Ari Väänänen ^1*, Aki Koskinen ¹, Matti Joensuu ¹, Mika Kivimäki ², Jussi Vahtera ¹, Anne Kouvonen ³, Paavo Jäppinen ⁴

¹ Finnish Institute of Occupational Health
² University College London
³ University of Nottingham
⁴ The Finnish Medical Association

^* To whom correspondence should be addressed. E-mail: ari.vaananen{at}ttl.fi.

	Abstract

Objectives. We examined whether the distinctive components of job control—decision authority, skill discretion, and predictability—were related to subsequent acute myocardial infarction (MI) events in a large population of initially heart disease–free industrial employees.

Methods. We prospectively examined the relation between the components of job control and acute MI among private-sector industrial employees. During an 18-year follow-up, 56 fatal and 316 nonfatal events of acute MI were documented among 7663 employees with no recorded history of cardiovascular disease at baseline (i.e., 1986).

Results. After adjustment for demographics, psychological distress, prevalent medical conditions, lifestyle risk factors, and socioeconomic characteristics, low decision autonomy (P<.53) and skill discretion (P<.10) were not significantly related to subsequent acute MI. By contrast, low predictability at work was associated with elevated risk of acute MI (P=.02). This association was driven by the strong effect of predictability on acute MI among employees aged 45 to 54 years.

Conclusions. Prospective evidence suggests that low predictability at work is an important component of job control, increasing long-term risk of acute MI among middle-aged employees.

Key Words: Cardiovascular Disease, Epidemiology, Occupational Health, Mortality