Job strain and ischemic heart disease: a prospective study using a new approach for exposure assessment.
BACKGROUND
Prolonged psychosocial load at the workplace may increase the risk of ischemic heart disease (IHD), but the issue is still unsettled. We analyzed the association between psychosocial workload and risk of IHD using a new approach allocating measures of psychosocial load to individuals based on the average exposure level in minor work units.


METHODS
Cohort study of 18,258 Danish public service workers in 1106 work units; 79% were women; 108 subjects with history of cardiovascular disease were excluded from the follow-up. The outcome was hospitalization due to IHD (angina pectoris or myocardial infarction) during the period 2002 to end of 2007.


RESULTS
During 87,428 person-years at risk (mean follow-up = 4.82 years), 101 subjects were admitted to a hospital due to IHD. Neither job strain (synergy of job demands and job control) nor general job dissatisfaction were related to IHD risk. However, compared with others, subjects who were allocated to the low job control category, had an increased risk of IHD, Hazard Ratio (95% CI) = 2.0 (1.1 to 3.6).


CONCLUSIONS
The findings presented do not lend support to the hypothesis that high job strain and job dissatisfaction are important determinants for IHD among Danish predominantly female public service workers.
Department of Occupational and Environmental Medicine, Copenhagen University Hospital Bispebjerg, Copenhagen NV DK-2400, Denmark. jpb@bbh.regionh.dk
Jens Peter
JP
Bonde
Torsten
T
Munch-Hansen
Esben
E
Agerbo
Poul
P
Suadicani
Joanna
J
Wieclaw
Niels
N
Westergaard-Nielsen
D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D004651:Employment / Q000523:psychology*; D005260:Female; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000453:epidemiology*; D016273:Occupational Exposure; D011446:Prospective Studies; D013315:Stress, Psychological / Q000150:complications*; D011795:Surveys and Questionnaires; D017132:Workplace; D055815:Young Adult