Evidence map›Paper›PMID 25262544›Full record

SynthesisThe lancet. Diabetes & endocrinology2015

Long working hours, socioeconomic status, and the risk of incident type 2 diabetes: a meta-analysis of published and unpublished data from 222 120 individuals.

Mika Kivimäki, Marianna Virtanen, Ichiro Kawachi, Solja T Nyberg, Lars Alfredsson, G David Batty, Jakob B Bjorner, Marianne Borritz, Eric J Brunner, Hermann Burr and 24 more

Abstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The lancet. Diabetes & endocrinology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 123 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
123citing papers in PubMed, 7 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

123 citing papers in PubMed, 7 syntheses or guidelines pooled it.

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  7. Job insecurity and risk of diabetes: a meta-analysis of individual participant data.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2016
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63 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

34 authors.

Mika KivimäkiDepartment of Epidemiology and Public Health, University College London, London, UK; Hjelt Institute, Medical Faculty, University of Helsinki, Helsinki, Finland. Electronic address: m.kivimaki@ucl.ac.uk.
Marianna VirtanenFinnish Institute of Occupational Health, Helsinki, Tampere, and Turku, Finland.
Ichiro KawachiHarvard School of Public Health, Department of Society, Human Development and Health, Boston, MA, USA.
Solja T NybergFinnish Institute of Occupational Health, Helsinki, Tampere, and Turku, Finland.
Lars AlfredssonCentre for Occupational and Environmental Medicine, Stockholm County Council, Sweden; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
G David BattyDepartment of Epidemiology and Public Health, University College London, London, UK; Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK; Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, UK.
Jakob B BjornerNational Research Centre for the Working Environment, Copenhagen, Denmark.
Marianne BorritzDepartment of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark.
Eric J BrunnerDepartment of Epidemiology and Public Health, University College London, London, UK.
Hermann BurrFederal Institute for Occupational Safety and Health, Berlin, Germany.
Nico DraganoInstitute for Medical Sociology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany.
Jane E FerrieDepartment of Epidemiology and Public Health, University College London, London, UK; School of Social and Community Medicine, University of Bristol, Bristol, UK.
Eleonor I FranssonInstitute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; School of Health Sciences, Jönköping University, Jönköping, Sweden; Stress Research Institute, Stockholm University, Stockholm, Sweden.
Mark HamerDepartment of Epidemiology and Public Health, University College London, London, UK.
Katriina HeikkiläFinnish Institute of Occupational Health, Helsinki, Tampere, and Turku, Finland; School of Medicine, University of Tampere, Tampere, Finland.
Anders KnutssonDepartment of Health Sciences, Mid Sweden University, Sundsvall, Sweden.
Markku KoskenvuoDepartment of Public Health, University of Helsinki, Helsinki, Finland.
Ida E H MadsenNational Research Centre for the Working Environment, Copenhagen, Denmark.
Martin L NielsenDepartment of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark.
Maria NordinDepartment of Psychology, Umeå University, Umeå, Sweden.
Tuula OksanenFinnish Institute of Occupational Health, Helsinki, Tampere, and Turku, Finland.
Jan H PejtersenDanish National Centre for Social Research, Copenhagen, Denmark.
Jaana PenttiFinnish Institute of Occupational Health, Helsinki, Tampere, and Turku, Finland.
Reiner RuguliesNational Research Centre for the Working Environment, Copenhagen, Denmark; Department of Public Health and Department of Psychology, University of Copenhagen, Copenhagen, Denmark.
Paula SaloFinnish Institute of Occupational Health, Helsinki, Tampere, and Turku, Finland; Department of Psychology, University of Turku, Turku, Finland.
Johannes SiegristInstitute for Medical Sociology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany.
Andrew SteptoeDepartment of Epidemiology and Public Health, University College London, London, UK.
Sakari SuominenFolkhälsan Research Center, Helsinki, Finland; Nordic School of Public Health, Göteborg, Sweden; Department of Public Health, University of Turku, Turku, Finland.
Töres TheorellStress Research Institute, Stockholm University, Stockholm, Sweden.
Jussi VahteraFinnish Institute of Occupational Health, Helsinki, Tampere, and Turku, Finland; Department of Public Health, University of Turku, Turku, Finland; Turku University Hospital, Turku, Finland.
Peter J M WesterholmOccupational and Environmental Medicine, Uppsala University, Uppsala, Sweden.
Hugo WesterlundStress Research Institute, Stockholm University, Stockholm, Sweden.
Archana Singh-ManouxDepartment of Epidemiology and Public Health, University College London, London, UK; Inserm U1018, Centre for Research in Epidemiology and Population Health, Villejuif, France.
Markus JokelaInstitute of Behavioral Sciences, University of Helsinki, Helsinki, Finland.

Funding

STATISTICS COREP01AG020166 · NIA · UNIVERSITY OF WISCONSIN-MADISON · PI RYFF, CAROL D. · 2002 to 2015
$50.6M
Socioeconomic gradient in CHD in early old ageR01HL036310 · NHLBI · UNIVERSITY OF LONDON · PI KIVIMAKI, MIKA J, MARMOT, MICHAEL G · 1986 to 2012
$3.1M
Health behaviors over the adult lifecourse and cognitive agingR01AG034454 · NIA · UNIVERSITY COLLEGE LONDON · PI KIVIMAKI, MIKA J, SINGH-MANOUX, ARCHANA · 2009 to 2013
$1.5M
British Heart Foundation RG/13/2/30098Medical Research Council G0100222Medical Research Council K013351Medical Research Council MR/K013351/1Medical Research Council MR/K026992/1NHLBI NIH HHS R01 HL036310NHLBI NIH HHS R01HL036310NIA NIH HHS P01 AG020166NIA NIH HHS R01 AG034454NIA NIH HHS R01AG034454
6 · The paper itself

Abstract

backgroundWorking 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.

methodsWe 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.

findingsDuring 1·7 million person-years at risk, 4963 individuals developed diabetes (incidence 29 per 10 000 person-years). 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 significant heterogeneity in study-specific estimates (I(2)=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, difference in incidence 13 per 10 000 person-years, I(2)=0%, p=0·4662), but was null in the high socioeconomic status group (1·00, 95% CI 0·80-1·25, incidence difference zero per 10 000 person-years, I(2)=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.

interpretationIn this meta-analysis, the link between longer working hours and type 2 diabetes was apparent only in individuals in the low socioeconomic status groups.

fundingMedical 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 Affairs and Employment (Netherlands), Economic and Social Research Council, US National Institutes of Health, and British Heart Foundation.

Indexed as

Work Schedule ToleranceAdultDiabetes Mellitus, Type 2FemaleHumansIncidenceMaleMiddle AgedRisk FactorsSocial Class

Identifiers

PMID25262544
PMCPMC4286814

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.