Nylén L, Voss M, Floderus B
National Institute for Working Life, SE-112 79 Stockholm, Sweden.
Occup Environ Med. 2001 Jan;58(1):52-7. doi: 10.1136/oem.58.1.52.
To examine mortality before 70 years of age among women and men relative to unemployment, part time work, overtime work, and extra work. Age, marital status, children, smoking and alcohol habits, use of sleeping pills and tranquilisers, stress, shift work, personality factors, and long lasting or serious illness were taken into account as potential confounding factors.
The study group comprised a subcohort of the Swedish twin registry, people born in 1926-58. Data were based on a postal questionnaire of 1973 and on information from the Swedish Causes of Death Registry. All subjects reporting a main occupation were selected, 9500 women and 11 132 men, and mortality from all causes during 1973-96 was analysed. The subjects were treated as a sample from the general population regardless of the twinning.
Unemployment in 1973 among both women and men showed an association with increased mortality. The adjusted relative risk (RR) (95% confidence interval (95% CI)) was 1.98 (1.16 to 3.38), for women and 1.43 (0.91 to 2.25) for men. For the first 5 years of follow up, a threefold increase in risk was found for men (RR (95% CI) 3.29 (1.33 to 8.17)). The RR declined by time, but remained increased throughout the 24 year study period. In women overtime work of more than 5 hours a week was followed by an increased mortality rate (RR (95% CI) 1.92 (1.13 to 3.25)). A protective effect of moderate overtime work of a maximum 5 hours a week was shown for men (RR (95% CI) 0.58 (0.43 to 0.80)), whereas an increased mortality was indicated for part time work (RR (95% CI) 1.58 (0.91 to 2.77)) and extra work (work outside employment) of more than 5 hours a week (RR (95% CI) 1.29 (0.99 to 1.69)).
Unemployment and some time aspects of work were associated with subsequent mortality, even when controlling for social, behavioural, work, and health related factors. The idea that losing a job may have less importance for women than for men is not supported by this study.
研究70岁之前男性和女性的死亡率与失业、兼职工作、加班工作及额外工作之间的关系。年龄、婚姻状况、子女情况、吸烟和饮酒习惯、安眠药和镇静剂的使用、压力、轮班工作、性格因素以及长期或严重疾病被视为潜在的混杂因素。
研究组包括瑞典双胞胎登记处的一个亚队列，即1926年至1958年出生的人群。数据基于1973年的邮政调查问卷以及瑞典死亡原因登记处的信息。选取了所有报告主要职业的受试者，共9500名女性和11132名男性，并分析了1973年至1996年期间所有原因导致的死亡率。无论是否为双胞胎，这些受试者都被视为来自普通人群的样本。
1973年女性和男性的失业情况均与死亡率增加有关。调整后的相对风险（RR）（95%置信区间（95%CI））女性为1.98（1.16至3.38），男性为1.43（0.91至2.25）。在随访的前5年中，男性的风险增加了两倍（RR（95%CI）3.29（1.33至8.17））。RR随时间下降，但在整个24年的研究期间仍保持升高。在女性中，每周加班超过5小时会导致死亡率上升（RR（95%CI）1.92（1.13至3.25））。对于男性，每周最多加班5小时的适度加班有保护作用（RR（95%CI）0.58（0.43至0.80）），而兼职工作（RR（95%CI）1.58（0.91至2.77））和每周额外工作（本职工作之外的工作）超过5小时（RR（95%CI）1.29（0.99至1.69））则表明死亡率增加。
即使在控制了社会、行为、工作和健康相关因素之后，失业和工作的某些时间方面仍与随后的死亡率相关。本研究不支持失业对女性的重要性可能低于男性这一观点。
