| First author, year | Reference | Study participants | STUDY RATING | Effect of job strain |
|---|---|---|---|---|
| CORONARY HEART DISEASE | ||||
| Case-control studies - MI | ||||
| Alfreddson, 1982 | (4, 6) | 334 employed men and 882 matched controls in Stockholm aged 40-64 | POSITIVE | Hectic job + monotony: NS Hectic job + no private visits: OR=1.30* Hectic job + no influence: OR=1.35* Hectic job + few possibilities to learn: OR=1.45* |
| Hammar, 1993 | 36 | 9,295 employed men and women and 26,101 matched controls in Sweden aged 30-64 | POSITIVE |
Hectic job: + monotony: RR=1.2* (men) RR=1.4* (women) + few possibilities to learn: RR=1.3* (both) + low influence on planning work: RR=1.3* (both) + low influence on work tempo: RR=1.2* (m) RR=1.1* (w) + low influence on work hours: RR=1.3* (m) RR=1.2* (w) |
| Cross-sectional studies | ||||
| Karasek, 1988 | (59) | 1960-62 US HES: 2,409 men 1971-75 US HANES: 2,424 men | POSITIVE | SOR= 1.50* (MI) SOR= 1.61* |
| Hall, 1993 | (new) | 5,921 Swedish women, aged 45-74 | NULL |
Job demands: OR=0.78*; Work control (NS); Low social support: OR=1.15# (CHD morbidity) |
| Cohort studies | ||||
| LaCroix, 1984 | (68) | 548 men, 328 women, aged 45-64, in Framingham, MA followed for 10 yrs | POSITIVE |
Self-report: All women:RR=2.92*; Clerical women:RR=5.21 **National job averages: Women***, and men** (CHD) |
| Alfreddson, 1985 | (5) | 958,096 Stockholm residents aged 20-64 followed for 1 year | POSITIVE |
Hectic job and low influence: NS Hectic job and monotony: Women: SMR=164*; Men: SMR=118*Men aged 20-54: SMR=153* Hectic job and few possibilities to learn: Women (NS); Men: SMR=128*; Men aged 20-54: SMR=157* (MI hospitaliz) |
| Reed, 1989 | (93) | 4,737 Hawaiian men, aged 45-65, followed for 18 years | NULL |
Non-significant trend for lower strain men to have higher CHD |
| Hall, 1993 | (new) | 5,921 Swedish women, aged 45-74, followed for 7-11 years | NULL |
Job demands: OR=0.67#; Work control, Social support (NS) (CHD mortality) |
| Alterman, 1994 | (new) | 1,683 men 1957-58 followed for 25 yrs since age 38-56 | NULL |
RR=1.5# (control for age); RR=1.4# (also control for srf, education); RR=1.0 (also control for occup status) |
| AMBULATORY BLOOD PRESSURE | ||||
| Cross-sectional studies | ||||
| Theorell, 1991 | (109) | 161 Swedish males aged 35-55 with borderline hypertension | POSITIVE |
Significantly associated with work, home and sleep DBP** SBP (NS) |
| Cohort studies | ||||
| Theorell, 1985 | (113) | 71 Stockholm men in 1981-82 followed for 10 yrs since age 18 | MIXED |
NS; but significant interaction: hypertensives have higher SBP rise at work if in a high strain job Sleep (n/a) |
| CASUAL BLOOD PRESSURE | ||||
| Cross-sectional studies | ||||
| Pieper, 1989 | (90) | 12,555 men in 3 US national and 2 regional studies | NULL |
Job strain (NS) Job decision latitude associated with lower SBP* |
| Alterman, 1994 | (new) | 1,683 men examined in 1957-58 | NULL |
Job Strain: SBP: 2.7 mm Hg (NS); DBP: 0.8 mm Hg (NS) Demands, Latitude (NS) |
| SMOKING | ||||
| Cross-sectional studies | ||||
| Mensch, 1988 | (81) | 5335 male and 4874 female employed US youth aged 19-27 in 1984 | POSITIVE |
Highest smoking rates in high demand-low latitude jobs* |
| Pieper, 1989 | (90) | 12,555 men in 3 US national and 2 regional studies | NULL |
Job strain (NS); Job decision latitude associated with lower smoking* |
| Alterman, 1994 | (new) | 1,683 men examined in 1957-58 | NULL |
Job Strain (NS); High demand (52%) vs low demand (60%)# High latitude (49%) vs low latitude (62%)*** |
| SERUM CHOLESTEROL | ||||
| Cross-sectional studies | ||||
| Pieper, 1989 | (90) | 12,555 men in 3 US national and 2 regional studies | NULL |
Latitude (NS); Demands (NS) |
| Alterman, 1994 | (new) | 1,683 men examined in 1957-58 | NULL |
Job Strain (NS); Latitude (NS); Demands (NS) |
| BODY FAT DISTRIBUTION | ||||
| Cross-sectional studies | ||||
| Georges, 1992 | (30) | 1,377 Mexican-American men aged 18-74 (1982-4 US HHANES) | NULL |
Skinfold thickness: F=4.93* Central body fat distribution (CBFD) (NS) |
SBP: systolic blood pressure DBP: diastolic blood pressure BP: blood pressure LVMI: left ventricular mass index SOR: standardized odds ratio; OR: odds ratio NS: not significant at p<0.05.