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Thacher JD, Roswall N, Lissåker C, Aasvang GM, Albin M, Andersson EM, Engström G, Eriksson C, Hvidtfeldt UA, Ketzel M, Khan J, Lanki T, Ljungman PLS, Mattisson K, Molnar P, Raaschou-Nielsen O, Oudin A, Overvad K, Petersen SB, Pershagen G, Poulsen AH, Pyko A, Rizzuto D, Rosengren A, Schioler L, Sjöström M, Stockfelt L, Tiittanen P, Sallsten G, Ögren M, Selander J, Sorensen M. Occupational noise exposure and risk of incident stroke: a pooled study of five Scandinavian cohorts. Occup Environ Med 2022; 79:oemed-2021-108053. [PMID: 35450950 PMCID: PMC9453564 DOI: 10.1136/oemed-2021-108053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 03/11/2022] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To investigate the association between occupational noise exposure and stroke incidence in a pooled study of five Scandinavian cohorts (NordSOUND). METHODS We pooled and harmonised data from five Scandinavian cohorts resulting in 78 389 participants. We obtained job data from national registries or questionnaires and recoded these to match a job-exposure matrix developed in Sweden, which specified the annual average daily noise exposure in five exposure classes (LAeq8h): <70, 70-74, 75-79, 80-84, ≥85 dB(A). We identified residential address history and estimated 1-year average road traffic noise at baseline. Using national patient and mortality registers, we identified 7777 stroke cases with a median follow-up of 20.2 years. Analyses were conducted using Cox proportional hazards models adjusting for individual and area-level potential confounders. RESULTS Exposure to occupational noise at baseline was not associated with overall stroke in the fully adjusted models. For ischaemic stroke, occupational noise was associated with HRs (95% CI) of 1.08 (0.98 to 1.20), 1.09 (0.97 to 1.24) and 1.06 (0.92 to 1.21) in the 75-79, 80-84 and ≥85 dB(A) exposure groups, compared with <70 dB(A), respectively. In subanalyses using time-varying occupational noise exposure, we observed an indication of higher stroke risk among the most exposed (≥85 dB(A)), particularly when restricting analyses to people exposed to occupational noise within the last year (HR: 1.27; 95% CI: 0.99 to 1.63). CONCLUSIONS We found no association between occupational noise and risk of overall stroke after adjustment for confounders. However, the non-significantly increased risk of ischaemic stroke warrants further investigation.
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Affiliation(s)
- Jesse D Thacher
- Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Nina Roswall
- Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Claudia Lissåker
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | - Maria Albin
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Center for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Eva M Andersson
- Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Gunnar Engström
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Charlotta Eriksson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Center for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | | | - Matthias Ketzel
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
- Global Centre for Clean Air Research (GCARE), University of Surrey, Guildford, UK
| | - Jibran Khan
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
- Danish Big Data Centre for Environment and Health (BERTHA), Aarhus University, Roskilde, Denmark
| | - Timo Lanki
- Department of Health Security, Finnish Institute for Health and Welfare (THL), Kuopio, Finland
- School of Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland
| | - Petter L S Ljungman
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Cardiology, Danderyd Hospital, Stockholm, Sweden
| | - Kristoffer Mattisson
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Peter Molnar
- Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ole Raaschou-Nielsen
- Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Anna Oudin
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
- Sustainable Health, Umeå University, Umeå, Sweden
| | - Kim Overvad
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Sesilje Bondo Petersen
- Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Göran Pershagen
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Center for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Aslak Harbo Poulsen
- Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Andrei Pyko
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Center for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Debora Rizzuto
- Aging Research Centre, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Stockholm Gerontology Research Centre, Stockholm, Sweden
| | - Annika Rosengren
- Molecular and Clinical Medicine, Sahlgrenska Cademy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Linus Schioler
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Mattias Sjöström
- Center for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Leo Stockfelt
- Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Pekka Tiittanen
- Department of Health Security, Finnish Institute for Health and Welfare (THL), Kuopio, Finland
| | - Gerd Sallsten
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Mikael Ögren
- Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Jenny Selander
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Mette Sorensen
- Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Natural Science and Environment, Roskilde University, Roskilde, Denmark
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Lissåker C, Hemmingsson T, Kjellberg K, Lindfors P, Selander J. Occupational stress and pregnancy-related hypertension and diabetes: Results from a nationwide prospective cohort. Scand J Work Environ Health 2021; 48:239-247. [PMID: 34897523 PMCID: PMC9523467 DOI: 10.5271/sjweh.4004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
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.
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Affiliation(s)
- Claudia Lissåker
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-171 77, Stockholm, Sweden.
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Ubalde-Lopez M, Garani-Papadatos T, Scelo G, Casas M, Lissåker C, Peters S, Nohr EA, Albin M, Lucas R, Papantoniou K, Polańska K, Ramlau-Hansen CH, Šarac J, Selander J, Skröder H, Vasileiou E, Kogevinas M, Bültmann U, Mehlum IS, Maule M. Working life, health and well-being of parents: a joint effort to uncover hidden treasures in European birth cohorts. Scand J Work Environ Health 2021; 47:550-560. [PMID: 34432068 PMCID: PMC8504161 DOI: 10.5271/sjweh.3980] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objective Birth cohorts collect valuable and under-utilized information on employment and health of parents before and during pregnancy, at birth, and sometimes after birth. In this discussion paper, we examine how these data could be exploited to study the complex relationships and interactions between parenthood, work, and health among parents themselves. Methods Using a web-based database of birth cohorts, we summarize information on maternal employment and health conditions and other potentially related variables in cohorts spread throughout Europe. This provided information on what data are available and could be used in future studies, and what was missing if specific questions are to be addressed, exploiting the opportunity to explore work–health associations across heterogenous geographical and social contexts. Results We highlight the many potentialities provided by birth cohorts and identify gaps that need to be addressed to adopt a life-course approach and investigate topics specific to the peri-pregnancy period, such as psychosocial aspects. We address the technical difficulties implied by data harmonization and the ethical challenges related to the repurposing of data, and provide scientific, ecological and economic arguments in favor of improving the value of data already available as a result of a serious investment in human and material resources. Conclusions There is a hidden treasure in birth cohorts that deserves to be brought out to study the relationships between employment and health among working parents in a time when the boundaries between work and life are being stretched more than ever before.
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Affiliation(s)
- Monica Ubalde-Lopez
- Cancer Epidemiology Unit, University of Turin, via Santena 7, 10126 Torino, Italy.
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Norlund F, Lissåker C, Wallert J, Held C, Olsson EM. Factors associated with emotional distress in patients with myocardial infarction: Results from the SWEDEHEART registry. Eur J Prev Cardiol 2018; 25:910-920. [PMID: 29692223 PMCID: PMC6009178 DOI: 10.1177/2047487318770510] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Background Emotional distress, symptoms of depression and anxiety, is common among patients after a myocardial infarction (MI), and is associated with an increased risk of cardiovascular morbidity. Real world population data on factors associated with emotional distress in MI patients are scarce. The aim was to determine factors associated with incident emotional distress two and 12 months post MI respectively, and with persistent emotional distress, versus remittent, in patients <75 years old. Design This was a registry-based observational study. Methods Data from the national SWEDEHEART registry on 27,267 consecutive patients with a first-time MI, followed up at two and 12 months post MI (n = 22,911), were included in the analyses. Emotional distress was assessed with the EuroQol-5D questionnaire. Several candidate sociodemographic and clinical factors were analysed for their association with emotional distress in multivariate models. Results Symptoms of emotional distress were prevalent in 38% and 33% at two and 12 months post MI respectively. At both time-points, previous depression and/or anxiety, readmission for new cardiovascular event, female gender, younger age, born outside the neighbouring Nordic countries, smoking and being neither employed nor retired showed the strongest associations with emotional distress. Other factors related to medical history, the MI and its care or were only modestly associated with emotional distress. Persistent emotional distress was associated with younger age, female gender, smoking and being born outside of the Nordic countries. Conclusion Previous depression/anxiety, female gender, younger age, smoking, born outside of the Nordic countries, neither employed nor retired and readmission due to cardiovascular events were strongly associated with emotional distress post MI. These factors may be of relevance in tailoring rehabilitation programmes.
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Affiliation(s)
- Fredrika Norlund
- 1 Department of Women's and Children's Health, Clinical Psychology in Healthcare, Uppsala University, Sweden
| | - Claudia Lissåker
- 1 Department of Women's and Children's Health, Clinical Psychology in Healthcare, Uppsala University, Sweden
| | - John Wallert
- 1 Department of Women's and Children's Health, Clinical Psychology in Healthcare, Uppsala University, Sweden
| | - Claes Held
- 1 Department of Women's and Children's Health, Clinical Psychology in Healthcare, Uppsala University, Sweden.,2 Department of Medical Sciences: Cardiology, Uppsala Clinical Research Centre, Uppsala University, Sweden
| | - Erik Mg Olsson
- 1 Department of Women's and Children's Health, Clinical Psychology in Healthcare, Uppsala University, Sweden
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