BACKGROUND & AIMS: BACKGROUND:The aim of this study was to examine the incidence and risk factors for anal sphincter tears (ASTs) at delivery. METHODS:A national population-based study was conducted with data from the Medical Birth Register including all primiparas with singleton pregnancy, who gave birth vaginally in Sweden from 1994 to 2004 (n=365,886). Women with a third and fourth degree AST were compared with those who gave birth during the same period without incurring such tears. RESULTS:The incidence of third degree AST increased by >60%, from 3.4% in 1994 to 5.2% in 2004 in spontaneous births, and from 8.7 to 14.8% in instrumental deliveries during the study period. The proportion of fourth degree AST increased from 0.3 to 0.55% in spontaneous births and from 0.8 to 1.4% in instrumental-assisted deliveries during the same period. Compared with non-instrumental delivery, vacuum extraction (VE) deliveries were related to an increased risk of AST. An infant birth weight of >4,000 g was also associated with an increased risk for both third and fourth degree AST. In addition, women born in Africa and Asia had significantly higher risk for both third and fourth degree AST compared to women born in Sweden. CONCLUSION:The incidence of third and fourth degree AST increased in both spontaneous births and instrumental deliveries. Instrumental delivery and an infant birth weight >4,000 g are the main risk factors for AST. Women from Africa and Asia have pronounced risks.

背景与目标：

BACKGROUND & AIMS: OBJECTIVE:It is unclear whether hydroxyapatite (HA) coating of uncemented cups used in primary total hip arthroplasty (THA) improves bone ingrowth and reduces the risk of aseptic loosening. We therefore investigated survival of different uncemented cups that were available with or without HA coating. METHOD:We investigated three different cup types used with or without HA coating registered in the Nordic Arthroplasty Register Association (NARA) database that were inserted due to osteoarthritis (n = 28,605). Cumulative survival rates and adjusted hazard ratios (HRs) for the risk of revision were calculated. RESULTS:Unadjusted 13-year survival for cup revision due to aseptic loosening was 97.9% (CI: 96.5-99.4) for uncoated and 97.8% (CI: 96.3-99.4) for HA-coated cups. Adjusted HRs were 0.66 (CI 0.42-1.04) for the presence of HA coating during the first 10 years and 0.87 (CI 0.14-5.38) from year 10-13, compared with uncoated cups. When considering the endpoint cup revision for any reason, unadjusted 13-year survival was similar for uncoated (92.5% [CI: 90.1-94.9]) and HA-coated (94.7% [CI: 93.2-96.3]) cups. The risk of revision of any component due to infection was higher in THA with HA-coated cups than in THA with uncoated cups (adjusted HR 1.4 [CI 1.1-1.9]). CONCLUSIONS:HA-coated cups have a similar risk of aseptic loosening as uncoated cups, thus the use of HA coating seems to not confer any added value in terms of implant stability. The risk of infection seemed higher in THA with use of HA-coated cups, an observation that must be investigated further.

背景与目标：

BACKGROUND & AIMS: :In the present study, we evaluated whether childhood differences in body height between singletons and twins persist into adulthood. Data from the Medical Birth Register of Norway were linked with data from the Norwegian National Conscript Service. This study used data on the 457,999 males who were born alive and without physical anomalies in single or twin births in Norway during 1967-1984 and who were examined at the mandatory military conscription (age 18-20 years; 1985-2003). For sibling comparisons, the authors selected the 1,721 sibships of full brothers that included at least 1 male born in a single birth and at least 1 male born in a twin birth (4,520 persons, including 2,493 twins and 2,027 singletons). An analysis of the total study population using generalized estimating equations showed that the twins were 0.6 cm (95% confidence interval: 0.4, 0.7) shorter than were the singletons after adjustment for a series of background factors. The fixed-effects regression analysis of the sibships that included both twins and singletons showed that the twins were 0.9 cm (95% confidence interval: 0.6, 1.2) shorter than were their singleton brothers. The study suggests that male twins born in Norway during 1967-1984 were slightly shorter in early adulthood than were singletons.

背景与目标： : 在本研究中，我们评估了单身和双胞胎之间的童年身高差异是否会持续到成年。来自挪威医疗出生登记册的数据与来自挪威国家应征者服务局的数据相关联。这项研究使用了有关1967-1984年间挪威单胎或双胎出生且没有身体异常的457,999名男性的数据，并在强制性征兵中接受了检查 (年龄18-20岁; 1985-2003岁)。为了进行兄弟姐妹比较，作者选择了完整兄弟的1,721兄弟姐妹，其中包括至少1个单胎出生的男性和至少1个双胞胎出生的男性 (4,520人，包括2,493个双胞胎和2,027个单胎)。使用广义估计方程对总研究人群进行的分析表明，在调整了一系列背景因素后，双胞胎的0.6厘米 (95% 置信区间: 0.4，0.7) 比单身夫妇短。对包括双胞胎和单胎的同胞进行的固定效应回归分析表明，双胞胎的0.9厘米 (95% 置信区间: 0.6，1.2) 比他们的单胎兄弟短。研究表明，1967-1984年在挪威出生的男性双胞胎在成年初期比单身双胞胎短。

BACKGROUND & AIMS: INTRODUCTION:The cementation of a total hip prosthesis may cause bone necrosis, either by direct toxicity or by generation of heat during the polymerization process. This necrotic bone may create conditions that encourage the growth of bacteria. We compared the revision rates due to infection in primary uncemented total hip arthroplasties (THAs) with those of cemented THAs with antibiotic-loaded cement and to those of cemented THAs without antibiotic cement. METHODS:Data from the Norwegian Arthroplasty Register for the period 1987-2003 were used. To have comparable groups, we analyzed only primary THAs performed because of primary osteoarthrosis, and where both the acetabular and the femoral component of the prosthesis were either uncemented or cemented (n = 56,275). RESULTS:In total, 252 revisions due to infection were reported. Compared to the uncemented THAs (n = 5,259), the risk of revision due to infection for THAs without antibiotic cement (n = 15,802) was increased 1.8 times (CI 1.0-3.1; p = 0.04). No differences could be detected when compared to THAs with antibiotic-loaded cement (n = 35,214) (RR 1.2, CI 0.7-2.0; p = 0.5). The average operating time for uncemented THAs was 15 min less than for cemented THAs. INTERPRETATION:The risk of revision due to infection was the same for uncemented and for cemented arthroplasties with antibiotic-loaded cement, but higher for cemented arthroplasties without antibiotic cement. Our findings can be explained by reduced resistance to infection caused by the cement, which appears to be neutralized by adding antibiotic to the cement.

背景与目标：

BACKGROUND & AIMS: :The antibiotic trimethoprim acts as a folate antagonist. Since trophoblasts are very sensitive to drugs that interfere with the folic acid cycle and thereby inhibit DNA synthesis, use of trimethoprim during the first trimester could be associated with miscarriage. A nationwide cohort study including all women in Denmark with a registered pregnancy between 1997 and 2005 was conducted. We used nationwide registers to identify all women giving birth, having a record of miscarriage or induced abortion. Data on exposure to trimethoprim were obtained from the National Prescription Register. Cox proportional hazard regression analysis with exposure to trimethoprim as a time-dependent variable was used to estimate the risk of miscarriage. The adjusted hazard ratio of having a miscarriage after exposure to trimethoprim in the first trimester compared to non-exposure was 2∙04 (95% confidence interval 1∙43-2∙91). Our results indicate that trimethoprim exposure in the first trimester is associated with a doubling of the hazard of miscarriage.

背景与目标： : 抗生素甲氧苄啶起叶酸拮抗剂的作用。由于滋养细胞对干扰叶酸循环从而抑制DNA合成的药物非常敏感，因此在孕早期使用甲氧苄啶可能与流产有关。进行了一项全国性的队列研究，包括丹麦所有有注册怀孕1997年和2005的妇女。我们使用全国范围的登记册来识别所有有流产或人工流产记录的分娩妇女。甲氧苄啶暴露的数据来自国家处方登记册。使用暴露于甲氧苄啶作为时间相关变量的Cox比例风险回归分析来估计流产的风险。与未接触相比，在孕早期暴露于甲氧苄啶后流产的调整的风险比为2*04 (95% 置信区间1*43-2*91)。我们的结果表明，孕早期甲氧苄氨嘧啶暴露与流产危险加倍有关。

BACKGROUND & AIMS: STUDY QUESTION:Are the fetal outcomes of singleton pregnancies that result from cleavage stage embryo transfer (ET) different from the outcomes from Day 5/6 blastocyst stage ET? SUMMARY ANSWER:There was a significantly higher risk of preterm birth (<37 weeks) in singletons after extended embryo culture (Day 5/6) compared with cleavage stage (Day 3) transfer. WHAT IS KNOWN ALREADY:Two recent studies, from Sweden and the USA, reported an increased risk of preterm birth in singleton pregnancies after Day 5/6 ET compared with Day 3 ET. The US study also showed increased early preterm births and the Swedish study showed increased fetal malformations in this group. STUDY DESIGN, SIZE AND DURATION:A retrospective cohort study was performed. Data were collected from the Canadian ART Register database for all singleton births after fresh IVF/ICSI ET cycles (2001-2009). PARTICIPANTS/MATERIALS, SETTING, METHODS:A total of 12 712 singleton births were included. Of these, 9506 resulted from a Day 3 ET and 3206 resulted from a blastocyst (Day 5/6) ET. MAIN RESULTS AND THE ROLE OF CHANCE:Preterm birth rate <37 weeks (unadjusted by potential confounding factors) was higher with Day 5/6 versus Day 3 transfers (17.2 versus 14.1%, P < 0.001). Using logistic regression analysis to adjust for confounding factors, preterm birth rate <37 weeks was the only outcome significantly increased after Day 5/6 compared with Day 3 transfer (odds ratio 1.32, 95% confidence interval 1.17-1.49). The following confounding factors were adjusted for: year of treatment (2001-2009), maternal age (continuous), parity (0 versus ≥1 birth), diagnosis category, number of oocytes retrieved [≤20 versus >20 (high responder group)], insemination method (IVF versus ICSI), number of embryos transferred (1, 2 or ≥3) and the presence of a vanishing twin (≥1 fetal heart on the initial ultrasonographic examination). LIMITATIONS, REASONS FOR CAUTION:Post-natal follow-up studies will be required to determine if this difference we observed translates into adverse long-term effects on these offspring. The rate of early preterm births (<32 weeks) was higher in Day 5/6 versus Day 3, but the low number of cases in this category did not have the power to show a difference (3.0 versus 2.7%, P = 0.34). WIDER IMPLICATIONS OF THE FINDINGS:We found a significantly higher risk of preterm birth (<37 weeks) in singletons after extended embryo culture (Day 5/6) compared with cleavage stage (Day 3) transfer, even when adjusting for confounding factors. Our findings are in agreement with the previous two studies; however, we did not show a difference in the very preterm deliveries (unlike the US study) or in fetal malformations (as in the Swedish study). We hypothesize that there may be a deleterious effect of prolonged in vitro embryo culture on subsequent placentation. Longer term follow-up studies will be required to determine if prolonged in vitro culture to the blastocyst stage has an adverse effect on the long-term health of offspring when compared with shorter cleavage stage culture. STUDY FUNDING/COMPETING INTEREST(S):None.

背景与目标：

BACKGROUND & AIMS: PURPOSE:To describe the content and potentials of the new Swedish national register on prescribed and dispensed medicines. METHODS:The Swedish Prescribed Drug Register contains information about age, sex and unique identifier of the patient as well as the prescriber's profession and practice. Information regarding drug utilization and expenditures for prescribed drugs in the entire Swedish population was extracted from the first six months July-December 2005 and compared with total drug sales in the country including OTC and hospital use. RESULTS:The total quantity of drugs sold in Sweden was 2666 million DDDs, corresponding to 1608 DDD/1000 inhabitants daily. The total expenditures were 1.6 billion Euro. The prescribed drugs, included in the register, accounted for 84% of the total utilization and 77% of the total expenditures. About half of all men and two-thirds of all women in the country purchased drugs. The proportion increased by age. The most common drugs for chronic treatment were diuretics among women (8.8% of the population) and antithrombotic agents among men (7.6%). Psychotropic drugs, corticosteroids and analgesics were more common among women, while men used antithrombotic agents, antidiabetic drugs, lipid lowering agents and ACE inhibitors to a greater extent. CONCLUSIONS:The new register provides valuable data on exposure to drugs and is useful to study patterns of drug utilization. The possibilities for record linkage to other health registers gives from an international perspective good opportunities to explore drug and disease associations and the risks, benefits, effectiveness and health economical effects of drug use.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:Studies show that migrant women are at greater risk of common mental disorders than the majority population, yet underrepresented in healthcare services. This study investigates the use of outpatient mental healthcare services over a five-year period among migrant and descendant women compared to majority women in Norway. METHODS:Using linked national registry data, we selected all women resident in Norway between 2009 and 2013 (N = 1,834,822). We conducted generalised estimated equations with logistic regression to assess if the odds of using outpatient mental healthcare services differed for migrant and descendant women compared to majority women. We also conducted generalised estimated equations with negative binomial regression to calculate consultation incidence rate ratios for migrant and descendant women relative to majority women among those with a common mental disorder. RESULTS:Both migrant and descendant women had lower odds (OR = 0.47 and OR = 0.60 respectively) of using outpatient mental healthcare services than majority women. Odds of using services increased with length of residency. We also found significant variation by country of origin. Among women with common mental disorders who had used services, migrants, but not descendants, had a lower consultation rate ratio than majority women. Analyses by region of origin revealed that this did not apply to women from EU European countries, North America and Australia and New Zealand. CONCLUSION:Women with migrant background are, overall, underrepresented in OPMH services. Findings indicate that migrant women may not only experience barriers to seeking and accessing care but also in maintaining access to care. This may especially be the case for newly arrived migrant women and women from non-Western countries. Treatment may not be culturally adapted for these groups. Closer investigation of the barriers migrant women experience after using OPMH services is required.

背景与目标：

BACKGROUND & AIMS: PURPOSE:Recruitment and follow-up in epidemiological studies are time-consuming and expensive. Combining online data collection with a register of individuals who agree to be contacted about research opportunities provides an efficient, cost-effective platform for population-based research. HealthWise Wales (HWW) aims to facilitate research by recruiting a cohort of individuals who have consented to be informed about research projects, advertising studies to participants, supporting data collection on specific topics and providing access to linked healthcare data for secondary analyses. In this paper, we describe the design of the project, ongoing data collection, methods of data linkage to routine healthcare records, baseline characteristics of participants, the strengths and limitations of the register, and the ways in which the project can support researchers. PARTICIPANTS:Adults (aged 16 years and above) living or receiving their healthcare in Wales are eligible for inclusion. Participants consent to be contacted for follow-up data collection and for their details to be used to access their routinely collected National Health Service records for research purposes. Data are collected using a web-based application, with new questionnaires added every 6 months. Data collection on sociodemographic and lifestyle factors is repeated at intervals of 2-3 years. Recruitment is ongoing, with 21 779 participants alive and currently registered. FINDINGS TO DATE:99% of participants have complete information on age and sex, and 64% have completed questionnaires on sociodemographic and lifestyle factors. These data can be linked with national health databases within the Secure Anonymised Information Linkage (SAIL) databank, with 93% of participants matching a record in SAIL. HWW has facilitated the recruitment of 43 826 participants to 15 different studies. FUTURE PLANS:The medium-term goal for the project is to enrol at least 50 000 adults. Recruitment strategies are being devised to achieve a study sample that closely models the population of Wales. Potential biosampling methods are also currently being explored.

背景与目标：

BACKGROUND & AIMS: OBJECTIVES:This study aimed to evaluate whether the early achievement of clinical remission influences overall survival in an inception cohort of patients with inflammatory polyarthritis (IP). METHODS:Consecutive early IP patients, recruited to a primary care based inception cohort from 1990 to 1994 and from 2000 to 2004 were eligible for this study. Remission was defined as absence of clinically detectable joint inflammation on a 51-joint count. In sensitivity analyses, less stringent definitions of remission were used, based on 28-joint counts. Remission was assessed at 1, 2 and 3 years after baseline. All patients were flagged with the national death register. Censoring was set at 1 May 2011. The effect of remission on mortality was analysed using the Cox proportional hazard regression model, and presented as HRs and 95% CIs. RESULTS:A total of 1251 patients were included in the analyses. Having been in remission at least once within the first 3 years of follow-up was associated with a significantly lower risk of death: HR 0.72 (95% CI 0.55 to 0.94). Patients who were in remission 1 year after the baseline assessments and had persistent remission over time had the greatest reduction in mortality risk compared with patients who never achieved remission within the first 3 years of follow-up: HR 0.58 (95% CI 0.37 to 0.91). Remission according to less stringent definitions was associated with progressively lower protective effect. CONCLUSIONS:Early and sustained remission is associated with decreased all-cause mortality in patients with IP. This result supports clinical remission as the target in the management of IP.

背景与目标：

BACKGROUND & AIMS: OBJECTIVE:To assess intrapartum epidural use during vaginal delivery among immigrant women giving birth in Norway, compared with Norwegian born women, and to explore associations between epidural use and other maternal characteristics, fetal and obstetrical variables. STUDY DESIGN:Population-based cohort study. Data were obtained from Norwegian Medical Birth Registry and Statistics Norway, including 602 095 deliveries in 1999-2014. Intrapartum epidural analgesia use was described in percentages. Multivariable logistic regression analysis was performed to investigate the association between maternal country of birth and intrapartum epidural use, adjusted with maternal and fetal comorbidity, age, stillbirth, birthweight, fetal presentation, delivery method and time period. RESULTS:There were significant differences in epidural use between women born in different parts of the world. Among nulliparous women, increased odds for intrapartum epidural use was observed among women born in Latin America compared with Norwegian born women, even after adjustment for maternal, fetal and obstetrical factors (aOR 1.93, CI 1.79-2.09). Reduced odds for intrapartum epidural use was observed among nulliparous women born in Sub-Saharan Africa (aOR 0.83, CI 0.78-0.88), East Asia and Pacific area (aOR 0.83, CI 0.80-0.87), and women with unknown country of birth (aOR 0.79, CI 0.71-0.89) compared with Norwegian born women. Similar pattern was observed among parous women from Latin America (aOR 1.69, CI 1.54-1.87), Sub-Saharan Africa (aOR 0.62, CI 0.57-0.67), East-Asia and Pacific area (aOR 0.68, CI 0.64-0.73), unknown country of birth (aOR 0.97, CI 0.84-1.13). Maternal hypertensive disorders, high infant birthweight, stillbirth, breech presentation and operative vaginal delivery increased the odds for use of intrapartum epidural analgesia. CONCLUSIONS:We found differences between immigrant women from different parts of the world and use of intrapartum epidural, possibly related to un-measurable issues like cultural differences, maternal expectations and knowledge of safety on pain relief during childbirth. Intrapartum epidural use was more frequent in conditions related to maternal co-morbidity and factors indicating complicated delivery.

背景与目标：

BACKGROUND & AIMS: AIM:To investigate demographics and outcomes of Vancouver type C periprosthetic femoral fractures (PPFF) treated with open reduction and internal fixation. METHODS:Patient data were obtained from medical charts of cases reported to the Swedish Hip Arthroplasty Register and/or from the National Patient Register. Vancouver type C fractures undergoing surgery between 2001 and 2011, in patients who had received their primary THR between 1979 and 2011, were included. Any further reoperation performed between 2001 and 2013 and related to the PPFF constituted the primary outcome. RESULTS:A total of 632 patients with 639 Vancouver type C fractures were identified. The majority of the patients were women (84%) and they had a fracture distal to a cemented stem (95%). The mean age at the time of fracture was 72 years. Treatment was performed with a locking plate (363 cases), a conventional plate (184 cases), an intramedullary nail (62 cases), or with double plating (30 cases). The overall reoperation rate was 17%, and mortality within one year of the operation was 16%. Locking plates had a significantly lower reoperation rate than conventional plates (p<0.001) and intramedullary nailing (p = 0.005). Interprosthetic femoral fractures did not have a statistically different outcome compared with non-IPFFs. CONCLUSIONS:The lowest reoperation rate was observed using locking plates in Vancouver type C fractures when compared with conventional plates or intramedullary nailing. The presence of an ipsilateral knee prosthesis did not influence the outcome of the surgical treatment.

背景与目标：

BACKGROUND & AIMS: BACKGROUND:An increasing number of young patients are undergoing knee arthroplasties. Thus, the long-term risks of having a knee prosthesis must be evaluated. This study focuses on the potential carcinogenic effects of the prosthesis; it is a long-term follow-up of all patients in Sweden between 1975 and 2006. METHODS:The incidence of cancer in a total population of operated individuals was compared to the overall national cancer incidence in Sweden by means of standardised incidence ratios. Analysis of cancer latency period was performed to identify potential aetiological factors. RESULTS:For male and female patients with rheumatoid arthritis (RA) or osteoarthritis (OA), the overall cancer risks were elevated, ranging from 1.10 (95% confidence interval (CI): 1.03-1.18) for men with OA to 1.26 (1.23-1.29) for men with RA. The greatest increases in risk were observed for the leukaemia subtypes, myelodysplastic syndromes (MDS) and essential thrombocytosis (ET), ranging from 3.31 (1.24-8.83) for ET in men with OA to 7.38 (1.85-29.51) for ET in women with RA. Increases in risk were also observed for breast cancer, prostate cancer and melanoma. The latency analysis revealed elevated risks late in the study period for both solid and haematopoietic cancers. However, only increases in MDS and possibly prostate cancer and melanoma rates appeared to be connected to the operation. CONCLUSION:This study showed that OA and RA arthroplasty patients have a significantly higher risk of cancer than the general population. Elevated risks of MDS and possibly prostate cancer and melanoma indicated a potential connection to exposure to metals in the implant. The observed excessive incidence of ET was likely associated with the inflammatory disease.

背景与目标：

BACKGROUND & AIMS: :This paper presents the principles of implementing register-based cohort studies as currently applied for real-time estimation of influenza vaccine effectiveness in Finland. All required information is retrieved from computerised national registers and deterministically linked via the unique personal identity code assigned to each Finnish resident. The study cohorts comprise large subpopulations eligible for a free seasonal influenza vaccination as part of the National Vaccination Programme. The primary outcome is laboratory-confirmed influenza. Each study subject is taken to be at risk of experiencing the outcome from the onset of the influenza season until the first of the following three events occurs: outcome, loss to follow up or end of season. Seasonal influenza vaccination is viewed as time-dependent exposure. Accordingly, each subject may contribute unvaccinated and vaccinated person-time during their time at risk. The vaccine effectiveness is estimated as one minus the influenza incidence rate ratio comparing the vaccinated with the unvaccinated within the study cohorts. Data collection in register-based research is an almost fully automated process. The effort, resources and the time spent in the field are relatively small compared to other observational study designs. This advantage is pivotal when vaccine effectiveness estimates are needed in real time. The paper outlines possible limitations of register-based cohort studies. It also addresses the need to explore how national and subnational registers available in the Nordic countries and elsewhere can be utilised in vaccine effectiveness research to guide decision making and to improve individual health as well as public health.

背景与目标： : 本文介绍了实施基于注册的队列研究的原则，该原则目前用于芬兰流感疫苗有效性的实时估计。所有必需的信息都从计算机化的国家登记册中检索，并通过分配给每个芬兰居民的唯一个人身份代码确定地链接。作为国家疫苗接种计划的一部分，研究队列包括符合免费季节性流感疫苗接种条件的大亚群。主要结果是实验室确认的流感。从流感季节开始，直到发生以下三个事件中的第一个，每个研究对象都有经历结果的风险: 结果，随访损失或季节结束。季节性流感疫苗接种被视为时间依赖性暴露。因此，每个受试者可能会在其处于危险中的时间内贡献未接种疫苗和接种疫苗的时间。疫苗有效性估计为1减去流感发病率比率，比较研究队列中接种疫苗和未接种疫苗的比率。基于寄存器的研究中的数据收集是一个几乎完全自动化的过程。与其他观察性研究设计相比，在该领域花费的精力，资源和时间相对较小。当需要实时评估疫苗有效性时，这一优势至关重要。本文概述了基于注册的队列研究的可能局限性。它还解决了探索如何在疫苗有效性研究中利用北欧国家和其他地方的国家和国家以下登记册的需求，以指导决策并改善个人健康和公共卫生。

BACKGROUND & AIMS: :Objectives The demographic changes in Europe underline the need for an extension of working lives. This study investigates the importance of physical work demands and psychosocial work factors for working beyond the state pension age (65 years). Methods We combined data from three cohorts of the general working population in Denmark (DWECS 2005 and 2010, and DANES 2008), where actively employed workers aged 55-59 years replied to questionnaires about work environment and were followed until the age of 66 years in the Danish AMRun register of paid employment. Using logistic regression analyses, we calculated prevalence ratios (PR) and 95% confidence intervals (CI) for the association between physical and psychosocial work factors and working beyond state pension age, adjusted for age, sex, cohort, cohabiting, sector, income, vocational education, working hours, lifestyle, and previous sickness absence. Results Of the 2884 workers aged 55-59 years, 1023 (35.5%) worked beyond the state pension age. Higher physical work demands was associated with a lower likelihood (PR 0.69, 95% CI 0.58-0.82) and a good psychosocial work environment was associated with higher likelihood (average of 7 items: PR 1.81, 95% CI 1.49-2.20) of working beyond state pension age. Stratified analyses did not change the overall pattern, ie, a good overall psychosocial work environment - as well as several specific psychosocial factors - increased the likelihood of working beyond state pension age, both for those with physically active and seated work. Conclusion While high physical work demands was a barrier, a good psychosocial work environment seems to facilitate working beyond state pension age, also for those with physically active work.

背景与目标： 目标欧洲的人口变化强调了延长工作寿命的必要性。这项研究调查了体力劳动需求和社会心理工作因素对于超过国家退休金年龄 (65岁) 的工作的重要性。方法我们结合了来自丹麦的三个普通工作人口队列 (DWECS 2005和2010，以及DANES 2008) 的数据，在这些队列中，年龄在55-59岁的积极就业工人回答了有关工作环境的问卷，并在丹麦AMRun有偿就业登记册中一直跟踪到66岁。使用逻辑回归分析，我们计算了身体和心理社会工作因素与国家养老金年龄以外工作之间的关联的患病率 (PR) 和95% 置信区间 (CI)，并根据年龄，性别，队列，同居，部门，收入，职业教育，工作时间，生活方式，和以前的疾病缺席。结果2884名年龄在55-59岁之间的工人中，1023 (35.5%) 的工作年龄超过了国家养老金年龄。较高的体力工作需求与较低的可能性相关 (PR 0.69，95% CI 0.58-0.82)，良好的社会心理工作环境与较高的工作可能性 (7个项目的平均值: PR 1.81，95% CI 1.49-2.20) 国家养老金年龄。分层分析并没有改变总体模式，即良好的整体社会心理工作环境以及一些特定的社会心理因素，增加了从事体育锻炼和坐着工作的人超过国家养老金年龄的工作可能性。结论虽然高体力劳动需求是一个障碍，但良好的心理社会工作环境似乎可以促进国家退休年龄以外的工作，对于那些从事体力劳动的人也是如此。