Abstract
Workplace factors (night work, long working hours, psychosocial work stress) have been reported to be associated with increased risk of cardiovascular disease (CVD). We investigated whether (i) workplace factors are associated with CVD risk factors independently of each other, (ii) workplace factors interact, thereby modifying associations and (iii) associations are explained by early life exposures. A total of 7916 employed participants in the 1958 British birth cohort underwent a clinical assessment at age 45 years. Regression analysis was used to examine associations between workplace factors and CVD risk factor levels with adjustment for early life exposures. Night work was associated with adverse levels of most CVD risk factors. Working > or =48 h/week was positively associated with body mass index (BMI) and waist circumference (WC). Low job control was positively associated with glycosylated haemoglobin (HbA1c) and inflammatory factors, and inversely associated with high-density lipoprotein (HDL)-cholesterol. Low demands were positively associated with systolic blood pressure (SBP), triglycerides and inflammatory factors and inversely associated with HDL-cholesterol. Several associations were weakened when workplace factors were adjusted for each other. Night workers in low-demand jobs had higher BMI [0.78 kg/m(2); 95% confidence interval (CI) 0.35, 1.21], WC (1.49 cm; 0.45, 2.52) and SBP (1.38 mmHg; -0.04, 2.81). HDL was lower for low control plus night work (-0.04 mmol/l; -0.08, -0.01) or long hours (-0.12; -0.18, -0.69). Adjustment for early life exposures explained 30-50% of most associations, e.g. night work/low demands associations reduced by 50% for BMI and WC, and by 39% for SBP. Associations between workplace factors and CVD risk factors in mid-adulthood arise in part from social and health disadvantage originating earlier in life.
Highlights
Work is a determinant of socio-economic inequalities in health, recognized by policy makers as an important point for intervention to improve health.[1]
Since individuals who experience an unfavourable social environment in early life are at greater risk of cardiovascular disease (CVD) independent of their circumstances in adulthood,[18] associations for workplace factors could be due to circumstances earlier in life
Night work was associated with most CVD risk factors examined, whereas long working hours was only associated with increased adiposity
Summary
Work is a determinant of socio-economic inequalities in health, recognized by policy makers as an important point for intervention to improve health.[1]. The nature of work has changed over the past two decades, moving towards a 24-hour society with increasing demand for goods and services to be provided around the clock.[2]. Workplace exposures, such as psycho-social stress, shift-work and long working hours, have been reported to be associated with increased risk of cardiovascular disease (CVD). There are several ways in which adverse workplace factors could increase the risk of CVD: direct metabolic consequences of circadian disruption for night workers, neuroendocrine effects of work stress and changes in health behaviours due to unfavourable or stressful work patterns.[13,14]. Workplace factors (night work, long working hours, psychosocial work stress) have been reported to be associated with increased risk of cardiovascular disease (CVD). We investigated whether (i) workplace factors are associated with CVD risk factors independently of each other, (ii) workplace factors interact, thereby modifying associations and (iii) associations are explained by early life exposures
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