Skip to main content
PMC home page
Occupational and Environmental Medicine logoLink to Occupational and Environmental Medicine
. 2003 Oct;60(10):779–783. doi: 10.1136/oem.60.10.779

Workplace bullying and the risk of cardiovascular disease and depression

M Kivimaki 1, M Virtanen 1, M Vartia 1, M Elovainio 1, J Vahtera 1, L Keltikangas-Jarvi 1
PMCID: PMC1740404  PMID: 14504368

Abstract

Aims: To examine exposure to workplace bullying as a risk factor for cardiovascular disease and depression in employees.

Methods: Logistic regression models were related to prospective data from two surveys in a cohort of 5432 hospital employees (601 men and 4831 women), aged 18–63 years. Outcomes were new reports of doctor diagnosed cardiovascular disease and depression during the two year follow up among those who were free from these diseases at baseline.

Results: The prevalence of bullying was 5% in the first survey and 6% in the second survey. Two per cent reported bullying experiences in both surveys, an indication of prolonged bullying. After adjustment for sex, age, and income, the odds ratio of incident cardiovascular disease for victims of prolonged bullying compared to non-bullied employees was 2.3 (95% CI 1.2 to 4.6). A further adjustment for overweight at baseline attenuated the odds ratio to 1.6 (95% CI 0.8 to 3.5). The association between prolonged bullying and incident depression was significant, even after these adjustments (odds ratio 4.2, 95% CI 2.0 to 8.6).

Conclusions: A strong association between workplace bullying and subsequent depression suggests that bullying is an aetiological factor for mental health problems. The victims of bullying also seem to be at greater risk of cardiovascular disease, but this risk may partly be attributable to overweight.

Full Text

The Full Text of this article is available as a PDF (317.4 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Amick B. C., 3rd, Kawachi I., Coakley E. H., Lerner D., Levine S., Colditz G. A. Relationship of job strain and iso-strain to health status in a cohort of women in the United States. Scand J Work Environ Health. 1998 Feb;24(1):54–61. doi: 10.5271/sjweh.278. [DOI] [PubMed] [Google Scholar]
  2. Bond L., Carlin J. B., Thomas L., Rubin K., Patton G. Does bullying cause emotional problems? A prospective study of young teenagers. BMJ. 2001 Sep 1;323(7311):480–484. doi: 10.1136/bmj.323.7311.480. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Bosma H., Peter R., Siegrist J., Marmot M. Two alternative job stress models and the risk of coronary heart disease. Am J Public Health. 1998 Jan;88(1):68–74. doi: 10.2105/ajph.88.1.68. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Cusack S. Workplace bullying: icebergs in sight, soundings needed. Lancet. 2000 Dec 23;356(9248):2118–2118. doi: 10.1016/S0140-6736(00)03489-9. [DOI] [PubMed] [Google Scholar]
  5. Elovainio Marko, Kivimäki Mika, Vahtera Jussi. Organizational justice: evidence of a new psychosocial predictor of health. Am J Public Health. 2002 Jan;92(1):105–108. doi: 10.2105/ajph.92.1.105. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Glassman A. H., Helzer J. E., Covey L. S., Cottler L. B., Stetner F., Tipp J. E., Johnson J. Smoking, smoking cessation, and major depression. JAMA. 1990 Sep 26;264(12):1546–1549. [PubMed] [Google Scholar]
  7. Hemingway H., Marmot M. Evidence based cardiology: psychosocial factors in the aetiology and prognosis of coronary heart disease. Systematic review of prospective cohort studies. BMJ. 1999 May 29;318(7196):1460–1467. doi: 10.1136/bmj.318.7196.1460. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Kivimäki M., Elovainio M., Vahtera J. Workplace bullying and sickness absence in hospital staff. Occup Environ Med. 2000 Oct;57(10):656–660. doi: 10.1136/oem.57.10.656. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Koh T. S., Koh T. H. Bullying in hospitals. Occup Environ Med. 2001 Sep;58(9):610–610. doi: 10.1136/oem.58.9.610. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Koskenvuo M., Kaprio J., Rose R. J., Kesäniemi A., Sarna S., Heikkilä K., Langinvainio H. Hostility as a risk factor for mortality and ischemic heart disease in men. Psychosom Med. 1988 Jul-Aug;50(4):330–340. doi: 10.1097/00006842-198807000-00002. [DOI] [PubMed] [Google Scholar]
  11. Kunst A. E., Groenhof F., Mackenbach J. P., Health E. W. Occupational class and cause specific mortality in middle aged men in 11 European countries: comparison of population based studies. EU Working Group on Socioeconomic Inequalities in Health. BMJ. 1998 May 30;316(7145):1636–1642. doi: 10.1136/bmj.316.7145.1636. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. McEwen B. S. Protective and damaging effects of stress mediators. N Engl J Med. 1998 Jan 15;338(3):171–179. doi: 10.1056/NEJM199801153380307. [DOI] [PubMed] [Google Scholar]
  13. Romanov K., Appelberg K., Honkasalo M. L., Koskenvuo M. Recent interpersonal conflict at work and psychiatric morbidity: a prospective study of 15,530 employees aged 24-64. J Psychosom Res. 1996 Feb;40(2):169–176. doi: 10.1016/0022-3999(95)00577-3. [DOI] [PubMed] [Google Scholar]
  14. Vartia M. A. Consequences of workplace bullying with respect to the well-being of its targets and the observers of bullying. Scand J Work Environ Health. 2001 Feb;27(1):63–69. doi: 10.5271/sjweh.588. [DOI] [PubMed] [Google Scholar]
  15. Voss M., Floderus B., Diderichsen F. Physical, psychosocial, and organisational factors relative to sickness absence: a study based on Sweden Post. Occup Environ Med. 2001 Mar;58(3):178–184. doi: 10.1136/oem.58.3.178. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Weinberg A., Creed F. Stress and psychiatric disorder in healthcare professionals and hospital staff. Lancet. 2000 Feb 12;355(9203):533–537. doi: 10.1016/S0140-6736(99)07366-3. [DOI] [PubMed] [Google Scholar]

Articles from Occupational and Environmental Medicine are provided here courtesy of BMJ Publishing Group

RESOURCES