Long-term psychosocial work environment and cardiovascular mortality among Swedish men

Objectives. This study examined the effect of cumulative exposure to work organization-psychological demands, work control, and social support-on prospectively measured cardiovascular disease mortality risk. Methods. The source population was a national sample of 22 517 subjects selected from the Swedish male population by Statistics Sweden in annual surveys between 1977 and 1981. Over a 14-year follow-up period, 521 deaths from cardiovascular disease were identified. A nested case-control design was used. Work environment exposure scores were assigned to cases and controls by linking lifetime job histories with a job exposure matrix. Results. Conditional logistic regression analysis was used in examining cardiovascular mortality risk in relation to work exposure after adjustment for age, year last employed, smoking exercise, education, social class, nationality, and physical job demands. In the final multi-variable analysis, workers with low work control had a relative risk of 1.83 (95% confidence interval [CI] = 1.19, 2.82) for cardiovascular mortality. Workers with combined exposure to low control and low support had a relative risk of 2.62 (95% CI = 1.22, 5.61). Conclusions. These results indicate that long-term exposure to low work control is a risk factor for cardiovascular disease mortality.