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Long working hours, socioeconomic status, and the risk of incident type 2 diabetes: a meta-analysis of published and unpublished data from 222 120 individuals
journal contributionposted on 2015-10-29, 15:12 authored by Mika Kivimaki, Marianna Virtanen, Ichiro Kawachi, Mark Hamer
Background Working long hours might have adverse health effects, but whether this is true for all socioeconomic status groups is unclear. In this meta-analysis stratified by socioeconomic status, we investigated the role of long working hours as a risk factor for type 2 diabetes. Methods We identified four published studies through a systematic literature search of PubMed and Embase up to April 30, 2014. Study inclusion criteria were English-language publication; prospective design (cohort study); investigation of the effect of working hours or overtime work; incident diabetes as an outcome; and relative risks, odds ratios, or hazard ratios (HRs) with 95% CIs, or sufficient information to calculate these estimates. Additionally, we used unpublished individual-level data from 19 cohort studies from the Individual-Participant-Data Meta-analysis in Working-Populations Consortium and international open-access data archives. Effect estimates from published and unpublished data from 222 120 men and women from the USA, Europe, Japan, and Australia were pooled with random-effects meta-analysis. Findings During 1·7 million person-years at risk, 4963 individuals developed diabetes (incidence 29 per 10 000 personyears). The minimally adjusted summary risk ratio for long (≥55 h per week) compared with standard working hours (35–40 h) was 1·07 (95% CI 0·89–1·27, difference in incidence three cases per 10 000 person-years) with signifi cant heterogeneity in study-specific estimates (I²=53%, p=0·0016). In an analysis stratified by socioeconomic status, the association between long working hours and diabetes was evident in the low socioeconomic status group (risk ratio 1·29, 95% CI 1·06–1·57, diff erence in incidence 13 per 10 000 person-years, I²=0%, p=0·4662), but was null in the high socioeconomic status group (1·00, 95% CI 0·80–1·25, incidence diff erence zero per 10 000 person-years, I²=15%, p=0·2464). The association in the low socioeconomic status group was robust to adjustment for age, sex, obesity, and physical activity, and remained after exclusion of shift workers. Interpretation In this meta-analysis, the link between longer working hours and type 2 diabetes was apparent only in individuals in the low socioeconomic status groups.
Medical Research Council, European Union New and Emerging Risks in Occupational Safety and Health research programme, Finnish Work Environment Fund, Swedish Research Council for Working Life and Social Research, German Social Accident Insurance, Danish National Research Centre for the Working Environment, Academy of Finland, Ministry of Social Aff airs and Employment (Netherlands), Economic and Social Research Council, US National Institutes of Health, and British Heart Foundation.
- Sport, Exercise and Health Sciences
Published inThe Lancet Diabetes and Endocrinology
CitationKIVIMAKI, M. ... et al., 2014. Long working hours, socioeconomic status, and the risk of incident type 2 diabetes: a meta-analysis of published and unpublished data from 222 120 individuals. The Lancet Diabetes and Endocrinology, 3 (1), pp. 27–34.
Publisher© Kivimäki et al. Published by Elsevier.
- VoR (Version of Record)
Publisher statementThis work is made available according to the conditions of the Creative Commons Attribution 3.0 Unported (CC BY 3.0) licence. Full details of this licence are available at: http://creativecommons.org/licenses/by/3.0/
NotesAuthors include: Mika Kivimäki, Marianna Virtanen, Ichiro Kawachi, Solja T Nyberg, Lars Alfredsson, G David Batty, Jakob B Bjorner, Marianne Borritz, Eric J Brunner, Hermann Burr, Nico Dragano, Jane E Ferrie, Eleonor I Fransson, Mark Hamer, Katriina Heikkilä, Anders Knutsson, Markku Koskenvuo, Ida E H Madsen, Martin L Nielsen, Maria Nordin, Tuula Oksanen, Jan H Pejtersen, Jaana Pentti, Reiner Rugulies, Paula Salo, Johannes Siegrist, Andrew Steptoe, Sakari Suominen, Töres Theorell, Jussi Vahtera, Peter J M Westerholm, Hugo Westerlund, Archana Singh-Manoux, Markus Jokela. Open Access article distributed under the terms of CC BY.