Job strain and major risk factors for coronary heart disease among employed males and females in a Swedish study on work, lipids and fibrinogen
Scandinavian Journal of Work Environment & HealthPublished 1 August 2002Open access
Lars Alfredsson, Niklas Hammar, Eleonor I. Fransson, Ulf dé Fairé, Johan Hallqvist, Anders Knutsson
Citations107
SJR quartileQ1
SJR score2.18
SNIP1.61
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
The results do not support the hypothesis that job strain has an adverse impact on serum total cholesterol and plasma fibrinogen levels, and suggest that an increased risk of coronary heart disease in association with job strain is mediated by other factors, possibly partly by hypertension and low levels of high-density lipoprotein cholesterol.
Abstract
The results do not support the hypothesis that job strain has an adverse impact on serum total cholesterol and plasma fibrinogen levels. They suggest that an increased risk of coronary heart disease in association with job strain, if causal, is mediated by other factors, possibly partly by hypertension and low levels of high-density lipoprotein cholesterol.
Keywords
MedicineHealth Professions
JNCI Journal of the National Cancer InstituteStatistical Aspects of the Analysis of Data From Retrospective Studies of Disease
14,860 Citations1959Nathan Mantel, William Haenszel
American Journal of Public HealthJob strain, work place social support, and cardiovascular disease: a cross-sectional study of a random sample of the Swedish working population.
2,672 Citations1988J V Johnson, E M Hall
It was found that self-reported psychological job demands, work control, and co-worker social support combined greater then multiplicatively in relation to CVD prevalence.
American Journal of Public HealthJob decision latitude, job demands, and cardiovascular disease: a prospective study of Swedish men.
1,590 Citations1981Robert Karasek, Dean Baker +3 more
The association between specific job characteristics and subsequent cardiovascular disease was tested using a large random sample of the male working Swedish population and the prospective development of coronary heart disease symptoms and signs was analyzed using a multivariate logistic regression technique.
American Journal of EpidemiologyRE: “ESTIMABILITY AND ESTIMATION IN CASE-REFERENT STUDIES”
1,557 Citations1977Max Halperin
American Journal of EpidemiologyESTIMABILITY AND ESTIMATION IN CASE-REFERENT STUDIES
1,325 Citations1976Olli S. Miettinen
The concepts that case-referent studies provide for the estimation of "relative risk" only if the illness is "rare", and that the rates and risks themselves are inestimable, are overly superficial and restrictve.
Journal of Occupational Health PsychologyCurrent issues relating to psychosocial job strain and cardiovascular disease research.
838 Citations1996Töres Theorell, Robert Karasek
Scandinavian Journal of Work Environment & HealthCombined effects of job strain and social isolation on cardiovascular disease morbidity and mortality in a random sample of the Swedish male working population.
682 Citations1989Jeffrey V. Johnson, E M Hall +1 more
Blue-collar workers showed the greatest risk for both morbidity and mortality when groups with highly isolated and strained conditions were compared to those in more collective and less strained conditions.
American Journal of Public HealthJob characteristics in relation to the prevalence of myocardial infarction in the US Health Examination Survey (HES) and the Health and Nutrition Examination Survey (HANES).
614 Citations1988Robert Karasek, Töres Theorell +4 more
It is found that employed males with jobs which are simultaneously low in decision latitude and high in psychological work load have a higher prevalence of myocardial infarction in both data bases.
American Journal of Public HealthLong-term psychosocial work environment and cardiovascular mortality among Swedish men.
346 Citations1996J V Johnson, Walter F. Stewart +3 more
Results indicate that long-term exposure to low work control is a risk factor for cardiovascular disease mortality.
American Journal of Public HealthDecision latitude, job strain, and myocardial infarction: a study of working men in Stockholm. The SHEEP Study Group. Stockholm Heart epidemiology Program.
327 Citations1998Töres Theorell, Akizumi Tsutsumi +6 more
Both negative change in inferred decision latitude and self-reported job strain are important risk indicators in men less than 55 years of age and in blue-collar workers.
Psychosomatic MedicineA Longitudinal Study of Job Strain and Ambulatory Blood Pressure
310 Citations1998Peter L. Schnall, Joseph E. Schwartz +3 more
New evidence is provided that job strain is an occupational risk factor in the etiology of essential hypertension, and change in job strain status partially predicted change in ABP.
Journal of Epidemiology & Community HealthHigh effort, low reward, and cardiovascular risk factors in employed Swedish men and women: baseline results from the WOLF Study.
266 Citations1998R Peter, Lars Alfredsson +4 more
Findings lend support to the hypothesis that effort-reward imbalance represents a specific constellation of stressful experience at work related to cardiovascular risk.
The LancetChildhood social circumstances and psychosocial and behavioural factors as determinants of plasma fibrinogen
259 Citations1996Eric J. Brunner, Michael Marmot +4 more
Evidence is provided that adult fibrinogen concentration is determined by factors operating throughout life, including the psychosocial characteristics, as a marker of the biological pathways that mediate the inverse socioeconomic gradient in coronary disease.
International Journal of EpidemiologyType of Occupation and Near-Future Hospitalization for Myocardial Infarction and Some Other Diagnoses
254 Citations1985Lars Alfredsson, Curt-Lennart Spetz +1 more
Male subjects employed in occupations where a high proportion reported a combination of hectic work and few possibilities to learn new things were more frequently hospitalized for myocardial infarction than other working men.
Current Hypertension ReportsMental stress as a causal factor in the development of hypertension and cardiovascular disease
232 Citations2001Thomas G. Pickering
Depression is emerging as the most important component with respect to cardiovascular disease.
American Journal of EpidemiologyOCCUPATIONAL STRAIN AND THE INCIDENCE OF CORONARY HEART DISEASE
192 Citations1989Dwayne Reed, Andrea Z. LaCroix +3 more
The hypothesis that men in high "strain" occupations have an increased risk of developing coronary heart disease was tested during an 18-year follow-up study from 1965-1983 of a cohort of 8,006 men of Japanese ancestry in Hawaii.
American Journal of EpidemiologyDecision Latitude, Psychologic Demand, Job Strain, and Coronary Heart Disease in the Western Electric Study
166 Citations1994Toni Alterman, Richard B. Shekelle +2 more
This study provided only limited evidence for associations between job characteristics and coronary heart disease mortality, and stratified by occupational class indicated that the effect of decision latitude was more pronounced for white-collar than for blue-collar workers.
Occupational and Environmental MedicineAssociation between job strain and prevalence of hypertension: a cross sectional analysis in a Japanese working population with a wide range of occupations: the Jichi Medical School cohort study
152 Citations2001Akizumi Tsutsumi, Kazunori Kayaba +2 more
The findings provided limited proof that job strain is related to hypertension in Japanese working men, and older men in a lower social class may be more vulnerable to the hypertensive effects of job strain.
BMJCoronary heart disease and mortality in middle aged men from different occupational classes in Sweden.
145 Citations1988Annika Rosengren, Hans Wedel +1 more
A retrospective analysis of the data showed that low occupational class was associated with slight increases in smoking rates, systolic blood pressure, serum cholesterol concentration, body mass index, and heart rate, and a weak but independent inverse relation was found between occupational class and fatal cancer.
CirculationJob Strain and the Prevalence and Outcome of Coronary Artery Disease
145 Citations1995Mark A. Hlatky, Lai Choi Lam +6 more
Job strain was not correlated with the prevalence or severity of coronary artery disease in a cohort of patients undergoing coronary angiography and was not a predictor of cardiac events (cardiac death or nonfatal myocardial infarction) during follow-up.
Occupational and Environmental MedicineJob strain, social support at work, and incidence of myocardial infarction.
135 Citations1998Niklas Hammar, Lars Alfredsson +1 more
The results indicate that jobs characterised by low decision latitude, high job strain, or low social support at work may be associated with an increased risk of acute myocardial infarction.
Occupational and Environmental MedicineJob strain and cardiovascular risk factors: a cross sectional study of employed Danish men and women.
130 Citations1991Bo Netterstrøm, Thomas Kristensen +3 more
Body mass index and HbA1C concentration were significantly associated with objective job strain independent of confounders and no significant association was found between coronary risk factors and subjective job strain.
International Archives of Occupational and Environmental HealthPsychosocial work environment and the risk of coronary heart disease
129 Citations2000Richard Peter, Johannés Siegrist
Information derived from theoretical models on psychosocial work environment may help to better identify populations at risk and to develop and apply specific, theory-guided preventive activities in the future.
Scandinavian Journal of Work Environment & HealthJob strain and ambulatory blood pressure profiles.
112 Citations1991Töres Theorell, Ulf dé Fairé +4 more
A measure of job strain derived from the occupational classification is useful in predicting variations in diastolic blood pressure levels during sleep and work for men with borderline hypertension.
American Journal of EpidemiologyPlasma Fibrinogen: Levels and Correlates in Young Adults
112 Citations1993Aaron R. Folsom, Hekmat T. Qamhieh +5 more
Even in young adults, fibrinogen is associated positively with most risk factors for atherosclerotic cardiovascular disease, which has implications for the role of fibr inogen as a risk factor and, potentially, for cardiovascular disease prevention.
Journal of Internal MedicineChronic work stress is associated with atherogenic lipids and elevated fibrinogen in middle‐aged men
111 Citations1997Johannés Siegrist, R. PETER +2 more
Chronic work stress is associated with atherogenic lipids and elevated fibrinogen in middle‐aged men and it is recommended that men with a history of chronic work stress be aware of their work-life balance.
Scandinavian Journal of Work Environment & HealthDoes a stressful psychosocial work environment mediate the effects of shift work on cardiovascular risk factors?
110 Citations1999Richard Peter, Lars Alfredsson +3 more
The results indicated that a stressful psychosocial work environment acts as a mediator of health-adverse effects of shift work on hypertension and, partly, atherogenic lipids.
Annual Review of Public HealthJob Strain and Cardiovascular Disease
99 Citations1994Peter L. Schnall
In 1985, Baker evaluated the evidence for these two models and concluded that the job strain model has greater "predictive power" than that of the P-E fit, which focuses on objective features of the work environment that can trigger disease.
American Journal of Industrial MedicineA follow-up study of job strain and heart disease among males in the NHANES1 population
98 Citations1997Kyle Steenland, Jeffrey G. Johnson +1 more
It is suggested that class-specific analyses are needed in studying job stress, and that "active" blue-collar workers with high control and high demand are protected against heart disease.
Social Science & MedicinePsychosocial work characteristics and cardiovascular disease risk factors in young adults: The CARDIA study
83 Citations1995Kurt J. Greenlund, Kiang Liu +4 more
Few associations supported the hypotheses that high job demands, low decision latitude or job strain are associated with increased levels of CVD risk factors, including methodologic, age and gender differences between studies.
International Archives of Occupational and Environmental HealthJob strain and arterial blood pressure, serum cholesterol, and smoking as risk factors for coronary heart disease in Japan
76 Citations1998Norito Kawakami, Takashi Haratani +1 more
It is suggested that job strain as defined in the job demands-control model is associated with increased systolic and diastolic blood pressures in male daytime workers in Japan and smoking might be affected by lower work-site social support.
HypertensionPerceived Job Stress but not Individual Cardiovascular Reactivity to Stress Is Related to Higher Blood Pressure at Work
74 Citations2001Jean Pierre Fauvel, P Quelin +3 more
This study quantifies high-professional strain effects on BP levels that appear to be higher only during the working period and to be independent from spontaneous BP variability and stress BP reactivity.
Scandinavian Journal of Work Environment & HealthDifferences in the incidence of myocardial infarction among occupational groups.
73 Citations1992Niklas Hammar, Lars Alfredsson +2 more
A case-referent study was carried out to estimate the relative risk of a first myocardial infarction in various occupational groups, and an increased incidence, compared with that of others employed, was found for persons in some occupations in production work, transport work, men, and service work.
AtherosclerosisAtherogenic risk in men suffering from occupational stress
70 Citations1988Johannés Siegrist, Herbert Matschinger +2 more
Blue-collar workers suffering from chronic occupational stress exhibit significantly higher values of an atherogenic index as compared to men exposed to less stress at work as well as experimental animal studies on the influence of chronic social stress on the development of atherosclerosis.
International Journal of Behavioral MedicineLipid lowering through work stress reduction
70 Citations1994Kristina Orth‐Gomér, Ingeborg Eriksson +3 more
Swedish civil servants, who reported considerable stress while working in larger government authorities, were randomized into either a work stress reduction intervention or a control group, which has implications for the efficacy of work stress interventions in decreasing coronary risk.
Social Science & MedicineJob characteristics of occupations and myocardial infarction risk: Effect of possible confounding factors
68 Citations1983Lars Alfredsson, Töres Theorell
It was concluded that occupations characterized by both high demand and at the same time small possibility of control or growth ('strain') are associated with an elevated MI risk regardless of the confounding factors.
Psychotherapy and PsychosomaticsCoping with Unfair Treatment at Work – What Is the Relationship between Coping and Hypertension in Middle-Aged Men and Women?
63 Citations2000Töres Theorell, Lars Alfredsson +2 more
In men, covert coping was associated with prevalence of hypertension, andCoping patterns were correlated with psychosocial work environment factors, in particular decision latitude.
Journal of Epidemiology & Community HealthAssociation between job characteristics and plasma fibrinogen in a normal working population: a cross sectional analysis in referents of the SHEEP Study. Stockholm Heart Epidemiology Program.
62 Citations1999Akizumi Tsutsumi, T Theorell +3 more
The results indicate that adverse job characteristics may be related to plasma fibrinogen concentrations and this relation is more relevant in female workers.
Psychological MedicineThe relationship between job strain and coronary heart disease: evidence from an English sample of the working male population
60 Citations2001Amanda Sacker, Mel Bartley +3 more
The analyses broadly support Karasek's demand–control model of job strain while independent associations between job strain and all CHD measures considered together indicate that job strain may have aetiological significance for heart disease.
Journal of Epidemiology & Community HealthLipid profile and socioeconomic status in healthy middle aged women in Sweden.
53 Citations1997Sarah Wamala, Alicja Wolk +2 more
Decision latitude at work was the strongest SES predictor of HDL levels in healthy middle aged Swedish women, after simultaneous adjustment for other SES measures, age, and all lifestyle factors in the multivariable regression model.
Psychosomatic MedicineRelation of Type A Behavior Pattern and Job-Related Psychosocial Factors to Nonfatal Myocardial Infarction: A Case-Control Study of Japanese Male Workers and Women
40 Citations2001Kouichi Yoshimasu
Type A behavior pattern may be an important risk factor for AMI especially in Japanese women, and persons in stressful psychosocial circumstances were less likely to participate in the study.
Japanese Circulation JournalAssociation Between Job Strain Status and Cardiovascular Risk in a Population of Taiwanese White-Collar Workers
21 Citations2001Chien‐Tien Su
Plasma fibrinogen was significantly and positively associated with job strain status in both male and female workers and also with decision latitude in female workers only.
Scandinavian Journal of Work Environment & HealthSocioeconomic status, workplace characteristics and plasma fibrinogen level of Japanese male employees
19 Citations2001Masao Ishizaki, Pekka Martikainen +3 more
Workplace characteristics are not significantly related to the plasma fibrinogen levels of male Japanese employees after adjustment for socioeconomic status, and they do not explain socioeconomic differences in plasma fibrinogen levels among these employees.
European Journal of Cardiovascular Prevention & RehabilitationBlood Lipid Levels in a Rural Male Population
15 Citations2001Anders Thelin, E-L Stiernström +1 more
It is indicated that diet is of minor significance for the blood lipid profile, whereas factors such as physical activity, body weight and the waist/hip ratio, smoking, alcohol consumption, and perhaps psychosocial working conditions are major independent factors affecting theBlood lipid profile most prominently among farmers, but also among non-farming rural men.