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

Heikkilä, K; Madsen, IE; Nyberg, ST; Fransson, EI; Ahola, K; Alfredsson, L; Bjorner, JB; ... IPD-Work Consortium; + view all (2014) Job strain and the risk of inflammatory bowel diseases: individual-participant meta-analysis of 95 000 men and women. PLoS One , 9 (2) , Article e88711. 10.1371/journal.pone.0088711. Green open access

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Abstract

Background and Aims Many clinicians, patients and patient advocacy groups believe stress to have a causal role in inflammatory bowel diseases, such as Crohn's disease and ulcerative colitis. However, this is not corroborated by clear epidemiological research evidence. We investigated the association between work-related stress and incident Crohn's disease and ulcerative colitis using individual-level data from 95 000 European adults. Methods We conducted individual-participant data meta-analyses in a set of pooled data from 11 prospective European studies. All studies are a part of the IPD-Work Consortium. Work-related psychosocial stress was operationalised as job strain (a combination of high demands and low control at work) and was self-reported at baseline. Crohn's disease and ulcerative colitis were ascertained from national hospitalisation and drug reimbursement registers. The associations between job strain and inflammatory bowel disease outcomes were modelled using Cox proportional hazards regression. The study-specific results were combined in random effects meta-analyses. Results Of the 95 379 participants who were free of inflammatory bowel disease at baseline, 111 men and women developed Crohn's disease and 414 developed ulcerative colitis during follow-up. Job strain at baseline was not associated with incident Crohn's disease (multivariable-adjusted random effects hazard ratio: 0.83, 95% confidence interval: 0.48, 1.43) or ulcerative colitis (hazard ratio: 1.06, 95% CI: 0.76, 1.48). There was negligible heterogeneity among the study-specific associations. Conclusions Our findings suggest that job strain, an indicator of work-related stress, is not a major risk factor for Crohn's disease or ulcerative colitis.

Type: Article
Title: Job strain and the risk of inflammatory bowel diseases: individual-participant meta-analysis of 95 000 men and women
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1371/journal.pone.0088711
Publisher version: http://dx.doi.org/10.1371/journal.pone.0088711
Language: English
Additional information: © 2014 Heikkila et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Epidemiology and Public Health
URI: https://discovery.ucl.ac.uk/id/eprint/1420243
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