Long-term psychosocial work environment and cardiovascular mortality among Swedish men.
J V Johnson,
W Stewart,
E M Hall,
P Fredlund and
T Theorell
Department of Health Policy, Johns Hopkins University, Baltimore, MD, 21205, USA
OBJECTIVES. This study examined the effect of cumulative exposureto work organization--psychological demands, work control, andsocial support on prospectively measured cardiovascular diseasemortality risk. METHODS. The source population was a nationalsample of 12517 subjects selected from the Swedish male populationby Statistics Sweden in annual surveys between 1977 and 1981.Over a 14-year follow-up period, 521 deaths from cardiovasculardisease were identified. A nested case-control design was used.Work environment exposure scores were assigned to cases andcontrols by linking lifetime job histories with a job exposurematrix. RESULTS. Conditional logistic regression analysis wasused in examining cardiovascular mortality risk in relationto work exposure after adjustment for age, year last employed,smoking, exercise, education, social class, nationality, andphysical job demands. In the final multi-variable analysis,workers with low work control had a relative risk of 1.83 (95%confidence interval [CI] = 1.19, 2.82) for cardiovascular mortality.Workers with combined exposure to low control and low supporthad a relative risk of 2.62 (95% CI=1.22, 5.61). CONCLUSIONS.These results indicate that long-term exposure to low work controlis a risk factor for cardiovascular disease mortality.
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