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  • 1.
    Alfredsson, Lars
    et al.
    lars.alfredsson@imm.ki.se.
    Hammar, Niklas
    Fransson, Eleanor
    de Faire, Ulf
    Hallqvist, Johan
    Knutsson, Anders
    Nilsson, Tohr
    Theorell, Törres
    Westerholm, Peter
    Job strain and major risk factors for coronary heart disease.: Baseline results from the WOLF Study2002In: Scandinavian Journal of Work, Environment & Health, ISSN 0355-3140, Vol. 28, no 4, p. 238-248Article in journal (Refereed)
    Abstract [en]

    The results do not support the hypothesis that job strain has an adverse impact on serum total cholesterol and plasma fibrinogen levels. They suggest that an increased risk of coronary heart disease in association with job strain, if causal, is mediated by other factors, possibly partly by hypertension and low levels of high-density lipoprotein cholesterol.

  • 2.
    Andersson, Eva
    et al.
    Sahlgrenska University Hospital.
    Knutsson, Anders
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Hagberg, S.
    Sahlgrenska University Hospital.
    Nilsson, T.
    Sundsvall Hospital.
    Karlsson, B.
    Umeå University.
    Alfredsson, L.
    Karolinska Institute.
    Torén, K.
    Sahlgrenska University Hospital.
    Incidence of asthma among workers exposed to sulfur dioxide and other irritant gases2006In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 27, no 4, p. 720-725Article in journal (Refereed)
    Abstract [en]

    The aim of the present study was to investigate whether repeated peak exposure (gassings) to sulphur dioxide (SO2) and other irritant gases increases the risk of new-onset asthma. A questionnaire was sent to 4,112 sulphite workers, of whom 1,919 completed the questionnaire and 396 completed the short-form questionnaire, which was sent out as a last reminder. A sample of 130 nonrespondents completed a telephone interview using the short-form questionnaire. The incidence of adult-onset, physician-diagnosed asthma during employment duration was analysed in relation to exposure to SO2 and gassings giving rise to respiratory symptoms. Incidence rates, as well as incidence rate ratios with 95% confidence interval (CI), were calculated. Further Cox regression models were used allowing assessment of hazard ratios (HR) stratified for sex and adjusted for atopy, smoking habits and age. The incidence rate for asthma among sulphite mill workers reporting gassings of SO2 was 6.2 out of 1,000 person-yrs, compared with 1.9 out of 1,000 person-yrs among subjects unexposed to SO2 and any gassings (HR (95% CI) 4.0 (2.1-7.7)). Among males reporting gassings to SO2, the HR (95% CI) for asthma was 5.8 (2.6-13) compared with unexposed males. In conclusion, repeated peak exposure to sulphur dioxide increased the incidence of asthma during work in sulphite pulp mills, which supports the hypothesis of irritant-induced asthma.

  • 3.
    Araghi, Marzieh
    et al.
    Karolinska Inst, Stockholm.
    Galanti, Maria Rosaria
    Karolinska Inst, Stockholm; Stockholm City Council.
    Lundberg, Michael
    Karolinska Inst, Stockholm.
    Lager, Anton
    Karolinska Inst, Stockholm; Stockholm City Council.
    Engstrom, Gunnar
    Lund Univ, Lund.
    Alfredsson, Lars
    Karolinska Inst, Stockholm.
    Knutsson, Anders
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Norberg, Margareta
    Umeå Univ, Umeå.
    Sund, Malin
    Umeå Univ, Umeå.
    Wennberg, Patrik
    Umeå Univ, Umeå.
    Lagerros, Ylva Trolle
    Karolinska Inst, Stockholm; Karolinska Univ Hosp Huddinge, Stockholm.
    Bellocco, Rino
    Univ Milano Bicocca, Milan, Italy; Karolinska Inst, Stockholm.
    Pedersen, Nancy L.
    Karolinska Inst, Stockholm.
    Ostergren, Per-Olof
    Lund Univ, Lund.
    Magnusson, Cecilia
    Karolinska Inst, Stockholm; Stockholm City Council.
    Use of moist oral snuff (snus) and pancreatic cancer: Pooled analysis of nine prospective observational studies2017In: International Journal of Cancer, ISSN 0020-7136, E-ISSN 1097-0215, Vol. 141, no 4, p. 687-693Article in journal (Refereed)
    Abstract [en]

    While smoking is a well-established risk factor for pancreatic cancer, the effect of smokeless tobacco is less well understood. We used pooled individual data from the Swedish Collaboration on Health Effects of Snus Use to assess the association between Swedish snus use and the risk of pancreatic cancer. A total of 424,152 male participants from nine cohort studies were followed up for risk of pancreatic cancer through linkage to health registers. We used shared frailty models with random effects at the study level, to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) adjusted for confounding factors. During 9,276,054 person-years of observation, 1,447 men developed pancreatic cancer. Compared to never-snus use, current snus use was not associated with risk of pancreatic cancer (HR 0.96, 95% CI 0.83-1.11) after adjustment for smoking. Swedish snus use does not appear to be implicated in the development of pancreatic cancer in men. Tobacco smoke constituents other than nicotine or its metabolites may account for the relationship between smoking and pancreatic cancer. What's new? While smoking is a well-established risk factor for pancreatic cancer, the effect of smokeless tobacco is less well understood. Smokeless tobacco like snus yields lower exposure to tobacco carcinogens compared with smoking, because it does not undergo combustion, but delivers an equivalent dose of nicotine. Using pooled individual data from the Swedish Collaboration on Health Effects of Snus Use, here the authors show that Swedish snus use does not appear to be implicated in the development of pancreatic cancer in men. Tobacco smoke constituents other than nicotine or its metabolites may account for the relationship between smoking and pancreatic cancer.

  • 4.
    Araghi, Marzieh
    et al.
    Karolinska Institutet, Stockholm.
    Galanti, Maria Rosaria
    Karolinska Institutet, Stockholm; Stockholm Health Care District, Stockholm County Council.
    Lundberg, Michael
    Karolinska Institutet, Stockholm.
    Liu, Zhiwei
    Karolinska Institutet, Stockholm.
    Ye, Weimin
    Karolinska Institutet, Stockholm.
    Lager, Anton
    Karolinska Institutet, Stockholm; Stockholm Health Care District, Stockholm County Council.
    Engström, Gunnar
    Lund University.
    Manjer, Jonas
    Skåne University Hospital Malmö.
    Alfredsson, Lars
    Karolinska Institutet, Stockholm.
    Knutsson, Anders
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Norberg, Margareta
    Umeå University.
    Palmqvist, Richard
    Umeå University.
    Gylling, Björn
    Umeå University.
    Wennberg, Patrik
    Umeå University.
    Lagerros, Ylva Trolle
    Karolinska Institutet, Stockholm; Karolinska University Hospital Huddinge.
    Bellocco, Rino
    Karolinska Institutet, Stockholm; University of Milano-Bicocca, Italy.
    Pedersen, Nancy L.
    Karolinska Institutet, Stockholm.
    Östergren, Per-Olof
    Lund University.
    Magnusson, Cecilia
    Karolinska Institutet, Stockholm; Stockholm Health Care District, Stockholm County Council.
    Smokeless tobacco (snus) use and colorectal cancer incidence and survival: Results from nine pooled cohorts2017In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 45, no 8, p. 741-748Article in journal (Refereed)
    Abstract [en]

    Aims: Although smoking is considered to be an established risk factor for colorectal cancer, the current evidence on the association between smokeless tobacco and colorectal cancer is scant and inconclusive. We used pooled individual data from the Swedish Collaboration on Health Effects of Snus Use to assess this association. Methods: A total of 417,872 male participants from nine cohort studies across Sweden were followed up for incidence of colorectal cancer and death. Outcomes were ascertained through linkage to health registers. We used shared frailty models with random effects at the study level to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Results: During 7,135,504 person-years of observation, 4170 men developed colorectal cancer. There was no clear association between snus use and colorectal cancer overall. Exclusive current snus users, however, had an increased risk of rectal cancer (HR 1.40: 95% CI 1.09, 1.79). There were no statistically significant associations between snus use and either all-cause or colorectal cancer-specific mortality after colorectal cancer diagnosis. Conclusions: Our findings, from a large sample, do not support any strong relationships between snus use and colorectal cancer risk and survival among men. However, the observed increased risk of rectal cancer is noteworthy, and in merit of further attention. 

  • 5. Brostedt, Erica M.
    et al.
    de Faire, Ulf
    Westerholm, Peter
    Knutsson, Anders
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Alfredsson, Lars
    Job strain and plasminogen activator inhibitor-1: results from the Swedish WOLF Study2004In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, Vol. 77, no 5, p. 341-344Article in journal (Refereed)
  • 6. Brostedt, Erika M.
    et al.
    Alfredsson, Lars
    Westerholm, Peter
    Knutsson, Anders
    de Faire, Ulf
    Job strain och PAI-12002In: Psykosocial belastning och riskfaktorer för hjärt-kärlsjukdom : Minisymposium i WOLF-projektet 8 februari 2001 / [ed] Peter Westerholm, Stockholm: Arbetslivsinstitutet , 2002, p. 3-6Chapter in book (Other academic)
  • 7. Brulin, Christin
    et al.
    Goine, Hans
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Edlund, C
    Knutsson, Anders
    Prevalence of long term sick leave among female home care personnel in Northern Sweden1998In: Journal of Occupational Rehabilitation, ISSN 1053-0487, Vol. 8, no 2, p. 103-111Article in journal (Refereed)
  • 8. Brulin, Christine
    et al.
    Gerdle, Björn
    Granlund, Brittmarie
    Höög, Jonas
    Knutsson, Anders
    Sundelin, Gunnevi
    Physical and psychosocial work related risk factors associated with musculoskeletal symptoms among home care personnel1998In: Scandinavian journal of caring sciences, ISSN 0283-9318, Vol. 12, no 2, p. 104-110Article in journal (Refereed)
    Abstract [en]

    The aim of this cross-sectional study was to investigate physical and psychosocial aspects of the work environment, sociodemographic data and certain lifestyle factors, and the relationship between these variables and complaints in the shoulder/neck and low back area among female home care personnel. A questionnaire was completed by 361 randomly selected women. Multiple logistic regression analyses were conducted to evaluate the importance of several exposure factors for complaints in the shoulder/neck and low back areas. The results of this study clearly indicate that 'standing in forward-bent and twisted postures' can be viewed as a risk factor for shoulder/neck pain. A combination of this physical exposure and 'no possibility of influencing the planning of work' gave an increase in odds ratio, indicating an interaction between these two exposure indices. However, this interaction was not found for low back pain. 'Standing in forward-bent and twisted postures', 'standing in awkward positions' and whether the subject had children staying at home were significantly correlated to complaints about the low back. In fact, the latter factor decreased the risk of having complaints. The results indicated that certain physical and psychosocial work risk factors could influence shoulder/neck and low back pain.

  • 9. Bråbäck, Lennart
    et al.
    Breborowicz, Andrzej
    Dreborg, Sten
    Knutsson, Anders
    Pieklik, H
    Björksten, Bengt
    Atopic sensitization and respiratory symptoms among Polish and Swedish school children1994In: Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology, ISSN 0954-7894, Vol. 24, no 9, p. 826-835Article in journal (Refereed)
    Abstract [en]

    Allergic sensitization and symptoms from the airways in relation to air pollution were compared in 10-12-year-old school children (n = 1113) from urban Konin in central Poland and both urban and rural parts of Sundsvall in northern Sweden. The measurements included parental questionnaires, skin-prick tests and serial peak flow measurements during 2 weeks with simultaneous monitoring of outdoor air pollutants. The skin-prick test technique was validated by IgE antibody determinations. The levels of common industrial pollutants, SO2 and smoke particles were much higher in Konin than in urban Sundsvall and the levels of NO2 were similar. Various respiratory symptoms were more often reported among school children in Konin (except for wheezing and diagnosed asthma). Multiple logistic regression analyses yielded the following increased odds ratios for children in Konin as compared with the reference group (rural Sundsvall): chest tightness and breathlessness 3.48 (95% confidence interval 2.08-5.82), exercise-induced coughing attacks 3.69 (95% confidence interval 1.68-8.10), recurrent episodes of common cold 2.79 (95% confidence interval 1.53-5.09) and prolonged cough 4.89 (95% confidence interval 2.59-9.23). In contrast, as compared with rural Sundsvall, the adjusted odds ratio for a positive skin-prick test was decreased in Konin, but increased in urban Sundsvall, 0.58 (95% confidence interval 0.37-0.91) and 1.67 (95% confidence interval 1.15-2.42) respectively. The study confirms that living in urban, as compared with rural areas, is associated with an increased prevalence of respiratory symptoms and sensitization to allergens. These differences could be explained by air pollution. Respiratory symptoms were more common in a similar urban group of Polish children who were exposed to even higher levels of air pollution. These children, however, had a much lower prevalence of sensitization to allergens, as compared with the Swedish children. This indicates that differences in lifestyle and standard of living between western Europe and a former socialist country influences the prevalence of atopy.

  • 10.
    Bråbäck, Lennart
    et al.
    Mid Sweden University.
    Breborowicz, Anna
    Julge, Kaja
    Knutsson, Anders
    Riikjärv, Mall Anne
    Vasar, Maire
    Björksten, Bengt
    Risk factors for respiratory symptoms and atopic sensitisation in the Baltic area1995In: Archives of Disease in Childhood, ISSN 0003-9888, Vol. 72, no 6, p. 487-493Article in journal (Refereed)
  • 11. Bylund, Sonja H.
    et al.
    Burström, Lage
    Knutsson, Anders
    A descriptive study of women injured by hand-arm vibration2002In: Annals of Occupational Hygiene, ISSN 0003-4878, Vol. 46, no 3, p. 299-307Article in journal (Refereed)
  • 12. Bögglid, Henrik
    et al.
    Knutsson, Anders
    Meta-analyse epidemiologischer literatur über schicharbeit und herzerkrankungen.2000In: Zeitschrift für Arbeitswissenschaft., ISSN 0340-2444, Vol. 54, no 3/4, p. 330-334Article in journal (Refereed)
    Abstract [en]

    Shift work has been associated with a higher risk of heart disease. The epidemiological literature is heterogeneous with some studies finding risks for shift workers twice as high as for day workers, while other studies do not find shift workers to be at a higher risk of heart disease. We have examined the literature, using a meta analytic approach to give both a more precise estimate of the risk and to explore reasons for the apparent heterogeneity. The analysis suggests that among the longitudinal studies using individual exposure classification at least two different study populations existed based on statistical testing, one finding an increased risk of heart disease with a meta risk estimate of 1.31 (95% confidence interval (CI): 1.17-1.45), the other finding no excess risk with an estimate of 0.96 (95% CI: 0.85-1.08). Study characteristics including publication year, geographic area, exposure estimation, outcome, follow up period, confounding control or overall quality of study did not explain the heterogeneity. In conclusion shift work seems in some instances, not explained by study characteristics, to raise the risk of heart disease.

  • 13. Bøggild, H
    et al.
    Knutsson, Anders
    Shift work, risk factors and cardiovascular disease1999In: Scandinavian Journal of Work Environment & Health, ISSN 0355-3140, Vol. 25, no 2, p. 85-99Article in journal (Refereed)
  • 14.
    Carlerby, Heidi
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Erling, Englund
    Research and Development Centre for the County Council of Västernorrland.
    Viitasara, Eija
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Knutsson, Anders
    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.
    Risk behaviour, parental background, and wealth: a cluster analysis among Swedish boys and girls in the HBSC study2012In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 40, no 4, p. 368-376Article in journal (Refereed)
    Abstract [en]

    Aim: To analyse how health risk behaviours (HRB) are clustered and associated with parental background and family wealth among Swedish boys and girls.

    Methods: Data were collected from Health Behaviour in School-aged Children (HBSC),a global cross-sectional survey for 1997/98, 2001/02, and 2005/06. A total of 11,972 boys and girls in grades 5, 7, and 9 participated in the study. The pupils were categorised in subgroups according to parental background: Swedish (80.0%), mixed (10.6%), and foreign (9.4%). Cluster analyses were used to identify HRB profiles. Multinomial logistic regression analysis was used to estimate associations between cluster allocation, parental background, and family affluence.

    Results: In total 11,232 pupils were identified and allocated to five cluster profiles, half of them in the cluster profile of low-risk behaviour. The most disadvantaged cluster was multiple HRB, which was characterised by high prevalence of smoking, drunkenness, low physical activity, and high soft-drink consumption. The cluster profile of multiple HRB was associated with both mixed background and foreign background in girls and with mixed background in boys.. The cluster profile of inadequate tooth brushing was associated with foreign background in both boys and girls. The cluster profiles of multiple HRB and inadequate tooth brushing were associated with low family affluence in girls.

    Conclusions: The cluster profiles of multiple HRB and inadequate tooth brushing were associated with parental foreign extraction in boys and girls and with low family affluence in girls. Prevention programmes based on identified clusters of HRB, including consideration of impact of socio-demographic indicators, are needed.

  • 15.
    Carlerby, Heidi
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Viitasara, Eija
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Knutsson, Anders
    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.
    How Bullying Involvement is Associated with the Distribution of Parental Background and With Subjective Health Complaints Among Swedish Boys and Girls2013In: Social Indicators Research, ISSN 0303-8300, E-ISSN 1573-0921, Vol. 111, no 3, p. 775-783Article in journal (Refereed)
    Abstract [en]

    This study aimed to analyze how bullying involvement is associated with the distribution of parental background and with subjective health complaints (SHC) among Swedish boys and girls. Data were collected from the World Health Organization, Health Behavior in School-aged Children (WHO/HBSC) survey, measurement years 1997/1998, 2001/2002 and 2005/2006. A total of 11,972 boys (50.6 %) and girls (49.4 %) in grades five, seven and nine participated in the study. The adolescents were categorized in subgroups according to parental background: Swedish (80.1 %), mixed (10.5 %) and foreign(9.7 %). Multivariate logistic regressions were used to estimate remaining risk of SHC in the categories of bullying involvement. The frequencies of bullying involvement once or more were: none involved (74.8 %), victims (10.6 %), bullies (10.3 %) and bully/victims (4.4 %). Six out of ten involved in bullying were boys. Boys of foreign background were more involved as bullies compared to boys of mixed or Swedish background. Girls of foreign background were more involved in all three categories of bullying than girls of mixed or Swedish background. Increased risk of SHC was estimated among all adolescents involved in bullying, with highest OR in the category of bully/victims, OR 3.95 (CI 3.13–4.97) for the boys and OR 4.51 (CI 4.51–6.40) for the girls. The multivariate models were stable even after adjustment for socio-demographics. There are some associations between bullying involvement and parental background. Regardless of parental background, family affluence, family structure and gender, all adolescents involved in bullying are at increased risk of SHC.

  • 16.
    Carlerby, Heidi
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Viitasara, Eija
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Knutsson, Anders
    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.
    How discrimination and participation are associated with psychosomatic problems among boys and girls in northern Sweden2012In: Health, ISSN 1949-5005, Vol. 4, no 10, p. 866-872Article in journal (Refereed)
    Abstract [en]

    Background: Negative impact on health from school disturbance due to asymmetric power relations such as discrimination and offensive treatment are frequent problems among students. This study sought to analyze associations between occurrence of discrimination at school, participation and psychosomatic problems. Methods: Pupils in grades 6–9 in ten schools in a northern Swedish municipality participated in the study. The frequency of discrimination at school was measured by six items: sex; culture or ethnicity; disability; religion beliefs; sexual preferences; and any other form of discrimination. The Social and Civic Objectives Scale (SCOS) was used for an estimation of the level of participation. The pupils’ health was measured by the PsychoSomatic Problem (PSP) scale. Multivariate logistic regression models were used for estimation of increased risk of PSP. The formula Z=d/s (d)was used to test mediation. Results: Two thirds of the boys and three fourths of the girls reported occurrences of discrimination at schools (p = 0.001). Discrimination was a mediating factor between participation and PSP among boys and girls as the mediating formula Z=d/s (d) was > + 2 SD, –2.59 for boys and –39.27 for girls. Independent of each other, low participation and discrimination were associated with increased risk of PSP. Conclusion: Discrimination was a mediating factor between participation and PSP. The mediating effectwas stronger in girls than in boys. There is a need for school health promotion programsfocusing on participation in terms of democratic processes, communication and cooperation in the classroom.

  • 17.
    Carlerby, Heidi
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Viitasara, Eija
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Knutsson, Anders
    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.
    Subjective health complaints among boys and girls in the Swedish HBSC study: focussing on parental foreign background2011In: International Journal of Public Health, ISSN 1661-8556, E-ISSN 1661-8564, Vol. 56, no 5, p. 457-464Article in journal (Refereed)
    Abstract [en]

    Objective: The general aim of this study was to explore the associations between foreign extraction and subjective health complaints (SHC) among school-aged children in Sweden. Methods: Data were obtained from the global cross-sectional survey Health Behaviour in School-aged Children (HBSC), 1997/1998, 2001/2002, and 2005/2006. A total of 11,972 pupils in grades 5, 7 and 9 participated in the survey. Logistic regression analyses were used to estimate remaining risk of SHC among the subgroups of pupils. The analyses were adjusted for socio-demographic indicators, grade and measurement year. Results: Parental background: Swedish n = 9,585, mixed n = 1,263, and foreign n = 1,124. The results showed an increased risk of SHC among girls with a foreign background OR 1.27 (95% CI 1.04-1.55) compared with girls with a Swedish background and among girls in single-adult households OR 1.42 (95% CI 1.20-1.67) compared with girls in two-adult households. No such differences were shown among boys. Conclusions: A significantly increased risk of ill health remained in girls of foreign background after adjustment for socio-demographic indicators, grade and measurement year. © 2011 Swiss School of Public Health.

  • 18.
    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
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    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 Individuals2017In: Epidemiology, ISSN 1044-3983, E-ISSN 1531-5487, Vol. 28, no 4, p. 619-626Article in journal (Refereed)
    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.

  • 19.
    du Prel, J. B.
    et al.
    Univ Ulm, Inst Hist Philosophy & Eth Med, D-89069 Ulm, Germany..
    Runeson-Broberg, R.
    Univ Uppsala Hosp, Occupat & Environm Med, Uppsala, Sweden..
    Westerholm, P.
    Univ Uppsala Hosp, Occupat & Environm Med, Uppsala, Sweden..
    Nordin, M.
    Stockholm Univ, Stress Res Inst, S-10691 Stockholm, Sweden..
    Fahlen, G.
    Natl Agcy Special Needs Educ & Sch, Harnosand, Sweden..
    Alfredsson, L.
    Karolinska Inst, Stockholm, Sweden..
    Knutsson, Anders
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences. Mid Sweden Univ, Sundsvall, Sweden..
    Peter, R.
    Univ Ulm, Inst Hist Philosophy & Eth Med, D-89069 Ulm, Germany..
    Work-Related Overcommitment: Is it a State or a Trait? - Results from the Swedish WOLF-Study.2015In: International Journal of Epidemiology, ISSN 0300-5771, E-ISSN 1464-3685, Vol. 44, no S1, p. 263-263, article id 3649Article in journal (Other academic)
  • 20.
    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
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Nordin, Maria
    Umeå Univ, Umeå; Stockholm Univ, Stockholm.
    Peter, Richard
    Ulm Univ, Ulm, Germany.
    Work overcommitment: Is it a trait or a state?2018In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 91, no 1, p. 1-11Article in journal (Refereed)
    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.

  • 21.
    Fahlén, Göran
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Goine, Hans
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Edlund, Curt
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Arrelöv, Britt
    Knutsson, Anders
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Peter, Richard
    Effort-reward imbalance, "locked in" at work and long term sick leave2009In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 82, no 2, p. 191-197Article in journal (Refereed)
    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.

  • 22.
    Fahlén, Göran
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Knutsson, Anders
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Effort-Reward Imbalance-modellen för psykosocial stress i arbetslivet: En jämförelse mellan två modeller för skattning av exponering2002In: Psykosocial belastning och riskfaktorer för hjärt-kärlsjukdom - Minisymposium i WOLF-projektet 8 februari 2001 / [ed] Pter Westerholm, Stockholm: Arbetslivsinstitutet , 2002, p. 7-10Chapter in book (Other academic)
  • 23.
    Fahlén, Göran
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Knutsson, Anders
    Peter, Richard
    Alfredsson, Lars
    Westerholm, Peter
    Evaluating stability and reactivity in work-related overcommitment under the ERI model: does the shortened questionnaire lead to changes in model properties?Manuscript (Refereed)
  • 24.
    Fahlén, Göran
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Knutsson, Anders
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    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 fatigue2006In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 79, no 5, p. 371-378Article in journal (Refereed)
    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.

  • 25.
    Fahlén, Göran
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Peter, Richard
    Knutsson, Anders
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    The Effort-reward imbalance model of psychosocial stress at the workplace - a comparison of ERI exposure assessment using two estimation methods2004In: Work & Stress, ISSN 0267-8373, E-ISSN 1464-5335, Vol. 18, no 1, p. 81-88Article in journal (Refereed)
    Abstract [en]

    It is not unusual for old data to be used in epidemiological studies. Recently developed instruments for measuring work-related stress did not exist when the data collection was carried out. Therefore, approximate questions are sometimes used. An apparent problem is the lack of validation of proxy questions. The aim of this study was to compare the original questions for measuring Effort-Reward Imbalance (ERI) with approximate questions. The study population corresponded with a subgroup in the WOLF-n (WOrk, Lipids, Fibrinogen-north) cohort study of cardiovascular risk in a working population in the north of Sweden: 655 men and 178 women. The agreement in exposure between the original and the approximate ERI single questions was relatively low throughout, whereas the correlation between the ERI subscales and the ERI ratios was reasonable. The latter agreement between the original and the approximate ERI ratio indicates that the approximate measures might have been useful in the past. Yet, whenever possible the implementation of the original questionnaire in study protocols is recommended since a complete measurement of ERI might help to further improve the internal consistency and the predictive validity of this exposure to effort-reward imbalance.

  • 26.
    Ferrie, Jane E.
    et al.
    University College London, London, United Kingdom; University of Bristol, Bristol, United Kingdom.
    Virtanen, Marianna
    Finnish Institute of Occupational Health, Helsinki, Tampere and Turku, Finland.
    Jokela, Markus
    University of Helsinki, Helsinki, Finland.
    Madsen, Ida E. H.
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Heikkilä, Katriina
    Finnish Institute of Occupational Health, Helsinki, Tampere and Turku, Finland.
    Alfredsson, Lars
    Karolinska Institutet, Stockholm; Stockholm County Council.
    Batty, G. David
    University College London, London, United Kingdom; University of Edinburgh, Edinburgh, United Kingdom.
    Bjorner, Jakob B.
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Borritz, Marianne
    Bispebjerg University Hospital, Copenhagen, Denmark.
    Burr, Hermann
    Federal Institute for Occupational Safety and Health, Bundesanstalt für Arbeitsschutz und Arbeitsmedizin), Berlin, Germany.
    Dragano, Nico
    University of Düsseldorf, Düsseldorf, Germany.
    Elovainio, Marko
    National Institute for Health and Welfare, Helsinki, Finland.
    Fransson, Eleonor I.
    Karolinska Institutet; Jönköping University, Jönköping; Stockholm University, Stockholm.
    Knutsson, Anders
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Koskenvuo, Markku
    University of Helsinki, Helsinki, Finland.
    Koskinen, Aki
    Finnish Institute of Occupational Health, Helsinki, Tampere and Turku, Finland.
    Kouvonen, Anne
    University of Helsinki, Helsinki, Finland.
    Kumari, Meena
    University of Essex, Colchester, United Kingdom.
    Nielsen, Martin L.
    Frederiksberg University Hospital, Copenhagen, Denmark.
    Nordin, Maria
    Umeå University, Umeå.
    Oksanen, Tuula
    Finnish Institute of Occupational Health, Helsinki, Tampere and Turku, Finland.
    Pahkin, Krista
    Finnish Institute of Occupational Health, Helsinki, Tampere and Turku, Finland.
    Pejtersen, Jan H.
    Danish National Centre for Social Research, Copenhagen, Denmark.
    Pentti, Jaana
    Finnish Institute of Occupational Health, Helsinki, Tampere and Turku, Finland.
    Salo, Paula
    Finnish Institute of Occupational Health, Helsinki, Tampere and Turku, Finland; University of Turku, Turku, Finland.
    Shipley, Martin J.
    University College London, London, United Kingdom.
    Suominen, Sakari B.
    University of Turku, Turku, Finland; Folkhälsan Research Center, Helsinki, Finland; University of Skövde, Skövde.
    Tabák, Adam
    University College London, London, United Kingdom; Semmelweis University, Budapest, Hungary.
    Theorell, Töres
    Stockholm County Council, Stockholm.
    Väänänen, Ari
    Finnish Institute of Occupational Health, Helsinki, Tampere and Turku, Finland.
    Vahtera, Jussi
    Finnish Institute of Occupational Health, Helsinki, Tampere and Turku, Finland; University of Turku, Turku, Finland; Turku University Hospital, Turku, Finland .
    Westerholm, Peter J. M.
    Turku University Hospital, Turku, Finland.
    Westerlund, Hugo
    Stockholm County Council, Stockholm.
    Rugulies, Reiner
    National Research Centre for the Working Environment, Copenhagen, Denmark; University of Copenhagen, Copenhagen, Denmark.
    Nyberg, Solja T.
    Finnish Institute of Occupational Health, Helsinki, Tampere and Turku, Finland.
    Kivimäki, Mika
    University College London, London, United Kingdom; Finnish Institute of Occupational Health, Helsinki, Tampere and Turku, Finland; University of Helsinki, Helsinki, Finland.
    Job insecurity and risk of diabetes: A meta-analysis of individual participant data2016In: CMJA. Canadian Medical Association Journal. Onlineutg. Med tittel: ECMAJ. ISSN 1488-2329, ISSN 0820-3946, E-ISSN 1488-2329, Vol. 188, no 17-18, p. E447-E455Article in journal (Refereed)
    Abstract [en]

    Background: Job insecurity has been associated with certain health outcomes. We examined the role of job insecurity as a risk factor for incident diabetes. Methods: We used individual participant data from 8 cohort studies identified in 2 open-access data archives and 11 cohort studies participating in the Individual-Participant-Data Meta-analysis in Working Populations Consortium. We calculated study-specific estimates of the association between job insecurity reported at baseline and incident diabetes over the follow-up period. We pooled the estimates in a meta-analysis to produce a summary risk estimate. Results: The 19 studies involved 140 825 participants from Australia, Europe and the United States, with a mean follow-up of 9.4 years and 3954 incident cases of diabetes. In the preliminary analysis adjusted for age and sex, high job insecurity was associated with an increased risk of incident diabetes compared with low job insecurity (adjusted odds ratio [OR] 1.19, 95% confidence interval [CI] 1.09-1.30). In the multivariable-adjusted analysis restricted to 15 studies with baseline data for all covariates (age, sex, socioeconomic status, obesity, physical activity, alcohol and smoking), the association was slightly attenuated (adjusted OR 1.12, 95% CI 1.01-1.24). Heterogeneity between the studies was low to moderate (age- and sex-adjusted model: I2 = 24%, p = 0.2; multivari-able-adjusted model: I2 = 27%, p = 0.2). In the multivariable-adjusted analysis restricted to high-quality studies, in which the diabetes diagnosis was ascertained from electronic medical records or clinical examination, the association was similar to that in the main analysis (adjusted OR 1.19, 95% CI 1.04-1.35). Interpretation: Our findings suggest that self-reported job insecurity is associated with a modest increased risk of incident diabetes. Health care personnel should be aware of this association among workers reporting job insecurity.

  • 27.
    Fransson, E.I.
    et al.
    Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77 Stockholm, Sweden.
    Nyberg, S
    Finnish Institute of Occupational Health, Helsinki, Finland.
    Heikkilä, K
    Finnish Institute of Occupational Health, Helsinki, Finland.
    Alfredsson, L
    Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77 Stockholm, Sweden.
    Bacquer, D
    Department of Public Health, Ghent University, Ghent, Belgium.
    Batty, G
    Department of Epidemiology and Public Health, University College London, London, United Kingdom.
    Bonenfant, S
    Versailles-Saint Quentin University, Versailles, France.
    Casini, A
    School of Public Health, Université Libre de Bruxelles, Brussels, Belgium.
    Clays, E
    Department of Public Health, Ghent University, Ghent, Belgium.
    Goldberg, M
    Versailles-Saint Quentin University, Versailles, France.
    Kittel, F
    School of Public Health, Université Libre de Bruxelles, Brussels, Belgium.
    Koskenvuo, M
    Department of Public Health, University of Helsinki, Helsinki, Finland.
    Knutsson, Anders
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Leineweber, C
    Stress Research Institute, Stockholm University, Stockholm, Sweden.
    Magnusson Hanson, L
    Stress Research Institute, Stockholm University, Stockholm, Sweden.
    Nordin, M
    Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden.
    Singh-Manoux, A
    Department of Epidemiology and Public Health, University College London, London, United Kingdom.
    Suominen, S
    Department of Public Health, University of Turku, Turku, Finland.
    Vahtera, J
    Department of Public Health, University of Turku, Turku, Finland.
    Westerholm, P
    Finnish Institute of Occupational Health, Turku, Finland.
    Westerlund, H
    Department of Epidemiology and Public Health, University College London, London, United Kingdom.
    Zins, M
    Versailles-Saint Quentin University, Versailles, France.
    Theorell, T
    Stress Research Institute, Stockholm University, Stockholm, Sweden.
    Kivimäki, M
    Department of Epidemiology and Public Health, University College London, London, United Kingdom.
    Comparison of alternative versions of the job demand-control scales in 17 European cohort studies: The IPD-Work consortium2012In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 12, no 1, p. Art. no. 62-Article in journal (Refereed)
    Abstract [en]

    Background: Job strain (i.e., high job demands combined with low job control) is a frequently used indicator of harmful work stress, but studies have often used partial versions of the complete multi-item job demands and control scales. Understanding whether the different instruments assess the same underlying concepts has crucial implications for the interpretation of findings across studies, harmonisation of multi-cohort data for pooled analyses, and design of future studies. As part of the ’IPD-Work’ (Individual-participant-data meta-analysis in working populations) consortium, we compared different versions of the demands and control scales available in 17 European cohort studies. Methods. Six of the 17 studies had information on the complete scales and 11 on partial scales. Here, we analyse individual level data from 70 751 participants of the studies which had complete scales (5 demand items, 6 job control items). Results. We found high Pearson correlation coefficients between complete scales of job demands and control relative to scales with at least three items (r > 0.90) and for partial scales with two items only (r = 0.76-0.88). In comparison with scores from the complete scales, the agreement between job strain definitions was very good when only one item was missing in either the demands or the control scale (kappa > 0.80); good for job strain assessed with three demand items and all six control items (kappa > 0.68) and moderate to good when items were missing from both scales (kappa = 0.54-0.76). The sensitivity was > 0.80 when only one item was missing from either scale, decreasing when several items were missing in one or both job strain subscales. Conclusions. Partial job demand and job control scales with at least half of the items of the complete scales, and job strain indices based on one complete and one partial scale, seemed to assess the same underlying concepts as the complete survey instruments. 

  • 28. Fransson, Eleonor
    et al.
    Alfredsson, Lars
    de Faire, Ulf
    Knutsson, Anders
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Westerholm, Peter
    Leisure time, occupational and household physical activity and risk factors for cardiovascular disease in working men and women: the WOLF study2003In: Scandinavian Journal of Public Health, ISSN 1403-4948, Vol. 31, no 5, p. 324-333Article in journal (Refereed)
  • 29.
    Fransson, Eleonor I.
    et al.
    Karolinska Inst, Inst Environm Med, SE-17177 Stockholm, Sweden .
    Heikkilä, Katriina
    Finnish Inst Occupat Hlth, Helsinki, Finland .
    Nyberg, Solja T.
    Finnish Inst Occupat Hlth, Helsinki, Finland .
    Zins, Marie
    Versailles St Quentin Univ, Versailles, France .
    Westerlund, Hugo
    UCL, Dept Epidemiol & Publ Hlth, London, England .
    Westerholm, Peter
    Uppsala Univ, Dept Occupat & Environm Med, Uppsala, Sweden .
    Väänänen, Ari
    Finnish Inst Occupat Hlth, Helsinki, Finland .
    Virtanen, Marianna
    Finnish Inst Occupat Hlth, Helsinki, Finland .
    Vahtera, Jussi
    Finnish Inst Occupat Hlth, Helsinki, Finland .
    Theorell, Töres
    Stockholm Univ, Stress Res Inst, S-10691 Stockholm, Sweden .
    Suominen, Sakari
    Univ Turku, Dept Publ Hlth, Turku, Finland .
    Singh-Manoux, Archana
    Inst Natl Sante & Rech Med, U1018, Ctr Res Epidemiol & Populat Hlth, Villejuif, France .
    Siegrist, Johannes
    Univ Dusseldorf, Dept Med Sociol, D-40225 Dusseldorf, Germany .
    Sabia, Séverine
    UCL, Dept Epidemiol & Publ Hlth, London, England .
    Rugulies, Reiner
    Natl Res Ctr Working Environm, Copenhagen, Denmark.
    Pentti, Jaana
    Finnish Inst Occupat Hlth, Helsinki, Finland .
    Oksanen, Tuula
    Finnish Inst Occupat Hlth, Helsinki, Finland .
    Nordin, Maria
    Umea Univ, Dept Publ Hlth & Clin Med Occupat & Environm Med, Umea, Sweden .
    Nielsen, Martin L.
    Bispebjerg Hosp, Dept Occupat & Environm Med, Copenhagen, Denmark .
    Marmot, Michael G.
    UCL, Dept Epidemiol & Publ Hlth, London, England .
    Magnusson Hanson, Linda L.
    Stockholm Univ, Stress Res Inst, S-10691 Stockholm, Sweden .
    Madsen, Ida E. H.
    Natl Res Ctr Working Environm, Copenhagen, Denmark .
    Lunau, Thorsten
    Univ Duisburg Essen, Inst Med Informat Biometry & Epidemiol, Essen, Germany .
    Leineweber, Constanze
    Stockholm Univ, Stress Res Inst, S-10691 Stockholm, Sweden .
    Kumari, Meena
    UCL, Dept Epidemiol & Publ Hlth, London, England .
    Kouvonen, Anne
    Queens Univ Belfast, Sch Sociol Social Policy & Social Work, Belfast, Antrim, Northern Ireland .
    Koskinen, Aki
    Finnish Inst Occupat Hlth, Helsinki, Finland .
    Koskenvuo, Markku
    Univ Helsinki, Dept Publ Hlth, Helsinki, Finland .
    Knutsson, Anders
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Kittel, France
    Univ Libre Brussels, Sch Publ Hlth, Brussels, Belgium .
    Jöckel, Karl-Heinz
    Univ Duisburg Essen, Inst Med Informat Biometry & Epidemiol, Essen, Germany .
    Joensuu, Matti
    Finnish Inst Occupat Hlth, Helsinki, Finland .
    Houtman, Irene L.
    Netherlands Org Appl Sci Res TNO, Hoofddorp, Netherlands .
    Hooftman, Wendela E.
    Netherlands Org Appl Sci Res TNO, Hoofddorp, Netherlands .
    Goldberg, Marcel
    Versailles St Quentin Univ, Versailles, France .
    Geuskens, Goedele A.
    Netherlands Org Appl Sci Res TNO, Hoofddorp, Netherlands .
    Ferrie, Jane E.
    Univ Bristol, Sch Social & Community Med, Bristol, Avon, England .
    Erbel, Raimund
    Univ Duisburg Essen, Dept Cardiol, W German Heart Ctr Essen, Essen, Germany .
    Dragano, Nico
    Univ Duisburg Essen, Inst Med Informat Biometry & Epidemiol, Essen, Germany .
    De Bacquer, Dirk
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium .
    Clays, Els
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium .
    Casini, Annalisa
    Univ Libre Brussels, Sch Publ Hlth, Brussels, Belgium .
    Burr, Hermann
    Fed Inst Occupat Safety & Hlth, Berlin, Germany.
    Borritz, Marianne
    Bispebjerg Hosp, Dept Occupat & Environm Med, Copenhagen, Denmark .
    Bonenfant, Sébastien
    Versailles St Quentin Univ, Versailles, France .
    Bjorner, Jakob B.
    Natl Res Ctr Working Environm, Copenhagen, Denmark .
    Alfredsson, Lars
    Karolinska Inst, Inst Environm Med, SE-17177 Stockholm, Sweden .
    Hamer, Mark
    UCL, Dept Epidemiol & Publ Hlth, London, England .
    Batty, G. David
    UCL, Dept Epidemiol & Publ Hlth, London, England .
    Kivimäki, Mika
    Finnish Inst Occupat Hlth, Helsinki, Finland .
    Job Strain as a Risk Factor for Leisure-Time Physical Inactivity: An Individual-Participant Meta-Analysis of Up to 170,000 Men and Women2012In: American Journal of Epidemiology, ISSN 0002-9262, E-ISSN 1476-6256, Vol. 176, no 12, p. 1078-1089Article, review/survey (Refereed)
    Abstract [en]

    Unfavorable work characteristics, such as low job control and too high or too low job demands, have been suggested to increase the likelihood of physical inactivity during leisure time, but this has not been verified in large-scale studies. The authors combined individual-level data from 14 European cohort studies (baseline years from 1985–1988 to 2006–2008) to examine the association between unfavorable work characteristics and leisure-time physical inactivity in a total of 170,162 employees (50% women; mean age, 43.5 years). Of these employees, 56,735 were reexamined after 2–9 years. In cross-sectional analyses, the odds for physical inactivity were 26% higher (odds ratio = 1.26, 95% confidence interval: 1.15, 1.38) for employees with high-strain jobs (low control/high demands) and 21% higher (odds ratio = 1.21, 95% confidence interval: 1.11, 1.31) for those with passive jobs (low control/low demands) compared with employees in low-strain jobs (high control/low demands). In prospective analyses restricted to physically active participants, the odds of becoming physically inactive during follow-up were 21% and 20% higher for those with high-strain (odds ratio = 1.21, 95% confidence interval: 1.11, 1.32) and passive (odds ratio = 1.20, 95% confidence interval: 1.11, 1.30) jobs at baseline. These data suggest that unfavorable work characteristics may have a spillover effect on leisure-time physical activity.

  • 30.
    Fransson, Eleonor I.
    et al.
    Department of Natural Science and Biomedicine, School of Health Sciences, Jönköping University, Box 1026, Jönköping, Sweden.
    Nyberg, Solja T.
    Finnish Institute of Occupational Health, Tampere, Finland.
    Heikkila, Katriina
    Finnish Institute of Occupational Health, Tampere, Finland.
    Alfredsson, Lars
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden .
    Bjorner, Jakob B.
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Borritz, Marianne
    Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark .
    Burr, Hermann
    Federal Institute for Occupational Safety and Health (BAuA), Berlin, Germany .
    Dragano, Nico
    Institute for Medical Sociology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany .
    Geuskens, Goedele A.
    Netherlands Organisation for Applied Scientific Research (TNO), Hoofddorp, Netherlands .
    Goldberg, Marcel
    Versailles-Saint Quentin University, Versailles, France .
    Hamer, Mark
    Department of Epidemiology and Public Health, University College London, London, United Kingdom.
    Hooftman, Wendela E.
    Netherlands Organisation for Applied Scientific Research (TNO), Hoofddorp, Netherlands .
    Houtman, Irene L.
    Netherlands Organisation for Applied Scientific Research (TNO), Hoofddorp, Netherlands .
    Joensuu, Matti
    Finnish Institute of Occupational Health, Helsinki, Finland .
    Jokela, Markus
    Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland .
    Knutsson, Anders
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Koskenvuo, Markku
    Department of Public Health, University of Helsinki, Helsinki, Finland.
    Koskinen, Aki
    Finnish Institute of Occupational Health, Helsinki, Finland.
    Kumari, Meena
    Department of Epidemiology and Public Health, University College London, London, United Kingdom .
    Leineweber, Constanze
    Stress Research Institute, Stockholm University, Stockholm, Sweden.
    Lunau, Thorsten
    Institute for Medical Sociology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany .
    Madsen, Ida E. H.
    National Research Centre for the Working Environment, Copenhagen, Denmark .
    Hanson, Linda L. Magnusson
    Stress Research Institute, Stockholm University, Stockholm, Sweden.
    Nielsen, Martin L.
    Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark .
    Nordin, Maria
    Department of Psychology, Umeå University, Umeå, Sweden .
    Oksanen, Tuula
    Finnish Institute of Occupational Health, Turku, Finland .
    Pentti, Jaana
    Finnish Institute of Occupational Health, Turku, Finland .
    Pejtersen, Jan H.
    Danish National Centre for Social Research, Copenhagen, Denmark.
    Rugulies, Reiner
    Department of Public Health, Department of Psychology, University of Copenhagen, Copenhagen, Denmark .
    Salo, Paula
    Finnish Institute of Occupational Health, Turku, Finland .
    Shipley, Martin J.
    Department of Epidemiology and Public Health, University College London, London, United Kingdom .
    Steptoe, Andrew
    Department of Epidemiology and Public Health, University College London, London, United Kingdom .
    Suominen, Sakari B.
    Folkhälsan Research Centre, Helsinki, Finland .
    Theorell, Toeres
    Stress Research Institute, Stockholm University, Stockholm, Sweden .
    Toppinen-Tanner, Salla
    Finnish Institute of Occupational Health, Helsinki, Finland .
    Vahtera, Jussi
    Finnish Institute of Occupational Health, Turku, Finland .
    Virtanen, Marianna
    Finnish Institute of Occupational Health, Helsinki, Finland .
    Vaananen, Ari
    Finnish Institute of Occupational Health, Helsinki, Finland .
    Westerholm, Peter J. M.
    Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden .
    Westerlund, Hugo
    Stress Research Institute, Stockholm University, Stockholm, Sweden .
    Zins, Marie
    Department of Natural Science and Biomedicine, School of Health Sciences, Jönköping University, Box 1026, Jönköping, Sweden .
    Britton, Annie
    Department of Epidemiology and Public Health, University College London, London, United Kingdom .
    Brunner, Eric J.
    Department of Epidemiology and Public Health, University College London, London, United Kingdom .
    Singh-Manoux, Archana
    Department of Epidemiology and Public Health, University College London, London, United Kingdom .
    Batty, G. David
    Department of Epidemiology and Public Health, University College London, London, United Kingdom .
    Kivimaki, Mika
    Department of Epidemiology and Public Health, University College London, London, United Kingdom .
    Job Strain and the Risk of Stroke An Individual-Participant Data Meta-Analysis2015In: Stroke, ISSN 0039-2499, E-ISSN 1524-4628, Vol. 46, no 2, p. 557-559Article in journal (Refereed)
    Abstract [en]

    Background and Purpose-Psychosocial stress at work has been proposed to be a risk factor for cardiovascular disease. However, its role as a risk factor for stroke is uncertain. Methods-We conducted an individual-participant-data meta-analysis of 196 380 males and females from 14 European cohort studies to investigate the association between job strain, a measure of work-related stress, and incident stroke. Results-In 1.8 million person-years at risk (mean follow-up 9.2 years), 2023 first-time stroke events were recorded. The age-and sex-adjusted hazard ratio for job strain relative to no job strain was 1.24 (95% confidence interval, 1.05; 1.47) for ischemic stroke, 1.01 (95% confidence interval, 0.75; 1.36) for hemorrhagic stroke, and 1.09 (95% confidence interval, 0.94; 1.26) for overall stroke. The association with ischemic stroke was robust to further adjustment for socioeconomic status. Conclusion-Job strain may be associated with an increased risk of ischemic stroke, but further research is needed to determine whether interventions targeting job strain would reduce stroke risk beyond existing preventive strategies.

  • 31.
    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
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    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 Study2015In: BioMed Research International, ISSN 2314-6133, E-ISSN 2314-6141, article id 371905Article in journal (Refereed)
    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.

  • 32. Fransson, Eleonor
    et al.
    Knutsson, Anders
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Westerholm, Peter
    Alfredsson, Lars
    Indications of recall bias found in a retrospective study of physical activity and myocardial infarction.2008In: Journal of Clinical Epidemiology, ISSN 0895-4356, E-ISSN 1878-5921, Vol. 61, no 8, p. 840-847Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To evaluate the presence of recall bias in retrospective studies of physical activity and myocardial infarction. STUDY DESIGN AND SETTING: In 2005, seventy-eight cases who had suffered from a myocardial infarction and 243 control subjects, who had previously participated in the Swedish WOLF (Work, Lipids, and Fibrinogen) study, were asked about their physical activity level during 1990-2005. The answers about recalled past leisure time, occupational, and household physical activity level were compared with physical activity level as reported at the baseline examination of the WOLF study in 1992-1998. RESULTS: The proportion who recalled the same activity level as originally reported ranged from 69% to 96% (cases) and 69% to 89% (controls), and the kappa values ranged from 0.30 to 0.91 (cases) and 0.46 to 0.59 (controls), with the exception of perceived physical workload in household work, which showed low agreement between the originally stated and later recalled activity levels. Some differences were found between cases and controls regarding recall of past occupational activity, indicating the presence of recall bias in this domain of physical activity. CONCLUSION: We cannot preclude the existence of recall bias when using retrospectively recalled information about occupational physical activity in studies of physical activity and myocardial infarction.

  • 33.
    Goine, Hans
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Edlund, C
    Knutsson, Anders
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Welfare systems: Communicating vessels?2006In: EUROPEAN JOURNAL OF PUBLIC HEALTH, 2006, Vol. 16, no Suppl 1, p. 95-95Conference paper (Refereed)
  • 34.
    Goine, Hans
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Knutsson, Anders
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Marklund, Staffan
    Karlsson, Berndt
    Sickness absence and early retirement at two workplaces: effects of organisational intervention in Sweden2004In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 58, no 1, p. 99-108Article in journal (Refereed)
    Abstract [en]

    This study sought to compare sickness absence and early retirement at two workplaces in Sweden before and after they had received financial support from the Working Life Fund and implemented vocational rehabilitation activities. Two paper and pulp manufacturing plants were compared and a cohort study was set up. The cohort included everyone born in 1934 or later who was employed in December 1988 (918 employees at Plant A and 1543 at Plant B). For 10 years (1989-98), sick leave and disability pensions were monitored. The periods before and after the intervention (1989-93 and 1994-98, respectively) were compared. Cumulative incidence was calculated for short-, long-term and very long-term sick leave, company pension and early retirement. There was no difference between the plants in terms of the three different outcomes when sick leave was measured before and after the intervention. Sick leave in Period 1 was strongly correlated with an elevated risk of sick leave in Period 2. The cumulative incidence of short-term sick leave decreased from 0.92 (95% CI, 0.91-0.93) in Period 1 to 0.79 (95% CI, 0.77-0.80) in Period 2. For employees in the upper age groups, relative risk for long-term and very long-term sick leave was elevated in both periods. The incidence of early retirement and company pension differed between the companies. We conclude that the size of financial investments in rehabilitation programmes has no significant impact on sickness absence or disability pension, based on a comparison between two paper and pulp manufacturing plants in Sweden during the early 1990s. Sickness absence and early retirement at two workplaces--effects of organisational intervention in Sweden.Goine H, Knutsson A, Marklund S, Karlsson B.Department of Public Health and Clinical Medicine, Occupational Medicine, University of Umea, Sweden. hans@goine.pp.seThis study sought to compare sickness absence and early retirement at two workplaces in Sweden before and after they had received financial support from the Working Life Fund and implemented vocational rehabilitation activities. Two paper and pulp manufacturing plants were compared and a cohort study was set up. The cohort included everyone born in 1934 or later who was employed in December 1988 (918 employees at Plant A and 1543 at Plant B). For 10 years (1989-98), sick leave and disability pensions were monitored. The periods before and after the intervention (1989-93 and 1994-98, respectively) were compared. Cumulative incidence was calculated for short-, long-term and very long-term sick leave, company pension and early retirement. There was no difference between the plants in terms of the three different outcomes when sick leave was measured before and after the intervention. Sick leave in Period 1 was strongly correlated with an elevated risk of sick leave in Period 2. The cumulative incidence of short-term sick leave decreased from 0.92 (95% CI, 0.91-0.93) in Period 1 to 0.79 (95% CI, 0.77-0.80) in Period 2. For employees in the upper age groups, relative risk for long-term and very long-term sick leave was elevated in both periods. The incidence of early retirement and company pension differed between the companies. We conclude that the size of financial investments in rehabilitation programmes has no significant impact on sickness absence or disability pension, based on a comparison between two paper and pulp manufacturing plants in Sweden during the early 1990s

  • 35. Hammar,
    et al.
    Andersson,
    Alfredsson, Lars
    Reuterwall,
    Nilsson,
    Hallquist,
    Knutsson, Anders
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Ahlbom, A
    Association of boiled and filtered coffee with incidence of first nonfatal myocardial infarction: the SHEEP and the VHEEP study2003In: Journal of Internal Medicine, ISSN 0954-6820, Vol. 253, no 6, p. 653-659Article in journal (Refereed)
  • 36. Hammar, Niklas
    et al.
    Andersson, T
    Reuterwall, C
    Nilsson, T
    Knutsson, Anders
    Hallqvist, J
    Ahlbom, A
    Geographical differences in the incidence of acute myocardial infarction in Sweden: Analyses of possible causes using two parallel case control studies2001In: Journal of Internal Medicine, ISSN 0954-6820, Vol. 249, no 2, p. 137-144Article in journal (Refereed)
  • 37.
    Heikkila, Katriina
    et al.
    Finnish Inst Occupat Hlth, Helsinki, Finland.
    Madsen, Ida E. H.
    Natl Res Ctr Working Environm, Copenhagen, Denmark.
    Nyberg, Solja T.
    Finnish Inst Occupat Hlth, Helsinki, Finland.
    Fransson, Eleonor I.
    Karolinska Inst, Inst Environm Med, S-10401 Stockholm, Sweden.
    Ahola, Kirsi
    Finnish Inst Occupat Hlth, Helsinki, Finland.
    Alfredsson, Lars
    Karolinska Inst, Inst Environm Med, S-10401 Stockholm, Sweden.
    Bjorner, Jakob B.
    Karolinska Inst, Inst Environm Med, S-10401 Stockholm, Sweden.
    Borritz, Marianne
    Bispebjerg Hosp, Dept Occupat & Environm Med, Copenhagen, Denmark.
    Burr, Hermann
    Fed Inst Occupat Safety & Hlth BAuA, Berlin, Germany.
    Knutsson, Anders
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Koskenvuo, Markku
    Univ Helsinki, Dept Publ Hlth, Helsinki, Finland.
    Koskinen, Aki
    Finnish Inst Occupat Hlth, Helsinki, Finland.
    Nielsen, Martin L.
    Bispebjerg Hosp, Dept Occupat & Environm Med, Copenhagen, Denmark.
    Nordin, Maria
    Umea Univ, Dept Psychol, S-90187 Umea, Sweden.
    Pahkin, Krista
    Finnish Inst Occupat Hlth, Helsinki, Finland.
    Pentti, Jaana
    Finnish Inst Occupat Hlth, Turku, Finland.
    Rugulies, Reiner
    Natl Res Ctr Working Environm, Copenhagen, Denmark.
    Salo, Paula
    Finnish Inst Occupat Hlth, Turku, Finland.
    Shipley, Martin J.
    UCL, Dept Epidemiol & Publ Hlth, London, England.
    Suominen, Sakari B.
    Folkhalsan Res Ctr, Helsinki, Finland.
    Theorell, Tores
    Stockholm Univ, Stress Res Inst, S-10691 Stockholm, Sweden.
    Vaananen, Ari
    Finnish Inst Occupat Hlth, Helsinki, Finland.
    Vahtera, Jussi
    Finnish Inst Occupat Hlth, Turku, Finland.
    Virtanen, Marianna
    Finnish Inst Occupat Hlth, Helsinki, Finland.
    Westerholm, Peter J. M.
    Uppsala Univ, Uppsala, Sweden.
    Batty, G. David
    UCL, Dept Epidemiol & Publ Hlth, London, England.
    Singh-Manoux, Archana
    UCL, Dept Epidemiol & Publ Hlth, London, England.
    Kivimaki, Mika
    UCL, Dept Epidemiol & Publ Hlth, London, England.
    Job strain and COPD exacerbations: an individual-participant meta-analysis2014In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 44, no 1, p. 247-251Article in journal (Refereed)
  • 38.
    Heikkila, Katriina
    et al.
    Finnish Inst Occupat Hlth, Helsinki, Finland.
    Nyberg, Solja T.
    Finnish Inst Occupat Hlth, Helsinki, Finland.
    Fransson, Eleonor I.
    Karolinska Inst, Inst Environm Med, S-10401 Stockholm, Sweden.
    Alfredsson, Lars
    Karolinska Inst, Inst Environm Med, S-10401 Stockholm, Sweden.
    De Bacquer, Dirk
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium.
    Bjorner, Jakob B.
    Natl Res Ctr Working Environm, Copenhagen, Denmark.
    Bonenfant, Sebastien
    INSERM, U1018, Ctr Res Epidemiol & Populat Hlth, Villejuif, France.
    Borritz, Marianne
    Bispebjerg Hosp, Dept Occupat Med, Copenhagen, Denmark.
    Burr, Hermann
    Ctr Maritime Hlth & Safety, Esbjerg, Denmark.
    Clays, Els
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium.
    Casini, Annalisa
    Univ Libre Brussels, Sch Publ Hlth, Brussels, Belgium.
    Dragano, Nico
    Univ Duisburg Essen, Inst Med Informat Biometry & Epidemiol, Essen, Germany.
    Erbel, Raimund
    Univ Duisburg Essen, W German Heart Ctr Essen, Dept Cardiol, Essen, Germany.
    Geuskens, Goedele A.
    TNO, Hoofddorp, Netherlands.
    Goldberg, Marcel
    INSERM, U1018, Ctr Res Epidemiol & Populat Hlth, Villejuif, France.
    Hooftman, Wendela E.
    TNO, Hoofddorp, Netherlands.
    Houtman, Irene L.
    TNO, Hoofddorp, Netherlands.
    Joensuu, Matti
    Finnish Inst Occupat Hlth, Helsinki, Finland.
    Joeckel, Karl-Heinz
    Univ Duisburg Essen, Inst Med Informat Biometry & Epidemiol, Essen, Germany.
    Kittel, France
    Univ Libre Brussels, Sch Publ Hlth, Brussels, Belgium.
    Knutsson, Anders
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Koskenvuo, Markku
    Univ Helsinki, Dept Publ Hlth, Helsinki, Finland.
    Koskinen, Aki
    Finnish Inst Occupat Hlth, Helsinki, Finland.
    Kouvonen, Anne
    Wroclaw Fac, Warsaw Sch Social Sci & Humanities, Wroclaw, Poland.
    Leineweber, Constanze
    Stockholm Univ, Stress Res Inst, S-10691 Stockholm, Sweden.
    Lunau, Thorsten
    Univ Duisburg Essen, Inst Med Informat Biometry & Epidemiol, Essen, Germany.
    Madsen, Ida E. H.
    Natl Res Ctr Working Environm, Copenhagen, Denmark.
    Hanson, Linda L. Magnusson
    Stockholm Univ, Stress Res Inst, S-10691 Stockholm, Sweden.
    Marmot, Michael G.
    UCL, Dept Epidemiol & Publ Hlth, London, England.
    Nielsen, Martin L.
    Bispebjerg Hosp, Dept Occupat & Environm Med, Copenhagen, Denmark.
    Nordin, Maria
    Umea Univ, Dept Publ Hlth & Clin Med Occupat & Environm Med, Umea, Sweden.
    Pentti, Jaana
    Finnish Inst Occupat Hlth, Turku, Finland.
    Salo, Paula
    Finnish Inst Occupat Hlth, Turku, Finland.
    Rugulies, Reiner
    Natl Res Ctr Working Environm, Copenhagen, Denmark.
    Steptoe, Andrew
    UCL, Dept Epidemiol & Publ Hlth, London, England.
    Siegrist, Johannes
    Univ Dusseldorf, Dept Med Sociol, D-40225 Dusseldorf, Germany.
    Suominen, Sakari
    Univ Turku, Dept Publ Hlth, Turku, Finland.
    Vahtera, Jussi
    Finnish Inst Occupat Hlth, Turku, Finland.
    Virtanen, Marianna
    Finnish Inst Occupat Hlth, Helsinki, Finland.
    Vaananen, Ari
    Finnish Inst Occupat Hlth, Helsinki, Finland.
    Westerholm, Peter
    Uppsala Univ, Uppsala, Sweden.
    Westerlund, Hugo
    Stockholm Univ, Stress Res Inst, S-10691 Stockholm, Sweden.
    Zins, Marie
    INSERM, U1018, Ctr Res Epidemiol & Populat Hlth, Villejuif, France.
    Theorell, Tores
    Stockholm Univ, Stress Res Inst, S-10691 Stockholm, Sweden.
    Hamer, Mark
    UCL, Dept Epidemiol & Publ Hlth, London, England.
    Ferrie, Jane E.
    UCL, Dept Epidemiol & Publ Hlth, London, England.
    Singh-Manoux, Archana
    INSERM, U1018, Ctr Res Epidemiol & Populat Hlth, Villejuif, France.
    Batty, G. David
    UCL, Dept Epidemiol & Publ Hlth, London, England.
    Kivimaeki, Mika
    Finnish Inst Occupat Hlth, Helsinki, Finland.
    Job Strain and Tobacco Smoking: An Individual-Participant Data Meta-Analysis of 166 130 Adults in 15 European Studies2012In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 7, no 7, article id e35463Article in journal (Refereed)
    Abstract [en]

    Background: Tobacco smoking is a major contributor to the public health burden and healthcare costs worldwide, but the determinants of smoking behaviours are poorly understood. We conducted a large individual-participant meta-analysis to examine the extent to which work-related stress, operationalised as job strain, is associated with tobacco smoking in working adults. Methodology and Principal Findings: We analysed cross-sectional data from 15 European studies comprising 166 130 participants. Longitudinal data from six studies were used. Job strain and smoking were self-reported. Smoking was harmonised into three categories never, ex- and current. We modelled the cross-sectional associations using logistic regression and the results pooled in random effects meta-analyses. Mixed effects logistic regression was used to examine longitudinal associations. Of the 166 130 participants, 17% reported job strain, 42% were never smokers, 33% ex-smokers and 25% current smokers. In the analyses of the cross-sectional data, current smokers had higher odds of job strain than never-smokers (age, sex and socioeconomic position-adjusted odds ratio: 1.11, 95% confidence interval: 1.03, 1.18). Current smokers with job strain smoked, on average, three cigarettes per week more than current smokers without job strain. In the analyses of longitudinal data (1 to 9 years of follow-up), there was no clear evidence for longitudinal associations between job strain and taking up or quitting smoking. Conclusions: Our findings show that smokers are slightly more likely than non-smokers to report work-related stress. In addition, smokers who reported work stress smoked, on average, slightly more cigarettes than stress-free smokers.

  • 39.
    Heikkila, Katriina
    et al.
    Finnish Inst Occupat Hlth, Helsinki, Finland.
    Nyberg, Solja T.
    Finnish Inst Occupat Hlth, Helsinki, Finland.
    Fransson, Eleonor I.
    Karolinska Inst, Inst Environm Med, S-10401 Stockholm, Sweden.
    Alfredsson, Lars
    Karolinska Inst, Inst Environm Med, S-10401 Stockholm, Sweden.
    De Bacquer, Dirk
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium.
    Bjorner, Jakob B.
    Natl Res Ctr Working Environm, Copenhagen, Denmark.
    Bonenfant, Sebastien
    Ctr Res Epidemiol & Populat Hlth, Inserm U1018, Villejuif, France.
    Borritz, Marianne
    Bispebjerg Hosp, Dept Occupat Med, Copenhagen, Denmark.
    Burr, Hermann
    Ctr Maritime Hlth & Safety, Esbjerg, Denmark.
    Clays, Els
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium.
    Casini, Annalisa
    Univ Libre Brussels, Sch Publ Hlth, Brussels, Belgium.
    Dragano, Nico
    Univ Duisburg Essen, Inst Med Informat Biometry & Epidemiol, Essen, Germany.
    Erbel, Raimund
    Univ Duisburg Essen, West German Heart Ctr Essen, Dept Cardiol, Essen, Germany.
    Geuskens, Goedele A.
    TNO, Hoofddorp, Netherlands.
    Goldberg, Marcel
    Ctr Res Epidemiol & Populat Hlth, Inserm U1018, Villejuif, France.
    Hooftman, Wendela E.
    TNO, Hoofddorp, Netherlands.
    Houtman, Irene L.
    TNO, Hoofddorp, Netherlands.
    Joensuu, Matti
    Finnish Inst Occupat Hlth, Helsinki, Finland.
    Joeckel, Karl-Heinz
    Univ Duisburg Essen, Inst Med Informat Biometry & Epidemiol, Essen, Germany.
    Kittel, France
    Univ Libre Brussels, Sch Publ Hlth, Brussels, Belgium.
    Knutsson, Anders
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Koskenvuo, Markku
    Univ Helsinki, Dept Publ Hlth, Helsinki, Finland.
    Koskinen, Aki
    Finnish Inst Occupat Hlth, Helsinki, Finland.
    Kouvonen, Anne
    Wroclaw Fac, Warsaw Sch Social Sci & Humanities, Wroclaw, Poland.
    Leineweber, Constanze
    Stockholm Univ, Stress Res Inst, S-10691 Stockholm, Sweden.
    Lunau, Thorsten
    Univ Duisburg Essen, Inst Med Informat Biometry & Epidemiol, Essen, Germany.
    Madsen, Ida E. H.
    Natl Res Ctr Working Environm, Copenhagen, Denmark.
    Hanson, Linda L. Magnusson
    Stockholm Univ, Stress Res Inst, S-10691 Stockholm, Sweden.
    Marmot, Michael G.
    UCL, Dept Epidemiol & Publ Hlth, London, England.
    Nielsen, Martin L.
    Bispebjerg Hosp, Dept Occupat & Environm Med, Copenhagen, Denmark.
    Nordin, Maria
    Umea Univ, Dept Publ Hlth & Clin Med Occupat & Environm Med, Umea, Sweden.
    Pentti, Jaana
    Finnish Inst Occupat Hlth, Turku, Finland.
    Salo, Paula
    Finnish Inst Occupat Hlth, Turku, Finland.
    Rugulies, Reiner
    Natl Res Ctr Working Environm, Copenhagen, Denmark.
    Steptoe, Andrew
    UCL, Dept Epidemiol & Publ Hlth, London, England.
    Siegrist, Johannes
    Univ Dusseldorf, Dept Med Sociol, D-40225 Dusseldorf, Germany.
    Suominen, Sakari
    Univ Turku, Dept Publ Hlth, Turku, Finland.
    Vahtera, Jussi
    Finnish Inst Occupat Hlth, Turku, Finland.
    Virtanen, Marianna
    Finnish Inst Occupat Hlth, Helsinki, Finland.
    Vaananen, Ari
    Finnish Inst Occupat Hlth, Helsinki, Finland.
    Westerholm, Peter
    Uppsala Univ, Uppsala, Sweden.
    Westerlund, Hugo
    Stockholm Univ, Stress Res Inst, S-10691 Stockholm, Sweden.
    Zins, Marie
    Ctr Res Epidemiol & Populat Hlth, Inserm U1018, Villejuif, France.
    Theorell, Tores
    Stockholm Univ, Stress Res Inst, S-10691 Stockholm, Sweden.
    Hamer, Mark
    UCL, Dept Epidemiol & Publ Hlth, London, England.
    Ferrie, Jane E.
    UCL, Dept Epidemiol & Publ Hlth, London, England.
    Singh-Manoux, Archana
    Ctr Res Epidemiol & Populat Hlth, Inserm U1018, Villejuif, France.
    Batty, G. David
    UCL, Dept Epidemiol & Publ Hlth, London, England.
    Kivimaki, Mika
    Finnish Inst Occupat Hlth, Helsinki, Finland.
    Job Strain and Alcohol Intake: A Collaborative Meta-Analysis of Individual-Participant Data from 140 000 Men and Women2012In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 7, no 7, p. Art. no. e40101-Article in journal (Refereed)
    Abstract [en]

    Background: The relationship between work-related stress and alcohol intake is uncertain. In order to add to the thus far inconsistent evidence from relatively small studies, we conducted individual-participant meta-analyses of the association between work-related stress (operationalised as self-reported job strain) and alcohol intake. Methodology and Principal Findings: We analysed cross-sectional data from 12 European studies (n = 142 140) and longitudinal data from four studies (n = 48 646). Job strain and alcohol intake were self-reported. Job strain was analysed as a binary variable (strain vs. no strain). Alcohol intake was harmonised into the following categories: none, moderate (women: 1-14, men: 1-21 drinks/week), intermediate (women: 15-20, men: 22-27 drinks/week) and heavy (women: > 20, men: > 27 drinks/week). Cross-sectional associations were modelled using logistic regression and the results pooled in random effects meta-analyses. Longitudinal associations were examined using mixed effects logistic and modified Poisson regression. Compared to moderate drinkers, non-drinkers and (random effects odds ratio (OR): 1.10, 95% CI: 1.05, 1.14) and heavy drinkers (OR: 1.12, 95% CI: 1.00, 1.26) had higher odds of job strain. Intermediate drinkers, on the other hand, had lower odds of job strain (OR: 0.92, 95% CI: 0.86, 0.99). We found no clear evidence for longitudinal associations between job strain and alcohol intake. Conclusions: Our findings suggest that compared to moderate drinkers, non-drinkers and heavy drinkers are more likely and intermediate drinkers less likely to report work-related stress.

  • 40.
    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
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    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 study2016In: British Journal of Cancer, ISSN 0007-0920, E-ISSN 1532-1827, Vol. 114, no 7, p. 813-818Article in journal (Refereed)
    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.

  • 41.
    Heikkilä, K.
    et al.
    Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, 00250 Helsinki, Finland .
    Fransson, E. I.
    School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Nyberg, S. T.
    Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, 00250 Helsinki, Finland .
    Zins, M.
    Centre for Research in Epidemiology and Population Health, Villejuif, France .
    Westerlund, H.
    Stress Research Institute, Stockholm University, Stockholm, Sweden .
    Westerholm, P.
    Department of Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden .
    Virtanen, M.
    Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, 00250 Helsinki, Finland .
    Vahtera, J.
    Finnish Institute of Occupational Health, Turku, Finland .
    Suominen, S.
    Department of Public Health, University of Turku, Turku, Finland .
    Steptoe, A.
    Department of Epidemiology and Public Health, University College London, London, United Kingdom .
    Salo, P.
    Finnish Institute of Occupational Health, Turku, Finland.
    Pentti, J.
    Finnish Institute of Occupational Health, Turku, Finland .
    Oksanen, T.
    Finnish Institute of Occupational Health, Turku, Finland.
    Nordin, M.
    Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden .
    Marmot, M. G.
    Department of Epidemiology and Public Health, University College London, London, United Kingdom .
    Lunau, T.
    Department of Medical Sociology, University of Düsseldorf, Düsseldorf, Germany .
    Ladwig, K. -H
    German Research Center for Environmental Health, Munich, Germany .
    Koskenvuo, M.
    Department of Public Health, University of Helsinki, Helsinki, Finland .
    Knutsson, Anders
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Kittel, F.
    School of Public Health, Université Libre de Bruxelles, Brussels, Belgium.
    Jöckel, K. -H
    Institute for Medical Informatics, Biometry, and Epidemiology, University Duisburg- Essen, Essen, Germany.
    Goldberg, M.
    Centre for Research in Epidemiology and Population Health, Villejuif, France .
    Erbel, R.
    Department of Cardiology, West-German Heart Center Essen, University Duisburg-Essen, Germany .
    Dragano, N.
    Department of Medical Sociology, University of Düsseldorf, Düsseldorf, Germany .
    DeBacquer, D.
    Department of Public Health, Ghent University, Ghent, Belgium .
    Clays, E.
    Department of Public Health, Ghent University, Ghent, Belgium .
    Casini, A.
    School of Public Health, Université Libre de Bruxelles, Brussels, Belgium.
    Alfredsson, L.
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden .
    Ferrie, J. E.
    Department of Epidemiology and Public Health, University College London, London, United Kingdom .
    Singh-Manoux, A.
    Centre for Research in Epidemiology and Population Health, Villejuif, France .
    Batty, G. D.
    Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, United Kingdom .
    Kivimäki, M.
    Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, 00250 Helsinki, Finland .
    Job strain and health-related lifestyle: Findings from an individual-participant meta-analysis of 118 000 working adults2013In: American Journal of Public Health, ISSN 0090-0036, E-ISSN 1541-0048, Vol. 103, no 11, p. 2090-2097Article in journal (Refereed)
    Abstract [en]

    Objectives. We examined the associations of job strain, an indicator of work-related stress, with overall unhealthy and healthy lifestyles. Methods. We conducted a meta-analysis of individual-level data from 11 European studies (cross-sectional data: n = 118 701; longitudinal data: n = 43 971). We analyzed job strain as a set of binary (job strain vs no job strain) and categorical (high job strain, active job, passive job, and low job strain) variables. Factors used to define healthy and unhealthy lifestyles were body mass index, smoking, alcohol intake, and leisure-time physical activity. Results. Individuals with job strain were more likely than those with no job strain to have 4 unhealthy lifestyle factors (odds ratio [OR] = 1.25; 95% confidence interval [CI] = 1.12, 1.39) and less likely to have 4 healthy lifestyle factors (OR = 0.89; 95% CI = 0.80, 0.99). The odds of adopting a healthy lifestyle during study follow-up were lower among individuals with high job strain than among those with low job strain (OR = 0.88; 95% CI = 0.81, 0.96). Conclusions. Work-related stress is associated with unhealthy lifestyles and the absence of stress is associated with healthy lifestyles, but longitudinal analyses suggest no straightforward cause-effect relationship between workrelated stress and lifestyle. Copyright © 2013 by the American Public Health Association®.

  • 42.
    Heikkilä, K.
    et al.
    Finnish Institute of Occupational Health, Uimalankatu 1, 33540 Tampere, Finland.
    Madsen, I. E. H.
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Nyberg, S. T.
    Finnish Institute of Occupational Health, Uimalankatu 1, 33540 Tampere, Finland.
    Fransson, E. I.
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden .
    Westerlund, H.
    Stress Research Institute, Stockholm University, Stockholm, Sweden .
    Westerholm, P. J. M.
    Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden .
    Virtanen, M.
    Finnish Institute of Occupational Health, Uimalankatu 1, 33540 Tampere, Finland.
    Vahtera, J.
    Finnish Institute of Occupational Health, Turku, Finland .
    Väänänen, A.
    Finnish Institute of Occupational Health, Uimalankatu 1, 33540 Tampere, Finland .
    Theorell, T.
    Stress Research Institute, Stockholm University, Stockholm, Sweden .
    Suominen, S. B.
    Department of Public Health, University of Turku, Turku, Finland .
    Shipley, M. J.
    Department of Epidemiology and Public Health, University College London, London, United Kingdom .
    Salo, P.
    Department of Psychology, University of Turku, Turku, Finland .
    Rugulies, R.
    Department of Public Health, Department of Psychology, University of Copenhagen, Copenhagen, Denmark .
    Pentti, J.
    Department of Public Health, University of Turku, Turku, Finland .
    Pejtersen, J. H.
    Danish National Centre for Social Research, Copenhagen, Denmark .
    Oksanen, T.
    Finnish Institute of Occupational Health, Turku, Finland .
    Nordin, M.
    Department of Psychology, Umeå University, Umeå, Sweden .
    Nielsen, M. L.
    Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark .
    Kouvonen, A.
    School of Sociology Social Policy and Social Work, Queen's University Belfast, Belfast, United Kingdom .
    Koskinen, A.
    Finnish Institute of Occupational Health, Uimalankatu 1, 33540 Tampere, Finland .
    Koskenvuo, M.
    Department of Public Health, University of Helsinki, Helsinki, Finland .
    Knutsson, Anders
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Ferrie, J. E.
    Social and Community Medicine, University of Bristol, Bristol, United Kingdom .
    Dragano, N.
    Institute for Medical Sociology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany .
    Burr, H.
    Federal Institute for Occupational Safety and Health (BAuA), Berlin, Germany .
    Borritz, M.
    Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark .
    Bjorner, J. B.
    National Research Centre for the Working Environment, Copenhagen, Denmark .
    Alfredsson, L.
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden .
    Batty, G. D.
    Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, United Kingdom .
    Singh-Manoux, A.
    Inserm U1018 Centre for Research in Epidemiology and Population Health, Villejuif, France .
    Kivimäki, M.
    Finnish Institute of Occupational Health, Uimalankatu 1, 33540 Tampere, Finland .
    Job strain and the risk of severe asthma exacerbations: A meta-analysis of individual-participant data from 100 000 European men and women2014In: Allergy. European Journal of Allergy and Clinical Immunology, ISSN 0105-4538, E-ISSN 1398-9995, Vol. 69, no 6, p. 775-783Article in journal (Refereed)
    Abstract [en]

    Background Many patients and healthcare professionals believe that work-related psychosocial stress, such as job strain, can make asthma worse, but this is not corroborated by empirical evidence. We investigated the associations between job strain and the incidence of severe asthma exacerbations in working-age European men and women. Methods We analysed individual-level data, collected between 1985 and 2010, from 102 175 working-age men and women in 11 prospective European studies. Job strain (a combination of high demands and low control at work) was self-reported at baseline. Incident severe asthma exacerbations were ascertained from national hospitalization and death registries. Associations between job strain and asthma exacerbations were modelled using Cox regression and the study-specific findings combined using random-effects meta-analyses. Results During a median follow-up of 10 years, 1 109 individuals experienced a severe asthma exacerbation (430 with asthma as the primary diagnostic code). In the age- and sex-adjusted analyses, job strain was associated with an increased risk of severe asthma exacerbations defined using the primary diagnostic code (hazard ratio, HR: 1.27, 95% confidence interval, CI: 1.00, 1.61). This association attenuated towards the null after adjustment for potential confounders (HR: 1.22, 95% CI: 0.96, 1.55). No association was observed in the analyses with asthma defined using any diagnostic code (HR: 1.01, 95% CI: 0.86, 1.19). Conclusions Our findings suggest that job strain is probably not an important risk factor for severe asthma exacerbations leading to hospitalization or death. © 2014 The Authors. Allergy Published by John Wiley & Sons Ltd.

  • 43.
    Heikkilä, Katriina
    et al.
    Finnish Institute of Occupational Health, Helsinki, Finland .
    Madsen, Ida E. H.
    National Research Centre for the Working Environment, Copenhagen, Denmark .
    Nyberg, Solja T.
    Finnish Institute of Occupational Health, Helsinki, Finland .
    Fransson, Eleonor I.
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden .
    Ahola, Kirsi
    Finnish Institute of Occupational Health, Helsinki, Finland .
    Alfredsson, Lars
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden .
    Bjorner, Jakob B.
    National Research Centre for the Working Environment, Copenhagen, Denmark .
    Borritz, Marianne
    Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark .
    Burr, Hermann
    Federal Institute for Occupational Safety and Health (BAuA), Berlin, Germany .
    Dragano, Nico
    Institute for Medical Sociology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany .
    Ferrie, Jane E.
    Department of Epidemiology and Public Health, University College London, London, United Kingdom .
    Knutsson, Anders
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Koskenvuo, Markku
    Department of Public Health, University of Helsinki, Helsinki, Finland .
    Koskinen, Aki
    Finnish Institute of Occupational Health, Helsinki, Finland .
    Nielsen, Martin L.
    Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark .
    Nordin, Maria
    Department of Psychology, Umeå University, Umeå, Sweden .
    Pejtersen, Jan H.
    Danish National Centre for Social Research, Copenhagen, Denmark .
    Pentti, Jaana
    Finnish Institute of Occupational Health, Helsinki, Tampere and Turku, Finland .
    Rugulies, Reiner
    National Research Centre for the Working Environment, Copenhagen, Denmark .
    Oksanen, Tuula
    Finnish Institute of Occupational Health, Helsinki, Tampere and Turku, Finland .
    Shipley, Martin J.
    Department of Epidemiology and Public Health, University College London, London, United Kingdom .
    Suominen, Sakari B.
    Folkhälsan Research Center, Helsinki, Finland .
    Theorell, Tores
    Stress Research Institute, Stockholm University, Stockholm, Sweden .
    Väananen, Ari
    Finnish Institute of Occupational Health, Helsinki, Finland .
    Vahtera, Jussi
    Finnish Institute of Occupational Health, Helsinki, Tampere and Turku, Finland .
    Virtanen, Marianna
    Finnish Institute of Occupational Health, Helsinki, Finland .
    Westerlund, Hugo
    Stress Research Institute, Stockholm University, Stockholm, Sweden .
    Westerholm, Peter J. M.
    Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden .
    Batty, G. David
    Department of Epidemiology and Public Health, University College London, London, United Kingdom .
    Singh-Manoux, Archana
    Department of Epidemiology and Public Health, University College London, London, United Kingdom .
    Kivimäki, Mika
    Department of Epidemiology and Public Health, University College London, London, United Kingdom .
    Job Strain and the Risk of Inflammatory Bowel Diseases: Individual-Participant Meta-Analysis of 95 000 Men and Women2014In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 9, no 2, p. e88711-Article in journal (Refereed)
    Abstract [en]

    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.

  • 44.
    Heikkilä, Katriina
    et al.
    Finnish Institute of Occupational Health, 00250 Helsinki, Finland.
    Nyberg, Solja T.
    Finnish Institute of Occupational Health, 00250 Helsinki, Finland.
    Theorell, Tores
    Stress Research Institute, Stockholm University, Stockholm, Sweden.
    Fransson, Eleonor I.
    Stress Research Institute, Stockholm University, Stockholm, Sweden.
    Alfredsson, Lars
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Bjorner, Jakob B.
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Bonenfant, Sebastien
    Versailles-Saint Quentin University, Versailles, France.
    Borritz, Marianne
    Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark.
    Bouillon, Kim
    Department of Epidemiology and Public Health, University College London, London, United Kingdom.
    Burr, Herman
    Federal Institute for Occupational Safety and Health (BAuA), Berlin, Germany.
    Dragano, Nico
    Institute for Medical Informatics, Biometry, and Epidemiology, University Duisburg-Essen, Essen, Germany.
    Geuskens, Goedele A.
    TNO, Hoofddorp, Netherlands.
    Goldberg, Marcel
    Versailles-Saint Quentin University, Versailles, France.
    Hamer, Mark
    Department of Epidemiology and Public Health, University College London, London, United Kingdom.
    Hooftman, Wendela E.
    TNO, Hoofddorp, Netherlands.
    Houtman, Irene L.
    TNO, Hoofddorp, Netherlands.
    Joensuu, Matti
    Finnish Institute of Occupational Health, 00250 Helsinki, Finland.
    Knutsson, Anders
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Koskenvuo, Markku
    Department of Public Health, University of Helsinki, Helsinki, Finland.
    Koskinen, Aki
    Finnish Institute of Occupational Health, 00250 Helsinki, Finland.
    Kouvonen, Anne
    School of Sociology, Social Policy and Social Work, Queen's University Belfast, Belfast, United Kingdom.
    Madsen, Ida E. H.
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Magnusson, Linda L.
    Stockholm Univ, Stress Res Inst, S-10691 Stockholm, Sweden .
    Marmot, Michael G.
    Department of Epidemiology and Public Health, University College London, London, United Kingdom.
    Nielsen, Martin L.
    Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark.
    Nordin, Maria
    Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umea University, Umea, Sweden.
    Oksanen, Tuula
    Finnish Institute of Occupational Health, Turku, Finland.
    Pentti, Jaana
    Finnish Institute of Occupational Health, Turku, Finland.
    Salo, Paula
    Finnish Institute of Occupational Health, Turku, Finland.
    Rugulies, Reiner
    Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
    Steptoe, Andrew
    Department of Epidemiology and Public Health, University College London, London, United Kingdom.
    Suominen, Sakari
    Folkhälsan Research Center, Helsinki, Finland.
    Vahtera, Jussi
    Department of Public Health, University of Turku, Turku, Finland.
    Virtanen, Marianna
    Finnish Institute of Occupational Health, 00250 Helsinki, Finland.
    Vaananen, Ari
    Finnish Institute of Occupational Health, 00250 Helsinki, Finland.
    Westerholm, Peter
    Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden.
    Westerlund, Hugo
    Stress Research Institute, Stockholm University, Stockholm, Sweden.
    Zins, Marie
    Versailles-Saint Quentin University, Versailles, France.
    Ferrie, Jane E.
    Department of Epidemiology and Public Health, University College London, London, United Kingdom.
    Singh-Manoux, Archana
    Department of Epidemiology and Public Health, University College London, London, United Kingdom.
    Batty, G. David
    Department of Epidemiology and Public Health, University College London, London, United Kingdom.
    Kivimaki, Mika
    Department of Epidemiology and Public Health, University College London, London, United Kingdom.
    Work stress and risk of cancer: meta-analysis of 5700 incident cancer events in 116 000 European men and women2013In: BMJ. British Medical Journal, E-ISSN 1756-1833, Vol. 346, p. Art. no. f165-Article in journal (Refereed)
    Abstract [en]

    Objective To investigate whether work related stress, measured and defined as job strain, is associated with the overall risk of cancer and the risk of colorectal, lung, breast, or prostate cancers. Design Meta-analysis of pooled prospective individual participant data from 12 European cohort studies including 116 056 men and women aged 17-70 who were free from cancer at study baseline and were followed-up for a median of 12 years. Work stress was measured and defined as job strain, which was self reported at baseline. Incident cancers (all n=5765, colorectal cancer n=522, lung cancer n=374, breast cancer n=1010, prostate cancer n=865) were ascertained from cancer, hospital admission, and death registers. Data were analysed in each study with Cox regression and the study specific estimates pooled in meta-analyses. Models were adjusted for age, sex, socioeconomic position, body mass index (BMI), smoking, and alcohol intake Results A harmonised measure of work stress, high job strain, was not associated with overall risk of cancer (hazard ratio 0.97, 95% confidence interval 0.90 to 1.04) in the multivariable adjusted analyses. Similarly, no association was observed between job strain and the risk of colorectal (1.16, 0.90 to 1.48), lung (1.17, 0.88 to 1.54), breast (0.97, 0.82 to 1.14), or prostate (0.86, 0.68 to 1.09) cancers. There was no clear evidence for an association between the categories of job strain and the risk of cancer. Conclusions These findings suggest that work related stress, measured and defined as job strain, at baseline is unlikely to be an important risk factor for colorectal, lung, breast, or prostate cancers.

  • 45.
    Hergens, Maria-Pia
    et al.
    Stockholm Cty Council, Dept Communicable Dis Control, S-11891 Stockholm, Sweden.
    Galanti, Rosaria
    Karolinska Inst, Dept Publ Hlth Sci, Stockholm, Sweden.
    Hansson, Jenny
    Karolinska Inst, Dept Publ Hlth Sci, Stockholm, Sweden.
    Fredlund, Peeter
    Stockholm Cty Council, Ctr Epidemiol & Community Med, S-11891 Stockholm, Sweden.
    Ahlbom, Anders
    Karolinska Inst, Inst Environm Med, S-10401 Stockholm, Sweden.
    Alfredsson, Lars
    Karolinska Inst, Inst Environm Med, S-10401 Stockholm, Sweden.
    Bellocco, Rino
    Univ Milano Bicocca, Dept Stat, Milan, Italy.
    Eriksson, Marie
    Umeå Univ, Dept Stat, S-90187 Umeå, Sweden.
    Fransson, Eleonor I.
    Jönköping Univ, Sch Hlth Sci, Jönköping, Sweden.
    Hallqvist, Johan
    Uppsala Univ, Dept Publ Hlth & Caring Sci, Uppsala, Sweden.
    Jansson, Jan-Håkan
    Umeå Univ, Dept Med, Umeå, Sweden.
    Knutsson, Anders
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Pedersen, Nancy
    Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden.
    Lagerros, Ylva Trolle
    Karolinska Inst, Dept Med, Unit Clin Epidemiol, Stockholm, Sweden.
    Otstergren, Per-Olof
    Lund Univ, Dept Clin Sci Malmo, Lund, Sweden.
    Magnusson, Cecilia
    Karolinska Inst, Dept Publ Hlth Sci, Stockholm, Sweden.
    Use of Scandinavian Moist Smokeless Tobacco (Snus) and the Risk of Atrial Fibrillation2014In: EPIDEMIOLOGY, ISSN 1044-3983, Vol. 25, no 6, p. 872-876Article in journal (Refereed)
    Abstract [en]

    Background: Snus is a smokeless tobacco product, widely used among Swedish men and increasingly so elsewhere. There is debate as to whether snus is an acceptable "harm-reduction" tobacco product. Since snus use delivers a dose of nicotine equivalent to cigarettes, and has been implicated in cardiac arrhythmia because of associations with sudden cardiovascular death, a relation with atrial fibrillation is plausible and important to investigate. Methods: To assess the relation between use of snus and risk of atrial fibrillation, we carried out a pooled analysis of 7 prospective Swedish cohort studies. In total, 274,882 men, recruited between 1978 and 2004, were followed via the National Patient Register for atrial fibrillation. Primary analyses were restricted to 127,907 never-smokers. Relative risks were estimated using Cox proportional hazard regression. Results: The prevalence of snus use was 25% among never-smokers. During follow-up, 3,069 cases of atrial fibrillation were identified. The pooled relative risk of atrial fibrillation was 1.07 (95% confidence interval = 0.97-1.19) in current snus users, compared with nonusers. Conclusion: Findings from this large national pooling project indicate that snus use is unlikely to confer any important increase in risk of atrial fibrillation.

  • 46.
    Hermansson, J.
    et al.
    Angereds Närsjukhus, Angered; Karolinska Inst, Stockholm.
    Hallqvist, J.
    Uppsala University, Uppsala.
    Karlsson, B.
    Umeå university.
    Knutsson, Anders
    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.
    Shift work, parental cardiovascular disease and myocardial infarction in males2018In: Occupational Medicine, ISSN 0962-7480, E-ISSN 1471-8405, Vol. 68, no 2, p. 120-125Article in journal (Refereed)
    Abstract [en]

    Background Shift work has been associated with an increased risk of cardiovascular disease (CVD). However, there is a need for more studies to determine whether there is an interaction between shift work and other risk factors of CVD, thereby increasing the risk of CVD in shift workers. Aims To discern whether shift work and parental mortality from myocardial infarction (MI) or sudden cardiac death (SCD) interact to increase the risk of MI in men. Methods A case-control dataset was used to assess interaction between shift work and parental history of CVD, using death from MI or SCD, or death before age 65, on an additive scale. Results were reported as relative excess risk due to interaction, attributable proportion due to interaction (AP) and synergy index (SI). Results There was an interaction between shift work and paternal mortality from MI or SCD, when both factors were present [SI = 2.39; 95% confidence interval (CI) 1.02. 5.6 and AP = 0.4; 95% CI 0.08. 0.73]. Conclusions Paternal mortality from MI or SCD interacts with shift work to increase the risk of MI in men.

  • 47.
    Hermansson, Jonas
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Bøggild, H.
    Hallqvist, J.
    Karlsson, B.
    Knutsson, Anders
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Nilsson, T.
    Reuterwall, C.
    Gillander-Gådin, Katja
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Interaction between shift work and coronary risk factors on risk of myocardial infarctionManuscript (preprint) (Other academic)
  • 48.
    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, 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
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Case fatality of myocardial infarction among shift workers2015In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 88, no 5, p. 599-605Article in journal (Refereed)
    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.

  • 49.
    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.

  • 50.
    Hermansson, Jonas
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Karlsson, B.
    Knutsson, Anders
    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.
    Interaction between parental history of myocardial infarction or sudden cardiac death and shift work on the incidence of myocardial infarction among malesManuscript (preprint) (Other academic)
123 1 - 50 of 134
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