Long working hours and risk of coronary heart disease and stroke : a systematic review and meta-analysis of published and unpublished data for 603 838 individuals

Background Long working hours might increase the risk of cardiovascular disease, but prospective evidence is scarce, imprecise, and mostly limited to coronary heart disease. We aimed to assess long working hours as a risk factor for incident coronary heart disease and stroke. Methods We identified published studies through a systematic review of PubMed and Embase from inception to Aug 20, 2014. We obtained unpublished data for 20 cohort studies from the Individual-Participant-Data Meta-analysis in Working Populations (IPD-Work) Consortium and open-access data archives. We used cumulative random-effects meta-analysis to combine effect estimates from published and unpublished data. Findings We included 25 studies from 24 cohorts in Europe, the USA, and Australia. The meta-analysis of coronary heart disease comprised data for 603 838 men and women who were free from coronary heart disease at baseline; the meta-analysis of stroke comprised data for 528 908 men and women who were free from stroke at baseline. Follow-up for coronary heart disease was 5.1 million person-years (mean 8.5 years), in which 4768 events were recorded, and for stroke was 3.8 million person-years (mean 7.2 years), in which 1722 events were recorded. In cumulative meta-analysis adjusted for age, sex, and socioeconomic status, compared with standard hours (35-40 h per week), working long hours (>= 55 h per week) was associated with an increase in risk of incident coronary heart disease (relative risk [RR] 1.13, 95% CI 1.02-1.26; p=0.02) and incident stroke (1.33, 1.11-1.61; p=0.002). The excess risk of stroke remained unchanged in analyses that addressed reverse causation, multivariable adjustments for other risk factors, and different methods of stroke ascertainment (range of RR estimates 1.30-1.42). We recorded a dose-response association for stroke, with RR estimates of 1.10 (95% CI 0.94-1.28; p=0.24) for 41-48 working hours, 1.27 (1.03-1.56; p=0.03) for 49-54 working hours, and 1.33 (1.11-1.61; p=0.002) for 55 working hours or more per week compared with standard working hours (p(trend) Interpretation Employees who work long hours have a higher risk of stroke than those working standard hours; the association with coronary heart disease is weaker. These findings suggest that more attention should be paid to the management of vascular risk factors in individuals who work long hours. Copyright (C) Kivimaki et al. Open Access article distributed under the terms of CC BY.Peer reviewe

Development of a new measure for mental retirement; testing of a three-factor structure of mentale retirement in different subgroups

Background  The aim of this study is to develop a new measure for the concept of mental retirement and test the construct validity of the measure. Employees who are 'mentally retired' are present at their work physically, but have already said their goodbyes mentally. Mental retirement has a three-factor structure: developmental proactivity, work engagement and perceived appreciation.  Methods  We use data from employees (N = 867) of five different organizations in the Netherlands. Mental retirement was assessed with 11 items in an online survey. In addition, socio-demographic characteristics like age, level of education and occupation, were measured. Next to tests of internal consistency, a confirmatory factor analysis (CFA) is performed to test the three-factor structure of mental retirement in this population and in different subgroups (age, education, occupation).  Results  The internal consistency varies from .80 to .94 for the developmental proactivity scale and the work engagement scale, respectively (appreciation was measured with one item). For the CFA, the three-factor model fits the data adequately. Multiple group analyses also shows equal factor loadings in all subgroups, but the mean levels of mental retirement differ across subgroups.  Conclusions This study confirms the three-factor model of mental retirement in a general group of employees as well as across different subgroups. However, this study only tested the construct validity. Future research should study validity more extensively and be longitudinal in nature. In addition, the causal chain of antecedent variables to mental retirement and its outcomes should be considered. These studies could also focus on the effects of interventions aiming at preventing or decreasing the level of mental retirement in organizations

Development of a new measure for mental retirement; testing of a three-factor structure of mentale retirement in different subgroups

Background  The aim of this study is to develop a new measure for the concept of mental retirement and test the construct validity of the measure. Employees who are 'mentally retired' are present at their work physically, but have already said their goodbyes mentally. Mental retirement has a three-factor structure: developmental proactivity, work engagement and perceived appreciation.  Methods  We use data from employees (N = 867) of five different organizations in the Netherlands. Mental retirement was assessed with 11 items in an online survey. In addition, socio-demographic characteristics like age, level of education and occupation, were measured. Next to tests of internal consistency, a confirmatory factor analysis (CFA) is performed to test the three-factor structure of mental retirement in this population and in different subgroups (age, education, occupation).  Results  The internal consistency varies from .80 to .94 for the developmental proactivity scale and the work engagement scale, respectively (appreciation was measured with one item). For the CFA, the three-factor model fits the data adequately. Multiple group analyses also shows equal factor loadings in all subgroups, but the mean levels of mental retirement differ across subgroups.  Conclusions This study confirms the three-factor model of mental retirement in a general group of employees as well as across different subgroups. However, this study only tested the construct validity. Future research should study validity more extensively and be longitudinal in nature. In addition, the causal chain of antecedent variables to mental retirement and its outcomes should be considered. These studies could also focus on the effects of interventions aiming at preventing or decreasing the level of mental retirement in organizations

Effect of a participative action intervention program on reducing mental retirement

Abstract Background The present study aimed to investigate the effects of a stepwise, bottom-up participatory program with a tailor-made intervention process addressing the level of mental retirement in a sample of Dutch employees. Mental retirement refers to feelings of being disconnected from your work and your organization. Prevention of mental retirement is important since sustainable employability is becoming more important in today’s society due to the ageing of the working population and the changes in skills demands. Methods This prospective cohort study with a one-year follow-up employs a sample of 683 employees of three organizations in The Netherlands, who filled out two questionnaires: at baseline and 1 year later. The dependent measure was mental retirement, which consists of three sub-concepts: developmental pro-activity, work engagement and perceived appreciation. Results Multilevel analysis (N = 466) showed that employees who more actively participated in the intervention(s) had a small but statistically significant larger decrease in mental retirement at follow-up. Conclusions The stepwise, bottom-up participatory program with a tailor-made intervention process shows a tendency to decrease the level of mental retirement in Dutch employees. However, the implementation of interventions could be further improved since it turned out to be very challenging to keep up participants’ commitment to the program. Future research should study the effectiveness of this program further with an improved study design (control group, multiple follow-ups, several data sources)

Process Evaluation of a Digital Platform-Based Implementation Strategy Aimed at Work Stress Prevention in a Health Care Organization

OBJECTIVE: The objective was to evaluate the process and feasibility of a digital platform-based implementation strategy aimed at work stress prevention. METHODS: The process evaluation was performed alongside a controlled trial within a health care organization, in the experimental group (N = 221). Mental models, context, and barriers and facilitators were measured. In addition, dose delivered, reach, and dose received were assessed. RESULTS: Employees reported relatively high readiness for change. Personnel shortage and a recent restructuring of the organization hindered use of the strategy. Low management support and high turnover stagnated strategy deployment. Dose delivered was 13/15, reach was 11/15, and dose received was 5/15. CONCLUSIONS: Strategy implementation was moderately successful, as sustained strategy use by the teams appeared to be a challenge. The strategy can be feasible with sufficient management support and resources