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Psychosocial job strain and coronary heart disease in a cohort of blue collar workers

University of British Columbia

This dissertation investigated the impact of cumulative and time-weighted average exposure to psychosocial stressors and moderators in a cohort of blue-collar workers in 14 sawmills located in the province of British Columbia (B.C.). The cohort, originally gathered to investigate the effects of chlorophenol anti-sapstain chemicals on sawmill workers' health, contains complete occupational histories for over 26,000 workers who worked for at least one year in a study mill between 1950 and 1985 and complete mortality outcomes. The analysis was focused on mortality from atherosclerosis but also investigated mortality from all-causes, cerebrovascular accidents, and suicides and accidents. This dissertation was a retrospective study in which exposure for five psychosocial workcondition variables was added to an existing cohort. There were several unique features to this investigation. First, this is the first cohort study of psychosocial work conditions and CHD outcomes which used multiple job history information to calculate exposures. Second, this is the first cohort study to model these exposures using duration of exposure as well as an intensity measure. Third, this is the first cohort study to use expert job evaluators to estimate psychosocial work conditions retrospectively. The main positive findings of this dissertation were that time-weighted average exposure to physically sedentary and noisy jobs was associated with increased risk of mortality from atherosclerotic heart disease. The main negative findings were that time-weighted average exposures for control, psychological demand and social support were not associated with atherosclerosis mortality. Although cumulative exposures to psychosocial variables were modeled definitive results were not found because of collinearity both among psychosocial variables. Secondary findings included an inverse association between time-weighted average physical demand for all-cause mortality and an inverse association between time-weighted average psychological demand and suicide mortality. Also, a weak direct association between psychological demand and cerebrovascular accidents was found which disappeared after controlling for employment duration. As well, the expert rater method used in this investigation was able to reliably and with validity estimate exposures to four psychosocial work conditions: control, physical demand, co-worker social support, and noise. Psychological demand was estimated with less reliability than these four variables and was not shown to be valid using tests for concurrent and predictive validity.

Thesis/Dissertation

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2009-05-28

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http://hdl.handle.net/2429/8439

Health Care and Epidemiology

University of British Columbia

UBCV

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