Job strain as a risk factor for coronary heart disease: a collaborative meta-analysis of individual participant data
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
The Lancet · 2012
What the research tells us
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.
Scope & interpretation
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 Published and unpublished data gave different estimates.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.
Study at a glance
- POPULATION & SAMPLE
- 13 cohorts and 197,473 workers free of coronary disease at baseline, with 2,358 incident events.
- EXPOSURE / INTERVENTION / SUBJECT
- Baseline high demands plus low control versus no job strain, using individual-participant-data meta-analysis.
- OUTCOMES
- Incident coronary heart disease and estimates by subgroup, publication status and adjustment model.
- TIME FRAME
- Mean follow-up of 7.5 years.
Editorial & review record
Record for v1.0 · Updated
Editorial responsibility: TAP Editorial Team
Scientific review
Not yet scientifically reviewed
Editorial note
Under the editorial responsibility of the TAP Editorial Team, this publication used AI assistance for content organization and editing. Scientific review is recorded separately on this page.
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How responsibilities and review are recorded ↗Scope of this reading note
Full-text populations/endpoints, subgroup results, publication-status comparisons and discussion. Repeated exposure measurements and all cohort reports have not been individually reviewed.
- Study funding
- 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.
- Competing interests
- The authors declare no conflicts and report no funder role in research or publication decisions.
Project support
Founded and supported by Resilio.
Revision history
- · v1.0
Added job-strain/coronary-disease evidence, separating adjustment models and causal-attribution assumptions.