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Mean increase in plasma testosterone when change from ”high job strain” (ratio between demand and control; average.

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Presentation on theme: "Mean increase in plasma testosterone when change from ”high job strain” (ratio between demand and control; average."— Presentation transcript:

1 Tores.Theorell@stressforskning.su.se

2 Mean increase in plasma testosterone when change from ”high job strain” (ratio between demand and control; average of two highest observations of four during study year) to ”low job strain” (average of two lowest) % increaseStandard error All men in study n=4414+/- 6 White collars only n=2323+/- 9 Blue collars only n=214+/- 8 Theorell, Karasek and Eneroth, Journal of Internal Medicine 227: 31-36, 1990

3 In women with acute onset of low back pain, low DHEA-s predicted persistent disability after six months (Hasselhorn, Theorell and Vingård, Spine E24-29, 2001) This was replicated in a larger group of 121 media workers (men and women) who were followed for 12 months: Again low DHEA-s predicted persistent pain Schell E, Theorell T, Hasson D, Arnetz B, Saraste H. Eur Spine J. 2007

4 Lack of cultural activities through work in relation to demand control model. SLOSH n=5100. Theorell Scand J Work Env Health suppl 2008 1.0 2.0 3.0 4.0 5.0 Adjusted for age, education, and branch Odds ratios with 95 % confidence intervals for low occurrence (never or some time per year) of cultural activities by the demand-control model (measured by DCQ 2006) Low strain Reference category PassiveActiveStrain

5 Bygren et al Psychosomatic Medicine 71:469-473, 2009 Local government officers in a municipality were allowed to visit self- selected cultural activities once a week for eight weeks films, concerts, or art exhibitions visits, or singing in a choir Random allocation 51/50 Significantly improved physical health, social functioning and vitality according to SF-36 (two-way interaction) after eight weeks in cultural activity group compared to control group

6 Study of effects of ethical/social management training. ”Classical” management course is compared with poetry/music sessions followed up by ethical discussions. Focus on difficult decisions that managers have to face. Both courses last for one year. Randomised allocation of manager participants. 24 managers in each group were followed for a year. Four employees for each manager were also followed. Work environment and mental health /questionnaire. Blood samples drawn for analysis of of hormones reflecting energy mobilisation (cortisol) and regeneration (DHEA:s) Employees rate increased Courage and less Laissez Faire in managers who participated in ethical management training (significant two way interactions) particularly after 18 months. Romanowska et al 2008

7 Joint analysis of participating managers and subordinates after 12 (end of interventions) and 18 months: Mental health (sleep disturbance, depression, mental exhaustion) showed significantly better development in ”artistic” manager education group than in ”classical” group particularly after 18 months DHEA-s (index of anabolism) concentration showed no difference after 12 months but significantly better development in ”artistic” than in ”classical” group after 18 months Cortisol (index of ”stress”) significantly different after 12 months (elevation in ”artistic” and reduction in ”classical” group) but no difference after 18 months Romanowska et al, in preparation 2009

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10 Managerial Leadership and Ischemic Heart Disease Among Employees: The Swedish WOLF Study Anna Nyberg (1), Lars Alfredsson (2,3), Töres Theorell (1), Hugo Westerlund (1), Jussi Vahtera (4), and Mika Kivimäki (5) 1.) Institute for Stress Research Stockholm University 2.) Institute for Environmental Medicine, Karolinska Inst 3.) Centre for Public Health, Karolinska Hospital 4.) Finnish Institute for Occupational Health 5.) University College London, Dep. Epidem/Publ Health Organisational and Environmental Medicine 2009

11 Association between employee score (fair management) and risk of subsequent myocardial infarction after adjustments. WOLF Stockholm (3122 men aged 25-65 at start followed for 10 years) Increase of one standard deviation on the scale was associated with reduced risk: 0.57 (CI 0.43-0.76) Those who reported that they had a fair and good management had a 43% reduction after adjustment for other risk factors. The longer the exposure to this management the more reduction

12 Risk of developing a myocardial infarction in Swedish working men during 10 years of follow-up in relation to covert coping (Stockholm WOLF study) Coping scoreNHR (95% CI) Low (4-7)7121 (ref.) Medium (8-10)12884.20 (1.25-14.13) High (11-16)7085.94 (1.75-20.20) Adjusted for age, demographic factors, behavioural risk factors, demand and decision latitude as well as for biological risk factors Leineweber et al Journ Epidemiol Comm Health, in press 2009

13 Hasson, D et al.. BMC Public Health. 78(5); 1-14, 2005

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15 Geometric means of individual saliva cortisol concentration in choir group (beginners) and information group of IBS patients, randomly selected for once a week meetings during a year. For each individual and assessment day there are geometric means of six assessments from morning to bedtime. Baseline, six months, nine months and twelve months from start Grape, Wikström, Ekman, Hasson and Theorell manuscript 2009


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