Li Jian, Loerbroks Adrian, Bosma Hans, Angerer Peter
Institute of Occupational and Social Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf.
J Occup Health. 2016 May 25;58(2):216-9. doi: 10.1539/joh.15-0326-OP. Epub 2016 Mar 24.
Individuals in employment experience stress at work, and numerous epidemiological studies have documented its negative health effects, particularly on cardiovascular disease (CVD). Although evidence on the various interrelationships between work stress and CVD has been accumulated, those observations have not yet been conceptualized in terms of a life course perspective. Using the chain of risk model, we would like to propose a theoretical model incorporating six steps: (1) work stress increases the risk of incident CVD in healthy workers. (2) Among those whose work ability is not fully and permanently damaged, work stress acts as a determinant of the process of return to work after CVD onset. (3) CVD patients experience higher work stress after return to work. (4) Work stress increases the risk of recurrent CVD in workers with prior CVD. (5) CVD patients who fully lose their work ability transit to disability retirement. (6) Disability retirees due to CVD have an elevated risk of CVD mortality. The life course perspective might facilitate an in-depth understanding of the diverse interrelationships between work stress and CVD, thereby leading to work stress management interventions at each period of the lifespan and three-level prevention of CVD.
在职人员会经历工作压力，大量流行病学研究已记录了其对健康的负面影响，尤其是对心血管疾病（CVD）的影响。尽管关于工作压力与心血管疾病之间各种相互关系的证据已经积累，但这些观察结果尚未从生命历程的角度进行概念化。使用风险链模型，我们想提出一个包含六个步骤的理论模型：（1）工作压力会增加健康工作者患心血管疾病的风险。（2）在那些工作能力未完全且永久性受损的人中，工作压力是心血管疾病发作后重返工作过程的一个决定因素。（3）心血管疾病患者重返工作后会经历更高的工作压力。（4）工作压力会增加既往患心血管疾病的工作者复发心血管疾病的风险。（5）完全丧失工作能力的心血管疾病患者会转为残疾退休。（6）因心血管疾病而残疾退休的人心血管疾病死亡风险升高。生命历程的观点可能有助于深入理解工作压力与心血管疾病之间的多种相互关系，从而在生命的每个阶段进行工作压力管理干预以及对心血管疾病进行三级预防。
