DMU Psychiatrie et Addictologie, Hôpital Corentin-Celton, AP-HP, Issy-les-Moulineaux, France.
Centre Maurice Halbwachs, EHESS, ENS-PSL, CNRS, INRAE, Paris, France.
BMJ Open. 2023 Jul 31;13(7):e074835. doi: 10.1136/bmjopen-2023-074835.
Distinguish the respective effects of social position, work environment and unemployment on cardiovascular and cancer risks.
A cross-sectional and retrospective observational study.
A population-based French cohort (CONSTANCES).
130 197 adults enrolled between 2012 and 2021 without missing values.
The associations of social position, work environment and unemployment exposure with the prevalence of cardiovascular events and cancers simultaneously tested using logistic regression models adjusting for common risk factors.
While social position, work environment and unemployment exposure are strongly inter-related with each other, they are not linked to the same cardiovascular and cancer outcomes. Low social position and long unemployment duration are significantly associated with an increased prevalence of angina pectoris, myocardial infarction and peripheral arterial disease (OR=1.22 to 1.90, p<0.04 to p<0.0001) but not of stroke. In contrast, a bad work environment is associated with an increased prevalence of stroke (OR=1.29, p<0.01) but not of angina pectoris, myocardial infarction and peripheral arterial disease. Low social position is associated with an increased prevalence of cervical and lung cancers (OR=1.73 and 1.95, p<0.002 and p<0.03) and a decreased prevalence of skin cancer (OR=0.70, p<0.0001) while a bad work environment is associated with an increased prevalence of breast, skin, prostate and colon cancers (OR=1.31 to 2.91, p<0.0002 to p<0.0001). Unemployment exposure is not associated with the prevalence of any type of cancers.
Social position, work environment and unemployment are associated with distinct cardiovascular and cancerous diseases that could add up during lifetime, they should therefore be considered all together in any preventive strategy.
区分社会地位、工作环境和失业对心血管疾病和癌症风险的各自影响。
一项横断面和回顾性观察研究。
基于人群的法国队列（CONSTANCES）。
2012 年至 2021 年间纳入的无缺失值的 130197 名成年人。
使用逻辑回归模型同时测试社会地位、工作环境和失业暴露与心血管事件和癌症患病率之间的关联，调整常见危险因素。
虽然社会地位、工作环境和失业暴露之间相互关联，但它们与不同的心血管和癌症结局无关。低社会地位和长失业时间与心绞痛、心肌梗死和外周动脉疾病的患病率增加显著相关（OR=1.22 至 1.90，p<0.04 至 p<0.0001），但与中风无关。相反，不良的工作环境与中风患病率增加相关（OR=1.29，p<0.01），但与心绞痛、心肌梗死和外周动脉疾病无关。低社会地位与宫颈癌和肺癌的患病率增加相关（OR=1.73 和 1.95，p<0.002 和 p<0.03），皮肤癌的患病率降低（OR=0.70，p<0.0001），而不良的工作环境与乳腺癌、皮肤癌、前列腺癌和结肠癌的患病率增加相关（OR=1.31 至 2.91，p<0.0002 至 p<0.0001）。失业暴露与任何类型癌症的患病率无关。
社会地位、工作环境和失业与不同的心血管和癌症疾病相关，这些疾病可能会在一生中累加，因此在任何预防策略中都应一并考虑。
