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Job Too Stressful? It Could Be Killing You

Study finds stress doubles death risk from heart problems

THURSDAY, Oct. 17, 2002 (HealthDayNews) -- Need more proof that a job that's too taxing can be a killer?

A new Finnish study shows that workplace stress more than doubles the risk of death from heart attack, stroke and other cardiovascular conditions.

It's not an especially new finding, says Mika Kivimaki, lead author of a paper describing the study in this week's British Medical Journal. What is new is that this study is the first to use both of the accepted models used to gauge workplace stress for one group of workers, he says.

One model measures stress by the amount of control a worker has, says Kivimaki, a senior researcher in psychology at the Finnish Institute of Occupational Health.

"The second [model] describes the effort put in at work and the reward you receive," he says. "Stress emerges when high physical or mental effort is combined with low reward -- monetary or psychological."

The study traces its roots to 1973, when it enlisted more than 800 healthy workers at a metal industry factory in Finland. The researchers followed the workers for more than a quarter century.

"After adjustment for age and sex, employees with high job strain, a combination of high demands at work and low job control had a 2.2-fold [slightly more than double] cardiovascular mortality risk compared with their colleagues with low job strain," the researchers report.

It's important to note that all the people in the study were healthy when it began, Kivimaki says.

"It is a well-known fact that if you already have heart disease, stress is a contributory factor to cardiovascular risk," he says. "This study found increased risk for workers who had no cardiovascular disease at baseline."

The finding emphasizes the need for anyone with a stressful job to pay attention to the known risk factors for heart disease, Kivimaki says.

"People under high stress in our study tended to gain weight, and their cholesterol levels increased," he says. "So a healthy lifestyle, including physical activity, will reduce the adverse effect."

It's also important to get a job that matches a worker's personality, says Dr. Paul J. Rosch, president of the American Institute of Stress.

"Some people thrive on the fast-lane, pressure-cooker work that destroys most of us," he says. "That same individual will feel stress doing assembly-line work. It's not the job; it's the job-individual interaction. The idea is to find some way to get a better sense of control over activities."

While employers tend to grumble about the kind of findings contained in the Finnish study, Rosch says, "The relationship between job stress and heart attacks is so well acknowledged that New York and other states view it as a work-related injury and compensate for it accordingly."

C. David Jenkins is a professor of preventive medicine at the University of North Carolina School of Public Health and a spokesman for the American Psychological Association. He says the Finnish results "are not surprising for someone who has been following these concepts. But here is a methodologically sound paper that confirms earlier findings. It shows that we have to take this [job-related stress] more seriously than it has been in the past."

There's just so much that a worker can do to relieve on-the-job stress, says Jenkins, and "the burden is more on the occupational medical people and management. They have to provide more flexibility in working conditions, because it seems that a lack of control is more important than the work burden itself."

"Also, the effort-reward balance could be improved by raising salaries, providing more prestige and more praise, more of a feeling of being appreciated by management to workers who don't feel they are adequately rewarded," Jenkins says. "The workplace has to be made more worker-friendly."

What To Do

For more information about job stress, visit the American Psychological Association or the University of New England.

SOURCES: Mika Kivimaki, Ph.D, senior researcher, psychology, Finnish Institute of Occupational Health, Helsinki; Paul J. Rosch, M.D., president, American Institute of Stress, Yonkers, N.Y.; C. David Jenkins, Ph.D, professor, preventive medicine, University of North Carolina, Chapel Hill; Oct. 19, 2002, British Medical Journal
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