The prospective relationship between work stressors and cardiovascular disease, using a comprehensive work stressor measure for exposure assessment

Abstract

The currently used instruments which measure the psychosocial work environment have been criticized. We analyzed the association between work stressors and cardiovascular disease, using the Maastricht Cohort Study Work Stressor Score (MCS-WSS), a comprehensive measure which has been associated with work strain. At baseline 11,489 employees of the Maastricht Cohort Study were participating. This prospective cohort study started in 1998 in the Netherlands and includes a heterogeneous population of employees. The psychosocial work environment, cardiovascular risk factors and the occurrence of cardiovascular disease were measured with questionnaires at various time points during follow-up, the last follow-up was in 2008. For a subsample of employees, CVD extracted from medical records was available. The MCS-WSS consists of items from emotional demands, psychological demands, role clarity, career possibilities, working overtime, job insecurity, cognitive demands, skills discretion and decision authority. Each item has its own contribution in inducing work strain, represented by its own weighting factor. The association between a high exposure to work stressors at baseline and cardiovascular morbidity was assessed with Cox regression analyses. Analyses were adjusted for age, gender, educational level, smoking, body mass index, alcohol consumption and leisure physical activity. During a median follow-up of 49 months, 309 employees developed incident cardiovascular disease. Overall, no significant associations were found between a high exposure to work stressors at baseline and cardiovascular morbidity. The results of this study indicate that high exposure to work stressors has no considerable impact on cardiovascular disease.