SynthesisScandinavian journal of work, environment & health2026
The demands-control-support work stress model and risk of ischemic heart disease: causal inference based on observational epidemiology.
Synthesis in Scandinavian journal of work, environment & health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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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.
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.
Who cites it
3 citing papers in PubMed.
- Job strain and ischemic heart disease: the balance of methodological bias and implications for prevention. Response to: Bonde JP et al. 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 · 2026Article
- Lavigne-Robichaud et al: Job strain and ischemic heart disease: the balance of methodological bias and implications for prevention. Author reply.Scandinavian journal of work, environment & health · 2026Article
- Work stress, physical work demands, and device-measured physical activity: independent and joint associations with cardiovascular disease risk.Annals of work exposures and health · 2026Article
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveReviews consistently suggest an association between job strain and ischemic heart disease (IHD), but causality remains uncertain. This study aimed to critically assess causal inference using the most informative epidemiological studies.
methodsA systematic search in PubMed and Embase up to 15 November 2024 identified observational studies reporting quantitative estimates of associations between job strain (defined by job demands and control) and IHD. Eligible studies were cohort or case-control designs with exposure data obtained independently by medically verified IHD (ICD-8/9: 410-414; ICD-10: I20-I25) and risk estimates adjusted at least for age, sex, and socio-economic status. One estimate per study was included in inverse-variance weighted random-effects meta-analyses. We evaluated main sources of upward and downward bias, potential confounding, and key criteria for causal inference including outcome specificity, exposure-response, and consistency.
resultsThis review comprised 25 cohort and 1 case-control study (122 risk estimates). The fully adjusted pooled relative risk estimate (RRE) for job strain and all IHD outcomes combined was 1.14 [95% confidence interval (CI) 1.06-1.23; 21 studies]. For myocardial infarction, the RRE was 1.08 (95% CI 1.00-1.15; 11 studies), and, in studies using job-exposure matrices, it was 1.06 (95% CI 0.99-1.13; 7 studies). Strong heterogeneity, small effect sizes, limited exposure-response evidence, net bias in unpredictable directions, and lack of confirmation of findings in studies using alternatives to self-reported exposure assessment preclude causal inference.
conclusionEvidence for a causal relationship between job strain and IHD is limited. At most, any true effect appears to be small.
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Registered trials
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