ArticleBMJ open2017
Job strain and the incidence of coronary heart diseases: does the association differ among occupational classes? A contribution from a pooled analysis of Northern Italian cohorts.
Article in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
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Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- The demands-control-support work stress model and risk of ischemic heart disease: causal inference based on observational epidemiology.Scandinavian journal of work, environment & health · 2026Pooled it
- Work Exposures and Development of Cardiovascular Diseases: A Systematic Review.Annals of work exposures and health · 2022Pooled it
- Examining the Association Between Occupational Strain and Risk of Angina Pectoris Among Older Working Adults in India Using Karasek's Job Demand Control Model.Research square · 2026Article
- Sex and gender differences in the associations between psychosocial stressors at work and coronary heart disease incidence: An 18-year longitudinal study of 5192 Canadian workers.American journal of preventive cardiology · 2025Article
- Coronary Heart Disease Attributable to Psychosocial Stressors at Work.JACC. Advances · 2025Article
- The Protective Role of Job Control/Autonomy on Mental Strain of Managers: A Cross-Sectional Study among Wittyfit's Users.International journal of environmental research and public health · 2022Article
- Respective Mediating Effects of Social Position and Work Environment on the Incidence of Common Cardiovascular Risk Factors.Journal of the American Heart Association · 2022Article
- Occupational class differences in ankle-brachial index and pulse wave velocity measurements to detect subclinical vascular disease.La Medicina del lavoro · 2021Article
- Cross-Sectional Survey on the Relationship Between Occupational Stress, Hormone Levels, and the Sleep Quality of Oilfield Workers in Xinjiang, China.International journal of environmental research and public health · 2019Article
- Cardiovascular disease prevention at the workplace: assessing the prognostic value of lifestyle risk factors and job-related conditions.International journal of public health · 2018Article
- Factors associated with adherence to recommendations to visit a physician after annual health checkups among Japanese employees: a cross-sectional observational study.Industrial health · 2018Observational
- Heart Rate Variability Frequency Domain Alterations among Healthy Nurses Exposed to Prolonged Work Stress.International journal of environmental research and public health · 2018Article
- Perceived Workplace Stress Is Associated with an Increased Risk of Prostate Cancer before Age 65.Frontiers in oncology · 2017Article
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo assess the association between job strain (JS) and the incidence of coronary heart disease (CHD) in North Italian employed men, adopting a stratified analysis by occupational class (OC).
methodsThe study was conducted on 4103 working men, CHD-free at baseline, enrolled in population-based and factory-based cohorts. Risk factor measurements and follow-up procedures were carried out adopting the WHO MONICA standardised procedures. OCs were derived from the Erikson-Goldthorpe-Portocarero classification. JS categories were defined based on overall sample medians of psychological job demand (PJD) and decision latitude (DL) derived from items of the Job Content Questionnaire, satisfying construct validity criteria. Age-adjusted and risk factors-adjusted CHD HRs were estimated from Cox models, contrasting high-strain (high PJD and low DL) versus non-high-strain categories.
resultsIn a median follow-up of 14.6 years, 172 CHD events occurred, corresponding to a CHD incidence rate of 2.78/1000 person-years. In the overall sample, high-strain compared with non-high-strain workers evidenced a 39% excess CHD risk, not statistically significant. No association was found among managers and proprietors. Conversely, the HR of high strain versus non-high strain was 1.78 (95% CI 1.20 to 2.66) among non-manual and manual workers, with no substantial differences between them. The exclusion of the events occurring in the first 3 years of follow-up did not change the results. Adopting the quadrant-term JS groupings, among manual and non-manual workers, high-strain and active (high PJD and high DL) categories in comparison to the low strain one (low PJD and high DL) showed HRs of 2.92 and 2.47, respectively.
conclusionsOur findings support the association of JS and CHD incidence among manual and non-manual workers. The non-high strain may not be the best reference category, when assessing the contribution of JS in determining CHD incidence.
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