TY - JOUR

T1 - Effort-reward imbalance at work and risk of type 2 diabetes in a national sample of 50,552 workers in Denmark

T2 - A prospective study linking survey and register data

AU - Nordentoft, Mads

AU - Rod, Naja H

AU - Bonde, Jens Peter

AU - Bjorner, Jakob B

AU - Madsen, Ida E H

AU - Pedersen, Line R M

AU - Cleal, Bryan

AU - Magnusson Hanson, Linda L

AU - Nexo, Mette A

AU - Pentti, Jaana

AU - Stenholm, Sari

AU - Sterud, Tom

AU - Vahtera, Jussi

AU - Rugulies, Reiner

N1 - Copyright © 2019 The Authors. Published by Elsevier Inc. All rights reserved.

PY - 2020/1/1

Y1 - 2020/1/1

N2 - OBJECTIVE: To examine the prospective relation between effort-reward imbalance at work and risk of type 2 diabetes.METHODS: We included 50,552 individuals from a national survey of the working population in Denmark, aged 30-64 years and diabetes-free at baseline. Effort-reward imbalance was defined, in accordance with the literature, as a mismatch between high efforts at work (e.g. high work pace, time pressure), and low rewards received in return (e.g. low recognition, job insecurity) and assessed as a continuous and a categorical variable. Incident type 2 diabetes was identified in national health registers. Using Cox regression we calculated hazard ratios (HR) and 95% confidence intervals (95% CI) for estimating the association between effort-reward imbalance at baseline and risk of onset of type 2 diabetes during follow-up, adjusted for sex, age, socioeconomic status, cohabitation, children at home, migration background, survey year and sample method.RESULTS: During 136,239 person-years of follow-up (mean = 2.7 years) we identified 347 type 2 diabetes cases (25.5 cases per 10,000 person-years). For each one standard deviation increase of the effort-reward imbalance score at baseline, the fully adjusted risk of type 2 diabetes during follow-up increased by 9% (HR: 1.09, 95% CI: 0.98-1.21). When we used effort-reward imbalance as a dichotomous variable, exposure to effort-reward imbalance was associated with an increased risk of type 2 diabetes with a HR of 1.27 (95% CI: 1.02-1.58).CONCLUSION: The results of this nationwide study of the Danish workforce suggest that effort-reward imbalance at work may be a risk factor for type 2 diabetes.

AB - OBJECTIVE: To examine the prospective relation between effort-reward imbalance at work and risk of type 2 diabetes.METHODS: We included 50,552 individuals from a national survey of the working population in Denmark, aged 30-64 years and diabetes-free at baseline. Effort-reward imbalance was defined, in accordance with the literature, as a mismatch between high efforts at work (e.g. high work pace, time pressure), and low rewards received in return (e.g. low recognition, job insecurity) and assessed as a continuous and a categorical variable. Incident type 2 diabetes was identified in national health registers. Using Cox regression we calculated hazard ratios (HR) and 95% confidence intervals (95% CI) for estimating the association between effort-reward imbalance at baseline and risk of onset of type 2 diabetes during follow-up, adjusted for sex, age, socioeconomic status, cohabitation, children at home, migration background, survey year and sample method.RESULTS: During 136,239 person-years of follow-up (mean = 2.7 years) we identified 347 type 2 diabetes cases (25.5 cases per 10,000 person-years). For each one standard deviation increase of the effort-reward imbalance score at baseline, the fully adjusted risk of type 2 diabetes during follow-up increased by 9% (HR: 1.09, 95% CI: 0.98-1.21). When we used effort-reward imbalance as a dichotomous variable, exposure to effort-reward imbalance was associated with an increased risk of type 2 diabetes with a HR of 1.27 (95% CI: 1.02-1.58).CONCLUSION: The results of this nationwide study of the Danish workforce suggest that effort-reward imbalance at work may be a risk factor for type 2 diabetes.

KW - Diabetes mellitus

KW - Epidemiology

KW - Occupation

KW - Population-based

KW - Psychosocial work factors

KW - Stress

UR - http://www.scopus.com/inward/record.url?scp=85074527262&partnerID=8YFLogxK

U2 - 10.1016/j.jpsychores.2019.109867

DO - 10.1016/j.jpsychores.2019.109867

M3 - Journal article

VL - 128

JO - Journal of Psychosomatic Research

JF - Journal of Psychosomatic Research

SN - 0022-3999

M1 - 109867

ER -