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|Title: ||Effort-reward imbalance at work in relation to incident coronary heart disease: a multicohort study of 90,164 individuals|
|Authors: ||Dragano, Nico|
Nyberg, Solja T.
Fransson, Eleonor I.
Bjorner, Jakob B.
Madsen, Ida E. H.
Nielsen, Martin L.
Pejtersen, Jan H.
Westerholm, Peter J. M .
Batty, G. David
|Issue Date: ||2016|
|Publisher: ||Lippincott, Williams & Wilkins|
|Citation: ||DRAGANO, N. ...et al., 2016. Effort-reward imbalance at work in relation to incident coronary heart disease: a multicohort study of 90,164 individuals. Epidemiology, In Press.|
|Abstract: ||heart disease is mostly based on a single operationalization of stressful work, known
as job strain, a combination of high demands and low job control. We examined if a
complementary stress measure which 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 metaanalysis.
Results: At baseline, 31.7% of study members reported effort-reward imbalance at
work and 15.9% 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 experienced job strain.
These findings support expanding focus beyond just job strain in future research on
|Description: ||This paper is in closed access until 12 months after publication.|
|Version: ||Accepted for publication|
|Publisher Link: ||http://journals.lww.com/epidem/pages/default.aspx|
|Appears in Collections:||Closed Access (Sport, Exercise and Health Sciences)|
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