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    "key": "kivimaki-2012",
    "id": "TAP-RDN-0060",
    "locale": "en",
    "path": "/research/kivimaki-2012/",
    "title": "TAP reading note: Job strain as a risk factor for coronary heart disease: a collaborative meta-analysis of individual participant data",
    "description": "Among European workers, job strain—high demands combined with low control—was associated with subsequent coronary heart disease. The age/sex-adjusted HR was 1.23, falling to 1.17 (95% CI 1.05–1.31) after socioeconomic adjustment. This is prospective evidence linking working conditions with long-term health.",
    "rights": "© The Allostasis Project. All rights reserved. Reproduction or adaptation requires separate permission, subject to applicable legal exceptions.",
    "version": "1.0",
    "updatedAt": "2026-10-29",
    "editorial": {
      "contentType": "evidence-review",
      "reviewState": "draft",
      "reviewedAt": null,
      "reviewedVersion": null,
      "updatedAt": "2026-10-29",
      "version": "1.0",
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      "author": null,
      "reviewer": null,
      "workflow": {
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          "usage": "used",
          "system": "OpenAI Codex",
          "scope": "Assisted source comparison, evidence extraction and bilingual research-note preparation. The materials consulted and unresolved scientific issues are specified in each note.",
          "version": "1.0",
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            "Source comparison and evidence extraction",
            "Bilingual research-note drafting and editorial comparison"
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      "revisions": [
        {
          "date": "2026-10-29",
          "version": "1.0",
          "description": "Added job-strain/coronary-disease evidence, separating adjustment models and causal-attribution assumptions."
        }
      ]
    },
    "original": {
      "id": "kivimaki-2012",
      "title": "Job strain as a risk factor for coronary heart disease: a collaborative meta-analysis of individual participant data",
      "authors": "Kivimäki M · Nyberg ST · Batty GD · Fransson EI · Heikkilä K · Alfredsson L · Bjorner JB · Borritz M · Burr H · Casini A · Clays E · De Bacquer D · Dragano N · Ferrie JE · Geuskens GA · Goldberg M · Hamer M · Hooftman WE · Houtman IL · Joensuu M · Jokela M · Kittel F · Knutsson A · Koskenvuo M · Koskinen A · Kouvonen A · Kumari M · Madsen IE · Marmot MG · Nielsen ML · Nordin M · Oksanen T · Pentti J · Rugulies R · Salo P · Siegrist J · Singh-Manoux A · Suominen SB · Väänänen A · Vahtera J · Virtanen M · Westerholm PJ · Westerlund H · Zins M · Steptoe A · Theorell T · IPD-Work Consortium",
      "journal": "The Lancet",
      "year": "2012",
      "url": "https://doi.org/10.1016/s0140-6736(12)60994-5",
      "doi": "10.1016/s0140-6736(12)60994-5",
      "pmid": "22981903"
    },
    "references": [
      {
        "id": "kivimaki-2012",
        "title": "Job strain as a risk factor for coronary heart disease: a collaborative meta-analysis of individual participant data",
        "authors": "Kivimäki M · Nyberg ST · Batty GD · Fransson EI · Heikkilä K · Alfredsson L · Bjorner JB · Borritz M · Burr H · Casini A · Clays E · De Bacquer D · Dragano N · Ferrie JE · Geuskens GA · Goldberg M · Hamer M · Hooftman WE · Houtman IL · Joensuu M · Jokela M · Kittel F · Knutsson A · Koskenvuo M · Koskinen A · Kouvonen A · Kumari M · Madsen IE · Marmot MG · Nielsen ML · Nordin M · Oksanen T · Pentti J · Rugulies R · Salo P · Siegrist J · Singh-Manoux A · Suominen SB · Väänänen A · Vahtera J · Virtanen M · Westerholm PJ · Westerlund H · Zins M · Steptoe A · Theorell T · IPD-Work Consortium",
        "journal": "The Lancet",
        "year": "2012",
        "url": "https://doi.org/10.1016/s0140-6736(12)60994-5",
        "doi": "10.1016/s0140-6736(12)60994-5",
        "pmid": "22981903"
      }
    ],
    "sections": [
      {
        "id": "finding",
        "title": "What the study found",
        "paragraphs": [
          "Among European workers, job strain—high demands combined with low control—was associated with subsequent coronary heart disease. The age/sex-adjusted HR was 1.23, falling to 1.17 (95% CI 1.05–1.31) after socioeconomic adjustment. This is prospective evidence linking working conditions with long-term health."
        ]
      },
      {
        "id": "limits",
        "title": "Scope & limitations",
        "paragraphs": [
          "13 cohorts and 197,473 workers free of coronary disease at baseline, with 2,358 incident events.",
          "Strain was mainly measured once at baseline, leaving possible residual confounding, changing exposure and reverse causation. Published and unpublished data gave different estimates. The reported population-attributable fraction assumes causality and is not a demonstrated intervention-preventable fraction."
        ]
      },
      {
        "id": "sample",
        "title": "Population & sample",
        "paragraphs": [
          "13 cohorts and 197,473 workers free of coronary disease at baseline, with 2,358 incident events."
        ]
      },
      {
        "id": "exposure",
        "title": "Exposure or intervention",
        "paragraphs": [
          "Baseline high demands plus low control versus no job strain, using individual-participant-data meta-analysis."
        ]
      },
      {
        "id": "outcomes",
        "title": "Outcomes",
        "paragraphs": [
          "Incident coronary heart disease and estimates by subgroup, publication status and adjustment model."
        ]
      },
      {
        "id": "duration",
        "title": "Time frame",
        "paragraphs": [
          "Mean follow-up of 7.5 years."
        ]
      },
      {
        "id": "funding",
        "title": "Research funding",
        "paragraphs": [
          "EU New OSH ERA and occupational-health funding bodies in Finland, Sweden, Germany and Denmark; Academy of Finland 132944; BUPA Foundation 22094477; Dutch Ministry of Social Affairs and Employment; MRC and NIH R01HL036310/R01AG034454; Wellcome fellowship support to G. D. Batty. Cohorts had additional funding."
        ]
      },
      {
        "id": "conflicts",
        "title": "Research conflicts of interest",
        "paragraphs": [
          "The authors declare no conflicts and report no funder role in research or publication decisions."
        ]
      },
      {
        "id": "basis",
        "title": "Reading scope",
        "paragraphs": [
          "Full-text populations/endpoints, subgroup results, publication-status comparisons and discussion. Repeated exposure measurements and all cohort reports have not been individually reviewed."
        ],
        "links": [
          {
            "label": "Full text in PubMed Central",
            "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC3486012/"
          }
        ]
      }
    ]
  }
}
