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a National Institute
for Working Life, SE-112 79 Stockholm, Sweden, b Institute of
Environmental Medicine, Karolinska Institutet, SE 17177 Stockholm,
Sweden
Correspondence to: Dr B Floderus Birgitta.floderus{at}imm.ki.se
Accepted 30 August 2000
OBJECTIVE
To examine
mortality before 70 years of age among women and men relative to
unemployment, part time work, overtime work, and extra work. Age,
marital status, children, smoking and alcohol habits, use of sleeping
pills and tranquilisers, stress, shift work, personality factors, and
long lasting or serious illness were taken into account as potential
confounding factors.
METHODS
The study
group comprised a subcohort of the Swedish twin registry, people born
in 1926-58. Data were based on a postal questionnaire of 1973 and on
information from the Swedish Causes of Death Registry. All subjects
reporting a main occupation were selected, 9500 women and 11 132 men,
and mortality from all causes during 1973-96 was analysed. The
subjects were treated as a sample from the general population
regardless of the twinning.
RESULTS
Unemployment
in 1973 among both women and men showed an association with increased
mortality. The adjusted relative risk (RR) (95% confidence interval
(95% CI)) was 1.98 (1.16 to 3.38), for women and 1.43 (0.91 to 2.25)
for men. For the first 5 years of follow up, a threefold increase in
risk was found for men (RR (95% CI) 3.29 (1.33 to 8.17)). The RR
declined by time, but remained increased throughout the 24 year study
period. In women overtime work of more than 5 hours a week was followed
by an increased mortality rate (RR (95% CI) 1.92 (1.13 to 3.25)). A
protective effect of moderate overtime work of a maximum 5 hours a week
was shown for men (RR (95% CI) 0.58 (0.43 to 0.80)), whereas an
increased mortality was indicated for part time work (RR (95% CI) 1.58 (0.91 to 2.77)) and extra work (work outside employment) of more than 5 hours a week (RR (95% CI) 1.29 (0.99 to 1.69)).
CONCLUSION
Unemployment
and some time aspects of work were associated with subsequent
mortality, even when controlling for social, behavioural, work, and
health related factors. The idea that losing a job may have less
importance for women than for men is not supported by this study.
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