Lifetime Exposure to Welding Fumes and Risk of Some Rare Cancers.

We investigated the association between exposure to welding fumes and the risk of biliary tract, male breast, bone, and thymus cancer, as well as cancer of the small intestine, eye melanoma, and mycosis fungoides, among men in a European, multicenter case-control study. From 1995-1997, 644 cases and 1,959 control subjects from 7 countries were studied with respect to information on welding and potential confounders. We linked the welding histories of the participants with a measurement-based exposure matrix to calculate lifetime exposure to welding fumes. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression models, conditional on country and 5-year age groups, and adjusted for education and relevant confounders. Regular welding was associated with an increased risk of cancer of the small intestine (OR = 2.30, 95% CI: 1.17, 4.50). Lifetime exposure to welding fumes above the median of exposed controls was associated with an increased risk of cancer of the small intestine (OR = 2.00, 95% CI: 1.07, 3.72) and male breast (OR = 2.07, 95% CI: 1.14, 3.77), and some elevation in risk was apparent for bone cancer (OR = 1.92, 95% CI: 0.85, 4.34) with increasing lifetime exposure to welding fumes. Welding fumes could contribute to an increased risk of some rare cancers.

Safety of Nicotine Replacement Therapy during Pregnancy: A Narrative Review.

BACKGROUND: Smoking during pregnancy is a public health problem worldwide and the leading preventable cause of fetal morbidity and mortality and obstetric disease. Although the risk of tobacco-related harm can be substantially reduced if mothers stop smoking in the first trimester, the proportion of women who do so remains modest; therefore, the treatment of smoking in pregnant women will be the first therapeutic measure that health professionals should adopt when providing care to pregnant women. The recommendation of nicotine replacement therapy during pregnancy remains controversial due to the potential effects on the health of the fetus. PURPOSE: The aim of this review was to provide an overview of human studies about the use of nicotine replacement therapy during pregnancy, evaluating the efficacy and safety of the different formulations. METHODS: The electronic databases PubMed and EMBASE were searched from May 2012 to May 2022. A total of 95 articles were identified through database searching using a combination of keywords. Out of 79 screened articles and after the removal of duplicates, 28 full-text articles were assessed for eligibility and 12 articles were finally included for review. RESULTS: Although demonstrated to be effective in adult smokers, evidence in support of NRT in pregnant women is limited. The results of the apparent safety of the use of NRT during pregnancy contradict the FDA classification of the different NRT formulations. Faster-acting formulations seem to be the safest and even most beneficial forms for the offspring. CONCLUSIONS: NRT is not completely harmless for the fetus or for the mother; however, if an adequate assessment of the risk-benefit binomial is made, its use during pregnancy to aid in quitting smoking does seem appropriate. It is necessary to establish individual recommendations on the formulation and dose to be used during pregnancy based on individual nicotinic needs.

Labour market affiliation among non-bullied colleagues at work units with reported bullying.

AIM: This study investigates if non-bullied employees in Work units (WUs) where bullying occur, are more prone to leave the WUs than employees in WUs with no bullying, and if the prevalence of workplace bullying had an impact on leaving the WUs. Leaving the workplace was defined by unemployment or change of workplace at follow-up. METHODS: We had data from 8326 Danish public health invited employees from 302 WUs. Of these 3036 responded to a questionnaire on working conditions and health in 2007. WUs were classified into three categories of WUs: (1) no bullying (0% bullied), (2) moderate prevalence of bullying (< 10% bullied), and (3) high prevalence of bullying (≥ 10% bullied). Bullied respondents were used to classify the WUs and excluded in the analyses. RESULTS: We found odds ratios (ORs) for unemployment 1 year later of 1.27 [95% CI 0.69-2.37] in WUs with moderate prevalence of bullying and 1.38 [95% CI 0.85-2.23] among employed in WUs with high prevalence of bullying, adjusted for size of WUs, age, sex, and job category. For turnover 1 year later the ORs were 1.27 [95% CI 0.78-2.15] and 1.46 [95% CI 0.99-2.15] in WUs with moderate and high prevalence of bullying, respectively. CONCLUSION: We did not find that non-bullied employees leave the WUs with moderate and high prevalence of bullying more than employees in WUs with no bullying behaviour 1 year later. Leaving the workplace tended to be higher among employees in WUs with high prevalence of bullying compared to no and moderate bullying.

The Effect of Psychosocial Work Factors on Headache: Results From the PRISME Cohort Study.

OBJECTIVE: To investigate the cross-sectional and longitudinal association between psychosocial work factors, assessed as work-unit averages, and headache. For comparison, we also applied individual exposure measures. METHODS: We used questionnaire-data on headache and psychosocial work factors (PWF). In total, 2247 employees were included in the cross-sectional analyses and 553 in the longitudinal analyses using work-unit averages. The corresponding numbers for the analyses using individual exposure measures were 4261 and 942 employees. RESULTS: Low skill discretion and low decision authority were most consistently associated with higher odds of headache across all analyses. Role conflicts, bullying, and effort-reward imbalance were associated with headache in some analyses. All PWF were associated with headache in cross-sectional analyses with individual exposure measures. CONCLUSION: This study partly supports the hypothesis of an effect of PWF, as a source of psychological stress, on the risk of headache.

Rare cancers of unknown etiology: lessons learned from a European multi-center case-control study.

Rare cancers together constitute one fourth of cancers. As some rare cancers are caused by occupational exposures, a systematic search for further associations might contribute to future prevention. We undertook a European, multi-center case-control study of occupational risks for cancers of small intestine, bone sarcoma, uveal melanoma, mycosis fungoides, thymus, male biliary tract and breast. Incident cases aged 35-69 years and sex-and age-matched population/colon cancer controls were interviewed, including a complete list of jobs. Associations between occupational exposure and cancer were assessed with unconditional logistic regression controlled for sex, age, country, and known confounders, and reported as odds ratios (OR) with 95% confidence intervals (CI). Interviewed were 1053 cases, 2062 population, and 1084 colon cancer controls. Male biliary tract cancer was associated with exposure to oils with polychlorinated biphenyls; OR 2.8 (95% CI 1.3-5.9); male breast cancer with exposure to trichloroethylene; OR 1.9 (95% CI 1.1-3.3); bone sarcoma with job as a carpenter/joiner; OR 4.3 (95% CI 1.7-10.5); and uveal melanoma with job as a welder/sheet metal worker; OR 1.95 (95% CI 1.08-3.52); and cook; OR 2.4 (95% CI 1.4-4.3). A confirmatory study of printers enhanced suspicion of 1,2-dichloropropane as a risk for biliary tract cancer. Results contributed to evidence for classification of welding and 1,2-dichloropronane as human carcinogens. However, despite efforts across nine countries, for some cancer sites only about 100 cases were interviewed. The Rare Cancer Study illustrated both the strengths and limitations of explorative studies for identification of etiological leads.

Turning the tide: reducing mortality among Danish merchant seafarers.

OBJECTIVES: While life at sea traditionally has presented a variety of potential hazards, rigorous measures have been taken in the past decades to ensure the safety and health of all aboard merchant ships. The aim of this study was to examine overall and cause-specific mortality among Danish seafarers in light of these changes. METHODS: A cohort of 44 555 male (75%) and female (25%) seafarers employed on Danish ships during 1986-1999 was established through records from the Danish Seafarer Registry. Subsequently, information on vital status and causes of death was linked to members of the cohort from the Danish Civil Registration System and the Danish Register of Causes of Death using unique personal identification numbers. Standardized mortality ratios (SMRs) were calculated for the seafarers using rates from a sample of the Danish employed population. RESULTS: Among seafarers with first employment prior to 1992, the overall mortality was high, with increases observed for many individual causes of death (overall SMR 1.78, 95% CI 1.72 to 1.83 for male seafarers; SMR 1.61, 95% CI 1.48 to 1.75 for female seafarers). Mortality among seafarers employed in the following period was reduced, with only a slight remaining excess of deaths. This excess in mortality was evident primarily among non-officers on board tankers and smaller ships. CONCLUSIONS: During recent decades, mortality among seafarers has changed, replacing the traditional image of a high-risk profession with almost normalised figures compared with the general working population. Marked imbalances in mortality according to job and ship categories have persisted though.

The longitudinal association between shift work and headache: results from the Danish PRISME cohort.

PURPOSE: We investigated the effect of shift work on headache. Furthermore, we investigated whether the association between shift work and headache was explained by potential mediators in terms of perceived stress, poor sleep and health behaviors. METHODS: In this longitudinal study, we used questionnaire data (collected in 2007 and 2009) from civil servants and hospital employees from the PRISME study. 2952 individuals were available for the analyses of shift work and headache and 2272 individuals were available for the analyses of shift work and migraine. Headache was operationalized as the participants' experience of "being bothered by headache during the past 4 weeks". Migraine was operationalized as "ever being diagnosed with migraine by a medical doctor". We used binary logistic regression to compare shift workers with permanent day workers and adjusted for socio-demographic factors. In a subsequent step, we adjusted for potential mediators. RESULTS: We found higher odds of unspecific headache (OR = 1.25; 95% CI 1.02-1.54) and migraine (OR = 1.72; 95% CI 1.04-2.86) among shift workers compared with day workers. Our results suggest that the effect of shift work on headache and migraine differ between men and women. Inclusion of potential mediators in the analyses did not attenuate the associations. CONCLUSION: Shift workers have higher risk of reporting being bothered by headache as well as reporting being diagnosed with migraine. Future research is needed to disentangle the underlying mechanisms with the aim of reducing headache related to occupational exposures.

Tobacco smoking and alcohol consumption as risk factors for thymoma - A European case-control study.

PURPOSE: Hardly anything is known about the aetiology of thymoma. This paper presents data regarding tobacco smoking and alcohol consumption in relation to thymoma from the first case-control study performed on this rare tumour. METHODS: A European multi-centre case-control study including incident cases aged 35-69 years with thymoma between 1995 and 1997, was conducted in seven countries. A set of controls, used in seven parallel case-control studies by the same research group was used, including population-based controls from five countries and hospital controls with colon cancer from two countries. Altogether 103 cases, accepted by a reference pathologist, 712 colon cancer controls, and 2071 population controls were interviewed. RESULTS: Tobacco smoking was moderately related with thymoma (OR 1.4, 95% CI 0.9-2.2), and a tendency to dose-response was shown (p = 0.04), with an increased risk for heavy smokers defined as ≥41 pack-years (OR 2.1, 95% CI 1.1-3.9). A high consumption of spirits defined as ≥25 g of alcohol per day was associated with an increased risk of thymoma (OR 2.4, 95% CI 1.1-5.4), whereas no association was found with beer or wine. CONCLUSIONS: Tobacco smoking and a high intake of spirits were indicated as risk factors for thymoma.

Emotional demands and exhaustion: cross-sectional and longitudinal associations in a cohort of Danish public sector employees.

PURPOSE: To examine cross-sectional and longitudinal associations between content-related emotional demands at work and exhaustion, and to investigate if these associations were modified by other psychosocial work characteristics. METHODS: In 2007, 4489 Danish public service employees participated in the PRISME study by completing postal questionnaires, and 3224 participated in the follow-up in 2009. Content-related emotional demands were measured by a scale (scored 1 to 5) based on five work-content-related items, and exhaustion was measured with the general exhaustion scale from the Copenhagen Burnout Inventory (CBI) (scored 1 to 5). The cross-sectional and longitudinal associations with exhaustion were analysed in the same model and adjusted for effects of potential confounders. Effect modifications were examined separately for self-reported emotional enrichment, meaningful work, job control, social support at work and quantitative demands. RESULTS: Exhaustion increased with increasing emotional demands, both cross-sectionally and longitudinally. However, although statistically significant, the effect was small. In the longitudinal analysis, a one unit increase in emotional demands was associated with a 0.03 unit (95% CI: 0.01-0.06) increase in exhaustion. We found statistically significant effect modification for three of six potentially modifying work characteristics. The effect of emotional demands on exhaustion was lower for participants with high levels of emotional enrichment (cross-sectionally and longitudinally), high levels of meaningful work (longitudinally), and higher for high levels of quantitative demands (cross-sectionally). CONCLUSIONS: Increasing content-related emotional demands were associated with increasing levels of exhaustion, cross-sectionally and longitudinally. This effect was reduced if the work was experienced as emotionally enriching and meaningful.

Latent toxoplasmosis and psychiatric symptoms - A role of tryptophan metabolism?

Toxoplasma gondii (TOX) is a common parasite which infects approximately one third of the human population. In recent years, it has been suggested that latent toxoplasmosis may be a risk factor for the development of mental disorders, particularly schizophrenia and anxiety. With regards to depression the results have been varied. The main objective of this study was to examine subpopulations from the Danish PRISME and GENDEP populations for TOX IgG antibodies. These consisted of: a group with symptoms of anxiety, a group suffering from burnout syndrome, as well as two different subpopulations with depression of differing severity. The secondary objective of this study was to examine whether tryptophan metabolism was altered in TOX-positive subjects within each subpopulation. Our results show that the anxiety and burnout populations were more likely to be TOX IgG seropositive. Furthermore, we find that the moderate-severe but not mild-moderate depressive subpopulation were associated with TOX seropositivety, suggesting a possible role of symptom severity. Additionally, we found that TOX positive subjects in the anxiety and burnout subpopulations had altered tryptophan metabolism. This relationship did not exist in the mild-moderate depressive subpopulation. These results suggest that TOX seropositivity may be related to anxiety, burnout and potentially to severity of depression. We furthermore show that the psychiatric symptoms could be associated with an altered tryptophan metabolism.

Colon cancer patients with a serious psychiatric disorder present with a more advanced cancer stage and receive less adjuvant chemotherapy - A Nationwide Danish Cohort Study.

BACKGROUND: Psychiatric patients with colorectal cancer may have delayed diagnosis and be oncologically undertreated. METHODS: The Danish Colorectal Cancer Group database comprised 25,194 colorectal cancer patients (CRC), (colon cancer (CC, n = 16,641), rectal cancer (RC, n = 8553)), having an operation in 2007-2013, were alive at least 30 days after operation, of which 422 have had at least one hospital contact for a serious psychiatric disorder; ICD-10: DF20-29: primary psychotic disorders, or DF30-39: affective disorders (exposed) in a period of 3650-120 days before the operation date. Pearson chi-squared test for cancer stage was calculated. Odds Ratio (OR) with 95% confidence interval (CI) for having had a palliative vs an intended curative aim of the operative treatment for CRC patients (cohort 1), and for having an oncological treatment for each cancer site CC or RC (cohort 2 and 3) in patients with and without a psychiatric history was estimated. We adjusted the OR for: age, gender, comorbidity index, cancer stage, socio-economic position group, and educational level. RESULTS: A higher cancer stage at the time of operation in patients with psychiatric disorders compared with patients without such a history was seen and may possibly point towards a delay in the diagnosis or in the treatment of CC in patients with psychiatric disorders. They also had decreased adjusted OR for having an oncological treatment, OR 0.55, 95% CI (0.40-0.76)), which was not explained by cancer stage. For patients with RC no difference was seen. CONCLUSIONS: Attention for CC patients with pre-existing serious psychiatric disorders is recommended.

Cancer incidence among merchant seafarers: an extended follow-up of a Danish cohort.

OBJECTIVES: While maritime safety generally has improved dramatically over the last century, modern seafarers are still faced with numerous occupational hazards potentially affecting their risk of chronic diseases such as cancer. The aim of this study is to offer updated information on the incidence of specific cancers among both male and female seafarers. METHODS: Using records from the Danish Seafarer Registry, all seafarers employed on Danish ships during 1986-1999 were identified, resulting in a cohort of 33 084 men and 11 209 women. Information on vital status and cancer was linked to each member of the cohort from the Danish Civil Registration System and the Danish Cancer Registry using the unique Danish personal identification number. SIRs were estimated for specific cancers using national rates. RESULTS: The overall incidence of cancer was increased for both male and female seafarers (SIR 1.19, 95% CI 1.15 to 1.23, and SIR 1.14, 95% CI 1.07 to 1.22) compared with the general population. This excess was primarily driven by increases in gastrointestinal, respiratory and genitourinary cancers. In addition, male seafarers working in areas with asbestos exposure showed significantly increased risk of mesothelioma. Finally, the male seafarers had an increased risk of lip cancer. CONCLUSIONS: The majority of cancers among seafarers continue to be lifestyle-related. However, occupational exposure to asbestos and ultraviolet radiation seems to affect the cancer pattern among the male seafarers as well.

Occupational exposure to organic solvents and risk of male breast cancer: a European multicenter case-control study.

Objectives The etiology of male breast cancer (MBC) is largely unknown but a causal role of exposure to organic solvents has been suggested. Previous studies on occupational risk factors of breast cancer were often restricted to women who are frequently exposed to lower levels and at a lower frequency than men. We investigated the association between MBC and occupational exposure to petroleum and oxygenated and chlorinated solvents in a multicenter case-control study of rare cancers in Europe. Methods The study included 104 MBC cases and 1901 controls. Detailed lifetime work history was obtained during interviews, together with sociodemographic characteristics, medical history and lifestyle factors. Occupational exposures to solvents were estimated from a job-exposure matrix. Odds ratios (OR) and their 95% confidence intervals (CI) were calculated using unconditional logistic regression models. Results Lifetime cumulative exposure to trichloroethylene >23.9 ppm years was associated with an increased MBC risk, compared to non-exposure [OR (95% CI): 2.1 (1.2-4.0); P trend <0.01). This increase in risk persisted when only exposures that occurred ≥10 years before diagnosis were considered. In addition, a possible role for benzene and ethylene glycol in MBC risk was suggested, but no exposure-response trend was observed. Conclusions These findings add to the evidence of an increased risk of breast cancer among men professionally exposed to trichloroethylene and possibly to benzene or ethylene glycol. Further studies should be conducted in populations with high level of exposure to confirm our results.

Does Workplace Bullying Affect Long-Term Sickness Absence Among Coworkers?

AIM: To examine if non-bullied employees at work units (WUs) with workplace bullying have more long-term sickness absence (LTSA) than employees in non-bullying WUs. METHODS: We included 7229 public health employees from 302 WUs and 3158 responders to a questionnaire on working conditions and health in 2007. WUs were classified into three categories of WUs; (1) no bullying (0% bullied); (2) moderate prevalence of bullying (less than 10% bullied); and (3) high prevalence of bullying (more than or equal to 10% bullied). LTSA (more than or equal to 30 consecutive days of sickness absence) during the following 2 years was obtained by linkage to the Danish register of sickness absence compensation benefits and social transfer payments. RESULTS: Non-bullied coworkers in WUs, where bullying was reported had 15% to 22% more LTSA compared with non-bullying WUs. CONCLUSION: Workplace bullying may be associated with LTSA in the entire WU.

The associations between workplace bullying, salivary cortisol, and long-term sickness absence: a longitudinal study.

BACKGROUND: Workplace stressors, such as bullying, are strongly related to subsequent long-term sickness absence, but little is known of the possible physiological mechanisms linking workplace stressors and sickness absence. The primary aim of this study was to investigate to what extent cortisol levels were associated with subsequent sickness absence and if cortisol mediated the association between workplace bullying and sickness absence. We additionally investigated possible bidirectional associations between bullying, cortisol, and long-term sickness absence. METHODS: Participants came from two Danish cohort studies, the "Psychosocial RIsk factors for Stress and MEntal disease" (PRISME) cohort and the "Workplace Bullying and Harassment" (WBH) cohort (n = 5418). Information about exposure to workplace bullying and morning and evening salivary cortisol was collected at three time points with approximately two years in between. After each data collection, all participants were followed for two years in registers, and cases with long-term sickness absence lasting 30 or more consecutive days were identified. The association between cortisol levels and subsequent sickness absence was assessed by logistic regression, while the extent to which the association between bullying and sickness absence was mediated by cortisol was quantified through natural direct and indirect effects. RESULTS: High evening cortisol was associated with a decreased risk of sickness absence (OR = 0.82, 95% CI = 0.68-0.99), but we did not find that high morning cortisol levels (OR = 0.98, 95% CI = 0.81-1.18) or high morning-to-evening slope (OR = 0.99, 95% CI = 0.82-1.18) were associated with subsequent sickness absence. We also tested for reverse causation and found that long-term sickness absence, but not salivary cortisol, was a strong risk factor for subsequent workplace bullying. There was no indication that cortisol mediated the association between workplace bullying and sickness absence. CONCLUSION: We found no straightforward and simple association between cortisol and long-term sickness absence. Furthermore, the association between workplace bullying and long-term sickness absence was not mediated by cortisol.

The Role of Psychological Stress Reactions in the Longitudinal Relation Between Workplace Bullying and Turnover.

OBJECTIVES: To investigate the association between workplace bullying and change of job/unemployment, and to investigate whether psychological stress reactions constitute a potential pathway linking workplace bullying and change of job/unemployment. METHODS: We used questionnaire data on workplace bullying and psychological stress reactions and register data on change of job/unemployment. We applied a multiple pathway approach to estimate the proportion of the association between workplace bullying and subsequent change of job/unemployment that was potentially mediated by psychological stress reactions. RESULTS: Workplace bullying was associated with risk of change of job (odds ratio [OR] = 1.35; 95% confidence interval [CI]: 1.06-1.72; 24% potentially mediated by psychological stress reactions) and unemployment (OR = 4.90; 95% CI: 3.18-7.55; 19% potentially mediated by psychological stress reactions). CONCLUSION: Workplace bullying has important consequences for labor market outcomes. Psychological stress reactions may play a vital role in this process.

Prolonged perceived stress and saliva cortisol in a large cohort of Danish public service employees: cross-sectional and longitudinal associations.

PURPOSE: It is well known that acute stress can lead to a transient increase in cortisol secretion, but the effects of prolonged stress on cortisol secretion are uncertain. This study examines the cross-sectional and longitudinal associations between prolonged perceived stress and salivary cortisol. METHODS: In 2007, 4467 Danish public service employees participated in a study of stress and mental health, and 3217 participated in a follow-up in 2009. Perceived stress during the past 4 weeks was assessed by Cohen's four item perceived stress scale. Participants were asked to collect saliva 30 min after awakening and at approximately 20:00 in the evening. The cortisol dependence on perceived stress was examined in regression analyses adjusted for effects of potential confounders. We adjusted for a large variation in saliva sampling times by modelling the time trajectory of cortisol concentrations in the morning and in the evening and examined if they were influenced by perceived stress. RESULTS: Perceived stress had no statistically significant effects on the level or time trajectory of morning or evening cortisol, neither cross-sectionally nor longitudinally. The 1 month prevalence of frequently perceived stress was low, approximately 2.5%. CONCLUSION: Our results did not support the hypothesis that prolonged perceived stress is associated with the level or time trajectory of morning or evening salivary cortisol.

Potential exposure to endocrine disrupting chemicals and selected adverse pregnancy outcomes: a follow-up study of pregnant women referred for occupational counselling.

BACKGROUND: Experimental evidence indicates that fetal exposure to xenobiotics with the potential to interfere with the endogenous steroid hormone regulation of fetal development may reduce birth weight. However, epidemiological studies are limited. The aim of the study was to investigate whether potential occupational exposure to endocrine disrupting chemicals (EDC) of the mother during pregnancy is associated with preterm birth and low birth weight. METHODS: Pregnant women referred to an Occupational Health Clinic (OHC) in two Danish regions (Copenhagen or Aarhus) between 1984 and 2010, suspected of being exposed to occupational reproductive hazards were included in the study. A job exposure matrix enabled estimation of potential occupational exposure to EDC on the basis of job title. Births by women potentially exposed to EDC (n = 582) were compared to births by women referred to an OHC on the suspicion of other exposures than EDC (n = 620), and to a sample of births by all occupationally active women in the same geographical regions (n = 346,544), including 1,077 births of the referred women's non-referred pregnancies. RESULTS: No indications of reduced birth weight or increased risk of preterm birth were found among women potentially exposed to EDC. Women potentially exposed to EDC had children with a higher birth weight compared to the sample of occupationally active women but not compared to other women referred to an OHC. CONCLUSIONS: Potential maternal exposure to EDC at Danish workplaces is not related to low birth weight or preterm birth among women referred to occupational counselling. Occupational exposures might be too weak on the average to cause these adverse effects or counselling at the OHCs is effective in preventing them.

Association analyses of depression and genes in the hypothalamus-pituitary-adrenal axis.

OBJECTIVE: Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis has been reported in depression. The aim was to investigate the potential association between depression and seven genes regulating or interfering with the HPA axis, including the gene encoding angiotensin converting enzyme (ACE). METHODS: In total, 78 single nucleotide polymorphisms (SNPs) and one insertion/deletion polymorphism were genotyped. The study included 408 individuals with depression and 289 controls. In a subset of cases, the interaction between genetic variants and stressful life events (SLEs) was investigated. RESULTS: After quality control, 68 genetic variants were left for analyses. Four of nine variants within ACE were nominally associated with depression and a gene-wise association was likewise observed. However, none of the SNPs located within AVP, CRH, CRHR1, CRHR2, FKBP5 or NC3C1 were associated with depression. One nominally significant interaction, most likely due to chance, was identified. CONCLUSION: The results indicate that ACE could be a potential candidate gene for depression.

Emotional Demands at Work and the Risk of Clinical Depression: A Longitudinal Study in the Danish Public Sector.

OBJECTIVE: This study is a 2-year follow-up study of different dimensions of work-related emotional demands as a predictor for clinical depression. METHODS: In a two-wave study, 3224 (72%) public employees from 474 work-units participated twice by filling in questionnaires. Sixty-two cases of clinical depression were diagnosed. Emotional demands were examined as perceived and content-related emotional demands, individually reported and work-unit based. Support, meaningful work, and enrichment were considered as potential effect modifiers. RESULTS: Individually reported perceived emotional demands predicted depression (odds ratio: 1.40; 95% confidence intervals: 1.02 to 1.92). The work-unit based odds ratio was in the same direction, though not significant. Content-related emotional demands did not predict depression. Support, meaningful work, and enrichment did not modify the results. CONCLUSIONS: The personal perception of emotional demands was a risk factor for clinical depression but specific emotionally demanding work tasks were not.