What are the possible mechanisms behind a relationship between cultural activities organised at work and employee health? This has not been discussed extensively in the Smad inhibitor scientific literature, but possible health promotion effects of cultural activities in general have been discussed scientifically. Cultural activities may promote creativity (Wikström 1994) and increase cohesiveness in groups (Cuypers et al.

2011). For specific activities, for instance choir singing, there are studies which have shown beneficial psychological and biological effects of choir rehearsals (Sandgren and Borg 2009; Kreutz et al. 2004) as well as of singing lessons (Grape et al. 2003). Similarly, amateur tango dancing stimulates beneficial endocrinological reactions (Quiroga Murcia et al. 2009). More long-lasting endocrinological effects favouring regenerative function have also been shown when the choir participation continues once a week for

several months (Grape et al. 2010). In samples of elderly people, there is extensive research showing that choir singing stimulates a feeling see more that life is worth living and that this motivates participants to assume health promoting life habits (Clift and Hancox 2001; Cohen 2009). All of these possible mechanisms could be relevant for possible effects of cultural activities at work. The workplace, however, is an arena on which cultural activities offered to the employees could have unexpected creative stimulating cultural experiences. Such activities may be different from the ones the employees would choose with family

and friends and the context is a different one. Interviews from our own pilot study (Theorell et al. 2009) illustrated that the introduction of a weekly cultural programme for employees “opened eyes” to unexpected worlds for some employees. In summary, possible health effects of cultural activities in the workplace could arise (1) because such activities may strengthen cohesiveness between employees and between management and employees resulting in improved psychosocial work environment why or (2) because of direct effects of the cultural activities themselves. The present study was designed to illuminate firstly whether cultural activities at work are related to mental health in employees and secondly to what extent possible associations between cultural activities at work and employee health could be explained statistically by indirect effects on psychosocial work environment variables as they are perceived by the employees themselves (“a listening/non-listening manager” and psychological demands and decision latitude). The former type of manager variable has been established in our previous studies as an important explanatory factor in “ongoing conflicts” (Oxenstierna et al. 2011).