Rugulies, R;
Framke, E;
Sørensen, JK;
Svane-Petersen, AC;
Alexanderson, K;
Bonde, JP;
Farrants, K;
... Madsen, IE; + view all
(2020)
Persistent and changing job strain and risk of coronary heart disease. A population-based cohort study of 1.6 million employees in Denmark.
Scandinavian Journal of Work, Environment & Health
, 46
(5)
pp. 498-507.
10.5271/sjweh.3891.
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Abstract
Objectives: This study aimed to examine the association between job strain and incident coronary heart disease (CHD) in Denmark, while accounting for changes of job strain. / Methods: We included all employees residing in Denmark in 2000, aged 30–59 years with no prevalent CHD (N=1 660 150). We determined exposure to job strain from 1996–2009 using a job exposure matrix (JEM) with annual updates. Follow-up for incident CHD was from 2001–2010 via linkage to health records. We used Cox regression to calculate hazard ratios (HR) and 95% confidence intervals (CI) for the association between job strain and incident CHD. / Results: During 16.1 million person-years, we identified 24 159 incident CHD cases (15.0 per 10 000 person-years). After adjustment for covariates, job strain in 2000 predicted onset of CHD during a mean follow-up of 9.71 years (HR 1.10, 95% CI 1.07–1.13). When analyzing changes in job strain from one year to the next and CHD in the subsequent year, persistent job strain (HR 1.07, 95% CI 1.03–1.10), onset of job strain (HR 1.20, 95% CI 1.12–1.29) and removal of strain (HR 1.20, 95% CI 1.12–1.28) were associated with higher CHD incidence compared to persistent no job strain. Associations were similar among men and women. / Conclusions: Job strain is associated with a higher risk of incident CHD in Denmark. As we used a JEM, we can rule out reporting bias. However, under- or overestimation of associations is possible due to non-differential misclassification of job strain and residual confounding by socioeconomic position.
| Type: | Article |
|---|---|
| Title: | Persistent and changing job strain and risk of coronary heart disease. A population-based cohort study of 1.6 million employees in Denmark |
| Location: | Finland |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.5271/sjweh.3891 |
| Publisher version: | https://doi.org/10.5271/sjweh.3891 |
| Language: | English |
| Additional information: | This work is licensed under a Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/). |
| Keywords: | cardiovascular disease; CHD; cohort study; coronary heart disease; Denmark; employee; epidemiology; JEM; job control; job exposure matrix; job strain; psychological demand; psychosocial work environment; strain; stress; work stress |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Epidemiology and Public Health |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10110062 |
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