Aims: To assess the associations of onset of workplace conflict on incident cardiovascular disease (CVD) and changes in biomarkers.

Methods: The study included 2704 employees aged 18–65 years and free of workplace conflict at baseline (T₀), from the Swedish Work, Lipids, Fibrinogen study (proportion of women: 17 %). Exposure to onset of workplace conflict was ascertained at T₁ using self-reports (mean interval between T₀ and T₁: 5 years). Participants were linked to nationwide registers to ascertain incident CVD. Changes in biomarkers, including body mass index, waist-hip ratio, high-density lipoprotein cholesterol, triglycerides, glucose and fibrinogen, were measured and calculated between T₀ and T₁. Cox regressions and linear regressions were applied for analyses on conflicts in relation to CVD and conflicts in relation to changes in biomarkers, respectively. Age, sex, educational level, marital status, pre-existing comorbidities, employment contract, and shift work were adjusted for in the main analyses.

Results: About 10 % experienced onset of workplace conflict between T₀ and T₁. Among 2682 participants who were free from CVD at T₀, 87 CVD events were recorded (mean follow-up from T₁: 7.8 years, incidence rate: 41.5/10,000 person-year). Onset of workplace conflict at T₁ was associated with 2.42 times (95 %CI 1.42, 4.12) higher risk of developing CVD during the follow-up period. Among 877 participants with information on changes in fibrinogen, onset of workplace conflict at T₁ was associated with fibrinogen increase from T₀ to T₁ (mean difference=0.14; 95 %CI 0.02, 0.25) and onset of high fibrinogen (OR=1.41; 95 %CI 1.04,1.90). These associations were largely robust for additional adjustments, restrictions and consideration of selection bias and were not likely to be affected by reverse causation.

Conclusions: Onset of workplace conflict was related to higher risks of developing CVD and fibrinogen increase.

Introduction: Sickness absence (SA) has been shown to be associated with several negative consequences, both for the affected individual as well as for society on the whole, in terms of economic loss. The most common reason for SA is SA due to common mental disorders (CMDs). Previous studies have indicated that there is an association between exposure to work-related offensive behaviours, such as harassment, bullying, violence and threats of different kinds and CMDs. However, the mechanistic pathway in this association is still largely unknown. For example, the associations between exposure to offensive or abusive behaviours and health outcomes may partially be explained by individual characteristics, including genetic predispositions and early experiences. The aim of the present study was to investigate the role of familial factors (genetics and shared early-life environment) and neuroticism in the associations between exposure to work-related violence/threats and harassment/bullying, and SA due to CMDs.

Method: The study sample included 8795 twin individuals from the Swedish Twin project of Disability pension and Sickness absence (STODS), including survey data from the Study of Twin Adults: Genes and Environment (STAGE) linked to national register data. Self-reported work-related violence and/or threats and work-related harassment including bullying and register data on SA due to CMDs were analysed using logistic regression on the whole sample, and conditional logistic regression among complete same-sex twin pairs discordant on exposures. Individuals were followed for a maximum of 13 years or until their first incident SA spell due to CMD. Interactions between neuroticism and exposures were assessed using both multiplicative and additive interaction analyses.

Results: Exposure to work-related violence/threats were associated with higher odds of SA due to CMDs when adjusting for age, sex, marital status, children living at home, education, type of residential area, work characteristics, and symptoms of depression and burnout (OR 2.11, 95% CI 1.52-2.95). Higher odds of SA due to CMDs were also found for exposure to harassment/bullying (OR 1.52, 95% CI 1.10-2.11) and a combined indicator of exposure to either of the kinds of exposure or exposure to both kinds, i.e. violence/threats and/or harassment/bullying (OR 1.98 95% CI 1.52-2.59), compared with the unexposed. Analyses of twin pairs discordant on exposure, using the unexposed twin sibling as reference, showed somewhat reduced ORs that were no longer statistically significant for all exposures. No multiplicative interaction was found between neuroticism and exposure to work-related violence/threats, or harassment. However, a statistically significant additive interaction was found between neuroticism and exposure to violence/threats, with higher odds of SA due to CMDs in the group scoring lower on neuroticism.

Conclusion: Exposure to work-related offensive behaviours were associated with SA due to CMDs. The results of the matched twin pair analysis indicated that these associations may be confounded by familial factors. In addition, an interaction effect between violence/threats and neuroticism was found. Thus, future studies investigating associations and causality between offensive behaviours at work and mental health-related outcomes should, when possible, consider familial factors and neuroticism.

Objectives: This study aimed to fill the data gap of the course of renal function decline in old age and explore changes in renal function across different health states with increasing age. Methods: This observational, retrospective, single-center cohort study included 5,112 Chinese older adults (3,321 men and 1,791 women, range 60–104 years). The individual rate of estimated glomerular filtration rate (eGFR) decline was analyzed using linear mixed-effects model to account for repeated measures over the years. Results: The median age was 66 years, median BMI was 24.56 kg/m2, and median eGFR was 89.86 mL/min.1.73 m2. For every 1-year increase in age, women’s eGFR decreased by 1.06 mL/min/1.73 m2 and men’s by 0.91 mL/min/1.73 m2. We observed greater age-related eGFR decline in men and women with high systolic blood pressure (SBP). Men with high triglyceride (TG), high low-density lipoprotein cholesterol (LDL-C), and low high-density lipoprotein cholesterol (HDL-C), had greater age-related eGFR decline. In women, different BMI groups showed significant differences in age-related eGFR decline, with the highest decline in those with obesity. Additionally, participants with normal baseline eGFR had a faster age-related decline than those with low baseline eGFR. Conclusion: The eGFR declined linearly with age in Chinese older adults, with women exhibiting a slightly faster decline than men. Both men and women should be cautious of SBP. Older adults with normal baseline renal function experienced a faster eGFR decline. Men with high TG, LDL-C, and low HDL-C levels, as well as obese women, should be vigilant in monitoring renal function.

Background: The number of chronic diseases has been associated with changes in depressive symptoms over time among middle-aged and older adults. This study aimed to explore the association between the number of chronic diseases and trajectories of depressive symptoms and the role of age in this association. Methods: A total of 12,974 middle-aged and older Chinese adults (≥ 45 years) participated in the China Health and Retirement Longitudinal Study (CHARLS) in waves 2011, 2013, 2015, 2018, and 2020. The number of chronic diseases was determined by self-reported hospital diagnosis of hypertension, dyslipidemia, diabetes, cancer, chronic lung diseases, liver disease, heart diseases, stroke, kidney diseases, digestive diseases, emotional, nervous, or psychiatric problems, memory-related disease, arthritis or rheumatism, asthma, and then obtaining the total number of chronic diseases. Depressive symptoms were measured by the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10). Group-based trajectory modeling (GBTM) was adopted to capture the trajectories of depressive symptoms over time. Multinomial logistic regressions were conducted to examine the association between the number of chronic diseases and trajectories of depressive symptoms and the role of age in this association. Results: Four distinct trajectories of depressive symptoms were observed in 34.68% individuals in mild, 40.76% in moderate, 19.41% in increasing, and 5.15% in severe group. Compared to participants without chronic diseases, those with one, two, three or more chronic diseases had a 1.81, 3, and 7.49-fold higher risk of developing severe depressive symptom trajectory, respectively. Moreover, the association between the number of chronic diseases and severe depressive symptoms trajectory differed by age (45–59 and ≥ 60 years) (P for interaction < 0.05). Conclusion: Participants with middle age may play a promoting role in the association between the number of chronic disease and severe depressive symptoms. The severe depressive symptoms intervention may be more beneficial for middle-aged adults.

Background: Previous studies have documented the impact of intergenerational contact on cognitive function in Chinese adults, however, few have focused on the possible mediating pathways. This study aimed to test a hypothetical model in which functional disability and depressive symptoms mediate the association between intergenerational contact and cognitive function. Methods: This longitudinal study included data of 3666 participants aged 45 years or older (mean age: 60.2 years) from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2015. Intergenerational contact was measured as the frequency of contact with children and categorized as frequent (≥ 1 time/week) or infrequent (< 1 time/week). Cognitive function was measured in two dimensions: episodic memory and executive function. Depressive symptoms and functional disability were assessed as continuous variables using the 10-item Center for Epidemiological Studies Depression Scale, Activities of Daily Living, and Instrumental Activities of Daily Living Scales. The mediating pathways were quantified using the SPSS PROCESS macro. Results: Frequent intergenerational contact correlated with a better cognitive function (coefficient: 0.73, 95%CI: 0.39 to 1.06), with plausible mediated pathways via functional disability without depressive symptoms (coefficient: 0.03, 95%CI: 0 to 0.06, proportion mediated: 4.11%), depressive symptoms without functional disability (coefficient: 0.04, 95%CI: 0.01 to 0.08, proportion mediated: 5.48%), and functional disability and depressive symptoms in a chain (coefficient: 0.01, 95%CI: 0 to 0.02, proportion mediated: 1.37%). Conclusion: Functional disability and depressive symptoms may partly explain the association between intergenerational contact and cognitive function. Further research is needed to explore the mechanisms underlying the association between intergenerational contact and cognitive function.

Aims. Adverse factors in the psychosocial work environment are associated with the onset of depression among those without a personal history of depression. However, the evidence is sparse regarding whether adverse work factors can also play a role in depression recurrence. This study aimed to prospectively examine whether factors in the psychosocial work environment are associated with first-time and recurrent treatment for depression.

Methods. The study included 24,226 participants from the Danish Well-being in Hospital Employees study. We measured ten individual psychosocial work factors and three theoretical constructs (effort–reward imbalance, job strain and workplace social capital). We ascertained treatment for depression through registrations of hospital contacts for depression (International Statistical Classification of Diseases and Related Health Problems version 10 [ICD-10]: F32 and F33) and redeemed prescriptions of antidepressant medication (Anatomical Therapeutic Chemical [ATC]: N06A) in Danish national registries. We estimated the associations between work factors and treatment for depression for up to 2 years after baseline among those without (first-time treatment) and with (recurrent treatment) a personal history of treatment for depression before baseline. We excluded participants registered with treatment within 6 months before baseline. In supplementary analyses, we extended this washout period to up to 2 years. We applied logistic regression analyses with adjustment for confounding.

Results. Among 21,156 (87%) participants without a history of treatment for depression, 350 (1.7%) had first-time treatment during follow-up. Among the 3070 (13%) participants with treatment history, 353 (11%) had recurrent treatment during follow-up. Those with a history of depression generally reported a more adverse work environment than those without such a history. Baseline exposure to bullying (odds ratio [OR] = 1.72, 95% confidence interval [95% CI]: 1.30–2.32), and to some extent also low influence on work schedule (OR = 1.27, 95% CI: 0.97–1.66) and job strain (OR = 1.24, 95% CI: 0.97–1.57), was associated with first-time treatment for depression during follow-up. Baseline exposure to bullying (OR = 1.40, 95% CI: 1.04–1.88), lack of collaboration (OR = 1.31, 95% CI: 1.03–1.67) and low job control (OR = 1.27, 95% CI: 1.00–1.62) were associated with recurrent treatment for depression during follow-up. However, most work factors were not associated with treatment for depression. Using a 2-year washout period resulted in similar or stronger associations.

Conclusions. Depression constitutes a substantial morbidity burden in the working-age population. Specific adverse working conditions were associated with first-time and recurrent treatment for depression and improving these may contribute to reducing the onset and recurrence of depression.

Aims: Exposure to work-related sexual harassment may increase the risk for certain adverse behavioural and emotional outcomes but less is known about its association with somatic diseases such as cardiovascular disease (CVD) and type 2 diabetes. This study investigated the prospective association of work-related sexual harassment and risk of cardiometabolic diseases. Methods and results: This cohort study included 88 904 Swedish men and women in paid work who responded to questions on workplace sexual harassment in the Swedish Work Environment Survey (1995–2015) and were free from cardiometabolic diseases at baseline. Cardiometabolic diseases (CVD and type 2 diabetes) were identified from the National Patient Register and Causes of Death Register through linkage. Cox proportional hazard regression was used, adjusting for socio-demographic, work-related psychosocial, and physical exposure at baseline. Overall, 4.8% of the participants (n = 4300) reported exposure to workplace sexual harassment during the previous 12 months. After adjustment for sex, birth country, family situation, education, income, and work-related factors, workplace sexual harassment was associated with increased incidence of CVD [hazard ratio (HR) 1.25, 95% confidence interval 1.03–1.51] and type 2 diabetes (1.45, 1.21–1.73). The HR for CVD (1.57, 1.15–2.15) and type 2 diabetes (1.85, 1.39–2.46) was increased for sexual harassment from superior or fellow workers, and sexual harassment from others was associated with type 2 diabetes (1.39, 1.13–1.70). The HR for both CVD (1.31, 0.95–1.81) and type 2 diabetes (1.72, 1.30–2.28) was increased for frequent exposure. Conclusion: The results of this study support the hypothesis that workplace sexual harassment is prospectively associated with cardiometabolic diseases. Future research is warranted to understand causality and mechanisms behind these associations.

Objectives: The aim of this study was to investigate associations between exposure to work-related violence/threats and harassment, and future sickness absence (SA) due to common mental disorders (CMDs), taking familial factors (shared genetics and early-life environment) and neuroticism into account. Methods: The study sample included 8795 twin individuals from the Swedish Twin Project of Disability Pension and Sickness Absence (STODS), including survey data from the Study of Twin Adults: Genes and Environment (STAGE). Self-reported work-related violence and/or threats as well as work-related harassment (including bullying) and national register data on SA due to CMDs were analyzed using standard logistic regression, and conditional logistic regression among complete twin pairs discordant on exposures. Individuals were followed for a maximum of 13 years. Interactions between neuroticism and exposures were assessed using both multiplicative and additive interaction analyses. Results: Exposure to work-related violence/threats was associated with higher odds of SA due to CMDs when adjusting for age, sex, marital status, children, education, type of living area, work characteristics, and symptoms of depression and burnout (OR 2.11, 95% CI 1.52-2.95). Higher odds of SA due to CMDs were also found for exposure to harassment (OR 1.52, 95% CI 1.10-2.11) and a combined indicator of exposure to violence/threats and/or harassment (OR 1.98, 95% CI 1.52-2.59), compared with the unexposed. Analyses of twins discordant on exposure, using the unexposed co-twin as reference, showed reduced ORs. These ORs were still elevated but no longer statistically significant, potentially due to a lack of statistical power. No multiplicative interaction was found between neuroticism and exposure to work-related violence/threats, or harassment. However, a statistically significant additive interaction was found between neuroticism and exposure to violence/threats, indicating higher odds of SA due to CMDs in the group scoring lower on neuroticism. Conclusions: Exposure to work-related offensive behaviors was associated with SA due to CMDs. However, the results indicated that these associations may be partly confounded by familial factors. In addition, an interaction between exposure and neuroticism was suggested. Thus, when possible, future studies investigating associations and causality between offensive behaviors at work and mental health-related outcomes, should consider familial factors and neuroticism.

Background: Workplace offensive behaviours, such as violence and bullying, have been linked to psychological symptoms, but their potential impact on suicide risk remains unclear. We aimed to assess the association of workplace violence and bullying with the risk of death by suicide and suicide attempt in multiple cohort studies. Methods: In this multicohort study, we used individual-participant data from three prospective studies: the Finnish Public Sector study, the Swedish Work Environment Survey, and the Work Environment and Health in Denmark study. Workplace violence and bullying were self-reported at baseline. Participants were followed up for suicide attempt and death using linkage to national health records. We additionally searched the literature for published prospective studies and pooled our effect estimates with those from published studies. Findings: During 1 803 496 person-years at risk, we recorded 1103 suicide attempts or deaths in participants with data on workplace violence (n=205 048); the corresponding numbers for participants with data on workplace bullying (n=191 783) were 1144 suicide attempts or deaths in 1 960 796 person-years, which included data from one identified published study. Workplace violence was associated with an increased risk of suicide after basic adjustment for age, sex, educational level, and family situation (hazard ratio 1.34 [95% CI 1.15-1.56]) and full adjustment (additional adjustment for job demands, job control, and baseline health problems, 1.25 [1.08-1.47]). Where data on frequency were available, a stronger association was observed among people with frequent exposure to violence (1.75 [1.27-2.42]) than occasional violence (1.27 [1.04-1.56]). Workplace bullying was also associated with an increased suicide risk (1.32 [1.09-1.59]), but the association was attenuated after adjustment for baseline mental health problems (1.16 [0.96-1.41]). Interpretation: Observational data from three Nordic countries suggest that workplace violence is associated with an increased suicide risk, highlighting the importance of effective prevention of violent behaviours at workplaces.