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Workplace bullying and violence as risk factors for type 2 diabetes: a multicohort study and meta-analysis
Authors:Tianwei Xu  Linda L Magnusson Hanson  Theis Lange  Liis Starkopf  Hugo Westerlund  Ida E H Madsen  Reiner Rugulies  Jaana Pentti  Sari Stenholm  Jussi Vahtera  Åse M Hansen  Mika Kivimäki  Naja H Rod
Institution:1.Section of Social Medicine, Department of Public Health,University of Copenhagen,Copenhagen,Denmark;2.Stress Research Institute,Stockholm University,Stockholm,Sweden;3.Section of Biostatistics, Department of Public Health,University of Copenhagen,Copenhagen,Denmark;4.Center for Statistics Science, Peking University,Beijing,People’s Republic of China;5.National Research Centre for the Working Environment,Copenhagen,Denmark;6.Department of Psychology,University of Copenhagen,Copenhagen,Denmark;7.Department of Public Health,University of Turku,Turku,Finland;8.Turku University Hospital,Turku,Finland;9.Finnish Institute of Occupational Health,Tampere and Turku,Finland;10.Department of Epidemiology and Public Health,University College London,London,UK;11.Clinicum, Faculty of Medicine,University of Helsinki,Helsinki,Finland
Abstract:

Aims/hypothesis

The aim of this multicohort study was to examine whether employees exposed to social stressors at work, such as workplace bullying and violence, have an increased risk of type 2 diabetes.

Methods

The study included 45,905 men and women (40–65 years of age and free of diabetes at baseline) from four studies in Sweden, Denmark and Finland. Workplace bullying and violence were self-reported at baseline. Incident diabetes was ascertained through national health and medication records and death registers. Marginal structural Cox models adjusted for age, sex, country of birth, marital status and educational level were used for the analyses.

Results

Nine per cent of the population reported being bullied at work and 12% were exposed to workplace violence or threats of violence. Bullied participants had a 1.46 (95% CI 1.23, 1.74) times higher risk of developing diabetes compared with non-bullied participants. Exposure to violence or threats of violence was also associated with a higher risk of diabetes (HR 1.26 95% CI 1.02, 1.56]). The risk estimates attenuated slightly when taking BMI into account, especially for bullying. The results were similar for men and women, and were consistent across cohorts.

Conclusions/interpretation

We found a higher risk of incident type 2 diabetes among employees exposed to bullying or violence in the workplace. Further research is needed to determine whether policies to reduce bullying and violence at work may reduce the incidence of type 2 diabetes in working populations. Research on the mechanisms is also highly warranted.
Keywords:
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