Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Department of Public Health Sciences, Stockholm University, Stockholm, Sweden.
Eur J Public Health. 2022 Jun 1;32(3):366-371. doi: 10.1093/eurpub/ckac019.
Psychosocial workplace factors may be associated with alcohol-related morbidity, but previous studies have had limited opportunities to take non-occupational explanatory factors into account. The aim of this study is to investigate associations between job control, job demands and their combination (job strain) and diagnosed alcohol-related morbidity while accounting for several potentially confounding factors measured across the life-course, including education.
Job control, job demands and job strain were measured using the Swedish job exposure matrix measuring psychosocial workload on the occupational level linked to over 3 million individuals based on their occupational titles in 2005 and followed up until 2016. Cox regression models were built to estimate associations with alcohol-related diagnoses recorded in patient registers.
Low job control was associated with an increased risk of alcohol-related morbidity, while high job demands tended to be associated with a decreased risk. Passive and high-strain jobs among men and passive jobs among women were also associated with an increased risk of alcohol diagnoses. However, all associations were found to be weakened in models adjusted for other factors measured prospectively over the life-course, especially in models that included level of education.
The associations between low job control and high job demands, and the risk of alcohol-related morbidity reflect underlying socioeconomic differences to some extent. Lower job control, however, remained associated with a higher risk of alcohol-related morbidity.
心理社会工作场所因素可能与酒精相关的发病率有关,但以前的研究很少有机会考虑非职业性解释因素。本研究旨在调查工作控制、工作需求及其组合(工作压力)与诊断出的酒精相关发病率之间的关系,同时考虑到一生中测量的几个潜在混杂因素,包括教育。
使用瑞典工作暴露矩阵测量心理社会工作量,该矩阵基于 2005 年的职业头衔,对超过 300 万人进行了职业水平的测量,并一直跟踪到 2016 年。使用 Cox 回归模型来估计与患者登记处记录的酒精相关诊断的关联。
低工作控制与酒精相关发病率的风险增加有关,而高工作需求往往与风险降低有关。男性的被动和高压力工作以及女性的被动工作也与酒精诊断的风险增加有关。然而,所有关联在调整了一生中前瞻性测量的其他因素的模型中都被削弱了,尤其是在包括教育水平的模型中。
低工作控制和高工作需求与酒精相关发病率的风险之间的关联在某种程度上反映了潜在的社会经济差异。然而,较低的工作控制仍然与更高的酒精相关发病率相关。