Mediation analysis for new recognition criteria, working hours and overwork-related disease: a nationwide ecological study using 11-year follow-up data in Taiwan
學年 107
學期 2
出版(發表)日期 2019-07-11
作品名稱 Mediation analysis for new recognition criteria, working hours and overwork-related disease: a nationwide ecological study using 11-year follow-up data in Taiwan
作品名稱(其他語言)
著者 Sheng-Hsuan Lin; Meng-Ying Chou; Ro-Ting Lin
單位
出版者
著錄名稱、卷期、頁數 BMJ Open 9(7), e028973
摘要 Objectives Taiwan revised its criteria for overwork-related cerebrovascular and cardiovascular disease (CCVD) in 2010. A new definition of overwork increased the number of recognised cases. Meanwhile, actual average working hours decreased. We estimated the effects of the revised criteria on the number of overwork-related CCVD cases and the mediation effect through reduced working hours. Methods From the Labor Insurance of Taiwan, we collected data on the total number of overwork-related CCVD cases from 2006 to 2016 and average monthly working hours for 13 industry groups. We conducted causal mediation analysis to investigate the mechanism of the effect of new criteria on CCVD mediated by working hours. Results From 2006 to 2016, 594 overwork-related cases of CCVD were recognised across 13 industry groups. After introducing the new criteria, overwork-related CCVD increased by 8.40 cases (per one million person-years) (95% CI 4.53 to 15.05), which resulted from a decrease of 1.54 (95% CI 0.22 to 3.82) cases due to reduced working hours (mediation effect) and an increase of 9.93 (95% CI 5.24 to 18.17) cases related to the effect of the criteria change and other covariates excluding working hours (alternative effect). Conclusions Working hours are an important mediator of the effect of policy on the rate of overwork-related CCVD. Introducing new criteria for recognising overwork-related disease might raise awareness and prompt reductions in working hours, which also help to reduce CCVD. Our findings suggest that understanding mediation effects is important to evaluating national health policies. 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.
關鍵字
語言 en_US
ISSN 2044-6055
期刊性質 國外
收錄於 SCI
產學合作
通訊作者
審稿制度
國別 GBR
公開徵稿
出版型式 ,電子版
相關連結

機構典藏連結 ( http://tkuir.lib.tku.edu.tw:8080/dspace/handle/987654321/120401 )