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Sustainable Working Life in a Swedish Twin Cohort-A Definition Paper with Sample Overview.

ABSTRACT: Background: A unified or consensus definition of "sustainable working life" remains lacking, although studies investigating risk factors for labour market exit are numerous. In this study, we aimed (1) to update the information and to explore a definition of "sustainable working life" via a systematic literature review and (2) to describe the working life trajectories via the prevalence of sickness absence (SA), disability pension (DP), and unemployment in a Swedish twin cohort to provide a sample overview in our Sustainable Working Life-project. Methods: A systematic literature review was conducted to explore the studies with the search phrase "sustainable working life" in PubMed, PsycInfo, and the Web of Science Database of Social Sciences in January 2021, resulting in a total of 51 references. A qualitative synthesis was performed for the definitions and the measures of "sustainable working life." Based on the Swedish Twin project Of Disability pension and Sickness absence (STODS), the current dataset to address sustainable working life includes 108 280 twin individuals born between 1925 and 1990. Comprehensive register data until 2016 for unemployment, SA and DP were linked to all individuals. Using STODS, we analysed the annual prevalence of SA, DP, and unemployment as working life trajectories over time across education and age groups. Results: The reviewed 16 full articles described several distinct definitions for sustainable working life between 2007 and 2020 from various perspectives, i.e., considering workplaces or employees, the individual, organizational or enterprise level, and the society level. The definition of "sustainable working life" appearing most often was the swAge-model including a broad range of factors, e.g., health, physical/mental/psychosocial work environment, work motivation/satisfaction, and the family situation and leisure activities. Our dataset comprised of 81%-94% of individuals who did not meet SA, DP, or unemployment during the follow-up in 1994-2016, being indicative for "sustainable working life." The annual prevalence across years had a decreasing trend of unemployment over time, whereas the prevalence of SA had more variation, with DP being rather stable. Both unemployment and DP had the highest prevalence among those with a lower level of education, whereas in SA, the differences in prevalence between education levels were minor. Unemployment was highest across the years in the youngest age group (18-27 years), the age group differences for SA were minor, and for DP, the oldest age group (58-65 years) had the highest prevalence. Conclusions: No consensus exists for a "sustainable working life," hence meriting further studies, and we intend to contribute by utilising the STODS database for the Sustainable Working Life project. In the upcoming studies, the existing knowledge of available definitions and frameworks will be utilised. The dataset containing both register data and self-reports enables detailed follow-up for labour market participation for sustainable working life.

SUBMITTER: Ropponen A

PROVIDER: S-EPMC8197988 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundTo improve a sustainable healthy working life, we have developed the intervention 'Staying healthy at work', which endeavours to enhance work participation of employees aged 45 years and older by increasing their problem-solving capacity and stimulating their awareness of their role and responsibility towards a healthy working life. This research study aims to evaluate the process and the effectiveness of the intervention compared with care as usual.Methods/designThe study is a cluster-randomized controlled trial design (randomized at the supervisor level), with a 1-year follow-up. Workers aged 45 years and older have been enrolled in the study. Workers in the intervention group are receiving the intervention 'Staying healthy at work'. The main focus of the intervention is to promote a healthy working life of ageing workers by: (1) changing workers awareness and behaviour, by emphasizing their own decisive role in attaining goals; (2) improving the supervisors' ability to support workers in taking the necessary action, by means of enhancing knowledge and competence; and (3) enhancing the use of the human resource professionals and the occupational health tools available within the organization. The supervisors in the intervention group have been trained how to present themselves as a source of support for the worker. Workers in the control group are receiving care as usual; supervisors in the control group have not participated in the training. Measurements have been taken at baseline and will be followed up at 3, 6 and 12 months. The primary outcome measures are vitality, work ability and productivity. The secondary outcomes measures include fatigue, job strain, work attitude, self-efficacy and work engagement. A process evaluation will be conducted at both the supervisor and the worker levels, and satisfaction with the content of the intervention will be assessed.DiscussionThe intervention 'Staying healthy at work' has the potential to provide evidence-based knowledge of an innovative method to promote a sustainable healthy working life in the older working population. The results of the study will be relevant for workers, employers, occupational health professionals and human resource professionals.Trial registrationThe trial is registered with the Dutch Trial Register under number NTR2270.

Project description:Aims/hypothesisWe aimed to examine the association between midlife type 2 diabetes mellitus and cerebrovascular disease (CBD) in late life, and further to explore whether genetic and early-life familial environmental factors (such as shared childhood socioeconomic status and adolescent environment) play a role in this association.MethodsIn this prospective nested case-control study based on the Swedish Twin Registry, 33,086 twin individuals who were born in 1958 or earlier and were CBD-free before the age of 60 were included. Midlife (40-59 years) type 2 diabetes was ascertained from self-report, the National Patient Registry (NPR) and glucose-lowering medication use. CBD diagnosis (cerebral infarction, occlusion of cerebral arteries, subarachnoid haemorrhage, intracerebral haemorrhage and unspecified CBD) and onset age were identified from the NPR. Late-life CBD was defined as CBD onset age ≥60 years. Generalised estimating equation (GEE) models were used to analyse unmatched case-control data (adjusted for the clustering of twins within a pair). Conditional logistic regression was used in co-twin matched case-control analyses in CBD-discordant twin pairs.ResultsOf all the participants, 1248 (3.8%) had midlife type 2 diabetes and 3121 (9.4%) had CBD in late life. In GEE models adjusted for age, sex, education, BMI, smoking, alcohol consumption, marital status, hypertension and heart disease, the ORs (95% CIs) of type 2 diabetes were 1.29 (1.03, 1.61) for cerebral infarction, 2.03 (1.20, 3.44) for occlusion of cerebral arteries, 0.52 (0.12, 2.21) for subarachnoid haemorrhage and 0.78 (0.45, 1.36) for intracerebral haemorrhage. In multi-adjusted conditional logistic regression, the OR of the type 2 diabetes-cerebral infarction association was 0.96 (0.51, 1.80). The differences in ORs from the GEE and co-twin control analyses were not statistically significant (p = 0.780).Conclusions/interpretationMidlife type 2 diabetes is significantly associated with increased risk of cerebral infarction and occlusion of cerebral arteries, but not intracerebral haemorrhage or subarachnoid haemorrhage in late life. Genetic and early-life familial environmental factors do not appear to account for the type 2 diabetes-cerebral infarction association, but further clarification is needed.

Project description:Importance:Psychiatric traits associated with categorically defined psychiatric disorders are heritable and present to varying degrees in the general population. It is commonly assumed that diagnoses represent the extreme end of continuously distributed traits in the population, but this assumption has yet to be robustly tested for many psychiatric phenotypes. Objective:To assess whether genetic risk factors associated with psychiatric disorders are also associated with continuous variation in milder population traits. Design, Setting, and Participants:This study combined a novel twin analytic approach with polygenic risk score (PRS) analyses in a large population-based twin sample. Phenotypic and genetic data were available from the Child and Adolescent Twin Study in Sweden. Inpatient data were available for January 1, 1987, to December 31, 2014, and outpatient data for January 1, 2001, to December 31, 2013. The last day of follow-up was December 31, 2014. Data analysis was performed from January 1, 2017, to September 30, 2017. Main Outcomes and Measures:Questionnaires that assessed traits of autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), learning difficulties, tic disorders (TDs), obsessive-compulsive disorder (OCD), anxiety, major depressive disorder (MDD), mania, and psychotic experiences were administered to a large Swedish twin sample. Individuals with clinical psychiatric diagnoses were identified using the Swedish National Patient Register. Joint categorical/continuous twin modeling was used to estimate genetic correlations between psychiatric diagnoses and continuous traits. The PRSs for psychiatric disorders were calculated based on independent discovery genetic data. The association between PRSs for each disorder and associated continuous traits was tested. Results:Phenotype data were available for 13 923 twin pairs (35.1% opposite sex and 31.7% same-sex females) at 9 years of age, 5165 pairs (36.9% opposite sex and 34.0% same-sex females) at 15 years of age, and 4273 pairs (36.5% opposite sex and 34.4% same-sex females) at 18 years of age. Genetic data were available for 13 412 individuals (50.2% females). Twin genetic correlations between numerous psychiatric diagnoses and corresponding traits ranged from 0.31 to 0.69. Disorder PRSs were associated with related population traits for ASD (β [SE] = 0.04 [0.01] at 9 years of age), ADHD (β [SE] = 0.27 [0.03] at 9 years of age), TDs (β [SE] = 0.02 [0.004] at 9 years of age), OCD (β [SE] = 0.13 [0.05] at 18 years of age), anxiety (β [SE] = 0.18 [0.08] at 9 years of age; β [SE] = 0.07 [0.02] at 15 years of age; and β [SE] = 0.40 [0.17] at 18 years of age), MDD (β [SE] = 0.10 [0.03] at 9 years of age; β [SE] = 0.11 [0.02] at 15 years of age; and β [SE] = 0.41 [0.10] at 18 years of age), and schizophrenia (β [SE] = 0.02 [0.01] at 18 years of age). Polygenic risk scores for depressive symptoms were associated with MDD diagnoses (odds ratio, 1.16; 95% CI, 1.02-1.32). Conclusions and Relevance:These results suggest that genetic factors associated with psychiatric disorders are also associated with milder variation in characteristic traits throughout the general population for many psychiatric phenotypes. This study suggests that many psychiatric disorders are likely to be continuous phenotypes rather than the categorical entities currently defined in diagnostic manuals, which has strong implications for genetic research in particular.

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Sustainable Working Life in a Swedish Twin Cohort-A Definition Paper with Sample Overview.

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