Do changes in effort-reward imbalance at work contribute to an explanation of the social gradient in angina?
Do changes in effort-reward imbalance at work contribute to an explanation of the social gradient in angina?
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DOI：
10.1136/oem.2004.016675
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发表时间：
2005-04-01
影响因子：
4.9
通讯作者：
Marmot, M
中科院分区：
文献类型：
--
作者：
Chandola, T;Siegrist, J;Marmot, M
目的：为了确定是否增加的努力-回报不平衡随着时间的推移增加心绞痛的风险，以及这种增加是否与较低的职业position.Methods：努力-回报不平衡（ERI）在工作中测量白厅II职业队列的伦敦为基础的公务员在基线（1985-88年）和1997年。采用Rose心绞痛问卷与2001年医生诊断的心绞痛相结合的自报健康问卷测量冠心病。结果：在男性中，ERI随时间的增加与心绞痛发生的风险增加相关。此外，由于ERI的增加在较低级别的公务员中更为常见，不平衡的变化在一定程度上有助于解释心绞痛的社会梯度。在女性中，增加不平衡与心绞痛的风险，因此并没有贡献的解释的社会gradient.Conclusions：减少在工作中的努力-回报不平衡可能会降低男性冠心病的风险。
Aims: To determine whether an increase in effort-reward imbalance over time increases the risk of angina, and whether such increases are associated with lower occupational position.Methods: Effort-reward imbalance (ERI) at work was measured in the Whitehall II occupational cohort of London based civil servants at baseline (1985-88) and in 1997. Coronary heart disease was measured in a self-reported health questionnaire by combining the Rose Angina Questionnaire with doctor diagnosed angina in 2001.Results: Among men, increase in ERI over time was associated with an increased risk of incident angina. Moreover, as increases in ERI were more common among lower grade civil servants, change in imbalance, to some extent, contributed to explaining the social gradient in angina. Among women, increases in imbalance were not associated with risk of angina, and therefore did not contribute to the explanation of the social gradient.Conclusions: Reductions in effort-reward imbalance at work may reduce the risk of coronary heart disease among men.