Low job control and risk of coronary heart disease in whitehall ii (prospective cohort) study

作者：Hans Bosma, Michael Gideon Marmot, Harry Hemingway, Amanda Nicholson, Eric John Brunner, Stephen Alfred Stansfeld · 发表于：BMJ · 年份：1997 · DOI：10.1136/bmj.314.7080.558 · 被引用次数：936 · 研究领域：Workplace Health and Well-being、Cardiac Health and Mental Health、Stress and Burnout Research

Abstract Objective: To determine the association between adverse psychosocial characteristics at work and risk of coronary heart disease among male and female civil servants. Design: Prospective cohort study (Whitehall II study). At the baseline examination (1985-8) and twice during follow up a self report questionnaire provided information on psychosocial factors of the work environment and coronary heart disease. Independent assessments of the work environment were obtained from personnel managers at baseline. Mean length of follow up was 5.3 years. Setting: London based office staff in 20 civil service departments. Subjects: 10 308 civil servants aged 35-55 were examined-6895 men (67%) and 3413 women (33%). Main outcome measures: New cases of angina (Rose questionnaire), severe pain across the chest, diagnosed ischaemic heart disease, and any coronary event. Results: Men and women with low job control, either self reported or independently assessed, had a higher risk of newly reported coronary heart disease during follow up. Job control assessed on two occasions three years apart, although intercorrelated, had cumulative effects on newly reported disease. Subjects with low job control on both occasions had an odds ratio for any subsequent coronary event of 1.93 (95% confidence interval 1.34 to 2.77) compared with subjects with high job control at both occasions. This association could not be explained by employment grade, negative affectivity, or classic coronary risk fact...