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  • 1.
    Aronsson, Vanda
    et al.
    Stockholm Univ.
    Toivanen, Susanna
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd. Stockholm Univ, Dept Publ Hlth Sci, Stockholm, Sweden..
    Leineweber, Constanze
    Stockholm Univ, Stress Res Inst, S-10691 Stockholm, Sweden..
    Nyberg, Anna
    Stockholm Univ, Stress Res Inst, S-10691 Stockholm, Sweden..
    Can a poor psychosocial work environment and insufficient organizational resources explain the higher risk of ill-health and sickness absence in human service occupations?: Evidence from a Swedish national cohort2019Inngår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 47, nr 3, s. 310-317Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: The aim of this study was to investigate differences in burnout, self-rated health (SRH) and sickness absence between human service occupations (HSOs) and other occupations, and whether they can be attributed to differences in psychosocial work environment and organizational resources. Methods: Data were derived from the Swedish Longitudinal Occupational Survey of Health, an approximately representative sample of the Swedish working population (n = 4408). Employment in HSOs, psychosocial work environment and organizational resources in 2012 predicted relative risks of sickness absence, burnout and suboptimal SRH in 2014 using modified Poisson regressions. The psychosocial work factors' and organizational resource variables' relative importance were estimated by adding them to the models one by one, and with population attributable fractions (PAFs). Results: Employment in HSOs was associated with a higher risk of sickness absence and the risk was explained by psychosocial and organizational factors, particularly high emotional demands, low work-time control and exposure to workplace violence. Employment in HSOs was not associated with burnout after sociodemographic factors were adjusted for, and furthermore not with SRH. A lower risk of suboptimal SRH was found in HSOs than in other occupations with equivalent psychosocial work environment and organizational resources. PAFs indicated that psychosocial work environment and organizational resource improvements could lead to morbidity reductions for all outcomes; emotional demands were more important in HSOs. Conclusions: HSOs had higher risks of sickness absence and burnout than other occupations. The most important work factors to address were high emotional demands, low work-time control, and exposure to workplace violence.

  • 2. Bernhard-Oettel, Claudia
    et al.
    Bergman, Louise
    Leineweber, Constanze
    Toivanen, Susanna
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Flourish, fight or flight: Health and well-being in self-employment over time-associations with business success2019Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Purpose: Around 9% of the working population in Sweden consists of self-employed business owners, but a considerable amount of them struggle to consolidate or expand their businesses. Among the factors predicting business success the decisive role of long-term health of business owners has been acknowledged only recently, but longitudinal studies testing this assumption are scarce. Based on the conservation of resources theory, good health can be seen as a resource that helps business owners to tackle high workloads and make business succeed.Design: Data from the Swedish Longitudinal Occupational Health Survey is used. Starting in 2012, N= 554 self-employed have answered three or more times in the biannual data collection. Latent growth curve modelling is employed to study general and mental health trajectories and their associations with business survival over time.Results: Preliminary descriptive analyses on biannual changes suggest that roughly one in ten self-employed leaves self-employment at follow-up. Job demands and emotional exhaustion are higher among those who leave compared to those who remain in business. After integrating new data collected in 2018, growth curve analyses are run over the whole longitudinal sample, and associations of health trajectories to business survival will be tested.Limitations: Data is collected with questionnaires, and business success is operationalized as business survival only.

  • 3.
    Berthelsen, Hanne
    et al.
    Malmo Univ, Ctr Work Life & Evaluat Studies, Malmo, Sweden..
    Muhonen, Tuija
    Malmo Univ, Ctr Work Life & Evaluat Studies, Malmo, Sweden..
    Toivanen, Susanna
    Mälardalens högskola, Akademin för hälsa, vård och välfärd. Stockholm University, Dept of Publ Health Sciences, Stockholm, Sweden.
    What happens to the physical and psychosocial work environment when activity-based offices are introduced into academia?2018Inngår i: Journal of Corporate Real Estate, ISSN 1463-001X, E-ISSN 1479-1048, Vol. 20, nr 4, s. 230-243Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose There is an increased interest for introducing activity-based offices at universities. The purpose of this study is to contribute to the knowledge about the importance of the built environment for the psychosocial work environment within academia by analyzing how staff at a large Swedish university experienced the physical and psychosocial work environment before and after moving to activity-based offices. Design/methodology/approach A Web-based survey was distributed to all employees at two faculties at a university three months before (2015, n = 217, response rate 51 per cent) and nine months after (2016, n = 200, response rate 47 per cent) relocation to a new activity-based university building. Findings In the new premises, a vast majority (86 per cent) always occupied the same place when possible, and worked also more often from home. The social community at work had declined and social support from colleagues and supervisors was perceived to have decreased. The participants reported a lower job satisfaction after the relocation and were more likely to seek new jobs. No aspects in the physical or psychosocial work environment were found to have improved after the relocation. Research/limitations implications The study had a two-wave cross-sectional design, which does not allow establishing causal relations. Practical implications There is reason to be cautious about relocation to activity-based offices at universities. The potential savings in costs for premises may lead to may be followed by an increase in other costs. The risk that staff cannot concentrate on their work in activity-based university workplaces and lose their sense of community with colleagues are factors, which in the long run may lead to decreased efficiency, more conflicts and poorer well-being. Originality/value This paper contributes with new knowledge concerning changes in the physical and psychosocial work environment when relocating from cell offices to activity-based offices in a university setting.

  • 4.
    Bujacz, Aleksandra
    et al.
    Karolinska Institutet, Stockholm, Sweden.
    Eib, Constanze
    Uppsala University, Uppsala, Sweden.
    Toivanen, Susanna
    Mälardalens högskola, Akademin för hälsa, vård och välfärd. Stockholm University, Dept of Publ Health Sciences, Stockholm, Sweden.
    Not All Are Equal: A Latent Profile Analysis of Well-Being Among the Self-Employed2019Inngår i: Journal of Happiness Studies, ISSN 1389-4978, E-ISSN 1573-7780Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This study uses a person-centered approach to distinguish between subpopulations of self-employed individuals using multidimensional well-being indicators. Data were obtained from European Social Survey including a sample of 3461 self-employed individuals from 29 European countries. The analysis has empirically identified six distinct profiles named ‘unhappy’, ‘languishing’, ‘happy’, ‘satisfied’, ‘passionate’, and ‘flourishing’. The profiles were associated with significant differences in well-being, health and work-related variables. The results highlight the heterogeneity of the self-employed population, and describe the complex—both hedonic and eudaimonic—character of the well-being concept in this population.

  • 5.
    Bälter, O.
    et al.
    Department of Media Technology and Interaction Design, KTH—Royal Institute of Technology, Stockholm, Sweden.
    Hedin, B.
    Department of Media Technology and Interaction Design, KTH—Royal Institute of Technology, Stockholm, Sweden.
    Tobiasson, H.
    Department of Media Technology and Interaction Design, KTH—Royal Institute of Technology, Stockholm, Sweden.
    Toivanen, Susanna
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Walking outdoors during seminars improved perceived seminar quality and sense of well-being among participants2018Inngår i: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 15, nr 2, artikkel-id 303Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Low levels of physical activity and sedentary behaviour are a growing health problem globally. Physical inactivity is associated with increased risk of numerous ailments, cardiovascular disease and mortality. Our primary aim was to perform a feasibility study on how to incorporate physical activity among students and teachers in regular teaching activities. The second aim was to investigate how students and teachers perceived the differences between outdoor walking seminars and regular indoor seminars. By transforming an on-campus course into a blended course, we were able to conduct seminars outdoors in nearby nature while walking. These walking seminars were evaluated among 131 students and nine teachers leading the walking seminars. The responses to the student survey and teacher interviews indicate that discussions, sense of well-being and the general quality of the seminar improved, regardless of how physically active participants were the rest of the time. The study shows one way to increase physical activity with small means; in our case, a reorganization of how we prepared for the seminars which allowed for walking discussions.

  • 6.
    Canivet, Catarina
    et al.
    Lund University, Sweden.
    Bodin, Theo
    Emmelin, Maria
    Lund University, Sweden.
    Toivanen, Susanna
    CHESS, (Centre for Health Equity Studies), Stockholm, Sweden.
    Moghaddassi, Mahnaz
    Lund University, Sweden.
    Östergren, Per-Olof
    Lund University, Sweden.
    Precarious employment is a risk factor for poor mental health in young individuals in Sweden: a cohort study with multiple follow-ups.2016Inngår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 16, artikkel-id 687Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: The globalisation of the economy and the labour markets has resulted in a growing proportion of individuals who find themselves in a precarious labour market situation, especially among the young. This pertains also to the Nordic countries, despite their characterisation as well developed welfare states with active labour market policies. This should be viewed against the background of a number of studies, which have shown that several aspects of precarious employment are detrimental to mental health. However, longitudinal studies from the Nordic region that examine the impact of precarious labour market conditions on mental health in young individuals are currently lacking. The present study aims to examine this impact in a general cohort of Swedish young people.

    METHODS: Postal questionnaires were sent out in 1999/2000 to a stratified random sample of the Scania population, Sweden; the response rate was 58 %. All of those who responded at baseline were invited to follow-ups after 5 and 10 years. Employment precariousness was determined based on detailed questions about present employment, previous unemployment, and self-rated risk of future unemployment. Mental health was assessed by GHQ-12. For this study individuals in the age range of 18-34 years at baseline, who were active in the labour market (employed or seeking job) and had submitted complete data from 1999/2000, 2005, and 2010 on employment precariousness and mental health status, were selected (N = 1135).

    RESULTS: Forty-two percent of the participants had a precarious employment situation at baseline. Labour market trajectories that included precarious employment in 1999/2000 or 2005 predicted poor mental health in 2010: the incidence ratio ratio was 1.4 (95 % CI: 1.1-2.0) when excluding all individuals with mental health problems at baseline and adjusting for age, gender, social support, social capital, and economic difficulties in childhood. The population attributable fraction regarding poor mental health in the studied age group was 18 %.

    CONCLUSIONS: This study supported the hypothesis that precarious employment should be regarded as an important social determinant for subsequent development of mental health problems in previously mentally healthy young people.

  • 7.
    Dellve, Lotta
    et al.
    Göteborgs universitet, Sweden.
    Håkansta, Carin
    Karlstads universitet, Sweden.
    Toivanen, Susanna
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd. Stockholm University, Dept of Publ Health Sciences, Stockholm, Sweden.
    Kylin, Camilla
    Karlstads universitet, Sweden.
    Lindberg, Per
    Högskolan i Gävle, Sweden.
    Rydenfält, Christofer
    Lunds tekniska högskola, Sweden.
    Ståhl, Christian
    Linköpings universitet, Sweden.
    Berglund, Leif
    Luleå tekniska universitet, Sweden.
    Kaltenbrunner Nykvist, Monica
    Högskolan i Gävle, Sweden.
    Snabbt förändrade arbetsmiljöer kräver forskning som bidrar till bred kunskap och metodik2018Inngår i: Arbetsmarknad & Arbetsliv, ISSN 1400-9692, Vol. 24, nr 3-4, s. 85-89Artikkel i tidsskrift (Annet vitenskapelig)
  • 8.
    Drake, Emma
    et al.
    Stockholm University, Stockholm, Sweden.
    Toivanen, Susanna
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd. Stockholm University, Stockholm, Sweden.
    Leineweber, Constanze
    Stockholm University, Stockholm, Sweden.
    Nyberg, Anna
    Stockholm University, Stockholm, Sweden.
    Is combining human service work with family caregiving associated with additional odds of emotional exhaustion and sickness absence? A cross-sectional study based on a Swedish cohort2020Inngår i: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 93, nr 1, s. 55-65Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    PURPOSE: The aim of the study is to examine to what extent human service work and family caregiving is associated with emotional exhaustion and sickness absence, and to what extent combining human service work and family caregiving is associated with additional odds.

    METHODS: Data were derived from participants in paid work from the Swedish Longitudinal Occupational Survey of Health, year 2016 (n = 11 951). Logistic regression analyses were performed and odds ratios and 95% confidence intervals estimated for the association between human service work and family caregiving, respectively, as well as combinations of the two on one hand, and emotional exhaustion and self-reported sickness absence on the other hand. Interaction between human service work and family caregiving was assessed as departure from additivity with Rothman's synergy index.

    RESULTS: Human service work was not associated with higher odds of emotional exhaustion, but with higher odds of sickness absence. Providing childcare was associated with higher odds of emotional exhaustion, but lower odds of sickness absence, and caring for a relative was associated with higher odds of both emotional exhaustion and sickness absence. There was no indication of an additive interaction between human service work and family caregiving in relation to neither emotional exhaustion nor sickness absence.

    CONCLUSIONS: We did not find support for the common assumption that long hours providing service and care for others by combining human service work with family caregiving can explain the higher risk of sickness absence or emotional exhaustion among employees in human service occupations.

  • 9.
    Dunlavy, A. C.
    et al.
    Stockholm University/Karolinska Institutet.
    Juárez, S.
    Stockholm University/Karolinska Institutet.
    Toivanen, Susanna
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd. Stockholm University/Karolinska Institutet.
    Rostila, M.
    Stockholm University/Karolinska Institutet.
    Suicide risk among native- and foreign-origin persons in Sweden: a longitudinal examination of the role of unemployment status2019Inngår i: Social Psychiatry and Psychiatric Epidemiology, ISSN 0933-7954, E-ISSN 1433-9285, Vol. 54, nr 5, s. 579-590Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: Prior research has documented an association between unemployment and elevated suicide risk. Yet, few Swedish studies have explicitly considered how such risk may vary by different migration background characteristics among persons of foreign-origin, who often experience diverse forms of labor market marginalization. This study examines the extent to which unemployment status may differentially influence suicide risk among the foreign-origin by generational status, region of origin, age at arrival, and duration of residence. Methods: Population-based registers were used to conduct a longitudinal, open cohort study of native-origin and foreign-origin Swedish residents of working age (25–64 years) from 1993 to 2008. Hazard ratios and 95% confidence intervals for suicide mortality were estimated using gender-stratified Cox proportional hazards models. Results: Elevated suicide risk observed among foreign-origin unemployed groups was generally of a similar or lower magnitude than that found in unemployed native-origin, although unemployed second-generation Swedish men demonstrated significantly greater (p < 0.05) excess risk of suicide than that observed among their native-origin counterparts. Unemployed foreign-born men with a younger age at arrival and longer duration of residence demonstrated an increased risk of suicide, while those who arrived as adults, and a shorter duration of residence did not show any increased risk. Among foreign-born women, excess suicide risk persisted regardless of age at arrival and duration of residence in the long-term unemployed. Conclusions: Multiple migration background characteristics should be considered when examining relationships between employment status and suicide among the foreign-origin.

  • 10. Eto, Fabiola Naomi
    et al.
    Santos, RS
    Melo, ECP
    Harter Griep, Rosane
    Toivanen, Susanna
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd. Stockholm University, Dept of Publ Health Sciences, Stockholm, Sweden.
    958 Comparing two approaches to scoring allostatic load in brazilian civil servants: April 2018 Occupational and Environmental Medicine 75(Suppl 2):A309.1-A3092018Inngår i: Occupational and Environmental Medicine, 2018, Vol. 75(Suppl2), s. A309.1-a309.Konferansepaper (Fagfellevurdert)
  • 11.
    Fahlén Bergh, Cecilia
    et al.
    Karolinska Institutet,Stockholm, Sweden.
    Toivanen, Susanna
    Stockholm University, Dept of Publ Health Sciences, Stockholm, Sweden.
    Johnell, Kristina
    Karolinska Institutet, Stockholm,Sweden.
    Calissendorff, Jan
    Karolinska Institutet, Stockholm,Sweden.
    Skov, Jakob
    Karolinska Institutet, Stockholm,Sweden.
    Falhammar, Henrik
    Karolinska Institutet, Stockholm,Sweden.
    Nathanson, David
    Karolinska Institutet, Stockholm,Sweden.
    Lindh, Jonatan D
    Karolinska Institutet, Stockholm,Sweden.
    Mannheimer, Buster
    Karolinska Institutet, Stockholm,Sweden.
    Factors of importance for discontinuation of thiazides associated with hyponatremia in Sweden: A population-based register study.2019Inngår i: Pharmacoepidemiology and Drug Safety, ISSN 1053-8569, E-ISSN 1099-1557Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    PURPOSE: In a patient with clinically significant hyponatremia without other clear causes, thiazide treatment should be replaced with another drug. Data describing to which extent this is being done are scarce. The aim of this study was to investigate sociodemographic and socioeconomic factors that may be of importance for the withdrawal of thiazide diuretics in patients hospitalized due to hyponatremia.

    METHODS: The study population was sampled from a case-control study investigating individuals hospitalized with a main diagnosis of hyponatremia. For every case, four matched controls were included. In the present study, cases (n = 5204) and controls (n = 7425) that had been dispensed a thiazide diuretic prior to index date were identified and followed onward regarding further dispensations. To investigate the influence of socioeconomic and sociodemographic factors, multiple logistic regression was used.

    RESULTS: The crude prevalence of thiazide withdrawal for cases and controls was 71.9% and 10.8%, respectively. Thiazide diuretics were more often withdrawn in medium-sized towns (adjusted OR, 1.52; 95% CI, 1.21-1.90) and rural areas (aOR, 1.81; 95% CI, 1.40-2.34) compared with metropolitan areas and less so among divorced (aOR, 0.72; 95% CI, 0.53-0.97). However, education, employment status, income, age, country of birth, and gender did not influence withdrawal of thiazides among patients with hyponatremia.

    CONCLUSIONS: Thiazide diuretics were discontinued in almost three out of four patients hospitalized due to hyponatremia. Educational, income, gender, and most other sociodemographic and socioeconomic factors were not associated with withdrawal of thiazides.

  • 12.
    Gisselmann, Marit
    et al.
    Myndigheten för ungdoms- och civilsamhällesfrågor, Sweden.
    Hemström, Örjan
    Statistiska centralbyrån, Sweden.
    Toivanen, Susanna
    Mälardalens högskola, Akademin för hälsa, vård och välfärd. Stockholm University, Dept of Publ Health Sciences, Stockholm, Sweden.
    Kön, genus och skillnader i hälsa2018Inngår i: Den orättvisa hälsan - om socioekonomiska skillnader i hälsa och livslängd / [ed] Mikael Rostila & Susanna Toivanen, Stockholm: Liber, 2018, 267, s. 67-85Kapittel i bok, del av antologi (Fagfellevurdert)
  • 13. Griep, Rosane Härter
    et al.
    Bastos, Leonardo S
    Fonseca, Maria de Jesus Mendes da
    Silva-Costa, Aline
    Portela, Luciana Fernandes
    Toivanen, Susanna
    Mälardalens högskola, Akademin för hälsa, vård och välfärd. Stockholm University, Dept of Publ Health Sciences, Stockholm, Sweden.
    Rotenberg, Lucia
    Years worked at night and body mass index among registered nurses from eighteen public hospitals in Rio de Janeiro, Brazil.2014Inngår i: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 14, artikkel-id 603Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Employees working night shifts are at a greater risk of being overweight or obese. Few studies on obesity and weight gain analyze the years of exposure to night work. The aim of this study was to determine the relationship between the years of exposure to night work and body mass index (BMI) among registered nurses.

    METHODS: A cross-sectional analysis was performed in 18 largest public hospitals in Rio de Janeiro, Brazil. A total of 2,372 registered nurses (2,100 women) completed a comprehensive questionnaire concerning sociodemographic, professional, lifestyle, and health behavioral data. Current and past exposures to night shifts as well as BMI values were measured as continuous variables. A gamma regression model was used with an identity link function to establish the association.

    RESULTS: The association between years of exposure to night work and BMI was statistically significant for both women and men after adjusting for all covariates [β = 0.036; CI95% = 0.009-0.063) and β = 0.071 (CI95% = 0.012-0.129), respectively]. The effect of night work was greater among men than women. For example, for those women who have worked at night for 20 years the estimated average BMI was 25.6 kg/m2 [range, 25.0-26.2]. In relation to men, after 20 years of exposure to night work the estimated average BMI was 26.9 kg/m2 [range, 25.6-28.1].

    CONCLUSIONS: These findings suggest that night shift exposure is related to BMI increases. Obesity prevention strategies should incorporate improvements in work environments, such as the provision of proper meals to night workers, in addition to educational programs on the health effects of night work.

  • 14.
    Griep, Rosane Härter
    et al.
    Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Brazil.
    Nobre, Aline Araújo
    Fundação Oswaldo Cruz, Rio de Janeiro RJ, Brazil.
    Alves, Márcia Guimarães de Mello
    Universidade Federal Fluminense, Niterói RJ, Brazil.
    da Fonseca, Maria de Jesus Mendes
    Universidade Federal Fluminense, Niterói RJ, Brazil.
    Cardoso, Letícia de Oliveira
    Universidade Federal Fluminense, Niterói RJ, Brazil.
    Giatti, Luana
    Universidade Federal de Ouro Preto, Belo Horizonte MG, Brazil.
    Melo, Enirtes Caetano Prates
    Fundação Oswaldo Cruz, Rio de Janeiro RJ, Brazil.
    Toivanen, Susanna
    Stockholm University, Dept of Publ Health Sciences, Stockholm, Sweden.
    Chor, Dóra
    Fundação Oswaldo Cruz, Rio de Janeiro RJ, Brazil.
    Job strain and unhealthy lifestyle: results from the baseline cohort study, Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).2015Inngår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 15, artikkel-id 309Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Unhealthy lifestyle choices, such as smoking and sedentary behavior, are among the main modifiable risk factors for chronic non-communicable diseases. The workplace is regarded as an important site of potential health risks where preventive strategies can be effective. We investigated independent associations among psychosocial job strain, leisure-time physical inactivity, and smoking in public servants in the largest Brazilian adult cohort.

    METHODS: We conducted a cross-sectional analysis of baseline data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)-a multicenter prospective cohort study of civil servants. Our analytical samples comprised 11,779 and 11,963 current workers for, respectively, analyses of job strain and leisure-time physical activity and analyses of job strain and smoking. Job strain was assessed using the Brazilian version of the Swedish Demand-Control-Support Questionnaire; physical activity was evaluated using a short form of the International Physical Activity Questionnaire. We also examined smoking status and number of cigarettes smoked per day. The association reported in this paper was assessed by means of multinomial and logistic regression, stratified by sex.

    RESULTS: Among men, compared with low-strain activities (low demand and high control), job strain showed an association with physical inactivity (odds ratio [OR] = 1.34; 95% confidence interval [CI] = 1.09-1.64) or with the practice of physical activities of less than recommended duration (OR = 1.44; 95% CI = 1.15-1.82). Among women, greater likelihood of physical inactivity was identified among job-strain and passive-job groups (OR = 1.47; 95% CI = 1.22-1.77 and OR = 1.42; 95% CI = 1.20-1.67, respectively). Greater control at work was a protective factor for physical inactivity among both men and women. Social support at work was a protective factor for physical inactivity among women, as was smoking for both genders. We observed no association between demand or control dimensions and smoking.

    CONCLUSIONS: Job strain, job control, and social support were associated with physical activity. Social support at work was protective of smoking. Our results are comparable to those found in more developed countries; they provide additional evidence of an association between an adverse psychosocial work environment and health-related behaviors.

  • 15.
    Griep, Rosane Härter
    et al.
    Fundacao Oswaldo Cruz, Brazil.
    Toivanen, Susanna
    Stockholm University, Dept of Publ Health Sciences, Stockholm, Sweden.
    Santos, Itamar S
    Universidade de Sao Paulo, Brazil.
    Rotenberg, Lucia
    Fundacao Oswaldo Cruz, Brazil.
    Juvanhol, Leidjaira Lopes
    Fundacao Oswaldo Cruz, Brazil.
    Goulart, Alessandra C
    Universidade de Sao Paulo, Brazil.
    Aquino, Estela M
    Universidade Federal da Bahia, Brazil.
    Benseñor, Isabela
    Universidade de Sao Paulo, Brazil.
    Work-family conflict, lack of time for personal care and leisure, and job strain in migraine: Results of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).2016Inngår i: American Journal of Industrial Medicine, ISSN 0271-3586, E-ISSN 1097-0274, Vol. 59, nr 11, s. 987-1000Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Work-family conflict and time scarcity may affect health. We investigated the association between these issues and migraine, taking into account job strain.

    METHODS: Baseline data from ELSA-Brasil (6,183 women; 5,664 men) included four indicators of work-family conflict: time- and strain-based interference of work with family (TB-WFC, SB-WFC), interference of family with work (FWC) and lack of time for personal care and leisure (LOT). Migraine was classified according to International Headache Society criteria.

    RESULTS: Among women, definite migraine was associated with SB-WFC (odds ratio [OR] = 1.28; 95% confidence interval [CI] 1.06-1.55), FWC (OR = 1.32; 1.00-1.75), and LOT (OR = 1.30; 1.08-1.58). Probable migraine was associated with SB-WFC (OR = 1.17; 1.00-1.36). High psychological job demands and low social support interacted with LOT in association with definite migraine. Among men, probable migraine was associated with LOT (OR = 1.34; 1.09-1.64), and there were interactions between job strain and WFC for probable migraine.

    CONCLUSIONS: Balancing the demands of professional and domestic spheres could be highly relevant in the management of migraines. Am. J. Ind. Med. 59:987-1000, 2016. © 2016 Wiley Periodicals, Inc.

  • 16.
    Griep, Rosane Härter
    et al.
    Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Brazil.
    Toivanen, Susanna
    Stockholm University, Dept of Publ Health Sciences, Stockholm, Sweden.
    van Diepen, Cornelia
    Portsmouth University, Portsmouth, UK.
    Guimarães, Joanna M N
    Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Brazil.
    Camelo, Lidyane V
    Faculty of Medicine, Universidade Federal de Minas Gerais, Minas Gerais, Brazil.
    Juvanhol, Leidjaira Lopes
    Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Brazil.
    Aquino, Estela M
    Federal University of Bahia, Salvador, Bahia, Brazil.
    Chor, Dóra
    Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Brazil.
    Work-Family Conflict and Self-Rated Health: the Role of Gender and Educational Level. Baseline Data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).2016Inngår i: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 23, nr 3, s. 372-382Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    PURPOSE: This study examined gender differences in the association between work-family conflict and self-rated health and evaluated the effect of educational attainment.

    METHOD: We used baseline data from ELSA-Brasil, a cohort study of civil servants from six Brazilian state capitals. Our samples included 12,017 active workers aged 34-72 years. Work-family conflict was measured by four indicators measuring effects of work on family, effects of family in work and lack of time for leisure and personal care.

    RESULTS: Women experienced more frequent work-family conflict, but in both genders, increased work-family conflict directly correlated with poorer self-rated health. Women's educational level interacted with three work-family conflict indicators. For time-based effects of work on family, highly educated women had higher odds of suboptimal self-rated health (OR = 1.54; 95 % CI = 1.19-1.99) than less educated women (OR = 1.14; 95 % CI = 0.92-1.42). For strain-based effects of work on family, women with higher and lower education levels had OR = 1.91 (95 % CI 1.48-2.47) and OR = 1.40 (95 % CI 1.12-1.75), respectively. For lack of time for leisure and personal care, women with higher and lower education levels had OR = 2.60 (95 % CI = 1.95-3.47) and OR = 1.11 (95 % CI = 0.90-1.38), respectively.

    CONCLUSION: Women's education level affects the relationship between work-family conflict and self-rated health. The results may contribute to prevention activities.

  • 17.
    Hagqvist, E.
    et al.
    Stockholm University, Sweden.
    Vinberg, S.
    Mid Sweden University, Sweden.
    Toivanen, Susanna
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd. Stockholm University, Sweden.
    Hagström, M.
    Mid Sweden University, Sweden.
    Granqvist, S.
    Mid Sweden University, Sweden.
    Landstad, B. J.
    Mid Sweden University, Sweden.
    Falling outside the system: Occupational safety and health inspectors’ experiences of micro-enterprises in Sweden2020Inngår i: Safety Science, ISSN 0925-7535, E-ISSN 1879-1042, Vol. 125, artikkel-id 104631Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    In this study, 11 Swedish occupational safety and health (OSH) inspectors were interviewed about their views of and experiences interacting with micro-enterprises (1-9 employees). The qualitative content analysis found one theme, “Falling outside the system”, and three subthemes, “The inspector—shaped by specific standards”, “The bureaucrat and the micro-entrepreneur—two separate worlds”, and “System faults and system changes”. According to the inspectors, the Swedish OSH regulatory system, with inspectors on the front line, neglects the specific needs, circumstances and characteristics of micro-enterprises. Therefore, we suggest revising the OSH regulatory system and following inspection methods and enforcement styles to better address the needs of micro-enterprises.

  • 18. Hagqvist, Emma
    et al.
    Bernhard-oettel, Claudia
    Toivanen, Susanna
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd. Stockholm University, Dept of Publ Health Sciences, Stockholm, Sweden.
    Balancing work and life when self-employed: the role of gender contexts2018Inngår i: Gender perspectives on self-employment focusing on work - life balance and working conditions, 2018Konferansepaper (Fagfellevurdert)
  • 19.
    Hagqvist, Emma
    et al.
    Mid Sweden University, Östersund, Sweden.
    Toivanen, Susanna
    Stockholm University, Dept of Publ Health Sciences, Stockholm, Sweden.
    Bernhard-Oettel, Claudia
    Stockholm University, 106 91 Stockholm, Sweden.
    Balancing Work and Life When Self-Employed: The Role of Business Characteristics, Time Demands, and Gender Contexts2018Inngår i: Social Sciences, ISSN 2076-0760, E-ISSN 2076-0760, Vol. 7, nr 8, s. 139-Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This study explores individual and contextual risk factors in relation to work interfering with private life (WIL) and private life interfering with work (LIW) among self-employed men and women across European countries. It also studies the relationship between interference (LIW and WIL) and well-being among self-employed men and women. Drawing on data from the fifth round of the European Working Conditions Survey, a sample of self-employed men and women with active businesses was extracted. After applying multilevel regressions, results show that although business characteristics are important, the most evident risk factor for WIL and LIW is time demands. Both time demands and business characteristics also seem to be important factors in relation to gender differences in level of interference. There is a relationship between well-being and both WIL and LIW, and time demands is again an important factor. Gender equality in the labor market did not relate to level of interference, nor did it affect the relationship between interference and well-being. However, in gender-separated analyses, LIW and LIW interacted with gender equality in the labor market in different ways for women’s and men’s well-being. In conclusion, gender relations are important in interference and how interference relates to well-being

  • 20.
    Hagqvist, Emma
    et al.
    Mid Sweden University, Östersund, Sweden.
    Toivanen, Susanna
    Stockholm University, Stockholm, Sweden.
    Vinberg, Stig
    Mid Sweden University, Östersund, Sweden.
    The gender time gap: Time use among self-employed women and men compared to paid employees in Sweden2019Inngår i: Time & Society, ISSN 0961-463X, E-ISSN 1461-7463, Vol. 28, nr 2, s. 680-696Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    In this article, the authors set out to study the time use of men and women in Sweden, comparing self-employed and employed individuals. Previous studies indicate that there are reasons to believe that both gendered time use and mechanisms related to time use might differ between the self-employed and employees. Employing time use data, the aim was to study whether there are differences in gendered time use between self-employed individuals and employees in Sweden, and furthermore, which mechanism relates to gendered time use among self-employed individuals and employees. The results show that self-employed men and women distribute their time in a more gender-traditional manner than employees. In addition, relative resources are found to be an important factor related to gendered time use among the self-employed. For employees, gender relations tend to be a mechanism related to …

  • 21. Hökerberg, Yara Hahr Marques
    et al.
    Reichenheim, Michael Eduardo
    Faerstein, Eduardo
    Passos, Sonia Regina Lambert
    Fritzell, Johan
    Toivanen, Susanna
    Mälardalens högskola, Akademin för hälsa, vård och välfärd. Stockholm University, Dept of Publ Health Sciences, Stockholm, Sweden.
    Westerlund, Hugo
    Cross-cultural validity of the demand-control questionnaire: Swedish and Brazilian workers.2014Inngår i: Revista de Saude Publica, ISSN 0034-8910, E-ISSN 1518-8787, Vol. 48, nr 3, s. 486-96, artikkel-id S0034-89102014000300486Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE To evaluate the cross-cultural validity of the Demand-Control Questionnaire, comparing the original Swedish questionnaire with the Brazilian version. METHODS We compared data from 362 Swedish and 399 Brazilian health workers. Confirmatory and exploratory factor analyses were performed to test structural validity, using the robust weighted least squares mean and variance-adjusted (WLSMV) estimator. Construct validity, using hypotheses testing, was evaluated through the inspection of the mean score distribution of the scale dimensions according to sociodemographic and social support at work variables. RESULTS The confirmatory and exploratory factor analyses supported the instrument in three dimensions (for Swedish and Brazilians): psychological demands, skill discretion and decision authority. The best-fit model was achieved by including an error correlation between work fast and work intensely (psychological demands) and removing the item repetitive work (skill discretion). Hypotheses testing showed that workers with university degree had higher scores on skill discretion and decision authority and those with high levels of Social Support at Work had lower scores on psychological demands and higher scores on decision authority. CONCLUSIONS The results supported the equivalent dimensional structures across the two culturally different work contexts. Skill discretion and decision authority formed two distinct dimensions and the item repetitive work should be removed.

  • 22.
    Klingelschmidt, Justine
    et al.
    Inserm, U1085, Équipe ESTER, Angers, France.
    Milner, Allison
    University of Melbourne, Melbourne, Australie.
    Khireddine-Medouni, Imane
    Santé publique France, Direction Santé Travail, Saint-Maurice, France.
    Witt, Katrina
    Monash University, Fitzroy, Australia.
    Alexopoulos, Evangelos C
    IASO General Hospital, Athens, Greece.
    Toivanen, Susanna
    Stockholm University, Dept of Publ Health Sciences, Stockholm, Sweden.
    LaMontagne, Anthony D
    Stockholm University, Stockholm, Suede.
    Chastang, Jean-François
    Université d’Angers, Équipe ESTER, Angers, France.
    Niedhammer, Isabelle
    Université d’Angers, Équipe ESTER, Angers, France.
    Le suicide chez les travailleurs du secteur agriculture, sylviculture et pêche: une revue systématique de la littérature et méta-analyse2019Inngår i: Archives des maladies professionnelles et de l'environnement, ISSN 1775-8785, E-ISSN 1778-4190, Vol. 79, nr 4, s. 561-562Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [fr]

    ObjectifsLes objectifs de l’étude étaient de quantifier le risque de suicide des travailleurs de l’agriculture, de la sylviculture et de la pêche via une revue systématique de la littérature et une méta-analyse et d’étudier les éventuelles variations de risque au sein de cette population selon ses caractéristiques professionnelles et sociodémographiques. Jusqu’à présent, le suicide au sein de cette population n’avait jamais fait l’objet d’une revue systématique de la littérature et/ou d’une méta-analyse.MéthodesUne revue systématique de la littérature sur la période 1995–2016 et une méta-analyse à partir de la base de données MEDLINE via le moteur de recherche Pubmed ont été réalisées conformément aux recommandations PRISMA. La méta-analyse a permis de calculer une estimation poolée de la taille d’effet du risque de suicide au sein de la population d’intérêt. Des analyses par sous-groupes ont ensuite été …

  • 23.
    Klingelschmidt, Justine
    et al.
    Research Institute for Environmental and Occupational Health (IRSET), Epidemiology in Occupational Health and Ergonomics (ESTER) Team, Angers, France..
    Milner, Allison
    University of Melbourne, Melbourne School of Population and Global Health, Centre for Health Equity, Melbourne, Australia..
    Khireddine-Medouni, Imane
    Santé Publique France, Direction Santé Travail, Saint-Maurice, France.
    Witt, Katrina
    Monash University, Turning Point, Eastern Health Clinical School, Fitzroy, Australia.
    Alexopoulos, Evangelos C
    Occupational Health Unit, “IASO” General Hospital, Athens, Greece.
    Toivanen, Susanna
    Stockholm University, Centre for Health Equity Studies, Stockholm, Sweden.
    LaMontagne, Anthony D
    Deakin University, Centre for Population Health Research, School of Health & Social Development, Geelong, Australia.
    Chastang, Jean-François
    Research Institute for Environmental and Occupational Health (IRSET), Epidemiology in Occupational Health and Ergonomics (ESTER) Team, Angers, France.
    Niedhammer, Isabelle
    Research Institute for Environmental and Occupational Health (IRSET), Epidemiology in Occupational Health and Ergonomics (ESTER) Team, Angers, France..
    Suicide among agricultural, forestry, and fishery workers: A systematic literature review and meta-analysis.2018Inngår i: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 44, nr 1, s. 3-15, artikkel-id 3682Artikkel, forskningsoversikt (Fagfellevurdert)
    Abstract [en]

    Objectives This review aimed to quantify suicide risk among agricultural, forestry, and fishery workers and study potential variations of risk within this population. Methods We conducted a systematic literature review and meta-analysis from 1995 to 2016 using MEDLINE and following the PRISMA guidelines. A pooled effect size of suicide risk among the population of interest was calculated using meta-analysis. Subgroup analyses were conducted to investigate whether effect size differed according to population or study characteristics. Meta-regression was used to identify sources of heterogeneity. Results The systematic review identified 65 studies, of which 32 were included in the meta-analysis. Pooled effect size was 1.48 [95% confidence interval (CI) 1.30-1.68] representing an excess of suicide risk among the population of interest. Subgroup analysis showed that this effect size varied according to geographic area, with a higher effect size in Japan. The following study characteristics were found to contribute to the between-study variance: reference group, measure of effect size, and study design. Conclusions Our findings suggest an excess of suicide risk among agricultural, forestry, and fishery workers and demonstrated that this excess may be even higher for these groups in Japan. This review highlights the need for suicide prevention policies focusing on this specific population of workers. More research is also needed to better understand the underlying factors that may increase suicide risk in this population.

  • 24.
    Lundeberg, Olle
    et al.
    Stockholm University, Stockholm, Sweden.
    Toivanen, Susanna
    Stockholm University, Dept of Publ Health Sciences, Stockholm, Sweden.
    Sense of Coherence and Social Structure2019Inngår i: Encyclopedia of Environmental Health, vol 5, Edition: 2nd, Saunders Elsevier, 2019, s. 704-709Kapittel i bok, del av antologi (Fagfellevurdert)
    Abstract [en]

    In the international literature on the importance of social and psychosocial factors for health, a number of concepts focused on people’s relation to their environment are put forward, albeit in different forms. A common theme is whether people’s cognition of and reaction to their environment may influence their health, and even promote health or buffer stress. Of these concepts, the notion of sense of coherence (SOC) developed by medical sociologist Aaron Antonovsky has gained much attention. According to Antonovsky’s salutogenic model, people who perceive their life as comprehensible and meaningful and who also consider themselves capable of managing problems are better able to deal successfully with health-threatening stressful situations of everyday life. Salutogenesis, the origin of health, focuses on the interaction between people and the structures of society, and elucidates how people manage stress and stay well despite stressful situations and hardships.

  • 25. Manhica, Hélio
    et al.
    Toivanen, Susanna
    Mälardalens högskola, Akademin för hälsa, vård och välfärd. Stockholm University, Dept of Publ Health Sciences, Stockholm, Sweden.
    Hjern, Anders
    Rostila, Mikael
    Mortality in adult offspring of immigrants: a Swedish national cohort study.2015Inngår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 10, nr 2, artikkel-id e0116999Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Higher risks of psychiatric disorders and lower-than-average subjective health in adulthood have been demonstrated in offspring of immigrants in Sweden compared with offspring of native Swedes, and linked to relative socioeconomic disadvantage. The present study investigated mortality rates in relation to this inequity from a gender perspective.

    METHODS: We used data from national registers covering the entire Swedish population aged 18-65 years. Offspring of foreign-born parents who were either Swedish born or had received residency in Sweden before school age (<7 years) were defined as "offspring of immigrants." We used Cox regression models to examine the association between parental country of birth and mortality between 1990 and 2008, with adjustment for education, income, age and family type.

    RESULTS: Male offspring of immigrants from the Middle East (HR:2.00, CI:1.66-2.26), other non-European countries (HR:1.80, CI:1.36-2.36) and Finland (HR:1.56, CI:1.48-1.65) showed an age-adjusted excess mortality risk from all causes of death when compared to offspring with Swedish-born parents. Income, but not education, greatly attenuated these increased mortality risks. No excess mortality rates were found among female offspring of immigrants, with the exception of external cause of death among offspring of Finnish immigrants.

    CONCLUSION: The study demonstrates high mortality rates in male offspring of immigrants from Finland and non-European countries that are associated with economic, but not educational, disadvantage. No increased mortality rates were found among female offspring of immigrants. Future studies are needed to explain this gender differential and why income, but not education, predicts mortality in male offspring of immigrants.

  • 26. Mellner, Christin
    et al.
    Peters, Pascale
    Toivanen, Susanna
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd. Stockholm University, Dept of Publ Health Sciences, Stockholm, Sweden.
    Individual Perceptions of Boundary Control Mitigate the Effect of (in) Congruence Between Workers’ Preferred Work/Non-Work Boundaries and their Enacted Boundary Management on Work-Life Conflict2019Inngår i: Abstract Book of the 19th European Association of Work and Organizational Psychology, 2019, s. 693-694Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Purpose: Rapid development of boundary-transcending ICTs have led to more flexible forms of work organization, marking a fundamental shift in the flexibility and permeability of employees’ work-nonwork boundaries. This study investigates the inter-relationships between employees’ boundary management types, representing boundary (in)congruence between their preferred and enacted boundary management, and work-life conflict, and the potential moderating role of perceived boundary control herein.

    Design/Methodology: Data comprised 3,154 Swedish professional workers in different occupations within both the public and private sector. Correlations, t-tests, Chi square tests and univariate general linear model analyses (ANCOVA) were performed.

    Findings: Enacted integration as well as boundary incongruence were both positively associated with work-life-conflict. Moreover, incongruence accompanied by a high degree of enacted integration increased work-life conflict. Finally, boundary control mitigated work-life conflict. This was especially the case among employees preferring segmentation but enacting integration, i.e., boundary incongruence, but also among employees both preferring and enacting integration, i.e., boundary congruence.

    Practical implications: This study provides new and valuable knowledge on different boundary management types, reflecting boundary (in)congruence, that are associated with increased work-life conflict depending on the specific type of (in)congruence in question, and the role of boundary control herein as an important factor to combat work-life conflict. This kind of knowledge is of high relevance in contemporary working life characterized by an ever-increased blurring of work-nonwork boundaries. Organizations play an important role in creating new legitimate beliefs and as such, leisure norms could be implemented that promote employees’ boundary control, and subsequent reduced work-life conflict.

  • 27. Modin, Bitte
    et al.
    Ostberg, Viveca
    Toivanen, Susanna
    Mälardalens högskola, Akademin för hälsa, vård och välfärd. Stockholm University, Dept of Publ Health Sciences, Stockholm, Sweden.
    Sundell, Knut
    Psychosocial working conditions, school sense of coherence and subjective health complaints. A multilevel analysis of ninth grade pupils in the Stockholm area.2011Inngår i: Journal of Adolescence, ISSN 0140-1971, E-ISSN 1095-9254, Vol. 34, nr 1, s. 129-39Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This study explores the psychosocial working conditions of 7930 Swedish 9th grade students, distributed over 475 classes and 130 schools, in relation to their subjective health using multilevel modeling. At the individual level, students with "strained" working conditions in school (i.e. those experiencing a high level of demands in combination with a low level of control) demonstrated significantly worse health compared to students in "low-strain" situations. "Strained" conditions in combination with a weak school-related sense of coherence were especially unfavourable for health. These findings remained significant when support from teachers, school marks, norm-breaking behaviours, family-relations and certain class- and school-contextual conditions were adjusted for. Thus, while demands are an essential part of school work, this study suggests that high levels of control and a strong school-related sense of coherence can protect against the more detrimental effects on health that high demands at school may cause.

  • 28.
    Niedhammer, Isabelle
    et al.
    Research Institute for Environmental and Occupational Health (IRSET), Epidemiology in Occupational Health and Ergonomics (ESTER) Team, Angers, France.
    Milner, Allison
    University of Melbourne, Melbourne School of Population and Global Health, Centre for Health Equity, Melbourne, Australia.
    Witt, Katrina
    Monash University, Turning Point, Eastern Health Clinical School, Fitzroy, Australia.
    Klingelschmidt, Justine
    Santé publique France, Direction Santé Travail, Saint-Maurice, France.
    Khireddine-Medouni, Imane
    Santé publique France, Direction Santé Travail, Saint-Maurice, France.
    Alexopoulos, Evangelos C
    Occupational Health Unit, “IASO” General Hospital, Athens, Greece.
    Toivanen, Susanna
    Stockholm University, Centre for Health Equity Studies, Stockholm, Sweden..
    Chastang, Jean-François
    Research Institute for Environmental and Occupational Health (IRSET), Epidemiology in Occupational Health and Ergonomics (ESTER) Team, Angers, France.
    LaMontagne, Anthony D
    Deakin University, Centre for Population Health Research, School of Health & Social Development, Geelong, Australia.
    Response to letter to the editor from Dr Rahman Shiri: The challenging topic of suicide across occupational groups.2018Inngår i: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 44, nr 1, s. 108-110, artikkel-id 3698Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    We thank Dr Rahman Shiri (1) for his careful reading of our systematic review and meta-analysis on suicide among agricultural, forestry, and fishery workers (2). Our paper had the objective of providing a pooled effect size of suicide for this occupational group. Suicide is a crucial issue in public and occupational health. Suicide has a multifactorial etiology and recent systematic reviews and meta-analyses have pointed out the role of occupational exposures, mainly psychosocial work stressors, as risk factors for suicide (3, 4). Suicide is a very rare event in the general population and still more seldom in the working population. Indeed, unemployed and economically inactive people have a higher risk of suicide compared to employed people (5, 6). However, the total number of suicides is greater in the employed population than among the economically inactive or unemployed (6). Shiri's letter (1) questioned several aspects of our review and meta-analysis. One comment related to the single reference database used in our review and a suggestion that our review could not be considered to be systematic. The review was based on Medline because our main interest was in quantitative epidemiologic studies. This is the largest database for biomedical literature and we would argue the most pertinent. Furthermore, we checked the reference lists of the most recent papers and literature reviews, and Shiri did not report any paper that was missing. No review, whether searching one or more databases, can expect to be totally exhaustive. There may always be missing studies, especially if we consider grey literature. Thus we assert that our review was systematic, while acknowledging that it may not be perfectly comprehensive. Shiri suggested an absence of quality assessment of the studies included in our meta-analysis. First, quality was considered in the context of our comments in the discussion section. Second, as suggested by Rothman et al (7), quality assessment was replaced by regression analyses of the effect of each quality item (study characteristics, ie, study design, effect measure, reference group, and adjustment). Third, because most studies included in this review were based on objective data (census, administrative, or register data), they were free of many of the sources of bias that exist in studies where information on exposure and outcome must be collected from participants. Consequently, many of the items related to quality were not pertinent, such as response and follow-up rates, coverage and representativeness of the sample, selection, etc. Contrary to what Shiri suggested, all study designs can be informative in this topic because all of them are able to provide an unbiased estimate of the effect size. In addition, the prospective and case-control studies may have shortcomings. For example, we excluded five studies including three prospective and case-control studies in the sensibility analysis because the group of interest was defined on the basis of the exposure to chemicals (pesticides) rather than job title. Our choice to retain the least adjusted models was justified because aggregated data were used for the meta-analysis. Therefore, unless all included studies adjusted for the same covariates measured in the same way, adjusted estimates cannot be meaningfully provided in an aggregate data meta-analysis. In addition, as the objective was above all descriptive and not etiological or explanatory, and as it is the norm in the exploration of social inequalities in health (8), the results from the least (gender- and age-) adjusted models were in line with the objective. Indeed, including more adjustment variables could lead to overadjustment as they may be intermediate variables on the causal pathways between occupation and suicide. Our strategy was in line with previous meta-analyses on similar topics (9-11). Consequently, we would argue that our results are not likely to be largely due to confounding, contrary to the comment by Shiri. Indeed, the study of the contribution of underlying factors in explaining social inequalities in health outcomes is a fully-fledged topic of research (12-15), but this is relevant research to conduct after demonstrating that inequalities exist between social or occupational groups. Several of Shiri's comments were about statistical aspects of our analyses. First, it was suggested that we did not correctly extract the confidence intervals for the estimates of several studies. We disagree. We used the STATA metan suite of commands using log-transformed effect sizes and standard errors. Our figure 1 and the values of effect sizes and confidence intervals were provided by STATA, this explains why there may be small differences in these values compared with the results published in some studies. Using log-transformed effect sizes and confidence intervals, the analysis provided the same results. Second, our subgroup comparison was based on subsamples that were independent. As not all studies provided information for these subgroups, each subgroup was treated as a unit of analysis. This strategy allows the use of all relevant subgroups and comparisons between them (16). Third, we were also criticized for the use of random-effects models. Random-effects models are generally more plausible for meta-analysis based on studies from the published literature, because the fixed-effect model assumed that the entire corpus of literature has been obtained, ie, that every study has been or ever will be written on the topic has been included, which is an implausible assumption. We also assumed differences in effect size between studies and between subgroups, and the use of random-effects models was consistent with such an assumption. However, random-effects models produce wider confidence intervals compared to fixed-effect models (16). These models are thus more conservative, making our results all the more robust. One of Shiri's comments related to the reference group used in the studies for the comparison of agricultural, forestry, and fishery workers. Although we reported that the studies using a specific occupational group as reference group provided a higher effect size than the studies using other reference groups, we did not explicitly recognize and state in the paper that the results for Japan were based on two studies using a specific occupational group as reference; we concede that this may explain why we found a much more elevated effect size for Japan. Shiri's results (1) allow to conclude that the difference between Japan and the other geographic areas could be explained by the choice of reference group-we are grateful to him for raising this point. However, we would note that the effect size of suicide was still elevated and significant for agricultural, forestry, and fishery workers even after this change in the reference group for these two studies. Nevertheless, the choice of the optimal reference group is not obvious. If we consider the general population as the reference group, as unemployed people and economically inactive people (including people who may not be working due to illness or disability) are part of it and have a higher risk of suicide than employed people, the effect size provided by the nine studies using the general population as the reference is likely to be underestimated, which may contribute to an underestimation of the observed effect size of suicide among agricultural, forestry, and fishery workers in our study. The comparison was made in our paper with the other occupational groups (ie, the working population except the group of interest) as the reference, which was used by nine other studies, but this did not allow to determine the exact rank of the group of interest in the occupational hierarchy. Another relevant choice would have been to retain the group with the lowest suicide risk (for example, the high-skilled occupational group) as the reference, which would have led to a much higher effect size of suicide for agricultural, forestry, and fishery workers. To conclude, as statistical power in detecting differences between subgroups may be low in subgroup analyses and meta-regression, the absence of significant results according to subgroups found in our results cannot be interpreted as evidence that the effect size is the same across subgroups. Consequently, our meta-analysis reporting a significant excess of risk of suicide among agricultural, forestry, and fishery workers may also be a good incentive for more research among this group of workers to (i) confirm this observed excess of risk using differing methodological approaches to meta-analysis and (ii) explore the potential differences within this group and the underlying factors that may explain this excess of risk. References 1. Shiri R. Suicide among agricultural, forestry, and fishery workers. Scand J Work Environ Health - online first. https://doi.org/10.5271/sjweh.3697 2. Klingelschmidt J, Milner A, Khireddine-Medouni I, Witt K, Alexopoulos EC, Toivanen S, et al. Suicide among agricultural, forestry, and fishery workers: a systematic literature review and meta-analysis. Scand J Work Environ Health - online first. https://doi.org/10.5271/sjweh.3682 3. Milner A, Witt K, LaMontagne AD, Niedhammer I. Psychosocial job stressors and suicidality: a meta-analysis and systematic review. Occup Environ Med - online first. https://doi.org/10.1136/oemed-2017-104531 4. Leach LS, Poyser C, Butterworth P. Workplace bullying and the association with suicidal ideation/thoughts and behaviour: a systematic review. Occup Environ Med. 2017;74(1):72-9. https://doi.org/10.1136/oemed-2016-103726 5. Milner A, Page A, LaMontagne AD. Long-term unemployment and suicide: a systematic review and meta-analysis. PLoS One. 2013;8(1):e51333. https://doi.org/10.1371/journal.pone.0051333 6. Milner A, Morrell S, Lamontagne AD. Economically inactive, unemployed and employed suicides in Australia by age and sex over a 10-year period: what was the impact of the 2007 economic recession? Int J Epidemiol. 2014;43(5):1500-7. https://doi.org/10.1093/ije/dyu148 7. Rothman KJ, Greenland S, Lash TL. Modern Epidemiology - Third Edition. Philadelphia: Wolters Kluwer Health - Lippincott Williams & Wilkins; 2008. 8. Lundberg I, Hemmingsson T, Hogstedt C. Work and social inequalities in health in Europe. Brussels: P.I.E. Peter Lang SA; 2007. 9. Milner A, Spittal MJ, Pirkis J, Lamontagne AD. Suicide by occupation: systematic review and meta-analysis. Br J Psychiatry. 2013;203(6):409-16. https://doi.org/10.1192/bjp.bp.113.128405 10. Lorant V, Deliege D, Eaton W, Robert A, Philippot P, Ansseau M. Socioeconomic inequalities in depression: a meta-analysis. Am J Epidemiol. 2003;157(2):98-112. https://doi.org/10.1093/aje/kwf182 11. Grittner U, Kuntsche S, Gmel G, Bloomfield K. Alcohol consumption and social inequality at the individual and country levels--results from an international study. Eur J Public Health. 2013;23(2):332-9. https://doi.org/10.1093/eurpub/cks044 12. Niedhammer I, Bourgkard E, Chau N. Occupational and behavioural factors in the explanation of social inequalities in premature and total mortality: a 12.5-year follow-up in the Lorhandicap study. Eur J Epidemiol. 2011;26(1):1-12. https://doi.org/10.1007/s10654-010-9506-9 13. Niedhammer I, Chastang JF, David S, Kelleher C. The contribution of occupational factors to social inequalities in health: findings from the national French SUMER survey. Soc Sci Med. 2008;67(11):1870-81. https://doi.org/10.1016/j.socscimed.2008.09.007 14. Chazelle E, Lemogne C, Morgan K, Kelleher CC, Chastang JF, Niedhammer I. Explanations of educational differences in major depression and generalised anxiety disorder in the Irish population. J Affect Disord. 2011;134(1-3):304-14. https://doi.org/10.1016/j.jad.2011.05.049 15. Niedhammer I, Lesuffleur T, Coutrot T, Chastang JF. Contribution of working conditions to occupational inequalities in depressive symptoms: results from the national French SUMER survey. Int Arch Occup Environ Health. 2016;89(6):1025-37.https://doi.org/10.1007/s00420-016-1142-6 16. Borenstein M, Hedges LV, Higgins JPT, Rothstein HR. Introduction to meta-analysis: John Wiley & Sons, Ltd. ISBN: 978-0-470-05724-7; 2009. https://doi.org/10.1002/9780470743386.

  • 29.
    Nyberg, Anna
    et al.
    Stockholm University, Stockholm, Sweden.
    Johansson, Gun
    Karolinska Institutet, Stockholm, Sweden..
    Westerlund, Hugo
    Stockholm University, Stockholm, Sweden.
    Rostila, Mikael
    Stockholm University, Stockholm, Sweden.
    Toivanen, Susanna
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd. Stockholm University, Stockholm, Sweden.
    Status incongruence in human service occupations and implications for mild-to-severe depressive symptoms and register-based sickness absence: A prospective cohort study.2019Inngår i: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 46, nr 2, s. 209-217Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective This study aimed to investigate the hypothesis that negative status incongruence may contribute to explain higher risk of mental ill-health and sickness absence in human service occupations (HSO). Methods Participants from the Swedish Longitudinal Occupational Survey of Health who responded to questionnaires in both 2014 and 2016 (N=11 814; 42% men, 58% women) were included. Status incongruence between register-based educational level and subjective social status was assessed. The association between employment in a HSO and status incongruence was estimated in linear regression analyses adjusted for age, income, work hours, sickness absence, childcare, and job qualification match. The prospective associations between status incongruence and mild-to-severe depressive symptoms and register-based sickness absence ≥31 days respectively were estimated with logistic regression analyses in models adjusted for age and outcomes at baseline. All analyses were stratified by gender. Results Employment in a HSO was associated with more negative status incongruence in both genders [standardized coefficient men 0.04, 95% confidence interval (CI) 0.02-0.07; women 0.06, 95% CI 0.04-0.09]. More negative status incongruence was furthermore associated with higher odds of mild-to-severe depressive symptoms (men OR 1.18, 95% CI 1.08-1.29; women OR 1.17, 95% CI 1.09-1.26) and sickness absence ≥31 days (men OR 1.40, 95% CI 1.23-1.59; women OR 1.17, 95% CI 1.07-1.28) two years later. Conclusion Status incongruence is somewhat higher among HSO than other occupations and associated with increased odds of depressive symptoms and sickness absence.

  • 30.
    Oksala, Tarkko
    et al.
    Aalto University, Otakaari, Finland.
    Toivanen, Susanna
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Oksala, Aino
    Stockholm University, Stockholm, Sweden.
    Architectural Cognition Sociology2018Inngår i: Sociology and Anthropology, ISSN 2331-6179, E-ISSN 2331-6187, Vol. 6, nr 7, s. 579-588Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this paper is to promote Architectural Sociology keeping cognition in focus. Firstly architecture, cognition and society are considered in their relationships. Secondly associations promoting cognition, its study and extensions of architectural cognition are discussed. This all is made in order to form a clear conceptual basis to understand architectural action in socio-psychological reality. This is tested by using architectural goal setting as example. Application of the frame in solving recent challenges is commented.

  • 31.
    Pena Gralle, Ana Paula Bruno
    et al.
    Sergio Arouca National School of Public Health, Oswaldo Cruz Foundation, Brazil.
    Barbosa Moreno, Arlinda
    Sergio Arouca National School of Public Health, Oswaldo Cruz Foundation, Brazil.
    Lopes Juvanhol, Leidjaira
    Sergio Arouca National School of Public Health, Oswaldo Cruz Foundation, Brazil.
    Mendes da Fonseca, Maria de Jesus
    Sergio Arouca National School of Public Health, Oswaldo Cruz Foundation, Brazil.
    Prates Melo, Enirtes Caetano
    Sergio Arouca National School of Public Health, Oswaldo Cruz Foundation, Brazil.
    Antunes Nunes, Maria Angélica
    School of Medicine, Federal University of Rio Grande do Sul, Brazil.
    Toivanen, Susanna
    Stockholm University, Dept of Publ Health Sciences, Stockholm, Sweden.
    Griep, Rosane Härter
    Sergio Arouca National School of Public Health, Oswaldo Cruz Foundation, Brazil.
    Job strain and binge eating among Brazilian workers participating in the ELSA-Brasil study: does BMI matter?2017Inngår i: Journal of Occupational Health, ISSN 1341-9145, E-ISSN 1348-9585, Vol. 59, nr 3, s. 247-255Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: To assess the association between job strain and binge eating as well as the effect-modifying influence of body mass index (BMI) on this association.

    METHODS: A total of 11,951 active civil servants from the multicenter Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) was included in this cross-sectional analysis. Job strain was assessed using the Demand-Control-Support Questionnaire. Binge eating was defined as eating a large amount of food with a sense of lack of control over what and how much is eaten in less than 2 hours at least twice a week. Multiple logistic regression was used to determine the association between binge eating and job strain as well as its interaction with BMI.

    RESULTS: After adjustment, and using low-strain job as the reference category, binge eating was associated with high-strain job (high demand/low control: odds ratio [OR]=1.58, 95% confidence interval [CI] 1.26-1.98), active job (high demand/high control: OR=1.35, 95% CI 1.07-1.70), and passive job (low demand/low control: OR=1.24, 95% CI 1.01-1.53). Psychological job demands were positively associated with binge eating (OR=1.04, 95% CI 1.01-1.07), while greater job control and social support at work were each inversely associated with binge eating (OR=0.95, 95% CI 0.92-0.97 and OR=0.96, 95% CI 0.94-0.98, respectively). BMI modified the association between job strain and binge eating: Heavier psychological job demands were associated with higher odds of binge eating among obese participants, while a stronger inverse association between job control and binge eating was seen among slimmer participants.

    CONCLUSIONS: Job strain increases the odds of binge eating and this association is modified by BMI.

  • 32.
    Portela, Luciana Fernandes
    et al.
    National School of Public Health (ENSP/Fiocruz), Brazil.
    Kröning Luna, Caroline
    Oswaldo Cruz Institute (IOC/Fiocruz), Brazil.
    Rotenberg, Lúcia
    Oswaldo Cruz Institute (IOC/Fiocruz), Brazil.
    Silva-Costa, Aline
    Oswaldo Cruz Institute (IOC/Fiocruz), Brazil.
    Toivanen, Susanna
    Stockholm University, Dept of Publ Health Sciences, Stockholm, Sweden.
    Araújo, Tania
    State University of Feira de Santana, Brazil.
    Griep, Rosane Härter
    Oswaldo Cruz Institute (IOC/Fiocruz), Brazil.
    Job Strain and Self-Reported Insomnia Symptoms among Nurses: What about the Influence of Emotional Demands and Social Support?2015Inngår i: BioMed Research International, ISSN 2314-6133, E-ISSN 2314-6141, Vol. 2015, artikkel-id 820610Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Job strain, derived from high psychological demands and low job control, is associated with insomnia, but information on the role of emotional demands and social support in this relationship is scarce. The aims of this study were (i) to test the association between job strain and self-reported insomnia symptoms, (ii) to evaluate the combination of emotional demands and job control regarding insomnia symptoms, and (iii) to analyze the influence of social support in these relationships. This cross-sectional study refers to a sample of nurses (N = 3,013 and N = 3,035 for Job Strain and Emotional demand-control model, resp.) working at public hospitals in Rio de Janeiro, Brazil. Data were collected through a self-report questionnaire. The prevalence of insomnia symptoms was 34.3%. Job strain was associated with increased odds for insomnia symptoms (OR: 2.20); the same result was observed with the combination of emotional demands and low job control (OR: 1.99). In both models, the inclusion of low social support combined with high demands and low job control led to increased odds for insomnia symptoms, compared to groups with high social support from coworkers and supervisors. Besides job strain, the study of emotional demands and social support are promising with regards to insomnia symptoms, particularly among nurses.

  • 33.
    Rostila, Mikael
    et al.
    Stockholms universitet, Sweden.
    Toivanen, SusannaMälardalens högskola, Akademin för hälsa, vård och välfärd. Stockholm University, Dept of Publ Health Sciences, Stockholm, Sweden.
    Den orättvisa hälsan – om socioekonomiska skillnader i hälsa och livslängd2018Collection/Antologi (Fagfellevurdert)
    Abstract [sv]

    Den orättvisa hälsan ger en översikt av det tvärvetenskapliga forskningsfältet inom ojämlikhet i hälsa: hur den uppstår, hur den kan mätas och förklaras, hur den varierar över livscykeln och vad vi kan göra för att minska den. Läsaren får ett samhälleligt perspektiv på hälsa, sjukdom och livslängd med utgångspunkt i sociala bestämningsfaktorer.Läs merDenna andra upplaga har uppdaterats med nya forskningsrön, statistik och aktuella referenser.Boken vänder sig till studerande inom folkhälsa, samhällsvetenskapliga ämnen, vård och medicin. Den riktar sig även till verksamma, policyformulerare och beslutsfattare inom folkhälsoområdet.Sagt om boken:"Denna bok, vilken på ett sammanhållet sätt behandlar hur ojämlikhet i hälsa kommer till uttryck i Sverige och hur olika slags livsvillkor och omständigheter bidrar till ojämlikheter i hälsa, har en viktig roll att fylla som kunskapsunderlag och utgångspunkt för pågående diskussioner. Den ojämlika hälsan är en utmaning för hela samhället, och jag hoppas därför att denna bok kan bidra till att ytterligare öka medvetenhet om problemen och stimulera olika samhällsaktörer att se sin och roll bidra med lösningar."Olle LundbergProfessor, ordförande för Kommissionen för jämlik hälsa 2015-2017(Citat ur bokens förord)Om författarnaRedaktörerMikael Rostila är professor i folkhälsovetenskap och prefekt på Institutionen för folkhälsovetenskap vid Stockholms universitet.Susanna Toivanen är professor i sociologi och verksam på Akademin för hälsa, vård och välfärd vid Mälardalens högskola och som forskare på Institutionen för folkhälsovetenskap vid Stockholms universitet.Medförfattarna är forskare och experter inom bland annat folkhälsa, sociologi, socialmedicin och epidemiologi.

  • 34.
    Rostila, Mikael
    et al.
    Stockholms universitet, Sweden.
    Toivanen, Susanna
    Mälardalens högskola, Akademin för hälsa, vård och välfärd. Stockholm University, Dept of Publ Health Sciences, Stockholm, Sweden.
    Epilog - Vägar mot mer rättvis hälsa2018Inngår i: Den orättvisa hälsan - om socioekonomiska skillnader i hälsa och livslängd / [ed] Mikael Rostila & Susanna Toivanen, Stockholm: Liber, 2018, 2, s. 381-394Kapittel i bok, del av antologi (Fagfellevurdert)
  • 35.
    Rostila, Mikael
    et al.
    Stockholms universitet, Sweden.
    Toivanen, Susanna
    Mälardalens högskola, Akademin för hälsa, vård och välfärd. Stockholm University, Dept of Publ Health Sciences, Stockholm, Sweden.
    Introduktion - Den orättvisa hälsan2018Inngår i: Den orättvisa hälsan - om socioekonomiska skillnader i hälsa och livslängd / [ed] Mikael Rostila & Susanna Toivanen, Stockholm: Liber, 2018, 2, s. 17-30Kapittel i bok, del av antologi (Fagfellevurdert)
  • 36.
    Toivanen, Susanna
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Arbetsmiljö och utformning av aktivitetsbaserade kontor2018Inngår i: Gränslöst arbete: En forskarantologi om arbetsmiljöutmaningar i anknytning till ett gränslöst arbetsliv / [ed] Gunnar Aronsson, Stockholm: Arbetsmiljöverket , 2018, s. 73-83Kapittel i bok, del av antologi (Fagfellevurdert)
    Abstract [sv]

    Detta kapitel fokuserar på flexkontor, det vill säga den typ av öppna kontor där anställda inte har egna fasta arbetsstationer utan växlar mellan olika arbetsmiljöer inom kontoret utifrån den aktuella arbetsuppgiften [1]. Utgångspunkten för kapitlet är konceptet New Ways of Working vilket för arbetsplatsens del förespråkar ett slut på individuella arbetsytor och sittplatser i dagens flexibla kontorsmiljöer [2]. I stället uppmuntras anställda att organisera sitt arbete utifrån egna behov i ett öppet zonindelat kontorsrum där man delar utrustning och arbetsytor med kollegor. I flexkontor finns vanligtvis plats för cirka 75 procent av personalstyrkan samtidigt, vilket förutsätter att en del arbetstagare regelbundet arbetar från alternativa arbetsplatser, oftast hemmet, caféer, kontorshotell och liknande ställen eller på resan [3, 4, 5].

  • 37.
    Toivanen, Susanna
    Mälardalens högskola, Akademin för hälsa, vård och välfärd. Stockholm University, Dept of Publ Health Sciences, Stockholm, Sweden.
    Exploring the interplay between work stress and socioeconomic position in relation to common health complaints: the role of interaction.2011Inngår i: American Journal of Industrial Medicine, ISSN 0271-3586, E-ISSN 1097-0274, Vol. 54, nr 10, s. 780-90Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: This study explored the interplay between work stress and socioeconomic position and investigated if the interaction of work stress and low socioeconomic position is associated with poorer health.

    METHODS: A representative sample of the Swedish working population, including 2,613 employees (48.7% women) aged 19-64 years, was analyzed. The health outcomes were poor self-rated health, psychological distress, and musculoskeletal pain. Work stress was operationalized as job strain and effort-reward imbalance, and socioeconomic position as occupational class. Interaction analysis was based on departure from additivity as criterion, and a synergy index (SI) was applied, using odds ratios (ORs) from logistic regressions for women and men.

    RESULTS/CONCLUSIONS: In fully adjusted models, work stress, and in a lesser extent also socioeconomic position, was associated with higher odds for the three health complaints. The prevalence of poorer health was highest among those individuals jointly exposed to high work stress and low occupational class, with ORs ranging from 1.94 to 6.77 (95%CI 1.01-18.65) for poor self-rated health, 2.42-8.44 (95%CI 1.28-27.06) for psychological distress and 1.93-3.93 (95%CI 1.11-6.78) for musculoskeletal pain. The joint influence of work stress and low socioeconomic position on health was additive rather than multiplicative.

  • 38.
    Toivanen, Susanna
    Mälardalens högskola.
    Framtidens arbetsplatser: Att utveckla hållbara och friska kontor2015Rapport (Annet vitenskapelig)
    Abstract [sv]

    Framtidens arbetsplatser ger nyanserad kunskap om kontor och kontorsutveckling. Det är en praktiskt inriktad skrift som ger vägledning och stöd vid planering och utveckling av nya kontor, ombyggnation av befintliga lokaler samt kontorsflytt. Den reder ut begrepp och fungerar som underlag vid diskussioner mellan fastighetsutvecklare, kontorshyresgäster, arkitekter, arbetsledning, skyddsombud, kontorsanställda och andra intressenter. Innehållet i skriften bygger på aktuell forskning om kontor, arbetsmiljö och hälsa. – Kunskap om framtidens hållbara och friska kontorsarbetsplatser är en solid bas för framgångsrika affärer och goda kundrelationer, säger Susanna Toivanen, forskare och författare till skriften.

  • 39.
    Toivanen, Susanna
    Mälardalens högskola, Akademin för hälsa, vård och välfärd. Stockholm University, Dept of Publ Health Sciences, Stockholm, Sweden.
    Income differences in stroke mortality: a 12-year follow-up study of the Swedish working population.2011Inngår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 39, nr 8, s. 797-804Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIMS: This study explored the association between income and stroke mortality in the total working population in Sweden and examined whether the associations differ by gender or for stroke subtypes intracerebral haemorrhage (ICH) or brain infarction (BI).

    METHODS: This was a register-based study among nearly 3 million working women and men (30-64 years in 1990) with a 12-year follow up (1991-2002) for mortality from stroke (4886 deaths). Income was measured as annual registered income from work in 1990. Gender-specific Cox regressions were applied with adjustments for sociodemographic covariates.

    RESULTS: The age-adjusted hazard ratio (95% confidence interval) of lowest versus highest income quartile was 1.80 (1.48-2.19) for any stroke, 1.68 (1.29-2.17) for ICH and 2.23 (1.53-3.22) for BI in women, and the corresponding figures for men were 2.12 (1.92-2.34), 2.02 (1.77-2.31), and 2.09 (1.77-2.46). Adjustment for covariates attenuated these associations to 1.69 (1.33-2.15) for any stroke and 1.56 (1.14-2.14) for ICH in women and to 1.98 (1.74-2.24) for any stroke and 1.77 (1.44-2.19) for BI in men. In contrast, adjustment for covariates amplified the estimates to 2.36 (1.52-3.66) for BI in women and to 2.05 (1.73-2.44) for ICH in men.

    CONCLUSIONS: Risk of stroke mortality was highest in the lowest income group, with a gradient for the intermediate groups, in both women and men. The risk of mortality from BI was highest in women with the lowest income and the risk of ICH was highest in men with the lowest income.

  • 40.
    Toivanen, Susanna
    Mälardalens högskola, Akademin för hälsa, vård och välfärd. Stockholm University, Dept of Publ Health Sciences, Stockholm, Sweden.
    Job control and the risk of incident stroke in the working population in Sweden.2008Inngår i: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 34, nr 1, s. 40-7Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVES: This study estimated the risk of incident stroke according to the level of job control and examined whether the association between job control and the risk of stroke varied as a function of gender.

    METHODS: This was a register-based cohort study of nearly 3 million working people (age 30-64 years in 1990) with a 13-year follow-up (1991-2003) for incident stroke (50 114 events). Job control was aggregated to the data by a secondary data source (job-exposure matrix) in 1990. Gender-specific Cox regressions were applied.

    RESULTS: The age- and workhour-adjusted hazard ratio of the lowest versus the highest job control quartile was 1.25 [95% confidence interval (95% CI) 1.17-1.32] for any stroke, 1.33 (95% CI 1.15-1.55) for intracerebral hemorrhage, and 1.22 (95% CI 1.14-1.31) for brain infarction among the women, and the corresponding figures for the men were 1.24 (95% CI 1.21-1.28), 1.30 (95% CI 1.21-1.40), 1.23 (95% CI 1.19-1.28), respectively. Adjustment for education, marital status, and income attenuated these associations to 1.07 (95% CI 1.01-1.14) for any stroke, 1.22 (95% CI 1.04-1.42) for intracerebral hemorrhage, and 1.04 (95% CI 0.97-1.12) for brain infarction for the women and to 1.08 (95% CI 1.04-1.12), 1.12 (95% CI 1.03-1.22), 1.08 (95% CI 1.04-1.13), respectively, for the men.

    CONCLUSIONS: The relative risk of stroke was higher in low job-control occupations. The association between job control and stroke subtypes varied as a function of gender. The relative risk of intracerebral hemorrhage was highest for the women in low job-control occupations.

  • 41.
    Toivanen, Susanna
    Mälardalens högskola, Akademin för hälsa, vård och välfärd. Stockholm University, Dept of Publ Health Sciences, Stockholm, Sweden.
    Social Determinants of Stroke as Related to Stress at Work among Working Women: A Literature Review.2012Inngår i: Stroke Research and Treatment, ISSN 2090-8105, E-ISSN 2042-0056, Vol. 2012, artikkel-id 873678Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    In adult life, many of the social determinants of health are connected to working life. Yet, our knowledge of the role of work-related factors for the risk of stroke is fairly limited. In contemporary occupational health research, the Demand-Control Model (DCM) is frequently used to measure work stress. Previous literature reviews of the association of work stress and cardiovascular disease (CVD) do not include stroke as a specific outcome. Results regarding work stress and the risk of CVD are less evident in working women. With the focus on working women, the purpose of the present paper was to review the current research into the DCM in relation to stroke and to scrutinize potential gender differences. A literature search was performed and eight studies from three countries were identified. Based on the reviewed studies, there is some evidence that high psychological demands, low job control, and job strain are associated with increased stroke risk in women as well as in men. Any major reduction in deaths and disability from stroke is likely to come from decreasing social inequalities in health, and reducing work stress has a potential to contribute to a reduced risk of stroke in working populations.

  • 42.
    Toivanen, Susanna
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd. Stockholm University, Dept of Publ Health Sciences, Stockholm, Sweden.
    Ute är inne - kom igång med kontorsarbete utomhus2019Rapport (Annet (populærvitenskap, debatt, mm))
    Abstract [en]

    This is a popular science publication about outdoor office work. It includes a literature review, results from own pilot projects and examples from the office market in Sweden. The report is a collaboration with Akademiska Hus, a public real estate company in the university sector. Download here: https://www.akademiskahus.se/globalassets/dokument/hallbarhet/ute_ar_inne_a4_susanna_toivanen_akademiska-hus_2019_05_13.pdf

  • 43.
    Toivanen, Susanna
    et al.
    Stockholm University, Dept of Publ Health Sciences, Stockholm, Sweden.
    Griep, Rosane Härter
    Oswaldo Cruz Institute, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil..
    Mellner, Christin
    Stockholm University, Stockholm, Sweden.
    Vinberg, Stig
    Mid Sweden University, Östersund, Sweden.
    Eloranta, Sandra
    Scandinavian Development Services, Stockholm, Sweden.
    Mortality differences between self-employed and paid employees: a 5-year follow-up study of the working population in Sweden.2016Inngår i: Occupational and Environmental Medicine, ISSN 1351-0711, E-ISSN 1470-7926, Vol. 73, nr 9, s. 627-36Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVES: Analyse mortality differences between self-employed and paid employees with a focus on industrial sector, educational level and gender using Swedish register data.

    METHODS: A cohort of the total working population (4 776 135 individuals; 7.2% self-employed; 18-100 years of age at baseline 2003) in Sweden with a 5-year follow-up (2004-2008) for all-cause and cause-specific mortality (57 743 deaths). Self-employed individuals were categorised as sole proprietors or limited liability company (LLC) owners according to their enterprise's legal form. Cox proportional hazards models were applied to compare mortality rates between sole proprietors, LLC owners and paid employees, adjusted for sociodemographic confounders.

    RESULTS: Mortality from cardiovascular diseases was 16% lower and from suicide 26% lower among LLC owners than among paid employees, adjusted for confounders. Within the industrial category, all-cause mortality was 13-15% lower among sole proprietors and LLC owners compared with employees in manufacturing and mining (MM) as well as personal and cultural services (PCS), and 11-20% higher in sole proprietors in trade, transport and communication and the welfare industry (W). A significant three-way interaction indicated 17-23% lower all-cause mortality among male LLC owners in MM and female sole proprietors in PCS, and 50% higher mortality in female sole proprietors in W than in employees in the same industries.

    CONCLUSIONS: Mortality differences between self-employed individuals and paid employees vary by the legal form of self-employment, across industries, and by gender. Differences in work environment exposures and working conditions, varying market competition across industries and gender segregation in the labour market are potential mechanisms underlying these findings.

  • 44.
    Toivanen, Susanna
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd. Stockholm University, Dept of Publ Health Sciences, Stockholm, Sweden.
    Hagqvist, Emma
    Stockholms universitet..
    Landstad, Bodil
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences..
    Nordenmark, Mikael
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences..
    Östergren, Per-Olof
    Lunds universitet..
    Vinberg, Stig
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences..
    Mikroföretagares arbetsmiljö och hälsa med fokus på genus och etnicitet - innovationer för tillsyn2019Inngår i: Arbetsmiljö och ohälsa i ett genusperspektiv: uppdragsforskning med relevans för tillsynsverksamhete, Stockholm: Arbetsmiljöverket , 2019, s. 43-55Kapittel i bok, del av antologi (Annet vitenskapelig)
  • 45.
    Toivanen, Susanna
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd. Stockholm University, Dept of Publ Health Sciences, Stockholm, Sweden.
    Hemström, Orjan
    Income differences in cardiovascular disease: is the contribution from work similar in prevalence versus mortality outcomes?2006Inngår i: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 13, nr 1, s. 89-100Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The objective of this research is to study the contribution of adverse working conditions to the association between income and cardiovascular disease (CVD), and to analyze differences across prevalence and mortality outcomes. Cross-sectional data from the Swedish Surveys of Living Conditions, 1996-1999 (N = 6,405), and longitudinal registry data for the period 1990-95 (10,916 CVD deaths) were used, including employed wage earners, aged 40-64. Working conditions were assessed through self-reports and imputed from a job exposure matrix, respectively. Multiple logistic and Poisson regressions were applied. There were strong associations between income and CVD. Those in the lowest income quartile had 3.6 (prevalence) and 2.1 (mortality) times higher risk of CVD, compared to those in the highest income quartile (with a gradient for the intermediate groups). In the survey, low job control and physical demands contributed 8-10% to the association between income and CVD prevalence. This contribution was 10% for low job control in the mortality follow-up. A small proportion of the association between income and the prevalence of or mortality from CVD is attributable to working conditions.

  • 46.
    Toivanen, Susanna
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd. Stockholm University, Dept of Publ Health Sciences, Stockholm, Sweden.
    Hemström, Orjan
    Is the impact of job control on stroke independent from socioeconomic status?: a large-scale study of the Swedish working population.2008Inngår i: Stroke, ISSN 0039-2499, E-ISSN 1524-4628, Vol. 39, nr 4, s. 1321-3Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND AND PURPOSE: The main purpose of this study was to test whether the impact of job control on stroke mortality is independent of socioeconomic factors.

    METHODS: This was a register-based cohort study of nearly 3.5 million working people (25 to 64 years of age in the 1990 Swedish Census) with a 5-year follow-up for stroke mortality. Job control was aggregated to the data from a secondary data source (job exposure matrix). Gender-specific Poisson regressions were performed.

    RESULTS: Compared with high job control occupations, low job control was significantly related to hemorrhagic (relative risk, 1.54; 95% CI, 1.10 to 2.17) and all-stroke mortality (relative risk, 1.50; 95% CI, 1.11 to 2.03) in women but not in men. The significance of job control in women was independent of all confounders included (marital status, education level, and occupational class). Class-specific analyses indicated a consistent effect of job control for most classes (significant for female lower nonmanuals). However, low job control did not increase the risk of stroke mortality in upper nonmanuals.

    CONCLUSIONS: Job control was significantly related to hemorrhagic and all-stroke mortality in women but not in men.

  • 47.
    Toivanen, Susanna
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd. Department of Public Health Sciences, Stockholm University, Stockholm, Sweden.
    Härter Griep, R.
    Department of Public Health Sciences, Stockholm University, Stockholm, Sweden.
    Mellner, C.
    Department of Psychology, Stockholm University, Stockholm, Sweden.
    Nordenmark, M.
    Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden.
    Vinberg, S.
    Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden.
    Eloranta, S.
    Scandinavian Development Services, Stockholm, Sweden.
    Hospitalization due to stroke and myocardial infarction in self-employed individuals and small business owners compared with paid employees in Sweden—a 5-year study2019Inngår i: Small Business Economics, ISSN 0921-898X, E-ISSN 1573-0913, Vol. 53, nr 2 SI, s. 343-354Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Analysing Swedish population register data, the aim of the present study is to investigate differences in acute cardiovascular disease (CVD) in terms of stroke and myocardial infarction incidence between self-employed individuals and paid employees and to study whether the associations vary by gender or across industrial sectors. A cohort of nearly 4.8 million employed individuals (6.7% self-employed in 2003) is followed-up for hospitalization due to stroke and myocardial infarction (2004–2008). Self-employed individuals are defined as sole proprietors and limited liability company owners according to legal type of their enterprise. Negative binomial regression models are applied to compare hospitalization rates between the self-employed and paid employees, adjusted for socioeconomic and demographic confounders. Two- and three-way interaction are tested between occupational group, industrial sector, and gender. Limited liability company owners have significantly lower hospitalization for myocardial infarction than paid employees. Regarding two-way interaction, sole proprietors have higher myocardial infarction hospitalization in trade, transport and communication, and lower in agriculture, forestry, and fishing than paid employees. Limited liability company owners have lower hospitalization rate for myocardial infarction than employees in several industries. The results highlight the importance of enterprise legal type and industrial sector for CVD among self-employed individuals.

  • 48.
    Toivanen, Susanna
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd. Stockholm University, Dept of Publ Health Sciences, Stockholm, Sweden.
    Mellner, Christin
    Vinberg, Stig
    Self-employed persons in Sweden - mortality differentials by industrial sector and enterprise legal form: a five-year follow-up study.2015Inngår i: American Journal of Industrial Medicine, ISSN 0271-3586, E-ISSN 1097-0274, Vol. 58, nr 1, s. 21-32Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVES: This study investigated mortality differentials between self-employed persons in Sweden, considering industrial sector, enterprise characteristics and socio-demographic factors.

    METHODS: Data on 321,274 self-employed persons were obtained from population registers in Sweden. Cox proportional hazards models were used to compare all-cause and cause-specific mortality rate ratios by industrial sector and enterprise legal form, adjusted for confounders.

    RESULTS: All-cause mortality was 10-32% higher in self-employed persons in Manufacturing and Mining, Trade and Communication, and Not Specified and Other sectors than in Agriculture, Forestry, and Fishing. Mortality from cardiovascular disease was 23% higher in Trade and Communication, and from neoplasms 17-51% higher in Manufacturing and Mining, Not Specified, and Other. Mortality from suicide was 45-60% lower in Personal and Cultural Services, and in Not Specified. Mortality was 8-16% higher in sole proprietorship than limited partnership.

    CONCLUSIONS: Further research of working conditions is warranted, considering industry and enterprise legal form.

  • 49.
    Toivanen, Susanna
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd. Stockholm University, Dept of Publ Health Sciences, Stockholm, Sweden.
    Modin, Bitte
    Social determinants of health at different phases of life.2011Inngår i: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 18, nr 1, s. 1-4Artikkel i tidsskrift (Fagfellevurdert)
  • 50.
    Toivanen, Susanna
    et al.
    Stockholm University, Dept of Publ Health Sciences, Stockholm, Sweden.
    Vinberg, Stig
    Arbete och ojämlikhet i hälsa i vuxenlivet2018Inngår i: Den orättvisa hälsan - om socioekonomiska skillnader i hälsa och livslängd / [ed] Mikael Rostila & Susanna Toivanen, Stockholm: Liber, 2018, 2, s. 335-360Kapittel i bok, del av antologi (Fagfellevurdert)
12 1 - 50 of 52
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