Jaana Pentti - Academia.edu (original) (raw)
Papers by Jaana Pentti
Lancet (London, England), Jan 19, 2015
Long working hours might increase the risk of cardiovascular disease, but prospective evidence is... more Long working hours might increase the risk of cardiovascular disease, but prospective evidence is scarce, imprecise, and mostly limited to coronary heart disease. We aimed to assess long working hours as a risk factor for incident coronary heart disease and stroke. We identified published studies through a systematic review of PubMed and Embase from inception to Aug 20, 2014. We obtained unpublished data for 20 cohort studies from the Individual-Participant-Data Meta-analysis in Working Populations (IPD-Work) Consortium and open-access data archives. We used cumulative random-effects meta-analysis to combine effect estimates from published and unpublished data. We included 25 studies from 24 cohorts in Europe, the USA, and Australia. The meta-analysis of coronary heart disease comprised data for 603 838 men and women who were free from coronary heart disease at baseline; the meta-analysis of stroke comprised data for 528 908 men and women who were free from stroke at baseline. Follo...
Journal of epidemiology and community health, Jan 20, 2015
The role of socioeconomic status in work disability among employees with diabetes is not well kno... more The role of socioeconomic status in work disability among employees with diabetes is not well known. We examined the association between socioeconomic status and work disability among employees with and without diabetes taking into account comorbid conditions. We used individual participant data from three occupational cohorts from Finland, France and the UK (employees with diabetes, n=2170, age-matched and sex-matched controls without diabetes, n=4340). In all cohorts, survey data were linked with register data and the employees were followed up on average for 4.4 years. Socioeconomic status was based on occupational titles. Work disability (sickness absence and disability pension) was indexed as the numbers of disability days and episodes. The study-specific estimates were pooled using meta-analysis and effect modifications were studied with meta-regression. The average numbers of disability days and episodes per year were 1.5-3.5 times higher for persons with diabetes compared to...
Diabetes care, Jan 6, 2015
We examined trends of diagnosis-specific work disability after newly diagnosed diabetes, comparin... more We examined trends of diagnosis-specific work disability after newly diagnosed diabetes, comparing individuals with diabetes with those without diabetes, and identified the subgroups with the highest levels of work disability. The register data of diabetes medication and in- and outpatient hospital visits were used to identify all recorded new diabetes cases among the population aged 25-59 years in Sweden in 2006 (n = 14,098). Data for a 4-year follow-up of ICD-10 physician-certified sickness absence and disability pension days (2007‒2010) were obtained from the National Social Insurance Agency. Comparisons were made using a random sample of the population without recorded diabetes (n = 39,056). The most common causes of work disability were mental and musculoskeletal disorders; diabetes as a reason for disability was rare. Most of the excess work disability among people with diabetes compared with those without diabetes was owing to mental disorders (mean difference adjusted for co...
Occupational and Environmental Medicine, 2001
OBJECTIVESEmployees are thought to lengthen their weekends by voluntary absenteeism, but the magn... more OBJECTIVESEmployees are thought to lengthen their weekends by voluntary absenteeism, but the magnitude of such potentially reversible behaviour is not known.METHODSA follow up study based on employers' registers on the dates of work contracts and absences in 27 541 permanent full time municipal employees in five towns during 1993–7. The absence rate on each weekday separately for all sick leaves
PLOS ONE, 2015
Retirement has been suggested to reduce medication adherence, but no evidence is available for st... more Retirement has been suggested to reduce medication adherence, but no evidence is available for statins. We investigated changes in adherence to statins among Swedish adults after retirement. A prospective cohort study was carried out on all individuals living in Sweden on 31 December 2004, alive in 2010, having purchased statins in the second half of 2005, and retired in 2008 (n=11 718). We used prescription dispensing data in 2006-2010 to determine nonadherence (defined as <80% of days covered by filled prescriptions) before and after old-age or disability retirement. Using multiple repeat measurements of filled statin prescriptions, we calculated the annual prevalence rates of nonadherence for those who continued therapy. Discontinuation was defined as no statin dispensations during a calendar year. After adjustment for age at retirement, the prevalence ratio (PR) of nonadherence after retirement in comparison with those before retirement was 1.23 [95% confidence interval (CI) 1.17-1.29] for the men and 1.19 (95% CI 1.13-1.26) for the women. A post-retirement increase in nonadherence was consistently observed across the strata of age at retirement, marital status, education, income, type of retirement, and participants with and without cardiovascular disease, the largest increases being observed for statin use in secondary prevention (men: PR 1.38, 95% CI 1.26-1.54; women: PR 1.43, 1.18-1.72). For primary prevention, the corresponding prevalence ratios were 1.18 (95% CI 1.13‒1.25) and 1.18 (95% CI 1.11-1.24), respectively. Retirement appears to be associated with increased nonadherence to statin therapy among Swedish men and women.
Circulation, Jan 11, 2015
-Childhood adverse psychosocial factors (e.g., parental divorce, long-term financial difficulties... more -Childhood adverse psychosocial factors (e.g., parental divorce, long-term financial difficulties) and adult neighborhood disadvantage have both been linked to increased cardiovascular disease (CVD). However, their combined effects on disease risk are not known. -Participants were 37 699 adults from the Finnish Public Sector study whose data were linked to a national neighborhood disadvantage grid using residential addresses between years 2000 and 2008 and who responded to a survey on childhood psychosocial adversities and adult CVD-risk behaviors in 2008/09. Survey data were also linked to national registers on hospitalization, mortality, and prescriptions to assess CVD-risk factors in 2008/09 and to ascertain incident CVD (coronary heart disease or cerebrovascular disease) between the survey and the end of December 2011 (mean follow-up time 2.94 years, SD=0.44). Combined exposure to high childhood adversity and high adult disadvantage was associated with CVD risk factors (hypertension, dyslipidaemia, diabetes, obesity, smoking, heavy alcohol use, and physical inactivity), and with a 2.25-fold (95% Confidence Interval (CI) 1.39-3.63) hazard of incident CVD compared to a low childhood adversity and low adult disadvantage. This hazard ratio attenuated by 16.6% but remained statistically significant after adjustment for the CVD risk factors (1.96, 95% CI 1.22-3.16). Exposure to high childhood adversity or high adult neighborhood disadvantage alone was not significantly associated with CVD in fully-adjusted models. -These findings suggest that individuals with both childhood psychosocial adversity and adult neighborhood disadvantage are at an increased risk of CVD. In contrast, those with only one of these exposures have little or no excess risk after controlling for conventional risk factors.
Sleep Medicine, 2015
Previous research suggests a possible link between sleep-medication use and mortality, especially... more Previous research suggests a possible link between sleep-medication use and mortality, especially cancer deaths, but findings are mixed, and large population-based studies are lacking. Data from the Finnish Public Sector study were linked to the Finnish Cancer Register and the Drug Prescription Register of Finland. A total of 5053 cancer cases (mean age of 57.4 years) diagnosed in 2002-2011, and their 24,388 controls free of cancer and matched for sex, age, socioeconomic status, employer, and geographical area, were identified. The use of sleep medications was defined as purchases of prescribed sleep medications. Both quantity and duration of prior sleep-medication use during the seven years studied were associated with increased odds of having cancer. Compared with participants not using sleep medications, the odds ratio was 1.18-fold (95% confidence interval (CI): 1.01-1.39) for those who used >100 defined daily doses per year and 1.16-fold (95% CI: 1.01-1.34) for those who had such a medication for >3 years. Site-specific analyses showed a more pronounced association of quantity and duration of sleep-medication use with subsequent cancer of the respiratory system (odds ratio for >100 defined daily doses per year vs. no use: 3.47; 95% CI: 1.97-6.11). No associations were found with other cancer sites. In this register-based study, sleep-medication use was associated with an increased cancer incidence of the respiratory system. Further studies are needed to examine potential carcinogenic mechanisms associated with hypnotic medications.
PLOS ONE, 2015
To investigate whether adverse experiences in childhood predict non-adherence to statin therapy i... more To investigate whether adverse experiences in childhood predict non-adherence to statin therapy in adulthood.
International Journal of Epidemiology, 2015
Changes in health-related behaviour may be a key mechanism linking impaired sleep to poor health,... more Changes in health-related behaviour may be a key mechanism linking impaired sleep to poor health, but evidence on this is limited. In this study, we analysed observational data to determine whether onset of impaired sleep is followed by changes in health-related behaviours. We used data from 37 508 adults from the longitudinal Finnish Public Sector Study. In analysis of 59 152 person-observations on duration and quality of sleep and health-related behaviours (alcohol consumption, smoking, physical activity and weight control), data were treated as a series of non-randomized pseudo-trials with strict predefined criteria for data inclusion and temporality. Smokers who experienced onset of short sleep were less likely to quit smoking than those with persistent normal sleep [odds ratio (OR) = 0.78, 95% confidence interval (CI): 0.64-0.97]. Onset of short sleep also predicted initiating high-risk alcohol consumption (OR = 1.17, 95% CI: 1.00-1.37). Onset of disturbed sleep was associated with changes in all assessed health-related behaviours: initiation of high-risk alcohol consumption (OR = 1.23, 95% CI: 1.05-1.45), quitting smoking (OR = 0.80, 95% CI: 0.63-1.00), becoming physically inactive (OR = 1.17, 95% CI: 1.06-1.30) and becoming overweight or obese (OR = 1.12, 95% CI: 1.01-1.23). Findings suggest that the onset of short or disturbed sleep are risk factors for adverse changes in health-related behaviours. These findings highlight potential pathways linking impaired sleep to the development of lifestyle-related morbidity and mortality.
Journal of Epidemiology and Community Health, 2002
Objective: To study the relation of contractual and perceived employment security to employee hea... more Objective: To study the relation of contractual and perceived employment security to employee health.Design: Cross sectional survey.Setting: Municipal sector employees in eight Finnish towns.Participants: 5981 employees with a permanent contract and 2786 employees with a non-permanent contract (2194 fixed term contract, 682 government subsidised contract).Outcome measures: Poor self rated health, chronic disease, and psychological distress.Results: Compared with permanent employees, fixed
PloS one, 2014
Self-rated health (SRH) is a valid measure of health status and associated with mortality. Based ... more Self-rated health (SRH) is a valid measure of health status and associated with mortality. Based on individual-level biannual repeat data on SRH we sought to characterize the natural history of poor SRH during the 12 years prior to death in men and women in different age groups. We conducted a retrospective analysis of the Health and Retirement Study participants who died between 1998 and 2010 and had at least two SRH measurements in the 12 years prior to death. We used a nested case-control design to compare SRH trajectories of deceased men and women aged 30-64, 65-79 and 80 years versus surviving participants. The cases comprised 3,350 deceased participants who were matched to surviving controls (n = 8,127). SRH was dichotomized into good vs. poor health. Men and women dying at age 65-79 and ≥ 80 years had 1.5 to 3 times higher prevalence of poor SRH already 11-12 years prior to death compared to surviving controls. The risk estimates remained statistically significant even after ...
European journal of public health, Jan 18, 2015
Environmental factors may affect adolescents' eating habits and thereby body weight. However,... more Environmental factors may affect adolescents' eating habits and thereby body weight. However, the contribution of school neighbourhood environment is poorly understood. This study examined the association between proximity of a fast-food outlet or grocery store to school and adolescents' eating habits and overweight. Participants were 23 182 adolescents (mean age 15 years) who responded to a classroom survey in 181 lower secondary schools in Finland (2008-09). School location was linked to data on distance from school to the nearest fast-food outlet or grocery store (≤100 m, 101-500 m, >500 m) using global positioning system-coordinate databases. Outcomes were irregular eating habits (skipping breakfast, skipping free school lunch, skipping free school-provided snacks and not having family dinners), the accumulation of these habits and overweight, including obesity (body mass index ≥ 25 kg/m(2)). Thirteen percentage of the participants were overweight. Having a fast-food ...
Preventive medicine, 2015
We examined whether change in distance to or number of sports facilities is related to change in ... more We examined whether change in distance to or number of sports facilities is related to change in metabolic equivalent task (MET) hours/week. 25,834 Finnish Public Sector study cohort participants reported their weekly physical activity in 2000 and 2008. Distances from each participant's home to the nearest facility and number of facilities within 500m from home were calculated from geographic coordinates. We assessed changes in weekly MET hours of physical activity between the baseline and the follow-up in relation to change in distance to the nearest facility (remained close, decreased, remained distant, increased) and number of facilities <500m from home (remained high, increased, remained low, decreased). The average decrease in MET hours was greater for those whose distance to a sports facility increased (-1.4 (95% CI -3.8--0.96)) (vs. remained close). The same was observed for those for whom the number of facilities near home decreased (-2.35 (95% CI -4.84-0.14)) (vs. re...
We studied health-related selection and consequences of an organizational downsizing among 886 mu... more We studied health-related selection and consequences of an organizational downsizing among 886 municipal employees. Measurements of health indicators were conducted before any rumor of the downsizing and immediately after the downsizing 3 years later. Results of predownsizing health showed that those who did not find employment after the staff reductions were older employees with high preexisting morbidity. Those getting a new job elsewhere were younger and had better health already before the downsizing than the stayers. After the downsizing, deterioration of health was most likely in the stayers working in groups of major staff reductions and among the nonemployed leavers. In the reemployed leavers, the risk of increased health problems was lower than in others including employees working in no or minor downsizing groups.
It is commonly assumed that social capital influences health, but only few studies have examined ... more It is commonly assumed that social capital influences health, but only few studies have examined this hypothesis in the context of the workplace. The present prospective cohort study of 6028 public sector employees in Finland investigated social capital as a workplace characteristic which potentially affects employee health. The two indicators of social capital were trust in the labour market, measured by security of the employment contract, and trust in co-worker support. Self-rated health status and psychological distress were used as indicators of health. The combination of subsidised job contract and low co-worker support (i.e. the lowest category of social capital) was associated with poorer health prospects than the combination of permanent employment and high support (the highest social capital category) in an age-adjusted model, but this association disappeared in logistic regression analysis adjusted by sociodemographic background factors and baseline health. Fixed-term employment predicted better self-rated health and less psychological distress when compared with permanent employment. Co-worker support was most common in permanent and least common in subsidised employees and it was associated with better self-rated health in women. Our findings suggest only partial support for the hypothesis of work-related social capital as a health resource.
In occupational life, a mismatch between high expenditure of effort and receiving few rewards may... more In occupational life, a mismatch between high expenditure of effort and receiving few rewards may promote the co-occurrence of lifestyle risk factors, however, there is insufficient evidence to support or refute this hypothesis. The aim of this study is to examine the extent to which the dimensions of the Effort-Reward Imbalance (ERI) model -effort, rewards and ERI -are associated with the co-occurrence of lifestyle risk factors.
Background: Prior studies on social capital and health have assessed social capital in residentia... more Background: Prior studies on social capital and health have assessed social capital in residential neighbourhoods and communities, but the question whether the concept should also be applicable in workplaces has been raised. The present study reports on the psychometric properties of an 8-item measure of social capital at work.
Occup Environ Medicine, 2008
To study the effect of a preventive vocationally oriented intervention on rates of sickness absen... more To study the effect of a preventive vocationally oriented intervention on rates of sickness absence and disability pension in employees considered to be at risk of future work disability. An observational register-based study of public sector employees. 2236 intervention programme participants and 8944 matched controls were followed up for 8 years. Multidisciplinary intervention was carried out at rehabilitation institutions. Data on demographics and sickness absences were obtained from employers' records and information about health at baseline, participation in the intervention and subsequent disability pension from national registers. Before the intervention participants had 17% more annual sick leave days and a 23% higher rate of absence spells lasting >21 days than controls. In the intervention year and 3 subsequent years, the sickness absence rate among participants reduced to that observed among controls but thereafter increased to the pre-intervention level (p for curvilinear trend <0.001 for absence days and 0.03 for absence spells). The association between the intervention and future disability pension was non-proportional among participants. Compared to controls, risk among participants was lower in the first 4 years of follow-up but thereafter returned to the previous higher level. The temporary decline in sickness absence attributable to the intervention totalled 6673 absence days per 1000 employees and the cumulative reduction in disability was 56.4 years. These direct health benefits may not fully cover the costs of the intervention. The risk of work disability can be temporarily reduced in employees at risk by means of a vocationally oriented multidisciplinary intervention programme.
The aim of this prospective study was to examine the link between individual and ecological workp... more The aim of this prospective study was to examine the link between individual and ecological workplace social capital and the co-occurrence of adverse lifestyle risk factors such as smoking, heavy drinking, physical inactivity and overweight. Data on 25 897 female and 5476 male public sector employees were analysed. Questionnaire surveys conducted in 2000-2002 (baseline) and 2004-2005 (follow-up) were used to assess workplace social capital, lifestyle risk factors and other characteristics. Multilevel multinomial logistic regression analysis was used to examine associations between individual and ecological social capital and the co-occurrence of lifestyle risk factors. In the cross-sectional analysis adjusted for age, sex, marital status and employer, low social capital at work at both the individual and ecological level was associated with at least a 1.3 times higher odds of having more than two lifestyle risk factors versus having no risk factors. Similar associations were found in the prospective setting. However, additional adjustment for the co-occurrence of risk factors and socioeconomic status at baseline attenuated the result to non-significant. Social capital at work seems to be associated with a lowered risk of co-occurrence of multiple lifestyle risk factors but does not clearly predict the future risk of this co-occurrence.
Lancet (London, England), Jan 19, 2015
Long working hours might increase the risk of cardiovascular disease, but prospective evidence is... more Long working hours might increase the risk of cardiovascular disease, but prospective evidence is scarce, imprecise, and mostly limited to coronary heart disease. We aimed to assess long working hours as a risk factor for incident coronary heart disease and stroke. We identified published studies through a systematic review of PubMed and Embase from inception to Aug 20, 2014. We obtained unpublished data for 20 cohort studies from the Individual-Participant-Data Meta-analysis in Working Populations (IPD-Work) Consortium and open-access data archives. We used cumulative random-effects meta-analysis to combine effect estimates from published and unpublished data. We included 25 studies from 24 cohorts in Europe, the USA, and Australia. The meta-analysis of coronary heart disease comprised data for 603 838 men and women who were free from coronary heart disease at baseline; the meta-analysis of stroke comprised data for 528 908 men and women who were free from stroke at baseline. Follo...
Journal of epidemiology and community health, Jan 20, 2015
The role of socioeconomic status in work disability among employees with diabetes is not well kno... more The role of socioeconomic status in work disability among employees with diabetes is not well known. We examined the association between socioeconomic status and work disability among employees with and without diabetes taking into account comorbid conditions. We used individual participant data from three occupational cohorts from Finland, France and the UK (employees with diabetes, n=2170, age-matched and sex-matched controls without diabetes, n=4340). In all cohorts, survey data were linked with register data and the employees were followed up on average for 4.4 years. Socioeconomic status was based on occupational titles. Work disability (sickness absence and disability pension) was indexed as the numbers of disability days and episodes. The study-specific estimates were pooled using meta-analysis and effect modifications were studied with meta-regression. The average numbers of disability days and episodes per year were 1.5-3.5 times higher for persons with diabetes compared to...
Diabetes care, Jan 6, 2015
We examined trends of diagnosis-specific work disability after newly diagnosed diabetes, comparin... more We examined trends of diagnosis-specific work disability after newly diagnosed diabetes, comparing individuals with diabetes with those without diabetes, and identified the subgroups with the highest levels of work disability. The register data of diabetes medication and in- and outpatient hospital visits were used to identify all recorded new diabetes cases among the population aged 25-59 years in Sweden in 2006 (n = 14,098). Data for a 4-year follow-up of ICD-10 physician-certified sickness absence and disability pension days (2007‒2010) were obtained from the National Social Insurance Agency. Comparisons were made using a random sample of the population without recorded diabetes (n = 39,056). The most common causes of work disability were mental and musculoskeletal disorders; diabetes as a reason for disability was rare. Most of the excess work disability among people with diabetes compared with those without diabetes was owing to mental disorders (mean difference adjusted for co...
Occupational and Environmental Medicine, 2001
OBJECTIVESEmployees are thought to lengthen their weekends by voluntary absenteeism, but the magn... more OBJECTIVESEmployees are thought to lengthen their weekends by voluntary absenteeism, but the magnitude of such potentially reversible behaviour is not known.METHODSA follow up study based on employers' registers on the dates of work contracts and absences in 27 541 permanent full time municipal employees in five towns during 1993–7. The absence rate on each weekday separately for all sick leaves
PLOS ONE, 2015
Retirement has been suggested to reduce medication adherence, but no evidence is available for st... more Retirement has been suggested to reduce medication adherence, but no evidence is available for statins. We investigated changes in adherence to statins among Swedish adults after retirement. A prospective cohort study was carried out on all individuals living in Sweden on 31 December 2004, alive in 2010, having purchased statins in the second half of 2005, and retired in 2008 (n=11 718). We used prescription dispensing data in 2006-2010 to determine nonadherence (defined as &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;80% of days covered by filled prescriptions) before and after old-age or disability retirement. Using multiple repeat measurements of filled statin prescriptions, we calculated the annual prevalence rates of nonadherence for those who continued therapy. Discontinuation was defined as no statin dispensations during a calendar year. After adjustment for age at retirement, the prevalence ratio (PR) of nonadherence after retirement in comparison with those before retirement was 1.23 [95% confidence interval (CI) 1.17-1.29] for the men and 1.19 (95% CI 1.13-1.26) for the women. A post-retirement increase in nonadherence was consistently observed across the strata of age at retirement, marital status, education, income, type of retirement, and participants with and without cardiovascular disease, the largest increases being observed for statin use in secondary prevention (men: PR 1.38, 95% CI 1.26-1.54; women: PR 1.43, 1.18-1.72). For primary prevention, the corresponding prevalence ratios were 1.18 (95% CI 1.13‒1.25) and 1.18 (95% CI 1.11-1.24), respectively. Retirement appears to be associated with increased nonadherence to statin therapy among Swedish men and women.
Circulation, Jan 11, 2015
-Childhood adverse psychosocial factors (e.g., parental divorce, long-term financial difficulties... more -Childhood adverse psychosocial factors (e.g., parental divorce, long-term financial difficulties) and adult neighborhood disadvantage have both been linked to increased cardiovascular disease (CVD). However, their combined effects on disease risk are not known. -Participants were 37 699 adults from the Finnish Public Sector study whose data were linked to a national neighborhood disadvantage grid using residential addresses between years 2000 and 2008 and who responded to a survey on childhood psychosocial adversities and adult CVD-risk behaviors in 2008/09. Survey data were also linked to national registers on hospitalization, mortality, and prescriptions to assess CVD-risk factors in 2008/09 and to ascertain incident CVD (coronary heart disease or cerebrovascular disease) between the survey and the end of December 2011 (mean follow-up time 2.94 years, SD=0.44). Combined exposure to high childhood adversity and high adult disadvantage was associated with CVD risk factors (hypertension, dyslipidaemia, diabetes, obesity, smoking, heavy alcohol use, and physical inactivity), and with a 2.25-fold (95% Confidence Interval (CI) 1.39-3.63) hazard of incident CVD compared to a low childhood adversity and low adult disadvantage. This hazard ratio attenuated by 16.6% but remained statistically significant after adjustment for the CVD risk factors (1.96, 95% CI 1.22-3.16). Exposure to high childhood adversity or high adult neighborhood disadvantage alone was not significantly associated with CVD in fully-adjusted models. -These findings suggest that individuals with both childhood psychosocial adversity and adult neighborhood disadvantage are at an increased risk of CVD. In contrast, those with only one of these exposures have little or no excess risk after controlling for conventional risk factors.
Sleep Medicine, 2015
Previous research suggests a possible link between sleep-medication use and mortality, especially... more Previous research suggests a possible link between sleep-medication use and mortality, especially cancer deaths, but findings are mixed, and large population-based studies are lacking. Data from the Finnish Public Sector study were linked to the Finnish Cancer Register and the Drug Prescription Register of Finland. A total of 5053 cancer cases (mean age of 57.4 years) diagnosed in 2002-2011, and their 24,388 controls free of cancer and matched for sex, age, socioeconomic status, employer, and geographical area, were identified. The use of sleep medications was defined as purchases of prescribed sleep medications. Both quantity and duration of prior sleep-medication use during the seven years studied were associated with increased odds of having cancer. Compared with participants not using sleep medications, the odds ratio was 1.18-fold (95% confidence interval (CI): 1.01-1.39) for those who used &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;100 defined daily doses per year and 1.16-fold (95% CI: 1.01-1.34) for those who had such a medication for &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;3 years. Site-specific analyses showed a more pronounced association of quantity and duration of sleep-medication use with subsequent cancer of the respiratory system (odds ratio for &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;100 defined daily doses per year vs. no use: 3.47; 95% CI: 1.97-6.11). No associations were found with other cancer sites. In this register-based study, sleep-medication use was associated with an increased cancer incidence of the respiratory system. Further studies are needed to examine potential carcinogenic mechanisms associated with hypnotic medications.
PLOS ONE, 2015
To investigate whether adverse experiences in childhood predict non-adherence to statin therapy i... more To investigate whether adverse experiences in childhood predict non-adherence to statin therapy in adulthood.
International Journal of Epidemiology, 2015
Changes in health-related behaviour may be a key mechanism linking impaired sleep to poor health,... more Changes in health-related behaviour may be a key mechanism linking impaired sleep to poor health, but evidence on this is limited. In this study, we analysed observational data to determine whether onset of impaired sleep is followed by changes in health-related behaviours. We used data from 37 508 adults from the longitudinal Finnish Public Sector Study. In analysis of 59 152 person-observations on duration and quality of sleep and health-related behaviours (alcohol consumption, smoking, physical activity and weight control), data were treated as a series of non-randomized pseudo-trials with strict predefined criteria for data inclusion and temporality. Smokers who experienced onset of short sleep were less likely to quit smoking than those with persistent normal sleep [odds ratio (OR) = 0.78, 95% confidence interval (CI): 0.64-0.97]. Onset of short sleep also predicted initiating high-risk alcohol consumption (OR = 1.17, 95% CI: 1.00-1.37). Onset of disturbed sleep was associated with changes in all assessed health-related behaviours: initiation of high-risk alcohol consumption (OR = 1.23, 95% CI: 1.05-1.45), quitting smoking (OR = 0.80, 95% CI: 0.63-1.00), becoming physically inactive (OR = 1.17, 95% CI: 1.06-1.30) and becoming overweight or obese (OR = 1.12, 95% CI: 1.01-1.23). Findings suggest that the onset of short or disturbed sleep are risk factors for adverse changes in health-related behaviours. These findings highlight potential pathways linking impaired sleep to the development of lifestyle-related morbidity and mortality.
Journal of Epidemiology and Community Health, 2002
Objective: To study the relation of contractual and perceived employment security to employee hea... more Objective: To study the relation of contractual and perceived employment security to employee health.Design: Cross sectional survey.Setting: Municipal sector employees in eight Finnish towns.Participants: 5981 employees with a permanent contract and 2786 employees with a non-permanent contract (2194 fixed term contract, 682 government subsidised contract).Outcome measures: Poor self rated health, chronic disease, and psychological distress.Results: Compared with permanent employees, fixed
PloS one, 2014
Self-rated health (SRH) is a valid measure of health status and associated with mortality. Based ... more Self-rated health (SRH) is a valid measure of health status and associated with mortality. Based on individual-level biannual repeat data on SRH we sought to characterize the natural history of poor SRH during the 12 years prior to death in men and women in different age groups. We conducted a retrospective analysis of the Health and Retirement Study participants who died between 1998 and 2010 and had at least two SRH measurements in the 12 years prior to death. We used a nested case-control design to compare SRH trajectories of deceased men and women aged 30-64, 65-79 and 80 years versus surviving participants. The cases comprised 3,350 deceased participants who were matched to surviving controls (n = 8,127). SRH was dichotomized into good vs. poor health. Men and women dying at age 65-79 and ≥ 80 years had 1.5 to 3 times higher prevalence of poor SRH already 11-12 years prior to death compared to surviving controls. The risk estimates remained statistically significant even after ...
European journal of public health, Jan 18, 2015
Environmental factors may affect adolescents' eating habits and thereby body weight. However,... more Environmental factors may affect adolescents' eating habits and thereby body weight. However, the contribution of school neighbourhood environment is poorly understood. This study examined the association between proximity of a fast-food outlet or grocery store to school and adolescents' eating habits and overweight. Participants were 23 182 adolescents (mean age 15 years) who responded to a classroom survey in 181 lower secondary schools in Finland (2008-09). School location was linked to data on distance from school to the nearest fast-food outlet or grocery store (≤100 m, 101-500 m, >500 m) using global positioning system-coordinate databases. Outcomes were irregular eating habits (skipping breakfast, skipping free school lunch, skipping free school-provided snacks and not having family dinners), the accumulation of these habits and overweight, including obesity (body mass index ≥ 25 kg/m(2)). Thirteen percentage of the participants were overweight. Having a fast-food ...
Preventive medicine, 2015
We examined whether change in distance to or number of sports facilities is related to change in ... more We examined whether change in distance to or number of sports facilities is related to change in metabolic equivalent task (MET) hours/week. 25,834 Finnish Public Sector study cohort participants reported their weekly physical activity in 2000 and 2008. Distances from each participant's home to the nearest facility and number of facilities within 500m from home were calculated from geographic coordinates. We assessed changes in weekly MET hours of physical activity between the baseline and the follow-up in relation to change in distance to the nearest facility (remained close, decreased, remained distant, increased) and number of facilities <500m from home (remained high, increased, remained low, decreased). The average decrease in MET hours was greater for those whose distance to a sports facility increased (-1.4 (95% CI -3.8--0.96)) (vs. remained close). The same was observed for those for whom the number of facilities near home decreased (-2.35 (95% CI -4.84-0.14)) (vs. re...
We studied health-related selection and consequences of an organizational downsizing among 886 mu... more We studied health-related selection and consequences of an organizational downsizing among 886 municipal employees. Measurements of health indicators were conducted before any rumor of the downsizing and immediately after the downsizing 3 years later. Results of predownsizing health showed that those who did not find employment after the staff reductions were older employees with high preexisting morbidity. Those getting a new job elsewhere were younger and had better health already before the downsizing than the stayers. After the downsizing, deterioration of health was most likely in the stayers working in groups of major staff reductions and among the nonemployed leavers. In the reemployed leavers, the risk of increased health problems was lower than in others including employees working in no or minor downsizing groups.
It is commonly assumed that social capital influences health, but only few studies have examined ... more It is commonly assumed that social capital influences health, but only few studies have examined this hypothesis in the context of the workplace. The present prospective cohort study of 6028 public sector employees in Finland investigated social capital as a workplace characteristic which potentially affects employee health. The two indicators of social capital were trust in the labour market, measured by security of the employment contract, and trust in co-worker support. Self-rated health status and psychological distress were used as indicators of health. The combination of subsidised job contract and low co-worker support (i.e. the lowest category of social capital) was associated with poorer health prospects than the combination of permanent employment and high support (the highest social capital category) in an age-adjusted model, but this association disappeared in logistic regression analysis adjusted by sociodemographic background factors and baseline health. Fixed-term employment predicted better self-rated health and less psychological distress when compared with permanent employment. Co-worker support was most common in permanent and least common in subsidised employees and it was associated with better self-rated health in women. Our findings suggest only partial support for the hypothesis of work-related social capital as a health resource.
In occupational life, a mismatch between high expenditure of effort and receiving few rewards may... more In occupational life, a mismatch between high expenditure of effort and receiving few rewards may promote the co-occurrence of lifestyle risk factors, however, there is insufficient evidence to support or refute this hypothesis. The aim of this study is to examine the extent to which the dimensions of the Effort-Reward Imbalance (ERI) model -effort, rewards and ERI -are associated with the co-occurrence of lifestyle risk factors.
Background: Prior studies on social capital and health have assessed social capital in residentia... more Background: Prior studies on social capital and health have assessed social capital in residential neighbourhoods and communities, but the question whether the concept should also be applicable in workplaces has been raised. The present study reports on the psychometric properties of an 8-item measure of social capital at work.
Occup Environ Medicine, 2008
To study the effect of a preventive vocationally oriented intervention on rates of sickness absen... more To study the effect of a preventive vocationally oriented intervention on rates of sickness absence and disability pension in employees considered to be at risk of future work disability. An observational register-based study of public sector employees. 2236 intervention programme participants and 8944 matched controls were followed up for 8 years. Multidisciplinary intervention was carried out at rehabilitation institutions. Data on demographics and sickness absences were obtained from employers' records and information about health at baseline, participation in the intervention and subsequent disability pension from national registers. Before the intervention participants had 17% more annual sick leave days and a 23% higher rate of absence spells lasting >21 days than controls. In the intervention year and 3 subsequent years, the sickness absence rate among participants reduced to that observed among controls but thereafter increased to the pre-intervention level (p for curvilinear trend <0.001 for absence days and 0.03 for absence spells). The association between the intervention and future disability pension was non-proportional among participants. Compared to controls, risk among participants was lower in the first 4 years of follow-up but thereafter returned to the previous higher level. The temporary decline in sickness absence attributable to the intervention totalled 6673 absence days per 1000 employees and the cumulative reduction in disability was 56.4 years. These direct health benefits may not fully cover the costs of the intervention. The risk of work disability can be temporarily reduced in employees at risk by means of a vocationally oriented multidisciplinary intervention programme.
The aim of this prospective study was to examine the link between individual and ecological workp... more The aim of this prospective study was to examine the link between individual and ecological workplace social capital and the co-occurrence of adverse lifestyle risk factors such as smoking, heavy drinking, physical inactivity and overweight. Data on 25 897 female and 5476 male public sector employees were analysed. Questionnaire surveys conducted in 2000-2002 (baseline) and 2004-2005 (follow-up) were used to assess workplace social capital, lifestyle risk factors and other characteristics. Multilevel multinomial logistic regression analysis was used to examine associations between individual and ecological social capital and the co-occurrence of lifestyle risk factors. In the cross-sectional analysis adjusted for age, sex, marital status and employer, low social capital at work at both the individual and ecological level was associated with at least a 1.3 times higher odds of having more than two lifestyle risk factors versus having no risk factors. Similar associations were found in the prospective setting. However, additional adjustment for the co-occurrence of risk factors and socioeconomic status at baseline attenuated the result to non-significant. Social capital at work seems to be associated with a lowered risk of co-occurrence of multiple lifestyle risk factors but does not clearly predict the future risk of this co-occurrence.