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  • 1.
    Hermansson, Jonas
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Gillander Gådin, Katja
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Karlsson, Berndt
    Umeå Universitet.
    Lindahl, Bernt
    Umeå Universitet.
    Stegmayr, Birgitta
    Umeå Universitet.
    Knutsson, Anders
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Ischemic stroke and shift work2007In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 33, no 6, p. 435-439Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: This study analyzed the potential association between shift work and ischemic stroke. METHODS: The analysis was carried out using a nested case-control study consisting of 138 shift workers and 469 day workers from the register of the Northern Sweden Monitoring of Trends and Determinants in Cardiovascular Diseases (MONICA) study and the Vasterbotten Intervention Programme. Logistic regression analysis was used to analyze the risk estimate for day workers in a comparison with shift workers and the risk of ischemic stroke. RESULTS: The crude odds ratio for shift workers' risk of experiencing an ischemic stroke was 1.0 (95% confidence interval 0.6-1.8) for both the men and the women. The risk estimates were consistent despite the introduction of several recognized risk factors for ischemic stroke in the logistic regression models. CONCLUSIONS: In the present study, none of the findings indicated a higher risk of shift workers undergoing an ischemic stroke than day workers.

  • 2.
    Knutsson, Anders
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Mortality of shift workers2017In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 43, no 2, p. 97-98Article in journal (Refereed)
  • 3.
    Knutsson, Anders
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Alfredsson, L
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Karlsson, B
    Clinic of Occupational and Environmental Medicine, Norrlands University Hospital, Umeå, Sweden.
    Åkerstedt, T
    Stress Research Institute, Stockholm University, Stockholm, Sweden.
    Fransson, E
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Westerholm, P
    Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden.
    Westerlund, H
    Stress Research Institute, Stockholm University, Stockholm, Sweden.
    Breast cancer among shift workers: results of the WOLF longitudinal cohort study2013In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 39, no 2, p. 170-177Article in journal (Refereed)
    Abstract [en]

    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.

  • 4.
    Knutsson, Anders
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Böggild, H
    Gastrointestinal disorders among shift workers2010In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 36, no 2, p. 85-95Article, review/survey (Refereed)
    Abstract [en]

    Objective Our aim was to review published literature on the association between shift work and gastrointestinal (GI) disorders.

    Methods A systematic review of the literature was conducted of studies that have reported GI symptoms and diseases among shift workers. We used Medline to search for articles from 1966-2009. Next, we manually searched articles in the reference list of each article and previous reviews.

    Results Twenty studies met the inclusion criteria. Four of six studies showed a significant association between shift work and GI symptoms, and five of six studies reported an association between shift work and peptic ulcer disease. Two of three studies showed an association between shift work and functional GI disease. Only a few studies have examined gastroesophageal reflux disease, chronic inflammatory bowel diseases, or GI cancers in relation to shift work.

    Conclusions Our general judgment is that shift workers appear to have increased risk of GI symptoms and peptic ulcer disease. However, control for potential confounders (eg, smoking, age, socioeconomic status, and other risk factors) was often lacking or insufficient in many of the studies we examined.

  • 5.
    Virtanen, Marianna
    et al.
    Finnish Inst Occupat Hlth, Helsinki, Finland; Uppsala Univ, Dept Publ Hlth & Caring Sci, Uppsala.
    Jokela, Markus
    Univ Helsinki, Inst Behav Sci, Helsinki, Finland.
    Madsen, Ida E. H.
    Natl Res Ctr Working Environm, Copenhagen, Denmark.
    Hanson, Linda L. Magnusson
    Stockholm Univ, Stress Res Inst, Stockholm.
    Lallukka, Tea
    Finnish Inst Occupat Hlth, Helsinki, Finland; Univ Helsinki, Dept Publ Hlth, Helsinki, Finland.
    Nyberg, Solja T.
    Univ Helsinki, Dept Publ Hlth, Helsinki, Finland.
    Alfredsson, Lars
    Karolinska Inst, Inst Environm Med, Stockholm; Stockholm Cty Council, Ctr Occupat & Environm Med, Stockholm.
    Batty, G. David
    UCL, Dept Epidemiol & Publ Hlth, London, England.
    Bjorner, Jakob B.
    Natl Res Ctr Working Environm, Copenhagen, Denmark.
    Borritz, Marianne
    Koge Hosp, Dept Occupat Med, Koge, Denmark.
    Burr, Hermann
    Fed Inst Occupat Safety & Hlth BAuA, Berlin, Germany.
    Dragano, Nico
    Univ Dusseldorf, Med Fac, Inst Med Sociol, Dusseldorf, Germany.
    Erbel, Raimund
    Univ Duisburg Essen, Dept Cardiol, West German Heart Ctr Essen, Essen, Germany.
    Ferrie, Jane E.
    UCL, Dept Epidemiol & Publ Hlth, London, England; Univ Bristol, Sch Social & Community Med, Bristol, Avon, England.
    Heikkila, Katriina
    London Sch Hyg & Trop Med, Dept Hlth Serv & Policy, London, England.
    Knutsson, Anders
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Koskenvuo, Markku
    Univ Helsinki, Dept Publ Hlth, Helsinki, Finland.
    Lahelma, Eero
    Univ Helsinki, Dept Publ Hlth, Helsinki, Finland.
    Nielsen, Martin L.
    Frederiksberg Univ Hosp, Unit Social Med, Copenhagen, Denmark.
    Oksanen, Tuula
    Finnish Inst Occupat Hlth, Helsinki, Finland.
    Pejtersen, Jan H.
    Danish Natl Ctr Social Res, Copenhagen, Denmark.
    Pentti, Jaana
    Univ Helsinki, Dept Publ Hlth, Helsinki, Finland.
    Rahkonen, Ossi
    Univ Helsinki, Dept Publ Hlth, Helsinki, Finland.
    Rugulies, Reiner
    Univ Copenhagen, Dept Publ Hlth, Copenhagen, Denmark; Univ Copenhagen, Dept Psychol, Copenhagen, Denmark.
    Salo, Paula
    Finnish Inst Occupat Hlth, Helsinki, Finland; Univ Turku, Dept Psychol, Turku, Finland.
    Schupp, Jurgen
    German Inst Econ Res, Berlin, Germany; Free Univ Berlin, Berlin, Germany.
    Shipley, Martin J.
    UCL, Dept Epidemiol & Publ Hlth, London, England.
    Siegrist, Johannes
    Singh-Manoux, Archana
    UCL, Dept Epidemiol & Publ Hlth, London, England; INSERM, Ctr Res Epidemiol & Populat Hlth, Villejuif, France.
    Suominen, Sakari B.
    Univ Turku, Dept Publ Hlth, Turku, Finland; Univ Skövde, Skövde; Folkhälsan Res Ctr, Helsinki, Finland.
    Theorell, Tores
    Stockholm Univ, Stress Res Inst, Stockholm.
    Vahtera, Jussi
    Univ Turku, Dept Publ Hlth, Turku, Finland; Turku Univ Hosp, Turku, Finland.
    Wagner, Gert G.
    German Inst Econ Res, Berlin, Germany; Max Planck Inst Human Dev, Berlin, Germany; Berlin Univ Technol, Berlin, Germany.
    Wang, Jian Li
    Univ Ottawa, Sch Epidemiol Publ Hlth & Prevent Med, Inst Mental Hlth Res, Ottawa, ON, Canada.
    Yiengprugsawan, Vasoontara
    Australian Natl Univ, Ctr Res Ageing Hlth & Wellbeing, Canberra, ACT, Australia; Australian Natl Univ, ARC Ctr Excellence Populat Ageing Res, Canberra, ACT, Australia.
    Westerlund, Hugo
    Stockholm Univ, Stress Res Inst, Stockholm.
    Kivimaki, Mika
    Finnish Inst Occupat Hlth, Helsinki, Finland; Univ Helsinki, Dept Publ Hlth, Helsinki, Finland; UCL, Dept Epidemiol & Publ Hlth, London, England.
    Long working hours and depressive symptoms: systematic review and meta-analysis of published studies and unpublished individual participant data2018In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 44, no 3, p. 239-250Article, review/survey (Refereed)
    Abstract [en]

    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 strong 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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