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Job strain and high work demands and lack of opportunity to control work are related to increased risk of coronorary heart disease in British government employees

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The Whitehall II study has followed prospectively over 10 000 London based civil servants (government department employees) for a mean of 11 years, in particular identifying those who developed coronary heart disease (CHD). Data were collected on known coronary risk factors and self-reported questionnaires detailed such work characteristics as job demands and decision latitude (degree of control over skill use, time allocation and authority to make decisions).

Those with high scores in both areas were defined as having “job strain”. They proved to be at the greatest risk of CHD, regardless of their coronary risk factors or domestic psychosocial support (hazard ratio 1.57 (CI 1.26–1.96)). A high score for either of the components also led to a higher risk of CHD.

The authors suggest the policy implications of their research are that strategies for work place health promotion should rely on redesigning jobs by reducing psychological demands and increasing individuals’ say in decisions about their work as well as offering more variety in job tasks. The next step should be intervention studies to evaluate the utility of any such changes.