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Journal: Scandinavian journal of work, environment & health


Blunted nighttime blood pressure dipping is an established cardiovascular risk factor. This study examined the effect of job strain on nighttime blood pressure dipping among men and women with high blood pressure.

Concepts: Blood, Myocardial infarction, Atherosclerosis, Hypertension, Blood vessel, Cardiovascular disease, Blood pressure, Orthostatic hypotension


Objectives This systematic review and meta-analysis combined published study-level data and unpublished individual-participant data with the aim of quantifying the relation between long working hours and the onset of depressive symptoms. Methods We searched PubMed and Embase for published prospective cohort studies and included available cohorts with unpublished individual-participant data.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 Results We identified ten published cohort studies and included unpublished individual-participant data from 18 studies.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.

Concepts: Epidemiology, Evidence-based medicine, Systematic review, Meta-analysis, Study heterogeneity, North America


Objectives This review aimed to quantify suicide risk among agricultural, forestry, and fishery workers and study potential variations of risk within this population. Methods We conducted a systematic literature review and meta-analysis from 1995 to 2016 using MEDLINE and following the PRISMA guidelines. A pooled effect size of suicide risk among the population of interest was calculated using meta-analysis. Subgroup analyses were conducted to investigate whether effect size differed according to population or study characteristics. Meta-regression was used to identify sources of heterogeneity. Results The systematic review identified 65 studies, of which 32 were included in the meta-analysis. Pooled effect size was 1.48 [95% confidence interval (CI) 1.30-1.68] representing an excess of suicide risk among the population of interest. Subgroup analysis showed that this effect size varied according to geographic area, with a higher effect size in Japan. The following study characteristics were found to contribute to the between-study variance: reference group, measure of effect size, and study design. Conclusions Our findings suggest an excess of suicide risk among agricultural, forestry, and fishery workers and demonstrated that this excess may be even higher for these groups in Japan. This review highlights the need for suicide prevention policies focusing on this specific population of workers. More research is also needed to better understand the underlying factors that may increase suicide risk in this population.

Concepts: Medical statistics, Systematic review, Following, Confidence interval, Normal distribution, Effect size, Meta-analysis, Gene V. Glass


Objectives The deleterious health effects of long working hours have been previously investigated, but there is a dearth of studies on mortality resulting from accidents or suicide. This prospective study aims to examine the association between working hours and external-cause mortality (accidents and suicide) in Korea, a country with some of the longest working hours in the world. Methods Employed workers (N=14 484) participating in the Korean National Health and Nutrition Examination Survey (KNHANES) were matched with the Korea National Statistical Office’s death registry from 2007-2016 (person-years = 81 927.5 years, mean weighted follow-up duration = 5.7 years). Hazard ratios (HR) for accident (N=25) and suicide (N=27) mortality were estimated according to weekly working hours, with 35-44 hours per week as the reference. Results Individuals working 45-52 hours per week had higher risk of total external cause mortality compared to those working 35-44 hours per week [HR 2.79, 95% confidence interval (CI) 1.22-6.40], adjusting for sex, age, household income, education, occupation, and depressive symptoms. Among the external causes of death, suicide risk was higher (HR 3.89, 95% CI 1.06-14.29) for working 45-52 hours per week compared to working 35-44 hours per week. Working >52 hours per week also showed increased risk for suicide (HR 3.74, 95% CI 1.03-13.64). No statistically significant associations were found for accident mortality. Conclusions Long working hours are associated with higher suicide mortality rates in Korea.


Objectives The United States is the only advanced economy globally that does not guarantee its workers paid vacation leave. Although empirical studies have linked paid vacation leave to happiness and stress, no study has investigated the association between paid vacation leave and depression. Using a nationally-representative longitudinal sample of 3380 working men and women aged 45-52 years from the National Longitudinal Survey of Youth 1979, this study explored whether paid vacation leave may protect against depression. Methods Multivariate linear and logistic regression models were employed to estimate the impacts of the number of annual paid vacation days of leave measured at age 40 on depression measured using the 7-item Center for Epidemiologic Studies Depression Scale (CES-D) short form (CES-D-SF) scale at age 50. Models were adjusted for demographic and socioeconomic factors, physical health, weekly hours, and individual fixed effects. Results For every ten additional days of paid vacation leave, the odds of depression in women was 29% lower [odds ratio (OR) 0.71, 95% confidence interval (CI) 0.55-0.92, P=0.01); there was no association in men. Linear regression models showed no association in either men or women. For every 10 days of paid leave, the odds of depression were 36% lower in White women and 38% lower in women with ≥2 children. Conclusions This study provides the first evidence on the linkage between paid vacation leave and depression, and supports a protective effect in White women with ≥2 children. Should this association be truly causal, and assuming a uniform effect across all ages in working adult women, the results from this study would suggest that a hypothetical increase in the average number of days of paid vacation leave of 10 days could avoid an estimated 568 442 cases of depression in women each year and lead to a cost savings of US$2.94 billion annually. Policies that mandate paid vacation leave may have marked positive impacts on the population health and economic burden of depression among working women in the USA.


Objectives This cross-sectional study investigated the associations between office type (cellular, shared-room, small open-plan, and medium-sized open-plan) and employees' ease of interaction with coworkers, subjective well-being, and job satisfaction. Methods A brief survey including measures of office type, ease of interaction with coworkers, subjective well-being, and job satisfaction was sent electronically to 1500 Swedish real-estate agents, 271 of whom returned usable surveys. The data were analyzed using a regression-based serial multiple mediation model (PROCESS Model 6), which tested whether the relationship between office type and job satisfaction would be mediated by ease of interaction and, in turn, subjective well-being. Results A negative relationship was found between the number of coworkers sharing an office and employees' job satisfaction. This association was serially mediated by ease of interaction with coworkers and subjective well-being, with employees working in small and medium-sized open-plan offices reporting lower levels of both these aspects than employees who work in either cellular or shared-room offices. Conclusions Open-plan offices may have short-term financial benefits, but these benefits may be lower than the costs associated with decreased job satisfaction and well-being. Therefore, decision-makers should consider the impact of office type on employees rather than focusing solely on cost-effective office layout, flexibility, and productivity.

Concepts: Cross-sectional study, Office, Open plan


Procedural justice perceptions are shown to be associated with minor psychiatric disorders, long sickness absence spells, and poor self-rated health, but previous studies have rarely considered how changes in procedural justice influence changes in health.

Concepts: Psychology, Mental disorder, Change, Psychiatry, Justice


Objectives This study aimed to assess the economic credentials of a workplace-delivered intervention to reduce sitting time among desk-based workers. Methods We performed within-trial cost-efficacy analysis and long-term cost-effectiveness analysis (CEA) and recruited 231 desk-based workers, aged 24-65 years, across 14 worksites of one organization. Multicomponent workplace-delivered intervention was compared to usual practice. Main outcome measures including total device-measured workplace sitting time, body mass index (BMI), self-reported health-related quality of life (Assessment of Quality of Life-8D, AQoL-8D), and absenteeism measured at 12 months. Results Compared to usual practice, the intervention was associated with greater cost (AU$431/person), benefits in terms of reduced workplace sitting time [-46.8 minutes/8-hour workday, 95% confidence interval (CI): -69.9- -23.7] and increased workplace standing time (42.2 minutes/8-hour workday, 95% CI 23.8-60.6). However, there were no significant benefits for BMI [0.148 kg/m 2(95% CI-1.407-1.703)], QoL-8D [-0.006 (95% CI -0.074-0.063)] and absenteeism [2.12 days (95% CI -2.01-6.26)]. The incremental cost-efficacy ratios (ICER) ranged from AU$9.94 cost/minute reduction in workplace sitting time to AU$13.37/minute reduction in overall sitting time. CEA showed the intervention contributed to higher life year (LY) gains [0.01 (95% CI 0.009-0.011)], higher health-adjusted life year (HALY) gains [0.012 (95% CI 0.0105 - 0.0135)], and higher net costs [AU$344 (95% CI $331-358)], with corresponding ICER of AU$34 443/LY and AU$28 703/HALY if the intervention effects were to be sustained for five-years. CEA results were sensitive to assumptions surrounding intervention-effect decay rate and discount rate. Conclusions The intervention was cost-effective over the lifetime of the cohort when scaled up to the national workforce and provides important.


Objectives The aim of this study was to characterize the descriptive epidemiology of insomnia in midlife and explore the relative importance of different occupational risk factors for insomnia among older workers. Methods A questionnaire was mailed to all adults aged 50-64 years registered with 24 English general practices. Insomnia was defined as having at least one of four problems with sleep severely in the past three months. Subjects were also asked about employment conditions, feelings concerning work, and their health. Associations were assessed by logistic regression and population attributable fractions (PAF) calculated. Results Analysis was based on 8067 respondents (5470 in paid work), 18.8% of whom reported insomnia. It was more common among women, smokers, obese individuals, those living alone, and those in financial hardship, and less prevalent among the educated, those in South-East England, and those with friendships and leisure-time pursuits. Occupational risk factors included unemployment, shift working, lack of control and support at work, job insecurity, job dissatisfaction and several of its determinants (lacking a sense of achievement, feeling unappreciated, having difficult work colleagues, feeling unfairly criticized). Population burden of insomnia was associated more strongly with difficulties in coping with work demands, job insecurity, difficult colleagues, and lack of friendships at work [population attributable fraction (PAF) 15-33%] than shift work and lack of autonomy or support (PAF 5-7%). It was strongly associated with seven measures of poorer self-assessed health. Conclusions Employment policies aimed at tackling insomnia among older workers may benefit from focusing particularly on job-person fit, job security and relationships in the workplace.

Concepts: Regression analysis, Epidemiology, Sleep deprivation, Sleep disorder, Employment, Shift work, Attributable risk, Fraction


This study examines whether precarious employment increases the risk of serious psychological distress (SPD) in a nationally representative cohort of Japanese middle-aged people.

Concepts: Cohort study