Does working while ill trigger serious coronary events? The Whitehall II study.
OBJECTIVE
Working while ill has been found to predict coronary heart disease. We tested if this association was due to triggering.


METHODS
We used a nested case-control study in an occupational cohort to examine sickness absences during a 2-year period immediately before the first coronary event for 133 cases and 928 matched controls without a history of coronary events. Working while ill was defined as no absence despite being unhealthy (suboptimal self-rated health or psychological distress).


RESULTS
The odds of a coronary event were not higher for cases who worked while ill than for correspondingly unhealthy controls who took >0 to 14 days of absence per year (OR = 0.62; 95% CI = 0.28 to 1.38). These results were little affected by multiple adjustments.


CONCLUSIONS
We found no evidence that working while ill acts as a short-term trigger for coronary events.
Westerlund
Hugo
H
Stress Research Institute, Stockholm University, SE-106 91 Stockholm, Sweden. hugo.westerlund@stress.su.se
Kivimaki
Mika
M
Ferrie
Jane E
JE
Marmot
Michael
M
Shipley
Martin J
MJ
Vahtera
Jussi
J
Head
Jenny
J
D000328:Adult; D016022:Case-Control Studies; D016001:Confidence Intervals; D003327:Coronary Disease / Q000453:epidemiology / Q000209:etiology*; D004651:Employment; D005260:Female; D006304:Health Status; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016272:Occupational Health; D016017:Odds Ratio; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D018582:Sick Leave; D018434:Sickness Impact Profile; D013315:Stress, Psychological; D017132:Workplace