Job Strain and the Risk of Stroke

Abstract

Stroke is a major cause of morbidity, mortality, and disability worldwide.1,2 Psychosocial stress may increase the risk of developing stroke, 3 although prospective evidence to confirm this is scarce. Job strain, for example, is one of the Background and Purpose-Psychosocial stress at work has been proposed to be a risk factor for cardiovascular disease.However, its role as a risk factor for stroke is uncertain. Methods-We conducted an individual-participant-data meta-analysis of 196 380 males and females from 14 European cohort studies to investigate the association between job strain, a measure of work-related stress, and incident stroke. Results-In 1.8 million person-years at risk (mean follow-up 9.2 years), 2023 first-time stroke events were recorded. The age-and sex-adjusted hazard ratio for job strain relative to no job strain was 1.24 (95% confidence interval, 1.05;1.47) for ischemic stroke, 1.01 (95% confidence interval, 0.75;1.36) for hemorrhagic stroke, and 1.09 (95% confidence interval, 0.94;1.26) for overall stroke. The association with ischemic stroke was robust to further adjustment for socioeconomic status. Conclusion-Job strain may be associated with an increased risk of ischemic stroke, but further research is needed to determine whether interventions targeting job strain would reduce stroke risk beyond existing preventive strategies.

Predicting Cardiovascular Disease from Psychosocial Safety Climate: A Prospective Cohort Study from Australia

“…Job strain is also associated with an increased risk of 104 ischemic stroke, (Fransson et al, 2015), and research has found support for both job strain and 105 effort-reward imbalance as independent risk factors for stroke (Jood, Karlsson, et al, 2017). …”

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

“…Associations between stroke and job strain or its components have previously been reported from largescale prospective studies (7,(25)(26)(27), while others (28-30) did not find any association between job strain and stroke. There is also conflicting data regarding whether the association between job strain is confined to ischemic stroke or whether it also influences the risk of hemorrhagic stroke (5,26).…”

“…This model postulates that high psychological demands in terms of volume and intensity of workload combined with low individual control over pace and content of work tasks result in high strain or stress (job strain). A recent meta-analysis of 14 European cohort studies concluded an increased risk of ischemic stroke for those exposed to job strain (7). There are also recent systematic reviews showing increased risk of stroke in relation to long working hours (8) and shift work (9).…”

Good practice in occupational health services – Certification of stroke as an accident at work. Need for secondary prevention in people returning to work after acute cerebrovascular events

“…[19] na podstawie badań 196 380 mężczyzn i kobiet z 14 krajów europejskich. Autorzy ryzyko (skorygowane o wiek i płeć) udaru niedokrwiennego mózgu dla pracy stresującej w porównaniu z pracą niezwiązaną z tym obciążeniem oszacowali na 1,24 (95% przedział ufności (confidence interval -CI): 1,05-1,47), udaru krwotocznego -1,01 (95% CI: 0,75-1,36), a dla udarów bez względu na mechanizm -1,09 (95% CI: 0,94--1,26) [19].…”

“…Jeśli weźmie się pod uwagę powyższe dane, któ-re wskazują, że stres w miejscu pracy zwiększa ryzyko wystąpienia udaru niedokrwiennego o 20%, cytowana publikacja [19] może uzasadniać słuszność zakwalifikowania opisanego incydentu jako wypadku przy pracy. Nagłym zdarzeniem wywołanym przyczyną zewnętrzną, powodującym uraz lub śmierć, które nastąpiło w związku z pracą, był udar niedokrwienny spowodowany silnym stresem.…”