1.
Kivimäki, Mika, et al.
(author)
Associations of job strain and lifestyle risk factors with risk of coronary artery disease : a meta-analysis of individual participant data
2013
In: CMJA. Canadian Medical Association Journal. Onlineutg. Med tittel. - : CMA Joule Inc.. - 0820-3946 .- 1488-2329. ; 185:9, s. 763-769
Journal article (peer-reviewed) abstract
Background: It is unclear whether a healthy lifestyle mitigates the adverse effects of job strain on coronary artery disease. We examined the associations of job strain and lifestyle risk factors with the risk of coronary artery disease.Methods: We pooled individual-level data from 7 cohort studies comprising 102 128 men and women who were free of existing coronary artery disease at baseline (1985–2000). Questionnaires were used to measure job strain (yes v. no) and 4 lifestyle risk factors: current smoking, physical inactivity, heavy drinking and obesity. We grouped participants into 3 lifestyle categories: healthy (no lifestyle risk factors), moderately unhealthy (1 risk factor) and unhealthy (2–4 risk factors). The primary outcome was incident coronary artery disease (defined as first nonfatal myocardial infarction or cardiac-related death).Results: There were 1086 incident events in 743 948 person-years at risk during a mean follow-up of 7.3 years. The risk of coronary artery disease among people who had an unhealthy lifestyle compared with those who had a healthy lifestyle (hazard ratio [HR] 2.55, 95% confidence interval [CI] 2.18–2.98; population attributable risk 26.4%) was higher than the risk among participants who had job strain compared with those who had no job strain (HR 1.25, 95% CI 1.06–1.47; population attributable risk 3.8%). The 10-year incidence of coronary artery disease among participants with job strain and a healthy lifestyle (14.7 per 1000) was 53% lower than the incidence among those with job strain and an unhealthy lifestyle (31.2 per 1000).Interpretation: The risk of coronary artery disease was highest among participants who reported job strain and an unhealthy lifestyle; those with job strain and a healthy lifestyle had half the rate of disease. A healthy lifestyle may substantially reduce disease risk among people with job strain.
2.
Falkenberg, Helena, et al.
(author)
Short- and long-term effects of major organisational change on minor psychiatric disorder and self-rated health : Results from the Whitehall II study
2013
In: Occupational and Environmental Medicine. - : BMJ. - 1351-0711 .- 1470-7926. ; 70:10, s. 688-696
Journal article (peer-reviewed) abstract
Objective To investigate short- and long-term effects of major organisational change on minor psychiatric disorder and self-rated health for women and men in different employment grades.Methods Minor psychiatric disorder and self-rated health among 6710 British civil servants (1993 women and 4717 men) in three employment grades from the Whitehall II study were examined from 1985 to 1988 under stable employment conditions. The short-term effects of organisational change were investigated in 1991–1993 after a time of major restructuring aiming at increasing the influence of market forces in the civil service and the long-term effects were investigated in 1997–1999.Results Those who had experienced organisational change and those who anticipated organisational change reported more negative short-term health effects (minor psychiatric disorder and poor self-rated health) compared with those who reported no change. No major differences were found depending on employment grade or gender. The negative health effects had diminished during 1997–1999 for those who reported that a major change had happened before 1991–1993. Those who anticipated an organisational change in 1991–1993 still reported more ill-health in 1997–1999 (both minor psychiatric disorder and self-reported health) than those in the comparison group.Conclusions The results indicate that organisational change affects employees’ health negatively in the short term but also that it is possible to recover from such negative effects. As it was not possible to discern any definite difference between the gender and grades, the results point at the importance of working proactively to implement organisational change for women and men at all levels.
3.
Heikkilä, K., et al.
(author)
Job strain and health-related lifestyle : Findings from an individual-participant meta-analysis of 118 000 working adults
2013
In: American Journal of Public Health. - 0090-0036 .- 1541-0048. ; 103:11, s. 2090-2097
Journal article (peer-reviewed) abstract
Objectives. We examined the associations of job strain, an indicator of work-related stress, with overall unhealthy and healthy lifestyles. Methods. We conducted a meta-analysis of individual-level data from 11 European studies (cross-sectional data: n = 118 701; longitudinal data: n = 43 971). We analyzed job strain as a set of binary (job strain vs no job strain) and categorical (high job strain, active job, passive job, and low job strain) variables. Factors used to define healthy and unhealthy lifestyles were body mass index, smoking, alcohol intake, and leisure-time physical activity. Results. Individuals with job strain were more likely than those with no job strain to have 4 unhealthy lifestyle factors (odds ratio [OR] = 1.25; 95% confidence interval [CI] = 1.12, 1.39) and less likely to have 4 healthy lifestyle factors (OR = 0.89; 95% CI = 0.80, 0.99). The odds of adopting a healthy lifestyle during study follow-up were lower among individuals with high job strain than among those with low job strain (OR = 0.88; 95% CI = 0.81, 0.96). Conclusions. Work-related stress is associated with unhealthy lifestyles and the absence of stress is associated with healthy lifestyles, but longitudinal analyses suggest no straightforward cause-effect relationship between workrelated stress and lifestyle. Copyright © 2013 by the American Public Health Association®.
4.
Heikkilä, Katriina, et al.
(author)
Work stress and risk of cancer: meta-analysis of 5700 incident cancer events in 116 000 European men and women
2013
In: The BMJ. - : BMJ. - 1756-1833. ; 345:f165
Journal article (peer-reviewed) 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.
5.
Knutsson, Anders, 1942-, et al.
(author)
Breast cancer among shift workers : results of the WOLF longitudinal cohort study
2013
In: Scandinavian Journal of Work, Environment and Health. - : Scandinavian Journal of Work, Environment and Health. - 0355-3140 .- 1795-990X. ; 39:2, s. 170-177
Journal article (peer-reviewed) abstract
OBJECTIVE: The aim of this study was to investigate whether shift work (with or without night work) is associated with increased risk of breast cancer. METHODS: The population consisted of 4036 women. Data were obtained from WOLF (Work, Lipids, and Fibrinogen), a longitudinal cohort study. Information about baseline characteristics was based on questionnaire responses and medical examination. Cancer incidence from baseline to follow-up was obtained from the national cancer registry. Two exposure groups were identified: shift work with and without night work. The group with day work only was used as the reference group in the analysis. Cox regression analysis was used to calculate relative risk. RESULTS: In total, 94 women developed breast cancer during follow-up. The average follow-up time was 12.4 years. The hazard ratio for breast cancer was 1.23 [95% confidence interval (95% CI) 0.70-2.17] for shifts without night work and 2.02 (95% CI 1.03-3.95) for shifts with night work. When including only women <60 years of age, the risk estimates were 1.18 (95% CI 0.67-2.07) for shifts without night work, and 2.15 (95% CI 1.10-4.21) for shifts with night work. CONCLUSIONS: Our results indicate an increased risk for breast cancer among women who work shifts that includes night work.
6.
Theorell, Töres, et al.
(author)
Job strain and cardiovascular disease risk factors : Meta-analysis of individual-participant data from 47,000 men and women
2013
In: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 8:6, s. e67323-
Journal article (peer-reviewed) abstract
BackgroundJob strain is associated with an increased coronary heart disease risk, but few large-scale studies have examined the relationship of this psychosocial characteristic with the biological risk factors that potentially mediate the job strain – heart disease association.Methodology and Principal FindingsWe pooled cross-sectional, individual-level data from eight studies comprising 47,045 participants to investigate the association between job strain and the following cardiovascular disease risk factors: diabetes, blood pressure, pulse pressure, lipid fractions, smoking, alcohol consumption, physical inactivity, obesity, and overall cardiovascular disease risk as indexed by the Framingham Risk Score. In age-, sex-, and socioeconomic status-adjusted analyses, compared to those without job strain, people with job strain were more likely to have diabetes (odds ratio 1.29; 95% CI: 1.11–1.51), to smoke (1.14; 1.08–1.20), to be physically inactive (1.34; 1.26–1.41), and to be obese (1.12; 1.04–1.20). The association between job strain and elevated Framingham risk score (1.13; 1.03–1.25) was attributable to the higher prevalence of diabetes, smoking and physical inactivity among those reporting job strain.ConclusionsIn this meta-analysis of work-related stress and cardiovascular disease risk factors, job strain was linked to adverse lifestyle and diabetes. No association was observed between job strain, clinic blood pressure or blood lipids.
7.
Virtanen, Marianna, et al.
(author)
Perceived job insecurity as a risk factor for incident coronary heart disease : systematic review and meta-analysis
2013
In: The BMJ. - : BMJ. - 1756-1833. ; 347
Journal article (peer-reviewed) abstract
Objective To determine the association between self reported job insecurity and incident coronary heart disease.Design A meta-analysis combining individual level data from a collaborative consortium and published studies identified by a systematic review.Data sources We obtained individual level data from 13 cohort studies participating in the Individual-Participant-Data Meta-analysis in Working Populations Consortium. Four published prospective cohort studies were identified by searches of Medline (to August 2012) and Embase databases (to October 2012), supplemented by manual searches.Review methods Prospective cohort studies that reported risk estimates for clinically verified incident coronary heart disease by the level of self reported job insecurity. Two independent reviewers extracted published data. Summary estimates of association were obtained using random effects models.Results The literature search yielded four cohort studies. Together with 13 cohort studies with individual participant data, the meta-analysis comprised up to 174 438 participants with a mean follow-up of 9.7 years and 1892 incident cases of coronary heart disease. Age adjusted relative risk of high versus low job insecurity was 1.32 (95% confidence interval 1.09 to 1.59). The relative risk of job insecurity adjusted for sociodemographic and risk factors was 1.19 (1.00 to 1.42). There was no evidence of significant differences in this association by sex, age (<50 v >= 50 years), national unemployment rate, welfare regime, or job insecurity measure.Conclusions The modest association between perceived job insecurity and incident coronary heart disease is partly attributable to poorer socioeconomic circumstances and less favourable risk factor profiles among people with job insecurity.
