H. Burr

Work stress and risk of cancer : meta-analysis of 5700 incident cancer events in 116 000 European men and women

Objective To investigate whether work related stress, measured and defined as job strain, is associated with the overall risk of cancer and the risk of colorectal, lung, breast, or prostate cancers. Design Meta-analysis of pooled prospective individual participant data from 12 European cohort studies including 116 056 men and women aged 17-70 who were free from cancer at study baseline and were followed-up for a median of 12 years. Work stress was measured and defined as job strain, which was self reported at baseline. Incident cancers (all n=5765, colorectal cancer n=522, lung cancer n=374, breast cancer n=1010, prostate cancer n=865) were ascertained from cancer, hospital admission, and death registers. Data were analysed in each study with Cox regression and the study specific estimates pooled in meta-analyses. Models were adjusted for age, sex, socioeconomic position, body mass index (BMI), smoking, and alcohol intake Results A harmonised measure of work stress, high job strain, was not associated with overall risk of cancer (hazard ratio 0.97, 95% confidence interval 0.90 to 1.04) in the multivariable adjusted analyses. Similarly, no association was observed between job strain and the risk of colorectal (1.16, 0.90 to 1.48), lung (1.17, 0.88 to 1.54), breast (0.97, 0.82 to 1.14), or prostate (0.86, 0.68 to 1.09) cancers. There was no clear evidence for an association between the categories of job strain and the risk of cancer. Conclusions These findings suggest that work related stress, measured and defined as job strain, at baseline is unlikely to be an important risk factor for colorectal, lung, breast, or prostate cancers.

Job strain in relation to body mass index: pooled analysis of 160 000 adults from 13 cohort studies

Abstract.  Nyberg ST, Heikkilä K, Fransson EI, Alfredsson L, De Bacquer D, Bjorner JB, Bonenfant S, Borritz M, Burr H, Casini A, Clays E, Dragano N, Erbel R, Geuskens GA, Goldberg M, Hooftman WE, Houtman IL, Jöckel K‐H, Kittel F, Knutsson A, Koskenvuo M, Leineweber C, Lunau T, Madsen IEH, Magnusson Hanson LL, Marmot MG, Nielsen ML, Nordin M, Oksanen T, Pentti J, Rugulies R, Siegrist J, Suominen S, Vahtera J, Virtanen M, Westerholm P, Westerlund H, Zins M, Ferrie JE, Theorell T, Steptoe A, Hamer M, Singh‐Manoux A, Batty GD, Kivimäki M, for the IPD‐Work Consortium (Finnish Institute of Occupational Health, Helsinki, Finland; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Jönköping University, Jönköping, Sweden; Ghent University, Ghent, Belgium; National Research Centre for the Working Environment, Copenhagen, Denmark; Versailles‐Saint Quentin University, Versailles, France; Centre for Research in Epidemiology and Population Health, Villejuif, France; Bispebjerg University Hospital, Copenhagen, Denmark; Centre for Maritime Health and Safety, Esbjerg, Denmark; Université Libre de Bruxelles, Brussels, Belgium; University Duisburg‐Essen, Essen, Germany; West‐German Heart Center Essen, University Duisburg‐Essen, Essen, Germany; TNO, Hoofddorp, the Netherlands; Mid Sweden University, Sundsvall, Sweden; University of Helsinki, Helsinki, Finland; Stockholm University, Stockholm, Sweden; University College London, London, UK; Bispebjerg University Hospital, Copenhagen, Denmark; Umeå University, Umeå, Sweden; Finnish Institute of Occupational Health, Turku, Finland; Harvard School of Public Health, Boston, MA, USA; University of Copenhagen, Copenhagen, Denmark; University of Düsseldorf, Düsseldorf, Germany; University of Turku, Turku; Folkhälsan Research Center, Helsinki; Turku University Hospital, Turku, Finland; Uppsala University, Uppsala; Karolinska Institutet, Stockholm, Sweden; University of Bristol, Bristol; University of Edinburgh, Edinburgh, UK; and University of Helsinki, Helsinki, Finland). Job strain in relation to body mass index: pooled analysis of 160 000 adults from 13 cohort studies. J Intern Med 2012; 272: 65–73.

Job strain as a risk factor for clinical depression: systematic review and meta-analysis with additional individual participant data.

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.

Selbstberichteter allgemeiner Gesundheitszustand nach Beruf und Alter in der Erwerbsbevölkerung

ZusammenfassungBei Berufsgruppen wurde der selbstberichtete allgemeine Gesundheitszustand unter besonderer Berücksichtigung des Alters untersucht. Hierzu wurden Daten der repräsentativen Telefonbefragungen GEDA 2009 und 2010 (N = 26.303) ausgewertet. Bei Professionen zeigte sich eine niedrige Prävalenz für einen schlechten Gesundheitszustand, hingegen fand sich bei den Beschäftigten in einfachen Diensten und – bei den Männern – in einfachen manuellen Berufen eine hohe. Bei älteren Beschäftigten war die Prävalenz für einen schlechten allgemeinen Gesundheitszustand höher als bei den jüngeren. Allerdings war der diesbezügliche Unterschied zwischen Älteren und Jüngeren bei männlichen Managern sowie bei Frauen mit qualifizierten kaufmännischen und Verwaltungsberufen signifikant schwächer als im allgemeinen Durchschnitt. Bei Männern mit qualifizierten manuellen Berufen und Frauen mit einfachen manuellen Berufen war der Unterschied zwischen Älteren und Jüngeren hingegen signifikant stärker. Die mit dem Alter steigende Gesundheitskluft zwischen den Berufsgruppen sollte mehr Beachtung finden. Zum Verständnis des Zusammenhangs zwischen Arbeit, Alter und Gesundheit sind gezielte Längsschnittstudien notwendig. Es kann irreführend sein, Untersuchungen der Zusammenhänge von Arbeit und Gesundheit für das Alter zu adjustieren, da das Alter diese Beziehung moderieren kann.AbstractIn ocupations, 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.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.

Job strain and the risk of severe asthma exacerbations: a meta‐analysis of individual‐participant data from 100 000 European men and women

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.

Arbeit und Gesundheit

ZusammenfassungHintergrundFragen zum Zusammenhang von Arbeitsfaktoren einerseits und psychischer und physischer Gesundheit der Beschäftigten andererseits sind in Deutschland aktuell und werden weiter aktuell bleiben.FragestellungInzwischen liegt hierzulande eine Reihe von Datensätzen vor, die Daten sowohl zu Arbeit als auch Gesundheit enthalten. Oft allerdings sind sie Wissenschaftler(inne)n, die in diesem Themenfeld tätig sind, nicht bekannt. Ziel des Beitrags ist, diese Datensätze systematisch vorzustellen.Material und MethodeInhalt und Hintergrunddaten umfassender, zugänglicher, aktueller und für die deutsche Erwerbsbevölkerung repräsentativer Datensätze wurden 13 Hauptkategorien und 97 Unterkategorien zugeordnet.ErgebnisVon 32 Datensätzen erfüllten 20 die Einschlusskriterien. 2537 Fragebogenitems wurden klassifiziert; 8 Datensätze haben den Schwerpunkt „Arbeit“, 4 den Schwerpunkt „Gesundheit“, 4 sind allgemeine Bevölkerungsstudien, und 4 sind europäische Studien mit deutschen Teilstichproben. Neben der tabellarischen Auflistung im Artikel steht Interessierten eine detaillierte Exceltabelle zu Verfügung (info-zentrum@baua.bund.de).SchlussfolgerungenDie vorliegende Übersicht zeigt Fülle und auch Potenziale der aktuellen Datenlage zu „Arbeit und Gesundheit“ in Deutschland auf. Potenziale schließen die Verknüpfungen von Datenquellen ein. Es mangelt allerdings noch an landesweiten Kohortenstudien über das gesamte Altersspektrum des Erwerbsalters mit umfassender Erfassung von Arbeit und Gesundheit. Deren Potenzial für Wissenschaft und Gesellschaft lässt sich aus Nordamerika, Großbritannien, den Niederlanden, Skandinavien und Japan ableiten.AbstractBackgroundIssues concerning the association of work with physical and psychological health among workers are and will remain relevant in Germany.ObjectivesCurrently, there are many data sets available covering both work and health aspects; however, they are often not known to the scientists in the field. The aim of this article is to present these data sets in a systematic overview.MethodsContent and background data of recent large and accessible data sets representative for the working population were classified into 13 main categories and 97 subcategories.ResultsOut of 32 data sets available 20 fulfilled the inclusion criteria. A total of 2537 items were classified: 8 data sets with the main topic “work”, 4 studies with a focus on “health”, 4 general population studies and 4 European studies with German subsamples. In addition to the table overview given in this article, those interested can obtain access to a detailed excel file via info-zentrum@baua.bund.de.ConclusionThis overview of data sets indicates the breadth and potential of current data concerning work and health in Germany. Among the potential s may be data linkage of different sources. What is lacking, however, is a nationwide cohort study covering work and health in detail and for all age groups of workers. The benefit of such investigations for science and society can be derived from North America and Canada, the UK, the Netherlands, Scandinavia and Japan.

[Self-rated general health by occupation and age in the working population in Germany].

ZusammenfassungBei Berufsgruppen wurde der selbstberichtete allgemeine Gesundheitszustand unter besonderer Berücksichtigung des Alters untersucht. Hierzu wurden Daten der repräsentativen Telefonbefragungen GEDA 2009 und 2010 (N = 26.303) ausgewertet. Bei Professionen zeigte sich eine niedrige Prävalenz für einen schlechten Gesundheitszustand, hingegen fand sich bei den Beschäftigten in einfachen Diensten und – bei den Männern – in einfachen manuellen Berufen eine hohe. Bei älteren Beschäftigten war die Prävalenz für einen schlechten allgemeinen Gesundheitszustand höher als bei den jüngeren. Allerdings war der diesbezügliche Unterschied zwischen Älteren und Jüngeren bei männlichen Managern sowie bei Frauen mit qualifizierten kaufmännischen und Verwaltungsberufen signifikant schwächer als im allgemeinen Durchschnitt. Bei Männern mit qualifizierten manuellen Berufen und Frauen mit einfachen manuellen Berufen war der Unterschied zwischen Älteren und Jüngeren hingegen signifikant stärker. Die mit dem Alter steigende Gesundheitskluft zwischen den Berufsgruppen sollte mehr Beachtung finden. Zum Verständnis des Zusammenhangs zwischen Arbeit, Alter und Gesundheit sind gezielte Längsschnittstudien notwendig. Es kann irreführend sein, Untersuchungen der Zusammenhänge von Arbeit und Gesundheit für das Alter zu adjustieren, da das Alter diese Beziehung moderieren kann.AbstractIn ocupations, 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.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.

The association of health and voluntary early retirement pension and the modifying effect of quality of supervision: Results from a Danish register-based follow-up study:

Objectives: The aims of this article are to (1) determine whether and to what extent general perceived health and quality of supervision predict voluntary early retirement pension (VERP) and (2) assess whether quality of supervision modifies the association between general perceived health and VERP. Methods: Employees aged 49–64 years who participated in the Danish Work Environment Cohort Study in 2000 were selected. Their questionnaire data about health and work were linked to register data on social transfer payments, among others VERP, from 2001 to 2012 in the Danish Register for Evaluation of Marginalization (N=1167). Cox proportional hazards analyses were performed to identify the prospective association of general perceived health and quality of supervision on VERP. Relative excess risks due to interaction (RERIs) were calculated to assess whether quality of supervision modified the association between health and VERP. Results: Employees with poor health at baseline had an increased risk of VERP during follow-up (hazard ratio [HR]=1.23; 95% confidence interval [CI] 1.02–1.49). Quality of supervision at baseline was not associated to VERP during follow-up (HR=1.04; 95% CI 0.90–1.21). There was no statistically significant interaction of poor health and poor quality of supervision with regard to risk of VERP (RERI=−0.33; 95% CI −1.79 to 1.14). Conclusions: This study did not support the notion that quality of supervision buffers the association between poor health and VERP. Future research is needed to determine whether other aspects of supervision, for example supervisors’ opportunities to effectuate workplace adjustments, may modify the association of poor health and VERP.

Long working hours and cancer risk: a multi-cohort study.

Overtime work and long working hours are associated with an increased risk of many adverse health outcomes, such as coronary heart disease and stroke. However, the relationship of excess working hours with incident cancer is unclear. To address this gap in the knowledge, we examined the association between weekly working hours and cancer risk using individual-participant data from 12 prospective studies from Denmark, Finland, Germany, Sweden, the Netherlands and the UK.Our analyses were based on data from 116 462 working men and women, who were free of cancer at study baseline. Incident cancers were ascertained from national cancer, hospitalisation and death registers. Weekly working hours were self-reported. During a follow-up ranging from 4 to 22 years, 4 371 participants were diagnosed with cancer (n colorectal cancer: 393, n lung cancer: 247, n breast cancer: 833, n prostate cancer: 534). Compared to standard working time (35–40 hours/week), working >55 hours/week was not associated with the overall cancer incidence (multivariable-adjusted HR (95% CI): 1.00 (0.85, 1.16). Similarly, working hours were unrelated to incident colorectal, lung and prostate cancers. Compared to standard hours, working >55 hours/week was associated with 1.60-fold (95% CI: 1.12–2.29) risk of female breast cancer. This association was independent of age, socioeconomic position, shift- and night-time work and lifestyle factors, but it may have been influenced by residual confounding from parity. To our knowledge, ours is the largest investigation of this topic to-date and the first to examine the association of working hours with the overall cancer risk and the risk of specific cancers. Our findings suggest that working long hours is not a risk factor for cancer in general, or lung, colorectal or prostate cancers in particular. The observed association with breast cancer would warrant further research.

Selbstberichteter allgemeiner Gesundheitszustand nach Beruf und Alter in der Erwerbsbevölkerung@@@Self-rated general health by occupation and age in the working population in Germany

ZusammenfassungBei Berufsgruppen wurde der selbstberichtete allgemeine Gesundheitszustand unter besonderer Berücksichtigung des Alters untersucht. Hierzu wurden Daten der repräsentativen Telefonbefragungen GEDA 2009 und 2010 (N = 26.303) ausgewertet. Bei Professionen zeigte sich eine niedrige Prävalenz für einen schlechten Gesundheitszustand, hingegen fand sich bei den Beschäftigten in einfachen Diensten und – bei den Männern – in einfachen manuellen Berufen eine hohe. Bei älteren Beschäftigten war die Prävalenz für einen schlechten allgemeinen Gesundheitszustand höher als bei den jüngeren. Allerdings war der diesbezügliche Unterschied zwischen Älteren und Jüngeren bei männlichen Managern sowie bei Frauen mit qualifizierten kaufmännischen und Verwaltungsberufen signifikant schwächer als im allgemeinen Durchschnitt. Bei Männern mit qualifizierten manuellen Berufen und Frauen mit einfachen manuellen Berufen war der Unterschied zwischen Älteren und Jüngeren hingegen signifikant stärker. Die mit dem Alter steigende Gesundheitskluft zwischen den Berufsgruppen sollte mehr Beachtung finden. Zum Verständnis des Zusammenhangs zwischen Arbeit, Alter und Gesundheit sind gezielte Längsschnittstudien notwendig. Es kann irreführend sein, Untersuchungen der Zusammenhänge von Arbeit und Gesundheit für das Alter zu adjustieren, da das Alter diese Beziehung moderieren kann.AbstractIn ocupations, 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.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.