Changes in Smoking During Retirement Transition : A Longitudinal Cohort Study

Aims: We examined the effect of retirement transition on changes in smoking, identified trajectories of smoking around the retirement transition, and investigated factors predicting the membership in the trajectories. Methods: This longitudinal cohort study included 1,432 current or former smokers who entered into statutory retirement in 2000-2011 and who filled out two to four questionnaires sent at four-year intervals. Effect of retirement on smoking was analysed as a non-randomized pseudo-trial in which we compared the likelihood of quitting and relapsing smoking between two subsequent survey waves among those who retired and did not retire. We used latent class analysis to identify trajectories of smoking status and smoking intensity (low: 10 cigarettes/day), and multinomial logistic regression models to assess pre-retirement factors associated with smoking trajectories. Results: Retirement transition was associated with 1.7-fold odds of quitting smoking (95% confidence intervals 1.3-2.2) compared with no retirement transition. We identified three smoking status trajectories: 'sustained non-smoking' (61% of the participants), 'sustained smoking' (23%) and 'decreasing smoking' (16%). For 489 baseline smokers, we identified three smoking intensity trajectories: 'sustained high intensity smoking' (32% of the participants), 'sustained low intensity smoking' (32%) and 'decreasing high intensity smoking' (35%). Living outside an inner urban area predicted membership in the 'decreasing smoking' versus 'sustained smoking' trajectory. Conclusions: Smokers are more likely to quit smoking during transition to retirement than before or after it. Characteristics of the smoking environment may affect smoking behaviour around retirement.Peer reviewe

Changes in drinking as predictors of changes in sickness absence : a case-crossover study

Background We investigated whether changes in alcohol use predict changes in the risk of sickness absence in a case-crossover design. Methods Finnish public sector employees were surveyed in 2000, 2004 and 2008 on alcohol use and covariates. Heavy drinking was defined as either a weekly intake that exceeded recommendations (12 units for women; 23 for men) or having an extreme drinking session. The responses were linked to national sickness absence registers. We analysed the within-person relative risk of change in the risk of sickness absence in relation to change in drinking. Case period refers to being sickness absent within 1 year of the survey and control period refers to not being sickness absent within 1 year of the survey. Results Periods of heavy drinking were associated with increased odds of self-certified short-term (1-3 days) sickness absence (multivariable-adjusted OR 1.21, 95% CI 1.07 to 1.38 for all participants; 1.62, 95% CI 1.19 to 2.21 for men and 1.15, 95% CI 1.00 to 1.33 for women). A higher risk of short-term sickness absence was also observed after increase in drinking (OR=1.27, 95% CI 1.07 to 1.52) and a lower risk was observed after decrease in drinking (OR=0.83, 95% CI 0.69 to 1.00). Both increase (OR=1.38, 95% CI 1.21 to 1.57) and decrease (OR=1.27, 95% CI 1.19 to 1.43) in drinking were associated with increased risk of long-term (> 9 days) medically certified all-cause sickness absence. Conclusion Increase in drinking was related to increases in short-term and long-term sickness absences. Men and employees with a low socioeconomic position in particular seemed to be at risk.Peer reviewe

Neighbourhood characteristics as a predictor of adherence to dietary recommendations : A population-based cohort study of Finnish adults

Aims: To investigate the association of six-year cumulative level of socioeconomic neighbourhood disadvantage and population density with subsequent adherence to dietary recommendations, controlling for preceding dietary adherence, in adults in Finland. Methods: Population-based Health and Social Support (HeSSup) study participants from four age groups (20-24, 30-34, 40-44 and 50-54 years at baseline in 1998). Data on diet and alcohol consumption were obtained from the 2003 and 2012 surveys and information on neighbourhoods from Statistics Finland Grid database (n = 10,414 men and women). Participants diet was measured as adherence to Nordic Nutrition recommendation (score range 0-100). Neighbourhood disadvantage was measured by median household income, proportion of those with primary education only and unemployment rate, and population density by the number of adult population between years 2007 and 2012. Linear models were used to assess the associations of neighbourhood characteristics with the score for adherence to dietary recommendations in 2012. Results: Cumulative neighbourhood socioeconomic disadvantage was associated with slightly weaker (1.49 (95% confidence interval (CI) -1.89 to -1.09) point decrease in dietary score) adherence while higher population density was associated with better (0.70 (95% CI 0.38-1.01) point increase in dietary score) adherence to dietary recommendations. These associations remained after controlling for prior dietary habits, sociodemographic, chronic cardio-metabolic diseases, and severe life events. Conclusions: These longitudinal findings support the hypothesis that neighbourhood characteristics affect dietary habits.Peer reviewe

Physical Activity across Retirement Transition by Occupation and Mode of Commute

Purpose Retirement induces changes in the composition of daily physical activity. Our aim was to examine changes in accelerometer-measured physical activity around transition to statutory retirement among men and women by occupational category and by preretirement modes of commuting. Methods We included 562 workers (mean [SD] age, 63.3 [1.1] yr; 85% women) from the Finnish Retirement and Aging study. The participants wore an accelerometer on their nondominant wrist for 1 wk before and 1 wk after retirement, with 1 yr between the measurements. We compared mean daily activity counts before and after retirement between manual and nonmanual occupations by gender and by preretirement commuting mode using linear models with generalized estimating equations. Results Before retirement, women were more active than men (2550 (95% confidence interval, 2500-2590) vs 2060 (1970-2140) mean daily activity counts), with the most active group being women in manual occupations. After retirement, physical activity decreased by 3.9% among women and increased, albeit nonsignificantly, by 3.1% in men. The decrease was most pronounced among women in manual and increase among men in nonmanual occupations. After retirement, women remained more active than men (2450 (95% confidence interval 2390-2500) vs 2120 (2010-2230) counts). Active commuting, especially cycling, before retirement was associated with higher physical activity both before and after retirement, and these people also maintained their total activity lever better than did those who commuted by public transportation. Conclusions Although women in manual occupations decreased and men in nonmanual occupations increased their activity after retirement, women were more active than men both before and after retirement. Those who engaged in active commuting before retirement maintained their activity level also after retirement.Peer reviewe

Risk and Prognostic Factors of Low Back Pain: Repeated Population-based Cohort Study in Sweden

Study Design. Prospective longitudinal cohort study. Objective. To determine the associations for workload and health-related factors with incident and recurrent low back pain (LBP), and to determine the mediating role of health-related factors in associations between physical workload factors and incident LBP. Summary of Background Data. It is not known whether the risk factors for the development of LBP are also prognostic factors for recurrence of LBP and whether the associations between physical workload and incident LBP are mediated by health-related factors. We used data from the Swedish Longitudinal Occupational Survey of Health study. Those responding to any two subsequent surveys in 2010 to 2016 were included for the main analyses (N = 17,962). Information on occupational lifting, working in twisted positions, weight/height, smoking, physical activity, depressive symptoms, and sleep problems were self-reported. Incident LBP was defined as pain limiting daily activities in the preceding three months in participants free from LBP at baseline. Recurrent LBP was defined as having LBP both at baseline and follow-up. For the mediation analyses, those responding to three subsequent surveys were included (N = 3516). Methods. Main associations were determined using generalized estimating equation models for repeated measures data. Mediation was examined with counterfactual mediation analysis. Results. All risk factors at baseline but smoking and physical activity were associated with incident LBP after adjustment for confounders. The strongest associations were observed for working in twisted positions (risk ratio = 1.52, 95% CI 1.37, 1.70) and occupational lifting (risk ratio = 1.52, 95% CI 1.32, 1.74). These associations were not mediated by health-related factors. The studied factors did not have meaningful effects on recurrent LBP. Conclusion. The findings suggest that workload and health-related factors have stronger effects on the development than on the recurrence or progression of LBP, and that health-related factors do not mediate associations between workload factors and incident LBP.Peer reviewe

Neighborhood socioeconomic status and adherence to dietary recommendations among Finnish adults : A retrospective follow-up study

Neighborhood socioeconomic status (SES) is associated with dietary habits among the residents, but few studies have examined this association separately among long-term residents and movers. We calculated cumulative neighborhood SES score weighted by residential time in each address over 6 years for non-movers (n = 7704) and movers (n = 8818) using national grid database. Increase in average neighborhood SES was associated with higher adherence to dietary recommendations in both groups. Among the movers, an upward trajectory from low to high neighborhood SES was also associated with better adherence. Our findings suggest high SES areas might offer healthier food environments than low SES areas.Peer reviewe

Childhood adversity, adult socioeconomic status and risk of work disability : a prospective cohort study

Objectives To examine the combined effects of childhood adversities and low adult socioeconomic status (SES) on the risk of future work disability. Methods Included were 34 384 employed Finnish Public Sector study participants who responded to questions about childhood adversities (none vs any adversity, eg, parental divorce or financial difficulties) in 2008, and whose adult SES in 2008 was available. We categorised exposure into four groups: neither (reference), childhood adversity only, low SES only or both. Participants were followed from 2009 until the first period of register-based work disability (sickness absence >9 days or disability pension) due to any cause, musculoskeletal or mental disorders; retirement; death or end of follow-up (December 2011). We ran Cox proportional hazard models adjusted for behavioural, health-related and work-related covariates, and calculated synergy indices for the combined effects. Results When compared with those with neither exposure, HR for work disability from any cause was increased among participants with childhood adversity, with low SES, and those with both exposures. The highest hazard was observed in those with both exposures: HR 2.53, 95% CI 2.29 to 2.79 for musculoskeletal disability, 1.55, 95% CI 1.36 to 1.78 for disability due to mental disorders and 1.29, 95% CI 1.20 to 1.39 for disability due to other reasons. The synergy indices did not indicate synergistic effects. Conclusions These findings indicate that childhood psychosocial adversity and low adult SES are additive risk factors for work disability.Peer reviewe

Työterveysyhteistyö 2000-luvulla -kirjallisuuskatsaus suomalaisista julkaisuista

Työterveysyhteistyöllä tarkoitetaan työnantajan, työntekijöiden ja työterveyshuollon suunnitelmallista ja tavoitteellista yhteistyötä työntekijän työhyvinvoinnin tukemiseksi. Tämän artikkelin tavoitteena on tarkastella työterveysyhteistyöhön liittyvää suomalaista kirjallisuutta, joka on julkaistu ajanjaksolla 1/2000–9/2017. Kirjallisuuskatsauksessa haettiin vastauksia seuraaviin kysymyksiin: 1. Mistä muodostuu toimiva työterveysyhteistyö? 2. Minkä kontekstien näkökulmista työterveysyhteistyöstä on tutkittu ja ketkä ovat tiedonantajina? 3. Millä menetelmillä työterveysyhteistyötä on tutkittu? Kirjallisuuskatsaus on kuvaileva ja integroiva. Julkaisuja haettiin useista tietokannoista (Medic, Arto, Melinda), julkaisuiden lähdeviitteistä sekä asiantuntijoiden kautta. Katsaukseen hyväksyttiin tieteelliset (12) ja vertaisarvioimattomat (32) tutkimukset, joten analysoitava aineisto muodostui 44 julkaisusta. Kirjallisuuskatsauksen mukaan 1) toimiva työterveysyhteistyö on tavoitteellista ja se perustuu työpaikan tarpeisiin. Työterveysyhteistyöllä työterveystoiminnan tulisi kiinnittyä osaksi työpaikan strategiaa ja toimintaa. Toimivan työterveysyhteistyön edellytyksenä on säännöllinen, aktiivinen ja luottamuksellinen vuorovaikutus sekä sovitut roolit ja vastuut. 2) Työterveysyhteistyötä oli tutkittu yhteistyön, työterveyshuollon ja työpaikan näkökulmista. Julkaisuissa käsiteltiin yhteistyökäytäntöjen arviointia, kehittämistä sekä yhteistyön sujuvuuteen liittyvien tekijöiden kuvaamista. Työterveyshuollon näkökulmasta käsiteltiin pääosin työterveyshuollon toiminnan arviointia ja työterveysyhteistyön kehittämistä osana työterveyshuollon prosesseja. Työpaikan näkökulmasta kuvattiin työpaikan odotuksia ja kokemuksia yhteistyöstä. 3) Tutkimusmenetelmät olivat pääosin laadullisia sekä monimenetelmällisiä. Katsaus osoittaa, että toimiva työterveysyhteistyö perustuu yleisiin yhteistyöhön liittyviin tekijöihin. Tieteellisten tutkimusten vähäinen määrä ja kuvaileva ote osoittavat, että tarvitaan lisätietoa siitä, mistä toimiva työterveysyhteistyö koostuu