RESUMO
BACKGROUND: Adverse psychosocial working environments characterized by job strain (the combination of high demands and low control at work) are associated with an increased risk of depressive symptoms among employees, but evidence on clinically diagnosed depression is scarce. We examined job strain as a risk factor for clinical depression. METHOD: We identified published cohort studies from a systematic literature search in PubMed and PsycNET and obtained 14 cohort studies with unpublished individual-level data from the Individual-Participant-Data Meta-analysis in Working Populations (IPD-Work) Consortium. Summary estimates of the association were obtained using random-effects models. Individual-level data analyses were based on a pre-published study protocol. RESULTS: We included six published studies with a total of 27 461 individuals and 914 incident cases of clinical depression. From unpublished datasets we included 120 221 individuals and 982 first episodes of hospital-treated clinical depression. Job strain was associated with an increased risk of clinical depression in both published [relative risk (RR) = 1.77, 95% confidence interval (CI) 1.47-2.13] and unpublished datasets (RR = 1.27, 95% CI 1.04-1.55). Further individual participant analyses showed a similar association across sociodemographic subgroups and after excluding individuals with baseline somatic disease. The association was unchanged when excluding individuals with baseline depressive symptoms (RR = 1.25, 95% CI 0.94-1.65), but attenuated on adjustment for a continuous depressive symptoms score (RR = 1.03, 95% CI 0.81-1.32). CONCLUSIONS: Job strain may precipitate clinical depression among employees. Future intervention studies should test whether job strain is a modifiable risk factor for depression.
Assuntos
Transtorno Depressivo/etiologia , Estresse Ocupacional/complicações , HumanosRESUMO
BACKGROUND: Many patients and healthcare professionals believe that work-related psychosocial stress, such as job strain, can make asthma worse, but this is not corroborated by empirical evidence. We investigated the associations between job strain and the incidence of severe asthma exacerbations in working-age European men and women. METHODS: We analysed individual-level data, collected between 1985 and 2010, from 102 175 working-age men and women in 11 prospective European studies. Job strain (a combination of high demands and low control at work) was self-reported at baseline. Incident severe asthma exacerbations were ascertained from national hospitalization and death registries. Associations between job strain and asthma exacerbations were modelled using Cox regression and the study-specific findings combined using random-effects meta-analyses. RESULTS: During a median follow-up of 10 years, 1 109 individuals experienced a severe asthma exacerbation (430 with asthma as the primary diagnostic code). In the age- and sex-adjusted analyses, job strain was associated with an increased risk of severe asthma exacerbations defined using the primary diagnostic code (hazard ratio, HR: 1.27, 95% confidence interval, CI: 1.00, 1.61). This association attenuated towards the null after adjustment for potential confounders (HR: 1.22, 95% CI: 0.96, 1.55). No association was observed in the analyses with asthma defined using any diagnostic code (HR: 1.01, 95% CI: 0.86, 1.19). CONCLUSIONS: Our findings suggest that job strain is probably not an important risk factor for severe asthma exacerbations leading to hospitalization or death.
Assuntos
Asma Ocupacional/epidemiologia , Asma Ocupacional/etiologia , Estresse Psicológico , Progressão da Doença , Europa (Continente)/epidemiologia , Feminino , Humanos , Masculino , Modelos de Riscos Proporcionais , Risco , Índice de Gravidade de Doença , População BrancaRESUMO
In occupations, self-rated general health status was examined under special consideration of age. Data from the GEDA 2009 and 2010 surveys (N = 26,303) were analyzed. Professionals had a low prevalence of poor health, whereas unskilled service workers and-among males-unskilled manual workers had a high prevalence. In older workers the prevalence of poor general health was greater than among younger workers. However, the difference in health between young and old was significantly smaller than the general pattern among male managers and women in skilled commercial and administrative occupations. Among male skilled workers and female unskilled manual workers, the difference in health between young and old was greater. The-with increasing age-growing health gap between occupational groups should receive more attention. In order to understand the relationship between work, age and health, targeted longitudinal sectional studies are needed. It might be misleading to adjust associations between work and health by age, because age might moderate this relationship.
Assuntos
Autoavaliação Diagnóstica , Emprego/classificação , Emprego/estatística & dados numéricos , Nível de Saúde , Adolescente , Adulto , Distribuição por Idade , Escolaridade , Feminino , Alemanha/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Distribuição por Sexo , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto JovemRESUMO
BACKGROUND: Occupational and leisure-time physical activity are considered to provide similar health benefits. The authors tested this hypothesis. METHODS: A representative sample of Danish employees (n=7144, 52% females) reported levels of occupational and leisure-time physical activity in 2005. Long-term sickness absence (LTSA) spells of ≥3 consecutive weeks were retrieved from a social-transfer payment register from 2005 to 2007. RESULTS: 341 men and 620 females experienced a spell of LTSA during the period. Cox analyses adjusted for age, gender, smoking, alcohol, body mass index, chronic disease, social support from immediate superior, emotional demands, social class and occupational or leisure-time physical activity showed a decreased risk for LTSA among workers with moderate (HR 0.85, CI 0.72 to 1.01) and high (HR 0.77, CI 0.62 to 0.95) leisure-time physical activity in reference to those with low leisure-time physical activity. In contrast, an increased risk for LTSA was shown among workers with moderate (HR 1.59, CI 1.35 to 1.88) and high (HR 1.84, CI 1.55 to 2.18) occupational physical activity referencing those with low occupational physical activity. CONCLUSION: The hypothesis was rejected. In a dose-response manner, occupational physical activity increased the risk for LTSA, while leisure-time physical activity decreased the risk for LTSA. The findings indicate opposing effects of occupational and leisure-time physical activity on global health.
Assuntos
Exercício Físico/fisiologia , Atividades de Lazer , Ocupações/estatística & dados numéricos , Adolescente , Adulto , Idoso , Consumo de Bebidas Alcoólicas , Índice de Massa Corporal , Doença Crônica , Dinamarca , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Comportamento Sedentário , Licença Médica/estatística & dados numéricos , Fumar , Classe Social , Apoio Social , Adulto JovemRESUMO
BACKGROUND: High muscle strength is considered relevant for preventing musculoskeletal disorders and long-term sickness absence. However, prospective studies on the association between muscle strength and future musculoskeletal disorders and long-term sickness absence are few and show contrasting results. AIMS: To investigate the association between low muscle strength and future musculoskeletal disorders and long-term sickness absence. METHODS: Muscle strength in trunk flexion and extension, shoulder elevation and abduction as well as handgrip was recorded from a representative sample of Danish workers (n = 421) in 1995. Musculoskeletal disorders were reported 5 years later (in 2000). Information on long-term sickness absence was retrieved from a register of social transfer payments in the period 1996-2007. RESULTS: Regression analyses adjusted for age, gender, smoking, body mass index and physical work demands showed that workers with low muscle strength (the lowest quartile) of trunk extension and flexion, shoulder elevation and abduction and handgrip did not have a significantly increased risk for future musculoskeletal disorders or long term sickness absence compared with stronger workers. CONCLUSIONS: Low muscle strength does not seem to be a good predictor for musculoskeletal disorders and long-term sickness absence in the general working population.
Assuntos
Absenteísmo , Força Muscular/fisiologia , Doenças Musculoesqueléticas/epidemiologia , Dor/epidemiologia , Licença Médica/estatística & dados numéricos , Adulto , Dinamarca/epidemiologia , Feminino , Seguimentos , Mãos/fisiopatologia , Humanos , Dor Lombar/epidemiologia , Masculino , Estudos Prospectivos , Medição de Risco , Dor de Ombro/epidemiologia , Tronco/fisiopatologiaRESUMO
BACKGROUND: Evidence of an association between job strain and obesity is inconsistent, mostly limited to small-scale studies, and does not distinguish between categories of underweight or obesity subclasses. OBJECTIVES: To examine the association between job strain and body mass index (BMI) in a large adult population. METHODS: We performed a pooled cross-sectional analysis based on individual-level data from 13 European studies resulting in a total of 161 746 participants (49% men, mean age, 43.7 years). Longitudinal analysis with a median follow-up of 4 years was possible for four cohort studies (n = 42 222). RESULTS: A total of 86 429 participants were of normal weight (BMI 18.5-24.9 kg m(-2) ), 2149 were underweight (BMI < 18.5 kg m(-2) ), 56 572 overweight (BMI 25.0-29.9 kg m(-2) ) and 13 523 class I (BMI 30-34.9 kg m(-2) ) and 3073 classes II/III (BMI ≥ 35 kg m(-2) ) obese. In addition, 27 010 (17%) participants reported job strain. In cross-sectional analyses, we found increased odds of job strain amongst underweight [odds ratio 1.12, 95% confidence interval (CI) 1.00-1.25], obese class I (odds ratio 1.07, 95% CI 1.02-1.12) and obese classes II/III participants (odds ratio 1.14, 95% CI 1.01-1.28) as compared with participants of normal weight. In longitudinal analysis, both weight gain and weight loss were related to the onset of job strain during follow-up. CONCLUSIONS: In an analysis of European data, we found both weight gain and weight loss to be associated with the onset of job strain, consistent with a 'U'-shaped cross-sectional association between job strain and BMI. These associations were relatively modest; therefore, it is unlikely that intervention to reduce job strain would be effective in combating obesity at a population level.
Assuntos
Índice de Massa Corporal , Emprego/psicologia , Sobrepeso/epidemiologia , Sobrepeso/psicologia , Estresse Psicológico/etiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Estudos Transversais , Europa (Continente)/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Obesidade/psicologia , Razão de Chances , Aumento de PesoRESUMO
OBJECTIVE: To investigate if job insecurity and poor labour market chances predict a decline in self-rated health in the Danish workforce. DESIGN: Job insecurity, labour market chances, self-rated health and numerous covariates were measured in 1809 women and 1918 men who responded to a questionnaire in 1995 and again in 2000. Multivariate logistic regression analyses were used to analyse the impact of job insecurity and labour market chances measured in 1995 on decline in health in 2000. SETTING: Prospective cohort study with a representative sample of the Danish workforce using the Danish Work Environment Cohort Study (DWECS). All participants were employed at baseline. MAIN RESULTS: Women with job insecurity had an increased risk of a decline in health at follow-up, after adjustment for all covariates (OR = 1.78, 95% CI: 1.24 to 2.54). Effect estimates were strongest among women 50 years of age or younger with poor labour market chances (OR = 2.13, 95% CI: 1.32 to 3.45). Among men, there was no main effect for job insecurity. However, men aged 50 years or younger with poor labour market chances showed an OR of 1.64 (95% CI: 0.95 to 2.84) for a decline in health. CONCLUSION: Job insecurity is a predictor for a decline in health in employed women in Denmark. Among men, a suggestive effect of job insecurity was found in employees aged 50 years or younger with poor labour market chances.
Assuntos
Emprego/psicologia , Nível de Saúde , Saúde Ocupacional , Fatores Etários , Ansiedade , Dinamarca , Feminino , Seguimentos , Indicadores Básicos de Saúde , Humanos , Satisfação no Emprego , Masculino , Estudos Prospectivos , Fatores Sexuais , Desemprego/psicologiaRESUMO
BACKGROUND: One in seven married couples is involuntarily infertile. Several chemical exposures in the work environment have been hypothesized to affect female reproduction, and some are present in products used in hairdressing and related trades. Recent Swedish findings indicate that employment in hairdressing poses a risk for female reproductive function. This study examined the possible association between work as a hairdresser and subsequent hospital contact due to female infertility. METHODS: A cohort of all women in Denmark aged 20-44 years on 1 January 1998 (baseline) and registered as economically active hairdressers, according to national registers, was formed to calculate age-standardized risk ratios (RRs) for hospital contacts due to female infertility during a 5-year follow-up period. Hairdressers were compared to a standard population, that is, all economically active women in Denmark aged 20-44 years at baseline, and to women working as shop assistants. RESULTS: Sixty-eight cases of hospital contact due to female infertility were observed among the female hairdressers. On the basis of the standard population, the expected number was 73.27, which gives an observed RR of 0.928 (95% CI: 0.72-1.18). Hairdressers and shop assistants exhibited similar rates of hospital contact due to female infertility (1.01; 95% CI: 0.77-1.29). CONCLUSION: The findings are not corroborating the hypothesis that hairdressers are at increased risk of infertility, but small risks in the entire group or high risks in small subgroups may not be detected by the study.
Assuntos
Barbearia , Fertilidade , Infertilidade Feminina/diagnóstico , Adulto , Dinamarca/epidemiologia , Feminino , Seguimentos , Humanos , Infertilidade Feminina/epidemiologia , Razão de Chances , Sistema de Registros , Fatores de RiscoRESUMO
BACKGROUND: Previous studies of the risk of heart disease after shift work reached different estimates and review authors disagree about the validity of some of the studies. A cross sectional study showed that shift workers had a higher prevalence of nearly every unfavourable work environment factor investigated. Conflicts at work and low decision latitude were more frequent among shift workers, and all-day walking or standing work and part-time jobs were more often found among female shift workers. OBJECTIVES: To estimate the risk of circulatory disease in a prospective follow up of a representative sample of gainfully employed Danes, considering known or suspected confounding factors. METHODS: A cohort of 5517 people who were gainfully employed in 1990 were followed up for all hospital treatments due to circulatory diseases (390-458, ICD-8; I00-I99, ICD-10) from 1991 to 2002 inclusive. A log linear Poisson regression model was applied to control confounding factors and calculate the relative risk for 927 men and women working nights, evenings, or other non-day shifts compared to 4579 day workers. RESULTS: Non-day workers compared to day workers had a relative risk (RR) for all circulatory diseases of 1.31 (95% CI 1.06-1.63). Without control for BMI and smoking, the RR estimate was 1.33 (95% CI 1.07-1.65). For a subgroup of workers with at least three years' seniority, the RR was 1.40 (95% CI 1.09-1.81). The population based aetiological fraction of shift work was estimated to 5%. CONCLUSION: This study adds to a growing body of evidence suggesting that shift work carries an excess risk of circulatory diseases.
Assuntos
Doenças Cardiovasculares/epidemiologia , Doenças Profissionais/epidemiologia , Tolerância ao Trabalho Programado/fisiologia , Adulto , Índice de Massa Corporal , Dinamarca/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Estudos Prospectivos , Sistema de Registros , Fatores de Risco , Distribuição por Sexo , Fumar/epidemiologiaRESUMO
BACKGROUND: Recent studies suggest that prolonged standing at work is associated with the development of diseases of varicose veins (VV). AIMS: To assess the risk of hospitalisation due to VV in the lower extremities prospectively in workers standing or walking at least 75% of their time at work. METHODS: A representative random sample of 9653 working age adults was drawn from the Central Population Register of Denmark in 1991. Of these, 8664 accepted to be interviewed by telephone (response rate 90%). Respondents (2939 men and 2708 women) were 20-59 years old and employed in 1990. Risk ratios for VV were estimated by log-linear Poisson regression models separately for men and women with adjustment for smoking status, body mass index (BMI), heavy lifting, and, for females only, number of children at baseline. RESULTS: During 12 years of follow up, 40 hospitalisations due to VV were observed among the men and 71 among the women. For employees with jobs that require prolonged standing or walking compared to all other employees, the relative risk was 1.75 (95% CI 0.92 to 3.34) for men and 1.82 (95% CI 1.12 to 2.95) for women. The pooled estimate of the relative risk was 1.78 (95% CI 1.19 to 2.68). The aetiological fraction of prolonged standing or walking at work was estimated as 22.5% for men and 22.6% for women. CONCLUSIONS: This prospective study confirms that prolonged standing at work constitutes an excess risk of hospital treatment due to varicose veins and accounts for more than one fifth of all cases of working age.
Assuntos
Hospitalização , Doenças Profissionais/etiologia , Postura , Complicações na Gravidez/etiologia , Varizes/etiologia , Trabalho , Adulto , Dinamarca , Feminino , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Medicina do Trabalho/métodos , Gravidez , Estudos Prospectivos , Medição de Risco , Estudos de AmostragemRESUMO
AIM: To investigate whether the effect of socioeconomic position on risk of myocardial infarction (MI) is mediated by differential exposure or differential susceptibility to psychosocial work environment. METHODS: Data were used from three prospective population studies conducted in Copenhagen. A total of 16 214 employees, 44% women, aged 20-75 years, with initial examination between 1974 and 1992 were followed until 1996 for incident (hospital admission or death) MI. Register based information on job categories was used. Psychosocial job exposures were measured indirectly by means of a job exposure matrix based on the Danish Work Environment Cohort Study 1990. RESULTS: During follow up, 731 subjects were diagnosed with an MI: 610 men and 121 women (35% fatal). The hazards by socioeconomic position showed a graded effect with a hazard ratio (HR) of 1.57 (95% CI 1.23 to 2.03) for unskilled workers compared to executive managers. Despite a strong and graded association in risk of MI related to decision authority and skill discretion, only skill discretion mediated the effect of socioeconomic position. The HR for unskilled workers was reduced to 1.47 (0.93 to 2.31) after adjustment for decision authority and other cardiovascular risk factors, and to 1.07 (0.72 to 1.60) after adjustment for skill discretion and cardiovascular risk factors. No sign of synergy was found. CONCLUSIONS: Decision authority and skill discretion were strongly related to socioeconomic position; and the effect on risk of MI was partially mediated by skill discretion. Improvements in psychosocial work environment, especially possibilities for skill discretion, might contribute to reducing the incidence of MI and social inequality in MI.
Assuntos
Infarto do Miocárdio/epidemiologia , Doenças Profissionais/epidemiologia , Classe Social , Adulto , Idoso , Tomada de Decisões , Dinamarca/epidemiologia , Métodos Epidemiológicos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Destreza Motora , Infarto do Miocárdio/mortalidade , Doenças Profissionais/mortalidade , Fatores Socioeconômicos , Local de TrabalhoRESUMO
OBJECTIVES: Both shift work and other work environment factors have been shown to be related to heart disease. This study examined whether shift work is associated with other work environment factors related to heart disease in a random sample of the population. If so, shift work could be acting as a proxy for work environment differences. METHODS: Data on 5940 employees in the Danish Work Environment Cohort Study from 1990 were reanalyzed. The information included work schedules [permanent day work, irregular workhours (including morning work), 2-shift or fixed evening and 3-shift or fixed night], length of workweek, physical factors (noise, heat, dust, passive smoking, walking, standing and monotonous repetitive tasks), and psychosocial factors (including demands and control dimensions, social support, conflicts and job insecurity). RESULTS: At least 1 group of shift workers had a higher prevalence of nearly every unfavorable work environment factor investigated. Exceptions were dust exposure and quantitative demands. Especially conflicts at work and low decision latitude were higher among all the groups of shift workers, and all-day walking or standing work and part-time jobs were more often found among female shift workers. The 3 different shiftwork groups were exposed to different parts of the work environment, and also men and women in shift work differed in relation to the work environment. Age and social class influenced the relationship, but not in any particular pattern. CONCLUSIONS: In a heterogenous population shift work was found to be associated with other work environment factors suspected to cause heart disease.
Assuntos
Cardiopatias/etiologia , Doenças Profissionais/etiologia , Tolerância ao Trabalho Programado , Adolescente , Adulto , Estudos de Coortes , Dinamarca/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ocupações , Fatores de RiscoRESUMO
OBJECTIVES: This study attempts to determine whether or not prolonged standing at work involves an excess risk for the occurrence of varicose veins. METHODS: A cohort of 1.6 million 20-to-59-year-old Danes gainfully employed in 1991 were followed for 3 years according to first hospitalization due to varicose veins of the lower extremities. The exposure data came from a representative sample of the baseline population. Altogether 5940 people were interviewed about occupational exposure and confounding factors. RESULTS: For men working mostly in a standing position, the risk ratio for varicose veins was 1.85 [95% confidence interval (95% CI) 1.33-2.36] in a comparison with all other men. The corresponding risk ratio for women was 2.63 (95% CI 2.25-3.02). The results were adjusted for age, social group, and smoking. CONCLUSIONS: Working in a standing position is associated with subsequent hospitalization due to varicose veins for both men and women.
Assuntos
Doenças Profissionais/epidemiologia , Postura , Varizes/epidemiologia , Trabalho , Adulto , Fatores Etários , Interpretação Estatística de Dados , Dinamarca/epidemiologia , Feminino , Seguimentos , Hospitalização , Humanos , Masculino , Registro Médico Coordenado , Pessoa de Meia-Idade , Doenças Profissionais/etiologia , Razão de Chances , Estudos Prospectivos , Fatores Sexuais , Fumar/efeitos adversos , Fatores de Tempo , Varizes/etiologia , Insuficiência Venosa/epidemiologiaRESUMO
Occupational exposures are related to work processes carried out by the individual worker. A classification of the work processes was developed on the basis of analyses of several databases. Work-process data were collected in a sample of Danish employees. An unambiguous, exhaustive work-process classification was developed where the work process was defined as the transformation of a work object into a product. A test showed that at least 85% of free-text data on occupational injuries contained work-process data. To illustrate applications of the classification, work-process data were used to define highly exposed and unexposed job groups. This classification may be useful for (for example) major general surveys to supplement the exposure information that job and industry classifications yield.
Assuntos
Idoso , População Rural , Apoio Social , Telefone , Feminino , Humanos , Relações Interpessoais , Maine , Masculino , Projetos Piloto , VoluntáriosRESUMO
Reduced-stringency DNA reassociation conditions allow low stability duplexes to be detected in prokaryotic, plant, fish, avian, mammalian, and primate genomes. Highly diverged families of sequences can be detected in avian, mouse, and human unique sequence dNAs. Such a family has been described among twelve species of birds; based on species specific melting profiles and fractionation of sequences belonging to this family, it was concluded that permissive reassociation conditions did not artifactually produce low stability structures (1). We report S1 nuclease and optical melting experiments, and further fractionation of the diverged family to confirm sequence specific DNA reassociation at 50 degrees in 0.5 M phosphate buffer.