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1.
Artigo em Inglês | MEDLINE | ID: mdl-31810172

RESUMO

BACKGROUND: Every second employee in Europe complains about work-related stress. Occupational stress due to an imbalance between efforts spent and rewards gained (effort-reward imbalance = ERI) is well investigated and it is associated with mental and physical health. A common guess is that leisure-time physical activity (LTPA) has beneficial effects on work-related stress. Yet, evidence in support of this assumption is weak, especially regarding ERI-stress. Longitudinal studies investigating the role of LTPA on ERI are missing. Therefore, this study aims to investigate the effect of LTPA on work-related stress by ERI over time. METHODS: 3961 socially insured employees that were born in 1959 or 1965 and working in the first (t1: 2011) and second wave (t2: 2014) of the lidA-study were included. Work-related stress was measured by ERI, LTPA by the self-rated weekly frequency of physical activities. Besides the direct effect, a moderating effect of LTPA on ERI over time was tested in the multiple linear regression analysis. RESULTS: The ERI at t1 was strongly associated with ERI at t2. While LTPA had no direct effect on ERI(t2), it was a significant moderator of ERI from t1 to t2: The higher the frequency of LTPA, the lower ERI was over time. This interaction of LTPA with ERI remained after adjustment for socio-demographic factors. CONCLUSIONS: The long-term moderating effect of LTPA on ERI is in agreement with former investigations on the role of LTPA on work-related stress, generally, and on its cross-sectional effect on ERI-stress, specifically. Some of Hill's criteria of a causal association in epidemiology (biological gradient, temporality, consistency) support our findings. As LTPA has also been shown to exert a protective effect on health outcomes that are associated with ERI, the moderation of ERI by LTPA could partly explain this protective effect. Future observational and interventional studies are required to support our results over more than two age groups and study times.

2.
Spinal Cord ; 2019 Nov 14.
Artigo em Inglês | MEDLINE | ID: mdl-31728014

RESUMO

STUDY DESIGN: Cross-sectional study using data from the 2012 community survey of the Swiss Spinal Cord Injury Cohort Study. OBJECTIVES: To identify associations between selected factors related to the social background, health, functional independence, and the environment of persons with spinal cord injury (SCI) and their labor market participation. SETTING: Community-based, Switzerland. METHODS: Labor market participation (i.e., involvement in paid work or not) was determined for a sample of 966 persons with traumatic SCI who were of employable age at the time of the survey. Applying an exploratory approach, potential predictors of labor market participation were selected based on the literature and using a bidirectional stepwise variable selection approach. Descriptive statistics were calculated and weighted bootstrapped multiple logistic regressions were applied to describe the associations between the selected predictor variables and labor market participation, controlling for sociodemographic and SCI-related characteristics. RESULTS: A total of 568 (58.8%) of the participants were involved in paid work at the time of the survey. From the 17 selected predictor variables, general functional independence and Swiss citizenship showed a significant positive association, and chronic pain a negative association with involvement in paid work. CONCLUSIONS: Beyond previously established sociodemographic and injury-related risk factors such as female gender, low education, and high lesion severity, functional independence, chronic pain, and nationality proved crucial for labor market participation. These factors should receive particular attention in medical and vocational strategies striving for a sustainable work integration of persons with SCI.

3.
J Occup Environ Med ; 61(11): 898-904, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31490898

RESUMO

OBJECTIVE: The aim of this study was to test nonsymmetric effects of cost/gain imbalance at work on depression, based on the effort-reward imbalance (ERI) model. METHODS: Study participants were derived from two large national studies from Germany and Sweden. Associations between the ERI scales, including the effort-reward (E-R) ratio in 2016 and depression (in 2016 for German sample, and in 2018 for Swedish sample) were examined by multivariable logistic regression. RESULTS: In both samples, high cost/low gain, but not low cost/high gain, is associated with depression, with a 3- to 5-fold elevated risk in the highest decile of the E-R ratio. CONCLUSIONS: The short version of the ERI questionnaire is a psychometrically useful tool for epidemiological research. The finding demonstrating nonsymmetric effects of cost/gain imbalance contributes to a theoretical clarification of this stress-theoretical model.

4.
Psychoneuroendocrinology ; 109: 104399, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31394489

RESUMO

Chronic stress experienced at work is considered a major health challenge for modern societies. In fact there is ample evidence that deleterious work environments, based on high efforts in relation to few rewards, substantially augment the risk for a number of highly prevalent diseases (e.g. ischemic heart disease, stroke). One potential pathway mediating these associations involves the stress-related activation of the hypothalamus-pituitary-adrenocortical (HPA) axis with proceeding alterations in the secretion of its main effector hormone cortisol. In this study we assessed a prospective, two-year effect of effort-reward imbalance (ERI) on cortisol secretion, based on a sub sample (N = 150; mean ±â€¯SD age: 42.4 ±â€¯11.1; 84.0% female) of the ongoing Dresden Burnout Study (DBS). The provided ERI measures were collected as part of the online baseline and first follow up assessment. Further, cortisol secretion patterns over prolonged periods of time were evaluated in three consecutive years of laboratory baseline and follow up visits. Our findings suggest prospective associations between ERI and cortisol, indicating a blunted cortisol secretion in response to long-term work stress (p < 0.001). Given the regulatory properties of cortisol on various central and peripheral target tissues (e.g. cardiovascular system, liver, adipose tissue), a long-term decrease of cortisol availability can be hypothesized to cause multiple health-challenging consequences. Based on our findings, providing work environments where high efforts are always linked with high rewards have to be considered an important issue for employees health.

5.
J Epidemiol Community Health ; 73(11): 993-1001, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31406014

RESUMO

OBJECTIVES: To examine the association between effort-reward imbalance and incident long-term benzodiazepine use (LTBU). METHODS: We included 31 077 employed participants enrolled in the French population-based CONSTANCES cohort between 2012 and 2014 who had not undergone LTBU in the 2 years before enrolment. LTBU was examined using drug reimbursement administrative databases. The effort-reward imbalance was calculated in quartiles. We computed ORs (95% CIs) for LTBU according to effort-reward imbalance over a 2-year follow-up period. We adjusted for age, gender, education, occupational grade, income, marital status, tobacco smoking, risk of alcohol use disorder, depressive symptoms and self-rated health. RESULTS: Over the 2-year follow-up, 294 (0.9%) participants experienced incident LTBU. In the univariable analysis, effort-reward imbalance was associated with subsequent LTBU with ORs of 1.79 (95% CI 1.23 to 2.62) and 2.73 (95% CI 1.89 to 3.95) for the third and fourth quartiles, respectively, compared with the first quartile. There was no interaction between effort-reward imbalance and any of the considered variables other than tobacco smoking (p=0.033). The association remained significant in both smokers and non-smokers, with higher odds for smokers (p=0.031). In the fully adjusted model, the association remained significant for the third and fourth quartiles, with ORs of 1.74 (95% CI 1.17 to 2.57) and 2.18 (95% CI 1.50 to 3.16), respectively. These associations were dose dependent (p for trend <0.001). CONCLUSIONS: Effort-reward imbalance was linked with incident LTBU over a 2-year follow-up period after adjustment for sociodemographic and health-related factors. Thus, screening and prevention of the risk of LTBU should be systematised among individuals experiencing effort-reward imbalance, with special attention paid to smokers.

6.
Artigo em Inglês | MEDLINE | ID: mdl-31438554

RESUMO

A growing burden of mental illness, and in particular depression, among workers is a concern of occupational public health. Scientific evidence has revealed consistent associations of work-related stress, as measured by theoretical models, with depression, but mostly so in developed countries. This contribution explores these associations in a developing Latin American country, Brazil, by applying an internationally established work stress model, the effort-reward imbalance (ERI). This model focuses on the work contract where unjust exchange between high efforts spent and low rewards received in turn contributes to stress-related disorders. The model's extrinsic ('effort', 'reward') and intrinsic components ('over-commitment'), as well as their combination, are hypothesized to be related to a higher risk of depressive episodes (DE). Using cross-sectional data from the ELSA-Brasil study, including 10,034 workers from the public sector, we observed increased prevalence ratio (PR) of DE according to ERI scales. The quartiles of highest 'effort' (PR = 1.85; 1.44-2.37), highest 'over-commitment' (PR = 3.62; 2.80-4.70) and lowest 'reward' (PR = 3.44; 2.55-4.64) were associated with DE, on adjusted models, as well was the E-R ratio (PR = 2.47; 1.92-3.17). An additive interaction was identified between the E-R ratio and 'over-commitment'. The results support the use of ERI as a screening tool for work stress in the Brazilian context and will offer guidance for worksite health promotion programs.


Assuntos
Depressão/psicologia , Estresse Ocupacional/psicologia , Adulto , Idoso , Brasil/epidemiologia , Estudos de Coortes , Estudos Transversais , Depressão/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estresse Ocupacional/epidemiologia , Recompensa , Local de Trabalho/psicologia
7.
Stroke ; 50(7): 1879-1882, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31216962

RESUMO

Background and Purpose- Long working hours (LWHs) are a potential risk factor for stroke. The aim of this study was to investigate this association in a large general population cohort. Methods- We used the French population-based cohort, CONSTANCES (Cohorte des Consultants des Centres d'Examens de Santé), to retrieve information on age, sex, smoking, and working hours from the baseline, self-administered questionnaire. Other cardiovascular risk factors and previous occurrence of stroke were taken from a parallel medical interview. We defined LWH as working time >10 hours daily for at least 50 days per year. Participants with primarily part-time jobs were excluded as were those with stroke before LWH exposure. We used logistic models to estimate the association between LWH and stroke, stratified by age, sex, and occupation. In additional modeling, we excluded subjects whose stroke occurred within 5 years of the first reported work exposure. Results- Among the 143 592 participants in the analyses, there were 1224 (0.9%) strokes, 42 542 (29.6%) reported LWH, and 14 481 (10.1%) reported LWH for 10 years or more. LWH was associated with an increased risk of stroke: adjusted odds ratio of 1.29 (95% CI, 1.11-1.49). Being exposed to LWH for 10 years or more was more strongly associated with stroke, adjusted odds ratio of 1.45 (95% CI, 1.21-1.74). The association showed no differences between men and women but was stronger in white-collar workers under 50 years of age. Conclusions- This large analysis reveals a significant association between stroke and exposure to LWH for 10 years or more. The findings are relevant for individual and global prevention.

8.
J Psychosom Res ; 122: 13-23, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31126406

RESUMO

OBJECTIVES: We investigate the relationship between control in productive activities (paid work, housework, caregiving) and well-being in persons with a physical disability and their caregiving partners from a dyadic perspective, exploring not only the effect of own control on well-being, but also the effect of the partners' control on well-being. We further evaluated socioeconomic and caregiving characteristics as potential risk factors for low control in productive activities. METHODS: Longitudinal dyadic data from the pro-WELL survey (n = 246) including persons with spinal cord injury (SCI) and their caregiving partners were used and mixed-effects regression modelling was applied. Well-being was operationalized with a cognitive (Satisfaction with Life Scale, SWLS) and an affective component (Positive and Negative Affect Scale, PANAS). RESULTS: Control at work was positively related to well-being in persons with SCI, but less so in caregiving partners. Control in housework and caregiving was associated with higher well-being. The partners' control was linked to affective well-being. Poor socioeconomic conditions were negatively related to control at work and in caregiving, but not to control in housework. Caregiving characteristics seem unrelated to control at work or housework, but higher objective caregiver burden was linked to reduced control in caregiving. CONCLUSIONS: Our findings suggest that low control in productive activities are common in the disability setting and represent an instrumental factor for reduced well-being that is augmented by poor socioeconomic conditions and high objective burden of care. Interventions aiming to optimize well-being through the integration in productive activities should take into account opportunities of exerting control.

9.
SSM Popul Health ; 7: 100351, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30705934

RESUMO

Background: To further explain the association between low socioeconomic position and increased risk of poor health, research started to consider life course conditions, including previous occupational positions and patterns of social mobility in the analysis. We describe patterns of intragenerational social mobility and investigate their associations with depressive symptoms. Methods: We use data from the French CONSTANCES study, a population-based cohort and restrict the sample to people aged 45 to 60. Based on detailed retrospective data with annual information on respondents' occupational position, we assess the modal social class for two time periods - early adulthood (age 25-34) and mid-adulthood (age 35-44). Depressive symptoms are measured by the Centre for Epidemiologic Studies Depression Scale (CES-D), using sex-specific cut-points. Results: Our study reveals that most respondents remained in stable working careers, but these careers were less frequent amongst participants with lower socioeconomic positions compared with higher ones. In contrast to several earlier findings we observe no independent associations of intragenerational social mobility processes and health once the social positions of origin and destination are considered. However, our findings confirm a social gradient in the prevalence of depressive symptoms for stable working careers. Conclusions: Our findings underline the importance of integrating data into analysis on starting and ending points of social mobility processes within entire histories of labor market participation.

10.
Aging Ment Health ; : 1-8, 2019 Feb 21.
Artigo em Inglês | MEDLINE | ID: mdl-30789009

RESUMO

OBJECTIVES: To investigate type and load of productive activities as potential determinants of mental health and well-being in elderly persons with a physical disability. METHODS: We used data from a Swiss population-based sample of 314 adults at or past the legal retirement age (65 for men, 64 for women) who live with a chronic physical disability, spinal cord injury. Engagement in housework, volunteering, and paid work were dichotomized (no; some engagement) and three groups of engagement types were constructed (none; housework only; volunteering and/or paid work). Load of engagement was appraised using a sumscore on the overall frequency as well as the total number of performed activities. We used regression modelling to draw causal inference regarding the associations of type and load of engagement with general mental health (Mental Health Inventory, SF-36), self-reported depression (Self-Administered Comorbidity Questionnaire, SCQ), and well-being (WHOQoL-BREF items). RESULTS: Engagement in volunteering was positively related to well-being. Persons engaged only in housework reported better well-being and lower prevalence of depression than non-engaged persons, however, persons engaged in volunteering or paid work reported the highest well-being and the lowest prevalence of depression. The productivity sumscore tertiles and the number of performed activities were both positively linked to well-being and negatively linked to depression, while their association with general mental health was less pronounced. CONCLUSION: Strengthening the engagement in productive activities among the elderly with a chronic physical disability is suggested as a promising strategy to promote well-being and reduce the prevalence of depression.

12.
Workplace Health Saf ; 67(3): 131-136, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30442068

RESUMO

The body of research pertaining to work-related stress and health among Turkish workers is sparse. It was the aim of this study to test the feasibility of two work stress scales of the Turkish short version of the Effort-Reward Imbalance (ERI-SV) questionnaire among staff and faculty in an academic university setting. We also assessed and examined if work stress was associated with depressive symptoms, using Center for Epidemiological Studies-Depression (CES-D) scale. The two ERI-SV scales and the CES-D scale were distributed to 170 study subjects employed at a southern university in Turkey, in which 67% ( n = 114/170) responded. We examined Cronbach's alpha coefficients for the internal consistency of the two main work stress scales of the ERI-SV, and scale structural validity was assessed using exploratory factor analysis. Logistic regression was performed to test the hypothesis of associations of work stress with depressive symptoms. Cronbach's alpha coefficients were .75 and .76 for the scales "Effort" and "Reward," respectively. Two separate factors were extracted according to the theoretical assumption of the ERI model. Associations between ERI and depressive symptoms were significant (odds ratio [OR] = 3.80 for Effort-Reward [E-R] ratio with an increase per SD, and 7.39 for the high work stress group as defined by an E-R ratio > 1.0). This study provides evidence of the feasibility of the short version of the Turkish ERI questionnaire by pointing to a strong association of stressful work with depressive symptoms in this group of academic workers. Further psychometric properties of the ERI questionnaire are required before its wider application in research and practice.


Assuntos
Depressão/epidemiologia , Estresse Ocupacional/psicologia , Recompensa , Universidades , Carga de Trabalho/psicologia , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Psicológicos , Escalas de Graduação Psiquiátrica , Inquéritos e Questionários , Turquia/epidemiologia , Adulto Jovem
13.
Int J Epidemiol ; 48(2): 402-414, 2019 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-30403783

RESUMO

BACKGROUND: With changing employment histories in European labour markets, occupational health research needs to be supplemented by an approach that integrates adverse characteristics of entire employment histories, in terms of precarious, discontinued and disadvantaged employment careers. We analyse associations of adverse employment histories and six measures of health functioning, including affective, physical and cognitive functioning. METHODS: We use baseline data from the CONSTANCES study with detailed retrospective data on previous employment histories that are linked to current health functioning among people aged 45-60 years (men = 15 134; women = 16 584). The following career characteristics are assessed (all referring to careers between ages 25 and 45 years): number of jobs with temporary contracts, number of job changes, number of unemployment periods, years out of work, mode occupational position and lack of job promotion. The measures of health functioning range from depressive symptoms, standing balance, walking speed, lung function, to verbal memory and semantic fluency. RESULTS: For both men and women, multilevel regressions (participant nested in health-examination centre) revealed that adverse employment histories are associated with poor health functioning later on, in particular persistent disadvantage in terms of low occupational position, repeated periods of unemployment and weak labour-market ties (years out of work). Findings remain consistent after excluding respondents who had a health-related career interruption or already retired before age 45 years and, additionally, after adjusting for age, partnership and education. CONCLUSION: Findings call for increased intervention efforts among more disadvantaged groups of the labour market at early-career stages.

14.
Int Arch Occup Environ Health ; 92(4): 467-480, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30406331

RESUMO

PURPOSE: Despite its importance a comprehensive assessment of health functioning has rarely been included in epidemiological investigations of work-related health outcomes. In this study, we analyzed associations of a health-adverse psychosocial work environment with a comprehensive set of subjective and objective measures of health functioning that cover the three domains of affective, cognitive, and physical functioning. METHODS: Baseline data from the French CONSTANCES cohort study were used with a sample of 24,327 employed men and women aged 45-60. Psychosocial work environment was measured by the short version of the effort-reward imbalance (ERI) questionnaire. Measures of health functioning were depressive symptoms, semantic fluency, verbal memory, walking speed, standing balance and lung function. RESULTS: First, we replicated main psychometric properties of the ERI questionnaire in the French cohort. Second, ERI scales revealed consistent associations with depressive symptoms, but less consistent links to cognitive and physical function. Among men, we observed an association of stressful work with reduced lung function. CONCLUSIONS: This study demonstrated consistent associations of stressful work in terms of effort-reward imbalance with affective functioning in a large sample of male and female employees. Relationships with physical functioning were less consistent and restricted to men, and cognitive functioning was only marginally associated with stressful work. We also established the psychometric properties of the French short version of the ERI questionnaire, thus offering a tool for guiding and harmonizing further research in this field.


Assuntos
Nível de Saúde , Estresse Ocupacional/psicologia , Recompensa , Local de Trabalho/psicologia , Cognição , Estudos de Coortes , Depressão , Feminino , França , Humanos , Masculino , Pessoa de Meia-Idade , Equilíbrio Postural , Psicometria , Testes de Função Respiratória , Fatores Sexuais , Inquéritos e Questionários , Caminhada/fisiologia
15.
Int J Equity Health ; 19(1): 3, 2019 12 31.
Artigo em Inglês | MEDLINE | ID: mdl-31892324

RESUMO

BACKGROUND: Socioeconomic position (SEP) is an important contextual factor in the Stress Process Model of caregiving. However, the basic assumption that low SEP is associated with greater caregiver burden has so far lacked empirical support. The objective of this study was to investigate social inequalities in the caregiver burden among caregiving partners of persons with a physical disability, i.e., spinal cord injury (SCI), applying a dyadic approach. More specifically, we investigated 1) the association of the caregivers' SEP with caregiver burden ('actor effect'); 2) the association of the care-receivers' SEP with caregiver burden ('partner effect'), and 3) potential mediators of the association between SEP and caregiver burden. METHODS: Cross-sectional survey data from 118 couples of persons with SCI and their partners living in Switzerland was used. We firstly employed logistic regression to investigate the actor and partner effects of SEP on objective (hours of caregiving) and subjective caregiver burden (Zarit Burden Interview). We additionally used structural equation modelling to explore whether unfulfilled support needs, psychosocial resources and the care-receivers health status mediated the association between SEP and caregiver burden. SEP was operationalized by household income, education, subjective social position, financial strain and home ownership. RESULTS: We observed a consistent trend towards higher objective and subjective burden in lower SEP groups. Caregivers with higher subjective social positon and home ownership indicated lower subjective burden, and caregivers with higher education and absence of financial strain reported lower objective burden. Further evidence suggested a partner effect of SEP on caregiver burden, whereby objective caregiver burden was reduced in couples where the care-receiver had a higher educational level. The negative association between SEP and subjective burden was partially mediated by the unfulfilled support needs and deprived psychological resources of the caregiver, and the poor health status of the care-receiver. Similar mediation effects were not supported for objective burden. CONCLUSIONS: Our study, in the context of SCI, provides support for the contextual role of SEP in the Stress Process Model of caregiving. To reduce subjective caregiver burden, policy programs may target the strengthening of psychosocial resources, or the improvement of access to support services for caregivers with low SEP.

16.
Psychol Health ; : 1-17, 2019 Dec 31.
Artigo em Inglês | MEDLINE | ID: mdl-31888380

RESUMO

Objectives: Failed reciprocity at work and in partnerships was shown to adversely affect wellbeing in general populations, but evidence in disability settings is widely lacking. We explore the effects of failed reciprocity on wellbeing and the impact of the partners' perception of reciprocity on wellbeing in persons with a physical disability and their partners.Design: We use longitudinal dyadic data from the pro-WELL study, a Swiss survey of persons with spinal cord injury (SCI) and their partners (n = 246). Two-level mixed-models with random effects for persons and repeated measures were applied.Main outcome measures: Cognitive wellbeing was measured with the Satisfaction with Life Scale and affective wellbeing with the Positive and Negative Affect Scale short-form.Results: Failed reciprocity at work and in the partnership was associated with all indicators of wellbeing in persons with SCI and with cognitive wellbeing and negative affect in caregiving partners. Life satisfaction of caregiving partners and positive affect of persons with SCI was lower if the partner perceived the partnership as non-reciprocal.Conclusion: Negative associations of failed reciprocity with wellbeing are not restricted to general populations but equally apply to the disability setting and dyadic analyses reveal the importance of the partners' perception of partnership reciprocity for wellbeing.

17.
Saf Health Work ; 9(3): 334-338, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30370166

RESUMO

Background: With global changes in the current state of work and employment, the role of health-adverse psychosocial work environments has received increasing attention in developed as well as in rapidly developing countries. Thus, there is a need to apply valid measurement tools for monitoring and preventive purposes. This study aims to examine the factorial structure and psychometric properties of the Persian version of the effort-reward imbalance (ERI) questionnaire, assessing one of the internationally leading concepts of stressful work. Methods: This descriptive cross-sectional study of a random sample of 202 white collar employees in an industrial company in Iran analyzes the ERI scales by exploratory and confirmatory factor analysis. Moreover, aspects of construct and criterion validity are tested. To this end, correlations of ERI scales with subscales of organizational injustice, a complementary work stress model, and also the correlations of ERI scales with a questionnaire assessing psychosomatic symptoms are performed. Results: Internal consistency of the three ERI scales was satisfactory (Cronbach α effort: 0.76, reward: 0.79, overcommitment: 0.75). Fit indices of confirmatory factor analysis pointed to an adequate representation of the theoretical construct (e.g., adjusted goodness of fit index (AGFI): 0.73, goodness of fit index (GFI): 0.78). Negative correlations with subscales of organizational injustice supported the notion of construct validity of the ERI scales, and positive correlations of ERI scales with psychosomatic symptoms indicated preliminary criterion validity. Conclusion: The Persian version of the ERI questionnaire has acceptable psychometric properties and can be used as a valid instrument in research on this topic.

18.
Am J Ind Med ; 61(10): 861-868, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30101498

RESUMO

BACKGROUND: Research evidence suggests harmful effects of overtime work on risk of heart disease. However, whether withdrawing compensation for overtime work (time-off or money) provides a relevant explanation of this association has not been explored. METHODS: Using cohort data, we included 6345 employees from Germany (3079 men and 3266 women), and applied Poisson regression analysis to examine the prospective association of overtime work without compensation with risk of self-reported incident heart disease over 2 years. RESULTS: Uncompensated overtime work was associated with an elevated risk of heart disease after adjustment for relevant variables (RR = 1.85, 95%CI: 1.05-3.25), compared to no overtime work. Stratified analyses indicated particularly strong effects among women and among employees with low socioeconomic position. CONCLUSIONS: In line with the stress-theoretical model of effort-reward imbalance at work, these findings document an important role of compensation on heart disease in the frame of overtime work.


Assuntos
Cardiopatias/epidemiologia , Estresse Ocupacional/epidemiologia , Admissão e Escalonamento de Pessoal/estatística & dados numéricos , Salários e Benefícios/estatística & dados numéricos , Carga de Trabalho/estatística & dados numéricos , Adulto , Estudos de Coortes , Feminino , Alemanha/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Recompensa , Fatores de Risco , Autorrelato , Fatores Sexuais , Classe Social
19.
Environ Int ; 119: 558-569, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30125833

RESUMO

BACKGROUND: The World Health Organization (WHO) and the International Labour Organization (ILO) are developing a joint methodology for estimating the national and global work-related burden of disease and injury (WHO/ILO joint methodology), with contributions from a large network of experts. In this paper, we present the protocol for two systematic reviews of parameters for estimating the number of deaths and disability-adjusted life years of ischaemic heart disease from exposure to long working hours, to inform the development of the WHO/ILO joint methodology. OBJECTIVES: We aim to systematically review studies on occupational exposure to long working hours (Systematic Review 1) and systematically review and meta-analyse estimates of the effect of long working hours on ischaemic heart disease (Systematic Review 2), applying the Navigation Guide systematic review methodology as an organizing framework. The selection of both, the exposure and the health outcome is justified by substantial scientific evidence on adverse effects of long working hours on ischaemic heart disease risk. DATA SOURCES: Separately for Systematic Reviews 1 and 2, we will search electronic academic databases for potentially relevant records from published and unpublished studies, Medline, EMBASE, Web of Science, CISDOC and PsychINFO. We will also search electronic grey literature databases, Internet search engines and organizational websites; hand-search reference list of previous systematic reviews and included study records; and consult additional experts. STUDY ELIGIBILITY AND CRITERIA: We will include working-age (≥15 years) workers in the formal and informal economy in any WHO and/or ILO Member State, but exclude children (<15 years) and unpaid domestic workers. For Systematic Review 1, we will include quantitative prevalence studies of relevant levels of exposure to long working hours (i.e. 35-40, 41-48, 49-54 and ≥55 h/week) stratified by country, sex, age and industrial sector or occupation. For Systematic Review 2, we will include randomized controlled trials, cohort studies, case-control studies and other non-randomized intervention studies with an estimate of the relative effect of relevant level(s) of long working hours on the prevalence of, incidence of or mortality from ischaemic heart disease, compared with the theoretical minimum risk exposure level (i.e. 35-40 h/week). STUDY APPRAISAL AND SYNTHESIS METHODS: At least two review authors will independently screen titles and abstracts against the eligibility criteria at a first stage and full texts of potentially eligible records at a second stage, followed by extraction of data from qualifying studies. At least two review authors will assess risk of bias and the quality of evidence, using the most suited tools currently available. For Systematic Review 2, if feasible, we will combine relative risks using meta-analysis. We will report results using the guidelines for accurate and transparent health estimates reporting (GATHER) for Systematic Review 1 and the preferred reporting items for systematic reviews and meta-analyses guidelines (PRISMA) for Systematic Review 2. PROSPERO registration number: CRD42017084243.


Assuntos
Isquemia Miocárdica/epidemiologia , Traumatismos Ocupacionais , Revisão Sistemática como Assunto , Carga de Trabalho , Humanos , Projetos de Pesquisa , Organização Mundial da Saúde
20.
Epidemiology ; 29(4): e35-e36, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29851896
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