# Occupational history of psychosocial work environment exposures and risk of autoimmune rheumatic diseases – a Danish register-based cohort study

## TL;DR

This study explores how psychosocial work conditions in Denmark relate to autoimmune rheumatic diseases like rheumatoid arthritis.

## Contribution

The study uses job-exposure matrices and national registries to assess psychosocial work exposures and autoimmune disease risk in a large Danish cohort.

## Key findings

- Higher decision authority and development opportunities at work are linked to lower autoimmune disease risk.
- Physical violence in the workplace is associated with increased rheumatoid arthritis risk.
- Job insecurity and role conflicts showed no significant association with autoimmune diseases.

## Abstract

This population-based cohort study examined the association between psychosocial work environment exposures and autoimmune rheumatic diseases, including rheumatoid arthritis (RA), systemic sclerosis (SS), and systemic lupus erythematosus (SLE).

The total Danish working population, 19–58 years of age (N=2 319 337) was followed from 1997–2018 (37 529 977 person years). Quantitative demands, decision authority, emotional demands, job insecurity, physical violence, role conflicts and possibilities for development at work, as well as a combined psychosocial index were assessed by job-exposure matrices (JEM) and linked with diagnoses of autoimmune rheumatic diseases, ie, RA, SS, and SLE identified in The Danish National Patient Registry. For each psychosocial work environment exposure, recent exposure, accumulated exposure, and number of years with high exposure level were calculated for every employee. Associations with autoimmune rheumatic diseases were assessed by Poisson regression analyses.

The results show that employees in occupations with higher decision authority and, to some degree, possibilities for development at work, have lower risks of autoimmune rheumatic diseases, while employment in occupations with high risk of physical violence involves a higher risk of rheumatoid arthritis. No association was observed for job insecurity or role conflicts at work. The results on quantitative demands, emotional demands and the psychosocial index were less conclusive.

These findings generally do not support that psychosocial work environment exposures are major risk factors for autoimmune rheumatic diseases, but low decision authority, possibilities for development at work, physical violence and possibly the sum of recent adverse psychosocial exposure may be of importance.