A systematic review of studies in the contributions of the work environment to ischaemic heart disease development

Abstract

Background: There is need for an updated systematic review of associations between occupational exposures and ischaemic heart disease (IHD), using the GRADE system. Methods: Inclusion criteria: (i) publication in English in peer-reviewed journal between 1985 and 2014, (ii) quantified relationship between occupational exposure (psychosocial, organizational, physical and other ergonomic job factors) and IHD outcome, (iii) cohort studies with at least 1000 participants or comparable case-control studies with at least 50 + 50 participants, (iv) assessments of exposure and outcome at baseline as well as at follow-up and (v) gender and age analysis. Relevance and quality were assessed using predefined criteria. Level of evidence was then assessed using the GRADE system. Consistency of findings was examined for a number of confounders. Possible publication bias was discussed. Results: Ninety-six articles of high or medium high scientific quality were finally included. There was moderately strong evidence (grade 3 out of 4) for a relationship between job strain and small decision latitude on one hand and IHD incidence on the other hand. Limited evidence (grade 2) was found for iso-strain, pressing work, effort-reward imbalance, low support, lack of justice, lack of skill discretion, insecure employment, night work, long working week and noise in relation to IHD. No difference between men and women with regard to the effect of adverse job conditions on IHD incidence. Conclusions: There is scientific evidence that employees, both men and women, who report specific occupational exposures, such as low decision latitude, job strain or noise, have an increased incidence of IHD.

Prevalence and Determinants of Job Stress in Patients with Inflammatory Bowel Disease

“…Job stress measured with this instrument has previously been shown to be associated with and predict physical health across different diseases. [35][36][37] The novel aspect of our study is that, to our knowledge, it is the first to systematically evaluate job stress in a large cohort of patients with IBD.…”

The psychosocial work environment is associated with risk of stroke at working age

“…Previous studies of coronary disease indicate that these instruments are relatively robust with respect to recall bias. A recent systematic review of high quality studies found similar associations to job strain in case-control and prospective studies (4). Moreover, in a study of myocardial infarction at working age, self-rated and job exposure matrix based assessments of job demands and decision latitude showed similar relations in cases and controls, further supporting a limited influence of recall bias on these measures (37).…”

“…Education and socioeconomic status are consistently reported to be associated with stroke (1), and an association with psychosocial stress has been suggested (2). There is also an accumulating literature suggesting an association between cardiovascular disease and the psychosocial work environment (3)(4)(5). The main body of evidence comes from studies on coronary heart disease, while stroke has been less studied.…”

Informal caregiving as a risk factor for type 2 diabetes in individuals with favourable and unfavourable psychosocial work environments: A longitudinal multi-cohort study

“…A similar approach has been applied in a previous study investigating the association between supervisor support and sickness absence in diabetic individuals, using the same cohort studies [32]. Low social support at work was more common among caregivers compared to non-caregivers, which is a noteworthy finding, given the mitigating effect of social support at work on health [33][34][35].…”