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The role of unhealthy lifestyle factors in the adverse health effects of working conditions in workers with a low SEP. Meta-analyses in longitudinal datasets.

Projectomschrijving

Doel

Werknemers met een lage sociaal economische positie (SEP) hebben vaak een slechtere gezondheid dan werknemers met een hogere SEP. Slechte arbeidsomstandigheden en ongezonde leefstijl spelen hier een rol in, maar welke factoren dat precies zijn en hoe ze elkaar onderling beïnvloeden is onbekend. Wat is het effect van slechte fysieke en psychosociale arbeidsomstandigheden op leefstijl bij werknemers met een lage SEP? En wat is de invloed van ongezonde leefstijl op de nadelige gezondheidseffecten van slechte arbeidsomstandigheden?

Aanpak/werkwijze

In dit project zijn epidemiologische analyses uitgevoerd in vijf grote longitudinale studies: GLOBE, Doetinchem Cohort Studie (DCS), Lifelines, PAGO Bouw en SHARE. De databestanden zijn complementair aan elkaar waarbij verschillende belastende arbeidsomstandigheden en leefstijlfactoren zijn gemeten onder verschillende groepen (lage SEP) werknemers. Na afzonderlijke analyses in elk databestand naar de relatie tussen arbeidsomstandigheden en leefstijl, zijn de resultaten uit de verschillende bestanden samengevoegd en onderzocht.

Resultaten

Een hoge fysieke werkbelasting en een hoge psychosociale belasting blijken gerelateerd te zijn aan een ongezonde leefstijl. Daarbij levert de combinatie van een hoge werkbelasting met obesitas een extra verhoogd risico op een slechte ervaren gezondheid. Verder is gebleken dat de slechtere gezondheid onder werknemers met lichamelijk zwaar werk niet wordt verklaard door roken, alcoholgebruik, overgewicht en weinig bewegen. De gezondheidseffecten komen dus direct door het zware werk en mogelijk door andere factoren, die niet zijn onderzocht in deze studie.

Producten

De resultaten zijn beschreven in internationaal wetenschappelijke artikelen en een factsheet. Ook zijn de resultaten op congressen en bijeenkomsten gepresenteerd.

Producten

Titel: The mediating role of unhealthy behavior in the relationship between shift work and perceived health
Auteur: Karin I. Proper, Eva Jaarsma, Suzan J. W. Robroek, Jolinda L. D. Schram, Hendriek Boshuizen, H. Susan J. Picavet, W. M. Monique Verschuren & Sandra H. van Oostrom
Link: https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-021-11350-2
Titel: The Mediating Effect of Unhealthy Behaviors and Body Mass Index in the Relation Between High Physical Workload and Self-Rated Poor Health in Male Construction Workers
Auteur: Karin I. Proper, Bart Cillekens, Jos W.R. Twisk, Pieter Coenen, Suzan J.W. Robroek & Sandra H. van Oostrom
Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7409768/
Titel: The mediating role of unhealthy behaviors and body mass index in the relationship between high job strain and self-rated poor health among lower educated workers
Auteur: S. H. van Oostrom, A. Nachat, B. Loef & K. I. Proper
Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7826307/
Titel: Verhoogd risico op slechte gezondheid voor werknemers met zwaar werk en obesitas
Auteur: RIVM
Link: https://www.rivm.nl/nieuws/verhoogd-risico-op-slechte-gezondheid-voor-werknemers-met-zwaar-werk-en-obesitas
Titel: Leefstijl geen verklaring relatie stress-gezondheid
Auteur: Sandra H. van Oostrom, Bette Loef & Karin I. Proper
Link: https://voedingnu.nl/artikelen/leefstijl-geen-verklaring-relatie-stress-gezondheid
Titel: Factsheet - Werkomstandigheden, leefstijl en gezondheid in de bouw
Link: https://www.rivm.nl/documenten/factsheet-werkomstandigheden-leefstijl-en-gezondheid-in-bouw

Verslagen


Samenvatting van de aanvraag

The HEALTH INEQUALITIES between populations of higher versus lower socioeconomic position (SEP) are substantial. Poor working conditions and unhealthy lifestyles contribute to the disease burden, and are more prevalent in low SEP groups than in higher SEP groups. INTERPLAY WORKING CONDITIONS AND LIFESTYLE FACTORS Poor working conditions and unhealthy lifestyles are independent determinants of the poorer health status in low SEP workers, but they likely also interact. Particular working conditions, which are prevalent in low SEP workers, may prompt unhealthy lifestyles. For example, a high physical workload or a high work pressure is associated with smoking and excessive alcohol consumption. Knowledge on their interplay and how they explain the adverse health effects in low SEP workers is however lacking. The OBJECTIVE of this project is to get insight into the interplay between specific and combined working conditions and lifestyle factors, and the role of lifestyle in the adverse health effects of poor working conditions in low SEP workers and low SEP workers with a chronic disease. More specifically, the following RESEARCH QUESTIONS have been formulated: 1. What is the effect of poor working conditions (i.e. physical and psychosocial working conditions) on lifestyle behaviors among low SEP workers and low SEP workers with a chronic disease? 2. Which subgroups (moderators) can be identified based on unhealthy lifestyle behaviors that have an increased effect of poor working conditions on health (i.e. perceived general, physical and mental health)? 3. What is the mediating role of unhealthy lifestyle behaviors in the adverse health effect of poor working conditions among low SEP workers and low SEP workers with a chronic disease? The STUDY POPULATION consists of workers with a LOW SEP, here defined by low educational level. In addition, the study population consists of low SEP workers with one or more of the following CHRONIC DISEASES: diabetes type 2, cardiovascular diseases, lung diseases, depression, and back disorders. These diseases are particularly prevalent among low SEP workers, have a high disease burden, and are related to poor working conditions. The project consists of LONGITUDINAL DATA ANALYSES in 5 large cohort studies. We apply a longitudinal design, and perform analyses on existing datasets: GLOBE, DCS, Lifelines, PME Construction Industry, and SHARE. The cohort studies are clearly complementary and each has its own strength: - GLOBE: focus on socioeconomic health inequalities, long follow-up - DCS: extensive and objective measurements of lifestyle behaviors, long follow-up and extensive information on shift work - Lifelines: large numbers, heterogeneous low SEP worker population - PME construction: workers in the construction industry - SHARE: older workers aged 50+ years from 27 European countries The project distinguishes 4 STUDIES: Study 1 consists of statistical analyses (Mixed Models) to answer research question 1. Pooling of the results (meta-analysis) will identify the working conditions and lifestyle factors of significance to be studied in study 2 and 3. Study 2 consists of longitudinal data analyses using additive interaction effects (RERI terms) to answer research question 2. Study 3 consists of mediation analyses by means of the counterfactual framework to answer research question 3. Study 4 is aimed at the dissemination of the findings from study 1-3. OUTCOME Study 1 will give insight into which physical and psychosocial working conditions are related to which unhealthy lifestyles in low SEP workers, and whether this is different for low SEP workers with a chronic disease. Study 2 will identify subgroups of low SEP workers based on unhealthy lifestyle behaviors, who have an increased adverse health effect of poor working conditions. Study 3 will yield input to determine to what extent and which unhealthy lifestyles mediate the health effect of poor working conditions. Study 4 will enhance successful dissemination of the results to all relevant stakeholders. DISSEMINATION The results will be summarized and presented in various ways to reach all relevant stakeholders, including workers with a low SEP, employers, trade organizations, occupational health professionals, policy makers, and scientists. A variety of dissemination activities and products will be delivered, such as an accessible summary of the findings (e.g. infographic and factsheet), scientific papers, an article in a national professional journal, presentation on websites, conferences, and newsletter of Volandis. Moreover, the results will form input for policy measures to promote health among lower SEP workers, and low SEP workers with a chronic disease. We will formulate to what extent policy should be focused on a single factor (i.e. either a specific working condition or lifestyle), or on both thus implying integral policy.

Kenmerken

Projectnummer:
531001412
Looptijd: 100%
Looptijd: 100 %
2018
2020
Gerelateerde subsidieronde:
Projectleider en penvoerder:
Prof. dr. K.I. Proper
Verantwoordelijke organisatie:
RIVM