Skip to main content
NCBI home page
Journal of Epidemiology and Community Health logoLink to Journal of Epidemiology and Community Health
. 1998 Feb;52(2):93–100. doi: 10.1136/jech.52.2.93

Psychosocial work environment and cardiovascular risk factors in an occupational cohort in France

I Niedhammer, M Goldberg, A Leclerc, S David, I Bugel, M F Landre
PMCID: PMC1756662  PMID: 9578855

Abstract

STUDY OBJECTIVE: Concordant results have been reported in several studies for the effects of job stress on cardiovascular disease, but the potential mechanisms of these effects have seldom been explored. The aim of this study was therefore to examine, in women and men, the cross sectional relations between psychosocial work variables (psychological demands, decision latitude, and social support) and cardiovascular risk factors (hypertension, hyperlipidaemia, diabetes, overweight, smoking, and alcohol consumption). PARTICIPANTS: The original cohort comprised 20,625 volunteers (men aged from 40 to 50 and women from 35 to 50) employed by the French Company Electricite De France-Gaz De France and followed up yearly since 1989. The study was restricted to the 13,226 volunteers in the cohort who were still working and answered a self administered questionnaire on psychosocial work factors in 1995. DESIGN: Data were based on replies to this questionnaire. Three psychosocial work environment exposure scores were used to assess psychological demands, decision latitude, and social support at work respectively. The main outcome measures were the prevalence of hypertension, hyperlipidaemia, and diabetes within the previous 12 months, overweight, smoking, and alcohol consumption. MAIN RESULTS: Psychosocial work factors were significantly associated with hypertension, hyperlipidaemia, overweight, smoking, and alcohol consumption, but not with diabetes. In men, low decision latitude was associated with hypertension, high decision latitude and high social support with overweight, low decision latitude with alcohol consumption. Moreover, the risk of hyperlipidaemia increased in men exposed to both high psychological demands and low social support. In women, low decision latitude was related to hyperlipidaemia, high psychological demands with overweight, high psychological demands and high decision latitude with smoking, and low social support with alcohol consumption. CONCLUSIONS: These cross sectional results underline the potential effects of psychosocial work characteristics on cardiovascular risk factors and the differences between the effects of job stress in men and women, and confirm the direct mechanisms (through physiological variables) and indirect mechanisms (through behavioural risk factors) potentially involved in the relation between psychosocial work characteristics and cardiovascular disease.

 

Full Text

The Full Text of this article is available as a PDF (120.4 KB).

Selected References

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

  1. Alfredsson L., Karasek R., Theorell T. Myocardial infarction risk and psychosocial work environment: an analysis of the male Swedish working force. Soc Sci Med. 1982;16(4):463–467. doi: 10.1016/0277-9536(82)90054-5. [DOI] [PubMed] [Google Scholar]
  2. Alfredsson L., Spetz C. L., Theorell T. Type of occupation and near-future hospitalization for myocardial infarction and some other diagnoses. Int J Epidemiol. 1985 Sep;14(3):378–388. doi: 10.1093/ije/14.3.378. [DOI] [PubMed] [Google Scholar]
  3. Alfredsson L., Theorell T. Job characteristics of occupations and myocardial infarction risk:effect of possible confounding factors. Soc Sci Med. 1983;17(20):1497–1503. doi: 10.1016/0277-9536(83)90094-1. [DOI] [PubMed] [Google Scholar]
  4. Alterman T., Shekelle R. B., Vernon S. W., Burau K. D. Decision latitude, psychologic demand, job strain, and coronary heart disease in the Western Electric Study. Am J Epidemiol. 1994 Mar 15;139(6):620–627. doi: 10.1093/oxfordjournals.aje.a117051. [DOI] [PubMed] [Google Scholar]
  5. Björntorp P. Visceral fat accumulation: the missing link between psychosocial factors and cardiovascular disease? J Intern Med. 1991 Sep;230(3):195–201. doi: 10.1111/j.1365-2796.1991.tb00431.x. [DOI] [PubMed] [Google Scholar]
  6. Björntorp P. Visceral obesity: a "civilization syndrome". Obes Res. 1993 May;1(3):206–222. doi: 10.1002/j.1550-8528.1993.tb00614.x. [DOI] [PubMed] [Google Scholar]
  7. Brunner E., Davey Smith G., Marmot M., Canner R., Beksinska M., O'Brien J. Childhood social circumstances and psychosocial and behavioural factors as determinants of plasma fibrinogen. Lancet. 1996 Apr 13;347(9007):1008–1013. doi: 10.1016/s0140-6736(96)90147-6. [DOI] [PubMed] [Google Scholar]
  8. Burton B. T., Foster W. R., Hirsch J., Van Itallie T. B. Health implications of obesity: an NIH Consensus Development Conference. Int J Obes. 1985;9(3):155–170. [PubMed] [Google Scholar]
  9. Caplan R. D., Cobb S., French J. R., Jr Relationships of cessation of smoking with job stress, personality, and social support. J Appl Psychol. 1975 Apr;60(2):211–219. doi: 10.1037/h0076471. [DOI] [PubMed] [Google Scholar]
  10. Chapman A., Mandryk J. A., Frommer M. S., Edye B. V., Ferguson D. A. Chronic perceived work stress and blood pressure among Australian government employees. Scand J Work Environ Health. 1990 Aug;16(4):258–269. doi: 10.5271/sjweh.1786. [DOI] [PubMed] [Google Scholar]
  11. Chesney M. A., Sevelius G., Black G. W., Ward M. M., Swan G. E., Rosenman R. H. Work environment, type A behavior, and coronary heart disease risk factors. J Occup Med. 1981 Aug;23(8):551–555. [PubMed] [Google Scholar]
  12. Cohen S., Schwartz J. E., Bromet E. J., Parkinson D. K. Mental health, stress, and poor health behaviors in two community samples. Prev Med. 1991 Mar;20(2):306–315. doi: 10.1016/0091-7435(91)90029-4. [DOI] [PubMed] [Google Scholar]
  13. Conway T. L., Vickers R. R., Jr, Ward H. W., Rahe R. H. Occupational stress and variation in cigarette, coffee, and alcohol consumption. J Health Soc Behav. 1981 Jun;22(2):155–165. [PubMed] [Google Scholar]
  14. Dawber T. R., Kannel W. B. The Framingham study. An epidemiological approach to coronary heart disease. Circulation. 1966 Oct;34(4):553–555. doi: 10.1161/01.cir.34.4.553. [DOI] [PubMed] [Google Scholar]
  15. Dyer A. R., Stamler J., Paul O., Berkson D. M., Lepper M. H., McKean H., Shekelle R. B., Lindberg H. A., Garside D. Alcohol consumption, cardiovascular risk factors, and mortality in two Chicago epidemiologic studies. Circulation. 1977 Dec;56(6):1067–1074. doi: 10.1161/01.cir.56.6.1067. [DOI] [PubMed] [Google Scholar]
  16. Green K. L., Johnson J. V. The effects of psychosocial work organization on patterns of cigarette smoking among male chemical plant employees. Am J Public Health. 1990 Nov;80(11):1368–1371. doi: 10.2105/ajph.80.11.1368. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Haan M. N. Job strain and ischaemic heart disease: an epidemiologic study of metal workers. Ann Clin Res. 1988;20(1-2):143–145. [PubMed] [Google Scholar]
  18. Hammar N., Alfredsson L., Theorell T. Job characteristics and the incidence of myocardial infarction. Int J Epidemiol. 1994 Apr;23(2):277–284. doi: 10.1093/ije/23.2.277. [DOI] [PubMed] [Google Scholar]
  19. Heliövaara M., Aromaa A. Parity and obesity. J Epidemiol Community Health. 1981 Sep;35(3):197–199. doi: 10.1136/jech.35.3.197. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. House J. S., Strecher V., Metzner H. L., Robbins C. A. Occupational stress and health among men and women in the Tecumseh Community Health Study. J Health Soc Behav. 1986 Mar;27(1):62–77. [PubMed] [Google Scholar]
  21. Härenstam A. B., Theorell T. P. Work conditions and urinary excretion of catecholamines--a study of prison staff in Sweden. Scand J Work Environ Health. 1988 Aug;14(4):257–264. doi: 10.5271/sjweh.1923. [DOI] [PubMed] [Google Scholar]
  22. Johansson G., Johnson J. V., Hall E. M. Smoking and sedentary behavior as related to work organization. Soc Sci Med. 1991;32(7):837–846. doi: 10.1016/0277-9536(91)90310-9. [DOI] [PubMed] [Google Scholar]
  23. Johnson J. V., Hall E. M. Job strain, work place social support, and cardiovascular disease: a cross-sectional study of a random sample of the Swedish working population. Am J Public Health. 1988 Oct;78(10):1336–1342. doi: 10.2105/ajph.78.10.1336. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Johnson J. V., Hall E. M., Theorell T. Combined effects of job strain and social isolation on cardiovascular disease morbidity and mortality in a random sample of the Swedish male working population. Scand J Work Environ Health. 1989 Aug;15(4):271–279. doi: 10.5271/sjweh.1852. [DOI] [PubMed] [Google Scholar]
  25. Johnson J. V., Stewart W., Hall E. M., Fredlund P., Theorell T. Long-term psychosocial work environment and cardiovascular mortality among Swedish men. Am J Public Health. 1996 Mar;86(3):324–331. doi: 10.2105/ajph.86.3.324. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Karasek R. A., Theorell T., Schwartz J. E., Schnall P. L., Pieper C. F., Michela J. L. Job characteristics in relation to the prevalence of myocardial infarction in the US Health Examination Survey (HES) and the Health and Nutrition Examination Survey (HANES). Am J Public Health. 1988 Aug;78(8):910–918. doi: 10.2105/ajph.78.8.910. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Karasek R., Baker D., Marxer F., Ahlbom A., Theorell T. Job decision latitude, job demands, and cardiovascular disease: a prospective study of Swedish men. Am J Public Health. 1981 Jul;71(7):694–705. doi: 10.2105/ajph.71.7.694. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Kasl S. V. The influence of the work environment on cardiovascular health: a historical, conceptual, and methodological perspective. J Occup Health Psychol. 1996 Jan;1(1):42–56. doi: 10.1037//1076-8998.1.1.42. [DOI] [PubMed] [Google Scholar]
  29. Landsbergis P. A., Schnall P. L., Warren K., Pickering T. G., Schwartz J. E. Association between ambulatory blood pressure and alternative formulations of job strain. Scand J Work Environ Health. 1994 Oct;20(5):349–363. doi: 10.5271/sjweh.1386. [DOI] [PubMed] [Google Scholar]
  30. Light K. C., Turner J. R., Hinderliter A. L. Job strain and ambulatory work blood pressure in healthy young men and women. Hypertension. 1992 Aug;20(2):214–218. doi: 10.1161/01.hyp.20.2.214. [DOI] [PubMed] [Google Scholar]
  31. Marmot M. G. Alcohol and coronary heart disease. Int J Epidemiol. 1984 Jun;13(2):160–167. doi: 10.1093/ije/13.2.160. [DOI] [PubMed] [Google Scholar]
  32. Marmot M. G., Elliott P., Shipley M. J., Dyer A. R., Ueshima H., Beevers D. G., Stamler R., Kesteloot H., Rose G., Stamler J. Alcohol and blood pressure: the INTERSALT study. BMJ. 1994 May 14;308(6939):1263–1267. doi: 10.1136/bmj.308.6939.1263. [DOI] [PMC free article] [PubMed] [Google Scholar]
  33. Matthews K. A., Haynes S. G. Type A behavior pattern and coronary disease risk. Update and critical evaluation. Am J Epidemiol. 1986 Jun;123(6):923–960. doi: 10.1093/oxfordjournals.aje.a114347. [DOI] [PubMed] [Google Scholar]
  34. Netterstrøm B., Kristensen T. S., Damsgaard M. T., Olsen O., Sjøl A. Job strain and cardiovascular risk factors: a cross sectional study of employed Danish men and women. Br J Ind Med. 1991 Oct;48(10):684–689. doi: 10.1136/oem.48.10.684. [DOI] [PMC free article] [PubMed] [Google Scholar]
  35. Pieper C., LaCroix A. Z., Karasek R. A. The relation of psychosocial dimensions of work with coronary heart disease risk factors: a meta-analysis of five United States data bases. Am J Epidemiol. 1989 Mar;129(3):483–494. doi: 10.1093/oxfordjournals.aje.a115159. [DOI] [PubMed] [Google Scholar]
  36. Reed D. M., LaCroix A. Z., Karasek R. A., Miller D., MacLean C. A. Occupational strain and the incidence of coronary heart disease. Am J Epidemiol. 1989 Mar;129(3):495–502. doi: 10.1093/oxfordjournals.aje.a115160. [DOI] [PubMed] [Google Scholar]
  37. Schnall P. L., Landsbergis P. A., Baker D. Job strain and cardiovascular disease. Annu Rev Public Health. 1994;15:381–411. doi: 10.1146/annurev.pu.15.050194.002121. [DOI] [PubMed] [Google Scholar]
  38. Schnall P. L., Pieper C., Schwartz J. E., Karasek R. A., Schlussel Y., Devereux R. B., Ganau A., Alderman M., Warren K., Pickering T. G. The relationship between 'job strain,' workplace diastolic blood pressure, and left ventricular mass index. Results of a case-control study. JAMA. 1990 Apr 11;263(14):1929–1935. [PubMed] [Google Scholar]
  39. Schnall P. L., Schwartz J. E., Landsbergis P. A., Warren K., Pickering T. G. Relation between job strain, alcohol, and ambulatory blood pressure. Hypertension. 1992 May;19(5):488–494. doi: 10.1161/01.hyp.19.5.488. [DOI] [PubMed] [Google Scholar]
  40. Schwartz J. E., Pieper C. F., Karasek R. A. A procedure for linking psychosocial job characteristics data to health surveys. Am J Public Health. 1988 Aug;78(8):904–909. doi: 10.2105/ajph.78.8.904. [DOI] [PMC free article] [PubMed] [Google Scholar]
  41. Theorell T., Ahlberg-Hulten G., Jodko M., Sigala F., de la Torre B. Influence of job strain and emotion on blood pressure in female hospital personnel during workhours. Scand J Work Environ Health. 1993 Oct;19(5):313–318. doi: 10.5271/sjweh.1469. [DOI] [PubMed] [Google Scholar]
  42. Theorell T., Alfredsson L., Knox S., Perski A., Svensson J., Waller D. On the interplay between socioeconomic factors, personality and work environment in the pathogenesis of cardiovascular disease. Scand J Work Environ Health. 1984 Dec;10(6 Spec No):373–380. doi: 10.5271/sjweh.2305. [DOI] [PubMed] [Google Scholar]
  43. Theorell T., Hamsten A., de Faire U., Orth-Gomér K., Perski A. Psychosocial work conditions before myocardial infarction in young men. Int J Cardiol. 1987 Apr;15(1):33–46. doi: 10.1016/0167-5273(87)90290-7. [DOI] [PubMed] [Google Scholar]
  44. Theorell T., Perski A., Orth-Gomér K., Hamsten A., de Faire U. The effects of the strain of returning to work on the risk of cardiac death after a first myocardial infarction before the age of 45. Int J Cardiol. 1991 Jan;30(1):61–67. doi: 10.1016/0167-5273(91)90125-9. [DOI] [PubMed] [Google Scholar]
  45. Theorell T., de Faire U., Johnson J., Hall E., Perski A., Stewart W. Job strain and ambulatory blood pressure profiles. Scand J Work Environ Health. 1991 Dec;17(6):380–385. doi: 10.5271/sjweh.1690. [DOI] [PubMed] [Google Scholar]
  46. Van Egeren L. F. The relationship between job strain and blood pressure at work, at home, and during sleep. Psychosom Med. 1992 May-Jun;54(3):337–343. doi: 10.1097/00006842-199205000-00009. [DOI] [PubMed] [Google Scholar]
  47. Westman M., Eden D., Shirom A. Job stress, cigarette smoking and cessation: the conditioning effects of peer support. Soc Sci Med. 1985;20(6):637–644. doi: 10.1016/0277-9536(85)90402-2. [DOI] [PubMed] [Google Scholar]
  48. Zimmet P., Baba S. Central obesity, glucose intolerance and other cardiovascular disease risk factors: an old syndrome rediscovered. Diabetes Res Clin Pract. 1990;10 (Suppl 1):S167–S171. doi: 10.1016/0168-8227(90)90158-p. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Epidemiology and Community Health are provided here courtesy of BMJ Publishing Group

RESOURCES