Previous studies examining the association between job stress and blood lipids have produced mixed findings. We sought to investigate the association between job stress and blood lipids among Chinese workers. Methods: A total of 544 subjects (367 men and 177 women) without known diseases from the Stress and Health in Shenzhen Workers (SHISO) cross-sectional study were analyzed. Job stress was evaluated by the effort-reward imbalance (ERI) model. The associations between job stress and blood lipids, such as for total cholesterol (TCHO), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C), were explored by multiple linear regression. The association between job stress and combined dyslipidemia was examined by multiple logistic regression. Results: Compared with their corresponding low level groups, groups with high levels of effort, overcommitment and ERI had a significantly increased risk of combined dyslipidemia with adjusted odd ratios (ORs) of 3.5 (95% CI 1.8-6.7), 4.2 (95% CI 2.3-7.7) and 2.7 (95% CI 1.5-5.1), respectively, whereas high rewards significantly reduced the risk of combined dyslipidemia (adjusted OR 0.3, 95% CI 0.2-0.6) compared with low rewards. Effort, overcommitment and ERI were significantly positively related to TG and LDL-C, while rewards were inversely related to them. No significant associations were observed between job stress and TCHO and HDL-C. The results were similar for men and women. Conclusions: Effort, overcommitment, low reward and ERI increased the risk of dyslipidemia among Chinese workers, and they were significantly associated with TG and LDL-C rather than TCHO or HDL-C. Increasing blood lipids may be the possible link between job stress and coronary heart disease. (J Occup Health 2011; 53: 334-342)
Job Stress and Carotid Intima-media Thickness in Chinese Workers: Weixian XU, et al. Department of Cardiology, Peking University ThirdHospital and Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, China-Objectives: Carotid intima-media thickness (CIMT) can be used as a surrogate marker for cardiovascular health, and job stress is a risk factor for cardiovascular disease. However, there have been a limited number of studies focusing on the association between job stress and CIMT. The goal of this study was to explore the association between job stress and CIMT in a Chinese working population. Methods: The study included 734 participants (508 males and 226 females) without coronary heart disease. Job stress was evaluated using the effort-reward imbalance (ERI) questionnaire at work. ERI is the ratio between efforts and rewards (weighted by number of items). High resolution carotid ultrasonographic studies were performed using a Sequoia 512 ultrasound system with an 8-13 MHz linear array transducer to assess CIMT. Results: This study detected gender-specific associations between the indictors of the ERI model and increased CIMT among the study participants in China. This study demonstrated a robust association in women between the key indicators of ERI, effort, overcommitment and ERI, and increased CIMT (adjusted r 2 =0.258, p=0.001; adjusted r 2 =0.261; p<0.001; adjusted r 2 =0.274; p<0.001, respectively). Reward was inversely correlated with CIMT (adjusted r 2 =0.282, p<0.001), controlling for age, hypertension, diabetes mellitus, hyperlipidaemia and body mass index. For men, a similar pattern of associations was observed, but the associations were lost after adjustment for confounders. Conclusions: Our resultsshow that effort, overcommitment and ERI may be associated with early atherosclerosis predicted by CIMT in women, and reward is inversely related to CIMT. (J Occup Health 2010; 52: 257-262)
Effort and ERI are positively associated with HbA1c, and reward is inversely related to HbA1c among Chinese women. The association is not accounted for by age, BMI, and physical exercise. More efforts should be made to improve the job stress status of Chinese working women for the purpose of DM prevention.
The interaction effect of overcommitment and ERI on hypertension was independent and synergistic.
Effort, overcommitment, and ERI are significantly associated with fibrinogen among Chinese workers. High fibrinogen may be a possible link between job stress and cardiovascular disease.
Objective Relevant studies reported that job stress played an important role on hypertension. However, previous studies have produced mixed fi ndings because of the use of different job stress questionnaires and different populations. The knowledge about the effect of job stress on blood pressure is rare among Chinese population. The aim was to explore the association between job stressors, such as effort, reward, over commitment, effort-reward imbalance (ERI) and blood pressure among Chinese workers. Methods The Stress and Health in Shenzhen Workers (SHISO) study was a cross-sectional study which aimed to evaluate the impact of job stress on physical health in Shenzhen workers. A total of 881 took part in this SHISO study. The authors excluded subjects who had a history or new detected diseases at the medical checkup including heart disease, or peripheral arterial or cerebrovascular diseases, and participants with incomplete questionnaires. The fi nal sample was 734 subjects (508 men and 226 women). Simplifi ed Chinese version of effort-reward imbalance questionnaire (ERIQ) was used to evaluate job stress level. Blood pressure (BP) was taken by standard and periodically calibrated mercury sphygmomanometers in the sitting position by the trained technicians. The authors defi ned hypertension as systolic blood pressure (SBP) ≥140 mm Hg or diastolic blood pressure (DBP) ≥90 mm Hg or both, or use of blood pressure lowering medication, or hypertension history with a physician's diagnosis certifi cate. ResultsThe subjects with hypertension reported signifi cant higher effort, over commitment, and ERI, while lower reward. Among men, high effort, high over commitment and high ERI increased risk of presence of hypertension, with odd ratios (OR) of 10.0 (95% CI 5.8 to 17.3), 5.0 (95% CI 3.0 to 8.2) and 11.1 (95% CI 5.7 to 21.6), respectively, compared with the low level of job stress. After adjustment for age, BMI, dyslipidemia and diabetes mellitus, the associations were still signifi cant, with an adjusted OR of 4.6 (95% CI 2.5 to 8.5), 5.0 (95% CI 2.7 to 9.2) and 8.2 (95% CI 3.9 to 17.1), for effort, over commitment, and ERI, respectively. High reward played as a protective factor with OR of 0.3 (95% CI 0.2 to 0.6), and adjusted OR of 0.2 (95% CI 0.1 to 0.5), compared with low level of reward. Among women, the results were similar, and the adjusted OR was 3.3 (95% CI 1.2 to 8.9), 4.1 (95% CI 1.4 to 11.8), 3.8 (95% CI 1.3 to 10.7) and 0.2 (95% CI 0.1 to 0.7) for effort, over commitment, ERI and reward, respectively. Conclusion Job stressors such as high effort, over commitment, ERI increased risk of hypertension and high reward reduced risk of hypertension among Chinese workers. It is of great interest to understand and improve job stress among Chinese workers for the purpose of prevention of hypertension. Further studies in larger sample size and in prospective design will be needed to confi rm the role of job stressors on hypertension among Chinese workers.
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