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Psychosocial work environment and ambulatory blood pressure: independent and combined effect of demand-control and effort-reward imbalance models.
Occup Environ Med. 2013 Nov; 70(11):815-22.OE

Abstract

BACKGROUND

Two main theoretical models have been used to assess the impact of psychosocial work factors on blood pressure (BP): the demand-control model (DC) and the effort-reward imbalance (ERI) model. Little is known about their independent and combined effect.

OBJECTIVE

To examine the independent and combined effect of the DC and ERI models on ambulatory BP (ABP).

METHOD

Data were collected three times over 7 years from 3395 white-collar women and men using a repeated cross-sectional design. On each occasion, psychosocial work factors were measured using validated scales. ABP was measured every 15 min during a working day. Systolic and diastolic ABP means were examined in relation to contemporaneous and past exposure. Both models were mutually adjusted. A combined exposure variable was computed.

RESULTS

In men, high strain, and active, passive and ERI exposure were associated with ABP using contemporaneous exposure. However, the high strain/ABP association was not significant after adjustment for ERI. In women, no association was found with the DC model, while women exposed to ERI had higher ABP. Use of past exposure showed a stronger association between ABP and active exposure in men, while ERI associations were attenuated. Combined exposure to active jobs and to ERI was associated with ABP in both genders.

CONCLUSIONS

In men, associations with the DC model were mixed. Associations between high job strain and ABP were not independent of ERI exposure while both DC intermediate groups were independently associated with ABP. In women, no association was found with the DC model. ERI exposure was independently associated with ABP using contemporaneous exposure, but not using past exposure. Combined active and ERI exposure was also associated with ABP.

Authors+Show Affiliations

Santé des populations: URESP, Centre de recherche du CHU de Québec City, Québec, Canada.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24143020

Citation

Trudel, Xavier, et al. "Psychosocial Work Environment and Ambulatory Blood Pressure: Independent and Combined Effect of Demand-control and Effort-reward Imbalance Models." Occupational and Environmental Medicine, vol. 70, no. 11, 2013, pp. 815-22.
Trudel X, Brisson C, Milot A, et al. Psychosocial work environment and ambulatory blood pressure: independent and combined effect of demand-control and effort-reward imbalance models. Occup Environ Med. 2013;70(11):815-22.
Trudel, X., Brisson, C., Milot, A., Masse, B., & Vézina, M. (2013). Psychosocial work environment and ambulatory blood pressure: independent and combined effect of demand-control and effort-reward imbalance models. Occupational and Environmental Medicine, 70(11), 815-22. https://doi.org/10.1136/oemed-2013-101416
Trudel X, et al. Psychosocial Work Environment and Ambulatory Blood Pressure: Independent and Combined Effect of Demand-control and Effort-reward Imbalance Models. Occup Environ Med. 2013;70(11):815-22. PubMed PMID: 24143020.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Psychosocial work environment and ambulatory blood pressure: independent and combined effect of demand-control and effort-reward imbalance models. AU - Trudel,Xavier, AU - Brisson,Chantal, AU - Milot,Alain, AU - Masse,Benoit, AU - Vézina,Michel, Y1 - 2013/08/28/ PY - 2013/10/22/entrez PY - 2013/10/22/pubmed PY - 2013/12/16/medline SP - 815 EP - 22 JF - Occupational and environmental medicine JO - Occup Environ Med VL - 70 IS - 11 N2 - BACKGROUND: Two main theoretical models have been used to assess the impact of psychosocial work factors on blood pressure (BP): the demand-control model (DC) and the effort-reward imbalance (ERI) model. Little is known about their independent and combined effect. OBJECTIVE: To examine the independent and combined effect of the DC and ERI models on ambulatory BP (ABP). METHOD: Data were collected three times over 7 years from 3395 white-collar women and men using a repeated cross-sectional design. On each occasion, psychosocial work factors were measured using validated scales. ABP was measured every 15 min during a working day. Systolic and diastolic ABP means were examined in relation to contemporaneous and past exposure. Both models were mutually adjusted. A combined exposure variable was computed. RESULTS: In men, high strain, and active, passive and ERI exposure were associated with ABP using contemporaneous exposure. However, the high strain/ABP association was not significant after adjustment for ERI. In women, no association was found with the DC model, while women exposed to ERI had higher ABP. Use of past exposure showed a stronger association between ABP and active exposure in men, while ERI associations were attenuated. Combined exposure to active jobs and to ERI was associated with ABP in both genders. CONCLUSIONS: In men, associations with the DC model were mixed. Associations between high job strain and ABP were not independent of ERI exposure while both DC intermediate groups were independently associated with ABP. In women, no association was found with the DC model. ERI exposure was independently associated with ABP using contemporaneous exposure, but not using past exposure. Combined active and ERI exposure was also associated with ABP. SN - 1470-7926 UR - https://www.unboundmedicine.com/medline/citation/24143020/Psychosocial_work_environment_and_ambulatory_blood_pressure:_independent_and_combined_effect_of_demand_control_and_effort_reward_imbalance_models_ L2 - http://oem.bmj.com/cgi/pmidlookup?view=long&pmid=24143020 DB - PRIME DP - Unbound Medicine ER -