Workplace bullying and workplace violence as risk factors for cardiovascular disease: a multi-cohort study

Abstract

Participants were 79 201 working men and women, aged 18-65 years and free of CVD and were sourced from three cohort studies from Sweden and Denmark. Exposure to workplace bullying and violence was measured at baseline using self-reports. Participants were linked to nationwide health and death registers to ascertain incident CVD, including coronary heart disease and cerebrovascular disease. Study-specific results were estimated by marginal structural Cox regression and were combined using fixed-effect meta-analysis. Nine percent reported being bullied at work and 13% recorded exposure to workplace violence during the past year. We recorded 3229 incident CVD cases with a mean follow-up of 12.4 years (765 in the first 4 years). After adjustment for age, sex, country of birth, marital status, and educational level, being bullied at work vs. not was associated with a hazard ratio (HR) of 1.59 [95% confidence interval (CI) 1.28-1.98] for CVD. Experiencing workplace violence vs. not was associated with a HR of 1.25 (95% CI 1.12-1.40) for CVD. The population attributable risk was 5.0% for workplace bullying and 3.1% for workplace violence. The excess risk remained similar in analyses with different follow-up lengths, cardiovascular risk stratifications, and after additional adjustments. Dose-response relations were observed for both workplace bullying and violence (P trend < 0.001). There was only negligible heterogeneity in study-specific estimates.

Clinical Characteristics of Patients Seeking Treatment for Common Mental Disorders Presenting With Workplace Bullying Experiences

“…A growing body of evidence has established that being exposed to such bullying tend to have a range of detrimental effects on victims, hence also being a major work-related predictor of mental, psychosomatic and to some extent physical health problems ( Vartia, 2001 ; Nielsen et al, 2012 ; Lever et al, 2019 ). Symptoms include negative health conditions such as, cardiovascular disease ( Jacob and Kostev, 2017 ; Xu et al, 2018 ), musculoskeletal pain ( Høgh et al, 2011 ; Kääriä et al, 2012 ; Buhaug et al, 2020 ), gastrointestinal symptoms ( Lever et al, 2019 ), sleep difficulties ( Hansen et al, 2014 ; Verkuil et al, 2015 ; Lever et al, 2019 ; Rodríguez-Muñoz et al, 2020 ), symptoms of post-traumatic stress ( Mikkelsen and Einarsen, 2002 ; Tatar and Yüksel, 2019 ), and general stress ( Vartia, 2001 ), in addition to being associated with an increase in CMD ( Verkuil et al, 2015 ; Finstad et al, 2019 ; Lo Presti et al, 2019 ; Rodríguez-Muñoz et al, 2020 ).…”

Workplace Bullying and Medically Certified Sickness Absence: Direction of Associations and the Moderating Role of Leader Behavior

“…Their findings showed that exposure to bullying increased the duration of the absence among women, but not among men. However, due to the strong effects of bullying on both subsequent health complaints (Kivimäki et al., 2003; Finne et al., 2011; Xu et al., 2018a,b) and risk of disability retirement (Nielsen et al., 2017b), an association between bullying and the duration of absence seems reasonable. As a replication and extension of previous research on workplace bullying and sickness absence, this study will examine the impact of exposure to bullying on both the risk and the duration of sickness absence.…”

“…Hence, workplace bullying is not about single episodes of conflict or harassment at the workplace, but a form of persistent abuse where the exposed employee is unable to withstand or cope with the mistreatment (Einarsen, 1999; Einarsen et al., 2011). Both longitudinal studies and meta-analyses have established workplace bullying as a significant risk factor for health outcomes such as anxiety and depression (Nielsen and Einarsen, 2012; Verkuil et al., 2015), somatic complaints (Hoobler et al., 2010; Kääriä et al., 2012; Tynes et al., 2013), cardiovascular disease (Xu et al., 2018a,b), diabetes (Xu et al., 2018a,b), and disability retirement (Nielsen et al., 2017b). Comparisons with other psychosocial exposures show that bullying is one of the most detrimental predictors of health problems (Schutte et al., 2014).…”

Seven days in medicine: 14-20 November 2018

“…People who are bullied or experience violence at work had a higher risk of cardiovascular disease, and the greater the exposure to these stressors the higher the risk was, in a prospective study of nearly 80 000 working adults in Denmark and Sweden published in the European Heart Journal 3. The authors said, “The effect of bullying and violence on the incidence of cardiovascular disease in the general population is comparable to other risk factors, such as diabetes and alcohol drinking, which further highlights the importance of workplace bullying and workplace violence in relation to cardiovascular disease prevention.”…”