miun.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Job strain as a risk factor for coronary heart disease: A collaborative meta-analysis of individual participant data
Department of Epidemiology and Public Health, University College London, London WC1E 6BT, United Kingdom.
Finnish Institute of Occupational Health, Helsinki, Finland.
Department of Epidemiology and Public Health, University College London, London WC1E 6BT, United Kingdom.
Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Show others and affiliations
2012 (English)In: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 380, no 9852, p. 1491-1497Article in journal (Refereed) Published
Abstract [en]

Background Published work assessing psychosocial stress (job strain) as a risk factor for coronary heart disease is inconsistent and subject to publication bias and reverse causation bias. We analysed the relation between job strain and coronary heart disease with a meta-analysis of published and unpublished studies. Methods We used individual records from 13 European cohort studies (1985-2006) of men and women without coronary heart disease who were employed at time of baseline assessment. We measured job strain with questions from validated job-content and demand-control questionnaires. We extracted data in two stages such that acquisition and harmonisation of job strain measure and covariables occurred before linkage to records for coronary heart disease. We defined incident coronary heart disease as the first non-fatal myocardial infarction or coronary death. Findings 30 214 (15%) of 197 473 participants reported job strain. In 1•49 million person-years at risk (mean follow-up 7•5 years [SD 1•7]), we recorded 2358 events of incident coronary heart disease. After adjustment for sex and age, the hazard ratio for job strain versus no job strain was 1•23 (95% CI 1•10-1•37). This effect estimate was higher in published (1•43, 1•15-1•77) than unpublished (1•16, 1•02-1•32) studies. Hazard ratios were likewise raised in analyses addressing reverse causality by exclusion of events of coronary heart disease that occurred in the first 3 years (1•31, 1•15-1•48) and 5 years (1•30, 1•13-1•50) of follow-up. We noted an association between job strain and coronary heart disease for sex, age groups, socioeconomic strata, and region, and after adjustments for socioeconomic status, and lifestyle and conventional risk factors. The population attributable risk for job strain was 3•4%. Interpretation Our findings suggest that prevention of workplace stress might decrease disease incidence; however, this strategy would have a much smaller effect than would tackling of standard risk factors, such as smoking. Funding Finnish Work Environment Fund, the Academy of Finland, the Swedish Research Council for Working Life and Social Research, the German Social Accident Insurance, the Danish National Research Centre for the Working Environment, the BUPA Foundation, the Ministry of Social Affairs and Employment, the Medical Research Council, the Wellcome Trust, and the US National Institutes of Health.

Place, publisher, year, edition, pages
2012. Vol. 380, no 9852, p. 1491-1497
National Category
Public Health, Global Health, Social Medicine and Epidemiology Occupational Health and Environmental Health Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:miun:diva-17376DOI: 10.1016/S0140-6736(12)60994-5ISI: 000310272000029Scopus ID: 2-s2.0-84867845081OAI: oai:DiVA.org:miun-17376DiVA, id: diva2:570649
Note

CODEN: LANCA

Available from: 2012-11-20 Created: 2012-11-19 Last updated: 2018-01-12Bibliographically approved

Open Access in DiVA

fulltext(284 kB)391 downloads
File information
File name FULLTEXT01.pdfFile size 284 kBChecksum SHA-512
232c4bb3995ae5e0ac2a79e7556c4651d24325b661c7a5d9ff98348acec90b54257beeeabecc5469258787442cff66c9b336da0892b35ca6f1e2c1bb8a2a804a
Type fulltextMimetype application/pdf

Other links

Publisher's full textScopus

Authority records BETA

Knutsson, Anders

Search in DiVA

By author/editor
Knutsson, Anders
By organisation
Department of Health Sciences
In the same journal
The Lancet
Public Health, Global Health, Social Medicine and EpidemiologyOccupational Health and Environmental HealthCardiac and Cardiovascular Systems

Search outside of DiVA

GoogleGoogle Scholar
Total: 391 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

doi
urn-nbn

Altmetric score

doi
urn-nbn
Total: 214 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf