Purpose: We investigated the association between hyperacusis and aspects of psychosocial work environment in a general population. The objectives were to investigate (1) prevalence and characteristics (among age, sex, access to social support at home, education, smoking, physical exercise, and perceived general health) of hyperacusis in a general working population and (2) associations between hyperacusis and psychosocial factors in the work environment. The psychosocial work aspects included effort, reward, overcommitment, worry, and social and emotional support.

Methods: Using data from a sample stratified for age and sex from the Österbotten Environmental Health Study in Finland, currently employed participants with self-reported hyperacusis and referents were compared on questionnaire instruments quantifying six aspects of their psychosocial work environment.

Results: Among 856 currently employed participants, 47 constituted a hyperacusis group and 809 a reference group. The hyperacusis group scored significantly higher than the referents on worry at work, social support at work, and reward at work, but not on emotional support at work, work overcommitment, or effort at work. About 40% of the hyperacusis group scored on the upper quartile of the three former work environment factors, with odds ratios ranging from 1.91 to 2.56.

Conclusions: The results suggest that worrying about aspects at work, perceiving low social support, and not perceiving being rewarded at work are associated with hyperacusis.

BACKGROUND: Primary prevention of cardiovascular disease often fails because of poor adherence among practitioners and individuals to prevention guidelines. We aimed to investigate whether ultrasound-based pictorial information about subclinical carotid atherosclerosis, targeting both primary care physicians and individuals, improves prevention.

METHODS: Visualization of asymptomatic atherosclerotic disease for optimum cardiovascular prevention (VIPVIZA) is a pragmatic, open-label, randomised controlled trial that was integrated within the Västerbotten Intervention Programme, an ongoing population-based cardiovascular disease prevention programme in northern Sweden. Individuals aged 40, 50, or 60 years with one or more conventional risk factors were eligible to participate. Participants underwent clinical examination, blood sampling, and ultrasound assessment of carotid intima media wall thickness and plaque formation. Participants were randomly assigned 1:1 with a computer-generated randomisation list to an intervention group (pictorial representation of carotid ultrasound plus a nurse phone call to confirm understanding) or a control group (not informed). The primary outcomes, Framingham risk score (FRS) and European systematic coronary risk evaluation (SCORE), were assessed after 1 year among participants who were followed up. This study is registered with ClinicalTrials.gov, number NCT01849575.

FINDINGS: 3532 individuals were enrolled between April 29, 2013, and June 7, 2016, of which 1783 were randomly assigned to the control group and 1749 were assigned to the intervention group. 3175 participants completed the 1-year follow-up. At the 1-year follow-up, FRS and SCORE differed significantly between groups (FRS 1·07 [95% CI 0·11 to 2·03, p=0·0017] and SCORE 0·16 [0·02 to 0·30, p=0·0010]). FRS decreased from baseline to the 1-year follow-up in the intervention group and increased in the control group (-0·58 [95% CI -0·86 to -0·30] vs 0·35 [0·08 to 0·63]). SCORE increased in both groups (0·13 [95% CI 0·09 to 0·18] vs 0·27 [0·23 to 0·30]).

INTERPRETATION: This study provides evidence of the contributory role of pictorial presentation of silent atherosclerosis for prevention of cardiovascular disease. It supports further development of methods to reduce the major problem of low adherence to medication and lifestyle modification.

Introduction: Higher midlife body mass index (BMI) is suggested to increase the risk of dementia, but weight loss during the preclinical dementia phase may mask such effects. Methods: We examined this hypothesis in 1,349,857 dementia-free participants from 39 cohort studies. BMI was assessed at baseline. Dementia was ascertained at follow-up using linkage to electronic health records (N = 6894). We assumed BMI is little affected by preclinical dementia when assessed decades before dementia onset and much affected when assessed nearer diagnosis. Results: Hazard ratios per 5-kg/m(2) increase in BMI for dementia were 0.71 (95% confidence interval = 0.66-0.77), 0.94 (0.89-0.99), and 1.16 (1.05-1.27) when BMI was assessed 10 years, 10-20 years, and >20 years before dementia diagnosis. Conclusions: The association between BMI and dementia is likely to be attributable to two different processes: a harmful effect of higher BMI, which is observable in long follow-up, and a reverse-causation effect that makes a higher BMI to appear protective when the follow-up is short. 

The main objective is to study the effects of job crafting activities of elder care and nursing home employees on their perceived well-being and quality of care in two European countries, Spain and Sweden. The Job Crafting, the General Health, and the Quality of Care questionnaires were administered to 530 employees. Correlations and hierarchical regression analyses were performed. Results confirm the effects of job crafting on quality of care (r = .291, p < .01; β = .261, p < .01; ΔR² = .065, p < .01) and employees’ well-being (r = .201, p < .01; β = .171, p < .01; ΔR² = .028, p < .01). A positive linear relationship was found between job crafting and well-being in Spain and Sweden and with quality of care in Spain. On the contrary, in Sweden, the relationship between job crafting and well-being was not linear. Job crafting contributes significantly to employees’ and residents’ well-being. Management should promote job crafting to co-create meaningful and productive work. Cultural effects are proposed to explain the differences found.

Background: Knowledge about the impact of occupational exposures, such as work stress, on the risk of atrial fibrillation is limited. The present study aims to investigate the association between job strain, a measure of work stress, and atrial fibrillation.

Design: Prospective cohort study design and fixed-effect meta-analysis.

Methods: Data from the Swedish Longitudinal Occupational Survey of Health (SLOSH) was utilised for the main analysis, combining self-reported data on work stress at baseline with follow-up data on atrial fibrillation from nationwide registers. Cox proportional hazard regression analyses were used to estimate hazard ratios and 95% confidence intervals (CIs). A fixed-effect meta-analysis was conducted to pool the results from the present study with results from two similar previously published studies.

Results: Based on SLOSH data, job strain was associated with an almost 50% increased risk of atrial fibrillation (hazard ratio 1.48, 95% CI 1.00-2.18) after adjustment for age, sex and education. Further adjustment for smoking, physical activity, body mass index and hypertension did not alter the estimated risk. The meta-analysis of the present and two previously published studies showed a consistent pattern, with job strain being associated with increased risk of atrial fibrillation in all three studies. The estimated pooled hazard ratio was 1.37 (95% CI 1.13-1.67).

Conclusion: The results highlight that occupational exposures, such as work stress, may be important risk factors for incident atrial fibrillation.

Background Obesity increases the risk of several chronic diseases, but the extent to which the obesity-related loss of disease-free years varies by lifestyle category and across socioeconomic groups is unclear. We estimated the number of years free from major non-communicable diseases in adults who are overweight and obese, compared with those who are normal weight.

Methods We pooled individual-level data on body-mass index (BMI) and non-communicable diseases from men and women with no initial evidence of these diseases in European cohort studies from the Individual-Participant-Data Meta-Analysis in Working Populations consortium. BMI was assessed at baseline (1991-2008) and non-communicable diseases (incident type 2 diabetes, coronary heart disease, stroke, cancer, asthma, and chronic obstructive pulmonary disease) were ascertained via linkage to records from national health registries, repeated medical examinations, or self-report. Disease-free years from age 40 years to 75 years associated with underweight (BMI <18.5 kg/m(2)), overweight (>= 25 kg/m(2) to <30 kg/m(2)), and obesity (class I [mild] >= 30 kg/m(2) to < 35 kg/m(2); class II-III [severe] >= 35 kg/m(2)) compared with normal weight (>= 18.5 kg/m(2) to <25 kg/m(2)) were estimated.

Findings Of 137 503 participants from ten studies, we excluded 6973 owing to missing data and 10 349 with prevalent disease at baseline, resulting in an analytic sample of 120 181 participants. Of 47 127 men, 211 (0.4%) were underweight, 21 468 (45.6%) normal weight, 20 738 (44.0%) overweight, 3982 (8.4%) class I obese, and 728 (1.5%) class II-III obese. The corresponding numbers among the 73 054 women were 1493 (2.0%), 44 760 (61.3%), 19 553 (26.8%), 5670 (7.8%), and 1578 (2.2%), respectively. During 1 328 873 person-years at risk (mean follow-up 11.5 years [range 6.3-18.6]), 8159 men and 8100 women developed at least one non-communicable disease. Between 40 years and 75 years, the estimated number of disease-free years was 29.3 (95% CI 28.8-29.8) in normal-weight men and 29.4 (28.7-30.0) in normal-weight women. Compared with normal weight, the loss of disease-free years in men was 1.8 (95% CI -1.3 to 4.9) for underweight, 1.1 (0.7 to 1.5) for overweight, 3.9 (2.9 to 4.9) for class I obese, and 8.5 (7.1 to 9.8) for class II-III obese. The corresponding estimates for women were 0.0 (-1.4 to 1.4) for underweight, 1.1 (0.6 to 1.5) for overweight, 2.7 (1.5 to 3.9) for class I obese, and 7.3 (6.1 to 8.6) for class II-III obese. The loss of disease-free years associated with class II-III obesity varied between 7.1 and 10.0 years in subgroups of participants of different socioeconomic level, physical activity level, and smoking habit.

Interpretation Mild obesity was associated with the loss of one in ten, and severe obesity the loss of one in four potential disease-free years during middle and later adulthood. This increasing loss of disease-free years as obesity becomes more severe occurred in both sexes, among smokers and non-smokers, the physically active and inactive, and across the socioeconomic hierarchy. 

Background: There is growing evidence for a negative impact of traffic-related air pollution on risk of dementia. However, the contribution of noise exposure to this association has been rarely examined.

Objective: We aimed to investigate the individual and combined effect of noise and air pollution on risk of dementia.

Methods: Data on dementia incidence over a 15 year period was obtained from the Betula project, a longitudinal study on health and ageing. Estimates of annual mean levels of nitrogen oxides (NOx) at the participants’ residential address were obtained using a land-use regression model. Modelled data provided road traffic noise levels (Leq. 24 h) at the participants’ residential address at baseline. Cox proportional hazard regression was used to calculate hazard ratios (HR).

Results: Of 1721 participants at baseline, 302 developed dementia during the follow up period. Exposure to noise levels (Leq. 24 h) > 55 dB had no significant effect on dementia risk (HR 0.95; CI: 0.57, 1.57). Residing in the two highest quartiles of NOx exposure was associated with an increased risk of dementia. The risk associated with NOx was not modified by adjusting for noise. Moreover, we found no significant interaction effects between NOx and road traffic noise on dementia risk.

Conclusion: We found no evidence that exposure to road traffic noise, either independently or in combination with traffic air pollution, was associated with risk of dementia in our study area. Our results suggest that pollution should be considered the main component in the association between traffic related exposures and dementia.

Projektet Aktivitetsbaserat Kontor (AktiKon) har följt och utvärderat en förändringsprocess i Örnsköldsviks kommun där tjänstemännen i kommunen flyttade från cellkontor till antingen ett aktivitetsbaserat kontor (AB-kontor) eller ett cellkontor. Syftet med forskningsprojektet var att studera effekter på arbetsmiljö, fysisk aktivitet, hälsa och produktivitet i aktivitetsbaserad kontorsmiljö och kunna jämföra med fortsatt arbete i cellkontor. Mätningar med enkäter, fokusgruppsintervjuer, gåturer och observationer utfördes 6 mån före flytt och 6 respektive 18 månader efter flytt. Individuella intervjuer av personer med upplevd funktionsnedsättning utfördes ca 10 månader efter flytt. Rörelsemätningar utfördes vid fem olika tillfällen under flyttprocessen.

I denna rapport har vi valt att redovisa enkätresultat från anställda som vi har kunnat följa över tid, d.v.s. individer där vi har resultat från enkät besvarad före flytt och från minst ett tillfälle efter flytt. Den ursprungliga studiepopulationen som studerades med denna metod bestod från början av 374 anställda och vid den sista uppföljningen, 18 månader efter flytt, av 152 anställda i AB-kontoret och 63 i cellkontoret. De två grupperna som flyttade till olika kontorsmiljöer var inte helt jämförbara. Exempelvis var det fler män och chefer som flyttade till AB-kontoret och yrkesgrupperna var inte heller lika, men alla som ingick i projektet var tjänstemän inom samma kommun.

De som flyttade till AB-kontoret upplevde den nya kontorsmiljön som estetiskt tilltalande och luftkvaliteten god. De som flyttade till nya cellkontor hade utifrån kvalitativa intervjuer inte en lika positiv uppfattning vad gäller kontorets design och inredning.

Arbetsbelastningen och olika typer av krav såg lika ut över tid för respektive grupp. Det var vid 18 månader efter flytt ingen skillnad jämfört med före flytt i hälsofrämjande arbetsfaktorer undersökta med WEMS-instrumentet (Work Experience Measurement Scale) för de som flyttat till AB-kontor. Det var inte heller någon skillnad över tid i jämförelse med de som flyttat till cellkontor. Datorstödet upplevdes mycket positivt av de som flyttade till AB-kontoret och de blev något mer nöjda än de som flyttade till cellkontor. Det fanns i AB-kontoret inte någon säker skillnad i upplevelse av samarbete mellan olika arbetsgrupper eller inom hela organisationen vid 18 månader efter flytt jämfört med utgångsläget och inte heller någon säker skillnad över tid jämfört med cellkontoret. De som flyttade till AB-kontor rapporterade efter flytten en ökad störning av ljud och besvär av bristande avskildhet. Man upplevde i genomsnitt en lägre produktivitet i AB-kontoret efter flytt och det fanns en skillnad mellan de två kontorstyperna över tid.

Cheferna var generellt nöjda med att arbeta i AB-kontor och de upplevde inte någon minskad produktivitet vid övergång till AB-kontor. I genomsnitt blev det emellertid en minskad nöjdhet med kontorets utformning i gruppen som flyttade till AB-kontor. Nöjdheten med AB-kontoret varierade beroende på yrke och typ av arbetsuppgifter. De som hade mycket enskilt och koncentrationskrävande datorarbete upplevde mindre nöjdhet efter flytt och angav att de helst ville arbeta i cellkontor om de fick välja. De som arbetade mycket i grupp, behövde vara idérika och ofta diskuterade med kollegor föredrog att arbeta i AB-kontor. Bland dem som helst ville arbeta i cellkontor fanns det en ökad förekomst av problem med stress, långvarig utmattning och psykiska besvär.

Det framkom ökade problem med koncentrationen hos de som flyttade till AB-kontor. Det fanns däremot inga säkra skillnader över tid mellan grupperna vad gäller skattning av allmän hälsa och förekomst av andra typer av besvär.

Redan före flytten hade båda grupperna tillgång till höj- och sänkbara bord och det var vanligt att arbeta stående under en rätt stor del av arbetsdagen. Efter flytten ökade tiden i gående och antal steg något i AB-kontoret jämfört med cellkontoret. I AB-kontoret fanns tillgång till gå-band, men dessa användes endast av ett fåtal anställda. Den centralt belägna öppna trappan var omtyckt och användes mycket.

Sammanfattningsvis visar studien att nöjdhet, preferens och produktivitet i AB-kontor varierar mycket beroende på vilka arbetsuppgifter man har. AB-kontoret fungerar särskilt bra för personer med ledningsuppdrag. För att AB-kontoret ska kunna fungera bra även för personer med funktionsnedsättning måste det finnas system för att fånga upp individuella problem och möjliggöra anpassningar vid behov. Detta gäller särskilt vid psykiska besvär och kognitiva svårigheter. Det är angeläget att det i AB-kontoret finns tillgång till stödytor och resurser i tillräcklig omfattning för alla de olika arbetsuppgifter som ska utföras.

En viktig erfarenhet i projektet är betydelsen av att kunna beskriva den kontext som förändringen sker i. Genom att göra en processutvärdering har det funnits möjlighet att på ett adekvat sätt tolka och förstå de effekter som framkom vid övergång till AB-kontor.

Framgångsfaktorer vid övergång till AB-kontor är noggrann kartläggning och analys före flytt, samverkan, delaktighet, överenskomna regler och förhållningssätt, och övergripande rutiner som inkluderar hela kontoret för det fortsatta arbetsmiljöarbetet.

Purpose - Hierarchical and flat organizational types are predominant in Spain and Sweden, respectively. To study how managers' commitment and work overcommitment (WOC) affect employee well-being, and job perception in these different countries can shed insight on how to improve eldercare organization. The purpose of this paper was to study the association between eldercare employee exposure to managers' commitment and WOC, and employee mental well-being and job perception and how these associations differed between Spain and Sweden.

Design/methodology/approach - A questionnaire with validated questions on commitment, WOC, mental well-being and job perception, operationalized as the perception of quality of care and turnover intent, was sent out to eldercare managers and employees in Spain and Sweden. t-Tests, (2) and linear regression were applied to study the associations and differences between the countries.

Findings - Interaction analyses revealed that Spanish employees' mental well-being and job perception were influenced by their managers' commitment and WOC in that manager commitment improved and WOC impaired well-being and job perception. However, the Swedish eldercare employees were not influenced by their managers on these parameters.

Practical implications - The impact of managerial commitment and WOC differed between employees in Spain and Sweden, possibly because the preconditions for leadership varied due to differences in organizational type.

Originality/value - This study compares the managers' impact on employee health and job perception in two countries with different organizational prerequisites. Moreover, managers' commitment and WOC were estimated by the managers themselves and did not rely on the employees' perception, which improved ecological validity.