PEOPLE WHO HAVE highly demanding jobs and little freedom to make decisions are 23 per cent more likely to have a heart attack, a new study says.
The study, which was published in The Lancet, looked at nearly 200,000 people from seven different European countries.
Mika Kivimäki from University College London, who led the research, explained:
The pooling of published and unpublished studies allowed us to investigate the association between coronary heart disease (CHD) and exposure to job strain [defined by high work demands and low decision control] with greater precision than has been previously possible.
Kivimäki said their findings indicate that job strain “is associated with a small, but consistent, increased risk of experiencing a first CHD event such as a heart attack”.
Kivimäki also said that previous studies examining the impact of job strain on heart disease have been “inconsistent in their findings, limited in scope, and plagued by methodological shortcomings including publication bias and reverse causation bias”.
Participants
Kivimäki and colleagues analysed job strain in employees without CHD who participated in 13 European national cohorts conducted in Belgium, Denmark, Finland, France, Netherlands, Sweden, and the UK between 1985 and 2006.
All participants completed questionnaires at the start of the studies to assess job demands, excessive workload, the level of time-pressure demands, and freedom to make decisions.
The researchers recorded 2356 events of incident CHD – a first non-fatal heart attack or coronary death – during the average 7.5 year course of follow-up.
The 23 per cent higher risks for people who reported job strain remained the same even after taking into account factors such as lifestyle, age, gender, and socioeconomic status.
What is more, said Kivimäki:
The overall population attributable risk (PAR) for CHD events was around 3.4 per cent, suggesting that if the association were causal, then job strain would account for a notable proportion of CHD events in working populations. As such, reducing workplace stress might decrease disease incidence.
But Kivimäki said that this strategy would have a much smaller effect than tackling standard risk factors such as smoking (PAR 36 per cent) and physical inactivity (PAR 12 per cent).
Bo Netterstrøm from Bispebjerg Hospital, Copehagen, Denmark noted that job strain is a measure of only part of a “psychosocially damaging” work environment:
which implies that prevention of workplace stress could reduce incidence of coronary heart disease to a greater extent than stated in the authors’ interpretation of the calculated population-attributable risk for job strain.
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