Bosma H, Peter R, Siegrist J, Marmot M
International Centre for Health and Society, Department of Epidemiology and Public Health, University College London Medical School, England.
Am J Public Health. 1998 Jan;88(1):68-74. doi: 10.2105/ajph.88.1.68.
This study examined the association between two alternative job stress models-the effort-reward imbalance model and the job strain model-and the risk of coronary heart disease among male and female British civil servants.
The logistic regression analyses were based on a prospective cohort study (Whitehall II study) comprising 6895 men and 3413 women aged 35 to 55 years. Baseline measures of both job stress models were related to new reports of coronary heart disease over a mean 5.3 years of follow-up.
The imbalance between personal efforts (competitiveness, work-related overcommitment, and hostility) and rewards (poor promotion prospects and a blocked career') was associated with a 2.15-fold higher risk of new coronary heart disease. Job strain and high job demands were not related to coronary heart disease; however, low job control was strongly associated with new disease. The odds ratios for low job control were 2.38 and 1.56 for self-reported and externally assessed job control, respectively. Work characteristics were simultaneously adjusted and controlled for employment grade level, negative affectivity, and coronary risk factors.
This is apparently the first report showing independent effects of components of two alternative job stress models-the effort-reward imbalance model and the job strain model (job control only)-on coronary heart disease.
本研究探讨了两种替代性工作压力模型——努力-回报失衡模型和工作压力模型——与英国男女公务员冠心病风险之间的关联。
逻辑回归分析基于一项前瞻性队列研究（怀特霍尔二世研究），该研究包括6895名男性和3413名年龄在35至55岁之间的女性。两种工作压力模型的基线测量值与平均5.3年随访期间冠心病的新发病例相关。
个人努力（竞争力、工作过度投入和敌意）与回报（晋升前景不佳和职业受阻）之间的失衡与新发冠心病风险高出2.15倍相关。工作压力和高工作要求与冠心病无关；然而，低工作控制与新发病例密切相关。自我报告的工作控制和外部评估的工作控制的低工作控制比值比分别为2.38和1.56。对工作特征同时进行了调整，并控制了就业等级水平、消极情感和冠心病风险因素。
这显然是首份显示两种替代性工作压力模型——努力-回报失衡模型和工作压力模型（仅工作控制）——的组成部分对冠心病具有独立影响的报告。
