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Long working hours and symptoms of anxiety and depression: a 5-year follow-up of the Whitehall II study

Published online by Cambridge University Press:  18 February 2011

M. Virtanen*
Affiliation:
Finnish Institute of Occupational Health, Helsinki, Finland
J. E. Ferrie
Affiliation:
Department of Epidemiology and Public Health, University College London, UK
A. Singh-Manoux
Affiliation:
Department of Epidemiology and Public Health, University College London, UK INSERM U1018, France Centre de Gérontologie, Hôpital Ste Périne, AP-HP, Paris, France
M. J. Shipley
Affiliation:
Department of Epidemiology and Public Health, University College London, UK
S. A. Stansfeld
Affiliation:
Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Queen Mary's School of Medicine and Dentistry, London, UK
M. G. Marmot
Affiliation:
Department of Epidemiology and Public Health, University College London, UK
K. Ahola
Affiliation:
Finnish Institute of Occupational Health, Helsinki, Finland
J. Vahtera
Affiliation:
Finnish Institute of Occupational Health, Helsinki, Finland Department of Public Health, University of Turku, Finland Turku University Hospital, Finland
M. Kivimäki
Affiliation:
Department of Epidemiology and Public Health, University College London, UK
*
*Address for correspondence: Dr M. Virtanen, Finnish Institute of Occupational Health, Work and Mental Health Team, Topeliuksenkatu 41 aA, FIN-00250 Helsinki, Finland. (Email: [email protected])

Abstract

Background

Although long working hours are common in working populations, little is known about the effect of long working hours on mental health.

Method

We examined the association between long working hours and the onset of depressive and anxiety symptoms in middle-aged employees. Participants were 2960 full-time employees aged 44 to 66 years (2248 men, 712 women) from the prospective Whitehall II cohort study of British civil servants. Working hours, anxiety and depressive symptoms, and covariates were measured at baseline (1997–1999) followed by two subsequent measurements of depressive and anxiety symptoms (2001 and 2002–2004).

Results

In a prospective analysis of participants with no depressive (n=2549) or anxiety symptoms (n=2618) at baseline, Cox proportional hazard analysis adjusted for baseline covariates showed a 1.66-fold [95% confidence interval (CI) 1.06–2.61] risk of depressive symptoms and a 1.74-fold (95% CI 1.15–2.61) risk of anxiety symptoms among employees working more than 55 h/week compared with employees working 35–40 h/week. Sex-stratified analysis showed an excess risk of depression and anxiety associated with long working hours among women [hazard ratios (HRs) 2.67 (95% CI 1.07–6.68) and 2.84 (95% CI 1.27–6.34) respectively] but not men [1.30 (0.77–2.19) and 1.43 (0.89–2.30)].

Conclusions

Working long hours is a risk factor for the development of depressive and anxiety symptoms in women.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2011

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References

Ahola, K, Hakanen, J (2007). Job strain, burnout, and depressive symptoms: a prospective study among dentists. Journal of Affective Disorders 104, 103110.CrossRefGoogle ScholarPubMed
Ahola, K, Honkonen, T, Isometsa, E, Kalimo, R, Nykyri, E, Aromaa, A, Lönnqvist, J (2005). The relationship between job-related burnout and depressive disorders: results from the Finnish Health 2000 Study. Journal of Affective Disorders 88, 5562.CrossRefGoogle ScholarPubMed
Ala-Mursula, L, Vahtera, J, Pentti, J, Kivimaki, M (2004). Effect of employee worktime control on health: a prospective cohort study. Occupational and Environmental Medicine 61, 254261.CrossRefGoogle ScholarPubMed
Alfredsson, L, Spetz, CL, Theorell, T (1985). Type of occupation and near-future hospitalization for myocardial infarction and some other diagnoses. International Journal of Epidemiology 14, 378388.CrossRefGoogle ScholarPubMed
Artazcoz, L, Borrell, C, Benach, J (2001). Gender inequalities in health among workers: the relation with family demands. Journal of Epidemiology and Community Health 55, 639647.CrossRefGoogle ScholarPubMed
Batty, GD, Hunt, K, Emslie, C, Lewars, H, Gale, CR (2009). Alcohol problems and all-cause mortality in men and women: predictive capacity of a clinical screening tool in a 21-year follow-up of a large, UK-wide, general population-based survey. Journal of Psychosomatic Research 66, 317321.CrossRefGoogle Scholar
Bildt, C, Michelsen, H (2002). Gender differences in the effects from working conditions on mental health: a 4-year follow-up. International Archives of Occupational and Environmental Health 75, 252258.CrossRefGoogle Scholar
Blumenthal, JA (2008). Depression and coronary heart disease: association and implications for treatment. Cleveland Clinic Journal of Medicine 75 (Suppl. 2), S48S53.CrossRefGoogle ScholarPubMed
Broadbent, DE (1985). The clinical impact of job design. British Journal of Clinical Psychology 24, 3344.CrossRefGoogle ScholarPubMed
Caruso, CC, Bushnell, T, Eggerth, D, Heitmann, A, Kojola, B, Newman, K, Rosa, RR, Sauter, SL, Vila, B (2006). Long working hours, safety, and health: toward a National Research Agenda. American Journal of Industrial Medicine 49, 930942.CrossRefGoogle Scholar
Caruso, CC, Hitchcock, EM, Dick, RB, Russo, JM, Schmit, JM (2004). Overtime and Extended Work Shifts: Recent Findings on Illnesses, Injuries, and Health Behaviors. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health: Cincinnati.Google Scholar
Dahlgren, A, Kecklund, G, Akerstedt, T (2006). Overtime work and its effects on sleep, sleepiness, cortisol and blood pressure in an experimental field study. Scandinavian Journal of Work Environment and Health 32, 318327.CrossRefGoogle Scholar
De Raeve, L, Kant, I, Jansen, NW, Vasse, RM, van den Brandt, PA (2009). Changes in mental health as a predictor of changes in working time arrangements and occupational mobility: results from a prospective cohort study. Journal of Psychosomatic Research 66, 137145.CrossRefGoogle ScholarPubMed
Ettner, SL, Frank, RG, Kessler, RC (1997). The impact of psychiatric disorders on labor market outcomes. Industrial and Labor Relations Review 51, 6481.CrossRefGoogle Scholar
Ferrie, JE, Kivimaki, M, Singh-Manoux, A, Shortt, A, Martikainen, P, Head, J, Marmot, M, Gimeno, D, De Vogli, R, Elovainio, M, Shipley, MJ (2009). Non-response to baseline, non-response to follow-up and mortality in the Whitehall II cohort. International Journal of Epidemiology 38, 831837.CrossRefGoogle ScholarPubMed
Fujino, Y, Horie, S, Hoshuyama, T, Tsutsui, T, Tanaka, Y (2006). A systematic review of working hours and mental health burden [in Japanese]. Sangyo Eiseigaku Zasshi 48, 8797.CrossRefGoogle ScholarPubMed
Gjerdingen, D, McGovern, P, Bekker, M, Lundberg, U, Willemsen, T (2000). Women's work roles and their impact on health, well-being, and career: comparisons between the United States, Sweden, and The Netherlands. Women and Health 31, 120.CrossRefGoogle ScholarPubMed
Goldberg, DP (1972). The Detection of Psychiatric Illness by Questionnaire. Oxford University Press: London.Google Scholar
Hamer, M, Kivimaki, M, Lahiri, A, Marmot, MG, Steptoe, A (2010). Persistent cognitive depressive symptoms are associated with coronary artery calcification. Atherosclerosis 210, 209213.CrossRefGoogle ScholarPubMed
Handwerger, K (2009). Differential patterns of HPA activity and reactivity in adult posttraumatic stress disorder and major depressive disorder. Harvard Review of Psychiatry 17, 184205.CrossRefGoogle ScholarPubMed
Jansen, NW, Kant, I, Kristensen, TS, Nijhuis, FJ (2003). Antecedents and consequences of work-family conflict: a prospective cohort study. Journal of Occupational and Environmental Medicine 45, 479491.CrossRefGoogle ScholarPubMed
Jenkins, R, Lewis, G, Bebbington, P, Brugha, T, Farrell, M, Gill, B, Meltzer, H (1997). The National Psychiatric Morbidity surveys of Great Britain – initial findings from the household survey. Psychological Medicine 27, 775789.CrossRefGoogle ScholarPubMed
Kivimaki, M, Head, J, Ferrie, JE, Shipley, MJ, Steptoe, A, Vahtera, J, Marmot, MG (2007). Hypertension is not the link between job strain and coronary heart disease in the Whitehall II study. American Journal of Hypertension 20, 11461153.Google Scholar
Kleppa, E, Sanne, B, Tell, GS (2008). Working overtime is associated with anxiety and depression: the Hordaland Health Study. Journal of Occupational and Environmental Medicine 50, 658666.CrossRefGoogle ScholarPubMed
Lundberg, U (2002). Gender, multiple roles and physiological reactions. In Gender and Social Inequalities in Health (ed. Wamala, S. and Lynch, J.), pp. 121155. Studentlitteratur: Stockholm.Google Scholar
Lundberg, U, Hellström, B (2002). Workload and morning salivary cortisol in women. Work and Stress 16, 356363.CrossRefGoogle Scholar
Lundberg, U, Parr, D (2000). Neurohormonal factors, stress, health and gender. In Handbook of Gender, Culture, and Health (ed. Eisler, R. M. and Hersen, M.), pp. 2141. Lawrence Erlbaum: Mahwah, NJ.Google Scholar
Marmot, M, Brunner, E (2005). Cohort profile: the Whitehall II study. International Journal of Epidemiology 34, 251256.CrossRefGoogle ScholarPubMed
Mathers, CD, Loncar, D (2006). Projections of global mortality and burden of disease from 2002 to 2030. PLoS Medicine 3, e442.CrossRefGoogle ScholarPubMed
Matthews, S, Power, C (2002). Socio-economic gradients in psychological distress: a focus on women, social roles and work-home characteristics. Social Science and Medicine 54, 799810.CrossRefGoogle ScholarPubMed
Michelsen, H, Bildt, C (2003). Psychosocial conditions on and off the job and psychological ill health: depressive symptoms, impaired psychological wellbeing, heavy consumption of alcohol. Occupational and Environmental Medicine 60, 489496.CrossRefGoogle ScholarPubMed
Nylen, L, Voss, M, Floderus, B (2001). Mortality among women and men relative to unemployment, part time work, overtime work, and extra work: a study based on data from the Swedish twin registry. Occupational and Environmental Medicine 58, 5257.CrossRefGoogle Scholar
Ormel, J, Oldehinkel, AJ, Nolen, WA, Vollebergh, W (2004). Psychosocial disability before, during, and after a major depressive episode: a 3-wave population-based study of state, scar, and trait effects. Archives of General Psychiatry 61, 387392.CrossRefGoogle Scholar
Park, J, Kim, Y, Chung, HK, Hisanaga, N (2001). Long working hours and subjective fatigue symptoms. Industrial Health 39, 250254.CrossRefGoogle ScholarPubMed
Peterson, U, Demerouti, E, Bergstrom, G, Samuelsson, M, Asberg, M, Nygren, A (2008). Burnout and physical and mental health among Swedish healthcare workers. Journal of Advanced Nursing 62, 8495.CrossRefGoogle ScholarPubMed
Prince, M, Patel, V, Saxena, S, Maj, M, Maselko, J, Phillips, MR, Rahman, A (2007). No health without mental health. Lancet 370, 859877.CrossRefGoogle ScholarPubMed
Sekine, M, Chandola, T, Martikainen, P, Marmot, M, Kagamimori, S (2006). Work and family characteristics as determinants of socioeconomic and sex inequalities in sleep: The Japanese Civil Servants Study. Sleep 29, 206216.CrossRefGoogle ScholarPubMed
Shields, M (1999). Long working hours and health. Health Reports 11, 3348.Google ScholarPubMed
Singh-Manoux, A, Akbaraly, TN, Marmot, M, Melchior, M, Ankri, J, Sabia, S, Ferrie, JE (2010). Persistent depressive symptoms and cognitive function in late midlife: the Whitehall II study. Journal of Clinical Psychiatry 71, 13791385.CrossRefGoogle ScholarPubMed
Sokejima, S, Kagamimori, S (1998). Working hours as a risk factor for acute myocardial infarction in Japan: case-control study. British Medical Journal 317, 775780.CrossRefGoogle ScholarPubMed
Sparks, K, Cooper, C, Fried, Y, Shirom, A (1997). The effects of hours of work on health: a meta-analytic review. Journal of Occupational and Organizational Psychology 70, 391408.CrossRefGoogle Scholar
Spurgeon, A, Harrington, JM, Cooper, CL (1997). Health and safety problems associated with long working hours: a review of the current position. Occupational and Environmental Medicine 54, 367375.CrossRefGoogle Scholar
Stafford, M, Chandola, T, Marmot, M (2007). Association between fear of crime and mental health and physical functioning. American Journal of Public Health 97, 20762081.CrossRefGoogle ScholarPubMed
Stansfeld, SA, Head, J, Fuhrer, R, Wardle, J, Cattell, V (2003). Social inequalities in depressive symptoms and physical functioning in the Whitehall II study: exploring a common cause explanation. Journal of Epidemiology and Community Health 57, 361367.CrossRefGoogle ScholarPubMed
Stansfeld, SA, Head, J, Marmot, MG (1998). Explaining social class differences in depression and well-being. Social Psychiatry and Psychiatric Epidemiology 33, 19.CrossRefGoogle ScholarPubMed
Steptoe, A, Wardle, J, Lipsey, Z, Mills, R, Oliver, G, Jarvis, M, Kirschbaum, C (1998). A longitudinal study of work load and variations in psychological well-being, cortisol, smoking, and alcohol consumption. Annals of Behavioral Medicine 20, 8491.CrossRefGoogle ScholarPubMed
Suwazono, Y, Okubo, Y, Kobayashi, E, Kido, T, Nogawa, K (2003). A follow-up study on the association of working conditions and lifestyles with the development of (perceived) mental symptoms in workers of a telecommunication enterprise. Occupational Medicine (London) 53, 436442.CrossRefGoogle ScholarPubMed
Tarumi, K, Hagihara, A, Morimoto, K (2003). A prospective observation of onsets of health defects associated with working hours. Industrial Health 41, 101108.CrossRefGoogle ScholarPubMed
Thomas, CM, Morris, S (2003). Cost of depression among adults in England in 2000. British Journal of Psychiatry 183, 514519.CrossRefGoogle ScholarPubMed
Vaguer, C, Van Bastelaer, A (2004). Working times. European Communities: Statistics in focus, population and social conditions, Theme 3-7/2004.Google Scholar
van der Hulst, M (2003). Long workhours and health. Scandinavian Journal of Work Environment and Health 29, 171188.CrossRefGoogle ScholarPubMed
Virtanen, M, Ferrie, JE, Singh-Manoux, A, Shipley, MJ, Vahtera, J, Marmot, MG, Kivimäki, M (2010). Overtime work and incident coronary heart disease: the Whitehall II prospective cohort study. European Heart Journal 31, 17371744.CrossRefGoogle ScholarPubMed
Virtanen, M, Honkonen, T, Kivimaki, M, Ahola, K, Vahtera, J, Aromaa, A, Lönnqvist, J (2007). Work stress, mental health and antidepressant medication findings from the Health 2000 Study. Journal of Affective Disorders 98, 189197.CrossRefGoogle ScholarPubMed
Virtanen, M, Singh-Manoux, A, Ferrie, JE, Gimeno, D, Marmot, MG, Elovainio, M, Jokela, M, Vahtera, J, Kivimäki, M (2009). Long working hours and cognitive function: the Whitehall II Study. American Journal of Epidemiology 169, 596605.CrossRefGoogle ScholarPubMed
Waghorn, GR, Chant, DC (2005). Employment restrictions among persons with ICD-10 anxiety disorders: characteristics from a population survey. Journal of Anxiety Disorders 19, 642657.CrossRefGoogle ScholarPubMed
Warr, BP (1990). Decision latitude, job demands, and employee well being. Work and Stress 4, 285294.CrossRefGoogle Scholar
White, IR, Altmann, DR, Nanchahal, K (2004). Mortality in England and Wales attributable to any drinking, drinking above sensible limits and drinking above lowest-risk level. Addiction 99, 749756.CrossRefGoogle ScholarPubMed
Yamazaki, S, Fukuhara, S, Suzukamo, Y, Morita, S, Okamura, T, Tanaka, T, Ueshima, H (2007). Lifestyle and work predictors of fatigue in Japanese manufacturing workers. Occupational Medicine (London). 57, 262269.CrossRefGoogle ScholarPubMed