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Original research
Adverse employment histories and allostatic load: associations over the working life
  1. Morten Wahrendorf1,
  2. Tarani Chandola2,
  3. Marcel Goldberg3,4,
  4. Marie Zins3,4,
  5. Hanno Hoven1,
  6. Johannes Siegrist5
  1. 1Centre for Health and Society, Institute of Medical Sociology, Heinrich-Heine-University of Düsseldorf, Medical Faculty, Düsseldorf, Germany
  2. 2Department of Social Statistics, University of Manchester, Manchester, UK
  3. 3Population-Based Epidemiologic Cohorts Unit, INSERM, UMS 011, Villejuif, France
  4. 4Faculté de Médecine, Paris University, Paris, France
  5. 5Senior Professorship Work Stress Research, Heinrich-Heine-University of Düsseldorf, Medical Faculty, Düsseldorf, Germany
  1. Correspondence to PD Dr Morten Wahrendorf, Centre for Health and Society, Institute of Medical Sociology, Heinrich-Heine-University of Düsseldorf, Medical Faculty, Düsseldorf, Nordrhein-Westfalen, Germany; wahrendorf{at}uni-duesseldorf.de

Abstract

Background Most studies on the health impact of occupational stress use single-point measures of stress at work. This study analyses the associations of properties of entire employment trajectories over an extended time period with a composite score of allostatic load (AL).

Methods Data come from the French CONSTANCES cohort, with information on adverse employment histories between ages 25 and 45 and a composite score of AL (based on 10 biomarkers, range 0–10) among people aged 45 or older (47 680 women and 45 035 men). Data were collected by questionnaires (including retrospective employment histories) or by health examinations (including blood-based biomarkers). We distinguish six career characteristics: number of temporary jobs, number of job changes, number of unemployment periods, years out of work, mode occupational position and lack of job promotion.

Results For both men and women, results of negative binomial regressions indicate that adverse employment histories are related to higher levels of AL, particularly histories that are characterised by a continued disadvantaged occupational position, repeated periods of unemployment or years out of work. Findings are adjusted for partnership, age and education, and respondents with a health-related career interruption or early retirement are excluded.

Conclusions Our study highlights physiological responses as a mechanism through which chronic stress during working life is linked to poor health and calls for intervention efforts among more disadvantaged groups at early stages of labour market participation.

  • work stress
  • life course epidemiology
  • employment
  • occupational health

Data availability statement

Data may be obtained from a third party and are not publicly available. Access to raw data requires the submission of a research project, that is examined by the CONSTANCES international scientific Committee and authorised by the Institutional Steering Committee. The code of data management and data analyses are available upon request from the corresponding author.

http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/jech-2021-217607

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    Data availability statement

    Data may be obtained from a third party and are not publicly available. Access to raw data requires the submission of a research project, that is examined by the CONSTANCES international scientific Committee and authorised by the Institutional Steering Committee. The code of data management and data analyses are available upon request from the corresponding author.

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    Footnotes

    • Contributors All authors (MW, TC, MG, MZ, HH and JS) have contributed as follows: MG and MZ designed the study, including quality assurance and control, and helped supervise the field activities and provided the data. MW, TC and JS developed the study’s analytical strategy and the conceptual frame of the study. HH helped to conduct the literature review and assisted in the data analyses. MW had the main responsibility for data management and analyses, and drafted the first version of the manuscript. All authors critically reviewed the first draft of the manuscript and approved its submission.

    • Funding This work was supported by funding from the German research foundation (Deutsche Forschungsgemeinschaft), project number: SI 236/16-1 and WA 3065/5-1). The CONSTANCES Cohort Study was supported and funded by the Caisse Nationale d’Assurance Maladie des Travailleurs Salariés. The CONSTANCES Cohort Study is an 'Infrastructure nationale en Biologie et Santé' and benefits from a grant from ANR (ANR-11-INBS-0002). CONSTANCES is also partly funded by MSD, AstraZeneca and Lundbeck.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.