Job strain, job demands, decision latitude, and risk of coronary heart disease within the Whitehall II study.
OBJECTIVE
To investigate the association between job strain and components of the job strain model and coronary heart disease (CHD) risk.


METHODS
Prospective cohort study (Whitehall II study). At the first phase of the study (1985-1988), data on self reported psychosocial work characteristics were collected from all participants. Participants were followed up until the end of phase 5 (1997-2000), with mean length of follow up of 11 years.


METHODS
London based office staff in 20 civil service departments.


METHODS
6,895 male and 3,413 female civil servants aged 35-55.


METHODS
Incident validated CHD.


RESULTS
People with concurrent low decision latitude and high demands (job strain) were at the highest risk for CHD. High job demands, and, less consistently, low decision latitude, predicted CHD incidence. The effect of job strain on CHD incidence was strongest among younger workers, but there was no effect modification by social support at work, or employment grade.


CONCLUSIONS
Job strain, high job demands, and, to some extent, low decision latitude, are associated with an increased risk of CHD among British civil servants.
Kuper
H
H
International Centre for Health and Society, Department of Epidemiology and Public Health, University College London, London, UK. hannah.kuper@lshtm.ac.uk
Marmot
M
M
D000328:Adult; D000367:Age Factors; D003327:Coronary Disease / Q000453:epidemiology / Q000209:etiology*; D003657:Decision Making; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007588:Job Satisfaction; D008131:London / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology / Q000209:etiology*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012944:Social Support; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000150:complications*; D011795:Surveys and Questionnaires