Showing papers by "Hermann Burr published in 2010"

Physical demands at work, physical fitness, and 30-year ischaemic heart disease and all-cause mortality in the Copenhagen Male Study.

Abstract: Objective No previous long-term prospective studies have examined if workers with low cardiorespiratory fitness have an increased risk of cardiovascular mortality due to high physical work demands. We tested this hypothesis. Method We carried out a 30-year follow-up of the Copenhagen Male Study of 5249 employed men aged 40–59 years. We excluded from follow-up 274 men with a history of myocardial infarction, prevalent symptoms of angina pectoris, or intermittent claudication. We estimated physical fitness [maximal oxygen consumption (VO 2 Max)] using the Astrand cycling test and determined physical work demands with two self-reported questions. Results In the Copenhagen Male Study, 587 men (11.9%) died due to ischaemic heart disease (IHD). Using men with low physical work demands as the reference group, Cox analyses – adjusted for age, blood pressure, smoking, alcohol consumption, body mass index, diabetes, and hypertension – showed that high physical work demands were associated with an increased risk of IHD mortality in the least fit [VO 2 Max range 15–26, N=892, hazard ratio (HR) 2.04, 95% confidence interval (95% CI) 1.20–3.49] and moderately fit (VO 2 Max range 27–38, N=3037, HR 1.75, 95% CI 1.24–2.46), but not among the most fit men (VO 2 Max range 39–78, N=1014, HR 1.08, 95% CI 0.52–2.17). We found a similar, although slightly weaker, relationship with respect to all-cause mortality. Conclusions The hypothesis was supported. Men with low and medium physical fitness have an increased risk of cardiovascular and all-cause mortality if exposed to high physical work demands. Ours observations suggest that, among men with high physical work demands, being physically fit protects against adverse cardiovascular effects.

Prognostic factors for long-term sickness absence among employees with neck–shoulder and low-back pain

Abstract: Objective The aim of this study was to identify prognostic factors for long-term sickness absence among employees with neck–shoulder or low-back pain. Methods In 2000, a representative sample of Danish employees (N=5036) rated their average pain intensity in the neck–shoulder and low-back during the last three months on a 10-point scale; using a questionnaire, they also reported on physical and psychosocial work factors, health behavior, work ability and self-efficacy. Employees reporting pain intensity of ≥4 were considered to have musculoskeletal pain. As a result, we defined two populations to be included in our analyses: people with pain in the neck–shoulder (N=848) and low-back (N=676) regions. Data on long-term sickness absence of ≥3 weeks for the period 2001–2002 were attained from the Danish national register of social transfer payments. Results One fifth of employees with neck–shoulder and low-back pain experienced long-term sickness absence during the two-year follow-up. Among employees with neck–shoulder and low-back pain, respectively, the main significant risk factors were (i) pain intensity [hazard ratio (HR)=1.12, 95% confidence interval (95% CI) 1.02–1.24 and HR=1.13, 95% CI 1.01–1.26] and (ii) heavy physical work (HR=1.68, 95% CI 1.21–2.33 and HR=1.41 95% CI 1.00–2.01). Conclusion Preventive initiatives for long-term sickness absence should aim to reduce pain intensity and heavy physical work among employees with neck–shoulder and low-back pain.

Do dimensions from the Copenhagen Psychosocial Questionnaire predict vitality and mental health over and above the job strain and effort—reward imbalance models?:

Abstract: Aims: The Copenhagen Psychosocial Questionnaire (COPSOQ) comprises dimensions (emotional demands, demands of hiding emotions, meaning of work, quality of leadership, and predictability) that are no...

The effect of the work environment and performance-based self-esteem on cognitive stress symptoms among Danish knowledge workers

Abstract: Aims: Interpersonal relations at work as well as individual factors seem to play prominent roles in the modern labour market, and arguably also for the change in stress symptoms. The aim was to examine whether exposures in the psychosocial work environment predicted symptoms of cognitive stress in a sample of Danish knowledge workers (i.e. employees working with sign, communication or exchange of knowledge) and whether performance-based self-esteem had a main effect, over and above the work environmental factors. Methods: 349 knowledge workers, selected from a national, representative cohort study, were followed up with two data collections, 12 months apart. We used data on psychosocial work environment factors and cognitive stress symptoms measured with the Copenhagen Psychosocial Questionnaire (COPSOQ), and a measurement of performance-based self-esteem. Effects on cognitive stress symptoms were analyzed with a GLM procedure with and without adjustment for baseline level. Results: Measures at baseline of quantitative demands, role conflicts, lack of role clarity, recognition, predictability, influence and social support from management were positively associated with cognitive stress symptoms 12 months later. After adjustment for baseline level of cognitive stress symptoms, follow-up level was only predicted by lack of predictability. Performance-based self-esteem was prospectively associated with cognitive stress symptoms and had an independent effect above the psychosocial work environment factors on the level of and changes in cognitive stress symptoms. Conclusions: The results suggest that both work environmental and individual characteristics should be taken into account in order to capture sources of stress in modern working life.

Person-related work and incident use of antidepressants: relations and mediating factors from the Danish work environment cohort study.

Abstract: Objectives Previous Danish studies have shown that employees who “work with people” (ie, do person-related work) are at increased risk of hospitalization with a diagnosis of depression. However, these studies were purely register-based and consequently unable to point to factors underlying this elevated risk. This paper examines whether person-related work is associated with incident use of antidepressants, and whether this association is mediated by several work environment exposures. Methods Self-reported data from the Danish work environment cohort study in 2000 were linked with the use of antidepressants between 2001–2006. We included 4958 respondents in our study after excluding those with severe depressive symptoms or use of antidepressants at baseline. Results Compared to employees doing non-person-related work, the use of antidepressants was increased statistically significantly for healthcare workers and statistically non-significantly for educational workers. The use of antidepressants was not elevated for social or customer service workers, or those doing “other” types of person-related work. The increased risks of antidepressant-use for healthcare and educational workers were attenuated when adjusted for emotional demands at work. Conclusions The results imply that healthcare and educational workers in Denmark are at increased risk of depression and that this risk is partly mediated by the high emotional demands of the work.

Psychosocial work environment and its association with socioeconomic status. A comparison of Spain and Denmark

Abstract: Aims: The purpose of this study was to describe psychosocial work environment inequalities among wage earners in Spain and Denmark. Methods: Data came from the Spanish COPSOQ (ISTAS 21) and the Danish COPSOQ II surveys both performed in 2004–05 and based on national representative samples of employees with a 60% response rate. Study population was 3,359 Danish and 6,685 Spanish women and men. Only identical items from both surveys were included to construct 18 psychosocial scales. Socioeconomic status was categorized according to the European Socioeconomic Classification System. Analysis included ordinal logistic regression and multiple correspondence analysis after categorizing all scales. Results: A relationship between socioeconomic status and psychosocial work environment in both Denmark and Spain was observed, with wider social inequalities in Spain for many scales, describing a strong interaction effect between socioeconomic status and country. Conclusions: Socioeconomic status is related to psychosocial work environment and some adverse psychosocial conditions tend to cluster in lower socioeconomic status groups in both Spain and Denmark. This effect could be modified by a country’s characteristics, such as economic and labour market structures, normative regulations and industrial relations including workorganization. Hence, preventive strategies to reduce social inequalities in working conditions should consider the combination of actions at the macro and micro levels.

Long work hours and physical fitness: 30-year risk of ischaemic heart disease and all-cause mortality among middle-aged Caucasian men

Abstract: Background No previous long-term studies have examined if workers with low physical fitness have an increased risk of cardiovascular mortality due to long work hours. The aim of this study was to test this hypothesis. Methods The study comprised 30-year follow-up of a cohort of 5249 gainfully employed men aged 40–59 years in the Copenhagen Male Study. 274 men with cardiovascular disease were excluded from the follow-up. Physical fitness (maximal oxygen consumption, Vo 2 max) was estimated using the Astrand bicycle ergometer test, and number of work hours was obtained from questionnaire items; 4943 men were eligible for the incidence study. Results 587 men (11.9%) died because of ischaemic heart disease (IHD). Cox analyses adjusted for age, blood pressure, smoking, alcohol, body mass index, diabetes, hypertension, physical work demands, and social class, showed that working more than 45 h/week was associated with an increased risk of IHD mortality in the least fit (Vo 2 max range 15–26; HR 2.28, 95% CI 1.10 to 4.73), but not intermediate (Vo 2 max range 27–38; HR 0.94, 95% CI 0.59 to 1.51) and most fit men (Vo 2 max range 39–78; HR 0.91, 95% CI 0.41 to 2.02) referencing men working less than 40 h/week. Conclusions The findings indicate that men with low physical fitness are at increased risk for IHD mortality from working long hours. Men working long hours should be physically fit.

Fitness, work, and leisure-time physical activity and ischaemic heart disease and all-cause mortality among men with pre-existing cardiovascular disease.

Abstract: Objective Our aim was to study the relative impact of physical fitness, physical demands at work, and physical activity during leisure time on ischaemic heart disease (IHD) and all-cause mortality among employed men with pre-existing cardiovascular disease (CVD). Method We carried out a 30-year follow-up of the Copenhagen Male Study of 274 gainfully employed men, aged 40–59 years who had a history of CVD (ie, myocardial infarction, angina pectoris, and intermittent claudication). We estimated physical fitness [maximal oxygen consumption (VO 2 Max)] using the Astrand cycling test and determined physical work demands and leisure-time physical activity using a self-reported questionnaire. Results Among 274 men with a history of CVD, 93 men died from IHD. Using male employees with a history of CVD and a low level of fitness as the reference group, our Cox analyses – adjusted for age, blood pressure, smoking, alcohol consumption, body mass index, diabetes, hypertension, physical work demands, leisure-time physical activity, and social class – showed a substantially reduced risk for IHD mortality among employees who were intermediately fit [VO 2 Max range 25–36; hazard ratio (HR) 0.54, 95% confidence interval (95% CI) CI 0.32–0.93] and highly fit (VO 2 Max range 37–50; HR 0.28, 95% CI 0.12–0.66). We found a positive, but statistically non-significant association between physical demands at work and all-cause mortality. Conclusion Among gainfully employed men with pre-existing CVD, a high physical fitness was associated with a substantially reduced risk for IHD and all-cause mortality.

Physical work demands, hypertension status, and risk of ischemic heart disease and all-cause mortality in the Copenhagen Male Study

Abstract: Objective Increased risk of ischemic heart disease (IHD) mortality from high physical work demands has been observed among men with low physical fitness and leisure time physical activity. We tested whether hypertensive men are at a particularly high risk of IHD mortality when exposed to high physical work demands. Method We carried out a 30-year follow-up of the Copenhagen Male Study of 5249 gainfully employed men aged 40–59 years. Of these, 274 men with a history of myocardial infarction or prevalent symptoms of angina pectoris or intermittent claudication were excluded from the follow-up. Men were classified as having hypertension when any of the following factors was present: (i) treatment for hypertension, (ii) a systolic blood pressure of >160 mm Hg, or (iii) a diastolic blood pressure of >90 mm Hg. Physical work demands were determined by two self-reported questions. Results Of the eligible study population, 587 men (11.9%) died due to IHD. Hypertensive men had more than a doubled risk of IHD mortality [hazard ratio (HR) 2.16, 95% confidence interval (95% CI) 1.80–2.59]. Cox analyses – adjusted for age, smoking, alcohol, body mass index, diabetes, physical fitness, leisure time physical activity, and social class – showed that high physical work demands were associated with an increased risk of IHD and all-cause mortality among normotensive men (N=4127, HR 1.36, 95% CI 0.96–1.92 and HR 1.24, 95% CI 1.06–1.44, respectively), but not among the hypertensive men (N=808, HR 1.07, 95% CI 0.63–1.81 and HR 1.07, 95% CI 0.80–1.42, respectively) using men with low physical work demands as the reference. Conclusion Compared to normotensive men, hypertensive men did not have a higher risk of IHD or all-cause mortality from high physical work demands.