scholarly journals Work Stress and Loss of Years Lived Without Chronic Disease: an 18-year Follow-up of 1.5 Million Employees in Denmark

2021 ◽  
Author(s):  
Jeppe Karl Sørensen ◽  
Elisabeth Framke ◽  
Jacob Pedersen ◽  
Kristina Alexanderson ◽  
Jens P. Bonde ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Life Expectancy ◽  
Chronic Diseases ◽  
Work Stress ◽  
Disease Incidence ◽  
High Stress ◽  
Health Behaviours ◽  
Life Years ◽  
Disease Free

Abstract We aimed to examine the association between exposure to work stress and chronic disease incidence and loss of chronic disease-free life years in the Danish workforce. The study population included 1,592,491 employees, aged 30 to 59 in 2000 and without prevalent chronic diseases. We assessed work stress as the combination of job strain and effort-reward imbalance using job exposure matrices. We used Cox regressions to estimate risk of incident hospital-diagnoses or death of chronic diseases (i.e., type 2 diabetes, coronary heart disease, stroke, cancer, asthma, chronic obstructive pulmonary disease, heart failure, and dementia) during 18 years of follow-up and calculated corresponding chronic disease-free life expectancy from age 30 to age 75. Individuals working in occupations with high prevalence of work stress had a higher risk of incident chronic disease compared to those in occupations with low prevalence of work stress (women: HR 1.04 (95% CI 1.02 to 1.05), men: HR 1.12 (95% CI 1.11 to 1.14)). The corresponding loss in chronic disease-free life expectancy was 0.25 (95% CI -0.10 to 0.60) and 0.84 (95% CI 0.56 to 1.11) years in women and men, respectively. Additional adjustment for health behaviours attenuated these associations among men. We conclude that men working in high-stress occupations have a small loss of years lived without chronic disease compared to men working in low-stress occupations. This finding appeared to be partially attributable to harmful health behaviours. In women, high work stress indicated a very small and statistically non-significant loss of years lived without chronic disease.

scholarly journals 1175Work stress and loss of years lived without chronic disease; an 18-year prospective cohort study

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Jeppe K. Sørensen ◽  
Elisabeth Framke ◽  
Jacob Pedersen ◽  
Kristina Alexanderson ◽  
Jens P. Bonde ◽  
...  
Keyword(s):  
Cohort Study ◽  
Chronic Disease ◽  
High Risk ◽  
Life Expectancy ◽  
Work Stress ◽  
Job Strain ◽  
Low Risk ◽  
Effort Reward Imbalance ◽  
Reward Imbalance ◽  
Disease Free

Abstract Background Aim: To examine the association of work stress with future chronic disease incidence and loss of chronic disease-free life years in the Danish workforce. Method A population-based prospective register-based cohort study of all employees aged 30-59 in 2000 in Denmark, without chronic diseases at baseline (n = 1,592,491). Using job exposure matrices, we assessed exposure to work stress by a combined measure of job strain and effort-reward imbalance. We estimated the risk of incident hospital-diagnosed chronic disease or death (i.e., type 2 diabetes, coronary heart disease, stroke, cancer, asthma, chronic obstructive pulmonary disease, heart failure, and dementia) during 18 years of follow-up and corresponding chronic disease-free life expectancy. Results Individuals working in occupations with high risk of both job strain and effort-reward imbalance had a slightly higher risk of future incident chronic disease compared to those in occupations with low risk of both stressors. The hazard ratio was 1.04 (95% CI 1.02 to 1.05) in women and 1.12 (95% CI 1.11 to 1.14) in men. The corresponding loss in chronic disease-free life expectancy was 0.25 years in women and 0.84 years in men. Conclusion Working in occupations with a high risk of work stress was associated with a small loss of years lived without chronic disease compared to working in occupations with low risk of work stress. Key messages According to our findings, employees in occupations with high risk of work stress live slightly shorter lives free of chronic diseases compared to employees in occupations with low risk of work stress.

scholarly journals Healthy lifestyle and life expectancy free of chronic diseases

JMS SKIMS ◽  
2020 ◽  
Vol 23 (1) ◽  
pp. 54-56
Author(s):  
Peerzada Umar Farooq Baba ◽  
Adil Hafeez Wani
Keyword(s):  
Physical Activity ◽  
Life Expectancy ◽  
Chronic Diseases ◽  
Healthy Lifestyle ◽  
Lifestyle Factors ◽  
Total Life Expectancy ◽  
Lifestyle Measures ◽  
Disease Free ◽  
Total Life

The average life expectancy in the world has increased substantially in the past few decades. Modifiable lifestyle factors including smoking, physical activity, alcohol intake, body weight, and diet quality affect both total life expectancy and incidence of chronic diseases. Few studies have comprehensively examined how a combination of multiple lifestyle factors may relate to life expectancy free from major diseases such as diabetes, cardiovascular disease, and cancer. A Harvard team examined the effect of healthy lifestyle factors on life expectancy free of chronic diseases, using data from up to 34 years of follow-up in the Nurses’ Health Study (NHS) (1980-2014; n=73 196) and 28 years of follow-up in the Health Professions Follow-up Study (HPFS)(1986-2014;n=38 366). A healthy lifestyle score based on information on five lifestyle factors—diet, smoking, physical activity, alcohol consumption, and body mass index (BMI) was derived. Five low-risk lifestyle factors included: never smoking, body mass index 18.5-24.9, moderate to vigorous physical activity (≥30 minutes/day), moderate alcohol intake (women: 5-15 g/day; men 5-30 g/day), and a higher diet quality score (upper 40%). Women who met all the healthful lifestyle measures had an additional 10.7 years of disease-free life compared with women who met no healthful lifestyle measures. For men, the number was 7.6 additional disease-free years. So it was concluded that a healthier lifestyle was associated with an increased total life expectancy and life expectancy free of cancer, cardiovascular disease, and type 2 diabetes. Findings suggest that the promotion of a healthy lifestyle would help to reduce healthcare burdens. Public policies for improving food and the physical environment conducive to adopting a healthy diet and lifestyle are critical to improving life expectancy, especially life expectancy free of major chronic diseases. Source: BMJ 2020; 368:l6669 http://dx.doi.org/10.1136/bmj.l6669

scholarly journals Job strain and loss of healthy life years between ages 50 and 75 by sex and occupational position: analyses of 64 934 individuals from four prospective cohort studies

2018 ◽  
Vol 75 (7) ◽  
pp. 486-493 ◽  
Author(s):  
Linda L Magnusson Hanson ◽  
Hugo Westerlund ◽  
Holendro S Chungkham ◽  
Jussi Vahtera ◽  
Naja H Rod ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Life Expectancy ◽  
Working Conditions ◽  
Job Strain ◽  
Health Expectancy ◽  
Low Grade ◽  
Occupational Position ◽  
Psychosocial Working Conditions ◽  
Life Years ◽  
Disease Free

ObjectivesPoor psychosocial working conditions increase the likelihood of various types of morbidity and may substantially limit quality of life and possibilities to remain in paid work. To date, however, no studies to our knowledge have quantified the extent to which poor psychosocial working conditions reduce healthy or chronic disease-free life expectancy, which was the focus of this study.MethodsData were derived from four cohorts with repeat data: the Finnish Public Sector Study (Finland), GAZEL (France), the Swedish Longitudinal Occupational Survey of Health (Sweden) and Whitehall II (UK). Healthy (in good self-rated health) life expectancy (HLE) and chronic disease-free (free from cardiovascular disease, cancer, respiratory disease and diabetes) life expectancy (CDFLE) was calculated from age 50 to 75 based on 64 394 individuals with data on job strain (high demands in combination with low control) at baseline and health at baseline and follow-up.ResultsMultistate life table models showed that job strain was consistently related to shorter HLE (overall 1.7 years difference). The difference in HLE was more pronounced among men (2.0 years compared with 1.5 years for women) and participants in lower occupational positions (2.5 years among low-grade men compared with 1.7 years among high-grade men). Similar differences in HLE, although smaller, were observed among those in intermediate or high occupational positions. Job strain was additionally associated with shorter CDFLE, although this association was weaker and somewhat inconsistent.ConclusionsThese findings suggest that individuals with job strain have a shorter health expectancy compared with those without job strain.

scholarly journals Effects of a work-stress intervention in Swedish primary care versus treatment as usual: RCT-study

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
C Sandheimer ◽  
T Hedenrud ◽  
G Hensing ◽  
K Holmgren
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Work Stress ◽  
Collaborative Care ◽  
High Stress ◽  
Intervention Group ◽  
Treatment As Usual ◽  
Primary Health ◽  
Rehabilitative Measures

Abstract Background Work stress is an increasing burden in society. To identify early symptoms of work stress in primary health care (PHC) could result in earlier and better adjusted care. A work stress questionnaire (WSQ) was developed in PHC for this task. We aimed to evaluate if the use of WSQ, in combination with physician’s feedback, results in differences in health care visits and treatment compared to treatment as usual (TAU) in patients reporting high stress. Our hypothesis was that patients receiving the intervention would generate more visits to rehabilitation providers during follow-up compared to TAU. Methods A two-armed RCT was conducted at seven primary health care centres (PHCC) in Region Västra Götaland, Sweden. One group received the WSQ-intervention and the controls received TAU. Employed not sick-listed persons aged 18-64 that sought care for mental and physical health complaints at the PHCCs participated. Register data on health care visits and treatments 12 months prior inclusion and 12 months after was obtained and analysed with Fisher’s exact test together with questionnaire data (WSQ and background features). Results A total of 271 participants were included in the study, 132 intervention and 139 controls. The proportion that visited psychologists/psychotherapists was higher among the intervention group with high stress (19.5%, n = 87) during follow-up compared to corresponding controls (7.2%, n = 97) (p = 0.048). Collaborative care measures were more common among the stressed intervention participants (23%) post-inclusion compared to the stressed controls (11.3%) (p = 0.048). Conclusions Significant differences were found between the WSQ intervention group and the controls reporting high stress in visits to psychologists and in amount of received collaborative care. This confirms our hypothesis that the WSQ can help physicians to identify work stress and give suitable rehabilitative measures at an earlier stage in the care process compared to TAU. Key messages The use of WSQ with physicians’ feedback generated more visits to psychologists and more received collaborative care compared to treatment as usual. Findings of the study indicate that the WSQ can assist in identifying work stress in primary care and accommodate rehabilitative measures compared to treatment as usual.

scholarly journals Physical activity level as a predictor of healthy and chronic disease-free life expectancy between ages 50 and 75

2018 ◽  
Vol 47 (3) ◽  
pp. 423-429 ◽  
Author(s):  
Tuija Leskinen ◽  
Sari Stenholm ◽  
Ville Aalto ◽  
Jenny Head ◽  
Mika Kivimäki ◽  
...  
Keyword(s):  
Physical Activity ◽  
Chronic Disease ◽  
Life Expectancy ◽  
Physical Activity Level ◽  
Activity Level ◽  
Disease Free

Loneliness, Social Isolation, and Chronic Disease Outcomes

2020 ◽  
Author(s):  
Julie Christiansen ◽  
Rikke Lund ◽  
Pamela Qualter ◽  
Christina Maar Andersen ◽  
Susanne S Pedersen ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Chronic Diseases ◽  
Social Isolation ◽  
Chronic Obstructive ◽  
Behavioral Factors ◽  
Multiple Mediation ◽  
Individual Level ◽  
Danish Patient ◽  
Reported Data

Abstract Background Research suggests that loneliness and social isolation (SI) are serious public health concerns. However, our knowledge of the associations of loneliness and SI with specific chronic diseases is limited. Purpose The present prospective cohort study investigated (a) the longitudinal associations of loneliness and SI with four chronic diseases (cardiovascular disease [CVD], chronic obstructive pulmonary disease [COPD], diabetes mellitus Type 2 [T2D], and cancer), (b) the synergistic association of loneliness and SI with chronic disease, and (c) baseline psychological and behavioral explanatory factors. Methods Self-reported data from the 2013 Danish “How are you?” survey (N = 24,687) were combined with individual-level data from the National Danish Patient Registry on diagnoses in a 5 year follow-up period (2013–2018). Results Cox proportional hazard regression analyses showed that loneliness and SI were independently associated with CVD (loneliness: adjusted hazard ratio (AHR) = 1.20, 95% confidence interval [CI; 1.03, 1.40]; SI: AHR = 1.23, 95% CI [1.04, 146]) and T2D (loneliness: AHR =1.90, 95% CI [1.42, 2.55]; SI: AHR = 1.59, 95% CI [1.15, 2.21]). No significant associations were found between loneliness or SI and COPD and cancer, respectively. Likewise, loneliness and SI did not demonstrate a synergistic effect on chronic disease. Multiple mediation analysis indicated that loneliness and SI had an indirect effect on CVD and T2D through both baseline psychological and behavioral factors. Conclusion Loneliness and SI were independently associated with a diagnosis of CVD and T2D within a 5 year follow-up period. The associations of loneliness and SI with CVD and T2D were fully explained by baseline psychological and behavioral factors.

Long-term survival benefits of docetaxel plus cyclophosphamide compared to doxorubicin plus cyclophosphamide in the adjuvant treatment of operable breast cancer

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 563-563
Author(s):  
M. Thompson ◽  
B. Seal ◽  
M. Tangirala ◽  
L. Asmar ◽  
S. Jones
Keyword(s):  
Clinical Trial ◽  
Life Expectancy ◽  
Life Time ◽  
Stage I ◽  
Trial Period ◽  
Term Survival ◽  
Life Years ◽  
The Us ◽  
Disease Free

563 Background: The U.S. Oncology Adjuvant Trial 9735 recently demonstrated disease-free survival and overall survival (OS) benefits over 7 years for docetaxel plus cyclophosphamide (TC) compared with doxorubicin plus cyclophosphamide (AC) as adjuvant treatment for women with operable stage I-III invasive breast cancer (BC). The life-time benefits of TC vs. AC, however, are unknown. This analysis aimed to project potential life-time survival benefits of TC vs. AC as adjuvant therapy for operable BC. Methods: The 7-year follow-up results of the 9735 study combined with US average life expectancy were used to project the life-time survival benefits of TC vs. AC. In the base case (scenario 1), it was assumed the survival advantage of TC did not persist beyond the 7-year clinical trial period. Rather, all patients alive and disease-free at 7 years (from the starting age of 51 to the age of 58), regardless of treatment, were assumed to be cured and received the average remaining life expectancy of a 58-year old woman in the US general population. As survival benefits from chemotherapy may persist beyond the clinical trial period, two sensitivity analyses were conducted: 1) greater life expectancy in the TC arm of 1.8 months equivalent to the mean difference in OS between TC and AC within the clinical trial period (scenario 2) and 2) greater life expectancy in the TC arm of 22 months equivalent to the difference in survival at the end of 7 years (scenario 3). The total life years gained (LYs) and quality-adjusted life years gained (QALYs) were then calculated. Results: Per patient LYs gained in scenarios 1, 2, and 3 were 0.850, 0.930, and 1.755, respectively; while QALYs gained were slightly lower at 0.674, 0.736 and 1.383, respectively. Applying this benefit to a cohort of 167,133 women in the US with newly diagnosed stage I-III invasive BC in 2008, the gains were 142,063 LYs and 112,648 QALYS in scenario 1. Conclusions: In addition to survival benefit observed within the clinical trial period, the use of TC is associated with long-term survival benefits compared to AC in patients with stage I-III invasive BC. The results provide additional support of the value of TC in the management of early stage BC. [Table: see text]

scholarly journals ‘You gotta have something to chew on’: perceptions of stress-induced eating and weight gain among office workers in South Korea

2020 ◽  
pp. 1-13
Author(s):  
Sohyun Park ◽  
Eunju Sung
Keyword(s):  
Weight Gain ◽  
South Korea ◽  
Work Stress ◽  
Weight Change ◽  
Disease Incidence ◽  
Health Behaviours ◽  
Office Workers ◽  
Healthy Weight ◽  
Work Related ◽  
Insufficient Physical Activity

Abstract Objective: Job-related chronic stress has been discussed as a risk factor for weight change and metabolic disorders. The current study was conducted to understand the situations in which stress-induced eating occurs among office workers and how workers perceive stress to influence their daily eating practices and weight change. Design: In-depth, one-on-one interviews were conducted with office workers. Setting: Metropolitan areas in South Korea. Participants: Twenty-two office workers from thirteen companies participated in the study. Results: Most participants mentioned that they often felt work-related stress and reported various levels of perceived stress, as measured with open-ended questions. The main sources of work stress were (i) the nature of job characteristics, (ii) performance evaluations and (iii) relationships within the organisation. Participants linked stress with increased food consumption and cravings for sweet, savoury and greasy foods. Many participants emphasised the links between multiple health behaviours and stress. Not only dietary choices but also alcohol consumption, sleeping difficulty and insufficient physical activity were related to coping with work stress and demands. Finally, most participants who perceived work stress believed that their weight gain in adulthood was triggered by work stress. Conclusions: It is necessary to consider promoting behavioural modifications to support weight management and providing a means for stress management and the minimisation of stress-inducing working environments for workers to maintain or achieve a healthy weight and to prevent chronic disease incidence.

scholarly journals Total knee arthroplasty improves the quality-adjusted life years in patients who exceeded their estimated life expectancy

2021 ◽  
Vol 45 (3) ◽  
pp. 635-641
Author(s):  
Michele Palazzuolo ◽  
Alexander Antoniadis ◽  
Jaad Mahlouly ◽  
Julien Wegrzyn
Keyword(s):  
Total Knee Arthroplasty ◽  
Life Expectancy ◽  
Elderly Patients ◽  
Quality Adjusted Life Years ◽  
Life Years ◽  
Total Knee ◽  
One Year ◽  
End Stage ◽  
Quality Adjusted Life

Abstract Purpose Total knee arthroplasty (TKA) is the treatment of choice for end-stage osteoarthritis though its risk-benefit ratio in elderly patients remains debated. This study aimed to evaluate the functional outcome, rates of complication and mortality, and quality-adjusted life years (QALY) in patients who exceeded their estimated life expectancy. Methods Ninety-seven TKA implanted in 86 patients who exceeded their estimated life expectancy at the time of TKA were prospectively included in our institutional joint registry and retrospectively analyzed. At latest follow-up, the functional outcome with the Knee Society Score (KSS), rates of complication and mortality, and QALY with utility value of EuroQol-5D score were evaluated. Results At a mean follow-up of three ± one years, the pre- to post-operative KSS improved significantly (p < 0.01). The rates of surgical and major medical complications related to TKA were 3% and 10%, respectively. The re-operation rate with readmission was 3% while no TKA was revised. The 30-day and one year mortality was 1% and 3%, respectively. The pre- to one year post-operative QALY improved significantly (p < 0.01). The cumulative QALY five years after TKA was four years. Assuming that these patients did not undergo TKA, their cumulative QALY at five years would have been only two years. Conclusion TKA is an effective procedure for the treatment of end-stage osteoarthritis in patients who exceeded their estimated life expectancy. TKA provided significant improvement in function and quality of life without adversely affecting overall morbidity and mortality. Therefore, TKA should not be contra-indicated in elderly patients based on their advanced age alone.

scholarly journals Systematic review and meta analysis of differential attrition between active and control arms in randomized controlled trials of lifestyle interventions in chronic disease

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bevens W ◽  
Shoushtari A ◽  
Jelinek P ◽  
Jelinek GA ◽  
Weiland TJ
Keyword(s):  
Systematic Review ◽  
Chronic Disease ◽  
Chronic Diseases ◽  
Lifestyle Intervention ◽  
Meta Analysis ◽  
Research Question ◽  
Lifestyle Interventions ◽  
And Control

Abstract Background Attrition is a major obstacle for lifestyle interventions sustained for the medium-to-long term and can have significant consequences on the internal validity of a trial. When the degree of attrition differs between active and control arms this is termed differential attrition and is an important consideration during initial stages of trial planning. Objectives The primary research question of this study was: what is the differential attrition between treatment arms in lifestyle interventions for prevalent chronic diseases? Methods We performed a systematic review and meta-analysis of 23 studies involving a lifestyle intervention component in cohorts with chronic diseases. The search accessed three databases: Scopus, Medline Ovid and Web of Science. Attrition between treatment arms was analysed using a random-effects model and examined the relationship between the relative attrition and potential moderators, such as time to final follow-up, time to first follow-up, type of disease, type of control, type of intervention and length of treatment. Results The pooled risk ratio was 1.00 (95% CI 0.97 – 1.03) and only one study fell outside this range. A univariable association was described between the pooled risk ration and length (years) to final follow-up, which did not remain in the multivariable model. Conclusions Ultimately, we found no evidence of differential attrition in medium-to-long term lifestyle intervention studies for chronic disease, increasing confidence in conducting such studies with minimal potential of attrition bias. Trial registration PROSPERO registration number CRD42018084495.

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