Objectives Job strain has previously been shown to predict disability pension, but it is unknown whether effortreward imbalance (ERI), another major stress model, is also associated with disability ...pension. Methods We examined ERI as a risk factor for diagnosis-specific disability pension in a cohort of 51 874 public-sector employees in Finland. To control for reporting bias, work unit-level scores of ERI (based on the survey responses of 35 260 employees in 2000-2002) were constructed and linked to all eligible employees. A sub-cohort of the respondents was analyzed also with individual-level ERI. Disability pension data were derived from national pension registers with no loss to follow-up. The outcomes were all-cause disability pension and disability pension due to depression, musculoskeletal diseases, and ischemie heart diseases (IHD). Multivariate Cox proportional hazard models (adjusted for sociodemographic factors, baseline health, and work-related characteristics) were used for analyses. Results During a mean 8.9 years of follow-up, 4542 participants were granted disability pension. An increased risk for disability pension due to depression was detected for both high work unit-and individual-level ERI hazard ratio (HR) 1.63,95% confidence interval (95% CI) 1.31-2.04 and HR 1.90,95% CI 1.51-2.40, respectively.High individual-level ERI increased the risk of disability pension due to musculoskeletal diseases (HR 1.32,95% CI 1.13-1.53), but no association was observed for work unit-level ERI (HR 1.02, 95% CI 0.88-1.19). ERI was not associated with disability pension due to IHD. Conclusion The present study showed a consistent association between high ERI and an increased risk of disability pension due to depression.
Purpose Epidemiological studies use self-reports from repeated surveys to ascertain incident disease. However, the accuracy of such measurements remains unknown, as validity studies have typically ...relied on data from prevalent, rather than incident, disease. This study examined the validity of self-reports in the detection of new-onset disease with measurements at baseline and follow-up conditions. Methods We conducted a prospective cohort study of 34,616 Finnish public-sector employees. Data from self-reported, physician-diagnosed diseases from two surveys approximately 4 years apart were compared with corresponding records in comprehensive national health registers used as the validity criterion. Results There was a considerable degree of misclassification for self-reports as a measure of incident disease. The specificity of self-reports was equally high for the prevalent and incident diseases (range, 93%–99%), but the sensitivity of self-reports was considerably lower for incident than for prevalent diseases: hypertension (55% vs. 86%), diabetes (62% vs. 96%), asthma (63% vs. 91%), coronary heart disease (62% vs. 78%), and rheumatoid arthritis (63% vs. 83%). Conclusions This study suggests that the sensitivity of self-reports is substantially worse for incident than for prevalent diseases. Results from studies on self-reported incident chronic conditions should be interpreted with caution.
Parasites indirectly affect life‐history evolution of most species. Combating parasites requires costly immune defenses that are assumed to trade off with other life‐history traits. In vertebrate ...males, immune defense is thought to trade off with reproductive success, as androgens enhancing sexual signaling can suppress immunity. The phenotypic relationship between male androgen levels and immune function has been addressed in many experimental studies. However, these do not provide information on either intra‐ or intersex genetic correlations, necessary for understanding sexual and sexually antagonistic selection theories. We measured male and female humoral antibody responses to a novel antigen (bovine gamma globulin), total immunoglobulin G, and the male testosterone level of a laboratory population of the bank vole (Myodes glareolus). Although we studied five traits, factor‐analytic modeling of the additive genetic (co)variance matrix within a restricted maximum likelihood–animal model supported genetic variation in three dimensions. Sixty‐five percent of the genetic variation contrasted testosterone with both immune measures in both sexes; consequently, selection for the male trait (testosterone) will have correlated effects on the immune system not only in males but also in females. Thus, our study revealed an intra‐ and intersexual genetic trade‐off between immunocompetence and male reproductive effort, of which only indirect evidence has existed so far.
Health and retirement are bi-directionally linked. Health is central to the timing of retirement, and retirement may have varying effects on health. Three studies of the special section of this issue ...add to the evidence about factors determining early retirement from three different perspectives. Blekesaune and Skirbekk investigated how personality factors were associated with non-disability and disability pension in Norway; Gørtz studied working conditions, health and early retirement in the day-care sector in Denmark; and Clarke et al. modelled trajectories of expectations not to retire early but to work full time after age 62 in a sample of older Americans as well as implications for health when such expectations were unmet. All studies incorporated health measures in the analyses. Nevertheless, health can have several roles in the retirement process. The complexity of the relationship of health and retirement is discussed in this commentary, several methodological issues are addressed and implications for future studies are identified.
Objectives
Work‐time control is associated with lower sickness absence rates, but it remains unclear whether this association differs by type of diagnosis and sub‐dimension of work‐time control ...(control over daily hours and control over time off) and whether certain vulnerable groups benefit more from higher levels of work‐time control.
Methods
Survey data from the Finnish 10‐town study in 2004 were used to examine if baseline levels of work‐time control were associated with register data on diagnose‐specific sickness absence for 7 consecutive years (n = 22 599). Cox proportional hazard models were conducted, adjusted for age, sex, education, occupational status, shift work including nights, and physical/mental workload.
Results
During follow‐up, 2,818 individuals were on sick leave (≥10 days) due to musculoskeletal disorders and 1724 due to mental disorders. Employees with high (HR = 0.80, 95% CI 0.74‐0.87; HR = 0.76, 95% CI 0.70‐0.82, respectively) and moderate (HR = 0.83, 95% CI 0.77‐0.90; HR = 0.85, 95% CI 0.79‐0.91, respectively) levels of control over daily hours/control over time off had a decreased risk of sickness absence due to musculoskeletal disorders. Sub‐group analyses revealed that especially workers who were older benefitted the most from higher levels of work‐time control. Neither sub‐dimension of work‐time control was related to sickness absence due to mental disorders.
Conclusions
Over a 7‐year period of follow‐up, high and moderate levels of work‐time control were related to lower rates of sickness absence due to musculoskeletal disorders, but not due to mental disorders.
Shift work and physical inactivity Cheng, Wan-Ju; Härmä, Mikko; Ropponen, Annina ...
Scandinavian journal of work, environment & health,
05/2020, Letnik:
46, Številka:
3
Journal Article
Recenzirano
Odprti dostop
Objectives Shift work is a risk factor for chronic diseases, and physical inactivity can have an influence on this association. We examined whether intra-individual changes in working time ...characteristics were associated with changes in physical inactivity and examined the risk factors for physical inactivity among shift workers in a 17-year longitudinal study cohort. Methods Study participants were 95 177 employees from the Finnish public sector. Work schedule information was based on questionnaire responses and additional register-based working time characteristics for 26 042 employees. The associations between working time characteristics and physical inactivity were examined using a fixed-effects logistic model. To investigate the risk factors for physical inactivity among shift workers, the odds ratios (OR) of worktime control and having small children were calculated. Results Compared with day work, shift work without night shifts was associated with physical inactivity among men OR 1.38, 95% confidence interval (CI) 1.09-1.74, whereas shift work with night shifts was negatively associated with physical inactivity among women (OR 0.85, 95% CI 0.76-0.96). Register-based working time data confirmed that workers with a higher percentage of night shifts had a lower risk of physical inactivity. Having small children was associated with physical inactivity among shift workers (OR 1.47, 95% CI 1.32-1.65). Conclusions Both survey and objective working hour data revealed that workers having work schedules with night shifts were more likely to be physically active. Having small children was a risk factor for physical inactivity among shift workers.
Objective This study examined the associations between shift work and use of antihypertensive, lipid-lowering, and antidiabetic medications. Methods Survey data from two cohorts of Finnish men (N=11 ...998) and women (N=49 944) working in multiple occupations where shift work was used were linked to national Drug Prescription Register data, with up to 11 years of follow-up. In each cohort, age-stratified Cox proportional hazard regression models were computed to examine any incident use of prescription medication for each of the three medical conditions, separately comparing each of two groups of rotating shift workers (those whose schedules included night shifts, and those whose schedules did not include night shifts) with day workers who worked in a similar range of occupations. Results In the larger cohort, among participants aged 40-49 at baseline, shift work without night shifts was associated with increased use of type-2 diabetes medication after adjustments for sex, occupational status, marital status, alcohol consumption, smoking, and physical activity hazard ratio (HR) 1.28, 95% confidence interval (CI) 1.01-1.62, while shift work with night shifts was associated with increased use of dyslipidemia medication after adjustments (HR 1.33, 95% CI 1.12-1.57). There were no such associations among younger and older shift workers. Also in the larger cohort, among those aged <50 years at baseline, both types of shift work were associated with increased use of hypertension medication after adjustments up to HR 1.20 (95% CI 1.05-1.37). There were no positive associations in the smaller cohort. Conclusions There was mixed evidence regarding the use of medications for cardiovascular risk factors by shift workers. Selection effects may have affected the associations.
There is a scarcity of evidence on the association between shift work, sleeping parameters, heart rate variability (HRV), and chronotype, i.e., morningness and eveningness. The aims of this study ...were to 1) compare participants with different chronotypes (morning (M), evening (E), or neither (N)) in terms of their total sleep time, sleep efficiency, and HRV parameters, taking their age into account, and 2) examine whether self-reported work-related stress, the length of the working career and years performing shift work affect this association. The participants of the study were home care workers working in two shifts in one municipality in Eastern Finland (N = 395). Of these, 52 females (mean age 42.78 y, SD 12.92 y) completed the study questionnaire and participated in physiological measurements. Several sleep-related parameters were assessed (total sleep time, sleep efficiency, number of awakenings, and length of awakening) and indices of autonomic nervous system based on HRV were calculated. The participants worked in two shifts: a morning shift (7:00-15:00 h) and an evening shift (14:00-21:30 h). All these parameters were assessed during the night before the first work shift (N1), the night before the second work shift (N2), the night before the final work shift (N3), and the night before the first day off work (N4). According to the results, 21.2% of the participants were M-types, 17.3% were E-types, and 61.5% were N-types. On average, the participants had been in working life for 18.8 years and performing shift work for 13.7 years. On night N3, E-types had a significantly shorter total sleep time and spent less time in bed compared to M- and N-types. The total sleep time of M-type and N-type participants was on average 66 minutes and 82 minutes longer, respectively, when compared to E-types on night N3. There were no statistically significant differences in actigraphy-based sleep quality parameters between M-, N-, and E-types on nights N1, N2, and N4. Our results together indicate that M- and N-type individuals may have better sleep quality than E-types, which was also reflected in HRV parameters. Further research with longitudinal study design and workplace interventions is needed to determine how the chronotype can be optimally and individually utilized to improve the health and well-being of morning-type and evening-type people. This is particularly important for both younger and older workers entering the workforce to support healthier and longer working lives.
Work disability affects quality of life, earnings, and opportunities to contribute to society. Work characteristics, lifestyle and sociodemographic factors have been associated with the risk of work ...disability, but few multifactorial algorithms exist to identify individuals at risk of future work disability. We developed and validated a parsimonious multifactorial score for the prediction of work disability using individual-level data from 65,775 public-sector employees (development cohort) and 13,527 employed adults from a general population sample (validation cohort), both linked to records of work disability. Candidate predictors for work disability included sociodemographic (3 items), health status and lifestyle (38 items), and work-related (43 items) variables. A parsimonious model, explaining > 99% of the variance of the full model, comprised 8 predictors: age, self-rated health, number of sickness absences in previous year, socioeconomic position, chronic illnesses, sleep problems, body mass index, and smoking. Discriminative ability of a score including these predictors was high: C-index 0.84 in the development and 0.83 in the validation cohort. The corresponding C-indices for a score constructed from work-related predictors (age, sex, socioeconomic position, job strain) were 0.79 and 0.78, respectively. It is possible to identify reliably individuals at high risk of work disability by using a rapidly-administered prediction score.
Obesity and overweight are suggested to increase the risk of occupational injury but longitudinal evidence to confirm this is rare. We sought to evaluate obesity and overweight as risk factors for ...occupational injuries.
A total of 69,515 public sector employees (80% women) responded to a survey in 2000-2002, 2004 or 2008. Body mass index (kg/m(2)) was derived from self-reported height and weight and was linked to records of subsequent occupational injuries obtained from national registers. Different injury types, locations and events or exposures (the manner in which the injury was produced or inflicted) were analyzed by body mass index category adjusting for baseline socio-demographic characteristics, work characteristics, health-risk behaviors, physical and mental health, insomnia symptoms, and sleep duration. During the mean follow-up of 7.8 years (SD = 3.2), 18% of the employees (N = 12,204) recorded at least one occupational injury. Obesity was associated with a higher overall risk of occupational injury; multivariable adjusted hazard ratio (HR) 1.21 (95% CI 1.14-1.27). A relationship was observed for bone fractures (HR = 1.37; 95% CI: 1.10-1.70), dislocations, sprains and strains (HR = 1.36; 95% CI: 1.25-1.49), concussions and internal injuries (HR = 1.26; 95% CI: 1.11-1.44), injuries to lower extremities (HR = 1.62; 95%: 1.46-1.79) and injuries to whole body or multiple sites (HR = 1.37; 95%: 1.10-1.70). Furthermore, obesity was associated with a higher risk of injuries caused by slipping, tripping, stumbling and falling (HR = 1.55; 95% CI: 1.40-1.73), sudden body movement with or without physical stress (HR = 1.24; 95% CI: 1.10-1.41) and shock, fright, violence, aggression, threat or unexpected presence (HR = 1.33; 95% CI: 1.03-1.72). The magnitude of the associations between overweight and injuries was smaller, but the associations were generally in the same direction as those of obesity.
Obese employees record more occupational injuries than those with recommended healthy weight.
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