Psychosocial adjustment, work environment, and sick-leave/work participation after the Oslo terrorist attack July 22nd, 2011

Serious events such as disasters, accidents or terrorism in the workplace can shed new light on how employees respond to stress within the context of their work environment. This project was based on the terrorist attack on the Norwegian ministries on July 22, 2011. We have studied psychosocial effects of the terror, focusing on the employees, the working environment and sick leave. The aim of the project has been to explore factors promoting or inhibiting satisfactory working conditions and health, as well as a high degree of work participation. The study had a prospective, longitudinal design, and the third and final round of data collection was conducted in March / April 2014. Data was mainly obtained using web-based questionnaires. All employees in the ministries in Oslo were invited to participate. In the spring of 2015, we collected data from NAV and Statistics Norway about doctor certified sick leave, from the years before and after July 22, 2011. The data file was ready for use in spring 2017. The last part of the project period (2017-2020) included work on data analysis, article writing and publishing. Several articles from the study have been published regarding the health and working environment of the employees. Some articles have also used sick leave as the main variable, of which five are published or accepted for publication, and two are under preparation. The results of the study showed that a significant proportion of employees sustained psychological stress reactions after the event. The incidence was particularly high among those who had been at work during the attack, but also among those who had not been at work, many had post-traumatic stress reactions. In both categories, many people fulfilled the symptom criteria for the diagnosis of PTSD in the first 1-3 years after the event. Access to data prior to the event made it possible to conclude that the experience of the working environment changed little from before to after the terror. Mental health was strongly associated with work environment defined as leadership support, predictability at work, role clarity and role conflict. For both men and women who had been present at work during the event, there was a doubling of sick leave from before to the first two years after the event. Among those not been present, it was not possible to register any increase in sick leave. In general, sick leave among employees was low before the incident, and even with an increase in the first two years after, sick leave was considered as low compared to the national level. Indeed, a significant proportion of employees with high levels of psychological stress reactions continued to work despite the stress symptoms. Several measures that were taken to support the employees' working environment and health in the aftermath of the terror were considered positive. Some specific factors in the work environment were related to low sickness absence, such as support from leader or colleagues and having control over the work progression. Experiences of conflict in work objectives or implementation were related to a greater likelihood of sick leave. Clearly defined roles, predictability at work and control over one's work situation were particularly important for those most severely exposed to the attack. Sickness absence also depended on the degree to which employees felt safe in the work situation and how they felt that the safety requirements were met.

Prosjektet har gitt mer kunnskap om sammenhenger mellom reaksjoenr etter traumatiske hendelser, arbeidsmiljø og sykefravær. Et opplæringsprogram som ble gitt for ledere i departementene etter terrorangrepet tok utgangspunkt i tidligere erfaringer mer enn i empirisk kunnskap. Forskningen har nå med større sikkerhet slått fast hva som er viktig for de ansatte etter slike hendelser og dokumentert hvilke faktorer som bidrar til raskere restitusjon, bedre helse og lavere sykefravær. Resultatene er viktige for beredskap for lignende situasjoner. Resultatene er sannsynligvis også anvendelige i forhold til mennesker og miljøer som pådrar seg stressreaksjoner av andre årsaker.

Background Psychological reactions in the aftermath of traumatic events are documented in numereous studies. Less is known about how extreme events affect workplace environments and how factors in the work environment interact with our psychological and s omatic health. The present study will therefore examine work environment factors, health and sick leave rates in relation to the bombing of the Norwegian ministries in July 2011, utilizing a longitudinal design. Objective The overall objective of the pro ject is to explore conditions that promote or inhibit satisfactory working conditions and satisfactory health levels as well as a high level of work participation by obtaining new research-based knowledge concerning psychosocial aftereffects of trauma tha t might cause employee withdrawal or exclusion from working life. Method Data have already been collected using web-based questionnaires during the spring of 2012. The next wave of data collection will be performed during the spring of 2013 and again in 2014. A specifically unique aspect of the present study will be its prospective, longitudinal design, including baseline data collected for 3 ministries by the National Institute of Occupational Health (NIOH/STAMI) prior to the attack. Scientific impor tance The present study represents a unique opportunity to gain new insights into an extreme situation in which the interaction between work environment factors, health and work participation/sick leave rates can be studied. We believe that findings from this project will have important implications for research focusing on work environment and sick leave policies in general.