The Association Between Effort-Reward Imbalance and Coronary Atherosclerosis in a Chinese Sample

Background Previous studies of job strain and coronary heart disease (CHD) have produced mixed findings. We aimed to examine the association between job stress evaluated by the effort reward imbalance (ERI) model and coronary atherosclerosis assessed by coronary angiography in a Chinese sample. Methods Three-hundred twenty participants accepting coronary angiography for the first time were enrolled in series. Job stressors were evaluated by the ERI model. The presence and severity of CHD were assessed by measuring the coronary artery stenosis (the presence of >50% luminal stenosis in one or more major coronary arteries). The association between job stressors and CHD was examined by multivariate analysis. Results Compared with the low-level group, high-level effort, overcommitment, and ERI increased CHD risk with odds ratio (OR) 2.5 (95% confidence interval (CI): 1.2-5.0), 2.5 (95% CI: 1.2-5.0), 2.4(95% CI: 1.2-4.9), respectively, after adjustment for confounders. They were also significantly positively correlated with the complexity of coronary artery lesions, respectively. Dose response relationships were observed. Conclusions ERI was associated with coronary artery lesions in a sample of Chinese workers. Longitudinal research and interventional designs are needed to confirm the mechanism and to provide evidence for the prevention of CHD. Am. J. Ind. Med. 53:655-661, 2010. (C) 2010 Wiley-Liss, Inc.