International Journal of Epidemiology 2002;31:1169-1178
© International Epidemiological Association 2002
Special Theme: Psychosocial |
Work-related psychosocial factors and carotid atherosclerosis
a Department of Community Medicine
b Department of Medicine, Orthopedics and Surgery, Lund University, Malmö University Hospital, Malmö, Sweden.
Correspondence: Maria Rosvall, Department of Community Medicine, Malmö University Hospital, SE-205 02 Malmö, Sweden. E-mail: maria.rosvall{at}smi.mas.lu.se
Abstract
Background In order to better understand the role of work environment in the earlier stages of the cardiovascular disease process, we wanted to investigate the influence of work-related psychosocial factors on preclinical atherosclerosis.
Methods Cross-sectional data was used to examine the association between psychological job demands, job decision latitude, and carotid atherosclerosis in 2658 vocationally-active Swedish men and women, ages 46–65, from the general population. Odds ratios of carotid plaque prevalence and carotid artery intima-media thickness (IMT), determined by B-mode ultrasound, were estimated across combinations of job demands and decision latitude.
Results Women in job situations with high demands and low decision latitude (‘job strain’) showed a high plaque prevalence odds (odds ratio [OR] = 1.68, 95% CI: 1.14, 2.48), and a thicker IMT in the carotid bifurcation area (mean difference: 0.15 mm, 95% CI: 0.07, 0.23) compared with women in job situations with low demands and high decision latitude (‘relaxed’). Adjustment for covariates only slightly reduced the magnitude of these associations. No such associations were seen in men. However, women in job situations with high demands and high decision latitude (‘active’) also showed high odds for carotid plaque, and a thicker IMT in the carotid bifurcation, compared with women in ‘relaxed’ job situations. In men, those in ‘active’ job situations had a low carotid plaque prevalence odds, while IMT in the carotid bifurcation did not differ from those in ‘relaxed’ job situations. Results showed only weak associations with IMT in the common carotid artery (CCA) in both men and women.
Conclusion The specific hypothesis that high job demands interact synergistically with low decision latitude in the development of carotid atherosclerosis could not be supported in this study, neither in men nor in women. Instead a more complex pattern of interaction between job demands and decision latitude was shown.
Keywords Atherosclerosis, carotid arteries, ultrasonography, stress, work, psychosocial factors, sex factors
Accepted 17 July 2002
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