title: Job strain, effort-reward imbalance and ambulatory blood pressure: results of a cross-sectional study in call handler operators.
abstract: OBJECTIVE
  To examine the association between two job stress models-the job strain (JDC) and the effort-reward imbalance (ERI) model-and ambulatory blood pressure monitoring in call handler operators.
  
  
  METHODS
  Participants included 74 women (age, 34.9 ± 9.9 years) and 26 men (age 36.0 ± 10.8 years) who were monitored on 2 workdays for ambulatory blood pressure. Measures of both job stress models were related to blood pressure by the generalized estimating equations (GEE) method while adjusting for potential confounders (gender, age, cigarette smoking, alcohol consumption, educational level, marital status, time of day, and work schedule).
  
  
  RESULTS
  Workshifts were associated with an increase of 3-4 and 14 mmHg in mean arterial pressure (MAP) compared with diurnal activities out of work and sleeping period, respectively (P < 0.001). Ambulatory blood pressure was also significantly related with work schedule preference: unpleasant work schedule was associated with an increase of 2 mmHg in MAP compared with pleasant work schedule (P = 0.013). In the ERI model, subjects scoring high in work stress have higher ambulatory blood pressure at work, at home, and during sleep. Work stress by time interaction was not longer significant when controlling for potential confounders: generalized estimating equations revealed that MAP was influenced by BMI (>25 vs. <25: 0.7 (0.2-1.1) mmHg), workshift preference (unpleasant vs. pleasant: 2 (0.4-3.6) mmHg), and time of day. Weak not significant relation was found between ABP and psychosocial factors evaluated by the JDC and ERI models.
  
  
  CONCLUSIONS
  These results do not support work stress as a significant factor influencing ABP in a homogeneous group of call-handlers. Complementary information independently obtained from the two work stress models could provide more exhaustive explanations on the stress-related effects on blood pressure.
authors.affiliation: Department of Traumatology, Orthopaedic and Occupational Medicine, University of Torino, Via Zuretti 29, Turin, Italy. giovanni.maina@unito.it
authors.forename: Giovanni
authors.initials: G
authors.lastname: Maina
authors.forename: Massimo
authors.initials: M
authors.lastname: Bovenzi
authors.forename: Antonio
authors.initials: A
authors.lastname: Palmas
authors.forename: Andrea
authors.initials: A
authors.lastname: Prodi
authors.forename: Francesca Larese
authors.initials: FL
authors.lastname: Filon
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory; D003430:Cross-Sectional Studies; D005260:Female; D015277:Hotlines; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D009784:Occupational Diseases; D016272:Occupational Health; D012201:Reward; D013315:Stress, Psychological / Q000453:epidemiology / Q000523:psychology*; D014940:Work Schedule Tolerance / Q000502:physiology / Q000523:psychology; D017132:Workplace / Q000523:psychology*