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  • 1.
    du Prel, Jean-Baptist
    et al.
    Ulm Univ, Ulm, Germany; Univ Wuppertal, Wuppertal, Germany.
    Runeson-Broberg, Roma
    Uppsala Univ Hosp, Uppsala.
    Westerholm, Peter
    Uppsala Univ Hosp, Uppsala.
    Alfredsson, Lars
    Karolinska Inst, Stockholm; Stockholm City Council, Stockholm.
    Fahlen, Goran
    Natl Agcy Special Needs Educ & Sch, Härnösand.
    Knutsson, Anders
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för hälsovetenskap.
    Nordin, Maria
    Umeå Univ, Umeå; Stockholm Univ, Stockholm.
    Peter, Richard
    Ulm Univ, Ulm, Germany.
    Work overcommitment: Is it a trait or a state?2018Ingår i: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 91, nr 1, s. 1-11Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Effort-reward imbalance (ERI) is a well-tested work-related stress model with three components, the two extrinsic components "efforts" and "rewards" and the one intrinsic component "overcommitment". While an imbalance between "efforts" and "rewards" leads to strain reactions, "work-related overcommitment" (OC) has been described as a personal characteristic with a set of attitudes, behaviours, and emotions reflecting excessive striving combined with a strong desire for approval. However, the question whether OC is a personality trait or a response pattern sensitive to changes in the work context (state) is still open. 2940 Swedish industrial employees were included in this longitudinal analysis of the WOLF-Norrland data over 5 years. A change of OC index or its subscales were regressed against a change of freedom of choice at work, extra work, and ERI adjusted for age, sex, and education. While OC was insensitive to changes in freedom of choice at work and extra work, it was clearly associated with changes of work-related stress over time. Three of four OC subscales exhibited statistically significant associations with ERI. For the first time, we studied fundamental characteristics of OC as an independent personality variable (trait) or an outcome variable subject to changes in the work environment (state). The association between external ERI and OC over time supports our hypothesis of OC being a state. Further investigations are needed to establish OC as a trait or a state.

  • 2.
    Fahlén, Göran
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Goine, Hans
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Edlund, Curt
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Arrelöv, Britt
    Knutsson, Anders
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Peter, Richard
    Effort-reward imbalance, "locked in" at work and long term sick leave2009Ingår i: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 82, nr 2, s. 191-197Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: The objective was to study the relationship between a situation characterized as being in a "locked-in" position (LIP) in occupation and/or place of work, Effort-reward imbalance (ERI), and long-term sick leave. METHODS: The study population derived from one section of a cross-sectional study SKA (sick-leave, culture and attitudes), and comprised all employees at the Swedish Social Insurance Agency responsible for management and compensation of illness in the working population. The analyses were performed for 2,951 women and 534 men who had complete data. Logistic regression was used to calculate odds ratio (OR) for ERI and sick-leave, the latter only for women. RESULTS: The results showed a strong association between LIP within the place of work and ERI (for women OR = 3.28 95% CI 2.65-4.07, and for men 2.74 1.75-4.30). Also LIP within occupation resulted in high ERI (for women OR = 1.96 1.57-2.41, and for men 1.92 1.22-3.03). In women, ERI (OR = 1.40 1.15-1.70) as well as LIP within place of work (1.88 1.50-2.36) and within occupation (1.48 1.12-1.86) were associated with sick leave. ERI showed a significant mediating effect between LIP and sick leave, within place of work and within occupation (Z value 2.20 and 2.88, respectively). CONCLUSIONS: High ERI is associated with a situation characterized by being locked-in within an occupation or/and within a place of work. The results thereby support the theoretical model of Effort-reward imbalance. The results show that high ERI and being locked in are associated with long-term sick leave. ERI is a potential mediator of the association between being locked in and sick leave.

  • 3.
    Fahlén, Göran
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Knutsson, Anders
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Peter, Richard
    University of Ulm, Germany.
    Åkerstedt, Torbjörn
    Karolinska Institutet, Stockholm.
    Nordin, Maria
    University of Umeå, Umeå.
    Alfredsson, Lars
    Karolinska Institutet, Stockholm; Stockholm County Council, Stockholm.
    Westerholm, Peter
    National Institute for Working Life, Stockholm.
    Effort-reward imbalance, sleep disturbances and fatigue2006Ingår i: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 79, nr 5, s. 371-378Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives: The objective of this study was to investigate the validity of the effort-reward imbalance (ERI) model in relation to disturbed sleep and fatigue. Methods: The study population derived from a subset of the WOLF (WOrk, Lipids, Fibrinogen) cohort study of cardiovascular risk in a working population who replied to the ERI-questionnaire comprising 789 men and 214 women. Cox regression analysis was used to calculate the prevalence ratio (PR) for sleep disorders and fatigue in relation to the components of ERI. Results: As sleep disturbances and fatigue, based on literature, were defined to be represented by the uppermost quintile, 14% of the men and 23% of the women were affected by sleep disturbances while 14 and 26%, respectively, were affected by fatigue. Higher levels of exposure for the ERI components were associated with increased prevalence of sleep disturbances and fatigue. For men, the strongest association was seen between high overcommitment and fatigue (PR 5.77, 95% confidence interval 2.89-11.5). For women, high effort and sleep disturbances (PR 4.04, CI 1.53-10.7), high effort/reward ratio and sleep disturbances (PR 4.13, CI 1.62-10.5), and between low reward and fatigue (PR 4.36, CI 1.79-10.6) yielded the most obvious associations. Conclusions: The present study adds sleep disturbances and fatigue to the list of adverse consequences of effort-reward imbalance.

  • 4.
    Hermansson, Jonas
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för hälsovetenskap.
    Gillander Gådin, Katja
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för hälsovetenskap.
    Karlsson, B.
    Department of Public Health and Clinical Medicine, Occupational Medicine, University of Umeå, Umeå, Sweden .
    Reuterwall, C.
    Department of Public Health and Clinical Medicine, Occupational Medicine, University of Umeå, Umeå, Sweden .
    Hallqvist, J.
    Department of Public Health and Caring Sciences, Preventive Medicine, Uppsala University, Box 564, Uppsala, Sweden.
    Knutsson, Anders
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för hälsovetenskap.
    Case fatality of myocardial infarction among shift workers2015Ingår i: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 88, nr 5, s. 599-605Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: Shift work has been associated with an excess risk of cardiovascular disease (CVD) and more specifically myocardial infarction (MI). The majority of the studies that found a positive association between shift work and CVD have been based on incidence data. The results from studies on cardiovascular-related mortality among shift workers have shown little or no elevated mortality associated with shift work. None of the previous studies have analysed short-term mortality (case fatality) after MI. Therefore, we investigated whether shift work is associated with increased case fatality after MI compared with day workers.Methods: Data on incident cases with first MI were obtained from case–control study conducted in two geographical sites in Sweden (Stockholm Heart Epidemiology Program and Västernorrland Heart Epidemiology Program), including 1,542 cases (1,147 men and 395 women) of MI with complete working time information and 65 years or younger. Case fatality was defined as death within 28 days of onset of MI. Risk estimates were calculated using logistic regression.Results: The crude odds ratios for case fatality among male shift workers were 1.63 [95 % confidence interval (CI) 1.12, 2.38] and 0.56 (95 % CI 0.26, 1.18) for female shift workers compared with day workers. Adjustments for established cardiovascular risk factors such as diabetes type II and socio-economic status did not alter the results.Conclusion: Shift work was associated with increased risk of case fatality among male shift workers after the first MI.

  • 5.
    Siegrist, Johannes
    et al.
    Department of Medical Sociology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany.
    Dragano, Nico
    Department of Medical Sociology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany.
    Nyberg, Solja T.
    Finnish Institute of Occupational Health, Helsinki, Finland .
    Lunau, Thorsten
    Department of Medical Sociology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany.
    Alfredsson, Lars
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden .
    Erbel, Raimund
    Department of Cardiology, West-German Heart Center Essen, University Duisburg-Essen, Essen, Germany .
    Fahlén, Goran
    National Agency for Special Needs Education and Schools, Härnösand, Sweden .
    Goldberg, Marcel
    Versailles-Saint Quentin University, Versailles, France .
    Joeckel, Karl-Heinz
    Institute for Medical Informatics Biometry and Epidemiology, University Duisburg-Essen, Essen, Germany .
    Knutsson, Anders
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för hälsovetenskap.
    Leineweber, Constanze
    Stress Research Institute, Stockholm University, Stockholm, Sweden.
    Magnusson Hanson, Linda L.
    Stress Research Institute, Stockholm University, Stockholm, Sweden.
    Nordin, Maria
    Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden .
    Rugulies, Reiner
    National Research Centre for the Working Environment, Copenhagen, Denmark .
    Schupp, Jurgen
    German Institute for Economic Research, Berlin, Germany .
    Singh-Manoux, Archana
    Inserm U1018, Centre for Research in Epidemiology and Population Health, Villejuif, France .
    Theorell, Tores
    Stress Research Institute, Stockholm University, Stockholm, Sweden.
    Wagner, Gert G.
    German Institute for Economic Research, Berlin, Germany .
    Westerlund, Hugo
    Stress Research Institute, Stockholm University, Stockholm, Sweden.
    Zins, Marie
    Versailles-Saint Quentin University, Versailles, France .
    Heikkilä, Katriina
    Finnish Institute of Occupational Health, Helsinki, Finland .
    Fransson, Eleonor I.
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden .
    Kivimäki, Mika
    Finnish Institute of Occupational Health, Helsinki, Finland .
    Validating abbreviated measures of effort-reward imbalance at work in European cohort studies: the IPD-Work consortium2014Ingår i: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 87, nr 3, s. 249-256Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Effort-reward imbalance (ERI) is an established conceptualisation of work stress. Although a validated effort-reward questionnaire is available for public use, many epidemiological studies adopt shortened scales and proxy measures. To examine the agreement between different abbreviated measures and the original instrument, we compared different versions of the effort-reward scales available in 15 European cohort studies participating in the IPD-Work (Individual-participant-data meta-analysis in working populations) consortium. Five of the 15 studies provide information on the original ('complete') scales measuring 'effort' and 'reward', whereas the 10 remaining studies used 'partial' scales. To compare different versions of the ERI scales, we analyse individual-level data from 31,790 participants from the five studies with complete scales. Pearson's correlation between partial and complete scales was very high in case of 'effort' (where 2 out of 3 items were used) and very high or high in case of 'reward', if at least 4 items (out of 7) were included. Reward scales composed of 3 items revealed good to satisfactory agreement, and in one case, a reward scale consisting of 2 items only demonstrated a modest, but still acceptable degree of agreement. Sensitivity and specificity of a composite measure, the ratio of effort and reward, comparing partial versus complete scales ranged between 59-93 and 85-99 %, respectively. Complete and partial scales were strongly associated with poor self-rated health. Our results support the notion that short proxy measures or partial versions of the original scales can be used to assess effort-reward imbalance.

  • 6.
    Sjödin, Fredrik
    et al.
    Univ Gavle, Ctr Built Environm, S-80176 Gavle, Sweden.
    Kjellberg, Anders
    Center for Built Environment, University of Gävle, 80176 Gävle, Sweden .
    Knutsson, Anders
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för hälsovetenskap.
    Landström, Ulf
    Univ Gavle, Ctr Built Environm, S-80176 Gavle, Sweden.
    Lindberg, Lennart
    Univ Gavle, Ctr Built Environm, S-80176 Gavle, Sweden.
    Measures against preschool noise and its adverse effects on the personnel: an intervention study2014Ingår i: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 87, nr 1, s. 95-110Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of the study was to analyze the exposure effects of different types of noise measures carried out at preschools. The project was carried out as an intervention study. The investigation included 89 employees at 17 preschools in the northern part of Sweden. Individual noise recordings and recordings in dining rooms and play halls were made at two departments in each preschool. The adverse effects on the employees were analyzed with validated questionnaires and saliva cortisol samples. Evaluations were made before and 1 year after the first measurement. Between the two measurements, measures were taken to improve the sound environments at the preschools. The effects of the measures varied a lot, with respect to both the sound environments and health. Regarding acoustical measures, significant changes were seen for some of the variables analyzed. For most of the tested effects, the changes, however, were very small and non-significant. The effects of organizational measures on the objective and subjective noise values were in overall less pronounced. Acoustical measures improved the subjectively rated sound environment more than organizational measures. This may be due to the high work effort needed to implement organizational measures. Even though the sound level was not lower, the personnel experienced improvements of the sound environment.

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