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  • 1.
    Albrecht, Sophie C.
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute.
    Leineweber, Constanze
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute.
    The mediating effect of work-life interference on the relationship between work-time control and depressive and musculoskeletal symptoms2020In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 46, no 5, p. 469-479Article in journal (Refereed)
    Abstract [en]

    Objectives Evidence shows that work-time control (WTC) affects health but underlying mechanisms are still unclear. Work-life interference (WLI) might be a step on the causal pathway. The present study examined whether WLI mediates effects on mental and physical health and contrasted these to other causal pathways.

    Methods Four biennial waves from the Swedish Longitudinal Occupational Survey of Health (SLOSH, N=26 804) were used. Cross-lagged analyses were conducted to estimate if WLI mediated effects from WTC (differentiating between control over daily hours and time off) to subsequent depressive and musculoskeletal symptoms. Other causal directions (reversed mediation, direct and reversed direct effects) and robustness of mediation (by including covariates) were examined.

    Results WLI partially mediated the relationship of WTC (control over daily hours/time off) with both health outcomes. Indirect effect estimates were small for depressive symptoms (-0.053 for control over time off and -0.018 for control over daily hours) and very small for musculoskeletal symptoms (-0.007 and -0.003, respectively). While other causal directions were generally weaker than causal mediational pathways, they played a larger role for musculoskeletal compared to depressive symptoms. Estimates relating to control over time off were in general larger than for control over daily hours.

    Conclusions Our results suggest that WLI mediates part of the effect from WTC to mental/musculoskeletal symptoms, but small estimates suggest that (i) WTC plays a small but consistent role in effects on health and (ii) particularly regarding musculoskeletal disorders, other causal directions and mediators need to be further examined.

  • 2.
    Almroth, Melody
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences. Karolinska Institutet, Sweden.
    Hemmingsson, Tomas
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences. Karolinska Institutet, Sweden.
    Falkstedt, Daniel
    Kjellberg, Katarina
    Carlsson, Emma
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences. Karolinska Institutet, Sweden.
    Pan, Kuan-Yu
    Berglund, Karin
    Thern, Emelie
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences. Karolinska Institutet, Sweden.
    The role of working conditions in educational differences in all-cause and ischemic heart disease mortality among Swedish men2024In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 50, no 4, p. 300-309Article in journal (Refereed)
    Abstract [en]

    Objectives This study aims to investigate the extent to which low job control and heavy physical workload in middle age explain educational differences in all-cause and ischemic heart disease (IHD) mortality while accounting for important confounding factors.

    Methods The study is based on a register-linked cohort of men who were conscripted into the Swedish military at around the age of 18 in 1969/1970 and were alive and registered in Sweden in 2005 (N=46 565). Cox proportional hazards regression models were built to estimate educational differences in all-cause and IHD mortality and the extent to which this was explained by physical workload and job control around age 55 by calculating the reduction in hazard ratio (HR) after adjustments. Indicators of health, health behavior, and other factors measured during conscription were accounted for.

    Results We found a clear educational gradient for all-cause and IHD mortality (HR 2.07 and 2.47, respectively, for the lowest compared to the highest education level). A substantial part was explained by the differential distribution of the confounding factors. However, work-related factors, especially high physical workload, also played important explanatory roles.

    Conclusion Even after accounting for earlier life factors, low job control and especially high physical workload seem to be important mechanistic factors in explaining educational inequalities in all-cause and IHD mortality. It is therefore important to find ways to reduce physical workload and increase job control in order to decrease inequalities in mortality.

  • 3. Anund, Anna
    et al.
    Ahlström, Christer
    Fors, Carina
    Åkerstedt, Torbjörn
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Are professional drivers less sleepy than non-professional drivers?2018In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 44, no 1, p. 88-95Article in journal (Refereed)
    Abstract [en]

    Objective It is generally believed that professional drivers can manage quite severe fatigue before routine driving performance is affected. In addition, there are results indicating that professional drivers can adapt to prolonged night shifts and may be able to learn to drive without decreased performance under high levels of sleepiness. However, very little research has been conducted to compare professionals and non-professionals when controlling for time driven and time of day.

    Method The aim of this study was to use a driving simulator to investigate whether professional drivers are more resistant to sleep deprivation than non-professional drivers. Differences in the development of sleepiness (self-reported, physiological and behavioral) during driving was investigated in 11 young professional and 15 non-professional drivers.

    Results Professional drivers self-reported significantly lower sleepiness while driving a simulator than nonprofessional drivers. In contradiction, they showed longer blink durations and more line crossings, both of which are indicators of sleepiness. They also drove faster. The reason for the discrepancy in the relation between the different sleepiness indicators for the two groups could be due to more experience to sleepiness among the professional drivers or possibly to the faster speed, which might unconsciously have been used by the professionals to try to counteract sleepiness.

    Conclusion Professional drivers self-reported significantly lower sleepiness while driving a simulator than non-professional drivers. However, they showed longer blink durations and more line crossings, both of which are indicators of sleepiness, and they drove faster.

  • 4. Badarin, K.
    et al.
    Hemmingsson, Tomas
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). Karolinska Institutet, Sweden.
    Almroth, M.
    Falkstedt, D.
    Hillert, L.
    Kjellberg, K.
    Does a change to an occupation with a lower physical workload reduce the risk of disability pension? A cohort study of employed men and women in Sweden2022In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 48, no 8, p. 662-671Article in journal (Refereed)
    Abstract [en]

    This study investigated if a change to an occupation with lowerphysical workload was associated with a reduced risk of disabilitypension (DP). A change to lower physical workload was associatedwith a reduced risk of DP. Older workers had the largest decreasedrisk for musculoskeletal DP. Generally, a larger reduction in physicalworkload was associated with the greatest reduced risk of DP.

  • 5. Beckers, Debby G. J.
    et al.
    Kompier, Michiel A. J.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Härmä, Mikko
    Worktime control: theoretical conceptualization, current empirical knowledge, and research agenda2012In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 38, no 4, p. 291-297Article in journal (Other academic)
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  • 6.
    Billingsley, Sunnee
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Sociology.
    Brandén, Maria
    Stockholm University, Faculty of Social Sciences, Department of Sociology. Linköping University, Sweden.
    Aradhya, Siddartha
    Stockholm University, Faculty of Social Sciences, Department of Sociology.
    Drefahl, Sven
    Stockholm University, Faculty of Social Sciences, Department of Sociology.
    Andersson, Gunnar
    Stockholm University, Faculty of Social Sciences, Department of Sociology.
    Mussino, Eleonora
    Stockholm University, Faculty of Social Sciences, Department of Sociology.
    COVID-19 mortality across occupations and secondary risks for elderly individuals in the household: A population register-based study2022In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 48, no 1, p. 52-60Article in journal (Refereed)
    Abstract [en]

    Objectives This is the first population-level study to examine inequalities in COVID-19 mortality according to working-age individuals' occupations and the indirect occupational effects on COVID-19 mortality of older individuals who live with them.

    Methods We used early-release data for the entire population of Sweden of all recorded COVID-19 deaths from 12 March 2020 to 23 February 2021, which we linked to administrative registers and occupational measures. Cox proportional hazard models assessed relative risks of COVID-19 mortality for the working-aged population registered in an occupation in December 2018 and the older population who lived with them.

    Results Among working aged-adults, taxi/bus drivers had the highest relative risk of COVID-19 mortality: over four times that of skilled workers in IT, economics, or administration when adjusted only for basic demographic characteristics. After adjusting for socioeconomic factors (education, income and country of birth), there are no occupational groups with clearly elevated (statistically significant) COVID-19 mortality. Neither a measure of exposure within occupations nor the share that generally can work from home were related to working-aged adults' risk of COVID-19 mortality. Instead of occupational factors, traditional socioeconomic risk factors best explained variation in COVID-19 mortality. Elderly individuals, however, faced higher COVID-19 mortality risk both when living with a delivery or postal worker or worker(s) in occupations that generally work from home less, even when their socioeconomic factors are taken into account.

    Conclusions Inequalities in COVID-19 mortality of working-aged adults were mostly based on traditional risk factors and not on occupational divisions or characteristics in Sweden. However, older individuals living with those who likely cannot work from home or work in delivery or postal services were a vulnerable group.

  • 7. Blindow, Katrina
    et al.
    Bondestam, Fredrik
    Johansson, Gun
    Bodin, Theo
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute.
    Nyberg, Anna
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute. Karolinska Institutet, Sweden; Uppsala University, Sweden.
    Sexual and gender harassment in Swedish workplaces: A prospective cohort study on implications for long-term sickness absence2021In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 47, no 6, p. 466-474Article in journal (Refereed)
    Abstract [en]

    Objectives This prospective cohort study aimed to investigate gender harassment and sexual harassment as risk factors for prospective long-term sickness absence (LTSA, >= 21 days). Furthermore, support from colleagues was investigated as a moderating factor of this association.

    Methods Information on gender harassment, sexual harassment and support by colleagues were derived from the biannual Swedish Work Environment Survey 1999-2013, a representative sample of the Swedish working population (N=64 297). Information on LTSA as well as demographic and workplace variables were added from register data. Relative rates of LTSA the year following the exposure were determined using modified Poisson regression.

    Results Monthly to daily exposure to gender harassment was a risk factor for prospective LTSA among women [rate ratio (RR) 1.04, 95% confidence interval (CI) 1.02-1.05] and men (RR 1.07, 95% CI 1.04-1.10). Monthly to daily exposure to sexual harassment was also a risk factor for LTSA among women (RR 1.05, 95% CI 1.01-1.10) and men (RR 1.07, 95% CI 1.02-1.13). Exposure to sexual or gender harassment once in the last 12 months was not associated with LTSA. There was no support for an interaction between either of the exposures and support from colleagues in relation to LTSA.

    Conclusions Sexual harassment and gender harassment appear to contribute to a small excess risk for LTSA among women and men. For both kinds of offensive behaviors, the pervasiveness appears to be important for the outcome. The role of support by colleagues was inconclusive and needs further investigation.

  • 8. Blindow, Katrina J.
    et al.
    Thern, Emelie
    Hernando-Rodriguez, Julio C.
    Nyberg, Anna
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute. Stockholm University, Faculty of Social Sciences, Department of Psychology, Biological psychology. Karolinska Institutet, Sweden; Uppsala University, Sweden.
    Magnusson Hanson, Linda L.
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute. Stockholm University, Faculty of Social Sciences, Department of Psychology, Biological psychology.
    Gender-based harassment in Swedish workplaces and alcohol-related morbidity and mortality: A prospective cohort study2023In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 49, no 6, p. 395-404Article in journal (Refereed)
    Abstract [en]

    Objective: The study investigated experiences of different types of work-related gender-based harassment (GBH), specifically sexual and gender harassment, as risk factors for alcohol-related morbidity and mortality (ARMM).

    Methods: Information about experiences of (i) sexual harassment (SH-I) and (ii) gender harassment (GH-I) from inside the organization and (iii) sexual harassment from a person external to the organization (SH-E) were obtained from the Swedish Work Environment Survey 1995–2013, a biannual cross-sectional survey, administered to a representative sample of the Swedish working population. The survey responses from 86 033 individuals were connected to multiple registers containing information about alcohol-related diagnoses, treatment, or cause of death. Cox proportional hazard models were fitted to assess hazard ratios (HR) of incident ARMM during a mean follow-up of eight (SH-I and GH-I) and ten (SH-E) years.

    Results: A higher prospective risk estimate of ARMM was found among participants who reported experiences of SH-E [HR 2.01, 95% confidence interval (CI) 1.61–2.52], GH-I (HR 1.33, CI 1.03–1.70), or SH-I (HR 2.37, CI 1.42–3.00). Additional analyses, distinguishing one-time from reoccurring harassment experiences, indicated a dose–response relationship for all three harassment types. Gender did not modify the associations. Under the assumption of causality, 9.3% (95% CI 5.4–13.1) of the risk of ARMM among Swedish women and 2.1% (95% CI 0.6–3.6) among Swedish men would be attributable to any of the three types of GBH included in this study.

    Conclusions: Experiences of GBH in the work context may be a highly relevant factor in the etiology of ARMM.

  • 9.
    Blomqvist, Sandra
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute.
    Virtanen, Marianna
    LaMontagne, Anthony D.
    Magnusson Hanson, Linda L.
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute.
    Perceived job insecurity and risk of suicide and suicide attempts: a study of men and women in the Swedish working population2022In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 48, no 4, p. 293-301Article in journal (Refereed)
    Abstract [en]

    Objective Whether perceived job insecurity increases the risk of suicidal behaviors is unclear. Improved understanding in this area could inform efforts to reduce suicide risk among those experiencing elevated job insecurity during the COVID-19 pandemic as well as post-pandemic. We aimed to investigate if perceived job insecurity predicted increased risk of suicide mortality and suicide attempts.

    Method Employees (N=65 571), representative of the Swedish working population who participated in the Swedish Work Environment Survey in 1991–2003, were followed up through 2016 in the National Inpatient and Death Registers. Suicide deaths and suicide attempts were defined according to International Classification of Diseases (ICD) 10 and ICD-8/9 codes of underlying cause of death and in-/outpatient care. Job insecurity and subsequent risk of suicide and suicide attempt were investigated with marginal structural Cox regression analyses and inverse probability of treatment weighting to control for confounding.

    Results Perceived job insecurity was associated with an elevated risk of suicide [hazard ratio (HR) 1.51, 95% confidence interval (CI) 1.03–2.20], but not with incident suicide attempts (HR 1.03, CI 0.86–1.24). Estimates remained similar after considering prevalent/previous poor mental health, other work factors, and when restricting the follow up time to ten years.

    Conclusion The study suggests that job insecurity is associated with an increased risk of suicide mortality. Concerns about elevated job insecurity and suicide levels in the wake of the current pandemic could thus be considered in strategies to reduce the population health impact job insecurity both during and following the COVID-19 pandemic.

  • 10. Bokenberger, Kathleen
    et al.
    Ström, Peter
    Aslan, Anna K. Dahl
    Åkerstedt, Torbjörn
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Pedersen, Nancy L.
    Shift work and cognitive aging: a longitudinal study2017In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 43, no 5, p. 485-493Article in journal (Refereed)
    Abstract [en]

    Objectives The few studies of shift work and late life cognitive functioning have yielded mixed findings. The aim of the present study is to estimate the association between shift-work experience and change in cognitive performance before and after retirement age among older adults who were gainfully employed. Methods Five hundred and ninety five participants with no dementia were followed up for a mean of 17.6 standard deviation (SD) 8.8 years from a Swedish population-based sample. Participants had self-reported information on any type of shift-work experience (ever/never) in 1984 and measures of cognitive performance (verbal, spatial, memory, processing speed, and general cognitive ability) from up to 9 waves of cognitive assessments during 1986-2012. Night work history (ever/never) from 1998-2002 was available from a subsample (N = 320). Early adult cognitive test scores were available for 77 men. Results In latent growth curve modeling, there were no main effects of any-type or night shift work on the mean scores or rate of change in any of the cognitive domains. An interaction effect between any-type shift work and education on cognitive performance at retirement was noted. Lower-educated shift workers performed better on cognitive tests than lower-educated day workers at retirement. Sensitivity analyses, however, indicated that the interactions appeared to be driven by selection effects. Lower-educated day workers demonstrated poorer cognitive ability in early adulthood than lower-educated shift workers, who may have selected jobs entailing higher cognitive demand. Conclusion There was no difference in late-life cognitive aging between individuals with a history of working shifts compared to those who had typical day work schedules during midlife.

  • 11. Bonde, Jens Peter
    et al.
    Hansen, Johnni
    Kolstad, Henrik A.
    Mikkelsen, Sigurd
    Olsen, Jorgen H.
    Blask, David E.
    Harma, Mikko
    Kjuus, Helge
    de Koning, Harry J.
    Olsen, Jorn
    Moller, Morten
    Schernhammer, Eva S.
    Stevens, Richard G.
    Åkerstedt, Torbjörn
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Work at night and breast cancer - report on evidence-based options for preventive actions2012In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 38, no 4, p. 380-390Article in journal (Refereed)
    Abstract [en]

    In 2007, the International Agency for Research on Cancer classified shift work involving circadian disruption as probably carcinogenic to humans (group 2A), primarily based on experimental and epidemiologic evidence for breast cancer. In order to examine options for evidence-based preventive actions, 16 researchers in basic, epidemiological and applied sciences convened at a workshop in Copenhagen 26-27 October 2011. This paper summarizes the evidence from epidemiological and experimental studies and presents possible recommendations for prevention of the effects of night work on breast cancer. Among those studies that quantified duration of shift work, there were statistically significant elevations in risk only after about 20 years working night shift. It is unclear from these studies whether or not there is a modest but real elevated risk for shorter durations. Hence, restriction of the total number of years working night shift could be one future preventive recommendation for shift workers. The diurnal secretion of melatonin by the pineal gland with peak in secretory activity during the night is a good biochemical marker of the circadian rhythm. Disruption of the diurnal melatonin secretion pattern can be diminished by restricting the number of consecutive night shifts. Reddish light and reduced light intensity during work at night could potentially help diminish the inhibitory activity of light with strong intensity on the melatonin secretion, but further mechanistic insight is needed before definite recommendations can be made. Earlier or more intensive mammography screening among female night shift worker is not recommended because the harm benefit ratio in this age group may not be beneficial. Preventive effects of melatonin supplementation on breast cancer risk have not been clearly documented, but may be a promising avenue if a lack of side effects can be shown even after long-term ingestion. Women with previous or current breast cancer should be advised not to work night shifts because of strong experimental evidence demonstrating accelerated tumor growth by suppression of melatonin secretion. Work during the night is widespread worldwide. To provide additional evidence-based recommendations on prevention of diseases related to night shift work, large studies on the impact of various shift schedules and type of light on circadian rhythms need to be conducted in real work environments.

  • 12. Conway, Paul Maurice
    et al.
    Erlangsen, Annette
    Grynderup, Matias Brødsgaard
    Clausen, Thomas
    Rugulies, Reiner
    Bjorner, Jakob Bue
    Burr, Hermann
    Francioli, Laura
    Garde, Anne Helene
    Hansen, Åse Marie
    Magnusson Hanson, Linda
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute.
    Kirchheiner-Rasmussen, Jonas
    Kristensen, Tage S.
    Mikkelsen, Eva Gemzøe
    Stenager, Elsebeth
    Thorsen, Sannie Vester
    Villadsen, Ebbe
    Høgh, Annie
    Workplace bullying and risk of suicide and suicide attempts: A register-based prospective cohort study of 98 330 participants in Denmark2022In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 48, no 6, p. 425-434Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim of this study was to analyze whether individuals reporting exposure to workplace bullying had a higher risk of suicidal behavior, including both suicide attempt and death by suicide, than those not reporting such exposure. Methods: Using a prospective cohort study design, we linked data from nine Danish questionnaire-based surveys (2004–2014) to national registers up to 31 December 2016. Exposure to workplace bullying was measured by a single item. Suicide attempts were identified in hospital registers and death by suicide in the Cause of Death Reg-ister. Among participants with no previous suicide attempts, we estimated hazard ratios (HR) and 95% confidence intervals (CI), adjusting for sex, age, marital status, socioeconomic status, and history of psychiatric morbidity. Results: The sample consisted of 98 330 participants (713 798 person-years), 63.6% were women, and the mean age was 44.5 years. Of these participants, 10 259 (10.4%) reported workplace bullying. During a mean follow-up of 7.3 years, we observed 184 cases of suicidal behavior, including 145 suicide attempts, 35 deaths by suicide and 4 cases that died by suicide after surviving a suicide attempt. The fully-adjusted HR for the association between workplace bullying and suicidal behavior was 1.65 (95% CI 1.06–2.58). The HR for suicide attempts and death by suicide were 1.65 (1.09–2.50) and 2.08 (0.82–5.27), respectively. Analyses stratified by sex showed a sta-tistically significant association between workplace bullying and suicidal behavior among men but not women. Conclusions: The results suggest that exposure to workplace bullying is associated with an elevated risk of suicidal behavior among men.

  • 13.
    Dahlgren, Anna
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Kecklund, Göran
    Åkerstedt, Torbjörn
    Different levels of work-related stress and the effects on sleep, fatigue and cortisol2005In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 31, no 4, p. 277-285Article in journal (Refereed)
    Abstract [en]

    Methods Thirty-four white-collar workers participated under two different conditions. One workweek with a relatively high stress level (H) and one with a lower stress level (L) as measured through self-rated stress during workdays. The workers wore activity monitors, filled out a sleep diary, gave saliva samples (for cortisol), and rated their sleepiness and stress during one workday and one free day. Results During the week with stress the number of workhours increased and total sleep time decreased. Sleepiness showed a significant interaction between weeks and time of day, with particularly high levels towards the evenings of the stress week. Cortisol also showed a significant interaction, with a more flattened pattern, probably due to increased evening levels during the stress week. Stress (restlessness) at bedtime was significantly increased during the stress week. Conclusion The results demonstrate that a workweek with a high workload and much stress increases sleepiness and workhours, impairs sleep, and affects the pattern of diurnal cortisol secretion.

  • 14.
    Dahlgren, Anna
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology. National Institute for Psychosocial Medicine, Stockholm.
    Kecklund, Göran
    National Institute for Psychosocial Medicine, Stockholm.
    Åkerstedt, Torbjörn
    National Institute for Psychosocial Medicine, Stockholm.
    Overtime work and its effects on sleep, sleepiness, cortisol and blood pressure in an experimental field study2006In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 32, no 4, p. 318-327Article in journal (Refereed)
    Abstract [en]

    Objectives Previous studies of long workhours and their effects on stress, sleep, and health show inconclusive results. This inconclusiveness may be partly due to methodological problems such as the use of between-group designs or comparisons before and after reorganizations. In addition, stress is usually a confounder. A within-person design was used to examine the effects of working 8- or 12-hour shifts in the absence of additional stress. Methods In an experimental field study, 16 white-collar workers [9 women, mean age 45.9 (SD 15) years] undertook one workweek with normal workhours (8 hours) and 1 week of overtime with 4 extra hours of regular worktasks (12 hours). The participants wore actigraphs, rated sleepiness (Karolinska Sleepiness Scale) and stress throughout the day, and rated workload and how exhausted they felt. Saliva samples were collected on Mondays and Thursdays for cortisol analysis. On these days, ambulatory heart rate and blood pressure were also measured for 24 hours. Results Overtime was associated with higher levels of exhaustion. Sleepiness showed a significant interaction between conditions, with higher levels at the end of the workweek featuring overtime. Total sleep time was shorter in the overtime week. There were no significant differences between ratings of stress and workload. Cortisol showed a circadian variation but no main effect of condition. Conclusions One week of overtime work with a moderate workload produced no main effects on physiological stress markers. Nevertheless, sleep was negatively affected, with shorter sleeps during overtime work and greater problems with fatigue and sleepiness.

  • 15. Dahlgren, Anna
    et al.
    Tucker, Philip
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Swansea University, United Kingdom.
    Bujacz, Aleksandra
    Frögéli, Elin
    Rudman, Ann
    Gustavsson, Per
    Intensive longitudinal study of newly graduated nurses' quick returns and self-rated stress2021In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 47, no 5, p. 404-407Article in journal (Refereed)
    Abstract [en]

    Objective Little is known about the relationship between quick returns (QR) - shift combinations that result in inter-shift rest periods <11 hours) and stress. The current study examined whether variations in the frequency of QR, both between and within individuals, were associated with changes in self-rated stress.

    Methods A questionnaire was sent weekly to newly graduated nurses during the first 12 weeks of work. Stress was measured with four items from the Stress-Energy Questionnaire on a scale from 1 not at all to 5 very much [mean 2.65, standard deviation (SD) 1.08]. Shifts worked in the past week were reported and QR were identified by evening-morning shift combinations (mean 0.98, SD 0.90 per week). In total, 350 persons were included in the analysis (3556 observations). Data were analyzed with a multilevel residual dynamic structural equation model (RDSEM) using Bayesian estimation procedures.

    Results There was no between-person effect of QR on stress averaged across measurement occasions (0.181, 95% CI -0.060-0.415). However, there was a small within-person effect of QR (0.031, 95% CI 0.001-0.062), meaning that more QR during a given week, compared to that person's average, was associated with an increase in their level of stress during that week.

    Conclusions Nurses were likely to report increased stress during weeks in which they worked more QR. Intervention studies are needed to determine whether the relationship is causal.

  • 16. Falkstedt, Daniel
    et al.
    Backhans, Mona
    Lundin, Andreas
    Allebeck, Peter
    Hemmingsson, Tomas
    Stockholm University, Faculty of Social Sciences, Centre for Social Research on Alcohol and Drugs (SoRAD). Karolinska Institutet, Sweden.
    Do working conditions explain the increased risks of disability pension among men and women with low education?: A follow-up of Swedish cohorts2014In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 40, no 5, p. 483-492Article in journal (Refereed)
    Abstract [en]

    Objectives Rates of disability pension are greatly increased among people with low education. This study examines the extent to which associations between education and disability pensions might be explained by differences in working conditions. Information on individuals at age 13 years was used to assess confounding of associations. Method Two nationally representative samples of men and women born in 1948 and 1953 in Sweden (22 889 participants in total) were linked to information from social insurance records on cause (musculoskeletal, psychiatric, and other) and date (from 1986-2008) of disability pension. Education data were obtained from administrative records. Occupation data were used for measurement of physical strain at work and job control. Data on paternal education, ambition to study, and intellectual performance were collected in school. Results Women were found to have higher rates of disability pension than men, regardless of diagnosis, whereas men had a steeper increase in disability pension by declining educational level. Adjustment of associations for paternal education, ambition to study, and intellectual performance at age 13 had a considerable attenuating effect, also when disability pension with a musculoskeletal diagnosis was the outcome. Despite this, high physical strain at work and low job control both contributed to explain the associations between low education and disability pensions in multivariable models. Conclusion Working conditions seem to partly explain the increased rate of disability pension among men and women with lower education even though this association does reflect considerable selection effects based on factors already present in late childhood.

  • 17. Garde, Anne Helene
    et al.
    Begtrup, Luise
    Bjorvatn, Bjørn
    Bonde, Jens Peter
    Hansen, Johnni
    Hansen, Åse Marie
    Härmä, Mikko
    Aarrebo Jensen, Marie
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute.
    Kolstad, Henrik A.
    Dyreborg Larsen, Ann
    Lie, Jenny Anne
    Moreno, Claudia R. C.
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute. University of São Paulo, Brazil.
    Nabe-Nielsen, Kirsten
    Sallinen, Mikael
    How to schedule night shift work in order to reduce health and safety risks2020In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 46, no 6, p. 557-569Article in journal (Refereed)
    Abstract [en]

    Objectives This discussion paper aims to provide scientifically based recommendations on night shift schedules, including consecutive shifts, shift intervals and duration of shifts, which may reduce health and safety risks. Short-term physiological effects in terms of circadian disruption, inadequate sleep duration and quality, and fatigue were considered as possible links between night shift work and selected health and safety risks, namely, cancer, cardio-metabolic disease, injuries, and pregnancy-related outcomes.

    Method In early 2020, 15 experienced shift work researchers participated in a workshop where they identified relevant scientific literature within their main research area.

    Results Knowledge gaps and possible recommendations were discussed based on the current evidence. The consensus was that schedules which reduce circadian disruption may reduce cancer risk, particularly for breast cancer, and schedules that optimize sleep and reduce fatigue may reduce the occurrence of injuries. This is generally achieved with fewer consecutive night shifts, sufficient shift intervals, and shorter night shift duration.

    Conclusions Based on the limited, existing literature, we recommend that in order to reduce the risk of injuries and possibly breast cancer, night shift schedules have: (i) ≤3 consecutive night shifts; (ii) shift intervals of ≥11 hours; and (iii) ≤9 hours shift duration. In special cases – eg, oil rigs and other isolated workplaces with better possibilities to adapt to daytime sleep – additional or other recommendations may apply. Finally, to reduce risk of miscarriage, pregnant women should not work more than one night shift in a week.

  • 18.
    Halonen, Jaana
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Finnish Institute of Occupational Health, Finland.
    Lallukka, Tea
    Virtanen, Marianna
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. University of Uppsala, Sweden.
    Rod, Naja H.
    Magnusson Hanson, Linda L.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Bi-directional relation between effort-reward imbalance and risk of neck-shoulder pain: assessment of mediation through depressive symptoms using occupational longitudinal data2019In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 45, no 2, p. 126-133Article in journal (Refereed)
    Abstract [en]

    Objectives Bi-directional associations between perceived effort-reward imbalance (FRI) at work and neck-shoulder pain have been reported. There is also evidence of associations between ERI and depressive symptoms, and between depressive symptoms and pain while the links between ERI, depressive symptoms and pain have not been tested. We aimed to assess whether depressive symptoms mediate the association between ERI and neck-shoulder pain, as well as the association between neck-shoulder pain and ERI.

    Methods We used prospective data from three consecutive surveys of the Swedish Longitudinal Occupational Survey of Health (SLOSH) study. ERI was assessed with a short version of the ERI questionnaire, and pain was defined as having had neck-shoulder pain that affected daily life during the past three months. Depressive symptoms were assessed with a continuous scale based on six-items of the (Hopkins) Symptom Checklist. Counterfactual mediation analyses were applied using exposure measures from 2010/2012 (T1), depressive symptoms from 2012/2014 (T2), and outcomes from 2014/2016 (T3), and including only those free of outcome at T1 and T2 (N=2876-3239).

    Results ERI was associated with a higher risk of neck-shoulder pain [risk ratio (RR) for total effect 1.22, 95% confidence interval (CI) 1.00-1.48] and 41% of this total effect was mediated through depressive symptoms. Corresponding RR for association between neck-shoulder pain and ERI was 1.34 (95% CI 1.09-1.64), but the mediating role of depressive symptoms was less consistent.

    Conclusions Depressive symptoms appear to be an intermediate factor in the relationship between ERI and neck-shoulder pain.

  • 19. Harma, Mikko
    et al.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute.
    Tucker, Philip
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute.
    Working hours and health - key research topics in the past and future2024In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 50, no 4, p. 233-243Article in journal (Refereed)
    Abstract [en]

    Objective: This paper discusses the past and present highlights of working hours and health research and identifies key research needs for the future. Method: We analyzed over 220 original articles and reviews on working hours and health in the Scandinavian Journal of Work, Environment & Health published during the last 50 years. Key publications from other journals were also included. Results: The majority of identified articles focussed on the effects of shift and night work, with fewer studying long and reduced working hours and work time control. We observed a transition from small-scale experimental and intensive field studies to large-scale epidemiological studies utilizing precise exposure assessment, reflecting the recent emergence of register -based datasets and the development of analytic methods and alternative study designs for randomized controlled designs. The cumulative findings provide convincing evidence that shift work and long working hours, which are often associated with night work and insufficient recovery, increase the risk of poor sleep and fatigue, sickness absence, occupational injuries, and several chronic health conditions such as cardiovascular diseases and cancer. The observed risks are strongly modified by individual and work -related factors. Conclusions: Although the observed health risks of shift work and long working hours are mostly low or moderate, the widespread prevalence of exposure and the hazardousness of the many associated potential outcomes makes such working time arrangements major occupational health risks. Further research is needed to identify exposure-response associations, especially in relation to the chronic health effects, and to elucidate underlying pathways and effective personalized intervention strategies.

  • 20.
    Holmgren, Rebecka
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute. Stockholm University, Faculty of Social Sciences, Department of Psychology, Work and organizational psychology.
    Sørensen, Kathrine
    Dalsager, Louise
    Rugulies, Reiner
    Östberg, Viveca
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences.
    Magnusson Hanson, Linda
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute. Stockholm University, Faculty of Social Sciences, Department of Psychology, Biological psychology.
    Workplace bullying, symptoms of anxiety and the interaction with leadership quality: a longitudinal study using dynamic panel models with fixed effects2023In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 49, no 1, p. 64-74Article in journal (Refereed)
    Abstract [en]

    Objectives: Workplace bullying has been suggested to increase symptoms of anxiety. A reverse relationship has also been proposed. However, so far only few earlier studies have investigated this topic and the reported associations might partly be explained by unmeasured individual characteristics. In this study, we aim to examine the temporality and directionality between workplace bullying and anxiety symptoms, taking time-invariant characteristics into account. Furthermore, we aim to examine whether leadership quality modifies these associations.

    Methods: We included 13 491 individuals from two nationwide cohort studies in Sweden and Denmark. Using cross-lagged structural equation models (SEM) and dynamic panel models with fixed effects, we examined contemporaneous and lagged associations between self-reported workplace bullying and anxiety. Cohort-specific results were estimated and combined using fixed-effect meta-analysis.

    Results: The cross-lagged SEM models supported contemporaneous and lagged relationships in both directions (from workplace bullying to symptoms of anxiety and vice versa). In contrast, only contemporaneous relationships remained statistically significant and of considerable magnitude in the dynamic panel models with fixed effects. Specifically, exposure to workplace bullying was related to a concurrent increase in anxiety symptoms (b=0.61, 95% confidence interval 0.32–0.90). No support of interaction with leadership quality was found.

    Conclusions: The results indicate that onset of workplace bullying is associated with an immediate or short-term increase in anxiety symptoms. This study provides novel insights regarding temporal aspects and causal inference of the bullying-anxiety relationship useful for managing psychological hazards and preventing mental illness at work.

  • 21.
    Ingre, Michael
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Åkerstedt, Torbjörn
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Ekstedt, Mirjam
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Periodic self-rostering in shift work: correspondence between objective work hours, work hour preferences (personal fit), and work schedule satisfaction2012In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 38, no 4, p. 327-336Article in journal (Refereed)
    Abstract [en]

    Objectives The main objective of the present study was to investigate relative personal fit as the association between rated needs and preferences for work hours, on the one hand, and actual work hours, on the other hand, in three groups (hospital, call-center, and police) working with periodic self-rostering. We also examined the association between personal fit and satisfaction with the work schedule and preference for a fixed and regular shift schedule, respectively. Methods We collected questionnaire data and objective work hour data over 6-12 months from the computerized self-rostering system. The response rate of the questionnaire was 69% at the hospital and call-center and 98% among the police. In total, 29 433 shifts for 285 shift workers were included in the study. Data was analyzed by means of mixed ANOVA, Kendal tau correlations and ordinal (proportional odds) logistic regression. Results The results show that evening types worked relatively more hours during the evening and night hours compared to morning types as an indication of relative personal fit. Relative personal fit was also found for long shift, short rest, and morning-, evening- and night-shift frequency, but only personal fit related to morning, evening and night-shift was associated with satisfaction with work hours. Reported conflicts at the workplace about work hours and problems with lack of predictability of time for family/leisure activities, was associated with poor satisfaction and a preference for a fixed shift schedule. Conclusions The present study shows that periodic self-rostering is associated with relative personal fit, in particular with respect to night, evening, and morning work. Personal fit seems to be associated with satisfaction with work hours and may be a moderator of tolerance to shift work exposure.

  • 22. Jonsson, Johanna
    et al.
    Muntaner, Carles
    Bodin, Theo
    Alderling, Magnus
    Balogh, Rebeka
    Burström, Bo
    Davis, Letitia
    Gunn, Virginia
    Hemmingsson, Tomas
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences. Karolinska Institutet, Sweden.
    Julià, Mireia
    Kjellberg, Katarina
    Kreshpaj, Bertina
    Orellana, Cecilia
    Padrosa, Eva
    Wegman, David H.
    Matilla-Santander, Nuria
    Low-quality employment trajectories and risk of common mental disorders, substance use disorders and suicide attempt: a longitudinal study of the Swedish workforce2021In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 47, no 7, p. 509-520Article in journal (Refereed)
    Abstract [en]

    Objective High-quality longitudinal evidence exploring the mental health risk associated with low-quality employment trajectories is scarce. We therefore aimed to investigate the risk of being diagnosed with common mental disorders, substance use disorders, or suicide attempt according to low-quality employment trajectories.

    Methods A longitudinal register-study based on the working population of Sweden (N=2 743 764). Employment trajectories (2005–2009) characterized by employment quality and pattern (constancy, fluctuation, mobility) were created. Hazard ratios (HR) were estimated using Cox proportional hazards regression models for first incidence (2010–2017) diagnosis of common mental disorders, substance use disorders and suicide attempt as dependent on employment trajectories.

    Results We identified 21 employment trajectories, 10 of which were low quality (21%). With the exception of constant solo self-employment, there was an increased risk of common mental disorders (HR 1.07–1.62) and substance use disorders (HR 1.05–2.19) for all low-quality trajectories. Constant solo self-employment increased the risk for substance use disorders among women, while it reduced the risk of both disorders for men. Half of the low-quality trajectories were associated with a risk increase of suicide attempt (HR 1.08–1.76).

    Conclusions Low-quality employment trajectories represent risk factors for mental disorders and suicide attempt in Sweden, and there might be differential effects according to sex – especially in terms of self-employment. Policies ensuring and maintaining high-quality employment characteristics over time are imperative. Similar prospective studies are needed, also in other contexts, which cover the effects of the Covid-19 pandemic as well as the mechanisms linking employment trajectories with mental health.

  • 23. Klingelschmidt, J.
    et al.
    Milner, A.
    Khireddine-Medouni, I.
    Witt, K.
    Alexopoulos, E. C.
    Toivanen, Susanna
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    La Montagne, A. D.
    Chastang, J. -F.
    Niedhammer, I.
    Suicide among agricultural, forestry, and fishery workers: a systematic literature review and meta-analysis2018In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 44, no 1, p. 3-15Article, review/survey (Refereed)
    Abstract [en]

    Objectives This review aimed to quantify suicide risk among agricultural, forestry, and fishery workers and study potential variations of risk within this population.

    Methods We conducted a systematic literature review and meta-analysis from 1995 to 2016 using MEDLINE and following the PRISMA guidelines. A pooled effect size of suicide risk among the population of interest was calculated using meta-analysis. Subgroup analyses were conducted to investigate whether effect size differed according to population or study characteristics. Meta-regression was used to identify sources of heterogeneity.

    Results The systematic review identified 65 studies, of which 32 were included in the meta-analysis. Pooled effect size was 1.48 [95% confidence interval (CI) 1.30–1.68] representing an excess of suicide risk among the population of interest. Subgroup analysis showed that this effect size varied according to geographic area, with a higher effect size in Japan. The following study characteristics were found to contribute to the between-study variance: reference group, measure of effect size, and study design.

    Conclusions Our findings suggest an excess of suicide risk among agricultural, forestry, and fishery workers and demonstrated that this excess may be even higher for these groups in Japan. This review highlights the need for suicide prevention policies focusing on this specific population of workers. More research is also needed to better understand the underlying factors that may increase suicide risk in this population.

  • 24. Knutsson, Anders
    et al.
    Alfredsson, Lars
    Karlsson, Berndt
    Åkerstedt, Torbjörn
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Fransson, Eleonor I.
    Westerholm, Peter
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Breast cancer among shift workers: results of the WOLF longitudinal cohort study2013In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 39, no 2, p. 170-177Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The aim of this study was to investigate whether shift work (with or without night work) is associated with increased risk of breast cancer. METHODS: The population consisted of 4036 women. Data were obtained from WOLF (Work, Lipids, and Fibrinogen), a longitudinal cohort study. Information about baseline characteristics was based on questionnaire responses and medical examination. Cancer incidence from baseline to follow-up was obtained from the national cancer registry. Two exposure groups were identified: shift work with and without night work. The group with day work only was used as the reference group in the analysis. Cox regression analysis was used to calculate relative risk. RESULTS: In total, 94 women developed breast cancer during follow-up. The average follow-up time was 12.4 years. The hazard ratio for breast cancer was 1.23 [95% confidence interval (95% CI) 0.70-2.17] for shifts without night work and 2.02 (95% CI 1.03-3.95) for shifts with night work. When including only women <60 years of age, the risk estimates were 1.18 (95% CI 0.67-2.07) for shifts without night work, and 2.15 (95% CI 1.10-4.21) for shifts with night work. CONCLUSIONS: Our results indicate an increased risk for breast cancer among women who work shifts that includes night work.

  • 25. Kreshpaj, Bertina
    et al.
    Orellana, Cecilia
    Burström, Bo
    Davis, Letitia
    Hemmingsson, Tomas
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences. Karolinska Institutet, Sweden.
    Johansson, Gun
    Kjellberg, Katarina
    Jonsson, Johanna
    Wegman, David H.
    Bodin, Theo
    What is precarious employment? A systematic review of definitions and operationalizations from quantitative and qualitative studies2020In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 46, no 3, p. 235-247Article, review/survey (Refereed)
    Abstract [en]

    Objectives The lack of a common definition for precarious employment (PE) severely hampers the comparison of studies within and between countries, consequently reducing the applicability of research findings. We carried out a systematic review to summarize how PE has been conceptualized and implemented in research and identify the construct's dimensions in order to facilitate guidance on its operationalization.

    Methods According to PRISMA guidelines, we searched Web of Science and Scopus for publications with variations of PE in the title or abstract. The search returned 1225 unique entries, which were screened for eligibility. Exclusion criteria were (i) language other than English, (ii) lack of a definition for PE, and (iii) non-original research. A total of 63 full-text articles were included and qualitative thematic-analysis was performed in order to identify dimensions of PE.

    Results We identified several theory-based definitions of PE developed by previous researchers. Most definitions and operationalizations were either an accommodation to available data or the direct result of qualitative studies identifying themes of PE. The thematic-analysis of the selected articles resulted in a multidimensional construct including the following three dimensions: employment insecurity, income inadequacy, and lack of rights and protection.

    Conclusions Despite a growing number of studies on PE, most fail to clearly define the concept, severely restricting the advancement of the research of PE as a social determinant of health. Our combined theoretical and empirical review suggests that a common multidimensional definition could be developed and deployed in different labor market contexts using a variety of methodological approaches.

  • 26.
    Leineweber, Constanze
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Eib, Constanze
    University of East Anglia, UK.
    Peristera, Paraskevi
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Bernhard-Oettel, Claudia
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Work and organizational psychology.
    The influence of and change in procedural justice on self-rated health trajectories: Swedish Longitudinal Occupational Survey of Health results2016In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 42, no 4, p. 320-328Article in journal (Refereed)
    Abstract [en]

    Objectives: Procedural justice perceptions are shown to be associated with minor psychiatric disorders, long sickness absence spells, and poor self-rated health, but previous studies have rarely considered how changes in procedural justice influence changes in health. Methods: Data from four consecutive biennial waves of the Swedish Longitudinal Survey of Health (SLOSH) (N=5854) were used to examine trajectories of self-rated health. Adjusting for age, sex, socioeconomic position, and marital status, we studied the predictive power of change in procedural justice perceptions using individual growth curve models within a multilevel framework. Results: The results show that self-rated health trajectories slowly decline over time. The rate of change was influenced by age and sex, with older people and women showing a slower rate. After adjusting for age, sex, socioeconomic position, and marital status, procedural justice was significantly associated with self-rated health. Also, improvements in procedural justice were associated with improvements in self-rated health. Additionally, a reverse relationship with and change in self-rated health predicting procedural justice was found. Conclusions: Our findings support the idea that procedural justice at work is a crucial aspect of the psychosocial work environment and that changes towards more procedural justice could influence self-rated health positively. The reciprocal association of procedural justice and self-rated health warrants further research.

  • 27. Lissåker, Claudia
    et al.
    Hemmingsson, Tomas
    Kjellberg, Katarina
    Lindfors, Petra
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Work and organizational psychology.
    Selander, Jenny
    Occupational stress and pregnancy-related hypertension and diabetes: Results from a nationwide prospective cohort2022In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 48, no 3, p. 239-247Article in journal (Refereed)
    Abstract [en]

    Objectives: Using a large, national, prospective cohort, while adjusting for other work exposures, this study aims to investigate whether exposure to occupational stress during pregnancy is associated with hypertensive disorders of pregnancy (HDP) and gestational diabetes.

    Methods: Our cohort consisted of 1 102 230 singleton births between 1994–2014 in Sweden, based on high-quality register data of Swedish pregnancies. Exposure to occupational stress was obtained from a job exposure matrix (JEM) constructed from 12 questions pertaining to the psychosocial work environment from the 1997–2013 cycles of Swedish Work Environment Survey, including approximately 75 000 individuals. We utilized the decision authority, demands, and social support indices. Decision authority and demands were combined to categorize occupations into low, active, passive, and high strain work. We estimated relative risks (RR) and adjusted for relevant confounders, such as age, smoking and other work exposures.

    Results: Occupations with lower levels of decision authority were associated with increased risks of 12–23% for HDP and preeclampsia and 36–58% for gestational diabetes compared to occupations with the highest levels of decision authority. Passive occupations had increased risks of 10% for HDP and preeclampsia and 15% for gestational diabetes when compared to low strain jobs. No significant associations were found for high strain occupations.

    Conclusions: As a whole, occupational stress was not consistently associated with pregnancy outcomes in our study. However, decision authority was associated with an increased risk for pregnancy-related complications. Further studies should investigate whether improvements in working conditions can help decrease these risks.

  • 28.
    Magnusson Hanson, Linda L.
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Leineweber, Constance
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Chungkham, Holendro Singh
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institute, Sweden.
    Work-home interference and its prospective relation to major depression and treatment with antidepressants2014In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 40, no 1, p. 66-73Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: Few longitudinal studies have investigated if "work-home interference" (WHI), conflicts between work and home demands, predicts depressive disorders. We examined if WHI was prospectively associated with indicators of major depression in a nationally representative sample.

    METHODS: We used multiple logistic and Cox regression models to examine if self-reported WHI was related to probable major depression [scoring high on a brief self-report scale based on the (Hopkins) Symptom Checklist] and/or any new antidepressant treatment using the prescribed drug register during a 2-year follow-up. The analytic sample comprised 1576 men and 1678 women, working respondents to the Swedish Longitudinal Occupational Survey of Health (SLOSH), free of major depression and prior purchases of antidepressants at baseline.

    RESULTS: Altogether, 7% experienced high (very often/the whole time) and 32% moderate (sometimes) WHI. Overall, the analyses indicated prospective associations between especially high WHI and major depression and/or antidepressant treatment also when adjusting for work characteristics (demands, control, support, overtime). However, the estimates for major depression differed by sex. Separate analyses indicated that only women with high WHI were significantly more likely to have subsequent major depression. Analyses further indicated an elevated rate of antidepressant treatment for men in particular, partly explained by work characteristics and that major depression was related to subsequent high WHI.

    CONCLUSIONS: Based on a two-year follow-up, this study indicated that high WHI prospectively predicted major depression and/or antidepressant treatment, though effects appeared to differ to some extent by sex.

  • 29.
    Magnusson Hanson, Linda L.
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Madsen, Ida E. H.
    Rugulies, Reiner
    Peristera, Paraskevi
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Descatha, Alexis
    Temporal relationships between job strain and low-back pain2017In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 43, no 5, p. 396-404Article in journal (Refereed)
    Abstract [en]

    Objectives Psychosocial working conditions are suggested risk factors for low-back pain, but it is unclear whether these associations are causal. The present study examined whether there are lagged and bidirectional associations between job strain and low-back pain and further controlled for unmeasured time-invariant confounding.

    Methods The study was based on four biennial waves of data from the Swedish Longitudinal Occupational Survey of Health (SLOSH), including 3084 men and women. Cross-lagged analyses using structural equation modeling (SEM) were conducted on job strain, a combination of high job demands and low control, and any as well as low-back pain severity (how much any problems affected the respondents life). Analogous SEM (dynamic panel) models with fixed effects were also fitted to remove confounding from time-invariant factors (such as non-observed individual and environmental factors, eg, genetics, childhood conditions, personality).

    Results The SEM models indicated bidirectional associations between job strain and any back pain over a 2-year time lag (β=0.21 and 0.19, P<0.05), when adjusting for a range of covariates. Job strain was also associated with an increase in low-back pain severity and vice versa. However, the SEM models with fixed-effects showed no statistically significant lagged relationships between job strain and any or low-back pain severity (β=-0.05 and β=0.00, respectively).

    Conclusions This study suggests that associations between job strain and low-back pain with a lag of years may be due to residual confounding by time invariant characteristics. Further studies are, however, needed to elucidate short-term relationships.

  • 30. Méndez-Rivero, Fabrizio
    et al.
    Matilla-Santander, Nuria
    Gunn, Virginia
    Wegman, David H.
    Hernando-Rodriguez, Julio C.
    Kvart, Signild
    Julià, Mireia
    Kreshpaj, Bertina
    Bodin, Theo
    Hemmingsson, Tomas
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences.
    Muntaner, Carles
    Padrosa, Eva
    Almroth, Melody
    Can psychosocial risk factors mediate the association between precarious employment and mental health problems in Sweden? Results from a register-based study2024In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990XArticle in journal (Refereed)
    Abstract [en]

    Objectives 

    The aim of this study was to examine the mediating effect of the psychosocial work environment on the association between precarious employment (PE) and increased risk of common mental disorders (CMD), substance use disorders and suicide attempts.

    Methods

    This longitudinal register-study was based on the working population of Sweden, aged 25-60 years in 2005 (N=2 552 589). Mediation analyses based on a decomposition of counterfactual effects were used to estimate the indirect effect of psychosocial risk factors (PRF) (mediators, measured in 2005) on the association between PE (exposure, measured in 2005) and the first diagnosis of CMD, substance use disorders, and suicide attempts occurring over 2006-2017.

    Results

    The decomposition of effects showed that the indirect effect of the PRF is practically null for the three outcomes considered, among both sexes. PE increased the odds of being diagnosed with CMD, substance use disorders, and suicide attempts, among both men and women. After adjusting for PE, low job control increased the odds of all three outcomes among both sexes, while high job demands decreased the odds of CMD among women. High job strain increased the odds of CMD and suicide attempts among men, while passive job increased the odds of all three outcomes among women.

    Conclusion

    The results of this study did not provide evidence for the hypothesis that psychosocial risks could be the pathways linking precarious employment with workers' mental health. Future studies in different social contexts and labour markets are needed.

  • 31. Niedhammer, Isabelle
    et al.
    Milner, Allison
    Witt, Katrina
    Klingelschmidt, Justine
    Khireddine-Medouni, Imane
    Alexopoulos, Evangelos C.
    Toivanen, Susanna
    Stockholm University, Faculty of Social Sciences, Centre for Health Equity Studies (CHESS).
    Chastang, Jean-Francois
    LaMontagne, Anthony D.
    Response to letter to the editor from Dr Rahman Shiri: The challenging topic of suicide across occupational groups2018In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 44, no 1, p. 108-110Article in journal (Other academic)
  • 32. Nijp, Hylco H.
    et al.
    Beckers, Debby G. J.
    Geurts, Sabine A. E.
    Tucker, Philip
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Kompier, Michiel A. J.
    Systematic review on the association between employee worktime control and work-non-work balance, health and well-being, and job-related outcomes2012In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 38, no 4, p. 299-313Article, review/survey (Refereed)
    Abstract [en]

    Objectives The aim of this review was to assess systematically the empirical evidence for associations between employee worktime control (WTC) and work non-work balance, health/well-being, and job-related outcomes (eg, job satisfaction, job performance). Method A systematic search of empirical studies published between 1995-2011 resulted in 63 relevant papers from 53 studies. Five different categories of WTC measurements were distinguished (global WTC, multidimensional WTC, flextime, leave control, and other subdimensions of WTC). For each WTC category, we examined the strength of evidence for an association with (i) work non-work balance, (ii) health/well-being, and (iii) job-related outcomes. We distinguished between cross-sectional, longitudinal, and intervention studies. Evidence strength was assessed based on the number of studies and their convergence in terms of study findings. Results (Moderately) strong cross-sectional evidence was found for positive associations between global WTC and both work non-work balance and job-related outcomes, whereas no consistent evidence was found regarding health/well-being. Intervention studies on global WTC found moderately strong evidence for a positive causal association with work non-work balance and no or insufficient evidence for health/well-being and job-related outcomes. Limited to moderately strong cross-sectional evidence was found for positive associations between multidimensional WTC and our outcome categories. Moderately strong cross-sectional evidence was found for positive associations between flextime and all outcome categories. The lack of intervention or longitudinal studies restricts clear causal inferences. Conclusions This review has shown that there are theoretical and empirical reasons to view WTC as a promising tool for the maintenance of employees' work non-work balance, health and well-being, and job-related outcomes. At the same time, however, the current state of evidence allows only very limited causal inferences to be made regarding the impact of enhanced WTC.

  • 33.
    Nyberg, Anna
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Johansson, Gun
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Rostila, Mikael
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences.
    Toivanen, Susanna
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences. Mälardalen University, Sweden.
    Status incongruence in human service occupations and implications for mild-to-severe depressive symptoms and register-based sickness absence: A prospective cohort study2020In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 46, no 2, p. 209-217Article in journal (Refereed)
    Abstract [en]

    Objective This study aimed to investigate the hypothesis that negative status incongruence may contribute to explain higher risk of mental ill-health and sickness absence in human service occupations (HSO).

    Methods Participants from the Swedish Longitudinal Occupational Survey of Health who responded to questionnaires in both 2014 and 2016 (N=11 814; 42% men, 58% women) were included. Status incongruence between register-based educational level and subjective social status was assessed. The association between employment in a HSO and status incongruence was estimated in linear regression analyses adjusted for age, income, work hours, sickness absence, childcare, and job qualification match. The prospective associations between status incongruence and mild-to-severe depressive symptoms and register-based sickness absence >= 31 days respectively were estimated with logistic regression analyses in models adjusted for age and outcomes at baseline. All analyses were stratified by gender.

    Results Employment in a HSO was associated with more negative status incongruence in both genders [standardized coefficient men 0.04, 95% confidence interval (CI) 0.02-0.07; women 0.06, 95% CI 0.04-0.09]. More negative status incongruence was furthermore associated with higher odds of mild-to-severe depressive symptoms (men OR 1.18, 95% CI 1.08-1.29; women OR 1.17, 95% CI 1.09-1.26) and sickness absence >= 31 days (men OR 1.40, 95% CI 1.23-1.59; women OR 1.17, 95% CI 1.07-1.28) two years later.

    Conclusion Status incongruence is somewhat higher among HSO than other occupations and associated with increased odds of depressive symptoms and sickness absence.

  • 34. Pan, Kuan-Yu
    et al.
    Almroth, Melody
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences. Karolinska Institutet, Sweden.
    Nevriana, Alicia
    Hemmingsson, Tomas
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences. Karolinska Institutet, Sweden.
    Kjellberg, Katarina
    Falkstedt, Daniel
    Trajectories of psychosocial working conditions and all-cause and cause-specific mortality: a Swedish register-based cohort study2023In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 49, no 7, p. 496-505Article in journal (Refereed)
    Abstract [en]

    Objectives While psychosocial working conditions have been associated with morbidity, their associations with mortality, especially cause-specific mortality, have been less studied. Additionally, few studies considered the time-varying aspect of exposures. We aimed to examine trajectories of job demand–control status in relation to all-cause and cause-specific mortality, including cardiovascular diseases (CVD), suicide, and alcohol-related mortality.

    Methods The study population consisted of around 4.5 million individuals aged 16-60 years in Sweden in 2005. Job control and demands were respectively measured using job exposure matrices (JEM). Trajectories of job control and demands throughout 2005–2009 were identified using group-based trajectory modelling, and job demand–control categories were subsequently classified. Deaths in 2010–2019 were recorded in the national cause of death register. Cox regression models were used.

    Results A total of 116 242 individuals died in 2010–2019. For both job control and demands, we identified four trajectories, which were parallel to each other and represented four levels of exposures. Low control and passive jobs were associated with higher all-cause, CVD, and suicide mortality among both men and women. High strain jobs were associated with higher all-cause and CVD mortality among men, while low control, passive jobs, and high strain jobs were associated with higher alcohol-related mortality among women.

    Conclusions The trajectories identified may suggest stable levels of job control and demands over time. Poor psychosocial working conditions are related to all-cause and cause-specific mortality, and these patterns vary to some extent between men and women.

  • 35. Rugulies, Reiner
    et al.
    Framke, Elisabeth
    Sørensen, Jeppe Karl
    Coop Svane-Petersen, Annemette
    Alexanderson, Kristina
    Bonde, Jens Peter
    Farrants, Kristin
    Meulengracht Flachs, Esben
    Magnusson Hanson, Linda L.
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute.
    Nyberg, Solja T.
    Kivimaki, Mika
    Madsen, Ida E. H.
    Persistent and changing job strain and risk of coronary heart disease: A population-based cohort study of 1.6 million employees in Denmark2020In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 46, no 5, p. 498-507Article in journal (Refereed)
    Abstract [en]

    Objectives This study aimed to examine the association between job strain and incident coronary heart disease (CHD) in Denmark, while accounting for changes of job strain.

    Methods We included all employees residing in Denmark in 2000, aged 30–59 years with no prevalent CHD (N=1 660 150). We determined exposure to job strain from 1996–2009 using a job exposure matrix (JEM) with annual updates. Follow-up for incident CHD was from 2001–2010 via linkage to health records. We used Cox regression to calculate hazard ratios (HR) and 95% confidence intervals (CI) for the association between job strain and incident CHD.

    Results During 16.1 million person-years, we identified 24 159 incident CHD cases (15.0 per 10 000 person-years). After adjustment for covariates, job strain in 2000 predicted onset of CHD during a mean follow-up of 9.71 years (HR 1.10, 95% CI 1.07–1.13). When analyzing changes in job strain from one year to the next and CHD in the subsequent year, persistent job strain (HR 1.07, 95% CI 1.03–1.10), onset of job strain (HR 1.20, 95% CI 1.12–1.29) and removal of strain (HR 1.20, 95% CI 1.12–1.28) were associated with higher CHD incidence compared to persistent no job strain. Associations were similar among men and women.

    Conclusions Job strain is associated with a higher risk of incident CHD in Denmark. As we used a JEM, we can rule out reporting bias. However, under- or overestimation of associations is possible due to non-differential misclassification of job strain and residual confounding by socioeconomic position.

  • 36. Sallinen, Mikael
    et al.
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Shift work, sleep and sleepiness - differences between shift schedules and systems2010In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 36, no 2, p. 121-133Article in journal (Refereed)
    Abstract [en]

    In this narrative review, we examined what level of research evidence is available that shift workers' sleep-wake disturbances can be minimized through ergonomic shift scheduling. We classified the pertinent studies conducted on real shift workers in field conditions by the type of shift system and study design (ie, whether the shift systems were modified or not - "treatment" versus "no treatment"). The results of the observational studies in which no changes to the shift system were made (ie, no treatment) showed that, irrespective of the shift system, night and early-morning shifts and quick returns are associated with short sleep and increases in sleepiness. The same is true for very long shifts (>16 hours) and extremely long weekly working hours (>55 hours). For all categories of shift systems, there was a lack of controlled intervention studies, limiting the possibility to provide solution-focused recommendations for shift scheduling. Most of the controlled intervention studies had been conducted on workers under regular 3-shift systems. These studies suggested that a change from slowly backward-rotating shifts to rapidly forward-rotating shifts is advantageous for alertness and, to some degree, sleep. We also found that a change from an 8- to 12-hour shift system does not necessarily result in impairments in the sleep-wake pattern. The level of research evidence was affected by many of the studies' frequent methodological limitations in measuring sleep and sleepiness. In all, to have reliable and solution-focused recommendations for shift scheduling, methodologically sound controlled intervention studies are required in different categories of shift systems.

  • 37.
    Schiller, Helena
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    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).
    Hellgren, Carina
    Åkerstedt, Torbjörn
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
    Barck-Holst, Peter
    Kecklund, Göran
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Radboud University, The Netherlands.
    The impact of reduced worktime on sleep and perceived stress – a group randomized intervention study using diary data2017In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 43, no 2, p. 109-116Article in journal (Refereed)
    Abstract [en]

    Objective Insufficient time for recovery between workdays may cause fatigue and disturbed sleep. This study evaluated the impact of an intervention that reduced weekly working hours by 25% on sleep, sleepiness and perceived stress for employees within the public sector.

    Method Participating workplaces (N=33) were randomized into intervention and control groups. Participants (N=580, 76% women) worked full-time at baseline. The intervention group (N=354) reduced worktime to 75% with preserved salary during 18 months. Data were collected at baseline and after 9 and 18 months follow-up. Sleep quality, sleep duration, sleepiness, perceived stress,and worries and stress at bedtime were measured with diary during one week per data collection.

    Result A multilevel mixed model showed that compared with the control group, at the 18-month follow-up, the intervention group had improved sleep quality and sleep duration (+23 minutes) and displayed reduced levels of sleepiness, perceived stress, and worries and stress at bedtime on workdays (P<0.002). The same effects were shown for days off (P<0.006), except for sleep length. Effect sizes were small (Cohen’s f2<0.08). Adding gender, age, having children living at home, and baseline values of sleep quality and worries and stress at bedtime as additional between-group factors did not influence the results.

    Conclusion A 25% reduction of weekly work hours with retained salary resulted in beneficial effects on sleep, sleepiness and perceived stress both on workdays and days off. These effects were maintained over an 18-month period. This randomized intervention thus indicates that reduced worktime may improve recovery and perceived stress.

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  • 38. Selander, Jenny
    et al.
    Bluhm, Gösta
    Nilsson, Mats
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Hallqvist, Johan
    Theorell, Töres
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Willix, Pernilla
    Pershagen, Göran
    Joint effects of job strain and road-traffic and occupational noise on myocardial infarction2013In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 39, no 2, p. 195-203Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The aim of this study was to assess the joint effect of job strain and both road-traffic and occupational noise on myocardial infarction (MI). METHOD: We conducted a population based case-control study on first time MI in Stockholm County during 1992-1994. Participants answered a questionnaire and underwent a physical examination. Residential road-traffic noise exposure was based on residential history combined with information on traffic intensity and distance to nearby roads. Occupational noise exposure was assessed by occupational history combined with a job-exposure matrix derived from measurements. Job strain was based on questions regarding psychological demands and decision latitude. A total of 3050 study participants (1252 cases and 1798 controls) were included in the study. RESULTS: An increased risk of MI was indicated among participants exposed to road-traffic noise [odds ratio (OR) 1.23, 95% confidence interval (95% CI) 1.01-1.51], occupational noise (OR 1.17, 95% CI 0.98-1.41) and job strain (OR 1.39, 95% CI 1.17-1.65). Participants exposed to one, two, or three of these factors showed an increased risk (OR 1.16, 95% CI 0.97-1.40, OR 1.57, 95% CI 1.24-1.98, and OR 2.27, 95% CI 1.41-3.64, respectively). Exposure to two or three of these factors occurred among about 20% of the controls. CONCLUSION: Our results indicate that exposure to a combination of noise exposure and job strain increases the risk of MI substantially. Such exposures affect a considerable part of the population, which has relevance for prioritization of preventative measures.

  • 39.
    Sverke, Magnus
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    The importance of the psychosocial work environment for employee well-being and work motivation2009In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 35, no 4, p. 241-243Article in journal (Refereed)
  • 40.
    Tan, Edwin C. K.
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute. Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI). University of Sydney, Australia; Monash University, Australia.
    Pan, Kuan-Yu
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute. Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI). Amsterdam University Medical Center, The Netherlands; Vrije Universiteit, The Netherlands.
    Magnusson Hanson, Linda L
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute.
    Fastbom, Johan
    Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute.
    Wang, Hui-Xin
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute. Stockholm University, Faculty of Social Sciences, Aging Research Center (ARC), (together with KI).
    Psychosocial job strain and polypharmacy: a national cohort study2020In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 46, no 6, p. 589-598Article in journal (Refereed)
    Abstract [en]

    Objectives: Psychosocial job strain has been associated with a range of adverse health outcomes. The aim of this study was to examine the association between psychosocial job strain and prospective risk of polypharmacy (the prescription of ≥5 medications) and to evaluate whether coping strategies can modify this risk.

    Methods: Cohort study of 9703 working adults [mean age 47.5 (SD 10.8) years; 54% female] who participated in the Swedish Longitudinal Occupational Survey of Health (SLOSH) at baseline in 2006 or 2008. Psychosocial job strain was represented by job demands and control, and measured by the Swedish version of the demand–control questionnaire. The outcome was incidence of polypharmacy over an eight-year follow-up period. Information on dispensed drugs were extracted from the Swedish Prescribed Drug Register. Logistic regression was used to estimate the association of job strain status with polypharmacy, adjusted for a range of confounders.

    Results: During the follow-up, 1409 people developed polypharmacy (incident rate: 20.6/1000 person-years). In comparison to workers with low-strain jobs (high control/low demands), those with high-strain jobs (low control/high demands) had a significantly higher risk of incident polypharmacy (OR 1.40, 95% CI 1.04–1.89). The impact of high-strain jobs on developing polypharmacy remained among those with covert coping strategies (ie, directed inwards or towards others) but not among those with open coping strategies (ie, primarily directed toward the stressor).

    Conclusions: Workers in high-strain jobs may be at an increased risk of polypharmacy. Open coping strategies may reduce the negative impact of psychosocial job strain on risk of polypharmacy.

  • 41.
    Theorell, Töres
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Commentary triggered by the individual participant datameta-analysis consortium study of job strain and myocardial infarction risk2014In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 40, no 1, p. 89-95Article in journal (Other academic)
  • 42.
    Thern, Emelie
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences. Karolinska Institute, Sweden.
    Matilla-Santander, Nuria
    Bodin, Theo
    Hemmingsson, Tomas
    Stockholm University, Faculty of Social Sciences, Department of Public Health Sciences. Karolinska Institute, Sweden.
    Precarious employment at a young age and labor-market marginalization during middle-adulthood: A register-linked cohort study2023In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 49, no 3, p. 201-210Article in journal (Refereed)
    Abstract [en]

    Objective The present study aims to investigate the association between exposure to precarious employment three years after graduation and the risk of labor market marginalization (LMM) ten years later.

    Methods A registered-linked cohort study based on the Swedish Work, Illness, and Labor-market Participation (SWIP) cohort was conducted among all individuals born between 1973 and 1976, who were registered in Sweden the year they turned 27 years old (N=365 702). Information on the exposure of labor market establishment three years after graduating from school and outcome of LMM ten years after graduating was collected from nationwide registers. Relative risk ratios (RRR) with 95% confidence intervals (CI) were obtained by multinominal logistic regression.

    Results After considering important covariates, young adults in precarious employment three years after graduation were at an increased risk of future long-term unemployment (RRR 2.31), later precarious employment (RRR 2.85), and long-term sickness absence/disability pension (RRR 1.43) compared to individuals who had obtained standard employment arrangements within three years of graduating. Young precariously employed men had a slightly strong association compared to females with regards to all outcomes.

    Conclusion The result of this study suggests that both young men and women in precarious employment three years after graduation are more likely to have a weaker attachment to the labor force later in life compared to individuals of the same age in standard employment. This is important as the prevalence of precarious employment is increasing globally, and young adults appear to be especially vulnerable.

  • 43.
    Toivanen, Susanna
    Stockholm University, Faculty of Social Sciences, Department of Sociology.
    Job control and risk of incident stroke in the working population in Sweden2008In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 34, no 1, p. 40-47Article in journal (Refereed)
  • 44. Tucker, Philip
    et al.
    Brown, Menna
    Dahlgren, Anna
    Davies, Gwyneth
    Ebden, Philip
    Folkard, Simon
    Hutchings, Hayley
    Åkerstedt, Torbjörn
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    The impact of junior doctors' worktime arrangements on their fatigue and well-being2010In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 36, no 6, p. 458-465Article in journal (Refereed)
    Abstract [en]

    Objective Many doctors report working excessively demanding schedules that comply with the European Working Time Directive (EWTD). We compared groups of junior doctors working on different schedules in order to identify which features of schedule design most negatively affected their fatigue and well-being in recent weeks.

    Methods Completed by 336 doctors, the questionnaires focused on the respondents’ personal circumstances, work situation, work schedules, sleep, and perceptions of fatigue, work–life balance and psychological strain.

    Results Working 7 consecutive nights was associated with greater accumulated fatigue and greater work–life interference, compared with working just 3 or 4 nights. Having only 1 rest day after working nights was associated with increased fatigue. Working a weekend on-call between 2 consecutive working weeks was associated with increased work–life interference. Working frequent on-calls (either on weekends or during the week) was associated with increased work–life interference and psychological strain. Inter-shift intervals of <10 hours were associated with shorter periods of sleep and increased fatigue. The number of hours worked per week was positively associated with work–life interference and fatigue on night shifts.

    Conclusion The current findings identify parameters, in addition to those specified in the EWTD, for designing schedules that limit their impact on doctors’ fatigue and well-being.

  • 45.
    Tucker, Philip
    et al.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute. Swansea University, United Kingdom.
    Härmä, Mikko
    Ojajärvi, Anneli
    Kivimäki, Mika
    Leineweber, Constanze
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Oksanen, Tuula
    Salo, Paula
    Vahtera, Jussi
    Associations between shift work and use of prescribed medications for the treatment of hypertension, diabetes, and dyslipidemia: a prospective cohort study2019In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 45, no 5, p. 465-474Article in journal (Refereed)
    Abstract [en]

    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=11998) 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.

  • 46. Virtanen, Marianna
    et al.
    Jokela, Markus
    Madsen, Ida E. H.
    Magnusson Hanson, Linda L.
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Lallukka, Tea
    Nyberg, Solja T.
    Alfredsson, Lars
    Batty, G. David
    Bjorner, Jakob B.
    Borritz, Marianne
    Burr, Hermann
    Dragano, Nico
    Erbel, Raimund
    Ferrie, Jane E.
    Heikkilä, Katriina
    Knutsson, Anders
    Koskenvuo, Markku
    Lahelma, Eero
    Nielsen, Martin L.
    Oksanen, Tuula
    Pejtersen, Jan H.
    Pentti, Jaana
    Rahkonen, Ossi
    Rugulies, Reiner
    Salo, Paula
    Schupp, Jürgen
    Shipley, Martin J.
    Siegrist, Johannes
    Singh-Manoux, Archana
    Suominen, Sakari B.
    Theorell, Töres
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Vahtera, Jussi
    Wagner, Gert G.
    Wang, Jian Li
    Yiengprugsawan, Vasoontara
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Stress Research Institute.
    Kivimäki, Mika
    Long working hours and depressive symptoms: systematic review and meta-analysis of published studies and unpublished individual participant data2018In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 44, no 3, p. 239-250Article, review/survey (Refereed)
    Abstract [en]

    Objectives This systematic review and meta-analysis combined published study-level data and unpublished individual-participant data with the aim of quantifying the relation between long working hours and the onset of depressive symptoms.

    Methods We searched PubMed and Embase for published prospective cohort studies and included available cohorts with unpublished individual-participant data. We used a random-effects meta-analysis to calculate summary estimates across studies.

    Results We identified ten published cohort studies and included unpublished individual-participant data from 18 studies. In the majority of cohorts, long working hours was defined as working >= 55 hours per week. In multivariable-adjusted meta-analyses of 189 729 participants from 35 countries [96 275 men, 93 454 women, follow-up ranging from 1-5 years, 21 747 new-onset cases), there was an overall association of 1.14 (95% confidence interval (CI) 1.03-1.25] between long working hours and the onset of depressive symptoms, with significant evidence of heterogeneity (I-2 = 45.1%, P=0.004). A strong association between working hours and depressive symptoms was found in Asian countries (1.50, 95% CI 1.13-2.01), a weaker association in Europe (1.11, 95% CI 1.00-1.22), and no association in North America (0.97, 95% CI 0.70-1.34) or Australia (0.95, 95% CI 0.70-1.29). Differences by other characteristics were small.

    Conclusions This observational evidence suggests a moderate association between long working hours and onset of depressive symptoms in Asia and a small association in Europe.

  • 47.
    von Thiele Schwarz, Ulrica
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Lindfors, Petra
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Lundberg, Ulf
    Stockholm University, Faculty of Social Sciences, Department of Psychology.
    Health-related effects of worksite interventions involving physical exercise and reduced workhours2008In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 34, no 3, p. 179-188Article in journal (Refereed)
    Abstract [en]

    Objectives This study examined the health-related effects of two worksite interventions, physical exercise and reduced workhours, on women employed in dentistry.

    Methods Six workplaces were randomized to one of the following three conditions: (i) 2.5 hours of weekly, mandatory physical exercise of middle-to-high intensity to be performed during workhours (N=62), (ii) a reduction of full-time weekly workhours from 40 to 37.5 hours (N=50), and (iii) reference. In all, 177 women participated. Biomarkers and self-ratings in questionnaires were obtained before the intervention (T1), and six (T2) and 12 months (T3) after the intervention.

    Results The results showed increased levels of physical activity and exercise in all of the groups, the level of physical exercise being significantly greater in the physical exercise group. Repeated-measures analyses of variance using data from T1 and T3 for biological measures and all three time points for self-ratings produced significant interaction effects for glucose, waist-to-hip ratio, and work ability and clear trends for general symptoms and upper-extremity disorders. Posthoc analyses showed that the results of the health-related measures differed between the interventions, decreased glucose and upper-extremity disorders in the exercise group, and increased high-density lipoprotein and waist-to-hip ratio among those working reduced hours.

    Conclusions These results show that the two interventions had small and varied effects on biomarkers and self-reports of different aspects of health among women. It is suggested that interventions involving a modest reduction in workhours seem to be more effective if these hours are used for physical exercise.

  • 48.
    Wadensjö, Eskil
    et al.
    Stockholm University, Faculty of Social Sciences, The Swedish Institute for Social Research (SOFI).
    Järvholm, Bengt
    Albin, Maria
    Johansson, Gunn
    Perspectives of working life research2009In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 35, no 5, p. 394-396Article in journal (Refereed)
  • 49.
    Xu, Tianwei
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute. University of Copenhagen, Denmark; National Research Centre of the Working Environment, Denmark.
    Rugulies, Reiner
    Vahtera, Jussi
    Pentti, Jaana
    Mathisen, Jimmi
    Lange, Theis
    Clark, Alice J.
    Magnusson Hanson, Linda. L.
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute.
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute.
    Ervasti, Jenni
    Virtanen, Marianna
    Kivimäki, Mika
    Rod, Naja H.
    Workplace psychosocial resources and risk of cardiovascular disease among employees: a multi-cohort study of 135 669 participants2022In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 48, no 8, p. 621-631Article in journal (Refereed)
    Abstract [en]

    Objective In terms of prevention, it is important to determine effects on cardiovascular disease (CVD) when some workplace psychosocial resources are high while others are low. The aim of the study was to assess the prospective relationship between clustering of workplace psychosocial resources and risk of CVD among employees.

    Methods We pooled data from three cohort studies of 135 669 employees (65% women, age 18–65 years and free of CVD) from Denmark, Finland and Sweden. Baseline horizontal resources (culture of collaboration and support from colleagues) and vertical resources (leadership quality and procedural justice) were measured using standard questionnaire items. Incident CVD, including coronary heart and cerebrovascular disease, was ascertained using linked electronic health records. We used latent class analysis to assess clustering (latent classes) of workplace psychosocial resources. Cox proportional hazard models were used to examine the association between these clusters and risk of CVD, adjusting for demographic and employment-related factors and pre-existing physical and mental disorders.

    Results We identified five clusters of workplace psychosocial resources from low on both vertical and horizontal resources (13%) to generally high resources (28%). High horizontal resources were combined with either intermediate [hazard ratio (HR) 0.84, 95% confidence interval (CI) 0.74–0.95] or high (HR 0.88, 95% CI 0.78–1.00) vertical resources were associated with lower risks of CVD compared to those with generally low resources. The association was most prominent for cerebrovascular disease (eg, general high resources: HR 0.80, 95% CI 0.67–0.96).

    Conclusions Individuals with high levels of workplace psychosocial resources across horizontal and vertical dimensions have a lower risk of CVD, particularly cerebrovascular disease.

  • 50.
    Åhlin, Julia K.
    et al.
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute.
    Peristera, Paraskevi
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute.
    Westerlund, Hugo
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute.
    Magnusson Hanson, Linda L.
    Stockholm University, Faculty of Social Sciences, Department of Psychology, Stress Research Institute.
    Psychosocial working characteristics before retirement and depressive symptoms across the retirement transition: a longitudinal latent class analysis2020In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 46, no 5, p. 488-497Article in journal (Refereed)
    Abstract [en]

    Objectives Retirement is a major life transition. However, previous evidence on its mental health effects has been inconclusive. Whether retirement is desirable or not may depend on pre-retirement work characteristics. We investigated trajectories of depressive symptoms across retirement and how a number of psychosocial working characteristics influenced these trajectories.

    Methods We included 1735 respondents from the Swedish Longitudinal Occupational Survey of Health (SLOSH), retiring during 2008–2016 (mean retirement age 66 years). They had completed biennial questionnaires reporting job demands, decision authority, workplace social support, efforts, rewards, procedural justice and depressive symptoms. We applied group-based trajectory modelling to model trajectories of depressive symptoms across retirement. Multinomial logistic regression analyses estimated the associations between psychosocial working characteristics and depressive symptom trajectories.

    Results We identified five depression trajectories. In four of them, depressive symptoms decreased slightly around retirement. In one, the symptom level was initially high, then decreased markedly across retirement. Perceptions of job demands, job strain, workplace social support, rewards, effort–reward imbalance and procedural justice were associated with the trajectories, while perceptions of decision authority and work efforts were only partly related to the trajectories.

    Conclusions We observed a rather positive development of depressive symptoms across retirement in a sample of Swedish retirees. For a small group with poor psychosocial working characteristics, symptoms clearly decreased, which may indicate that a relief from poor working characteristics is associated with an improvement for some retirees. However, for other retirees poor working characteristics were associated with persistent symptoms, suggesting a long-term effect of these work stressors. Key terms depression; effort–reward imbalance; job control; job demand; job strain; longitudinal study; mental health; older worker; SLOSH; stress; Swedish Longitudinal Occupational Survey of Health; work stress.

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