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Biomedical subjects

T Theorell

Publications and source records attributed to T Theorell.

At least 73 records · Page 4Linked to original sources
PubMed1996

Musculoskeletal Disorders: Work-related Risk Factors and Prevention.

Work-related musculoskeletal disorders cause chronic pain and functional impairment, impose heavy costs on society, and reduce productivity. In this position paper from the Scientific Committee for Musculoskeletal Disorders of the ICOH, the most important risk factors at work are described. Work-related musculoskeletal disorders have high incidences and prevalences among workers who are exposed to manual handling, repetitive and static work, vibrations, and poor psychological and social conditions. The application of ergonomic principles in the workplace is the best method for prevention. International organizations should develop standards, common classifications, and terminologies. Surveillance systems should be further developed nationally and in workplaces, and more effort should be directed to information dissemination, education, and training.

Journal Article↗
PubMed1996

Long-term psychosocial work environment and cardiovascular mortality among Swedish men.

OBJECTIVES: This study examined the effect of cumulative exposure to work organization--psychological demands, work control, and social support on prospectively measured cardiovascular disease mortality risk. METHODS: The source population was a national sample of 12517 subjects selected from the Swedish male population by Statistics Sweden in annual surveys between 1977 and 1981. Over a 14-year follow-up period, 521 deaths from cardiovascular disease were identified. A nested case-control design was used. Work environment exposure scores were assigned to cases and controls by linking lifetime job histories with a job exposure matrix. RESULTS: Conditional logistic regression analysis was used in examining cardiovascular mortality risk in relation to work exposure after adjustment for age, year last employed, smoking, exercise, education, social class, nationality, and physical job demands. In the final multi-variable analysis, workers with low work control had a relative risk of 1.83 (95% confidence interval [CI] = 1.19, 2.82) for cardiovascular mortality. Workers with combined exposure to low control and low support had a relative risk of 2.62 (95% CI=1.22, 5.61). CONCLUSIONS: These results indicate that long-term exposure to low work control is a risk factor for cardiovascular disease mortality.

Adult↗
PubMed1995

Adaptedness and coping in dysphagic students.

Using a definition based on Bowlby and Pörn, an effort is made to interpret adaptedness and coping in 87 dysphagic students (corresponding to a prevalence of dysphagia in 9% of the boys and 12% of the girls) found in a screening study utilizing a questionnaire. Coping patterns and methods of adaptation were explored in a telephone interview with dysphagic students. Those who stated that their dysphagia influenced their daily living were classified as subjectively maladapted (S-maladapted; n = 9). Compared with the S-adapted students, the S-maladapted students reported more defects in ability to eat, more inappropriate beliefs about the causes and management of dysphagia, and greater desires regarding eating than S-adapted students (p < 0.05). The environmental conditions more often impaired the eating ability in S-maladapted students (p < 0.05). Anxiety at mealtime was reported more frequently than in S-adapted students (p < 0.05). Every second S-maladapted student had reduced self-esteem because of dysphagia (p < 0.05). The S-maladapted students had talked about their dysphagia with parents and/or friends and visited a school physician because of dysphagia more often than S-adapted students (p < 0.05). Two of 9 students felt confirmed by the physician and experienced help. There was concordance between the students' own beliefs regarding the causes of dysphagia and corresponding coping strategy.

Adaptation, Physiological↗
PubMed1995

Symptoms and personality in patients with chronic functional dyspepsia.

Twenty-five patients, 12 men and 13 women, aged 24-50 yr, who had consulted physicians and had received the diagnosis functional dyspepsia after extensive examination 6-8 years prior to this study, and were still suffering from this condition, were compared with community control subjects pair-wise matched for age and sex. Control subjects who had ever consulted a physician for gastrointestinal symptoms were excluded. Questionnaires measuring symptoms, job strain, social support and personality traits were used. Relatively few differences were found between groups. Compared to the community controls, however, the patients reported more gastrointestinal and nervous symptoms, and higher somatization, measured by Symptom Check List-90. The extent of reported overall distress was greater in patients than in control subjects. The detachment score (Karolinska Scales of Personality) was significantly lower in patients than in control subjects; this difference was also significant in separate analysis for men. Female patients had lower socialization and higher suspicion scores than female control subjects. Male patients reported more decision latitude (job control) than male control subjects.

Adult↗
PubMed1995

Psychological reactions in men screened for prostate cancer.

OBJECTIVE: To investigate the possible negative psychological impact of screening for prostate cancer with special focus on the impact of false positive and true positive test results. SUBJECTS AND METHODS: As part of an early detection study for prostate cancer psychological and psychophysiological reactions to various phases of the diagnostic procedures were examined in 2400 randomly selected men divided into various groups. Their psychophysiological reactions were assessed by measurements of serum cortisol and their psychological reactions by questionnaires directed at determining emotional states and sleep disturbance. In a stratified sample of the population (100 men) measurements were made at the time of the screening examination and again 2 weeks later. In patients undergoing biopsy (307 men) measurements were made 2 weeks after screening, but before they were informed of the biopsy results, and again 4 and 16 weeks after screening. RESULTS: Serum cortisol levels at the screening examination were higher than corresponding levels of a comparable sample of Swedish men during normal daily activity, indicating that an invitation to examination for prostate cancer per se might create emotional stress. Two weeks after the screening the elevated levels had decreased to normal. The highest cortisol levels were found in men who had undergone biopsy, immediately before they were informed of the results 2 weeks after screening. After they were informed, cortisol levels fell, regardless of the results of the biopsy. The patterns of emotional state and sleep disturbance were similar except that sleep disturbance was delayed. CONCLUSION: In screening programmes for prostate cancer it is important to define clearly the high-risk groups to minimize the risk of adverse psychological reactions in those subjects with a low risk of having the disease. The results also emphasize the need to reduce the number of false positive results by choosing diagnostic tests of high specificity. The interval between a test and informing the subject of the results should be minimized to decrease the duration of the increased emotional stress.

Aged↗
PubMed1995

Urinary excretion of catecholamines during the first months after delivery.

The urinary excretion of free catecholamines was assessed in 17 women 3 times after delivery; after 3 weeks, 6 weeks and 6 months, respectively. Relatively high levels were found both for adrenaline and noradrenaline excretion, on the first and third occasions, with significantly lowered levels on the second one. Mothers who had had a negative experience of their delivery (according to interview) as well as mothers who felt tired during the mid-phase of the follow-up (according to diaries) had very small variations in catecholamine excretion and did not show increased levels 6 months after delivery. Whether the mother experienced her infant as crying or not had no significant association with catecholamine output.

Crying↗
PubMed1995

Social support, job strain and musculoskeletal pain among female health care personnel.

OBJECTIVES: This study explored the relationship between psychosocial work environment and the musculoskeletal pain among health care personnel. MATERIALS AND METHODS: Ninety registered nurses and nurse's aides working in different hospitals in or just outside Stockholm and working in different kinds of care constituted the study group. Data were collected by means of questionnaires, including questions about symptoms (low-back pain, pain in the neck, and pain in the shoulders), the perception of social support from co-workers and superiors, conflicts, feelings of isolation, poor relations with superiors, psychological demands, authority over decisions, and skill utilization (job-strain factors). RESULTS: An ordinal univariate logistic regression analysis showed that psychological demands, authority over decisions, skill utilization, and support at work had a statistically significant effect on symptoms from the lower back, while symptoms from the neck and shoulders were related to support a work only. When support at work and job strain were entered into a multivariate logistic regression model, a difference in the patterns of associations between low-back pain and symptoms from the neck and shoulders was found. Symptoms from the back were significantly related to job strain--the higher the strain, the more symptoms in the low back. Symptoms from the neck and shoulders on the other hand were more associated with social support at work--the lower the support score the more severe the symptoms. CONCLUSIONS: Low-back pain seemed to be related to job strain, while symptoms from the neck and shoulders were to a greater extent related to relational and emotional factors.

Adult↗
PubMed1995

Physical strength and endurance in relation to perceived psychosocial work environment, sleep disturbance and coping strategies in men. Stockholm MUSIC I (MUsculo-Skeletal Intervention Centre) Study Group, Stockholm.

The study explored relationships between subjective descriptions of psychosocial work situation, sleep disturbance and coping patterns at work on the one hand and performance during a test of physical strength and perceived effort during a muscular endurance test on the other. The physical strength of the shoulders flexors was measured. The subjective degree of effort was rated 60 and 90 seconds after the beginning of a test of isometric endurance of the neck extensor muscles. Four samples with numbers of about 80 subjects each were studied, first of all one sample of men and one of women from the general working population and secondly a sample of "super male" workers (furniture removers) and a sample of "service oriented female" workers (medical secretaries). The findings indicated that there is a relationship among men between self-reported coping strategies at work and results in the physical tests. Thus, in the random sample of men, individuals who described open coping patterns were found to perceive more effort after one minute and also after one minute and a half of the physical endurance test and were also found to be physically stronger than other individuals. Those who described themselves as less supported socially than other men reported more subjective effort and tended to be physically stronger than other individuals. Among furniture removers, those who described that they had a high degree of covert coping tended to report a higher degree of subjective effort after one minute. Among men in both groups, a high degree of sleep disturbance tended to be associated with more perceived effort during the endurance test.(ABSTRACT TRUNCATED AT 250 WORDS)

Adaptation, Psychological↗
PubMed1995

[Work and health--new challenges for public health research and practice].

In a period of transition from industrial to post-industrial society with its focus on the service and information sector the nature of work is changing as well as the impact of work on human health. This paper describes leading concepts which were developed in social sciences to better account for this impact, especially so the so called job strain model. Moreover, it gives a selective, but representative review of recent empirical findings based on these concepts with coronary risk and disease as main outcome criteria. Finally, the paper discusses practical implications with regard to public health: preventive measures which aim at structural rather than individual intervention. The main focus of these measures is on work organisation and manpower policy.

Coronary Disease↗
PubMed1994

'Person under train' incidents from the subway driver's point of view--a prospective 1-year follow-up study: the design, and medical and psychiatric data.

UNLABELLED: From the subway driver's point of view, a 'person under train' (PUT) incident is a serious life event. This study focuses on the 1-yr consequences of such events. Follow-up was made 3 wk, 3 months and 1 yr after the event. 40 consecutive PUT subway drivers were followed. For each PUT driver, a control driver matched with regard to gender, age and country of birth was followed at identical intervals. MAIN RESULTS: the PUT group had significantly more sick days during the interval from the event to 3 wk later. During the period 3 wk to 3 months after the event no difference between the groups was observed. From 3 months to 1 yr after the PUT significantly more days were again reported by the PUT group. 38% in the PUT groups vs 14% in the control group had at least 1 month of sickness absence during this period. A mild acute psychophysiological reaction was observed 3 wk after the event, with elevated prolactin and increased sleep disturbance in the PUT group. Such acute reactions were transitory and not correlated with long-term sick leave, which was predicted independently, however, by a high plasma cortisol level (analysed in men) and a high depression score. Drivers in the group with seriously injured victims were absent from work for longer periods than drivers in the groups with mildly injured or dead victims. PUT victims described a successively worsened psychosocial work situation during the 12 months of follow-up whereas the drivers in the control group described an unchanged situation.

Absenteeism↗
PubMed1994

Job characteristics and the incidence of myocardial infarction.

In Sweden, there are large differences in the incidence of myocardial infarction (MI) among occupational groups. These differences may to some extent be due to work environment factors, including psychosocial job strain. The aim of the present study was to estimate the relative risk (RR) of MI for Swedish men and women in high strain occupations as compared to those in low strain occupations. The association between job strain and MI was studied by case-control methods. The study base comprised the population of four Swedish counties from 1976-1981 and of Stockholm county from 1976-1984. Incident cases of MI were identified through hospital discharges together with deaths. Information about occupation was obtained from the 1970 and the 1975 censuses and individuals were characterized with regard to job strain on the basis of their job title. In all, 9295 cases and 26 101 controls with unchanged type of occupation from 1970 to 1975 were included in the analyses. Men and women aged < 65 in high strain occupations showed an RR of 1.1-1.4, and men age < 55 an RR of 1.2-1.6 compared to those in low strain occupations. Similar results were obtained in analyses of male white and blue collar workers respectively. If the association between job strain and MI is causal this could be of great importance in explaining differences in MI incidence among occupational groups in Sweden.

Cross-Sectional Studies↗
PubMed1994

Coping style in relation to the consumption of factor concentrate in HIV-infected hemophiliacs during the years after their infection became known.

A psychosocial investigation offered to all HIV-infected men with moderately severe or severe hemophilia in Sweden was made in 1986. Most of these men had been infected in the years 1980-1984 and told about their own infection in 1985. A noninfected group of hemophiliacs was used as a reference group in the psychosocial investigation. A psychosocial prognosis was made on the basis of the coping style observed by means of the Coping Wheel. Among subjects who showed evidence of a passive-pessimistic copying style, there was a significant decrease in the number of factor concentrate units received in 1987 and 1988. Among subjects in the group with a more active-optimistic coping style, there was a tendency of increasing the use of factor concentrate during the years after the HIV-infection became known. This result indicates that awareness of HIV-infection may influence specific hemophilia behavior among subjects with passive-depressed copying style.

Adaptation, Psychological↗
PubMed1994

Psychosocial self-prognosis in relation to mortality and morbidity in hemophiliacs with HIV infection.

HIV-infected hemophiliacs participated in a psychosocial prognosis study. The Coping Wheel was filled out 1-2 years after the subjects had been told that they were HIV-infected and between 1 and 7 years after they had become infected. The number of significant signs of disease as well as mortality were recorded during the years following the psychosocial measurements. These measures were related to three measures of anticipated future activities derived from the Coping Wheel, namely 'number of activities for oneself', 'number of activities with others' and a combined measure 'number of activities for oneself in relation to number of activities with others'. The results indicated that the subject's own psychosocial prognosis added to the prediction of mortality. The most important psychosocial factor was the combined measure: those with few anticipated activities for oneself in relation to activities with others had a greater likelihood of dying soon during follow-up. The latter prediction was true even after adjustment for age and condition of the immune system (CD4 count) at the start of follow-up. The conclusion is that the Coping Wheel, applied as in the present examination, may be of help in prognosis and in identifying psychosocial needs in patients with HIV infection.

Adaptation, Psychological↗
PubMed1994

Lipid lowering through work stress reduction.

Swedish civil servants, who reported considerable stress while working in larger government authorities, were randomized into either a work stress reduction intervention or a control group. Four work units constituted the intervention group (n = 94). and one unit formed the control group (n = 35). Participants in the two groups were of similar age and two thirds were women. Psychosocial, lifestyle, and physiological assessments were made before, during, and after the 8-month intervention period. A significant decrease in apolipoprotein B/apolipoprotein A I ratio (p < 0.05) occurred in the intervention group but not in the control group. No changes were seen in either group in smoking, eating. exercise, relative weight, or other lifestyle factors. which could explain the lipid profile changes. Stimulation from and autonomy over work increased in the intervention group (p < 0.01) hut remained the same in the control group. Results have implications for the efficacy of work stress interventions in decreasing coronary risk.

Journal Article↗
PubMed1994

Mechanisms of cardiac risk among professional drivers.

This literature review indicates that professional drivers have excess cardiac risk that is not fully explained by standard risk factors. The contribution of occupation is suggested by two independent methods and by psychophysiological studies during on the job driving. Driving has been conceptualized as a threat-avoidance task. Stimuli encountered in traffic are not inherently aversive but become so by association with driving experience, a formulation corroborated by laboratory studies in which stimuli such as car headlights elicit cardiovascular hyperreactivity and electroencephalographic signs of arousal in professional drivers. More-advanced neurophysiological methods (event-related potentials) show higher cortical electronegativity to imperative signals among professional drivers than among non-driver referents. These data are viewed in light of reports of possible associations between event-related slow potentials and cardiac risk. A clinically and ecologically relevant neurocardiological model is proposed, and preventive strategies, including workplace interventions, are suggested.

Adult↗