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  • 1.
    Dragano, Nico
    et al.
    Univ Dusseldorf, Dusseldorf, Germany.
    Siegrist, Johannes
    Univ Dusseldorf, Dusseldorf, Germany.
    Nyberg, Solja T.
    Univ Helsinki, Helsinki, Finland.
    Lunau, Thorsten
    Univ Dusseldorf, Dusseldorf, Germany.
    Fransson, Eleonor I.
    Karolinska Inst, Stockholm; Jönköping Univ, Jönköping; Stockholm Univ, Stockholm.
    Alfredsson, Lars
    Karolinska Inst, Stockholm; Stockholm City Council, Stockholm.
    Bjorner, Jakob B.
    Natl Res Ctr Working Environm, Copenhagen, Denmark.
    Borritz, Marianne
    Frederiksberg Univ Hosp, Copenhagen, Denmark.
    Burr, Hermann
    Fed Inst Occupat Safety & Hlth BAuA, Berlin, Germany.
    Erbel, Raimund
    Univ Duisburg Essen, Essen, Germany.
    Fahlen, Goran
    Natl Agcy Special Needs Educ & Sch, Härnösand.
    Goldberg, Marcel
    Paris Descartes Univ, Paris, France.
    Hamer, Mark
    UCL, London, England; Univ Loughborough, Loughborough, Leics, England.
    Heikkila, Katriina
    London Sch Hyg & Trop Med, London, England; Royal Coll Surgeons England, London, England.
    Joeckel, Karl-Heinz
    Univ Duisburg Essen, Essen, Germany.
    Knutsson, Anders
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för hälsovetenskap.
    Madsen, Ida E. H.
    Natl Res Ctr Working Environm, Copenhagen, Denmark.
    Nielsen, Martin L.
    AS3 Co, AS3 Employment, Viby J, Denmark.
    Nordin, Maria
    Stockholm Univ, Stockholm; Umeå Univ, Umeå.
    Oksanen, Tuula
    Finnish Inst Occupat Hlth, Helsinki, Finland; Finnish Inst Occupat Hlth, Tampere, Finland; Finnish Inst Occupat Hlth, Turku, Finland.
    Pejtersen, Jan H.
    Danish Natl Ctr Social Res, Copenhagen, Denmark.
    Pentti, Jaana
    Finnish Inst Occupat Hlth, Helsinki, Finland; Finnish Inst Occupat Hlth, Tampere, Finland; Finnish Inst Occupat Hlth, Turku, Finland.
    Rugulies, Reiner
    Natl Res Ctr Working Environm, Copenhagen, Denmark; Univ Copenhagen, Dept Publ Hlth, Copenhagen, Denmark; Univ Copenhagen, Dept Psychol, Copenhagen, Denmark.
    Salo, Paula
    Finnish Inst Occupat Hlth, Helsinki, Finland; Finnish Inst Occupat Hlth, Tampere, Finland; Finnish Inst Occupat Hlth, Turku, Finland; Univ Turku, Dept Psychol, Turku, Finland.
    Schupp, Juergen
    German Inst Econ Res, Berlin, Germany.
    Singh-Manoux, Archana
    UCL, Dept Epidemiol & Publ Hlth, London, England.
    Steptoe, Andrew
    UCL, Dept Epidemiol & Publ Hlth, London, England.
    Theorell, Tores
    Stockholm Univ, Stockholm, Sweden.
    Vahtera, Jussi
    Univ Turku, Turku, Finland; Turku Univ Hosp, Turku, Finland.
    Westerholm, Peter J. M.
    Uppsala Univ, Uppsala.
    Westerlund, Hugo
    Stockholm Univ, Stockholm, Sweden.
    Virtanen, Marianna
    Finnish Inst Occupat Hlth, Helsinki, Finland; Finnish Inst Occupat Hlth, Tampere, Finland; Finnish Inst Occupat Hlth, Turku, Finland.
    Zins, Marie
    Paris Descartes Univ, Paris, France; Univ Paris Saclay, Paris, France.
    Batty, G. David
    UCL, Dept Epidemiol & Publ Hlth, London , England.
    Kivimäki, Mika
    Univ Helsinki, Fac Med, Helsinki, Finland; UCL, London, England; Finnish Inst Occupat Hlth, Helsinki, Finland; Finnish Inst Occupat Hlth, Tampere, Finland; Finnish Inst Occupat Hlth, Turku, Finland.
    Effort-Reward Imbalance at Work and Incident Coronary Heart Disease A Multicohort Study of 90,164 Individuals2017Inngår i: Epidemiology, ISSN 1044-3983, E-ISSN 1531-5487, Vol. 28, nr 4, s. 619-626Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Epidemiologic evidence for work stress as a risk factor for coronary heart disease is mostly based on a single measure of stressful work known as job strain, a combination of high demands and low job control. We examined whether a complementary stress measure that assesses an imbalance between efforts spent at work and rewards received predicted coronary heart disease.

    Methods: This multicohort study (the "IPD-Work" consortium) was based on harmonized individual-level data from 11 European prospective cohort studies. Stressful work in 90,164 men and women without coronary heart disease at baseline was assessed by validated effort-reward imbalance and job strain questionnaires. We defined incident coronary heart disease as the first nonfatal myocardial infarction or coronary death. Study-specific estimates were pooled by random effects meta-analysis.

    Results: At baseline, 31.7% of study members reported effort-reward imbalance at work and 15.9% reported job strain. During a mean follow-up of 9.8 years, 1,078 coronary events were recorded. After adjustment for potential confounders, a hazard ratio of 1.16 (95% confidence interval, 1.00-1.35) was observed for effort-reward imbalance compared with no imbalance. The hazard ratio was 1.16 (1.01-1.34) for having either effort-reward imbalance or job strain and 1.41 (1.12-1.76) for having both these stressors compared to having neither effort-reward imbalance nor job strain.

    Conclusions: Individuals with effort-reward imbalance at work have an increased risk of coronary heart disease, and this appears to be independent of job strain experienced. These findings support expanding focus beyond just job strain in future research on work stress.

  • 2.
    Fransson, Eleonor I.
    et al.
    Jonkoping Univ, Sch Hlth Sci, S-55111 Jonkoping, Sweden.;Karolinska Inst, Inst Environm Med, S-17177 Stockholm, Sweden..
    Stadin, Magdalena
    Jonkoping Univ, Sch Hlth Sci, S-55111 Jonkoping, Sweden..
    Nordin, Maria
    Umea Univ, Dept Psychol, S-90187 Umea, Sweden.;Stockholm Univ, Stress Res Inst, S-10691 Stockholm, Sweden..
    Malm, Dan
    Jonkoping Univ, Sch Hlth Sci, S-55111 Jonkoping, Sweden.;Cty Hosp Ryhov, Dept Internal Med, S-55185 Jonkoping, Sweden..
    Knutsson, Anders
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för hälsovetenskap.
    Alfredsson, Lars
    Karolinska Inst, Inst Environm Med, S-17177 Stockholm, Sweden..
    Westerholm, Peter J. M.
    Uppsala Univ, Occupat & Environm Med, S-75185 Uppsala, Sweden..
    The Association between Job Strain and Atrial Fibrillation: Results from the Swedish WOLF Study2015Inngår i: BioMed Research International, ISSN 2314-6133, E-ISSN 2314-6141, artikkel-id 371905Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Introduction. Atrial fibrillation (AF) is a common heart rhythmdisorder. Several life-style factors have been identified as risk factors for AF, but less is known about the impact of work-related stress. This study aims to evaluate the association between work-related stress, defined as job strain, and risk of AF. Methods. Data from the Swedish WOLF study was used, comprising 10,121 working men and women. Job strain was measured by the demand-control model. Information on incident AF was derived from national registers. Cox proportional hazard regression was used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the association between job strain and AF risk. Results. In total, 253 incident AF cases were identified during a total follow-up time of 132,387 person-years. Job strain was associated with AF risk in a time-dependent manner, with stronger association after 10.7 years of follow-up (HR 1.93, 95% CI 1.10-3.36 after 10.7 years, versus HR 1.11, 95% CI 0.67-1.83 before 10.7 years). The results pointed towards a dose-response relationship when taking accumulated exposure to job strain over time into account. Conclusion. This study provides support to the hypothesis that work-related stress defined as job strain is linked to an increased risk of AF.

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  • 3.
    Heikkila, Katriina
    et al.
    London Sch Hyg & Trop Med, Dept Hlth Serv Res & Policy, London WC1, England.
    Nyberg, Solja T.
    Finnish Inst Occupat Hlth, Tampere 33100, Finland.
    Madsen, Ida E. H.
    Natl Res Ctr Working Environm, DK-2100 Copenhagen, Denmark.
    de Vroome, Ernest
    TNO, NL-2316 ZL Leiden, Netherlands.
    Alfredsson, Lars
    Karolinska Inst, Inst Environm Med, S-17177 Stockholm, Sweden.
    Bjorner, Jacob J.
    Natl Res Ctr Working Environm, DK-2100 Copenhagen, Denmark.
    Borritz, Marianne
    Koge Hosp, DK-4600 Koge, Denmark.
    Burr, Hermann
    Fed Inst Occupat Safety & Hlth, D-10317 Berlin, Germany.
    Erbel, Raimund
    Univ Duisburg Essen, West German Heart Ctr Essen, Dept Cardiol, D-45122 Essen, Germany.
    Ferrie, Jane E.
    UCL, Dept Epidemiol & Publ Hlth, London WC1E 6BT, England.
    Fransson, Eleonor I.
    Karolinska Inst, Inst Environm Med, S-17177 Stockholm, Sweden.
    Geuskens, Goedele A.
    TNO, NL-2316 ZL Leiden, Netherlands.
    Hooftman, Wendela E.
    TNO, NL-2316 ZL Leiden, Netherlands.
    Houtman, Irene L.
    TNO, NL-2316 ZL Leiden, Netherlands.
    Joeckel, Karl-Heinz
    Univ Duisburg Essen, Inst Med Informat Biometry & Epidemiol, Fac Med, D-45122 Essen, Germany.
    Knutsson, Anders
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för hälsovetenskap.
    Koskenvuo, Markku
    Univ Helsinki, Dept Publ Hlth, Helsinki 00140, Finland.
    Lunau, Thorsten
    Univ Dusseldorf, Fac Med, Inst Med Sociol, D-40225 Dusseldorf, Germany.
    Nielsen, Martin L.
    Frederiksberg Univ Hosp, Unit Social Med, DK-2000 Frederiksberg, Denmark.
    Nordin, Maria
    Umea Univ, Dept Psychol, S-90187 Umea, Sweden.
    Oksanen, Tuula
    Finnish Inst Occupat Hlth, Tampere 33100, Finland.
    Pejtersen, Jan H.
    Danish Natl Ctr Social Res, DK-1052 Copenhagen, Denmark.
    Pentti, Jaana
    Finnish Inst Occupat Hlth, Tampere 33100, Finland.
    Shipley, Martin J.
    UCL, Dept Epidemiol & Publ Hlth, London WC1E 6BT, England.
    Steptoe, Andrew
    UCL, Dept Epidemiol & Publ Hlth, London WC1E 6BT, England.
    Suominen, Sakari B.
    Univ Turku, Dept Publ Hlth, Turku 20014, Finland.
    Theorell, Toeres
    Stockholm Univ, Stress Res Inst, SE-10691 Stockholm, Sweden.
    Vahtera, Jussi
    Finnish Inst Occupat Hlth, Tampere 33100, Finland.
    Westerholm, Peter J. M.
    Uppsala Univ, Occupat & Environm Med, S-75185 Uppsala, Sweden.
    Westerlund, Hugo
    Stockholm Univ, Stress Res Inst, SE-10691 Stockholm, Sweden.
    Dragano, Nico
    Univ Dusseldorf, Fac Med, Inst Med Sociol, D-40225 Dusseldorf, Germany.
    Rugulies, Reiner
    Natl Res Ctr Working Environm, DK-2100 Copenhagen, Denmark.
    Kawachi, Ichiro
    Harvard Univ, Sch Publ Hlth, Dept Soc Human Dev & Hlth, 665 Huntington Ave, Boston, MA 02115 USA.
    Batty, G. David
    UCL, Dept Epidemiol & Publ Hlth, London WC1E 6BT, England.
    Singh-Manoux, Archana
    UCL, Dept Epidemiol & Publ Hlth, London WC1E 6BT, England.
    Virtanen, Marianna
    Finnish Inst Occupat Hlth, Tampere 33100, Finland.
    Kivimaki, Mika
    Finnish Inst Occupat Hlth, Tampere 33100, Finland.
    Long working hours and cancer risk: a multi-cohort study2016Inngår i: British Journal of Cancer, ISSN 0007-0920, E-ISSN 1532-1827, Vol. 114, nr 7, s. 813-818Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Working longer than the maximum recommended hours is associated with an increased risk of cardiovascular disease, but the relationship of excess working hours with incident cancer is unclear. Methods: This multi-cohort study examined the association between working hours and cancer risk in 116 462 men and women who were free of cancer at baseline. Incident cancers were ascertained from national cancer, hospitalisation and death registers; weekly working hours were self-reported. Results: During median follow-up of 10.8 years, 4371 participants developed cancer (n colorectal cancer: 393; n lung cancer: 247; n breast cancer: 833; and n prostate cancer: 534). We found no clear evidence for an association between working hours and the overall cancer risk. Working hours were also unrelated the risk of incident colorectal, lung or prostate cancers. Working >= 55 h per week was associated with 1.60-fold (95% confidence interval 1.12-2.29) increase in female breast cancer risk independently of age, socioeconomic position, shift-and night-time work and lifestyle factors, but this observation may have been influenced by residual confounding from parity. Conclusions: Our findings suggest that working long hours is unrelated to the overall cancer risk or the risk of lung, colorectal or prostate cancers. The observed association with breast cancer would warrant further research.

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  • 4.
    Kivimäki, Mika
    et al.
    UCL, Dept Epidemiol & Publ Hlth, England.
    Nyberg, Solja T.
    Univ Helsinki, Helsinki, Finland.
    Batty, G. David
    UCL, England.
    Kawachi, Ichiro
    Harvard TH Chan Sch Publ Hlth, Boston, USA.
    Jokela, Markus
    Univ Helsinki, Helsinki, Finland.
    Alfredsson, Lars
    Stockholm Cty Council, Stockholm.
    Bjorner, Jakob B.
    Natl Res Ctr Working Environm, Copenhagen O, Denmark.
    Borritz, Marianne
    Bispebjerg Univ Hosp Copenhagen, Copenhagen NV, Denmark.
    Burr, Hermann
    Fed Inst Occupat Safety & Hlth BAuA, Berlin, Germany.
    Dragano, Nico
    Univ Dusseldorf, Dusseldorf, Germany.
    Fransson, Eleonor I.
    Jönköping Univ, Jönköping.
    Heikkilä, Katriina
    London Sch Hyg & Trop Med, London, England.
    Knutsson, Anders
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för hälsovetenskap.
    Koskenvuo, Markku
    Univ Helsinki, Helsinki, Finland.
    Kumari, Meena
    Univ Essex, Essex, England.
    Madsen, Ida E. H.
    Natl Res Ctr Working Environm, Copenhagen O, Denmark.
    Nielsen, Martin L.
    AS3 Co, AS3 Employment, Denmark.
    Nordin, Maria
    Stockholm Univ, Stockholm.
    Oksanen, Tuula
    Finnish Inst Occupat Hlth, Helsinki, Finland.
    Pejtersen, Jan H.
    Danish Natl Ctr Social Res, Copenhagen K, Denmark.
    Pentti, Jaana
    Univ Helsinki, Helsinki, Finland.
    Rugulies, Reiner
    Natl Res Ctr Working Environm, Copenhagen O, Denmark.
    Salo, Paula
    Finnish Inst Occupat Hlth, Helsinki, Finland.
    Shipley, Martin J.
    UCL, London, England.
    Suominen, Sakari
    Univ Skövde, Skövde.
    Theorell, Töres
    Stockholm Univ, Stockholm.
    Vahtera, Jussi
    Univ Turku, Turku, Finland.
    Westerholm, Peter
    Uppsala Univ, Uppsala.
    Westerlund, Hugo
    Stockholm Univ, Stockholm.
    Steptoe, Andrew
    UCL, London, England.
    Singh-Manoux, Archana
    Hop Paul Brousse, Villejuif, France.
    Hamer, Mark
    Loughborough Univ Technol, Leics, England.
    Ferrie, Jane E.
    Univ Bristol, Avon, England.
    Virtanen, Marianna
    Finnish Inst Occupat Hlth, Helsinki, Finland.
    Tabak, Adam G.
    UCL, London, England.
    Long working hours as a risk factor for atrial fibrillation: a multi-cohort study2017Inngår i: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 38, nr 34, s. 2621-2628Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aims Studies suggest that people who work long hours are at increased risk of stroke, but the association of long working hours with atrial fibrillation, the most common cardiac arrhythmia and a risk factor for stroke, is unknown. We examined the risk of atrial fibrillation in individuals working long hours (>= 55 per week) and those working standard 35-40 h/week.

    Methods and results In this prospective multi-cohort study from the Individual-Participant-Data Meta-analysis in Working Populations (IPD-Work) Consortium, the study population was 85 494 working men and women (mean age 43.4 years) with no recorded atrial fibrillation. Working hours were assessed at study baseline (1991-2004). Mean follow-up for incident atrial fibrillation was 10 years and cases were defined using data on electrocardiograms, hospital records, drug reimbursement registers, and death certificates. We identified 1061 new cases of atrial fibrillation (10-year cumulative incidence 12.4 per 1000). After adjustment for age, sex and socioeconomic status, individuals working long hours had a 1.4-fold increased risk of atrial fibrillation compared with those working standard hours (hazard ratio = 1.42, 95% CI= 1.13-1.80, P= 0.003). There was no significant heterogeneity between the cohort-specific effect estimates (I-2= 0%, P = 0.66) and the finding remained after excluding participants with coronary heart disease or stroke at baseline or during the follow-up (N= 2006, hazard ratio= 1.36, 95% CI= 1.05-1.76, P = 0.0180). Adjustment for potential confounding factors, such as obesity, risky alcohol use and high blood pressure, had little impact on this association.

    Conclusion Individuals who worked long hours were more likely to develop atrial fibrillation than those working standard hours.

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  • 5.
    Kivimäki, Mika
    et al.
    Univ Helsinki, Helsinki, Finland; UCL, London, England.
    Pentti, Jaana
    Univ Helsinki, Helsinki, Finland; Univ Turku, Turku, Finland.
    Ferrie, Jane E.
    UCL, London, England; Univ Bristol, Avon, England.
    Batty, G. David
    UCL, Dept Epidemiol & Publ Hlth, London WC1E 6BT, England..
    Nyberg, Solja T.
    Univ Helsinki, Helsinki, Finland.
    Jokela, Markus
    Univ Helsinki, Helsinki, Finland.
    Virtanen, Marianna
    Uppsala Univ, Uppsala.
    Alfredsson, Lars
    Stockholm Cty Council, Stockholm; Karolinska Inst, Stockholm.
    Dragano, Nico
    Univ Dusseldorf, Dusseldorf, Germany.
    Fransson, Eleonor I.
    Stockholm Cty Council, Stockholm; Jönköping Univ, Jönköping; Stockholm Univ, Stockholm.
    Goldberg, Marcel
    INSERM, Populat Based Epidemiol Cohorts Unit, Villejuif, France; Versailles St Quentin Univ, Villejuif, France.
    Knutsson, Anders
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för hälsovetenskap.
    Koskenvuo, Markku
    Univ Helsinki, Helsinki, Finland.
    Koskinen, Aki
    Finnish Inst Occupat Hlth, Helsinki, Finland.
    Kouvonen, Anne
    Univ Helsinki, Helsinki, Finland; SWPS Univ Social Sci & Humanities Wroclaw, Wroclaw, Poland; Queens Univ Belfast, Belfast, North Ireland.
    Luukkonen, Ritva
    Univ Helsinki, Helsinki, Finland.
    Oksanen, Tuula
    Rugulies, Reiner
    Natl Res Ctr Working Environm, Copenhagen, Denmark; Univ Copenhagen, Copenhagen, Denmark.
    Siegrist, Johannes
    Univ Dusseldorf, Dusseldorf, Germany.
    Singh-Manoux, Archana
    UCL, London, England; Ctr Res Epidemiol & Populat Hlth, INSERM, Villejuif, France.
    Suominen, Sakari
    Univ Turku, Turku, Finland; Folkhälsan Res Ctr, Helsinki, Finland; Univ Skövde, Skövde; Univ Kent, Canterbury, Kent, England.
    Theorell, Tores
    Stockholm Univ, Stockholm; Finnish Inst Occupat Hlth, Helsinki, Finland.
    Vaananen, Ari
    Finnish Inst Occupat Hlth, Helsinki, Finland.
    Vahtera, Jussi
    Univ Turku, Turku, Finland; Turku Univ Hosp, Turku, Finland.
    Westerholm, Peter J. M.
    Uppsala Univ, Uppsala.
    Westerlund, Hugo
    Stockholm Univ, Stockholm.
    Zins, Marie
    INSERM, Populat Based Epidemiol Cohorts Unit, Villejuif, France; Versailles St Quentin Univ, Villejuif, France.
    Strandberg, Timo
    Univ Helsinki, Helsinki, Finland; Helsinki Univ Hosp, Helsinki, Finland; Univ Oulu, Oulu, Finland.
    Steptoe, Andrew
    UCL, London, England..
    Deanfield, John
    UCL, London, England.
    Work stress and risk of death in men and women with and without cardiometabolic disease: a multicohort study2018Inngår i: The Lancet Diabetes and Endocrinology, ISSN 2213-8587, E-ISSN 2213-8595, Vol. 6, nr 9, s. 705-713Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background Although some cardiovascular disease prevention guidelines suggest a need to manage work stress in patients with established cardiometabolic disease, the evidence base for this recommendation is weak. We sought to clarify the status of stress as a risk factor in cardiometabolic disease by investigating the associations between work stress and mortality in men and women with and without pre-existing cardiometabolic disease. Methods In this multicohort study, we used data from seven cohort studies in the IPD-Work consortium, initiated between 1985 and 2002 in Finland, France, Sweden, and the UK, to examine the association between work stress and mortality. Work stress was denoted as job strain or effort-reward imbalance at work. We extracted individual-level data on prevalent cardiometabolic diseases (coronary heart disease, stroke, or diabetes [without differentiation by diabetes type]) at baseline. Work stressors, socioeconomic status, and conventional and lifestyle risk factors (systolic and diastolic blood pressure, total cholesterol, smoking status, BMI, physical activity, and alcohol consumption) were also assessed at baseline. Mortality data, including date and cause of death, were obtained from national death registries. We used Cox proportional hazards regression to study the associations of work stressors with mortality in men and women with and without cardiometabolic disease. Results We identified 102 633 individuals with 1 423 753 person-years at risk (mean follow-up 13.9 years [SD 3.9]), of whom 3441 had prevalent cardiometabolic disease at baseline and 3841 died during follow-up. In men with cardiometabolic disease, age-standardised mortality rates were substantially higher in people with job strain (149.8 per 10 000 person-years) than in those without (97.7 per 10 000 person-years; mortality difference 52.1 per 10 000 person-years; multivariable-adjusted hazard ratio [HR] 1.68, 95% CI 1.19-2.35). This mortality difference for job strain was almost as great as that for current smoking versus former smoking (78.1 per 10 000 person-years) and greater than those due to hypertension, high total cholesterol concentration, obesity, physical inactivity, and high alcohol consumption relative to the corresponding lower risk groups (mortality difference 5.9-44.0 per 10 000 person-years). Excess mortality associated with job strain was also noted in men with cardiometabolic disease who had achieved treatment targets, including groups with a healthy lifestyle (HR 2.01, 95% CI 1.18-3.43) and those with normal blood pressure and no dyslipidaemia (6.17, 1.74-21.9). In all women and in men without cardiometabolic disease, relative risk estimates for the work stress-mortality association were not significant, apart from effort-reward imbalance in men without cardiometabolic disease (mortality difference 6.6 per 10 000 person-years; multivariable-adjusted HR 1.22, 1.06-1.41). Interpretation In men with cardiometabolic disease, the contribution of job strain to risk of death was clinically significant and independent of conventional risk factors and their treatment, and measured lifestyle factors. Standard care targeting conventional risk factors is therefore unlikely to mitigate the mortality risk associated with job strain in this population.

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  • 6.
    Kivimäki, Mika
    et al.
    UCL, Dept Epidemiol & Publ Hlth, London WC1E 6BT, England.
    Virtanen, Marianna
    Finnish Inst Occupat Hlth, Helsinki, Finland.
    Kawachi, Ichiro
    Harvard Univ, Sch Publ Hlth, Dept Soc Human Dev & Hlth, Boston, MA 02115 USA.
    Nyberg, Solja T.
    Finnish Inst Occupat Hlth, Helsinki, Finland.
    Alfredsson, Lars
    Stockholm Cty Council, Ctr Occupat & Environm Med, Stockholm, Sweden.
    Batty, G. David
    UCL, Dept Epidemiol & Publ Hlth, London WC1E 6BT, England.
    Björner, Jakob B.
    Natl Res Ctr Working Environm, Copenhagen, Denmark.
    Borritz, Marianne
    Bispebjerg Hosp, Dept Occupat & Environm Med, Copenhagen, Denmark.
    Brunner, Eric J.
    UCL, Dept Epidemiol & Publ Hlth, London WC1E 6BT, England.
    Burr, Hermann
    Fed Inst Occupat Safety & Hlth, Berlin, Germany.
    Dragano, Nico
    Univ Dusseldorf, Fac Med, Inst Med Sociol, Dusseldorf, Germany.
    Ferrie, Jane E.
    UCL, Dept Epidemiol & Publ Hlth, London WC1E 6BT, England.
    Fransson, Eleonor I.
    Karolinska Inst, Inst Environm Med, Stockholm, Sweden.
    Hamer, Mark
    UCL, Dept Epidemiol & Publ Hlth, London WC1E 6BT, England.
    Heikkila, Katriina
    Finnish Inst Occupat Hlth, Helsinki, Finland.
    Knutsson, Anders
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för hälsovetenskap.
    Koskenvuo, Markku
    Univ Helsinki, Dept Publ Hlth, Helsinki, Finland.
    Madsen, Ida E. H.
    Natl Res Ctr Working Environm, Copenhagen, Denmark.
    Nielsen, Martin L.
    Bispebjerg Hosp, Dept Occupat & Environm Med, Copenhagen, Denmark.
    Nordin, Maria
    Umea Univ, Dept Psychol, S-90187 Umea, Sweden.
    Oksanen, Tuula
    Finnish Inst Occupat Hlth, Helsinki, Finland.
    Pejtersen, Jan H.
    Danish Natl Ctr Social Res, Copenhagen, Denmark.
    Pentti, Jaana
    Finnish Inst Occupat Hlth, Helsinki, Finland.
    Rugulies, Reiner
    Natl Res Ctr Working Environm, Copenhagen, Denmark.
    Salo, Paula
    Finnish Inst Occupat Hlth, Helsinki, Finland.
    Siegrist, Johannes
    Univ Dusseldorf, Fac Med, Inst Med Sociol, Dusseldorf, Germany.
    Steptoe, Andrew
    UCL, Dept Epidemiol & Publ Hlth, London WC1E 6BT, England.
    Suominen, Sakari
    Folkhalsan Res Ctr, Helsinki, Finland.
    Theorell, Tres
    Stockholm Univ, Stress Res Inst, S-10691 Stockholm, Sweden.
    Vahtera, Jussi
    Finnish Inst Occupat Hlth, Helsinki, Finland.
    Westerholm, Peter J. M.
    Uppsala Univ, Occupat & Environm Med, Uppsala, Sweden.
    Westerlund, Hugo
    Stockholm Univ, Stress Res Inst, S-10691 Stockholm, Sweden.
    Singh-Manoux, Archana
    UCL, Dept Epidemiol & Publ Hlth, London WC1E 6BT, England.
    Jokela, Markus
    Univ Helsinki, Inst Behav Sci, Helsinki, Finland.
    Long working hours, socioeconomic status, and the risk of incident type 2 diabetes: a meta-analysis of published and unpublished data from 222 120 individuals2015Inngår i: LANCET DIABETES & ENDOCRINOLOGY, ISSN 2213-8587, Vol. 3, nr 1, s. 27-34Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background Working long hours might have adverse health effects, but whether this is true for all socioeconomic status groups is unclear. In this meta-analysis stratified by socioeconomic status, we investigated the role of long working hours as a risk factor for type 2 diabetes. Methods We identified four published studies through a systematic literature search of PubMed and Embase up to April 30, 2014. Study inclusion criteria were English-language publication; prospective design (cohort study); investigation of the effect of working hours or overtime work; incident diabetes as an outcome; and relative risks, odds ratios, or hazard ratios (HRs) with 95% CIs, or sufficient information to calculate these estimates. Additionally, we used unpublished individual-level data from 19 cohort studies from the Individual-Participant-Data Meta-analysis in Working-Populations Consortium and international open-access data archives. Effect estimates from published and unpublished data from 222 120 men and women from the USA, Europe, Japan, and Australia were pooled with random-effects meta-analysis. Findings During 1.7 million person-years at risk, 4963 individuals developed diabetes (incidence 29 per 10 000 person-years). The minimally adjusted summary risk ratio for long (>= 55 h per week) compared with standard working hours (35-40 h) was 1.07 (95% CI 0.89-1.27, difference in incidence three cases per 10 000 person-years) with significant heterogeneity in study-specific estimates (I-2 = 53%, p = 0.0016). In an analysis stratified by socioeconomic status, the association between long working hours and diabetes was evident in the low socioeconomic status group (risk ratio 1.29, 95% CI 1.06-1.57, difference in incidence 13 per 10 000 person-years, I-2 = 0%, p = 0.4662), but was null in the high socioeconomic status group (1. 00, 95% CI 0.80-1.25, incidence diff erence zero per 10 000 person-years, I-2 = 15%, p = 0.2464). The association in the low socioeconomic status group was robust to adjustment for age, sex, obesity, and physical activity, and remained after exclusion of shift workers. Interpretation In this meta-analysis, the link between longer working hours and type 2 diabetes was apparent only in individuals in the low socioeconomic status groups. Copyright (C) Kivimaki et al. Open Access article distributed under the terms of CC BY.

    Fulltekst (pdf)
    fulltext
  • 7.
    Virtanen, M.
    et al.
    School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland.
    Jokela, M.
    Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland.
    Lallukka, T.
    Finnish Institute of Occupational Health, Helsinki, Finland.
    Magnusson Hanson, L.
    Stress Research Institute, Stockholm University, Stockholm, Sweden.
    Pentti, J.
    Department of Public Health, Clinicum, University of Helsinki, Helsinki, Finland.
    Nyberg, S. T.
    Department of Public Health, Clinicum, University of Helsinki, Helsinki, Finland.
    Alfredsson, L.
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Batty, G. D.
    Department of Epidemiology & Public Health, University College London, London, United Kingdom.
    Casini, A.
    IPSY, Université catholique de Louvain (UCLouvain), Louvain-la-Neuve & School of Public Health, Université libre de Bruxelles (ULB), Brussels, Belgium.
    Clays, E.
    Department of Public Health, Ghent University, Ghent, Belgium.
    DeBacquer, D.
    Department of Public Health, Ghent University, Ghent, Belgium.
    Ervasti, J.
    Finnish Institute of Occupational Health, Helsinki, Finland.
    Fransson, Eleonor I.
    Högskolan i Jönköping, HHJ, Avd. för naturvetenskap och biomedicin.
    Halonen, J. I.
    Stress Research Institute, Stockholm University, Stockholm, Sweden.
    Head, J.
    Department of Epidemiology & Public Health, University College London, London, United Kingdom.
    Kittel, F.
    IPSY, Université catholique de Louvain (UCLouvain), Louvain-la-Neuve & School of Public Health, Université libre de Bruxelles (ULB), Brussels, Belgium.
    Knutsson, Anders
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Leineweber, C.
    Stress Research Institute, Stockholm University, Stockholm, Sweden.
    Nordin, M.
    Department of Psychology, Umeå University, Umeå, Sweden.
    Oksanen, T.
    Finnish Institute of Occupational Health, Helsinki, Finland.
    Pietiläinen, O.
    Department of Public Health, Clinicum, University of Helsinki, Helsinki, Finland.
    Rahkonen, O.
    Department of Public Health, Clinicum, University of Helsinki, Helsinki, Finland.
    Salo, P.
    Finnish Institute of Occupational Health, Helsinki, Finland.
    Singh-Manoux, A.
    Department of Epidemiology & Public Health, University College London, London, United Kingdom.
    Stenholm, S.
    Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland.
    Suominen, S. B.
    Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland.
    Theorell, T.
    Stress Research Institute, Stockholm University, Stockholm, Sweden.
    Vahtera, J.
    Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland.
    Westerholm, P.
    Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden.
    Westerlund, H.
    Stress Research Institute, Stockholm University, Stockholm, Sweden.
    Kivimäki, M.
    Department of Public Health, Clinicum, University of Helsinki, Helsinki, Finland.
    Long working hours and change in body weight: analysis of individual-participant data from 19 cohort studies2019Inngår i: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective:

    To examine the relation between long working hours and change in body mass index (BMI).

    Methods:

    We performed random effects meta-analyses using individual-participant data from 19 cohort studies from Europe, US and Australia (n = 122,078), with a mean of 4.4-year follow-up. Working hours were measured at baseline and categorised as part time (<35 h/week), standard weekly hours (35–40 h, reference), 41–48 h, 49–54 h and ≥55 h/week (long working hours). There were four outcomes at follow-up: (1) overweight/obesity (BMI ≥ 25 kg/m2) or (2) overweight (BMI 25–29.9 kg/m2) among participants without overweight/obesity at baseline; (3) obesity (BMI ≥ 30 kg/m2) among participants with overweight at baseline, and (4) weight loss among participants with obesity at baseline.

    Results:

    Of the 61,143 participants without overweight/obesity at baseline, 20.2% had overweight/obesity at follow-up. Compared with standard weekly working hours, the age-, sex- and socioeconomic status-adjusted relative risk (RR) of overweight/obesity was 0.95 (95% CI 0.90–1.00) for part-time work, 1.07 (1.02–1.12) for 41–48 weekly working hours, 1.09 (1.03–1.16) for 49–54 h and 1.17 (1.08–1.27) for long working hours (P for trend <0.0001). The findings were similar after multivariable adjustment and in subgroup analyses. Long working hours were associated with an excess risk of shift from normal weight to overweight rather than from overweight to obesity. Long working hours were not associated with weight loss among participants with obesity.

    Conclusions:

    This analysis of large individual-participant data suggests a small excess risk of overweight among the healthy-weight people who work long hours. 

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