title: The Association between Job Strain and Atrial Fibrillation: Results from the Swedish WOLF Study.
abstract: BACKGROUND
  Atrial fibrillation (AF) is a common heart rhythm disorder. Several life-style factors have been identified as risk factors for AF, but less is known about the impact of work-related stress. This study aims to evaluate the association between work-related stress, defined as job strain, and risk of AF.
  
  
  METHODS
  Data from the Swedish WOLF study was used, comprising 10,121 working men and women. Job strain was measured by the demand-control model. Information on incident AF was derived from national registers. Cox proportional hazard regression was used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the association between job strain and AF risk.
  
  
  RESULTS
  In total, 253 incident AF cases were identified during a total follow-up time of 132,387 person-years. Job strain was associated with AF risk in a time-dependent manner, with stronger association after 10.7 years of follow-up (HR 1.93, 95% CI 1.10-3.36 after 10.7 years, versus HR 1.11, 95% CI 0.67-1.83 before 10.7 years). The results pointed towards a dose-response relationship when taking accumulated exposure to job strain over time into account.
  
  
  CONCLUSIONS
  This study provides support to the hypothesis that work-related stress defined as job strain is linked to an increased risk of AF.
authors.affiliation: School of Health Sciences, Jönköping University, 551 11 Jönköping, Sweden ; Institute of Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden.
authors.forename: Eleonor I
authors.initials: EI
authors.lastname: Fransson
authors.affiliation: School of Health Sciences, Jönköping University, 551 11 Jönköping, Sweden.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Stadin
authors.affiliation: Department of Psychology, Umeå University, 901 87 Umeå, Sweden ; Stress Research Institute, Stockholm University, 106 91 Stockholm, Sweden.
authors.forename: Maria
authors.initials: M
authors.lastname: Nordin
authors.affiliation: School of Health Sciences, Jönköping University, 551 11 Jönköping, Sweden ; Department of Internal Medicine, County Hospital Ryhov, 551 85 Jönköping, Sweden.
authors.forename: Dan
authors.initials: D
authors.lastname: Malm
authors.affiliation: Department of Health Sciences, Mid Sweden University, 851 70 Sundsvall, Sweden.
authors.forename: Anders
authors.initials: A
authors.lastname: Knutsson
authors.affiliation: Institute of Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden.
authors.forename: Lars
authors.initials: L
authors.lastname: Alfredsson
authors.affiliation: Occupational and Environmental Medicine, Uppsala University, 751 85 Uppsala, Sweden.
authors.forename: Peter J M
authors.initials: PJ
authors.lastname: Westerholm
mesh_terms: D000328:Adult; D001281:Atrial Fibrillation / Q000209:etiology*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D016016:Proportional Hazards Models; D012307:Risk Factors; D013315:Stress, Psychological / Q000150:complications*; D013548:Sweden; D044465:White People / Q000523:psychology; D014937:Work / Q000502:physiology* / Q000523:psychology