Voluntary early retirement and mortality in patients with and without chronic diseases: a nationwide Danish Registry study.

OBJECTIVE: This study explores how the choice of voluntary early retirement (VER) affects mortality in a population where VER is available 5 years before regular retirement age. STUDY DESIGN: This retrospective cohort study uses a registry-based follow-up design with access to Nationwide Danish Registry Data. METHODS: The study includes all Danish individuals who between 2000 and 2015 were part of an unemployment insurance fund and working at the time of their 60th (P60) or 62nd (P62) birthday. Those alive 1 year from their 60th or 62nd birthday were included in the mortality analysis. Individuals were registered as VER recipients if they chose the benefit within 1 year from P60 or P62. Three-year mortality likelihood following the first year from inclusion was explored for both cohorts separately. Multiple subgroups were explored in the mortality analysis, including individuals with chronic obstructive pulmonary disease (COPD), heart failure, and diabetes. RESULTS: P60 included 627,278 individuals, and VER was chosen by 22.5%. P62 included 379,196 individuals, and VER was chosen by 33.4%. The likelihood of VER in the P60 was lower in healthy individuals (odds ratio [OR] 0.87, confidence interval [CI] 0.85-0.88) and higher in COPD (OR 1.15, CI 1.07-1.22) and heart failure patients (OR 1.15, CI 1.05-1.25). Three-year mortality was significantly higher in those choosing VER in P60 (OR 1.28, CI 1.22-1.34), which was also found for all health subgroups (healthy, OR 1.18, CI 1.07-1.30; COPD, OR 1.55, CI 1.16-2.07; heart failure, OR 1.42, CI 1.02-1.98; diabetes, OR 1.36, CI 1.12-1.65). The increased mortality risk was not found in the P62 cohort. CONCLUSION: The choice of VER is more likely in patients with COPD and heart failure. VER in the P60 cohort is associated with an increased mortality likelihood, which was not found in the P62 cohort, which may be explained by health selection bias.

The interaction of smoking and noise on temporary threshold shifts.

Four separate experiments examined the effects of cigarette smoking on temporary threshold shifts (TTS) following noise exposure. One experiment compared smokers and non-smokers after the subjects had abstained from smoking for at least 6 h. A second experiment tested only smokers who smoked a cigarette just before noise exposure, during the noise exposure and in a control condition during which they did not smoke. A third experiment tested only non-smokers who were exposed to noise after chewing nicotine gum or after a control condition in which they rested without chewing the gum. A fourth experiment tested smokers and non-smokers in one condition which required them to smoke a cigarette just prior to noise exposure and in another condition which prevented them from smoking. The results indicate that smokers consistently evidence slightly smaller TTS than do non-smokers. Non-smokers evidenced significantly greater TTS at one frequency after they had chewed nicotine gum than when they had not. These results suggest that the smaller TTS associated with cigarette smoking is related to both the chronic and the acute effects of smoking and that these effects may be more attributable to carbon monoxide than to nicotine.