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Göteborg, Sweden

Selden A.I.,Orebro University | Ahlborg Jr. G.,Institute of Stress Medicine | Ahlborg Jr. G.,Gothenburg University
International Archives of Occupational and Environmental Health | Year: 2011

Purpose: Despite decades of experimental and observational studies, the carcinogenic risks to humans associated with occupational exposure to perchloroethylene (PER) remain uncertain. The aims of the present study were to further examine the possible associations. Methods: A national cohort of dry-cleaning and laundry workers (n = 10,389) assembled in 1984 was followed up for new cases of cancer by matching with the Swedish cancer register from 1985 to 2006 (inclusive), and the results were compared with expected frequencies derived from national reference data. Results: Follow-up was complete for 90.9% of the cohort (2,810 men, 6,630 women). The overall standardised cancer incidence ratio (SIR) for all subjects was close to unity (SIR 0.96; 95% confidence interval (CI) 0.91-1.02) with a slightly more favourable outcome in women (SIR 0.91; 95% CI 0.85-0.98) than in men (SIR 1.10; 95% CI 0.99-1.23). Significantly elevated rates of lung cancer (SIR 1.45; 95% CI 1.03-1.98) and non-Hodgkin's lymphoma (SIR 2.05; 95% CI 1.30-3.07) were seen in men, but for both types of cancer, the point estimates were similar in genuine laundry workers and dry-cleaners exposed to PER, respectively. There was no significant excess of cancer of the oesophagus, larynx, uterine cervix, liver, kidney or urinary bladder. Conclusions: The absence of individual or collective data on PER exposure from participating dry-cleaning shops and laundries involved and limited information on exposure time hampered the risk assessment related to PER. However, no clear association between PER exposure and subsequent cancer morbidity in the workers was evident from this historically prospective cohort. © 2010 The Author(s).

Lindegard A.,Institute of Stress Medicine | Larsman P.,Institute of Stress Medicine | Hadzibajramovic E.,Institute of Stress Medicine | Ahlborg Jr. G.,Institute of Stress Medicine | Ahlborg Jr. G.,Gothenburg University
International Archives of Occupational and Environmental Health | Year: 2014

Objectives: To evaluate the influence of perceived stress and musculoskeletal ache/pain, separately and in combination, at baseline, on self-rated work ability and work performance at two-year follow-up. Methods: Survey data were collected with a 2-year interval. Health care workers participating at both waves were included. Inclusion criteria were good self-reported work ability and unchanged self-rated work performance at baseline, resulting in 770 participants; 617 women and 153 men. Musculoskeletal pain was assessed using the question "How often do you experience pain in joints and muscles, including the neck and low back?", perceived stress with a modified version of a single item from the QPS-Nordic questionnaire, work performance by the question "Have your work performance changed during the preceding 12 months?" and work ability by a single item from the work ability index. Associations between baseline data and the two outcomes at follow-up were analysed by means of the log binomial model and expressed as risk ratios (RR) with 95 % confidence intervals (CI). Results: A combination of frequent musculoskeletal pain and perceived stress constituted the highest risk for reporting decreased work performance (RR 1.7; CI 1.28-2.32) and reduced work ability (RR 1.7; CI 1.27-2.30) at follow-up. Separately, frequent pain, but not stress, was clearly associated with both outcomes. Conclusion: The results imply that proactive workplace interventions in order to maintain high work performance and good work ability should include measures to promote musculoskeletal well-being for the employees and measures, both individual and organizational, to minimize the risk of persistent stress reactions. © 2013 The Author(s).

Glise K.,Institute of Stress Medicine | Glise K.,Gothenburg University | Ahlborg Jr G.,Institute of Stress Medicine | Ahlborg Jr G.,Gothenburg University | Jonsdottir I.H.,Institute of Stress Medicine
BMC Psychiatry | Year: 2012

Background: Long-term sick leave due to mental health problems, especially among women, is a substantial problem in many countries, and a major reason for this is thought to be psychosocial stress. The recovery period of different patient groups with stress-related mental health problems can differ considerably. We have studied the course of mental health symptoms during 18 months of multimodal treatment in relation to sex and age in a group of patients with stress-related exhaustion.Methods: The study group includes 232 patients (68% women) referred to a stress clinic and who fulfilled the criteria for Exhaustion Disorder (ED). The majority also fulfilled diagnostic criteria for depression and/or anxiety; this was similar among women and men. Symptoms were assessed at baseline, three, six, 12 and 18 months by the Shirom-Melamed Burnout Questionnaire (SMBQ) and the Hospital Anxiety and Depression scale (HAD). A total SMBQ mean score of ≥ 4 was used to indicate clinical burnout, which correlates well with the clinical diagnosis of ED.Results: There were no statistically significant differences between women and men or between young and old patients in the self-reported symptoms at baseline. The proportion that had high burnout scores decreased over time, but one-third still had symptoms of clinical burnout after 18 months. Symptoms indicating probable depression or anxiety (present in 34% and 65% of the patients at baseline, respectively) declined more rapidly, in most cases within the first three months, and were present only in one out of 10 after 18 months. The course of illness was not related to sex or age. The duration of symptoms before seeking health care, but not the level of education or co-morbid depression, was a predictor of recovery from symptoms of burnout after 18 months.Conclusions: The course of mental illness in patients seeking specialist care for stress-related exhaustion was not related to sex or age. The burden of mental symptoms is high and similar for men and women, and at the 18 month follow-up, one-third of the study group still showed symptoms of burnout. A long duration of symptoms before consultation was associated with a prolonged time of recovery, which underlines the importance of early detection of stress-related symptoms. © 2012 Glise et al; licensee BioMed Central Ltd.

Glise K.,Institute of Stress Medicine | Glise K.,Gothenburg University | Hadzibajramovic E.,Institute of Stress Medicine | Jonsdottir I.H.,Institute of Stress Medicine | Ahlborg Jr. G.,Gothenburg University
International Archives of Occupational and Environmental Health | Year: 2010

Objective The aim of this study was to assess the construct and predictive validity of a new instrument for selfrating of stress-related Exhaustion Disorder (s-ED). Methods Public healthcare workers and social insurance officers, 85% females, were included (N = 2,683) in a longitudinal study. The s-ED instrument, based on clinical criteria for Exhaustion Disorder, was used at baseline to classify participants into three categories: non-s-ED, light/moderate s-ED and pronounced s-ED. Other assessments include burnout, anxiety, depression and work ability. Sick leave at follow-up after 2 years was defined as 14 days of ongoing sick leave (SA14) or a period of 60 days of sick leave during the last 12 months (SA60). Associations at baseline were expressed as prevalence ratios, and adjusted relative risks (RR) were calculated using Cox regression. Results At baseline, 16% reported s-ED. Scores of depression, anxiety and burnout and the rate of poor work ability increased with increasing severity of s-ED. Selfreported exhaustion at baseline increased the risk of reporting sickness absence at follow-up; pronounced s-ED RR 2.7; CI 1.8-4.0 for SA14 and RR 3.4; CI 2.3-5.2 for SA60. Conclusions Self-rated ED corresponded well to established scales for mental health, indicating sufficient construct validity. Individuals reporting s-ED at baseline were more likely to report sickness absence at follow-up, confirming its predictive properties. The s-ED instrument may be a useful tool for occupational health services in identifying human service workers at risk of having or developing a potentially disabling stress-related mental illness. © Springer-Verlag 2009.

Arvidson E.,Institute of Stress Medicine | Borjesson M.,Karolinska University Hospital | Borjesson M.,Gothenburg University | Ahlborg G.,Institute of Stress Medicine | And 4 more authors.
BMC Public Health | Year: 2013

Background: With increasing age, physical capacity decreases, while the need and time for recovery increases. At the same time, the demands of work usually do not change with age. In the near future, an aging and physically changing workforce risks reduced work ability. Therefore, the impact of different factors, such as physical activity, on work ability is of interest. Thus, the aim of this study was to evaluate the association between physical activity and work ability using both cross sectional and prospective analyses. Methods. This study was based on an extensive questionnaire survey. The number of participants included in the analysis at baseline in 2004 was 2.783, of whom 2.597 were also included in the follow-up in 2006. The primary outcome measure was the Work Ability Index (WAI), and the level of physical activity was measured using a single-item question. In the cross-sectional analysis we calculated the level of physical activity and the prevalence of poor or moderate work ability as reported by the participants. In the prospective analysis we calculated different levels of physical activity and the prevalence of positive changes in WAI-category from baseline to follow-up. In both the cross sectional and the prospective analyses the prevalence ratio was calculated using Generalized Linear Models. Results: The cross-sectional analysis showed that with an increased level of physical activity, the reporting of poor or moderate work ability decreased. In the prospective analysis, participants reporting a higher level of physical activity were more likely to have made an improvement in WAI from 2004 to 2006. Conclusions: The level of physical activity seems to be related to work ability. Assessment of physical activity may also be useful as a predictive tool, potentially making it possible to prevent poor work ability and improve future work ability. For employers, the main implications of this study are the importance of promoting and facilitating the employees' engagement in physical activity, and the importance of the employees' maintaining a physically active lifestyle. © 2013 Arvidson et al.; licensee BioMed Central Ltd.

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