Evidence map›Paper›PMID 30452614›Full record

ArticleEuropean heart journal2019

Workplace bullying and workplace violence as risk factors for cardiovascular disease: a multi-cohort study.

Tianwei Xu, Linda L Magnusson Hanson, Theis Lange, Liis Starkopf, Hugo Westerlund, Ida E H Madsen, Reiner Rugulies, Jaana Pentti, Sari Stenholm, Jussi Vahtera and 4 more

Abstract read
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In one paragraph

Article in European heart journal, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
44citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

44 citing papers in PubMed, 3 syntheses or guidelines pooled it.

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  10. Workplace violence: A complex challenge demanding a systemic response.Scandinavian journal of work, environment & health · 2025
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors.

Tianwei XuSection of Epidemiology, Department of Public Health, University of Copenhagen, Gothersgade 160, DK-1123 Copenhagen, Denmark.
Linda L Magnusson HansonDivision for Epidemiology, Stress Research Institute, Stockholm University, SE-10691, Stockholm, Sweden.
Theis LangeSection of Biostatistics, Department of Public Health, University of Copenhagen, Øster Farimagsgade 2A, DK-1353 Copenhagen, Denmark.
Liis StarkopfSection of Biostatistics, Department of Public Health, University of Copenhagen, Øster Farimagsgade 2A, DK-1353 Copenhagen, Denmark.
Hugo WesterlundDivision for Epidemiology, Stress Research Institute, Stockholm University, SE-10691, Stockholm, Sweden.
Ida E H MadsenNational Research Centre for the Working Environment, Lersø Parkallé 105, DK-2100 Copenhagen, Denmark.
Reiner RuguliesSection of Epidemiology, Department of Public Health, University of Copenhagen, Gothersgade 160, DK-1123 Copenhagen, Denmark.
Jaana PenttiDepartment of Public Health, University of Turku and Turku University Hospital, FI-20014 Turku, Finland.
Sari StenholmDepartment of Public Health, University of Turku and Turku University Hospital, FI-20014 Turku, Finland.
Jussi VahteraDepartment of Public Health, University of Turku and Turku University Hospital, FI-20014 Turku, Finland.
Åse M HansenNational Research Centre for the Working Environment, Lersø Parkallé 105, DK-2100 Copenhagen, Denmark.
Marianna VirtanenDivision for Epidemiology, Stress Research Institute, Stockholm University, SE-10691, Stockholm, Sweden.
Mika KivimäkiFinnish Institute of Occupational Health, Topeliuksenkatu 41 b, FI-00250 Helsinki, Finland.
Naja H RodSection of Epidemiology, Department of Public Health, University of Copenhagen, Gothersgade 160, DK-1123 Copenhagen, Denmark.

Funding

Medical Research Council MR/K013351/1Medical Research Council MR/R024227/1
6 · The paper itself

Abstract

aimsTo assess the associations between bullying and violence at work and cardiovascular disease (CVD). METHODS AND

resultsParticipants were 79 201 working men and women, aged 18-65 years and free of CVD and were sourced from three cohort studies from Sweden and Denmark. Exposure to workplace bullying and violence was measured at baseline using self-reports. Participants were linked to nationwide health and death registers to ascertain incident CVD, including coronary heart disease and cerebrovascular disease. Study-specific results were estimated by marginal structural Cox regression and were combined using fixed-effect meta-analysis. Nine percent reported being bullied at work and 13% recorded exposure to workplace violence during the past year. We recorded 3229 incident CVD cases with a mean follow-up of 12.4 years (765 in the first 4 years). After adjustment for age, sex, country of birth, marital status, and educational level, being bullied at work vs. not was associated with a hazard ratio (HR) of 1.59 [95% confidence interval (CI) 1.28-1.98] for CVD. Experiencing workplace violence vs. not was associated with a HR of 1.25 (95% CI 1.12-1.40) for CVD. The population attributable risk was 5.0% for workplace bullying and 3.1% for workplace violence. The excess risk remained similar in analyses with different follow-up lengths, cardiovascular risk stratifications, and after additional adjustments. Dose-response relations were observed for both workplace bullying and violence (Ptrend < 0.001). There was only negligible heterogeneity in study-specific estimates.

conclusionBullying and violence are common at workplaces and those exposed to these stressors are at higher risk of CVD.

Indexed as

BullyingAdultCardiovascular DiseasesCohort StudiesDenmarkFemaleFollow-Up StudiesHumansMaleMiddle AgedRegistriesRisk FactorsSwedenWorkplace ViolenceBullyingCardiovascular diseaseOccupational healthPsychosocial stressViolenceWorkplace

Identifiers

PMID30452614

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.