Job Strain and the Risk of Inflammatory Bowel Diseases: Individual-Participant Meta-Analysis of 95 000 Men and Women

Katriina Heikkilä; Ida E H Madsen; Solja T Nyberg; Eleonor I Fransson; Kirsi Ahola; Lars Alfredsson; Jakob B Bjorner; Marianne Borritz; Hermann Burr; Nico Dragano; Jane E Ferrie; Anders Knutsson; Markku Koskenvuo; Aki Koskinen; Martin L Nielsen; Maria Nordin; Jan H Pejtersen; Jaana Pentti; Reiner Rugulies; Tuula Oksanen; Martin J Shipley; Sakari B Suominen; Töres Theorell; Ari Väänänen; Jussi Vahtera; Marianna Virtanen; Hugo Westerlund; Peter J M Westerholm; G David Batty; Archana Singh-Manoux; Mika Kivimäki; IPD-Work Consortium

doi:10.1371/journal.pone.0088711

Job Strain and the Risk of Inflammatory Bowel Diseases: Individual-Participant Meta-Analysis of 95 000 Men and Women

Katriina Heikkilä, Ida E H Madsen, Solja T Nyberg, Eleonor I Fransson, Kirsi Ahola, Lars Alfredsson, Jakob B Bjorner, Marianne Borritz, Hermann Burr, Nico Dragano, Jane E Ferrie, Anders Knutsson, Markku Koskenvuo, Aki Koskinen, Martin L Nielsen, Maria Nordin, Jan H Pejtersen, Jaana Pentti, Reiner Rugulies, Tuula OksanenMartin J Shipley, Sakari B Suominen, Töres Theorell, Ari Väänänen, Jussi Vahtera, Marianna Virtanen, Hugo Westerlund, Peter J M Westerholm, G David Batty, Archana Singh-Manoux, Mika Kivimäki, IPD-Work Consortium

17 Citations (Scopus)

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.

Original language	English
Article number	e88711
Journal	PLOS ONE
Volume	9
Issue number	2
Pages (from-to)	1-7
Number of pages	7
ISSN	1932-6203
DOIs	https://doi.org/10.1371/journal.pone.0088711
Publication status	Published - 18 Feb 2014

Keywords

Female
Humans
Inflammatory Bowel Diseases
Male
Risk
Stress, Psychological
Work

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Heikkilä, K., Madsen, I. E. H., Nyberg, S. T., Fransson, E. I., Ahola, K., Alfredsson, L., Bjorner, J. B., Borritz, M., Burr, H., Dragano, N., Ferrie, J. E., Knutsson, A., Koskenvuo, M., Koskinen, A., Nielsen, M. L., Nordin, M., Pejtersen, J. H., Pentti, J., Rugulies, R., ... IPD-Work Consortium (2014). Job Strain and the Risk of Inflammatory Bowel Diseases: Individual-Participant Meta-Analysis of 95 000 Men and Women. PLOS ONE, 9(2), 1-7. [e88711]. https://doi.org/10.1371/journal.pone.0088711

Heikkilä, K, Madsen, IEH, Nyberg, ST, Fransson, EI, Ahola, K, Alfredsson, L, Bjorner, JB, Borritz, M, Burr, H, Dragano, N, Ferrie, JE, Knutsson, A, Koskenvuo, M, Koskinen, A, Nielsen, ML, Nordin, M, Pejtersen, JH, Pentti, J, Rugulies, R, Oksanen, T, Shipley, MJ, Suominen, SB, Theorell, T, Väänänen, A, Vahtera, J, Virtanen, M, Westerlund, H, Westerholm, PJM, Batty, GD, Singh-Manoux, A, Kivimäki, M & IPD-Work Consortium 2014, 'Job Strain and the Risk of Inflammatory Bowel Diseases: Individual-Participant Meta-Analysis of 95 000 Men and Women', PLOS ONE, vol. 9, no. 2, e88711, pp. 1-7. https://doi.org/10.1371/journal.pone.0088711

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title = "Job Strain and the Risk of Inflammatory Bowel Diseases: Individual-Participant Meta-Analysis of 95 000 Men and Women",

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.",

keywords = "Female, Humans, Inflammatory Bowel Diseases, Male, Risk, Stress, Psychological, Work",

author = "Katriina Heikkil{\"a} and Madsen, {Ida E H} and Nyberg, {Solja T} and Fransson, {Eleonor I} and Kirsi Ahola and Lars Alfredsson and Bjorner, {Jakob B} and Marianne Borritz and Hermann Burr and Nico Dragano and Ferrie, {Jane E} and Anders Knutsson and Markku Koskenvuo and Aki Koskinen and Nielsen, {Martin L} and Maria Nordin and Pejtersen, {Jan H} and Jaana Pentti and Reiner Rugulies and Tuula Oksanen and Shipley, {Martin J} and Suominen, {Sakari B} and T{\"o}res Theorell and Ari V{\"a}{\"a}n{\"a}nen and Jussi Vahtera and Marianna Virtanen and Hugo Westerlund and Westerholm, {Peter J M} and Batty, {G David} and Archana Singh-Manoux and Mika Kivim{\"a}ki and {IPD-Work Consortium}",

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T1 - Job Strain and the Risk of Inflammatory Bowel Diseases

T2 - Individual-Participant Meta-Analysis of 95 000 Men and Women

AU - Heikkilä, Katriina

AU - Madsen, Ida E H

AU - Nyberg, Solja T

AU - Fransson, Eleonor I

AU - Ahola, Kirsi

AU - Alfredsson, Lars

AU - Bjorner, Jakob B

AU - Borritz, Marianne

AU - Burr, Hermann

AU - Dragano, Nico

AU - Ferrie, Jane E

AU - Knutsson, Anders

AU - Koskenvuo, Markku

AU - Koskinen, Aki

AU - Nielsen, Martin L

AU - Nordin, Maria

AU - Pejtersen, Jan H

AU - Pentti, Jaana

AU - Rugulies, Reiner

AU - Oksanen, Tuula

AU - Shipley, Martin J

AU - Suominen, Sakari B

AU - Theorell, Töres

AU - Väänänen, Ari

AU - Vahtera, Jussi

AU - Virtanen, Marianna

AU - Westerlund, Hugo

AU - Westerholm, Peter J M

AU - Batty, G David

AU - Singh-Manoux, Archana

AU - Kivimäki, Mika

AU - IPD-Work Consortium

PY - 2014/2/18

Y1 - 2014/2/18

N2 - 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.

AB - 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.

KW - Female

KW - Humans

KW - Inflammatory Bowel Diseases

KW - Male

KW - Risk

KW - Stress, Psychological

KW - Work

U2 - 10.1371/journal.pone.0088711

DO - 10.1371/journal.pone.0088711

M3 - Journal article

C2 - 24558416

SN - 1932-6203

VL - 9

SP - 1

EP - 7

JO - PLoS Computational Biology

JF - PLoS Computational Biology

IS - 2

M1 - e88711

ER -

Job Strain and the Risk of Inflammatory Bowel Diseases: Individual-Participant Meta-Analysis of 95 000 Men and Women

Abstract

Keywords

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