Skip to main content
Top
Published in: European Journal of Epidemiology 4/2022

21-03-2022 | Coronary Heart Disease | MORTALITY

Work stress and loss of years lived without chronic disease: an 18-year follow-up of 1.5 million employees in Denmark

Authors: Jeppe K. Sørensen, Elisabeth Framke, Jacob Pedersen, Kristina Alexanderson, Jens P. Bonde, Kristin Farrants, Esben M. Flachs, Linda L. Magnusson Hanson, Solja T. Nyberg, Mika Kivimäki, Ida E. H. Madsen, Reiner Rugulies

Published in: European Journal of Epidemiology | Issue 4/2022

Login to get access

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 30–59 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 1.02–1.05), men: HR 1.12 (95% CI 1.11–1.14)). The corresponding loss in chronic disease-free life expectancy was 0.25 (95% CI − 0.10 to 0.60) and 0.84 (95% CI 0.56–1.11) 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.
Appendix
Available only for authorised users
Literature
1.
go back to reference GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020;396(10258):1204–22. GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020;396(10258):1204–22.
2.
go back to reference GBD 2017 DALYs and HALE Collaborators. Global, regional, and national disability-adjusted life-years (DALYs) for 359 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392(10159):1859–922. GBD 2017 DALYs and HALE Collaborators. Global, regional, and national disability-adjusted life-years (DALYs) for 359 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392(10159):1859–922.
3.
go back to reference Karasek R. Job demands, job decision latitude, and mental strain: Implications for job redesign. Adm Sci Q. 1979;24:285–307.CrossRef Karasek R. Job demands, job decision latitude, and mental strain: Implications for job redesign. Adm Sci Q. 1979;24:285–307.CrossRef
4.
go back to reference Siegrist J. Adverse health effects of high-effort/low-reward conditions. J Occup Health Psychol. 1996;1(1):27–41.CrossRef Siegrist J. Adverse health effects of high-effort/low-reward conditions. J Occup Health Psychol. 1996;1(1):27–41.CrossRef
5.
go back to reference Kivimäki M, Nyberg ST, Batty GD, Fransson EI, Heikkilä K, Alfredsson L, et al. Job strain as a risk factor for coronary heart disease: a collaborative meta-analysis of individual participant data. Lancet. 2012;380(9852):1491–7.CrossRef Kivimäki M, Nyberg ST, Batty GD, Fransson EI, Heikkilä K, Alfredsson L, et al. Job strain as a risk factor for coronary heart disease: a collaborative meta-analysis of individual participant data. Lancet. 2012;380(9852):1491–7.CrossRef
6.
go back to reference Rugulies R, Framke E, Sørensen JK, Svane-Petersen AC, Alexanderson K, Bonde JP, et al. Persistent and changing job strain and risk of coronary heart disease. A population-based cohort study of 1.6 million employees in Denmark. Scand J Work Environ Health. 2020;46(5):498–507.CrossRef Rugulies R, Framke E, Sørensen JK, Svane-Petersen AC, Alexanderson K, Bonde JP, et al. Persistent and changing job strain and risk of coronary heart disease. A population-based cohort study of 1.6 million employees in Denmark. Scand J Work Environ Health. 2020;46(5):498–507.CrossRef
7.
go back to reference Dragano N, Siegrist J, Nyberg ST, Lunau T, Fransson EI, Alfredsson L, et al. Effort-reward imbalance at work and incident coronary heart disease: a multicohort study of 90,164 individuals. Epidemiology. 2017;28(4):619–26.CrossRef Dragano N, Siegrist J, Nyberg ST, Lunau T, Fransson EI, Alfredsson L, et al. Effort-reward imbalance at work and incident coronary heart disease: a multicohort study of 90,164 individuals. Epidemiology. 2017;28(4):619–26.CrossRef
8.
go back to reference Fransson EI, Nyberg ST, Heikkilä K, Alfredsson L, Bjorner JB, Borritz M, et al. Job strain and the risk of stroke: an individual-participant data meta-analysis. Stroke. 2015;46(2):557–9.CrossRef Fransson EI, Nyberg ST, Heikkilä K, Alfredsson L, Bjorner JB, Borritz M, et al. Job strain and the risk of stroke: an individual-participant data meta-analysis. Stroke. 2015;46(2):557–9.CrossRef
9.
go back to reference Nyberg ST, Fransson EI, Heikkilä K, Ahola K, Alfredsson L, Bjorner JB, et al. Job strain as a risk factor for type 2 diabetes: a pooled analysis of 124,808 men and women. Diabetes Care. 2014;37(8):2268–75.CrossRef Nyberg ST, Fransson EI, Heikkilä K, Ahola K, Alfredsson L, Bjorner JB, et al. Job strain as a risk factor for type 2 diabetes: a pooled analysis of 124,808 men and women. Diabetes Care. 2014;37(8):2268–75.CrossRef
10.
go back to reference Nordentoft M, Rod NH, Bonde JP, Bjorner JB, Madsen IEH, Pedersen LRM, et al. Effort-reward imbalance at work and risk of type 2 diabetes in a national sample of 50,552 workers in Denmark: a prospective study linking survey and register data. J Psychosom Res. 2020;128:109867.CrossRef Nordentoft M, Rod NH, Bonde JP, Bjorner JB, Madsen IEH, Pedersen LRM, et al. Effort-reward imbalance at work and risk of type 2 diabetes in a national sample of 50,552 workers in Denmark: a prospective study linking survey and register data. J Psychosom Res. 2020;128:109867.CrossRef
11.
go back to reference Magnusson Hanson LL, Westerlund H, Chungkham HS, Vahtera J, Rod NH, Alexanderson K, et al. 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. Occup Environ Med. 2018;75(7):486–93.CrossRef Magnusson Hanson LL, Westerlund H, Chungkham HS, Vahtera J, Rod NH, Alexanderson K, et al. 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. Occup Environ Med. 2018;75(7):486–93.CrossRef
12.
go back to reference Nyberg ST, Singh-Manoux A, Pentti J, Madsen IEH, Sabia S, Alfredsson L, et al. Association of healthy lifestyle with years lived without major chronic diseases. JAMA Intern Med. 2020;180(5):760–8.CrossRef Nyberg ST, Singh-Manoux A, Pentti J, Madsen IEH, Sabia S, Alfredsson L, et al. Association of healthy lifestyle with years lived without major chronic diseases. JAMA Intern Med. 2020;180(5):760–8.CrossRef
13.
go back to reference Framke E, Sørensen JK, Andersen PK, Svane-Petersen AC, Alexanderson K, Bonde JP, et al. Contribution of income and job strain to the association between education and cardiovascular disease in 1.6 million Danish employees. Eur Heart J. 2020;41(11):1164–78.CrossRef Framke E, Sørensen JK, Andersen PK, Svane-Petersen AC, Alexanderson K, Bonde JP, et al. Contribution of income and job strain to the association between education and cardiovascular disease in 1.6 million Danish employees. Eur Heart J. 2020;41(11):1164–78.CrossRef
14.
go back to reference Petersson F, Baadsgaard M, Thygesen LC. Danish registers on personal labour market affiliation. Scand J Public Health. 2011;39(7 Suppl):95–8.CrossRef Petersson F, Baadsgaard M, Thygesen LC. Danish registers on personal labour market affiliation. Scand J Public Health. 2011;39(7 Suppl):95–8.CrossRef
15.
go back to reference Burr H, Bjorner JB, Kristensen TS, Tüchsen F, Bach E. Trends in the Danish work environment in 1990–2000 and their associations with labor-force changes. Scand J Work Environ Health. 2003;29(4):270–9.CrossRef Burr H, Bjorner JB, Kristensen TS, Tüchsen F, Bach E. Trends in the Danish work environment in 1990–2000 and their associations with labor-force changes. Scand J Work Environ Health. 2003;29(4):270–9.CrossRef
16.
go back to reference Feveile H, Olsen O, Burr H, Bach E. Danish work environment cohort study 2005: from idea to sampling design. Stat Transit. 2007;8(3):441–58. Feveile H, Olsen O, Burr H, Bach E. Danish work environment cohort study 2005: from idea to sampling design. Stat Transit. 2007;8(3):441–58.
17.
go back to reference Fransson EI, Nyberg ST, Heikkilä K, Alfredsson L, De Bacquer D, Batty GD, et al. Comparison of alternative versions of the job demand-control scales in 17 European cohort studies: the IPD-Work consortium. BMC Public Health. 2012;12(1):62.CrossRef Fransson EI, Nyberg ST, Heikkilä K, Alfredsson L, De Bacquer D, Batty GD, et al. Comparison of alternative versions of the job demand-control scales in 17 European cohort studies: the IPD-Work consortium. BMC Public Health. 2012;12(1):62.CrossRef
18.
go back to reference Siegrist J, Dragano N, Nyberg ST, Lunau T, Alfredsson L, Erbel R, et al. Validating abbreviated measures of effort-reward imbalance at work in European cohort studies: the IPD-Work consortium. Int Arch Occup Environ Health. 2014;87(3):249–56.CrossRef Siegrist J, Dragano N, Nyberg ST, Lunau T, Alfredsson L, Erbel R, et al. Validating abbreviated measures of effort-reward imbalance at work in European cohort studies: the IPD-Work consortium. Int Arch Occup Environ Health. 2014;87(3):249–56.CrossRef
19.
go back to reference Lynge E, Sandegaard JL, Rebolj M. The Danish national patient register. Scand J Public Health. 2011;39(7 Suppl):30–3.CrossRef Lynge E, Sandegaard JL, Rebolj M. The Danish national patient register. Scand J Public Health. 2011;39(7 Suppl):30–3.CrossRef
20.
go back to reference Helweg-Larsen K. The Danish register of causes of death. Scand J Public Health. 2011;39(7 Suppl):26–9.CrossRef Helweg-Larsen K. The Danish register of causes of death. Scand J Public Health. 2011;39(7 Suppl):26–9.CrossRef
23.
go back to reference Andersen JS, Olivarius Nde F, Krasnik A. The Danish national health service register. Scand J Public Health. 2011;39(7 Suppl):34–7.CrossRef Andersen JS, Olivarius Nde F, Krasnik A. The Danish national health service register. Scand J Public Health. 2011;39(7 Suppl):34–7.CrossRef
24.
go back to reference Baadsgaard M, Quitzau J. Danish registers on personal income and transfer payments. Scand J Public Health. 2011;39(7 Suppl):103–5.CrossRef Baadsgaard M, Quitzau J. Danish registers on personal income and transfer payments. Scand J Public Health. 2011;39(7 Suppl):103–5.CrossRef
25.
go back to reference Bondo Petersen S, Flachs EM, Prescott EIB, Tjønneland A, Osler M, Andersen I, et al. Job-exposure matrices addressing lifestyle to be applied in register-based occupational health studies. Occup Environ Med. 2018;75:890–7.CrossRef Bondo Petersen S, Flachs EM, Prescott EIB, Tjønneland A, Osler M, Andersen I, et al. Job-exposure matrices addressing lifestyle to be applied in register-based occupational health studies. Occup Environ Med. 2018;75:890–7.CrossRef
27.
go back to reference Holt H, Geerdsen LP, Christensen G, Klitgaard C, Lind ML. Det kønsopdelte arbejdsmarked—en kvantitativ og kvalitativ belysning [The gender segregated labour market—aquantitative and qualitative illustration]. Copenhagen: Danish National Institute of Social Research; 2006. Holt H, Geerdsen LP, Christensen G, Klitgaard C, Lind ML. Det kønsopdelte arbejdsmarked—en kvantitativ og kvalitativ belysning [The gender segregated labour market—aquantitative and qualitative illustration]. Copenhagen: Danish National Institute of Social Research; 2006.
28.
go back to reference Heikkilä K, Fransson EI, Nyberg ST, Zins M, Westerlund H, Westerholm P, et al. Job strain and health-related lifestyle: findings from an individual-participant meta-analysis of 118,000 working adults. Am J Public Health. 2013;103(11):2090–7.CrossRef Heikkilä K, Fransson EI, Nyberg ST, Zins M, Westerlund H, Westerholm P, et al. Job strain and health-related lifestyle: findings from an individual-participant meta-analysis of 118,000 working adults. Am J Public Health. 2013;103(11):2090–7.CrossRef
29.
go back to reference Kouvonen A, Kivimäki M, Virtanen M, Heponiemi T, Elovainio M, Pentti J, et al. Effort-reward imbalance at work and the co-occurrence of lifestyle risk factors: cross-sectional survey in a sample of 36,127 public sector employees. BMC Public Health. 2006;6:24.CrossRef Kouvonen A, Kivimäki M, Virtanen M, Heponiemi T, Elovainio M, Pentti J, et al. Effort-reward imbalance at work and the co-occurrence of lifestyle risk factors: cross-sectional survey in a sample of 36,127 public sector employees. BMC Public Health. 2006;6:24.CrossRef
30.
go back to reference Heikkilä K. Work stress and adverse health behaviors. In: Theorell T, editor. Handbook of socioeconomic determinants of occupational health. Berlin: Springer; 2020. p. 677–88.CrossRef Heikkilä K. Work stress and adverse health behaviors. In: Theorell T, editor. Handbook of socioeconomic determinants of occupational health. Berlin: Springer; 2020. p. 677–88.CrossRef
31.
go back to reference Scheike TH, Zhang MJ. Direct modelling of regression effects for transition probabilities in multistate models. Scand J Stat. 2007;34(1):17–32.CrossRef Scheike TH, Zhang MJ. Direct modelling of regression effects for transition probabilities in multistate models. Scand J Stat. 2007;34(1):17–32.CrossRef
32.
go back to reference Mansourvar Z, Martinussen T, Scheike TH. An additive-multiplicative restricted mean residual life model. Scand J Stat. 2016;43(2):487–504.CrossRef Mansourvar Z, Martinussen T, Scheike TH. An additive-multiplicative restricted mean residual life model. Scand J Stat. 2016;43(2):487–504.CrossRef
33.
34.
go back to reference Armstrong BG. Effect of measurement error on epidemiological studies of environmental and occupational exposures. Occup Environ Med. 1998;55(10):651–6.CrossRef Armstrong BG. Effect of measurement error on epidemiological studies of environmental and occupational exposures. Occup Environ Med. 1998;55(10):651–6.CrossRef
35.
go back to reference Youngstrom EA. A primer on receiver operating characteristic analysis and diagnostic efficiency statistics for pediatric psychology: we are ready to ROC. J Pediatr Psychol. 2014;39(2):204–21.CrossRef Youngstrom EA. A primer on receiver operating characteristic analysis and diagnostic efficiency statistics for pediatric psychology: we are ready to ROC. J Pediatr Psychol. 2014;39(2):204–21.CrossRef
36.
go back to reference Madsen IEH, Nyberg ST, Magnusson Hanson LL, Ferrie JE, Ahola K, Alfredsson L, et al. Job strain as a risk factor for clinical depression: systematic review and meta-analysis with additional individual participant data. Psychol Med. 2017;47(8):1342–56.CrossRef Madsen IEH, Nyberg ST, Magnusson Hanson LL, Ferrie JE, Ahola K, Alfredsson L, et al. Job strain as a risk factor for clinical depression: systematic review and meta-analysis with additional individual participant data. Psychol Med. 2017;47(8):1342–56.CrossRef
37.
go back to reference Rugulies R, Aust B, Madsen IE. Effort-reward imbalance at work and risk of depressive disorders. A systematic review and meta-analysis of prospective cohort studies. Scand J Work Environ Health. 2017;43(4):294–306.CrossRef Rugulies R, Aust B, Madsen IE. Effort-reward imbalance at work and risk of depressive disorders. A systematic review and meta-analysis of prospective cohort studies. Scand J Work Environ Health. 2017;43(4):294–306.CrossRef
38.
go back to reference Mikkelsen S, Coggon D, Andersen JH, Casey P, Flachs EM, Kolstad HA, et al. Are depressive disorders caused by psychosocial stressors at work? A systematic review with metaanalysis. Eur J Epidemiol. 2021;36(5):479–96.CrossRef Mikkelsen S, Coggon D, Andersen JH, Casey P, Flachs EM, Kolstad HA, et al. Are depressive disorders caused by psychosocial stressors at work? A systematic review with metaanalysis. Eur J Epidemiol. 2021;36(5):479–96.CrossRef
39.
go back to reference Merikangas KR, He JP, Burstein M, Swanson SA, Avenevoli S, Cui L, et al. Lifetime prevalence of mental disorders in U.S. adolescents: results from the National Comorbidity Survey Replication-Adolescent Supplement (NCS-A). J Am Acad Child Adolesc Psychiatry. 2010;49(10):980–9.CrossRef Merikangas KR, He JP, Burstein M, Swanson SA, Avenevoli S, Cui L, et al. Lifetime prevalence of mental disorders in U.S. adolescents: results from the National Comorbidity Survey Replication-Adolescent Supplement (NCS-A). J Am Acad Child Adolesc Psychiatry. 2010;49(10):980–9.CrossRef
40.
go back to reference Nyberg ST, Batty GD, Pentti J, Virtanen M, Alfredsson L, Fransson EI, et al. Obesity and loss of disease-free years owing to major non-communicable diseases: a multicohort study. Lancet Public Health. 2018;3:e490–7.CrossRef Nyberg ST, Batty GD, Pentti J, Virtanen M, Alfredsson L, Fransson EI, et al. Obesity and loss of disease-free years owing to major non-communicable diseases: a multicohort study. Lancet Public Health. 2018;3:e490–7.CrossRef
41.
go back to reference Head J, Chungkham HS, Hyde M, Zaninotto P, Alexanderson K, Stenholm S, et al. Socioeconomic differences in healthy and disease-free life expectancy between ages 50 and 75: a multi-cohort study. Eur J Public Health. 2019;29(2):267–72.CrossRef Head J, Chungkham HS, Hyde M, Zaninotto P, Alexanderson K, Stenholm S, et al. Socioeconomic differences in healthy and disease-free life expectancy between ages 50 and 75: a multi-cohort study. Eur J Public Health. 2019;29(2):267–72.CrossRef
42.
go back to reference Stenholm S, Head J, Kivimäki M, Kawachi I, Aalto V, Zins M, et al. Smoking, physical inactivity and obesity as predictors of healthy and disease-free life expectancy between ages 50 and 75: a multicohort study. Int J Epidemiol. 2016;45(4):1260–70.CrossRef Stenholm S, Head J, Kivimäki M, Kawachi I, Aalto V, Zins M, et al. Smoking, physical inactivity and obesity as predictors of healthy and disease-free life expectancy between ages 50 and 75: a multicohort study. Int J Epidemiol. 2016;45(4):1260–70.CrossRef
43.
go back to reference Stenholm S, Head J, Aalto V, Kivimäki M, Kawachi I, Zins M, et al. Body mass index as a predictor of healthy and disease-free life expectancy between ages 50 and 75: a multicohort study. Int J Obes. 2017;41(5):769–75.CrossRef Stenholm S, Head J, Aalto V, Kivimäki M, Kawachi I, Zins M, et al. Body mass index as a predictor of healthy and disease-free life expectancy between ages 50 and 75: a multicohort study. Int J Obes. 2017;41(5):769–75.CrossRef
Metadata
Title
Work stress and loss of years lived without chronic disease: an 18-year follow-up of 1.5 million employees in Denmark
Authors
Jeppe K. Sørensen
Elisabeth Framke
Jacob Pedersen
Kristina Alexanderson
Jens P. Bonde
Kristin Farrants
Esben M. Flachs
Linda L. Magnusson Hanson
Solja T. Nyberg
Mika Kivimäki
Ida E. H. Madsen
Reiner Rugulies
Publication date
21-03-2022
Publisher
Springer Netherlands
Published in
European Journal of Epidemiology / Issue 4/2022
Print ISSN: 0393-2990
Electronic ISSN: 1573-7284
DOI
https://doi.org/10.1007/s10654-022-00852-x

Other articles of this Issue 4/2022

European Journal of Epidemiology 4/2022 Go to the issue