Nilsen Charlotta, Andel Ross, Fritzell Johan, Kåreholt Ingemar
Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden
School of Aging Studies, University of South Florida, Tampa, FL, USA.
Eur J Public Health. 2016 Dec;26(6):1055-1061. doi: 10.1093/eurpub/ckw086. Epub 2016 Jun 21.
Survival reflects the accumulation of multiple influences experienced over the life course. Given the amount of time usually spent at work, the influence of work may be particularly important. We examined the association between work-related stress in midlife and subsequent mortality, investigating whether sense of coherence modified the association.
Self-reported work-related stress was assessed in 1393 Swedish workers aged 42-65 who participated in the nationally representative Level of Living Survey in 1991. An established psychosocial job exposure matrix was applied to measure occupation-based stress. Sense of coherence was measured as meaningfulness, manageability and comprehensibility. Mortality data were collected from the Swedish National Cause of Death Register. Data were analyzed with hazard regression with Gompertz distributed baseline intensity.
After adjustment for socioeconomic position, occupation-based high job strain was associated with higher mortality in the presence of a weak sense of coherence (HR, 3.15; 1.62-6.13), a result that was stronger in women (HR, 4.48; 1.64-12.26) than in men (HR, 2.90; 1.12-7.49). Self-reported passive jobs were associated with higher mortality in the presence of a weak sense of coherence in men (HR, 2.76; 1.16-6.59). The link between work stress and mortality was not significant in the presence of a strong sense of coherence, indicating that a strong sense of coherence buffered the negative effects of work-related stress on mortality.
Modifications to work environments that reduce work-related stress may contribute to better health and longer lives, especially in combination with promoting a sense of coherence among workers.
生存反映了一生中所经历的多种影响的积累。鉴于通常在工作上花费的时间量，工作的影响可能尤为重要。我们研究了中年时期与工作相关的压力与随后死亡率之间的关联，调查连贯感是否会改变这种关联。
在1991年参与具有全国代表性的生活水平调查的1393名年龄在42 - 65岁的瑞典工人中，对自我报告的与工作相关的压力进行了评估。应用一种既定的社会心理工作暴露矩阵来衡量基于职业的压力。连贯感通过意义感、可管理性和可理解性来衡量。死亡率数据从瑞典国家死亡原因登记处收集。使用具有Gompertz分布基线强度的风险回归对数据进行分析。
在调整社会经济地位后，在连贯感较弱的情况下，基于职业的高工作压力与较高的死亡率相关（风险比，3.15；1.62 - 6.13），这一结果在女性中（风险比，4.48；1.64 - 12.26）比在男性中（风险比，2.90；1.12 - 7.49）更明显。在连贯感较弱的男性中，自我报告的消极工作与较高的死亡率相关（风险比，2.76；1.16 - 6.59）。在连贯感较强的情况下，工作压力与死亡率之间的联系不显著，这表明强烈的连贯感缓冲了与工作相关的压力对死亡率的负面影响。
改善工作环境以减少与工作相关的压力可能有助于增进健康和延长寿命，特别是与促进工人的连贯感相结合时。
