Long working hours and risk of cardiovascular outcomes and diabetes type II: five-year follow-up of the Gutenberg Health Study (GHS).
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ABSTRACT: Objectives
The aims of this study were to determine if there was an increased risk of incident cardiovascular disease (CVD) and diabetes and an increase in arterial stiffness in participants who reported working 41-54 h per week and more than 55 h compared to those who worked 40 h or less over a time interval of 5 years.Methods
In a subsample of the population-based prospective Gutenberg Health Study (GHS) study, we examined working participants younger than 65 years at baseline (n = 7241) and after 5 years. To test the association of working time at baseline and incident cardiovascular events and diabetes type II, we estimated hazard ratios (HR) using competing risks models. For a change in the arterial stiffness index (SI) based on assessment using a Pulse Trace PCA2 device, we used multivariate linear regression models.Results
The SI increased in those working more than 55 h per week (beta coefficiant = 0.32 m/s (95% CI 0.07-0.58) compared to those working 40 h and less after adjustment for sex, age and SES. Due to small numbers there was no significant association of working hours and clinically manifest cardiovascular events and diabetes type II in the 5-year follow-up time.Conclusions
Further studies are needed to confirm the results on working hours and arterial stiffness. Analyses of the 10-year follow-up with more events may clarify the results for incident cardiovascular events and metabolic outcomes.
SUBMITTER: K R
PROVIDER: S-EPMC8755657 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Background:The aim of this study was to determine if there is an increased risk of incident cardiovascular disease (CVD) resulting from workplace mobbing measured with two mobbing instruments in the Gutenberg Health Study. Methods:In this prospective study, we examined working persons younger than 65?years for the presence of mobbing at baseline and at a 5-year follow-up using a single-item and a 5-item instrument. We used multivariate models to investigate the association between mobbing and incident CVD, hypertension, and change in arterial stiffness and further stratified the models by sex. Results:After adjustment for confounders, mobbed workers appeared to have a higher risk of incident CVD than those not mobbed (single-item HR?=?1.28, 95% CI 0.73-2.24; 5-item HR?=?1.57, 95% CI 0.96-2.54). With the 5-item instrument, men who reported mobbing had a higher risk of incident CVD (HR?=?1.77, 95% CI 1.01-3.09), while no association was observed for women (HR?=?1.05, 95% CI 0.38-2.91). There was no difference in risks between men and women with the single-item instrument. No association between mobbing and incident hypertension and arterial stiffness was seen. Conclusions:Our results show an indication of an increased risk of incident CVD for those mobbed at baseline when using the whole study population. Differences in risks between men and women when using the five-item instrument may be due to the instrument itself. Still, it is essential to detect or prevent workplace mobbing, and if present, to apply an intervention to halt it in order to minimize its adverse effects on CVD.
| S-EPMC7291638 | biostudies-literature
Project description:IntroductionWork-life conflicts (WLC) may impact health, but few studies prospectively consider the impact of WLC on objective outcomes such as cardiovascular disease. Using data from the Gutenberg Health Study (GHS), we examined if WLC at baseline was associated with an increased five-year incidence of cardiovascular events (myocardial infarct, stroke, atrial fibrillation, peripheral artery disease, coronary artery disease, chronic heart failure, sudden cardiac death). We also considered if WLC was associated with incident hypertension and arterial stiffness and if the effects of WLC on cardiovascular health differ for men and women.MethodsA working subsample of the 15,010 GHS cohort participants completed the Copenhagen Psychosocial Questionnaire, which included five "work-privacy conflict" questions at baseline and at the five-year follow-up. Relative risks for incident hypertension due to increased WLC at baseline (WLC scores exceeding 60 out of 100) were estimated with Poisson regression in the subgroup of participants without hypertension at baseline (n = 2426). Categories of WLC at baseline and follow-up were also used to examine the risk of hypertension due to chronic/recurrent WLC. In this subgroup, we also examined the association between WLC as a continuous score ranging from 0 to 100 with change to arterial stiffness after five years using linear regression. Hazard ratios were estimated for incident cardiovascular events in a larger subsample of participants without prevalent cardiovascular disease at baseline (n = 3698) using Cox regression. We used various multivariable regression models to adjust for sex, age, socioeconomic status, occupational, household, and cardiovascular risk factors.ResultsWe found no association between WLC and incident hypertension or increased arterial stiffness. The fully-adjusted relative risk for WLC >60 at baseline and hypertension was 0.93 (95% 0.74-1.17). The risk of hypertension due to chronic/recurrent WLC >60 was increased but not statistically significant (RR = 1.13, 95% CI 0.83-1.54). Overall, hazard ratios for incident cardiovascular events were also not increased. However, stratifying the results by sex resulted in a hazard ratio of 1.47 (95% CI 0.54-3.98) for incident cardiovascular disease among women in the fully adjusted model.ConclusionsAlthough our results were not statistically significant, they indicate that WLC is negatively impacting the cardiovascular health of women. While these results need to be confirmed with additional research and a longer follow-up, interventions to prevent WLC will promote health and could be especially beneficial for women.
| S-EPMC8104925 | biostudies-literature
Project description:AbstractHypertension causes a substantial burden to society. Some studies found that hypertension was associated with the working type and working hours. The purpose of the current study is to assess the dose-response relationship between working hours and hypertension.Data of 12,080 adults aged 18 to 65 years who attended the China Health and Nutrition Survey (CHNS) between 1989 and 2011 were analyzed. Hypertension was determined based on systolic and/or diastolic blood pressure measures, or having doctor-diagnosed hypertension. Multivariable Cox regression and restricted cubic spline to assess the dose-response relationship between working hours and hypertension.A total of 12,080 participants including 5852 females and 6228 males. By the last follow-up (2011), a total of 830 participants were hypertensive, with an incidence of 6.9%. After adjusting socio-demographic, lifestyle factors, as well as occupation type, compared with those who worked 35 to 49 hours per week, participants who worked no more than 34 hours per week (HR: 1.21, 95%CI: 1.03-1.41) and at least 56 hours per week (HR: 1.38, 95%CI: 1.19-1.59) had a higher risk of hypertension. The significant association between long working hours (at least 56 hours per week) and hypertension was observed among females (HR: 1.38, 95%CI: 1.16-1.64) and males (HR: 1.36, 95%CI: 1.04-1.78). Among manual workers, the relationship between long working hours and hypertension was observed (HR: 1.49, 95%CI: 1.10-2.02). The relationship between long working hours (HR: 1.21, 95%CI: 1.01-1.44) and short working hours (HR: 1.37, 95%CI: 1.16-1.61) and hypertension was observed among nonmanual workers. The hazard ratio of hypertension and working time displayed U-shape non-linear relationship (Ptrend < .001, non-linear P < .001). The non-linear response-dose relationship was found in manual worker, nonmanual worker, and male (Ptrend < .001, non-linear P < .001).The association between working time and hypertension showed U-shape relationship. Specifically, overtime work was an important occupational risk factors for adults, and short work time was related to hazard ratio of hypertension in nonmanual workers.
| S-EPMC8078318 | biostudies-literature
Project description:Objective This study aimed to estimate prospective associations between long working hours and (i) redeemed prescriptions for psychotropic drugs and (ii) psychiatric hospital treatment due to mood, anxiety or stress-related disease, among full-time employees in Denmark. Methods Full-time employees who participated in the Danish Labor Force Survey sometime in the period 2000-2013 (N=131 321] were followed for up to five years in national registers for redeemed prescriptions for psychotropic drugs and psychiatric hospital treatment due to mood, anxiety or stress-related disease. Rate ratios (RR) were estimated for 41-48 versus 32-40 and >48 versus 32-40 working hours a week. The analyses were controlled for sex, age, night shift work, calendar time of the interview and socioeconomic status (SES). Prevalent cases were excluded in primary analyses. Results The RR for psychotropic drugs were estimated at 0.94 [99% confidence interval (CI) 0.88-1.01] for 41-48 versus 32-40 working hours a week and 1.08 (99% CI 0.99-1.18) for >48 versus 32-40 working hours a week. The corresponding RR for psychiatric hospital treatments were estimated at 0.90 (95% CI 0.75-1.08) and 0.96 (95% CI 0.76-1.21). We did not find any statistically significant interaction between weekly working hours and age, sex, SES or night shift work. Conclusion Long working hours as they occur in in the general working population of Denmark are not an important predictor of mental ill health.
| S-EPMC8126440 | biostudies-literature
Project description:The Bjork Shiley valve (BSV) is considered as the pioneer among modern disc valves, and eventually evolved into a reliable prosthesis after considerable research and multiple modifications. Various case reports have been published with follow-up of different types of BSV. We are reporting the longest follow-up ever published of a plano-convex type of BSV. Our patient's valve was implanted in 1973 due to a congenital bicuspid aortic valve with concomitant severe, symptomatic aortic stenosis, discovered at the age of 27. She presented with exertional dyspnoea, syncope and chest pain; however, her cardiovascular status remained stable and these symptoms abated after successful valve replacement at the age of 34. She is now 77 years old with no limitations in her activities and is able to walk a few miles most days of the week. Her echocardiograms throughout the decades have shown acceptable gradients across the aortic prosthesis without evidence of haemolysis. Our case report includes a summary of the patient with a discussion of the evidence that supports the durability of the original plano-convex BSV.
| S-EPMC6716407 | biostudies-literature
Project description:To compare community involvement of pediatricians exposed to enhanced residency training as part of the Dyson Community Pediatrics Training Initiative (CPTI) with involvement reported by a national sample of pediatricians.A cross-sectional analyses compared 2008-2010 mailed surveys of CPTI graduates 5 years after residency graduation with comparably aged respondents in a 2010 mailed national American Academy of Pediatrics survey of US pediatricians (CPTI: n = 234, response = 56.0%; national sample: n = 243; response = 59.9%). Respondents reported demographic characteristics, practice characteristics (setting, time spent in general pediatrics), involvement in community child health activities in past 12 months, use of ?1 strategies to influence community child health (eg, educate legislators), and being moderately/very versus not at all/minimally skilled in 6 such activities (eg, identify community needs). ?(2) statistics assessed differences between groups; logistic regression modeled the independent association of CPTI with community involvement adjusting for personal and practice characteristics and perspectives regarding involvement.Compared with the national sample, more CPTI graduates reported involvement in community pediatrics (43.6% vs 31.1%, P < .01) and being moderately/very skilled in 4 of 6 community activities (P < .05). Comparable percentages used ?1 strategies (52.2% vs 47.3%, P > .05). Differences in involvement remained in adjusted analyses with greater involvement by CPTI graduates (adjusted odds ratio 2.4, 95% confidence interval 1.5-3.7).Five years after residency, compared with their peers, more CPTI graduates report having skills and greater community pediatrics involvement. Enhanced residency training in community pediatrics may lead to a more engaged pediatrician workforce.
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Project description:PURPOSE: To assess longitudinal changes in parapapillary atrophy in the adult population of Greater Beijing. METHODS: The population-based Beijing Eye Study 2006 included 3251 subjects who had participated in the Beijing Eye Study 2001 and returned for re-examination. The mean age was 60.4 ± 10.1 years. Using optic disc photographs, we measured parapapillary atrophy which was divided into alpha zone and beta zone. RESULTS: Overall progression rate of alpha zone was seen in 0.6 ± 0.1% (95% confidence interval (CI):0.3,0.9) of the subjects and of beta zone in 8.2 ± 0.5% (95%CI:7.2,9.1) of the subjects. In binary regression analysis, rate of progression of alpha zone was significantly associated higher age (P = 0.04) and the co-progression of zone Beta (P<0.001). Rate of progression of beta zone was significantly associated with higher age (P<0.001; odds ratio (OR):1.11;95%CI:1.10,1.14), higher intraocular pressure (P<0.001;OR:1.10;95%CI:1.05,1.14), higher myopic refractive error (P<0.001;OR:0.71; 95%CI:0.67,0.75), rural region of habitation (P = 0.002;OR: 0.58; 95%CI:0.41,0.82), presence of glaucomatous optic nerve damage (P<0.001;OR:2.89; 95%CI:1.62,5.14), co-progression of alpha zone (P<0.001;OR:7.13;95%CI:2.43,20.9), absence of arterial hypertension (P = 0.03;OR: 0.70; 95%CI:0.51,0.96), and thicker central corneal thickness (P = 0.02;OR:1.01;95%CI:1.00,1.01). Subjects with a non-glaucomatous optic nerve damage (n = 22) as compared to the remaining subjects did not vary in the progression rate of alpha zone (0.0% versus 0.6 ± 0.1%; P = 1.0) and beta zone (8.2 ± 0.5% versus 6.3 ± 0.6%;P = 1.0). CONCLUSIONS: In adult Chinese in Greater Beijing, the 5-year progression rate of beta zone of parapapillary atrophy (seen in 8.2 ± 0.5% of subjects) was significantly correlated with higher age, rural region of habitation, absence of arterial hypertension, higher intraocular pressure, higher myopic refractive error, thicker central corneal thickness, and presence of glaucoma. It was not associated with non-glaucomatous optic nerve damage.
| S-EPMC3346821 | biostudies-other
Project description:ObjectivesTaiwan revised its criteria for overwork-related cerebrovascular and cardiovascular disease (CCVD) in 2010. A new definition of overwork increased the number of recognised cases. Meanwhile, actual average working hours decreased. We estimated the effects of the revised criteria on the number of overwork-related CCVD cases and the mediation effect through reduced working hours.MethodsFrom the Labor Insurance of Taiwan, we collected data on the total number of overwork-related CCVD cases from 2006 to 2016 and average monthly working hours for 13 industry groups. We conducted causal mediation analysis to investigate the mechanism of the effect of new criteria on CCVD mediated by working hours.ResultsFrom 2006 to 2016, 594 overwork-related cases of CCVD were recognised across 13 industry groups. After introducing the new criteria, overwork-related CCVD increased by 8.40 cases (per one million person-years) (95% CI 4.53 to 15.05), which resulted from a decrease of 1.54 (95% CI 0.22 to 3.82) cases due to reduced working hours (mediation effect) and an increase of 9.93 (95% CI 5.24 to 18.17) cases related to the effect of the criteria change and other covariates excluding working hours (alternative effect).ConclusionsWorking hours are an important mediator of the effect of policy on the rate of overwork-related CCVD. Introducing new criteria for recognising overwork-related disease might raise awareness and prompt reductions in working hours, which also help to reduce CCVD. Our findings suggest that understanding mediation effects is important to evaluating national health policies.
| S-EPMC6677939 | biostudies-literature
Project description:Active surveillance (AS) is an important yet underutilized strategy to reduce prostate cancer (PCa) overtreatment.To examine the 5-yr outcomes of AS in a population-based setting.From the National Prostate Cancer Register of Sweden, we identified 11 726 men ?70 yr diagnosed with very low-risk to intermediate-risk PCa from 2003 to 2007 who completed 5 yr of follow-up. Of these men, 1729 (15%) chose AS for the primary management strategy.We calculated the probability of discontinuation of AS over time, and Cox proportional hazards models were used to determine factors associated with discontinuation. Reasons for discontinuation were assessed by data extraction from medical charts.By 5 yr, 64% of the men remained on AS. Predictors of discontinuation were younger age, fewer comorbidities, more education, higher prostate-specific antigen (PSA), and clinical stage T2 disease; marital status did not predict discontinuation. In a subset with data on the reason for discontinuation (86%), 20% of men discontinued because of patient preference, 52% because of PSA progression, 24% because of biopsy progression, and 3% for other reasons.In a population-based setting, the majority of men remained on AS at 5 yr. However, one-fifth of the men who discontinued AS did so for nonbiologic reasons. Thus, there is a need for support and counseling for men to continue AS in the absence of signs of progression to improve adherence to AS and decrease overtreatment.Active surveillance (AS) is an important option to delay or avoid treatment for men with favorable prostate cancer features. This study shows that at 5 yr, 64% of men across an entire population remained on AS. We concluded that AS is a durable option and that counseling may be useful to promote adherence for men without progression.
| S-EPMC4280355 | biostudies-literature
Project description:ObjectivesThis study evaluated the utility and quality-of-life year measurements for patients with coronary artery disease who underwent any of 3 therapeutic strategies with a 5-year follow-up.MethodsQuality-of-life data were obtained from the Medicine, Angioplasty, or Surgery Study II trial. To obtain utilities, the 36-Item Short-Form questionnaire was converted to a 6-Dimensional Health State Classification System.ResultsOf the 611 initial patients, 579 completed the questionnaire. In all, 188 patients received the surgical treatment-194 the percutaneous, and the remaining 197 the medical. The median utility scores for the 5 years analyzed were 0.809 (95% confidence interval [CI] 0.794-0.842) for patients assigned to percutaneous coronary intervention, 0.755 (95% CI 0.723-0.774) for medical treatment, and 0.780 (95% CI 0.761-0.809) for coronary artery bypass graft surgery. The difference between percutaneous coronary intervention and medical treatment was statistically significant (P?<?.05, Dunn test). The median cumulative quality-of-life years across the 5 years were 3.802 (95% CI 3.668-3.936) for percutaneous, 3.540 (95% CI 3.399-3.681) for medical, and 3.764 (95% CI 3.638-3.890) for surgery. Additionally, the median quality-of-life years between percutaneous and medical treatment was 0.262 (95% CI 0.068-0.456), between surgery and medical treatment it was 0.224 (95% CI 0.036-0.413), and between surgery and percutaneous coronary intervention it was -0.038 (95% CI -0.221 to -0.146).ConclusionCoronary artery bypass surgery and percutaneous coronary intervention were similar regarding cumulative quality-of-life years; however, they were both superior to that of medical treatment. The results presented are valuable data for further cost-utility studies.
| S-EPMC5815720 | biostudies-literature