title: Prospective study on occupational stress and risk of stroke.
abstract: BACKGROUND
  No prospective studies have examined the association between occupational stress according to the job demand-control model and the risk of stroke in Asian populations.
  
  
  METHODS
  We conducted a multicenter community-based prospective study of 6553 Japanese male and female workers. Occupational stress was evaluated using a Japanese version of the job demand-control model questionnaire. We used the Cox proportional hazards model to evaluate the association between occupational stress and stroke.
  
  
  RESULTS
  During a mean follow-up of 11 years, we identified 147 incident strokes. Multivariable analysis revealed a more than 2-fold increase in the risk of total stroke among men with job strain (combination of high job demand and low job control) (hazard ratio, 2.73; 95% confidence interval, 1.17-6.38) compared with counterpart men with low strain (combination of low job demand and high job control) after adjustment for age, educational attainment, occupation, smoking status, alcohol consumption, physical activity, and study area. Additional adjustments for biologic risk factors attenuated the hazard ratio, but there continued to be statistical significance (hazard ratio, 2.53; 95% confidence interval, 1.08-5.94). In women, no statistically significant differences were found for any stroke incidence among the job characteristic categories.
  
  
  CONCLUSIONS
  Occupational stress related to job strain was associated with incident strokes among Japanese men.
authors.affiliation: Occupational Health Training Center, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan. tsutsumi@med.uoeh-u.ac.jp
authors.forename: Akizumi
authors.initials: A
authors.lastname: Tsutsumi
authors.forename: Kazunori
authors.initials: K
authors.lastname: Kayaba
authors.forename: Kazuomi
authors.initials: K
authors.lastname: Kario
authors.forename: Shizukiyo
authors.initials: S
authors.lastname: Ishikawa
mesh_terms: D017677:Age Distribution; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D007588:Job Satisfaction; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009784:Occupational Diseases / Q000150:complications / Q000453:epidemiology*; D011336:Probability; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D013315:Stress, Psychological / Q000150:complications / Q000453:epidemiology*; D020521:Stroke / Q000453:epidemiology* / Q000209:etiology*; D011795:Surveys and Questionnaires; D016019:Survival Analysis; D016526:Workload