Piros S, Karlehagen S, Lappas G, Wilhelmsen L
Section of Preventive Cardiology, Heart and Lung Institute, Göteborg University, Göteborg, Sweden.
J Cardiovasc Risk. 2000 Oct;7(5):395-400. doi: 10.1177/204748730000700513.
Railway engine drivers have had an increased risk of myocardial infarction which could be due to reported low decision latitude and low social support but not to elevated somatic risk factors.
To study somatic and psychosocial risk factors for myocardial infarction among railway engine drivers prospectively.
A prospective study of 2318 drivers followed for 10 years.
Risk factors were surveyed in conjunction with periodic health checks at 15 different centres but with common methodology and commonly used questionnaires. Questionnaire and register information on myocardial infarction during follow-up was recorded.
Within this group of engine drivers, age, family history of myocardial infarction, systolic blood pressure and low body height were independent predictors of myocardial infarction, but diabetes, elevated serum cholesterol and smoking were not. Neither were a longer time in the occupation or work-related psychosocial factors. The drivers were all at the lower end of the decision authority and latitude scale and had low social support. With this limited span, it may be difficult to detect these variables as risk factors within this group.
Several well-known, somatic risk factors for myocardial infarction were documented in this study, whereas psychosocial working conditions, which were common to all the drivers, were not significantly related to outcome.
铁路机车司机心肌梗死风险增加，这可能是由于报告的决策自由度低和社会支持少，而非躯体危险因素升高。
前瞻性研究铁路机车司机中心肌梗死的躯体和心理社会危险因素。
对2318名司机进行为期10年的前瞻性研究。
在15个不同中心结合定期健康检查对危险因素进行调查，但采用共同的方法和常用问卷。记录随访期间关于心肌梗死的问卷和登记信息。
在这群机车司机中，年龄、心肌梗死家族史、收缩压和身高较低是心肌梗死的独立预测因素，但糖尿病、血清胆固醇升高和吸烟不是。职业年限较长或与工作相关的心理社会因素也不是。这些司机都处于决策权限和自由度范围的较低端，且社会支持少。在这个有限范围内，可能难以将这些变量检测为该组内的危险因素。
本研究记录了几个众所周知的心肌梗死躯体危险因素，而所有司机共有的心理社会工作条件与结果无显著相关性。
