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This cohort study examines disease-free life-years in participants with varying combinations of lifestyle risk factors. Question Are different combinations of lifestyle factors associated with years lived without chronic diseases? Findings In a multicohort study of 116 & x202f;043 participants, a statistically significant association between overall healthy lifestyle score and an increased number of disease-free life-years was noted. Of 16 different lifestyle profiles studied, the 4 that were associated with the greatest disease-free life years included body mass index lower than 25 and at least 2 of 3 factors: never smoking, physical activity, and moderate alcohol consumption. Meaning Various healthy lifestyle profiles appear to be associated with extended gains in life lived without type 2 diabetes, cardiovascular and respiratory diseases, and cancer. Importance It is well established that selected lifestyle factors are individually associated with lower risk of chronic diseases, but how combinations of these factors are associated with disease-free life-years is unknown. Objective To estimate the association between healthy lifestyle and the number of disease-free life-years. Design, Setting, and Participants A prospective multicohort study, including 12 European studies as part of the Individual-Participant-Data Meta-analysis in Working Populations Consortium, was performed. Participants included 116 & x202f;043 people free of major noncommunicable disease at baseline from August 7, 1991, to May 31, 2006. Data analysis was conducted from May 22, 2018, to January 21, 2020. Exposures Four baseline lifestyle factors (smoking, body mass index, physical activity, and alcohol consumption) were each allocated a score based on risk status: optimal (2 points), intermediate (1 point), or poor (0 points) resulting in an aggregated lifestyle score ranging from 0 (worst) to 8 (best). Sixteen lifestyle profiles were constructed from combinations of these risk factors. Main Outcomes and Measures The number of years between ages 40 and 75 years without chronic disease, including type 2 diabetes, coronary heart disease, stroke, cancer, asthma, and chronic obstructive pulmonary disease. Results Of the 116 & x202f;043 people included in the analysis, the mean (SD) age was 43.7 (10.1) years and 70 & x202f;911 were women (61.1%). During 1.45 million person-years at risk (mean follow-up, 12.5 years; range, 4.9-18.6 years), 17 & x202f;383 participants developed at least 1 chronic disease. There was a linear association between overall healthy lifestyle score and the number of disease-free years, such that a 1-point improvement in the score was associated with an increase of 0.96 (95% CI, 0.83-1.08) disease-free years in men and 0.89 (95% CI, 0.75-1.02) years in women. Comparing the best lifestyle score with the worst lifestyle score was associated with 9.9 (95% CI 6.7-13.1) additional years without chronic diseases in men and 9.4 (95% CI 5.4-13.3) additional years in women (P

Background Job strain is implicated in many atherosclerotic diseases, but its role in peripheral artery disease ( PAD ) is unclear. We investigated the association of job strain with hospital records of PAD , using individual‐level data from 11 prospective cohort studies from Finland, Sweden, Denmark, and the United Kingdom. Methods and Results Job strain (high demands and low control at work) was self‐reported at baseline (1985–2008). PAD records were ascertained from national hospitalization data. We used Cox regression to examine the associations of job strain with PAD in each study, and combined the study‐specific estimates in random effects meta‐analyses. We used τ 2 , I 2 , and subgroup analyses to examine heterogeneity. Of the 139 132 participants with no previous hospitalization with PAD , 32 489 (23.4%) reported job strain at baseline. During 1 718 132 person‐years at risk (mean follow‐up 12.8 years), 667 individuals had a hospital record of PAD (3.88 per 10 000 person‐years). Job strain was associated with a 1.41‐fold (95% CI, 1.11–1.80) increased average risk of hospitalization with PAD . The study‐specific estimates were moderately heterogeneous (τ 2 =0.0427, I 2 : 26.9%). Despite variation in their magnitude, the estimates were consistent in both sexes, across the socioeconomic hierarchy and by baseline smoking status. Additional adjustment for baseline diabetes mellitus did not change the direction or magnitude of the observed associations. Conclusions Job strain was associated with small but consistent increase in the risk of hospitalization with PAD , with the relative risks on par with those for coronary heart disease and ischemic stroke.

Aims: A systematic review and meta-analysis have found that long working hours were prospectively associated with an increased risk of overall stroke. The primary aim of the present study was to test if this finding could be reproduced in a sample that has been randomly selected from the general workforce of Denmark. A secondary aim was to estimate the association for haemorrhagic and ischaemic stroke separately. Methods: Individual participant data on 20- to 64-year-old employees were drawn from the Danish Labour Force Survey, 1999–2013, and linked to data on socio-economic status (SES), migrations, hospitalisations and deaths from national registers. The participants were followed from the time of the interview until the end of 2014. Poisson regression was used to estimate age-, sex- and SES-adjusted rate ratios for stroke as a function of weekly working hours. Results: With 35–40 working hours per week as reference, the estimated rate ratios for overall stroke were 0.97 (95% confidence interval (CI) 0.83–1.13) for 41–48 working hours, 1.10 (95% CI 0.86–1.39) for 49–54 working hours and 0.89 (95% CI 0.69–1.16) for ≥55 working hours. The estimated rate ratios per one category increase in working hours were 0.99 (95% CI 0.93–1.06) for overall stroke, 0.96 (95% CI 0.88–1.05) for ischaemic stroke and 1.15 (95% CI 1.02–1.31) for haemorrhagic stroke. Conclusions: Our analysis does not support the hypothesis that long working hours are associated with increased rates of overall stroke. It suggests, however, that long working hours might be associated with increased rates of haemorrhagic stroke.

Background Identifying young children at risk for socio-emotional developmental problems at an early stage, to prevent serious problems later in life, is crucial. Therefore, we need high quality measures to identify those children at risk for social-emotional problems who require further evaluation and intervention. Objective To systematically identify parent report measures of infant and toddler (0-24 months) social-emotional development for use in primary care settings. Methods We conducted a systematic review applying a narrative synthesis approach. We searched Medline, PsychInfo, Embase and SocIndex for articles published from 2008 through September 2015 to identify parent-report measures of infant and toddler social-emotional development. Data on the characteristics of the measures, including psychometric data, were collected. Results Based on 3310 screened articles, we located 242 measures that were screened for eligibility. In all 18 measures of infant and toddler social-emotional development were included. Ten of the measures were developed specifically for measuring social-emotional development, and eight were measures including subscales of social-emotional development. The measures varied with respect to, e.g. the time of publication, number of items, age span, cost and amount of psychometric data available. Conclusions Several measures of infant and toddler social-emotional development have been developed within the last decade. The majority of psychometric data are available through manuals, not peer-reviewed journals. Although all measures show acceptable reliability, the most comprehensive and psychometrically sound measures are the Ages and Stages Questionnaires: Social-Emotional-2, Infant-Toddler Social and Emotional Assessment, Brief Infant-Toddler Social and Emotional Assessment and Child Behaviour Checklist 1½-5.

BackgroundAdverse psychosocial working environments characterized by job strain (the combination of high demands and low control at work) are associated with an increased risk of depressive symptoms among employees, but evidence on clinically diagnosed depression is scarce. We examined job strain as a risk factor for clinical depression.MethodWe identified published cohort studies from a systematic literature search in PubMed and PsycNET and obtained 14 cohort studies with unpublished individual-level data from the Individual-Participant-Data Meta-analysis in Working Populations (IPD-Work) Consortium. Summary estimates of the association were obtained using random-effects models. Individual-level data analyses were based on a pre-published study protocol.ResultsWe included six published studies with a total of 27 461 individuals and 914 incident cases of clinical depression. From unpublished datasets we included 120 221 individuals and 982 first episodes of hospital-treated clinical depression. Job strain was associated with an increased risk of clinical depression in both published [relative risk (RR) = 1.77, 95% confidence interval (CI) 1.47–2.13] and unpublished datasets (RR = 1.27, 95% CI 1.04–1.55). Further individual participant analyses showed a similar association across sociodemographic subgroups and after excluding individuals with baseline somatic disease. The association was unchanged when excluding individuals with baseline depressive symptoms (RR = 1.25, 95% CI 0.94–1.65), but attenuated on adjustment for a continuous depressive symptoms score (RR = 1.03, 95% CI 0.81–1.32).ConclusionsJob strain may precipitate clinical depression among employees. Future intervention studies should test whether job strain is a modifiable risk factor for depression.

Objectives Sleep problems and adverse psychosocial working conditions are associated with increased risk of long-term sickness absence. Because sleep problems affect role functioning they may also exacerbate any effects of psychosocial working conditions and vice versa. We examined whether sleep problems and psychosocial working conditions interact in their associations with long-term sickness absence. Methods We linked questionnaire data from participants to two surveys of random samples of the Danish working population (N=10 752) with registries on long-term sick leave during five years after questionnaire response. We defined sleep problems by self-reported symptoms and/or register data on hypnotics purchases of hypnotics. Psychosocial working conditions included quantitative and emotional demands, influence, supervisor recognition and social support, leadership quality, and social support from colleagues. Using time-to-event models, we calculated hazard ratios (HR) and differences and examined interaction as departure from multiplicativity and additivity. Results During 40 165 person-years of follow-up, we identified 2313 episodes of long-terms sickness absence. Sleep problems predicted risk of long-term sickness absence [HR 1.54, 95% confidence interval (95% CI) 1.38–1.73]. This association was statistically significantly stronger among participants with high quantitative demands and weaker among those with high supervisor recognition (P

Background: Workplace social capital (WSC) is an emerging topic among both work environment professionalsand researchers. We examined (i) whether high WSC protected against risk of long-term sickness absence (LTSA) ina random sample of the Danish workforce during a 1-year follow-up and (ii) whether the association of WSC withsickness absence was modified by occupational grade. Methods: We measured WSC by self-report in a cohort of3075 employees and linked responses to a national register of sickness absence. We calculated hazard ratios (HRs)and 95% confidence intervals (CIs) of onset of LTSA (21 days), adjusted for covariates. We stratified analyses byoccupational grade and examined if there was an interaction effect of WSC and occupational grade. Results:A one standard deviation higher WSC score predicted a reduced risk of sickness absence after adjustment forsociodemographic variables, prevalent health problems and health behaviours (HR = 0.85, 95% CI = 0.74–0.99). TheHR was attenuated and lost statistical significance after further adjustment for occupational grade (HR = 0.90, 95%CI = 0.78–1.04). When stratified by occupational grade, high WSC predicted a decreased risk of sickness absenceamong higher grade workers (HR = 0.61, 95% CI = 0.44–0.84) but not among lower grade workers (HR = 0.98, 95%CI = 0.83–1.15). The interaction effect of WSC and occupational grade was statistically significant (HR = 0.97, 95%CI = 0.95–0.99). Conclusion: High WSC might reduce risk of LTSA. However, the protective effect appears to belimited to workers of higher occupational grade. Background: Workplace social capital (WSC) is an emerging topic among both work environment professionals and researchers. We examined (i) whether high WSC protected against risk of long-term sickness absence (LTSA) in a random sample of the Danish workforce during a 1-year follow-up and (ii) whether the association of WSC with sickness absence was modified by occupational grade. Methods: We measured WSC by self-report in a cohort of 3075 employees and linked responses to a national register of sickness absence. We calculated hazard ratios (HRs) and 95% confidence intervals (CIs) of onset of LTSA (21 days), adjusted for covariates. We stratified analyses by occupational grade and examined if there was an interaction effect of WSC and occupational grade. Results: A one standard deviation higher WSC score predicted a reduced risk of sickness absence after adjustment for sociodemographic variables, prevalent health problems and health behaviours (HR = 0.85, 95% CI = 0.74–0.99). The HR was attenuated and lost statistical significance after further adjustment for occupational grade (HR = 0.90, 95% CI = 0.78–1.04). When stratified by occupational grade, high WSC predicted a decreased risk of sickness absence among higher grade workers (HR = 0.61, 95% CI = 0.44–0.84) but not among lower grade workers (HR = 0.98, 95% CI = 0.83–1.15). The interaction effect of WSC and occupational grade was statistically significant (HR = 0.97, 95% CI = 0.95–0.99). Conclusion: High WSC might reduce risk of LTSA. However, the protective effect appears to be limited to workers of higher occupational grade.

Aim In surveys non-responders may introduce bias and lower the validity of the studies. Ways to increase response rates are therefore important. The purpose of the study was to investigate if an unconditional monetary incentive can increase the response rate for vulnerable children and youths in a postal questionnaire survey. Methods The study was designed as a randomized controlled trial. The study population consisted of 262 children and youth who participated in an established intervention study aimed at creating networks for different groups of vulnerable children and youths. The mean age of the participants was 16.7 years (range 11–28) and 67.9% were female. The questionnaire was adapted to three different age groups and covered different aspects of the participants’ life situation, including the dimensions from the Strengths and Difficulties Questionnaire (SDQ). In the follow-up survey, participants were randomly allocated to two groups that either received a €15 voucher for a supermarket together with the questionnaire or only received the questionnaire. We used Poisson regression to estimate the differences in response rate (Rate Ratio RR) between the intervention group and the control group. Results The response rate was 75.5% in the intervention group and 42.9% in the control group. The response rate in the intervention group was significantly higher than in the control group when adjusting for age and gender (Rate Ratio, RR 1.73; 95% CI 1.38–2.17). We did not find any significant differences in scales scores between the two groups for the five scales of the SDQ. In stratified analyses, we found the effect of the incentive to be higher for males (RR 2.81; 95% CI 1.61–4.91) than for females (1.43; 95% CI 1.12–1.84). Conclusions Monetary incentives can increase the response rate for vulnerable children and youths in surveys. Trial registration The trial was retrospectively registered at ClinicalTrials.gov Identifier: NCT01741675.

Introduction Studies have indicated that long working hours is associated with circulatory diseases. The aim of the present studies was to test if long working hours were prospectively associated with ischaemic heart disease (IHD), usage of antihypertensive drugs (AD) and stroke, in a large randomly selected sample from the general workforce of Denmark. Methods Self-reported data on weekly working hours from the Danish Labour Force Survey (1999–2013) was linked to national registers. Participants were followed until becoming a case, emigration/dead due other causes or end of study period (2014). Poisson regression was used to analyse incidence rates as a function of weekly working hours. The analyses were controlled for calendar time, time since start of follow-up, age, sex, SES, night and health care work (the latter two for IHD only). Result Around 1 45 000 persons were included with 3635 cases of IHD, 20 648 cases of AD and 1737 cases of stroke. With 32–40 hours/week serving as reference, the estimated rate ratios for IHD were 0.95 (95% CI: 0.85–1.06) for 41–48 and 1.07 (0.94–1.21) for >48 hours/week. The corresponding rate ratios for AD were 0.99 (0.95–1.04) and 1.02 (0.97–1.08). In the study of stroke 35–40 working hours/week served as reference. The estimated rate ratios for overall stroke were 0.97 (95% CI: 0.83–1.13) for 41–48, 1.10 (0.86–1.39) for 49–54, and 0.89 (0.69–1.16) for ≥55 hours/week. The estimated rate ratios per one category increase in working hours were 0.99 (0.93–1.06) for overall stroke, 0.96 (0.88–1.05) for ischaemic stroke and 1.15 (1.02–1.31) for haemorrhagic stroke. Discussion The analyses cannot confirm long working hours to be associated with IHD, AD or overall stroke. Data suggest however, that long working hours might be associated with increased rates of haemorrhagic stroke.

Objectives This systematic review and meta-analysis combined published study-level data and unpublished individual-participant data with the aim of quantifying the relation between long working hours and the onset of depressive symptoms. Methods We searched PubMed and Embase for published prospective cohort studies and included available cohorts with unpublished individual-participant data. We used a random-effects meta-analysis to calculate summary estimates across studies. Results We identified ten published cohort studies and included unpublished individual-participant data from 18 studies. In the majority of cohorts, long working hours was defined as working ≥55 hours per week. In multivariable-adjusted meta-analyses of 189 729 participants from 35 countries [96 275 men, 93 454 women, follow-up ranging from 1-5 years, 21 747 new-onset cases), there was an overall association of 1.14 (95% confidence interval (CI) 1.03-1.25] between long working hours and the onset of depressive symptoms, with significant evidence of heterogeneity (I 2=45.1%, P=0.004). A moderate association between working hours and depressive symptoms was found in Asian countries (1.50, 95% CI 1.13-2.01), a weaker association in Europe (1.11, 95% CI 1.00-1.22), and no association in North America (0.97, 95% CI 0.70-1.34) or Australia (0.95, 95% CI 0.70-1.29). Differences by other characteristics were small. Conclusions This observational evidence suggests a moderate association between long working hours and onset of depressive symptoms in Asia and a small association in Europe. CC BY 4.0

Summary Background Working long hours might have adverse health effects, but whether this is true for all socioeconomic status groups is unclear. In this meta-analysis stratified by socioeconomic status, we investigated the role of long working hours as a risk factor for type 2 diabetes. Methods We identified four published studies through a systematic literature search of PubMed and Embase up to April 30, 2014. Study inclusion criteria were English-language publication; prospective design (cohort study); investigation of the effect of working hours or overtime work; incident diabetes as an outcome; and relative risks, odds ratios, or hazard ratios (HRs) with 95% CIs, or sufficient information to calculate these estimates. Additionally, we used unpublished individual-level data from 19 cohort studies from the Individual-Participant-Data Meta-analysis in Working-Populations Consortium and international open-access data archives. Effect estimates from published and unpublished data from 222 120 men and women from the USA, Europe, Japan, and Australia were pooled with random-effects meta-analysis. Findings During 1·7 million person-years at risk, 4963 individuals developed diabetes (incidence 29 per 10 000 person-years). The minimally adjusted summary risk ratio for long (≥55 h per week) compared with standard working hours (35–40 h) was 1·07 (95% CI 0·89–1·27, difference in incidence three cases per 10 000 person-years) with significant heterogeneity in study-specific estimates ( I 2 =53%, p=0·0016). In an analysis stratified by socioeconomic status, the association between long working hours and diabetes was evident in the low socioeconomic status group (risk ratio 1·29, 95% CI 1·06–1·57, difference in incidence 13 per 10 000 person-years, I 2 =0%, p=0·4662), but was null in the high socioeconomic status group (1·00, 95% CI 0·80–1·25, incidence difference zero per 10 000 person-years, I 2 =15%, p=0·2464). The association in the low socioeconomic status group was robust to adjustment for age, sex, obesity, and physical activity, and remained after exclusion of shift workers. Interpretation In this meta-analysis, the link between longer working hours and type 2 diabetes was apparent only in individuals in the low socioeconomic status groups. Funding Medical Research Council, European Union New and Emerging Risks in Occupational Safety and Health research programme, Finnish Work Environment Fund, Swedish Research Council for Working Life and Social Research, German Social Accident Insurance, Danish National Research Centre for the Working Environment, Academy of Finland, Ministry of Social Affairs and Employment (Netherlands), Economic and Social Research Council, US National Institutes of Health, and British Heart Foundation.

BACKGROUND: Epidemiologic evidence for work stress as a risk factor for coronary heart disease is mostly based on a single measure of stressful work known as job strain, a combination of high demands and low job control. We examined whether a complementary stress measure that assesses an imbalance between efforts spent at work and rewards received predicted coronary heart disease. METHODS: This multi-cohort study (the 'IPD-Work' consortium) was based on harmonized individual-level data from 11 European prospective cohort studies. Stressful weappork in 90,164 men and women without coronary heart disease at baseline was assessed by validated effort-reward imbalance and job strain questionnaires. We defined incident coronary heart disease as the first non-fatal myocardial infarction or coronary death. Study-specific estimates were pooled by random-effects meta-analysis. RESULTS: At baseline, 31.7% of study members reported effort-reward imbalance at work and 15.9% reported job strain. During a mean follow-up of 9.8 years, 1078 coronary events were recorded. After adjustment for potential confounders, a hazard ratio of 1.16 (95% confidence interval 1.00-1.35) was observed for effort-reward imbalance compared to no imbalance. The hazard ratio was 1.16 (1.01-1.34) for having either effort-reward imbalance or job strain, and 1.41 (1.12-1.76) for having both these stressors compared to having neither effort-reward imbalance nor job strain. CONCLUSIONS: Individuals with effort-reward imbalance at work have an increased risk of coronary heart disease, and this appears to be independent of job strain experienced. These findings support expanding focus beyond just job strain in future research on work stress.This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

BACKGROUND: Job insecurity has been associated with certain health outcomes. We examined the role of job insecurity as a risk factor for incident diabetes. METHODS: We used individual participant data from 8 cohort studies identified in 2 open-access data archives and 11 cohort studies participating in the Individual-Participant-Data Meta-analysis in Working Populations Consortium. We calculated study-specific estimates of the association between job insecurity reported at baseline and incident diabetes over the follow-up period. We pooled the estimates in a meta-analysis to produce a summary risk estimate. RESULTS: The 19 studies involved 140 825 participants from Australia, Europe and the United States, with a mean follow-up of 9.4 years and 3954 incident cases of diabetes. In the preliminary analysis adjusted for age and sex, high job insecurity was associated with an increased risk of incident diabetes compared with low job insecurity (adjusted odds ratio [OR] 1.19, 95% confidence interval [CI] 1.09-1.30). In the multivariable-adjusted analysis restricted to 15 studies with baseline data for all covariates (age, sex, socioeconomic status, obesity, physical activity, alcohol and smoking), the association was slightly attenuated (adjusted OR 1.12, 95% CI 1.01-1.24). Heterogeneity between the studies was low to moderate (age- and sex-adjusted model: I2 = 24%, p = 0.2; multivariable-adjusted model: I2 = 27%, p = 0.2). In the multivariable-adjusted analysis restricted to high-quality studies, in which the diabetes diagnosis was ascertained from electronic medical records or clinical examination, the association was similar to that in the main analysis (adjusted OR 1.19, 95% CI 1.04-1.35). INTERPRETATION: Our findings suggest that self-reported job insecurity is associated with a modest increased risk of incident diabetes. Health care personnel should be aware of this association among workers reporting job insecurity.

To investigate the association between self-reported exposure to disturbing noise and risk of long-term sickness absence (LTSA) for more than two consecutive weeks among office workers. LTSA was measured using register data that were linked to survey data from 2,883 office workers aged 18–59 who were surveyed in 2005 on exposure to disturbing noise. The risk of LTSA was investigated using Cox proportional hazards model. Of the study population, 4.4 % had LTSA in the 1-year follow-up period. Compared to office workers who were ‘rarely or never’ exposed to disturbing noise at work, office workers who reported being ‘frequently’ exposed to disturbing noise had a significantly increased estimated risk of LTSA when adjusting for age, gender, smoking status, and managerial position (HR = 1.90; 95 % CI, 1.12–3.22). After additional adjustment for psychosocial work conditions, the estimated risk of LTSA for office workers who were frequently exposed to disturbing noise became marginally insignificant (HR = 1.73; 95 % CI, 0.99–3.01). A subgroup analysis showed that women who reported being frequently exposed to disturbing noise had a significantly increased estimated risk of LTSA (HR = 1.94; 95 % CI, 1.04–3.64), whereas the corresponding risk for men was insignificant (HR = 1.28; 95 % CI, 0.37–4.41). This study indicates that frequent self-reported exposure to disturbing noise at work is associated with increased risk of LTSA among office workers and that this association may be stronger for women than for men.

Trust is essential for the success of change, but transformational change challenges trust. This paper analyses how trust dynamics develop over time in two Danish manufacturing firms affected by major change programmes. The results show that change creates uncertainty among employees, thereby provoking intense scrutiny of management intentions and a tendency to make interpretations that exaggerate management intentions—with the end result of reduced trust. Management then react similarly with negative interpretations of employee reactions, creating a vicious cycle of reduced trust. The paper proposes a model for how change and trust interact and suggests a managerial strategy for trust repair: Strong management actions that symbolise integrity, competence and benevolence may counteract reduced trust, but if low trust turns into distrust, the result may be a deadlock that both parties find difficult to break.

Although the mental health consequences of domestic violence are well documented, empirical evidence is scarce regarding the mental health effects of violence in the workplace. Most studies have used data from small occupation-specific samples, limiting their generalizability. This article examines whether direct exposure to work-related violence is associated with clinically pertinent mental health problems, measured by purchases of psychotropics (antidepressants, anxiolytics, hypnotics), in a cross-occupational sample of 15,246 Danish employees free from using psychotropics at baseline. Self-reported data on work-related violence were merged with other data on purchases of medications through a national registry to estimate cause-specific hazard ratios during 3.6 years (1,325 days) of follow-up in the years 1996-2008. Outcomes were examined as competing risks, and analyses were adjusted for gender, age, cohabitation, education, income, social support from colleagues, social support from supervisor, and influence and quantitative demands at work. Work-related violence was associated with purchasing antidepressants alone (hazard ratio = 1.38, 95% confidence interval: 1.09, 1.75) or in combination with anxiolytics (hazard ratio = 1.74, 95% confidence interval: 1.13, 2.70) but not with purchasing anxiolytics or hypnotics only. The frequency of violent episodes and risk of caseness were unrelated. Work-related violence is associated with increased risk of clinically pertinent mental health problems. Reducing levels of work-related violence may help to prevent mental disorders in the working population.

Aims: The aim of the present paper is to present the development of the second version of the Copenhagen Psychosocial Questionnaire (COPSOQ II). Methods: The development of COPSOQ II took place in five main steps: (1) We considered practical experience from the use of COPSOQ I, in particular feedback from workplace studies where the questionnaire had been used; (2) All scales concerning workplace factors in COPSOQ I were analyzed for differential item functioning (DIF) with regard to gender, age and occupational status; (3) A test version of COPSOQ II including new scales and items was developed and tested in a representative sample of working Danes between 20 and 59 years of age. In all, 3,517 Danish employees participated in the study. The overall response rate was 60.4%; (4) Based on psychometric analyses, the final questionnaire was developed; and (5) Criteria-related validity of the new scales was tested. Results: The development of COPSOQ II resulted in a questionnaire with 41 scales and 127 items. New scales on values at the workplace were introduced including scales on Trust, Justice and Social inclusiveness. Scales on Variation, Work pace, Recognition, Work-family conflicts and items on offensive behaviour were also added. New scales regarding health symptoms included: Burnout, Stress, Sleeping troubles and Depressive symptoms. In general, the new scales showed good criteria validity. All in all, 57% of the items of COPSOQ I were retained in COPSOQ II. Conclusions: The COPSOQ I concept has been further developed and new validated scales have been included.

Aims: To analyse the predictive validity of 18 psychosocial work environment scales from the Copenhagen Psychosocial Questionnaire version II (COPSOQ II) with regard to risk of sickness absence. Methods: The study population consisted of 3188 wage earners (52% women) from a representative sample of Danish residents. Participants received the long version of the COPSOQ II in autumn and winter 2004—2005, including 18 psychosocial work environment scales from the domains ‘‘Demands at work’’, ‘‘Work organization and job contents’’, and ‘‘Interpersonal relations and leadership’’. The study endpoint was register-based sickness absence of 3 weeks or more in the 1-year period following completion of the COPSOQ II. Associations between COPSOQ scales at baseline and sickness absence at follow-up were analysed with Cox proportional hazards models, adjusted for age, gender, prevalence of a health problem at baseline, and occupational grade. Results: Sickness absence during follow-up was predicted by a one standard deviation increase on the scales of cognitive demands (hazard ratio (HR) 1.17, 95% confidence interval (CI) 1.00—1.37), emotional demands (HR 1.28, 95% CI 1.10—1.50), and role conflicts (HR 1.32, 95% CI 1.15—1.52). After applying adjustment for multiple testing, the effect of emotional demands and of role conflict remained statistically significant, but not the effect of cognitive demands. Conclusions: Selected psychosocial work environment factors from the COPSOQ predict register-based sickness absence in the Danish workforce.

Background and Purpose— Psychosocial stress at work has been proposed to be a risk factor for cardiovascular disease. However, its role as a risk factor for stroke is uncertain. Methods— We conducted an individual-participant-data meta-analysis of 196 380 males and females from 14 European cohort studies to investigate the association between job strain, a measure of work-related stress, and incident stroke. Results— In 1.8 million person-years at risk (mean follow-up 9.2 years), 2023 first-time stroke events were recorded. The age- and sex-adjusted hazard ratio for job strain relative to no job strain was 1.24 (95% confidence interval, 1.05;1.47) for ischemic stroke, 1.01 (95% confidence interval, 0.75;1.36) for hemorrhagic stroke, and 1.09 (95% confidence interval, 0.94;1.26) for overall stroke. The association with ischemic stroke was robust to further adjustment for socioeconomic status. Conclusion— Job strain may be associated with an increased risk of ischemic stroke, but further research is needed to determine whether interventions targeting job strain would reduce stroke risk beyond existing preventive strategies.

Long working hours might increase the risk of cardiovascular disease, but prospective evidence is scarce, imprecise, and mostly limited to coronary heart disease. We aimed to assess long working hours as a risk factor for incident coronary heart disease and stroke., SCOPUS: ar.j, info:eu-repo/semantics/published

To study the indoor climate, the psychosocial work environment and occupants' symptoms in offices a cross-sectional questionnaire survey was made in 11 naturally and 11 mechanically ventilated office buildings. Nine of the buildings had mainly cellular offices; five of the buildings had mainly open-plan offices, whereas eight buildings had a mixture of cellular, multi-person and open-plan offices. A total of 2301 occupants, corresponding to a response rate of 72%, completed a retrospective questionnaire. The questionnaire comprised questions concerning environmental perceptions, mucous membrane irritation, skin irritation, central nervous system (CNS) symptoms and psychosocial factors. Occupants in open-plan offices are more likely to perceive thermal discomfort, poor air quality and noise and they more frequently complain about CNS and mucous membrane symptoms than occupants in multi-person and cellular offices. The association between psychosocial factors and office size was weak. Open-plan offices may not be suited for all job types. PRACTICAL IMPLICATION: Open-plan offices may be a risk factor for adverse environmental perceptions and symptoms.

Background The relation of social capital with population health has been discussed controversially in the public health literature. Recently, workplace social capital (WSC) has gained great interest in occupational health, in particular in the Nordic countries. In this study, we investigate whether high WSC is prospectively associated with a reduced risk of long-term sickness absence (LTSA) and whether this association is similar or different for employees with high …

OBJECTIVE The status of psychosocial stress at work as a risk factor for type 2 diabetes is unclear because existing evidence is based on small studies and is subject to confounding by lifestyle factors, such as obesity and physical inactivity. This collaborative study examined whether stress at work, defined as “job strain,” is associated with incident type 2 diabetes independent of lifestyle factors. RESEARCH DESIGN AND METHODS We extracted individual-level data for 124,808 diabetes-free adults from 13 European cohort studies participating in the IPD-Work Consortium. We measured job strain with baseline questionnaires. Incident type 2 diabetes at follow-up was ascertained using national health registers, clinical screening, and self-reports. We analyzed data for each study using Cox regression and pooled the study-specific estimates in fixed-effect meta-analyses. RESULTS There were 3,703 cases of incident diabetes during a mean follow-up of 10.3 years. After adjustment for age, sex, and socioeconomic status (SES), the hazard ratio (HR) for job strain compared with no job strain was 1.15 (95% CI 1.06–1.25) with no difference between men and women (1.19 [1.06–1.34] and 1.13 [1.00–1.28], respectively). In stratified analyses, job strain was associated with an increased risk of diabetes among those with healthy and unhealthy lifestyle habits. In a multivariable model adjusted for age, sex, SES, and lifestyle habits, the HR was 1.11 (1.00–1.23). CONCLUSIONS Findings from a large pan-European dataset suggest that job strain is a risk factor for type 2 diabetes in men and women independent of lifestyle factors.

An intervention study was performed in a mechanically ventilated office building in which there were severe indoor climate complaints among the occupants. In one part of the building a new heating and ventilation strategy was implemented by renovating the HVAC system, and a carpet was replaced with a low-emitting vinyl floor material; the other part of the building was kept unchanged, serving as a control. A comprehensive indoor climate investigation was performed before and after the intervention. Over a 2-week period, the occupants completed a daily questionnaire regarding their comfort and health. Physiological examinations of eyes, nose and lungs were performed on each occupant. Physical, chemical and sensory measurements were performed before and after the intervention. The renewal of the flooring material was performed after a sensory test of alternative solutions in the laboratory. Before the floor material was installed in the office building, a full-scale exposure experiment was performed in the laboratory. The new ventilation strategy and renovation of the HVAC system were selected on the basis of laboratory experiments on a full-scale mock-up of a cellular office. The severity of occupants' environmental perceptions and symptoms was significantly reduced by the intervention.

Background: Previous studies have shown that gainfully employed individuals with high work demands and low control at work (denoted "job strain") are at increased risk of common mental disorders, including depression. Most existing studies have, however, measured depression using self-rated symptom scales that do not necessarily correspond to clinically diagnosed depression. In addition, a meta-analysis from 2008 indicated publication bias in the field. Methods: This study protocol describes the planned design and analyses of an individual participant data meta-analysis, to examine whether job strain is associated with an increased risk of clinically diagnosed unipolar depression based on hospital treatment registers. The study will be based on data from approximately 120,000 individuals who participated in 14 studies on work environment and health in 4 European countries. The self-reported working conditions data will be merged with national registers on psychiatric hospital treatment, primarily hospital admissions. Study-specific risk estimates for the association between job strain and depression will be calculated using Cox regressions. The study-specific risk estimates will be pooled using random effects meta-analysis. Discussion: The planned analyses will help clarify whether job strain is associated with an increased risk of clinically diagnosed unipolar depression. As the analysis is based on pre-planned study protocols and an individual participant data meta-analysis, the pooled risk estimates will not be influenced by selective reporting and publication bias. However, the results of the planned study may only pertain to severe cases of unipolar depression, because of the outcome measure applied. First version: Study protocol for examining job strain as a risk factor for severe unipolar depression in an individual participant meta-analysis of 14 European cohorts [version 1; peer review: 2 approved]. doi: 10.12688/f1000research.2-233.v1

Aims: This study presents a French version of the Copenhagen Psychosocial Questionnaire (COPSOQ) and analyses its psychometric properties for the purpose of validation. The questionnaire assesses psychosocial risk factors at work. The French questionnaire (derived from the Danish short version) is composed of 32 items grouped into 17 scales measuring five domains and eight additional questions assessing aggressive behaviour at work. Method: The questionnaire was administered to 935 employees of a large firm in the Parisian area. Results: All psychometric analyses performed (internal consistency of the scales, exploratory factor analysis, concurrent validity analysis) gave satisfactory results and demonstrated the validity of the French COPSOQ. Conclusions: A new questionnaire is now available in French. A large body of data is currently being gathered in view of comparing occupations and types of firms using this new instrument.

OBJECTIVE: The aim of this study was to examine whether shared and open-plan offices are associated with more days of sickness absence than cellular offices. METHODS: The analysis was based on a national survey of Danish inhabitants between 18–59 years of age (response rate 62%), and the study population consisted of the 2403 employees that reported working in offices. The different types of offices were characterized according to self-reported number of occupants in the space. The log-linear Poisson model was used to model the number of self-reported sickness absence days depending on the type of office; the analysis was adjusted for age, gender, socioeconomic status, body mass index, alcohol consumption, smoking habits, and physical activity during leisure time. RESULTS: Sickness absence was significantly related to having a greater number of occupants in the office (P6 persons) had 62% more days of sickness absence (RR 1.62, 95% CI 1.30–2.02). CONCLUSION: Occupants sharing an office and occupants in open-plan offices (>6 occupants) had significantly more days of sickness absence than occupants in cellular offices.

Aims: To evaluate the construct validity of the Copenhagen Psychosocial Questionnaire II (COPSOQ II) by means of tests for differential item functioning (DIF) and differential item effect (DIE). Methods: We used a Danish general population postal survey (n = 4,732 with 3,517 wage earners) with a one-year register based follow up for long-term sickness absence. DIF was evaluated against age, gender, education, social class, public/private sector employment, and job type using ordinal logistic regression. DIE was evaluated against job satisfaction and self-rated health (using ordinal logistic regression), against depressive symptoms, burnout, and stress (using multiple linear regression), and against long-term sick leave (using a proportional hazards model). We used a cross-validation approach to counter the risk of significant results due to multiple testing. Results: Out of 1,052 tests, we found 599 significant instances of DIF/DIE, 69 of which showed both practical and statistical significance across two independent samples. Most DIF occurred for job type (in 20 cases), while we found little DIF for age, gender, education, social class and sector. DIE seemed to pertain to particular items, which showed DIE in the same direction for several outcome variables. Discussion: The results allowed a preliminary identification of items that have a positive impact on construct validity and items that have negative impact on construct validity. These results can be used to develop better shortform measures and to improve the conceptual framework, items and scales of the COPSOQ II. Conclusions: We conclude that tests of DIF and DIE are useful for evaluating construct validity.

Aim: To determine minimally important differences (MIDs) for scales in the first version of the Copenhagen Psychosocial Questionnaire (COPSOQ). Methods: Data were taken from two separate studies: a national population survey (N = 1062), and an intervention study at 14 workplaces (N = 1505). On the basis of the population survey, the MID for each COPSOQ scale was calculated as one-half of a standard deviation (0.5 SD). For the core COPSOQ scales on ‘‘Quantitative demands’’, ‘‘Influence at work’’, ‘‘Predictability’’, ‘‘Social support (from colleagues and supervisors, respectively)’’, and ‘‘Job satisfaction’’, the MIDs were evaluated in the intervention study, where score differences for the scales were linked to the respondents’ global self-evaluation of the impact of the interventions. The scales were scored from 0 to 100 in both studies. Results: The MIDs calculated as 0.5 SD were, on average, 9.2 (range 6.8—14.9) for the long version scales, and 10.8 (range 7.6—14.9) for the medium-length version scales. The analysis of the self-evaluated changes on the scale scores for the core COPSOQ scales showed that the anchor-based estimates of MID were generally lower than 0.5 SD. Conclusions: We recommend the following MID values for the COPSOQ scales: ‘‘Quantitative demands’’, 0.3 SD; ‘‘Influence’’, 0.2 SD; ‘‘Predictability’’, 0.3 SD; ‘‘Social support from colleagues’’, 0.3 SD; ‘‘Social support from supervisor’’, 0.7 SD; and ‘‘Job satisfaction’’, 0.4 SD. For all other COPSOQ scales, where we do not have anchor-based results, we recommend the conventional MID value of 0.5 SD.

Objective The aim of the study was to elucidate the development of the psychosocial work environment in Denmark from 1997–2005. Methods The analyses were based on two national questionnaire surveys (N 1 =1062; N 2 =3517) of randomly selected employees who completed the Copenhagen Psychosocial Questionnaire. The psychosocial work environment was described by 19 scales and 6 single items. Results Quality of leadership and social support from supervisors were the only dimensions that saw improvements. The negative developments were: higher work pace, less influence (job control), less ­possibilities for development (skill discretion), lower level of meaning of work, more role conflicts, decreased role clarity, reduced sense of community, less social support from colleagues, increased conflicts at work, more threats of violence and more slander and gossip. Conclusions The psychosocial work environment in Denmark has deteriorated during the period 1997–2005. This deterioration was seen not just among certain groups of employees but in all subgroups, incorporating gender, age and socioeconomic status. The negative development of a country’s psychosocial work environment is worrying; as such, there is a strong need to change this negative trend.

The aim was to investigate the association between building-relatedsymptoms (BRS) in office buildings and the inflammatory potency of dust (PD).Furthermore, the association between dust potency and various building characteristicswas investigated. Occupants of 22 office buildings received a retrospectivequestionnaire about BRS (2301 respondents). Dust was collected fromgroups of offices and building characteristics were recorded. The potency of adust sample to induce interleukin-8 (IL-8) secretion from the lung epithelial cellline A549 was measured as the slope of the initial linear part of the concentration-response curve. Symptoms of the central nervous system (CNS) wereassociated with the potency of surface dust (OR ¼ 1.4). This association may bedue to an association between an index of CNS symptoms and dust potency inoffices of 1-6 occupants (OR ¼ 1.5). No single symptoms correlated with thepotency of surface dust. The PD was not related to single building factors. Theinflammatory PD may be used as an integrated proxy measure of biologicallyactive compounds in dust, reflecting health relevant properties of the dust.

To estimate the prevalence of bullying and to identify risk groups in a representative population sample. The data for this study was taken from the second Danish Psychosocial Work Environment Study (DPWES). The sample consisted of 3,429 employees between 20 and 59-years. The response rate for the study was 60.4%. The study showed that 8.3% of the respondents had been bullied within the past year, 1.6% of the sample reported daily to weekly bullying. Co-workers (71.5%) and managers/supervisors (32.4%) were most often reported as perpetrators of bullying, but bullying from subordinates (6%) was also reported. We found significant differences in the prevalence of bullying for both occupational status and work process, a variable characterizing the employees main task in their job. Unskilled workers reported the highest prevalence of bullying, while managers/supervisors the lowest prevalence. People working with things (male-dominated occupations) and people working with clients/patients (female-dominated occupations) reported higher prevalence of bullying than people working with symbols or customers. No significant gender or age differences were found. These findings suggest that types of work and gender ratio are risk factors in the onset of workplace bullying. Future studies should take into account the type of work and the gender ratio of the organization.

arbejdstidens tilrettelæggelse er et af de forhold i arbejdslivet, som har størst indfl ydelse på privatlivet. Artiklen undersøger, hvilken rolle arbejdstidens længde og placering samt graden af indflydelse på placeringen af arbejdstiden spiller for oplevelsen af balance mellem arbejde og privatliv. Desuden undersøges, hvordan oplevelsen af balance mellem arbejde og privatliv ser ud i forskellige familie-typer og for ansatte i stillinger med potentielt grænseløst arbejde sammenlignet med ansatte i andre stillinger. Artiklen konkluderer, at øget indflydelse på placeringen af arbejdstiden har en positiv, men ret begrænset virkning, og ikke ser ud til at kunne mindske de negative konsekvenser af lange og uregelmæssige arbejdstider. Hvis balancen mellem arbejde og privatliv for alvor skal bedres, er det derfor nødvendigt at mindske arbejdstiden for de mest belastede grupper og at reducere arbejdet på 'skæve' tidspunkter mest muligt.

Since 1990 we have been witnessing a comprehensive development in theory and research concerning the concept social capital in the fields of economy, aid to developing countries, and public health. However, the concept has only been applied to the field of work environment research to a very limited degree. In this article we introduce the concept in a work environment context. We suggest a definition of organizational social capital comprising three key factors: trust, justice, and collaborative capacity. Furthermore, we illustrate our model by analyzing data from two empirical studies: The national Danish study of psychosocial factors at work (the Copenhagen Psychosocial Questionnaire (COPSOQ) Study) and the BEST study (Better psychosocial work environment: a study of workplace interventions). In both studies we find clear associations between organizational social capital and the quality of the psychosocial work environment. We also find positive associations between workplace social capital and job satisfaction, involvement in the workplace, general health, and measures of psychological well-being. We conclude that a theory on organizational social capital has potential as a framework for research and development covering both psychosocial work environment, productivity, and the health of the employees.