title: Low job control and risk of coronary heart disease in Whitehall II (prospective cohort) study.
abstract: OBJECTIVE
  To determine the association between adverse psychosocial characteristics at work and risk of coronary heart disease among male and female civil servants.
  
  
  METHODS
  Prospective cohort study (Whitehall II study). At the baseline examination (1985-8) and twice during follow up a self report questionnaire provided information on psychosocial factors of the work environment and coronary heart disease. Independent assessments of the work environment were obtained from personnel managers at baseline. Mean length of follow up was 5.3 years.
  
  
  METHODS
  London based office staff in 20 civil service departments.
  
  
  METHODS
  10,308 civil servants aged 35-55 were examined-6895 men (67%) and 3413 women (33%).
  
  
  METHODS
  New cases of angina (Rose questionnaire), severe pain across the chest, diagnosed ischaemic heart disease, and any coronary event.
  
  
  RESULTS
  Men and women with low job control, either self reported or independently assessed, had a higher risk of newly reported coronary heart disease during follow up. Job control assessed on two occasions three years apart, although intercorrelated, had cumulative effects on newly reported disease. Subjects with low job control on both occasions had an odds ratio for any subsequent coronary event of 1.93 (95% confidence interval 1.34 to 2.77) compared with subjects with high job control at both occasions. This association could not be explained by employment grade, negative affectivity, or classic coronary risk factors. Job demands and social support at work were not related to the risk of coronary heart disease.
  
  
  CONCLUSIONS
  Low control in the work environment is associated with an increased risk of future coronary heart disease among men and women employed in government offices. The cumulative effect of low job control assessed on two occasions indicates that giving employees more variety in tasks and a stronger say in decisions about work may decrease the risk of coronary heart disease.
authors.affiliation: Department of Epidemiology and Public Health, University College London Medical School.
authors.forename: H
authors.initials: H
authors.lastname: Bosma
authors.forename: M G
authors.initials: MG
authors.lastname: Marmot
authors.forename: H
authors.initials: H
authors.lastname: Hemingway
authors.forename: A C
authors.initials: AC
authors.lastname: Nicholson
authors.forename: E
authors.initials: E
authors.lastname: Brunner
authors.forename: S A
authors.initials: SA
authors.lastname: Stansfeld
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003327:Coronary Disease / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D008131:London / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology* / Q000523:psychology; D016017:Odds Ratio; D011446:Prospective Studies; D011593:Psychology, Social; D012307:Risk Factors