scholarly journals Genetic and Environmental Contributions to Long-Term Sick Leave and Disability Pension: A Population-Based Study of Young Adult Norwegian Twins

2013 ◽  
Vol 16 (4) ◽  
pp. 759-766 ◽  
Author(s):  
Line C. Gjerde ◽  
Gun Peggy Knudsen ◽  
Nikolai Czajkowski ◽  
Nathan Gillespie ◽  
Steven H. Aggen ◽  
...  

Although exclusion from the workforce due to long-term sick leave (LTSL) and disability pension (DP) is a major problem in many Western countries, the etiology of LTSL and DP is not well understood. These phenomena have a strong association as most patients receiving DP have first been on LTSL. However, only a few of those on LTSL end up with DP. The present study aimed to investigate the common and specific genetic and environmental risk factors for LTSL and DP. The present study utilizes a population-based sample of 7,710 young adult twins from the Norwegian Institute of Public Health Twin Panel, which has been linked to the Historical-Event Database (FD-Trygd; 1998–2008). Univariate and bivariate twin models were fitted to determine to what degree genetic and environmental factors contribute to variation in LTSL and DP. The estimated heritabilities of LTSL and DP were 0.49 and 0.66, respectively. There was no evidence for shared environmental or sex-specific factors. The phenotypic-, genetic-, and non-familial environmental correlations between the variables were 0.86, 0.82, and 0.94, respectively. Our results indicate that familial transmission of LTSL and DP is due to genetic and not environmental factors. The risk factors contributing to LTSL and DP were mainly shared, suggesting that what increases risk for LTSL also increases risk for DP. However, a non-negligible part of the genetic variance was not shared between the variables, which may contribute to explaining why some progress from LTSL to DP, whereas others return to work.

2008 ◽  
Vol 18 (3) ◽  
pp. 224-231 ◽  
Author(s):  
N. E. Karlsson ◽  
J. M. Carstensen ◽  
S. Gjesdal ◽  
K. A. E. Alexanderson

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  

Abstract Twin design is an important tool to analyze the role of genetic and environmental factors, and to better understand causal mechanisms in public health research. Twin studies have reliably shown that genetic factors are important not only for physiological traits but also for psychological and health behavioral traits as well as for health-related work incapacity in terms of sick leave and disability pension. As many countries face an aging workforce, it is becoming ever more important to understand the underlying causes of work incapacity across the entire working life. In the past decade, twin data in combination with national register data have been used to deepen our understanding of the role of genetic and environmental influences on the complex processes of sick leave and disability pension. The aim of this workshop is to present and discuss methods and results of studies based on the large Swedish, Finnish and Norwegian twin cohorts. Linear structural equations are intensively utilized in modern methods of twin studies. A variety of models are available to answer different research questions, such as the dynamics behind associations between traits and developmental processes in longitudinal designs - models also applicable in health at work and social security. Further, analyzing twin pairs discordant for an outcome or risk factor (co-twin control) provides a unique possibility to control for familial (genetic and shared environmental) factors, since cases and controls are matched optimally being twins. Findings based on twin cohorts suggest that familial factors are relevant to many risk factors as well as for work incapacity. By controlling for these unobserved confounding factors, the co-twin control design may provide more accurate estimates of risk factors for work incapacity and complement the epidemiological findings of unrelated subjects. Based on population-based twin cohort studies with long follow-up, indications also exist that familial confounding may have different roles in the associations between risk factors and work incapacity. For example, in regard to various disability pension diagnosis groups and depending on study designs (one vs. two time points, longer vs. shorter follow-up etc.). Results from prospective studies on various risk factors, including adolescents’ mental health problems, for future sick leave and disability pension will be presented. Another presentation focuses on the stability and change in genetic and environmental factors influencing work incapacity from age 18 until retirement and the likelihood of causality between educational attainment, lifestyle and work incapacity. Finally, results on adverse outcomes of sick leave due to mental disorders using an open cohort design adjusting for familial factors will be presented. During the time of rapid development in molecular genetics, the twin study design has maintained its importance and will continue to cast light on different aspects of work incapacity. Key messages Twin design offers a unique tool in public health research to examine and control for familial (genetic and shared environmental) factors. Genetic factors seem to play an important role in understanding the complex causes of work incapacity in terms of sick leave and disability pension.


2014 ◽  
Vol 17 (1) ◽  
pp. 1-9 ◽  
Author(s):  
Line C. Gjerde ◽  
Espen Røysamb ◽  
Nikolai Czajkowski ◽  
Gun Peggy Knudsen ◽  
Kristian Østby ◽  
...  

Personality disorders (PDs) reduce global functioning, are associated with high levels of work disability, and are thus also likely to influence long-term sick leave (LTSL). Previous research has indicated significant genetic influence on both DSM-IV PDs and LTSL. To what degree genes contributing to PDs also influence LTSL has not been investigated. The aims of the current study were to investigate which PDs were significantly associated with LTSL, to what extent the genetic contributions to these PDs account for the heritability of LTSL, and to explore the hypothesis of a causal association between PDs and LTSL. The sample consisted of 2,771 young, adult Norwegian twins, born 1967–1979. PDs were assessed using the Structured Interview for DSM-IV Personality (SIDP-IV). The age range for the interview was 20–32. The data were subsequently linked to public records of LTSL (sick leave >16 days) up to 11 years later. The odds ratio for being in the highest LTSL category (>15% sick leave) when fulfilling the DSM-IV criteria for any PD diagnosis was 2.6 (1.8–3.8, 95% CI). Dimensional representations of schizotypal, paranoid, and borderline PD were independently and significantly associated with LTSL. The heritability of LTSL was 0.50. Genetic factors shared with the PDs accounted for 20% of this. The association between PDs and LTSL was due to shared genetic and not environmental influences, and was mainly explained by one common genetic factor. The hypothesis of a causal association was not supported, indicating that the association is explained by overlapping genetic liability between PDs and LTSL.


2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
R Orstavik ◽  
K Seglem ◽  
L C Gjerde ◽  
F Torvik ◽  
E Røysamb ◽  
...  

Abstract Background For the past decade, researchers from the Nordic countries have taken the advantage of their large twin cohorts and reliable official registries to deepen our understanding of sick leave and disability pension. This presentation will give a brief summary of studies based on data from The Norwegian Twin Registry (NTR). Methods Monozygotic twins develop from one fertilized egg cell and are genetically identical, while dizygotic twins are the result of two fertilized egg cells and share, as ordinary siblings, in average 50% of their segregating genes. With data from large cohorts of twins reared together, it is possible to calculate the proportion of variance in an outcome that stems from genetic, shared and non-shared environmental factors respectively. Furthermore, when exploring the contribution from measured risk factors on specific outcomes, adjustment for unmeasured confounders (genes and shared environment) can bring us closer to determine causality in epidemiological studies. Both methods were applied in our studies. NTR now includes data from about 30 000 twins, but until recently we focused on a subsample of about 8 000 young adults (born 1967-1979). Data from questionnaires and interviews were linked to registries on sick leave and disability pension. Results In line with previous studies, we found that the liability to sick leave and disability pensioning, as well as the transition from the former to the latter, was strongly to moderately influenced by genetic factors. We found no evidence for “social transmission”, e.g. that environmental factors shared by the twins contributed to these outcomes. Further details and results from studies on measured risk factors, with emphasize on mental health, will be presented at the conference. Conclusions Twin studies cast light on different aspects of work incapacity, including reducing stigma such as those associated with theories of social transmission of health related benefits.


Heart ◽  
2021 ◽  
pp. heartjnl-2021-319129
Author(s):  
Marios Rossides ◽  
Susanna Kullberg ◽  
Johan Grunewald ◽  
Anders Eklund ◽  
Daniela Di Giuseppe ◽  
...  

ObjectivesPrevious studies showed a strong association between sarcoidosis and heart failure (HF) but did not consider risk stratification or risk factors to identify useful aetiological insights. We estimated overall and stratified HRs and identified risk factors for HF in sarcoidosis.MethodsSarcoidosis cases were identified from the Swedish National Patient Register (NPR; ≥2 International Classification of Diseases-coded visits, 2003–2013) and matched to general population comparators. They were followed for HF in the NPR. Treated were cases who were dispensed ≥1 immunosuppressant ±3 months from the first sarcoidosis visit (2006–2013). Using Cox models, we estimated HRs adjusted for demographics and comorbidity and identified independent risk factors of HF together with their attributable fractions (AFs).ResultsDuring follow-up, 204 of 8574 sarcoidosis cases and 721 of 84 192 comparators were diagnosed with HF (rate 2.2 vs 0.7/1000 person-years, respectively). The HR associated with sarcoidosis was 2.43 (95% CI 2.06 to 2.86) and did not vary by age, sex or treatment status. It was higher during the first 2 years after diagnosis (HR 3.7 vs 1.9) and in individuals without a history of ischaemic heart disease (IHD; HR 2.7 vs 1.7). Diabetes, atrial fibrillation and other arrhythmias were the strongest independent clinical predictors of HF (HR 2.5 each, 2-year AF 20%, 16% and 12%, respectively).ConclusionsAlthough low, the HF rate was more than twofold increased in sarcoidosis compared with the general population, particularly right after diagnosis. IHD history cannot solely explain these risks, whereas ventricular arrhythmias indicating cardiac sarcoidosis appear to be a strong predictor of HF in sarcoidosis.


BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e045678
Author(s):  
Marit Müller De Bortoli ◽  
Inger M. Oellingrath ◽  
Anne Kristin Moeller Fell ◽  
Alex Burdorf ◽  
Suzan J. W. Robroek

ObjectivesThe aim of this study is to assess (1) whether lifestyle risk factors are related to work ability and sick leave in a general working population over time, and (2) these associations within specific disease groups (ie, respiratory diseases, cardiovascular disease and diabetes, and mental illness).SettingTelemark county, in the south-eastern part of Norway.DesignLongitudinal study with 5 years follow-up.ParticipantsThe Telemark study is a longitudinal study of the general working population in Telemark county, Norway, aged 16 to 50 years at baseline in 2013 (n=7952) and after 5-year follow-up.Outcome measureSelf-reported information on work ability (moderate and poor) and sick leave (short-term and long-term) was assessed at baseline, and during a 5-year follow-up.ResultsObesity (OR=1.64, 95% CI: 1.32 to 2.05) and smoking (OR=1.62, 95% CI: 1.35 to 1.96) were associated with long-term sick leave and, less strongly, with short-term sick leave. An unhealthy diet (OR=1.57, 95% CI: 1.01 to 2.43), and smoking (OR=1.67, 95% CI: 1.24 to 2.25) were associated with poor work ability and, to a smaller extent, with moderate work ability. A higher lifestyle risk score was associated with both sick leave and reduced work ability. Only few associations were found between unhealthy lifestyle factors and sick leave or reduced work ability within disease groups.ConclusionLifestyle risk factors were associated with sick leave and reduced work ability. To evaluate these associations further, studies assessing the effect of lifestyle interventions on sick leave and work ability are needed.


2011 ◽  
Vol 57 (6) ◽  
pp. 637-645 ◽  
Author(s):  
Richard E. Adams ◽  
Lin T. Guey ◽  
Semyon F. Gluzman ◽  
Evelyn J. Bromet

Background: The Chornobyl nuclear power plant explosion in April 1986 was one of the worst ecological disasters of the 20th century. As with most disasters, its long-term mental health consequences have not been examined. Aims: This study describes the psychological well-being and risk perceptions of exposed women 19–20 years later and the risk factors associated with mental health. Methods: We assessed Chornobyl-related post-traumatic stress disorder (PTSD), major depressive episode (MDE) and overall distress among three groups of women in Kyiv, Ukraine ( N = 797): mothers of small children evacuated to Kyiv in 1986 from the contaminated area near the plant (evacuees); mothers of their children’s classmates (neighbourhood controls); and population-based controls from Kyiv. Risk perceptions and epidemiologic correlates were also obtained. Results: Evacuees reported poorer well-being and more negative risk perceptions than controls. Group differences in psychological well-being remained after adjustment for epidemiologic risk factors but became non-significant when Chornobyl risk perceptions were added to the models. Conclusions: The relatively poorer psychological well-being among evacuees is largely explained by their continued concerns about the physical health risks stemming from the accident. We suggest that this is due to the long-term, non-resolvable nature of health fears associated with exposure.


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