Peter Westerholm

Peter Westerholm
Uppsala University | UU · Department of Medical Sciences

Doctor of Medicine

About

176
Publications
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9,256
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Introduction
- Strains and stresses at work burdening your health resources and adding to life circumstances detracting from perceived life quality, health and well-being
Skills and Expertise

Publications

Publications (176)
Article
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Background Elevated apolipoprotein B (apoB) and elevated apoB/apoA-1 ratio increase the risk of myocardial infarction (MI) and stroke, whereas high apoA-1 is protective. We study how these apolipoproteins are associated with major adverse cardiovascular events (MACEs), whether apoA-1 contributes to this association, and whether abnormal values occu...
Article
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To examine the relation between long working hours and change in body mass index (BMI). We performed random effects meta-analyses using individual-participant data from 19 cohort studies from Europe, US and Australia (n = 122,078), with a mean of 4.4-year follow-up. Working hours were measured at baseline and categorised as part time (<35 h/week),...
Article
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Objective To examine whether physical inactivity is a risk factor for dementia, with attention to the role of cardiometabolic disease in this association and reverse causation bias that arises from changes in physical activity in the preclinical (prodromal) phase of dementia. Design Meta-analysis of 19 prospective observational cohort studies. Da...
Article
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Purpose: Effort-reward imbalance (ERI) is a well-tested work-related stress model with three components, the two extrinsic components "efforts" and "rewards" and the one intrinsic component "overcommitment". While an imbalance between "efforts" and "rewards" leads to strain reactions, "work-related overcommitment" (OC) has been described as a pers...
Article
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This paper provides a narrative of the national intervention strategy in Sweden aimed to restrict the industrial use of asbestos. For many years, asbestos was imported for widespread industrial use, resulting in large amounts throughout Swedish society. In 1972, the whistle was blown in a Communist Party parliamentary motion describing asbestos as...
Article
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Introduction: Higher midlife body mass index (BMI) is suggested to increase the risk of dementia, but weight loss during the preclinical dementia phase may mask such effects. Methods: We examined this hypothesis in 1,349,857 dementia-free participants from 39 cohort studies. BMI was assessed at baseline. Dementia was ascertained at follow-up usi...
Article
Aims: Studies suggest that people who work long hours are at increased risk of stroke, but the association of long working hours with atrial fibrillation, the most common cardiac arrhythmia and a risk factor for stroke, is unknown. We examined the risk of atrial fibrillation in individuals working long hours (≥55 per week) and those working standa...
Article
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Background: Epidemiologic evidence for work stress as a risk factor for coronary heart disease is mostly based on a single measure of stressful work known as job strain, a combination of high demands and low job control. We examined whether a complementary stress measure that assesses an imbalance between efforts spent at work and rewards received...
Article
Background: In aging societies, zest for work may be pivotal when deciding to stay occupationally active longer. Psychosocial work stress is a prevalent public health problem and may have an impact on zest for work. Work over-commitment (WOC) is a personal coping strategy for work stress with excessive striving and a health risk. However, the long...
Article
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Background: Although overweight and obesity have been studied in relation to individual cardiometabolic diseases, their association with risk of cardiometabolic multimorbidity is poorly understood. Here we aimed to establish the risk of incident cardiometabolic multimorbidity (ie, at least two from: type 2 diabetes, coronary heart disease, and stro...
Article
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Background Adverse psychosocial working environments characterized by job strain (the combination of high demands and low control at work) are associated with an increased risk of depressive symptoms among employees, but evidence on clinically diagnosed depression is scarce. We examined job strain as a risk factor for clinical depression. Method W...
Article
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Background: Job insecurity has been associated with certain health outcomes. We examined the role of job insecurity as a risk factor for incident diabetes. Methods: We used individual participant data from 8 cohort studies identified in 2 open-access data archives and 11 cohort studies participating in the Individual-Participant-Data Meta-analys...
Article
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Objective Recommendations regarding physical activity typically include both leisure time and occupational physical activity. However, the results from previous studies on occupational physical activity and the association with myocardial infarction have been inconsistent. The aim of this study was to investigate if occupational physical activity i...
Article
Introduction The aim of this study was to test whether (i) sense of belonging with work predicted sleep quality or if (ii) sleep quality predicted sense of belonging with work. Both hypotheses are likely since the feeling of not belonging to a group is highly stressful, and since disturbed sleep may lead to hostility and poor relationships. Method...
Article
Introduction Atrial fibrillation is a common heart rhythm disorder affecting 1–3% of the adult population. Despite being such a prevalent disorder, the knowledge about risk factors preceding the disease is very limited, especially regarding work related factors. The aim of the present study was to estimate the association between the exposure to ex...
Article
Background: The amount and perception of domestic work may affect satisfaction with everyday life, but further knowledge is needed about the relationship between domestic work division and health and well-being. Aim: To describe the division of, and satisfaction with, domestic work and responsibility for home/family in adults living with a partner....
Article
Full-text available
Working longer than the maximum recommended hours is associated with an increased risk of cardiovascular disease, but the relationship of excess working hours with incident cancer is unclear. METHODS: This multi-cohort study examined the association between working hours and cancer risk in 116 462 men and women who were free of cancer at baseline....
Article
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Background: Working longer than the maximum recommended hours is associated with an increased risk of cardiovascular disease, but the relationship of excess working hours with incident cancer is unclear. Methods: This multi-cohort study examined the association between working hours and cancer risk in 116 462 men and women who were free of cance...
Article
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. Atrial fibrillation (AF) is a common heart rhythm disorder. Several life-style factors have been identified as risk factors for AF, but less is known about the impact of work-related stress. This study aims to evaluate the association between work-related stress, defined as job strain, and risk of AF. Methods . Data from the Swedish WOLF study wa...
Article
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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. We identified published studies through a systematic review of PubMed and Embase fro...
Article
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Objective: To quantify the association between long working hours and alcohol use. Design: Systematic review and meta-analysis of published studies and unpublished individual participant data. Data sources: A systematic search of PubMed and Embase databases in April 2014 for published studies, supplemented with manual searches. Unpublished individu...
Article
Psychosocial stress at work has been proposed to be a risk factor for cardiovascular disease. However, its role as a risk factor for stroke is uncertain. We conducted an individual-participant-data meta-analysis of 196 380 males and females from 14 European cohort studies to investigate the association between job strain, a measure of work-related...
Article
OBJECTIVE: To quantify the association between long working hours and alcohol use. DESIGN: Systematic review and meta-analysis of published studies and unpublished individual participant data. DATA SOURCES: A systematic search of PubMed and Embase databases in April 2014 for published studies, supplemented with manual searches. Unpublished individu...
Article
Full-text available
Background Working long hours might have adverse health effects, but whether this is true for all socioeconomic status groups is unclear. In this meta-analysis stratified by socioeconomic status, we investigated the role of long working hours as a risk factor for type 2 diabetes. Methods We identified four published studies through a systematic li...
Conference Paper
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INTRODUCTION: In globally orientated working world stress is of rising importance as a health risk. ERI (effort-reward-imbalance) is a well-tested work-related stress model with three components: While an imbalance between its extrinsic components 'efforts' and 'rewards' leads to strain reactions 'work-related overcommitment' (WOC) has been describ...
Article
Full-text available
Objective: The status of psychosocial stress at work as a risk factor for type 2 diabetes is unclear because existing evidence is based on small studies and is subject to confounding by lifestyle factors, such as obesity and physical inactivity. This collaborative study examined whether stress at work, defined as "job strain," is associated with i...
Article
To the Editor:Chronic obstructive pulmonary disease (COPD) is a major cause of mortality and disability worldwide (1). The clinical course of COPD is characterised by exacerbations, which can be minor and manageable at home or in primary care, or severe, leading to hospitalisation or even death. Known causes of exacerbations include tobacco smoke,...
Article
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Background International codes of ethics play an important role in guiding professional practice in developing countries. In the occupational health setting, codes developed by international agencies have substantial import on protecting working populations from harm. This is particularly so under globalisation which has transformed processes of pr...
Article
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Many patients and healthcare professionals believe that work-related psychosocial stress, such as job strain, can make asthma worse, but this is not corroborated by empirical evidence. We investigated the associations between job strain and the incidence of severe asthma exacerbations in working-age European men and women. We analysed individual-le...
Article
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To the Editor:Chronic obstructive pulmonary disease (COPD) is a major cause of mortality and disability worldwide (1). The clinical course of COPD is characterised by exacerbations, which can be minor and manageable at home or in primary care, or severe, leading to hospitalisation or even death. Known causes of exacerbations include tobacco smoke,...
Article
Full-text available
Background and aims: Many clinicians, patients and patient advocacy groups believe stress to have a causal role in inflammatory bowel diseases, such as Crohn's disease and ulcerative colitis. However, this is not corroborated by clear epidemiological research evidence. We investigated the association between work-related stress and incident Crohn'...
Article
Background: Previous studies have shown that gainfully employed individuals with high work demands and low control at work (denoted “job strain”) are at increased risk of common mental disorders, including depression. Most existing studies have, however, measured depression using self-rated symptom scales that do not necessarily correspond to clini...
Article
Full-text available
Background: Previous studies have shown that gainfully employed individuals with high work demands and low control at work (denoted "job strain") are at increased risk of common mental disorders, including depression. Most existing studies have, however, measured depression using self-rated symptom scales that do not necessarily correspond to clin...
Article
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The need for ethical guidelines in occupational health is widely recognised as key to good occupational health practice. Efforts by the International Commission on Occupational Health (ICOH) to update its Ethical Code led to the establishment of a Code Review Group (CRG) to which was affiliated an Africa Working Group to develop input to the ICOH C...
Article
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Objective To determine the association between self reported job insecurity and incident coronary heart disease. Design A meta-analysis combining individual level data from a collaborative consortium and published studies identified by a systematic review. Data sources We obtained individual level data from 13 cohort studies participating in the I...
Data
Web figure: Sub-group analysis of the association between job insecurity and coronary heart disease, multivariable adjusted. P for difference gives the statistical significance of group differences based on heterogeneity index. Welfare regime: Scandinavian (Denmark, Finland, Sweden); Anglo-Saxon (UK, US); Bismarckian (Belgium, Germany)
Article
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Job strain is associated with an increased coronary heart disease risk, but few large-scale studies have examined the relationship of this psychosocial characteristic with the biological risk factors that potentially mediate the job strain - heart disease association. We pooled cross-sectional, individual-level data from eight studies comprising 47...
Article
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Objectives: We examined the associations of job strain, an indicator of work-related stress, with overall unhealthy and healthy lifestyles. Methods: We conducted a meta-analysis of individual-level data from 11 European studies (cross-sectional data: n = 118,701; longitudinal data: n = 43,971). We analyzed job strain as a set of binary (job stra...
Article
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Background: It is unclear whether a healthy lifestyle mitigates the adverse effects of job strain on coronary artery disease. We examined the associations of job strain and lifestyle risk factors with the risk of coronary artery disease. Methods: We pooled individual-level data from 7 cohort studies comprising 102 128 men and women who were free...
Article
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To investigate whether work related stress, measured and defined as job strain, is associated with the overall risk of cancer and the risk of colorectal, lung, breast, or prostate cancers. Meta-analysis of pooled prospective individual participant data from 12 European cohort studies including 116 056 men and women aged 17-70 who were free from can...
Data
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Appendix 2: Supplementary information on potential confounders
Data
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Appendix 1: Full details of studies and participants
Data
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Appendix 3: Flow charts and participants’ characteristics by study
Article
By record-linkage of the 1975 Swedish census and the Medical Birth Register of infants born in 1976, 1,161 infants were identified who were born to women coded as laboratory workers in the census. These infants were compared to all 98,354 infants born in Sweden in 1976. There was a higher than expected number of infants who died neonatally and/or h...
Article
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Unfavorable work characteristics, such as low job control and too high or too low job demands, have been suggested to increase the likelihood of physical inactivity during leisure time, but this has not been verified in large-scale studies. The authors combined individual-level data from 14 European cohort studies (baseline years from 1985-1988 to...
Article
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Objective: The aim of this study was to investigate whether shift work (with or without night work) is associated with increased risk of breast cancer. Methods: The population consisted of 4036 women. Data were obtained from WOLF (Work, Lipids, and Fibrinogen), a longitudinal cohort study. Information about baseline characteristics was based on...
Article
: Published work assessing psychosocial stress (job strain) as a risk factor for coronary heart disease is inconsistent and subject to publication bias and reverse causation bias. We analysed the relation between job strain and coronary heart disease with a meta-analysis of published and unpublished studies. Methods : We used individual records fr...
Article
Full-text available
Tobacco smoking is a major contributor to the public health burden and healthcare costs worldwide, but the determinants of smoking behaviours are poorly understood. We conducted a large individual-participant meta-analysis to examine the extent to which work-related stress, operationalised as job strain, is associated with tobacco smoking in workin...
Article
Full-text available
The relationship between work-related stress and alcohol intake is uncertain. In order to add to the thus far inconsistent evidence from relatively small studies, we conducted individual-participant meta-analyses of the association between work-related stress (operationalised as self-reported job strain) and alcohol intake. We analysed cross-sectio...
Data
Studies and participants included in the analyses. (DOC)
Data
Associations of alcohol intake and work job strain in demographic subgroups1. (DOC)
Data
Associations of smoking and work stress in demographic subgroups1. (DOC)
Data
Study design and recruitment of participants in the 12 European studies included in our individual-participant meta-analyses of alcohol intake and work stress. (DOC)
Data
Associations of tobacco smoking and job strain (adjusted for age, sex and socioeconomic position). (DOC)