Metabolic syndrome and poor self-rated health as risk factors for premature employment exit: a longitudinal study among 55 016 middle-aged and older workers from the Lifelines Cohort Study and Biobank.

BACKGROUND: Poor self-rated health (SRH) is a well-established risk factor for premature employment exit through unemployment, work disability, and early retirement. However, it is unclear whether the premature employment exit risk associated with underlying cardio-metabolic health conditions is fully captured by poor SRH. This study examines the metabolic syndrome (MetS), an early-stage risk factor for cardiovascular disease and type two diabetes mellitus, as a risk factor for premature employment exit while controlling for poor SRH. METHODS: We analyzed data from N = 55 016 Dutch workers (40-64 years) from five waves of the Lifelines Cohort Study and Biobank. MetS components were based on physical measures, blood markers, and medication use. SRH and employment states were self-reported. The associations between MetS, SRH, and premature employment exit types were analyzed using competing risk regression analysis. RESULTS: During 4.3 years of follow-up, MetS remained an independent risk factor for unemployment [adjusted subdistribution hazard ratio (SHR): 1.14, 95% CI: 1.03, 1.25] and work disability (adjusted SHR: 1.33, 95% CI: 1.11, 1.58) when adjusted for poor SRH, common chronic diseases related to labor market participation (i.e., cancer, musculoskeletal-, pulmonary-, and psychiatric diseases), and sociodemographic factors. MetS was not associated with early retirement. CONCLUSIONS: Poor SRH did not fully capture the risk for unemployment and work disability associated with MetS. More awareness about MetS as a 'hidden' cardio-metabolic risk factor for premature employment exit is needed among workers, employers, and occupational health professionals. Regular health check-ups including MetS assessment and MetS prevention might help to prolong healthy working lives.

Metabolic syndrome increases the risk for premature employment exit: A longitudinal study among 60 427 middle-aged and older workers from the Lifelines Cohort Study and Biobank.

OBJECTIVES: This study aimed to examine whether (i) metabolic syndrome (MetS) increases the risk for premature employment exit and (ii) a dose-response relationship exists between an increasing number of MetS components and premature employment exit among middle-aged and older workers. METHODS: A sample of N=60 427 Dutch workers (40-64 years old) from the Lifelines Cohort Study and Biobank were examined using data from five measurement waves during a total median follow-up time of 4.2 years. MetS components were based on physical measures, blood markers, and medication use. Premature employment exit types (ie, unemployment, work disability, and early retirement) were determined using questionnaires. MetS and number of MetS components were examined as risk factors for premature employment exit using competing risk regression analysis. RESULTS: MetS significantly increased the risk for work disability [adjusted sub distribution hazard ratio (SHR) 1.78, 95% confidence interval (CI) 1.54-2.05] and unemployment (adjusted SHR 1.16, 95% CI 1.06-1.26). A clear dose-response relationship was found for an increasing number of MetS components and work disability. No associations were found between MetS (components) and early retirement after adjusting for sociodemographic factors. CONCLUSIONS: MetS was identified as a modifiable early-stage cardio-metabolic risk factor especially for work disability and, to a lesser extent, for unemployment. Further, a clear dose-response relationship was found between an increasing number of MetS components and work disability. MetS interventions and prevention might help to prolong working lives. More awareness is needed among employers and occupational health professionals about the premature employment exit risk faced by middle-aged and older workers with MetS.

Context-dependent responses of terrestrial invertebrates to anthropogenic nitrogen enrichment: A meta-analysis.

Anthropogenic increases in nitrogen (N) concentrations in the environment are affecting plant diversity and ecosystems worldwide, but relatively little is known about N impacts on terrestrial invertebrate communities. Here, we performed an exploratory meta-analysis of 4365 observations from 126 publications reporting on the richness (number of taxa) or abundance (number of individuals per taxon) of terrestrial arthropods or nematodes in relation to N addition. We found that the response of invertebrates to N enrichment is highly dependent on both species' traits and local climate. The abundance of arthropods with incomplete metamorphosis, including agricultural pest species, increased in response to N enrichment. In contrast, arthropods exhibiting complete or no metamorphosis, including pollinators and detritivores, showed a declining abundance trend with increasing N enrichment, particularly in warmer climates. These contrasting and context-dependent responses may explain why we detected no overall response of arthropod richness. For nematodes, the abundance response to N enrichment was dependent on mean annual precipitation and varied between feeding guilds. We found a declining trend in abundance with N enrichment in dry areas and an increasing trend in wet areas, with slopes differing between feeding guilds. For example, at mean levels of precipitation, bacterivore abundance showed a positive trend in response to N addition while fungivore abundance declined. We further observed an overall decline in nematode richness with N addition. These N-induced changes in invertebrate communities could have negative consequences for various ecosystem functions and services, including those contributing to human food production.

El aumento de las concentraciones de nitrógeno en el medio ambiente de forma antropogénica está afectando a la diversidad vegetal y a los ecosistemas de todo el mundo, pero aún se sabe relativamente poco sobre su impacto en comunidades de invertebrados terrestres. En este trabajo realizamos modelos meta-analíticos para explorar el efecto del enriquecimiento de nitrógeno en comunidades de invertebrados terrestres a escala global. Para ello, utilizamos una base de datos proveniente de 4.365 observaciones pareadas correspondientes a 126 publicaciones que estudiaron el efecto del enriquecimiento de nitrógeno en la riqueza (número de taxones) y/o abundancia (número de individuos por taxón) de artrópodos y/o nematodos. Encontramos que la respuesta de los invertebrados al enriquecimiento de nitrógeno depende en gran medida tanto de los rasgos de las especies como del clima local. La abundancia de artrópodos con metamorfosis incompleta, incluyendo especies que pueden crear plagas agrícolas, aumentó en respuesta al enriquecimiento de nitrógeno. Por el contrario, los artrópodos con metamorfosis completa o nula, incluidos polinizadores y detritívoros, mostraron una tendencia negativa de su abundancia con respecto al aumento de nitrógeno, especialmente en climas más cálidos. Además, no detectamos una respuesta general de la riqueza de artrópodos posiblemente por la variabilidad en respuestas observadas, tanto negativas como positivas. En el caso de los nematodos, la respuesta de sus abundancias al enriquecimiento de nitrógeno fue dependiente de la precipitación media anual y de su grupo trófico. En general, observamos una respuesta negativa de la abundancia de nematodos al enriquecimiento de nitrógeno en zonas secas y una tendencia positiva en zonas más húmedas, pero además los diferentes grupos tróficos estudiados presentaron diferentes respuestas. Por ejemplo, la abundancia de bacterívoros mostró una tendencia positiva en respuesta al enriquecimiento de nitrógeno bajo niveles medios de precipitación, mientras que la abundancia de fungívoros disminuyó. Además, observamos un descenso general de la riqueza de nematodos con más enriquecimiento de nitrógeno. Estos cambios inducidos por el nitrógeno en las comunidades de invertebrados podrían tener consecuencias negativas para diversas funciones y servicios de los ecosistemas, incluyendo aquellos que contribuyen a la producción de alimentos.

Transitioning out of work and metabolic syndrome incidence: a longitudinal study among 13 303 older workers from the Lifelines Cohort Study and Biobank.

BACKGROUND: This study investigates (1) whether different employment transition types (ie, unemployment, work disability, early retirement and regular retirement) are associated with metabolic syndrome (MetS) incidence among older workers (50-64 years) and (2) whether occupational group moderates the association between employment transition type and MetS incidence. METHODS: A sample of 13 303 older Dutch workers from the Lifelines Cohort Study and Biobank was examined using longitudinal data from two comprehensive measurement waves with a mean follow-up time of 3.7 years. MetS components were based on physical measures, blood markers and medication use. Employment transitions were determined using questionnaires. Logistic regression analysis was performed to examine the association between employment transition type and MetS incidence. RESULTS: Older workers who transitioned from employment to unemployment (adjusted OR 1.39, 95% CI 1.05 to 1.82) or work disability (adjusted OR 1.89, 95% CI 1.15 to 3.10) had a significantly higher MetS incidence than the working control group. No association between early retirement or regular retirement with MetS incidence was found after adjusting for sociodemographic, educational and occupational factors. Occupational group did not moderate the association between employment transition type and MetS incidence. CONCLUSION: The results suggest that older workers who transition from employment to unemployment or work disability are at risk for developing MetS. More awareness among occupational physicians and general practitioners about MetS incidence in late working life is needed in general and more specific among older workers who transition into unemployment or work disability.

Metabolic syndrome incidence in an aging workforce: Occupational differences and the role of health behaviors.

This study investigates whether the incidence of metabolic syndrome (MetS), and its components, differs by occupational group among older workers (45-65 years) and whether health behaviors (smoking, leisure-time physical activity, diet quality, and alcohol consumption) can explain these differences. A sample of older workers (N = 34,834) from the North of the Netherlands was investigated. We analyzed data from two comprehensive measurement waves of the Lifelines Cohort Study and Biobank. MetS components were determined by physical measurements, blood markers, medication use, and self-reports. Occupational group and health behaviors were assessed by questionnaires. The association between occupational groups and MetS incidence was examined using logistic regression analysis. Health behaviors were subsequently added to the model to examine whether they can explain differences in MetS incidence between occupational groups. Low skilled white-collar (OR: 1.24; 95 % CI: 1.12, 1.37) and low skilled blue-collar (OR: 1.37; 95 % CI: 1.18, 1.59) workers had a significantly higher MetS incidence risk than high skilled white-collar workers. Similar occupational differences were observed on MetS component level. Combinations of unhealthy behaviors were more prevalent among blue-collar workers. MetS incidence in older workers differs between occupational groups and health behaviors explain a substantial part of these differences. Health promotion tailored to occupational groups may be beneficial specifically among older low skilled blue-collar workers. Research into other factors that contribute to occupational differences is needed as well as studies spanning the entire working life course.