Prospective study on occupational stress and risk of stroke.
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.
Tsutsumi
Akizumi
A
Occupational Health Training Center, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan. tsutsumi@med.uoeh-u.ac.jp
Kayaba
Kazunori
K
Kario
Kazuomi
K
Ishikawa
Shizukiyo
S
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