title: Psychosocial work environment and risk of ischemic stroke and coronary heart disease: a prospective longitudinal study of 75 236 construction workers.
abstract: OBJECTIVE
  The present study aimed to investigate whether different dimensions of psychosocial stress, as measured by the job demand-control model (JDC), were associated with increased risks of ischemic stroke and coronary heart disease (CHD).
  
  
  METHODS
  A cohort of 75 236 male construction workers was followed from 1989-2004. Exposure to psychosocial stress was determined by a questionnaire answered in 1989-1993. Events of ischemic stroke and CHD were found by linkage to the Swedish Causes of Death and National Patient registers. Hazard ratios (HR) were obtained from Cox regression models, adjusted for age, smoking habits, body mass index and systolic blood pressure.
  
  
  RESULTS
  There were 1884 cases of CHD and 739 cases of ischemic stroke. Regarding ischemic stroke, no association was found between job demands [HR 1.12, 95% confidence interval (95% CI) 0.89-1.40, highest versus lowest quintile] or job control (HR 1.04, 95% CI 0.82-1.32, lowest versus highest quintile). Regarding CHD, job demands were associated to CHD (HR 1.18, 95% CI 1.02-1.37, highest vs. lowest quintile), but no consistent trend was seen among quintiles. The results were inconsistent in relation to job control. The division of JDC into four categories showed no significant associations with either ischemic stroke or CHD.
  
  
  CONCLUSIONS
  This exploratory study showed no significant associations between psychosocial work environment and ischemic stroke, and the associations between job demands and control and CHD were inconsistent and weak. The combination of job control and job demand showed no significant associations with either ischemic stroke or CHD.
authors.affiliation: Department of Occupational and Environmental Medicine, Institution of Medicine, Sahlgrenska Academy, University of Gothenburg, Box 414, 405 30 Gothenburg, Sweden. linus.schioler@amm.gu.se.
authors.forename: Linus
authors.initials: L
authors.lastname: Schiöler
authors.forename: Mia
authors.initials: M
authors.lastname: Söderberg
authors.forename: Annika
authors.initials: A
authors.lastname: Rosengren
authors.forename: Bengt
authors.initials: B
authors.lastname: Järvholm
authors.forename: Kjell
authors.initials: K
authors.lastname: Torén
mesh_terms: D000328:Adult; D060389:Construction Industry; D003327:Coronary Disease / Q000453:epidemiology*; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology*; D013548:Sweden / Q000453:epidemiology; D017132:Workplace