Article

A longitudinal general population-based study of job strain and risk for coronary heart disease and stroke in Swedish men

BMJ Open (Impact Factor: 2.27). 03/2014; 4(3):e004355. DOI: 10.1136/bmjopen-2013-004355
Source: PubMed

ABSTRACT

The aim was to investigate whether psychosocial stress based on the job-demand-control (JDC) model increased the risk for coronary heart disease (CHD) and stroke.
Swedish men.
The Primary Prevention Study (PPS) comprises 6070 men born between 1915 and 1925 free from previous history of CHD and stroke at baseline (1974-1977). Psychosocial workplace exposure was assessed using a job-exposure matrix (JEM) for the JDC model based on occupation at baseline. The participants were followed from baseline examination, until death, until hospital discharge or until 75 years of age, whichever occurred first, using the Swedish national register on cause of death and the Swedish hospital discharge register for non-fatal and fatal stroke and CHD events. Cox regression models were used with stroke or CHD as the outcome, using JDC model and age as explanatory variables, as well as stratified models with regard to smoking, self-reported stress, socioeconomic status, obesity, hypertension and diabetes.
Risk for stroke and CHD.
There was an increased risk (HR) for CHD in relation to high strain (HR 1.31, 95% CI 1.01 to 1.70). The risk was further increased among ever-smokers and among blue-collar workers. There was a relation between low control and increased risk for CHD (HR 1.19, 95% CI 1.06 to 1.35). There was no increased risk for stroke in any of the JDC categories.
Exposure to occupational psychosocial stress defined as job strain or low control increased the risk for CHD, especially among smokers and blue-collar workers. There was no increased risk for stroke in any of the JDC categories.

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Available from: Mia Söderberg, Mar 25, 2015
    • "Blue-collar jobs tend to be characterized by lower levels of autonomy, lower intellectual discretion and poorer task variety as compared to white-collar jobs [27]. The JDC model was initially developed with data from blue-collar professions, and consequently may capture work stressors that are more pertinent to this occupational subpopulation [26]. By contrast, there is emerging evidence that OJ is relatively more impactful among white-collar employees [28] [29], which has been attributed to their specific relationship with their employer, involving obligations and expectations beyond the formal contract, implying high levels of commitment and trust [28]. "
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