Occupational Medicine: State of the Art Reviews; Chapter 2: Research Findings Linking Workplace Factors to CVD Outcomes Authors: Paul Landsbergis, Kyle Steenland, Lawrence Fine, Karen Belkic, Peter Schnall, Dean Baker, Tores Theorell, Johannes Siegrist, Richard Peter, Robert Karasek, Michael Marmot, Chantal Brisson, Finn Tuchsen
A variety of workplace conditions have been implicated as risk factors for cardiovascular disease (CVD). These include shift work, long work hours, and chemical (e.g., carbon disulfide, nitrate esters, carbon monoxide, methylene chloride, solvents), physical (e.g., cold, heat, noise, passive smoking, sedentary work) and psychosocial conditions. The most consistent evidence is provided by sources of psychosocial stress at work. The evidence strongly suggests a causal association between job strain (a combination of high psychological demands and low job decision latitude, or low job control) and hypertension and CVD. Low decision latitude is also a risk factor for CVD. As yet limited but convincing evidence exists for a role of another psychosocial factor effort-reward imbalance (ERI) with similar observed effect sizes as job strain. In addition, threat-avoidant vigilant work (TAV) has been identified through studies of single occupations as a potentially helpful explanatory variable as to why groups such as professional drivers — whose work is characterized by high TAV, — have the most consistent evidence of elevated risk of CVD and hypertension.