Job, Psychological Factors and Coronary Heart Disease

Karasek, Robert; Theorell, Töres; Schwartz, Joseph; Pieper, Carl F.; Alfredsson, Lars

doi:10.1159/000406198

Cited by 125 publications

(57 citation statements)

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“…Particular interest has been focused on the relationship between hypertension and/or coronary heart disease and occupational stressors, operationalized as specific job problems, high job demands, job dissatisfaction, and low job rewards.13-'1 This work has yielded inconsistent findings, with some studies showing positive associations13"14"16-25 and others indicating null or negative associations.612152- 29 Work by Karasek and his colleagues suggests that there is a strong association between job strain, conceptualized as the joint effect of high job demands and low decision latitude or control, and an increased prevalence and/or incidence of coronary heart disease and myocardial infarction when traditional risk factors such as age, race, cholesterol, and smoking are controlled for.14,18 20 Also, job strain has recently been shown to be positively associated with elevated diastolic blood pressure and a higher left-ventricularmass index in a case-control study of employees from several occupations (odds ratio of 3.1). 25 Although some studies have used case-control or prospective designs, 18,25 most of the studies using Karasek does not permit evaluations of the associations between workers' self-perceptions of their jobs and disease status.…”

Section: Intoductonmentioning

confidence: 99%

Job strain and prevalence of hypertension in a biracial population of urban bus drivers.

Albright

Winkleby²,

Ragland³

et al. 1992

Am J Public Health

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OBJECTIVES. In this study we tested the association between occupational stress--as measured by job demands, decision latitude, and job strain--and hypertension in a population of 1396 Black and White bus drivers. METHODS. Height, weight, blood pressure, and medical history were assessed by physical exam. Drivers completed a questionnaire assessing their work schedules, personal habits, and self-perceptions about job demands and decision latitude. RESULTS. Univariate analyses revealed significant inverse associations; lower levels of job demands and job strain were associated with a higher prevalence of hypertension for Blacks and Whites. After 12 confounding variables were controlled for, the association between these two measures of occupational stress and hypertension became nonsignificant. Decision latitude was also not significantly associated with hypertension. CONCLUSIONS. Our findings are inconsistent with previous studies' findings of a positive association between job strain and chronic diseases. The difference in results may be explained by our incorporation of individuals' perceptions in the measurement of occupational stressors and our use of individuals from a single occupation with comparable job responsibilities and income, thus controlling for potential confounding by social class.

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Section: Intoductonmentioning

confidence: 99%

Job strain and prevalence of hypertension in a biracial population of urban bus drivers.

Albright

Winkleby²,

Ragland³

et al. 1992

Am J Public Health

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show abstract

“…The research of Karasek, Theorell and colleagues suggests that it is this combination of high demands and low control that produces job strain.7'2 Workers in high strain jobs have been shown to have greater risk of developing CVD. [7][8][9]11 However, important methodological challenges to etiological inference remain in the occupational stress field'3'14 despite 20 years of research. These include: an over-reliance on cross-sectional as opposed to prospective designs; lack of generalizability due to the frequent restriction of samples to healthy, employed males; lack of valid and reliable measures of chronic disease outcomes; lack of exposure data with stress being evaluated on the basis of only a single measure in time; and incomplete models of the stress process.…”

Section: Introductionmentioning

confidence: 99%

Job strain, work place social support, and cardiovascular disease: a cross-sectional study of a random sample of the Swedish working population.

1988

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This cross-sectional study investigates the relationship between the psychosocial work environment and cardiovascular disease (CVD) prevalence in a randomly selected, representative sample of 13,779 Swedish male and female workers. It was found that self-reported psychological job demands, work control, and coworker social support combined greater then multiplicatively in relation to CVD prevalence. An age-adjusted prevalence ratio (PR) of 2.17 (95% CI-1.32, 3.56) was observed among workers with high demands, low control, and low social support compared to a low IntroductionThe role of a stressful work environment in the devel-

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“…(See figure 1. ) Karasek's job-strain model has demonstrated that the combination of increased work pace and lack of influence on job situation contributes to an excessive risk of ischemic heart disease (19,20). We have estimated that the influence on job situation is almost similar for both suburban and city bus drivers, whereas the work load is assessed to be highest among the city bus drivers, due to traffic problems particularly.…”

Section: Discussionmentioning

confidence: 93%

Impact of work-related and psychosocial factors on the development of ischemic heart disease among urban bus drivers in Denmark.

Netterstrøm

Juel²

1988

Scand J Work Environ Health

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NETTERSTR0M B, JUEL K. Impact of work-related and psychosocial factors on the developmentof ischemic heart disease among urban bus drivers in Denmark. Scand J Work En viron Health 14 (1988) 231-238. From 1978 to 1985, 2 465 male bus drivers in the three major cities in Denmark were followed with regardto hospitaladmissiondue to myocardial infarction(Ml) and death due to ischemic heart disease (lHD). In all 2 045 (83 010) of these men responded in 1978 to a questionnaire on psychosocial well-being and work conditions. The respondents did not differ from the nonrespondents regardinghospital admissions and death in the follow-up period (1978)(1979)(1980)(1981)(1982)(1983)(1984). Sixty-two cases of MI were registered among the 2045 bus driversin 1978-1984. On this basis relativerisk for MI was calculated with a multiple regression model for independent variablesregarding psychosocial well-being and work conditions. High work load (drivingin heavytraffic) wassignificantly associatedwith the occurrenceof MI. Of the psychosocial factors "no socialcontact with colleagues" and "increased work pace" werealso significantly associated with the occurrence of MI. Smokinghabits tended to be associated with the occurrence of MI, whilestress symptoms and job dissatisfaction did not. The mental burden on bus drivers working in heavy traffic seems a possible explanation for the findings.

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Job, Psychological Factors and Coronary Heart Disease

Cited by 125 publications

References 0 publications

Job strain and prevalence of hypertension in a biracial population of urban bus drivers.

Job strain and prevalence of hypertension in a biracial population of urban bus drivers.

Job strain, work place social support, and cardiovascular disease: a cross-sectional study of a random sample of the Swedish working population.

Impact of work-related and psychosocial factors on the development of ischemic heart disease among urban bus drivers in Denmark.

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