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Vilsbøl S, Christiansen DH, Budtz CR, Andersen JH, Mose S. Change in number of pain sites - which factors are important? A 12-year prospective cohort study. BMC Musculoskelet Disord 2024; 25:219. [PMID: 38500099 PMCID: PMC10949606 DOI: 10.1186/s12891-024-07344-x] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 03/07/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND Pain in multiple body sites is common and often persistent. The purpose of this prospective study was to examine the change in the number of pain sites (NPS) over time and to evaluate to which extent clinical, demographic, lifestyle and health-related factors predict a change in NPS. METHODS This was a population-based longitudinal cohort study of adults (n = 2,357). Data on pain, demographic, lifestyle, and health-related variables were collected by questionnaires in 2008 and 2020 and register data from 2006 to 2017. Data was analysed with linear regression. RESULTS We found a mean decrease in NPS over the 12-year follow-up period (-0.36 (95% CI; -0.44; -0.27) and 56% of this sample reported no change or only one pain site increase/decrease over 12 years. While participants reporting pain for less than 3 months at baseline had almost no change in NPS (-0.04 (95% CI; -0.18; 0.10)), participants with pain for longer than 3 months decreased by -0.51 (95% CI; -0.62; -0.41). Age at baseline (20-49 years), pain intensity, and obesity (BMI ≥ 30) were associated with an increase in NPS over the follow-up period. CONCLUSIONS NPS is relatively stable over time. We found a small mean decrease in NPS over 12 years varying between participants with pain for longer than 3 months and pain for less than 3 months respectively. The results also indicate that pain intensity, age, and obesity could be relevant factors to consider when predicting change in NPS.
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Affiliation(s)
- Susanne Vilsbøl
- School of Physiotherapy, VIA University College, Holstebro, Denmark
| | - David Høyrup Christiansen
- Centre for Research in Health and Nursing, Research, Regional Hospital Central Jutland, Viborg, Denmark
- Department of Clinical Medicine, Health, Aarhus University, Aarhus, Denmark & Elective Surgery Center, Silkeborg Regional Hospital, Silkeborg, Denmark
| | - Cecilie Rud Budtz
- Elective Surgery Center, Silkeborg Regional Hospital, Silkeborg, Denmark
| | - Johan Hviid Andersen
- Department of Clinical Medicine, Health, Aarhus University, Aarhus, Denmark & Elective Surgery Center, Silkeborg Regional Hospital, Silkeborg, Denmark
- Department of Occupational Medicine, University Research Clinic, Danish Ramazzini Center, Goedstrup Hospital, Aarhus University, Herning, Denmark
| | - Søren Mose
- School of Physiotherapy, VIA University College, Holstebro, Denmark.
- Elective Surgery Center, Silkeborg Regional Hospital, Silkeborg, Denmark.
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Mose S, Budtz CR, Rønn Smidt H, Kent P, Smith A, Hviid Andersen J, Christiansen DH. How do people with chronic pain explain their use, or non-use, of pain-related healthcare services? A qualitative study of patient experiences. Disabil Rehabil 2023; 45:4207-4217. [PMID: 36398748 DOI: 10.1080/09638288.2022.2147589] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 11/09/2022] [Indexed: 11/19/2022]
Abstract
PURPOSE This study aims to explore how people with chronic pain explain their use or non-use of pain-related healthcare services and their expectations of the healthcare provider, and explore how explanations and expectations vary between different levels of pain-related healthcare use. MATERIALS AND METHODS We conducted 20 individual semi-structured interviews with purposely sampled adults between 39 and 77 years of age with chronic pain. All interviews were audio-recorded, transcribed and analysed using a thematical template analysis approach. RESULTS Four key drivers for pain-related healthcare use were identified: (1) the healthcare system facilitates clinical pathways, (2) appraisal of pain-related healthcare initiatives influences future use, (3) autonomy, beliefs and values determine healthcare behaviour, and (4) recommendations from others impact healthcare behaviour. Comparing explanations across different pain-related healthcare user groups (high, medium and low) showed that perceived needs, beliefs and values, and appraisal of previous healthcare experiences differed between these groups. CONCLUSIONS Beliefs, pain characteristics, recommendations, and the search for a diagnostic label, often initiate pain-related healthcare use. Healthcare is modified by two interconnected systems: (1) perceived needs, beliefs and values and (2) previous healthcare experiences. Differences related to these systems could explain some of the variance in pain-related healthcare use.Implications for RehabilitationDifferent use of pain-related healthcare services for people with chronic pain could be related to differences in perceived needs, beliefs and values and appraisal of previous healthcare.It may be helpful to explore the perceived needs and beliefs of those seeking healthcare due to chronic pain.Previous healthcare experiences may impact and should be explored.
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Affiliation(s)
- Søren Mose
- Department of Occupational Medicine, University Research Clinic, Danish Ramazzini Centre, Goedstrup Hospital, Glostrup, Denmark
- School of Physiotherapy, VIA University College, Holstebro, Denmark
| | - Cecile Rud Budtz
- Department of Occupational Medicine, University Research Clinic, Danish Ramazzini Centre, Goedstrup Hospital, Glostrup, Denmark
| | - Helle Rønn Smidt
- School of Physiotherapy, VIA University College, Holstebro, Denmark
| | - Peter Kent
- School of Allied Health, Curtin University, Perth, WA, Australia
- Center for Muscle and Joint Health, University of Southern Denmark, Odense, Denmark
| | - Anne Smith
- School of Allied Health, Curtin University, Perth, WA, Australia
| | - Johan Hviid Andersen
- Department of Occupational Medicine, University Research Clinic, Danish Ramazzini Centre, Goedstrup Hospital, Glostrup, Denmark
- Department of Clinical Medicine, Health, Aarhus University, Aarhus, Denmark
| | - David Høyrup Christiansen
- Department of Clinical Medicine, Health, Aarhus University, Aarhus, Denmark
- Regional Hospital Central Jutland, Viborg, Denmark
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Maagaard M, Plambech MZ, Funder KS, Schou NK, Mølgaard AK, Stormholt ER, Leth MF, Bukhari S, Mortensen A, Lunn TH, Tryggedsson I, Nørskov AK, Zamany C, Toquer P, Jaeger P, Andersen JH, Mathiesen O. The effect of oral dexamethasone on duration of analgesia after upper limb surgery under infraclavicular brachial plexus block: a randomised controlled trial. Anaesthesia 2023; 78:1465-1471. [PMID: 37864459 DOI: 10.1111/anae.16149] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2023] [Indexed: 10/22/2023]
Abstract
The effects of oral dexamethasone on peripheral nerve blocks have not been investigated. We randomly allocated adults scheduled for forearm or hand surgery to oral placebo (n = 61), dexamethasone 12 mg (n = 61) or dexamethasone 24 mg (n = 57) about 45 min before lateral infraclavicular block. Mean (SD) time until first pain after block were: 841 (327) min; 1171 (318) min; and 1256 (395) min, respectively. Mean (98.3%CI) differences in time until first postoperative pain for dexamethasone 24 mg vs. placebo and vs. dexamethasone 12 mg were: 412 (248-577) min, p < 0.001; and 85 (-78 to 249) min, p = 0.21, respectively. Mean (98.3%CI) difference in time until first postoperative pain for dexamethasone 12 mg vs. placebo was 330 (186-474) min, p < 0.001. Both 24 mg and 12 mg of oral dexamethasone increased the time until first postoperative pain compared with placebo in patients having upper limb surgery under infraclavicular brachial plexus block.
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Affiliation(s)
- M Maagaard
- Centre for Anaesthesiological Research, Department of Anaesthesiology, Zealand University Hospital, Køge, Denmark
| | - M Z Plambech
- Department of Anaesthesiology, Naestved, Slagelse and Ringsted Hospitals, Slagelse, Denmark
| | - K S Funder
- Department of Anaesthesia and Intensive Care, Bispebjerg and Frederiksberg Hospital, Copenhagen University Hospital, Denmark
| | - N K Schou
- Centre for Anaesthesiological Research, Department of Anaesthesiology, Zealand University Hospital, Køge, Denmark
| | - A K Mølgaard
- Department of Anaesthesiology, Naestved, Slagelse and Ringsted Hospitals, Slagelse, Denmark
| | - E R Stormholt
- Centre for Anaesthesiological Research, Department of Anaesthesiology, Zealand University Hospital, Køge, Denmark
| | - M F Leth
- Centre for Anaesthesiological Research, Department of Anaesthesiology, Zealand University Hospital, Køge, Denmark
| | - S Bukhari
- Centre for Anaesthesiological Research, Department of Anaesthesiology, Zealand University Hospital, Køge, Denmark
| | - A Mortensen
- Department of Anaesthesiology, Naestved, Slagelse and Ringsted Hospitals, Slagelse, Denmark
| | - T H Lunn
- Department of Anaesthesia and Intensive Care, Bispebjerg and Frederiksberg Hospital, Copenhagen University Hospital, Denmark
| | - I Tryggedsson
- Department of Orthopaedic Surgery and Traumatology, Bispebjerg and Frederiksberg Hospital, Copenhagen University Hospital, Denmark
| | - A K Nørskov
- Department of Anaesthesiology, Copenhagen University Hospital, North Zealand Hospital, Hillerød, Denmark
| | - C Zamany
- Department of Orthopaedic Surgery, Trauma Unit, Zealand University Hospital, Køge, Denmark
| | - P Toquer
- Department of Orthopaedic Surgery, Trauma Unit, Zealand University Hospital, Køge, Denmark
| | - P Jaeger
- Department of Anaesthesia, The Juliane Marie Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - J H Andersen
- Centre for Anaesthesiological Research, Department of Anaesthesiology, Zealand University Hospital, Køge, Denmark
| | - O Mathiesen
- Centre for Anaesthesiological Research, Department of Anaesthesiology, Zealand University Hospital, Køge, Denmark
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Kyndi M, Willert MV, Vestergaard JM, Andersen JH, Christiansen DH, Dalgaard VL. Long-term follow-up study of work status among patients with work-related mental disorders referred to departments of occupational medicine in Denmark. BMJ Open 2023; 13:e072217. [PMID: 37935518 PMCID: PMC10632875 DOI: 10.1136/bmjopen-2023-072217] [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: 02/20/2023] [Accepted: 10/09/2023] [Indexed: 11/09/2023] Open
Abstract
OBJECTIVES To describe the 5 year work status in patients referred for suspected work-related common mental disorders. To develop a prognostic model. DESIGN Register-based nationwide longitudinal follow-up study. SETTING All departments of occupational medicine in Denmark. PARTICIPANTS 17 822 patients aged 18-67 years, seen for the first time at a Department of Occupational Medicine in Denmark from 2000 to 2013 and diagnosed with stress, depression, post-traumatic stress disorder, anxiety or other mental disorders. INTERVENTIONS All patients were seen for diagnostic assessment and causal evaluation of the work-relatedness of their disorders. Some departments offered patients with stress disorders psychological treatment, which, however, was not organised according to patient selection or type of treatment. PRIMARY AND SECONDARY OUTCOME MEASURES Register data were collected for 5 year periods before and after the patients' first assessment at a department. Weekly percentages of patients are presented according to work status. The outcome in the prognostic model was a high Work Participation Score (ie, working>75% of potential work weeks/year) at 5 year follow-up. RESULTS For all subgroups of patients, a high proportion were working (>75%) 1-5 years before assessment, and all experienced a large reduction in work status at time of assessment. At 1 year follow-up, almost 60% of patients with stress were working, whereas in the other patient subgroups, less than 40% were working. In the following years, practically no increase was observed in the percentage of patients working in any of the subgroups. Based on these 5 year follow-up data, we developed a work participation model with only moderate discrimination and calibration. CONCLUSIONS In Denmark, not all return to previous work status 5 years after a referral due to a suspected work-related common mental disorder. We developed a prognostic model with only moderate discrimination and calibration for long-term work participation after suggested work-related common mental disorders.
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Affiliation(s)
- Marianne Kyndi
- Department of Occupational Medicine, University Clinic, Gødstrup Regional Hospital, Herning, Denmark
- Department of Occupational and Environmental Medicine, Aalborg University Hospital, Aalborg, Denmark
- Department of Occupational Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Morten Vejs Willert
- Department of Occupational Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Jesper Medom Vestergaard
- Department of Occupational Medicine, University Clinic, Gødstrup Regional Hospital, Herning, Denmark
- Department of Occupational Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Johan Hviid Andersen
- Department of Occupational Medicine, University Clinic, Gødstrup Regional Hospital, Herning, Denmark
| | - David Høyrup Christiansen
- Centre for Research in Health and Nursing, Research, Regional Hospital Central Jutland, Viborg, Denmark
- Department of Clinical Medicine, Health, Aarhus University, Aarhus, Denmark
- Elective surgery centre, Silkeborg Regional Hospital, Silkeborg, Denmark
| | - Vita Ligaya Dalgaard
- Department of Occupational Medicine, University Clinic, Gødstrup Regional Hospital, Herning, Denmark
- Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
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Jahn A, Andersen JH, Christiansen DH, Seidler A, Dalbøge A. Occupational mechanical exposures as risk factor for chronic low-back pain: a systematic review and meta-analysis. Scand J Work Environ Health 2023; 49:453-465. [PMID: 37581384 PMCID: PMC10838064 DOI: 10.5271/sjweh.4114] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Indexed: 08/16/2023] Open
Abstract
OBJECTIVES The association between occupational mechanical exposures and low-back pain (LBP) has been studied in several systematic reviews. However, no systematic review addressing chronic LBP exists. The aim of this systematic review and meta-analysis was to examine the association between occupational mechanical exposures and chronic LBP. METHODS The study was registered in PROSPERO. We used an existing systematic review to identify articles published before January 2014. For studies published between January 2014 and September 2022, a systematic literature search was conducted in six databases. Two authors independently excluded articles, extracted data, and assessed risk of bias and level of evidence (GRADE). Meta-analyses were conducted using random-effects models comparing highest versus lowest exposure group with sensitivity analyses based on study quality (low/moderate versus high risk of bias), study design (cohort versus case-control), and outcome definition (non-specific LBP versus specific chronic LBP). RESULTS Twenty-six articles were included. Highest pooled odd ratios (OR) were found for combined mechanical exposures [OR 2.2, 95% confidence interval (CI) 1.4-3.6], lifting/carrying loads (OR 1.7, 95% CI 1.4-2.2), and non-neutral postures (OR 1.5, 95% CI 1.2-1.9). For the remaining mechanical exposures (ie, whole-body vibrations, standing/walking, and sitting), OR ranged between 1.0 and 1.4. In the sensitivity analyses, generally, higher pooled OR were found in low/moderate risk of bias studies, case-control studies, and studies of specific chronic LBP. CONCLUSIONS Moderate evidence of an association was found for lifting/carrying loads, non-neutral postures, and combined mechanical exposures. Low or very low evidence was found for whole-body vibrations, standing/walking, and sitting. Studies using standardized exposure definition, metric, and technical measurements are highly warranted.
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Affiliation(s)
- Alexander Jahn
- Danish Ramazzini Centre, Department of Occupational Medicine, Palle Juul-Jensens Boulevard 99, Aarhus University Hospital, Aarhus N, Denmark.
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Willert MV, Christiansen DH, Dalgaard L, Vestergaard JM, Andersen JH, Kyndi M. Developing prognostic models for health care utilization in patients with work-related mental health problems. BMC Health Serv Res 2023; 23:834. [PMID: 37550656 PMCID: PMC10405445 DOI: 10.1186/s12913-023-09802-z] [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] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 07/10/2023] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND The long-term prognosis for employees with work-related mental health problems is unclear. We aim to describe long-term trends in health care utilization (HCU) and develop multivariable prognostic models for long-term mental health care utilization. METHODS From the Danish Occupational Medicine Cohort we included mental health patients (N = 17,822) assessed from 2000 to 2013 at Departments of Occupational Medicine. Outcomes were general health (general practitioner, somatic hospital) and mental health (psychiatrist/psychologist, psychiatric hospital) HCU obtained from registries five years before/after assessment. The 10-year period was divided into phases relative to assessment: 5 - 3 years before, 2 years before/after, and 3-5 years after. We developed gender-stratified Lasso-penalized multivariable prognostic models for HCU 3-5 years after assessment assessing both calibration and discrimination. RESULTS Prevalent HCU for general practitioner, psychiatrist/psychologist and psychiatric hospital services was relatively stable 5 - 3 years prior to assessment, then rising during the 2 years before/after. At 3-5 years after assessment prevalent general practitioner HCU declined to previous levels, while prevalent HCU for psychologist/psychiatrist and psychiatric hospital services remained elevated compared to previous levels during years 5 - 3. Prognostic models for long-term psychologist/psychiatrist and psychiatric hospital HCU indicated acceptable calibration and modest discrimination. CONCLUSIONS Prevalent HCU rose two years before/after assessment and remained elevated for psychiatrist/psychologist and psychiatric hospital HCU 3-5 years after. Gender-stratified prognostic models were developed for long-term mental health HCU, but discrimination and calibration should be further improved before out-of-sample application for personal prognosis. TRIAL REGISTRATION The study was registered at clinicaltrials.gov (Identifier: NCT04459793) prior to analyses.
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Affiliation(s)
- Morten Vejs Willert
- Dept. of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Juul-Jensens Boulevard 35, Aarhus N, DK-8200, Denmark.
| | - David Høyrup Christiansen
- Research, Regional Hospital Central Jutland, Viborg, Denmark
- Department of Clinical Medicine, Health, Aarhus University, Aarhus, Denmark
- Elective Surgery Centre, Regional Hospital Silkeborg, Silkeborg, Denmark
| | - Ligaya Dalgaard
- Dept of Occupational Medicine, University Research Clinic, Danish Ramazzini Center, Regional Hospital Gødstrup, Herning, Denmark
- Department of Psychology and Behavioral Sciences, Aarhus University, Aarhus, Denmark
| | - Jesper Medom Vestergaard
- Dept. of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Juul-Jensens Boulevard 35, Aarhus N, DK-8200, Denmark
- Dept of Occupational Medicine, University Research Clinic, Danish Ramazzini Center, Regional Hospital Gødstrup, Herning, Denmark
| | - Johan Hviid Andersen
- Department of Clinical Medicine, Health, Aarhus University, Aarhus, Denmark
- Dept of Occupational Medicine, University Research Clinic, Danish Ramazzini Center, Regional Hospital Gødstrup, Herning, Denmark
| | - Marianne Kyndi
- Dept. of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Juul-Jensens Boulevard 35, Aarhus N, DK-8200, Denmark
- Dept of Occupational Medicine, University Research Clinic, Danish Ramazzini Center, Regional Hospital Gødstrup, Herning, Denmark
- Danish Ramazzini Centre, Dept. of Occupational and Environmental Medicine, Aalborg University Hospital, Aalborg, Denmark
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Dalgaard VL, Willert MV, Kyndi M, Vestergaard JM, Andersen JH, Christiansen DH. Cohort Profile: The Danish Occupational Medicine Cohort-a nationwide cohort of patients with work-related disease. Int J Epidemiol 2023; 52:e201-e210. [PMID: 36869758 PMCID: PMC10396417 DOI: 10.1093/ije/dyad013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 02/10/2023] [Indexed: 03/05/2023] Open
Affiliation(s)
- Vita Ligaya Dalgaard
- Department of Occupational Medicine, University Research Clinic, Danish Ramazzini Centre, Gødstrup Hospital, Herning, Denmark
- Department of Psychology and Behavioral Sciences, Aarhus University, Aarhus C, Denmark
| | - Morten Vejs Willert
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus N, Denmark
| | - Marianne Kyndi
- Department of Occupational Medicine, University Research Clinic, Danish Ramazzini Centre, Gødstrup Hospital, Herning, Denmark
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus N, Denmark
- Department of Occupational and Environmental Medicine, Danish Ramazzini Centre, Aalborg University Hospital, Aalborg, Denmark
| | - Jesper Medom Vestergaard
- Department of Occupational Medicine, University Research Clinic, Danish Ramazzini Centre, Gødstrup Hospital, Herning, Denmark
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus N, Denmark
| | - Johan Hviid Andersen
- Department of Occupational Medicine, University Research Clinic, Danish Ramazzini Centre, Gødstrup Hospital, Herning, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark
| | - David Høyrup Christiansen
- Department of Occupational Medicine, University Research Clinic, Danish Ramazzini Centre, Gødstrup Hospital, Herning, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark
- Elective Surgery Centre, Silkeborg Regional Hospital, Silkeborg, Denmark
- Centre for Research in Health and Nursing, Research, Regional Hospital Central Jutland, Viborg, Denmark
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Kempel MK, Winding TN, Böttcher M, Hansen SN, Andersen JH. Childhood socioeconomic position and cardiometabolic risk in young adulthood- the impact of mental health. BMC Public Health 2023; 23:1136. [PMID: 37312084 DOI: 10.1186/s12889-023-15942-y] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 05/19/2023] [Indexed: 06/15/2023] Open
Abstract
BACKGROUND Low socioeconomic position in childhood is associated with greater cardiometabolic disease risk later in life. The aim of the current study is to examine the mediating impact of mental health on the association between childhood socioeconomic position and cardiometabolic disease risk in young adulthood. METHODS We used a combination of national registers, longitudinal questionnaire-data and clinical measurements from a sub-sample (N = 259) of a Danish youth cohort. Childhood socioeconomic position was indicated by the educational level of the mother and the father at age 14. Mental health was measured by four different symptom scales at four age-points (age 15, 18, 21 and 28), and combined into one global score. Cardiometabolic disease risk was measured by nine biomarkers at age 28-30 and combined into one global score by sample-specific z-scores. We conducted analyses within the causal inference framework and evaluated the associations using nested counterfactuals. RESULTS We found an inverse association between childhood socioeconomic position and cardiometabolic disease risk in young adulthood. The proportion of the association which was mediated by mental health was 10 (95% CI: -4; 24) % and 12 (95% CI: -4; 28) % using educational level of the mother and the father as indicator, respectively. CONCLUSIONS Accumulated poorer mental health in childhood, youth and early adulthood partially explained the association between low childhood socioeconomic position and increased cardiometabolic disease risk in young adulthood. The results of the causal inference analyses rely on the underlying assumptions and correct depiction of the DAG. Since these are not all testable, we cannot exclude violations that potentially could bias the estimates. If the findings can be replicated, this would support a causal relationship and direct potentials for intervention. However, the findings point to a potential for intervention in young age in order to impede the translation of childhood social stratification into later cardiometabolic disease risk disparities.
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Affiliation(s)
- Mia Klinkvort Kempel
- Department of Occupational Medicine, Danish Ramazzini Centre, University Research Clinic, Goedstrup Hospital, Herning, Denmark.
- Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark.
- , Gl. Landevej 61, Herning, 7400, Denmark.
| | - Trine Nøhr Winding
- Department of Occupational Medicine, Danish Ramazzini Centre, University Research Clinic, Goedstrup Hospital, Herning, Denmark
- Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Morten Böttcher
- Cardiovascular Research Unit, Department of Cardiology, University Research Clinic, Goedstrup Hospital, Herning, Denmark
- Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark
| | | | - Johan Hviid Andersen
- Department of Occupational Medicine, Danish Ramazzini Centre, University Research Clinic, Goedstrup Hospital, Herning, Denmark
- Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark
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Jahn A, Andersen JH, Christiansen DH, Seidler A, Dalbøge A. Association between occupational exposures and chronic low back pain: Protocol for a systematic review and meta-analysis. PLoS One 2023; 18:e0285327. [PMID: 37146040 PMCID: PMC10162539 DOI: 10.1371/journal.pone.0285327] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 04/19/2023] [Indexed: 05/07/2023] Open
Abstract
INTRODUCTION The association between occupational mechanical exposures and chronic low back pain (LBP) has been widely studied, however, few systematic reviews have evaluated the evidence of an association. Furthermore, little is known of the impact of occupational psychosocial exposures on chronic LBP. The aim of this systematic review and meta-analysis is to study the association between occupational mechanical and psychosocial exposures and chronic LBP. METHODS The study will be conducted as a systematic review using another systematic review published in 2014 as basis and has been registered in the International Prospective Register of Systematic Reviews (PROSPERO) with registration number CRD42021281996. A systematic literature search will be performed in 6 scientific databases to identified potential relevant studies published after 2014. Studies will systematically be excluded through a screening process performed independently by 2 reviewers. Exposures will include occupational mechanical and psychosocial exposures, and outcome will include chronic LBP (LBP ≥3 months, "degenerative" diseases, and lumbosacral radiculopathy). Study population will include persons in or above working age, and study designs will comprise cohort and case-control studies. The quality of each included study will be methodologically assessed by 2 independent reviewers and level of evidence of an association will be graded using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) system. In meta-analyses, effect sizes will be addressed using random-effect models, sensitivity analyses will explore the robustness of the meta-analysis, and heterogeneity assessed. DISCUSSION This systematic review and meta-analysis will assess the evidence available of the association between occupational mechanical and psychosocial exposures and chronic LBP. The review can provide essential knowledge on the association, exposure-response relationships, thresholds, which may pave the way for political decisions on the occupational environment and the labour market insurance policy.
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Affiliation(s)
- Alexander Jahn
- Danish Ramazzini Centre, Department of Occupational Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Johan Hviid Andersen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Occupational Medicine-University Research Clinic, Danish Ramazzini Centre, Goedstrup Hospital, Herning, Denmark
| | - David Høyrup Christiansen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Elective Surgery Centre, Silkeborg Regional Hospital, Silkeborg, Denmark
- Research, Regional Hospital Central Jutland, Viborg, Denmark
| | - Andreas Seidler
- Institute and Policlinic of Occupational and Social Medicine (IPAS), Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Annett Dalbøge
- Danish Ramazzini Centre, Department of Occupational Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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Korshøj M, Svendsen SW, Hendriksen PF, Gupta N, Holtermann A, Andersen JH, Dalbøge A, Frost P. Agreement between an expert-rated mini job exposure matrix of occupational biomechanical exposures to the lower body and technical measurements or observation: a method comparison study. BMJ Open 2022; 12:e064035. [PMID: 36576183 PMCID: PMC9723893 DOI: 10.1136/bmjopen-2022-064035] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES Investigating the agreement between an expert-rated mini job exposure matrix (JEM) of lower body exposures and technical measurements of worktime spent standing/walking and observation-based estimates of time spent kneeling/squatting and total load lifted per workday. METHODS We chose 16 job titles from the 121 job groups in the lower body JEM and included them in the mini JEM. New expert ratings for the mini JEM were performed by the same five occupational physicians who performed the ratings for the lower body JEM. For each job title and type of exposure, the exposure estimates were a mean of the five independent ratings. Technical measurements of standing/walking for all 16 job titles, and for 8 job titles workplace observations were performed of kneeling/squatting and total load lifted per workday. Data were collected from September to December 2015 and supplemented by data from the NOMAD and DPhacto studies collected between 2011 and 2013. All data were collected in Denmark. Agreement between expert-based and measured/observed lower body exposures by job titles was evaluated using Spearman's rank correlation, Bland-Altman plots evaluated systematic deviations and limits of agreement (LoA). RESULTS Standing/walking showed a rank correlation of 0.55, kneeling/squatting 0.83 and total load lifted per workday 0.71. The mini JEM estimates did not systematically deviate from the technical measurements/observations for time spent standing/walking (mean difference 0.20 hours/workday, LoA -1.63, 2.03 hours/workday) and kneeling/squatting (mean difference -0.35 hours/workday, LoA -1.21, 0.51 hours/workday). For total load lifted per workday, the mini JEM systematically overestimated the exposures compared with the observations (mean difference -909 kg/workday, LoA -3000, 1147 kg/workday). CONCLUSIONS There was moderate to very high agreement between an expert-rated mini JEM of standing/walking, kneeling/squatting, and lifting exposures and corresponding technical measurements/observations. This method comparison study supports the use of the expert-based lower body JEM in large-scale occupational epidemiological studies.
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Affiliation(s)
- Mette Korshøj
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Department of Occupational and Social Medicine, Holbæk Hospital, a part of Copenhagen University Hospital, Holbæk, Denmark
| | - Susanne Wulff Svendsen
- Danish Ramazzini Centre, Department of Occupational Medicine, Gødstrup Hospital, University Research Clinic, Gødstrup, Denmark
| | | | - Nidhi Gupta
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Andreas Holtermann
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Johan Hviid Andersen
- Danish Ramazzini Centre, Department of Occupational Medicine, Gødstrup Hospital, University Research Clinic, Gødstrup, Denmark
| | - Annett Dalbøge
- Danish Ramazzini Centre, Department of Occupational Medicine, Aarhus University Hospital, Aarhus N, Denmark
| | - Poul Frost
- Danish Ramazzini Centre, Department of Occupational Medicine, Aarhus University Hospital, Aarhus N, Denmark
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Dalbøge A, Frost P, Andersen JH, Svendsen SW. Associations between single and combined occupational mechanical exposures and surgery for subacromial impingement syndrome: a nationwide Danish cohort study. Scand J Work Environ Health 2022; 48:490-497. [PMID: 35532098 PMCID: PMC9888441 DOI: 10.5271/sjweh.4032] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE This study aimed to evaluate whether the risk of surgery for subacromial impingement syndrome (SIS) increases with the number of combined occupational mechanical exposures compared with single exposure. METHODS We reanalyzed data from a register-based cohort study of the entire Danish working population (N=2 374 403) with 14 118 events of surgery for SIS (2003-2008). Exposure information in 10-year windows was obtained by combining occupational codes with a job exposure matrix. For single and combined mechanical exposures, we created three exposure variables of the number of years with specific exposure intensities with or without co-existing mechanical exposures. We used logistic regression as survival analysis. RESULTS We found exposure-response relations for duration and intensity of each single mechanical exposure except for repetition. The single effect of arm elevation >90º reached a maximum adjusted odds ratio (ORadj) of 1.7 [95% confidence interval (CI) 1.5-2.0], which increased to 1.8 (95% CI 1.5-2.0), 2.0 (95% CI 1.9-2.2), and 2.2 (95% CI 2.0-2.5) when combined with repetition, force, and both. When combining repetition with arm elevation >90º, force, and both, ORadj increased from 1.5 (95% CI 1.3-1.8) to 2.1 (95% CI 1.8-2.4), 2.5 (95% CI 2.4-2.9), and 2.7 (95% CI 2.4-3.0). For force, ORadj increased from 2.5 (95% CI 2.1-2.9) to 2.6 (95% CI 2.3-2.8), 2.8 (95% CI 2.4-3.2), and 3.0 (95% CI 2.6-3.4). CONCLUSION We found an increased risk of surgery for SIS with the number of combined exposures; the risk was especially pronounced when the combined exposures included force.
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Affiliation(s)
- Annett Dalbøge
- Danish Ramazzini Centre, Department of Occupational Medicine, Aarhus University Hospital, Aarhus, Denmark,Danish Ramazzini Centre, Department of Occupational Medicine - University Research Clinic, Gødstrup Hospital, Denmark,
Correspondence to: Annett Dalbøge, Danish Ramazzini Centre, Department of Occupational Medicine, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark. [E-mail: ]
| | - Poul Frost
- Danish Ramazzini Centre, Department of Occupational Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Johan Hviid Andersen
- Danish Ramazzini Centre, Department of Occupational Medicine - University Research Clinic, Gødstrup Hospital, Denmark
| | - Susanne Wulff Svendsen
- Danish Ramazzini Centre, Department of Occupational Medicine - University Research Clinic, Gødstrup Hospital, Denmark
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Christiansen DH, Nielsen KJ, Andersen DR, Andersen JH. Musculoskeletal health climate is associated with musculoskeletal pain and sickness absence among workers: a cross-sectional study. BMJ Open 2022; 12:e056485. [PMID: 35414557 PMCID: PMC9006822 DOI: 10.1136/bmjopen-2021-056485] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES This study aimed to investigate whether a musculoskeletal health climate, expressing the shared perceptions among workers concerning musculoskeletal health, is associated with number of musculoskeletal pain sites and sickness absence. DESIGN Cross-sectional study. SETTING Six slaughterhouses from 2 companies in Denmark and 6 home-nursing units and 12 nursing homes from 1 municipality in Jutland, Denmark. PARTICIPANTS A total of 1092 slaughter house workers and 410 care workers completed an online questionnaire from February to October 2019. OUTCOME MEASURES The exposure variable was musculoskeletal health climate assessed by two domains; (1) perceived management priority of musculoskeletal health measured by a modified subscale from the Nordic Safety Climate Questionnaire and (2) work group pain acceptance which was a modified version of the activity engagement subscale of the chronic pain acceptance scale. Outcomes variables were number of musculoskeletal pain sites (0-6) and days with sickness absence. RESULTS The associations between the two subscales, number of musculoskeletal pain sites and sickness absence were calculated using mixed linear and generalised estimating equation regression models. Higher perceived management priority scores were associated with a lower number of musculoskeletal pain sites across both job groups: β=-.57 (95% CI -0.91 to -0.23) and sickness absence (>5 days) due to musculoskeletal pain prevalence ratio (PR) 0.79 (95% CI 0.57 to 1.08). In contrast higher work group pain acceptance scores were associated with higher number of musculoskeletal pain sites: β=0.38 (0.11 to 0.66), whereas associations with sickness absences seemed to be modified by job groups; PR 1.59 care workers and PR 0.86 slaughterhouse workers. CONCLUSION The observed relationship between musculoskeletal health climate, musculoskeletal pain sites and sickness absence indicate that cultural factors should receive increased attention in work place preventive interventions.
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Affiliation(s)
- David Høyrup Christiansen
- Department of Occupational Medicine - University Research Clinic, Regional Hospital West Jutland, Herning, Denmark
- Department of Clinical Medicine, Aarhus Universitet Health, Aarhus, Denmark
| | - Kent Jacob Nielsen
- Department of Occupational Medicine - University Research Clinic, Regional Hospital West Jutland, Herning, Denmark
| | - Dorte Raaby Andersen
- Department of Occupational Medicine - University Research Clinic, Regional Hospital West Jutland, Herning, Denmark
| | - Johan Hviid Andersen
- Department of Occupational Medicine - University Research Clinic, Regional Hospital West Jutland, Herning, Denmark
- Department of Clinical Medicine, Aarhus Universitet Health, Aarhus, Denmark
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Kempel MK, Winding TN, Böttcher M, Andersen JH. Evaluating the association between socioeconomic position and cardiometabolic risk markers in young adulthood by different life course models. BMC Public Health 2022; 22:694. [PMID: 35397504 PMCID: PMC8994289 DOI: 10.1186/s12889-022-13158-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 03/30/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Cardiometabolic health in adulthood is associated with socioeconomic position (SEP) in childhood. Although this has been studied by previous research several questions need to be addressed. E.g. knowledge about the association with timing, extent of the exposure as well as lifestyle and adult SEP, is essential to address the increasing social gradient in cardiometabolic diseases.
Methods
This study included a sub-sample (N = 264, 50% women, age 28–30) from an ongoing cohort study. We used a combination of national registers, longitudinal questionnaire data and clinical data. We examined the association between childhood SEP and cardiometabolic risk, measured by a score of multiple risk markers in young adulthood. SEP-indicators included mother’s educational level and household income. The association was evaluated by four different life course models; the latent effects model, the pathway model, the cumulative model and the social mobility model.
Results
We found an inverse association between mother’s educational level and cardiometabolic risk. The association was statistically significant evaluated by the pathway and cumulative life course models, however statistically insignificant evaluated by the latent effects model. No specific association with social mobility was observed. However, high adult educational level seems to have a protecting impact on the association. No association was found between household income and cardiometabolic risk in any of the applied life course models.
Conclusion
Low childhood SEP, represented by mother’s educational level but not household income, is associated with increased cardiometabolic risk in young adulthood. The accumulation of exposure, lifestyle and adult educational attainment are important for the association. In contrast, intergenerational social mobility does not seem to have a specific impact on the association and we find no evidence for a particular timing in childhood.
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Riddervold B, Andersen JH, Dalbøge A. Occupational lifting, carrying, pushing, pulling loads and risk of surgery for subacromial impingement syndrome: a register-based cohort study. Occup Environ Med 2022; 79:oemed-2021-108166. [PMID: 35318274 PMCID: PMC9453562 DOI: 10.1136/oemed-2021-108166] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 03/06/2022] [Indexed: 11/10/2022]
Abstract
AIM The aim was to examine exposure-response relations between surgery for subacromial impingement syndrome (SIS) and intensities of lifting/carrying and pushing/pulling loads during a 10-year time window. METHODS We conducted a register-based cohort study (2003-2008), comprising persons born in Denmark (1933-1977) with ≥5 years of work experience (N=2 374 403). Information on surgery for SIS was retrieved from the Danish National Patient Register (N=14 188). Occupational mechanical exposures comprising lifting/carrying loads ≥10 kg and pushing/pulling loads ≥50 kg were assessed by combining individual register-based job codes with our expert-based Shoulder job exposure matrix. We created three intensity-specific exposure duration variables by dividing the intensity for lifting/carrying and pushing/pulling loads into three categories (low, medium and high), and summed up number of years in each exposure category for a 10-year time window. The associations were analysed using logistic regression technique equivalent to discrete survival analysis. RESULTS The adjusted OR (ORadj) increased with both exposure duration and intensity of lifting/carrying and pushing/pulling. For lifting/carrying, the ORadj reached a maximum of 1.78 (95% CI 1.66 to 1.89), 2.52 (95% CI 2.32 to 2.74) and 2.96 (95% CI 2.53 to 3.47) after 10 years of exposures for the three exposure intensities. For pushing/pulling, maximum ORadj was 1.44 (95% CI 1.31 to 1.58), 1.68 (95% CI 1.58 to 1.79) and 1.72 (95% CI 1.50 to 2.00), respectively. CONCLUSION We found exposure-response relations for lifting/carrying and pushing/pulling across the 10-year time window. The risk was especially pronounced for lifting/carrying compared with pushing/pulling. We did not find indications of safe exposure intensities.
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Affiliation(s)
- Bjørn Riddervold
- Department of Environmental and Occupational Medicine, Aarhus University, Aarhus, Denmark
| | - Johan Hviid Andersen
- Danish Ramazzini Centre, Department of Occupational Medicine, Regional Hospital West Jutland - University Research Clinic, Herning, Denmark
| | - Annett Dalbøge
- Department of Environmental and Occupational Medicine, Aarhus University, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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Kempel MK, Winding TN, Böttcher M, Andersen JH. Subjective social status and cardiometabolic risk markers in young adults. Psychoneuroendocrinology 2022; 137:105666. [PMID: 35038663 DOI: 10.1016/j.psyneuen.2022.105666] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 01/03/2022] [Accepted: 01/07/2022] [Indexed: 12/22/2022]
Abstract
BACKGROUND Low subjective social status (SSS), the perceived status in the social hierarchy, is associated with cardiometabolic risk in middle-aged and older adults. However, most studies are cross-sectional and very little is known about the association in adolescence and young adulthood. The aims of this study were; a) to prospectively investigate the association between SSS at ages 15 and 28 and cardiometabolic risk at age 28-30 and b) to examine if such an association was independent of smoking, physical activity and objective measures of social position. METHODS The study used questionnaire information at ages 15 and 28 from the West Jutland Cohort Study (N = 3681), health measurements from a sub-sample of the cohort (N = 264, age 28-30, 50% women) and information from population-based national registers. The independent variable was a measure of SSS evaluated by a 10-rung ladder scale and dichotomized at the 25th percentile of data from the cohort study population. The outcome measure was a composite score of cardiometabolic risk including measures of lipids, inflammation, blood pressure and glucose-metabolism. Co-variates included smoking, physical activity, childhood and adulthood socioeconomic position. Sex-stratified linear regression analyses were performed to evaluate the associations between SSS and cardiometabolic risk. RESULTS In both sexes, low SSS at age 28, but not at age 15, was significantly associated with increased cardiometabolic risk at age 28-30. Neither smoking, physical activity, childhood or adulthood objective socioeconomic position fully explained the associations. CONCLUSION In young adulthood, SSS was inversely related to cardiometabolic risk after accounting for smoking, physical activity and objective measures of socioeconomic position. These findings suggest that SSS could play a role in the social disparities in cardiometabolic risk in addition to traditional measures of socioeconomic position.
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Affiliation(s)
- Mia Klinkvort Kempel
- Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark; Department of Occupational Medicine - University Research Clinic, Danish Ramazzini Centre, Goedstrup Hospital, Herning, Denmark.
| | - Trine Nøhr Winding
- Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark; Department of Occupational Medicine - University Research Clinic, Danish Ramazzini Centre, Goedstrup Hospital, Herning, Denmark
| | - Morten Böttcher
- Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark; Cardiovascular Research Unit - University Research Clinic, Department of Cardiology, Goedstrup Hospital, Herning, Denmark
| | - Johan Hviid Andersen
- Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark; Department of Occupational Medicine - University Research Clinic, Danish Ramazzini Centre, Goedstrup Hospital, Herning, Denmark
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Kempel MK, Winding TN, Lynggaard V, Brantlov S, Andersen JH, Böttcher M. Traditional and novel cardiometabolic risk markers across strata of body mass index in young adults. Obes Sci Pract 2021; 7:727-737. [PMID: 34877012 PMCID: PMC8633932 DOI: 10.1002/osp4.528] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 02/17/2021] [Revised: 04/27/2021] [Accepted: 05/09/2021] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Cardiometabolic risk increases with increasing body mass index (BMI). The exact mechanism is poorly understood, and traditional risk assessment of young adults with obesity has shown to be ineffective. Greater knowledge about potential new effective biomarkers and the use of advanced cardiac imaging for risk assessment in young adults is, therefore, necessary. OBJECTIVE This study aims to explore traditional and novel cardiometabolic risk markers across strata of BMI in young adults. METHODS Participants (N = 264, 50% women, age 28-30 years) were invited from an ongoing cohort study, based on BMI and sex. BMI-strata were: BMI <25, 25-30, >30 kg/m2, representing normal weight (NW), overweight (OW), and obesity (OB). Participants underwent cardiac computed tomography to detect coronary artery calcification, measures of body composition, blood pressure measurements, and a comprehensive panel of circulating cardiometabolic risk markers. RESULTS No significant coronary artery calcifications were detected in this study. Minor differences in median levels of traditional risk markers were detected across BMI-strata, for example, total cholesterol (men- NW: 4.7 (4.3-5.1) and OB: 4.8 (4.2-5.6) mmol/L, p = 0.58; women- NW: 4.3 (3.9-4.8) and OB: 4.7 (4.2-5.3) mmol/L, p = 0.016), whereas substantial differences were seen in markers of inflammation and glucose metabolism, for example, high sensitive CRP (men- NW: 0.6 (0.3-1.1) and OB: 2.8 (1.5-4.0) mg/L, p < 0.001; women- NW: 0.7 (0.3-1.7) and OB: 4.0 (2.2-7.8) mg/L, p < 0.001) and insulin (men- NW: 47.0 (35.0-59.0) and OB: 113.5 (72.0-151.0) pmol/L, p < 0.001; women- NW: 44.0 (35.0-60.0) and OB: 84.5 (60.0-126.0) pmol/L, p < 0.001). CONCLUSION In young adults, obesity is associated with an early onset insulin resistance and inflammatory response prior to development of coronary artery calcification and deterioration of lipid profiles.
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Affiliation(s)
- Mia Klinkvort Kempel
- Department of Occupational Medicine – University Research ClinicDanish Ramazzini CentreRegional Hospital West JutlandHerningDenmark
| | - Trine Nøhr Winding
- Department of Occupational Medicine – University Research ClinicDanish Ramazzini CentreRegional Hospital West JutlandHerningDenmark
| | - Vibeke Lynggaard
- Cardiovascular Research UnitDepartment of CardiologyGødstrup HospitalHerningDenmark
| | - Steven Brantlov
- Department of Procurement and Clinical EngineeringCentral Denmark RegionAarhusDenmark
| | - Johan Hviid Andersen
- Department of Occupational Medicine – University Research ClinicDanish Ramazzini CentreRegional Hospital West JutlandHerningDenmark
| | - Morten Böttcher
- Cardiovascular Research UnitDepartment of CardiologyGødstrup HospitalHerningDenmark
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Mose S, Kent P, Smith A, Andersen JH, Christiansen DH. Trajectories of Musculoskeletal Healthcare Utilization of People with Chronic Musculoskeletal Pain - A Population-Based Cohort Study. Clin Epidemiol 2021; 13:825-843. [PMID: 34557040 PMCID: PMC8455515 DOI: 10.2147/clep.s323903] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 08/20/2021] [Indexed: 12/29/2022] Open
Abstract
Background and Aim Chronic musculoskeletal pain is common and associated with more general healthcare-seeking. However, musculoskeletal-related healthcare utilization is under-explored. This study aimed to explore, describe and profile trajectories of long-term musculoskeletal healthcare for people reporting chronic musculoskeletal pain. Methods This exploratory prognostic cohort study combined survey and national health register data from a representative group of adult Danes reporting chronic musculoskeletal pain (N = 2929). Trajectories of long-term musculoskeletal healthcare use were generated using latent class growth analysis. Types of healthcare-seeking, individual, sociodemographic, health, belief and work-related factors were used to describe and profile identified trajectories. Results We identified five distinct trajectories of long-term musculoskeletal healthcare utilization (low stable, low ascending, low descending, medium stable and high stable). The low stable trajectory group (no or almost no annual contacts) represented 39% of the sample, whereas the high stable trajectory group (consistent high number of annual contacts) represented 8%. Most healthcare-seeking was in primary healthcare settings (GP/physiotherapy/chiropractor). Opioid consumption was primarily in the high stable trajectory group, and surgery was rare. There were statistically significant differences across the five trajectory groups in individual, sociodemographic, health, belief and work-related profiles. Conclusion Long-term use of musculoskeletal healthcare services varied in this chronic musculoskeletal pain population. Almost 40% coped without seeking care, whereas 8% had consistent high use of healthcare services. Chronic musculoskeletal pain was mostly managed in primary care settings, which aligns with musculoskeletal guidelines, as did the use of pain medication and surgery. People with different musculoskeletal healthcare trajectories had different individual, sociodemographic, health, belief and work-related profiles. ![]()
Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use: https://youtu.be/o24sO5gidU4
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Affiliation(s)
- Søren Mose
- Department of Occupational Medicine, Danish Ramazzini Centre - University Research Clinic, Herning, Denmark.,School of Physiotherapy, VIA University College, Holstebro, Denmark
| | - Peter Kent
- Curtin School of Allied Health, Curtin University, Perth, WA, Australia.,Center for Muscle and Joint Health, University of Southern Denmark, Odense, Denmark
| | - Anne Smith
- Curtin School of Allied Health, Curtin University, Perth, WA, Australia
| | - Johan Hviid Andersen
- Department of Occupational Medicine, Danish Ramazzini Centre - University Research Clinic, Herning, Denmark
| | - David Høyrup Christiansen
- Department of Occupational Medicine, Danish Ramazzini Centre - University Research Clinic, Herning, Denmark
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Mose S, Kent P, Smith A, Andersen JH, Christiansen DH. Number of musculoskeletal pain sites leads to increased long-term healthcare contacts and healthcare related costs - a Danish population-based cohort study. BMC Health Serv Res 2021; 21:980. [PMID: 34535148 PMCID: PMC8447684 DOI: 10.1186/s12913-021-06994-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 09/07/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND People with musculoskeletal pain seek more healthcare than the general population, however little is known about the long-term effect on healthcare use. The aim of this study was to examine the consequences of number of musculoskeletal pain sites on long-term care-seeking and healthcare-related costs and explore how health anxiety influences this relationship. METHODS We conducted a Danish population-based longitudinal cohort study of 4883 participants combining self-reported survey data from 2008 with ten-year follow-up data from national health registers. Using a causal inference framework, we examined associations between number of pain sites (range 0-7)/level of health anxiety (high/low level) and face-to-face healthcare contacts/healthcare-related costs. Data were analyzed using negative binomial regression with generalized estimating equations. Regression models were adjusted for sex, age, duration of pain, level of education, comorbidity, personality traits, risk of depression, marital status, physical job exposure, and previous healthcare utilization. RESULTS For each additional pain site general healthcare contacts (Incidence Rate Ratio (IRR): 1.04 (95% CI: 1.03-1.05)), healthcare-related costs (IRR: 1.06 (95% CI: 1.03-1.08) and musculoskeletal healthcare contacts (IRR: 1.11 (95% CI:1.09-1.14) increased. Those with high levels of health anxiety at baseline had a slightly higher number of general healthcare contacts (IRR 1.06 (1.01-1.11), independent of number of pain sites. However, level of anxiety did not influence the effect of number of pain sites on any healthcare use or cost outcomes. CONCLUSIONS We found evidence for a causal association between increasing number of pain sites and greater healthcare use and cost, and high levels of health anxiety did not increase the strength of this association. This suggests that number of pain sites could be a potential target for biopsychosocial interventions in order to reduce the need for future care-seeking.
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Affiliation(s)
- S Mose
- Department of Occupational Medicine, University Research Clinic, Danish Ramazzini Centre, Herning, Denmark. .,VIA University College, School of Physiotherapy, Holstebro, Denmark.
| | - P Kent
- Curtin School of Allied Health, Curtin University, Perth, WA, Australia.,Center for Muscle and Joint Health, University of Southern Denmark, Odense, Denmark
| | - A Smith
- Curtin School of Allied Health, Curtin University, Perth, WA, Australia
| | - J H Andersen
- Department of Occupational Medicine, University Research Clinic, Danish Ramazzini Centre, Herning, Denmark
| | - D H Christiansen
- Department of Occupational Medicine, University Research Clinic, Danish Ramazzini Centre, Herning, Denmark
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Andersen LPS, Hogh A, Andersen JH, Biering K. Depressive Symptoms Following Work-Related Violence and Threats and the Modifying Effect of Organizational Justice, Social Support, and Safety Perceptions. J Interpers Violence 2021; 36:7110-7135. [PMID: 30827135 DOI: 10.1177/0886260519831386] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Work-related threats and violence is a major occupational hazard and the consequences for victims may be a range of physical and psychological symptoms. The purpose of this study was to examine the associations between exposure to work-related violence and threats and subsequent risk for depression and to examine whether the associations were modified by social support, organizational justice and safety perceptions. Questionnaire data was collected in 2010, 2011 and in 2015. A total of 5,342 employees from special schools, psychiatric wards, eldercare and the Prison and Probation Services (PPS) participated in the first round in 2010. The analysis was performed by multivariate logistic regression. Staff exposed for work-related threats and violence had an increased risk for depression compared to non-exposed staff. The risk was highest for staff working in PPS. Compared to low levels, there were a tendency for high levels of social support, organizational justice and safety perception to attenuate the associations between work-related threats and violence and depression. However, none of the differences were statistically significant. Many employees working in human service sectors are exposed to work-related threats and violence which increases the risk for depression. The risk for depression following work-related threats and violence may be modified by social support, organizational justice and the perception of safety workplace. It is recommended that workplaces adopt an integrated organizational approach including both prevention of work-related threats and violence and intervention to modify the health consequences of work-related threats and violence.
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Norheim KL, Bøggild H, Andersen JH, Omland Ø, Bønløkke JH, Madeleine P. Retirement status and frailty: a cross-sectional study of the phenotype of manual workers aged 50-70 years. Eur J Public Health 2021; 31:116-121. [PMID: 33164046 DOI: 10.1093/eurpub/ckaa188] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The frailty phenotype is predictive of mortality and has been identified in the working population. This cross-sectional study aimed to investigate the prevalence of frailty and individual frailty symptoms among active and retired Danish manual workers and to delineate the relationship between frailty and lifestyle factors. METHODS Manual workers aged 50-70 years answered questions relating to the Fried criteria for frailty (weight loss, exhaustion, slowness, weakness and inactivity). Only men were included in the analyses and respondents were stratified according to work status: active workers (n = 1555), early retirees (n = 289) and workers retired at or after normal pension age (n = 291). Associations between pre-frailty/frailty, work status and various lifestyle factors were estimated using binomial logistic regression. RESULTS Overall, the prevalence of pre-frailty (one or two symptoms) and frailty (three or more symptoms) was 33.3% and 1.5%, respectively. Those who had retired early were more likely to be pre-frail/frail compared with active workers (odds ratio 2.20, 95% CI 1.61-3.01). Exhaustion was the most prominent symptom reported by 22.2% of active workers, 34.6% of early retirees and 16.5% of workers retired at normal retirement age. Lifestyle factors including obesity, physical inactivity and smoking but not alcohol intake were associated with pre-frailty/frailty. CONCLUSION Symptoms of frailty are identifiable and present among both active and retired manual workers. Data suggest discrepancies among Danish manual workers, with some having unhealthy lifestyles and being more prone to develop pre-frailty and frailty already in their sixth decade of life.
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Affiliation(s)
- Kristoffer L Norheim
- Sport Sciences - Performance and Technology, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark.,Department of Occupational and Environmental Medicine, Danish Ramazzini Centre, Aalborg University Hospital, Aalborg, Denmark
| | - Henrik Bøggild
- Public Health and Epidemiology Group, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Johan Hviid Andersen
- Department of Occupational Medicine, Danish Ramazzini Centre, University Research Clinic, Regional Hospital West Jutland, Herning, Denmark
| | - Øyvind Omland
- Department of Occupational and Environmental Medicine, Danish Ramazzini Centre, Aalborg University Hospital, Aalborg, Denmark
| | - Jakob H Bønløkke
- Department of Occupational and Environmental Medicine, Danish Ramazzini Centre, Aalborg University Hospital, Aalborg, Denmark
| | - Pascal Madeleine
- Sport Sciences - Performance and Technology, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
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21
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Jahn A, Rysgaard TK, Andersen JH, Winding TN. Adverse childhood experiences and future self-rated health: a prospective cohort study. BMC Public Health 2021; 21:895. [PMID: 33975578 PMCID: PMC8114537 DOI: 10.1186/s12889-021-10941-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 04/28/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Negative life events (re) occurring during childhood is often described as adverse childhood experiences (ACEs) and may have long-lasting negative effects on health. Previous studies on the association between ACEs and self-rated health (SRH) have primarily been focusing on chronic diseases in elderly, non-Scandinavian populations using a cross-sectional design. The aim of the study was to examine the associations between ACEs and SRH in early adulthood and to investigate if disadvantageous health-behavioral strategies explain the association between ACEs and SRH. METHODS A prospective cohort study using data from The West Jutland Cohort Study (N = 2.255). Baseline data on exposure to ACEs were collected from surveys at the age of 15 and 18 and respondents were categorized into having experienced 0, 1-2, 3 or > 4 ACEs. The outcome SRH stems from surveys at the age of 21 and 28 and was dichotomized into moderate and good SRH. The association between ACE-categories and SRH at age 21 and 28 were analyzed separately by logistic regression with a two-step adjustment model, adjusting for potential confounders and disadvantageous health-behavioral strategies. RESULTS More than half of the participants reported at least one ACE (56.3%) with "bullying" and "loss of parent, parental separation or divorce" being the most prevalent. Participants who reported > 4 ACEs, compared to those with 0 ACEs, had a 2.6-fold increased odds (95% CI 1.3; 5.1) of having moderate SRH at the age of 21, and a 2.7-fold increased odds (95% CI 1.4; 5.4) of moderate SRH at the age of 28 years, when adjusted for potential confounders. Further, small attenuations of the estimates were seen when adjusting for disadvantageous health-behavioral strategies. A significant exposure response relationship between the ACE-categories and moderate SRH were seen both at age 21 and 28. CONCLUSION The study showed an association between ACEs and moderate SRH in young adulthood, and experiencing multiple ACEs increased the odds of reporting moderate SRH. Information on ACEs could help identifying people with a higher risk of future health problems and accentuates a growing need for early prevention in homes with children who has experienced adverse events.
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Affiliation(s)
- Alexander Jahn
- Department of Occupational Medicine, Danish Ramazzini Centre, University Research Clinic, Regional Hospital West Jutland, Gl. Landevej 61, 7400, Herning, Denmark.
| | - Timmi K Rysgaard
- Department of Occupational Medicine, Danish Ramazzini Centre, University Research Clinic, Regional Hospital West Jutland, Gl. Landevej 61, 7400, Herning, Denmark
| | - Johan Hviid Andersen
- Department of Occupational Medicine, Danish Ramazzini Centre, University Research Clinic, Regional Hospital West Jutland, Gl. Landevej 61, 7400, Herning, Denmark
| | - Trine Nøhr Winding
- Department of Occupational Medicine, Danish Ramazzini Centre, University Research Clinic, Regional Hospital West Jutland, Gl. Landevej 61, 7400, Herning, Denmark
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22
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Abstract
Patients on sick leave due to work-related stress often present with cognitive complaints. The primary aim of this prospective cohort study was to examine potential long-term consequences of previous ongoing work-related stress in terms of cognitive functioning four years after initial professional care seeking. We tested a group of patients with work-related stress complaints with a comprehensive neuropsychological test battery. Patients were examined at a department of occupational medicine and tested at baseline, one-year follow-up and four-year follow-up. At each time point, we compared the performance of patients with healthy controls matched pairwise on sex, age and length of education. This paper presents the results from the four-year follow-up. Patients improved on their neuropsychological test performance during the four years but the main improvements took place during the first year. At baseline, the main impairments in the patient group concerned executive function and mental speed. At four-year follow-up, patients displayed slightly lower scores on the neuropsychological tests relative to controls but only the difference on immediate memory was significant corresponding to a small effect size (Cohen's d). More than half of the patients who participated in the four-year follow-up reported that they felt only slightly or partially recovered. The level of work participation among the former patients improved considerably during the four-year follow-up period.Lay SummaryThis study examines the long-term consequences of work-related stress in terms of cognitive functioning and recovery four years after initial professional care seeking. After four years, patients continued to display significantly lower memory scores than controls but no other significant differences between the groups were found on neuropsychological tests. Levels of work participation among patients improved considerably over time, yet, more than half of the former patients who participated in the four-year follow-up did not feel completely recovered.
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Affiliation(s)
- Vita Ligaya Dalgaard
- Department of Occupational Medicine, Danish Ramazzini Centre, Regional Hospital West Jutland, University Clinic, Herning, Denmark
- Department of Psychology and Behavioral Sciences, Aarhus University, Aarhus C, Denmark
| | - Johan Hviid Andersen
- Department of Occupational Medicine, Danish Ramazzini Centre, Regional Hospital West Jutland, University Clinic, Herning, Denmark
| | | | - Lars Peter Andersen
- Department of Occupational Medicine, Danish Ramazzini Centre, Regional Hospital West Jutland, University Clinic, Herning, Denmark
| | - Anita Eskildsen
- Department of Occupational Medicine, Danish Ramazzini Centre, Regional Hospital West Jutland, University Clinic, Herning, Denmark
- Department of Affective Disorders, Aarhus University Hospital - Skejby, Aarhus N, Denmark
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23
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Just-Noerregaard V, Andersen JH, Nohr EA, Vestergaard JM, Winding TN. How does engagement in society in adolescence affect educational attainment and employment in early adulthood: A prospective cohort study. PLoS One 2021; 16:e0249312. [PMID: 33793623 PMCID: PMC8016247 DOI: 10.1371/journal.pone.0249312] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 03/16/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction Educational attainment and employment are essential for young people to develop the skills needed to participate in society and maintain a stable connection to the labour market in adult life. The objective of this study was to examine associations between engagement in society, measured by leisure time activities and part-time work in mid and late adolescence and educational attainment and employment in early adulthood. Method A cohort of Danish young people born in 1989 was followed in a prospective study with questionnaires in 2004 (n = 3,054) and 2007 (n = 2,400) where information on leisure time activities and part-time work was collected. Information on connection to education and work was collected from a register of social benefits when participants were 25–29 years old and divided into high and low connection. The associations were examined using logistic regression and stratified by gender and childhood socioeconomic groups. Results Part-time work was, both in mid (OR: 1.7 [95% CI 1.3; 2.2]) and late (1.9 [1.4;2.6]) adolescence, positively associated with connection to education and work. Leisure time activities in mid adolescence were associated with connection to education and work (OR:1.6 [1.2;2.1]). Among men engagement in society showed strongest associations with later connection to education or work in mid adolescence (ORs up to 2.2), whereas the associations for women seemed strongest in late adolescence (ORs up to 2.8). Conclusion The study showed that adolescent engagement in society had positive associations with later educational attainment and employment, with stronger impact of part-time work compared to leisure time activities. The study identified differences between genders and the timing of engagement. Associations were consistent across socioeconomic groups.
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Affiliation(s)
- Vivi Just-Noerregaard
- Department of Occupational Medicine, Danish Ramazzini Centre, University Research Clinic, Regional Hospital West Jutland, Herning, Denmark
- * E-mail:
| | - Johan Hviid Andersen
- Department of Occupational Medicine, Danish Ramazzini Centre, University Research Clinic, Regional Hospital West Jutland, Herning, Denmark
| | - Ellen Aagaard Nohr
- Research Unit for Gynaecology and Obstetrics, Institute for Clinical Research, University of Southern Denmark, Odense, Denmark
- Centre of Women’s, Family and Child Health, University of South-Eastern Norway, Kongsberg, Norway
| | - Jesper Medom Vestergaard
- Department of Occupational Medicine, Danish Ramazzini Centre, University Research Clinic, Regional Hospital West Jutland, Herning, Denmark
| | - Trine Nohr Winding
- Department of Occupational Medicine, Danish Ramazzini Centre, University Research Clinic, Regional Hospital West Jutland, Herning, Denmark
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24
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Jakobsen AL, Hansen CD, Andersen JH. The association between perceived social support in adolescence and positive mental health outcomes in early adulthood: a prospective cohort study. Scand J Public Health 2021; 50:404-411. [PMID: 33645305 DOI: 10.1177/1403494821993718] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIMS The link between perceived social support and mental health has received much attention from numerous scientific fields in recent years. Most studies, however, have examined associations only over relatively short follow-up periods using global measures of perceived social support and dichotomous negative indicators of mental health. We investigated the long-term association between perceived social support from friends, parents and teachers and multiple positive hedonic and eudemonic indicators of mental health, including hope, meaningfulness and subjective well-being. METHODS This study used questionnaire data from 2004, 2007 and 2010 from the West Jutland Birth Cohort study with linked register data. The study population consisted of 3681 adolescents born in 1989. Multiple linear and ordered logistic regression were used to analyse the association between perceived social support at age 14/15 years and mental health indicators at age 20/21 years while controlling for possible confounders, including the Big Five personality traits and baseline symptoms of depression. RESULTS The results show that perceived social support from friends in adolescence was positively associated with all indicators of mental health in early adulthood. Furthermore, perceived paternal social support was positively associated with meaningfulness and subjective well-being, while perceived social support from teachers was positively associated with meaningfulness. CONCLUSIONS Overall, the results from this study indicate that perceived social support in adolescence, particularly support from friends, could promote positive mental health outcomes in early adulthood.
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Affiliation(s)
| | - Claus D Hansen
- Department of Sociology and Social Work, Aalborg University, Denmark
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25
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Mikkelsen S, Coggon D, Andersen JH, Casey P, Flachs EM, Kolstad HA, Mors O, Bonde JP. Are depressive disorders caused by psychosocial stressors at work? A systematic review with metaanalysis. Eur J Epidemiol 2021; 36:479-496. [PMID: 33580479 PMCID: PMC8159794 DOI: 10.1007/s10654-021-00725-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [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: 05/07/2020] [Accepted: 01/25/2021] [Indexed: 11/25/2022]
Abstract
In the last decade, many studies have examined associations between poor psychosocial work environment and depression. We aimed to assess the evidence for a causal association between psychosocial factors at work and depressive disorders. We conducted a systematic literature search from 1980 to March 2019. For all exposures other than night and shift work and long working hours, we limited our selection of studies to those with a longitudinal design. We extracted available risk estimates for each of 19 psychosocial exposures, from which we calculated summary risk estimates with 95% confidence intervals (PROSPERO, identifier CRD42019130266). 54 studies were included, addressing 19 exposures and 11 different measures of depression. Only data on depressive episodes were sufficient for evaluation. Heterogeneity of exposure definitions and ascertainment, outcome measures, risk parameterization and effect contrasts limited the validity of meta-analyses. Summary risk estimates were above unity for all but one exposure, and below 1.60 for all but another. Outcome measures were liable to high rates of false positives, control of relevant confounding was mostly inadequate, and common method bias was likely in a large proportion of studies. The combination of resulting biases is likely to have inflated observed effect estimates. When statistical uncertainties and the potential for bias and confounding are taken into account, it is not possible to conclude with confidence that any of the psychosocial exposures at work included in this review is either likely or unlikely to cause depressive episodes or recurrent depressive disorders.
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Affiliation(s)
- Sigurd Mikkelsen
- Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark.
| | - David Coggon
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Johan Hviid Andersen
- Department of Occupational Medicine, Danish Ramazzini Centre, University Research Clinic, Herning, Denmark
| | - Patricia Casey
- Department of Psychiatry, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Esben Meulengracht Flachs
- Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Henrik Albert Kolstad
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark
| | - Ole Mors
- Department of Psychosis, Aarhus University Hospital - Psychiatry, Aarhus, Denmark
| | - Jens Peter Bonde
- Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
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26
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Winding TN, Skouenborg LA, Mortensen VL, Andersen JH. Is bullying in adolescence associated with the development of depressive symptoms in adulthood?: A longitudinal cohort study. BMC Psychol 2020; 8:122. [PMID: 33213518 PMCID: PMC7678151 DOI: 10.1186/s40359-020-00491-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 03/27/2020] [Accepted: 11/12/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Being bullied in adolescence is linked to mental health problems like anxiety, depressive- and somatic symptoms and can have negative consequences on both an individual and a societal level. However, evidence regarding the long-term mental health consequences of bullying in adolescence is limited. The aim of this study was to examine whether being bullied at age 15 or 18 was associated with experiencing depressive symptoms at age 28, and to examine whether being bullied at both ages 15 and 18 increased the risk of experiencing depressive symptoms at age 28. METHODS A prospective cohort study, which applied data from the West Jutland Cohort Study, was conducted. Bullying and depressive symptoms were measured on the basis of self-reported data from surveys in 2004, 2007 and 2017. Depressive symptoms were measured with the Center for Epidemiological Studies Depression Scale. A total of 1790 participants were included in the study, and analyzed by multiple logistic regressions. RESULTS The results showed associations between being bullied at age 15 or 18 and the reporting of depressive symptoms at age 28 when adjusted for potential confounders. An exposure-response relationship was seen in those who were bullied at both ages 15 and 18. This group had the highest risk of developing depressive symptoms at age 28. CONCLUSIONS Being bullied in adolescence was associated with developing depressive symptoms in adulthood and there was an exposure-response relationship between being bullied over time and the later reporting of depressive symptoms. The results highlight the need to provide more detailed information to schools and local communities about the negative consequences of bullying. Such increased awareness may help reduce the risk of young people developing depressive symptoms later in life.
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Affiliation(s)
- Trine Nøhr Winding
- Department of Occupational Medicine-University Research Clinic, Danish Ramazzini Centre, Regional Hospital West Jutland, Gl. Landevej 61, 7400, Herning, Denmark.
| | - Lisbeth Astrid Skouenborg
- Department of Occupational Medicine-University Research Clinic, Danish Ramazzini Centre, Regional Hospital West Jutland, Gl. Landevej 61, 7400, Herning, Denmark
| | - Vibeke Lie Mortensen
- Department of Occupational Medicine-University Research Clinic, Danish Ramazzini Centre, Regional Hospital West Jutland, Gl. Landevej 61, 7400, Herning, Denmark
| | - Johan Hviid Andersen
- Department of Occupational Medicine-University Research Clinic, Danish Ramazzini Centre, Regional Hospital West Jutland, Gl. Landevej 61, 7400, Herning, Denmark
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27
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Christiansen DH, McCray G, Winding TN, Andersen JH, Nielsen KJ, Karstens S, Hill JC. Measurement properties of the musculoskeletal health questionnaire (MSK-HQ): a between country comparison. Health Qual Life Outcomes 2020; 18:200. [PMID: 32576190 PMCID: PMC7313180 DOI: 10.1186/s12955-020-01455-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Accepted: 06/17/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Musculoskeletal Health Questionnaire (MSK-HQ) has been developed to measure musculoskeletal health status across musculoskeletal conditions and settings. However, the MSK-HQ needs to be further evaluated across settings and different languages. OBJECTIVE The objective of the study was to evaluate and compare measurement properties of the MSK-HQ across Danish (DK) and English (UK) cohorts of patients from primary care physiotherapy services with musculoskeletal pain. METHODS MSK-HQ was translated into Danish according to international guidelines. Measurement invariance was assessed by differential item functioning (DIF) analyses. Test-retest reliability, measurement error, responsiveness and minimal clinically important change (MCIC) were evaluated and compared between DK (n = 153) and UK (n = 166) cohorts. RESULTS The Danish version demonstrated acceptable face and construct validity. Out of the 14 MSK-HQ items, three items showed DIF for language (pain/stiffness at night, understanding condition and confidence in managing symptoms) and three items showed DIF for pain location (walking, washing/dressing and physical activity levels). Intraclass Correlation Coefficients for test-retest were 0.86 (95% CI 0.81 to 0.91) for DK cohort and 0.77 (95% CI 0.49 to 0.90) for the UK cohort. The systematic measurement error was 1.6 and 3.9 points for the DK and UK cohorts respectively, with random measurement error being 8.6 and 9.9 points. Receiver operating characteristic (ROC) curves of the change scores against patients' own judgment at 12 weeks exceeded 0.70 in both cohorts. Absolute and relative MCIC estimates were 8-10 points and 26% for the DK cohort and 6-8 points and 29% for the UK cohort. CONCLUSIONS The measurement properties of MSK-HQ were acceptable across countries, but seem more suited for group than individual level evaluation. Researchers and clinicians should be aware that some discrepancy exits and should take the observed measurement error into account when evaluating change in scores over time.
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Affiliation(s)
- David Høyrup Christiansen
- Occupational Medicine, Danish Ramazzini Centre, Regional Hospital West Jutland - University Research Clinic, Herning, Denmark
- Department of Clinical Medicine, Health, Aarhus University, Aarhus, Denmark
| | - Gareth McCray
- School of Primary, Community and Social Care, Keele University, Staffordshire, UK
| | - Trine Nøhr Winding
- Occupational Medicine, Danish Ramazzini Centre, Regional Hospital West Jutland - University Research Clinic, Herning, Denmark
| | - Johan Hviid Andersen
- Occupational Medicine, Danish Ramazzini Centre, Regional Hospital West Jutland - University Research Clinic, Herning, Denmark
- Department of Clinical Medicine, Health, Aarhus University, Aarhus, Denmark
| | - Kent Jacob Nielsen
- Occupational Medicine, Danish Ramazzini Centre, Regional Hospital West Jutland - University Research Clinic, Herning, Denmark
| | - Sven Karstens
- Department of Computer Science; Therapeutic Sciences, Trier University of applied Sciences, Trier, Germany
| | - Jonathan C. Hill
- School of Primary, Community and Social Care, Keele University, Staffordshire, UK
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Flachs EM, Petersen SEB, Kolstad HA, Schlünssen V, Svendsen SW, Hansen J, Budtz-Jørgensen E, Andersen JH, Madsen IEH, Bonde JPE. Cohort Profile: DOC*X: a nationwide Danish occupational cohort with eXposure data - an open research resource. Int J Epidemiol 2020; 48:1413-1413k. [PMID: 31730707 DOI: 10.1093/ije/dyz110] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2019] [Indexed: 11/14/2022] Open
Affiliation(s)
- Esben Meulengracht Flachs
- Department of Occupational and Environmental Medicine, Bispebjerg-Frederiksberg Hospital, Copenhagen, Denmark
| | | | - Henrik Albert Kolstad
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark
| | - Vivi Schlünssen
- National Research Centre for the Working Environment, Copenhagen, Denmark.,Department of Public Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - Susanne Wulff Svendsen
- Danish Ramazzini Centre, Department of Occupational Medicine, Regional Hospital West Jutland - University Research Clinic, Herning, Denmark
| | - Johnni Hansen
- The Danish Cancer Society, Research Center, Copenhagen, Denmark
| | - Esben Budtz-Jørgensen
- Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Johan Hviid Andersen
- Danish Ramazzini Centre, Department of Occupational Medicine, Regional Hospital West Jutland - University Research Clinic, Herning, Denmark
| | | | - Jens Peter Ellekilde Bonde
- Department of Occupational and Environmental Medicine, Bispebjerg-Frederiksberg Hospital, Copenhagen, Denmark.,Institute of, Public, Health, University of Copenhagen, Copenhagen, Denmark
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Steen PB, Poulsen PH, Andersen JH, Biering K. Subjective social status is an important determinant of perceived stress among adolescents: a cross-sectional study. BMC Public Health 2020; 20:396. [PMID: 32295550 PMCID: PMC7161273 DOI: 10.1186/s12889-020-08509-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 01/02/2019] [Accepted: 03/11/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Stress is an increasing public health problem, and the association between stress and subjective social status (SSS) among adolescents has received little attention. SSS in society have shown to be associated with perceived stress, but the association between SSS in school and stress has never been examined. The aim of this study was to explore the association between SSS and perceived stress in Danish adolescent boys and girls. METHODS Data was collected in 2017 in frame of The Danish Occupation of Children and Adolescents Cohort (FOCA cohort), where Danish 9th graders (age 15/16) from 1746 schools participated in a survey (4527 girls, 3654 boys, aged 15 to 16 years). SSS in society and SSS in school were the exposure variables, and the level of perceived stress was the outcome variable. Associations between SSS in school and in society separately with perceived stress was analysed using linear regression models stratified by gender and adjusted to social and health-related factors (e.g. neighbourhood safety, home characteristics, grade meaning, homework load, self-rated health, smoking, alcohol consumption). RESULTS The mean overall PSS score was 14.7; for girls the score was 16.3, and for boys it was 12.6. The analyses revealed a strong linear association between SSS, in both society and school, and perceived stress. The lower the SSS, the higher perceived stress. The associations were the same for both genders, but girls reported a higher level of stress than did boys. CONCLUSION We found that girls reported a higher level of perceived stress than boys. Furthermore, we found a strong association between low SSS in society and especially SSS in school and a high level of perceived stress among Danish adolescents.
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Affiliation(s)
- Pernille Bach Steen
- Department of Occupational Medicine, Danish Ramazzini Centre, Regional Hospital West Jutland – University Research Clinic, Gl. Landevej 61, DK-7400 Herning, Denmark
| | - Per Høgh Poulsen
- Department of Occupational Medicine, Danish Ramazzini Centre, Regional Hospital West Jutland – University Research Clinic, Gl. Landevej 61, DK-7400 Herning, Denmark
| | - Johan Hviid Andersen
- Department of Occupational Medicine, Danish Ramazzini Centre, Regional Hospital West Jutland – University Research Clinic, Gl. Landevej 61, DK-7400 Herning, Denmark
| | - Karin Biering
- Department of Occupational Medicine, Danish Ramazzini Centre, Regional Hospital West Jutland – University Research Clinic, Gl. Landevej 61, DK-7400 Herning, Denmark
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30
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Jensen JD, Andersen JH, Winding TN. Psychological resources in adolescence and the association with labour market participation in early adulthood: a prospective cohort study. BMC Public Health 2020; 20:386. [PMID: 32209059 PMCID: PMC7092559 DOI: 10.1186/s12889-020-08531-w] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 03/16/2020] [Indexed: 11/25/2022] Open
Abstract
Background Young adults at the age of 25–29 in Denmark have the highest unemployment rate and are at higher risk of labour market marginalization. Exclusion from the labour market may have negative individual consequences on mental and physical health and can lead to increasing societal expenditures due to social benefits. It is important to understand what factors determine or protect against early labour market marginalization. The aim of the present study was to investigate the association between psychological resources in adolescence and labour market participation in early adulthood, and whether the associations differed by gender. Methods This prospective cohort study used questionnaire data collected through the West Jutland Cohort study in 2004 and 2007. The study population (N = 2982) consisted of people born in 1989 and living in the county of Ringkjoebing at baseline in 2004. Outcome was dichotomized as +/− 12 months of passive labour market participation during the age of 25–29. Psychological resources were measured as self-esteem, sense of coherence and mastery. Logistic regression analyses were performed to investigate the associations between psychological resources and labour market participation. Results Results indicated associations between high levels of mastery or sense of coherence in adolescence and high labour market participation in early adulthood. The strongest associations were observed for females with a medium (OR: 1.9, 95% CI: 1.3–2.8) or high level (OR: 1.6, 95% CI: 1.0–2.4) of mastery or a high level of sense of coherence (OR: 1.6 95% CI: 1.0–2.4) at age 15 and for males with a medium (OR: 2.7, 95% CI: 1.5–3.8) or high (OR: 1.9, 95% CI: 1.1–3.5) level of mastery or a high level of sense of coherence (OR: 1.7, 95% CI: 0.9–3.1) at age 18. Conclusion The results of the present study indicate associations between a high level of sense of coherence or mastery in adolescence and high labour market participation in early adulthood in a Danish context. Psychological resources seemed to play a bigger role for females in early adolescence compared to males, for whom a larger impact was seen in late adolescence.
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Affiliation(s)
- Jacob Devantie Jensen
- Ramboll Management Consulting, Stakeholder Intelligence, Olof Palmes Allé 22, 8200, Aarhus, Denmark
| | - Johan Hviid Andersen
- Department of Occupational Medicine, Danish Ramazzini Centre, University Research Clinic, Regional Hospital West Jutland, Gl. Landevej 61, 7400, Herning, Denmark
| | - Trine Nøhr Winding
- Department of Occupational Medicine, Danish Ramazzini Centre, University Research Clinic, Regional Hospital West Jutland, Gl. Landevej 61, 7400, Herning, Denmark.
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Poulsen PH, Biering K, Winding TN, Aagaard Nohr E, Andersen JH. Influences of childhood family factors on depressive symptoms in adolescence and early adulthood: A Danish longitudinal study. Scand J Public Health 2020; 48:715-725. [PMID: 31960768 DOI: 10.1177/1403494819870056] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Aims: The study examined the timing of family socio-economic factors during early (aged 0-8 years) and late (aged 9-14 years) childhood, as well as psychosocial variables in relation to depressive symptoms at the ages of 15, 18 and 21. Methods: This prospective cohort study included 3014 young people from western Denmark. Exposure variables were equivalised household income (income), mother's educational level and mother's labour market participation (LMP), derived from registers and self-reported variables family functioning, subjective social status and negative life events. The outcome variable was depressive symptoms. Associations were analysed using logistic regression, adjusted for other exposure variables and sex. Results: In early childhood, mother's low LMP was associated with higher risk of depressive symptoms at the age of 15, whereas mother's low educational level and lower income was associated with higher risk of depressive symptoms at the age of 21. In late childhood, lower income, mother's low educational level and mother's low LMP was associated with higher risk of depressive symptoms at the ages of 15 and 21. Poorer family functioning was associated with depressive symptoms at the age of 15-21, with estimates ranging from 1.8 to 2.6. Reporting two or more negative life events were associated with depressive symptoms at the ages of 15 and 18. Conclusions: Timing of low income, mother's low educational level and mother's low LMP during childhood in relation to future depressive symptoms in the offspring appears to be of some importance in this Danish youth cohort. Family functioning and negative life events were the most stable risk factors for depressive symptoms. Results should, however, be interpreted with caution due to the risk of reverse causality.
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Affiliation(s)
- Per Hoegh Poulsen
- Danish Ramazzini Centre, Department of Occupational Medicine, University Research Clinic, Regional Hospital West Jutland, Denmark
| | - Karin Biering
- Danish Ramazzini Centre, Department of Occupational Medicine, University Research Clinic, Regional Hospital West Jutland, Denmark
| | - Trine Nøhr Winding
- Danish Ramazzini Centre, Department of Occupational Medicine, University Research Clinic, Regional Hospital West Jutland, Denmark
| | - Ellen Aagaard Nohr
- Institute of Clinical Research, University of Southern Denmark, Department of Obstetrics and Gynaecology, Odense University Hospital, Denmark
| | - Johan Hviid Andersen
- Danish Ramazzini Centre, Department of Occupational Medicine, University Research Clinic, Regional Hospital West Jutland, Denmark
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Poulsen PH, Biering K, Winding TN, Nohr EA, Petersen LV, Ulijaszek SJ, Andersen JH. How does psychosocial stress affect the relationship between socioeconomic disadvantage and overweight and obesity? Examining Hemmingsson's model with data from a Danish longitudinal study. BMC Public Health 2019; 19:1475. [PMID: 31699059 PMCID: PMC6839153 DOI: 10.1186/s12889-019-7699-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 05/20/2019] [Accepted: 09/26/2019] [Indexed: 11/23/2022] Open
Abstract
Background Chronic stress in childhood may increase the risk of overweight and obesity in young people. Erik Hemmingsson has suggested a new obesity causation model which focuses on psychosocial stress. The aim was to examine the associations between socioeconomic disadvantage and overweight and obesity and examine if these associations attenuate, when the effect of the different domains from Eric Hemmingsson’s obesity causation model were taken into account. Methods A longitudinal study using data from The West Jutland Cohort Study (N = 2879). Outcome was overweight and obesity combined derived from self-reported weight and height at age 15, 18, 21 and 28 years. Exposure variables were equivalised household income, educational level and labour market participation of the mother derived from registers and psychosocial variables derived from questionnaires. A three-step adjustment model using logistic regression and stratified by gender was applied. Results Mother’s low educational level was associated with a 3-fold increased odds of obesity in 18 year-old-girls, which attenuated when adjusting for the domains adult distress, disharmonious family environment and offspring distress. In 28 year-old girls, a 2.5-fold increased odds of obesity was observed, which attenuated when mutual adjusted for other socioeconomic variables and attenuated even further when adjusting for all the domains. In 18-year-old boys, a 3-fold increased odds of obesity was observed which attenuated after adjustments for adult distress, disharmonious family environment and offspring distress. In 21-year old boys, a four-fold increased odds of obesity was observed that attenuated after adjustments. At age 28 years, a three-fold increased odds of obesity was observed, which vanished in the fully adjusted model. Conclusions Our study confirms to some extent that the associations between socioeconomic disadvantage and overweight and obesity can be explained by the domains included in Erik Hemmingsson’s model, although our results should be interpreted with caution. Adult distress, disharmonious family environment and offspring distress accounted for some of the association in girls, whereas in boys it was primarily offspring distress, which had the greatest impact. Young people’s educational attainment can act as a buffer in the relationship between mother’s lower educational level and obesity at age 28 years.
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Affiliation(s)
- Per Hoegh Poulsen
- Danish Ramazzini Centre, Department of Occupational Medicine, University Research Clinic, Regional Hospital West Jutland, Gl. Landevej 61, 7400, Herning, Denmark.
| | - Karin Biering
- Danish Ramazzini Centre, Department of Occupational Medicine, University Research Clinic, Regional Hospital West Jutland, Gl. Landevej 61, 7400, Herning, Denmark
| | - Trine Nøhr Winding
- Danish Ramazzini Centre, Department of Occupational Medicine, University Research Clinic, Regional Hospital West Jutland, Gl. Landevej 61, 7400, Herning, Denmark
| | - Ellen Aagaard Nohr
- Institute of Clinical Research, Department of Obstetrics & Gynecology, University of Southern Denmark, Odense University Hospital, Odense, Denmark
| | - Liselotte Vogdrup Petersen
- National Center for Register-Based Research, Aarhus University, Fuglesangs Allé 26, 8210, Aarhus V, Denmark
| | - Stanley J Ulijaszek
- Unit for Biocultural Variation and Obesity, Institute of Social and Cultural Anthropology, University of Oxford, Oxford, UK
| | - Johan Hviid Andersen
- Danish Ramazzini Centre, Department of Occupational Medicine, University Research Clinic, Regional Hospital West Jutland, Gl. Landevej 61, 7400, Herning, Denmark
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Evanoff B, Yung M, Buckner-Petty S, Baca M, Andersen JH, Roquelaure Y, Descatha A, Dale AM. Cross-national comparison of two general population job exposure matrices for physical work exposures. Occup Environ Med 2019; 76:567-572. [PMID: 30894424 PMCID: PMC6703148 DOI: 10.1136/oemed-2018-105408] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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: 08/03/2018] [Revised: 12/13/2018] [Accepted: 02/08/2019] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Job exposure matrices (JEMs) are increasingly used to estimate physical workplace exposures. We conducted a cross-national comparison of exposure estimates from two general population JEMs to aid the interpretation of exposure-outcome associations across countries and to explore the feasibility of cross-national application of JEMs to provide workplace physical exposure estimates. METHODS We compared physical exposure estimates from two general population JEMs created from the FrenchCohorte des consultants des Centres d'examens de santé study (27 exposure variables) and the American Occupational Information Network database (21 exposure variables). These exposure variables were related to physical demands or ergonomic risk factors for musculoskeletal disorders. We used a crosswalk to match French Profession et Catégorie Sociale job codes with American Standard Occupational Classification job codes and calculated Spearman's correlations and Cohen's kappa values for exposure variable pairs between these French and American JEMs. We defined a priori 50 matched French and American JEM variable pairs that measured similar exposures. RESULTS All variable pairs measuring similar physical exposures demonstrated positive correlations. Among the 50 matched pairs, 33 showed high correlation (ρ≥0.70) and 46 showed at least moderate agreement (κ≥0.41). Exposures expected to be mutually exclusive (manual work vs office work) showed strongly negative correlations. CONCLUSIONS French and American general population physical exposure JEMs were related, sharing moderate to high association and moderate to substantial agreement between the majority of variable pairs measuring similar exposures. These findings will inform cross-national comparisons of study results and support some uses of general population JEMs outside their countries of origin.
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Affiliation(s)
- Bradley Evanoff
- Division of General Medical Sciences, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Marcus Yung
- Division of General Medical Sciences, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Skye Buckner-Petty
- Division of General Medical Sciences, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Matthew Baca
- Division of General Medical Sciences, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Johan Hviid Andersen
- Department of Occupational Medicine, Danish Ramazzini Centre, Regional Hospital West Jutland, University Research Clinic, Herning, Denmark
| | - Yves Roquelaure
- INSERM, U1085, IRSET (Institute de recherché en santé, environnement et travail), ESTER Team, University of Angers, Angers, France
| | - Alexis Descatha
- INSERM, U1085, IRSET (Institute de recherché en santé, environnement et travail), ESTER Team, University of Angers, Angers, France.,AP-HP, EMS (Samu92), Occupational Health Unit, Raymond Poincaré University Hospital, Garches, France.,INSERM, UMR 1168 UMS011, University of Versailles Saint-Quentin-en-Yvelines, Villejuif, France
| | - Ann Marie Dale
- Division of General Medical Sciences, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
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Lindholdt L, Lund T, Andersen JH, Hansen CD, Labriola M. Cohort profile: the Danish Future Occupation of Children and Adolescents cohort (the FOCA cohort): education, work-life, health and living conditions in a life-course perspective. BMJ Open 2019; 9:e022784. [PMID: 30772844 PMCID: PMC6398691 DOI: 10.1136/bmjopen-2018-022784] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
PURPOSE The Future Occupation of Children and Adolescents cohort (the FOCA cohort) is a large population-based cohort study that was established as a resource for research in order to study adolescence factors and future educational and vocational trajectories in a life-course perspective. The cohort covers a broad array of themes within public health, including diseases and health behaviours. Through linkage to register data on the participants' parents, the cohort allows investigation of parental effects over time on adolescents' behaviours and interactions across generations. PARTICIPANTS The FOCA cohort consists of 13 100 adolescents attending ninth grade in Denmark during the first quarter of 2017, independent of school type. FINDINGS TO DATE Included were 6685 girls (51.03%) and 6415 boys (48.97%) with an average age of 15.85 years, representing 650 schools (37.23%), covering all options in the Danish school system and widely distributed across the country. The use of the personal identification number allowed for a merge of parents to all adolescents in the cohort, resulting in the identification of 25 911 registered parents. Register data on parents' socio-economic position and labour market history showed representativeness among the adolescents' socio-economic background compared with the general population in Denmark. FUTURE PLANS The adolescents will be followed by ongoing linkage to administrative registers. Future studies will focus on factors affecting future health, education, work and well-being in a life-course perspective and for specific research projects, it will be possible to apply for permission to link data to further ongoing national registers covering all participants.
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Affiliation(s)
- Louise Lindholdt
- Department of Public Health, University of Aarhus, Aarhus, Denmark
- DEFACTUM, Central Denmark Region, Aarhus, Denmark
| | - Thomas Lund
- Centre for Social Medicine, Frederiksberg and Bispebjerg Hospital, Copenhagen, Denmark
- Research Centre for Youth and Employment, Regional Hospital West Jutland, University Research Clinic, Herning, Denmark
| | - Johan Hviid Andersen
- Research Centre for Youth and Employment, Regional Hospital West Jutland, University Research Clinic, Herning, Denmark
- Department of Occupational Medicine, Danish Ramazzini Centre, Regional Hospital West Jutland, University Research Clinic, Herning, Denmark
| | - Claus D Hansen
- Research Centre for Youth and Employment, Regional Hospital West Jutland, University Research Clinic, Herning, Denmark
- Department of Sociology and Social Work, Aalborg University, Aalborg, Denmark
| | - Merete Labriola
- Department of Public Health, University of Aarhus, Aarhus, Denmark
- Research Centre for Youth and Employment, Regional Hospital West Jutland, University Research Clinic, Herning, Denmark
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Evanoff BA, Yung M, Buckner-Petty S, Andersen JH, Roquelaure Y, Descatha A, Dale AM. The CONSTANCES job exposure matrix based on self-reported exposure to physical risk factors: development and evaluation. Occup Environ Med 2019; 76:398-406. [PMID: 30705110 PMCID: PMC6520135 DOI: 10.1136/oemed-2018-105287] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 06/11/2018] [Revised: 11/28/2018] [Accepted: 12/16/2018] [Indexed: 11/27/2022]
Abstract
Objectives Job exposure matrices (JEMs) can be constructed from expert-rated assessments, direct measurement and self-reports. This paper describes the construction of a general population JEM based on self-reported physical exposures, its ability to create homogeneous exposure groups (HEG) and the use of different exposure metrics to express job-level estimates. Methods The JEM was constructed from physical exposure data obtained from the Cohorte des consultants des Centres d’examens de santé (CONSTANCES). Using data from 35 526 eligible participants, the JEM consisted of 27 physical risk factors from 407 job codes. We determined whether the JEM created HEG by performing non-parametric multivariate analysis of variance (NPMANOVA). We compared three exposure metrics (mean, bias-corrected mean, median) by calculating within-job and between-job variances, and by residual plots between each metric and individual reported exposure. Results NPMANOVA showed significantly higher between-job than within-job variance among the 27 risk factors (F(253,21964)=61.33, p<0.0001, r2=41.1%). The bias-corrected mean produced more favourable HEG as we observed higher between-job variance and more explained variance than either means or medians. When compared with individual reported exposures, the bias-corrected mean led to near-zero mean differences and lower variance than other exposure metrics. Conclusions CONSTANCES JEM using self-reported data yielded HEGs, and can thus classify individual participants based on job title. The bias-corrected mean metric may better reflect the shape of the underlying exposure distribution. This JEM opens new possibilities for using unbiased exposure estimates to study the effects of workplace physical exposures on a variety of health conditions within a large general population study.
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Affiliation(s)
- Bradley A Evanoff
- Division of General Medical Sciences, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Marcus Yung
- Division of General Medical Sciences, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Skye Buckner-Petty
- Division of General Medical Sciences, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Johan Hviid Andersen
- Department of Occupational Medicine, Danish Ramazzini Centre, Regional Hospital West Jutland, University Research Clinic, Herning, Denmark
| | - Yves Roquelaure
- INSERM, U1085, IRSET (Institute de recherché en santé, environnement et travail), ESTER Team, University of Angers, Angers, France
| | - Alexis Descatha
- INSERM, U1085, IRSET (Institute de recherché en santé, environnement et travail), ESTER Team, University of Angers, Angers, France.,AP-HP, EMS (Samu92), Occupational Health Unit, Raymond Poincaré University Hospital, Garches, France.,INSERM, UMR 1168 UMS011, University of Versailles Saint-Quentin-en-Yvelines, Villejuif, France
| | - Ann Marie Dale
- Division of General Medical Sciences, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
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Poulsen PH, Biering K, Winding TN, Nohr EA, Andersen JH. How does childhood socioeconomic position affect overweight and obesity in adolescence and early adulthood: a longitudinal study. BMC Obes 2018; 5:34. [PMID: 30524739 PMCID: PMC6276194 DOI: 10.1186/s40608-018-0210-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 08/23/2018] [Indexed: 12/27/2022]
Abstract
Background Childhood socioeconomic position (SEP) has previously been associated with increased risk of overweight among children and adolescents. However, it remains uncertain whether the timing of exposure is important in relation to developing overweight in early adulthood. We aimed to examine how SEP during early (0-8 years) and late childhood (9-14 years) relates to overweight at age 15, 18 and 21. Methods Longitudinal study in Western Denmark of 2879 young people (aged 15 in 2004). Exposure variables from registers were yearly household income, parental highest educational level and parental labour market participation (LMP), supplemented with questionnaire information about "family functioning" (age 15). Outcome variables were overweight and obesity, measured at three-time points.We analyzed the adjusted associations between childhood SEP and overweight and obesity using multinomial logistic regression, stratified on gender. Results Early childhood: Parental lower educational level increased girls' risk of overweight and obesity at age 18 and 21 between RR = 1.8 (95% CI 1.0;3.4) and RR = 5.2 (95% CI 1.4;19.3). Girls reporting poor "family functioning" had up to twice the risk of overweight and obesity at age 21. Boys, whose fathers had a lower level of education had up to 2.4 times the risk of obesity at age 21. Parental low LMP increased boys' risk of obesity at age 18 and 21 between RR = 2.2 (95% CI 1.3;3.8) and RR = 2.8 (95% CI 1.3;6.1). Late childhood: Parental lower level of education tripled the risk of overweight and obesity among girls at age 18 and among both genders at age 21. Conclusion This study confirmed to some extent that economic, social and psychological insecurity and inequality as measured by lower parental educational level, lower household income, low labour market participation and poor family function during childhood was associated with an increased risk of overweight and especially obesity in adolescence and early adulthood in both genders. Despite some imprecise measures, the direction of the associations pointed to several associations, which all were in the hypothesized direction. Timing of lower household income and parental low LMP in childhood seemed to be gender-specific in some way, but this warrants more studies.
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Affiliation(s)
- Per Hoegh Poulsen
- 1Danish Ramazzini Centre, Department of Occupational Medicine, University Research Clinic, Regional Hospital West Jutland, Gl. Landevej 61, 7400 Herning, Denmark
| | - Karin Biering
- 1Danish Ramazzini Centre, Department of Occupational Medicine, University Research Clinic, Regional Hospital West Jutland, Gl. Landevej 61, 7400 Herning, Denmark
| | - Trine Nøhr Winding
- 1Danish Ramazzini Centre, Department of Occupational Medicine, University Research Clinic, Regional Hospital West Jutland, Gl. Landevej 61, 7400 Herning, Denmark
| | - Ellen Aagaard Nohr
- Institute of Clinical Research, Department of Obstetrics & Gynecology, Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | - Johan Hviid Andersen
- 1Danish Ramazzini Centre, Department of Occupational Medicine, University Research Clinic, Regional Hospital West Jutland, Gl. Landevej 61, 7400 Herning, Denmark
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Budtz CR, Andersen JH, de Vos Andersen NB, Christiansen DH. Responsiveness and minimal important change for the quick-DASH in patients with shoulder disorders. Health Qual Life Outcomes 2018; 16:226. [PMID: 30526622 PMCID: PMC6288952 DOI: 10.1186/s12955-018-1052-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [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: 09/04/2018] [Accepted: 11/27/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Responsiveness and minimal important change (MIC) are central measurement properties when interpreting scores from health questionnaires. The aim of the study was to evaluate the responsiveness and MIC of the Danish version of the shortened version the Disabilities of the Arm, Shoulder and Hand questionnaire (Quick-DASH) in patients with shoulder disorders referred to primary care physiotherapy treatment. METHODS The study included 261 patients who completed questionnaires at baseline and 3 and 6 months follow up. Absolute and relative change scores was analysed using receiver-operating-characteristics (ROC) curve analysis with the Patient Global Impression of Change (PGIC) as external anchor. RESULTS At both 3 and 6 months follow up, the Area under the Curve (ROC AUC) exceeded 0.70 and MIC was 9.1 and 13.6 at 3 and 6 months respectively. CONCLUSION The Danish version of the Quick-DASH demonstrated adequate ability to measure changes in disability over 3 and 6 months in patients with shoulder disorders undergoing primary care physiotherapy treatment.
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Affiliation(s)
- Cecilie Rud Budtz
- Department of Occupational Medicine, Regional Hospital West Jutland, University Research Clinic, Gl. Landevej 61, 7400, Herning, Denmark.
| | - Johan Hviid Andersen
- Department of Occupational Medicine, Regional Hospital West Jutland, University Research Clinic, Gl. Landevej 61, 7400, Herning, Denmark
| | - Nils-Bo de Vos Andersen
- Central Denmark Region, Primary Health Care and Quality Improvement, Skottenborg 26, 8800, Viborg, Denmark
| | - David Høyrup Christiansen
- Department of Occupational Medicine, Regional Hospital West Jutland, University Research Clinic, Gl. Landevej 61, 7400, Herning, Denmark.,Department of Clinical Medicine, Health, Aarhus University, Palle Juul-Jensens Boulevard 82, 8200, Aarhus, Denmark
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Andersen JH, Malmros P, Ebbehoej NE, Flachs EM, Bengtsen E, Bonde JP. Systematic literature review on the effects of occupational safety and health (OSH) interventions at the workplace. Scand J Work Environ Health 2018; 45:103-113. [PMID: 30370910 DOI: 10.5271/sjweh.3775] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Objectives The aim of this review was to assess the evidence that occupational safety and health (OSH) legislative and regulatory policy could improve the working environment in terms of reduced levels of industrial injuries and fatalities, musculoskeletal disorders, worker complaints, sick leave and adverse occupational exposures. Methods A systematic literature review covering the years 1966‒2017 (February) was undertaken to capture both published and gray literature studies of OSH work environment interventions with quantitative measures of intervention effects. Studies that met specified in- and exclusion criteria went through an assessment of methodological quality. Included studies were grouped into five thematic domains: (i) introduction of OHS legislation, (ii) inspection/enforcement activity, (iii) training, such as improving knowledge, (iv), campaigns, and (v) introduction of technical device, such as mechanical lifting aids. The evidence synthesis was based on meta-analysis and a modified Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. Results The search for peer-reviewed literature identified 14 743 journal articles of which 45 fulfilled the inclusion criteria and were eligible for meta-analysis. We identified 5181 articles and reports in the gray literature, of which 16 were evaluated qualitatively. There was moderately strong evidence for improvement by OHS legislation and inspections with respect to injuries and compliance. Conclusions This review indicates that legislative and regulatory policy may reduce injuries and fatalities and improve compliance with OHS regulation. A major research gap was identified with respect to the effects of OSH regulation targeting psychological and musculoskeletal disorders.
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Affiliation(s)
- Johan Hviid Andersen
- Johan Hviid Andersen, Professor, Department of Occupational Medicine, Danish Ramazzini Centre, Regional Hospital West Jutland - University Clinic, Gl. Landevej 61, 7400 Herning, Denmark.
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Abstract
AIMS The primary aim was to investigate the association between somatic symptoms at ages 15 or 18 and reduced labour market participation at age 23, when socioeconomic, social, and mental health risk factors were taken into account. METHODS The study included 3223 participants from the West Jutland Cohort Study with questionnaire information on somatic symptoms at ages 15 or 18 and with register information on labour market participation at age 23, gathered from a national register on all public transfer benefits for a 52-week period. The analyses included additional information about socioeconomic background, number of negative life events, social climate in the family, social relations with friends, and depressive symptoms. Logistic regression analyses yielded odds ratios with 95% confidence intervals. RESULTS Among the males, associations between reporting somatic symptoms at age 18 and low labour market participation was seen in both crude and adjusted analyses (odds ratio: 1.66; 95% confidence intervals: 1.01-2.75), whereas the association among the females disappeared after adjustments (odds ratio: 0.97; 95% confidence intervals: 0.63-1.52). CONCLUSIONS The males that reported somatic symptoms in late adolescence appeared to be the most vulnerable to future reduced labour market participation.
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Affiliation(s)
- Trine Nøhr Winding
- Department of Occupational Medicine - University Research Clinic, Regional Hospital West Jutland, Denmark
| | - Johan Hviid Andersen
- Department of Occupational Medicine - University Research Clinic, Regional Hospital West Jutland, Denmark
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Timmerby N, Andersen JH, Søndergaard S, Østergaard SD, Bech P. A Systematic Review of the Clinimetric Properties of the 6-Item Version of the Hamilton Depression Rating Scale (HAM-D6). Psychother Psychosom 2018; 86:141-149. [PMID: 28490031 DOI: 10.1159/000457131] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 01/20/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND In a study aimed at identifying the items carrying information regarding the global severity of depression, the 6-item Hamilton Depression Rating Scale (HAM-D6) was derived from the original 17-item version of the scale (HAM-D17). Since then, the HAM-D6 has been used in a wide range of clinical studies. We now provide a systematic review of the clinimetric properties of HAM-D6 in comparison with those of HAM-D17 and the Montgomery Asberg Depression Rating Scale (MADRS). METHODS We conducted a systematic search of the literature in PubMed, PsycInfo, and EMBASE databases in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. Studies reporting data on the clinimetric validity of the HAM-D6 and either the HAM-D17 or MADRS in non-psychotic unipolar or bipolar depression were included in the synthesis. RESULTS The search identified 681 unique records, of which 51 articles met the inclusion criteria. According to the published literature, HAM-D6 has proven to be superior to both HAM-D17 and MADRS in terms of scalability (each item contains unique information regarding syndrome severity), transferability (scalability is constant over time and irrespective of sex, age, and depressive subtypes), and responsiveness (sensitivity to change in severity during treatment). CONCLUSIONS According to the published literature, the clinimetric properties of HAM-D6 are superior to those of both the HAM-D17 and MADRS. Since the validity of HAM-D6 has been demonstrated in both research and clinical practice, using the scale more consistently would facilitate translation of results from one setting to the other.
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Affiliation(s)
- N Timmerby
- Psychiatric Research Unit, Mental Health Centre North Zealand, University of Copenhagen, Hillerød, Denmark
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Jakobsen ELT, Biering K, Kærgaard A, Andersen JH. Neck-Shoulder Pain and Work Status among Former Sewing Machine Operators: A 14-year Follow-up Study. J Occup Rehabil 2018; 28:80-88. [PMID: 28260173 DOI: 10.1007/s10926-017-9702-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Purpose A total of 243 Danish female sewing machine operators lost their jobs in 1996 because of outsourcing. The aim was to investigate the employment status during follow-up from 1996 to 2008, and to estimate to what extent former neck-shoulder pain had an impact on later work participation. Methods Assessment of neck-shoulder pain was based on questionnaires completed in 1994. The Danish Register-Based Evaluation of Marginalization (DREAM) register was used to describe employment status during the follow-up period. Register data were explored by sequence analyses and graphics, and the association between neck-shoulder pain and work participation was analyzed by logistic regression analysis. Results In all, 987 working years were lost during follow-up, and a sequence index plot revealed interrupted and heterogeneous courses of incomes. The odds ratio between neck and shoulder pain and a work participation score less than 75% was 1.49 (95% CI 0.84-2.67). Conclusions After outsourcing of the textile industry, the former sewing machine operators had decreased work participation and frequent transitions between different income types. Previous neck-shoulder pain tended to be associated with poor work participation. The results suggest that increased attention should be to given to dismissed workers from other industries that become outsourced, especially unskilled workers with similar work-related health limitations. Additionally, we concluded that time-to-event measures in research involving employment status are insufficient because of the many transitions that take place in working life.
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Affiliation(s)
- Emma Lise Thorlund Jakobsen
- Department of Occupational Medicine, Danish Ramazzini Centre, Regional Hospital West Jutland - University Research Clinic, Gl. Landevej 61, 7400, Herning, Denmark.
| | - Karin Biering
- Department of Occupational Medicine, Danish Ramazzini Centre, Regional Hospital West Jutland - University Research Clinic, Gl. Landevej 61, 7400, Herning, Denmark
| | - Anette Kærgaard
- Department of Occupational Medicine, Danish Ramazzini Centre, Regional Hospital West Jutland - University Research Clinic, Gl. Landevej 61, 7400, Herning, Denmark
| | - Johan Hviid Andersen
- Department of Occupational Medicine, Danish Ramazzini Centre, Regional Hospital West Jutland - University Research Clinic, Gl. Landevej 61, 7400, Herning, Denmark
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Affiliation(s)
- S Mikkelsen
- Department of Occupational and Environmental Medicine,Bispebjerg University Hospital,Copenhagen,Denmark
| | - J H Andersen
- Department of Occupational Medicine,Danish Ramazzini Centre, The Regional Hospital West Jutland,Herning,Denmark
| | - J P Bonde
- Department of Occupational and Environmental Medicine,Bispebjerg University Hospital,Copenhagen,Denmark
| | - Å M Hansen
- Department of Public Health,University of Copenhagen,Copenhagen,Denmark
| | - H Kolstad
- Department of Occupational Medicine,Danish Ramazzini Centre, Aarhus University Hospital,Århus,Denmark
| | - J F Thomsen
- Department of Occupational and Environmental Medicine,Bispebjerg University Hospital,Copenhagen,Denmark
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Lindholdt L, Andersen JH, Lund T, Labriola M. Mental health across two generations –A cohort-study among 10,716 Danish adolescents. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx189.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- L Lindholdt
- Section of Clinical Social Medicine and Rehabilitation, Dep. of Public Health, Aarhus University, Aarhus, Denmark
| | - JH Andersen
- Section of Clinical Social Medicine and Rehabilitation, Dep. of Public Health, Aarhus University, Aarhus, Denmark
| | - T Lund
- Section of Clinical Social Medicine and Rehabilitation, Dep. of Public Health, Aarhus University, Aarhus, Denmark
| | - M Labriola
- Section of Clinical Social Medicine and Rehabilitation, Dep. of Public Health, Aarhus University, Aarhus, Denmark
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Affiliation(s)
- JH Andersen
- Department of Occupational Medicine, Danish Ramazzini Centre, Herning, Denmark
| | - L Lindholdt
- Section of Clinical Social Medicine and Rehabilitation, Dep. of Public Health, Aarhus University, Aarhus, Denmark
| | - TN Winding
- Department of Occupational Medicine, Danish Ramazzini Centre, Herning, Denmark
| | - T Lund
- Research Centre for Youth & Employment, Herning, Denmark
| | - M Labriola
- Section of Clinical Social Medicine and Rehabilitation, Dep. of Public Health, Aarhus University, Aarhus, Denmark
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Jakobsen ELT, Biering K, Kærgaard A, Dalbøge A, Andersen JH. Long-term prognosis for neck-shoulder pain and disorders: a 14-year follow-up study. Occup Environ Med 2017; 75:90-97. [PMID: 28835395 DOI: 10.1136/oemed-2017-104422] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 07/05/2017] [Accepted: 07/20/2017] [Indexed: 11/03/2022]
Abstract
OBJECTIVES The long-term prognosis for neck-shoulder pain and disorders and the impact of shoulder exposure among former sewing machine operators were investigated in a 14-year follow-up study. METHODS Information on neck-shoulder pain and disorders was collected by questionnaire and clinical examination at baseline in 243 female sewing machine operators and by questionnaire 14 years later. During follow-up, information on comorbidity and job exposures was obtained from registers and by linking register-based D-ISCO 88 codes with a job exposure matrix. Logistic regression analyses were performed to examine associations between neck-shoulder pain and disorders at baseline and neck-shoulder pain and physical functioning at follow-up. RESULTS We found an association between neck-shoulder disorders at baseline and neck-shoulder pain at follow-up (OR 5.9;95% CI 1.9 to 17.7), and between neck-shoulder pain at baseline and neck-shoulder pain at follow-up (OR 8.2;95% CI 3.5 to 19.2). Associations between neck-shoulder disorders and pain at baseline and limited physical functioning at follow-up had ORs of 5.0 (95% CI 1.5 to 16.1) and 2.2 (95% CI 1.1 to 4.6), respectively. In women still working in 2008, the association between neck-shoulder pain in 1994 and in 2008 seemed to be stronger for those in jobs with high job shoulder exposure. CONCLUSIONS The results suggest a long-term adverse prognosis for neck-shoulder pain. High job shoulder exposure can worsen this prognosis for those who continue working. This knowledge could influence the counselling given to similar workers and emphasises the need to prevent neck-shoulder pain.
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Affiliation(s)
- Emma Lise Thorlund Jakobsen
- Department of Occupational Medicine, Danish Ramazzini Centre, Regional Hospital West Jutland, University Research Clinic, Herning, Denmark
| | - Karin Biering
- Department of Occupational Medicine, Danish Ramazzini Centre, Regional Hospital West Jutland, University Research Clinic, Herning, Denmark
| | - Anette Kærgaard
- Department of Occupational Medicine, Danish Ramazzini Centre, Regional Hospital West Jutland, University Research Clinic, Herning, Denmark
| | - Annett Dalbøge
- Department of Occupational Medicine, Danish Ramazzini Centre, Regional Hospital West Jutland, University Research Clinic, Herning, Denmark.,Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark
| | - Johan Hviid Andersen
- Department of Occupational Medicine, Danish Ramazzini Centre, Regional Hospital West Jutland, University Research Clinic, Herning, Denmark
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Dalgaard VL, Andersen LPS, Andersen JH, Willert MV, Carstensen O, Glasscock DJ. Work-focused cognitive behavioral intervention for psychological complaints in patients on sick leave due to work-related stress: Results from a randomized controlled trial. J Negat Results Biomed 2017; 16:13. [PMID: 28830555 PMCID: PMC5567478 DOI: 10.1186/s12952-017-0078-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [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: 02/10/2017] [Accepted: 07/18/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Work-related stress is a global problem with negative implications for individuals and society. The purpose of the current study was to evaluate a stress management intervention for patients on sick leave due to work-related stress complaints using a three-armed randomized controlled design. METHODS Participants were patients referred from three municipalities to the regional Department of Occupational Medicine. Inclusion criteria were: 1) sick leave due to work-related stress complaints, 2) a diagnosis of adjustment disorder or reactions to severe stress (ICD 10 code: F43,2 - F 43,9 not PTSD) or mild depressive episode (F 32.0). Through a double randomization procedure patients (n = 163) were randomized to either an intervention group (n = 58), a 'control group A' receiving a clinical examination (n = 56), or 'control group B' (n = 49) receiving no offers at the department. The intervention comprised six sessions of individual cognitive behavioral therapy and the offer of a small workplace intervention. Questionnaire data were analyzed with multivariate repeated measurements analysis. Primary outcomes assessed were perceived stress and general mental health. Secondary outcomes were sleep quality and cognitive failures. Follow-up was at four and 10 months after baseline. RESULTS Complaints were significantly reduced in all groups over time. No group effects were observed between the intervention group and control group A that was clinically assessed. Significant group effects were found for perceived stress and memory when comparing the intervention group to group B, but most likely not due to an intervention effect. CONCLUSION Psychological complaints improved substantially over time in all groups, but there was no significant treatment effect on any outcomes when the intervention group was compared to control group A that received a clinical assessment. TRIAL REGISTRATION ISRCTN ISRCTN91404229. Registered 03 August 2012 (retrospectively registered).
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Affiliation(s)
- Vita Ligaya Dalgaard
- Danish Ramazzini Centre, Department of Occupational Medicine, The Regional Hospital West Jutland - University Research Clinic, Herning, Denmark.
| | - Lars Peter Sønderbo Andersen
- Danish Ramazzini Centre, Department of Occupational Medicine, The Regional Hospital West Jutland - University Research Clinic, Herning, Denmark
| | - Johan Hviid Andersen
- Danish Ramazzini Centre, Department of Occupational Medicine, The Regional Hospital West Jutland - University Research Clinic, Herning, Denmark
| | - Morten Vejs Willert
- Danish Ramazzini Centre, Department of Occupational Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Ole Carstensen
- Danish Ramazzini Centre, Department of Occupational Medicine, The Regional Hospital West Jutland - University Research Clinic, Herning, Denmark
| | - David John Glasscock
- Danish Ramazzini Centre, Department of Occupational Medicine, The Regional Hospital West Jutland - University Research Clinic, Herning, Denmark
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Dalbøge A, Frost P, Andersen JH, Svendsen SW. Surgery for subacromial impingement syndrome in relation to intensities of occupational mechanical exposures across 10-year exposure time windows. Occup Environ Med 2017; 75:176-182. [DOI: 10.1136/oemed-2017-104511] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 07/17/2017] [Accepted: 07/28/2017] [Indexed: 02/06/2023]
Abstract
ObjectivesWe aimed to identify intensities of occupational mechanical exposures (force, arm elevation and repetition) that do not entail an increased risk of surgery for subacromial impingement syndrome (SIS) even after prolonged durations of exposure. Additionally, we wanted to evaluate if exposure to hand-arm vibration (HAV) is an independent risk factor.MethodsWe used data from a register-based cohort study of the entire Danish working population (n=2 374 403). During follow-up (2003–2008), 14 118 first-time events of surgery for SIS occurred. For each person, we linked register-based occupational codes (1993–2007) to a general population job exposure matrix to obtain year-by-year exposure intensities on measurement scales for force, upper arm elevation >90° and repetition and expert rated intensities of exposure to HAV. For 10-year exposure time windows, we calculated the duration of exposure at specific intensities above minimal (low, medium and high). We used a logistic regression technique equivalent to discrete survival analysis adjusting for cumulative effects of other mechanical exposures.ResultsWe found indications of safe exposure intensities for repetition (median angular velocity <45°/s), while force exertion ≥10% of maximal voluntary electrical activity and upper arm elevation >90° >2 min/day implied an increased risk reaching ORs of 1.7 and 1.5 after 10 years at low intensities. No associations were found for HAV.ConclusionsWe found indications of safe exposure intensities for repetition. Any intensities of force and upper arm elevation >90° above minimal implied an increased risk across 10-year exposure time windows. No independent associations were found for HAV.
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Eskildsen A, Fentz HN, Andersen LP, Pedersen AD, Kristensen SB, Andersen JH. Perceived stress, disturbed sleep, and cognitive impairments in patients with work-related stress complaints: a longitudinal study. Stress 2017; 20:371-378. [PMID: 28605986 DOI: 10.1080/10253890.2017.1341484] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Patients on sick leave due to work-related stress often present with cognitive impairments as well as sleep disturbances. The aim of this longitudinal study was to examine the role of perceived stress and sleep disturbances in the longitudinal development in cognitive impairments in a group of patients with prolonged work-related stress (N = 60) during a period of 12 months following initial professional care-seeking. Objective cognitive impairments (neuropsychological tests) were measured on two occasions - at initial professional care-seeking and at 12-month follow-up. Questionnaires on perceived stress, sleep disturbances, and cognitive complaints were completed seven times during the 12 months which facilitated multilevel analysis with segregation of within-person (change) and between-person (baseline level) components of the time-varying predictors (perceived stress and sleep disturbances). Change in perceived stress was associated with concurrent and subsequent change in self-reported cognitive complaints over the period of 12 months and to a lesser extent the change in performance on neuropsychological tests of processing speed from baseline to 12-month follow-up. Change in sleep disturbances was also associated with concurrent and subsequent change in self-reported cognitive complaints over the 12 months but not with change on neuropsychological test performance. Although the mechanism behind the improvement in cognitive impairments in patients with work-related stress should be further explored in future studies, the results could suggest that improvement in cognitive impairments is partly mediated by decreasing levels of perceived stress and, to a lesser extent, decreasing levels of sleep disturbances. Lay summary This study examines the role of perceived stress and sleep disturbances in respect to the development of cognitive impairments (e.g. memory and concentration) in a group of patients with work-related stress. We found that change in cognitive impairments seems to be partly explained by change in perceived stress and, to a lesser extent, sleep disturbances over time. This could suggest that cognitive impairments can be reduced by stress management interventions which aim to reduce perceived stress and sleep disturbances but future studies are needed to confirm this interpretation.
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Affiliation(s)
- Anita Eskildsen
- a Department of Occupational Medicine , Danish Ramazzini Centre, The Regional Hospital West Jutland - University Research Clinic , Herning , Denmark
| | - Hanne Nørr Fentz
- b Department of Psychology and Behavioral Sciences, School of Business and Social Sciences , Aarhus University , Aarhus C , Denmark
| | - Lars Peter Andersen
- a Department of Occupational Medicine , Danish Ramazzini Centre, The Regional Hospital West Jutland - University Research Clinic , Herning , Denmark
| | - Anders Degn Pedersen
- c Department of Psychology and Behavioural Sciences , Aarhus University , Aarhus C , Denmark
| | | | - Johan Hviid Andersen
- a Department of Occupational Medicine , Danish Ramazzini Centre, The Regional Hospital West Jutland - University Research Clinic , Herning , Denmark
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Dalgaard VL, Aschbacher K, Andersen JH, Glasscock DJ, Willert MV, Carstensen O, Biering K. Return to work after work-related stress: a randomized controlled trial of a work-focused cognitive behavioral intervention. Scand J Work Environ Health 2017. [PMID: 28650513 DOI: 10.5271/sjweh.3655] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Objectives This study aimed to evaluate the effect of a stress management intervention (SMI) on lasting return to work (RTW) among patients with work-related stress complaints. Methods Sickness benefit departments from three local municipalities referred patients on sick leave with work-related adjustment disorders or mild depression to the Department of Occupational Medicine, Regional Hospital West Jutland. A 2× randomization procedure allocated patients into one of three groups: intervention (N=58), control A (which received a clinical assessment; N=56), or control B (no assessment; N=49). Treatment comprised individual work-focused cognitive behavioral therapy (CBT) with an optional workplace intervention. The outcome was time until lasting RTW (16 and 44 weeks follow-up) using register data. Results Median number of weeks until lasting RTW was 15, 19, and 32 for the intervention group, control A, and control B respectively. However, for group B, clinical assessment was not part of the inclusion process, which may have introduced selection bias. In the fully-adjusted Cox regression model, the intervention group exhibited significantly faster lasting RTW at 44 weeks; hazard ratio (HR) 1.57 [95% confidence interval (95% CI) 1.01-2.44] relative to control group A, with a non-significant trend evident at 16 weeks; HR 1.70 (95% CI 0.94-3.10), when controlling for age, gender, occupation, sick leave during previous year, full or partial sick leave, and diagnosis. Unadjusted analyses remained directionally consistent but were reduced to marginal significance. Conclusions There was a tendency towards faster lasting RTW in the intervention group compared to control A, which received clinical assessment, in all analyses. The intervention group returned to work about 4 weeks earlier than control A, which could translate into substantial financial gains.
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Affiliation(s)
- Vita Ligaya Dalgaard
- Danish Ramazzini Centre, Dept. of Occupational Medicine, The Regional Hospital West Jutland - University Research Clinic, Gl. Landevej 61, 7400, Herning, Denmark.
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Vad MV, Frost P, Rosenberg J, Andersen JH, Svendsen SW. Inguinal hernia repair among men in relation to occupational mechanical exposures and lifestyle factors: a longitudinal study. Occup Environ Med 2017; 74:769-775. [PMID: 28546321 DOI: 10.1136/oemed-2016-104160] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Revised: 04/07/2017] [Accepted: 04/21/2017] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To evaluate exposure-response relationships between occupational mechanical exposures and first-time lateral and medial inguinal hernia repair and effects of lifestyle factors. To estimate if occupational mechanical exposures advance the repairs. METHODS This longitudinal study was based on a cohort of men aged 18-65 years with questionnaire data from the Musculoskeletal Research Database at the Danish Ramazzini Centre. We estimated occupational mechanical exposures using a job exposure matrix. First-time inguinal hernia repairs from 1998 to 2014 were identified in the Danish Hernia Database. We used Cox regression analyses and calculated excess fractions among the exposed and rate advancement periods (RAPs). RESULTS Among 17 967 men, we identified 382 lateral and 314 medial repairs. The risk of lateral repairs increased with time spent standing/walking with an HR of 1.45 (95% CI 1.12 to 1.88) for ≥6 hours/day versus <4 hours/day, corresponding to an excess fraction of cases of 31% in the group with ≥6 hours/day. This group had a RAP of 6.7 (95% CI 2.6 to 10.8) years. Medial repairs were not associated with occupational mechanical exposures. A body mass index ≥30 kg/m2 showed lower HRs for both repair types. Leisure-time physical activity and smoking status were not related to any of the outcomes. CONCLUSIONS Assuming a causal relationship, the results suggest that around 30% of all first-time lateral inguinal hernia repairs in the highest exposure category would be preventable if the time spent standing/walking could be reduced from ≥6 to <4 hours/day. The repairs might even be postponed by 6-7 years.
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Affiliation(s)
- Marie Vestergaard Vad
- Danish Ramazzini Centre, Department of Occupational Medicine, Regional Hospital West Jutland-University Research Clinic, Herning, Denmark.,Danish Ramazzini Centre, Department of Occupational Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Poul Frost
- Danish Ramazzini Centre, Department of Occupational Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Jacob Rosenberg
- Department of Surgical Gastroenterology, Herlev Hospital, University of Copenhagen, Herlev, Denmark
| | - Johan Hviid Andersen
- Danish Ramazzini Centre, Department of Occupational Medicine, Regional Hospital West Jutland-University Research Clinic, Herning, Denmark
| | - Susanne Wulff Svendsen
- Danish Ramazzini Centre, Department of Occupational Medicine, Regional Hospital West Jutland-University Research Clinic, Herning, Denmark
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