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Fröberg A, Sacco L, Suorsa K, Leskinen T, Hettiarachchi P, Svartengren M, Stenholm S, Westerlund H. Changes in Accelerometer-Measured Physical Activity and Sedentary Time Across Retirement Transition as a Predictor of Self-Rated Health. J Phys Act Health 2024:1-9. [PMID: 38702051 DOI: 10.1123/jpah.2023-0558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 02/20/2024] [Accepted: 04/01/2024] [Indexed: 05/06/2024]
Abstract
BACKGROUND Retirement transition has been shown to associate with changes in physical activity (PA) and self-rated health (SRH), but their interrelationship is less studied. The aim was to investigate changes in accelerometer-measured total PA, moderate to vigorous PA (MVPA), and sedentary time across retirement transition as a predictor of SRH. METHODS Data from the Swedish Retirement Study and the Finnish Retirement and Aging study were harmonized and pooled. Data from 3 waves (about 12 mo apart) were included: 1 preretirement (wave 1) and 2 postretirement follow-ups (wave 2-3). A totally of 245 participants (27% men) were included. Thigh-worn accelerometers were used to collect data for PA variables (wave 1-2), and SRH was obtained from the questionnaire (wave 1-3). RESULTS Between wave 1 and 2, total PA decreased with 11 (CI, -22 to -1) minutes per day, MVPA was stable (0 [CI, -3 to 3] min), and sedentary time decreased nonsignificantly with 9 (CI, -20 to 1) minutes. SRH changed between all 3 waves (all P < .001). At preretirement, 10 more minutes of MVPA was associated with greater odds of better SRH when adjusting for accelerometer wear-time, cohort, sex, age, and occupational status (odds ratio: 1.11 [95% CI, 1.02-1.22]). This association was no longer statistically significant when additionally adjusting for marital status, body mass index, and smoking. No significant associations were observed between changes in the PA variables during retirement transition and SRH at postretirement follow-ups. CONCLUSIONS This study showed a cross-sectional association between MVPA and greater odds of reporting better SRH before retirement. No longitudinal associations were observed between changes in the PA variables from before to after retirement and later changes in SRH.
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Affiliation(s)
- Andreas Fröberg
- Department of Food and Nutrition, and Sport Science, University of Gothenburg, Gothenburg, Sweden
| | - Lawrence Sacco
- Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Kristin Suorsa
- Department of Public Health, University of Turku, and Turku University Hospital, Turku, Finland
- Center for Population Health Research, University of Turku, and Turku University Hospital, Turku, Finland
| | - Tuija Leskinen
- Department of Public Health, University of Turku, and Turku University Hospital, Turku, Finland
- Center for Population Health Research, University of Turku, and Turku University Hospital, Turku, Finland
| | | | - Magnus Svartengren
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
- Department of Occupational and Environmental Medicine, Uppsala University Hospital, Uppsala, Sweden
| | - Sari Stenholm
- Department of Public Health, University of Turku, and Turku University Hospital, Turku, Finland
- Center for Population Health Research, University of Turku, and Turku University Hospital, Turku, Finland
| | - Hugo Westerlund
- Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden
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Virtanen P, Nummi T, Westerlund H, Östergren PO, Janlert U, Hammarström A. Active labour market policies in emerging adulthood may act as a protective factor against future depressiveness: an analysis of the long-term trajectories of depressive symptoms in the Northern Swedish Cohort. Front Public Health 2024; 12:1345034. [PMID: 38655526 PMCID: PMC11035740 DOI: 10.3389/fpubh.2024.1345034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 03/20/2024] [Indexed: 04/26/2024] Open
Abstract
Introduction Drawing upon the framework of life course epidemiology, this study aligns with research on the mental health consequences of significant social transitions during early adulthood. The focus is on the variation in initial labour market attachment and the development of depressiveness, assuming that a firm attachment is associated with decreasing depressiveness. Methods The baseline investigation of the studied cohort (n = 1,001) took place during their final year of compulsory schooling at age 16. Follow-up surveys were conducted at ages 18, 21, 30, and 43. Depressiveness was measured with a five-item score. Multiple trajectory analysis, incorporating five labour market statuses observed over seven half-year periods from ages 18 to 21, was employed to categorize the cohort into six distinct groups. Among these, 'All-time education,' 'From education to employment,' 'Education and employment,' and 'From employment to education' were considered to demonstrate firm labour market attachment. Meanwhile, 'Active labour market policy' and 'Unemployment' represented less firm attachment. Results The trajectory of depressive symptoms among the total cohort from age 16 to age 43 exhibited a 'broken stick' pattern, reaching its lowest point at age 21. This pattern was evident in all groups classified as having a firm attachment. A substantial decrease in depressiveness was also observed in the relatively weakly attached 'Active labour market policy' group, whereas no 'broken stick' pattern emerged in the 'Unemployment' group. The disparities in the levels of depressiveness observed at age 21 remained relatively stable across the measurements at ages 30 and 43. Discussion The results were as expected, except for the observed improvement in mental health within the 'Active labour market policy' group. Supported labour market attachment during emerging adulthood can enhance mental well-being similarly to regular mainstream attachment. In terms of policy recommendations, the consistently high levels of depressiveness within the 'Unemployment' group underscore the importance of reducing long-term and repeated unemployment in young age. The findings regarding the 'Active labour market policy' provide evidence of the intervention's benefits. While the primary goal of these measures is to create jobs for the unemployed, they also include elements that contribute to participants' mental health.
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Affiliation(s)
- Pekka Virtanen
- Faculty of Social Sciences, Tampere University, Tampere, Finland
- Karolinska Institutet, Stockholm, Sweden
| | - Tapio Nummi
- Faculty of Information Technology and Communication Sciences, Tampere University, Tampere, Finland
| | - Hugo Westerlund
- Department of Psychology, Stress Research Institute, Stockholm University, Stockholm, Sweden
| | - Per-Olof Östergren
- Social Medicine and Global Health, Department of Clinical Sciences in Malmö, Lund University, Lund, Sweden
| | - Urban Janlert
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Anne Hammarström
- Karolinska Institutet, Stockholm, Sweden
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
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Raza A, Partonen T, Hanson LM, Asp M, Engström E, Westerlund H, Halonen JI. Daylight during winters and symptoms of depression and sleep problems: A within-individual analysis. Environ Int 2024; 183:108413. [PMID: 38171042 DOI: 10.1016/j.envint.2023.108413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 11/23/2023] [Accepted: 12/29/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND With climate change Northern areas of the globe are expected to have less daylight during winters due to less snow and more cloudiness. While wintertime has been linked to mental health problems, the role of wintertime daylight has been scarcely studied. We examined longitudinal associations for wintertime objective exposure to global radiation and self-reported daylight exposure with symptoms of depression and sleep problems. METHODS Our analytical sample included 15,619 respondents from three Swedish Longitudinal Occupational Surveys of Health (2012, 2014 and 2016). Objective exposure was global radiation (MJ/m2, November-January and November-February). Subjective exposure was based on self-reported time spent outdoors in daylight (<1 h vs. ≥ 1 h, November-January). Symptoms of depression were evaluated using a six-item subscale of the (Hopkins) Symptom Checklist. Fixed-effects method with conditional logistic regression controlled for time-invariant participant characteristics by design and time-varying covariates were added into models. RESULTS One unit increase in the four-month averaged global radiation was associated with lower odds of depressive symptoms (OR 0.69, 95 % CI 0.52-0.91). These findings were confirmed using four-month cumulative exposure (OR 0.91, 95 % CI 0.85-0.98). Individuals reporting ≥ 1 h exposure to daylight during winter months were less likely to report depressive symptoms (OR 0.72, 95 % CI 0.60-0.82) compared to time when their exposure was < 1 h. Higher three-month exposure to global radiation suggested a protective association for sleep problems. CONCLUSION These findings suggest that higher exposure to daylight during winters may contribute to lower likelihood of depression symptoms.
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Affiliation(s)
- Auriba Raza
- Stress Research Institute, Department of Psychology, Stockholm University, SE-106 91 Stockholm, Sweden.
| | - Timo Partonen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, P.O. Box 30, FI-00271 Helsinki, Finland
| | - Linda Magnusson Hanson
- Stress Research Institute, Department of Psychology, Stockholm University, SE-106 91 Stockholm, Sweden
| | - Magnus Asp
- Department of Community Planning Services, Swedish Meteorological and Hydrological Institute, SE-601 76 Norrköping, Sweden
| | - Erik Engström
- Department of Community Planning Services, Swedish Meteorological and Hydrological Institute, SE-601 76 Norrköping, Sweden
| | - Hugo Westerlund
- Stress Research Institute, Department of Psychology, Stockholm University, SE-106 91 Stockholm, Sweden
| | - Jaana I Halonen
- Stress Research Institute, Department of Psychology, Stockholm University, SE-106 91 Stockholm, Sweden; Department of Health Security, Finnish Institute for Health and Welfare, P.O. Box 30, FI-00271 Helsinki, Finland
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Hammarström A, Bean C, Pingel R, Janlert U, Westerlund H, Östergren PO, Virtanen P. Why does youth unemployment lead to scarring of depressive symptoms in adulthood? The importance of early adulthood drinking. Scand J Public Health 2023:14034948231208472. [PMID: 38153038 DOI: 10.1177/14034948231208472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
AIM The aim of the paper is to analyse if alcohol consumption could explain the scarring effect of youth unemployment on later depressive symptoms. METHODS The analyses are based on the 24-year follow-up of school leavers in a municipality in Northern Sweden (the Northern Swedish Cohort). Four-way decomposition analyses were performed to analyse if alcohol use at age 30 years could mediate and/or moderate the effect of youth unemployment (ages 18/21 years) on depressive symptoms in later adulthood (age 43 years). RESULTS Excessive alcohol use at early adulthood (age 30 years) mediates 18% of the scarring effect of youth unemployment on depressive symptoms in later adulthood. The scarring effect was seen among both those with and without excessive alcohol use. CONCLUSIONS Youth unemployment leads to poor mental health later in life and part of these relations are explained by excessive alcohol consumption in early adulthood. Policy interventions should target the prevention of youth unemployment for reaching a lower alcohol consumption and better mental health.
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Affiliation(s)
- Anne Hammarström
- IMM, Karolinska Institutet, Sweden
- Department of Epidemiology and Global Health, Umeå University, Sweden
| | | | - Ronnie Pingel
- Department of Statistics, Uppsala University, Sweden
| | - Urban Janlert
- Department of Epidemiology and Global Health, Umeå University, Sweden
| | | | - Per Olof Östergren
- Social Medicine and Global Health, Department of Clinical Sciences in Malmö, Lund University, Sweden
| | - Pekka Virtanen
- IMM, Karolinska Institutet, Sweden
- Faculty of Social Sciences, Tampere University, Finland
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Blomqvist S, Alexanderson K, Vahtera J, Westerlund H, Magnusson Hanson LL. Downsizing and purchases of psychotropic drugs: A longitudinal study of stayers, changers and unemployed. PLoS One 2023; 18:e0295383. [PMID: 38064436 PMCID: PMC10707493 DOI: 10.1371/journal.pone.0295383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 11/20/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND The evidence is insufficient regarding the association between organizational downsizing and employee mental health. Our aim was to analyze trajectories of prescribed sedatives and anxiolytics with a sufficiently long follow-up time to capture anticipation, implementation and adaption to a downsizing event among stayers, changers and those who become unemployed compared to unexposed employees. METHOD Residents in Sweden aged 20-54 years in 2007, with stable employment between 2004 and 2007, were followed between 2005 and 2013 (n = 2,305,795). Employment at a workplace with staff reductions ≥18% between two subsequent years in 2007-2011 (n = 915,461) indicated exposure to, and timing of, downsizing. The unexposed (n = 1,390,334) were randomized into four corresponding sub-cohorts. With generalized estimating equations, we calculated the odds ratios (OR) of purchasing prescribed anxiolytics or sedatives within nine 12-month periods, from four years before to four years after downsizing. In order to investigate whether the groups changed their probability of purchases over time, odds ratios (OR) and their 95% confidence intervals (95% CI) were calculated contrasting the prevalence of purchases during the first and the last 12-month period within four time periods for each exposure group. RESULTS The odds of purchasing psychotropic drugs increased more for changers (sedatives OR 1.08, 95% CI 1.05-1.11) and unemployed (anxiolytics OR 1.08, 95% CI 1.03-1.14), compared to unexposed before downsizing, while for stayers purchases increased more than for unexposed during and after downsizing. Among those without previous sickness absence, stayers increased their purchases of psychotropic drugs from the year before the event up to four years after the event. CONCLUSION This study indicates that being exposed to downsizing is associated with increased use of sedatives and anxiolytics, before the event among those who leave, but especially thereafter for employees who stay in the organization.
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Affiliation(s)
- Sandra Blomqvist
- Stress Research Institute, Stockholm University, Stockholm, Sweden
| | | | - Jussi Vahtera
- Department of Public Health, University of Turku, Turku, Finland
| | - Hugo Westerlund
- Stress Research Institute, Stockholm University, Stockholm, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Stenfors CUD, Stengård J, Magnusson Hanson LL, Kecklund LG, Westerlund H. Green sleep: Immediate residential greenspace and access to larger green areas are associated with better sleep quality, in a longitudinal population-based cohort. Environ Res 2023; 234:116085. [PMID: 37207733 DOI: 10.1016/j.envres.2023.116085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 04/16/2023] [Accepted: 05/08/2023] [Indexed: 05/21/2023]
Abstract
OBJECTIVE Sleep is pivotal to health, wellbeing and functioning in daily life, but sleep difficulties are common and may be affected by modifiable qualities in the residential surrounding environment, in terms of greenspace. However, population-based studies on individual-level greenspace and sleep are limited. The objective of the current study was thus to investigate prospective associations between fine-grained individual-level residential greenspace and sleep, and moderating effects of life style (physical activity, work status) and sex, in a nationwide population-based Swedish cohort. METHODS Participants of the Swedish Longitudinal Occupational Survey of Health (SLOSH)-a population-based sample of adults in Sweden-were studied during 2014-2018 (19,375 individuals; 43,062 observations). Residential greenspace land cover, and coherent green area size, were assessed via high resolution geographic information systems, at 50, 100, 300, 500 and 1000 m buffers around residences. Prospective greenspace and sleep associations were assessed via multilevel general linear models, adjusting for demographic, socioeconomic (individual and neighborhood), life style and urban factors. RESULTS Higher greenspace availability in the immediate residential surroundings (50 m and 100 m buffer zones) was associated with less sleep difficulties, even after adjustment for confounders. Greenspace effects were generally greater among non-working individuals. Among the physically active, and among non-working, greenspace and green area size further away from home (300, 500 and 1000 m, i.e. dependent on mobility) were also associated with less sleep difficulties. CONCLUSIONS Residential greenspace in the immediate residential surroundings is associated with significantly less sleep difficulties. Greenspace further away from home was associated with better sleep especially among the physically active, and non-working individuals. The results highlight the importance of greenspace in the immediate residential-surrounding environment for sleep, and the need to integrate health and environmental policies, urban planning and greening.
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Affiliation(s)
- Cecilia U D Stenfors
- Department of Psychology, Stress Research Institute, Stockholm University, Stockholm, Sweden.
| | - Johanna Stengård
- Department of Psychology, Stress Research Institute, Stockholm University, Stockholm, Sweden
| | | | - Lars Göran Kecklund
- Department of Psychology, Stress Research Institute, Stockholm University, Stockholm, Sweden
| | - Hugo Westerlund
- Department of Psychology, Stress Research Institute, Stockholm University, Stockholm, Sweden
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Blomqvist S, Virtanen M, Westerlund H, Magnusson Hanson LL. Associations between COVID-19-related changes in the psychosocial work environment and mental health. Scand J Public Health 2023; 51:664-672. [PMID: 36964650 PMCID: PMC10040465 DOI: 10.1177/14034948231160633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 10/25/2022] [Accepted: 02/13/2023] [Indexed: 03/26/2023]
Abstract
BACKGROUND Individuals' lives have been substantially affected by the COVID-19 pandemic. We aimed to describe changes in psychosocial work environment and mental health and to investigate associations between job insecurity and mental ill-health in relation to changes in other psychosocial work factors, loneliness and financial worries. METHODS A sub-sample of individuals from the eighth Swedish Longitudinal Occupational Survey of Health answered a web-based survey in early 2021 about current and pandemic-related changes in health, health behaviours, work and private life. We investigated participants working before the pandemic (N=1231) in relation to standardised measures on depression, anxiety and loneliness, together with psychosocial work factors, in descriptive and logistic regression analyses. RESULTS While 9% reached the clinical threshold for depression and 6% for anxiety, more than a third felt more worried, lonelier or in a low mood since the start of the pandemic. Two per cent had been dismissed from their jobs, but 16% experienced workplace downsizings. Conditioning on socio-demographic factors and prior mental-health problems, the 8% experiencing reduced job security during the pandemic had a higher risk of anxiety, but not of depression, compared to employees with unaltered or increased job security. Loneliness and other psychosocial work factors explained more of the association than objective measures of job insecurity and financial worries. CONCLUSIONS Reduced job security during the COVID-19 pandemic seems to have increased the risk of anxiety among individuals with a strong labour market attachment, primarily via loneliness and other psychosocial work factors. This illustrates the potentially far-reaching effects of the pandemic on mental health in the working population.
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Affiliation(s)
- Sandra Blomqvist
- Stress Research Institute at Department of Psychology, Stockholm University, Sweden
| | - Marianna Virtanen
- School of Educational Sciences and Psychology, University of Eastern Finland, Finland
| | - Hugo Westerlund
- Stress Research Institute at Department of Psychology, Stockholm University, Sweden
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Magnusson Hanson LL, Pentti J, Nordentoft M, Xu T, Rugulies R, Madsen IEH, Conway PM, Westerlund H, Vahtera J, Ervasti J, Batty GD, Kivimäki M. Association of workplace violence and bullying with later suicide risk: a multicohort study and meta-analysis of published data. Lancet Public Health 2023; 8:e494-e503. [PMID: 37393088 DOI: 10.1016/s2468-2667(23)00096-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 04/24/2023] [Accepted: 04/25/2023] [Indexed: 07/03/2023]
Abstract
BACKGROUND Workplace offensive behaviours, such as violence and bullying, have been linked to psychological symptoms, but their potential impact on suicide risk remains unclear. We aimed to assess the association of workplace violence and bullying with the risk of death by suicide and suicide attempt in multiple cohort studies. METHODS In this multicohort study, we used individual-participant data from three prospective studies: the Finnish Public Sector study, the Swedish Work Environment Survey, and the Work Environment and Health in Denmark study. Workplace violence and bullying were self-reported at baseline. Participants were followed up for suicide attempt and death using linkage to national health records. We additionally searched the literature for published prospective studies and pooled our effect estimates with those from published studies. FINDINGS During 1 803 496 person-years at risk, we recorded 1103 suicide attempts or deaths in participants with data on workplace violence (n=205 048); the corresponding numbers for participants with data on workplace bullying (n=191 783) were 1144 suicide attempts or deaths in 1 960 796 person-years, which included data from one identified published study. Workplace violence was associated with an increased risk of suicide after basic adjustment for age, sex, educational level, and family situation (hazard ratio 1·34 [95% CI 1·15-1·56]) and full adjustment (additional adjustment for job demands, job control, and baseline health problems, 1·25 [1·08-1·47]). Where data on frequency were available, a stronger association was observed among people with frequent exposure to violence (1·75 [1·27-2·42]) than occasional violence (1·27 [1·04-1·56]). Workplace bullying was also associated with an increased suicide risk (1·32 [1·09-1·59]), but the association was attenuated after adjustment for baseline mental health problems (1·16 [0·96-1·41]). INTERPRETATION Observational data from three Nordic countries suggest that workplace violence is associated with an increased suicide risk, highlighting the importance of effective prevention of violent behaviours at workplaces. FUNDING Swedish Research Council for Health, Working Life and Welfare, Academy of Finland, Finnish Work Environment Fund, and Danish Working Environment Research Fund.
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Affiliation(s)
| | - Jaana Pentti
- Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland; Department of Public Health, University of Turku, Turku, Finland; Centre for Population Health Research, Turku University Hospital, University of Turku, Turku, Finland; Finnish Institute of Occupational Health, Helsinki, Finland
| | - Mads Nordentoft
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Tianwei Xu
- Stress Research Institute, Stockholm University, Stockholm, Sweden
| | - Reiner Rugulies
- National Research Centre for the Working Environment, Copenhagen, Denmark; Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Ida E H Madsen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | | | - Hugo Westerlund
- Stress Research Institute, Stockholm University, Stockholm, Sweden
| | - Jussi Vahtera
- Department of Public Health, University of Turku, Turku, Finland; Centre for Population Health Research, Turku University Hospital, University of Turku, Turku, Finland
| | - Jenni Ervasti
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - G David Batty
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Mika Kivimäki
- Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland; Finnish Institute of Occupational Health, Helsinki, Finland; UCL Faculty of Brain Sciences, University College London, London, UK
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Berthelsen H, Owen M, Westerlund H. Leadership, work environment and caries prevention - what is good for the staff, is also good for the patients. Acta Odontol Scand 2023; 81:196-201. [PMID: 35979905 DOI: 10.1080/00016357.2022.2111345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVES Dental caries is a health problem that can be prevented. The aim of this study is to analyse if the quality of leadership, in Swedish Public Dental Health clinics, influences the extent to which patients with caries receive preventive care, and if any such effect is mediated through a collaborative work climate, clear role expectations and a low average level of burnout among staff. METHODS The multilevel cross-sectional design includes work environment data from surveys of 75 general public dental clinics, register-based data on preventive measures provided to 5398 patients who received a dental filling due to a caries diagnosis, and patient demographics. Using a multilevel path analysis with logistic regression, we tested a model with one direct and three indirect pathways, controlling for the potential confounding effect of patient demographic factors. RESULTS Leadership quality, as assessed by the staff at the clinic, was associated with increased odds of patients with caries receiving prevention, controlling for patient demographic factors. Leadership quality was also positively related to a collaborative work climate, clear role expectations and a low average level of burnout among staff. Against expectations, however, no indirect effect from leadership quality on prevention through the other work environment factors was found. CONCLUSIONS In conclusion, the quality of leadership in Swedish Public Dental Health clinics was positively related to a good work environment for staff and to delivery of preventive care to patients experiencing caries.
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Affiliation(s)
- Hanne Berthelsen
- Centre for Work Life and Evaluation Studies (CTA) & Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Mikaela Owen
- Centre for Workplace Excellence, University of South Australia, Adelaide, Australia
| | - Hugo Westerlund
- The Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden
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Platts LG, Sacco LB, Hiyoshi A, Westerlund H, Cahill KE, König S. Job Quality in the Late Career in Sweden, Japan and the United States. Res Aging 2023; 45:259-279. [PMID: 35588492 PMCID: PMC10021131 DOI: 10.1177/01640275221075985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Increasing numbers of older workers continue to work after being eligible to claim a state pension, yet little is known about the quality of these jobs. We examine how psychosocial and physical job quality as well as job satisfaction vary over the late career in three contrasting national settings: Sweden, Japan and the United States. Analyses using random effects modelling drew on data from the Swedish Longitudinal Occupational Survey of Health (n = 13,936-15,520), Japanese Study of Ageing and Retirement (n = 3704) and the Health and Retirement Study (n = 6239 and 8002). Age was modelled with spline functions in which two knots were placed at ages indicating eligibility for pensions claiming or mandatory retirement. In each country, post-pensionable-age jobs were generally less stressful, freer and more satisfying than jobs held by younger workers, results that held irrespective of gender or education level.
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Affiliation(s)
- Loretta G Platts
- Department of Psychology, Stress Research Institute, 123910Stockholm University, Stockholm, Sweden
| | - Lawrence B Sacco
- Department of Psychology, Stress Research Institute, 123910Stockholm University, Stockholm, Sweden
| | - Ayako Hiyoshi
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, 6233Örebro University, Örebro, Sweden
| | - Hugo Westerlund
- Department of Psychology, Stress Research Institute, 123910Stockholm University, Stockholm, Sweden
| | - Kevin E Cahill
- 6019Center on Aging & Work at Boston College, Boston, MA, United States
| | - Stefanie König
- Department of Psychology, and Centre for Ageing and Health, 3570University of Gothenburg, Gothenburg, Sweden
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Raza A, Hanson LLM, Westerlund H, Mäkelä P, Halonen JI. Access to Alcohol Outlets From Home and Work in Sweden: Longitudinal Associations With Problem Drinking. J Stud Alcohol Drugs 2023; 84:37-44. [PMID: 36799672 DOI: 10.15288/jsad.21-00365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE The association of proximity of alcohol outlets to the workplace with problem drinking has not been previously studied. We examined longitudinal associations of living and working in proximity to alcohol outlets with problem drinking. METHOD The data consisted of 13,306 employed respondents to the Swedish Longitudinal Occupational Survey of Health between 2012 and 2018. Road distances from the respondents' home and workplace to the nearest liquor outlet, beer outlet, and bar were calculated by Statistics Sweden. We used distance variables both as categorized, to indicate changes in distance, and as continuous variables. Self-reported problem drinking was assessed using modified Cut-Annoyed-Guilty-Eye (CAGE) questions. Binomial logistic regression with generalized estimating equation was used to examine the associations. RESULTS A decrease (vs. remained unchanged) in the distance from home to a liquor outlet was associated with a higher likelihood of problem drinking (odds ratio = 1.21, 95% confidence interval [1.02, 1.45]). A protective association for problem drinking was observed when the distance from home to a beer outlet increased (vs. remained unchanged) (0.65 [0.44, 0.95]). A decrease (vs. remained unchanged) in the distance from work to a bar was also associated with a higher likelihood of problem drinking (1.37 [1.00, 1.88]). The likelihood of problem drinking was increased also per 1-km decrease in distance from home to liquor outlets (1.01 [1.00, 1.02]), risk estimates being higher for women than for men. CONCLUSIONS Alcohol outlet proximity to the workplace could be an additional determinant of harmful alcohol consumption behavior. Reducing the number of on- and off-premise alcohol outlets could reduce the level of harmful alcohol consumption.
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Affiliation(s)
- Auriba Raza
- Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Linda L M Hanson
- Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Hugo Westerlund
- Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Pia Mäkelä
- Alcohol, Drugs and Addictions Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Jaana I Halonen
- Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden.,Department of Health Security, Finnish Institute for Health and Welfare, Helsinki, Finland
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12
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Blomqvist S, Alexanderson K, Vahtera J, Westerlund H, Magnusson Hanson LL. Retraction: Downsizing and purchases of psychotropic drugs: A longitudinal study of stayers, changers and unemployed. PLoS One 2023; 18:e0285004. [PMID: 37079656 PMCID: PMC10118102 DOI: 10.1371/journal.pone.0285004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2023] Open
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13
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Raza A, Pulakka A, Hanson LLM, Westerlund H, Halonen JI. Distance to sports facilities and low frequency of exercise and obesity: a cross-sectional study. BMC Public Health 2022; 22:2036. [DOI: 10.1186/s12889-022-14444-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 10/25/2022] [Indexed: 11/09/2022] Open
Abstract
Abstract
Background
Little research has investigated the associations between proximity to physical activity facilities and behavior-related health and the majority have focused on proximity from home address. We add to the literature by examining proximity of these facilities to work and home address and including a wide range of physical activity facilities. We assess the associations for proximity of physical activity facilities from home and work address with self-reported frequency of exercise and obesity.
Methods
Our analytical sample of 7358 participants was from the 2018 wave of the Swedish Longitudinal Occupational Survey of Health. We used logistic binomial regression adjusting for age, sex, education, civil status, individual socioeconomic status, neighborhood socioeconomic status, number of children under 12 years of age, work strain, and chronic disease.
Results
Longer distance from home to paid outdoor and paid indoor physical activity facilities was associated with low frequency of exercise (fully adjusted Relative Risk for both 1.01, 95% CI 1.01–1.02). Associations of any or free outdoor facility with low frequency of exercise were not robust. Findings also indicated associations between long distance from workplace to any and paid outdoor facility and low frequency of exercise. Results for obesity were in the similar direction, however, these were not statistically significant.
Conclusion
Increased distance of paid outdoor and paid indoor physical activity facilities from home and of paid outdoor facilities from work was associated with low frequency of exercise. Longitudinal and larger studies are needed to confirm our findings, particularly regarding obesity.
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14
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Xu T, Rugulies R, Vahtera J, Pentti J, Mathisen J, Lange T, Clark AJ, Magnusson Hanson LL, Westerlund H, Ervasti J, Virtanen M, Kivimäki M, Rod NH. Workplace psychosocial resources and risk of cardiovascular disease among employees: a multi-cohort study of 135 669 participants. Scand J Work Environ Health 2022; 48:621-631. [PMID: 35752989 PMCID: PMC10546613 DOI: 10.5271/sjweh.4042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE In terms of prevention, it is important to determine effects on cardiovascular disease (CVD) when some workplace psychosocial resources are high while others are low. The aim of the study was to assess the prospective relationship between clustering of workplace psychosocial resources and risk of CVD among employees. METHODS We pooled data from three cohort studies of 135 669 employees (65% women, age 18-65 years and free of CVD) from Denmark, Finland and Sweden. Baseline horizontal resources (culture of collaboration and support from colleagues) and vertical resources (leadership quality and procedural justice) were measured using standard questionnaire items. Incident CVD, including coronary heart and cerebrovascular disease, was ascertained using linked electronic health records. We used latent class analysis to assess clustering (latent classes) of workplace psychosocial resources. Cox proportional hazard models were used to examine the association between these clusters and risk of CVD, adjusting for demographic and employment-related factors and pre-existing physical and mental disorders. RESULTS We identified five clusters of workplace psychosocial resources from low on both vertical and horizontal resources (13%) to generally high resources (28%). High horizontal resources were combined with either intermediate [hazard ratio (HR) 0.84, 95% confidence interval (CI) 0.74-0.95] or high (HR 0.88, 95% CI 0.78-1.00) vertical resources were associated with lower risks of CVD compared to those with generally low resources. The association was most prominent for cerebrovascular disease (eg, general high resources: HR 0.80, 95% CI 0.67-0.96). CONCLUSIONS Individuals with high levels of workplace psychosocial resources across horizontal and vertical dimensions have a lower risk of CVD, particularly cerebrovascular disease.
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Affiliation(s)
- Tianwei Xu
- Stress Research Institute, Stockholm University, Stockholm, Sweden
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- National Research Centre of the Working Environment, Copenhagen, Denmark
| | - Reiner Rugulies
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- National Research Centre of the Working Environment, Copenhagen, Denmark
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Jussi Vahtera
- Department of Public Health, University of Turku, Turku, Finland
- The Centre for Population Health Research, University of Turku, Turku, Finland
- Turku University Hospital, Turku, Finland
| | - Jaana Pentti
- Department of Public Health, University of Turku, Turku, Finland
- Clinicum, Faculty of Medicine, University of Helsinki, Finland
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Jimmi Mathisen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Theis Lange
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Alice J Clark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Novo Nordisk A/S, Søborg, Denmark
| | | | - Hugo Westerlund
- Stress Research Institute, Stockholm University, Stockholm, Sweden
| | - Jenni Ervasti
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Marianna Virtanen
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland
- Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Mika Kivimäki
- Clinicum, Faculty of Medicine, University of Helsinki, Finland
- Finnish Institute of Occupational Health, Helsinki, Finland
- Department of Epidemiology and Public Health, University College, London, UK
| | - Naja H Rod
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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15
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Owen MS, Berthelsen H, Jamieson SD, Westerlund H. A Quick "Environment Check" for All Ages: Validating the New Age-Inclusive Work Environments Instrument. Innov Aging 2022; 6:igac066. [PMID: 36588624 PMCID: PMC9795836 DOI: 10.1093/geroni/igac066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Indexed: 11/06/2022] Open
Abstract
Background and Objectives The global aging workforce necessitates new approaches in designing work environments to cater to the needs of increasingly age-diverse work groups. The Organisation for Economic Co-operation and Development (OECD) has in reaction outlined that organizations need to provide age-inclusive work environments that support the needs of their multigenerational workforce, to ensure their sustainability and profitability. To capture the age inclusiveness of the work environment, the present study proposes and validates an age-inclusive "environment check" for organizations referred to as the Age-Inclusive Work Environment Instrument (AIWEI), which covers discrimination, inclusion, and development opportunities. Research Design and Methods We validate the 9-item AIWEI using cross-sectional and multilevel data from 2,892 Swedish workers across 101 workplaces who completed an online survey, using confirmatory factor analyses across young, middle-age, and older workers. Using a nomological approach, we also evaluate the concurrent validity of the AIWEI with a 2-1-1 path analysis. Results The factor analyses supported a 3-factor model comprising of inclusion, discrimination, and development opportunities, across 3 age groups (i.e., young, middle-age, and older workers). These 3 factors had high Intraclass Coefficient (ICC) scores showing consistency in responding in the workplace. In accordance with the nomological approach, the factors of the AIWEI were linked with Psychosocial Safety Climate, burnout, and engagement, demonstrating concurrent validity for the AIWEI. Discussion and Implications This new "environment check" provides a way to capture age-inclusive work environments for both younger and older workers, in an age-diverse workforce. In the validation process, age-inclusive work environments were found to exist as a group phenomenon, through shared perceptions within an organization, as well as an individual phenomenon, as experiences specific to an individual. This is important for the development and implementation of policies and strategies designed to benefit workers and organizations.
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Affiliation(s)
- Mikaela S Owen
- Behaviour–Brain–Body Research Group & Psychosocial Safety Climate Global Observatory, Justice & Society, University of South Australia, Adelaide, Australia
| | - Hanne Berthelsen
- Address correspondence to: Hanne Berthelsen, Dr. Odont, MPH, DDS, Centre for Work Life and Evaluation Studies (CTA) and Faculty of Odontolgy, Malmö University, S-20506 Malmö, Sweden. E-mail:
| | - Stephanie D Jamieson
- Centre for Workplace Excellence, Business School, University of South Australia, Adelaide, Australia
| | - Hugo Westerlund
- Stress Research Institute, Stockholm University, Stockholm, Sweden
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16
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Karatuna I, Owen M, Westerlund H, Berthelsen H. The Role of Staff-Assessed Care Quality in the Relationship between Job Demands and Stress in Human Service Work: The Example of Dentistry. Int J Environ Res Public Health 2022; 19:12795. [PMID: 36232093 PMCID: PMC9566637 DOI: 10.3390/ijerph191912795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/29/2022] [Accepted: 10/03/2022] [Indexed: 06/16/2023]
Abstract
The aim of this study was to investigate staff-assessed care quality at the clinic as a predictor of stress and as a moderator between job demands (quantitative demands and role conflict) and stress among dental professionals as an example of human service workers. Cross-sectional questionnaire data from 1012 dental professionals (i.e., dentists, dental hygienists and dental nurses) working at 99 clinics were analysed by confirmatory factor analysis and a two-level hierarchical linear model. Stress, quantitative demands and role conflict were measured by the Swedish standard version of COPSOQ III and care quality was measured by three proprietary items. The results showed that staff-assessed care quality at the clinic was of importance for the individual workers' experiences of stress. Furthermore, the staff's joint assessment of the care quality at the clinic mitigated the negative effect of role conflict on stress among dental nurses. These results indicate that a high level of staff-assessed care quality at the clinic can contribute to reduced stress in dental professionals.
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Affiliation(s)
- Işıl Karatuna
- Department of Psychology, Faculty of Social Sciences, Beykoz University, 34805 Istanbul, Turkey
| | - Mikaela Owen
- Centre for Workplace Excellence, University of South Australia, Adelaide, SA 5001, Australia
| | - Hugo Westerlund
- Department of Psychology, Stress Research Institute, Stockholm University, 106 91 Stockholm, Sweden
| | - Hanne Berthelsen
- Centre for Work Life and Evaluation Studies (CTA) & the Faculty of Odontology, Malmö University, 205 06 Malmö, Sweden
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17
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Nyberg ST, Batty GD, Pentti J, Madsen IEH, Alfredsson L, Bjorner JB, Borritz M, Burr H, Ervasti J, Goldberg M, Jokela M, Knutsson A, Koskinen A, Lallukka T, Lindbohm JV, Nielsen ML, Oksanen T, Pejtersen JH, Pietiläinen O, Rahkonen O, Rugulies R, Shipley MJ, Sipilä PN, Sørensen JK, Stenholm S, Suominen S, Väänänen A, Vahtera J, Virtanen M, Westerlund H, Zins M, Singh-Manoux A, Kivimäki M. Association of alcohol use with years lived without major chronic diseases: A multicohort study from the IPD-Work consortium and UK Biobank. Lancet Reg Health Eur 2022; 19:100417. [PMID: 35664051 PMCID: PMC9160494 DOI: 10.1016/j.lanepe.2022.100417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Background Heavy alcohol consumption increases the risk of several chronic diseases. In this multicohort study, we estimated the number of life-years without major chronic diseases according to different characteristics of alcohol use. Methods In primary analysis, we pooled individual-level data from up to 129,942 adults across 12 cohort studies with baseline data collection on alcohol consumption, drinking patterns, and history between 1986 and 2005 (the IPD-Work Consortium). Self-reported alcohol consumption was categorised according to UK guidelines - non-drinking (never or former drinkers); moderate consumption (1-14 units); heavy consumption (>14 units per week). We further subdivided moderate and heavy drinkers by binge drinking pattern (alcohol-induced loss of consciousness). In addition, we assessed problem drinking using linked data on hospitalisations due to alcohol abuse or poisoning. Follow-up for chronic diseases for all participants included incident type 2 diabetes, coronary heart disease, stroke, cancer, and respiratory disease (asthma and chronic obstructive pulmonary disease) as ascertained via linkage to national morbidity and mortality registries, repeated medical examinations, and/or self-report. We estimated years lived without any of these diseases between 40 and 75 years of age according to sex and characteristics of alcohol use. We repeated the main analyses using data from 427,621 participants in the UK Biobank cohort study. Findings During 1·73 million person-years at risk, 22,676 participants in IPD-Work cohorts developed at least one chronic condition. From age 40 to 75 years, never-drinkers [men: 29·3 (95%CI 27·9-30·8) years, women 29·8 (29·2-30·4) years)] and moderate drinkers with no binge drinking habit [men 28·7 (28·4-29·0) years, women 29·6 (29·4-29·7) years] had the longest disease-free life span. A much shorter disease-free life span was apparent in participants who experienced alcohol poisoning [men 23·4 (20·9-26·0) years, women 24·0 (21·4-26·5) years] and those with self-reported heavy overall consumption and binge drinking [men: 26·0 (25·3-26·8), women 27·5 (26·4-28·5) years]. The pattern of results for alcohol poisoning and self-reported alcohol consumption was similar in UK Biobank. In IPD-Work and UK Biobank, differences in disease-free years between self-reported moderate drinkers and heavy drinkers were 1·5 years or less. Interpretation Individuals with alcohol poisonings or heavy self-reported overall consumption combined with a binge drinking habit have a marked 3- to 6-year loss in healthy longevity. Differences in disease-free life between categories of self-reported weekly alcohol consumption were smaller. Funding Medical Research Council, National Institute on Aging, NordForsk, Academy of Finland, Finnish Work Environment Fund.
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Affiliation(s)
- Solja T Nyberg
- Clinicum, Department of Public Health, Faculty of Medicine, University of Helsinki, Tukholmankatu 8B, FI-00014 Helsingin yliopisto, Helsinki, Finland.,Faculty of Social Sciences, University of Tampere, Tampere, Finland.,Finnish Institute of Occupational Health, Helsinki, Finland
| | - G David Batty
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Jaana Pentti
- Clinicum, Department of Public Health, Faculty of Medicine, University of Helsinki, Tukholmankatu 8B, FI-00014 Helsingin yliopisto, Helsinki, Finland.,Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Ida E H Madsen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Lars Alfredsson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Centre for Occupational and Environmental Medicine, Stockholm County Council, Sweden
| | - Jakob B Bjorner
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | | | - Hermann Burr
- Federal Institute for Occupational Safety and Health (BAuA), Berlin, Germany
| | - Jenni Ervasti
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Marcel Goldberg
- Paris Descartes University, Paris, France.,Inserm UMS 011, Population-Based Epidemiological Cohorts Unit, Villejuif, France
| | - Markus Jokela
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Anders Knutsson
- Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden
| | - Aki Koskinen
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Tea Lallukka
- Clinicum, Department of Public Health, Faculty of Medicine, University of Helsinki, Tukholmankatu 8B, FI-00014 Helsingin yliopisto, Helsinki, Finland
| | - Joni V Lindbohm
- Clinicum, Department of Public Health, Faculty of Medicine, University of Helsinki, Tukholmankatu 8B, FI-00014 Helsingin yliopisto, Helsinki, Finland
| | | | - Tuula Oksanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Jan H Pejtersen
- VIVE-The Danish Center for Social Science Research, Copenhagen, Denmark
| | - Olli Pietiläinen
- Clinicum, Department of Public Health, Faculty of Medicine, University of Helsinki, Tukholmankatu 8B, FI-00014 Helsingin yliopisto, Helsinki, Finland
| | - Ossi Rahkonen
- Clinicum, Department of Public Health, Faculty of Medicine, University of Helsinki, Tukholmankatu 8B, FI-00014 Helsingin yliopisto, Helsinki, Finland
| | - Reiner Rugulies
- National Research Centre for the Working Environment, Copenhagen, Denmark.,Department of Public Health and Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Martin J Shipley
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Pyry N Sipilä
- Clinicum, Department of Public Health, Faculty of Medicine, University of Helsinki, Tukholmankatu 8B, FI-00014 Helsingin yliopisto, Helsinki, Finland
| | - Jeppe K Sørensen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Sari Stenholm
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Sakari Suominen
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland.,School of Health Science, University of Skövde, Skövde, Sweden
| | - Ari Väänänen
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Jussi Vahtera
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Marianna Virtanen
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland.,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Hugo Westerlund
- Stress Research Institute, Stockholm University, Stockholm, Sweden
| | - Marie Zins
- Paris Descartes University, Paris, France.,Inserm UMS 011, Population-Based Epidemiological Cohorts Unit, Villejuif, France
| | - Archana Singh-Manoux
- Department of Epidemiology and Public Health, University College London, London, UK.,Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases, Université de Paris, France
| | - Mika Kivimäki
- Clinicum, Department of Public Health, Faculty of Medicine, University of Helsinki, Tukholmankatu 8B, FI-00014 Helsingin yliopisto, Helsinki, Finland.,Department of Epidemiology and Public Health, University College London, London, UK
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18
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Berg N, Nummi T, Bean CG, Westerlund H, Virtanen P, Hammarström A. Risk factors in adolescence as predictors of trajectories of somatic symptoms over 27 years. Eur J Public Health 2022; 32:696-702. [PMID: 35904464 PMCID: PMC9527955 DOI: 10.1093/eurpub/ckac081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Somatic symptoms among adolescents are common, yet little is known about long-term trajectories of somatic symptoms and the factors in adolescence that shape them. We examined individual, family and school-based factors at age 16 as predictors of trajectories of somatic symptoms over 27 years. METHODS Participants from the Northern Swedish Cohort (n = 1001) responded to questions about individual factors (e.g. health behaviours), family factors (e.g. contact with parents, social and material adversity) and school satisfaction at age 16; as well as 10 somatic symptoms at ages 16, 18, 21, 30 and 43. Teacher assessments at age 16 included overall ability at school and peer relations. Age 16 predictors of somatic symptom trajectory group membership were analysed using multinomial logistic regression. RESULTS Poor contact with mother and poor school satisfaction were significant predictors of adverse symptom trajectories among both men and women. Low birth weight and low parental academic involvement were contributing factors for women, while smoking and social adversity were more relevant factors for men. CONCLUSIONS Our findings emphasize the importance of a holistic approach that considers the unique contributions of individual, family and school-based factors in the development of trajectories of somatic symptoms from adolescence to middle age.
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Affiliation(s)
- Noora Berg
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland.,Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Tapio Nummi
- Faculty of Information Technology and Communication Sciences/Statistics, Tampere University, Tampere, Finland
| | - Christopher G Bean
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.,School of Psychology, The University of Adelaide, Adelaide, SA, Australia
| | - Hugo Westerlund
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Pekka Virtanen
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Anne Hammarström
- Institute of Environmental Medicine, Unit of Occupational Medicine, Karolinska Institutet Stockholm, Sweden.,Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
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19
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Stengård J, Virtanen M, Leineweber C, Westerlund H, Wang HX. The Implication of Physically Demanding and Hazardous Work on Retirement Timing. IJERPH 2022; 19:ijerph19138123. [PMID: 35805780 PMCID: PMC9265406 DOI: 10.3390/ijerph19138123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 06/28/2022] [Accepted: 06/28/2022] [Indexed: 12/10/2022]
Abstract
The need to retain individuals longer in the workforce is acknowledged in many high-income countries. The present study therefore aimed to examine the importance of physically demanding work tasks (PDWT) and physically hazardous work environment (PHWE) in relation to retirement timing among pensionable workers (≥61 years). A particular question was whether PDWT and PHWE increased in importance with age. Six waves (2008–2018) of the Swedish Longitudinal Occupational Survey of Health (SLOSH) were used (n = 5201; 56% women and 44% men; mean age at first survey was 61.0 (SD 2.0) years). Discrete time-event history analysis, stratified by socioeconomic position and gender, showed that among blue-collar workers, PDWT and PHWE were associated with an increased likelihood of retiring within the next two years. With increasing age, high-level PHWE was associated with higher probability of retiring among blue-collar men, whereas heavy PDWT was associated with lower probability of retiring among blue-collar women. Among white-collar workers, having at least some PDWT compared to no PDWT was associated with a lower likelihood of retiring within the next two years. With increasing age, exposure to PHWE was associated with higher probability of retiring among white-collar women. These results suggest that to delay retirements, organizations could offer their older employees, especially blue-collar workers and the oldest white-collar women, alternatives to PDWT and PHWE.
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Affiliation(s)
- Johanna Stengård
- Stress Research Institute, Department of Psychology, Stockholm University, 11419 Stockholm, Sweden; (C.L.); (H.W.); (H.-X.W.)
- Correspondence:
| | - Marianna Virtanen
- School of Educational Sciences and Psychology, University of Eastern Finland, 80101 Joensuu, Finland;
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, 17177 Stockholm, Sweden
| | - Constanze Leineweber
- Stress Research Institute, Department of Psychology, Stockholm University, 11419 Stockholm, Sweden; (C.L.); (H.W.); (H.-X.W.)
| | - Hugo Westerlund
- Stress Research Institute, Department of Psychology, Stockholm University, 11419 Stockholm, Sweden; (C.L.); (H.W.); (H.-X.W.)
| | - Hui-Xin Wang
- Stress Research Institute, Department of Psychology, Stockholm University, 11419 Stockholm, Sweden; (C.L.); (H.W.); (H.-X.W.)
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20
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Van Vianen AEM, Van Laethem M, Leineweber C, Westerlund H. Work changes and employee age, maladaptive coping expectations, and well-being: a Swedish cohort study. Int Arch Occup Environ Health 2022; 95:1317-1330. [PMID: 34997325 PMCID: PMC9273551 DOI: 10.1007/s00420-021-01824-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 12/08/2021] [Indexed: 11/29/2022]
Abstract
Purpose Older workers are expected to suffer more from work changes than younger ones, but empirical evidence is lacking. Negative responses to work changes may result rather from maladaptive coping expectations. This study examined possible age differences in job and life satisfaction, and sleep disturbances, after work changes (voluntary and involuntary job changes, reorganizations) and the moderating role of maladaptive coping expectations. Methods Four biennial waves from the Swedish Longitudinal Occupational Survey of Health (SLOSH) including respondents who participated in all four waves (n = 3084). We used multilevel path analyses to estimate direct and moderated relationships between work changes and outcomes. Results Involuntary job changes were associated with lower job and life satisfaction and more sleep disturbances. Reorganizations were only associated with lower job satisfaction. Older employees were more satisfied with their jobs and lives than younger employees and experienced more sleep disturbances. After involuntary job changes, older employees had similar (lower) levels of well-being as younger ones, but they reported more sleep disturbances when having experienced reorganizations. Maladaptive coping expectations were related to lower job and life satisfaction and more sleep disturbances. Employees with maladaptive coping expectations reported more sleep disturbances after involuntary job changes and reorganizations. Conclusion Our results suggest that there are few age differences in well-being after work changes. Employee well-being seems to mostly depend on maladaptive coping expectations. Organizations aiming to prepare employees for job changes and reorganizations could focus their efforts on employees with maladaptive expectations rather than on older ones.
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Affiliation(s)
- Annelies E M Van Vianen
- Department of Work and Organizational Psychology, University of Amsterdam, Postbox 15919, 1001 NK, Amsterdam, Netherlands.
| | - Michelle Van Laethem
- Department of Work and Organizational Psychology, University of Amsterdam, Postbox 15919, 1001 NK, Amsterdam, Netherlands
| | - Constanze Leineweber
- Department of Psychology, Stress Research Institute, Stockholm University, Stockholm,, Sweden
| | - Hugo Westerlund
- Department of Psychology, Stress Research Institute, Stockholm University, Stockholm,, Sweden
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21
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Xu T, Clark AJ, Pentti J, Rugulies R, Lange T, Vahtera J, Magnusson Hanson LL, Westerlund H, Kivimäki M, Rod NH. Characteristics of Workplace Psychosocial Resources and Risk of Diabetes: A Prospective Cohort Study. Diabetes Care 2022; 45:59-66. [PMID: 34740912 PMCID: PMC9004314 DOI: 10.2337/dc20-2943] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 10/05/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To examine whether characteristics of workplace psychosocial resources are associated with the risk of type 2 diabetes among employees. RESEARCH DESIGN AND METHODS Participants were 49,835 employees (77% women, aged 40-65 years, and diabetes free at baseline) from the Finnish Public Sector cohort study. Characteristics of horizontal (culture of collaboration and support from colleagues) and vertical (leadership quality and organizational procedural justice) psychosocial resources were self-reported. Incident type 2 diabetes (n = 2,148) was ascertained through linkage to electronic health records from national registers. We used latent class modeling to assess the clustering of resource characteristics. Cox proportional hazards models were used to examine the relationship between the identified clusters and risk of type 2 diabetes during 10.9 years of follow-up, adjusting for age, sex, marital status, educational level, type of employment contract, comorbidity, and diagnosed mental disorders. RESULTS We identified four patterns of workplace psychosocial resources: unfavorable, favorable vertical, favorable horizontal, and favorable vertical and horizontal. Compared with unfavorable, favorable vertical (hazard ratio 0.87 [95% CI 0.78; 0.97]), favorable horizontal (0.77 [0.67; 0.88]), and favorable vertical and horizontal (0.77 [0.68; 0.86]) resources were associated with a lower risk of type 2 diabetes, with the strongest associations seen in employees at age ≥55 years (Pinteraction = 0.03). These associations were robust to multivariable adjustments and were not explained by reverse causation. CONCLUSIONS A favorable culture of collaboration, support from colleagues, leadership quality, and organizational procedural justice are associated with a lower risk of employees developing type 2 diabetes than in those without such favorable workplace psychosocial resources.
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Affiliation(s)
- Tianwei Xu
- 1Stress Research Institute, Stockholm University, Stockholm, Sweden.,2Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,3National Research Centre of the Working Environment, Copenhagen, Denmark
| | - Alice J Clark
- 2Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,4Novo Nordisk A/S, Søborg, Denmark
| | - Jaana Pentti
- 5Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,6Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland
| | - Reiner Rugulies
- 2Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,3National Research Centre of the Working Environment, Copenhagen, Denmark.,7Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Theis Lange
- 2Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Jussi Vahtera
- 6Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland.,8Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | | | - Hugo Westerlund
- 1Stress Research Institute, Stockholm University, Stockholm, Sweden
| | - Mika Kivimäki
- 5Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,9Department of Epidemiology and Public Health, University College, London, U.K.,10Finnish Institute of Occupational Health, Helsinki, Finland
| | - Naja H Rod
- 2Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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22
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Stengård J, Leineweber C, Virtanen M, Westerlund H, Wang HX. Do good psychosocial working conditions prolong working lives? Findings from a prospective study in Sweden. Eur J Ageing 2021; 19:677-688. [PMID: 36052189 PMCID: PMC9424473 DOI: 10.1007/s10433-021-00672-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2021] [Indexed: 11/29/2022] Open
Abstract
Due to an ageing population, governments in European countries are striving to keep older workers longer in the workforce. Remarkably few studies have paid attention to the influence of psychosocial working conditions on timing of retirement for older workers in and beyond normative retirement age. The aim of the present study was to examine whether good psychosocial working conditions contribute to prolonged working lives among older workers (59 years and above). A particular question was whether such conditions increase in importance with age. Seven waves (2006–2018) of the Swedish Longitudinal Occupational Survey of Health (SLOSH) were used (N = 6000, observations = 10,632). Discrete-time event history analyses showed that higher levels of job resources (decision authority [OR 1.13, 95% CI 1.06–1.22], skill use [OR 1.17, 95% CI 1.07–1.29], learning opportunities [OR 1.22, 95% CI 1.13–1.31], social support [OR 1.29 (95% CI 1.16–1.42], work-time control [OR 1.07, 95% CI 1.01–1.13], and reward [OR 1.40, 95% CI 1.24–1.57])—but not lower levels of job demands (quantitative and emotional demands or effort)—were associated with working longer (continued work two years later). Also, low effort-reward imbalance (OR 0.84 [95% CI 0.73–0.96]) was associated with working longer. In addition, skill use, work-time control, reward, and low effort-reward imbalance increased in importance with age for continued work. These results suggest that providing older workers with control over their work tasks, giving opportunities for learning and using their skills, as well as rewarding and acknowledging their achievements, may keep them in the workforce longer. Especially, job resources may grow in importance with age.
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23
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Sacco L, Cahill K, Westerlund H, Platts L. Changes in Job Quality as People Work Beyond Pensionable Age in Sweden. Innov Aging 2021. [PMCID: PMC8969914 DOI: 10.1093/geroni/igab046.1605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
This paper uses data from the biennial Swedish Longitudinal Occupational Survey of Health to examine changes in job quality among older workers, controlling for work intensity and employment characteristics. Job quality outcomes included job satisfaction and physical (dangerous, strenuous or unpleasant work) and psychosocial (job strain, effort-reward imbalance, work time control) working conditions. First difference estimation was used to analyze within-individual changes in job quality, as well as changes in hours, employment characteristics (shifting to a non-permanent contract, the private sector and self-employment) and health. Individuals who worked beyond pensionable age experienced statistically significant improvements in job quality, with larger improvements among those who reduced working hours and shifted from permanent to non-permanent contracts, from the public into the private sector, and from wage-and-salary to self-employment. We conclude that work beyond pensionable age is a distinctive period characterized by employment that becomes more flexible and rewarding and less stressful.
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Affiliation(s)
| | - Kevin Cahill
- Center on Aging & Work at Boston College, Chestnut Hill, Massachusetts, United States
| | - Hugo Westerlund
- Stockholm University, Stockholm University, Stockholms Lan, Sweden
| | - Loretta Platts
- Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Stockholms Lan, Sweden
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24
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Platts L, Ignatowicz A, Westerlund H, Rasoal D. Having a Post-Retirement Job: Improvisation and Containing Commitments. Innov Aging 2021. [PMCID: PMC8969979 DOI: 10.1093/geroni/igab046.1604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
This qualitative paper focuses on individuals who work after pensionable age, a distinctive period in the late career when workers are supported by the known and reliable income of a pension. Using constant comparative analysis, we analyzed interviews from a purposive sample of 25 Swedish people in their late sixties and early seventies. We examined conditions for being in paid work in terms of enabling factors (self-employment, shift work, shortage occupation), improvisation, and the role of chance. The interviews revealed that post-retirement workers took charge of the aspects of work that mattered most to them, evading the disciplinary aspects of work by controlling scheduling and limiting the duration of their commitment. These constrained commitments had knock-on effects of improving psychosocial working conditions. Women and immigrants—groups facing low pensions—experienced the greatest financial consequences of being unable to work in their retirement years in order to supplement their pension income.
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Affiliation(s)
- Loretta Platts
- Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Stockholms Lan, Sweden
| | | | - Hugo Westerlund
- Stockholm University, Stockholm University, Stockholms Lan, Sweden
| | - Dara Rasoal
- Dalarna University, Falun, Dalarnas Lan, Sweden
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25
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Westerlund H, Platts L, Sacco L, Hiyoshi A, Cahill K, König S. Job Quality in the Late Career in Sweden, Japan, and the United States. Innov Aging 2021. [PMCID: PMC8680481 DOI: 10.1093/geroni/igab046.1606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
This paper examines job satisfaction and psychosocial and physical job quality over the late career in three contrasting national settings: Sweden, Japan and the United States. The data come from an ex-post harmonized dataset of individuals aged 50 to 75 years constructed from the biennial Swedish Longitudinal Occupational Survey of Health (SLOSH, 2006–2018, n=13936 to 15520), Japanese Study of Ageing and Retirement (JSTAR, 2006–2013, n=3704) and the United States Health and Retirement Study (HRS, 2006–2016, n=6239 and 8002). The job quality outcomes were physical labour, psychosocial working conditions (time pressure, discretion, pay satisfaction, job security) and job satisfaction. Random effects modelling was performed with age modelled with spline functions in which two knots were placed at ages indicating eligibility for pensions claiming or mandatory retirement. Interestingly, in each country, post-pensionable-age jobs were generally less stressful, freer, and more satisfying than jobs held by younger workers.
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Affiliation(s)
- Hugo Westerlund
- Stockholm University, Stockholm University, Stockholms Lan, Sweden
| | - Loretta Platts
- Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Stockholms Lan, Sweden
| | | | | | - Kevin Cahill
- Center on Aging & Work at Boston College, Chestnut Hill, Massachusetts, United States
| | - Stefanie König
- University of Gothenburg, Gothenburg, Gotlands Lan, Sweden
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26
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Ervasti J, Pentti J, Nyberg ST, Shipley MJ, Leineweber C, Sørensen JK, Alfredsson L, Bjorner JB, Borritz M, Burr H, Knutsson A, Madsen IE, Magnusson Hanson LL, Oksanen T, Pejtersen JH, Rugulies R, Suominen S, Theorell T, Westerlund H, Vahtera J, Virtanen M, Batty GD, Kivimäki M. Long working hours and risk of 50 health conditions and mortality outcomes: a multicohort study in four European countries. Lancet Reg Health Eur 2021; 11:100212. [PMID: 34917998 PMCID: PMC8642716 DOI: 10.1016/j.lanepe.2021.100212] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Studies on the association between long working hours and health have captured only a narrow range of outcomes (mainly cardiometabolic diseases and depression) and no outcome-wide studies on this topic are available. To achieve wider scope of potential harm, we examined long working hours as a risk factor for a wide range of disease and mortality endpoints. METHODS The data of this multicohort study were from two population cohorts from Finland (primary analysis, n=59 599) and nine cohorts (replication analysis, n=44 262) from Sweden, Denmark, and the UK, all part of the Individual-participant Meta-analysis in Working Populations (IPD-Work) consortium. Baseline-assessed long working hours (≥55 hours per week) were compared to standard working hours (35-40 h). Outcome measures with follow-up until age 65 years were 46 diseases that required hospital treatment or continuous pharmacotherapy, all-cause, and three cause-specific mortality endpoints, ascertained via linkage to national health and mortality registers. FINDINGS 2747 (4·6%) participants in the primary cohorts and 3027 (6·8%) in the replication cohorts worked long hours. After adjustment for age, sex, and socioeconomic status, working long hours was associated with increased risk of cardiovascular death (hazard ratio 1·68; 95% confidence interval 1·08-2·61 in primary analysis and 1·52; 0·90-2·58 in replication analysis), infections (1·37; 1·13-1·67 and 1·45; 1·13-1·87), diabetes (1·18; 1·01-1·38 and 1·41; 0·98-2·02), injuries (1·22; 1·00-1·50 and 1·18; 0·98-1·18) and musculoskeletal disorders (1·15; 1·06-1·26 and 1·13; 1·00-1·27). Working long hours was not associated with all-cause mortality. INTERPRETATION Follow-up of 50 health outcomes in four European countries suggests that working long hours is associated with an elevated risk of early cardiovascular death and hospital-treated infections before age 65. Associations, albeit weak, were also observed with diabetes, musculoskeletal disorders and injuries. In these data working long hours was not related to elevated overall mortality. FUNDING NordForsk, the Medical Research Council, the National Institute on Aging, the Wellcome Trust, Academy of Finland, and Finnish Work Environment Fund.
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Affiliation(s)
- Jenni Ervasti
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Jaana Pentti
- Finnish Institute of Occupational Health, Helsinki, Finland
- Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Public Health, University of Turku, and Population Research Centre, University of Turku and Turku University Hospital, Turku, Finland
| | - Solja T. Nyberg
- Finnish Institute of Occupational Health, Helsinki, Finland
- Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Martin J. Shipley
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Constanze Leineweber
- Stress Research Institute at the Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Jeppe K. Sørensen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Lars Alfredsson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Jakob B. Bjorner
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | | | - Hermann Burr
- Federal Institute for Occupational Safety and Health, Berlin, Germany
| | - Anders Knutsson
- Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden
| | - Ida E.H. Madsen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | | | - Tuula Oksanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Jan H. Pejtersen
- VIVE–The Danish Center for Social Science Research, Copenhagen, Denmark
| | - Reiner Rugulies
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Denmark
- Department of Psychology, University of Copenhagen, Denmark
| | - Sakari Suominen
- Department of Public Health, University of Turku, and Population Research Centre, University of Turku and Turku University Hospital, Turku, Finland
- University of Skövde, School of Health and Education, Skövde, Sweden
| | - Töres Theorell
- Stress Research Institute at the Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Hugo Westerlund
- Stress Research Institute at the Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Jussi Vahtera
- Department of Public Health, University of Turku, and Population Research Centre, University of Turku and Turku University Hospital, Turku, Finland
| | - Marianna Virtanen
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland
- Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
| | - G. David Batty
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Mika Kivimäki
- Finnish Institute of Occupational Health, Helsinki, Finland
- Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Epidemiology and Public Health, University College London, London, UK
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27
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Garefelt J, Gershagen S, Kecklund G, Westerlund H, Platts LG. How does work impact daily sleep quality? A within-individual study using actigraphy and self-reports over the retirement transition. J Sleep Res 2021; 31:e13513. [PMID: 34734447 DOI: 10.1111/jsr.13513] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 10/13/2021] [Accepted: 10/14/2021] [Indexed: 11/30/2022]
Abstract
This study examined how the cessation of work at retirement affects daily measures of actigraphy-measured and self-rated sleep quality. Time in bed or asleep and stress at bedtime were examined as potential mechanisms. In total 117 employed participants who were aged 60-72 years and planned to retire soon were recruited to the Swedish Retirement Study. Sleep quality was measured in a baseline week using accelerometers, diaries, and questionnaires. Subjective sleep measures were sleep quality, restless sleep, restorative sleep, getting enough sleep, estimated wake after sleep onset, difficulties falling asleep, too early final awakening, and difficulties waking up. Actigraphy measures were sleep efficiency, wake after sleep onset, and average awakening length. After 1 and 2 years, the measurements were repeated for the now retired participants. Daily variations in sleep quality before and after retirement were analysed using multilevel modelling, with time in bed or asleep and stress at bedtime as potential mediators. We found that several self-reports of sleep improved (e.g., +0.2 standard deviations for sleep quality and +0.5 standard deviations for restorative sleep) while objective sleep quality remained unchanged or decreased slightly with retirement (e.g., -0.8% for sleep efficiency). Increased time in bed or asleep and stress at bedtime accounted partially for the improvements in self-rated sleep quality at retirement. In conclusion, actigraph-measured and self-reported sleep quality do not change in concert at retirement, highlighting the interest of studying both outcomes. The main effects of retirement from work concern subjective experiences of recovery more than sleep quality per se.
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Affiliation(s)
- Johanna Garefelt
- Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Sara Gershagen
- Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Göran Kecklund
- Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Hugo Westerlund
- Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Loretta G Platts
- Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden
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28
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Raza A, Hanson LM, Westerlund H, Mäkelä P, Halonen JI. Living and working in proximity to alcohol outlets and problem drinking: a longitudinal study. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Problem drinking causes burden for healthcare and society. No prior study has investigated the association between proximity of alcohol outlets to workplace and problem drinking. We assessed longitudinal associations of living and working in proximity to alcohol outlets with problem drinking.
Methods
Data comprised of employed respondents of the Swedish Longitudinal Occupational Survey of Health between 2012 and 2018. Road distances from home and from workplace addresses to the nearest liquor outlet, beer outlet, and bar were provided by Statistics Sweden. Self-reported problem drinking was assessed using modified Cut-Annoyed-Guilty-Eye questions. Within-individual analyses (N = 777) applied conditional logistic regression where each individual served as his/her case and control at two different time points. Between-individual analyses (N = 13306) applied binomial logistic regression with generalized estimating equation. Covariates were (age and sex for between-individual models), occupational position, civil status, chronic disease, work strain, and home/workplace neighborhood socioeconomic status.
Results
Within-individuals, the odds ratio for being a problem drinker was 3.42 (95 % CI, 1.41-8.27) and 2.99 (1.11-8.05) per each successive halving of the distance from work to beer outlets and bars, respectively. No within-individual associations were observed for proximity of outlets to home. Between-individuals, halving of distance from home to liquor outlet [1.06 (1.01-1.12)] and to bar [1.07 (1.00-1.16)] was associated with problem drinking. For distance from work, estimates were similar but did not reach statistical significance.
Conclusions
These findings suggest that alcohol outlet proximity to one's workplace could be a determinant of alcohol consumption behavior. Reducing the number of on- and off-premises alcohol outlets, even those that only sell beer, could reduce the level of harmful alcohol consumption.
Key messages
Alcohol outlet proximity to one’s workplace could be an additional determinant of alcohol consumption behavior. Reducing the number of on- and off-premises alcohol outlets, even those that only sell beer, could reduce the level of harmful alcohol consumption.
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Affiliation(s)
- A Raza
- Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden
| | - LM Hanson
- Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden
| | - H Westerlund
- Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden
| | - P Mäkelä
- Alcohol, Drugs and Addictions Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - JI Halonen
- Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden
- Department of Health Security, Finnish Institute for Health and Welfare, Helsinki, Finland
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29
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Peristera P, Nyberg A, Magnusson Hanson LL, Westerlund H, Platts LG. How consistently does sleep quality improve at retirement? Prospective analyses with group-based trajectory models. J Sleep Res 2021; 31:e13474. [PMID: 34474505 DOI: 10.1111/jsr.13474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 08/16/2021] [Accepted: 08/17/2021] [Indexed: 11/29/2022]
Abstract
Growing evidence indicates that retiring from paid work is associated, at least in the short-term, with dramatic reductions in sleep difficulties and more restorative sleep. However, much is still not known, in particular how universal these improvements are, how long they last, and whether they relate to the work environment. A methodological challenge concerns how to model time when studying abrupt changes such as retirement. Using data from Swedish Longitudinal Occupational Survey of Health (n = 2,148), we studied difficulties falling asleep, difficulties maintaining sleep, premature awakening, restless sleep, a composite scale of these items, and non-restorative sleep. We compared polynomial and B-spline functions to model time in group-based trajectory modelling. We estimated variations in the individual development of sleep difficulties around retirement, relating these to the pre-retirement work environment. Reductions in sleep difficulties at retirement were sudden for all outcomes and were sustained for up to 11 years for non-restorative sleep, premature awakening, and restless sleep. Average patterns masked distinct patterns of change: groups of retirees experiencing greatest pre-retirement sleep difficulties benefitted most from retiring. Higher job demands, lower work time control, lower job control, and working full-time were work factors that accounted membership in these groups. Compared to polynomials, B-spline models more appropriately estimated time around retirement, providing trajectories that were closer to the observed shapes. The study highlights the need to exercise care in modelling time over a sudden transition because using polynomials can generate artefactual uplifts or omit abrupt changes entirely, findings that would have fallacious implications.
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Affiliation(s)
- Paraskevi Peristera
- Department of Psychology, Stress Research Institute, Stockholm University, Stockholm, Sweden
| | - Anna Nyberg
- Department of Psychology, Stress Research Institute, Stockholm University, Stockholm, Sweden.,Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | | | - Hugo Westerlund
- Department of Psychology, Stress Research Institute, Stockholm University, Stockholm, Sweden.,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Loretta G Platts
- Department of Psychology, Stress Research Institute, Stockholm University, Stockholm, Sweden
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30
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Raza A, Pulakka A, Magnusson Hanson LL, Westerlund H, Halonen JI. Commuting distance and behavior-related health: A longitudinal study. Prev Med 2021; 150:106665. [PMID: 34081935 DOI: 10.1016/j.ypmed.2021.106665] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 05/18/2021] [Accepted: 05/29/2021] [Indexed: 10/21/2022]
Abstract
Health benefits of active commuting and short commuting time are well-documented; however, limited evidence exists on the effects of commuting distance. We examined longitudinal associations between commuting distance and behavior-related health. Participants were from four survey waves of the Swedish Longitudinal Occupational Survey of Health (2012, 2014, 2016, and 2018). Analytical sample included 11,023 individuals and 21,769 observations. Random effects method used binomial logistic regression with generalized estimating equations. The outcomes were self-reported physical inactivity, overweight, smoking, problem drinking, and disturbed sleep. Models were adjusted for age, sex, occupational position, civil status, chronic disease, work strain, number of children under 12, and home/workplace neighborhood socioeconomic status. Using continuous measure, long commuting distance was associated with a higher odds of physical inactivity (OR 1.06; 95% CI, 1.04-1.09 per doubling of distance), overweight (OR 1.02; 95% CI, 1.00-1.04), and disturbed sleep (OR 1.03; 95% CI, 1.00-1.05) in fully adjusted models. Using categorized measure, individuals who commuted longer distance had a higher odds of physical inactivity compared to those with the shortest commute (3.1 km - <7.9 km vs. <3.1 km: OR 1.15; 95% CI, 1.04-1.28 and 7.9 km - <20 km vs. <3.1 km: OR 1.18; 95% CI, 1.06-1.32, fully adjusted model). Such dose-response associations were not observed for overweight or disturbed sleep. Our results suggest short commuting distance may be beneficial for behavior-related health.
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Affiliation(s)
- Auriba Raza
- Stress Research Institute, Department of Psychology, Stockholm University, SE-106 91 Stockholm, Sweden
| | - Anna Pulakka
- Department of Public Health Solutions, Finnish Institute for Health and Welfare, P.O. Box 30, FI-00271 Helsinki, Finland
| | - Linda L Magnusson Hanson
- Stress Research Institute, Department of Psychology, Stockholm University, SE-106 91 Stockholm, Sweden
| | - Hugo Westerlund
- Stress Research Institute, Department of Psychology, Stockholm University, SE-106 91 Stockholm, Sweden
| | - Jaana I Halonen
- Stress Research Institute, Department of Psychology, Stockholm University, SE-106 91 Stockholm, Sweden; Department of Health Security, Finnish Institute for Health and Welfare, P.O. Box 30, FI-00271, Helsinki, Finland.
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31
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Stadin M, Nordin M, Broström A, Magnusson Hanson LL, Westerlund H, Fransson EI. The ICT demands index included in the Swedish Longitudinal Occupational Survey of Health (SLOSH). Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- M Stadin
- Uppsala University; Jönköping University
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32
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Berthelsen H, Owen M, Westerlund H. Does workplace social capital predict care quality through job satisfaction and stress at the clinic? A prospective study. BMC Public Health 2021; 21:1320. [PMID: 34225680 PMCID: PMC8259017 DOI: 10.1186/s12889-021-11320-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 06/14/2021] [Indexed: 11/10/2022] Open
Abstract
Background Welfare societies like Sweden face challenges in balancing the budget while meeting the demand for good quality healthcare. The aim of this study was to analyse whether care quality, operationalized as survival of dental fillings, is predicted by workplace social capital and if this effect is direct or indirect (through stress and/or job satisfaction among staff at the clinic), controlling for patient demographics. Methods The prospective design includes A) work environment data from surveys of 75 general public dental clinics (aggregated data based on 872 individual ratings), and B) register-based survival of 9381dental fillings performed during a 3-month period around the time of the survey, and C) patient demographics (age, gender, income level and birth place). Using a multi-level discrete-time proportional hazard model, we tested whether clinic-level social capital, stress, and job satisfaction could predict tooth-level filling failure, controlling for patient demographics. One direct and two indirect pathways, moderated by filling tooth, location, and filling type, were tested. Results High workplace social capital reduced the risk of early failure of fillings in molar teeth, mediated by group-perceived job satisfaction (indirect path: OR = 0.93, p < .05, direct path from job satisfaction: OR = 0.89, p < .05). Contrary to expectations, we found no support for a direct effect from social capital on care quality or for the indirect pathway via stress at the clinic level. Conclusions Workplace social capital boosted the quality of dental fillings through increased levels of job satisfaction. In addition, staff at clinics with higher social capital reported less stress and higher levels of job satisfaction. These results indicate that promotion of social capital may improve both occupational health and care quality.
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Affiliation(s)
- Hanne Berthelsen
- Centre for Work Life and Evaluation Studies (CTA) & Faculty of Odontology, Malmö University, Malmö, Sweden.
| | - Mikaela Owen
- Centre for Workplace Excellence, University of South Australia, Adelaide, SA, Australia
| | - Hugo Westerlund
- Department of Psychology, The Stress Research Institute, Stockholm University, Stockholm, Sweden
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Halonen JI, Chandola T, Hyde M, Leinonen T, Westerlund H, Aalto V, Pentti J, Laaksonen M, Stenholm S, Mänty M, Vahtera J, Oksanen T, Kivimäki M, Virtanen M, Lallukka T. Psychotropic medication before and after disability retirement by pre-retirement perceived work-related stress. Eur J Public Health 2021; 30:158-163. [PMID: 31326988 DOI: 10.1093/eurpub/ckz131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Retirement has been associated with improved mental health, but it is unclear how much this is due to the removal of work-related stressors. We examined rates of psychotropic medication use before and after the transition to disability retirement due to mental, musculoskeletal and other causes by pre-retirement levels of perceived work stress (effort-reward imbalance, ERI). METHODS Register-based date and diagnosis of disability retirement of 2766 participants of the Finnish Public Sector study cohort were linked to survey data on ERI, social- and health-related covariates, and to national records on prescribed reimbursed psychotropic medication, measured as defined daily doses (DDDs). Follow-up for DDDs was 2-5 years before and after disability retirement. We assessed differences in the levels of DDDs before and after retirement among those with high vs. low level of pre-retirement ERI with repeated measures regression. RESULTS Those with high (vs. low) levels of ERI used slightly more psychotropic medication before disability retirement due to mental disorders [rate ratio (RR) 1.14, 95% confidence intervals (CI) 0.94-1.37], but after retirement this difference attenuated (RR 0.94, 95% CI 0.80-1.10, P for interaction 0.02). Such a change was not observed for the other causes of disability retirement. CONCLUSIONS The level of psychotropic medication use over the transition to disability retirement due to mental, but not musculoskeletal or other, causes was modified by pre-retirement perceived work-related stress. This suggests that among people retiring due to mental disorders those who had stressful jobs benefit from retirement more than those with low levels of work-related stress.
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Affiliation(s)
- Jaana I Halonen
- Finnish Institute of Occupational Health, Helsinki, Finland.,Stress Research Institute, Stockholm University, Stockholm, Sweden
| | - Tarani Chandola
- Centre for Innovative Ageing, Swansea University, Swansea, UK
| | - Martin Hyde
- Centre for Innovative Ageing, Swansea University, Swansea, UK
| | - Taina Leinonen
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Hugo Westerlund
- Stress Research Institute, Stockholm University, Stockholm, Sweden
| | - Ville Aalto
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Jaana Pentti
- Department of Public Health, University of Turku, Turku University Hospital, Turku, Finland.,Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Mikko Laaksonen
- Research Department, Finnish Center for Pension, Helsinki, Finland
| | - Sari Stenholm
- Department of Public Health, University of Turku, Turku University Hospital, Turku, Finland
| | - Minna Mänty
- Department of Public Health, University of Helsinki, Helsinki, Finland.,Statistics and Research, City of Vantaa, Vantaa, Finland
| | - Jussi Vahtera
- Department of Public Health, University of Turku, Turku University Hospital, Turku, Finland
| | - Tuula Oksanen
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Mika Kivimäki
- Finnish Institute of Occupational Health, Helsinki, Finland.,Department of Public Health, University of Helsinki, Helsinki, Finland.,Department of Epidemiology and Public Health, University College London, UK
| | - Marianna Virtanen
- Stress Research Institute, Stockholm University, Stockholm, Sweden.,School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland
| | - Tea Lallukka
- Finnish Institute of Occupational Health, Helsinki, Finland.,Department of Public Health, University of Helsinki, Helsinki, Finland
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Blindow K, Bondestam F, Johansson G, Bodin T, Westerlund H, Nyberg A. Sexual and gender harassment in Swedish workplaces: A prospective cohort study on implications for long-term sickness absence. Scand J Work Environ Health 2021; 47:466-474. [PMID: 34057478 PMCID: PMC8504545 DOI: 10.5271/sjweh.3971] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Objectives: This prospective cohort study aimed to investigate gender harassment and sexual harassment as risk factors for prospective long-term sickness absence (LTSA, ≥21 days). Furthermore, support from colleagues was investigated as a moderating factor of this association. Methods: Information on gender harassment, sexual harassment and support by colleagues were derived from the biannual Swedish Work Environment Survey 1999–2013, a representative sample of the Swedish working population (N=64 297). Information on LTSA as well as demographic and workplace variables were added from register data. Relative rates of LTSA the year following the exposure were determined using modified Poisson regression. Results: Monthly to daily exposure to gender harassment was a risk factor for prospective LTSA among women [rate ratio (RR) 1.04, 95% confidence interval (CI) 1.02–1.05] and men (RR 1.07, 95% CI 1.04–1.10). Monthly to daily exposure to sexual harassment was also a risk factor for LTSA among women (RR 1.05, 95% CI 1.01–1.10) and men (RR 1.07, 95% CI 1.02–1.13). Exposure to sexual or gender harassment once in the last 12 months was not associated with LTSA. There was no support for an interaction between either of the exposures and support from colleagues in relation to LTSA. Conclusions: Sexual harassment and gender harassment appear to contribute to a small excess risk for LTSA among women and men. For both kinds of offensive behaviors, the pervasiveness appears to be important for the outcome. The role of support by colleagues was inconclusive and needs further investigation.
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Affiliation(s)
- Katrina Blindow
- Institute of Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden.
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Sousa-Ribeiro M, Bernhard-Oettel C, Sverke M, Westerlund H. Health- and Age-Related Workplace Factors as Predictors of Preferred, Expected, and Actual Retirement Timing: Findings from a Swedish Cohort Study. Int J Environ Res Public Health 2021; 18:ijerph18052746. [PMID: 33800492 PMCID: PMC7967469 DOI: 10.3390/ijerph18052746] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 02/23/2021] [Accepted: 03/04/2021] [Indexed: 11/16/2022]
Abstract
To address the challenges of demographic aging, governments and organizations encourage extended working lives. This study investigates how individual health- and age-related workplace factors contribute to preferred, expected and actual retirement timing, as well as to the congruency between preferences vs. expectations, and preferences vs. actual retirement. We used data from a representative Swedish longitudinal sample comprising 4058 workers aged 50-64, with follow-up data regarding actual retirement timing available for 1164 respondents. Multinomial logistic regression analyses suggest that later preferred, expected, and actual retirement timing were, to different extent, influenced by better health, an age-friendly workplace and feeling positive regarding the future at work. Emotional exhaustion, age-related inequalities at work and experiencing aging as an obstacle increased the likelihood of preferring to retire earlier than one expected to, over retiring at the time one expected to. Those with better health and positive work prospects were less likely to prefer retiring earlier than they expected to, and more likely to being "pulled toward working until 65 and beyond", compared to being "pulled toward early retirement". Experiencing aging as an obstacle decreased the chances of being "pulled toward working until 65 and beyond". The results provide insights on how to facilitate extended working lives.
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36
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Raza A, Claeson M, Magnusson Hanson L, Westerlund H, Virtanen M, Halonen JI. Home and Workplace Neighborhood Socioeconomic Status and Behavior-related Health: A Within-individual Analysis. Ann Behav Med 2021; 55:779-790. [PMID: 33580661 PMCID: PMC8311784 DOI: 10.1093/abm/kaaa116] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background The influence of individual and home neighborhood socioeconomic status (SES) on health-related behaviors have been widely studied, but the majority of these studies have neglected the possible impact of the workplace neighborhood SES. Objective To examine within-individual associations between home and work place neighborhood SES and health-related behaviors in employed individuals. Methods We used participants from the Swedish Longitudinal Occupational Survey of Health who responded to a minimum of two surveys between 2012 and 2018. Data included 12,932 individuals with a total of 35,332 observations. We used fixed-effects analysis with conditional logistic regression to examine within-individual associations of home, workplace, as well as time-weighted home and workplace neighborhood SES index, with self-reported obesity, physical activity, smoking, excessive alcohol consumption, sedentary lifestyle, and disturbed sleep. Results After adjustment for covariates, participants were more likely to engage in risky alcohol consumption when they worked in a workplace that was located in the highest SES area compared to time when they worked in a workplace that was located in the lowest SES area (adjusted odds ratios 1.98; 95% confidence interval: 1.12 to 3.49). There was an indication of an increased risk of obesity when individuals worked in the highest compared to the time when they worked in the lowest neighborhood SES area (1.71; 1.02–2.87). No associations were observed for the other outcomes. Conclusion These within-individual comparisons suggest that workplace neighborhood SES might have a role in health-related behaviors, particularly alcohol consumption.
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Affiliation(s)
- Auriba Raza
- Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Martin Claeson
- Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Linda Magnusson Hanson
- Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Hugo Westerlund
- Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Marianna Virtanen
- Department of Psychology, University of Eastern Finland, Joensuu, Finland
| | - Jaana I Halonen
- Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden.,Department of Health Security, National Institute for Health and Welfare, Helsinki, Finland
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37
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Zaninotto P, Batty GD, Stenholm S, Kawachi I, Hyde M, Goldberg M, Westerlund H, Vahtera J, Head J. Socioeconomic Inequalities in Disability-free Life Expectancy in Older People from England and the United States: A Cross-national Population-Based Study. J Gerontol A Biol Sci Med Sci 2021; 75:906-913. [PMID: 31940032 PMCID: PMC7164527 DOI: 10.1093/gerona/glz266] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Indexed: 01/01/2023] Open
Abstract
Background We examined socioeconomic inequalities in disability-free life expectancy in older men and women from England and the United States and explored whether people in England can expect to live longer and healthier lives than those in the United States. Methods We used harmonized data from the Gateway to Global Aging Data on 14,803 individuals aged 50+ from the U.S. Health and Retirement Study (HRS) and 10,754 from the English Longitudinal Study of Ageing (ELSA). Disability was measured in terms of impaired activities and instrumental activities of daily living. We used discrete-time multistate life table models to estimate total life expectancy and life expectancy free of disability. Results Socioeconomic inequalities in disability-free life expectancy were of a similar magnitude (in absolute terms) in England and the United States. The socioeconomic disadvantage in disability-free life expectancy was largest for wealth, in both countries: people in the poorest group could expect to live seven to nine fewer years without disability than those in the richest group at the age of 50. Conclusions Inequalities in healthy life expectancy exist in both countries and are of similar magnitude. In both countries, efforts in reducing health inequalities should target people from disadvantaged socioeconomic groups.
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Affiliation(s)
- Paola Zaninotto
- Department of Epidemiology and Public Health, University College London, UK
| | - George David Batty
- Department of Epidemiology and Public Health, University College London, UK
| | - Sari Stenholm
- Department of Public Health, University of Turku and Turku University Hospital, Finland
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard University, Boston, Massachusetts
| | - Martin Hyde
- Centre for Innovative Ageing, College of Human and Health Sciences, Swansea University, UK
| | - Marcel Goldberg
- Inserm, Population-based Epidemiologic Cohorts Unit-UMS 011, Villejuif, France.,Inserm, Aging and Chronic Diseases, Epidemiological and Public Health Approaches, Villejuif, France
| | | | - Jussi Vahtera
- Department of Public Health, University of Turku and Turku University Hospital, Finland
| | - Jenny Head
- Department of Epidemiology and Public Health, University College London, UK
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38
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Berthelsen H, Muhonen T, Bergström G, Westerlund H, Dollard MF. Benchmarks for Evidence-Based Risk Assessment with the Swedish Version of the 4-Item Psychosocial Safety Climate Scale. Int J Environ Res Public Health 2020; 17:ijerph17228675. [PMID: 33266458 PMCID: PMC7700640 DOI: 10.3390/ijerph17228675] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 11/19/2020] [Accepted: 11/20/2020] [Indexed: 01/01/2023]
Abstract
The purpose of the present study was to validate the short version of The Psychosocial Safety Climate questionnaire (PSC-4, Dollard, 2019) and to establish benchmarks indicating risk levels for use in Sweden. Cross-sectional data from (1) a random sample of employees in Sweden aged 25–65 years (n = 2847) and (2) a convenience sample of non-managerial employees from 94 workplaces (n = 3066) were analyzed. Benchmarks for three PSC risk levels were developed using organizational compliance with Occupational Safety and Health (OSH) regulations as criterion. The results support the validity and usefulness of the Swedish PSC-4 as an instrument to indicate good, fair, and poor OSH practices. The recommended benchmark for indicating good OSH practices is an average score of >12.0, while the proposed cutoff for poor OSH practices is a score of ≤8.0 on the PSC-4. Scores between these benchmarks indicate fair OSH practices. Furthermore, aggregated data on PSC-4 supported its reliability as a workplace level construct and its association with quantitative demands, quality of leadership, commitment to the workplace, work engagement, job satisfaction, as well as stress and burnout. Thus, the Swedish version of PSC-4 can be regarded as a valid and reliable measure for both research and practical use for risk assessment at workplaces.
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Affiliation(s)
- Hanne Berthelsen
- Centre for Work Life and Evaluation Studies (CTA), Malmö University, 205 06 Malmö, Sweden;
- Section 4, Faculty of Odontology, Malmö University, 205 06 Malmö, Sweden
- Correspondence:
| | - Tuija Muhonen
- Centre for Work Life and Evaluation Studies (CTA), Malmö University, 205 06 Malmö, Sweden;
- Department of School Development and Leadership, Faculty of Education and Society, Malmö University, 205 06 Malmö, Sweden
| | - Gunnar Bergström
- Centre for Musculoskeletal Research, Department of Occupational Health Sciences and Psychology, University of Gävle, 801 76 Gävle, Sweden;
- Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institute, 171 77 Stockholm, Sweden
| | - Hugo Westerlund
- Department of Psychology, Stress Research Institute, Stockholm University, 106 91 Stockholm, Sweden;
| | - Maureen F. Dollard
- PSC Observatory, Centre for Workplace Excellence, Justice and Society, University of South Australia, Adelaide, SA 5001, Australia;
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Xu T, Magnusson Hanson LL, Clark AJ, Ersbøll AK, Westerlund H, Madsen IEH, Rugulies R, Pentti J, Stenholm S, Vahtera J, Sørensen JK, Nordentoft M, Westendorp RGJ, Hansen ÅM, Oksanen T, Virtanen M, Kivimäki M, Rod NH. Onset of Workplace Bullying and Risk of Weight Gain: A Multicohort Longitudinal Study. Obesity (Silver Spring) 2020; 28:2216-2223. [PMID: 32929892 DOI: 10.1002/oby.22956] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 05/26/2020] [Accepted: 06/29/2020] [Indexed: 11/11/2022]
Abstract
OBJECTIVE This study aimed to examine the onset of workplace bullying as a risk factor for BMI increase. METHODS Repeated biennial survey data from three Nordic cohort studies were used, totaling 46,148 participants (67,337 participant observations) aged between 18 and 65 who did not have obesity and who were not bullied at the baseline. Multinomial logistic regression was applied for the analysis under the framework of generalized estimating equations. RESULTS Five percent reported onset of workplace bullying within 2 years from the baseline. In confounder-adjusted models, onset of workplace bullying was associated with a higher risk of weight gain of ≥ 1 BMI unit (odds ratio = 1.09; 95% CI: 1.01-1.19) and of ≥ 2.5 BMI units (odds ratio = 1.24; 95% CI: 1.06-1.45). A dose-response pattern was observed, and those exposed to workplace bullying more frequently showed a higher risk (Ptrend = 0.04). The association was robust to adjustments, restrictions, stratifications, and use of relative/absolute scales for BMI change. CONCLUSIONS Participants with exposure to the onset of workplace bullying were more likely to gain weight, a possible pathway linking workplace bullying to increased long-term risk of type 2 diabetes.
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Affiliation(s)
- Tianwei Xu
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Stress Research Institute, Stockholm University, Stockholm, Sweden
- National Research Center for the Working Environment, Copenhagen, Denmark
| | | | - Alice J Clark
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Annette K Ersbøll
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Hugo Westerlund
- Stress Research Institute, Stockholm University, Stockholm, Sweden
| | - Ida E H Madsen
- National Research Center for the Working Environment, Copenhagen, Denmark
| | - Reiner Rugulies
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- National Research Center for the Working Environment, Copenhagen, Denmark
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Jaana Pentti
- Clinicum, Faculty of Medicine, University of Helsinki, Finland
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland
| | - Sari Stenholm
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland
| | - Jussi Vahtera
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland
| | - Jeppe K Sørensen
- National Research Center for the Working Environment, Copenhagen, Denmark
| | - Mads Nordentoft
- National Research Center for the Working Environment, Copenhagen, Denmark
| | - Rudi G J Westendorp
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Åse M Hansen
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- National Research Center for the Working Environment, Copenhagen, Denmark
| | - Tuula Oksanen
- Finnish Institute of Occupational Health, Helsinki and Turku, Finland
| | - Marianna Virtanen
- Stress Research Institute, Stockholm University, Stockholm, Sweden
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland
| | - Mika Kivimäki
- Clinicum, Faculty of Medicine, University of Helsinki, Finland
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Naja H Rod
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Stress Research Institute, Stockholm University, Stockholm, Sweden
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40
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Åhlin JK, Peristera P, Westerlund H, Magnusson Hanson LL. Psychosocial working characteristics before retirement and depressive symptoms across the retirement transition: a longitudinal latent class analysis. Scand J Work Environ Health 2020; 46:488-497. [PMID: 32091111 PMCID: PMC7737805 DOI: 10.5271/sjweh.3889] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Indexed: 11/12/2022] Open
Abstract
Objectives Retirement is a major life transition. However, previous evidence on its mental health effects has been inconclusive. Whether retirement is desirable or not may depend on pre-retirement work characteristics. We investigated trajectories of depressive symptoms across retirement and how a number of psychosocial working characteristics influenced these trajectories. Methods We included 1735 respondents from the Swedish Longitudinal Occupational Survey of Health (SLOSH), retiring during 2008-2016 (mean retirement age 66 years). They had completed biennial questionnaires reporting job demands, decision authority, workplace social support, efforts, rewards, procedural justice and depressive symptoms. We applied group-based trajectory modelling to model trajectories of depressive symptoms across retirement. Multinomial logistic regression analyses estimated the associations between -psychosocial working characteristics and depressive symptom trajectories. Results We identified five depression trajectories. In four of them, depressive symptoms decreased slightly around retirement. In one, the symptom level was initially high, then decreased markedly across retirement. Perceptions of job demands, job strain, workplace social support, rewards, effort-reward imbalance and procedural justice were associated with the trajectories, while perceptions of decision authority and work efforts were only partly related to the trajectories. Conclusions We observed a rather positive development of depressive symptoms across retirement in a sample of Swedish retirees. For a small group with poor psychosocial working characteristics, symptoms clearly decreased, which may indicate that a relief from poor working characteristics is associated with an improvement for some retirees. However, for other retirees poor working characteristics were associated with persistent symptoms, suggesting a long-term effect of these work stressors.
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Affiliation(s)
- Julia K Åhlin
- The Division for Epidemiology, Stress Research Institute, Department of Psychology, Stockholm University, Stockholm SE-106 91, Sweden.
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41
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Garefelt J, Gershagen S, Kecklund G, Westerlund H, Platts LG. How does cessation of work affect sleep? Prospective analyses of sleep duration, timing and efficiency from the Swedish Retirement Study. J Sleep Res 2020; 30:e13157. [PMID: 32815209 DOI: 10.1111/jsr.13157] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 06/05/2020] [Accepted: 06/29/2020] [Indexed: 01/22/2023]
Abstract
Several strands of research indicate that work competes for time with sleep, but to what extent the timing and duration of sleep is affected by work is not known. Retirement offers a quasi-experimental life transition to study this in a within-individual study design. The few existing studies report that people sleep longer and later after retirement but mainly rely on self-reported data or between-individual analyses. We recruited 100 participants aged 61-72 years who were in paid work but would soon retire and measured them in a baseline week with accelerometers, diaries and questionnaires. After 1 and 2 years, the measurements were repeated for the now retired participants. Changes in sleep duration, timing, efficiency, chronotype and social jetlag were analysed using multilevel modelling. Gender, chronotype at baseline and partner's working status were analysed as potential effect modifiers. Sleep duration increased by 21 min, whereas sleep efficiency remained similar. Time of sleep onset and final awakening were postponed by 26 and 52 min, respectively, pushing midsleep forward from 03:17 to 03:37 hours. Changes in duration and timing of sleep were driven by weekday sleep, whereas weekend sleep stayed about the same. Social jetlag decreased but still occurred after retirement. Changes at retirement in sleep duration and timing were smaller for participants with a later chronotype and who had full-time working partners. These findings indicate that paid work generates sleep loss and hinders people from sleeping in line with their biological time.
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Affiliation(s)
- Johanna Garefelt
- Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Sara Gershagen
- Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Göran Kecklund
- Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Hugo Westerlund
- Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Loretta G Platts
- Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden
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42
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Magnusson Hanson LL, Rod NH, Vahtera J, Virtanen M, Ferrie J, Shipley M, Kivimäki M, Westerlund H. Job insecurity and risk of coronary heart disease: Mediation analyses of health behaviors, sleep problems, physiological and psychological factors. Psychoneuroendocrinology 2020; 118:104706. [PMID: 32460194 DOI: 10.1016/j.psyneuen.2020.104706] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 04/21/2020] [Accepted: 04/29/2020] [Indexed: 12/13/2022]
Abstract
Job insecurity has been linked to increased risk of coronary heart disease (CHD), but underlying mechanisms remain uncertain. Our aim was to assess the extent to which this association is mediated through life style, physiological, or psychological factors. A total of 3917 men and women free from CHD provided data on job insecurity in the Whitehall II cohort study in 1997-1999. The association between job insecurity and CHD was decomposed into a direct and indirect effect mediated through unhealthy behaviors (smoking, high alcohol consumption, physical inactivity), sleep disturbances, 'allostatic load', or psychological distress. The counterfactual analyses on psychological distress indicated a marginally significant association between job insecurity and incident CHD (hazard ratio (HR) 1.32; 95 % confidence interval (CI) 1.00-1.75). This association was decomposed into a direct (HR 1.22, 95 %CI 0.92-1.63) and indirect association (1.08, 95 %CI 1.01-1.15), suggesting that about 30 % of the total relationship was mediated by psychological distress. No mediation was indicated via health behaviors, sleep disturbances, or allostatic load, although job insecurity was related to disturbed sleep and C-reactive protein, which, in turn were associated with CHD. In conclusion, our results suggest that psychological distress may play a role in the relation between job insecurity and CHD.
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Affiliation(s)
- Linda L Magnusson Hanson
- Research Division for Epidemiology, Stress Research Institute, Stockholm University, Stockholm, Sweden.
| | - Naja H Rod
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Denmark
| | - Jussi Vahtera
- Department of Public Health, University of Turku, and Population Research Centre, University of Turku and Turku University Hospital, Turku, Finland
| | - Marianna Virtanen
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland; Division of Insurance Medicine, Department of Clinical Neurosicence, Karolinska Institutet, Stockholm, Sweden
| | - Jane Ferrie
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Martin Shipley
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Mika Kivimäki
- Department of Epidemiology and Public Health, University College London, London, UK; Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Hugo Westerlund
- Research Division for Epidemiology, Stress Research Institute, Stockholm University, Stockholm, Sweden
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Tan EC, Pan KY, Magnusson Hanson LL, Fastbom J, Westerlund H, Wang HX. Psychosocial job strain and polypharmacy: a national cohort study. Scand J Work Environ Health 2020; 46:589-598. [PMID: 32662868 PMCID: PMC7737808 DOI: 10.5271/sjweh.3914] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Objectives: Psychosocial job strain has been associated with a range of adverse health outcomes. The aim of this study was to examine the association between psychosocial job strain and prospective risk of polypharmacy (the prescription of ≥5 medications) and to evaluate whether coping strategies can modify this risk. Methods: Cohort study of 9703 working adults [mean age 47.5 (SD 10.8) years; 54% female] who participated in the Swedish Longitudinal Occupational Survey of Health (SLOSH) at baseline in 2006 or 2008. Psychosocial job strain was represented by job demands and control, and measured by the Swedish version of the demand–control questionnaire. The outcome was incidence of polypharmacy over an eight-year follow-up period. Information on dispensed drugs were extracted from the Swedish Prescribed Drug Register. Logistic regression was used to estimate the association of job strain status with polypharmacy, adjusted for a range of confounders. Results: During the follow-up, 1409 people developed polypharmacy (incident rate: 20.6/1000 person-years). In comparison to workers with low-strain jobs (high control/low demands), those with high-strain jobs (low control/high demands) had a significantly higher risk of incident polypharmacy (OR 1.40, 95% CI 1.04–1.89). The impact of high-strain jobs on developing polypharmacy remained among those with covert coping strategies (ie, directed inwards or towards others) but not among those with open coping strategies (ie, primarily directed toward the stressor). Conclusions: Workers in high-strain jobs may be at an increased risk of polypharmacy. Open coping strategies may reduce the negative impact of psychosocial job strain on risk of polypharmacy.
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Affiliation(s)
- Edwin Ck Tan
- Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden.
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Virtanen M, Jokela M, Lallukka T, Magnusson Hanson L, Pentti J, Nyberg ST, Alfredsson L, Batty GD, Casini A, Clays E, DeBacquer D, Ervasti J, Fransson E, Halonen JI, Head J, Kittel F, Knutsson A, Leineweber C, Nordin M, Oksanen T, Pietiläinen O, Rahkonen O, Salo P, Singh-Manoux A, Stenholm S, Suominen SB, Theorell T, Vahtera J, Westerholm P, Westerlund H, Kivimäki M. Long working hours and change in body weight: analysis of individual-participant data from 19 cohort studies. Int J Obes (Lond) 2020; 44:1368-1375. [PMID: 31767974 PMCID: PMC7260128 DOI: 10.1038/s41366-019-0480-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 10/01/2019] [Accepted: 10/27/2019] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To examine the relation between long working hours and change in body mass index (BMI). METHODS We performed random effects meta-analyses using individual-participant data from 19 cohort studies from Europe, US and Australia (n = 122,078), with a mean of 4.4-year follow-up. Working hours were measured at baseline and categorised as part time (<35 h/week), standard weekly hours (35-40 h, reference), 41-48 h, 49-54 h and ≥55 h/week (long working hours). There were four outcomes at follow-up: (1) overweight/obesity (BMI ≥ 25 kg/m2) or (2) overweight (BMI 25-29.9 kg/m2) among participants without overweight/obesity at baseline; (3) obesity (BMI ≥ 30 kg/m2) among participants with overweight at baseline, and (4) weight loss among participants with obesity at baseline. RESULTS Of the 61,143 participants without overweight/obesity at baseline, 20.2% had overweight/obesity at follow-up. Compared with standard weekly working hours, the age-, sex- and socioeconomic status-adjusted relative risk (RR) of overweight/obesity was 0.95 (95% CI 0.90-1.00) for part-time work, 1.07 (1.02-1.12) for 41-48 weekly working hours, 1.09 (1.03-1.16) for 49-54 h and 1.17 (1.08-1.27) for long working hours (P for trend <0.0001). The findings were similar after multivariable adjustment and in subgroup analyses. Long working hours were associated with an excess risk of shift from normal weight to overweight rather than from overweight to obesity. Long working hours were not associated with weight loss among participants with obesity. CONCLUSIONS This analysis of large individual-participant data suggests a small excess risk of overweight among the healthy-weight people who work long hours.
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Affiliation(s)
- Marianna Virtanen
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland.
- Stress Research Institute, Stockholm University, Stockholm, Sweden.
| | - Markus Jokela
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Tea Lallukka
- Finnish Institute of Occupational Health, Helsinki, Finland
- Department of Public Health, Clinicum, University of Helsinki, Helsinki, Finland
| | | | - Jaana Pentti
- Department of Public Health, Clinicum, University of Helsinki, Helsinki, Finland
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Solja T Nyberg
- Department of Public Health, Clinicum, University of Helsinki, Helsinki, Finland
| | - Lars Alfredsson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden
| | - G David Batty
- Department of Epidemiology & Public Health, University College London, London, UK
- School of Biological & Population Health Sciences, Oregon State University, Corvallis, USA
| | - Annalisa Casini
- IPSY, Université catholique de Louvain (UCLouvain), Louvain-la-Neuve & School of Public Health, Université libre de Bruxelles (ULB), Brussels, Belgium
| | - Els Clays
- Department of Public Health, Ghent University, Ghent, Belgium
| | - Dirk DeBacquer
- Department of Public Health, Ghent University, Ghent, Belgium
| | - Jenni Ervasti
- Finnish Institute of Occupational Health, Helsinki, Finland
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Eleonor Fransson
- Stress Research Institute, Stockholm University, Stockholm, Sweden
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Jaana I Halonen
- Stress Research Institute, Stockholm University, Stockholm, Sweden
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Jenny Head
- Department of Epidemiology & Public Health, University College London, London, UK
| | - France Kittel
- IPSY, Université catholique de Louvain (UCLouvain), Louvain-la-Neuve & School of Public Health, Université libre de Bruxelles (ULB), Brussels, Belgium
| | - Anders Knutsson
- Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden
| | | | - Maria Nordin
- Department of Psychology, Umeå University, Umeå, Sweden
| | - Tuula Oksanen
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Olli Pietiläinen
- Department of Public Health, Clinicum, University of Helsinki, Helsinki, Finland
| | - Ossi Rahkonen
- Department of Public Health, Clinicum, University of Helsinki, Helsinki, Finland
| | - Paula Salo
- Finnish Institute of Occupational Health, Helsinki, Finland
- Department of Psychology, University of Turku, Turku, Finland
| | - Archana Singh-Manoux
- Department of Epidemiology & Public Health, University College London, London, UK
- INSERM, U 1018, Villejuif, France
| | - Sari Stenholm
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Sakari B Suominen
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland
- Folkhälsan Research Center, Helsinki, Finland
- University of Skövde, Skövde, Sweden
| | - Töres Theorell
- Stress Research Institute, Stockholm University, Stockholm, Sweden
| | - Jussi Vahtera
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Peter Westerholm
- Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden
| | - Hugo Westerlund
- Stress Research Institute, Stockholm University, Stockholm, Sweden
| | - Mika Kivimäki
- Department of Public Health, Clinicum, University of Helsinki, Helsinki, Finland
- Department of Epidemiology & Public Health, University College London, London, UK
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Berthelsen H, Owen M, Wretlind K, Westerlund H. Does staff-assessed care quality predict early failure of dental fillings? A prospective study. Community Dent Oral Epidemiol 2020; 48:387-394. [PMID: 32469125 DOI: 10.1111/cdoe.12543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 04/03/2020] [Accepted: 05/03/2020] [Indexed: 12/01/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate staff-assessed care quality as an indicator of register-based measures of care quality at dental clinics, more specifically register-based measures of survival of dental fillings and initiation of preventive treatments for caries patients. METHODS This prospective study includes data from cross-sectional workplace psychosocial risk assessment surveys at dental clinics and register data on survival of dental fillings, and initiation of preventive treatment for caries patients obtained from the Swedish Quality Registry for Caries and Periodontal Disease (SKaPa) Demographic background data on the age, gender, income level and place of birth of patients was obtained from Statistics Sweden (SCB). The data were analysed using discrete-time multilevel survival analysis and multiple linear regression analysis. RESULTS The results showed that staff-assessed care quality rated by the total staff or by dental nurses at the clinic predicted the risk of replacement of dental fillings made due to a caries diagnosis during the 3-year follow-up period, controlling for potential confounding due to patient demographic characteristics (age, sex, income and country of birth). In contrast, the better the staff-assessed care quality at the clinic, the smaller the proportion of the patients received preventive care in addition to operative caries therapy when controlling for potential confounding due to patient demographics. Care quality assessed by dentists at the clinic did not predict either of these outcome measures. CONCLUSIONS Premature failure of dental fillings is costly for both patients and society, which leads to a need for relevant measures for following dental care quality. Our findings indicate that staff-assessed care quality - a cheap and easy measure to collect and follow continuously in dental practice - can be used to monitor aspects of quality in real time in order to facilitate continuous improvement and quickly amend quality problems. Also, it can be used for integrating quality improvement in systematic work environment risk management.
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Affiliation(s)
- Hanne Berthelsen
- Centre for Work Life and Evaluation Studies (CTA), Malmö University, Malmö, Sweden.,Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Mikaela Owen
- Centre for Workplace Excellence, University of South Australia, Adelaide, SA, Australia
| | | | - Hugo Westerlund
- The Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden
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46
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Xu T, Magnusson Hanson LL, Lange T, Starkopf L, Westerlund H, Madsen IEH, Rugulies R, Pentti J, Stenholm S, Vahtera J, Hansen ÅM, Virtanen M, Kivimäki M, Rod NH. Workplace bullying and workplace violence as risk factors for cardiovascular disease: a multi-cohort study. Eur Heart J 2020; 40:1124-1134. [PMID: 30452614 DOI: 10.1093/eurheartj/ehy683] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Revised: 07/15/2018] [Accepted: 10/08/2018] [Indexed: 11/14/2022] Open
Abstract
AIMS To assess the associations between bullying and violence at work and cardiovascular disease (CVD). METHODS AND RESULTS Participants were 79 201 working men and women, aged 18-65 years and free of CVD and were sourced from three cohort studies from Sweden and Denmark. Exposure to workplace bullying and violence was measured at baseline using self-reports. Participants were linked to nationwide health and death registers to ascertain incident CVD, including coronary heart disease and cerebrovascular disease. Study-specific results were estimated by marginal structural Cox regression and were combined using fixed-effect meta-analysis. Nine percent reported being bullied at work and 13% recorded exposure to workplace violence during the past year. We recorded 3229 incident CVD cases with a mean follow-up of 12.4 years (765 in the first 4 years). After adjustment for age, sex, country of birth, marital status, and educational level, being bullied at work vs. not was associated with a hazard ratio (HR) of 1.59 [95% confidence interval (CI) 1.28-1.98] for CVD. Experiencing workplace violence vs. not was associated with a HR of 1.25 (95% CI 1.12-1.40) for CVD. The population attributable risk was 5.0% for workplace bullying and 3.1% for workplace violence. The excess risk remained similar in analyses with different follow-up lengths, cardiovascular risk stratifications, and after additional adjustments. Dose-response relations were observed for both workplace bullying and violence (Ptrend < 0.001). There was only negligible heterogeneity in study-specific estimates. CONCLUSION Bullying and violence are common at workplaces and those exposed to these stressors are at higher risk of CVD.
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Affiliation(s)
- Tianwei Xu
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Gothersgade 160, DK-1123 Copenhagen, Denmark.,Division for Epidemiology, Stress Research Institute, Stockholm University, SE-10691, Stockholm, Sweden.,National Research Centre for the Working Environment, Lersø Parkallé 105, DK-2100 Copenhagen, Denmark
| | - Linda L Magnusson Hanson
- Division for Epidemiology, Stress Research Institute, Stockholm University, SE-10691, Stockholm, Sweden
| | - Theis Lange
- Section of Biostatistics, Department of Public Health, University of Copenhagen, Øster Farimagsgade 2A, DK-1353 Copenhagen, Denmark.,Centre for Statistical Science, Peking University, No. 5 Yiheyuan Road, Beijing CN-100871, China
| | - Liis Starkopf
- Section of Biostatistics, Department of Public Health, University of Copenhagen, Øster Farimagsgade 2A, DK-1353 Copenhagen, Denmark
| | - Hugo Westerlund
- Division for Epidemiology, Stress Research Institute, Stockholm University, SE-10691, Stockholm, Sweden
| | - Ida E H Madsen
- National Research Centre for the Working Environment, Lersø Parkallé 105, DK-2100 Copenhagen, Denmark
| | - Reiner Rugulies
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Gothersgade 160, DK-1123 Copenhagen, Denmark.,National Research Centre for the Working Environment, Lersø Parkallé 105, DK-2100 Copenhagen, Denmark.,Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, DK-1353 Copenhagen, Denmark
| | - Jaana Pentti
- Department of Public Health, University of Turku and Turku University Hospital, FI-20014 Turku, Finland
| | - Sari Stenholm
- Department of Public Health, University of Turku and Turku University Hospital, FI-20014 Turku, Finland
| | - Jussi Vahtera
- Department of Public Health, University of Turku and Turku University Hospital, FI-20014 Turku, Finland
| | - Åse M Hansen
- National Research Centre for the Working Environment, Lersø Parkallé 105, DK-2100 Copenhagen, Denmark.,Section of Social Medicine, Department of Public Health, University of Copenhagen, Gothersgade 160, DK-1123 Copenhagen, Denmark
| | - Marianna Virtanen
- Division for Epidemiology, Stress Research Institute, Stockholm University, SE-10691, Stockholm, Sweden.,Finnish Institute of Occupational Health, Topeliuksenkatu 41 b, FI-00250 Helsinki, Finland.,Department of Public Health and Caring Sciences, University of Uppsala, Husargatan 3, Uppsala, Sweden
| | - Mika Kivimäki
- Finnish Institute of Occupational Health, Topeliuksenkatu 41 b, FI-00250 Helsinki, Finland.,Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, UK.,Clinicum, Faculty of Medicine, PO Box 63, FI-00014 University of Helsinki, Helsinki, Finland
| | - Naja H Rod
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Gothersgade 160, DK-1123 Copenhagen, Denmark.,Division for Epidemiology, Stress Research Institute, Stockholm University, SE-10691, Stockholm, Sweden
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47
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Heikkilä K, Pentti J, Madsen IEH, Lallukka T, Virtanen M, Alfredsson L, Bjorner J, Borritz M, Brunner E, Burr H, Ferrie JE, Knutsson A, Koskinen A, Leineweber C, Magnusson Hanson LL, Nielsen ML, Nyberg ST, Oksanen T, Pejtersen JH, Pietiläinen O, Rahkonen O, Rugulies R, Singh‐Manoux A, Steptoe A, Suominen S, Theorell T, Vahtera J, Väänänen A, Westerlund H, Kivimäki M. Job Strain as a Risk Factor for Peripheral Artery Disease: A Multi-Cohort Study. J Am Heart Assoc 2020; 9:e013538. [PMID: 32342765 PMCID: PMC7428570 DOI: 10.1161/jaha.119.013538] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 02/07/2020] [Indexed: 01/21/2023]
Abstract
Background Job strain is implicated in many atherosclerotic diseases, but its role in peripheral artery disease (PAD) is unclear. We investigated the association of job strain with hospital records of PAD, using individual-level data from 11 prospective cohort studies from Finland, Sweden, Denmark, and the United Kingdom. Methods and Results Job strain (high demands and low control at work) was self-reported at baseline (1985-2008). PAD records were ascertained from national hospitalization data. We used Cox regression to examine the associations of job strain with PAD in each study, and combined the study-specific estimates in random effects meta-analyses. We used τ2, I2, and subgroup analyses to examine heterogeneity. Of the 139 132 participants with no previous hospitalization with PAD, 32 489 (23.4%) reported job strain at baseline. During 1 718 132 person-years at risk (mean follow-up 12.8 years), 667 individuals had a hospital record of PAD (3.88 per 10 000 person-years). Job strain was associated with a 1.41-fold (95% CI, 1.11-1.80) increased average risk of hospitalization with PAD. The study-specific estimates were moderately heterogeneous (τ2=0.0427, I2: 26.9%). Despite variation in their magnitude, the estimates were consistent in both sexes, across the socioeconomic hierarchy and by baseline smoking status. Additional adjustment for baseline diabetes mellitus did not change the direction or magnitude of the observed associations. Conclusions Job strain was associated with small but consistent increase in the risk of hospitalization with PAD, with the relative risks on par with those for coronary heart disease and ischemic stroke.
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Affiliation(s)
- Katriina Heikkilä
- Department of Health Services Research and PolicyLondon School of Hygiene and Tropical MedicineLondonUnited Kingdom
- Finnish Institute of Occupational HealthTampere, Helsinki and TurkuFinland
| | - Jaana Pentti
- Department of Public HealthUniversity of Turku and Turku University HospitalTurkuFinland
- Department of Public HealthUniversity of HelsinkiFinland
| | - Ida E. H. Madsen
- National Research Centre for the Working EnvironmentCopenhagenDenmark
| | - Tea Lallukka
- Finnish Institute of Occupational HealthTampere, Helsinki and TurkuFinland
- Department of Public HealthUniversity of HelsinkiFinland
| | - Marianna Virtanen
- Finnish Institute of Occupational HealthTampere, Helsinki and TurkuFinland
- Department of Public Health and Caring SciencesUniversity of UppsalaSweden
- Stress Research InstituteUniversity of StockholmSweden
| | - Lars Alfredsson
- Centre for Occupational and Environmental MedicineStockholm County CouncilStockholmSweden
- Institute of Environmental MedicineKarolinska InstituteStockholmSweden
| | - Jakob Bjorner
- National Research Centre for the Working EnvironmentCopenhagenDenmark
| | - Marianne Borritz
- Department of Occupational and Environmental MedicineBispebjerg HospitalCopenhagen UniversityCopenhagenDenmark
| | - Eric Brunner
- Department of Epidemiology and Public HealthUniversity College LondonLondonUnited Kingdom
| | - Hermann Burr
- Federal Institute for Occupational Safety and HealthBerlinGermany
| | - Jane E. Ferrie
- Department of Epidemiology and Public HealthUniversity College LondonLondonUnited Kingdom
- Bristol Medical School: Population Health SciencesUniversity of BristolUnited Kingdom
| | - Anders Knutsson
- Department of Health SciencesMid Sweden UniversitySundsvallSweden
| | - Aki Koskinen
- Finnish Institute of Occupational HealthTampere, Helsinki and TurkuFinland
| | | | | | | | | | - Tuula Oksanen
- Finnish Institute of Occupational HealthTampere, Helsinki and TurkuFinland
| | - Jan H. Pejtersen
- VIVEThe Danish Center for Social Science ResearchCopenhagenDenmark
| | | | - Ossi Rahkonen
- Department of Public HealthUniversity of HelsinkiFinland
| | - Reiner Rugulies
- National Research Centre for the Working EnvironmentCopenhagenDenmark
- Department of Public Health and Department of PsychologyUniversity of CopenhagenDenmark
| | - Archana Singh‐Manoux
- Department of Epidemiology and Public HealthUniversity College LondonLondonUnited Kingdom
| | - Andrew Steptoe
- Department of Epidemiology and Public HealthUniversity College LondonLondonUnited Kingdom
| | - Sakari Suominen
- Department of Public HealthUniversity of Turku and Turku University HospitalTurkuFinland
- University of SkövdeSweden
| | | | - Jussi Vahtera
- Department of Public HealthUniversity of Turku and Turku University HospitalTurkuFinland
| | - Ari Väänänen
- Finnish Institute of Occupational HealthTampere, Helsinki and TurkuFinland
| | | | - Mika Kivimäki
- Department of Public HealthUniversity of HelsinkiFinland
- Department of Epidemiology and Public HealthUniversity College LondonLondonUnited Kingdom
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Blomqvist S, Westerlund H, Alexanderson K, Magnusson Hanson LL. Labor market exit around retirement age in Sweden and trajectories of psychotropic drugs in a context of downsizing. BMC Public Health 2020; 20:618. [PMID: 32370787 PMCID: PMC7201680 DOI: 10.1186/s12889-020-08589-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 03/25/2020] [Indexed: 11/10/2022] Open
Abstract
Background A maintained psychological wellbeing is important in order to continue working longer and remain active into older age. However, little is known about impact of different organizational factors, such as downsizing, on the mental health of older workers exiting the labor market. The aim in this study was to investigate trajectories of purchases of psychotropic drugs in relation to labor market exit later in life in a context with and without downsizing. Method People living in Sweden, born 1941–1951, exiting paid work via unemployment, sickness absence/disability pension, or old-age pension were followed from 2005 to 2013 regarding purchases of psychotropic drugs. Individuals employed at a workplace closing down or downsizing with ≥18% between two subsequent years were compared to employees exiting from workplaces without downsizing or workplace closure. Generalized estimating equations was applied to derive trajectories of annual prevalence of purchased antidepressants, sedatives and anxiolytics from 4 years before to 4 years after a labour market exit. Results During the period around the exit, old-age retirees experiencing a downsizing/workplace closure did not decrease their purchases of sedatives (OR 1.01 95% CI 0.95–1.07) while the unexposed decreased their purchases during this period (OR 0.95 95% CI 0.92–0.98). Similar differences concerning sedatives and antidepressants between exposed and unexposed were seen for those exiting via sickness absence or disability pension. Furthermore, a significant difference in purchases of anxiolytics was observed between those exposed to downsizing (OR 1.10 95% CI 0.97–1.24) and the unexposed (OR 0.98 95% CI 0.91–1.06) exiting via old-age retirement during the time before the exit. Conclusion Downsizing or workplace closure, although weakly, was associated with higher prevalence of psychotropic drugs certain years around the labor market exit. The results support the idea that involuntary labor market exit in mature adulthood may negatively affect the development of mental health.
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Affiliation(s)
- Sandra Blomqvist
- Stress Research Institute, Stockholm University, SE-106 91, Stockholm, Sweden.
| | - Hugo Westerlund
- Stress Research Institute, Stockholm University, SE-106 91, Stockholm, Sweden
| | - Kristina Alexanderson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77, Stockholm, Sweden
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49
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Nyberg ST, Singh-Manoux A, Pentti J, Madsen IEH, Sabia S, Alfredsson L, Bjorner JB, Borritz M, Burr H, Goldberg M, Heikkilä K, Jokela M, Knutsson A, Lallukka T, Lindbohm JV, Nielsen ML, Nordin M, Oksanen T, Pejtersen JH, Rahkonen O, Rugulies R, Shipley MJ, Sipilä PN, Stenholm S, Suominen S, Vahtera J, Virtanen M, Westerlund H, Zins M, Hamer M, Batty GD, Kivimäki M. Association of Healthy Lifestyle With Years Lived Without Major Chronic Diseases. JAMA Intern Med 2020; 180:760-768. [PMID: 32250383 PMCID: PMC7136858 DOI: 10.1001/jamainternmed.2020.0618] [Citation(s) in RCA: 113] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
IMPORTANCE It is well established that selected lifestyle factors are individually associated with lower risk of chronic diseases, but how combinations of these factors are associated with disease-free life-years is unknown. OBJECTIVE To estimate the association between healthy lifestyle and the number of disease-free life-years. DESIGN, SETTING, AND PARTICIPANTS A prospective multicohort study, including 12 European studies as part of the Individual-Participant-Data Meta-analysis in Working Populations Consortium, was performed. Participants included 116 043 people free of major noncommunicable disease at baseline from August 7, 1991, to May 31, 2006. Data analysis was conducted from May 22, 2018, to January 21, 2020. EXPOSURES Four baseline lifestyle factors (smoking, body mass index, physical activity, and alcohol consumption) were each allocated a score based on risk status: optimal (2 points), intermediate (1 point), or poor (0 points) resulting in an aggregated lifestyle score ranging from 0 (worst) to 8 (best). Sixteen lifestyle profiles were constructed from combinations of these risk factors. MAIN OUTCOMES AND MEASURES The number of years between ages 40 and 75 years without chronic disease, including type 2 diabetes, coronary heart disease, stroke, cancer, asthma, and chronic obstructive pulmonary disease. RESULTS Of the 116 043 people included in the analysis, the mean (SD) age was 43.7 (10.1) years and 70 911 were women (61.1%). During 1.45 million person-years at risk (mean follow-up, 12.5 years; range, 4.9-18.6 years), 17 383 participants developed at least 1 chronic disease. There was a linear association between overall healthy lifestyle score and the number of disease-free years, such that a 1-point improvement in the score was associated with an increase of 0.96 (95% CI, 0.83-1.08) disease-free years in men and 0.89 (95% CI, 0.75-1.02) years in women. Comparing the best lifestyle score with the worst lifestyle score was associated with 9.9 (95% CI 6.7-13.1) additional years without chronic diseases in men and 9.4 (95% CI 5.4-13.3) additional years in women (P < .001 for dose-response). All of the 4 lifestyle profiles that were associated with the highest number of disease-free years included a body-mass index less than 25 (calculated as weight in kilograms divided by height in meters squared) and at least 2 of the following factors: never smoking, physical activity, and moderate alcohol consumption. Participants with 1 of these lifestyle profiles reached age 70.3 (95% CI, 69.9-70.8) to 71.4 (95% CI, 70.9-72.0) years disease free depending on the profile and sex. CONCLUSIONS AND RELEVANCE In this multicohort analysis, various healthy lifestyle profiles appeared to be associated with gains in life-years without major chronic diseases.
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Affiliation(s)
- Solja T Nyberg
- Clinicum, Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Archana Singh-Manoux
- Department of Epidemiology and Public Health, University College London, London, United Kingdom.,Inserm U1153, Epidemiology of Ageing and Neurodegenrative Diseases, Paris, France
| | - Jaana Pentti
- Clinicum, Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Department of Public Health, University of Turku, Turku University Hospital, Turku, Finland.,Centre for Population Health Research, University of Turku, Turku University Hospital, Turku, Finland
| | - Ida E H Madsen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Severine Sabia
- Department of Epidemiology and Public Health, University College London, London, United Kingdom.,Inserm U1153, Epidemiology of Ageing and Neurodegenrative Diseases, Paris, France
| | - Lars Alfredsson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden
| | - Jakob B Bjorner
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | | | - Hermann Burr
- Federal Institute for Occupational Safety and Health, Berlin, Germany
| | - Marcel Goldberg
- Faculty of Medicine, Paris Descartes University, Paris, France.,Inserm UMS 011, Population-Based Epidemiological Cohorts Unit, Villejuif, France
| | - Katriina Heikkilä
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Markus Jokela
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Anders Knutsson
- Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden
| | - Tea Lallukka
- Clinicum, Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Finnish Institute of Occupational Health, Helsinki, Finland
| | - Joni V Lindbohm
- Clinicum, Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | | | - Maria Nordin
- Stress Research Institute, Stockholm University, Stockholm, Sweden.,Department of Psychology, Umeå University, Umeå, Sweden
| | - Tuula Oksanen
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Jan H Pejtersen
- VIVE-The Danish Center for Social Science Research, Copenhagen, Denmark
| | - Ossi Rahkonen
- Clinicum, Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Reiner Rugulies
- National Research Centre for the Working Environment, Copenhagen, Denmark.,Department of Public Health and Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Martin J Shipley
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Pyry N Sipilä
- Clinicum, Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Sari Stenholm
- Department of Public Health, University of Turku, Turku University Hospital, Turku, Finland.,Centre for Population Health Research, University of Turku, Turku University Hospital, Turku, Finland
| | - Sakari Suominen
- Department of Public Health, University of Turku, Turku University Hospital, Turku, Finland.,University of Skövde, School of Health and Education, Skövde, Sweden
| | - Jussi Vahtera
- Department of Public Health, University of Turku, Turku University Hospital, Turku, Finland.,Centre for Population Health Research, University of Turku, Turku University Hospital, Turku, Finland
| | - Marianna Virtanen
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland.,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Hugo Westerlund
- Stress Research Institute, Stockholm University, Stockholm, Sweden
| | - Marie Zins
- Faculty of Medicine, Paris Descartes University, Paris, France.,Inserm UMS 011, Population-Based Epidemiological Cohorts Unit, Villejuif, France
| | - Mark Hamer
- Division of Surgery & Interventional Science, Faculty of Medical Sciences, University College London, London, United Kingdom
| | - G David Batty
- Department of Epidemiology and Public Health, University College London, London, United Kingdom.,School of Biological and Population Health Sciences, Oregon State University, Corvallis, Oregon
| | - Mika Kivimäki
- Clinicum, Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Department of Epidemiology and Public Health, University College London, London, United Kingdom
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50
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Ådnanes M, Cresswell-Smith J, Melby L, Westerlund H, Šprah L, Sfetcu R, Straßmayr C, Donisi V. Discharge planning, self-management, and community support: Strategies to avoid psychiatric rehospitalisation from a service user perspective. Patient Educ Couns 2020; 103:1033-1040. [PMID: 31836249 DOI: 10.1016/j.pec.2019.12.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 12/02/2019] [Accepted: 12/03/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE Psychiatric rehospitalisation is often seen as a negative outcome in terms of healthcare quality and cost, as well as potentially hindering the process of recovery. The purpose of our study was to explore psychiatric rehospitalisation from a service-user perspective, paying attention to how rehospitalisation can be avoided. METHOD Eight focus groups, including a total of 55 mental health service users, were conducted in six European countries (Austria, Finland, Italy, Norway, Romania, and Slovenia). The results were analysed using systematic text condensation. RESULTS All participants had been in touch with mental health services for at least one year, and had experienced more than one psychiatric hospitalisation. Participants emphasised the importance of discharge planning and psychoeducation both during and after the hospital stay, as well as the benefits of structured plans, coping strategies, self-monitoring techniques, and close contact with local community services.Social contacts and meaningful activities were also considered to be critical, as was support from peers and family members. CONCLUSION Efforts to avoid psychiatric rehospitalisation should include actions that support a functional day-to-day life, improve coping strategies, and build on cross-sectoral collaboration. PRACTICE IMPLICATIONS The study emphasises the need for psychoeducational and psychosocial interventions, starting already during the inpatient stay.
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Affiliation(s)
- M Ådnanes
- SINTEF Digital, Dept of Health Research, PO Box 4760 Torgarden, 7465 Trondheim, Norway.
| | - J Cresswell-Smith
- National Institute for Health and Welfare (THL), Mental Health Unit, Helsinki, Finland.
| | - L Melby
- SINTEF Digital, Dept of Health Research, Trondheim, Norway.
| | - H Westerlund
- Competence Centre for Experiential Knowledge and Service Development, Trondheim, Norway.
| | - L Šprah
- Research Centre of the Slovenian Academy of Sciences and Arts, Sociomedical Institute, Ljubljana, Slovenia.
| | - R Sfetcu
- National School of Public Health, Management and Professional Development, Bucharest; 2. Faculty of Psychology and Educational Sciences, Bucharest, Romania.
| | - C Straßmayr
- IMEHPS. Research - Forschungsinstitut für Sozialpsychiatrie, Vienna, Austria.
| | - V Donisi
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
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