Job strain, effort-reward imbalance, and coronary risk factors - complementary job stress models in risk estimation?

Purpose: To test whether combined information on job strain (JS) and on effort-reward imbalance (ERI) helps to improve the prediction of coronary risk. Methods: 2099 male participants in the baseline screening of the prospective Swedish Work Organization, Lipids, and Fibrinogen (WOLF) study underwent a clinical screening assessing bodyweight, blood lipids, and blood pressure and answered a standardized questionnaire measuring the psychosocial work environment, socio-demographic variables, and behavioral factors (i.e. smoking, physical activity). Associations between job strain, effort-reward imbalance and coronary risk factors (i.e. hypertension, elevated blood lipids) were tested. Results: Findings from multivariate logistic regression analysis showed the highest odd-ratios (OR) for men simultaneously exposed to the extrinsic component of effort-reward imbalance and to job strain. OR were 2.03 (95% confidence interval (CI) 1.18-3.49) for hypertension and 1.53 for low-density-lipoprotein (LDL)-cholesterol (95% CI 1.12-2.09), respectively. Conclusion: Combined information on effort-reward imbalance and on job strain may help to improve coronary risk prediction. (C) 2002 Elsevier Science B.V. All rights reserved.