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- Heikkila, Katriina, et al.
(author)
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Job strain and the risk of inflammatory bowel diseases : individual-participant meta-analysis of 95 000 men and women
- 2014
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In: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 9:2, s. e88711-
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Journal article (peer-reviewed)abstract
- Background and Aims: Many clinicians, patients and patient advocacy groups believe stress to have a causal role in inflammatory bowel diseases, such as Crohn's disease and ulcerative colitis. However, this is not corroborated by clear epidemiological research evidence. We investigated the association between work-related stress and incident Crohn's disease and ulcerative colitis using individual-level data from 95 000 European adults. Methods: We conducted individual-participant data meta-analyses in a set of pooled data from 11 prospective European studies. All studies are a part of the IPD-Work Consortium. Work-related psychosocial stress was operationalised as job strain (a combination of high demands and low control at work) and was self-reported at baseline. Crohn's disease and ulcerative colitis were ascertained from national hospitalisation and drug reimbursement registers. The associations between job strain and inflammatory bowel disease outcomes were modelled using Cox proportional hazards regression. The study-specific results were combined in random effects meta-analyses. Results: Of the 95 379 participants who were free of inflammatory bowel disease at baseline, 111 men and women developed Crohn's disease and 414 developed ulcerative colitis during follow-up. Job strain at baseline was not associated with incident Crohn's disease (multivariable-adjusted random effects hazard ratio: 0.83, 95% confidence interval: 0.48, 1.43) or ulcerative colitis (hazard ratio: 1.06, 95% CI: 0.76, 1.48). There was negligible heterogeneity among the study-specific associations. Conclusions: Our findings suggest that job strain, an indicator of work-related stress, is not a major risk factor for Crohn's disease or ulcerative colitis.
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- Heikkilä, Katriina, et al.
(author)
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Job Strain as a Risk Factor for Peripheral Artery Disease : A Multi-Cohort Study
- 2020
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In: Journal of the American Heart Association. - : Wiley-Blackwell. - 2047-9980 .- 2047-9980. ; 9:9
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Journal article (peer-reviewed)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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- Theorell, Töres, et al.
(author)
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Job strain and cardiovascular disease risk factors : Meta-analysis of individual-participant data from 47,000 men and women
- 2013
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In: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 8:6, s. e67323-
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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.
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- Grynderup, Matias Brødsgaard, et al.
(author)
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The associations between workplace bullying, salivary cortisol, and long-term sickness absence : a longitudinal study
- 2017
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In: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 17:1, s. 1-11
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Journal article (peer-reviewed)abstract
- BACKGROUND: Workplace stressors, such as bullying, are strongly related to subsequent long-term sickness absence, but little is known of the possible physiological mechanisms linking workplace stressors and sickness absence. The primary aim of this study was to investigate to what extent cortisol levels were associated with subsequent sickness absence and if cortisol mediated the association between workplace bullying and sickness absence. We additionally investigated possible bidirectional associations between bullying, cortisol, and long-term sickness absence.METHODS: Participants came from two Danish cohort studies, the "Psychosocial RIsk factors for Stress and MEntal disease" (PRISME) cohort and the "Workplace Bullying and Harassment" (WBH) cohort (n = 5418). Information about exposure to workplace bullying and morning and evening salivary cortisol was collected at three time points with approximately two years in between. After each data collection, all participants were followed for two years in registers, and cases with long-term sickness absence lasting 30 or more consecutive days were identified. The association between cortisol levels and subsequent sickness absence was assessed by logistic regression, while the extent to which the association between bullying and sickness absence was mediated by cortisol was quantified through natural direct and indirect effects.RESULTS: High evening cortisol was associated with a decreased risk of sickness absence (OR = 0.82, 95% CI = 0.68-0.99), but we did not find that high morning cortisol levels (OR = 0.98, 95% CI = 0.81-1.18) or high morning-to-evening slope (OR = 0.99, 95% CI = 0.82-1.18) were associated with subsequent sickness absence. We also tested for reverse causation and found that long-term sickness absence, but not salivary cortisol, was a strong risk factor for subsequent workplace bullying. There was no indication that cortisol mediated the association between workplace bullying and sickness absence.CONCLUSION: We found no straightforward and simple association between cortisol and long-term sickness absence. Furthermore, the association between workplace bullying and long-term sickness absence was not mediated by cortisol.
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- Hansen, Åse Marie, et al.
(author)
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A cohort study on self-reported role stressors at work and poor sleep - does sense of coherence moderate or mediate the associations? : does sense of coherence moderate or mediate the associations?
- 2018
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In: International Archives of Occupational and Environmental Health. - : Springer Science and Business Media LLC. - 1432-1246 .- 0340-0131. ; 91:4, s. 445-456
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Journal article (peer-reviewed)abstract
- AIM: The aim of the present study was to examine the bidirectional associations between subjective role ambiguity and role conflicts at work, respectively, and self-reported sleep 2 years later. In addition, we also examine whether sense of coherence (SOC) moderate or mediate the association between role stressors and poor sleep and between poor sleep and role stressors.METHODS: We used questionnaire data collected in 2006 and 2008 from the Workplace Bullying and Harassment cohort. In 2006, 3363 responded to the questionnaire and in 2008 1671 responded. In total, 1569 participants responded in both 2006 and 2008 to the questions on role stressors (in terms of role ambiguity and role conflicts at work) and sleep problems in both 2006 and 2008. Sleep problems were assessed with the awakening index (AWI) and the disturbed sleep index (DSI). Moderation and mediation analyses of the association were estimated using structural equation modelling.RESULTS: We found a prospective association between role stressors and sleep problems [beta values were 0.07 (95% CI 0.03-0.11) and 0.05 (CI 0.01-0.10) for DSI and AWI, respectively] when adjusting for sleep problems at baseline, age, sex, and life style factors (i.e. alcohol, smoking, and leisure time physical activity). SOC moderated the association showing that participants with lower SOC scores who reported higher role ambiguity reported sleep problems to a higher extent than participants with high SOC scores. SOC also mediated the association between role stressors and sleep problems. We also found support for sleep problems at baseline and role stressors 2 years later [DSI 0.04 (CI 0.00-0.08) and 0.15 (CI 0.09-0.21)] for role ambiguity and role conflicts, respectively. Similar results were observed for AWI.CONCLUSION: Subjective role stressors were prospectively associated with sleep problems. Yet, sleep problems could also prospectively predict subjective role stressors (i.e. reverse causation). The analyses also showed that SOC may be regarded as both a mediating and a moderating factor of the association between subjective role conflicts and poor sleep. We found that SOC moderated the prospective association so participants with low SOC report more sleep problems with subjective role conflicts compared to participants with high SOC. Finally, we also found SOC mediated the prospective association between subjective role stressors and sleep problems and the reverse association.
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- Virtanen, Marianna, et al.
(author)
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Perceived job insecurity as a risk factor for incident coronary heart disease : systematic review and meta-analysis
- 2013
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In: The BMJ. - : BMJ. - 1756-1833. ; 347
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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.
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- Conway, Paul Maurice, et al.
(author)
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Optimal Cut-Off Points for the Short-Negative Act Questionnaire and Their Association with Depressive Symptoms and Diagnosis of Depression
- 2018
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In: Annals of Work Exposures and Health. - : Oxford University Press (OUP). - 2398-7308 .- 2398-7316. ; 62:3, s. 281-294
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Journal article (peer-reviewed)abstract
- Objectives: The behavioural experience method has been extensively used in the literature for the measurement of potential bullying behaviours at work. However, this approach presents limitations when used to classify respondents as targets or non-targets of workplace bullying. Therefore, the present study aimed to: (i) identify optimal cut-off points, reflecting a possible subjectively experienced exposure to occasional and frequent workplace bullying, for the 9-item Short Negative Act Questionnaire (S-NAQ), and (ii) examine the criterion validity of these cut-off points in relation to depressive symptoms and diagnosis of depression.Methods: The study was based on a sample of 4882 participants from the Danish MODENA cohort study (year 2011), which included both the S-NAQ (score range 9-45) and a one-item measure applying the self-labelling method with a definition to assess occasional and frequent workplace bullying. We employed receiver operating characteristic (ROC) curve analyses to derive the cut-off points for the S-NAQ. Based on these cut-off points, we created a new S-NAQ variable with three levels of exposure (i.e. 'not exposed', 'first threshold', and 'second threshold') and tested its criterion validity in relation to depressive symptoms (N = 4071) and diagnosis of depression (N = 4844).Results: The S-NAQ cut-off points obtained were ≥12 and ≥16 when using occasional and frequent bullying as reference standards, respectively. Both cut-off points showed high classification accuracy (area under the curve = 0.89 and 0.93) as well as good sensitivity (84.8% and 88.0%) and specificity (77.4% and 94.7%). In the adjusted linear regression analyses, both the first (B = 0.78, 95% confidence interval [CI] = 0.66-0.90) and the second threshold of exposure (B = 1.65, 95% CI = 1.44-1.86) were significantly associated with depressive symptoms. In the adjusted logistic regression analyses, both the first (odds ratio [OR] = 3.55, 95% CI = 1.98-6.38) and the second threshold of exposure (OR = 5.90, 95% CI = 2.93-11.88) were significantly associated with diagnosis of depression.Conclusions: The two cut-off points for the S-NAQ identified in this study showed a significant association with both depressive symptoms and diagnosis of depression. However, future prospective studies are needed to establish the predictive validity of the proposed cut-off points.
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