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  • 1. Heikkilä, Katriina
    et al.
    Nyberg, Solja
    Theorell, Töres
    Fransson, Eleonor
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Alfredsson, Lars
    Bjorner, Jakob
    Bonenfant, Sébastien
    Borritz, Marianne
    Bouillon, Kim
    Burr, Hermann
    Dragano, Nico
    Geuskens, Goedele
    Goldberg, Marcel
    Hamer, Mark
    Hooftman, Wendela
    Houtman, Irene
    Joensuu, Matti
    Knutsson, Anders
    Koskenvuo, Markku
    Koskinen, Aki
    Kouvonen, Anne
    Madsen, Ida
    Magnusson Hanson, Linda
    Marmot, Michael
    Nielsen, Martin
    Nordin, Maria
    Oksanen, Tuula
    Pentti, Jaana
    Salo, Paula
    Rugulies, Reiner
    Steptoe, Andrew
    Suominen, Sakari
    Vahtera, Jussi
    Virtanen, Marianna
    Väänänen, Ari
    Westerholm, Peter
    Westerlund, Hugo
    Zins, Marie
    Ferrie, Jane
    Singh-Manoux, Archana
    Batty, David
    Kivimäki, Mika
    Work stress and risk of cancer: meta-analysis of 5700 incident cancer events in 116 000 European men and women2013In: BMJ. British Medical Journal, E-ISSN 1756-1833, Vol. 345, no f165Article in journal (Refereed)
    Abstract [en]

    Objective To investigate whether work related stress, measured and defined as job strain, is associated with the overall risk of cancer and the risk of colorectal, lung, breast, or prostate cancers.

    Design Meta-analysis of pooled prospective individual participant data from 12 European cohort studies including 116 056 men and women aged 17-70 who were free from cancer at study baseline and were followed-up for a median of 12 years. Work stress was measured and defined as job strain, which was self reported at baseline. Incident cancers (all n=5765, colorectal cancer n=522, lung cancer n=374, breast cancer n=1010, prostate cancer n=865) were ascertained from cancer, hospital admission, and death registers. Data were analysed in each study with Cox regression and the study specific estimates pooled in meta-analyses. Models were adjusted for age, sex, socioeconomic position, body mass index (BMI), smoking, and alcohol intake

    Results A harmonised measure of work stress, high job strain, was not associated with overall risk of cancer (hazard ratio 0.97, 95% confidence interval 0.90 to 1.04) in the multivariable adjusted analyses. Similarly, no association was observed between job strain and the risk of colorectal (1.16, 0.90 to 1.48), lung (1.17, 0.88 to 1.54), breast (0.97, 0.82 to 1.14), or prostate (0.86, 0.68 to 1.09) cancers. There was no clear evidence for an association between the categories of job strain and the risk of cancer.

    Conclusions These findings suggest that work related stress, measured and defined as job strain, at baseline is unlikely to be an important risk factor for colorectal, lung, breast, or prostate cancers.

  • 2.
    Virtanen, Marianna
    et al.
    Finnish Institute of Occupational Health, FI-00250 Helsinki, Finland .
    Nyberg, Solja
    Finnish Institute of Occupational Health, FI-00250 Helsinki, Finland .
    Batty, David
    Department of Epidemiology and Public Health, University College London, London, United Kingdom; Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, United Kingdom.
    Jokela, Markus
    Institute of Behavioral Sciences, University of Helsinki, Helsinki, Finland .
    Heikkilä, Katriina
    Finnish Institute of Occupational Health, FI-00250 Helsinki, Finland .
    Fransson, Eleonor
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. ADULT. Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Stress Research Institute, Stockholm University, Stockholm, Sweden .
    Alfredsson, Lars
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden .
    Bjorner, Jakob
    National Research Centre for the Working Environment, Copenhagen, Denmark .
    Borritz, Marianne
    Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark .
    Burr, Hermann
    Federal Institute for Occupational Safety and Health (BAuA), Berlin, Germany .
    Casini, Annalisa
    School of Public Health, Université Libre de Bruxelles, Brussels, Belgium .
    Clays, Els
    Department of Public Health, Ghent University, Ghent, Belgium .
    De Bacquer, Dirk
    Department of Public Health, Ghent University, Ghent, Belgium .
    Dragano, Nico
    Institute for Medical Sociology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany .
    Elovainio, Marko
    National Institute for Health and Welfare, Helsinki, Finland .
    Erbel, Raimund
    Department of Cardiology, West-German Heart Center Essen, University Duisburg-Essen, Essen, Germany .
    Ferrie, Jane
    Department of Epidemiology and Public Health, University College London, London, United Kingdom; School of Community and Social Medicine, University of Bristol, Bristol, United Kingdom .
    Hamer, Mark
    Department of Epidemiology and Public Health, University College London, London, United Kingdom .
    Jöckel, Karl-Heinz
    Institute for Medical Informatics, Biometry, and Epidemiology, University Duisburg-Essen, Germany .
    Kittel, France
    School of Public Health, Université Libre de Bruxelles, Brussels, Belgium .
    Knutsson, Anders
    Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden .
    Koskenvuo, Markku
    Department of Public Health, University of Helsinki, Finland .
    Koskinen, Aki
    Finnish Institute of Occupational Health, FI-00250 Helsinki, Finland .
    Lunau, Thorsten
    Institute for Medical Sociology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany .
    Madsen, Ida
    National Research Centre for the Working Environment, Copenhagen, Denmark .
    Nielsen, Martin
    Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark .
    Nordin, Maria
    Department of Psychology, Umeå University, Umeå, Sweden .
    Oksanen, Tuula
    Finnish Institute of Occupational Health, FI-00250 Helsinki, Finland .
    Pahkin, Krista
    Department of Epidemiology and Public Health, University College London, London, United Kingdom .
    Pejtersen, Jan
    Danish National Centre for Social Research, Copenhagen, Denmark .
    Pentti, Jaana
    Finnish Institute of Occupational Health, FI-00250 Helsinki, Finland .
    Rugulies, Reiner
    National Research Centre for the Working Environment, Copenhagen, Denmark; Department of Public Health, University of Copenhagen, Copenhagen, Denmark .
    Salo, Paula
    Finnish Institute of Occupational Health, FI-00250 Helsinki, Finland; Department of Psychology, University of Turku, Turku, Finland .
    Shipley, Martin
    Department of Epidemiology and Public Health, University College London, London, United Kingdom .
    Siegrist, Johannes
    Institute for Medical Sociology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany .
    Steptoe, Andrew
    Department of Epidemiology and Public Health, University College London, London, United Kingdom .
    Suominen, Sakari
    Folkhälsan Research Center, Helsinki, Finland; Department of Public Health, University of Turku, Finland; Nordic School of Public Health, Gothenburg, Sweden .
    Theorell, Töres
    Stress Research Institute, Stockholm University, Stockholm, Sweden .
    Toppinen-Tanner, Salla
    Finnish Institute of Occupational Health, FI-00250 Helsinki, Finland .
    Väänänen, Ari
    Finnish Institute of Occupational Health, FI-00250 Helsinki, Finland .
    Vahtera, Jussi
    Finnish Institute of Occupational Health, FI-00250 Helsinki, Finland; Department of Public Health, University of Turku, Finland; Turku University Hospital, Turku, Finland .
    Westerholm, Peter
    Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden .
    Westerlund, Hugo
    Stress Research Institute, Stockholm University, Stockholm, Sweden .
    Slopen, Natalie
    Department of Society, Human Development and Health, Harvard School of Public Health, Boston, MA, United States; Center for the Developing Child, Harvard University, Cambridge, MA, United States .
    Kawachi, Ichiro
    Department of Society, Human Development and Health, Harvard School of Public Health, Boston, MA, United States .
    Singh-Manoux, Archana
    Department of Epidemiology and Public Health, University College London, London, United Kingdom; Inserm U1018, Centre for Research in Epidemiology and Population Health, Villejuif, France .
    Kivimäki, Mika
    Finnish Institute of Occupational Health, FI-00250 Helsinki, Finland; Department of Epidemiology and Public Health, University College London, London, United Kingdom; Institute of Behavioral Sciences, University of Helsinki, Helsinki, Finland.
    Perceived job insecurity as a risk factor for incident coronary heart disease: systematic review and meta-analysis2013In: BMJ. British Medical Journal, E-ISSN 1756-1833, Vol. 347, no 7921, article id f4746Article in journal (Refereed)
    Abstract [en]

    Objective To determine the association between self reported job insecurity and incident coronary heart disease.

    Design A meta-analysis combining individual level data from a collaborative consortium and published studies identified by a systematic review.

    Data sources We obtained individual level data from 13 cohort studies participating in the Individual-Participant-Data Meta-analysis in Working Populations Consortium. Four published prospective cohort studies were identified by searches of Medline (to August 2012) and Embase databases (to October 2012), supplemented by manual searches.

    Review methods Prospective cohort studies that reported risk estimates for clinically verified incident coronary heart disease by the level of self reported job insecurity. Two independent reviewers extracted published data. Summary estimates of association were obtained using random effects models.

    Results The literature search yielded four cohort studies. Together with 13 cohort studies with individual participant data, the meta-analysis comprised up to 174 438 participants with a mean follow-up of 9.7 years and 1892 incident cases of coronary heart disease. Age adjusted relative risk of high versus low job insecurity was 1.32 (95% confidence interval 1.09 to 1.59). The relative risk of job insecurity adjusted for sociodemographic and risk factors was 1.19 (1.00 to 1.42). There was no evidence of significant differences in this association by sex, age (<50 v ≥50 years), national unemployment rate, welfare regime, or job insecurity measure.

    Conclusions The modest association between perceived job insecurity and incident coronary heart disease is partly attributable to poorer socioeconomic circumstances and less favourable risk factor profiles among people with job insecurity.

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