Authors
Abstract
Background: One of the practical models for the assessment of stressful working conditions due
to job strain is job demand and control model, which explains how physical and psychological
adverse consequences, including cardiovascular risk factors can be established due to high
work demands (the amount of workload, in addition to time limitations to complete that work)
and low control of the worker on his/her work (lack of decision making) in the workplace. The
aim of this study was to investigate how certain cardiovascular risk factors (including body mass
index [BMI], heart rate, blood pressure, cholesterol and smoking) and the job demand and
job control are related to each other. Materials and Methods: This prospective cohort study
was conducted on 500 workers of the petrochemical industry in south of Iran, 2009. The study
population was selected using simple random statistical method. They completed job demand
and control questionnaire. The cardiovascular risk factors data was extracted from the workers
hygiene profiles. Chi‑square (2
) test and hypothesis test () were used to assess the possible
relationship between different quantified variables, individual demographic and cardiovascular
risk factors. Results: The results of this study revealed that a significant relationship can be
found between job demand control model and cardiovascular risk factors. Chi‑square test
result for the heart rate showed the highest (2 = 145.078) relationship, the corresponding
results for smoking and BMI were 2 = 85.652 and 2 = 30.941, respectively. Subsequently,
hypothesis testing results for cholesterol and hypertension was 0.469 and 0.684, respectively.
Discussion: Job strain is likely to be associated with an increased risk of cardiovascular risk
factors among male staff in a petrochemical company in Iran. The parameters illustrated in
the Job demands and control model can act as acceptable predictors for the probability of
job stress occurrence followed by showing a high trend of CVD risk factors.
Keywords
et al. “Stress” and coronary heart disease: Psychosocial risk factors.
Med J Aust 2003;178:272‑6.
2. DeSanto Iennaco J, Cullen MR, Cantley L, Slade MD, Fiellin M,
Kasl SV. Effects of externally rated job demand and control on
depression diagnosis claims in an industrial cohort. Am J Epidemiol
2010;171:303‑11.
3. Johnson JV, Hall EM. Job strain, work place social support, and
cardiovascular disease: A cross‑sectional study of a random
sample of the Swedish working population. Am J Public Health
1988;78:1336‑42.
4. Theorell T. To be able to exert control over one’s own situation:
A necessary condition for coping with stressors. Washington, DC,
US: American Psychological Association; 2003.
5. Kivimäki M, Virtanen M, Elovainio M, Kouvonen A, Väänänen A,
Vahtera J. Work stress in the etiology of coronary heart disease – A
meta‑analysis. Scand J Work Environ Health 2006;32:431‑42.
6. Pikhart H, Bobak M, Pajak A, Malyutina S, Kubinova R, Topor R, et al.
Psychosocial factors at work and depression in three countries of
Central and Eastern Europe. Soc Sci Med 2004;58:1475‑82.
7. Stansfeld S, Candy B. Psychosocial work environment and mental
health – A meta‑analytic review. Scand J Work Environ Health
2006;32:443‑62.
8. Wang J. Perceived work stress and major depressive episodes in a
population of employed Canadians over 18 years old. J Nerv Ment
Dis 2004;192:160‑3.
9. Tennant C. Work‑related stress and depressive disorders.
J Psychosom Res 2001;51:697‑704.
10. Karasek RA, Theorell T, Schwartz JE, Schnall PL, Pieper CF,
Michela JL. Job characteristics in relation to the prevalence of
myocardial infarction in the US Health Examination Survey (HES)
and the Health and Nutrition Examination Survey (HANES). Am J
Public Health 1988;78:910‑8.11. Schnall PL, Landsbergis PA, Baker D. Job strain and cardiovascular
disease. Annu Rev Public Health 1994;15:381‑411.
12. Alfredsson L, Hammar N, Fransson E, de Faire U, Hallqvist J,
Knutsson A, et al. Job strain and major risk factors for coronary
heart disease among employed males and females in a Swedish
study on work, lipids and fibrinogen. Scand J Work Environ Health
2002;28:238‑48.
13. Tsutsumi A, Kayaba K, Hirokawa K, Ishikawa S, Jichi Medical School
Cohort Study Group. Psychosocial job characteristics and risk of
mortality in a Japanese community‑based working population: The
Jichi Medical School Cohort Study. Soc Sci Med 2006;63:1276‑88.
14. Alavinia SM, van Duivenbooden C, Burdorf A. Influence of
work‑related factors and individual characteristics on work ability
among Dutch construction workers. Scand J Work Environ Health
2007;33:351‑7.
15. Kivimäki M, Nyberg ST, Batty GD, Fransson EI, Heikkilä K,
Alfredsson L, et al. Job strain as a risk factor for coronary heart
disease: A collaborative meta‑analysis of individual participant data.
Lancet 2012;380:1491‑7.
16. Hakanen JJ, Schaufeli WB, Ahola K. The job demands‑resources
model: A three‑year cross‑lagged study of burnout, depression,
commitment, and work engagement. Work Stress 2008;22:224‑41.
17. Panagiotakos DB, Pitsavos C, Kogias Y, Mantas Y, Zombolos S,
Antonoulas A, et al. Marital status, depressive episodes, and
short‑term prognosis of patients with acute coronary syndrome:
Greek study of acute coronary syndrome (GREECS). Neuropsychiatr
Dis Treat 2008;4:425‑32.
18. Chambel MJ, Curral L. Stress in academic life: work characteristics
as predictors of student well being and performance. Appl Psychol
2005;54:135‑47.
19. Cheng Y, Kawachi I, Coakley EH, Schwartz J, Colditz G. Association
between psychosocial work characteristics and health functioning
in American women: Prospective study. BMJ 2000;320:1432‑6.
20. Vahtera J, Kivimäki M, Pentti J, Theorell T. Effect of change in the
psychosocial work environment on sickness absence: A seven year
follow up of initially healthy employees. J Epidemiol Community
Health 2000;54:484‑93.
21. Kuper H, Marmot M. Job strain, job demands, decision latitude,
and risk of coronary heart disease within the Whitehall II study.
J Epidemiol Community Health 2003;57:147‑53.
22. Kemmer FW, Bisping R, Steingrüber HJ, Baar H, Hardtmann F,
Schlaghecke R, et al. Psychological stress and metabolic control
in patients with type I diabetes mellitus. New England journal of
medicine. 1986;314:1078‑84
23. Karimi L, Nouri A. Do work demands and resources predict
work‑to‑family conflict and facilitation? A study of Iranian male
employees. J Fam Econ Issues 2009;30:193‑202.
24. Choobineh A, Ghaem H, Ahmedinejad P. Validity and reliability of
the Persian (Farsi) version of the Job Content Questionnaire: A study
among hospital nurses. East Mediterr Health J 2011;17:335‑41.
25. Rijk AE, Blanc PML, Schaufeli WB, Jonge J. Active coping and need
for control as moderators of the job demand–control model: Effects
on burnout. J Occup Organ Psychol 1998;71:1‑18.
26. Tsutsumi A, Kayaba K, Tsutsumi K, Igarashi M, Jichi Medical
School Cohort Study Group. Association between job strain
and prevalence of hypertension: A cross sectional analysis in a
Japanese working population with a wide range of occupations:
The Jichi Medical School cohort study. Occup Environ Med
2001;58:367‑73.
27. Karasek Jr RA. Job demands, job decision latitude, and mental
strain: Implications for job redesign. Adm Sci Q 1979; 24:
285‑308.
28. Collins SM, Karasek RA, Costas K. Job strain and autonomic indices
of cardiovascular disease risk. Am J Ind Med 2005;48:182‑93.
29. Fox ML, Dwyer DJ, Ganster DC. Effects of stressful job demands
and control on physiological and attitudinal outcomes in a hospital
setting. Acad Manage J 1993;36:289‑318.
30. Xu W, Zhao Y, Guo L, Guo Y, Gao W. Job stress and coronary heart
disease: A case‑control study using a Chinese population. J Occup
Health 2009;51:107‑13.
31. Otsuka T, Kawada T, Ibuki C, Kusama Y. Relationship between
job strain and radial arterial wave reflection in middle‑aged male
workers. Prev Med 2009;49:260‑4.
32. de Lange AH, Taris TW, Kompier MA, Houtman IL, Bongers PM.
Different mechanisms to explain the reversed effects of mental health
on work characteristics. Scand J Work Environ Health 2005;31:3‑14.
33. Why YP, Bishop GD, Tong EM, Diong SM, Enkelmann HC, Khader M,
et al. Cardiovascular reactivity of Singaporean male police officers
as a function of task, ethnicity and hostility. Int J Psychophysiol
2003;49:99‑110.
34. Steptoe A, Kivimäki M. Stress and cardiovascular disease. Nat Rev
Cardiol 2012;9:360‑70.
35. Gilbert‑Ouimet M, Trudel X, Brisson C, Milot A, Vézina M.
Adverse effects of psychosocial work factors on blood pressure:
Systematic review of studies on demand‑control‑support and
effort‑reward imbalance models. Scand J Work Environ Health.
2014; 40:109‑32.
36. Greiner BA, Krause N, Ragland D, Fisher JM. Occupational stressors
and hypertension: A multi‑method study using observer‑based job
analysis and self‑reports in urban transit operators. Soc Sci Med
2004;59:1081‑94.
37. Steptoe A, Siegrist J, Kirschbaum C, Marmot M. Effort‑reward
imbalance, overcommitment, and measures of cortisol and blood
pressure over the working day. Psychosom Med 2004;66:323‑9.
38. Nyberg ST, Fransson EI, Heikkilä K, Alfredsson L, Casini A,
Clays E, et al. Job strain and cardiovascular disease risk factors:
Meta‑analysis of individual‑participant data from 47,000 men and
women. PLoS One 2013;8:e67323.
39. Kivimäki M, Nyberg ST, Fransson EI, Heikkilä K, Alfredsson L,
Casini A, et al. Associations of job strain and lifestyle risk factors
with risk of coronary artery disease: A meta‑analysis of individual
participant data. CMAJ 2013;185:763‑9.
40. Siegrist J, Peter R, Junge A, Cremer P, Seidel D. Low status control,
high effort at work and ischemic heart disease: Prospective evidence
from blue‑collar men. Soc Sci Med 1990;31:1127‑34.
41. Kivimäki M, Leino‑Arjas P, Luukkonen R, Riihimäki H, Vahtera J,
Kirjonen J. Work stress and risk of cardiovascular mortality:
Prospective cohort study of industrial employees. BMJ 2002;325:857.
42. Karasek RA. Job demands, job decision latitude, and mental strain:
Implications for job redesign. Administrative science quarterly.
1979; 24:285.