The contribution of major risk factors and job strain to occupational class differences in coronary heart disease incidence: the MONICA Brianza and PAMELA population-based cohorts.
Objectives We investigated the contribution of major coronary heart disease (CHD) risk factors and job strain to occupational class differences in CHD incidence in a pooled-cohort prospective study in northern Italy. Methods 2964 men aged 25-74 from four northern Italian population-based cohorts wer...
| Publicado en: | Occupational & Environmental Medicine Vol. 68; no. 10; pp. 717 - 723 |
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| Autores principales: | , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
BMJ Publishing Group
Oct2011
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104686663&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104686663 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 13510711 22H jtl: Occupational & Environmental Medicine issn: 13510711 maglogo: N pubinfo: dt: Oct2011 vid: 68 iid: 10 pid: 8280 pub: BMJ Publishing Group artinfo: ui: 104686663 104686663 2011273219 10.1136/oem.2010.060822 NLM21193567 104686663 ppf: 717 ppct: 6 formats: tig: atl: The contribution of major risk factors and job strain to occupational class differences in coronary heart disease incidence: the MONICA Brianza and PAMELA population-based cohorts. aug: au: Ferrario MM Veronesi G Chambless LE Sega R Fornari C Bonzini M Cesana G sug: subj: Coronary Disease Epidemiology Occupational Diseases Epidemiology Social Class Adult Aged Prospective Studies Incidence Italy Male Middle Age Occupations and Professions Risk Factors Work Adult: 19-44 years Aged: 65+ years Middle Aged: 45-64 years Male ab: Objectives We investigated the contribution of major coronary heart disease (CHD) risk factors and job strain to occupational class differences in CHD incidence in a pooled-cohort prospective study in northern Italy. Methods 2964 men aged 25-74 from four northern Italian population-based cohorts were investigated at baseline and followed for first fatal or non-fatal CHD event (171 events). Standardised procedures were used for baseline risk factor measurements, follow-up and validation of CHD events. Four occupational classes were derived from the Erikson-Goldthorpe-Portocarero social class scheme: higher and lower professionals and administrators, non-manual workers, skilled and unskilled manual workers, and the self-employed. HRs were estimated with Cox models. Results Among CHD-free subjects, with non-manual workers as the reference group, age-adjusted excess risks were found for professionals and administrators (+84%, p=0.02), the self-employed (+72%, p=0.04) and manual workers (+63%, p=0.04). The relationship was consistent across different CHD diagnostic categories. Adjusting for major risk factors only slightly reduced the reported excess risks. In a sub-sample of currently employed subjects, adjusting for major risk factors, sport physical activity and job strain reduced the excess risk for manual workers (relative change = -71.4%) but did not substantially modify the excess risks of professionals and administrators and the self-employed. Conclusions In our study, we found higher CHD incidence rates for manual workers, professionals and administrators, and the self-employed, compared to non-manual workers. When the entire spectrum of job categories is considered, the job strain model helped explain the CHD excess risk for manual workers but not for other occupational classes. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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