Do early life exposures explain associations in mid-adulthood between workplace factors and risk factors for cardiovascular disease?

BACKGROUND

Workplace factors (night work, long working hours, psychosocial work stress) have been reported to be associated with increased risk of cardiovascular disease (CVD). We investigated whether (i) workplace factors are associated with CVD risk factors independently of each other, (ii) workplace factors interact, thereby modifying associations and (iii) associations are explained by early life exposures.

METHODS

A total of 7916 employed participants in the 1958 British birth cohort underwent a clinical assessment at age 45 years. Regression analysis was used to examine associations between workplace factors and CVD risk factor levels with adjustment for early life exposures.

RESULTS

Night work was associated with adverse levels of most CVD risk factors. Working > or =48 h/week was positively associated with body mass index (BMI) and waist circumference (WC). Low job control was positively associated with glycosylated haemoglobin (HbA1c) and inflammatory factors, and inversely associated with high-density lipoprotein (HDL)-cholesterol. Low demands were positively associated with systolic blood pressure (SBP), triglycerides and inflammatory factors and inversely associated with HDL-cholesterol. Several associations were weakened when workplace factors were adjusted for each other. Night workers in low-demand jobs had higher BMI [0.78 kg/m(2); 95% confidence interval (CI) 0.35, 1.21], WC (1.49 cm; 0.45, 2.52) and SBP (1.38 mmHg; -0.04, 2.81). HDL was lower for low control plus night work (-0.04 mmol/l; -0.08, -0.01) or long hours (-0.12; -0.18, -0.69). Adjustment for early life exposures explained 30-50% of most associations, e.g. night work/low demands associations reduced by 50% for BMI and WC, and by 39% for SBP.

CONCLUSIONS

Associations between workplace factors and CVD risk factors in mid-adulthood arise in part from social and health disadvantage originating earlier in life.