| 1. |
- Magnusson Hanson, Linda L., et al.
(författare)
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Job strain and loss of healthy life years between ages 50 and 75 by sex and occupational position : analyses of 64 934 individuals from four prospective cohort studies
- 2018
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Ingår i: Occupational and Environmental Medicine. - : BMJ. - 1351-0711 .- 1470-7926. ; 75:7, s. 486-493
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Tidskriftsartikel (refereegranskat)abstract
- Objectives Poor psychosocial working conditions increase the likelihood of various types of morbidity and may substantially limit quality of life and possibilities to remain in paid work. To date, however, no studies to our knowledge have quantified the extent to which poor psychosocial working conditions reduce healthy or chronic disease-free life expectancy, which was the focus of this study.Methods Data were derived from four cohorts with repeat data: the Finnish Public Sector Study (Finland), GAZEL (France), the Swedish Longitudinal Occupational Survey of Health (Sweden) and Whitehall II (UK). Healthy (in good self-rated health) life expectancy (HLE) and chronic disease-free (free from cardiovascular disease, cancer, respiratory disease and diabetes) life expectancy (CDFLE) was calculated from age 50 to 75 based on 64394 individuals with data on job strain (high demands in combination with low control) at baseline and health at baseline and follow-up.Results Multistate life table models showed that job strain was consistently related to shorter HLE (overall 1.7 years difference). The difference in HLE was more pronounced among men (2.0 years compared with 1.5 years for women) and participants in lower occupational positions (2.5 years among low-grade men compared with 1.7 years among high-grade men). Similar differences in HLE, although smaller, were observed among those in intermediate or high occupational positions. Job strain was additionally associated with shorter CDFLE, although this association was weaker and somewhat inconsistent.Conclusions These findings suggest that individuals with job strain have a shorter health expectancy compared with those without job strain.
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| 2. |
- 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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| 3. |
- 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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