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Effort-Reward Imbalance at Work and Incident Coronary Heart Disease: A Multi-Cohort Study of 90,164 Individuals

Author

Listed:
  • Dragano, Nico
  • Siegrist, Johannes
  • Nyberg, Solja T.
  • Lunau, Thorsten
  • Fransson, Eleonor I.
  • Alfredsson, Lars
  • Bjorner, Jakob B.
  • Borritz, Marianne
  • Burr, Hermann
  • Erbel, Raimund
  • Fahlen, Göran
  • Goldberg, Marcel
  • Hamer, Mark
  • Heikkilä, Katriina
  • Jöckel, Karl-Heinz
  • Madsen, Ida E.H.
  • Nielsen, Martin L.
  • Nordin, Maria
  • Oksanen, Tuula
  • Pejtersen, Jan H.
  • Pentti, Jaana
  • Rugulies, Reiner
  • Salo, Paula
  • Schupp, Jürgen
  • Singh-Manoux, Archana
  • Steptoe, Andrew
  • Theorell, Töres
  • Vahtera, Jussi
  • Westerholm, Peter J. M.
  • Westerlund, Hugo
  • Virtanen, Marianna
  • Zins, Marie
  • Batty, G. David
  • Kivimäki, Mika

Abstract

Background: Epidemiologic evidence for work stress as a risk factor for coronary heart disease is mostly based on a single measure of stressful work known as job strain, a combination of high demands and low job control. We examined whether a complementary stress measure that assesses an imbalance between efforts spent at work and rewards received predicted coronary heart disease. Methods: This multi-cohort study (the 'IPD-Work' consortium) was based on harmonized individual-level data from 11 European prospective cohort studies. Stressful work in 90,164 men and women without coronary heart disease at baseline was assessed by validated effort-reward imbalance and job strain questionnaires. We defined incident coronary heart disease as the first non-fatal myocardial infarction or coronary death. Study-specific estimates were pooled by random-effects meta-analysis. Results: At baseline, 31.7% of study members reported effort-reward imbalance at work and 15.9% reported job strain. During a mean follow-up of 9.8 years, 1078 coronary events were recorded. After adjustment for potential confounders, a hazard ratio of 1.16 (95% confidence interval 1.00-1.35) was observed for effort-reward imbalance compared to no imbalance. The hazard ratio was 1.16 (1.01-1.34) for having either effort-reward imbalance or job strain, and 1.41 (1.12-1.76) for having both these stressors compared to having neither effort-reward imbalance nor job strain. Conclusions: Individuals with effort-reward imbalance at work have an increased risk of coronary heart disease, and this appears to be independent of job strain experienced. These findings support expanding focus beyond just job strain in future research on work stress.

Suggested Citation

  • Dragano, Nico & Siegrist, Johannes & Nyberg, Solja T. & Lunau, Thorsten & Fransson, Eleonor I. & Alfredsson, Lars & Bjorner, Jakob B. & Borritz, Marianne & Burr, Hermann & Erbel, Raimund & Fahlen, Gör, 2017. "Effort-Reward Imbalance at Work and Incident Coronary Heart Disease: A Multi-Cohort Study of 90,164 Individuals," EconStor Open Access Articles and Book Chapters, ZBW - Leibniz Information Centre for Economics, vol. 28(4), pages 619-626.
  • Handle: RePEc:zbw:espost:222473
    DOI: 10.1097/EDE.0000000000000666
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    1. Isabelle Niedhammer & Hélène Sultan-Taïeb & Jean-François Chastang & Greet Vermeylen & Agnès Parent-Thirion, 2012. "Exposure to psychosocial work factors in 31 European countries," Post-Print halshs-01228097, HAL.
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    1. Alice Clark & Sari Stenholm & Jaana Pentti & Paula Salo & Theis Lange & Eszter Török & Tianwei Xu & Jesper Fabricius & Tuula Oksanen & Mika Kivimäki & Jussi Vahtera & Naja Hulvej Rod, 2021. "Workplace discrimination as risk factor for long-term sickness absence: Longitudinal analyses of onset and changes in workplace adversity," PLOS ONE, Public Library of Science, vol. 16(8), pages 1-15, August.
    2. Braunheim, Lisa & Dragano, Nico & Khachatryan, Kristine & Beutel, Manfred E. & Brähler, Elmar, 2024. "The effects of effort-reward imbalance on the job, overcommitment, and income on life satisfaction in Germany from a longitudinal perspective," Social Science & Medicine, Elsevier, vol. 341(C).
    3. Witvliet, M.I. & Toch-Marquardt, M. & Eikemo, T.A. & Mackenbach, J.P., 2020. "Improving job strain might reduce inequalities in cardiovascular disease mortality in european men," Social Science & Medicine, Elsevier, vol. 267(C).
    4. Viola Mambrey & Patricia Vu-Eickmann & Peter Angerer & Adrian Loerbroks, 2021. "Associations between Psychosocial Working Conditions and Quality of Care (i.e., Slips and Lapses, and Perceived Social Interactions with Patients)—A Cross-Sectional Study among Medical Assistants," IJERPH, MDPI, vol. 18(18), pages 1-15, September.
    5. Fermín Martínez-Zaragoza & Gemma Benavides-Gil & Tatiana Rovira & Beatriz Martín-del-Río & Silvia Edo & Rosa García-Sierra & Ángel Solanes-Puchol & Jordi Fernández-Castro, 2020. "When and how do hospital nurses cope with daily stressors? A multilevel study," PLOS ONE, Public Library of Science, vol. 15(11), pages 1-18, November.
    6. Jean-Baptist du Prel & Johannes Siegrist & Daniela Borchart, 2019. "The Role of Leisure-Time Physical Activity in the Change of Work-Related Stress (ERI) over Time," IJERPH, MDPI, vol. 16(23), pages 1-9, December.
    7. Michael Gast & Janina Lehmann & Elena Schwarz & Christian Hirning & Michael Hoelzer & Harald Guendel & Elisabeth Maria Balint, 2022. "A Single-Day Training for Managers Reduces Cognitive Stigma Regarding Mental Health Problems: A Randomized Trial," IJERPH, MDPI, vol. 19(7), pages 1-12, March.
    8. Orawan Kaewboonchoo & Grace Sembajwe & Jian Li, 2018. "Associations between Job Strain and Arterial Stiffness: A Large Survey among Enterprise Employees from Thailand," IJERPH, MDPI, vol. 15(4), pages 1-13, April.
    9. Harry Becher & Maureen F. Dollard & Peter Smith & Jian Li, 2018. "Predicting Circulatory Diseases from Psychosocial Safety Climate: A Prospective Cohort Study from Australia," IJERPH, MDPI, vol. 15(3), pages 1-10, February.

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