Scand J Work Environ Health 2004;30(2):85-128 pdf pdf
https://doi.org/10.5271/sjweh.769 | Issue date: Apr 2004
Is job strain a major source of cardiovascular disease risk?
Empirical studies on job strain and cardiovascular disease (CVD), their internal validity, and the likely direction of biases were examined. The 17 longitudinal studies had the highest validity ratings. In all but two, biases towards the null dominated. Eight, including several of the largest, showed significant positive results; three had positive, nonsignificant findings. Six of nine case-control studies had significant positive findings; recall bias leading to overestimation appears to be fairly minimal. Four of eight cross-sectional studies had significant positive results. Men showed strong, consistent evidence of an association between exposure to job strain and CVD. The data of the women were more sparse and less consistent, but, as for the men, most of the studies probably underestimated existing effects. Other elements of causal inference, particularly biological plausibility, corroborated that job strain is a major CVD risk factor. Additional intervention studies are needed to examine the impact of ameliorating job strain upon CVD-related outcomes.
Key terms angina pectoris; cardiovascular death; cardiovascular disease; coronary artery disease; decision latitude; IHD; ischemic heart disease; job control; job strain; myocardial infarction; psychological demand; review; risk; skill discretion; work control