Decision Latitude, Psychologic Demand, Job Strain, and Coronary Heart Disease in the Western Electric Study

Alterman, Toni; Shekelle, Richard B.; Vernon, Sally W.; Burau, Keith D.

doi:10.1093/oxfordjournals.aje.a117051

Cited by 153 publications

(113 citation statements)

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“…All of these studies reported a positive association between work stress and CHD that was robust to adjustment for other risk factors. The number of identified independent prospective cohort studies assessing the job-strain model was 11, relating to a 7-10 times greater total population than that for the other work-stress models (37)(38)(39)(40)(41)(42)(43)(44)(45)(46). Although the overall summary estimate of the age-and gender-adjusted relative risk for CHD among employees with job strain suggested increased risk, some single studies reported null findings.…”

Section: Discussionmentioning

confidence: 99%

“…Typically the studies assessed work stress at one point in time only. Eleven independent studies tested the job-strain model (37)(38)(39)(40)(41)(42)(43)(44)(45)(46). While the measure of job strain in all of these studies was generated by cross-tabulating the dichotomized or trichotomized scales of job demands and job control, the items included in these scales varied between the studies.…”

Section: Assessment Of Exposurementioning

confidence: 99%

“…For the job-strain model, the outcome definitions included diagnoses of CHD in hospital or mortality records (39,(42)(43)(44)(45)49) or Table 2. Characteristics of studies on work-stress models and coronary heart disease (CHD).…”

Section: Assessment Of Coronary Heart Diseasementioning

confidence: 99%

See 2 more Smart Citations

Work stress in the etiology of coronary heart disease—a meta-analysis

Kivimäki¹,

Virtanen²,

Elovainio³

et al. 2006

Scand J Work Environ Health

781

561

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Kivimäki M, Virtanen M, Elovainio M, Kouvonen A, Väänänen A, Vahtera J. Work stress in the etiology of coronary heart disease-a meta-analysis. Scand J Work Environ Health 2006;32(6 special issue):431-442.Objectives This study focused on estimating the relative risk of coronary heart disease (CHD) in association with work stress, as indicated by the job-strain model, the effort-reward imbalance model, and the organizational injustice model. MethodsA systematic review and meta-analysis of prospective cohort studies were carried out. Studies were eligible if they had published a quantitative estimate of the association between work stress and incident CHD or cardiovascular mortality by January 2006.Results Fourteen prospective cohort studies were identified. For a total of 83 014 employees, the age-and gender-adjusted relative ratio of CHD for high versus low job strain was 1.43 [95% confidence interval (95% CI) 1.15-1.84], but the ratio decreased to 1.16 (95% CI 0.94-1.43) after adjustment for risk factors and potential mediators. The age-and gender-adjusted risk ratio for a combination of high efforts and low rewards was 1.58 (95% CI 0.84-2.97) for 11 528 employees, and no reduction in the risk ratio was seen after further adjustments. For organizational injustice, the age-and gender-adjusted, and multiple-adjusted relative risks were 1.62 (95% CI 1.24-2.13) and 1.47 (95% CI 1.12-1.95), respectively, for a population of 7246 men and women. There was little standardization in the assessment of work stress within all three stress models, and significant heterogeneity in the effects of stress was observed between studies. Few studies were available for female samples. ConclusionsObservational data suggest an average 50% excess risk for CHD among employees with work stress. Further research is needed to confirm that a reduction in work stress will lead to a reduction in CHD risk.Key terms cardiovascular disease; effort-reward imbalance; job strain; mortality; organizational justice; prospective cohort study; psychosocial factors; systematic review; working population. Activation of the stress system in the hypothalamus and the brain stem helps the body to overcome the influence of short-term physical stressors. However, prolonged overactivity of these systems may cause wear and tear and play a role in coronary heart disease (CHD), infection, and accelerated aging (1). The recognition that the physiological reactions to stress cannot only protect, but also damage the body has provided a basis for epidemiologic research on work stress.Three models for work stress and coronary heart disease Work-stress models aim at describing factors that are likely to elicit harmful stress at work in a large proportion of employees. These factors are conceptualized at a level of generalization that allows for their identification in a wide range of occupations. The stress model most often cited and most widely tested is the two-dimensional job-strain model (2-4) ( Work stress in the etiology of coronary heart disease strain model adds...

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Section: Discussionmentioning

confidence: 99%

Section: Assessment Of Exposurementioning

confidence: 99%

See 1 more Smart Citation

Work stress in the etiology of coronary heart disease—a meta-analysis

Kivimäki¹,

Virtanen²,

Elovainio³

et al. 2006

Scand J Work Environ Health

781

561

View full text Add to dashboard Cite

show abstract

“…The full model has been confirmed in a minority of studies only (23)(24)(25)(26). Single components have only partially been found to be significantly related to smoking status (27)(28)(29)(30)(31)(32)(33) and, if so, more often among women than among men. Eight studies did not report any association between model components and smoking status (34)(35)(36)(37)(38)(39)(40)(41).…”

Section: The Challenge Of Mechanisms: Health Risk Behaviormentioning

confidence: 90%

Work stress and health risk behavior

Siegrist¹,

Rödel²

2006

Scand J Work Environ Health

297

218

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“…This meaning is clearly evident in Karasek's (1979) Longitudinal data would be more useful for examining causal hypotheses. Ideally, data on the predictor variables would be collected prospectively, and then symptom data would be collected years later, as has been done in a few of the major tests of the job demands-control model (e.g., Alterman, Shekelle, Vernon, & Burau, 1994). Finally, additional cardiovascular outcomes, such as heart disease and arterial disorder, should be ex-amined.…”

Section: Discussionmentioning

confidence: 99%