Don't Work Your Heart Out

Stressful jobs and unfair bosses can raise cardiac risks, study finds

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By Amanda Gardner
HealthDay Reporter

MONDAY, Oct. 24, 2005 (HealthDay News) -- If you want to protect your heart, take a look at your job -- and your boss.

British civil servants who felt they were being treated fairly at work were at reduced risk of coronary heart disease, a new study reports.

And perceptions of how fair their supervisor was appeared to be a key factor in how well they felt justice was being served.

"This is the first study to demonstrate that justice at work may protect against coronary heart disease," said lead author Mika Kivimaki, a professor at the University of Helsinki and the Finnish Institute of Occupational Health in Helsinki, Finland.

"Justice, equity and altruism have been the drivers of benign developments in human societies according to a wide range of studies across a broad spectrum of disciplines," Kivimaki said. "Our findings on coronary heart disease, the leading cause of death in all western societies, suggest that organizational justice is also a topic worthy of consideration in health research."

The study appears in the Oct. 24 issue of Archives of Internal Medicine.

The authors explained that people feel a sense of justice at work when they believe that higher-ups are considering their viewpoint, involving them in decision making and treating them truthfully.

This research fits well with previous studies, one of which had shown that employees had lower blood pressure on days they worked with a supervisor they perceived as fair.

Another study (conducted by the same team presenting the new results) found that workplace stress more than doubled the risk of death from heart attack, stroke and other cardiovascular conditions.

"There have been a lot of observational studies indicating that stress is related to heart disease. This seems more a fine tuning of that," said Dr. Stephen Siegel, clinical assistant professor of medicine at New York University School of Medicine.

And the idea of workplace stress being related to heart disease also fits with existing research. "Atherosclerotic disease is considered a work-related disability in New York City," Siegel said. "You would think it's the stress of going after the bad guy or running into a burning building but they don't talk about that as stress. They talk about the structure of the workplace, the politics, what the captain is going to say."

"There is a trend in this country [the U.S.] that's going towards better health," said Rania V. Sedhom, an employee benefits attorney with Meyer Suozzi English & Klein in New York City. "One of the ways we're not being becoming conscious is with justice at work. Since we do spend 12 to 13 hour days at work, it's important for us to interact better."

The new study appears to be the first research to look at the relationship between workplace justice and the onset of coronary heart disease.

The researchers used data on 6,442 male British civil servants aged 35 to 55 enrolled in the Whitehall II Study. None of the participants had coronary heart disease at the beginning of the study. Participants answered questionnaires on perceived justice at work as well as other work-related psychosocial factors at two different times (1985-1988 and 1989-1990). The researchers then monitored the group for heart attacks and other heart problems for about nine years.

Employees who perceived a high level of justice at work were at a 30 percent lower risk of incidents related to coronary heart disease than those who reported a low or intermediate level of justice. This effect appeared to be independent of cholesterol levels, body mass index, hypertension, smoking, alcohol consumption and physical activity level.

According to the experts, justice may mean less chronic stress which, in turn, means less coronary heart disease.

Siegel cautioned that the findings are only observational. "We can't really say that they prove anything," he said. "It's more that they raise questions and give insights possibly. There might be other risk factors."

It's also unclear if these findings, however tentative, could be extended to women, or to workers in other countries.

"It's a very important study and, particularly in the U.S., we have to take a look at this study and maybe conduct our own," Sedhom said.

"I think we in the U.S. work more hours per day than almost any other country and it's important for us to have this sort of justice at work and get a pat on the back from our employer or at least be given some feedback," he added. "When you feel appreciated in any area, particularly at work, you're going to do a better job and you're going to feel better. It's not costing the employer any more money."

More information

For more information about job stress, visit the American Psychological Association.

SOURCES: Mika Kivimaki, Ph.D., professor, University of Helsinki and Finnish Institute of Occupational Health, Helsinki, Finland; Stephen Siegel, M.D., clinical assistant professor of medicine, New York University School of Medicine, New York City; Rania V. Sedhom, Esq., employee benefits attorney, Meyer Suozzi English & Klein, New York City; Oct. 24, 2005, Archives of Internal Medicine

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