Ingrid Alethe Sivesind Mehlum

• Peters, Susan; Undem, Karina; Solovieva, Svetlana E.; Selander, Jenny; Schlünssen, Vivi & Hengel, Karen M. Oude [Show all 43 contributors for this article] (2024). Narrative review of occupational exposures and noncommunicable diseases. Annals of Occupational Hygiene. ISSN 0003-4878. doi: 10.1093/annweh/wxae045.
• Merkus, Suzanne; Hoff, Rune; Hasting, Rachel Louise; Undem, Karina; Robroek, Suzan J.W. & Gran, Jon Michael [Show all 7 contributors for this article] (2024). Gender and educational differences in work participation and working years lost in Norway. Scandinavian Journal of Work, Environment and Health. ISSN 0355-3140. doi: 10.5271/sjweh.4166. Full text in Research Archive Show summary

  Objectives This study aimed to quantify the duration of work participation and reasons for working years lost, according to gender and educational attainment, among a Norwegian population. Methods Register data on labor market attachment between 2000–2015 were obtained from Statistics Norway. We included five cohorts: individuals turning 20 (N=323 333), 30 (N=386 006), 40 (N=388 962), 50 (N=358 745), and 60 years (N=284 425) between 1 January 2000 and 31 December 2005. Individuals were followed for ten years. Data completeness allowed calculation of the average time spent in work and years lost to healthrelated absences and non-employment states per cohort. Changes in state probabilities over time were also depicted. Mean differences between genders and educational levels, and corresponding 95% confidence intervals were based on 1000 bootstrap samples. Results Both genders spent most time in work; however, per cohort, women worked approximately one year less than men. As cohorts aged, main reasons for working years lost changed from education and economic inactivity to sickness absence and disability pensioning; this trend was stronger for women than men. Individuals with a low education spent fewer years in work and more years in sickness absence and disability pensioning than highly educated peers. This difference tended to be larger for women and older cohorts. Conclusions Per cohort, women participated one year less in work than men and, depending on age, spent more time in education, economic inactivity, sickness absence, and disability pensioning. Stronger educational gradients were seen for work and health-related absences for older cohorts and women.

• Amin, Ridwanul; Mittendorfer-Rutz, Ellenor; Undem, Karina; Mehlum, Ingrid Sivesind & Hasting, Rachel Louise (2024). Does country of resettlement influence the risk of labor market marginalization among refugees? A cohort study in Sweden and Norway. Scandinavian Journal of Work, Environment and Health. ISSN 0355-3140. 50(4), p. 279–289. doi: 10.5271/sjweh.4154. Full text in Research Archive Show summary

  Objectives This study aimed to compare the risk of labor market marginalization among refugees across different host countries of resettlement and examine the moderating role of birth country and length of stay on these associations. Methods Cohorts of refugees and native-born individuals aged 19–60 in Sweden (N=3 605 949, 3.5% refugees) and Norway (N=1 784 861, 1.7% refugees) were followed during 2010–2016. Rates (per 1000 person-years) of long-term unemployment, long-term sickness absence, and disability pension were estimated for refugees and the host populations. Cox regression models estimated crude and adjusted (for sex, age, educational level, and civil status) hazard ratio (HRadj) for refugees compared to their respective host population, with 95% confidence intervals (CI). Analyses were also stratified by birth country and length of stay. Results Refugees in Norway and Sweden had a higher incidence of labor market marginalization compared to their host population. Refugees in Sweden had a comparatively lower relative risk of long-term unemployment but higher risk of disability pension (HRadj 3.44, 95% CI, 3.38–3.50 and HRadj 2.45, 2.35–2.56, respectively) than refugees in Norway (HRadj 3.70, 3.58–3.82 and HRadj 1.57, 1.49–1.66, respectively). These relative risks varied when stratifying by birth country. A shorter length of stay was associated with a higher risk of long-term unemployment and a lower risk of disability pension, with a stronger gradient in Sweden than in Norway. Conclusions The relative risk of labor market marginalization varied by the refugees’ birth country but followed similar trends in Sweden and Norway. Although speculative, these findings may hint at non-structural factors related to the refugee experience playing a more important role than host country structural factors for the risk of labor market marginalization among refugees. Future research, including host countries with more variability in structural factors, is required to further investigate these associations. The higher risk of long-term unemployment among refugees with shorter length of stay indicates a need for more efficient labor market integration policies for newly-arrived refugees.

• Solovieva, Svetlana E.; de Wind, Astrid; Undem, Karina; Dudel, Christian; Mehlum, Ingrid Sivesind & van den Heuvel, Swenne G. [Show all 8 contributors for this article] (2024). Socioeconomic differences in working life expectancy: a scoping review. BMC Public Health. ISSN 1471-2458. 24(1). doi: 10.1186/s12889-024-18229-y. Full text in Research Archive
• Nys, Evelien; Pauwels, Sara; Ádám, Balázs; Amaro, João ; Athanasiou, Athanasios & Bashkin, Osnat [Show all 52 contributors for this article] (2023). Recognition of COVID-19 with occupational origin: a comparison between European countries. Occupational and Environmental Medicine. ISSN 1351-0711. 80(12), p. 694–701. doi: 10.1136/oemed-2022-108726. Full text in Research Archive Show summary

  Objectives This study aims to present an overview of the formal recognition of COVID-19 as occupational disease (OD) or injury (OI) across Europe. Methods A COVID-19 questionnaire was designed by a task group within COST-funded OMEGA-NET and sent to occupational health experts of 37 countries in WHO European region, with a last update in April 2022. Results The questionnaire was filled out by experts from 35 countries. There are large differences between national systems regarding the recognition of OD and OI: 40% of countries have a list system, 57% a mixed system and one country an open system. In most countries, COVID-19 can be recognised as an OD (57%). In four countries, COVID-19 can be recognised as OI (11%) and in seven countries as either OD or OI (20%). In two countries, there is no recognition possible to date. Thirty-two countries (91%) recognise COVID-19 as OD/OI among healthcare workers. Working in certain jobs is considered proof of occupational exposure in 25 countries, contact with a colleague with confirmed infection in 19 countries, and contact with clients with confirmed infection in 21 countries. In most countries (57%), a positive PCR test is considered proof of disease. The three most common compensation benefits for COVID-19 as OI/OD are disability pension, treatment and rehabilitation. Long COVID is included in 26 countries. Conclusions COVID-19 can be recognised as OD or OI in 94% of the European countries completing this survey, across different social security and embedded occupational health systems.

• Nikkilä, Rayan; Peltomaa, Miikka; Carpén, Timo; Martinsen, Jan Ivar; Heikkinen, Sanna & Selander, Jenny [Show all 10 contributors for this article] (2023). Cancer incidence among visual artists: 45 years of follow-up in four Nordic countries. Acta Oncologica. ISSN 0284-186X. 62(10), p. 1265–1272. doi: 10.1080/0284186X.2023.2263150. Full text in Research Archive Show summary

  Introduction: Professional visual artists constitute a heterogeneous vocational group, including, but not limited to painters, photographers, textile artists, and sculptors who may face exposure to workplace hazardous substances and lifestyle factors that may contribute to the development of selected cancers. The objective of this registry-based cohort study was to assess the cancer incidence among Nordic visual artists. Materials and methods: This study is based on data from the Nordic Occupational Cancer (NOCCA) project that combines census data of 15 million people from all Nordic countries and cancer registries from 1961 to 2005. For the present study we selected a cohort of visual artists from Finland, Iceland, Norway, and Sweden. Standardized incidence ratio (SIR) analyses were conducted with the cancer incidence rates for the entire national study populations used as reference rates. Results: In male visual artists, there were statistically significant excesses in cancers of the tongue (SIR 2.91, 95% confidence interval 1.74–4.55), oral cavity (2.09, 1.26–3.27), pharynx (2.18, 1.45-–3.15), testis (1.91, 1.11–3.05), renal pelvis (2.48, 1.42–4.03) and bladder (1.33, 1.14–1.55). The risk was significantly decreased for cancers of the lip (0.45, 0.18-0.93) and stomach (0.65, 0.50–0.84). In female visual artists, the only significantly increased risk was observed for breast cancer (1.29, 1.13–1.48) and the only significantly decreased risk for stomach cancer (0.43, 0.17–0.88). The incidence of lung cancer was close to the population average in both sexes. Conclusions: The non-elevated incidence of lung cancer suggests a similar prevalence of smoking between visual artists and the general population, while the elevated risk of cancers of mouth and pharynx among male visual artists is suggestive of more widespread alcohol drinking. The excess risk of urogenital cancers might be associated with exposure to solvents.

• Laakso, Laura; Jokelainen, Pikka; Houe, Hans; Skjerve, Eystein; Hansen, Johnni & Lynge, Elsebeth [Show all 13 contributors for this article] (2023). No Excess Cancer Risk among Veterinarians in Denmark, Finland, Iceland, Norway, and Sweden after the 1980s. Cancers. ISSN 2072-6694. 15(16). doi: 10.3390/cancers15164079. Full text in Research Archive Show summary

  The cancer profile of veterinarians has received little research attention, despite the profession potentially being exposed to a wide range of known and suspected carcinogens. In this large-scale cohort study, we assessed cancer incidence in veterinarians in Denmark, Finland, Iceland, Norway, and Sweden, across more than 40 years (1961–2005). The cohort comprised 4708 veterinarians and 119,503 person-years at follow-up. The overall cancer incidence in veterinarians was close to the incidence in the total population in all countries and in all age groups. In male veterinarians, the standardized incidence ratios (SIR) in 1961–1990 were elevated for colon cancer (1.86, 95% confidence interval (CI) 1.39–2.44), prostate cancer (1.35, 95% CI 1.07–1.67), and especially skin melanoma (3.62, 95% CI 2.78–2.84), while there was no longer any statistically significant excess in the more recent follow-up period. Decreased SIRs were observed for lip cancer (0.11, 95% CI 0.00–0.62), laryngeal cancer (0.38, 95% CI 0.12–0.89), lung cancer (0.59, 95% CI 0.47–0.74), and stomach cancer (0.58, 95% CI 0.38–0.86), without a marked change in SIR over time. Non-significant excesses among male veterinarians were also observed in Hodgkin lymphoma (1961–1990 only), and leukaemia. This multi-country study indicates that there was an elevated incidence of several cancer types among male veterinarians before the 1990s but not after that. Some of the findings might rather be attributed to lifestyle factors and not directly to work conditions, but the excess risk of cancers of kidney and bladder, for example, might be related to work exposures.

• Hasting, Rachel Louise; Mehlum, Ingrid Sivesind; Undem, Karina; Robroek, Suzan J. W; Burdorf, Alex & Gran, Jon Michael [Show all 7 contributors for this article] (2023). The effects of a national, voluntary agreement for a more inclusive working life on work participation following long-term sickness absence: a Norwegian cohort study. Scandinavian Journal of Work, Environment and Health. ISSN 0355-3140. 49(7), p. 466–476. doi: 10.5271/sjweh.4112. Full text in Research Archive Show summary

  Objectives This study aimed to estimate the average individual effect of the company-level Norwegian Agreement on a More Inclusive Working Life (IA Agreement) on individuals’ (i) sustained return to work after a sickness absence (SA) episode, and (ii) recurrent SA. Methods Using register data, 79 253 men and 94 914 women born in Norway 1967–1976 were followed for one year between 2005 and 2010 after returning to work from an SA episode (>16 days). Weighted Cox proportional hazard models analysed time to first exit from work by companies’ IA status (IA/non-IA). Weighted cumulative incidence differences between IA and non-IA groups with 95% bootstrapped confidence intervals (CI) were calculated for the competing events of full SA, graded (<100%) SA, unemployment/economic inactivity, education, disability pension, and death/emigration. Stabilised inverse probability of treatment weights balanced IA/non-IA groups according to nine covariates. Analyses were stratified by gender, and separately for two initial SA diagnoses (musculoskeletal and psychological). Results Both men [adjusted hazard ratio (HR) 0.96, 95% CI 0.93–0.99] and women (adjusted HR 0.97, 95% CI 0.94–0.99) in IA companies were less likely to exit work in the year following SA. Similar findings were seen among individuals with musculoskeletal diagnoses and women with psychological diagnoses. Men with psychological diagnoses were more likely to exit work. Recurrent full and graded SA were more likely, and unemployment/economic inactivity less likely, in IA companies. However, the estimated effects were small and the CI often included the null. Conclusions Individuals working in IA companies were more likely to remain in work. This was mainly due to reduced unemployment/economic inactivity, suggesting the IA Agreement may have influenced work participation through other means than reduced SA.

• Nikkilä, Rayan; Mäkitie, Antti; Carpén, Timo; Hansen, Johnni; Heikkinen, Sanna & Lynge, Elsebeth [Show all 11 contributors for this article] (2023). Occupational variation in incidence of oropharyngeal cancer in the Nordic countries. European Archives of Oto-Rhino-Laryngology. ISSN 0937-4477. 281, p. 343–350. doi: 10.1007/s00405-023-08168-6. Show summary

  Purpose: Evaluate the occupational variation in incidence of oropharyngeal cancer (OPC). Methods: We calculated standardized incidence ratios (SIRs) of OPC in occupational categories in the Nordic countries relative to the entire national populations. The data covered 6155 OPC cases. Results: Among men high risk of OPC was observed, among else, in waiters (SIR 6.28, 95% CI 4.68–8.26), beverage workers (SIR 3.00, 95% CI 1.72–4.88), and artistic workers (SIR 2.97, 95% CI 2.31–3.76). Among women high risk of OPC was observed in waiters (SIR 2.02, 95% CI 1.41–2.81) and packers (SIR 1.73, 95% CI 1.07–2.64). The lowest SIRs were observed in female gardeners (SIR 0.27, 95% CI 0.12–0.51) and male farmers (SIR 0.30, 95% CI 0.25–0.35). Conclusion: The 20-fold variation in incidence of OPC between occupations needs further investigation in studies with detailed information on occupational and non-occupational risk factors.

• Mroueh, Rayan; Carpén, Timo; Mäkitie, Antti; Hansen, Johnni; Heikkinen, Sanna & Lynge, Elsebeth [Show all 12 contributors for this article] (2023). Occupational variation in the incidence of lip cancer in the Nordic countries. Acta Oncologica. ISSN 0284-186X. 62(6), p. 541–549. doi: 10.1080/0284186X.2023.2224053. Show summary

  Introduction While certain occupations, such as agriculture and fishery, have been associated with an increased risk of lip cancer, the occupational risk profile of lip cancer and its change over time remain poorly known. This study aims to evaluate the incidence of lip cancer across different occupations in the Nordic countries. Methods The Nordic Occupational Cancer Study (NOCCA) covers 14.9 million people and includes 45 years of cancer incidence data, from 1961 to 2005, linked to occupational categories for all the five Nordic populations. Standardized incidence ratios (SIRs) with 95% confidence intervals (CIs) were used to quantify the risk of lip cancer across occupational categories relative to the entire national populations. Results There were a total of 14,477 male and 3008 female lip cancer patients identified during follow up. The highest SIRs were observed among male fishermen (SIR 2.26, 95% CI: 2.04–2.50), gardeners (SIR 1.60, 95% CI: 1.48–1.72), and farmers (SIR 1.60, 95% CI: 1.55–1.66). A significantly reduced risk of lip cancer (SIR < 0.50) was observed among male physicians, teachers, religious workers, artistic workers, journalists, administrators, printers, waiters, and hairdressers. Among women, no occupations were associated with an increased risk of lip cancer. Conclusions The incidence of lip cancer varies widely between outdoor and indoor occupations. Occupations involving outdoor activity and exposure to sunlight show the most elevated SIRs.

• Molaug, Ina Charlotte; Aarhus, Lisa; Mehlum, Ingrid Sivesind; Stokholm, Zara Ann; Kolstad, Henrik A. & Engdahl, Bo Lars (2023). Occupational noise exposure and tinnitus: the HUNT Study. International Journal of Audiology. ISSN 1499-2027. doi: 10.1080/14992027.2023.2211735. Full text in Research Archive Show summary

  Objective: We aimed to assess the association between occupational noise exposure and tinnitus. Further, to assess whether the association depends on hearing status. Design: In this cross-sectional study, tinnitus (>1 h daily) was regressed on job exposure matrix (JEM)-based or self-reported occupational noise exposure, adjusted for confounders. Study sample: The 14,945 participants (42% men, 20–59 years) attended a population-based study in Norway (HUNT4, 2017-2019). Results: JEM-based noise exposure, assessed as equivalent continuous sound level normalised to 8-h working days (LEX 8 h), over the working career or as minimum 5 years ≥85 dB) was not associated with tinnitus. Years of exposure ≥80 dB (minimum one) was not associated with tinnitus. Self-reported high noise exposure (>15 h weekly ≥5 years) was associated with tinnitus overall and among persons with elevated hearing thresholds (prevalence ratio (PR) 1.3, 1.0–1.7), however not statistically significantly among persons with normal thresholds (PR 1.1, 0.8–1.5). Conclusions: Our large study showed no association between JEM-based noise exposure and tinnitus. This may to some extent reflect successful use of hearing protection. High self-reported noise exposure was associated with tinnitus, but not among normal hearing persons. This supports that noise-induced tinnitus to a large extent depends on audiometric hearing loss

• Keyes, Katherine; Kristensen, Petter; Undem, Karina & Mehlum, Ingrid Sivesind (2023). Relative Age Within School Grade, Including Delayed and Accelerated School Start: Associations With Midlife Psychiatric Disorders, Suicide, and Alcohol- and Drug-Related Mortality. American Journal of Epidemiology. ISSN 0002-9262. 192(9), p. 1453–1462. doi: 10.1093/aje/kwad111. Show summary

  Within a school grade, children who are young for grade are at increased risk of psychiatric diagnoses, but the long-term implications remain understudied, and associations with students who delay or accelerate entry underexplored. We used Norwegian birth cohort records (birth years: 1967-1976, N=626,928) linked to records in mid-life. On-time school entry was socially patterned; among those born in December, 23.0% of children in the lowest socio-economic position (SEP) delayed school entry, compared with 12.2% among the highest SEP. Among those who started school on time, there was no evidence for long-term associations between birth month and psychiatric/behavioral disorders or mortality, respectively. Controlling for SEP and other confounders, delayed school entry was associated with increased risk of psychiatric disorders and mortality. Children with delayed school entry were 1.31 times more likely to die by suicide (95% CI. 1.07-1.61) by midlife, and 1.96 times more likely to die from drug-related death (95% C.I. 1.59-2.40) by mid-life than those born late in the year who started school on time. Associations with delayed school entry are likely due to selection, and results thus underscore that long-term health risks can be tracked early in life, including through school entry timing, and are highly socially patterned.

• Amaro, Joana; Costa, Raquel; Popovic, Maja; Maule, Milena M.; Mehlum, Ingrid Sivesind & Lucas, Raquel (2023). Association of child neurodevelopmental or behavioural problems with maternal unemployment in a population-based birth cohort. Social Psychiatry and Psychiatric Epidemiology. ISSN 0933-7954. doi: 10.1007/s00127-023-02464-6. Show summary

  Purpose To estimate associations between suspected or diagnosed neurodevelopmental or behavioural problems in 7-year-old children and maternal unemployment at child age 7 and 10, in a Portuguese birth cohort. Methods We evaluated 5754 mothers and their children of the population-based birth cohort Generation XXI in Porto, Portugal. Data on suspected and diagnosed child neurodevelopmental and behavioural problems (exposures)—learning, attention and language problems, externalising behaviours, developmental delay, autism spectrum disorders, and other neurodevelopmental problems—were retrieved at 7 years of age by interviewing caregivers. Maternal employment status (outcome) was collected at the 7- and 10-year follow-up waves. Robust Poisson regression models were used to estimate associations. Results After adjustment for maternal and household characteristics, women were more likely to be unemployed at child age 10 if the child had, up to age 7, any of the following suspected problems: an autism spectrum disorder (PR = 1.73; 95% CI 1.07, 2.79), developmental delay (PR = 1.58; 95% CI 1.20, 2.06), externalising behaviours (PR = 1.29; 95% CI 1.11, 1.50) or learning problems (PR = 1.26; 95% CI 1.07, 1.48). When the exposure was restricted to clinically diagnosed disorders, the magnitude of associations remained similar but estimates were less precise. Associations with unemployment were stronger at child age 10 (prospective analyses), than at child age 7 (cross-sectional). Conclusion Having a child with learning, developmental or behavioural problems, or an autism spectrum disorder up to age 7 was associated with maternal unemployment three years later, even in a less affluent European economy where the dual-earner family structure is often necessary to make ends meet.

• Bonde, Jens Peter Ellekilde; Sell, Lea; Flachs, Esben Meulengracht; Coggon, David; Albin, Maria & Hengel, Karen Marieke Oude [Show all 17 contributors for this article] (2022). Occupational risk of COVID-19 related hospital admission in Denmark 2020-2021: a follow-up study. Scandinavian Journal of Work, Environment and Health. ISSN 0355-3140. 49(1), p. 84–95. doi: 10.5271/sjweh.4063. Full text in Research Archive Show summary

  Objective: Mounting evidence indicates increased risk of COVID-19 among healthcare personnel, but the evidence on risks in other occupations is limited. In this study, we quantify the occupational risk of COVID-19-related hospital admission in Denmark during 2020-2021. Methods: The source population included 2.4 million employees age 20-69 years. All information was retrieved from public registers. The risk of COVID-19 related hospital admission was examined in 155 occupations with at least 2000 employees (at-risk, N=1 620 231) referenced to a group of mainly office workers defined by a COVID-19 job exposure matrix (N=369 341). Incidence rate ratios (IRR) were computed by Poisson regression. Results: During 186 million person-weeks of follow-up, we observed 2944 COVID-19 related hospital admissions in at-risk occupations and 559 in referents. Adjusted risk of such admission was elevated in several occupations within healthcare (including health care assistants, nurses, medical practitioners and laboratory technicians but not physiotherapists or midwives), social care (daycare assistants for children aged 4-7, and nursing aides in institutions and private homes, but not family daycare workers) and transportation (bus drivers, but not lorry drivers). Most IRR in these at-risk occupations were in the range of 1.5-3. Employees in education, retail sales and various service occupations seemed not to be at risk. Conclusion: Employees in several occupations within and outside healthcare are at substantially increased risk of COVID-19. There is a need to revisit safety measures and precautions to mitigate viral transmission in the workplace during the current and forthcoming pandemics.

• Solovieva, Svetlana E.; Undem, Karina; Falkstedt, Daniel; Johansson, Gun; Kristensen, Petter & Pedersen, Jacob [Show all 9 contributors for this article] (2022). Utilizing a Nordic Crosswalk for Occupational Coding in an Analysis on Occupation-Specific Prolonged Sickness Absence among 7 Million Employees in Denmark, Finland, Norway and Sweden. International Journal of Environmental Research and Public Health (IJERPH). ISSN 1661-7827. 19(23). doi: 10.3390/ijerph192315674. Show summary

  We identified occupations with a high incidence of prolonged sickness absence (SA) in Nordic employees and explored similarities and differences between the countries. Utilizing data from national registers on 25–59-year-old wage-earners from Denmark, Finland, Norway and Sweden, we estimated the gender- and occupation-specific age-adjusted cumulative incidence of SA due to any cause, musculoskeletal diseases and mental disorders. To increase the comparability of occupations between the countries, we developed a Nordic crosswalk for occupational codes. We ranked occupational groups with the incidence of SA being statistically significantly higher than the population average of the country in question and calculated excess fractions with the employee population being the reference group. We observed considerable occupational differences in SA within and between the countries. Few occupational groups had a high incidence in all countries, particularly for mental disorders among men. In each country, manual occupations typically had a high incidence of SA due to any cause and musculoskeletal diseases, while service occupations had a high incidence due to mental disorders. Preventive measures targeted at specific occupational groups have a high potential to reduce work disability, especially due to musculoskeletal diseases. Particularly groups with excess SA in all Nordic countries could be at focus.

• Molaug, Ina Charlotte; Engdahl, Bo Lars; Mehlum, Ingrid Sivesind; Stokholm, Zara Ann; Kolstad, Henrik & Aarhus, Lisa (2022). Quantitative levels of noise exposure and 20-year hearing decline: findings from a prospective cohort study (the HUNT Study). International Journal of Audiology. ISSN 1499-2027. 63(1), p. 40–48. doi: 10.1080/14992027.2022.2143432. Full text in Research Archive Show summary

  Objective We aimed to assess the association between occupational noise exposure and long-term hearing decline. Design This prospective cohort study used linear regression to investigate the association between occupational noise exposure and 20-year hearing decline, adjusted for important confounders. Study sample The Norwegian cohort (N = 4,448) participated in two population-based health studies with pure-tone audiometry; HUNT2 1996–1998 and HUNT4 2017–2019. Exposure assessments included a quantitative job exposure matrix (JEM) and questionnaires. Results The participants (40.2% men, 20–39 years at baseline) had a mean 20-year decline (3–6 kHz) of 11.3 ± 9.8 decibels (dB). There was a positive association between 20-year logarithmic average noise level (JEM-based, LEX,20y) and 20-year hearing decline among men. Compared with no exposure ≥80 dB during follow-up, minimum 5 years of exposure ≥85 dB (JEM-based) predicted 2.6 dB (95% CI: 0.2–5.0) larger 20-year decline for workers aged 30–39 years at baseline, and −0.2 dB (95% CI: −2.2 to 1.7) for workers aged 20–29 years. Combining JEM information with self-reported noise exposure data resulted in stronger associations. Conclusion This large longitudinal study shows an association between JEM-based noise exposure level and increased 20-year hearing decline among men. Contrary to expectations, the associations were weaker among younger workers, which might reflect a latency period.

• Hoff, Rune; Maltzahn, Niklas; Hasting, Rachel Louise; Merkus, Suzanne; Undem, Karina & Kristensen, Petter [Show all 8 contributors for this article] (2022). An initiative for a more inclusive working life and its effect on return-to-work after sickness absence: a multistate longitudinal cohort study. Occupational and Environmental Medicine. ISSN 1351-0711. 12(11). doi: 10.1136/bmjopen-2022-062558. Full text in Research Archive Show summary

  Objectives To reduce sickness absence (SA) and increase work participation, the tripartite Agreement for a More Inclusive Working Life (IA) was established in Norway in 2001. IA companies have had access to several measures to prevent and reduce SA. Our aim in this paper was to estimate the average effect of having access to IA at the time of entering a first SA on later return-to-work (RTW) and on time spent in other work-related states. A secondary objective was to study how effects varied between women and men, and individuals with SA due to either musculoskeletal or psychological diagnoses. Design Population-based observational multistate longitudinal cohort study. Setting Individual characteristics and detailed longitudinal records of SA, work and education between 1997-2011 were obtained from population-wide registries. Participants Each individual born in Norway 1967–1976 who entered full-time SA during 2004–2011, with limited earlier SA, was included (n=187 930). Primary and secondary outcome measures Individual multistate histories containing dated periods of work, graded SA, full-time SA, non-employment and education. Methods Data were analysed in a multistate model with 500 days of follow-up. The effect of IA was assessed by estimating differences in state probabilities over time, adjusted for confounders, using inverse probability weighting. Results IA increased the probability of work after SA, with the largest difference between groups after 29 days (3.4 percentage points higher (95% CI 2.5 to 4.3)). Differences in 1-year expected length of stay were 8.4 additional days (4.9 to 11.9) in work, 7.6 (4.8 to 10.3) fewer days in full-time SA and 1.6 (-0.2 to 3.4) fewer days in non-employment. Similar trends were found within subgroups by sex, musculoskeletal and psychological diagnoses. The robustness of the findings was studied in sensitivity analyses. Conclusion Measures to prevent and reduce SA, as given through IA, were found to improve individuals’ RTW after entering SA.

• Carpén, Timo; Gille, Evelina; Hammarstedt-Nordenvall, Lalle; Hansen, Johnni; Heikkinen, Sanna & Lynge, Elsebeth [Show all 11 contributors for this article] (2022). Occupational risk variation of nasopharyngeal cancer in the Nordic countries. BMC Cancer. ISSN 1471-2407. 22. doi: 10.1186/s12885-022-10209-y. Show summary

  Background The aim of this study was to estimate occupational risk variation in the incidence of nasopharyngeal cancer (NPC) in a large population-based cohort of the Nordic Occupational Cancer (NOCCA) study Methods This study is based on a cohort of almost 15 million persons from Denmark, Finland, Iceland, Norway and Sweden, with 2898 nasopharyngeal cancer cases diagnosed in 1961–2005. The data on occupations were gathered from population censuses and cancer data from the national cancer registries. Standardized incidence ratios (SIR) with 95% confidence intervals (CI) were estimated using the national NPC incidence rates as the reference. Results There were 1980 male and 918 female NPC patients. The highest SIRs of NPC were observed among male waiters (SIR 3.69, 95% CI 1.91–6.45) and cooks and stewards (SIR 2.24, 95% CI 1.16–3.91). Among women, launderers had the highest SIR of NPC (2.04, 95% CI 1.02–3.65). Significantly decreased SIRs were found among male farmers (SIR 0.79, 95% CI 0.68–0.92) and male textile workers (SIR 0.49, 95% CI 0.22–0.93). Conclusions This study suggests that NPC may be associated with several work-related exposure agents such as smoking, kitchen air pollution and solvents. In future, occupational exposure-risk relations should be studied to understand more about causality and to assess effective prevention strategies.

• Heikkinen, Sanna; Demers, Paul A.; Hansen, Johnni; Jakobsen, Jarle; Kjærheim, Kristina & Lynge, Elsebeth [Show all 13 contributors for this article] (2022). Incidence of cancer among Nordic police officers. International Journal of Cancer. ISSN 0020-7136. 152(6), p. 1124–1136. doi: 10.1002/ijc.34311. Show summary

  Police work may expose officers to various circumstances that have potential for increasing their risk of cancer, including traffic-related air pollution, night shift work and radiation from radars. In this study, we examined the incidence of cancer among Nordic male and female police officers. We utilize data from the Nordic Occupational Cancer (NOCCA) project, which linked census data on occupations from Finland, Iceland, Norway and Sweden to national cancer registries for the period 1961 to 2005. We report standardized incidence ratios (SIR) and 95% confidence intervals (CI) of selected cancers for each country by sex, age and calendar period. The cohort included 38 523 male and 1998 female police officers. As compared with the general population, male police officers had a 7% (95% CI: 4-9%) excess cancer risk, with elevated SIRs for various cancer sites, including prostate (SIR 1.19, 1.14-1.25), breast (SIR 1.77, 1.05-2.80), colon (SIR 1.22, 1.12-1.32) and skin melanoma (SIR 1.44, 1.28-1.60). Conversely, male police officers had a lower risk of lung cancer than the general population (SIR 0.72, 0.66-0.77). In female police officers, the SIR for cancer overall was 1.15 (0.98-1.34), and there was a slight excess of cancers of the breast (SIR 1.25, 0.97-1.59) and colon (SIR 1.21, 0.55-2.30). In conclusion, cancer incidence among the police officers was slightly higher than in the general population. Notably, SIRs were elevated for cancer sites potentially related to night shift work, namely colon, breast and prostate cancer.

• Molaug, Ina Charlotte; Engdahl, Bo Lars; Degerud, Eirik Magnus Meek; Mehlum, Ingrid Sivesind & Aarhus, Lisa (2022). Occupation and 20-year hearing decline: findings from The HUNT Study. Occupational Medicine. ISSN 0962-7480. 72(9), p. 622–628. doi: 10.1093/occmed/kqac085. Full text in Research Archive Show summary

  Background: Studies show that certain occupations are associated with an increased risk of hearing loss. However, many studies are cross-sectional, and the few longitudinal studies are mostly small or focus on only one occupation. Aims: We aimed to quantify the long-term hearing decline among workers in different occupations and assess whether the change differs between the occupations. Methods: The study population was 4525 adults who participated in two population-based health studies in Norway, HUNT2 1996-1998 and HUNT4 2017-2019. Linear regression models assessed the association between occupations (clerks as reference) and 20-year hearing decline (hearing thresholds at 3-6 kHz, averaged over both ears) from HUNT2 to HUNT4. Models were adjusted for age, sex, recurrent ear infections, smoking and ear pathology. Results: Among the participants (40% men), the mean age at HUNT2 was 31.2 ± 5.4 years (range 20-39) and the average 20-year hearing decline was 11.3 ± 9.8 dB. Occupations that were associated with larger hearing decline included other craft and related trades workers (3.9 dB, 95% confidence interval [CI] 0.2-7.7) and building frame and related trades workers (3.4 dB, 95% CI 1.3-5.4). Among occupations with larger hearing decline, a higher proportion of the workers reported exposure to noise. Conclusions: This large longitudinal study shows a larger long-term hearing decline among building frame workers and craft and related trades workers. Differences between occupations were modest, which may indicate successful preventive measures in Norway during the last two decades.

• Undem, Karina; Leinonen, Taina; Kristensen, Petter; Merkus, Suzanne; Hasting, Rachel Louise & Gran, Jon Michael [Show all 7 contributors for this article] (2022). Gender Differences in Associations between Biomechanical and Psychosocial Work Exposures and Age of Withdrawal from Paid Employment among Older Workers. International Journal of Environmental Research and Public Health (IJERPH). ISSN 1661-7827. 19(17). doi: 10.3390/ijerph191710563. Full text in Research Archive Show summary

  Background: Work exposures are known predictors of withdrawal from employment, but the associations between work exposures and withdrawal may vary with gender. This study evaluated gender differences in associations between biomechanical and psychosocial work exposures and age of withdrawal from paid employment among older workers in Norway. Methods: 77,558 men and 67,773 women (born 1949–1953) were followed from age 62 until withdrawal from paid employment or end of follow-up in 2016 (up to five years follow-up). Information about eight biomechanical and seven psychosocial exposures was obtained from a gender-specific job exposure matrix. Using Cox regression, the difference in mean estimated time until withdrawal between non-exposed and exposed was calculated for each gender and work exposure separately. Results: The largest gender difference was found for high psychological demands. Among men, the non-exposed withdrew earlier than the exposed (−3.66 months (95% CI: −4.04–−3.25 months)), and contrary among women (0.71 (0.28–1.10)), resulting in a gender difference of 4.37 (3.81–4.97) months. Gender differences were also found for monotonous work (4.12 (3.51–4.69) months), hands above shoulder height (2.41 (1.76–3.10) months), and high iso-strain (2.14 (1.38–2.95) months). Conclusions: There were observed gender differences in the associations between some biomechanical and psychosocial work exposures and mean age of withdrawal from paid employment among older workers. However, the results are likely affected by the selection of who remains in the workforce at age 62 and should be interpreted accordingly.

• Jørgensen, Astrid Ytrehus; Aarhus, Lisa; Engdahl, Bo Lars; Bratsberg, Bernt Magne; Skirbekk, Vegard Fykse & Mehlum, Ingrid Sivesind (2022). Hearing loss, sick leave, and disability pension. Findings from the HUNT follow-up study. BMC Public Health. ISSN 1471-2458. 22. doi: 10.1186/s12889-022-13760-2. Full text in Research Archive Show summary

  Background Evidence on the association between hearing loss and sick leave or disability pension is to a great extent based on few cross-sectional studies and remains unclear. We aim to assess the associations in a long-term follow-up population study. Methods We used baseline data from a large population-based hearing study in Norway, the HUNT Hearing study (1996–1998). The sample included 21 754 adults (48.5% men, mean age at baseline 36.6 years). We used register data on sick leave and disability pension (1996–2011). Cox regression was used to assess the association between hearing loss at baseline (Pure tone average/PTA 0.5–4 kHz > 20 dB) and time to first physician-certified sick leave episode, as well as time to first disability pension payment. Results Hearing loss at baseline (yes/no) was weakly associated with time to first physician-certified sick leave episode: Hazard ratio (HR) 1.2 (95% confidence interval (CI) 1.1–1.3). Restricting the exposed group to people with both hearing loss and tinnitus, the HR was slightly increased: 1.3 (95% CI 1.1–1.6). Hearing loss in 1996–1998 was also associated with time to first received disability pension: HR 1.5 (95% CI 1.3–1.8). Stronger associations were found for disabling hearing loss (PTA > 35). Restricting the exposure to hearing loss and tinnitus, the HR was increased: 2.0 (95% CI 1.4–2.8). Conclusions This large population-based cohort study indicates that hearing loss is associated with increased risk of receiving disability pension, especially among younger adults and low educated workers. Hearing loss was weakly associated with sick leave.

• Maniscalco, Laura; Schouteden, Martijn; Boon, Jan; Vandenbroeck, Sofie; Mehlum, Ingrid Sivesind & Godderis, Lode [Show all 7 contributors for this article] (2022). The long-term effect of job mobility on workers’ mental health: a propensity score analysis. BMC Public Health. ISSN 1471-2458. 22(1). doi: 10.1186/s12889-022-13558-2. Show summary

  Objectives The main purpose of this longitudinal study was to elucidate the impact of external job mobility, due to a change of employer, on mental health. Methods A cohort of Belgian employees from the IDEWE occupational medicine registry was followed-up for twenty-seven years, from 1993 to 2019. The use of drugs for neuropsychological diseases was considered as an objective indicator of mental health. The covariates were related to demographic, physical, behavioural characteristics, occupational and work-related risks. Propensity scores were calculated with a Cox regression model with time-varying covariates. The PS matching was used to eliminate the systematic differences in subjects’ characteristics and to balance the covariates’ distribution at every time point. Results The unmatched sample included 11,246 subjects, with 368 (3.3%) that changed their job during the baseline year and 922 (8.2%) workers that left their employer during the follow-up. More than half of the matched sample were males, were aged less than 38 years old, did not smoke, were physically active, and normal weighted, were not exposed to shift-work, noise, job strain or physical load. A strong association between job mobility and neuropsychological treatment was found in the matched analysis (HR = 2.065, 95%CI = 1.397–3.052, P-value < 0.001) and confirmed in the sensitivity analysis (HR of 2.012, 95%CI = 1.359–2.979, P-value < 0.001). Furthermore, it was found a protective role of physical activity and a harmful role of job strain on neuropsychological treatment. Conclusions Our study found that workers with external job mobility have a doubled risk of treatment with neuropsychological medication, compared to workers without job mobility.

• Hasselhorn, Hans-Martin; Leinonen, Taina; Bültmann, Ute; Mehlum, Ingrid Sivesind; du Prel, Jean-Baptist & Kiran, Sibel [Show all 9 contributors for this article] (2022). The differentiated roles of health in the transition from work to retirement – conceptual and methodological challenges and avenues for future research. Scandinavian Journal of Work, Environment and Health. ISSN 0355-3140. 48(4), p. 312–321. doi: 10.5271/sjweh.4017. Full text in Research Archive Show summary

  Objectives The aim of this discussion paper is to (i) identify the differentiated roles of health in the work–retirement transition, and, with respect to these, (ii) highlight topics related to conceptual and methodological problems and challenges in research, and (iii) present avenues for future research. Methods This discussion paper summarizes an OMEGA-NET working group discussion ongoing from November 2018 to September 2021 with face-to-face and online meetings as well as a written online discourse. Results ‘Health’ and ‘retirement’ are ambiguous concepts. With respect to both, in retirement research, the choice of concept and indicator influences the findings. In addition, the impact of health on retirement is not necessarily a direct one, but can be influenced by further factors such as the ability, motivation and opportunity to work. The strong overall association of poor health with retiring early (path 1) bears the risk of masking distinct and deviating mechanisms in subgroups. In fact, there is evidence that also good health may lead to early retirement (path 2), while both poor health (path 3) and good health (path 4) may also make people retire later. Conclusions An increased awareness of the differentiated roles that health may have in the work–retirement transition as outlined in this discussion paper may support research to address questions relevant for policy and practice and increase the impact of research. Recommendations for occupational health and social research are given.

• Mijakoski, Dragan; Cheptea, Dumitru; Marca, Sandy Carla; Shoman, Yara; Caglayan, Cigdem & Bugge, Merete Drevvatne [Show all 19 contributors for this article] (2022). Determinants of Burnout among Teachers: A Systematic Review of Longitudinal Studies. International Journal of Environmental Research and Public Health (IJERPH). ISSN 1661-7827. 19(9). doi: 10.3390/ijerph19095776. Show summary

  We aimed to review the determinants of burnout onset in teachers. The study was conducted according to the PROSPERO protocol CRD42018105901, with a focus on teachers. We performed a literature search from 1990 to 2021 in three databases: MEDLINE, PsycINFO, and Embase. We included longitudinal studies assessing burnout as a dependent variable, with a sample of at least 50 teachers. We summarized studies by the types of determinant and used the MEVORECH tool for a risk of bias assessment (RBA). The quantitative synthesis focused on emotional exhaustion. We standardized the reported regression coefficients and their standard errors and plotted them using R software to distinguish between detrimental and protective determinants. A qualitative analysis of the included studies (n = 33) identified 61 burnout determinants. The RBA showed that most studies had external and internal validity issues. Most studies implemented two waves (W) of data collection with 6–12 months between W1 and W2. Four types of determinants were summarized quantitatively, namely support, conflict, organizational context, and individual characteristics, based on six studies. This systematic review identified detrimental determinants of teacher exhaustion, including job satisfaction, work climate or pressure, teacher self-efficacy, neuroticism, perceived collective exhaustion, and classroom disruption. We recommend that authors consider using harmonized methods and protocols such as those developed in OMEGA-NET and other research consortia

• Leinonen, Taina; Boets, Isabelle; Pletea, Elisabeta; Vandenbroeck, Sofie; Mehlum, Ingrid Sivesind & Hasselhorn, Hans-Martin [Show all 7 contributors for this article] (2022). A conceptual framework addressing the complex labour market dynamics of the work-to-retirement process. European Journal of Ageing. ISSN 1613-9372. doi: 10.1007/s10433-022-00704-3. Show summary

  The way in which retirement is conceptualized and measured is likely to influence the research findings. The previous literature has addressed a wide range of elements related to the complex work-to-retirement process, such as early, late and partial retirement, statutory retirement, work disability and unemployment paths to retirement, or different types of bridge employment. However, conceptual clarity in terms of connections between the different elements is called for. We introduce a conceptual framework of the work-to-retirement process to guide its future measurement. Together with information on the statutory retirement age, the main elements of the framework are based on employment and pension receipt, acknowledging that these may overlap. The framework is flexible to the user, providing the possibility to add various specifications—e.g. of types of employment, types of pension receipt, unemployment, and being outside the labour force—depending on the study context and aims. The framework highlights the complexity of the work-to-retirement process, bringing forth its multifaceted, multiphased and multidirectional features. Accounting for such complexity in later-life labour market dynamics helps to elaborate what is actually addressed when investigating “retirement”. Our conceptual framework can be utilized to enhance well-defined, precise and comparable measurement of the work-to-retirement process in studies.

• Jørgensen, Astrid Ytrehus; Engdahl, Bo Lars; Mehlum, Ingrid Sivesind & Aarhus, Lisa (2022). Weaker association between hearing loss and non-employment in recent generations. The HUNT cohort study. International Journal of Audiology. ISSN 1499-2027. p. 1–8. doi: 10.1080/14992027.2022.2045367. Full text in Research Archive Show summary

  Objectives To examine the prevalence of hearing loss (HL) among employed persons, the association between HL and non-employment, assessing whether this has changed over the last two decades. To identify susceptible groups for HL-related work problems and examine the association between HL and co-worker relations. Design Cross-sectional analyses of working-age participants (20–66 years). HL was defined as the pure-tone average threshold of 0.5–4 kHz in the better hearing ear: 20–34 dB (mild) or ≥35 dB (disabling). Associations were assessed with logistic regression. Study sample Data from two waves of the Trøndelag Health Study (HUNT): HUNT2 1996–1998 (N = 38,603), HUNT4 2017–2019 (N = 19,614). Results The nationally weighted prevalence of HL among employees was 5.8%. HL was associated with non-employment, more strongly in HUNT2 (odds ratio (OR) 2.2, 95% confidence interval (CI) 2.0–2.4) than HUNT4 (OR 1.9, CI 1.7–2.1). HL was not associated with poorer co-worker relations. The association between HL and non-optimal work performance was stronger among white-collar workers than blue-collar workers. Conclusions Our study shows that HL is common in the employed population. It also indicates a weakened association between HL and non-employment in recent generations. White-collar workers appear to be more vulnerable to HL-related work problems than blue-collar workers.

• Pronk, Anjoeka; Loh, Miranda; Kuijpers, Eelco; Albin, Maria; Selander, Jenny & Godderis, Lode [Show all 19 contributors for this article] (2022). Applying the exposome concept to working life health. The EU EPHOR project. Environmental Epidemiology. ISSN 2474-7882. 6(2). doi: 10.1097/EE9.0000000000000185. Show summary

  Exposures at work have a major impact on noncommunicable diseases (NCDs). Current risk reduction policies and strategies are informed by existing scientific evidence, which is limited due to the challenges of studying the complex relationship between exposure at work and outside work and health. We define the working life exposome as all occupational and related nonoccupational exposures. The latter includes nonoccupational exposures that may be directly or indirectly influenced by or interact with the working life of the individual in their relation to health. The Exposome Project for Health and Occupational Research aims to advance knowledge on the complex working life exposures in relation to disease beyond the single high exposure–single health outcome paradigm, mapping and relating interrelated exposures to inherent biological pathways, key body functions, and health. This will be achieved by combining (1) large-scale harmonization and pooling of existing European cohorts systematically looking at multiple exposures and diseases, with (2) the collection of new high-resolution external and internal exposure data. Methods and tools to characterize the working life exposome will be developed and applied, including sensors, wearables, a harmonized job exposure matrix (EuroJEM), noninvasive biomonitoring, omics, data mining, and (bio)statistics. The toolbox of developed methods and knowledge will be made available to policy makers, occupational health practitioners, and scientists. Advanced knowledge on working life exposures in relation to NCDs will serve as a basis for evidence-based and cost-effective preventive policies and actions. The toolbox will also enable future scientists to further expand the working life exposome knowledge base.

• Hasting, Rachel Louise; Merkus, Suzanne; Hanvold, Therese Nordberg; Kristensen, Petter; Gran, Jon Michael & Mehlum, Ingrid Sivesind (2022). Impact of the Norwegian Agreement for a More Inclusive Working Life on diagnosis-specific sickness absence in young adults: a difference-in-difference analysis. BMC Public Health. ISSN 1471-2458. 22. doi: 10.1186/s12889-022-12636-9. Full text in Research Archive Show summary

  Background The Norwegian Agreement for a More Inclusive Working Life (the IA Agreement) aims to reduce sickness absence (SA) and increase work participation. Potential impacts of the IA Agreement have not been thoroughly evaluated. The study aimed to estimate the impact of the IA Agreement on musculoskeletal and psychological SA prevalence and duration among young adult men and women, and to identify whether the impact was modified by economic activity or SA grade. Methods Data from national registries were combined for 372,199 individuals born in Norway 1967–1976. ICPC-2 codes identified musculoskeletal (L) and psychological (P) diagnoses. A difference-in-difference method compared prevalence and mean duration of first SA > 16 days between 2000 and 2005 separately for men and women working in IA companies relative to non-IA companies. Analyses were adjusted for mean company size and stratified by economic activity and SA grade (full/graded). Average marginal change was calculated with 95% confidence intervals (CI). Results The impacts of the IA Agreement on SA prevalence were mixed as the direction and size of marginal changes varied according to diagnosis, gender, and economic activity. However, there was a general tendency towards reduced mean SA duration for both diagnosis groups, and in particular men with musculoskeletal SA (− 16.6 days, 95% CI -25.3, − 7.9). Individuals with full SA in IA companies had greater reductions in mean SA duration. Only the wholesale and retail economic activity indicated a beneficial contribution of the IA Agreement for both SA prevalence and duration, in both diagnoses and genders. Conclusions Potential impacts of the IA Agreement on SA in young men and women varied according to diagnosis and economic activity. However, results indicated that the IA Agreement could reduce SA duration. Further research should identify reasons for gender and economic activity differences.

• Tamminga, Sietske J.; Kuijer, P. Paul F.M.; Badarin, Kathryn; Alfonso, Jose Hernan; Amaro, Joana & Curti, Stefania [Show all 13 contributors for this article] (2021). Towards harmonisation of case definitions for eight work-related musculoskeletal disorders - an international multi-disciplinary Delphi study. BMC Musculoskeletal Disorders. ISSN 1471-2474. 22. doi: 10.1186/s12891-021-04871-9. Show summary

  Background International consensus is needed on case definitions of work-related musculoskeletal disorders and diseases (MSDs) for use in epidemiological research. We aim to: 1) study what information is needed for the case definition of work-related low back pain (LBP), lumbosacral radicular syndrome (LRS), subacromial pain syndrome (SAPS), carpal tunnel syndrome (CTS), lateral and medial elbow tendinopathy, and knee and hip osteoarthritis, and to 2) seek consensus among occupational health professionals/researchers regarding the case definitions of these work-related MSDs. Methods A two-round Delphi study was conducted with occupational health professionals/researchers from 24 countries. Definition of work-related MSDs were composed of a case definition with work exposures. Round 1 included 32 case definitions and round 2, 60 case definitions. After two rounds, consensus required 75% of the panellists to rate a case definition including work exposures ≥7 points on a 9-point rating scale (completely disagree/completely agree). Results Fifty-eight panellists completed both rounds (response rate 90%). Forty-five (70%) panellists thought that for LBP a case definition can be based on symptoms only. Consensus was only reached for work-related medial elbow tendinopathy, while the lowest agreement was found for knee osteoarthritis. Where consensus was not reached, this was – except for LBP - related to physical examination and imaging rather than disagreement on key symptoms. Conclusion Consensus on case definitions was reached only for work-related medial elbow tendinopathy. Epidemiological research would benefit from harmonized case definitions for all MSDs including imaging and physical examination for LRS, SAPS, CTS, lateral elbow tendinopathy and hip and knee osteoarthritis.

• Canu, Irina Guseva; Marca, Sandy Carla; Dell'Oro, Francesca; Balázs, Ádám; Bergamaschi, Enrico & Besse, Christine [Show all 45 contributors for this article] (2021). Harmonized definition of occupational burnout. A systematic review, semantic analysis and Delphi consensus in 29 countries. Scandinavian Journal of Work, Environment and Health. ISSN 0355-3140. 47(2), p. 95–107. doi: 10.5271/sjweh.3935. Full text in Research Archive Show summary

  Objective A consensual definition of occupational burnout is currently lacking. We aimed to harmonize the definition of occupational burnout as a health outcome in medical research and reach a consensus on this definition within the Network on the Coordination and Harmonisation of European Occupational Cohorts (OMEGA-NET). Methods First, we performed a systematic review in MEDLINE, PsycINFO and Embase (January 1990 to August 2018) and a semantic analysis of the available definitions. We used the definitions of burnout and burnout-related concepts from the Systematized Nomenclature of Medicine Clinical Terms (SNOMED-CT) to formulate a consistent harmonized definition of the concept. Second, we sought to obtain the Delphi consensus on the proposed definition. Results We identified 88 unique definitions of burnout and assigned each of them to 1 of the 11 original definitions. The semantic analysis yielded a first proposal, further reformulated according to SNOMED-CT and the panelists' comments as follows: "In a worker, occupational burnout or occupational physical AND emotional exhaustion state is an exhaustion due to prolonged exposure to work-related problems”. A panel of 50 experts (researchers and healthcare professionals with an interest for occupational burnout) reached consensus on this proposal at the second round of the Delphi, with 82% of experts agreeing on it. Conclusion This study resulted in a harmonized definition of occupational burnout approved by experts from 29 countries within OMEGA-NET. Future research should address the reproducibility of the Delphi consensus in a larger panel of experts, representing more countries, and examine the practicability of the definition.

• Aktas, Emine; Bergbom, Barbara; Godderis, Lode; Kreshpaj, Bertina; Marinov, Mario & Mates, Dana [Show all 11 contributors for this article] (2021). Migrant workers occupational health research: an OMEGA-NET working group position paper. International Archives of Occupational and Environmental Health. ISSN 0340-0131. doi: 10.1007/s00420-021-01803-x. Show summary

  Objective: The aims of the study were: (1) to clarify the definitions of "migrant" used in occupational health research; (2) to summarize migrant workers' industry sectors, occupations and employment conditions; (3) to identify the occupational health and safety services available to migrant workers; (4) to summarize work-related health problems found among migrant workers; (5) to identify the methodological challenges to research into occupational health of migrant workers; and (6) to recommend improvements in migrant occupational health research. Methods: This position paper was prepared by researchers from several European countries and Australia, working within the EU COST Action OMEGA-NET. The paper drew on two recent systematic reviews on the occupational health of international migrant workers and other literature, and also identified uncertainties and gaps in the research literature. Migrants may, for example, be temporary or permanent, moving for specific jobs migrants or other reasons. Their ethnicity and language capabilities will affect their work opportunities. Results: The occupational health literature seldom adequately identifies the heterogeneity or characteristics of the migrant group being studied. Migrants tend to work in more physically and mentally demanding environments with higher exposures than native workers. Migrants tend to have an increased risk of physical and mental ill health, but less access to health care services. This has been demonstrated recently by high rates of COVID-19 and less access to health care. There have been a number of cross-sectional studies of migrant health but few long-term cohort studies were identified. Other study designs, such as registry-based studies, surveys and qualitative studies may complement cross-sectional studies. Mixed-methodology studies would be valuable in research on migrants' occupational health. Language and lack of trust are barriers to migrant research participation. Conclusion: Targeted research, especially longitudinal, identifying how these economically important but often-vulnerable workers can be best assisted is needed. Researchers should identify the characteristics of the migrant workers that they are studying including visa/migration circumstances (temporary, permanent, undocumented), racial and ethnic characteristics, existing skills and language abilities.

• Maltzahn, Niklas; Hoff, Rune; Aalen, Odd O.; Mehlum, Ingrid S.; Putter, Hein & Gran, Jon Michael (2021). A hybrid landmark Aalen-Johansen estimator for transition probabilities in partially non-Markov multi-state models. Lifetime Data Analysis. ISSN 1380-7870. 27, p. 737–760. doi: 10.1007/s10985-021-09534-4. Full text in Research Archive Show summary

  Multi-state models are increasingly being used to model complex epidemiological and clinical outcomes over time. It is common to assume that the models are Markov, but the assumption can often be unrealistic. The Markov assumption is seldomly checked and violations can lead to biased estimation of many parameters of interest. This is a well known problem for the standard Aalen-Johansen estimator of transition probabilities and several alternative estimators, not relying on the Markov assumption, have been suggested. A particularly simple approach known as landmarking have resulted in the Landmark-Aalen-Johansen estimator. Since landmarking is a stratification method a disadvantage of landmarking is data reduction, leading to a loss of power. This is problematic for “less traveled” transitions, and undesirable when such transitions indeed exhibit Markov behaviour. Introducing the concept of partially non-Markov multi-state models, we suggest a hybrid landmark Aalen-Johansen estimator for transition probabilities. We also show how non-Markov transitions can be identified using a testing procedure. The proposed estimator is a compromise between regular Aalen-Johansen and landmark estimation, using transition specific landmarking, and can drastically improve statistical power. We show that the proposed estimator is consistent, but that the traditional variance estimator can underestimate the variance of both the hybrid and landmark estimator. Bootstrapping is therefore recommended. The methods are compared in a simulation study and in a real data application using registry data to model individual transitions for a birth cohort of 184 951 Norwegian men between states of sick leave, disability, education, work and unemployment.

• Shoman, Yara; El May, Emna; Marca, Sandy Carla; Wild, Pascal; Bianchi, Renzo & Bugge, Merete Drevvatne [Show all 20 contributors for this article] (2021). Predictors of Occupational Burnout. A Systematic Review. International Journal of Environmental Research and Public Health (IJERPH). ISSN 1661-7827. 18(17). doi: 10.3390/ijerph18179188. Show summary

  We aimed to review occupational burnout predictors, considering their type, effect size and role (protective versus harmful), and the overall evidence of their importance. MEDLINE, PsycINFO, and Embase were searched from January 1990 to August 2018 for longitudinal studies examining any predictor of occupational burnout among workers. We arranged predictors in four families and 13 subfamilies of homogenous constructs. The plots of z-scores per predictor type enabled graphical discrimination of the effects. The vote-counting and binomial test enabled discrimination of the effect direction. The size of the effect was estimated using Cohen’s formula. The risk of bias and the overall evidence were assessed using the MEVORECH and GRADE methods, respectively. Eighty-five studies examining 261 predictors were included. We found a moderate quality of evidence for the harmful effects of the job demands subfamily (six predictors), and negative job attitudes, with effect sizes from small to medium. We also found a moderate quality of evidence for the protective effect of adaptive coping (small effect sizes) and leisure (small to medium effect sizes). Preventive interventions for occupational burnout might benefit from intervening on the established predictors regarding reducing job demands and negative job attitudes and promoting adaptive coping and leisure

• Kristensen, Petter; Hanvold, Therese Nordberg; Hasting, Rachel Louise; Merkus, Suzanne; Hoff, Rune & Mehlum, Ingrid Sivesind (2020). Work participation in young Norwegians: a 19-year follow up in a registry-based life-course cohort. Scandinavian Journal of Public Health. ISSN 1403-4948. 49(2), p. 176–187. doi: 10.1177/1403494820917507. Full text in Research Archive Show summary

  Aims: The study objectives were to provide a quantitative description of work participation among young adults, and to outline the relations between work participation and social, educational and health-related characteristics throughout the life-course. Methods: We collected data in several national registries for all 318,705 individuals born in Norway 1967–1971 who were national residents on 1 January 1993. The criterion for work was annual occupational income above the boundary which identifies the core workforce. We analysed associations between social, educational and health-related characteristics, and the number of years at work and the risk of never working during 19 years of follow-up (1993–2011; age 22–44 years). Results: The overall work participation was high, with a median of 14 years and a 0.074 risk of never working. Women worked fewer years than men (medians 11 v. 16 years) and had higher risk of never working (0.103 v. 0.047). Combined educational and health problems before 1993 had a strong influence on subsequent work participation. The educational gradient in risks of never working was considerably stronger for women than for men. Diagnostic groups of mental disorders had high risks of never working, ranging from affective (risk 0.150) and stress-related disorders (risk 0.163) to intellectual disability (risk 0.933). Conclusions: The complex problems characterising individuals with low work participation suggest that preventive measures should take sex into account and be targeted at social, educational and mental issues in early life, and focusing on identified vulnerable groups.

• Amaro, Joana; Queiroga, Ana Catarina; Amaro, João ; Mehlum, Ingrid Sivesind & Lucas, Raquel (2020). Work-life prevalence of self-reported occupational injuries in mothers of a birth cohort. International Journal of Occupational Safety and Ergonomics (JOSE). ISSN 1080-3548. doi: 10.1080/10803548.2020.1832353. Show summary

  Purpose: To study self-reported occupational injuries among mothers of a large birth cohort study and to assess the relation of their characteristics with different injury outcomes: occurrence, severity, temporal proximity and recurrence. Methods: We asked 4338 women whether they had ever had “an accident at work, even if it did not require medical treatment”. Participants were also asked the number of accidents throughout their working life, type of injury, and whether it occurred within the last 12 months. Results: Over a fifth (21.8%) of working-age mothers reported having had at least one occupational injury throughout their working life. Wounds and superficial injuries were the most frequently reported types of occupational injuries (11.0%), followed by dislocated bones and joints, sprains and strains (10.7%). Women who reported a history of occupational injuries also had a higher likelihood of reporting a work-related health problem (adjusted-OR=2.64; 95% CI [2.27, 3.07]) and of having a partner who also reported an occupational injury throughout their working life (adjusted-OR=1.86; 95% CI [1.33, 2.62]). Associations remained fairly stable across all outcomes. Conclusions: Our findings point towards a broadened understanding of occupational injury consequences and research focusing on family-level factors that account for the embeddedness of workers in households.

• Mehlum, Ingrid Sivesind & Aarhus, Lisa (2020). Occupational noise. A determinant of social inequalities in health. In Theorell, Töres (Eds.), Handbook of Socioeconomic Determinants of Occupational Health. From Macro-level to Micro-level Evidence. Springer Nature. ISSN 978-3-030-31437-8. p. 195–205. doi: 10.1007/978-3-030-31438-5_2. Show summary

  Occupational noise exposure is common in many workplaces and a well-known cause of noise-induced hearing loss and related to tinnitus and hyperacusis (hypersensitivity to sound), as well as other health outcomes, such as distress, hypertension, and occupational injuries. Hearing loss and many health conditions are more frequent in lower socioeconomic groups. Loud occupational noise is generally also more common among blue-collar workers, while white-collar workers are virtually unexposed. Therefore, occupational noise exposure would seem like a plausible cause of socioeconomic inequalities in hearing and other health outcomes; in other words, occupational noise could be a mediator (intermediate variable) between socioeconomic position and health. However, hardly any studies have investigated the impact of occupational noise exposure on social inequalities in hearing, and none seems to have studied its impact on other health outcomes. One study found that the association between socioeconomic position and hearing loss was reduced after controlling for occupational noise exposure, suggesting that occupational noise to a considerable extent could explain the association between occupation and hearing loss. There is a lack of studies addressing the impact of occupational noise exposure on social inequalities in health; thus, more studies specifically designed to investigate this topic are needed.

• Aarhus, Lisa; Kjærheim, Kristina; Heikkinen, Sanna; Martinsen, Jan Ivar; Pukkala, Eero & Selander, Jenny [Show all 10 contributors for this article] (2020). Occupational noise exposure and vestibular schwannoma. A case-control study in Sweden. American Journal of Epidemiology. ISSN 0002-9262. 189(11), p. 1342–1347. doi: 10.1093/aje/kwaa091. Show summary

  It has been suggested that the association between self-reported occupational noise exposure and vestibular schwannoma (VS) found in several studies, represents recall bias. Therefore, we aim to study the relation in a large case-control study using occupational noise measurements. We performed a case-control study from Sweden of 1913 VS cases diagnosed in 1961-2009 and 9566 age- and sex-matched population controls. We defined occupational history by linkage to national censuses from 1960, 1970, 1980, and 1990. We estimated occupational noise exposure for each case and control using a job-exposure matrix (JEM). There was no association between occupational noise exposure and VS. Among subjects assessed as ever exposed to occupational noise levels ≥85 dB (214 cases and 1142 controls), the odds ratio for VS per five years of exposure was 1.02 (95% confidence interval 0.90-1.17). Workers with noise levels of 85 dB or higher for at least 15 years (5-year latency period), showed no increased risk of VS (odds ratio 0.98, 0.73-1.31) compared to those who had never been exposed to noise levels of 75 dB or higher. To conclude, our large study does not support an association between occupational noise exposure and VS.

• Hanvold, Therese Nordberg; Kristensen, Petter; Corbett, Karina; Hasting, Rachel Louise & Mehlum, Ingrid Sivesind (2020). Long-term sickness absence among young and middle-aged workers in Norway. The impact of a population-level intervention. BMC Public Health. ISSN 1471-2458. 20. doi: 10.1186/s12889-020-09205-3. Full text in Research Archive Show summary

  Background The study objective was to evaluate the impact of a population-level intervention (the IA Agreement) on the of one-year risk for long-term sickness absence spells (LSAS) among young and middle aged workers in Norway. Methods Using an observational design, we conducted a quasi-experimental study to analyse registry data on individual LSAS for all employed individuals in 2000 (n = 298,690) and 2005 (n = 352,618), born in Norway between 1976 and 1967. The intervention of interest was the tripartite agreement for a more inclusive working life (the IA Agreement). We estimated difference in pre-post differences (DID) in LSAS between individuals working in IA companies with the intervention and companies without, in 2000 and 2005. We used logistic regression models and present odds ratios (DID OR) with accompanying 95% CI. We stratified analyses by sex, industry and company size. Results We found no significant change in the overall risk of long-term sickness absence spells after implementing the intervention among young and middle aged workers. Stratified by sex, the intervention resulted in a slight decrease in LSAS risk among female workers (DID OR 0.93 (0.91–0.96)) while the intervention showed no impact among male workers (DID OR 1.01 (0.97–1.06)). We found that companies signing the IA Agreement were large (≥50 employees) and often within the manufacturing and health and social sectors. In large manufacturing companies, we found a reduction in LSAS, among workers both in companies with and without the intervention, resulting in no statistically significant impact of the IA intervention. In large health and social companies, we found an increase in LSAS among workers both in companies with and without the intervention. The increase was smaller among the workers in companies offering the IA intervention compared with workers in companies without, resulting in a positive impact of the IA intervention in the health and social industry. This impact was statistically significant only among female workers. Conclusions The results indicate that the impact of the IA Agreement on the risk of long-term sickness absence spells varies considerably depending on sex and industry. These findings suggest that reducing LSAS may warrant industry-specific interventions.

• Bodin, Theo; Çağlayan, Çiğdem; Garde, Anne Helene; Gnesi, Marco; Jonsson, Johanna & Kiran, Sibel [Show all 15 contributors for this article] (2020). Precarious employment in occupational health – An omega-net working group position paper. Scandinavian Journal of Work, Environment and Health. ISSN 0355-3140. 46(3), p. 321–329. doi: 10.5271/sjweh.3860. Show summary

  Objectives The aims of this position paper are to (i) summarize research on precarious employment (PE) in the context of occupational health; (ii) develop a theoretical framework that distinguishes PE from related concepts and delineates important contextual factors; and (iii) identify key methodological challenges and directions for future research on PE and health. Methods This position paper is the result of a working group consisting of researchers from the EU, Turkey and the USA, who have discussed the issue over the course of six months (October 2018–April 2019), meeting both online and face-to-face on several occasions. Results The lack of a common theoretical framework of PE hinders it from becoming an established part of occupational and public health research. There are also issues regarding operationalization in surveys and registers. Further, previous research on PE and health suffers from methodological limitations including inadequate study designs and biased assessments of exposure and outcomes. PE is highly dependent on contextual factors and cross-country comparison has proven very difficult. We also point to the uneven social distribution of PE, ie, higher prevalence among women, immigrants, young and low educated. We propose a theoretical framework for understanding precarious employment as a multidimensional construct. Conclusions A generally accepted multidimensional definition of PE should be the highest priority. Future studies would benefit from improved exposure assessment, temporal resolution, and accounting for confounders, as well as testing possible mechanisms, eg, by adopting multi-level and intersectional analytical approaches in order to understand the complexity of PE and its relation to health.

• Canu, Irina Guseva; Mesot, Olivia; Gyorkos, Christina; Mediouni, Zakia; Mehlum, Ingrid Sivesind & Bugge, Merete Drevvatne (2019). Burnout syndrome in Europe: towards a harmonized approach in occupational health practice and research. Industrial Health. ISSN 0019-8366. 57(6), p. 745–752. doi: 10.2486/indhealth.2018-0159.
• Tang, Fang; Mehlum, Lars; Mehlum, Ingrid Sivesind & Qin, Ping (2019). Physical illness leading to absence from work and the risk of subsequent suicide. A national register-based study. European Journal of Public Health. ISSN 1101-1262. 29(6), p. 1073–1078. doi: 10.1093/eurpub/ckz101. Full text in Research Archive Show summary

  Background: Studies have shown that people with physical illness are at increased risk of suicide, but knowledge on the association between absence from work due to specific physical health problems and suicide risk is limited. This study aimed to examine the relationship between suicide risk and physical illness requiring leave from work across a range of specific physical diagnoses, and to study the interactions of mental illness and socioeconomic factors on this relationship. Methods: Using a nested case-control design, 9313 suicide cases and 169 235 matched controls were retrieved and interlinked from Norwegian national registries. Data on sick leave and related physical illness were derived from claims for sickness benefit and analyzed using conditional logistic regression. Results: For males, the risk of suicide increased progressively with the number of previous physical illness-related absences and the duration of recent physical illness-related absences. Absences related to digestive, musculoskeletal and neurological disorders as well as cancer and accidents/injuries were associated with a significantly increased risk of suicide. In contrast, females with a history of physical illness-related absence and a diagnosis of most organ or system specific illnesses were at a relatively reduced risk of suicide. In both genders, the suicide risk associated with physical illness resulting in absence from work differentiated significantly by history of sickness absence due to mental illness, and by education and income levels. Conclusions: The risk of suicide associated with physical illness requiring leave from work varied significantly by gender and by education and income status.

• Hoff, Rune; Putter, Hein; Mehlum, Ingrid Sivesind & Gran, Jon Michael (2019). Landmark estimation of transition probabilities in non-Markov multi-state models with covariates. Lifetime Data Analysis. ISSN 1380-7870. 25(4), p. 660–680. doi: 10.1007/s10985-019-09474-0. Full text in Research Archive Show summary

  In non-Markov multi-state models, the traditional Aalen–Johansen (AJ) estimator for state transition probabilities is generally not valid. An alternative, suggested by Putter and Spitioni, is to analyse a subsample of the full data, consisting of the individuals present in a specific state at a given landmark time-point. The AJ estimator of occupation probabilities is then applied to the landmark subsample. Exploiting the result by Datta and Satten, that the AJ estimator is consistent for state occupation probabilities even in non-Markov models given that censoring is independent of state occupancy and times of transition between states, the landmark Aalen–Johansen (LMAJ) estimator provides consistent estimates of transition probabilities. So far, this approach has only been studied for non-parametric estimation without covariates. In this paper, we show how semi-parametric regression models and inverse probability weights can be used in combination with the LMAJ estimator to perform covariate adjusted analyses. The methods are illustrated by a simulation study and an application to population-wide registry data on work, education and health-related absence in Norway. Results using the traditional AJ estimator and the LMAJ estimator are compared, and show large differences in estimated transition probabilities for highly non-Markov multi-state models.

• Hanvold, Therese Nordberg; Sterud, Tom; Kristensen, Petter & Mehlum, Ingrid Sivesind (2019). Mechanical and psychosocial work exposures: the construction and evaluation of a gender-specific job exposure matrix (JEM). Scandinavian Journal of Work, Environment and Health. ISSN 0355-3140. 45(3), p. 239–247. doi: 10.5271/sjweh.3774. Show summary

  Objectives: The aim of this study was to (i) construct and evaluate a gender-specific job exposure matrix (JEM) for mechanical and psychosocial work exposures and (ii) test its predictive validity for low-back pain. Methods: We utilized data from the Norwegian nationwide Survey of Living Conditions on work environment in 2006 and 2009. We classified occupations on a 4-digit level based on the Norwegian version of the International Standard Classification of Occupations (ISCO-88). The mechanical and psychosocial exposure information was collected by personal telephone interviews and included exposures that were known risk factors for low-back pain. We evaluated the agreement between the individual- and JEM-based exposure estimates, with kappa, sensitivity and specificity measures. We assessed the JEM`s predictive validity by testing the associations between low-back pain and the individual- and JEM-based exposure. Results: The results showed an overall fair-to-moderate agreement between the constructed JEM and individual work exposures. The JEM performed considerably better for mechanical work exposures compared with psychosocial work exposures. The predictive validity of the mechanical and psychosocial JEM showed a consistently lower but predominantly reproducible association with low-back pain for both genders. Conclusions: The mechanical estimates and psychosocial stressors, such as psychological demands, monotonous work and decision latitude in the constructed JEM, may be useful in large epidemiological register studies. The predictive validity of the matrix was evaluated as being overall acceptable, it can thus be an effective and versatile approach to estimate the relationship between work exposures and low-back pain.

• Kristensen, Petter; Corbett, Karina; Mohn, Ferdinand A; Hanvold, Therese Nordberg & Mehlum, Ingrid Sivesind (2018). Information bias of social gradients in sickness absence: a comparison of self-report data in the Norwegian Mother and Child Cohort Study (MoBa) and data in national registries. BMC Public Health. ISSN 1471-2458. 18:1275, p. 1–10. doi: 10.1186/s12889-018-6208-9. Full text in Research Archive Show summary

  Background: Measurement error in self-report questionnaires is a common source of bias in epidemiologic studies. The study aim was to assess information bias of the educational gradient in sickness absence among participants in the Norwegian Mother and Child Cohort Study (MoBa), comparing self-report data with national register data. Methods: MoBa is a national prospective cohort study. The present study included 49,637 participants, born 1967–1976, who gave birth 2000–2009. The highest completed education level was recorded in categories and as educational years. Sickness absence was defined as one or more spell lasting more than 16 days between pregnancy weeks 13 and 30. We computed sickness absence risk in mid-pregnancy in strata of education level. Associations between completed educational years and sickness absence were estimated as risk differences in binomial regression and compared between self-report and register data. In additional analyses, we aimed to explain discrepancies between estimates from the two data sources. Results: The overall registry-based sickness absence risk was 0.478 and decreased for increasingly higher education in a consistent fashion, yielding an additive risk difference in association with one additional education year of − 0.032 (95% confidence interval − 0.035 to − 0.030). The self-report risk was lower (0.307) with a corresponding risk difference of only − 0.013 (95% confidence interval − 0.015 to − 0.011). The main explanation of the lower risk difference in the self-report data was a tendency for mothers in low education categories to omit reporting sickness absence in the questionnaire. Conclusions: A plausible explanation for the biased self-report association is complexity of the sickness absence question and a resulting educational gradient in non-response. As shown for sickness absence in mid-pregnancy in the present study, national registries could be a preferred alternative to self-report questionnaires.

• Sterud, Tom; Tynes, Tore; Mehlum, Ingrid Sivesind; Veiersted, Kaj Bo; Bergbom, Barbara & Airila, Auli [Show all 10 contributors for this article] (2018). A systematic review of working conditions and occupational health among immigrants in Europe and Canada. BMC Public Health. ISSN 1471-2458. 18:770, p. 1–15. doi: 10.1186/s12889-018-5703-3. Full text in Research Archive Show summary

  Background: A systematic attempt to summarize the literature that examines working conditions and occupational health among immigrant in Europe and Canada. Methods: We established inclusion criteria, searched systematically for articles included in the Medline, Embase and Social Sciences Citation Index databases in the period 2000–2016 and checked the reference lists of all included papers. Results: Eighty-two studies were included in this review; 90% were cross-sectional and 80% were based on self-report. Work injuries were consistently found to be more prevalent among immigrants in studies from different countries and in studies with different designs. The prevalence of perceived discrimination or bullying was found to be consistently higher among immigrant workers than among natives. In general, however, we found that the evidence that immigrant workers are more likely to be exposed to physical or chemical hazards and poor psychosocial working conditions is very limited. A few Scandinavian studies support the idea that occupational factors may partly contribute to the higher risk of sick leave or disability pension observed among immigrants. However, the evidence for working conditions as a potential mediator of the associations between immigrant status and poor general health and mental distress was very limited. Conclusion: Some indicators suggest that immigrant workers in Europe and Canada experience poorer working conditions and occupational health than do native workers. However, the ability to draw conclusions is limited by the large gaps in the available data, heterogeneity of immigrant working populations, and the lack of prospectively designed cohort studies.

• Hoff, Rune; Corbett, Karina; Mehlum, Ingrid Sivesind; Mohn, Ferdinand A; Kristensen, Petter & Hanvold, Therese Nordberg [Show all 7 contributors for this article] (2018). The impact of completing upper secondary education - a multi-state model for work, education and health in young men. BMC Public Health. ISSN 1471-2458. 18. doi: 10.1186/s12889-018-5420-y. Full text in Research Archive Show summary

  Background: Completing upper secondary education is associated with higher work participation and less health-related absence from work. Although these outcomes are closely interrelated, most studies focus on single outcomes, using cross-sectional designs or short follow-up periods. As such, there is limited knowledge of the long-term outcomes, and how paths for completers and non-completers unfold over time. In this paper, we use multi-state models for time-to-event data to assess the long-term effects of completing upper secondary education on employment, tertiary education, sick leave, and disability pension over twelve and a half years for young men. Methods: Baseline covariates and twelve and a half years of follow-up data on employment, tertiary education, sick leave and disability pension were obtained from national registries for all males born in Norway between 1971 and 1976 (n =184951). The effects of completing upper secondary education (by age 23) were analysed in a multi-state framework, adjusting for both individual and family level confounders. All analyses were done separately for general studies and vocational tracks. Results: Completers do better on a range of outcomes compared to non-completers, for both fields of upper secondary education, but effects of completion change over time. The largest changes are for tertiary education and work, with the probability of work increasing reciprocally to the probability of education. Vocational students are quicker to transfer to the labour market, but tend to have more unemployment, sick leave and disability, and the absolute effects of completion on these outcomes are largest for vocational tracks. However, the relative effects of completion are larger for general studies. Conclusion: Completing upper secondary education increases long-term work participation and lowers health-related absence for young men, but effects diminish over time. Studies that have used shorter follow-up periods could be overstating the negative effects of dropout on labour market participation. Multi-state models are well suited to analyse data on work, education and health-related absence, and can be useful in understanding the dynamic aspects of these outcomes.

• Aarhus, Lisa & Mehlum, Ingrid Sivesind (2017). Arbeidsmedisinsk pasientutredning i Norge. Tidsskrift for Den norske legeforening. ISSN 0029-2001. 137(14-15). doi: 10.4045/tidsskr.16.0652. Show summary

  BAKGRUNN: De arbeidsmedisinske sykehusavdelingene og Statens arbeidsmiljøinstitutt etablerte et felles, anonymt utredningsregister i 2009. Formålet var å få bedre oversikt over arbeidsmedisinsk pasientutredning i Norge, inkludert endring i arbeidsrelatert eksponering og sykdom over tid. MATERIALE OG METODE: Utredende lege fyller ut et skjema etter pasientkonsultasjonen, hvorpå dette registreres elektronisk. Artikkelen bygger på analyse av registrerte pasientutredninger i perioden 2010-15. RESULTATER: Det var registrert 8 775 pasientutredninger. Flest menn ble utredet (75 %), og vanligste aldersgruppe var 50-69 år (52 %). Vanligste eksponering var irritanter/allergener (18 %) og organiske løsemidler (15 %), som ble registrert i henholdsvis noe økende og noe minkende grad i perioden. Industri og bergverksdrift toppet bransjestatistikken (30 %). Vanligste symptomorgan var lunger/luftveier (57 %), med astma, kols og lungekreft som hyppigste diagnoser. Andelen saker som ble vurdert å ha sannsynlig eller mulig arbeidsrelasjon, holdt seg stabil på rundt henholdsvis 40 % og 23 %. 16 % av pasientene mottok sykepenger, 10 % arbeidsavklaringspenger og 13 % uførepensjon på undersøkelsestidspunktet. FORTOLKNING: Arbeidsrelatert sykdom har store konsekvenser for enkeltmennesker og samfunn. Utredningsregisteret gir en god oversikt over pasientutredningen ved de arbeidsmedisinske avdelingene i Norge og kan avdekke endringer i arbeidsrelatert eksponering og sykdom over tid. Slik kan registeret bidra til målrettet forebyggende innsats.

• Kristensen, Petter; Keyes, Katherine M.; Susser, Ezra; Corbett, Karina; Mehlum, Ingrid Sivesind & Irgens, Lorentz M. (2017). High birth weight and perinatal mortality among siblings: A register based study in Norway, 1967-2011. PLOS ONE. ISSN 1932-6203. 12(2). doi: 10.1371/journal.pone.0172891. Full text in Research Archive Show summary

  Background: Perinatal mortality according to birth weight has an inverse J-pattern. Our aim was to estimate the influence of familial factors on this pattern, applying a cohort sibling design. We focused on excess mortality among macrosomic infants (>2 SD above the mean) and hypothesized that the birth weight-mortality association could be explained by confounding shared family factors. We also estimated how the participant’s deviation from mean sibling birth weight influenced the association. Methods and findings: We included 1 925 929 singletons, born term or post-term to mothers with more than one delivery 1967–2011 registered in the Medical Birth Registry of Norway. We examined z-score birth weight and perinatal mortality in random-effects and sibling fixed-effects logistic regression models including measured confounders (e.g. maternal diabetes) as well as unmeasured shared family confounders (through fixed effects models). Birth weight-specific mortality showed an inverse J-pattern, being lowest (2.0 per 1000) at reference weight (z-score +1 to +2) and increasing for higher weights. Mortality in the highest weight category was 15-fold higher than reference. This pattern changed little in multivariable models. Deviance from mean sibling birth weight modified the mortality pattern across the birth weight spectrum: small and medium-sized infants had increased mortality when being smaller than their siblings, and large-sized infants had an increased risk when outweighing their siblings. Maternal diabetes and birth weight acted in a synergistic fashion with mortality among macrosomic infants in diabetic pregnancies in excess of what would be expected for additive effects. Conclusions: The inverse J-pattern between birth weight and mortality is not explained by measured confounders or unmeasured shared family factors. Infants are at particularly high mortality risk when their birth weight deviates substantially from their siblings. Sensitivity analysis suggests that characteristics related to maternal diabetes could be important in explaining the increased mortality among macrosomic infants.

• Mehlum, Ingrid Sivesind (2016). Samfunnsmedisin og arbeidsmedisin. Michael. ISSN 1893-9651. 13, p. 120–125. Show summary

  Samfunnsmedisin handler om samspillet mellom samfunn og helse, mens arbeidsmedisin omhandler forholdet mellom arbeid og helse. De to fagområdene har mye felles, men det er også til dels store forskjeller mellom dem. Forebyggende og helsefremmende arbeid er viktige oppgaver for begge fagområder. Arbeidsmedisin praktiseres av leger både i bedriftshelsetjenester og ved arbeidsmedisinske avdelinger på sykehus, samt enkelte andre steder og befinner seg derfor både i første- og annenlinjen. Fagområdet har et gruppeperspektiv, men forholder seg også til enkeltpersoner gjennom utredning av arbeidsrelatert sykdom, helsekontroller og tilrettelegging av arbeid. Arbeidsmedisin kan derfor være vanskelig å plassere. Selv om arbeidsrelaterte helseproblemer er vanlige i befolkningen, er arbeidsmedisin lite synlig i det medisinske landskapet. Andre leger ser sannsynligvis flere tilfeller av arbeidsrelatert sykdom enn arbeidsmedisinere, og hvis de ikke tenker på at arbeid kan være årsak til sykdommen, er det ikke sikkert pasienten får den beste behandlingen.

• Skogstad, Marit; Johannessen, Håkon Andre; Tynes, Tore; Mehlum, Ingrid Sivesind; Nordby, Karl-Christian & Lie, Arve (2016). Systematic review of the cardiovascular effects of occupational noise. Occupational Medicine. ISSN 0962-7480. 66(1), p. 10–16. doi: 10.1093/occmed/kqv148. Show summary

  Abstract: Background Cross-sectional studies of occupational noise and cardiovascular effects show an association between noise and hypertension but for coronary heart disease or other cardiovascular diseases (CVDs) the evidence is not convincing. Aims: To assess possible associations between occupational noise exposure and the risk for cardiovascular effects in follow-up studies published after 1999. Methods: We performed a systematic critical literature review of original articles from key literature databases of associations between workplace noise and health. The studies were identified by search in Ovid Medline, Ovid Embase, Web of Science, Scopus and ProQuest Health and Safety Sciences Abstracts. We selected prospective studies of adequate quality with a measure of association between occupational noise exposure and cardiovascular health for the meta-analysis. Results: Twelve papers, all prospective and mostly with high quality but with methodological shortcomings in exposure assessment, were included in the review and meta-analysis. Exposure to noise at work was consistently positively associated with hypertension [Hazard ratio (HR) = 1.68; 95% confidence interval (CI) 1.10–2.57] and CVD [relative risk (RR) = 1.34; 95% CI 1.15–1.56]. In addition, we found a trivial effect of noise exposure on CVD mortality (HR = 1.12; 95% CI 1.02–1.24). Conclusions: Occupational noise exposure is strongly associated with hypertension. For other cardiovascular effects, this meta-analysis suggests a weak association, but the evidence is limited. More longitudinal studies on the effects of occupational noise on the cardiovascular system are warranted.

• Lie, Arve; Skogstad, Marit; Johannessen, Håkon Andre; Tynes, Tore; Mehlum, Ingrid Sivesind & Nordby, Karl-Christian [Show all 8 contributors for this article] (2016). Occupational noise exposure and hearing: a systematic review. International Archives of Occupational and Environmental Health. ISSN 0340-0131. 89(3), p. 351–372. doi: 10.1007/s00420-015-1083-5. Show summary

  Purpose: To give a systematic review of the development of noise-induced hearing loss (NIHL) in working life. Methods: A literature search in MEDLINE, Embase, Web of Science, Scopus, and Health and Safety Abstracts, with appropriate keywords on noise in the workplace and health, revealed 22,413 articles which were screened by six researchers. A total of 698 articles were reviewed in full text and scored with a checklist, and 187 articles were found to be relevant and of sufficient quality for further analysis. Results: Occupational noise exposure causes between 7 and 21 % of the hearing loss among workers, lowest in the industrialized countries, where the incidence is going down, and highest in the developing countries. It is difficult to distinguish between NIHL and age-related hearing loss at an individual level. Most of the hearing loss is age related. Men lose hearing more than women do. Heredity also plays a part. Socioeconomic position, ethnicity and other factors, such as smoking, high blood pressure, diabetes, vibration and chemical substances, may also affect hearing. The use of firearms may be harmful to hearing, whereas most other sources of leisure-time noise seem to be less important. Impulse noise seems to be more deleterious to hearing than continuous noise. Occupational groups at high risk of NIHL are the military, construction workers, agriculture and others with high noise exposure. Conclusion: The prevalence of NIHL is declining in most industrialized countries, probably due to preventive measures. Hearing loss is mainly related to increasing age.

• Corbett, Karina; Gran, Jon Michael; Kristensen, Petter & Mehlum, Ingrid Sivesind (2015). Adult social position and sick leave: the mediating effect of physical workload. Scandinavian Journal of Work, Environment and Health. ISSN 0355-3140. 41(6), p. 542–553. doi: 10.5271/sjweh.3525. Show summary

  Objective: This study aimed to quantify how much of the adult social gradient in sick leave can be attributed to the mediating role of physical workload while accounting for the role of childhood and adolescent social position and neuroticism. Methods: Our sample consisted of 2099 women and 1229 men from a Norwegian birth cohort study (born 1967–1976) who participated in the Nord-Trøndelag Health Study (2006–2008) (HUNT3). Data on sick leave (defined as >16 calendar days; 2006–2009) and social position during childhood, adolescence, and adulthood were obtained from national registers. Study outcome was time-to-first sick leave spell. Physical workload and neuroticism were self-reported in HUNT3. Mediating effects through physical workload were estimated using a method based on the additive hazards survival model. Results: A hypothetical change from highest to lowest group in adult social position was, for women, associated with 51.6 [95% confidence interval (95% CI) 24.7–78.5] additional spells per 100 000 person-days at risk, in a model adjusted for childhood and adolescent social position and neuroticism. The corresponding rate increase for men was 41.1 (95% CI 21.4–60.8). Of these additional spells, the proportion mediated through physical workload was 24% (95% CI 10–49) and 30% (95% CI 10–63) for women and men, respectively. Conclusions: The effect of adult social position on sick leave was partly mediated through physical workload, even while accounting for earlier life course factors. Our findings provide support that interventions aimed at reducing physical workload among those with lower adult social position could reduce sick leave risk.

• Kristensen, Petter; Corbett, Karina & Mehlum, Ingrid Sivesind (2015). The gender gap in sickness absence from work and the influence of parental absence on offspring absence 15 years later. Register-based cohort of Norwegians born in 1974-1976. BMC Public Health. ISSN 1471-2458. 15. doi: 10.1186/s12889-015-2037-2. Show summary

  Background: Women have shown consistently higher levels of sickness absence from work in comparison to men, but explanations for this gender gap have not been completely understood. Life-course studies suggest that health and health-related social benefits in adult age are influenced by early life experiences. We aimed to estimate intergenerational associations with a 15-year time gap between parents’ and offspring sickness absences, pursuing the hypothesis that this parental influence would have a stronger impact for women than for men. Methods: All persons born alive between 1974 and 1976 in Norway were followed up in several national registries. Employed persons considered to be at risk of sickness absence and also with parents at risk of sickness absence (n = 78 878) were followed in the calendar year of their 33rd birthday with respect to spells lasting >16 days. The probability of one or more spells during this year constituted the one-year risk under study. Additive risk differences in association with an exposure (parental sickness absence 15 years earlier) were estimated in a binomial regression analysis. The estimates were adjusted for parental socioeconomic factors. Results: The 1-year sickness absence risk was higher for women (30.4 %) than for men (12.3 %). The crude risk differences between those exposed and those unexposed to parental sickness absence were similar in percentage points (PP) for women (3.8; 95 % confidence interval (CI) 2.6 to 4.9) and men (3.8; 95 % CI 2.9 to 4.6). The risk differences were moderately attenuated after adjustment for parental education and father’s income to 3.4 PP (2.2 to 4.5) for women and 2.8 PP (2.0 to 3.7) for men. Male absence was more strongly associated with the father’s than with the mother’s sickness absence, while associations for women were stronger for the same diagnostic groups as their parents. Conclusions: Parental sickness absence was moderately associated with sickness absence in the next generation. Bias from unmeasured confounders cannot be entirely dismissed. Contrary to our hypothesis, associations were not stronger for women than for men. If parental sickness absence has a long-term causal effect, preventive measures could have an impact over generations.

• Alfonso, Jose Hernan; Thyssen, Jacob P.; Tynes, Tore; Mehlum, Ingrid Sivesind & Johannessen, Håkon Andre (2015). Self-reported occupational exposure to chemical and physical factors and risk of skin problems: A 3-year follow-up study of the general working population of Norway. Acta Dermato-Venereologica. ISSN 0001-5555. 95(8), p. 959–962. doi: 10.2340/00015555-2135. Full text in Research Archive Show summary

  Prospective studies on occupational dermatoses in the general working population are sparse. This study investigated prospectively the impact of self-reported occupational exposure to chemicals and physical factors on the risk of skin problems. The cohort comprised respondents drawn randomly from the general population in Norway, who were registered employed in 2006 and 2009 (n = 6,745). Indoor dry air (odds ratio (OR) 1.3; 95% confidence interval (95% CI) 1.1–1.6) was a significant baseline predictor of skin problems at follow-up, whereas exposure to cleaning products (OR 1.7; 95% CI 1.2–2.5), water (OR 1.4; 95% CI 1.1–1.9) and indoor dry air (OR 1.6; 95% CI 1.1–2.1) at both measurement time-points was significantly associated with skin problems. The population risk attributable to these factors was 16%. This study quantified the contribution of occupational exposure factors to skin problems in the general working population of Norway.

• Kristensen, Petter; Susser, Ezra; Irgens, Lorentz M.; Mehlum, Ingrid Alethe Sivesind; Corbett, Karina & Bjerkedal, Tor (2014). The association of high birth weight with intelligence in young adulthood: A cohort study of male siblings. American Journal of Epidemiology. ISSN 0002-9262. 180(9), p. 876–884. doi: 10.1093/aje/kwu241. Show summary

  We aimed to explore why, in population studies, the positive association between normal-range birth weight and intelligence becomes negative at the highest birth weights. The study population comprised 217,746 Norwegian male singletons born at term between 1967 and 1976. All had data on birth weight and intelligence quotient (IQ) score at the time of military conscription; 137,574 had data on sibling birth weights; and 62,906 had data on male sibling birth weights. We estimated associations between birth weight and IQ score by ordinary least squares regression for the total study population and by fixed-effects regression for comparisons of brothers. The crude mean IQ score was 1.2 points (95% confidence interval (CI): 0.3, 2.2) lower for those with birth weights of 5,000 g or more compared with the reference group (with birth weights of 4,000–4,499 g). This difference leveled off to 0.0 (95% CI: −0.8, 0.9) in multivariable ordinary least squares regression and reversed to 2.2 points (95% CI: 0.3, 4.2) higher in fixed-effects regression. Results differed mainly because, at a given birth weight, participants who had a sibling with macrosomia had a lower mean IQ score. Nevertheless, within families with 1 or more macrosomic siblings, as in other families, men with higher birth weights tended to have higher IQ scores. Thus, a family-level confounder introduces a cross-level bias that cannot be detected in individual-level studies. We suggest ways in which future studies might elucidate the nature of this confounder.

• Foss, Line; Gravseth, Hans Magne Ulrik; Kristensen, Petter; Claussen, Bjørgulf; Mehlum, Ingrid Alethe Sivesind & Skyberg , Knut (2013). “Inclusive working life in Norway”: a registry-based five-year follow-up study. Journal of Occupational Medicine and Toxicology. ISSN 1745-6673. 8. doi: 10.1186/1745-6673-8-19. Show summary

  Background: In 2001, the Norwegian authorities and major labour market partners signed an agreement regarding ‘inclusive working life’ (IW), whereby companies that participate are committed to reducing sickness absence. Our main aim was to determine the effect of the IW program and work characteristics by gender on long-term (>8 weeks) sickness absence (LSA). Methods: Self-reported data on work characteristics from the Oslo Health Study were linked to registry-based data on IW status, education and LSA. From 2001–2005, 10,995 participants (5,706 women and 5,289 men) aged 30, 40, 45 and 60 years were followed. A Cox regression was used to compute hazard ratios (HR) for LSA risk. The cohort was divided into an IW group (2,733 women and 2,058 men) and non-IW group (2,973/3,231). Results: 43.2% and 41.6% of women and 22.3%/24.3% of men (IW / non-IW, respectively) experienced at least one LSA. In a multivariate model, statistically significant risk factors for LSA were low education (stronger in men), shift work/night work or rotating hours (strongest in men in the non-IW group), and heavy physical work or work involving walking and lifting (men only and stronger in the non-IW group). Among men who engaged in shift work, the LSA risk was significantly lower in the IW group. Conclusions: Our results could suggest that IW companies that employ many men in shift work have implemented relevant efforts for reducing sickness absence. However, this study could not demonstrate a significant effect of the IW program on the overall LSA risk.

• Mehlum, Ingrid Alethe Sivesind; Kristensen, Petter; Veiersted, Kaj Bo; Wærsted, Morten & Punnett, Laura (2013). Does the threshold for reporting musculoskeletal pain or the probability of attributing work-relatedness vary by socioeconomic position or sex? Journal of Occupational and Environmental Medicine. ISSN 1076-2752. 55(8), p. 901–909. doi: 10.1097/JOM.0b013e31828dc8ec. Show summary

  Objective: To examine the effect of sex and socioeconomic position (SEP) on individuals’ perceptions of pain and its work-relatedness. Methods: We compared self-reported pain in neck–shoulder or arm with clinical diagnoses and workers’ judgments of work-relatedness with physicians’ assessments based on specific criteria, between sexes and high- and low-SEP participants in the Oslo Health Study (n = 217). Results: Clinical diagnoses were more frequent in low-SEP subjects than high-SEP subjects with pain and generally higher in women than in men. Pain attributed to work was more frequently assessed as work-related by the physicians in low-SEP subjects than high-SEP subjects and in men than in women of low SEP. Conclusions: The threshold for reporting pain seemed higher in lowSEP subjects and among women. Physicians were more likely to agree with low-SEP workers about work-relatedness.

• Kristensen, Petter; Corbett, Karina; Mehlum, Ingrid Alethe Sivesind & Bjerkedal, Tor (2012). Impact of aerobic fitness on musculoskeletal sickness absence 5-15 years later: a cohort study of 227 201 male Norwegian employees. Occupational and Environmental Medicine. ISSN 1351-0711. 69(4), p. 250–255. doi: 10.1136/oemed-2011-100144. Show summary

  Objectives: The aim of the study was to estimate associations between aerobic fitness among men at age 18–19 years and work absence due to musculoskeletal sickness 5–15 years later. Methods: All 321 975 men born between 1967 and 1976 in Norway were identified and followed up in several national registers. Men who completed an aerobic fitness test at military conscription during 1985–1995 (N=227 201) were followed from 2000 through 2003 with respect to a first musculoskeletal absence. Cox regression was conducted to estimate HRs between aerobic fitness (high, medium, poor) and musculoskeletal absence. Results: A total of 26 061 men had a musculoskeletal absence (absolute risk 0.115). Absence was associated with fitness level. Associations were confounded by other conscript characteristics (intellectual capacity, body mass index, musculoskeletal condition) and parental education level and were restricted to non-injury absence. With high fitness as reference, the adjusted non-injury HR estimates were 1.18 (95% CI 1.12 to 1.24) and 1.39 (1.31 to 1.47) for medium and poor fitness, respectively. Poor fitness men were more likely to achieve low educational attainment and employment in high-absence industries and enterprises. The impact of intellectual capacity and parental education level on absence was considerably larger than the effect from fitness. A subset analysis with fitness data of better quality yielded moderately stronger associations. Conclusions: Aerobic fitness among conscripts was moderately associated with non-injury musculoskeletal absence 5–15 years later. However, the overall impact of intellectual capacity and parental education appears to be greater than that of aerobic fitness.

• Mehlum, Ingrid Alethe Sivesind (2011). Hvor mye av sykefraværet er arbeidsrelatert? Tidsskrift for Den norske legeforening. ISSN 0029-2001. 131(2), p. 122–125. doi: 10.4045/tidsskr.10.0665. Show summary

  BAKGRUNN: Sykefravær er et aktuelt tema, blant annet etter revisjonen av intensjonsavtalen om et mer inkluderende arbeidsliv (IA-avtalen). I hvilken grad sykefravær kan ha sammenheng med arbeid, har likevel vært lite omtalt. MATERIALE OG METODE: Artikkelen bygger på et ikke-systematisk litteratursøk i PubMed og egen forskning og erfaring. RESULTATER: Forskjellige studier tyder på at en vesentlig del av sykefraværet kan skyldes sykdom forårsaket av arbeidsforhold. Tungt fysisk arbeid, belastende arbeidsstillinger og lav kontroll over arbeidssituasjonen er faktorer som er spesielt viktige. Personer med arbeidsrelatert sykdom har større behov for fravær fra jobben enn personer med tilsvarende sykdom som ikke skyldes arbeidet. Tiltak på arbeidsplassen som forebygger arbeidsrelatert sykdom, kan forebygge sykefravær. Sykefravær som skyldes ubalanse mellom individuelle ressurser og jobbkrav, kan ofte forebygges eller forkortes ved tiltak på arbeidsplassen, uansett hva som er årsaken til denne ubalansen. FORTOLKNING: Jeg mener at man bør legge mer vekt på primærforebyggende tiltak for å redusere arbeidsrelatert sykdom og tilrettelegge arbeidet for personer med økt risiko for sykefravær, men dette er ikke tilstrekkelig ivaretatt i dagens IA-avtale.

• Foss, Line; Gravseth, Hans Magne Ulrik; Kristensen, Petter; Claussen, Bjørgulf; Mehlum, Ingrid Alethe Sivesind & Knardahl, Stein [Show all 7 contributors for this article] (2011). The impact of workplace risk factors on long-term musculoskeletal sickness absence: a registry-based 5-year follow-up from the Oslo Health Study. Journal of Occupational and Environmental Medicine. ISSN 1076-2752. 53(12), p. 1478–1482. doi: 10.1097/JOM.0b013e3182398dec. Show summary

  Objective: To determine the influence of work-related risk factors by gender on long-term sickness absence with musculoskeletal diagnoses (LSM). Methods: Data from the Oslo Health Study were linked to the historical event database of Statistics Norway. Eight thousand three hundred thirty-three participants were followed from 2001 through 2005. Generalized linear models were used to compute risk differences for LSM. Results: In total, 12.6% of the women and 8.8% of the men experienced at least one LSM. Statistically, significant LSM risk increases between 0.039 and 0.086 in association with work environment were found for heavy physical work, low job control (men only), low support from superior (women only), and having shift/night work (men only). Conclusions: Women exhibited a higher LSM risk, but the associations with job exposures were stronger for men. This should be addressed when occupational health services give advice on preventive measures.

• Foss, Line; Gravseth, Hans Magne Ulrik; Kristensen, Petter; Claussen, Bjørgulf; Mehlum, Ingrid Alethe Sivesind & Skyberg , Knut (2010). Risk Factors for Long-Term Absence Due To Psychiatric Sickness: A Register-Based 5-Year Follow-Up From the Oslo Health Study. Journal of Occupational and Environmental Medicine. ISSN 1076-2752. 52(7), p. 698–705. doi: 10.1097/JOM.0b013e3181e98731. Show summary

  Objective: To identify individual and work-related predictors of long-term (8 weeks) sickness absence with psychiatric diagnoses (LSP). Methods: Data from the Oslo Health Study (response rate 46%) were linked to public registers. A total of 8333 subjects were followed from 2001 through 2005. Cox regression was used to compute hazard ratios for LSP. Results: At least one LSP was present in 7.8% of women and 3.9% of men. Poor support from superior had an independent and moderate effect. Path and linear regression analyses indicated that the effect of support from superior was mediated through mental distress and not the other way around. Selfreported mental distress had a strong independent effect. Conclusions: Women had a higher risk of LSP than men. Low education and poor support from superior and mental distress were found to be determinants of LSP.

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• Poulsson, Otto Melchior; Fridriksson, Johan Fridrik; Tómasson, Kristinn; Midtsundstad, Tove Irene; Mehlum, Ingrid Sivesind & Hilsen, Anne I [Show all 8 contributors for this article] (2017). Working environment and work retention. Nordisk ministerråd. ISBN 978-92-893-5196-6. 2017(559). 125 p.

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• Bugge, Merete Drevvatne & Mehlum, Ingrid Sivesind (2023). Forelesning på LIS-kurs: Årsakssammenhenger.
• Kiran, Sibel; Mehlum, Ingrid Sivesind & Nena, Evangelia (2022). Editorial: Non-standard Employment Relations, Job Insecurity, and Health. Frontiers in Public Health. ISSN 2296-2565. 10. doi: 10.3389/fpubh.2022.805947.
• Ubalde-Lopez, Monica; Garani-Papadatos, Tina; Scelo, Ghislaine; Casas, Maribel; Lisåker, Claudia & Peters, Susan [Show all 20 contributors for this article] (2021). Working life, health and well-being of parents: a joint effort to uncover hidden treasures in European birth cohorts. Scandinavian Journal of Work, Environment and Health. ISSN 0355-3140. 47(7), p. 550–560. doi: 10.5271/sjweh.3980. Show summary

  Objective Birth cohorts collect valuable and under-utilized information on employment and health of parents before and during pregnancy, at birth, and sometimes after birth. In this discussion paper, we examine how these data could be exploited to study the complex relationships and interactions between parenthood, work, and health among parents themselves. Methods Using a web-based database of birth cohorts, we summarize information on maternal employment and health conditions and other potentially related variables in cohorts spread throughout Europe. This provided information on what data are available and could be used in future studies, and what was missing if specific questions are to be addressed, exploiting the opportunity to explore work–health associations across heterogenous geographical and social contexts. Results We highlight the many potentialities provided by birth cohorts and identify gaps that need to be addressed to adopt a life-course approach and investigate topics specific to the peri-pregnancy period, such as psychosocial aspects. We address the technical difficulties implied by data harmonization and the ethical challenges related to the repurposing of data, and provide scientific, ecological and economic arguments in favor of improving the value of data already available as a result of a serious investment in human and material resources. Conclusions There is a hidden treasure in birth cohorts that deserves to be brought out to study the relationships between employment and health among working parents in a time when the boundaries between work and life are being stretched more than ever before.

• Kogevinas, Manolis; Schlünssen, Vivi; Mehlum, Ingrid Alethe Sivesind & Turner, Michelle C. (2020). The OMEGA-NET International Inventory of Occupational Cohorts. Annals of Work Exposures and Health. ISSN 2398-7308. 64(6), p. 565–568. doi: 10.1093/annweh/wxaa039. Show summary

  In a recent count of cohort studies in Europe capturing information on occupation and/or occupational exposures, we estimated that there are more than 60 major studies with some type of occupational information that enrolled over 30 million persons. With few exceptions there have been no large-scale analyses systematically combining cohorts from this extraordinary resource. We present the development of an inventory of cohorts with occupational information in Europe and internationally and describe the online interactive tool with detailed information on existing cohorts. The OMEGA-NET inventory can be accessed at http://occupationalcohorts.net/ includes cohorts, case-control studies nested within cohorts and intervention studies that are active or can substantiate that their data are potentially accessible; that include data on occupation and/or industry or at least one occupational exposure; and that have at least one follow-up, either already conducted or planned. We expect that this open access inventory will be an important prerequisite for use of this resource of existing studies for research and policy development.

• Aas, Oddfrid; Fossum, Trude; Mehlum, Ingrid Alethe Sivesind; Randem, Britt Grethe; Granslo, Jens-Tore & Haanes, Jan Vilis (2019). Å skifte yrke er ikke enkelt. Tidsskrift for Den norske legeforening. ISSN 0029-2001. 139(16), p. 1534–1535. doi: 10.4045/tidsskr.19.0647.
• Hasting, Rachel Louise; Hanvold, Therese Nordberg; Merkus, Suzanne; Kristensen, Petter & Mehlum, Ingrid Sivesind (2019). Evaluation of the Norwegian Agreement on a More Inclusive Working Life: sickness absence in four diagnosis groups . Occupational and Environmental Medicine. ISSN 1351-0711. 76, p. A11–A11. doi: 10.1136/OEM-2019-EPI.A11.
• Mehlum, Ingrid Sivesind; Hanvold, Therese Nordberg; Mehlum, Lars; Hasting, Rachel Louise; Merkus, Suzanne & Kristensen, Petter (2019). Are psychosocial working conditions associated with suicide and intentional self-harm? A register-based study of 420,895 Norwegians. Occupational and Environmental Medicine. ISSN 1351-0711. 76, p. A63–A63. doi: 10.1136/OEM-2019-EPI.A63.
• Kristensen, Petter; Hanvold, Therese Nordberg; Hasting, Rachel Louise; Merkus, Suzanne & Mehlum, Ingrid Sivesind (2019). Risk of mental health disorders in human service occupations: a register based study of 445,651 Norwegians. . Occupational and Environmental Medicine. ISSN 1351-0711. 76, p. A30–A30. doi: 10.1136/OEM-2019-EPI.A30.
• Turner, Michelle C. & Mehlum, Ingrid Sivesind (2018). Greater coordination and harmonisation of European occupational cohorts is needed. Occupational and Environmental Medicine. ISSN 1351-0711. 75(7), p. 475–476. doi: 10.1136/oemed-2017-104955.
• Tang, Fang; Mehlum, Lars; Mehlum, Ingrid Sivesind & Qin, Ping (2017). Suicide risk and physical illness leading to leave from work: a national study of people in Norwegian labor force.
• Midtsundstad, Tove Irene & Mehlum, Ingrid Sivesind (2017). The impact of the working environment on work retention of older worker. National report - Norway (det norske perspektivet).
• Kristensen, Petter; Susser, Ezra; Corbett, Karina; Mehlum, Ingrid Sivesind & Irgens, Lorentz M (2015). Macrosomia at birth and perinatal mortality: a register study of siblings born at term in Norway, 1967-2011.
• Mehlum, Ingrid Sivesind; Corbett, Karina; Gran, Jon Michael & Kristensen, Petter (2015). Do psychosocial working conditions mediate social inequalities in musculoskeletal and psychiatric sickness absence in a life-course perspective?
• Kristensen, Petter; Susser, Ezra; Corbett, Karina; Mehlum, Ingrid Sivesind & Irgens, Lorentz M (2015). Birth weight, perinatal mortality, and the family: a sibling study of singletons born at term in Norway, 1967-2011.
• Kristensen, Petter; Corbett, Karina & Mehlum, Ingrid Alethe Sivesind (2014). Arbeid og helse i et livsløpsperspektiv. Arbeid og helse. ISSN 0806-3648. p. 18–19.
• Mehlum, Ingrid Alethe Sivesind; Corbett, Karina; Gran, Jon Michael & Kristensen, Petter (2014). The relationship between socioeconomic position, working conditions and sickness absence in a life-course perspective.
• Kristensen, Petter; Susser, Ezra; Irgens, Lorentz M.; Mehlum, Ingrid Alethe Sivesind; Corbett, Karina & Bjerkedal, Tor (2014). Kristensen et al. respond to ”high birth weight and later health”. Response to invited commentary. American Journal of Epidemiology. ISSN 0002-9262. 180(9), p. 888–889. doi: 10.1093/aje/kwu244.
• Corbett, Karina; Mehlum, Ingrid Alethe Sivesind; McKeague, Ian; Susser, Ezra & Kristensen, Petter (2013). Does an unstable household income lead to poor cognitive outcomes? Norsk Epidemiologi, Supplement. ISSN 0803-4206. 23, p. 14–14.
• Corbett, Karina; Mehlum, Ingrid Alethe Sivesind; McKeague, Ian; Susser, Ezra & Kristensen, Petter (2013). Does an unstable household income lead to poor cognitive outcomes?
• Mehlum, Ingrid Alethe Sivesind; Susser, Ezra; Link, Bruce & Kristensen, Petter (2013). Socio-economic position in childhood and adulthood, intelligence, and mental health. Comprehensive Psychiatry. ISSN 0010-440X. 54.
• Kristensen, Petter; Mehlum, Ingrid Alethe Sivesind; Corbett, Karina & Bjerkedal, Tor (2013). Transgenerational sickness absence patterns in Norwegian families. Occupational and Environmental Medicine. ISSN 1351-0711. 70, p. A107–A107. doi: 10.1136/oemed-2013-101717.314.
• Mehlum, Ingrid Alethe Sivesind; Susser, Ezra; Link, Bruce; Corbett, Karina & Kristensen, Petter (2013). Social position and intelligence: which is the more important determinant of sickness absence in a life-course perspective? Occupational and Environmental Medicine. ISSN 1351-0711. 70, p. A111–A111. doi: 10.1136/oemed-2013-101717.326.
• Kristensen, Petter; Mehlum, Ingrid Alethe Sivesind; Corbett, Karina & Bjerkedal, Tor (2013). Social interaction: intergenerational sickness absence among Norwegians born in 1976 and their parents.
• Mehlum, Ingrid Alethe Sivesind; Corbett, Karina & Kristensen, Petter (2013). The interaction between work-related factors and life-course socioeconomic position and its effect on subsequent sickness absence.
• Mehlum, Ingrid Alethe Sivesind; Susser, Ezra; Link, Bruce; Corbett, Karina & Kristensen, Petter (2013). Social position and intelligence: which is the more important determinant of sickness absence in a life-course perspective?
• Kristensen, Petter; Mehlum, Ingrid Alethe Sivesind; Corbett, Karina & Bjerkedal, Tor (2013). Transgenerational sickness absence patterns in Norwegian families.
• Mehlum, Ingrid Alethe Sivesind; Susser, Ezra; Link, Bruce & Kristensen, Petter (2012). Socio-economic position in childhood and adulthood, intelligence, and health.
• Kristensen, Petter; Susser, Ezra; Mehlum, Ingrid Alethe Sivesind; Corbett, Karina & Bjerkedal, Tor (2012). The relationship between high birthweight and IQ in young adult age.
• Mehlum, Ingrid Alethe Sivesind; Susser, Ezra; Link, Bruce & Kristensen, Petter (2012). Socio-economic position in childhood and adulthood, intelligence, and mental health.
• Mehlum, Ingrid Alethe Sivesind; Kristensen, Petter & Punnett, Laura (2011). Is the threshold for reporting pain or the tendency to attribute the pain to the job linked to socioeconomic position or gender?
• Corbett, Karina; Mehlum, Ingrid Alethe Sivesind; Aalen, Odd O. & Kristensen, Petter (2011). Is risk of sickness absence associated with sibling sickness absence?
• Sterud, Tom; Tynes, Tore; Mehlum, Ingrid Sivesind; Veiersted, Kaj Bo; Bergbom, Barbara & Airila, Auli [Show all 10 contributors for this article] (2019). Arbeidsmiljø og helse blant innvandrerpopulasjoner. En systematisk gjennomgang av forskningslitteraturen i Europa og Canada . Nordisk ministerråd. ISSN 978-92-893-6016-6. Full text in Research Archive
• Aarhus, Lisa & Mehlum, Ingrid Sivesind (2019). Utredning av unge med arbeidsrelatert sykdom. Tidsskrift for den norske legeforening.
• Johannessen, Håkon Andre; Løchting, Ida; Bakke, Berit; Nielsen, Morten Birkeland; Skyberg, Knut & Mehlum, Ingrid Sivesind (2017). Effekter av myndighetstiltak på arbeidsmiljø og helse. En systematisk kunnskapsoppsummering. Statens arbeidsmiljøinstitutt. ISSN 1502-0932. Årgang 18(Nr. 5). Full text in Research Archive
• Midtsundstad, Tove Irene; Mehlum, Ingrid Sivesind & Hilsen, Anne I. (2017). The impact of the working environment on work retention of older workers. National report - Norway. Fafo. ISSN 0804-5135. Full text in Research Archive
• Corbett, Karina & Mehlum, Ingrid Sivesind (2016). Understanding sick leave risk in a lifecourse framework. A register-based birth cohort study of Norwegians born 1967–1976. Department of Occupational Medicine and Epidemiology, University of Oslo; National Institute of Occupational Health. ISSN 9788283332254. Full text in Research Archive
• Lie , Arve; Skogstad, Marit; Tynes, Tore; Johannessen, Håkon Andre; Nordby, Karl-Christian & Mehlum, Ingrid Alethe Sivesind [Show all 9 contributors for this article] (2013). Støy i arbeidslivet og helse. Statens arbeidsmiljøinstitutt. ISSN 1502-0932. Årgang 14(Nr. 10). Full text in Research Archive

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