Assessment of the healthy worker survivor effect in the relationship between psychosocial work-related factors and hypertension

Abstract

ObjectivesThe healthy worker survivor effect (HWSE) usually leads to underestimation of the effects of harmful occupational exposures. HWSE is characterised by the concomitance of three associations: (1) job status–subsequent exposure, (2) job status–disease and (3) previous exposure–job status. No study has reported the coexistence of these associations in the relationship between psychosocial work-related factors and health. We assessed if HWSE is present when measuring the effects of cumulative exposure to psychosocial work-related factors on the prevalence of hypertension in white-collar workers.MethodsData were obtained from two timepoints (1991–1993 at baseline and 1999–2001 at follow-up) of a prospective cohort study. At baseline, the population was composed of 9188 white-collar employees (women: 49.9%) in Quebec City. Job strain as psychosocial work-related factor and blood pressure were measured using validated methods. Job status (retirees vs employees) at follow-up was self-reported. Multiple multilevel robust Poisson regressions were used to estimate prevalence ratios of hypertension and risk ratios of retirement separately by gender. We performed multiple imputations to control selection bias due to missing values.ResultsRetirement eliminated the subsequent exposure to job strain de facto and was associated with the reduction in the prevalence of hypertension in younger (−33%) and older (−11%) men and in older women (−39%). Job strain was associated with job status in younger men and in women of any age.ConclusionData showed the presence of HWSE in younger men and older women given the coexistence of the three structural associations.

Illness prevalence rate in Tibet, China: Data from the 2018 National Health Service Survey

“…Digestive diseases, cardiovascular diseases, musculoskeletal diseases, respiratory diseases, and urogenital diseases accounted for the top ve diseases by body system with prevalences of 27.8%, 20.5%, 16.5%, 11.6% and 4.4%, respectively. Moreover, in terms of the composition of diseases, the top ve chronic diseases were hypertension (14.4%), rheumatoid arthritis (8.0%), cholelithiasis (6.3%), chronic gastritis (5.5%), and diabetes mellitus (0.9%) (data not shown).…”

“…In the traditional Tibetan dietary model, protein and fat provide approximately 60% of the daily energy intake, making food di cult to digest and be absorbed by the human body. Moreover, hypertension was the most common chronic diseases in Tibet, which may be related to the diet and awareness of Tibetans [15,16]. A high salt in diet and insu cient awareness of hypertension, which leads to an increase in medical treatment [17,18].…”

Illness prevalence rate in Tibet, China: data from the 2018 National Health Service Survey

“…In the traditional Tibetan dietary model, protein and fat provide approximately 60% of the daily energy intake, making food difficult to digest and be absorbed by the human body. Moreover, hypertension has been reported as the most common chronic disease in Tibet, which may be related to the diet and awareness of Tibetans [16,17]. A high-salt diet and an insufficient awareness of hypertension lead to an increase in medical treatment [18,19].…”

Illness prevalence rate in Tibet, China: data from the 2018 National Health Service Survey

“…In the traditional Tibetan dietary model, protein and fat provide approximately 60% of the daily energy intake, making food difficult to digest and be absorbed by the human body. Moreover, hypertension was the most common chronic diseases in Tibet, which may be related to the diet and awareness of Tibetans [15,16]. A high salt in diet and insufficient awareness of hypertension, which leads to an increase in medical treatment [17,18].…”