.42 0.71 0.45 1.10 1.13 0.67 1.92 0.96 0.66 1.38 Control Influence 1.15 1 1.37 1.14 1 1.40 1.32** 1.17 1.48 1.19* 1.05 1.39 1.19 1 1.45 1.21** 1.09 1.31 Possibilities for 1.41** 1.16 1.73 1.14 1 1.45 1.51** 1.30 1.74 1.28** 1.18 1.55 1.40* 1.12 1.76 1.35** 1.13 1.46 development Social support Colleagues' 1. 33** 1.17 1.59 1.24 0.99 1.55 1.36** 1.13 1.48 1.38* 1.04 1.84 1.09 0.90 1.31 1.26** 1.11 1.43 support Supervisors' 1. 29** 1.18 1.52 0.99 0.80 1.22 1.34** 1.14 1.55 1.23* 1.07 1.42 1.14 0.92 1.44 1.24** 1.11 1.38 support Rewards Recognition 1.11 0.91 1.34 0.93 0.76 1.13 1.22* 1.08 1.39 1.12 1 1.28 1.03 0.84 1.28 1.18* 1.05 1.33 Note: Salaried workers in manual occupations. Reference category for independent variables was no implementation of direct participation and for dependent variables poor for health. Black PRs indicate no association; bold p ≤ 0.05; bold *p ≤ 0.01; bold **p ≤ 0.001. All PRs were adjusted by 10 other labor management practices (working time, employment relationship, promotion, salary, and staffing), sex, and age. Abbreviation: CI, confidence interval. 10970274, 2022, 10, Downloaded from https://onlinelibrary.wiley.com/doi/10.1002/ajim.23414 by Spanish Cochrane National Provision (Ministerio de Sanidad), Wiley Online Library on [21/12/2022]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License LLORENS‐SERRANO ET AL. | 805 T A B L E 3 Prevalence ratios (PR) between psychosocial work factors and direct participation practices. Salaried workers in NON‐MANUAL occupations. Direct participation on operative issues Direct participation on tactical issues Consultation Delegation Consultation Delegation without without Delegation and without without Delegation and delegation consultation consultation delegation consultation consultation PR 95% CI PR 95% CI PR 95% CI PR 95% CI PR 95% CI PR 95% CI Demands Work pace 1.06 0.60 1.87 0.93 0.61 1.42 1.02 0.67 1.55 1.13 0.75 1.70 1.42 0.58 3.52 1.19 0.76 1.87 Control Influence 1.07 0.82 1.39 1.27* 1.09 1.51 1.28* 1.10 1.46 1 0.82 1.22 1.15* 1.05 1.25 1.27** 1.12 1.43 Possibilities for 0.86 0.66 1.12 1.09 0.96 1.24 1.08* 1.02 1.14 1.09 0.95 1.26 1.16 1.02 1.31 1.16** 1.07 1.27 development Social support Colleagues' 0.88 0.64 1.20 0.87 0.64 1.19 1.05 0.85 1.29 1.15 0.92 1.44 0.64 0.30 1.33 0.97 0.64 1.45 support Supervisors' 1 0.75 1.33 0.88 0.67 1.14 0.95 0.81 1.12 0.92 0.73 1.15 1.07 0.79 1.46 1.17 0.96 1.44 support Rewards Recognition 1.08 0.88 1.33 1.06 0.87 1.31 1.20 1.03 1.39 1.17 1.03 1.34 1.30 1 1.69 1.25** 1.09 1.42 Note: Salaried workers in nonmanual occupations. Reference category for independent variables was no implementation of direct participation and for dependent variables poor for health. Black PRs indicate no association; bold p ≤ 0.05; bold *p ≤ 0.01; bold **p ≤ 0.001. All PRs were adjusted by 10 other labor management practices (working time, employment relationship, promotion, salary, and staffing), sex, and age. Abbreviation: CI, confidence interval. tactical and operational issues (12 vs. 11 out of 18 observations), direct participation practices. Recognition was the only dimension although they were stronger for operational issues. In contrast, associated with consultation but regarding tactical issues only. The associations were more frequent (7 vs. 4 out of 18 observations) and two strongest associations recorded were with influence (PR 1.27 stronger in the case of tactical issues among workers in nonmanual p < 0.001), recognition (PR 1.25 p < 0.001) resulting from the occupations (Table 3). combined application of consultation and delegation on tactical Regarding psychosocial risk factors, no associations were issues. Recognition was the only factor with more associations observed between work pace and direct participation practices in among workers in nonmanual occupations than in manual ones either occupational group. (4 vs. 3 out of 6). About the remaining psychosocial factors, among manual occupations (Table 2), control, social support, and rewards dimensions were positively associated to the use of direct participation practices 4 | D IS CU SS IO N (23 out of 30). Associations were stronger and more numerous with influence and possibilities for development (12 out of 12) followed by When comparing the situation of workers to whom direct participa- support from colleagues and support from superiors (8 out of 12), tion practices were applied with that of workers among whom these resulting from the application of consultation and delegation practices were not used, our results corroborate those of previous combined or consultation alone and in relation to operative issues. research indicating that direct participation practices are associated The strongest association was with possibilities for development with better psychosocial working conditions.30,32–34,45–51,53–57 The (PR 1.51 and 1.41 p < 0.001), followed by support from colleagues use of direct participation practices was either associated consis- (PR 1.36 p < 0.001). tently with a healthier psychosocial work environment (mostly among Among nonmanual occupations (Table 3), the picture was manual occupations, who presented twice as many positive associa- substantially different since most of the tested associations were tions as nonmanual ones, and of greater strength) or it was null not significant (19 out of 30). However, influence, recognition, and (mostly among nonmanual occupations or in relation to work pace). possibilities for development were associated with the application of Therefore, according to our results, direct participation practices direct participation practices, either combined or when using have a potential of reducing work‐related psychosocial exposures delegation alone, and being more numerous and strongest regarding and their uneven distribution, and consequently, for decreasing work‐ tactical issues. Social support dimensions were not associated with related diseases and health inequalities.20 10970274, 2022, 10, Downloaded from https://onlinelibrary.wiley.com/doi/10.1002/ajim.23414 by Spanish Cochrane National Provision (Ministerio de Sanidad), Wiley Online Library on [21/12/2022]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License 806 | LLORENS‐SERRANO ET AL. Regarding degrees of discretion, for both manual and nonmanual influencing decision‐making processes, triggering the human capacity occupations, more frequent and intense improvements of psycho- of thinking creatively. social work environment were observed when consultation and Arguably, tasks in manual jobs are mainly designed to be simple delegation were used in combination, as expected.51 When consulta- and standardized, with very low possibilities to bring into play skills tion and delegation were used separately, consultation led to a and knowledge. Consequently, for workers in these occupations, healthier work environment among manual occupations, which we being consulted or deciding about operational or tactical issues (i.e., had not hypothesized. In contrast, delegation had better results than how to do their job, or which new tools and new technology should consultation among nonmanual occupations, as expected. Regarding be purchased, etc.) could change this situation, enabling their topics, direct participation on tactical issues had better outcomes knowledge and skills to be applied and challenged,45,54 and in doing than on operational issues among nonmanual occupations, as so, enhancing their dignity at work.79 Moreover, delegation and expected. However, among manual occupations, both operational consultation may facilitate informal learning,51 delegation through 33 and tactical issues had similar good results, an unexpected find- developing own job tasks and consultation through knowledge 32,63 56 ing. So, for both workers in manual and nonmanual occupations, sharing, allowing learning from coworkers and from line‐ higher discretionary degrees of participation were important for the management,80 thus, acquiring new skills and knowledge.66,81 psychosocial work environment, meanwhile topics were only impor- When used separately, consultation had stronger associations tant among nonmanual occupations. with control than delegation among manual occupations. In other words, consultation emerged as being more professionally stimulat- ing than delegation, which theoretically was an unexpected result.63 4.1 | Demands As for operational topics, since the tasks involved are relatively simpler, autonomy stemming from delegation can be trivial,80 No relationship was observed between direct participation therefore, being consulted on how to improve the way tasks are practices and work pace, neither among workers in manual performed might be more stimulating than delegation on how to do occupations nor among those in nonmanual occupations. Though them. Moreover, consultation could result in more professional consistent with previous studies,53,55,64 this result was unexpected development since it may occur in group structures more often than since a substantial part of the literature links direct participation to delegation.82 Group structures could make sharing experiences and work intensification.38,40,65–68 However, in most cases, direct reflecting with peers easier.80 Additionally, consultation may imply a participation practices have been studied in the context of lean or need to make inputs by management, resulting in a sort of vertical high‐performance management models and therefore, in conjunc- decentralization of information that otherwise workers would not tion with other management practices that are associated with know.83 All in all, consultation may extend knowledge flows, enabling work intensification, such as performance‐related payment,69 the use and learning of skills and knowledge in a more protean and just‐in‐time, waste and nonadded value activities reduction or substantive way than delegation for certain occupations. standardized work45,70–72 and understaffing,65 which could Among nonmanual occupations, more favorable results for compromise positive results of direct participation practices. 48,73 delegation (both alone and in combination with consultation) than Moreover, unlike previous research on direct participation, our for consultation are observed. Similarly, better results for tactical results were adjusted for other known causes of work intensifica- topics than for operational ones were observed, as theoretically tion, such as poor planning,37 time availability demands74 or expected for the dimensions of control and recognition. Delegation on staffing level constraints.75,76 Such controls may account for the tactical issues poses more challenges—that is, thinking creatively, differences between our results and the negative ones observed in acquiring new information, learning new tasks, having more decision previous studies. In other words, our research adds evidence to the latitude—and implies greater respect for workers' work‐related literature suggesting that the main causes of the work intensifica- knowledge.32,34 Even so, the associations between direct participa- tion may be wider resource pressures and other related labor‐ tion practices and control dimensions were less strong and less management practices that contextualize direct participation frequent among nonmanual occupations than in manual ones. implementation, rather than the direct participation practices Despite the increasing tendency toward routinization,84 nonmanual 33,53,75–78 themselves. jobs still have a richer content than many manual jobs and may therefore have less room for improvement with the implementation of direct participation practices.52,56 4.2 | Control Among workers in manual occupations, the implementation of direct 4.3 | Recognition participation practices, regardless of the degree of discretion or topic, was more frequently and strongly associated with possibilities of For workers in manual jobs, only combined use of consultation and development and influence, meaning greater possibilities for applying delegation showed relatively strong associations with recognition, and developing skills and knowledge and, to a lesser extent, for irrespective of the topic. So, only when these participatory processes 10970274, 2022, 10, Downloaded from https://onlinelibrary.wiley.com/doi/10.1002/ajim.23414 by Spanish Cochrane National Provision (Ministerio de Sanidad), Wiley Online Library on [21/12/2022]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License LLORENS‐SERRANO ET AL. | 807 mean management actively seeking and listening to proposals from 4.5 | Limitations and strengths rank‐and‐file workers on operational and tactical issues plus allowing them to decide, are indicators of management's recognition and The cross‐sectional nature of this study limits the inferences about respect. Probably, their joint use shows a truer management the causal direction of the associations, which must be more commitment to workers as experts and management respect for rigorously tested through longitudinal research or experimental manual workers' work‐related knowledge.45,85 designs. Moreover, developing a qualitative part of this study using focus groups or interviews to workers in manual occupations would be pertinent to understand better how direct participation practices 4.4 | Social support may lead to healthier working conditions. The study lacks contextual data, even at the company level (size, Among workers in manual jobs no associations were found sector, unionized workers' representation, and so on). However, the between social support and delegation used alone, meanwhile aim of the research was not to explore the determinants of direct consultation either alone or in combination with delegation participation implementation or its patterns (for which these variables presented favorable associations with support. Thus, our research are fundamental), but its associations with work‐related psychosocial suggests that support from colleagues and supervisors for doing risks. According to segmentation theory,16,90 the factors relevant to one's work is promoted by consultation among workers in manual working conditions are on the “demand” side; it is the labor‐ jobs. It could be that consultation is applied more frequently in management practices that determine them at the company level, group format than delegation, making it easier to help each other. and this is the reason why our controls were other labor‐ That may be the case since, for example, 2015 EWCS' results82 management practices which could be associated with the psycho- revealed that only 10% of the salaried and wage‐earning employees social work environment.13,21 Still, the role of workers' representa- worked in teams with autonomy. Regarding coworkers' social tives could be significant. Evidence from the field of occupational support, it could be argued that consultation gives opportunities to health showed where there is unionized representation of workers, 85 speak up and listen to others' problems and to solve problematic with collective power and a proactive approach, preventive action is situations, making the work easier.46,86 Correspondingly, these more frequent and has better results,91–95 also in relation to direct practices may create not only a group structure but a collective participation practices' implementation.96,97 However, our analysis process that promotes collaboration, not only during the consulta- does not address representative participation, which, in the European tion but also in everyday work. This could be especially important in Union, is based on workers' rights, recognized through legislation and jobs in which the individual is the basic unit of design, as it is more collective bargaining.98 A focus on representative participation frequent among manual occupations. The positive associations with together with direct participation practices would allow a discussion supervisors' support could be related to the need of redefinition of about ways of challenging the distribution of power, on questioning line‐managers' tasks in consultation structures, where they are the management prerogative, on strategic issues, and about asked to be facilitators and to collaborate with rank‐and‐file democracy in the workplace,99 but it would require a different workers. These new tasks related to functional support may be analytical framework and additional data, that of industrial relations. carried out by line managers outside the consultation structures, From the segmentation theory perspective, labor‐management also in everyday operations.51 The stronger associations with practices are conditioned as well by their social, institutional, and support when consultation is used to tackle operational issues economic context, and, in turn, are key factors in shaping these might be related to their greater connection to everyday work than contexts.14 Finally, due to the same limitations we cannot rule out the tactical issues. possibility that both, a healthier psychosocial work environment and In contrast, the lack of association with social support direct participation practices result from a common cause, such as dimensions among nonmanual occupations suggests that they do psychosocial safety climate,100 which is also shaped by the economic, not need the leverage of direct participation practices to create political, legislative, and labor relations context. However, a signifi- structures to work in a collaborative manner. The 2015 EWCS cant amount of covariates were adjusted in the models thus a number 82 results showed that workers in nonmanual occupations are more of cofounders were controlled. The fact that these issues were not likely to work in teams. analyzed at the macro, meso, and micro levels is another limitation of Yet, these results were unexpected since some previous this study. More research is needed that includes these levels, using research reported inverse associations between direct participation different methods to evaluate the role they play in the association 39,40 formulas and social support, which again may be due to the between work‐related psychosocial risks and direct participation influence of other labor‐management practices that are applied and practices.39,58,101,102 studied in conjunction with direct participation practices, which, in The data used come from a representative sample of employed turn, were controlled in our study. These practices may include workers in Spain. While the results corroborate prior research on performance‐related payment69 and understaffing,87 both associ- direct participation practices in other geographical settings with ated with work intensification and compromising time needed to quite different socioeconomic and institutional contexts, such as support peers.88,89 EU‐27‐Norway and UK, Greece, Sweden, the UK, or New 10970274, 2022, 10, Downloaded from https://onlinelibrary.wiley.com/doi/10.1002/ajim.23414 by Spanish Cochrane National Provision (Ministerio de Sanidad), Wiley Online Library on [21/12/2022]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License 808 | LLORENS‐SERRANO ET AL. Zealand,33,46,51,55,56,64 the labor‐management practices and the of control and social support. On the one hand, low levels of control work‐related psychosocial environment in Spain have characteristics and support have been reported to contribute significantly to the 51,103,104 and idiosyncrasies of their own, which may limit the development of illnesses of great importance in Western countries, generalization of these results to other countries. such as coronary heart disease1 and mortality,105 depression8,106 and This study has also some important strengths. It is one of the few death by suicide.107 On the other hand, there are major and existing studies on the impact of specific features of direct persistent inequalities in control and support between workers in participation on the psychosocial work environment measured by a manual and nonmanual occupations.17,18 validated instrument, stratifying its results by occupational group, and Moreover, following our evidence, and as other investigators based on a representative sample of the employed working have argued,33,48,54,71,75–78 it could be hypothesized that other population. Moreover, the analyses comparing different degrees of related labor‐management practices together with wider resource direct participation (consultation, delegation, or both), regarding the pressures that frame direct participation practices may be the cause same topics (operational or tactical), allowed us to create new of health‐impairing results (work intensification or competitiveness knowledge about what accounts for healthier working conditions among workers) found in some previous research, rather than the when using direct participation practices, for each occupational direct participation practices themselves. More research is needed to group. In addition, analyses include a wide range of indicators of draw conclusions on this. other labor‐management practices (working time, employment Direct participation does not change the basic power structure85 relationship, promotion, salary, and staffing) as controls to isolate but it may be an effective means to reduce unhealthy working the effects of direct participation practices from other labor‐ conditions and occupational inequalities at the company level.20 management practices, giving pertinent and interesting findings to Following Findlay et al.,75,101 while acknowledging financial, institu- question negative outcomes attributed previously to direct participa- tional, and technological pressures which condition the implementa- tion practices. Last, it shows findings according to occupational tion of these labor‐management practices, it is for the management, groups to visualize differences derived from inequalities both in the who holds the executive power in the workplace (and for labor who implementation of labor‐management practices and in psychosocial can condition it),93,96,97 to decide whether to use direct participation risk exposures. practices to achieve a healthier psychosocial work environment and As a result, this study has expanded the evidence on the better job quality. relationship between direct participation practices and working conditions and it gives some clues for their healthier implementation A UT H O R C O N T R I B U TI O NS at company level, particularly among workers in manual jobs. Clara Llorens‐Serrano and Salvador Moncada Lluís participated in the design of the work. All authors participated in the acquisition of data. Clara Llorens‐Serrano, Sergio Salas‐Nicás, and Albert Navarro‐Giné 5 | CONCLUSION REMARKS participated in the analysis of data. Clara Llorens‐Serrano participated in the interpretation of data and drafting the work. All authors revised Comparing the situation of workers to whom direct participation it, finally approved the version to be published and agreed to be practices are applied with that of workers among whom these accountable for all aspects of the work in ensuring that questions practices are not used, this empirical contribution showed that direct related to the accuracy or integrity of any part of the work are participation practices have the potential to reduce exposure to appropriately investigated and resolved. psychosocial risks among workers especially in manual occupations, achieving healthier working conditions, and improving job quality. ACKNOWLEDGME NT S According to our results, direct participation practices may This study was funded by Instituto de Salud Carlos III, Fondo de expand manual workers' opportunities for applying their skills and Investigación Sanitaria, Spanish Ministry of Economy, Industry and knowledge and thus increasing their work‐related dignity and their Competitiveness; Grant number: PI15/00161. learning of new abilities. They provide more chances for supportive contact with coworkers and supervisors, increase possibilities of CONFLIC T OF INTEREST attaining influence over their work, and, to a lesser extent, increase The authors declare no conflict of interest. recognition from management without increasing work intensifica- tion. Moreover, better outcomes are to be achieved when consulta- D I S C L O S U R E B Y A J I M E D I TO R O F R E C O R D tion and delegation are used in combination, but even when Paul A. Landsbergis declares that he has no conflicts of interest in the consultation is used alone and confined to immediate job issues, review and publication decision regarding this article. such as operational topics, this form of work organization, based on allowing rank‐and‐file workers to have a say in their day‐to‐day E T HI C S A P P R O V A L A N D I N F O R M E D C O NS E N T activities, has favorable results. All research procedures were approved by the Ethics Committee on The best results for using direct participation practices among Animal and Human Experimentations of the Autonomous University workers in manual jobs are found in the psychosocial risk dimensions of Barcelona (CEEAH/3445) and by ISTAS' Research Ethics 10970274, 2022, 10, Downloaded from https://onlinelibrary.wiley.com/doi/10.1002/ajim.23414 by Spanish Cochrane National Provision (Ministerio de Sanidad), Wiley Online Library on [21/12/2022]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License LLORENS‐SERRANO ET AL. | 809 Committee. Participation of salaried population was voluntary, and all using the European working conditions survey. Int Arch Occup participants provided informed oral consent. Data were rigorously Environ Health. 2021;94(3):459‐474. doi:10.1007/S00420-020- 01593-8 anonymized before analysis. 18. Myers S, Govindarajulu U, Joseph M, Landsbergis P. Changes in work characteristics over 12 years: findings from the 2002–2014 ORCID US National NIOSH Quality of Work Life Surveys. Am J Ind Med. Clara Llorens‐Serrano http://orcid.org/0000-0001-9957-3156 2019;62(6):511‐522. doi:10.1002/ajim.22971 Sergio Salas‐Nicás http://orcid.org/0000-0001-8671-9662 19. Donkin A, Marmot M. Targeting psychosocial factors to reduce health inequalities. In: Kivimäki M, Batty GD, Steptoe A, Albert Navarro‐Giné http://orcid.org/0000-0001-7153-4673 Kawachi I, eds. The Routledge international handbook of psycho- social epidemiology. Routledge; 2017:382‐391. doi:10.4324/ REFERENCES 9781315673097-18 1. Niedhammer I, Bertrais S, Witt K. Psychosocial work exposures and 20. Marmot M, Wilkinson R. Social Determinants of Health. Oxford health outcomes: a meta‐review of 72 literature reviews with Scholarship Online; 2009. doi:10.1093/acprof:oso/9780198565895. meta‐analysis. Scand J Work Environ Health. 2021;47(7):489‐508. 001.0001 doi:10.5271/sjweh.3968 21. Schnall PL, Dobson M, Landsbergis P. Globalization, work, and 2. European Commission. EU Strategic Framework on Health and cardiovascular disease. Int J Heal Serv. 2016;46(4):656‐692. doi:10. Safety at Work 2021–2027. Occupational Safety and Health in a 1177/0020731416664687 Changing World of Work. COM(2021) 323. 2021. 22. Montano D, Hoven H, Siegrist J. Effects of organisational‐level 3. ETUC, BussinessEurope, CEEP, SMEUnited. European Social Dia- interventions at work on employees' health: a systematic review. logue. Work Programme 2019–2021. 2019 BMC Public Health. 2014;14(1):135. doi:10.1186/1471-2458- 4. ILO. Workplace Stress: A Collective Challenge. 2016. 14-135 5. Karasek RA. Job demands, job decision latitude, and mental strain: 23. MacDonald LA, Härenstam A, Warren ND, Punnett L. Incorporating implications for job redesign. Adm Sci Q. 1979;24(2):285‐308. work organisation into occupational health research: an invitation doi:10.2307/2392498 for dialogue. Occup Environ Med. 2008;65(1):1‐3. doi:10.1136/ 6. Johnson J, Hall EM. Job strain, work place social support, and oem.2007.033860 cardiovascular disease: a cross‐sectional study of a random sample 24. LaMontagne AD, Keegel T, Louie AM, Ostry AS, Landsbergis P. of the Swedish working population. Am J Public Health. A systematic review of the job‐stress intervention evaluation 1988;78(10):1336‐1342. doi:10.2105/AJPH.78.10.1336 literature, 1990–2005. Int J Occup Environ Health. 2007;13(3): 7. Siegrist J. Adverse health effects of high‐effort/low‐reward 268‐280. doi:10.1179/OEH.2007.13.3.268 conditions. J Occup Health Psychol. 1996;1(1):27‐41. doi:10.1037/ 25. Kompier MA, Kristensen T. Organizational work stress interven- 1076-8998.1.1.27 tions in a theoretical, methodological and practical context. In: 8. Harvey SB, Modini M, Joyce S, et al. Can work make you mentally Dunham J, ed. Stress in the workplace: past, present and future. ill? A systematic meta‐review of work‐related risk factors for Whurr Publishers; 2001:164‐190. common mental health problems. Occup Environ Med. 2017;74(4): 26. Rugulies R. What is a psychosocial work environment? Scand 301‐310. doi:10.1136/oemed-2016-104015 J Work Environ Heal. 2019;45(1):1‐6. doi:10.5271/sjweh.3792 9. Theorell T, Hammarström A, Aronsson G, et al. A systematic review 27. De Spiegelaere S, Hoffmann A, Jagodziński R, Lafuente Hernández S, including meta‐analysis of work environment and depressive Rasnača Z, Vitols S. Democracy at work. In: Jepsen M, ed. symptoms. BMC Public Health. 2015;15:738. doi:10.1186/ Benchmarking working Europe 2019. ETUI; 2019:67‐89. s12889-015-1954-4 28. Busck O, Knudsen H, Lind J. The transformation of employee 10. Theorell T, Jood K, Järvholm LS, et al. A systematic review of participation: consequences for the work environment. Econ Ind studies in the contributions of the work environment to ischaemic Democr. 2010;31(3):285‐305. doi:10.1177/0143831X09351212. heart disease development. Eur J Public Health. 2016;26(3): 29. Wilkinson A, Gollan PJ, Marchington M, Lewin D. Conceptualizing 470‐477. doi:10.1093/eurpub/ckw025 Employee Participation in Organizations. In: Wilkinson A, Gollan PJ, 11. Kivimäki M, Kawachi I. Work stress as a risk factor for Marchington M, Lewin D, eds. The Oxford handbook of participation cardiovascular disease. Curr Cardiol Rep. 2015;17(9):74. doi:10. in organizations. Oxford University Press; 2010:1‐23. doi:10.1093/ 1007/s11886-015-0630-8 oxfordhb/9780199207268.003.0001 12. Kivimäki M, Ferrie JE, Kawachi I. Workplace stressors. In: 30. Gallie D. Direct participation and the quality of work. Hum Kivimäki M, Batty GD, Steptoe A, Kawachi I, eds. The Routledge Relations. 2013;66(4):453‐473. doi:10.1177/0018726712473035 international handbook of psychosocial epidemiology. Routledge; 31. Sisson K. Direct Participation and the Modernisation of Work 2019:85‐113. doi:10.4324/9781315673097-4 Organisation. Eurofound ed. Office for Official Publications of the 13. Landsbergis PA, Grzywacz JG, LaMontagne AD. Work organization, European Communities; 2000. job insecurity, and occupational health disparities. Am J Ind Med. 32. Hampson I, Sandberg A. The Swedish Contribution to Job Quality. 2014;57(5):495‐515. doi:10.1002/AJIM.22126 Vol 39. 2017. 14. Rubery J. Developing segmentation theory: a thirty year perspec- 33. Boxall P, Macky K. High‐involvement work processes, work tive. Économies et Sociétés. 2007;28(6):941‐964. intensification and employee well‐being. Work Employ Soc. 15. Green F, Mostafa T, Parent‐Thirion A, et al. Is job quality becoming 2014;28(6):963‐984. doi:10.1177/0950017013512714 more unequal? Ind Labor Relations Rev. 2013;66(4):753‐784. doi:10. 34. Hasle P, Sørensen OH. Employees as individually and collectively 1177/001979391306600402 acting subjects‐key contributions from nordic working life 16. Rubery J, Piasna A. Labour Market Segmentation and the EU Reform research. Nord J Work Life Stud. 2013;3(3):9‐29. doi:10.19154/ Agenda: Developing Alternatives to the Mainstream. ETUI, The njwls.v3i3.3009 European Trade Union Institute; 2016. 35. Michel A. Participation and self‐entrapment a 12‐year ethnography 17. Rigó M, Dragano N, Wahrendorf M, Siegrist J, Lunau T. Work of wall street participation practices' diffusion and evolving conse- stress on rise? Comparative analysis of trends in work stressors quences. Sociol Q. 2014;55(3):514‐536. doi:10.1111/tsq.12064 10970274, 2022, 10, Downloaded from https://onlinelibrary.wiley.com/doi/10.1002/ajim.23414 by Spanish Cochrane National Provision (Ministerio de Sanidad), Wiley Online Library on [21/12/2022]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License 810 | LLORENS‐SERRANO ET AL. 36. Mazmanian M, Orlikowski WJ, Yates JA. The autonomy paradox: 53. Llorens C, Navarro A, Salas S, Utzet M, Moncada S. For better or the implications of mobile email devices for knowledge profes- for worse? Psychosocial work environment and direct participation sionals. Organ Sci. 2013;24(5):1337‐1357. doi:10.1287/orsc. practices. Saf Sci. 2019;116:78‐85. doi:10.1016/j.ssci.2019.02.028 1120.0806 54. Felstead A, Gallie D, Green F, Henseke G. The determinants of 37. Valdés G, Barley SR. Be careful what you wish for: the learning skills use and work pressure: a longitudinal analysis. Econ Ind imperative in postindustrial work. Work Occup. 2016;43(4): Democr. 2019;40(3):730‐754. doi:10.1177/0143831X16656412 466‐501. doi:10.1177/0730888416655187 55. Dhondt S, Pot FD, Kraan KO. The importance of organizational 38. Pérez‐Zapata O, Serrano Pascual A, Alvarez‐Hernández G, level decision latitude for well‐being and organizational commit- Castaño Collado C. Knowledge work intensification and self‐ ment. Team Perform Manag. 2014;20:307‐327. doi:10.1108/TPM- management: the autonomy paradox. Work Organ Labour Glob. 03-2014-0025 2016;10(2):27‐49. doi:10.13169/workorgalaboglob.10.2.0027 56. Inanc H, Zhou Y, Gallie D, Felstead A, Green F. Direct participation 39. Jensen JM, Patel PC, Messersmith JG. High‐performance work and employee learning at work. Work Occup. 2015;42(4):447‐475. systems and job control: consequences for anxiety, role overload, doi:10.1177/0730888415580650 and turnover intentions. J Manage. 2013;39(6):1699‐1724. doi:10. 57. Piasna A, Smith M, Rose J, Rubery J, Burchell B, Rafferty A. 1177/0149206311419663 Participatory HRM practices and job quality of vulnerable workers. 40. Carter B, Danford A, Howcroft D, Richardson H, Smith A, Taylor P. Int J Hum Resour Manag. 2013;24(22):4094‐4115. doi:10.1080/ “Stressed out of my box”: employee experience of lean working 09585192.2013.845423 and occupational ill‐health in clerical work in the UK public 58. Boxall P, Winterton J. Which conditions foster high‐involvement sector. Work Employ Soc. 2013;27(5):747‐767. doi:10.1177/ work processes? A synthesis of the literature and agenda for 0950017012469064 research. Econ Ind Democr. 2018;39(1):27‐47. doi:10.1177/ 41. Bambra C, Egan M, Thomas S, Petticrew M, Whitehead M. The 0143831X15599584 psychosocial and health effects of workplace reorganisation. 2. 59. Moncada i Lluís S, Llorens Serrano C, Salas Nicás S, Moriña Soler D, A systematic review of task restructuring interventions. J Epidemiol Navarro Giné A. La tercera versión de COPSOQ‐Istas21. Un Community Health. 2007;61(12):1028‐1037. doi:10.1136/jech. instrumento internacional actualizado para la prevención de riesgos 2006.054999 psicosociales en el trabajo. Rev Esp Salud Publica. 2021;95:e1‐16. 42. Lahera Sánchez A. ¿Hacia una producción enriquecida? Trabajo en 60. Llorens C, Alós R, Cano E, et al. Psychosocial risk exposures and grupo y recualificación en empresas de ingeniería mecánica. AIBR labour management practices. An exploratory approach. Scand Rev Antropol Iberoam. 2006;01(03):428‐464. doi:10.11156/aibr. J Public Health. 2010;38(3 Suppl):125‐136. 010306 61. Domingo‐Salvany A, Bacigalupe A, Carrasco JM, Espelt A, 43. Lahera Sánchez A. La participación de los trabajadores en la calidad Ferrando J, Borrell C. Propuestas de clase social neoweberiana y total: nuevos dispositivos disciplinarios de organización del trabajo. neomarxista a partir de la Clasificación Nacional de Ocupaciones Rev Esp Invest Sociol. 2004;106:63. doi:10.2307/40184585 2011. Gac Sanit. 2013;27(3):263‐272. doi:10.1016/j.gaceta.2012. 44. Landsbergis PA, Adler PS, Babson S, et al. Lean production and 12.009 worker health: a discussion. New Solut. 1999;8(4):499‐523. doi:10. 62. Burr H, Berthelsen H, Moncada S, et al. The third version of the 2190/8DFT-3N8B-8TCF-M3U1 Copenhagen Psychosocial Questionnaire. Saf Health Work. 45. Huo ML, Boxall P. Are all aspects of lean production bad for 2019;10(4):482‐503. doi:10.1016/j.shaw.2019.10.002 workers? An analysis of how problem‐solving demands affect 63. Markey R, Harris C, Lind J, Busck O, Knudsen H. Employee employee well‐being. Hum Resour Manag J. 2018;28(4):569‐584. participation on work environment in food processing industry in doi:10.1111/1748-8583.12204 Denmark & New Zealand. Indian J Ind Relat. 2010;45(4):622‐634. 46. Håkansson M, Dellve L, Waldenström M, Holden RJ. Sustained lean 64. Kloutsiniotis PV, Katou AA, Mihail DM. Examining the “dark‐side” transformation of working conditions: a Swedish longitudinal case of high performance work systems in the Greek manufacturing study. Hum Factors Ergon Manuf. 2017;27(6):268‐279. doi:10. sector. Empl Relations. 2021;43(5):1104‐1129. doi:10.1108/ER-04- 1002/hfm.20710 2020-0170 47. Lantz A, Hansen N, Antoni C. Participative work design in lean 65. Hung DY, Harrison MI, Truong Q, Du X. Experiences of primary production: a strategy for dissolving the paradox between care physicians and staff following lean workflow redesign. BMC standardized work and team proactivity by stimulating team Health Serv Res. 2018;18(1):274. doi:10.1186/s12913-018-3062-5 learning? J Work Learn. 2015;27(1):19‐33. doi:10.1108/JWL-03- 66. Enehaug H. Ten successful years: a longitudinal case study of 2014-0026 autonomy, control and learning. Nord J Work Life Stud. 2017;7(1): 48. Hasle P. Lean production—an evaluation of the possibilities for an 67‐89. doi:10.18291/njwls.v7iS2.96693 employee supportive lean practice. Hum Factors Ergon Manuf. 67. Brännmark M, Holden RJ. Packages of participation: swedish 2014;24(1):40‐53. doi:10.1002/hfm.20350 employees' experience of Lean depends on how they are involved. 49. Ulhassan W, von Thiele Schwarz U, Thor J, Westerlund H. IIE Trans Occup Ergon Hum factors. 2013;1(2):93‐108. doi:10.1080/ Interactions between lean management and the psychosocial work 21577323.2012.729001 environment in a hospital setting—a multi‐method study. BMC 68. Wood S, van Veldhoven M, Croon M, de Menezes LM. Enriched job Health Serv Res. 2014;14:480. doi:10.1186/1472-6963-14-480 design, high involvement management and organizational perform- 50. Westgaard RH, Winkel J. Occupational musculoskeletal and ance: the mediating roles of job satisfaction and well‐being. Hum mental health: significance of rationalization and opportunities Relations. 2012;65(4):419‐445. doi:10.1177/0018726711432476 to create sustainable production systems—a systematic review. 69. Böckerman P, Bryson A, Ilmakunnas P. Does high involvement Appl Ergon. 2011;42(2):261‐296. doi:10.1016/j.apergo.2010. management lead to higher pay? J R Stat Soc Ser A. 2013;176(4): 07.002 861‐885. doi:10.1111/J.1467-985X.2012.01075.X 51. Gallie D, Zhou Y. Employee Involvement, Work Engagement and 70. Neirotti P. Work intensification and employee involvement in Skill Development. Eurofound; 2020. lean production: new light on a classic dilemma. Int J Hum Resour 52. Gallie D, Zhou Y. Work Organisation and Employee Involvement in Manag. 2020;31(15):1958‐1983. doi:10.1080/09585192.2018. Europe. Eurofound; 2013. doi:10.2806/35945 1424016 10970274, 2022, 10, Downloaded from https://onlinelibrary.wiley.com/doi/10.1002/ajim.23414 by Spanish Cochrane National Provision (Ministerio de Sanidad), Wiley Online Library on [21/12/2022]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License LLORENS‐SERRANO ET AL. | 811 71. Koukoulaki T. The impact of lean production on musculoskeletal 88. Maben J, Bridges J. Covid‐19: supporting nurses' psychological and and psychosocial risks: an examination of sociotechnical trends mental health. J Clin Nurs. 2020;29(15‐16):2742‐2750. doi:10. over 20 years. Appl Ergon. 2014;45(2 Part A):198‐212. doi:10. 1111/jocn.15307 1016/j.apergo.2013.07.018 89. Bridges J, May C, Fuller A, et al. Optimising impact and 72. Hasle P, Bojesen A, Jensen PL, Bramming P. Lean and the working sustainability: a qualitative process evaluation of a complex environment: a review of the literature. Int J Oper Prod Manag. intervention targeted at compassionate care. BMJ Qual Saf. 2012;32(7):829‐849. doi:10.1108/01443571211250103 2017;26(12):970‐977. doi:10.1136/BMJQS-2017-006702 73. Schneider A, Wehler M, Weigl M. Effects of work conditions on 90. Eurofound. Labour Market Segmentation: Piloting New Empirical and provider mental well‐being and quality of care: a mixed‐methods Policy Analyses. 2019. doi:10.2806/751649 intervention study in the emergency department. BMC Emerg Med. 91. Walters D, Wadsworth E. Worker Participation in the Management 2019;19(1):1. doi:10.1186/s12873-018-0218-x of Occupational Safety and Health: Qualitative Evidence from 74. Höge T, Hornung S. Perceived flexibility requirements: exploring ESENER‐2. EU‐OSHA; 2017. doi:10.2802/93677 mediating mechanisms in positive and negative effects on worker 92. Ollé‐Espluga L, Vergara‐Duarte M, Belvis F, Menéndez‐Fuster M, well‐being. Econ Ind Democr. 2015;36(3):407‐430. doi:10.1177/ Jódar P, Benach J. What is the impact on occupational health and 0143831X13511274 safety when workers know they have safety representatives? Saf 75. Findlay P, Lindsay C, McQuarrie J, Bennie M, Corcoran ED, Sci. 2015;74:55‐58. doi:10.1016/j.ssci.2014.11.022 Van Der Meer R. Employer choice and job quality: workplace 93. Hall A, Oudyk J, King A, Naqvi S, Lewchuk W. Identifying innovation, work redesign, and employee perceptions of job quality knowledge activism in worker health and safety representation: in a complex health‐care setting. Work Occup. 2017;44(1):113‐136. a cluster analysis. Am J Ind Med. 2016;59(1):42‐56. doi:10.1002/ doi:10.1177/0730888416678038 ajim.22520 76. Lindsay C, Commander J, Findlay P, Bennie M, Corcoran ED, 94. Janetzke H, Ertel M. Psychosocial risk management in Van Der Meer R. Lean', new technologies and employment in more and less favourable workplace conditions. Int J Work public health services: employees' experiences in the National Heal Manag. 2017;10(4):300‐317. doi:10.1108/IJWHM-09- Health Service. Int J Hum Resour Manag. 2014;25(21):2941‐2956. 2016-0063 doi:10.1080/09585192.2014.948900 95. Payá Castiblanque R, Pizzi A. Presencia sindical y gestión de 77. von Thiele Schwarz U, Nielsen KM, Stenfors‐Hayes T, Hasson H. riesgos laborales de origen psicosocial. Un análisis del caso Using kaizen to improve employee well‐being: results from two español. Rev Int Organ. 2020;24(24):325‐366. doi:10.17345/ organizational intervention studies. Hum Relations. 2017;70(8): rio24.325-366 966‐993. doi:10.1177/0018726716677071 96. Pohler DM, Luchak AA. Balancing efficiency, equity, and voice: the 78. Dellve L, Williamsson A, Strömgren M, Holden RJ, Eriksson A. impact of unions and high‐invo lvement work practices on work Lean implementation at different levels in Swedish hospitals: outcomes. Ind Labor Relations Rev. 2014;67(4):1063‐1094. doi:10. the importance for working conditions and stress. Int J Hum 1177/0019793914546295 Factors Ergon. 2015;3(3/4):235‐253. doi:10.1504/ijhfe.2015. 97. Knudsen H, Busck O, Lind J. Work environment quality: the role of 073001 workplace participation and democracy. Work Employ Soc. 79. Deery S, Kolar D, Walsh J. Can dirty work be satisfying? A mixed 2011;25(3):379‐396. doi:10.1177/0950017011407966 method study of workers doing dirty jobs. Work Employ Soc. 98. Hyman J, Mason B. Managing Employee Involvement and Participa- 2019;33(4):631‐647. doi:10.1177/0950017018817307 tion. SAGE Publications Ltd; 1995. 80. Lantz A, Hansen N, Antoni C. Participative work design in lean 99. Pateman C. Participation and Democratic Theory. Cambridge production A strategy for dissolving the paradox between University Press; 1970. standardized work and team proactivity by stimulating team 100. Dollard MF, Opie T, Lenthall S, et al. Psychosocial safety climate as learning? J Work Learn. 2015;27(1):19‐33. doi:10.1108/JWL-03- an antecedent of work characteristics and psychological strain: 2014-0026 a multilevel model. Work Stress. 2012;26(4):385‐404. doi:10.1080/ 81. Håkansson M, Holden RJ, Eriksson A, Dellve L. Managerial 02678373.2012.734154 practices that support lean and socially sustainable working 101. Findlay P, Warhurst C, Keep E, Lloyd C. Opportunity knocks? The conditions. Nord J Work Life Stud. 2017;7(3):63‐84. doi:10. possibilities and levers for improving job quality. Work Occup. 18291/njwls.v7i3.97091 2017;44(1):3‐22. doi:10.1177/0730888416689813 82. Eurofound. Sixth European Working Conditions Survey—Overview 102. Peccei R, Van De Voorde K. Human resource management–well‐ Report (2017 Update). 2017. doi:10.2806/422172 being–performance research revisited: past, present, and future. 83. De Spiegelaere S, Van Gyes G. Employee‐Driven Innovation and Hum Resour Manag J. 2019;29(4):539‐563. doi:10.1111/1748- Industrial Relations. In: Hoyrup S, Bonnafous‐Boucher M , Hasse C, 8583.12254 Lotz M, Moller K, eds. Employee‐driven innovation. Palgrave 103. Banyuls Llopis J, Recio Andreu A. Gestión empresarial y dinámica Macmillan; 2012:230‐245. doi:10.1057/9781137014764_12 laboral en España. Ekon Rev vasca Econ. 2015;87:182‐205. 84. Eurofound. What Do Europeans Do at Work? A Task‐Based Analysis: 104. Utzet M, Navarro A, Llorens C, Moncada S. Intensification and European Jobs Monitor 2016. Publications Office of the European isolation: psychosocial work environment changes in Spain Union; 2016. doi:10.2806/229525 2005–10. Occup Med (Chic Ill). 2015;65(5):405‐412. doi:10.1093/ 85. Vänje A, Brännmark M. Walking around the pyramids: managers' occmed/kqv062 shop‐floor activities in Lean‐inspired organizations. Econ Ind 105. Taouk Y, Spittal MJ, Lamontagne AD, Milner AJ. Psychosocial work Democr. 2017;38(3):495‐512. doi:10.1177/0143831X15580351 stressors and risk of all‐cause and coronary heart disease mortality: 86. Nielsen K, Randall R. The importance of employee participation and a systematic review and meta‐analysis. Scand J Work Environ Heal. perceptions of changes in procedures in a teamworking interven- 2020;46(1):19‐31. doi:10.5271/sjweh.3854 tion. Work Stress. 2012;26(2):91‐111. doi:10.1080/02678373. 106. Too LS, Leach L, Butterworth P. Is the association between poor 2012.682721 job control and common mental disorder explained by general 87. Cramer E, Hunter B. Relationships between working conditions and perceptions of control? Findings from an Australian longitudinal emotional wellbeing in midwives. Women and Birth. 2019;32(6): cohort. Scand J Work Environ Heal. 2020;46(3):311‐320. doi:10. 521‐532. doi:10.1016/j.wombi.2018.11.010 5271/sjweh.3869 10970274, 2022, 10, Downloaded from https://onlinelibrary.wiley.com/doi/10.1002/ajim.23414 by Spanish Cochrane National Provision (Ministerio de Sanidad), Wiley Online Library on [21/12/2022]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License 812 | LLORENS‐SERRANO ET AL. 107. Milner A, Witt K, LaMontagne AD, Niedhammer I. Psychosocial job stressors and suicidality: a meta‐analysis and systematic review. Occup How to cite this article: Llorens‐Serrano C, Salas‐Nicás S, Environ Med. 2018;75(4):245‐253. doi:10.1136/oemed-2017-104531 Navarro‐Giné A, Lluís SM. Delegation and consultation on operational and tactical issues: any difference in their S UP P O R T I N G I N F O R M A T I O N potentialities for a healthier psychosocial work environment? Additional supporting information can be found online in the Am J Ind Med. 2022;65:800‐812. doi:10.1002/ajim.23414 Supporting Information section at the end of this article.