Job mobility and health in the Danish workforce.

AIMS: The globalized economy has stimulated mobility in the labour market in many countries and Denmark has one of the highest rates of mobility between workplaces among the OECD countries. This raises the question of the potential health effects of mobility and the effect of disease on mobility. METHODS: This study was register-based with a longitudinal design using data on the entire Danish population in 1992-2006. The data included mobility between employers and workplaces and seven different diseases based on admissions to hospital and drug prescriptions. RESULTS: After adjusting for relevant confounders, an exposure-response relationship was seen between mobility and the incidence of ischaemic heart disease, stroke, duodenal ulcer, anxiety/depression and, most strongly, with alcohol-related disorders. The effects were not very strong, however, with odds ratios varying from 1.2 to 1.6. As expected, no effect was seen for colorectal cancer. We also found an effect of both somatic and mental disorders on mobility, but not for the two cancer types. Mobility did not seem to prevent being out of the labour force after diagnosis. CONCLUSIONS: Frequent mobility in the labour market increases the risk of cardiovascular disease, common mental disorders and alcohol-related disorders and these diagnoses also seem to increase the risk of subsequent mobility.

Addressing social inequality in aging by the Danish occupational social class measurement.

OBJECTIVE: To present the Danish Occupational Social Class (DOSC) measurement as a measure of socioeconomic position (SEP) applicable in a late midlife population, and to analyze associations of this measure with three aging-related outcomes in midlife, adjusting for education. METHOD: Systematic coding procedures of the DOSC measurement were applied to 7,084 participants from the Copenhagen Aging and Midlife Biobank (CAMB) survey. We examined the association of this measure of SEP with chronic conditions, self-rated health, and mobility in logistic regression analyses, adjusting for school education in the final analysis. RESULTS: The measure of SEP showed a strong social gradient along the social classes in terms of prevalence of chronic conditions, poor self-rated health, and mobility limitations. Adjusting for school education attenuated the association only to a minor degree. DISCUSSION: The DOSC measure was associated with aging-related outcomes in a midlife Danish population, and is, thus, well suited for future epidemiological research on social inequalities in health and aging.

Demand-specific work ability, poor health and working conditions in middle-aged full-time employees.

We investigated the prevalence of reduced demand-specific work ability, its association with age, gender, education, poor health, and working conditions, and the interaction between poor health and working conditions regarding reduced demand-specific work ability. We used cross-sectional questionnaire data from 3381 full-time employees responding to questions about vocational education, job demands and social support (working conditions), musculoskeletal pain (MSP) and major depression (MD) (poor health) and seven questions about difficulty managing different job demands (reduced demand-specific work ability). Reduced demand-specific work ability varied from 9% to 19% among the 46-year old and from 11% to 21% among the 56-year old. Age was associated with two, gender with four, and education with all measures of reduced demand-specific work ability. MSP was associated with four and MD was associated with six measures of reduced demand-specific work ability. We found no interaction between working conditions and poor health regarding reduced demand-specific work ability.

Employment consequences of depressive symptoms and work demands individually and combined.

BACKGROUND: Denmark, like other Western countries, is recently burdened by increasingly high social spending on employment consequences caused by ill mental health. This might be the result of high work demands affecting persons with ill mental health. Therefore, this study assesses to what extent depressive symptoms and high work demands, individually and combined, have an effect on employment consequences. METHODS: We conducted a population-based 7-year longitudinal follow-up study with baseline information from the year 2000 on socio-demographics, lifestyle, depressive symptoms and work demands. In total, 5785 employed persons, aged 40 and 50 years, were included. Information about employment status, sick leave and work disability was obtained from registers. Logistic regression models were used to measure separate and combined effects of depressive symptoms and work demands on job change, unemployment and sick leave during 2001-02 and work disability during 2003-07. RESULTS: After adjustment for covariates, high physical work demands and depressive symptoms had a graded effect on subsequent unemployment, sick leave and permanent work disability. Persons with both depressive symptoms and high physical demands had the highest risks, especially for sick leave, but the combined effect did not exceed the product of single effects. Persons who perceived high amount of work changed job significantly more frequently. CONCLUSION: Persons with depressive symptoms might have an increased risk of negative employment consequences irrespective of the kind and amount of work demands. This might be an effect on the level of work ability in general as well as partly the result of health selection and co-morbidity.

Main and combined effects of musculoskeletal pain frequency and avoidant coping on sickness absence: findings from a prospective cohort study.

OBJECTIVE: Musculoskeletal pain and avoidant coping predicts sickness absence, but how these 2 predictors relate to each other is unknown. We examined the main and combined effects of musculoskeletal pain and avoidant, behavioural coping on incidence of sickness absence. DESIGN AND SUBJECTS: Prospective cohort study of a sample of middle-aged Danes, economically active in 2006, reporting functional limitations due to musculoskeletal pain, n = 3115. METHODS: Data included surveys from 2000 and 2006 and register data from 2007. Outcome was sickness absence exceeding 2 consecutive weeks in 2007. The main effect of self-reported pain frequency and avoidant coping on sickness absence was analysed by multivariate logistic regression. The combined effect was calculated as departure from multiplicativity and by the inclusion of a product term. RESULTS: Daily pain and use of avoidant coping were both associated with sickness absence in multiple adjusted analyses, odds ratio (OR)daily pain = 1.83 (95% confidence interval (CI) 1.51-2.21) and OR(avoidant coping) = 1.52 (95% CI 1.24-1.88) (main effects). A modest combined effect of musculoskeletal pain and avoidant coping on sickness absence was suggested (p = 0.286). CONCLUSION: Avoidant coping and daily pain are both associated with sickness absence, but showed no strong signs of interactive effects. Clinicians should be aware of both factors.

Increasing prevalence of depression from 2000 to 2006.

AIM: Depression is the leading cause of disability and is projected to become the second highest burden of disease (measured in disability-adjusted life years) by 2020, but only a few studies have examined changes over time in the occurrence of depression. The aim of this study is to provide evidence to the hypothesis that the prevalence of depression is rising in the Danish population. We will do that in a longitudinal design among adult Danes by studying the trends from 2000 to 2006 of major depressive disorder (MDD) as well as the distribution across the whole Major Depression Inventory (MDI) scale. In addition, we will investigate whether the trend in MDD is similar across socioeconomic groups. METHODS: A random sample of 4759 Danes in their forties and fifties were followed in a longitudinal study based on postal questionnaires answered in 2000 and 2006. RESULTS: The prevalence of MDD increased from 2.0% to 4.9% during 2000-06. Also the distribution of the MDI score in its entirety moves higher up the scale, with the 90th percentile changing from 12 in year 2000 to 20 in 2006. The increasing prevalence is in absolute terms more pronounced among women in their forties and in lower socioeconomic positions. CONCLUSIONS: The rising MDI score indicates that MDD as well as mental health generally is of public health concern.

Job stress and the use of antidepressant medicine: a 3.5-year follow-up study among Danish employees.

OBJECTIVES: To investigate if exposure to adverse psychological job characteristics predicts incident use of antidepressants, taking into account differential misclassification and residual confounding. METHODS: A prospective cohort study with a 3.5-year follow-up of 4661 Danish employees, aged 40 and 50 years, drawn from a 10% random sample of the Danish population was carried out. Job characteristics were the predictor variables and use of antidepressants was the outcome variable. Survey data on psychosocial work environment were linked with register data on dispensing of antidepressant medicine between June 2000 and December 2003. Respondents with major depression at baseline, with antidepressant use in the 5 years preceding baseline, or not employed at baseline were excluded. RESULTS: Among men, the OR for antidepressant use was significantly increased for high quantitative demands (OR 2.12, 95% CI 1.29 to 3.48) and low social support from colleagues (OR 2.28, 95% 1.36 to 3.82) after adjustment for lifestyle factors, socio-demographic factors, co-morbidity, other work factors and depressive symptoms at baseline. Both effects were dose dependent. An interaction effect with high demands was found for high anticipated private social support and living with children. Among women, no effect of job characteristics on antidepressant use was found. CONCLUSION: Among men, but not among women, high quantitative demands and low social support from colleagues were predictive of incident use of antidepressants, indicating incident depressive episodes, even after taking into account differential misclassification and residual confounding. The effects were buffered for those with high anticipated private social support and for those having children.

Physiological Demands in Downhill Skiing.

The aerobic and strength requirements in downhill skiing are high, and the authors outline a conditioning program to help the skier meet them.