Dataset Information

Job Strain, Occupational Category, Systolic Blood Pressure, and Hypertension Prevalence: The Multi-Ethnic Study of Atherosclerosis.

ABSTRACT: OBJECTIVE:To assess associations of occupational categories and job characteristics with prevalent hypertension. METHODS:We analyzed 2517 Multi-Ethnic Study of Atherosclerosis participants, working 20+ hours per week, in 2002 to 2004. RESULTS:Higher job decision latitude was associated with a lower prevalence of hypertension, prevalence ratio?=?0.78 (95% confidence interval 0.66 to 0.91) for the top versus bottom quartile of job decision latitude. Associations, however, differed by occupation: decision latitude was associated with a higher prevalence of hypertension in health care support occupations (interaction P?=?0.02). Occupation modified associations of sex with hypertension: a higher prevalence of hypertension in women (vs men) was observed in health care support and in blue-collar occupations (interaction P?=?0.03). CONCLUSIONS:Lower job decision latitude is associated with hypertension prevalence in many occupations. Further research is needed to determine reasons for differential impact of decision latitude and sex on hypertension across occupations.

SUBMITTER: Landsbergis PA

PROVIDER: S-EPMC4636023 | biostudies-literature | 2015 Nov

REPOSITORIES: biostudies-literature

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Job Strain, Occupational Category, Systolic Blood Pressure, and Hypertension Prevalence: The Multi-Ethnic Study of Atherosclerosis.

Landsbergis Paul A PA Diez-Roux Ana V AV Fujishiro Kaori K Baron Sherry S Kaufman Joel D JD Meyer John D JD Koutsouras George G Shimbo Daichi D Shrager Sandi S Stukovsky Karen Hinckley KH Szklo Moyses M

Journal of occupational and environmental medicine 20151101 11

<h4>Objective</h4>To assess associations of occupational categories and job characteristics with prevalent hypertension.<h4>Methods</h4>We analyzed 2517 Multi-Ethnic Study of Atherosclerosis participants, working 20+ hours per week, in 2002 to 2004.<h4>Results</h4>Higher job decision latitude was associated with a lower prevalence of hypertension, prevalence ratio = 0.78 (95% confidence interval 0.66 to 0.91) for the top versus bottom quartile of job decision latitude. Associations, however, dif ...[more]

PMID: 26539765

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Project description:IMPORTANCE:Studies document a progressive increase in heart disease risk as systolic blood pressure (SBP) rises above 115 mm Hg, but it is unknown whether an SBP lower than 120 mm Hg among adults with hypertension (HTN) lowers heart failure, stroke, and myocardial infarction risk. OBJECTIVE:To examine the risk of incident cardiovascular (CV) events among adults with HTN according to 3 SBP levels: 140 mm Hg or higher; 120 to 139 mm Hg; and a reference level of lower than 120 mm Hg. DESIGN, SETTING, AND PARTICIPANTS:A total of 4480 participants with HTN but without prevalent CV disease at baseline (years 1987-1989) from the Atherosclerosis Risk in Communities Study were included. Measurements of SBP were taken at baseline and at 3 triennial visits; SBP was treated as a time-dependent variable and categorized as elevated (?140 mm Hg), standard (120-139 mm Hg), and low (<120 mm Hg). Multivariable Cox regression models included baseline age, sex, diabetes status, BMI, high cholesterol level, smoking status, and alcohol intake. MAIN OUTCOMES AND MEASURES:Incident composite CV events (heart failure, ischemic stroke, myocardial infarction, or death related to coronary heart disease). RESULTS:After a median follow-up of 21.8 years, a total of 1622 incident CV events had occurred. Participants with elevated SBP developed incident CV events at a significantly higher rate than those in the low BP group (adjusted hazard ratio [HR], 1.46; 95% CI, 1.26-1.69). However, there was no difference in incident CV event-free survival among those in the standard vs low SBP group (adjusted HR, 1.00; 95% CI, 0.85-1.17). Further adjustment for BP medication use or diastolic BP did not significantly affect the results. CONCLUSIONS AND RELEVANCE:Among patients with HTN, having an elevated SBP carries the highest risk for cardiovascular events, but in this categorical analysis, once SBP was below 140 mm Hg, an SBP lower than 120 mm Hg did not appear to lessen the risk of incident CV events.

Project description:BackgroundBreast cancer represented the leading cause of cancer deaths among women in Japan. Although physical activity has been reported protective against breast cancer, scientific evidence is limited on the risk of breast cancer according to job category or occupational activity in Japanese. Our objective was to examine the association of job category and occupational activity with breast cancer incidence in Japanese female workers using the data from the Japan Collaborative Cohort (JACC) Study.MethodsA prospective cohort study involving 19,041 women aged 40-79 years who have reported their occupational data and followed-up from 1988 to 2009. All variables were assessed by a self-administered questionnaire. Cancer incidence data were obtained from 24 areas of the JACC study through cancer population data registration, or review of hospital records. The Cox proportional hazard models were operated to calculate the hazard ratios (HRs) and corresponding 95% confidence intervals (CIs).ResultsThere were 138 incident cases of breast cancer during 13.3 years median follow-up period. Office workers compared with manual workers were at a higher risk of breast cancer after adjusting for reproductive health factors and physical activity indicators; the multivariable HR (95% CI) was 1.65 (1.07-2.55). Also, women who had mainly a sitting position during work compared with those moving during work had the higher risk: the multivariable HR (95%CI) of 1.45 (1.01-2.12). The excess risk of breast cancer was observed for office workers when time spent in walking was < 30 min/ day; HR (95% CI) was 1.11 (1.01-1.23), and for women mainly at a sitting position during work when time spent in walking was 30-59 min or < 30 min/day; HRs (95% CIs) were 1.87 (1.07-3.27) and 1.74 (1.07-2.83), respectively.ConclusionThe job category and occupational activity were associated with risk of breast cancer incidence. A high risk was observed in office workers and in women with a sitting position during work. These observed increased risks were evident in women with less daily walking activity.

Project description:Researchers and journalists have argued that work-related factors may be partly responsible for disproportionate COVID-19 infection and death rates among vulnerable groups. We evaluate these issues by describing racial and ethnic differences in the likelihood of work-related exposure to COVID-19. We extend previous studies by considering 12 racial and ethnic groups and five types of potential occupational exposure to the virus: exposure to infection, physical proximity to others, face-to-face discussions, interactions with external customers and the public, and working indoors. Most importantly, we stratify our results by occupational standing, defined as the proportion of workers within each occupation with at least some college education. This measure serves as a proxy for whether workplaces and workers employ COVID-19-related risk reduction strategies. We use the 2018 American Community Survey to identify recent workers by occupation, and link 409 occupations to information on work context from the Occupational Information Network to identify potential COVID-related risk factors. We then examine the racial/ethnic distribution of all frontline workers and frontline workers at highest potential risk of COVID-19, by occupational standing and by sex. The results indicate that, contrary to expectation, White frontline workers are often overrepresented in high-risk jobs while Black and Latino frontline workers are generally underrepresented in these jobs. However, disaggregation of the results by occupational standing shows that, in contrast to Whites and several Asian groups, Latino and Black frontline workers are overrepresented in lower standing occupations overall and in lower standing occupations associated with high risk, and thus may be less likely to have adequate COVID-19 protections. Our findings suggest that greater work exposures likely contribute to a higher prevalence of COVID-19 among Latino and Black adults and underscore the need for measures to reduce potential exposure for workers in low standing occupations and for the development of programs outside the workplace.

Project description:Researchers and journalists have argued that work-related factors may be partly responsible for disproportionate COVID-19 infection and death rates among vulnerable groups. We evaluate these claims by examining racial and ethnic differences in the likelihood of work-related exposure to COVID-19. We extend previous studies by considering 12 racial and ethnic groups and five types of potential occupational exposure to the virus: exposure to infection, physical proximity to others, face-to-face discussions, interactions with external customers and the public, and working indoors. Most importantly, we stratify our results by occupational standing, defined as the proportion of workers within each occupation with at least some college education. This measure serves as a proxy for whether workplaces and workers employ significant COVID-19-related risk reduction strategies. We use the 2018 American Community Survey to identify recent workers by occupation, and link 409 occupations to information on work context from the Occupational Information Network to identify potential COVID-related risk factors. We then examine the racial/ethnic distribution of all frontline workers and frontline workers at highest potential risk of COVID-19, by occupational standing and by sex. The results indicate that, contrary to expectation, White frontline workers are often overrepresented in high-risk jobs while Black and Latino frontline workers are generally underrepresented in these jobs. However, disaggregation of the results by occupational standing shows that, in contrast to Whites and several Asian groups, Latino and Black frontline workers are overrepresented in lower status occupations overall and in lower status occupations associated with high risk, and are thus less likely to have adequate COVID-19 protections. Our findings suggest that greater work exposures likely contribute to a higher prevalence of COVID-19 among Latino and Black adults and underscore the need for measures to reduce potential exposure for workers in low status occupations and for the development of programs outside the workplace.

Dataset Information

Job Strain, Occupational Category, Systolic Blood Pressure, and Hypertension Prevalence: The Multi-Ethnic Study of Atherosclerosis.

Publications

Job Strain, Occupational Category, Systolic Blood Pressure, and Hypertension Prevalence: The Multi-Ethnic Study of Atherosclerosis.

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