Finn Tüchsen - Academia.edu (original) (raw)

Papers by Finn Tüchsen

Research paper thumbnail of Chronic lower respiratory diseases among demolition and cement workers: a population-based register study

BMJ open, Jan 11, 2013

To estimate standardised hospitalisation ratios (SHR) for chronic lower respiratory diseases amon... more To estimate standardised hospitalisation ratios (SHR) for chronic lower respiratory diseases among demolition and cement workers in Denmark, 1995-2009. This is a population-based register study on data from 'the Occupational Hospitalisation Register'. SHR of chronic obstructive pulmonary disease (COPD) was calculated for both demolition and cement workers. Register study with data from all hospitals in Denmark. 895 demolition workers and 5633 cement and concrete workers were included in the study and all economical active men were used as reference group. We found a statistically significant high SHR for the cement workers, SHR=134 (95% CI 117 to 153). The SHR for demolition workers was 131 (95% CI 87 to 188). We find a higher risk of being hospitalised due to COPD in cement and concrete workers (significant) and demolition workers (insignificant) compared to gainfully employed men.

Research paper thumbnail of Time trend in hospitalised chronic lower respiratory diseases among Danish building and construction workers, 1981-2009: a cohort study

BMJ open, 2012

To show trends in age-standardised hospital admission ratios (SHR) for chronic lower respiratory ... more To show trends in age-standardised hospital admission ratios (SHR) for chronic lower respiratory diseases, estimated for Danish construction workers over three time periods (1981-1990, 1991-2000, 2001-2009). Within consecutive cohorts of all male building and construction workers in Denmark, selected occupations: bricklayers, carpenters, electricians, painters, plumbers and 'other construction workers' were followed up for hospitalisation due to chronic lower respiratory diseases. SHR was calculated for each occupation and time period. Time trend was calculated for construction workers at large using Poisson regression. Denmark. All gainfully employed male building and construction workers aged 20 or more. Age-standardised and gender-standardised hospitalisation ratios (SHR). The number of hospitalised construction workers at large was reduced from 1134 in the first 10-year period to 699 in the last 9-year period. Among all Danish males, it was, however, even more reduced as...

Research paper thumbnail of Mortality and morbidity among bridge and tunnel construction workers who worked long hours and long days constructing the Great Belt Fixed Link

Scandinavian journal of work, environment & health, 2005

This study aimed at estimating the mortality and morbidity of hospital treatment among bridge and... more This study aimed at estimating the mortality and morbidity of hospital treatment among bridge and tunnel workers who worked round the clock, long hours, and long weeks to construct the Great Belt Fixed Link. A cohort of all Danish workers in the construction industry was followed for death and first hospitalization and outpatient or emergency ward treatment over 6 years. Standardized mortality and morbidity ratios (SMR) were calculated for selected diagnoses, and 5123 bridge and tunnel construction workers were compared with all 109 383 Danish construction workers. The comparison showed an overall SMR of 124 with a 95% confidence interval (95% CI) of 97-155. For infectious diseases and intestinal infectious diseases, the corresponding values were 156 (95% CI 132-184) and 167 (95% CI 117-230), respectively. For diseases of the nervous system, it was 138 (95% CI 118-160), and including nerve, nerve root and plexus disorders it was 135 (95% CI 104-171), for instance, mononeuropathies o...

Research paper thumbnail of Referral bias in hospital register studies of geographical and industrial differences in health

Danish medical bulletin, 2004

The Danish National Hospital Register contains four patient types: full-time inpatients, part-tim... more The Danish National Hospital Register contains four patient types: full-time inpatients, part-time inpatients, outpatients and emergency ward patients. The aim of the present study was to investigate whether results from comparative hospital register studies depend on which patient types we choose to include in the analysis. The hospital register was linked to the centralised civil register and the employment classification module. All economically active persons in Denmark aged 20-59 years 1st January 1995 (N = 2,281,480) were followed for six years. We calculated SIRs, first by county then by industry and finally by industry adjusted for county, for a variety of diagnostic groups and for each of the following types of cases: A) full-time inpatients, B) all inpatients, C) all inpatients and outpatients, D) all patients. The ratio between the maximum and the minimum of the four types of SIRs was calculated for each combination of the examined population groups and diseases. A max/mi...

Research paper thumbnail of Hospitalization for lifestyle related diseases in long haul drivers compared with other truck drivers and the working population at large

Work (Reading, Mass.), 2009

Personal lifestyle and working conditions are closely linked for long haul truck drivers. We comp... more Personal lifestyle and working conditions are closely linked for long haul truck drivers. We compare lifestyle related diseases in long haul drivers with other drivers of goods and the working population at large. Standardized hospital treatment ratios (SHR) for lifestyle related diseases were compared for long haul truck drivers and other truck drivers to the working population at large. The follow up group comprised of 2,175 long haul drivers and 15,060 other truck drivers. An increased risk was found for lifestyle related diseases among truck drivers except for alcohol related diseases. We identified a strong association between hospital treatment for obesity and working as a driver and an association between diabetes and working as a driver. No major differences in lifestyle related diseases were found in long haul drivers compared to other truck drivers with the exception of a significant lower risk for alcohol-related diseases and a possibly higher risk for lung cancer in long...

Research paper thumbnail of Differences between day and nonday workers in exposure to physical and psychosocial work factors in the Danish eldercare sector

Scandinavian Journal of Work, Environment & Health, 2009

Objective The possible interaction between individual and occupational risk factors, the need for... more Objective The possible interaction between individual and occupational risk factors, the need for meaningful intervention, and the demand for valid shift work research make the accumulation of adverse exposures at certain times of the day of special relevance with respect to occupational health. The aim of the present study was therefore to examine whether there was a clustering of detrimental work factors among female eldercare workers in fixed evening or fixed night shifts when they are compared with workers in fixed day shifts. Methods This cross-sectional, questionnaire-based study was conducted among 4590 female health care workers in the Danish eldercare sector. The participants worked in nursing homes, in home care, or in both. They answered questions on job demands, job control, and social support, together with questions on physical and psychological violence, physical workload, and passive smoking. Results We found that-compared with day workers-fixed nonday workers were more exposed to low job control, low support from leaders, physical and psychological violence, and high physical demands. Nonday workers were, however, less exposed to high demands. These differences remained after control for age, job title, and workplace. Conclusions Exposures in the work environment of Danish eldercare workers varied between shifts. In a research perspective these findings stress the importance of adequate adjustment for work factors when the health effects of shift work are studied. Moreover, the results underscore the need for an increased awareness of work factors of special importance among nonday workers when interventions against shiftwork-related occupational disorders are designed.

Research paper thumbnail of Does evening work predict sickness absence among female carers of the elderly?

Scandinavian Journal of Work, Environment & Health, 2008

Objectives The aim of the present study was to predict the risk ratio of sickness absence lasting... more Objectives The aim of the present study was to predict the risk ratio of sickness absence lasting ≥2 weeks due to shift work among Danish workers caring for the elderly during the evening and at night. Methods A sample of Danish carers of the elderly were interviewed in 2005. The response rate was 78%. A cohort of 5627 shift and day workers was followed for sickness absence lasting ≥2 weeks and for sickness absence lasting ≥8 weeks in a sickness compensation register covering all social transfer payments in Denmark. Results Among the evening workers, the rate ratio (RR) of sickness absence lasting ≥2 weeks was 1.29 (95% confidence interval (95% CI) 1.10-1.52). The rate ratio for sickness absence lasting ≥8 weeks was 1.24 (95% CI 0.99-1.56). Conclusions Evening work may cause long-term sickness absence lasting ≥2 weeks.

Research paper thumbnail of Incidence of lung cancer among cobalt-exposed women

Scandinavian Journal of Work, Environment & Health, 1996

Objectives The purpose of this study was to estimate the risk of lung cancer for women occupation... more Objectives The purpose of this study was to estimate the risk of lung cancer for women occupationally exposed to cobalt-aluminate spinel. Methods A retrospective cohort of 874 women occupationally exposed to cobalt in two Danish porcelain factories and 520 woinen not exposed to cobalt were identified from personnel files. Vital status was assessed in the national population register, and incident cancer cases were traced in the national cancer register. Thirteen women (0.92%) were lost to follow-up. The observed deaths and incident cancer cases were cornpared with the expected number based on rates for all Danish women. Results The total mortality of the cohort was the same as for all Danish women. The incidence of all cancer was slightly elevated among the exposed women (67 observed, 55.8 expected) and equal to the expected in the reference group (60 observed, 60.6 expected). An increased lung cancer incidence was found both in the exposed group [8 cases, standardized incidence rate (SIR) 2.35, 95% confidence interval (95% CI) 1.014.61 and in the reference group (7 cases, SIR 1.99,95% CI 0. 8 4. 1). The exposed group had a relative risk ratio of 1.2 (95% CI 0.4-3.8) when compared with the reference group. C O~C~U S~O~S Both the cobalt-exposed group and the reference group had an increased lung cancer risk compared with all Danish women, but the risk was only slightly higher for the exposed group than for the reference group. The study was based on few persons, and we recommend a follow-up after five years.

Research paper thumbnail of Work-relatedness of mood disorders in Denmark

Scandinavian Journal of Work, Environment & Health, 2009

Objective To determine the work-relatedness of mood disorders. Methods From 2001-2005, we followe... more Objective To determine the work-relatedness of mood disorders. Methods From 2001-2005, we followed up all economically active people in Denmark, aged 20-59 years as of January 2001, for hospital contact due to mood disorders. We calculated gender-stratified standardized incidence ratios (SIR) by industry. Using the distribution of the SIR values as input, we used a Monte Carlo simulation to estimate what proportion of the mood disorder cases could be regarded as work-related and denoted them as excess fractions. Results In total, we observed 10 731 cases of mood disorder among the women and 8305 among the men. There were four industries among women and 13 among men that showed elevated SIR with confidence intervals not including unity. The excess fractions without social group adjustment were 0.248 [95% confidence interval (95% CI) 0.173-0.325] for the women and 0.363 (95% CI 0.294-0.433) for the men. The respective fractions with adjustment for social group were 0.233 (95% CI 0.162-0.303) and 0.361 (95% CI 0.293-0.430). Conclusion A substantial proportion of mood disorders among working people can be regarded as work-related. Hence, the workplace is an interesting arena for primary interventions.

Research paper thumbnail of Cardiovascular risk factors and primary selection into shift work

Scandinavian Journal of Work, Environment & Health, 2008

This study examined differences between future shift workers and future day workers as regards ca... more This study examined differences between future shift workers and future day workers as regards cardiovascular risk factors before they began different work schedules and the differences that remained after control for sociodemographic factors and general self-efficacy. Altogether 2870 newly educated social and health care workers filled out a questionnaire a few weeks before finishing their formal training and again 1 year after graduation. They answered questions on diabetes, hypertension, lifestyle habits, sociodemographic factors, and general self-efficacy. In the unadjusted analyses, baseline obesity was associated with fixed evening work at follow-up. Minimal or light-to-moderate leisure-time physical activity was associated with a decrease in the odds ratio (OR) for two or three shifts including night work. Smoking status was associated with fixed evening work, fixed night work, and two- or three- shift work including night work. After adjustment for sociodemographic factors and general self-efficacy, smoking was prospectively associated with fixed evening work [OR 1.56, 95% confidence interval (95% CI) 1.21-2.02] and fixed night work (OR 1.64, 95% CI 1.04-2.56). Being an ex-smoker was associated with two- or three-shift work including night work (OR 1.85, 95% CI 1.28-2.68). The association between two- and three-shift work and smoking was only of borderline significance (OR 1.37, 95% CI 1.00-1.87). Compared with future day workers, fixed evening or fixed night workers already smoked more before they began shift work. Being an ex-smoker was significantly associated with two- or three-shift work including night work. These results indicate that smoking status should not solely be treated as a mediator between some variants of shiftwork schedules and cardiovascular diseases but should also be considered a confounder.

Research paper thumbnail of Risk factors predicting hip pain in a 5-year prospective cohort study

Scandinavian Journal of Work, Environment & Health, 2003

Objectives The aim of the study was to identify and quantify risk factors for hip pain. Methods A... more Objectives The aim of the study was to identify and quantify risk factors for hip pain. Methods A representative sample of 5001 Danish men and women aged 18-65 years in 1990 were interviewed about occupational exposures (response rate 90%); 5 years later they were reinterviewed about hip pain (response rate 86%). Logistic regression with forced entry of all the independent variables was used to estimate the odds ratios for the possible risk factors. The impact of the various predictors was assessed through the calculation of population etiologic fractions. Results A double risk of hip pain was found for the women as compared with the men [odds ratio (OR) 2.28, 95% confidence interval (95% CI) 1.68-3.09]. The risk increased with body mass index. Whole-body vibration (OR 1.86, 95% CI 1.09-2.71) and physically demanding work (OR 1.83, 95% CI 1.23-2.71) were strong predictors of hip pain, while a squatting work posture was protective (OR 0.64, 95% CI 0.42-0.98). The impact of the statistically significant predictors (the etiologic fractions) was as follows: 0.49 for body mass index, 0.05 for whole body vibration, 0.10 for physically demanding work, and 0.32 for squatting (preventive). Conclusions Female gender, age, high body mass index, whole-body vibration, and physically demanding work are significant risk factors for hip pain.

Research paper thumbnail of Trends in the Danish work environment in 1990-2000 and their associations with labor-force changes

Scandinavian Journal of Work, Environment & Health, 2003

Objectives The aims of this study were (i) to describe the trends in the work environment in 1990... more Objectives The aims of this study were (i) to describe the trends in the work environment in 1990-2000 among employees in Denmark and (ii) to establish whether these trends were attributable to labor-force changes. Methods The split-panel design of the Danish Work Environment Cohort Study includes interviews with three cross-sections of 6067, 5454, and 5404 employees aged 18-59 years, each representative of the total Danish labor force in 1990, 1995 and 2000. In the cross-sections, the participation rate decreased over the period (90% in 1990, 80% in 1995, 76% in 2000). The relative differences in participation due to gender, age, and region did not change noticeably. Results Jobs with decreasing prevalence were clerks, cleaners, textile workers, and military personnel. Jobs with increasing prevalence were academics, computer professionals, and managers. Intense computer use, long workhours, and noise exposure increased. Job insecurity, part-time work, kneeling work posture, low job control, and skin contact with cleaning agents decreased. Labor-force changes fully explained the decline in low job control and skin contact to cleaning agents and half of the increase in long workhours, but not the other work environment changes. Conclusions The work environment of Danish employees improved from 1990 to 2000, except for increases in long workhours and noise exposure. From a specific work environment intervention point of view, the development has been less encouraging because declines in low job control, as well as skin contact to cleaning agents, were explained by labor-force changes.

Research paper thumbnail of Work environment of Danish shift and day workers

Scandinavian Journal of Work, Environment & Health, 2001

Objectives Both shift work and other work environment factors have been shown to be related to he... more Objectives Both shift work and other work environment factors have been shown to be related to heart disease. This study examined whether shift work is associated with other work environment factors related to heart disease in a random sample of the population. If so, shift work could be acting as a proxy for work environment differences. Methods Data on 5940 employees in the Danish Work Environment Cohort Study from 1990 were reanalyzed. The information included work schedules [permanent day work, irregular workhours (including morning work), 2-shift or fixed evening and 3-shift or fixed night], length of workweek, physical factors (noise, heat, dust, passive smoking, walking, standing and monotonous repetitive tasks), and psychosocial factors (including demands and control dimensions, social support, conflicts and job insecurity). Results At least 1 group of shift workers had a higher prevalence of nearly every unfavorable work environment factor investigated. Exceptions were dust exposure and quantitative demands. Especially conflicts at work and low decision latitude were higher among all the groups of shift workers, and all-day walking or standing work and part-time jobs were more often found among female shift workers. The 3 different shiftwork groups were exposed to different parts of the work environment, and also men and women in shift work differed in relation to the work environment. Age and social class influenced the relationship, but not in any particular pattern. Conclusions In a heterogenous population shift work was found to be associated with other work environment factors suspected to cause heart disease.

Research paper thumbnail of Standing at work and varicose veins

Scandinavian Journal of Work, Environment & Health, 2000

Objectives This study attempts to determine whether or not prolonged standing at work involves an... more Objectives This study attempts to determine whether or not prolonged standing at work involves an excess risk for the occurrence of varicose veins. Methods A cohort of 1.6 million 20-to-59-year-old Danes gainfully employed in 1991 were followed for 3 years according to first hospitalization due to varicose veins of the lower extremities. The exposure data came from a representative sample of the baseline population. Altogether 5940 people were interviewed about occupational exposure and confounding factors. Results For men working mostly in a standing position, the risk ratio for varicose veins was 1.85 [95% confidence interval (95% CI) 1.33-2.361 in a comparison with all other men. The corresponding risk ratio for women was 2.63 (95% CI 2.25-3.02). The results were adjusted for age, social group, and smoking. C O~C~U S~O~S Working in a standing position is associated with subsequent hospitalization due to varicose veins for both men and women.

Research paper thumbnail of Agricultural work and the risk of Parkinson's disease in Denmark, 1981-1993

Scandinavian Journal of Work, Environment & Health, 2000

Objectives This study examined the possible association between agricultural and horticultural wo... more Objectives This study examined the possible association between agricultural and horticultural work and the subsequent morbidity of Parkinson's disease. Methods Fixed cohorts of 2 273 872 men and women aged 20-59 years on 1 January 1981 and identified in the Central Population Register of Denmark were followed, and all first-time hospitalizations with Parkinson's disease as the prinEipa1 diagnosis during the 13 years until 3 1 December 1993 were recorded. Standardized hospitalization ratios (SHR) were calculated using all gainfully employed persons as the standard and by multiplying the ratio by 100. Ninety-five percent confidence intervals (95% CI) were calculated on the assumption of a Poisson distribution. Results A high risk of Parkinson's disease was found for the men and women in agriculture and horticulture (134 cases, SHR 132, 95% CI 11 1-156). Statistically significantly high risks were found for farmers (79 cases, SHR 130,95% CI 103-163) and for all men in agriculture and horticulture (109 cases, SHR 134,95% CI 109-162). Conclusions A consistent pattern of high Parkinson's disease morbidity was found among occupational groups employed in agriculture and horticulture.

Research paper thumbnail of Hospital contacts for chronic diseases among Danish seafarers and fishermen: A population-based cohort study

Scandinavian Journal of Public Health, 2007

Objectives: Seafarers' and fishermen's working conditions may impact on their lifestyle a... more Objectives: Seafarers' and fishermen's working conditions may impact on their lifestyle and health. Standardized hospital contact ratios (SHCRs) were compared in two time periods and the relative risks of hospital contact as a function of employment time were estimated. Methods: Cohorts of all Danish seafarers (officers and non-officers) registered by the Danish Maritime Authority (DMA) 1989—98 and fishermen retrieved from a pension registry 1989—98 were linked to the nationwide Occupational Hospitalization Registry (OHR) and followed up for incident diseases in two five-year time periods, from 1 January 1994 and 1 January 1999, respectively, using rates specific for age and calendar time for the entire Danish workforce as a reference. Results: The SHCRs for lung and cardiovascular diseases were high for non-officers. Among male officers, the SHCR for diabetes was high in the 1999 cohort and the SHCR for chronic heart diseases was statistically significantly higher in the 19...

Research paper thumbnail of A nationwide population study of severe head injury and Parkinson's disease

Parkinsonism & Related Disorders, 2009

The aim was to analyze prospectively the association between severe head injury and Parkinson's d... more The aim was to analyze prospectively the association between severe head injury and Parkinson's disease. All people in Denmark who were at least 20 years old as on 1 January 1981 were followed for hospitalisation due to previous head trauma during 1981e1993 and for hospital contacts due to PD during 1995e2004. We observed 107 cases of PD among people at hypothetical risk due to previous head injury. The expected number was 112.1, which yielded a standardised morbidity ratio of 0.954 (95% CI: 0.782e1.15). The study provides no support for severe head injury among adults being a risk factor for Parkinson's disease.

Research paper thumbnail of A 15-year prospective study of shift work and disability pension

Occupational and Environmental Medicine, 2008

Objective: To estimate the hazard ratio for disability pension associated with shift work. Method... more Objective: To estimate the hazard ratio for disability pension associated with shift work. Methods: Cohorts of shift and day workers were identified in three waves of the Danish Work Environment Cohort Study and followed up for incidence of disability pension in a national register of social transfer payment. A total of 3980 female and 4025 male employees were included in the cohorts. Information about shift work status, age, smoking habits, body mass index and ergonomic work environment were updated according to responses in subsequent waves of the survey when possible. Respondents reporting shift work were classified as shift workers in the following waves as well. Respondents were followed in the register from the time of first interview and were censored at the time of their 60th birthday, emigration, death or end of follow-up (18 June 2006). The authors used the Cox proportional hazards model to estimate hazard ratios for incidence of disability pension and 95% confidence intervals. Results: The authors observed 253 new disability pensions among women and 173 among men during 56 903 and 57 886 person-years at risk respectively, Among women, shift work predicted disability after adjustment for age, general health and socioeconomic status HR 1.39 (95% CI 1.07 to 1.82). After further adjustment for body mass index, smoking habits, socioeconomic status and ergonomic exposures the association remained statistically significant HR 1.34 (95% CI 1.02 to 1.75). Shift work was not associated with disability among men. Conclusion: Shift work might be moderately associated with disability pension among women; however, more powerful studies are needed to establish the possible association.

Research paper thumbnail of Hospital contacts for noise-related hearing loss among Danish seafarers and fishermen: A population-based cohort study

Noise and Health, 2008

Aims: Noise-induced hearing loss (NIHL) is a leading occupational disease and some seafarers and ... more Aims: Noise-induced hearing loss (NIHL) is a leading occupational disease and some seafarers and fi shermen may be at high risk. We present here standardized hospital contact ratios (SHCRs) for hearing loss among Danish seafarers and fi shermen. Materials and Methods: Cohorts of all Danish seafarers registered by the Danish Maritime Authority (DMA) and fi shermen retrieved from a 1989-1998 pension registry were linked to the nationwide Occupational Hospitalisation Registry (OHR) with follow-up for NIHL from 1994 to 2003, using rates specifi c for age and calendar time for the entire Danish workforce as a reference. Results: We found high SHCRs for NIHL: 165 [95% confi dence interval (CI) 131-206] among offi cers, 113 (79-157) for nonoffi cers and 119 (85-162) for fi shermen. The increased SHCR for hearing impairment among seafarers was solely found in engine room personnel (SHCR = 222; 95% CI 178-277). Compared to other seafarers, the engine room personnel had a relative risk ratio of 2.39 (95% CI: 1.74-3.26). Short-term employment is common in many trades. No duration response pattern was observed which may suggest a secondary healthy worker effect. Conclusions: These fi ndings indicate that hearing problems are frequent among men who work in the engine rooms on ships. Long-term cumulative effects of employment were not shown.

Research paper thumbnail of Work injuries and disability

Journal of Safety Research, 2009

This study estimated the hazard ratio for disability pension retirement (DPR) for persons who hav... more This study estimated the hazard ratio for disability pension retirement (DPR) for persons who have experienced a work injury causing absence lasting at least one day after the accidental injury occurred and to estimate the fraction of DPR attributable to work injuries. Methods: A total of 4,217 male and 4,105 female employees from a national survey were followed up for subsequent DPR. Results and impact on industry and government: Having had a work injury was a strong predictor of DPR among men. After control for age, smoking, body mass index, body postures, and physical demands, the hazard ratio (HR) among those employees who had ever experienced a work injury was 1.80 (95% confidence interval (CI): 1.20-2.68). No association was found among women. Summary: Having had a reportable work injury is a strong predictor of subsequent DPR for men.

Research paper thumbnail of Chronic lower respiratory diseases among demolition and cement workers: a population-based register study

BMJ open, Jan 11, 2013

To estimate standardised hospitalisation ratios (SHR) for chronic lower respiratory diseases amon... more To estimate standardised hospitalisation ratios (SHR) for chronic lower respiratory diseases among demolition and cement workers in Denmark, 1995-2009. This is a population-based register study on data from 'the Occupational Hospitalisation Register'. SHR of chronic obstructive pulmonary disease (COPD) was calculated for both demolition and cement workers. Register study with data from all hospitals in Denmark. 895 demolition workers and 5633 cement and concrete workers were included in the study and all economical active men were used as reference group. We found a statistically significant high SHR for the cement workers, SHR=134 (95% CI 117 to 153). The SHR for demolition workers was 131 (95% CI 87 to 188). We find a higher risk of being hospitalised due to COPD in cement and concrete workers (significant) and demolition workers (insignificant) compared to gainfully employed men.

Research paper thumbnail of Time trend in hospitalised chronic lower respiratory diseases among Danish building and construction workers, 1981-2009: a cohort study

BMJ open, 2012

To show trends in age-standardised hospital admission ratios (SHR) for chronic lower respiratory ... more To show trends in age-standardised hospital admission ratios (SHR) for chronic lower respiratory diseases, estimated for Danish construction workers over three time periods (1981-1990, 1991-2000, 2001-2009). Within consecutive cohorts of all male building and construction workers in Denmark, selected occupations: bricklayers, carpenters, electricians, painters, plumbers and 'other construction workers' were followed up for hospitalisation due to chronic lower respiratory diseases. SHR was calculated for each occupation and time period. Time trend was calculated for construction workers at large using Poisson regression. Denmark. All gainfully employed male building and construction workers aged 20 or more. Age-standardised and gender-standardised hospitalisation ratios (SHR). The number of hospitalised construction workers at large was reduced from 1134 in the first 10-year period to 699 in the last 9-year period. Among all Danish males, it was, however, even more reduced as...

Research paper thumbnail of Mortality and morbidity among bridge and tunnel construction workers who worked long hours and long days constructing the Great Belt Fixed Link

Scandinavian journal of work, environment & health, 2005

This study aimed at estimating the mortality and morbidity of hospital treatment among bridge and... more This study aimed at estimating the mortality and morbidity of hospital treatment among bridge and tunnel workers who worked round the clock, long hours, and long weeks to construct the Great Belt Fixed Link. A cohort of all Danish workers in the construction industry was followed for death and first hospitalization and outpatient or emergency ward treatment over 6 years. Standardized mortality and morbidity ratios (SMR) were calculated for selected diagnoses, and 5123 bridge and tunnel construction workers were compared with all 109 383 Danish construction workers. The comparison showed an overall SMR of 124 with a 95% confidence interval (95% CI) of 97-155. For infectious diseases and intestinal infectious diseases, the corresponding values were 156 (95% CI 132-184) and 167 (95% CI 117-230), respectively. For diseases of the nervous system, it was 138 (95% CI 118-160), and including nerve, nerve root and plexus disorders it was 135 (95% CI 104-171), for instance, mononeuropathies o...

Research paper thumbnail of Referral bias in hospital register studies of geographical and industrial differences in health

Danish medical bulletin, 2004

The Danish National Hospital Register contains four patient types: full-time inpatients, part-tim... more The Danish National Hospital Register contains four patient types: full-time inpatients, part-time inpatients, outpatients and emergency ward patients. The aim of the present study was to investigate whether results from comparative hospital register studies depend on which patient types we choose to include in the analysis. The hospital register was linked to the centralised civil register and the employment classification module. All economically active persons in Denmark aged 20-59 years 1st January 1995 (N = 2,281,480) were followed for six years. We calculated SIRs, first by county then by industry and finally by industry adjusted for county, for a variety of diagnostic groups and for each of the following types of cases: A) full-time inpatients, B) all inpatients, C) all inpatients and outpatients, D) all patients. The ratio between the maximum and the minimum of the four types of SIRs was calculated for each combination of the examined population groups and diseases. A max/mi...

Research paper thumbnail of Hospitalization for lifestyle related diseases in long haul drivers compared with other truck drivers and the working population at large

Work (Reading, Mass.), 2009

Personal lifestyle and working conditions are closely linked for long haul truck drivers. We comp... more Personal lifestyle and working conditions are closely linked for long haul truck drivers. We compare lifestyle related diseases in long haul drivers with other drivers of goods and the working population at large. Standardized hospital treatment ratios (SHR) for lifestyle related diseases were compared for long haul truck drivers and other truck drivers to the working population at large. The follow up group comprised of 2,175 long haul drivers and 15,060 other truck drivers. An increased risk was found for lifestyle related diseases among truck drivers except for alcohol related diseases. We identified a strong association between hospital treatment for obesity and working as a driver and an association between diabetes and working as a driver. No major differences in lifestyle related diseases were found in long haul drivers compared to other truck drivers with the exception of a significant lower risk for alcohol-related diseases and a possibly higher risk for lung cancer in long...

Research paper thumbnail of Differences between day and nonday workers in exposure to physical and psychosocial work factors in the Danish eldercare sector

Scandinavian Journal of Work, Environment & Health, 2009

Objective The possible interaction between individual and occupational risk factors, the need for... more Objective The possible interaction between individual and occupational risk factors, the need for meaningful intervention, and the demand for valid shift work research make the accumulation of adverse exposures at certain times of the day of special relevance with respect to occupational health. The aim of the present study was therefore to examine whether there was a clustering of detrimental work factors among female eldercare workers in fixed evening or fixed night shifts when they are compared with workers in fixed day shifts. Methods This cross-sectional, questionnaire-based study was conducted among 4590 female health care workers in the Danish eldercare sector. The participants worked in nursing homes, in home care, or in both. They answered questions on job demands, job control, and social support, together with questions on physical and psychological violence, physical workload, and passive smoking. Results We found that-compared with day workers-fixed nonday workers were more exposed to low job control, low support from leaders, physical and psychological violence, and high physical demands. Nonday workers were, however, less exposed to high demands. These differences remained after control for age, job title, and workplace. Conclusions Exposures in the work environment of Danish eldercare workers varied between shifts. In a research perspective these findings stress the importance of adequate adjustment for work factors when the health effects of shift work are studied. Moreover, the results underscore the need for an increased awareness of work factors of special importance among nonday workers when interventions against shiftwork-related occupational disorders are designed.

Research paper thumbnail of Does evening work predict sickness absence among female carers of the elderly?

Scandinavian Journal of Work, Environment & Health, 2008

Objectives The aim of the present study was to predict the risk ratio of sickness absence lasting... more Objectives The aim of the present study was to predict the risk ratio of sickness absence lasting ≥2 weeks due to shift work among Danish workers caring for the elderly during the evening and at night. Methods A sample of Danish carers of the elderly were interviewed in 2005. The response rate was 78%. A cohort of 5627 shift and day workers was followed for sickness absence lasting ≥2 weeks and for sickness absence lasting ≥8 weeks in a sickness compensation register covering all social transfer payments in Denmark. Results Among the evening workers, the rate ratio (RR) of sickness absence lasting ≥2 weeks was 1.29 (95% confidence interval (95% CI) 1.10-1.52). The rate ratio for sickness absence lasting ≥8 weeks was 1.24 (95% CI 0.99-1.56). Conclusions Evening work may cause long-term sickness absence lasting ≥2 weeks.

Research paper thumbnail of Incidence of lung cancer among cobalt-exposed women

Scandinavian Journal of Work, Environment & Health, 1996

Objectives The purpose of this study was to estimate the risk of lung cancer for women occupation... more Objectives The purpose of this study was to estimate the risk of lung cancer for women occupationally exposed to cobalt-aluminate spinel. Methods A retrospective cohort of 874 women occupationally exposed to cobalt in two Danish porcelain factories and 520 woinen not exposed to cobalt were identified from personnel files. Vital status was assessed in the national population register, and incident cancer cases were traced in the national cancer register. Thirteen women (0.92%) were lost to follow-up. The observed deaths and incident cancer cases were cornpared with the expected number based on rates for all Danish women. Results The total mortality of the cohort was the same as for all Danish women. The incidence of all cancer was slightly elevated among the exposed women (67 observed, 55.8 expected) and equal to the expected in the reference group (60 observed, 60.6 expected). An increased lung cancer incidence was found both in the exposed group [8 cases, standardized incidence rate (SIR) 2.35, 95% confidence interval (95% CI) 1.014.61 and in the reference group (7 cases, SIR 1.99,95% CI 0. 8 4. 1). The exposed group had a relative risk ratio of 1.2 (95% CI 0.4-3.8) when compared with the reference group. C O~C~U S~O~S Both the cobalt-exposed group and the reference group had an increased lung cancer risk compared with all Danish women, but the risk was only slightly higher for the exposed group than for the reference group. The study was based on few persons, and we recommend a follow-up after five years.

Research paper thumbnail of Work-relatedness of mood disorders in Denmark

Scandinavian Journal of Work, Environment & Health, 2009

Objective To determine the work-relatedness of mood disorders. Methods From 2001-2005, we followe... more Objective To determine the work-relatedness of mood disorders. Methods From 2001-2005, we followed up all economically active people in Denmark, aged 20-59 years as of January 2001, for hospital contact due to mood disorders. We calculated gender-stratified standardized incidence ratios (SIR) by industry. Using the distribution of the SIR values as input, we used a Monte Carlo simulation to estimate what proportion of the mood disorder cases could be regarded as work-related and denoted them as excess fractions. Results In total, we observed 10 731 cases of mood disorder among the women and 8305 among the men. There were four industries among women and 13 among men that showed elevated SIR with confidence intervals not including unity. The excess fractions without social group adjustment were 0.248 [95% confidence interval (95% CI) 0.173-0.325] for the women and 0.363 (95% CI 0.294-0.433) for the men. The respective fractions with adjustment for social group were 0.233 (95% CI 0.162-0.303) and 0.361 (95% CI 0.293-0.430). Conclusion A substantial proportion of mood disorders among working people can be regarded as work-related. Hence, the workplace is an interesting arena for primary interventions.

Research paper thumbnail of Cardiovascular risk factors and primary selection into shift work

Scandinavian Journal of Work, Environment & Health, 2008

This study examined differences between future shift workers and future day workers as regards ca... more This study examined differences between future shift workers and future day workers as regards cardiovascular risk factors before they began different work schedules and the differences that remained after control for sociodemographic factors and general self-efficacy. Altogether 2870 newly educated social and health care workers filled out a questionnaire a few weeks before finishing their formal training and again 1 year after graduation. They answered questions on diabetes, hypertension, lifestyle habits, sociodemographic factors, and general self-efficacy. In the unadjusted analyses, baseline obesity was associated with fixed evening work at follow-up. Minimal or light-to-moderate leisure-time physical activity was associated with a decrease in the odds ratio (OR) for two or three shifts including night work. Smoking status was associated with fixed evening work, fixed night work, and two- or three- shift work including night work. After adjustment for sociodemographic factors and general self-efficacy, smoking was prospectively associated with fixed evening work [OR 1.56, 95% confidence interval (95% CI) 1.21-2.02] and fixed night work (OR 1.64, 95% CI 1.04-2.56). Being an ex-smoker was associated with two- or three-shift work including night work (OR 1.85, 95% CI 1.28-2.68). The association between two- and three-shift work and smoking was only of borderline significance (OR 1.37, 95% CI 1.00-1.87). Compared with future day workers, fixed evening or fixed night workers already smoked more before they began shift work. Being an ex-smoker was significantly associated with two- or three-shift work including night work. These results indicate that smoking status should not solely be treated as a mediator between some variants of shiftwork schedules and cardiovascular diseases but should also be considered a confounder.

Research paper thumbnail of Risk factors predicting hip pain in a 5-year prospective cohort study

Scandinavian Journal of Work, Environment & Health, 2003

Objectives The aim of the study was to identify and quantify risk factors for hip pain. Methods A... more Objectives The aim of the study was to identify and quantify risk factors for hip pain. Methods A representative sample of 5001 Danish men and women aged 18-65 years in 1990 were interviewed about occupational exposures (response rate 90%); 5 years later they were reinterviewed about hip pain (response rate 86%). Logistic regression with forced entry of all the independent variables was used to estimate the odds ratios for the possible risk factors. The impact of the various predictors was assessed through the calculation of population etiologic fractions. Results A double risk of hip pain was found for the women as compared with the men [odds ratio (OR) 2.28, 95% confidence interval (95% CI) 1.68-3.09]. The risk increased with body mass index. Whole-body vibration (OR 1.86, 95% CI 1.09-2.71) and physically demanding work (OR 1.83, 95% CI 1.23-2.71) were strong predictors of hip pain, while a squatting work posture was protective (OR 0.64, 95% CI 0.42-0.98). The impact of the statistically significant predictors (the etiologic fractions) was as follows: 0.49 for body mass index, 0.05 for whole body vibration, 0.10 for physically demanding work, and 0.32 for squatting (preventive). Conclusions Female gender, age, high body mass index, whole-body vibration, and physically demanding work are significant risk factors for hip pain.

Research paper thumbnail of Trends in the Danish work environment in 1990-2000 and their associations with labor-force changes

Scandinavian Journal of Work, Environment & Health, 2003

Objectives The aims of this study were (i) to describe the trends in the work environment in 1990... more Objectives The aims of this study were (i) to describe the trends in the work environment in 1990-2000 among employees in Denmark and (ii) to establish whether these trends were attributable to labor-force changes. Methods The split-panel design of the Danish Work Environment Cohort Study includes interviews with three cross-sections of 6067, 5454, and 5404 employees aged 18-59 years, each representative of the total Danish labor force in 1990, 1995 and 2000. In the cross-sections, the participation rate decreased over the period (90% in 1990, 80% in 1995, 76% in 2000). The relative differences in participation due to gender, age, and region did not change noticeably. Results Jobs with decreasing prevalence were clerks, cleaners, textile workers, and military personnel. Jobs with increasing prevalence were academics, computer professionals, and managers. Intense computer use, long workhours, and noise exposure increased. Job insecurity, part-time work, kneeling work posture, low job control, and skin contact with cleaning agents decreased. Labor-force changes fully explained the decline in low job control and skin contact to cleaning agents and half of the increase in long workhours, but not the other work environment changes. Conclusions The work environment of Danish employees improved from 1990 to 2000, except for increases in long workhours and noise exposure. From a specific work environment intervention point of view, the development has been less encouraging because declines in low job control, as well as skin contact to cleaning agents, were explained by labor-force changes.

Research paper thumbnail of Work environment of Danish shift and day workers

Scandinavian Journal of Work, Environment & Health, 2001

Objectives Both shift work and other work environment factors have been shown to be related to he... more Objectives Both shift work and other work environment factors have been shown to be related to heart disease. This study examined whether shift work is associated with other work environment factors related to heart disease in a random sample of the population. If so, shift work could be acting as a proxy for work environment differences. Methods Data on 5940 employees in the Danish Work Environment Cohort Study from 1990 were reanalyzed. The information included work schedules [permanent day work, irregular workhours (including morning work), 2-shift or fixed evening and 3-shift or fixed night], length of workweek, physical factors (noise, heat, dust, passive smoking, walking, standing and monotonous repetitive tasks), and psychosocial factors (including demands and control dimensions, social support, conflicts and job insecurity). Results At least 1 group of shift workers had a higher prevalence of nearly every unfavorable work environment factor investigated. Exceptions were dust exposure and quantitative demands. Especially conflicts at work and low decision latitude were higher among all the groups of shift workers, and all-day walking or standing work and part-time jobs were more often found among female shift workers. The 3 different shiftwork groups were exposed to different parts of the work environment, and also men and women in shift work differed in relation to the work environment. Age and social class influenced the relationship, but not in any particular pattern. Conclusions In a heterogenous population shift work was found to be associated with other work environment factors suspected to cause heart disease.

Research paper thumbnail of Standing at work and varicose veins

Scandinavian Journal of Work, Environment & Health, 2000

Objectives This study attempts to determine whether or not prolonged standing at work involves an... more Objectives This study attempts to determine whether or not prolonged standing at work involves an excess risk for the occurrence of varicose veins. Methods A cohort of 1.6 million 20-to-59-year-old Danes gainfully employed in 1991 were followed for 3 years according to first hospitalization due to varicose veins of the lower extremities. The exposure data came from a representative sample of the baseline population. Altogether 5940 people were interviewed about occupational exposure and confounding factors. Results For men working mostly in a standing position, the risk ratio for varicose veins was 1.85 [95% confidence interval (95% CI) 1.33-2.361 in a comparison with all other men. The corresponding risk ratio for women was 2.63 (95% CI 2.25-3.02). The results were adjusted for age, social group, and smoking. C O~C~U S~O~S Working in a standing position is associated with subsequent hospitalization due to varicose veins for both men and women.

Research paper thumbnail of Agricultural work and the risk of Parkinson's disease in Denmark, 1981-1993

Scandinavian Journal of Work, Environment & Health, 2000

Objectives This study examined the possible association between agricultural and horticultural wo... more Objectives This study examined the possible association between agricultural and horticultural work and the subsequent morbidity of Parkinson's disease. Methods Fixed cohorts of 2 273 872 men and women aged 20-59 years on 1 January 1981 and identified in the Central Population Register of Denmark were followed, and all first-time hospitalizations with Parkinson's disease as the prinEipa1 diagnosis during the 13 years until 3 1 December 1993 were recorded. Standardized hospitalization ratios (SHR) were calculated using all gainfully employed persons as the standard and by multiplying the ratio by 100. Ninety-five percent confidence intervals (95% CI) were calculated on the assumption of a Poisson distribution. Results A high risk of Parkinson's disease was found for the men and women in agriculture and horticulture (134 cases, SHR 132, 95% CI 11 1-156). Statistically significantly high risks were found for farmers (79 cases, SHR 130,95% CI 103-163) and for all men in agriculture and horticulture (109 cases, SHR 134,95% CI 109-162). Conclusions A consistent pattern of high Parkinson's disease morbidity was found among occupational groups employed in agriculture and horticulture.

Research paper thumbnail of Hospital contacts for chronic diseases among Danish seafarers and fishermen: A population-based cohort study

Scandinavian Journal of Public Health, 2007

Objectives: Seafarers' and fishermen's working conditions may impact on their lifestyle a... more Objectives: Seafarers' and fishermen's working conditions may impact on their lifestyle and health. Standardized hospital contact ratios (SHCRs) were compared in two time periods and the relative risks of hospital contact as a function of employment time were estimated. Methods: Cohorts of all Danish seafarers (officers and non-officers) registered by the Danish Maritime Authority (DMA) 1989—98 and fishermen retrieved from a pension registry 1989—98 were linked to the nationwide Occupational Hospitalization Registry (OHR) and followed up for incident diseases in two five-year time periods, from 1 January 1994 and 1 January 1999, respectively, using rates specific for age and calendar time for the entire Danish workforce as a reference. Results: The SHCRs for lung and cardiovascular diseases were high for non-officers. Among male officers, the SHCR for diabetes was high in the 1999 cohort and the SHCR for chronic heart diseases was statistically significantly higher in the 19...

Research paper thumbnail of A nationwide population study of severe head injury and Parkinson's disease

Parkinsonism & Related Disorders, 2009

The aim was to analyze prospectively the association between severe head injury and Parkinson's d... more The aim was to analyze prospectively the association between severe head injury and Parkinson's disease. All people in Denmark who were at least 20 years old as on 1 January 1981 were followed for hospitalisation due to previous head trauma during 1981e1993 and for hospital contacts due to PD during 1995e2004. We observed 107 cases of PD among people at hypothetical risk due to previous head injury. The expected number was 112.1, which yielded a standardised morbidity ratio of 0.954 (95% CI: 0.782e1.15). The study provides no support for severe head injury among adults being a risk factor for Parkinson's disease.

Research paper thumbnail of A 15-year prospective study of shift work and disability pension

Occupational and Environmental Medicine, 2008

Objective: To estimate the hazard ratio for disability pension associated with shift work. Method... more Objective: To estimate the hazard ratio for disability pension associated with shift work. Methods: Cohorts of shift and day workers were identified in three waves of the Danish Work Environment Cohort Study and followed up for incidence of disability pension in a national register of social transfer payment. A total of 3980 female and 4025 male employees were included in the cohorts. Information about shift work status, age, smoking habits, body mass index and ergonomic work environment were updated according to responses in subsequent waves of the survey when possible. Respondents reporting shift work were classified as shift workers in the following waves as well. Respondents were followed in the register from the time of first interview and were censored at the time of their 60th birthday, emigration, death or end of follow-up (18 June 2006). The authors used the Cox proportional hazards model to estimate hazard ratios for incidence of disability pension and 95% confidence intervals. Results: The authors observed 253 new disability pensions among women and 173 among men during 56 903 and 57 886 person-years at risk respectively, Among women, shift work predicted disability after adjustment for age, general health and socioeconomic status HR 1.39 (95% CI 1.07 to 1.82). After further adjustment for body mass index, smoking habits, socioeconomic status and ergonomic exposures the association remained statistically significant HR 1.34 (95% CI 1.02 to 1.75). Shift work was not associated with disability among men. Conclusion: Shift work might be moderately associated with disability pension among women; however, more powerful studies are needed to establish the possible association.

Research paper thumbnail of Hospital contacts for noise-related hearing loss among Danish seafarers and fishermen: A population-based cohort study

Noise and Health, 2008

Aims: Noise-induced hearing loss (NIHL) is a leading occupational disease and some seafarers and ... more Aims: Noise-induced hearing loss (NIHL) is a leading occupational disease and some seafarers and fi shermen may be at high risk. We present here standardized hospital contact ratios (SHCRs) for hearing loss among Danish seafarers and fi shermen. Materials and Methods: Cohorts of all Danish seafarers registered by the Danish Maritime Authority (DMA) and fi shermen retrieved from a 1989-1998 pension registry were linked to the nationwide Occupational Hospitalisation Registry (OHR) with follow-up for NIHL from 1994 to 2003, using rates specifi c for age and calendar time for the entire Danish workforce as a reference. Results: We found high SHCRs for NIHL: 165 [95% confi dence interval (CI) 131-206] among offi cers, 113 (79-157) for nonoffi cers and 119 (85-162) for fi shermen. The increased SHCR for hearing impairment among seafarers was solely found in engine room personnel (SHCR = 222; 95% CI 178-277). Compared to other seafarers, the engine room personnel had a relative risk ratio of 2.39 (95% CI: 1.74-3.26). Short-term employment is common in many trades. No duration response pattern was observed which may suggest a secondary healthy worker effect. Conclusions: These fi ndings indicate that hearing problems are frequent among men who work in the engine rooms on ships. Long-term cumulative effects of employment were not shown.

Research paper thumbnail of Work injuries and disability

Journal of Safety Research, 2009

This study estimated the hazard ratio for disability pension retirement (DPR) for persons who hav... more This study estimated the hazard ratio for disability pension retirement (DPR) for persons who have experienced a work injury causing absence lasting at least one day after the accidental injury occurred and to estimate the fraction of DPR attributable to work injuries. Methods: A total of 4,217 male and 4,105 female employees from a national survey were followed up for subsequent DPR. Results and impact on industry and government: Having had a work injury was a strong predictor of DPR among men. After control for age, smoking, body mass index, body postures, and physical demands, the hazard ratio (HR) among those employees who had ever experienced a work injury was 1.80 (95% confidence interval (CI): 1.20-2.68). No association was found among women. Summary: Having had a reportable work injury is a strong predictor of subsequent DPR for men.