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Abstract
Large social inequalities exist in the risk of ischaemic heart disease (IHD), and
they are only partly explained by established cardiovascular disease risk factors.
Social class differences in psychosocial working conditions could be important explanatory
factors. In a cohort of 1752 employed males, age in years, mean (S.D.): 59.7 (3.5),
we investigated the issue. Self-reported psychosocial working conditions examined
were: influence on the job, work monotony, work pace, degree of satisfaction with
immediate superiors and colleagues, and ability to relax after working hours. One
hundred and fourteen men were excluded due to prevalent cardiovascular disease. During
the follow-up period (1985/86–1989), 46 men (approx. 3%) suffered an IHD event, 11
events were fatal. Compared with the rest, the highest social class had a relative
risk with 95% CI (RR) of IHD of 0.26 (0.06-1.09), an association which was not explained
by major potentially confounding or effect modifying factors: smoking, alcohol, physical
activity, blood pressure, hypertension, body mass index, serum cholesterol, serum
triglycerides, serum HDL, and serum selenium. Including psychosocial factors in the
multivariate model had little influence on the estimate, RR = 0.21 (0.05-0.95), and
yet there were highly significant differences in psychosocial working conditions between
social classes. Neither selfreported influence on the job, work monotony, work pace,
degree of satisfaction with immediate superiors and colleagues, nor interactions of
the above factors were significantly associated with risk of IHD. However, men who
reported that they were incapable of relaxing after working hours had a highly significant
approximately threefold increased risk of IHD. We conclude that in middle-aged and
elderly males self-reported, i.e. subjective psychosocial working conditions, did
not contribute to the explanation of social inequalities in IHD, and that self-reported
incapability to relax after work was associated with an increased risk of IHD.
Keywords
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Article info
Publication history
Accepted:
March 12,
1993
Received in revised form:
February 10,
1993
Received:
September 4,
1992
Identification
Copyright
© 1993 Published by Elsevier Inc.