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  • 1.
    Bergström, Gunnar
    et al.
    Karolinska Institutet.
    Bodin, Lennart
    Karolinska Institutet.
    Hagberg, Jan
    Karolinska Institutet.
    Lindh, Tomas
    Aronsson, Gunnar
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Josephson, Malin
    Uppsala Universitet.
    Does sickness presenteeism have an impact on future general health?2009In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 82, no 10, p. 1179-1190Article in journal (Refereed)
    Abstract [en]

    PURPOSE: The primary aim of this prospective study was to investigate whether working despite illness, so called "sickness presenteeism", has an impact on the future general health of two different working populations during a follow-up period of 3 years.

    METHODS: The study was based on two bodies of data collected at a number of Swedish workplaces from 1999 to 2003. The first material comprised 6,901 employees from the public sector and the second 2,862 subjects from the private sector. A comprehensive survey was issued three times: at baseline, after 18 months and after 3 years. Apart from the explanatory variable sickness presenteeism, several potential confounders were considered. The outcome variable was good/excellent versus fair/poor self-reported health.

    RESULTS: Sickness presenteeism at baseline was consistently found to heighten the risk of fair/poor health at both the 18-month and 3-year follow ups even after adjusting for the detected confounders.

    CONCLUSIONS: To the best of the authors' knowledge, this study is the first to show that sickness presenteeism appears to be an independent risk factor for future fair/poor general health.

  • 2. Dagher, Rada K.
    et al.
    McGovern, Patricia M.
    Dowd, Bryan E.
    Lundberg, Ulf
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Postpartum depressive symptoms and the combined load of paid and unpaid work: a longitudinal analysis2011In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 84, no 7, p. 735-743Article in journal (Refereed)
    Abstract [en]

    Purpose: To investigate the effects of total workload and other work-related factors on postpartum depression in the first 6 months after childbirth, utilizing a hybrid model of health and workforce participation. Methods: We utilized data from the Maternal Postpartum Health Study collected in 2001 from a prospective cohort of 817 employed women who delivered in three commu- nity hospitals in Minnesota. Interviewers collected data at enrollment and 5 weeks, 11 weeks, and 6 months after childbirth. The Edinburgh Postnatal Depression Scale measured postpartum depression. Independent variables included total workload (paid and unpaid work), job flex- ibility, supervisor and coworker support, available social support, job satisfaction, infant sleep problems, infant irritable temperament, and breastfeeding. Results: Total average daily workload increased from 14.4 h (6.8 h of paid work; 7.1% working at 5 weeks postpartum) to 15.0 h (7.9 h of paid work; 87% working at 6 months postpartum) over the 6 months. Fixed effects regression analyses showed worse depression scores were associated with higher total workload, lower job flexibility, lower social support, an infant with sleep problems, and breastfeeding. Conclusions: Working mothers of reproductive years may find the study results valuable as they consider merging their work and parenting roles after childbirth. Future studies should examine the specific mechanisms through which total workload affects postpartum depressive symptoms.

  • 3.
    Drake, Emma
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Toivanen, Susanna
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences. Mälardalen University, Sweden.
    Leineweber, Constanze
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Nyberg, Anna
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Is combining human service work with family caregiving associated with additional odds of emotional exhaustion and sickness absence? A cross-sectional study based on a Swedish cohort2020In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 93, no 1, p. 55-65Article in journal (Refereed)
    Abstract [en]

    Purpose The aim of the study is to examine to what extent human service work and family caregiving is associated with emotional exhaustion and sickness absence, and to what extent combining human service work and family caregiving is associated with additional odds. Methods Data were derived from participants in paid work from the Swedish Longitudinal Occupational Survey of Health, year 2016 (n = 11 951). Logistic regression analyses were performed and odds ratios and 95% confidence intervals estimated for the association between human service work and family caregiving, respectively, as well as combinations of the two on one hand, and emotional exhaustion and self-reported sickness absence on the other hand. Interaction between human service work and family caregiving was assessed as departure from additivity with Rothman's synergy index. Results Human service work was not associated with higher odds of emotional exhaustion, but with higher odds of sickness absence. Providing childcare was associated with higher odds of emotional exhaustion, but lower odds of sickness absence, and caring for a relative was associated with higher odds of both emotional exhaustion and sickness absence. There was no indication of an additive interaction between human service work and family caregiving in relation to neither emotional exhaustion nor sickness absence. Conclusions We did not find support for the common assumption that long hours providing service and care for others by combining human service work with family caregiving can explain the higher risk of sickness absence or emotional exhaustion among employees in human service occupations.

  • 4. du Prel, Jean-Baptist
    et al.
    Runeson-Broberg, Roma
    Westerholm, Peter
    Alfredsson, Lars
    Fahlén, Göran
    Knutsson, Anders
    Nordin, Maria
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Umeå University, Sweden.
    Peter, Richard
    Work overcommitment: Is it a trait or a state?2018In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 91, no 1, p. 1-11Article in journal (Refereed)
    Abstract [en]

    Effort-reward imbalance (ERI) is a well-tested work-related stress model with three components, the two extrinsic components efforts and rewards and the one intrinsic component overcommitment. While an imbalance between efforts and rewards leads to strain reactions, work-related overcommitment (OC) has been described as a personal characteristic with a set of attitudes, behaviours, and emotions reflecting excessive striving combined with a strong desire for approval. However, the question whether OC is a personality trait or a response pattern sensitive to changes in the work context (state) is still open. 2940 Swedish industrial employees were included in this longitudinal analysis of the WOLF-Norrland data over 5 years. A change of OC index or its subscales were regressed against a change of freedom of choice at work, extra work, and ERI adjusted for age, sex, and education. While OC was insensitive to changes in freedom of choice at work and extra work, it was clearly associated with changes of work-related stress over time. Three of four OC subscales exhibited statistically significant associations with ERI. For the first time, we studied fundamental characteristics of OC as an independent personality variable (trait) or an outcome variable subject to changes in the work environment (state). The association between external ERI and OC over time supports our hypothesis of OC being a state. Further investigations are needed to establish OC as a trait or a state.

  • 5. Finnes, Anna
    et al.
    Enebrink, Pia
    Ghaderi, Ata
    Dahl, JoAnne
    Nager, Anna
    Öst, Lars-Göran
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Clinical psychology.
    Psychological treatments for return to work in individuals on sickness absence due to common mental disorders or musculoskeletal disorders: a systematic review and meta-analysis of randomized-controlled trials2019In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 92, no 3, p. 273-293Article in journal (Refereed)
    Abstract [en]

    Purpose: Common mental disorders (CMDs) and musculoskeletal disorders are highly prevalent in the population and cause significant distress and disability, and high costs to society. The main objective of this systematic review and meta-analysis was to examine the outcome and comparative effectiveness of psychological interventions in reducing sickness absence (SA) due to CMDs or musculoskeletal disorders, compared to a waitlist control group, usual care or another clinical intervention.

    Methods: We reviewed 3515 abstracts of randomized controlled trials published from 1998 to 2017. Of these, 30 studies were included in the analysis.

    Results: The psychological interventions were overall more effective than treatment as usual in reducing SA (small effect sizes), but not compared to other clinical interventions. Results were similar for studies on CMDs and musculoskeletal pain. A few significant moderating effects were found for treatment-specific variables. However, these were  difficult to interpret as they pointed in different directions.

    Conclusion: There was a small but significant effect of psychological treatments in reducing SA. We identified areas of improvement such as methodological problems among the included studies and failure to specifically address RTW in the interventions that were evaluated. Clinical implications of the findings, and ways of improving methodological rigour of future studies are discussed.

  • 6. Kjellberg, Katarina
    et al.
    Lundin, Andreas
    Falkstedt, Daniel
    Allebeck, Peter
    Hemmingsson, Tomas
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). Karolinska Institutet, Sweden.
    Long-term physical workload in middle age and disability pension in men and women: a follow-up study of Swedish cohorts2016In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 89, no 8, p. 1239-1250Article in journal (Refereed)
    Abstract [en]

    The study investigates the association between level of long-term physical workload in middle age and disability pension (DP) before 61 years of age with adjustments made for early life factors, level of education, and psychosocial working conditions. Associations with DP overall, DP due to musculoskeletal disorders and DP due to psychiatric disorders were examined.

    The study is based on cohorts of 21,809 Swedish men and women born in 1948 and 1953, with data on physical workload estimated with a job exposure matrix based on occupational titles in 1985 and 1990 and follow-up data on diagnosis-specific DP in the years 1991-2009. Data on paternal education and intelligence were collected in primary school. Data on level of education were taken from administrative records. Data on psychosocial working conditions were estimated with a job exposure matrix based on occupational titles in 1990.

    Long-term exposure to high physical workload measured 5 years apart at around age 40 was strongly associated with DP due to musculoskeletal disorders up to the age of 61 among both men (HR 5.44, 95 % CI 3.35-8.84) and women (HR 3.82, CI 95 % 2.88-5.08). For women, the association between high physical load and overall DP was also significantly increased (HR 2.33, CI 95 % 1.92-2.82). The increased risks remained but were clearly attenuated after adjustments for fathers' education, IQ in childhood, achieved education and level of control at work.

    Exposure to high physical workload is associated with long-term risk of DP due to musculoskeletal disorders, even though adjustments for early life factors, level of education and psychosocial working conditions clearly attenuated the risks.

  • 7. Klug, Katharina
    et al.
    Bernhard-Oettel, Claudia
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Work and organizational psychology.
    Mäkikangas, Anne
    Kinnunen, Ulla
    Sverke, Magnus
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Work and organizational psychology.
    Development of perceived job insecurity among young workers: a latent class growth analysis2019In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 92, no 6, p. 901-918Article in journal (Refereed)
    Abstract [en]

    Purpose: Individual differences in the development of perceived job insecurity among young workers may be influenced by characteristics of the first job (contract type and sector) and individual background (education and previous unemployment), and can have implications for subsequent health and well-being. The aim of this study was to investigate the development of perceived job insecurity during the early career, as well as associations between different patterns of development (i.e., trajectories), predictors and outcomes.

    Methods: We conducted a latent class growth analysis to identify trajectories of perceived job insecurity and investigated their respective associations with predictors and outcomes across 6 years in a sample of 1711 German labor market entrants.

    Results: Six trajectories were identified: three showed stable job insecurity perceptions (stable moderate, 36%; stable low, 32%; stable high, 5%), two showed decrease (moderate to low, 12%; high to moderate, 3%), and one showed increasing job insecurity perceptions (low to moderate, 13%). Temporary contracts and previous unemployment predicted trajectories characterized by increasing, higher initial or higher overall levels of perceived job insecurity. In contrast, public sector employees and university graduates were less likely to experience persisting or increasing job insecurity. The trajectories differed in their overall levels of self-rated health and job satisfaction, but not with respect to change in these outcomes. Instead, increasing perceived job insecurity was associated with decreasing life satisfaction.

    Conclusions: The findings suggest that an insecure career start and individual risk factors may predispose young workers to an unfavorable development of both job insecurity perceptions and levels of well-being.

  • 8.
    Leineweber, Constanze
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Hagberg, Jan
    Svedberg, Pia
    Alexanderson, Kristina
    Sickness presenteeism is more than an alternative to sickness absence: results from the population-based SLOSH study2012In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 85, no 8, p. 905-914Article in journal (Refereed)
    Abstract [en]

    PURPOSE: Sickness presenteeism, defined as 'going to work despite judging that one should have reported in sick', is usually considered to be a complementary alternative to sickness absence. Nonetheless, several studies have reported a positive association between sickness absence and sickness presenteeism. The aim of the present study was to investigate whether the contemporaneous positive association between sickness absence and sickness presenteeism can be explained by illness, work incapacity, and/or work environment.

    METHODS: A cross-sectional study based on answers to a comprehensive questionnaire from 8,304 working women and men, those in the second wave of the nationally representative Swedish Longitudinal Occupational Survey of Health. Logistic regression was used to investigate the association between sickness presenteeism and sickness absence.

    RESULTS: Sickness absence was strongly associated with sickness presenteeism. Sickness absence of 1-7 days during a 12-month period more than doubled the odds of also having sickness presenteeism of more than 8 days during the same 12-month period (OR = 2.11; 95% CI: 1.79-2.49). Adjusting for age and sex did not attenuate the association; further adjustment for work environment, self-rated health, chronic diseases, and work capacity reduced the odds somewhat, but they remained highly significant (OR = 1.88; 95% CI: 1.56-2.25).

    CONCLUSIONS: The results suggest that sickness presenteeism is not, as earlier hypothesised, just an alternative to sickness absence, given a certain level of health or work incapacity. Other, so far unknown explanations for both sickness absence and sickness presenteeism must be sought.

  • 9. Lewinska, D
    et al.
    Palus, J
    Stepnik, M
    Dziubaltowska, E
    Beck, J
    Rydzynski, K
    Natarajan, A.T.
    Nilsson, Robert
    Stockholm University, Faculty of Science, Department of Genetics, Microbiology and Toxicology.
    Micronucleus frequency in peripheral blood lymphocytes and buccal mucosa cells of copper smelter workers, with special regard to arsenic exposure2007In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 80, no 5, p. 371-380Article in journal (Refereed)
    Abstract [en]

    Occupational exposure in copper smelters may produce various adverse health effects including cancer which, according to available epidemiologic data, is associated mainly with exposure to arsenic. Despite a number of well-documented studies reporting an increased risk of cancer among copper smelters workers, the data on genotoxic effects in this industry are scarce. In view of the above, an assessment of micronuclei (MN) frequency in peripheral blood lymphocytes and buccal epithelial cells from copper smelter workers was undertaken. Additionally, the clastogenic/aneugenic effect in lymphocytes was assessed with the fluorescence in situ hybridization (FISH). The study was conducted in three copper smelters in southwestern Poland. The subjects (n = 72) were enrolled among male workers at departments where As concentration in the air was up to at 80 μg/m3. Exposure was assessed by measurement of arsenic concentration in urine and toenail samples. The control group (n = 83) was recruited from healthy male individuals living in central Poland who did not report any exposure to known genotoxins. The results of our study showed a significant increase in MN frequency in peripheral blood lymphocytes and in buccal epithelial cells of smelter workers, compared to the controls (7.96 ± 4.28 vs. 3.47 ± 1.70 and 0.98 ± 0.76 vs. 0.50 ± 0.52, respectively). The FISH technique revealed the presence of clastogenic and aneugenic effects in peripheral blood lymphocytes in both groups. The clastogenic effect was slightly more pronounced in the smelter workers; however, the difference was not statistically significant. The mean arsenic concentrations in urine (total arsenic species) and in toenail samples in the exposed group were 54.04 ± 42.26 μg/l and 7.63 ± 7.24 μg/g, respectively, being significantly different from control group 11.01 ± 10.84 μg/l and 0.51 ± 0.05 μg/g. No correlation between As content in urine or toenail samples and the genotoxic effect was found under study.

  • 10.
    Nyberg, Anna
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Leineweber, Constanze
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Hanson Magnusson, Linda
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Gender differences in psychosocial work factors, work-personal life interface, and well-being among Swedish managers and non-managers2015In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 88, no 8, p. 1149-1164Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To explore differences in psychosocial work factors, work-personal life interface, and well-being between managers and non-managers, female and male managers, and managers in the public and private sectors.

    METHODS: Data were drawn from the Swedish Longitudinal Occupational Survey of Health (SLOSH) 2010, including 602 female managers, 4174 female non-managers, 906 male managers, and 2832 male non-managers. Psychosocial work factors, work-personal life interface, satisfaction, and well-being were investigated among non-managers and managers and male and female managers, using logistic regression analyses adjusted for age, educational level, staff category, and labour market sector.

    RESULTS: Both female and male managers reported high job demands and interference between work and personal life, but also high influence, high satisfaction with work and life, and low amount of sickness absence more often than non-managers of the same sex. However, female managers reported high quantitative and emotional demands, low influence, and work-personal life interference more frequently than male managers. More psychosocial work stressors were also reported in the public sector, where many women work. Male managers more often reported conflicts with superiors, lack of support, and personal life-work interference. Female managers reported poor well-being to a greater extent than male managers, but were more satisfied with their lives.

    CONCLUSION: Lack of motivation due to limited increase in satisfaction and organisational benefits is not likely to hinder women from taking on managerial roles. Managerial women's higher overall demands, lower influence at work, and poorer well-being relative to men's could hinder female managers from reaching higher organisational levels.

  • 11.
    Richter, Anne
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Schraml, Karin
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Leineweber, Constanze
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Work-family conflict, emotional exhaustion and performance-based self-esteem: reciprocal relationships2015In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 88, no 1, p. 103-112Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The three constructs of work-family conflict, emotional exhaustion and performance-based self-esteem are all related to tremendous negative consequences for the individual, the organization as well as for society. Even though there are studies that connect two of those constructs, the prospective relations between all three of them have not been studied yet.

    METHODS: We explored the prospective relations between the three constructs in a large Swedish data set representative of the Swedish workforce. Gender differences in the relations were investigated. Longitudinal data with a 2-year time lag were gathered from 3,387 working men and women who responded to the 2006 and 2008 waves of the Swedish Longitudinal Occupational Survey of Health. Four different cross-lagged models were analysed.

    RESULTS: In the best fitting model, higher levels of work-family conflict at time 1 were associated with an increased level of performance-based self-esteem at time 2, but not with emotional exhaustion, after controlling for having children, gender, education and age. Also, relationships between emotional exhaustion at time 1 and work-family conflict and performance-based self-esteem at time 2 could be established. Furthermore, relationships between performance-based self-esteem time 1 and work-family conflict and emotional exhaustion time 2 were found. Multiple-group analysis did not show any differences in the relations of the tested constructs over time for either men or women.

    CONCLUSIONS: We conclude that the three constructs are interrelated and best understood through a reciprocal model. No differences were found between men and women.

  • 12.
    Schiller, Helena
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Söderström, Marie
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. KBT-Centralen, Sweden.
    Lekander, Mats
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Rajaleid, Kristiina
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Radboud University, The Netherlands.
    A randomized controlled intervention of workplace-based group cognitive behavioral therapy for insomnia2018In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 91, no 4, p. 413-424Article in journal (Refereed)
    Abstract [en]

    Sleep disturbance is common in the working population, often associated with work stress, health complaints and impaired work performance. This study evaluated a group intervention at work, based on cognitive behavioral therapy (CBT) for insomnia, and the moderating effects of burnout scores at baseline. This is a randomized controlled intervention with a waiting list control group. Participants were employees working at least 75% of full time, reporting self-perceived regular sleep problems. Data were collected at baseline, post-intervention and at a 3-month follow-up through diaries, wrist-actigraphy and questionnaires including the Insomnia Severity Index (ISI) and the Shirom-Melamed Burnout Questionnaire (SMBQ). Fifty-one participants (63% women) completed data collections. A multilevel mixed model showed no significant differences between groups for sleep over time, while there was a significant effect on insomnia symptoms when excluding participants working shifts (N = 11) from the analysis (p = 0.044). Moreover, a moderating effect of baseline-levels of burnout scores was observed on insomnia symptoms (p = 0.009). A post-hoc analysis showed that individuals in the intervention group with low burnout scores at baseline (SMBQ < 3.75) displayed significantly reduced ISI scores at follow-up, compared to individuals with high burnout scores at baseline (p = 0.005). Group CBT for insomnia given at the workplace did not reduce sleep problems looking at the group as a whole, while it was indicated that the intervention reduced insomnia in employees with regular daytime work. The results also suggest that workplace-based group CBT may improve sleep in employees with primary insomnia if not concomitant with high burnout scores.

  • 13. Siegrist, Johannes
    et al.
    Dragano, Nico
    Nyberg, Solja T.
    Lunau, Thorsten
    Alfredsson, Lars
    Erbel, Raimund
    Fahlén, Göran
    Goldberg, Marcel
    Jöckel, Karl-Heinz
    Knutsson, Anders
    Leineweber, Constanze
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Magnusson Hanson, Linda L.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Nordin, Maria
    Rugulies, Reiner
    Schupp, Jürgen
    Singh-Manoux, Archana
    Theorell, Töres
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Wagner, Gert G.
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Zins, Marie
    Heikkilä, Katriina
    Fransson, Eleonor I.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden; Jönköping University, Sweden.
    Kivimäki, Mika
    Validating abbreviated measures of effort-reward imbalance at work in European cohort studies: the IPD-Work consortium2014In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 87, no 3, p. 249-256Article in journal (Refereed)
    Abstract [en]

    Effort-reward imbalance (ERI) is an established conceptualisation of work stress. Although a validated effort-reward questionnaire is available for public use, many epidemiological studies adopt shortened scales and proxy measures. To examine the agreement between different abbreviated measures and the original instrument, we compared different versions of the effort-reward scales available in 15 European cohort studies participating in the IPD-Work (Individual-participant-data meta-analysis in working populations) consortium. Five of the 15 studies provide information on the original ('complete') scales measuring 'effort' and 'reward', whereas the 10 remaining studies used 'partial' scales. To compare different versions of the ERI scales, we analyse individual-level data from 31,790 participants from the five studies with complete scales. Pearson's correlation between partial and complete scales was very high in case of 'effort' (where 2 out of 3 items were used) and very high or high in case of 'reward', if at least 4 items (out of 7) were included. Reward scales composed of 3 items revealed good to satisfactory agreement, and in one case, a reward scale consisting of 2 items only demonstrated a modest, but still acceptable degree of agreement. Sensitivity and specificity of a composite measure, the ratio of effort and reward, comparing partial versus complete scales ranged between 59-93 and 85-99 %, respectively. Complete and partial scales were strongly associated with poor self-rated health. Our results support the notion that short proxy measures or partial versions of the original scales can be used to assess effort-reward imbalance.

  • 14. Stadin, Magdalena
    et al.
    Nordin, Maria
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Umeå University, Sweden .
    Broström, Anders
    Magnusson Hanson, Linda L.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Fransson, Eleonor I.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Jönköping University, Sweden; Karolinska Institutet, Sweden.
    Information and communication technology demands at work: the association with job strain, effort-reward imbalance and self-rated health in different socio-economic strata2016In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 89, no 7, p. 1049-1058Article in journal (Refereed)
    Abstract [en]

    Purpose

    The use of information and communication technology (ICT) is common in modern working life. ICT demands may give rise to experience of work-related stress. Knowledge about ICT demands in relation to other types of work-related stress and to self-rated health is limited. Consequently, the aim of this study was to examine the association between ICT demands and two types of work-related stress [job strain and effort-reward imbalance (ERI)] and to evaluate the association between these work-related stress measures and self-rated health, in general and in different SES strata.

    Methods

    This study is based on cross-sectional data from the Swedish Longitudinal Occupational Survey of Health collected in 2014, from 14,873 gainfully employed people. ICT demands, job strain, ERI and self-rated health were analysed as the main measures. Sex, age, SES, lifestyle factors and BMI were used as covariates.

    Results

    ICT demands correlated significantly with the dimensions of the job strain and ERI models, especially with the demands (r = 0.42; p < 0.01) and effort (r = 0.51; p < 0.01) dimensions. ICT demands were associated with suboptimal self-rated health, also after adjustment for age, sex, SES, lifestyle and BMI (OR 1.49 [95 % CI 1.36–1.63]), but job strain (OR 1.93 [95 % CI 1.74–2.14) and ERI (OR 2.15 [95 % CI 1.95–2.35]) showed somewhat stronger associations with suboptimal self-rated health.

    Conclusion

    ICT demands are common among people with intermediate and high SES and associated with job strain, ERI and suboptimal self-rated health. ICT demands should thus be acknowledged as a potential stressor of work-related stress in modern working life.

  • 15. Stadin, Magdalena
    et al.
    Nordin, Maria
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Umeå University, Sweden.
    Broström, Anders
    Magnusson Hanson, Linda L.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Fransson, Eleonor I.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Jönköping University, Sweden.
    Repeated exposure to high ICT demands at work, and development of suboptimal self-rated health: findings from a 4-year follow-up of the SLOSH study2019In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 92, no 5, p. 717-728Article in journal (Refereed)
    Abstract [en]

    The knowledge about the association between Information and Communication Technology (ICT) demands at work and self-rated health (SRH) is insufficient. The aim of this study was to examine the association between repeated exposure to high ICT demands at work, and risk of suboptimal SRH, and to determine modifications by sex or socioeconomic position (SEP). A prospective design was used, including repeated measurement of ICT demands at work, measured 2 years apart. SRH was measured at baseline and at follow-up after 4 years. The data were derived from the Swedish Longitudinal Occupational Survey of Health (SLOSH), including 4468 gainfully employees (1941 men, 2527 women) with good SRH at baseline. In the total study sample, repeated exposure to high ICT demands at work was associated with suboptimal SRH at follow-up (OR 1.34 [CI 1.06-1.70]), adjusted for age, sex, SEP, health behaviours, BMI, job strain and social support. An interaction between ICT demands and sex was observed (p = 0.010). The risk was only present in men (OR 1.53 [CI 1.09-2.16]), and not in women (OR 1.17 [CI 0.85-1.62]). The risk of suboptimal SRH after consistently high ICT demands at work was most elevated in participants with high SEP (OR 1.68 [CI 1.02-2.79]), adjusted for age, sex, health behaviours, BMI and job strain. However, no significant interaction between ICT demands and SEP regarding SRH was observed. Repeated exposure to high ICT demands at work was associated with suboptimal SRH at follow-up, and the association was modified by sex.

  • 16. Svedberg, Pia
    et al.
    Mather, Lisa
    Bergström, Gunnar
    Lindfors, Petra
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Work and organizational psychology.
    Blom, Victoria
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Work and organizational psychology. Karolinska Institutet, Sweden; The Swedish School of Sport and Health Sciences, Sweden.
    Time pressure and sleep problems due to thoughts about work as risk factors for future sickness absence2018In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 91, no 8, p. 1051-1059Article in journal (Refereed)
    Abstract [en]

    Purpose: This study investigated whether time pressure or sleep problems due to thoughts about work are associated with future sickness absence (SA) among women and men employed in different sectors, also when adjusting for confounders including familial factors (genetics and shared environment).

    Methods: The study sample included 16,127 twin individuals (52% women), aged 19–47 years who in 2005 participated in an online survey including questions regarding time pressure, sleep, work and health. Register data on SA (> 14 days) were obtained from the National Social Insurance Agency and individuals were followed from date of survey response until 12/31/2013. Associations between time pressure, sleep problems due to thoughts about work and future SA were investigated using logistic regression analyses to assess odds ratios (OR) with 95% confidence intervals (CI).

    Results: In total 5723 (35%) individuals had an incident SA spell during follow-up. Sleep problems due to thoughts about work were associated with SA in the fully adjusted model (OR 1.22, CI 1.10–1.36). Stratified by sector, the highest estimate was found for state employees (OR 1.54, CI 1.11–2.13). Familial factors did not seem to influence the associations. We found no statistically significant associations between time pressure and SA. No sex differences were found.

    Conclusions: Results indicated that sleep problems due to thoughts about work is a risk factor for future SA. This follows previous research showing that sleep length and sleep disturbances, regardless of reason, are associated with SA. But, experiences of work-related time pressure seem to have no effect on SA.

  • 17.
    Taloyan, Marina
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Leineweber, Constanze
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Hyde, Martin
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Self-rated health amongst male and female employees in Sweden: a nationally representative study2015In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 88, no 7, p. 849-859Article in journal (Refereed)
    Abstract [en]

    Purpose Self-rated health (SRH) is a well-established measure within social epidemiology. However, most studies on SRH tend to be amongst the general population, where SRH has been found to be lower in women than in men. Few studies have specifically investigated patterns of SRH just within an employed population. The purpose of this study was to (1) investigate whether there are gender differences in reporting suboptimal SRH in an employed Swedish population and (2) study whether these differences could be explained by socio-economic, work-, health- and/or lifestyle-related factors. Methods This study is cross-sectional analysis of data from the 2008 wave of Swedish Longitudinal Occupational Survey of Health, a nationally representative cohort of the Swedish working population. This study includes the responses of 9,756 employed individuals. Logistic regression analyses were performed. Results After adjusting for age, income and working hours (full vs. part time), men had significantly higher odds of suboptimal SRH than women OR 1.38 (95 % CI 1.22-1.55). With stepwise inclusion of health factors such as long-standing disease, sleep quality and fatigue, the OR for men increased to 1.65 (95 % CI 1.44-1.89). Gender differences in reporting suboptimal SRH were attenuated to 1.29 (95 % CI 1.11-1.51) with the inclusion of lifestyle factors. However, they remained significant after inclusion of all explanatory variables. Conclusions In contrast to findings in general population studies, our results show that men in employment have higher odds of suboptimal SRH than their female counterparts. As SRH is an important indicator of health with a strong association with mortality, an excess risk of suboptimal SRH amongst employed men shows that more attention should be paid to men's health in the workplace.

  • 18.
    Theorell, Töres
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Nyberg, Anna
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Cultural activity at work: reciprocal associations with depressive symptoms in employees2019In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 92, no 8, p. 1131-1137Article in journal (Refereed)
    Abstract [en]

    Purpose Several studies have shown that cultural activities may promote health. There are also prospective population studies which show that regular participation in cultural activities could reduce morbidity and mortality. To what extent such associations could be applied to the work arena is not so well known, although findings in a few studies support the assumption that cultural activities organized from the work site might improve employee health. An important question discussed in the literature is the extent to which associations between cultural activity at work and employee mental health could be reversed, for instance, with depressive mood resulting in withdrawal from cultural activity at work (backwords) rather than the opposite (forwards). The present study addresses this question. Methods Using a biennial national job survey with seven waves (SLOSH), we examined 2-year follow-up periods in 7193 men and 9313 women in the years 2006-2018. The question regarding cultural activity at work was examined prospectively (using multilevel structural equation modelling) both forwards and backwards in relation to a standardized score for depressive mood (SCL-CD6) in participants working at least 30% both at start and end of the 2-year period. Results The analyses were made separately for men and women and with age and education level as confounders. The findings show that there are highly significant prospective relationships for both men and women in both directions concomitantly. Conclusions Participation in cultural activity at work may protect employees from worsening depressive feelings, but depressive feelings may also inhibit participation in such activities.

  • 19.
    Theorell, Töres
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Osika, Walter
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Leineweber, Constanze
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Magnusson Hanson, Linda L.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Bojner Horwitz, Eva
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Is cultural activity at work related to mental health in employees?2013In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 86, no 3, p. 281-288Article in journal (Refereed)
    Abstract [en]

    Objective: To examine relationships between work-based cultural activities and mental employee health in working Swedes.

    Hypothesis: A positive relationship between frequent cultural activity at work and good employee health was expected.

    Research design: Random sample of working Swedish men and women in three waves, 2006, 2008 and 2010, on average 60 % participation rate.

    Methods: A postal questionnaire with questions about cultural activities organised for employees and about emotional exhaustion (Maslach) and depressive symptoms (short form of SCL). Employee assessments of "non-listening manager" and work environment ("psychological demands" and "decision latitude") as well as socioeconomic variables were covariates. Cross-sectional analyses for each study year as well as prospective analyses for 2006-2008 and 2008-2010 were performed.

    Main outcome and results: Lower frequency of cultural activities at work during the period of high unemployment. The effects of relationships with emotional exhaustion were more significant than those with depressive symptoms. The associations were attenuated when adjustments were made for manager function (does your manager listen?) and demand/control. Associations were more pronounced during the period with low unemployment and high cultural activity at work (2008). In a prospective analysis, cultural activity at work in 2008 had an independent statistically significant "protective" effect on emotional exhaustion in 2010. No corresponding such association was found between 2006 and 2008.

    Conclusions: Cultural activities at work vary according to business cycle and have a statistical association with mental employee health, particularly with emotional exhaustion.

    Implications for future research: There are particularly pronounced statistical protective effects of frequent cultural activity at work on likelihood of emotional exhaustion among employees.

  • 20. Ulvestad, Bente
    et al.
    Randem, Britt Grethe
    Skare, Oivind
    Aalokken, Trond Mogens
    Myranek, Georg Karl
    Elihn, Karine
    Stockholm University, Faculty of Science, Department of Environmental Science and Analytical Chemistry.
    Lund, May Brit
    Lung function in asphalt pavers: a longitudinal study2017In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 90, no 1, p. 63-71Article in journal (Refereed)
    Abstract [en]

    To study longitudinal changes in lung function in asphalt pavers and a reference group of road maintenance workers, and to detect possible signs of lung disease by high-resolution computed tomography (HRCT) scans. Seventy-five asphalt pavers and 71 road maintenance workers were followed up with questionnaires and measurements of lung function. Not every worker was tested every year, but most of them had four or more measurement points. The 75 asphalt pavers were also invited to have HRCT scans of the lungs at the end of the follow-up period. Mean annual decline in forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) of the asphalt pavers was 58 and 35 ml, respectively. Adjusted for age at baseline, packyears of smoking and BMI, the asphalt pavers had a significant excess annual decline in FVC and FEV1 compared to the references. The screedmen, the most exposed group of the asphalt pavers, showed a significantly larger decline in FVC than the other asphalt pavers (P = 0.029). Fine intralobular fibrosis without evident cysts was identified with HRCT in three subjects (4 %). We conclude that our findings may indicate an excess annual decline in FVC and FEV1 related to exposure to asphalt fumes. The screedmen, who carry out their work behind and close to the paving machine, had the largest decline in lung function. The finding of adverse pulmonary effects in asphalt pavers calls for better technological solutions to prevent exposure.

  • 21. Westberg, Håkan
    et al.
    Elihn, Karine
    Stockholm University, Faculty of Science, Department of Environmental Science and Analytical Chemistry.
    Andersson, Eva
    Persson, Bodil
    Andersson, Lennart
    Bryngelsson, Ing-Liss
    Karlsson, Cathe
    Sjögren, Bengt
    Inflammatory markers and exposure to airborne particles among workers in a Swedish pulp and paper mill2016In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 89, no 5, p. 813-822Article in journal (Refereed)
    Abstract [en]

    To study the relationship between exposure to airborne particles in a pulp and paper mill and markers of inflammation and coagulation in blood. Personal sampling of inhalable dust was performed for 72 subjects working in a Swedish pulp and paper mill. Stationary measurements were used to study concentrations of total dust, respirable dust, PM10 and PM2.5, the particle surface area and the particle number concentrations. Markers of inflammation, interleukins (IL-1b, IL-6, IL-8, and IL-10), C-reactive protein (CRP), serum amyloid A (SAA), and fibrinogen and markers of coagulation factor VIII, von Willebrand, plasminogen activator inhibitor, and D-dimer were measured in plasma or serum. Sampling was performed on the last day of the work free period of 5 days, before and after the shift the first day of work and after the shifts the second and third day. In a mixed model analysis, the relationship between particulate exposures and inflammatory markers was determined. Sex, age, smoking, and BMI were included as covariates. The average 8-h time-weighted average (TWA) air concentration levels of inhalable dust were 0.30 mg/m(3), range 0.005-3.3 mg/m(3). The proxies for average 8-h TWAs of respirable dust were 0.045 mg/m(3). Significant and consistent positive relations were found between several exposure metrics (PM 10, total and inhalable dust) and CRP, SAA and fibrinogen taken post-shift, suggesting a dose-effect relationship. This study supports a relationship between occupational particle exposure and established inflammatory markers, which may indicate an increased risk of cardiovascular disease.

  • 22.
    Åhlin, Julia K.
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Griep, Yannick
    Magnusson Hanson, Linda L.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Trajectories of job demands and control: risk for subsequent symptoms of major depression in the nationally representative Swedish Longitudinal Occupational Survey of Health (SLOSH)2018In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 91, no 3, p. 263-272Article in journal (Refereed)
    Abstract [en]

    Purpose

    Depression is a global health concern. High job demands, low job control, and the combination (high strain) are associated with depression. However, few longitudinal studies have investigated changed or repeated exposure to demands and control related to depression. We investigated how trajectories of exposure to job demands and control jointly influence subsequent depression.

    Methods

    We included 7949 subjects from the Swedish Longitudinal Occupational Survey of Health, who completed questionnaires of perceived job demands and control, and depressive symptoms from 2006 to 2014. None of them were depressed between 2006 and 2012. Univariate and joint group-based trajectory models identified groups with similar development of demands and control across 2006–2012. Logistic regression estimated the risk for symptoms of major depression in 2014 according to joint trajectory groups.

    Results

    The joint trajectory model included seven groups, all with fairly stable levels of demands and control over time. Subjects in the high strain and active (high demands and high control) trajectories were significantly more likely to have subsequent major depressive symptoms compared to those having low strain, controlling for demographic covariates (OR 2.15; 95% Cl 1.24–3.74 and OR 2.04; 95% CI 1.23–3.40, respectively). The associations did not remain statistically significant after adjusting for previous depressive symptoms in addition to demographic covariates.

    Conclusions

    The results indicate that the levels of job demands and control were relatively unchanged across 6 years and suggest that long-term exposure to a high strain or active job may be associated with increased risk for subsequent depression.

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