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Neufcourt L, Castagné R, Wilsgaard T, Grimsgaard S, Chadeau-Hyam M, Vuckovic D, Ugarteche-Perez A, Farbu EH, Sandanger TM, Delpierre C, Kelly-Irving M. Educational patterning in biological health seven years apart: Findings from the Tromsø Study. Psychoneuroendocrinology 2024; 160:106670. [PMID: 37992555 DOI: 10.1016/j.psyneuen.2023.106670] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 11/07/2023] [Accepted: 11/09/2023] [Indexed: 11/24/2023]
Abstract
BACKGROUND Social-to-biological processes is one set of mechanisms underlying the relationship between social position and health. However, very few studies have focused on the relationship between social factors and biology at multiple time points. This work investigates the relationship between education and the dynamic changes in a composite Biological Health Score (BHS) using two time points seven years apart in a Norwegian adult population. METHODS We used data from individuals aged 30 years and above who participated in Tromsø6 (2007-2008) and Tromsø7 (2015-2016) (n = 8117). BHS was defined using ten biomarkers measured from blood samples and representing three physiological systems (cardiovascular, metabolic, inflammatory). The higher the BHS, the poorer the health status. FINDINGS Linear regression models carried out on BHS revealed a strong educational gradient at two distinct time points but also over time. People with lower educational attainment were at higher risk of poor biological health at a given time point (βlow education Tromsø6=0.30 [95 %-CI=0.18-0.43] and βlow education Tromsø7=0.30 [95 %-CI=0.17-0.42]). They also presented higher longitudinal BHS compared to people with higher education (βlow education = 0.89 [95 %-CI=0.56-1.23]). Certain biomarkers related to the cardiovascular system and the metabolic system were strongly socially distributed, even after adjustment for sex, age, health behaviours and body mass index. CONCLUSION This longitudinal analysis highlights that participants with lower education had their biological health deteriorated to a greater extent over time compared to people with higher education. Our findings provide added evidence of the biological embodiment of social position, particularly with respect to dynamic aspects for which little evidence exists.
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Affiliation(s)
- Lola Neufcourt
- CERPOP-UMR1295, EQUITY research team, Inserm, Université Toulouse III Paul Sabatier, Toulouse, France.
| | - Raphaële Castagné
- CERPOP-UMR1295, EQUITY research team, Inserm, Université Toulouse III Paul Sabatier, Toulouse, France
| | - Tom Wilsgaard
- Department of Community Medicine, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway
| | - Sameline Grimsgaard
- Department of Community Medicine, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway
| | - Marc Chadeau-Hyam
- Department of Epidemiology and Biostatistics, School of Public Health, Faculty of Medicine, Imperial College London, London, UK; MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Dragana Vuckovic
- Department of Epidemiology and Biostatistics, School of Public Health, Faculty of Medicine, Imperial College London, London, UK; MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Ainhoa Ugarteche-Perez
- CERPOP-UMR1295, EQUITY research team, Inserm, Université Toulouse III Paul Sabatier, Toulouse, France
| | - Erlend Hoftun Farbu
- Department of Community Medicine, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway
| | - Torkjel M Sandanger
- Department of Community Medicine, Faculty of Health Sciences, UiT the Arctic University of Norway, Tromsø, Norway
| | - Cyrille Delpierre
- CERPOP-UMR1295, EQUITY research team, Inserm, Université Toulouse III Paul Sabatier, Toulouse, France
| | - Michelle Kelly-Irving
- CERPOP-UMR1295, EQUITY research team, Inserm, Université Toulouse III Paul Sabatier, Toulouse, France
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Norbye AD, Farbu EH, Terjesen CL, Fleten N, Höper AC. The level of health anxiety before and during the COVID-19 pandemic. PLoS One 2023; 18:e0285799. [PMID: 37224119 DOI: 10.1371/journal.pone.0285799] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 04/29/2023] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND Concerns about disease and an increase in health anxiety levels are expected consequences of the COVID-19 pandemic. However, there have been few longitudinal studies of health anxiety in the general population during this time period. The aim of this study was to examine health anxiety levels before and during the COVID-19 pandemic in an adult, working population in Norway. MATERIAL AND METHODS This study included 1012 participants aged 18-70 years with one or more measurements of health anxiety (1402 measurements total) from the pre-pandemic period (2015 to March 11, 2020) and/or during the COVID-19 pandemic (March 12, 2020 to March 31, 2022). Health anxiety was measured with the revised version of the Whiteley Index-6 scale (WI-6-R). We estimated the effect of the COVID-19 pandemic on health anxiety scores with a general estimation equation analysis, and age, gender, education, and friendship were included in subgroup analyses. RESULTS We found no significant change in health anxiety scores during the COVID-19 pandemic compared to the pre-pandemic period in our adult, working population. A sensitivity analysis restricted to participants with two or more measurements showed similar results. Moreover, the effect of the COVID-19 pandemic on health anxiety scores was not significant in any subgroup analysis. CONCLUSION Health anxiety remained stable, with no significant change observed between the pre-pandemic period and the first 2 years of the COVID-19 pandemic in an adult, working population in Norway.
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Affiliation(s)
- Anja Davis Norbye
- Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway
| | - Erlend Hoftun Farbu
- Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway
| | - Christoffer Lilja Terjesen
- Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway
- Department of Rehabilitation, University Hospital of North Norway, Tromsø, Norway
| | - Nils Fleten
- Norwegian Labour and Welfare Administration Troms and Finnmark, Tromsø, Norway
| | - Anje Christina Höper
- Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway
- Department of Occupational and Environmental Medicine, University Hospital of North Norway, Tromsø, Norway
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Stjernbrandt A, Hoftun Farbu E. Occupational cold exposure is associated with neck pain, low back pain, and lumbar radiculopathy. Ergonomics 2022; 65:1276-1285. [PMID: 35023451 DOI: 10.1080/00140139.2022.2027030] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 01/02/2022] [Indexed: 06/14/2023]
Abstract
Ambient cold exposure can pose health risks, and this study was aimed at investigating associations with musculoskeletal disorders. A postal survey was performed on 12,627 men and women, ages 18-70 years, living in northern Sweden. Statistical associations were determined using multiple logistic regression. The study sample consisted of 6,886 women (54.5%), and 5,741 men. Reporting high occupational ambient cold exposure was statistically significantly associated with neck pain (OR 1.36; 95% CI 1.16-1.59), low back pain (OR 1.38; 95% CI 1.17-1.63), and lumbar radiculopathy (OR 1.36; 95% CI 1.07-1.73), after adjusting for age, gender, body mass index, physical work load, daily smoking, and stress. We conclude that ambient cold exposure during work was an independent predictor of neck pain, low back pain, and lumbar radiculopathy. In occupational health care settings, cold exposure should be recognised as a possible risk factor for musculoskeletal disorders. Practitioner summary: This cross-sectional, survey-based study investigated associations between self-reported occupational ambient cold exposure and musculoskeletal disorders. It showed significant associations between high cold exposure and neck pain, low back pain and lumbar radiculopathy. In occupational health care settings, cold exposure should be recognised as a possible risk factor for musculoskeletal disorders.
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Affiliation(s)
- Albin Stjernbrandt
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
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Farbu EH, Höper AC, Reierth E, Nilsson T, Skandfer M. Cold exposure and musculoskeletal conditions; A scoping review. Front Physiol 2022; 13:934163. [PMID: 36117709 PMCID: PMC9475294 DOI: 10.3389/fphys.2022.934163] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 06/30/2022] [Indexed: 11/23/2022] Open
Abstract
Background: Musculoskeletal conditions are major contributors to years lived with disability. Cold exposure can be a risk factor, but any conclusion is obscure. Aim: The aim of the present scoping review was to identify the existing evidence of an association between cold exposure and musculoskeletal conditions. The aim also included to consider pain in different regions and their assessment, as well as different measures of cold exposure, effect sizes, and to assess the feasibility of future systematic reviews and meta-analyses. Eligibility criteria: The studies must have: an epidemiological design, defined cold exposure to come prior to the health outcome, defined exposure and outcome(s), existence of effect estimate(s) or data that made it possible to calculate such an estimate. Further, studies were required to be in English language and published in peer-reviewed journals. Studies that had a specific goal of studying cold exposure as an aggravator of already existing health problems were excluded. Sources: We searched Ovid MEDLINE(R) and Epub Ahead of Print, In-Process and Other Non-Indexed Citations, Daily and Versions(R), and Embase Classic + Embase for original studies. Charting method: The included studies were reviewed for study population, measurement of exposure and outcome, and effect size. Each publication was assessed for risk of bias. Results: The included studies were heterogeneous in populations, measures of cold exposure and musculoskeletal conditions. Most studies used self-reported data. They were mostly cross-sectional studies, only two were prospective and one was a case-control study. Associations were found for different cold exposures and regional musculoskeletal conditions, but the heterogeneity and lack of studies impeded valid synthesis of risk magnitude, or meta-analyses. Conclusion: The studies identified in this review indicate that cold exposure increases the risk of musculoskeletal conditions. However, there is a need for studies that better assess temporality between exposure and outcome. Future studies should also include better exposure assessment, including both objective measurements and measures of subjective experience of cold exposure. The heterogeneity in measurement of exposure and outcome impeded any meta-analysis.
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Affiliation(s)
- Erlend Hoftun Farbu
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
- *Correspondence: Erlend Hoftun Farbu,
| | - Anje Christina Höper
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Occupational and Environmental Medicine, University Hospital of North Norway, Tromsø, Norway
| | - Eirik Reierth
- Department of Library Services, UiT The Arctic University of Norway, Tromsø, Norway
| | - Tohr Nilsson
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden
| | - Morten Skandfer
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
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Farbu EH, Rypdal M, Skandfer M, Steingrímsdóttir ÓA, Brenn T, Stubhaug A, Nielsen CS, Höper AC. To tolerate weather and to tolerate pain: two sides of the same coin? The Tromsø Study 7. Pain 2022; 163:878-886. [PMID: 34510136 PMCID: PMC9009320 DOI: 10.1097/j.pain.0000000000002437] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 07/08/2021] [Accepted: 07/13/2021] [Indexed: 11/26/2022]
Abstract
ABSTRACT It is a common belief that weather affects pain. Therefore, we hypothesized that weather can affect pain tolerance. This study used data from over 18,000 subjects aged 40 years or older from the general population, who participated in the Tromsø Study 7. They underwent a one-time assessment of cuff algometry pressure pain tolerance (PPT) and cold pain tolerance (CPT), tested with a cold pressor test. The results showed a clear seasonal variation in CPT. The rate of withdrawal in the cold pressor test was up to 75% higher in months in the warmer parts of the year compared with January 2016. There was no seasonal variation in PPT. The study not only found a nonrandom short-term variation in PPT but also indications of such a variation in CPT. The intrinsic timescale of this short-term variation in PPT was 5.1 days (95% % confidence interval 4.0-7.2), which is similar to the observed timescales of meteorological variables. Pressure pain tolerance and CPT correlated with meteorological variables, and these correlations changed over time. Finally, temperature and barometric pressure predicted future values of PPT. These findings suggest that weather has a causal and dynamic effect on pain tolerance, which supports the common belief that weather affects pain.
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Affiliation(s)
- Erlend Hoftun Farbu
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Martin Rypdal
- Department of Mathematics and Statistics, UiT The Arctic University of Norway, Tromsø, Norway
| | - Morten Skandfer
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | | | - Tormod Brenn
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Audun Stubhaug
- Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Christopher Sivert Nielsen
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway
- Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway
| | - Anje Christina Höper
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
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Farbu EH, Höper AC, Brenn T, Skandfer M. Is working in a cold environment associated with musculoskeletal complaints 7-8 years later? A longitudinal analysis from the Tromsø Study. Int Arch Occup Environ Health 2020; 94:611-619. [PMID: 33226448 PMCID: PMC8068634 DOI: 10.1007/s00420-020-01606-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 10/30/2020] [Indexed: 12/28/2022]
Abstract
Objective Exposure to a cold environment at work is associated with a higher prevalence of musculoskeletal pain and chronic pain in cross-sectional studies. This study aims to determine the association between working in a cold environment ≥ 25% of the time and musculoskeletal complaints (MSC) 7–8 years later. Methods We followed participants from the sixth survey (Tromsø 6, 2007–2008) to the seventh survey (Tromsø 7, 2015–2016) of the Tromsø Study. Analyses included 2347 men and women aged 32–60 years who were not retired and not receiving full-time disability benefits in Tromsø 6. Three different binary outcomes were investigated in Tromsø 7: any MSC, severe MSC, and MSC in ≥ 3 anatomical regions. We excluded participants with severe MSC, MSC in ≥ 3 regions, or missing values in Tromsø 6. The association between working in a cold environment and future MSC were examined using Poisson regression and adjusted for age, sex, number of moderate MSC, education, physical activity at work, smoking status, body mass index, and self-reported health in Tromsø 6. Results 258 participants reported to work in a cold environment ≥ 25% of the time in Tromsø 6. They had an increased risk of having any MSC in Tromsø 7 (incidence rate ratio 1.15; 95% confidence interval 1.03–1.29). There was no significantly increased risk of severe MSC or MSC in ≥ 3 regions. Conclusion Working in a cold environment was associated with future MSC, but not with future severe MSC or future MSC in ≥ 3 regions. Electronic supplementary material The online version of this article (10.1007/s00420-020-01606-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Erlend Hoftun Farbu
- Department of Community Medicine, UiT-The Arctic University of Norway, Tromsø, Norway.
| | - Anje Christina Höper
- Department of Community Medicine, UiT-The Arctic University of Norway, Tromsø, Norway.,Department of Occupational and Environmental Medicine, University Hospital of North Norway, Tromsø, Norway
| | - Tormod Brenn
- Department of Community Medicine, UiT-The Arctic University of Norway, Tromsø, Norway
| | - Morten Skandfer
- Department of Community Medicine, UiT-The Arctic University of Norway, Tromsø, Norway
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Abstract
AIM The aim of this study was to investigate if working in a cold environment and feeling cold at work are associated with chronic pain (ie, lasting ≥3 months). METHODS We used data from the sixth survey (2007-2008) of the Tromsø Study. Analyses included 6533 men and women aged 30-67 years who were not retired, not receiving full-time disability benefits and had no missing values. Associations between working in a cold environment, feeling cold at work and self-reported chronic pain were examined with logistic regression adjusted for age, sex, education, body mass index, insomnia, physical activity at work, leisure time physical activity and smoking. RESULTS 779 participants reported working in a cold environment ≥25% of the time. This exposure was positively associated with pain at ≥3 sites (OR 1.57; 95% CI 1.23 to 2.01) and with neck, shoulder and leg pain, but not with pain at 1-2 sites. Feeling cold sometimes or often at work was associated with pain at ≥3 sites (OR 1.58; 95% CI 1.22 to 2.07 and OR 3.90; 95% CI 2.04 to 7.45, respectively). Feeling cold often at work was significantly and positively associated with pain at all sites except the hand, foot, stomach and head. CONCLUSION Working in a cold environment was significantly associated with chronic pain. The observed association was strongest for pain at musculoskeletal sites and for those who often felt cold at work.
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Affiliation(s)
- Erlend Hoftun Farbu
- Department of Community Medicine, UiT Norges arktiske universitet, Tromso, Norway
| | - Morten Skandfer
- Department of Community Medicine, UiT Norges arktiske universitet, Tromso, Norway
| | - Christopher Nielsen
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway
- Department of Pain Management and Research, Oslo Universitetssykehus, Oslo, Norway
| | - Tormod Brenn
- Department of Community Medicine, UiT Norges arktiske universitet, Tromso, Norway
| | - Audun Stubhaug
- Department of Pain Management and Research, Oslo Universitetssykehus, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo Faculty of Medicine, Oslo, Oslo, Norway
| | - Anje Christina Höper
- Department of Community Medicine, UiT Norges arktiske universitet, Tromso, Norway
- Department of Occupational and Environmental Medicine, University Hospital of North Norway, Tromso, Norway
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