Relationship of perceived job stress to total coronary risk in a cohort of working men and women in Belgium.

Abstract

To examine the relationships of job strain and iso-strain psychosocial work environment exposures to 'total coronary risk' (TCR) in a cohort of male and female workers in Belgium. The sample consists of 15,079 men and 4639 women aged 35-59 years employed in a wide range of occupations and free of any self-reported personal history of CHD. Karasek's job strain model was used to define high strain (high demands and low control), low strain, active and passive jobs. Iso-strain was defined as the combination of a high strain job with low worksite social support, and is compared to the other combinations. Total coronary risk is a composite measure based on a Framingham function assessing the risk of developing coronary heart disease (CHD) within the next 10 years; high and low levels of TCR were defined. Logistic regressions in each gender were applied to explore relationships, adjusting for age, level of education, occupational class and sector of employment. In male workers, the age-adjusted prevalence of high TCR is highest in (1) in the lowest quartile group of job control and (2) in the 'high strain' group. The multivariate logistic regressions comparing high strain, active and passive work exposures to low strain work did not indicate a significant association with high TCR. Likewise, iso-strain jobs were neither found to be associated with high TCR. Our cross-sectional analysis provides no support for the hypothesis that the psychosocial work environment is strongly associated with the TCR estimate in healthy workers.