Population Health and Optimal Health Practices Research Unit CHU de Québec-Laval University Quebec City Quebec Canada.
Departement of Social and Preventive Medicine Laval University Quebec City Quebec Canada.
J Am Heart Assoc. 2024 Aug 20;13(16):e032414. doi: 10.1161/JAHA.123.032414. Epub 2024 Aug 14.
Psychosocial stressors at work, defined by the job strain and effort-reward imbalance at work (ERI) models, were shown to increase coronary heart disease risk. No previous study has examined the adverse effect of psychosocial stressors at work from both models on atrial fibrillation (AF) incidence. The objective of this study was to examine the separate and combined effect of psychosocial stressors at work from the job strain and ERI models on AF incidence in a prospective cohort study.
A total of 5926 white-collar workers (3021 women and 2905 men) free of cardiovascular disease at baseline were followed for an average of 18 years. Job strain (high psychological demands combined with low decision latitude) and ERI were assessed using validated instruments. AF events were identified in medical databases with universal coverage. Hazard ratios (HRs) with 95% CIs were estimated using Cox regression models, controlling for socioeconomic characteristics and lifestyle-related and clinical risk factors. A total of 186 AF incident events were identified over 18 years. Workers exposed to job strain (HR, 1.83 [95% CI, 1.14-2.92]) and ERI (HR, 1.44 [95% CI, 1.05-1.98]) had a higher risk of AF in fully adjusted models. Combined exposure to job strain and ERI was associated with a 2-fold AF risk increase (HR, 1.97 [95% CI, 1.26-3.07]).
Psychosocial stressors at work from the job strain and ERI models are associated with an increased risk of AF, separately and in combination. Workplace prevention strategies targeting these psychosocial stressors at work may be effective to reduce the burden associated with AF.
工作中的心理社会压力源，由工作紧张和工作努力-回报失衡（ERI）模型定义，已被证明会增加冠心病风险。以前没有研究从这两个模型检查工作中的心理社会压力源对心房颤动（AF）发病率的不良影响。本研究的目的是在一项前瞻性队列研究中检查工作中的心理社会压力源分别和联合作用于 AF 发病率的情况。
共有 5926 名无心血管疾病的白领（3021 名女性和 2905 名男性）在基线时进行了平均 18 年的随访。使用经过验证的工具评估工作紧张（高心理需求与低决策自由度相结合）和 ERI。使用具有普遍覆盖范围的医疗数据库确定 AF 事件。使用 Cox 回归模型，控制社会经济特征以及与生活方式相关和临床风险因素，估计风险比（HR）和 95%CI。在 18 年中，共确定了 186 例 AF 事件。在完全调整的模型中，暴露于工作紧张（HR，1.83[95%CI，1.14-2.92]）和 ERI（HR，1.44[95%CI，1.05-1.98]）的工人发生 AF 的风险较高。工作紧张和 ERI 的联合暴露与 AF 风险增加 2 倍相关（HR，1.97[95%CI，1.26-3.07]）。
工作紧张和 ERI 模型中的工作心理社会压力源与 AF 风险的增加有关，单独作用和联合作用均如此。针对这些工作中的心理社会压力源的工作场所预防策略可能有助于降低与 AF 相关的负担。
