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Pulford A, Thapa A, Thomson RM, Guilding A, Green MJ, Leyland A, Popham F, Katikireddi SV. Does persistent precarious employment affect health outcomes among working age adults? A systematic review and meta-analysis. J Epidemiol Community Health 2022; 76:jech-2022-219292. [PMID: 36137738 PMCID: PMC9554022 DOI: 10.1136/jech-2022-219292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 08/31/2022] [Indexed: 12/05/2022]
Abstract
OBJECTIVE To evaluate the impact of persistent precarious employment (lasting 12+ months) on the health of working age adults, compared with more stable employment. Persistent precarity reflects a shift towards less secure forms of employment and may be particularly important for health. METHODS Nine databases were systematically searched to identify quantitative studies that assessed the relationship between persistent precarious employment and health outcomes. Risk of bias (RoB) was assessed using an adaptation of the Effective Public Health Practice Project tool. Narrative synthesis and random effects meta-analysis were conducted. Certainty of evidence was assessed using the Grades of Recommendations, Assessment, Development and Evaluation (GRADE) approach. RESULTS Of 12 940 records screened, 50 studies met the inclusion criteria and 29 were included in meta-analyses. RoB was generally high (n=18). The most reported outcome domain was mental health; with evidence also reported relating to general health, physical health,and health behaviours. Of GRADE assessed outcomes, persistent precarious employment was associated with increased risk of poor self-rated health (OR 1.53, 95% CI 1.09 to 2.14, I2=80%) and mental health symptoms (OR 1.44, 95% CI 1.23 to 1.70, I2=65%). The association with all-cause mortality was imprecisely estimated (OR 1.10, 5% CI 0.91 to 1.33, I2=73%). There was very low GRADE certainty across all outcomes. CONCLUSIONS Persistent precarious employment is associated with poorer health, particularly for outcomes with short time lags, though associations are small and causality is highly uncertain. Further research using more robust methods is needed but given potential health harms of persistent precarious employment, exploration of precautionary labour regulations and employment policies is warranted.
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Affiliation(s)
- Andrew Pulford
- Evidence for Action Team, Public Health Scotland Glasgow Office, Glasgow, UK
- MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Alekh Thapa
- College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, UK
| | - Rachel M Thomson
- MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Annette Guilding
- MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Michael James Green
- MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Alastair Leyland
- MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Frank Popham
- MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, Glasgow, UK
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Thomas RD, Davis JW, Cuccaro PM, Gemeinhardt GL. Assessing associations between insecure income and US workers’ health: An IPUMS-MEPS analysis. Soc Sci Med 2022; 309:115240. [DOI: 10.1016/j.socscimed.2022.115240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 07/01/2022] [Accepted: 07/23/2022] [Indexed: 10/15/2022]
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Li W, Ruan W, Chen Z, Yi G, Lu Z, Wang D. A meta-analysis of observational studies including dose-response relationship between long working hours and risk of obesity. Rev Endocr Metab Disord 2021; 22:837-845. [PMID: 33713311 DOI: 10.1007/s11154-021-09643-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/05/2021] [Indexed: 12/12/2022]
Abstract
We aimed to conduct a meta-analysis with stick reference and uniform cut-off of obesity to evaluate the relationship between long working hours and risk of obesity, using a quantitative dose-response method. The PubMed and Web of Science databases were searched through February 26, 2021, odds ratios (ORs) were pooled by using random-effects models and restricted cubic spline analysis with four knots was used to explore the dose-response relationship of working time and risk of obesity. Ten observational studies with 20 independent reports involving 189,590 participants were included in the present analysis. The summarized adjusted OR for the relationship between long working hours and obesity risk was 1.13 (95% CI: 1.01 to 1.26), when compared with weekly working hours less than and equal to 40 h using the random-effects model. A J-shaped association between long working hours and risk of obesity was observed (P < 0.001 for nonlinearity) for the dose-response relationship. Exclusion of any single study did not alter the combined relative risk. Individuals involved in long working hours are more likely to be obesity. Further studies are needed to confirm the results, and optimized and proper job arrangement should be established for improving the health of workers.
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Affiliation(s)
- Wenzhen Li
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Wenyu Ruan
- Shangluo Central Hospital, Shangluo, Shanxi, 726000, P. R. China
| | - Zhenlong Chen
- Wuhan Prevention and Treatment Center for Occupational Diseases, Wuhan, 430015, Hubei, China
| | - Guilin Yi
- Wuhan Prevention and Treatment Center for Occupational Diseases, Wuhan, 430015, Hubei, China
| | - Zuxun Lu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Dongming Wang
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China.
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Zhu Y, Liu J, Jiang H, Brown TJ, Tian Q, Yang Y, Wang C, Xu H, Liu J, Gan Y, Lu Z. Are long working hours associated with weight-related outcomes? A meta-analysis of observational studies. Obes Rev 2020; 21:e12977. [PMID: 31814253 DOI: 10.1111/obr.12977] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 10/18/2019] [Accepted: 10/18/2019] [Indexed: 01/03/2023]
Abstract
The relationship between long working hours and body weight outcomes remains inconclusive; thus, we conducted a meta-analysis to assess the effect of long working hours on weight-related outcomes. PubMed and Embase databases were searched from their inception to June 2019. A random-effects model was used to assess the pooled odds ratio (OR) and corresponding confidence interval (CI). Subgroup analyses and sensitivity analyses were conducted to explore sources of heterogeneity. Publication bias was evaluated by the Begg's and Egger's tests. A total of 29 articles involving 374 863 participants were included. The pooled OR of long working hours on weight-related outcomes was 1.13 (95% CI, 1.07-1.19). In subgroup analysis stratified by definition of outcomes, the pooled ORs of long working hours on "weight gain/BMI increase," "BMI ≥ 25 kg/m2 ," and "BMI ≥ 30 kg/m2 " were 1.19 (95% CI, 1.02-1.40), 1.07 (95% CI, 1.00-1.14), and 1.23 (95% CI, 1.09-1.39), respectively. We found evidence of publication bias, but correction for this bias using the trim-and-fill method did not alter the combined OR substantially. There was evidence to suggest that long working hours are associated with adverse weight-related outcomes. Preventative interventions such as improved flexibility and healthy working schedules should be established for employees.
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Affiliation(s)
- Yi Zhu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jianxin Liu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Heng Jiang
- Centre for Alcohol Policy Research, School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia.,Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Tracey J Brown
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Qingfeng Tian
- Department of Social Medicine, Zhengzhou University, Zhengzhou, China
| | - Yudi Yang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Chao Wang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Hongbin Xu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Junan Liu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yong Gan
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zuxun Lu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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Liu Q, Shi J, Duan P, Liu B, Li T, Wang C, Li H, Yang T, Gan Y, Wang X, Cao S, Lu Z. Is shift work associated with a higher risk of overweight or obesity? A systematic review of observational studies with meta-analysis. Int J Epidemiol 2019; 47:1956-1971. [PMID: 29850840 DOI: 10.1093/ije/dyy079] [Citation(s) in RCA: 101] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 04/20/2018] [Indexed: 12/20/2022] Open
Abstract
Background An increasing number of original studies suggest that exposure to shift work could be associated with the risk of overweight and obesity, but the results remain conflicted and inconclusive. This study aimed to quantitatively synthesize available epidemiological evidence on the association between shift work and the risk of overweight and obesity by a meta-analysis. Methods The authors searched PubMed, Embase and the reference lists of all included studies up to April 2017, with a verification search in December 2017. Inclusion criteria were original studies that reported odds ratios, relative risks or hazard ratios (ORs, RRs or HRs, respectively) of at least one outcome of overweight or obesity. Summary risk estimates were calculated by random-effect models. Results Twenty-six studies (7 cohort studies, 18 cross-sectional studies and 1 case-control study) involving 311 334 participants were identified. Among these studies, the cut-off points of overweight and obesity varied greatly, so the heterogeneity was substantial; however, the results were stable. Shift work was found to be positively associated with the risk of overweight [RR: 1.25; 95% confidence interval (95% CI): 1.08-1.44] and obesity (RR: 1.17; 95% CI: 1.12-1.22). Conclusions Individuals involved in shift work are more likely to become overweight or obese. Appropriate preventive interventions in the organization of shift schedules according to ergonomic criteria would allow shift workers to avoid potential health impairment.
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Affiliation(s)
- Qiaoyan Liu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jun Shi
- Department of Orthopedics, Shiyan Traditional Chinese Medicine Hospital, Shiyan, Hubei, China
| | - Peng Duan
- Department of Preventive Medicine, Research Center for Environment and Health, School of Public Health and Management, Hubei University of Medicine, Shiyan, China
| | - Bing Liu
- Center of Health Administration and Development Studies, Hubei University of Medicine, Shiyan, Hubei, China
| | - Tongfei Li
- Department of Pharmacology, School of Basic Medicine, Wuhan University, Wuhan, China
| | - Chao Wang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Hui Li
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Tingting Yang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yong Gan
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xiaojun Wang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shiyi Cao
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zuxun Lu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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Sun M, Feng W, Wang F, Li P, Li Z, Li M, Tse G, Vlaanderen J, Vermeulen R, Tse LA. Meta-analysis on shift work and risks of specific obesity types. Obes Rev 2018; 19:28-40. [PMID: 28975706 DOI: 10.1111/obr.12621] [Citation(s) in RCA: 191] [Impact Index Per Article: 31.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 08/27/2017] [Accepted: 08/28/2017] [Indexed: 12/17/2022]
Abstract
AIMS This systematic review and meta-analysis evaluated the associations between shift work patterns and risks of specific types of obesity. METHODS PubMed was searched until March 2017 for observational studies that examined the relationships between shift work patterns and obesity. Odds ratio for obesity was extracted using a fixed-effects or random-effects model. Subgroup meta-analyses were carried out for study design, specific obesity types and characteristics of shift work pattern. RESULTS A total of 28 studies were included in this meta-analysis. The overall odds ratio of night shift work was 1.23 (95% confidence interval = 1.17-1.29) for risk of obesity/overweight. Cross-sectional studies showed a higher risk of 1.26 than those with the cohort design (risk ratio = 1.10). Shift workers had a higher frequency of developing abdominal obesity (odds ratio = 1.35) than other obesity types. Permanent night workers demonstrated a 29% higher risk than rotating shift workers (odds ratio 1.43 vs. 1.14). CONCLUSION This meta-analysis confirmed the risks of night shift work for the development of overweight and obesity with a potential gradient association suggested, especially for abdominal obesity. Modification of working schedules is recommended, particularly for prolonged permanent night work. More accurate and detailed measurements on shift work patterns should be conducted in future research.
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Affiliation(s)
- M Sun
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - W Feng
- Shenzhen Prevention and Treatment Center for Occupational Diseases, Shenzhen, China
| | - F Wang
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - P Li
- Shenzhen Prevention and Treatment Center for Occupational Diseases, Shenzhen, China
| | - Z Li
- Shenzhen Prevention and Treatment Center for Occupational Diseases, Shenzhen, China
| | - M Li
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - G Tse
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Sha Tin, Hong Kong
| | - J Vlaanderen
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - R Vermeulen
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - L A Tse
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Sha Tin, Hong Kong.,Shenzhen Municipal Key Laboratory for health Risk Analysis, Shenzhen Research Institute of the Chinese University of Hong Kong, Shenzhen, China
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