Sexual violence in the workplace and associated health outcomes: a nationwide, cross-sectional analysis of women in Iceland

Background Workplace sexual violence against women is a pressing global issue with scarce knowledge on its health implications. Existing research is largely limited to specific occupations, which calls for comprehensive, populationbased studies. This study aimed to examine the associations between self -labelled workplace sexual violence and a variety of health outcomes in a nationally representative sample of Icelandic women aged 18-69 years. Methods Participants in this cross-sectional study were women in the Stress -And -Gene -Analysis (SAGA) cohort who answered the question regarding workplace sexual violence, defined in our study as encompassing all work sectors, academic settings, and other school environments. Eligible participants were women, aged 18-69 years, residing in Iceland, who spoke Icelandic and were listed in the Icelandic Population Register or had a contact number registered with the online 1819 service. Poisson and binomial regressions were used to assess the associations between workplace sexual violence and validated measures of current mental and physical health outcomes (eg, probable depression, general anxiety, and severe sleep problems). Multiple imputation was performed to account for missing values in the dataset. Findings The study was conducted from March 1, 2018, to July 1, 2019. Of the 113 814 women deemed eligible for study inclusion, 104 197 were invited to take part in the online survey. Of those invited, 30 403 women completed the survey and were included in the SAGA cohort. Among these participants, 15 812 provided answers to the question regarding exposure to workplace sexual harassment or violence. Exposure to sexual violence was associated with an increased prevalence of probable depression (prevalence ratio [PR] 1<middle dot>50 [95% CI 1<middle dot>41-1<middle dot>60]), general anxiety (PR 1<middle dot>49 [1<middle dot>40-1<middle dot>59]), social phobia (PR 1<middle dot>62 [1<middle dot>48-1<middle dot>78]), self -harm (PR 1<middle dot>86 [1<middle dot>53-2<middle dot>28]), suicidal ideation (PR 1<middle dot>68 [1<middle dot>44-1<middle dot>68]), suicide attempts (PR 1<middle dot>99 [1<middle dot>62-2<middle dot>44]), binge drinking (PR 1<middle dot>10 [1<middle dot>01-1<middle dot>20]), sleep problems (PR 1<middle dot>41 [1<middle dot>48-1<middle dot>91]), physical symptoms (PR 1<middle dot>59 [1<middle dot>48-1<middle dot>70]), and sick leave (PR 1<middle dot>20 [1<middle dot>12-1<middle dot>28]). The prevalence of the health outcomes among those exposed show age -related differences: younger women report anxiety or depression more frequently, while older women report sleep problems after experiencing workplace sexual violence. Interpretation In this cross-sectional study self -reported experiences of sexual violence in the workplace were associated with several self -reported health outcomes. The findings suggest a need for targeted interventions to promote workplace safety and to mitigate adverse health implications among people who have experienced workplace sexual violence. Future research should explore factors such as the frequency, duration, and relationship dynamics of workplace sexual violence, as well as the effect on different genders and sexual orientations, to deepen our understanding of these experiences and inform effective prevention strategies. Copyright (c) 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY -NC -ND 4.0 license.