Job strain and the risk of inflammatory bowel diseases: individual-participant meta-analysis of 95,000 men and women.

Katriina Heikkilä 1, * Ida Madsen 2 Solja Nyberg 1 Eleonor Fransson 3, 4, 5 Kirsi Ahola 1 Lars Alfredsson 3 Jakob Bjorner 2 Marianne Borritz 6 Hermann Burr 7 Nico Dragano 8 Jane Ferrie 9, 10 Anders Knutsson 11 Markku Koskenvuo 12 Aki Koskinen 1 Martin Nielsen 6 Maria Nordin 13 Jan Pejtersen 14 Jaana Pentti 1 Reiner Rugulies 15 Tuula Oksanen 1 Martin Shipley 9 Sakari Suominen 16, 17, 18 Töres Theorell 5 Ari Väänänen 1 Jussi Vahtera 1 Marianna Virtanen 1 Hugo Westerlund 5 Peter Westerholm 19 G David Batty 9, 20 Archana Singh-Manoux 9, 21 Mika Kivimäki 1
Abstract : 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's disease and ulcerative colitis using individual-level data from 95,000 European adults. We conducted individual-participant data meta-analyses in a set of pooled data from 11 prospective European studies. All studies are a part of the IPD-Work Consortium. Work-related psychosocial stress was operationalised as job strain (a combination of high demands and low control at work) and was self-reported at baseline. Crohn's disease and ulcerative colitis were ascertained from national hospitalisation and drug reimbursement registers. The associations between job strain and inflammatory bowel disease outcomes were modelled using Cox proportional hazards regression. The study-specific results were combined in random effects meta-analyses. Of the 95,379 participants who were free of inflammatory bowel disease at baseline, 111 men and women developed Crohn's disease and 414 developed ulcerative colitis during follow-up. Job strain at baseline was not associated with incident Crohn's disease (multivariable-adjusted random effects hazard ratio: 0.83, 95% confidence interval: 0.48, 1.43) or ulcerative colitis (hazard ratio: 1.06, 95% CI: 0.76, 1.48). There was negligible heterogeneity among the study-specific associations. Our findings suggest that job strain, an indicator of work-related stress, is not a major risk factor for Crohn's disease or ulcerative colitis.
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PLoS ONE, Public Library of Science, 2013, 9 (2), pp.e88711. 〈10.1371/journal.pone.0088711〉
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Katriina Heikkilä, Ida Madsen, Solja Nyberg, Eleonor Fransson, Kirsi Ahola, et al.. Job strain and the risk of inflammatory bowel diseases: individual-participant meta-analysis of 95,000 men and women.. PLoS ONE, Public Library of Science, 2013, 9 (2), pp.e88711. 〈10.1371/journal.pone.0088711〉. 〈inserm-01153091〉

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