| 1. |
- Fenstermacher, M.E., et al.
(författare)
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DIII-D research advancing the physics basis for optimizing the tokamak approach to fusion energy
- 2022
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Ingår i: Nuclear Fusion. - : IOP Publishing. - 0029-5515 .- 1741-4326. ; 62:4
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Tidskriftsartikel (refereegranskat)abstract
- DIII-D physics research addresses critical challenges for the operation of ITER and the next generation of fusion energy devices. This is done through a focus on innovations to provide solutions for high performance long pulse operation, coupled with fundamental plasma physics understanding and model validation, to drive scenario development by integrating high performance core and boundary plasmas. Substantial increases in off-axis current drive efficiency from an innovative top launch system for EC power, and in pressure broadening for Alfven eigenmode control from a co-/counter-I p steerable off-axis neutral beam, all improve the prospects for optimization of future long pulse/steady state high performance tokamak operation. Fundamental studies into the modes that drive the evolution of the pedestal pressure profile and electron vs ion heat flux validate predictive models of pedestal recovery after ELMs. Understanding the physics mechanisms of ELM control and density pumpout by 3D magnetic perturbation fields leads to confident predictions for ITER and future devices. Validated modeling of high-Z shattered pellet injection for disruption mitigation, runaway electron dissipation, and techniques for disruption prediction and avoidance including machine learning, give confidence in handling disruptivity for future devices. For the non-nuclear phase of ITER, two actuators are identified to lower the L-H threshold power in hydrogen plasmas. With this physics understanding and suite of capabilities, a high poloidal beta optimized-core scenario with an internal transport barrier that projects nearly to Q = 10 in ITER at ∼8 MA was coupled to a detached divertor, and a near super H-mode optimized-pedestal scenario with co-I p beam injection was coupled to a radiative divertor. The hybrid core scenario was achieved directly, without the need for anomalous current diffusion, using off-axis current drive actuators. Also, a controller to assess proximity to stability limits and regulate β N in the ITER baseline scenario, based on plasma response to probing 3D fields, was demonstrated. Finally, innovative tokamak operation using a negative triangularity shape showed many attractive features for future pilot plant operation.
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| 2. |
- Moberg, Christina, et al.
(författare)
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De unga gör helt rätt när de stämmer staten
- 2022
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Ingår i: Aftonbladet. - 1103-9000.
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- 1 620 forskare och lärare i forskarvärlden: Vi ställer oss bakom Auroras klimatkrav
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| 3. |
- Berglund, Anders, et al.
(författare)
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Changing Mindsets, Improving Creativity and Innovation in Engineering Education
- 2011
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Ingår i: Proceedings of the 13th International Conference on Engineering and Product Design Education E&PDE11. ; , s. 121-126
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Konferensbidrag (refereegranskat)abstract
- Universities need to reconfigure and rethink existing engineering beliefs in order to keep promoting students that can target and capitalize on tomorrow’s opportunities. This put pressure on promoting the best possible Engineering Education, which means continuant upgrades and revisions to existing curricula’s and faculties’ pedagogical methods and processes. This paper summarizes the experiences and lessons learned from a nationwide initiative to rethink and redesign existing engineering programs towards more traceable innovative practices. The Swedish Product Innovation Engineering Program (PIEp) and the Royal Institute of Technology (KTH) in particular have a long tradition of successful exchanges involving research and education. PIEp is committed to a system change towards innovation and entrepreneurship in institutes of higher education and research. From PIEp an organized network of senior researchers, PhD students, lecturers and students is seen as the seed for this change. Activities are conducted in three areas; research in product innovation, education for product innovation and industrial collaboration for product innovation. Turning away from one-timer and mere embryonic attempts, PIEp visions a systems shift through long term dedication to influence higher engineering education curricula design. KTH is currently performing a revision of all engineering program to fit the European Bologna higher education restructuring process. Encompassing both undergraduate and master level studies, the integration of engineering syllabus imperatives strive to converge with the internationally recognized CDIO standards and the new Swedish national degree specifications. The paper aims to summarize the initiative provided between PIEp, KTH and Stanford to stimulate Swedish Engineering faculty to embrace methods and tools for integrating creativity and innovation. Ultimately, building on the long experiences of successful workshops held by PIEp and KTH the overall ambition is to establish a change in mindsets, and by so influencing key participants to directly leave endurable footprints onto their respective Swedish Engineering Education Program. The paper has a descriptive character blending ‘best-of-both-worlds’ concepts as it reveals how a nationwide initiative has set up a learning hub overseas together with Stanford University. Utilizing this source of entrepreneurial and inspiring environment the ambition is to equip Swedish faculty with experiences, success stories, lessons learned, personal opinions, to provoke and challenge existing program and curricula design. In summary, the full paper version entails the set-up, reflections and actions outline by Swedish university representatives to address implementation of more transferability between innovation characteristics in respective education programs.
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| 4. |
- Bertilsson, Erik, et al.
(författare)
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Creation of the IMMA manikin with consideration of anthropometric diversity
- 2011
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Ingår i: 21st International Conference on Production Research: Innovation in Product and Production, ICPR 2011; Stuttgart; Germany; 31 July 2011 through 4 August 2011. - : Fraunhofer Verlag. - 9783839602935 - 3839602939
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Konferensbidrag (refereegranskat)abstract
- Digital human modelling (DHM) systems are used to simulate production processes and analyse the human-machine interaction, particularly at early development stages. Consideration of anthropometric variation is central in DHM simulations due to the necessity of ensuring intended accommodation levels. This paper describes the process of how digital human models are created and defined within the IMMA software. The process begins with the definition of a number of key measurements, which acts as the basis for the definition of several boundary manikins using a confidence ellipsoid methodology. These manikins represents the appropriate confidence region and hence the anthropometric diversity. Key measurements are then entered into regression equations to define the complete set of measurements for each manikin. These measurements are based on the appropriate ISO-standard. Finally, measurements are used to define the size and alignment of each segment in the biomechanical model of the manikin. The manikins are then used to automatically simulate and analyse human-machine interaction.
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| 5. |
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| 6. |
- Ervasti, Jenni, et al.
(författare)
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Long working hours and risk of 50 health conditions and mortality outcomes : a multicohort study in four European countries
- 2021
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Ingår i: The Lancet Regional Health. - : Elsevier BV. - 2666-7762. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- Background: Studies on the association between long working hours and health have captured only a narrow range of outcomes (mainly cardiometabolic diseases and depression) and no outcome-wide studies on this topic are available. To achieve wider scope of potential harm, we examined long working hours as a risk factor for a wide range of disease and mortality endpoints.Methods: The data of this multicohort study were from two population cohorts from Finland (primary analysis, n=59 599) and nine cohorts (replication analysis, n=44 262) from Sweden, Denmark, and the UK, all part of the Individual-participant Meta-analysis in Working Populations (IPD-Work) consortium. Baseline-assessed long working hours (≥55 hours per week) were compared to standard working hours (35-40 h). Outcome measures with follow-up until age 65 years were 46 diseases that required hospital treatment or continuous pharmacotherapy, all-cause, and three cause-specific mortality endpoints, ascertained via linkage to national health and mortality registers.Findings: 2747 (4·6%) participants in the primary cohorts and 3027 (6·8%) in the replication cohorts worked long hours. After adjustment for age, sex, and socioeconomic status, working long hours was associated with increased risk of cardiovascular death (hazard ratio 1·68; 95% confidence interval 1·08-2·61 in primary analysis and 1·52; 0·90-2·58 in replication analysis), infections (1·37; 1·13-1·67 and 1·45; 1·13-1·87), diabetes (1·18; 1·01-1·38 and 1·41; 0·98-2·02), injuries (1·22; 1·00-1·50 and 1·18; 0·98-1·18) and musculoskeletal disorders (1·15; 1·06-1·26 and 1·13; 1·00-1·27). Working long hours was not associated with all-cause mortality.Interpretation: Follow-up of 50 health outcomes in four European countries suggests that working long hours is associated with an elevated risk of early cardiovascular death and hospital-treated infections before age 65. Associations, albeit weak, were also observed with diabetes, musculoskeletal disorders and injuries. In these data working long hours was not related to elevated overall mortality.
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| 7. |
- Framke, Elisabeth, et al.
(författare)
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Contribution of income and job strain to the association between education and cardiovascular disease in 1.6 million Danish employees
- 2020
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Ingår i: European Heart Journal. - : Oxford University Press (OUP). - 0195-668X .- 1522-9645. ; 41:11, s. 1164-1178
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Tidskriftsartikel (refereegranskat)abstract
- Aims: We examined the extent to which associations between education and cardiovascular disease (CVD) morbidity and mortality are attributable to income and work stress.Methods and results: We included all employed Danish residents aged 30–59 years in 2000. Cardiovascular disease morbidity analyses included 1 638 270 individuals, free of cardiometabolic disease (CVD or diabetes). Mortality analyses included 41 944 individuals with cardiometabolic disease. We assessed education and income annually from population registers and work stress, defined as job strain, with a job-exposure matrix. Outcomes were ascertained until 2014 from health registers and risk was estimated using Cox regression. During 10 957 399 (men) and 10 776 516 person-years (women), we identified 51 585 and 24 075 incident CVD cases, respectively. For men with low education, risk of CVD was 1.62 [95% confidence interval (CI) 1.58–1.66] before and 1.46 (95% CI 1.42–1.50) after adjustment for income and job strain (25% reduction). In women, estimates were 1.66 (95% CI 1.61–1.72) and 1.53 (95% CI 1.47–1.58) (21% reduction). Of individuals with cardiometabolic disease, 1736 men (362 234 person-years) and 341 women (179 402 person-years) died from CVD. Education predicted CVD mortality in both sexes. Estimates were reduced with 54% (men) and 33% (women) after adjustment for income and job strain.Conclusion: Low education predicted incident CVD in initially healthy individuals and CVD mortality in individuals with prevalent cardiometabolic disease. In men with cardiometabolic disease, income and job strain explained half of the higher CVD mortality in the low education group. In healthy men and in women regardless of cardiometabolic disease, these factors explained 21–33% of the higher CVD morbidity and mortality.
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| 8. |
- Fransson, Eleonor I, et al.
(författare)
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Job strain and the risk of stroke : an individual-participant data meta-analysis
- 2015
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Ingår i: Stroke. - 0039-2499 .- 1524-4628. ; 46:2, s. 557-559
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND PURPOSE: Psychosocial stress at work has been proposed to be a risk factor for cardiovascular disease. However, its role as a risk factor for stroke is uncertain.METHODS: We conducted an individual-participant-data meta-analysis of 196 380 males and females from 14 European cohort studies to investigate the association between job strain, a measure of work-related stress, and incident stroke.RESULTS: In 1.8 million person-years at risk (mean follow-up 9.2 years), 2023 first-time stroke events were recorded. The age- and sex-adjusted hazard ratio for job strain relative to no job strain was 1.24 (95% confidence interval, 1.05;1.47) for ischemic stroke, 1.01 (95% confidence interval, 0.75;1.36) for hemorrhagic stroke, and 1.09 (95% confidence interval, 0.94;1.26) for overall stroke. The association with ischemic stroke was robust to further adjustment for socioeconomic status.CONCLUSION: Job strain may be associated with an increased risk of ischemic stroke, but further research is needed to determine whether interventions targeting job strain would reduce stroke risk beyond existing preventive strategies.
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| 9. |
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| 10. |
- Fransson, Eleonor, 1971-, et al.
(författare)
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Job strain as a risk factor for leisure-time physical inactivity : an individual-participant meta-analysis of up to 170,000 men and women
- 2012
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Ingår i: American Journal of Epidemiology. - Cary : Oxford University Press. - 0002-9262 .- 1476-6256. ; 176:12, s. 1078-1089
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Forskningsöversikt (refereegranskat)abstract
- Unfavorable work characteristics, such as low job control and too high or too low job demands, have been suggested to increase the likelihood of physical inactivity during leisure time, but this has not been verified in large-scale studies. The authors combined individual-level data from 14 European cohort studies (baseline years from 19851988 to 20062008) to examine the association between unfavorable work characteristics and leisure-time physical inactivity in a total of 170,162 employees (50 women; mean age, 43.5 years). Of these employees, 56,735 were reexamined after 29 years. In cross-sectional analyses, the odds for physical inactivity were 26 higher (odds ratio 1.26, 95 confidence interval: 1.15, 1.38) for employees with high-strain jobs (low control/high demands) and 21 higher (odds ratio 1.21, 95 confidence interval: 1.11, 1.31) for those with passive jobs (low control/low demands) compared with employees in low-strain jobs (high control/low demands). In prospective analyses restricted to physically active participants, the odds of becoming physically inactive during follow-up were 21 and 20 higher for those with high-strain (odds ratio 1.21, 95 confidence interval: 1.11, 1.32) and passive (odds ratio 1.20, 95 confidence interval: 1.11, 1.30) jobs at baseline. These data suggest that unfavorable work characteristics may have a spillover effect on leisure-time physical activity.
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| 11. |
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| 12. |
- Heikkila, Katriina, et al.
(författare)
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Job Strain and Alcohol Intake : A Collaborative Meta-Analysis of Individual-Participant Data from 140 000 Men and Women
- 2012
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 7:7, s. Art. no. e40101-
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Tidskriftsartikel (refereegranskat)abstract
- Background: The relationship between work-related stress and alcohol intake is uncertain. In order to add to the thus far inconsistent evidence from relatively small studies, we conducted individual-participant meta-analyses of the association between work-related stress (operationalised as self-reported job strain) and alcohol intake. Methodology and Principal Findings: We analysed cross-sectional data from 12 European studies (n = 142 140) and longitudinal data from four studies (n = 48 646). Job strain and alcohol intake were self-reported. Job strain was analysed as a binary variable (strain vs. no strain). Alcohol intake was harmonised into the following categories: none, moderate (women: 1-14, men: 1-21 drinks/week), intermediate (women: 15-20, men: 22-27 drinks/week) and heavy (women: > 20, men: > 27 drinks/week). Cross-sectional associations were modelled using logistic regression and the results pooled in random effects meta-analyses. Longitudinal associations were examined using mixed effects logistic and modified Poisson regression. Compared to moderate drinkers, non-drinkers and (random effects odds ratio (OR): 1.10, 95% CI: 1.05, 1.14) and heavy drinkers (OR: 1.12, 95% CI: 1.00, 1.26) had higher odds of job strain. Intermediate drinkers, on the other hand, had lower odds of job strain (OR: 0.92, 95% CI: 0.86, 0.99). We found no clear evidence for longitudinal associations between job strain and alcohol intake. Conclusions: Our findings suggest that compared to moderate drinkers, non-drinkers and heavy drinkers are more likely and intermediate drinkers less likely to report work-related stress.
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| 13. |
- Heikkila, Katriina, et al.
(författare)
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Job Strain and Tobacco Smoking : An Individual-Participant Data Meta-Analysis of 166 130 Adults in 15 European Studies
- 2012
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 7:7
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Tidskriftsartikel (refereegranskat)abstract
- Background: Tobacco smoking is a major contributor to the public health burden and healthcare costs worldwide, but the determinants of smoking behaviours are poorly understood. We conducted a large individual-participant meta-analysis to examine the extent to which work-related stress, operationalised as job strain, is associated with tobacco smoking in working adults. Methodology and Principal Findings: We analysed cross-sectional data from 15 European studies comprising 166 130 participants. Longitudinal data from six studies were used. Job strain and smoking were self-reported. Smoking was harmonised into three categories never, ex- and current. We modelled the cross-sectional associations using logistic regression and the results pooled in random effects meta-analyses. Mixed effects logistic regression was used to examine longitudinal associations. Of the 166 130 participants, 17% reported job strain, 42% were never smokers, 33% ex-smokers and 25% current smokers. In the analyses of the cross-sectional data, current smokers had higher odds of job strain than never-smokers (age, sex and socioeconomic position-adjusted odds ratio: 1.11, 95% confidence interval: 1.03, 1.18). Current smokers with job strain smoked, on average, three cigarettes per week more than current smokers without job strain. In the analyses of longitudinal data (1 to 9 years of follow-up), there was no clear evidence for longitudinal associations between job strain and taking up or quitting smoking. Conclusions: Our findings show that smokers are slightly more likely than non-smokers to report work-related stress. In addition, smokers who reported work stress smoked, on average, slightly more cigarettes than stress-free smokers.
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| 14. |
- Heikkilä, Katriina, et al.
(författare)
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Job Strain as a Risk Factor for Peripheral Artery Disease : A Multi-Cohort Study
- 2020
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Ingår i: Journal of the American Heart Association. - : Wiley-Blackwell. - 2047-9980. ; 9:9
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Tidskriftsartikel (refereegranskat)abstract
- Background Job strain is implicated in many atherosclerotic diseases, but its role in peripheral artery disease (PAD) is unclear. We investigated the association of job strain with hospital records of PAD, using individual-level data from 11 prospective cohort studies from Finland, Sweden, Denmark, and the United Kingdom. Methods and Results Job strain (high demands and low control at work) was self-reported at baseline (1985-2008). PAD records were ascertained from national hospitalization data. We used Cox regression to examine the associations of job strain with PAD in each study, and combined the study-specific estimates in random effects meta-analyses. We used τ2, I2, and subgroup analyses to examine heterogeneity. Of the 139 132 participants with no previous hospitalization with PAD, 32 489 (23.4%) reported job strain at baseline. During 1 718 132 person-years at risk (mean follow-up 12.8 years), 667 individuals had a hospital record of PAD (3.88 per 10 000 person-years). Job strain was associated with a 1.41-fold (95% CI, 1.11-1.80) increased average risk of hospitalization with PAD. The study-specific estimates were moderately heterogeneous (τ2=0.0427, I2: 26.9%). Despite variation in their magnitude, the estimates were consistent in both sexes, across the socioeconomic hierarchy and by baseline smoking status. Additional adjustment for baseline diabetes mellitus did not change the direction or magnitude of the observed associations. Conclusions Job strain was associated with small but consistent increase in the risk of hospitalization with PAD, with the relative risks on par with those for coronary heart disease and ischemic stroke.
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| 15. |
- Heikkilä, Katriina, et al.
(författare)
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Work stress and risk of cancer: meta-analysis of 5700 incident cancer events in 116 000 European men and women
- 2013
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Ingår i: The BMJ. - : BMJ. - 1756-1833. ; 345:f165
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Tidskriftsartikel (refereegranskat)abstract
- Objective To investigate whether work related stress, measured and defined as job strain, is associated with the overall risk of cancer and the risk of colorectal, lung, breast, or prostate cancers.Design Meta-analysis of pooled prospective individual participant data from 12 European cohort studies including 116 056 men and women aged 17-70 who were free from cancer at study baseline and were followed-up for a median of 12 years. Work stress was measured and defined as job strain, which was self reported at baseline. Incident cancers (all n=5765, colorectal cancer n=522, lung cancer n=374, breast cancer n=1010, prostate cancer n=865) were ascertained from cancer, hospital admission, and death registers. Data were analysed in each study with Cox regression and the study specific estimates pooled in meta-analyses. Models were adjusted for age, sex, socioeconomic position, body mass index (BMI), smoking, and alcohol intakeResults A harmonised measure of work stress, high job strain, was not associated with overall risk of cancer (hazard ratio 0.97, 95% confidence interval 0.90 to 1.04) in the multivariable adjusted analyses. Similarly, no association was observed between job strain and the risk of colorectal (1.16, 0.90 to 1.48), lung (1.17, 0.88 to 1.54), breast (0.97, 0.82 to 1.14), or prostate (0.86, 0.68 to 1.09) cancers. There was no clear evidence for an association between the categories of job strain and the risk of cancer.Conclusions These findings suggest that work related stress, measured and defined as job strain, at baseline is unlikely to be an important risk factor for colorectal, lung, breast, or prostate cancers.
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| 16. |
- Keyvani, Ali, et al.
(författare)
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Ergonomic Risk Assessment of a Manikin’s Wrist Movements - a Test Study in Manual Assembly
- 2013
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Konferensbidrag (refereegranskat)abstract
- Use of digital human modeling (DHM) tools enables early assessment of ergonomic risks in the production development process. This early risk assessment can indicate needs for preventive actions in order to decrease risks for work-related musculoskeletal disorders. A method for the assessment of physical workload has been developed, for the analysis of wrist joint data produced by a DHM tool. The method is tested in a simulation model of an actual manual assembly station in industry where it is assumed that physical workload problems exist. The results show that the method can be successfully applied on an industrial case. In addition, presumptive risks and possible diagnoses are predicted based on the similarity of the simulated task’s motions with motions from other known work class profiles stored in a database based on epidemiological research.
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| 17. |
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| 18. |
- Klein, Yannick, 1991-, et al.
(författare)
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Nature visits buffered against loneliness during COVID-19, especially among those working mainly remotely. A population-based study of working adults in Sweden
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundThe COVID-19 pandemic and associated restrictions posed challenges to people’s private and work lives. There was a rapid shift from on-site to remote working for many working adults in Sweden and internationally, while opportunities for in-person social and leisure activities indoors were limited. One challenge was thus the risk of increased loneliness and social isolation, especially among those working more remotely. In this context, nature visits may potentially mitigate loneliness. This study thus investigates whether a higher degree of remote work during COVID-19 was related to increased loneliness and whether nature visits mitigated loneliness, especially for those working mainly remotely, for which studies are limited. MethodsThe sample comprised a subsample of respondents to the Swedish Longitudinal Occupational Survey of Health 2020 (n = 984). The effect of remote work, nature-related habits (NRH), and time on loneliness (before – during COVID-19) were analyzed using linear mixed models while controlling for confounders.ResultsIn general, loneliness levels during COVID-19 were highest and increased the most compared to before the pandemic among the most remotely working individuals. Engaging daily in NRH was associated with lower levels of loneliness, particularly among individuals mostly working remotely. This was observed in a three-way interaction effect between remote work, NRH, and time on loneliness.ConclusionDaily nature visits may protect against loneliness during and beyond crises like COVID-19, particularly for those working mainly remotely. Policies preserving and facilitating access to natural environments may be crucial for promoting resilience during and beyond crises like COVID-19.
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| 19. |
- Lindehammer, Sabina, et al.
(författare)
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Early-Pregnancy Cytokines in Mothers to Children Developing Multiple, Persistent Islet Autoantibodies, Type 1 Diabetes, or Both Before 7 Years of Age.
- 2011
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Ingår i: American Journal of Reproductive Immunology. - : Wiley. - 1600-0897 .- 1046-7408. ; 66, s. 495-503
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Tidskriftsartikel (refereegranskat)abstract
- Citation Lindehammer SR, Fex M, Maziarz M, Hanson I, Marsal K, Lernmark Å on behalf of the Diabetes Prediction in Skåne (DiPiS) Study Group. Early-pregnancy cytokines in mothers to children developing multiple, persistent islet autoantibodies, type 1 diabetes, or both before 7 years of age. Am J Reprod Immunol 2011 Problem Increased levels of serum cytokines in early pregnancy may increase the risk of type 1 diabetes in the offspring. Method of study Early-pregnancy (between 10 and 16 gestational weeks) serum samples from non-diabetic index mothers (n = 48) of children who developed islet autoimmunity, type 1 diabetes, or both before 7 years of age were analyzed for IFN-γ, IL-10, IL-12, IL-13, IL-1β, IL-2, IL-4, IL-5, CXCL8, and TNF. Control mothers (n = 93) were matched for age, sampling date, and HLA-DQ genotypes. Results IFN-γ (P = 0.02) and IL-1β (P = 0.04) were elevated in the index mothers. All cytokines except IL-4 were highly correlated (P < 0.0001). IFN-γ [OR 1.39 (1.04, 1.85), P = 0.026] and possibly IL-2 [OR 1.21 (0.99, 1.48), P = 0.057] in early pregnancy were associated with an increased risk of multiple, persistent islet autoantibodies, type 1 diabetes, or both before 7 years of age in the offspring. However, the statistical significance for IL-2 was lost in the logistic regression when adjusted for gestational length at delivery and parity. Conclusion Increased Th1 cytokine levels during early pregnancy might contribute to an increased risk of islet autoimmunity, type 1 diabetes, or both in the offspring.
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| 20. |
- Madsen, Ida E H, et al.
(författare)
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Does good leadership buffer effects of high emotional demands at work on risk of antidepressant treatment? A prospective study from two Nordic countries
- 2014
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Ingår i: Social Psychiatry and Psychiatric Epidemiology. - : Springer Science and Business Media LLC. - 0933-7954 .- 1433-9285. ; 49:8, s. 1209-1218
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Emotionally demanding work has been associated with increased risk of common mental disorders. Because emotional demands may not be preventable in certain occupations, the identification of workplace factors that can modify this association is vital. This article examines whether effects of emotional demands on antidepressant treatment, as an indicator of common mental disorders, are buffered by good leadership.METHODS: We used data from two nationally representative work environment studies, the Danish Work Environment Cohort Study (n = 6,096) and the Swedish Longitudinal Occupational Survey of Health (n = 3,411), which were merged with national registers on antidepressant purchases. All individuals with poor self-reported baseline mental health or antidepressant purchases within 8.7 months before baseline were excluded, and data analysed prospectively. Using Cox regression, we examined hazard ratios (HRs) for antidepressants in relation to the joint effects of emotional demands and leadership quality. Buffering was assessed with Rothman's synergy index. Cohort-specific risk estimates were pooled by random effects meta-analysis.RESULTS: High emotional demands at work were associated with antidepressant treatment whether quality of leadership was poor (HR = 1.84, 95 % CI 1.32-2.57) or good (HR = 1.70, 95 % CI 1.25-2.31). The synergy index was 0.66 (95 % CI 0.34-1.28).CONCLUSIONS: Our findings suggest that good leadership does not substantially ameliorate any effects of emotional demands at work on employee mental health. Further research is needed to identify possible preventive measures for this work environment exposure.
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| 21. |
- Madsen, Ida E.H., et al.
(författare)
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Study protocol for examining job strain as a risk factor for severe unipolar depression in an individual participant meta-analysis of 14 European cohorts
- 2014
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Ingår i: F1000 Research. - : F1000 Research Ltd. - 2046-1402. ; 2
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Tidskriftsartikel (refereegranskat)abstract
- Background: Previous studies have shown that gainfully employed individuals with high work demands and low control at work (denoted "job strain") are at increased risk of common mental disorders, including depression. Most existing studies have, however, measured depression using self-rated symptom scales that do not necessarily correspond to clinically diagnosed depression. In addition, a meta-analysis from 2008 indicated publication bias in the field.Methods: This study protocol describes the planned design and analyses of an individual participant data meta-analysis, to examine whether job strain is associated with an increased risk of clinically diagnosed unipolar depression based on hospital treatment registers. The study will be based on data from approximately 120,000 individuals who participated in 14 studies on work environment and health in 4 European countries. The self-reported working conditions data will be merged with national registers on psychiatric hospital treatment, primarily hospital admissions. Study-specific risk estimates for the association between job strain and depression will be calculated using Cox regressions. The study-specific risk estimates will be pooled using random effects meta-analysis.Discussion: The planned analyses will help clarify whether job strain is associated with an increased risk of clinically diagnosed unipolar depression. As the analysis is based on pre-planned study protocols and an individual participant data meta-analysis, the pooled risk estimates will not be influenced by selective reporting and publication bias. However, the results of the planned study may only pertain to severe cases of unipolar depression, because of the outcome measure applied.
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| 22. |
- Magnusson Hanson, Linda, et al.
(författare)
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Association of workplace violence and bullying with later suicide risk : a multicohort study and meta-analysis of published data
- 2023
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Ingår i: The Lancet Public Health. - : Elsevier. - 2468-2667. ; 8:7, s. e494-e503
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Tidskriftsartikel (refereegranskat)abstract
- Background: Workplace offensive behaviours, such as violence and bullying, have been linked to psychological symptoms, but their potential impact on suicide risk remains unclear. We aimed to assess the association of workplace violence and bullying with the risk of death by suicide and suicide attempt in multiple cohort studies. Methods: In this multicohort study, we used individual-participant data from three prospective studies: the Finnish Public Sector study, the Swedish Work Environment Survey, and the Work Environment and Health in Denmark study. Workplace violence and bullying were self-reported at baseline. Participants were followed up for suicide attempt and death using linkage to national health records. We additionally searched the literature for published prospective studies and pooled our effect estimates with those from published studies. Findings: During 1 803 496 person-years at risk, we recorded 1103 suicide attempts or deaths in participants with data on workplace violence (n=205 048); the corresponding numbers for participants with data on workplace bullying (n=191 783) were 1144 suicide attempts or deaths in 1 960 796 person-years, which included data from one identified published study. Workplace violence was associated with an increased risk of suicide after basic adjustment for age, sex, educational level, and family situation (hazard ratio 1.34 [95% CI 1.15-1.56]) and full adjustment (additional adjustment for job demands, job control, and baseline health problems, 1.25 [1.08-1.47]). Where data on frequency were available, a stronger association was observed among people with frequent exposure to violence (1.75 [1.27-2.42]) than occasional violence (1.27 [1.04-1.56]). Workplace bullying was also associated with an increased suicide risk (1.32 [1.09-1.59]), but the association was attenuated after adjustment for baseline mental health problems (1.16 [0.96-1.41]). Interpretation: Observational data from three Nordic countries suggest that workplace violence is associated with an increased suicide risk, highlighting the importance of effective prevention of violent behaviours at workplaces.
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| 23. |
- Magnusson Hanson, Linda L., et al.
(författare)
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Antidepressant use and associations with psychosocial work characteristics : A comparative study of Swedish and Danish gainfully employed
- 2013
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Ingår i: Journal of Affective Disorders. - : Elsevier BV. - 0165-0327 .- 1573-2517. ; 149:1-3, s. 38-45
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Although depression is common, prevalence estimates of antidepressant use among the workforce and undisputed evidence relating psychosocial work characteristics to depression is scarce. This study cross-sectionally assesses the prevalence of antidepressant use among employed in Sweden and Denmark and prospectively examines associations between work characteristics and antidepressant use. METHODS: Data on work demands, influence and learning possibilities was collected 2005-2006 from two representative samples of employed aged 20-59 years from Sweden (n=4351) and Denmark (n=8064) and linked to purchases of antidepressants through national prescription drug registries. Standardized 12-month prevalences were calculated. Cox regressions on work characteristics and incident use were performed separately and estimates pooled. RESULTS: Employed Swedish residents had higher standardized prevalence than Danish, 6.0% compared to 5.0%. Working fast and conflicting demands were associated with incident use when estimates were pooled, but adjustment for baseline health attenuated these estimates. Emotionally disturbing situations were related to any incident use, and more strongly to use >179 defined daily dosages/year, even after adjustment for various covariates. LIMITATIONS: Statistics based on national prescription drug registries are influenced by, e.g., treatment seeking behaviours and other reasons for prescription than depression. Selective drop-out may also affect prevalence estimates. CONCLUSIONS: The study indicates that use of antidepressants among the workforce is relatively high and that employed Swedish residents had higher prevalence of antidepressant use than Danish. Relationships between work characteristics and antidepressant use were, however, similar with emotional demands showing the strongest association, indicating that particular groups of employees may be at increased risk.
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| 24. |
- Magnusson Hanson, Linda L., et al.
(författare)
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Multicohort study of change in job strain, poor mental health and incident cardiometabolic disease
- 2019
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Ingår i: Occupational and Environmental Medicine. - : BMJ Publishing Group Ltd. - 1351-0711 .- 1470-7926. ; 76, s. 785-792
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Several recent large-scale studies have indicated a prospective association between job strain and coronary heart disease, stroke and diabetes. Job strain is also associated with poorer mental health, a risk factor for cardiometabolic disease. This study investigates the prospective relationships between change in job strain, poor mental health and cardiometabolic disease, and whether poor mental health is a potential mediator of the relationship between job strain and cardiometabolic disease. Methods: We used data from five cohort studies from Australia, Finland, Sweden and UK, including 47 757 men and women. Data on job strain across two measurements 1-5 years apart (time 1 (T1)-time 2 (T2)) were used to define increase or decrease in job strain. Poor mental health (symptoms in the top 25% of the distribution of the scales) at T2 was considered a potential mediator in relation to incident cardiometabolic disease, including cardiovascular disease and diabetes, following T2 for a mean of 5-18 years. Results: An increase in job strain was associated with poor mental health (HR 1.56, 95% CI 1.38 to 1.76), and a decrease in job strain was associated with lower risk in women (HR 0.70, 95% CI 0.60-0.84). However, no clear association was observed between poor mental health and incident cardiometabolic disease (HR 1.08, 95% CI 0.96-1.23), nor between increase (HR 1.01, 95% CI 0.90-1.14) and decrease (HR 1.08, 95% CI 0.96-1.22) in job strain and cardiometabolic disease. Conclusions: The results did not support that change in job strain is a risk factor for cardiometabolic disease and yielded no support for poor mental health as a mediator.
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| 25. |
- Magnusson Hanson, Linda L., et al.
(författare)
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Temporal relationships between job strain and low-back pain
- 2017
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Ingår i: Scandinavian Journal of Work, Environment and Health. - : Scandinavian Journal of Work, Environment and Health. - 0355-3140 .- 1795-990X. ; 43:5, s. 396-404
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Tidskriftsartikel (refereegranskat)abstract
- Objectives Psychosocial working conditions are suggested risk factors for low-back pain, but it is unclear whether these associations are causal. The present study examined whether there are lagged and bidirectional associations between job strain and low-back pain and further controlled for unmeasured time-invariant confounding.Methods The study was based on four biennial waves of data from the Swedish Longitudinal Occupational Survey of Health (SLOSH), including 3084 men and women. Cross-lagged analyses using structural equation modeling (SEM) were conducted on job strain, a combination of high job demands and low control, and any as well as low-back pain severity (how much any problems affected the respondents life). Analogous SEM (dynamic panel) models with fixed effects were also fitted to remove confounding from time-invariant factors (such as non-observed individual and environmental factors, eg, genetics, childhood conditions, personality).Results The SEM models indicated bidirectional associations between job strain and any back pain over a 2-year time lag (β=0.21 and 0.19, P<0.05), when adjusting for a range of covariates. Job strain was also associated with an increase in low-back pain severity and vice versa. However, the SEM models with fixed-effects showed no statistically significant lagged relationships between job strain and any or low-back pain severity (β=-0.05 and β=0.00, respectively).Conclusions This study suggests that associations between job strain and low-back pain with a lag of years may be due to residual confounding by time invariant characteristics. Further studies are, however, needed to elucidate short-term relationships.
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| 26. |
- Nordentoft, Mads, et al.
(författare)
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Changes in effort-reward imbalance at work and risk of onset of sleep disturbances in a population-based cohort of workers in Denmark
- 2020
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Ingår i: Sleep Medicine: X. - : Elsevier BV. - 2590-1427. ; 2
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Tidskriftsartikel (refereegranskat)abstract
- Objective/background: Associations between exposure to effort-reward imbalance at work (eg, high time pressure/low appreciation) and risk of sleep disturbances have been reported, but the direction of the effect is unclear. The present study investigated changes in effort-reward imbalance and risk of concomitant and subsequent onset of sleep disturbances. Methods: Participants with sleep disturbances at baseline were excluded. We included participants from a population-based cohort in Denmark (n = 8,464, 53.6% women, mean age = 46.6 years), with three repeated measurements (2012 (T0); 2014 (T1); 2016 (T2)). Changes in effort-reward imbalance (T0-T1) were categorized into ‘increase’, ‘decrease’ and ‘no change’. Self-reported sleep disturbances (difficulties initiating or maintaining sleep, non-restorative sleep, daytime tiredness) were dichotomized (presence versus absence). We regressed concomitant (T1) and subsequent (T2) sleep disturbances on changes in effort-reward imbalance (T0-T1) and calculated odds ratios (OR) and 95% confidence intervals, adjusted for sex, age, education and cohabitation. Results: At follow-up, 8.4% (T1) and 12.5% (T2) reported onset of sleep disturbances. Increased effort-reward imbalance was associated with concomitant sleep disturbances (T1) (OR = 3.16, 2.56–3.81), whereas decreased effort-reward imbalance was not (OR = 1.22, 0.91–1.63). There was no association between increased effort-reward imbalance and subsequent sleep disturbances (T2) (OR = 1.00, 0.74–1.37). Results were similar for men and women. Conclusions: Increased effort-reward imbalance was associated with a three-fold higher risk of concomitant onset of sleep disturbances at two-year follow-up, but not subsequent onset of sleep disturbances at four-year follow-up, indicating that changes in effort-reward imbalance have immediate rather than delayed effects on sleep impairment. It is possible that the results from the two-year follow-up were to some extent affected by reverse causality.
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| 27. |
- Nordentoft, Mads, et al.
(författare)
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Effort-reward imbalance at work and risk of type 2 diabetes in a national sample of 50,552 workers in Denmark : A prospective study linking survey and register data
- 2020
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Ingår i: Journal of Psychosomatic Research. - : Elsevier BV. - 0022-3999 .- 1879-1360. ; 128
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To examine the prospective relation between effort-reward imbalance at work and risk of type 2 diabetes.Methods: We included 50,552 individuals from a national survey of the working population in Denmark, aged 30–64 years and diabetes-free at baseline. Effort-reward imbalance was defined, in accordance with the literature, as a mismatch between high efforts at work (e.g. high work pace, time pressure), and low rewards received in return (e.g. low recognition, job insecurity) and assessed as a continuous and a categorical variable. Incident type 2 diabetes was identified in national health registers. Using Cox regression we calculated hazard ratios (HR) and 95% confidence intervals (95% CI) for estimating the association between effort-reward imbalance at baseline and risk of onset of type 2 diabetes during follow-up, adjusted for sex, age, socioeconomic status, cohabitation, children at home, migration background, survey year and sample method.Results: During 136,239 person-years of follow-up (mean = 2.7 years) we identified 347 type 2 diabetes cases (25.5 cases per 10,000 person-years). For each one standard deviation increase of the effort-reward imbalance score at baseline, the fully adjusted risk of type 2 diabetes during follow-up increased by 9% (HR: 1.09, 95% CI: 0.98–1.21). When we used effort-reward imbalance as a dichotomous variable, exposure to effort-reward imbalance was associated with an increased risk of type 2 diabetes with a HR of 1.27 (95% CI: 1.02–1.58).Conclusion: The results of this nationwide study of the Danish workforce suggest that effort-reward imbalance at work may be a risk factor for type 2 diabetes.
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| 28. |
- Nordentoft, Mads, et al.
(författare)
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Effort-reward imbalance at work and weight changes in a nationwide cohort of workers in Denmark
- 2020
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Ingår i: American Journal of Industrial Medicine. - : Wiley. - 0271-3586 .- 1097-0274. ; 63:7, s. 634-643
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate the relation between effort-reward imbalance (ERI) at work and subsequent weight changes.Methods: We included participants from a population-based cohort of workers in Denmark (mean age = 47 years, 54% women) with two (n = 9005) or three repeated measurements (n = 5710). We investigated the association between (a) ERI (ie, the mismatch between high efforts spent and low rewards received at work) at baseline and weight changes after a 2-year follow-up (defined as >= 5% increase or decrease in body mass index (BMI) vs stable), and (b) onset and remission of ERI and subsequent changes in BMI. Using multinomial logistic regression we calculated risk ratios (RR) and 95% confidence intervals (CI), adjusted for sex, age, education, cohabitation, migration background, and follow-up time.Results: After 2 years, 15% had an increase and 13% a decrease in BMI. Exposure to ERI at baseline yielded RRs of 1.09 (95% CI: 0.95-1.25) and 1.04 (95% CI: 0.90-1.20) for the increase and decrease in BMI, respectively. There were no differences between sex and baseline BMI in stratified analyses. The onset of ERI yielded RRs of 1.04 (95% CI: 0.82-1.31) and 1.15 (95% CI: 0.84-1.57) for subsequent increase and decrease in BMI. The RRs for the remission of ERI and subsequent increase and decrease in BMI were 0.92 (95% CI: 0.71-1.20) and 0.78 (95% CI: 0.53-1.13), respectively. Of the ERI components, high rewards were associated with a lower risk of BMI increase.Conclusion: ERI was not a risk factor for weight changes. Future studies may investigate whether this result is generalizable to other occupational cohorts and settings.
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| 29. |
- Rhen, Ida-Märta, et al.
(författare)
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Dynamic wrist exposure analysis of a digital human model
- 2012
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Ingår i: Advances in Human Factors and Ergonomics 2012. - : CRC Press. - 9781466552623 ; , s. 3944-3953
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Konferensbidrag (refereegranskat)abstract
- Simulation and visualisation software such as digital human modelling (DHM) tools have been designed to predict and evaluate ergonomics within a virtual environment. Today’s DHM tools typically include observation-based evaluation methods, initially designed for visual observation. Direct measurement techniques enable assessment of quantitative data similar to the information derived from the DHM. Such technique allows detailed and time-dependent risk aspects to be considered in the ergonomics evaluation. No methods in commercial DHM software calculate time-dependent information, which is shown as an important risk factor in the development of work-related musculoskeletal disorder (WMSD). This paper presents and discusses an ergonomics assessment approach based on the theory of a dose-response relationship between exposure and the risk of arising injury. The focus of the approach presented is on the wrist-joint.
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| 30. |
- Rhen, Ida-Märta, 1975, et al.
(författare)
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Ergonomic risk assessment in DHM tools employing motion data : Exposure calculation and comparison to epidemiological reference data
- 2018
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Ingår i: International Journal of Human Factors Modelling and Simulation. - Olney : InderScience Publishers. - 1742-5549 .- 1742-5557. ; 6:1, s. 31-64
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Tidskriftsartikel (refereegranskat)abstract
- Digital human modelling (DHM) allows ergonomic risk assessment to be performed at early stages of design and development. Such assessment is typically based on observational methods, which do not take advantage of the potential of DHM tools to provide precise posture and motion data. This paper describes and illustrates an alternative assessment approach employing DHM tools, inspired by risk assessment based on direct measurements. A literature survey established a reference database of epidemiological associations between exposure and wrist-related disorders. This approach is illustrated by a DHM simulation of a car assembly task. Wrist posture and motion were simulated and compared to the database, predicting the prevalence of work-related musculoskeletal disorders on the basis of direct measurements.
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| 31. |
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| 32. |
- Rhén, Ida-Märta, et al.
(författare)
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Risk exposure assessment of dynamic wrist motions of a digital human model
- 2011
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Ingår i: Proceedings of NES2011 September 18—21, 2011 Oulu, Finland. - Oulu : University of Oulu. - 9789514295416 ; , s. 386-391
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Konferensbidrag (refereegranskat)abstract
- Software tools as Digital Human Modelling (DHM) has been designed to simulate and visualize the human work and to assess ergonomics conditions. No methods in commercial DHM software calculate time-dependent information, which is adequate in defining the relations between exposure and risk of disorders. The paper presents and discusses how an assembly task can be analysed with the help from a DHM-tool. Out comes from the study revealed that it is possible to generate output files with time-dependent wrist exposure data from a manikin in a DHM-tool. However, current evaluation methods do not take time-dependent information into consideration.
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| 33. |
- Rhen, Ida-Märta, et al.
(författare)
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Time dependent exposure analysis and risk assessment of a manikin's wrist movements
- 2011
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Ingår i: Proceedings of DHM, First International Symposium on Digital Human Modeling. - : Université Claude Bernard Lyon. - 9782953951509
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Konferensbidrag (refereegranskat)abstract
- The increased computerisation of design and engineering work has led to the development of software such as digital human modeling (DHM) tools. These tools can be used to simulate and visualise human work and for evaluating ergonomic conditions. Observational-based ergonomics methods, such as RULA and OWAS, may be used for characterizing workload and are typically integrated in DHM tools. However, using observational-based methods usually means that ergonomics evaluations are based on assessing static postures, i.e. not taking time-related aspects into account. This is usually also the case when industrial companies choose to customize the DHM software and integrate their own company specific ergonomics methods. Since time-sensitive aspects, such as frequency and angular velocity, are of importance in the ergonomics evaluation, it is necessary to be able to predict these variables also in an early stage of the design process. As observation methods are poor in terms of sensitivity they give rough estimations of ergonomic conditions. Consequently, researchers aim to develop dynamic evaluation methods where also time-dependent aspects, such as repetitiveness, velocity and duration in exposed positions, are considered. The objective of this study is to focus on the assessment of the wrist since a large amount of work related disorders is caused by this joint and also due to the fact that this is a relatively uncomplicated joint to explore from a biomechanical perspective. This paper displays initial findings from the literature for how to adequately and quantitatively assess wrist movements, appropriate evaluation criteria and for how to calculate cumulative load. Moreover, the paper illustrates how time significant wrist exposure data obtained from a DHM may be used for ergonomics assessment. This involves a proposed time consideration concept, based on a combination of modified and established evaluation methods, including suggestions for how to identify fundamental cycles.
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| 34. |
- Rugulies, Reiner, et al.
(författare)
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Persistent and changing job strain and risk of coronary heart disease : A population-based cohort study of 1.6 million employees in Denmark
- 2020
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Ingår i: Scandinavian Journal of Work, Environment and Health. - : Scandinavian Journal of Work, Environment and Health. - 0355-3140 .- 1795-990X. ; 46:5, s. 498-507
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Tidskriftsartikel (refereegranskat)abstract
- Objectives This study aimed to examine the association between job strain and incident coronary heart disease (CHD) in Denmark, while accounting for changes of job strain.Methods We included all employees residing in Denmark in 2000, aged 30–59 years with no prevalent CHD (N=1 660 150). We determined exposure to job strain from 1996–2009 using a job exposure matrix (JEM) with annual updates. Follow-up for incident CHD was from 2001–2010 via linkage to health records. We used Cox regression to calculate hazard ratios (HR) and 95% confidence intervals (CI) for the association between job strain and incident CHD.Results During 16.1 million person-years, we identified 24 159 incident CHD cases (15.0 per 10 000 person-years). After adjustment for covariates, job strain in 2000 predicted onset of CHD during a mean follow-up of 9.71 years (HR 1.10, 95% CI 1.07–1.13). When analyzing changes in job strain from one year to the next and CHD in the subsequent year, persistent job strain (HR 1.07, 95% CI 1.03–1.10), onset of job strain (HR 1.20, 95% CI 1.12–1.29) and removal of strain (HR 1.20, 95% CI 1.12–1.28) were associated with higher CHD incidence compared to persistent no job strain. Associations were similar among men and women.Conclusions Job strain is associated with a higher risk of incident CHD in Denmark. As we used a JEM, we can rule out reporting bias. However, under- or overestimation of associations is possible due to non-differential misclassification of job strain and residual confounding by socioeconomic position.
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| 35. |
- Sørensen, Jeppe K., et al.
(författare)
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Work stress and loss of years lived without chronic disease : an 18-year follow-up of 1.5 million employees in Denmark
- 2022
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Ingår i: European Journal of Epidemiology. - : Springer Science and Business Media LLC. - 0393-2990 .- 1573-7284. ; 37:4, s. 389-400
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Tidskriftsartikel (refereegranskat)abstract
- We aimed to examine the association between exposure to work stress and chronic disease incidence and loss of chronic disease-free life years in the Danish workforce. The study population included 1,592,491 employees, aged 30–59 in 2000 and without prevalent chronic diseases. We assessed work stress as the combination of job strain and effort-reward imbalance using job exposure matrices. We used Cox regressions to estimate risk of incident hospital-diagnoses or death of chronic diseases (i.e., type 2 diabetes, coronary heart disease, stroke, cancer, asthma, chronic obstructive pulmonary disease, heart failure, and dementia) during 18 years of follow-up and calculated corresponding chronic disease-free life expectancy from age 30 to age 75. Individuals working in occupations with high prevalence of work stress had a higher risk of incident chronic disease compared to those in occupations with low prevalence of work stress (women: HR 1.04 (95% CI 1.02–1.05), men: HR 1.12 (95% CI 1.11–1.14)). The corresponding loss in chronic disease-free life expectancy was 0.25 (95% CI − 0.10 to 0.60) and 0.84 (95% CI 0.56–1.11) years in women and men, respectively. Additional adjustment for health behaviours attenuated these associations among men. We conclude that men working in high-stress occupations have a small loss of years lived without chronic disease compared to men working in low-stress occupations. This finding appeared to be partially attributable to harmful health behaviours. In women, high work stress indicated a very small and statistically non-significant loss of years lived without chronic disease.
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| 36. |
- Theorell, Töres, et al.
(författare)
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Job Strain as a Risk Factor for Type 2 Diabetes : A Pooled Analysis of 124,808 Men and Women
- 2014
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Ingår i: Diabetes Care. - : American Diabetes Association. - 0149-5992 .- 1935-5548. ; 37:8, s. 2268-2275
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE The status of psychosocial stress at work as a risk factor for type 2 diabetes is unclear because existing evidence is based on small studies and is subject to confounding by lifestyle factors, such as obesity and physical inactivity. This collaborative study examined whether stress at work, defined as "job strain," is associated with incident type 2 diabetes independent of lifestyle factors. RESEARCH DESIGN AND METHODS We extracted individual-level data for 124,808 diabetes-free adults from 13 European cohort studies participating in the IPD-Work Consortium. We measured job strain with baseline questionnaires. Incident type 2 diabetes at follow-up was ascertained using national health registers, clinical screening, and self-reports. We analyzed data for each study using Cox regression and pooled the study-specific estimates in fixed-effect meta-analyses. RESULTS There were 3,703 cases of incident diabetes during a mean follow-up of 10.3 years. After adjustment for age, sex, and socioeconomic status (SES), the hazard ratio (HR) for job strain compared with no job strain was 1.15 (95% CI 1.06-1.25) with no difference between men and women (1.19 [1.06-1.34] and 1.13 [1.00-1.28], respectively). In stratified analyses, job strain was associated with an increased risk of diabetes among those with healthy and unhealthy lifestyle habits. In a multivariable model adjusted for age, sex, SES, and lifestyle habits, the HR was 1.11 (1.00-1.23). CONCLUSIONS Findings from a large pan-European dataset suggest that job strain is a risk factor for type 2 diabetes in men and women independent of lifestyle factors.
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| 37. |
- Theorell, Töres, et al.
(författare)
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Obesity and loss of disease-free years owing to major non-communicable diseases : a multicohort study
- 2018
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Ingår i: The Lancet Public Health. - : Elsevier Ltd. - 2468-2667. ; 3:10, s. e490-e497
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Tidskriftsartikel (refereegranskat)abstract
- Background: Obesity increases the risk of several chronic diseases, but the extent to which the obesity-related loss of disease-free years varies by lifestyle category and across socioeconomic groups is unclear. We estimated the number of years free from major non-communicable diseases in adults who are overweight and obese, compared with those who are normal weight. Methods: We pooled individual-level data on body-mass index (BMI) and non-communicable diseases from men and women with no initial evidence of these diseases in European cohort studies from the Individual-Participant-Data Meta-Analysis in Working Populations consortium. BMI was assessed at baseline (1991–2008) and non-communicable diseases (incident type 2 diabetes, coronary heart disease, stroke, cancer, asthma, and chronic obstructive pulmonary disease) were ascertained via linkage to records from national health registries, repeated medical examinations, or self-report. Disease-free years from age 40 years to 75 years associated with underweight (BMI <18·5 kg/m2), overweight (≥25 kg/m2 to <30 kg/m2), and obesity (class I [mild] ≥30 kg/m2 to <35 kg/m2; class II–III [severe] ≥35 kg/m2) compared with normal weight (≥18·5 kg/m2 to <25 kg/m2) were estimated. Findings: Of 137 503 participants from ten studies, we excluded 6973 owing to missing data and 10 349 with prevalent disease at baseline, resulting in an analytic sample of 120 181 participants. Of 47 127 men, 211 (0·4%) were underweight, 21 468 (45·6%) normal weight, 20 738 (44·0%) overweight, 3982 (8·4%) class I obese, and 728 (1·5%) class II–III obese. The corresponding numbers among the 73 054 women were 1493 (2·0%), 44 760 (61·3%), 19 553 (26·8%), 5670 (7·8%), and 1578 (2·2%), respectively. During 1 328 873 person-years at risk (mean follow-up 11·5 years [range 6·3–18·6]), 8159 men and 8100 women developed at least one non-communicable disease. Between 40 years and 75 years, the estimated number of disease-free years was 29·3 (95% CI 28·8–29·8) in normal-weight men and 29·4 (28·7–30·0) in normal-weight women. Compared with normal weight, the loss of disease-free years in men was 1·8 (95% CI −1·3 to 4·9) for underweight, 1·1 (0·7 to 1·5) for overweight, 3·9 (2·9 to 4·9) for class I obese, and 8·5 (7·1 to 9·8) for class II–III obese. The corresponding estimates for women were 0·0 (−1·4 to 1·4) for underweight, 1·1 (0·6 to 1·5) for overweight, 2·7 (1·5 to 3·9) for class I obese, and 7·3 (6·1 to 8·6) for class II–III obese. The loss of disease-free years associated with class II–III obesity varied between 7·1 and 10·0 years in subgroups of participants of different socioeconomic level, physical activity level, and smoking habit. Interpretation: Mild obesity was associated with the loss of one in ten, and severe obesity the loss of one in four potential disease-free years during middle and later adulthood. This increasing loss of disease-free years as obesity becomes more severe occurred in both sexes, among smokers and non-smokers, the physically active and inactive, and across the socioeconomic hierarchy. Funding: NordForsk, UK Medical Research Council, US National Institute on Aging, Academy of Finland, Helsinki Institute of Life Science, and Cancer Research UK.
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| 38. |
- Virtanen, Marianna, et al.
(författare)
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Long working hours and depressive symptoms : systematic review and meta-analysis of published studies and unpublished individual participant data
- 2018
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Ingår i: Scandinavian Journal of Work, Environment and Health. - : Nordic Association of Occupational Safety and Health. - 0355-3140 .- 1795-990X. ; 44:3, s. 239-250
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Forskningsöversikt (refereegranskat)abstract
- Objectives This systematic review and meta-analysis combined published study-level data and unpublished individual-participant data with the aim of quantifying the relation between long working hours and the onset of depressive symptoms. Methods We searched PubMed and Embase for published prospective cohort studies and included available cohorts with unpublished individual-participant data. We used a random-effects meta-analysis to calculate summary estimates across studies. Results We identified ten published cohort studies and included unpublished individual-participant data from 18 studies. In the majority of cohorts, long working hours was defined as working ≥55 hours per week. In multivariable-adjusted meta-analyses of 189 729 participants from 35 countries [96 275 men, 93 454 women, follow-up ranging from 1-5 years, 21 747 new-onset cases), there was an overall association of 1.14 (95% confidence interval (CI) 1.03-1.25] between long working hours and the onset of depressive symptoms, with significant evidence of heterogeneity (I 2=45.1%, P=0.004). A moderate association between working hours and depressive symptoms was found in Asian countries (1.50, 95% CI 1.13-2.01), a weaker association in Europe (1.11, 95% CI 1.00-1.22), and no association in North America (0.97, 95% CI 0.70-1.34) or Australia (0.95, 95% CI 0.70-1.29). Differences by other characteristics were small. Conclusions This observational evidence suggests a moderate association between long working hours and onset of depressive symptoms in Asia and a small association in Europe.
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| 39. |
- Xu, Tianwei, et al.
(författare)
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Onset of Workplace Bullying and Risk of Weight Gain : A Multicohort Longitudinal Study
- 2020
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Ingår i: Obesity. - : Wiley. - 1930-7381 .- 1930-739X. ; 28:11, s. 2216-2223
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Tidskriftsartikel (refereegranskat)abstract
- Objective: This study aimed to examine the onset of workplace bullying as a risk factor for BMI increase.Methods: Repeated biennial survey data from three Nordic cohort studies were used, totaling 46,148 participants (67,337 participant observations) aged between 18 and 65 who did not have obesity and who were not bullied at the baseline. Multinomial logistic regression was applied for the analysis under the framework of generalized estimating equations.Results: Five percent reported onset of workplace bullying within 2 years from the baseline. In confounder-adjusted models, onset of workplace bullying was associated with a higher risk of weight gain of >= 1 BMI unit (odds ratio = 1.09; 95% CI: 1.01-1.19) and of >= 2.5 BMI units (odds ratio = 1.24; 95% CI: 1.06-1.45). A dose-response pattern was observed, and those exposed to workplace bullying more frequently showed a higher risk (P-trend = 0.04). The association was robust to adjustments, restrictions, stratifications, and use of relative/absolute scales for BMI change.Conclusions: Participants with exposure to the onset of workplace bullying were more likely to gain weight, a possible pathway linking workplace bullying to increased long-term risk of type 2 diabetes.
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| 40. |
- Xu, Tianwei, et al.
(författare)
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Workplace bullying and violence as risk factors for type 2 diabetes : a multicohort study and meta-analysis
- 2018
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Ingår i: Diabetologia. - : Springer Science and Business Media LLC. - 0012-186X .- 1432-0428. ; 61:1, s. 75-83
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Tidskriftsartikel (refereegranskat)abstract
- AIMS/HYPOTHESIS: The aim of this multicohort study was to examine whether employees exposed to social stressors at work, such as workplace bullying and violence, have an increased risk of type 2 diabetes.METHODS: The study included 45,905 men and women (40-65 years of age and free of diabetes at baseline) from four studies in Sweden, Denmark and Finland. Workplace bullying and violence were self-reported at baseline. Incident diabetes was ascertained through national health and medication records and death registers. Marginal structural Cox models adjusted for age, sex, country of birth, marital status and educational level were used for the analyses.RESULTS: Nine per cent of the population reported being bullied at work and 12% were exposed to workplace violence or threats of violence. Bullied participants had a 1.46 (95% CI 1.23, 1.74) times higher risk of developing diabetes compared with non-bullied participants. Exposure to violence or threats of violence was also associated with a higher risk of diabetes (HR 1.26 [95% CI 1.02, 1.56]). The risk estimates attenuated slightly when taking BMI into account, especially for bullying. The results were similar for men and women, and were consistent across cohorts.CONCLUSIONS/INTERPRETATION: We found a higher risk of incident type 2 diabetes among employees exposed to bullying or violence in the workplace. Further research is needed to determine whether policies to reduce bullying and violence at work may reduce the incidence of type 2 diabetes in working populations. Research on the mechanisms is also highly warranted.
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| 41. |
- Xu, Tianwei, et al.
(författare)
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Workplace bullying and workplace violence as risk factors for cardiovascular disease : a multi-cohort study
- 2019
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Ingår i: European Heart Journal. - : Oxford University Press (OUP). - 0195-668X .- 1522-9645. ; 40:14, s. 1124-1134
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Tidskriftsartikel (refereegranskat)abstract
- AimsTo assess the associations between bullying and violence at work and cardiovascular disease (CVD).Methods and resultsParticipants were 79 201 working men and women, aged 18–65 years and free of CVD and were sourced from three cohort studies from Sweden and Denmark. Exposure to workplace bullying and violence was measured at baseline using self-reports. Participants were linked to nationwide health and death registers to ascertain incident CVD, including coronary heart disease and cerebrovascular disease. Study-specific results were estimated by marginal structural Cox regression and were combined using fixed-effect meta-analysis. Nine percent reported being bullied at work and 13% recorded exposure to workplace violence during the past year. We recorded 3229 incident CVD cases with a mean follow-up of 12.4 years (765 in the first 4 years). After adjustment for age, sex, country of birth, marital status, and educational level, being bullied at work vs. not was associated with a hazard ratio (HR) of 1.59 [95% confidence interval (CI) 1.28–1.98] for CVD. Experiencing workplace violence vs. not was associated with a HR of 1.25 (95% CI 1.12–1.40) for CVD. The population attributable risk was 5.0% for workplace bullying and 3.1% for workplace violence. The excess risk remained similar in analyses with different follow-up lengths, cardiovascular risk stratifications, and after additional adjustments. Dose–response relations were observed for both workplace bullying and violence (Ptrend < 0.001). There was only negligible heterogeneity in study-specific estimates.ConclusionBullying and violence are common at workplaces and those exposed to these stressors are at higher risk of CVD.
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| 42. |
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| 43. |
- Åhlin, Julia K., et al.
(författare)
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Interrelationships between job demands, low back pain and depression : A four-way decomposition analysis of direct and indirect effects of job demands through mediation and/or interaction
- 2021
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Ingår i: Journal of Affective Disorders. - : Elsevier BV. - 0165-0327 .- 1573-2517. ; 282, s. 219-226
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Tidskriftsartikel (refereegranskat)abstract
- Background: Psychosocial work stressors may lead to low back pain (LBP) through depressive symptoms or to depression through LBP. Depressive symptoms or LBP may also modify these associations.Methods: We examined prospective interrelationships between job demands, LBP and depsive symptoms. We used comparable data from three consecutive biennial surveys in 2010-2016, from the Swedish Longitudinal Occupational Survey of Health (SLOSH) and the Work Environment and Health in Denmark (WEHD) cohorts, broadly representative of the working populations in Sweden and Denmark. We conducted multivariate counterfactual based mediation analyses allowing for four-way decomposition of the total effect of job demands, on incident LBP (N=2813, 2701) and incident major depression (N=3707, 5496). The four components estimated direct and indirect effects through mediation and/or interaction.Results: We observed no association between job demands and incident LBP four years later, but job demands was associated with later major depression (relative risks=1.88, 95% confidence interval=1.45-2.31 in SLOSH and 1.64, 1.18-2.11 in WEHD, adjusted for age, sex, panel (SLOSH data), education, cohabitation, physically strenuous work and chronic diseases. About 37% of the association was attributed to interaction between job demands and LBP in SLOSH. No interaction was found in WEHD. LBP partly mediated the relationship, by 14% in SLOSH and 2%, while statistically insignificant in WEHD.Limitations: Possible limitations include lack of comparable data on disabling low back pain, different scales for depressive symptoms, misclassification and residual confounding. Conclusions: This suggests mainly a direct effect of job demands on major depression, or through other pathways than LBP.
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