MYOCARDIAL INFARCTION AND STROKE: 16-YEAR RISK AND STRESS AT WORK IN OPEN POPULATION OF 25–64-YEAR-OLD WOMEN IN RUSSIA/SIBERIA (WHO MONICA–PSYCHOSOCIAL PROGRAM)

Aim. To determine the effects of stress at workplace on the risks (HR: hazard ratio) of development of myocardial infarction and stroke in open population of 25-64-yearold women in Russia/Siberia (Novosibirsk).

Material and methods. Random representative sample of 25-64-year-old women (n=870) was examined in a framework of WHO MONICA-Psychosocial program in one of Novosibirsk districts. Stress at workplace was studied by using the Karasek scale; attitudes to work and prophylactic exams were studied by using the scale of “Knowledge and attitude towards one’s own health” of WHO MONICA-Psychosocial program. During 16 years (1994-2010), all first-time cases of myocardial infarction and stroke were studied in the cohort based on the WHO program of Register of Acute Myocardial Infarction and all available documentation. Cox regression model was used for determination of myocardial infarction and stroke risk over 16 years of follow-up.

Results. Prevalence rate of high level of stress in open population of 25-64-yearold women was 31,6%. High levels of stress at work were associated with high levels of responsibility, inability to get rest at the end of workday, frequent professional dissatisfaction, and decreased working ability. For 16 years, HR was by 3,22 times higher for myocardial infarction (p<0,05) and 1,96 times higher for stroke (p<0,05) in women with stress at work. Rates of myocardial infarction and stroke were higher in married women who experienced stress at work, belonged to categories of managers and physical labor, and had high and low level of education.

Conclusion. Prevalence of high level of stress at workplace is significant in open population of 25–64-year-old women in Russia/Siberia (Novosibirsk). In the presence of stress at workplace, HR of myocardial infarction and stroke were 2 to 3 times higher than without it. Social gradient affected HR of infarct and stroke.

1. Holmgren K, Dahlin-Ivanoff S, Björkelund C, Hensing G. The prevalence of work-related stress, and its association with self-perceived health and sick-leave, in a population of employed Swedish women. BMC Public Health. 2009; 9: 73.

2. Karasek R, Theorell T. Healthy work: stress, productivity and the reconstruction of working life. New York: Basic Books, 1990.

3. Boedeker W, Klindworth H. Hearts and minds at work in Europe. A European work-related public health report on cardiovascular diseases and mental ill health. BKK Bundesverband: Federal Association of Company Health Insurance Funds, Essen, 2007.

4. MONICA Psychosocial Optional Study. Suggested measurement instruments. Copenhagen: WHO Facsimile Urgent 3037 MRC, 1988; р. 33.

5. Karasek R.A. Job demands, job decision latitude and mental strain: implications for job redesign. Admin Sci Q 1979; 24: 285-307.

6. Gafarov V.V. Epidemiology and prevention of cardiovascular diseases in large industrial center of West Siberia. Novosibirsk: Polygraphist, 1992.

7. Milczarek M., Schneider E., González E. Report to European Agency for Safety and Health at Work: OSH in figures: stress at work — facts and figures. Luxembourg: Office for Official Publications of the European Communities, 2009.

8. Daniels K. Perceived risk from occupational stress: a survey of 15 European countries. Occupational and Environmental Medicine 2004; 61: 467-70.

9. European Foundation for the Improvement of Living and Working Conditions, Fourth European Working Conditions Survey. Luxembourg: Office for Official Publications of the European Communities, 2006.

10. Franche R.L., Williams A., Ibrahim S., et al. Path analysis of work conditions and work-family spillover as modifiable workplace factors associated with depressive symptomatology. Stress and Health 2006; 22: 91-103.

11. Jansen N.W., Kant I.J., van Amelsvoort L.G., et al. Work-family conflict as a risk factor for sickness absence. Occup Environ Med 2006; 63(7): 488-94.

12. Gafarov V.V., Panov D.O., Gromova E.A., et al. The influence of depression on risk development of acute cardiovascular diseases in the female population aged 25-64 in Russia. Int J Circumpolar Health 2013; 72: 1-5.

13. Gafarov V.V., Panov D.O., Gromova E.A., et al. Risk of arterial hypertension and trait anxiety in open population of 25–64-year-old women (16-year epidemiological study — WHO MONICA-Psychosocial program). Journal of Arterial Hypertension 2012; 18(4): 298-302.

14. Phillips S., Sen D., McNamee R. Prevalence and causes of self-reported work- related stress in head teachers. Occup Med (Lond) 2007; 57(5): 367-6.

15. Heslop P., Smith G. D., Metcalfe C, et al. Change in job satisfaction, and its association with self-reported stress, cardiovascular risk factors and mortality. Soc Sci Med 2002; 54(10): 1589-99.

16. Holmgren K., Dahlin Ivanoff S. Women on sickness absence — views of possibilities and obstacles for returning to work. A focus group study. Disabil Rehabil 2004; 26(4): 213-22.

17. Statistics Sweden: Women and men in Sweden 2006. Stockholm: Official Statistics of Sweden, 2006.

18. Lidwall U., Marklund S. What is healthy work for women and men? A case-control study of gender- and sector-specific effects of psycho-social working conditions on long-term sickness absence. Work 2006; 27(2): 153-63.

19. Gjerdingen D., McGovern P., Bekker M., et al. Women’s work roles and their impact on health, well-being, and career: comparisons between the United States, Sweden, and The Netherlands. Women Health 2000; 31(4): 1-20.

20. Gafarov V.V., Pak V.A., Gagulin I.V. et al. The WHO MONICA-based study of awareness and attitude to own health in 25–64-year-old women in Novosibirsk. Siberian Medical Journal (Tomsk) 2010; 25(4): 131-7.

21. Gafarov V.V., Gagulin I.V., Gafarova A.V., et al. Smoking and stress in the family and workplace: epidemiological study. The World of Science, Culture and Education 2013; 1(38): 250-2.

22. Kivimäki M., Leino-Arjas P., Luukkonen R. Work stress and risk of cardiovascular mortality: prospective cohort study of industrial employees. BMJ 2002; 325(7369): 857.

23. Michie S., Williams S. Reducing work-related psychological ill health and sickness absence: a systematic literature review. Occup Environ Med 2003; 60(1): 3-9.

24. Myint P. K, Luben R. N., Welch A. A. Effect of age on the relationship of occupational social class with prevalence of modifiable cardiovascular risk factors and cardiovascular diseases. A population-based cross-sectional study from European Prospective Investigation into Cancer — Norfolk (EPIC-Norfolk). Gerontology 2006; 52(1): 51-58.

25. Lallukka T., Chandola T., Hemingway H., et al. Job strain and symptoms of angina pectoris among British and Finnish middle-aged employees. J Epidemiol Community Health 2009; 63(12): 980-5.

26. Eaker E. D., Sullivan L.M., Kelly-Hayes M. Does job strain increase the risk for coronary heart disease or death in men and women? The Framingham Offspring Study. Am J Epidemiol 2004; 160(10): 1031-2.

27. Gallo W. T., Teng H.M., Falba T.A., et al. The impact of late career job loss on myocardial infarction and stroke: a 10 year follow up using the health and retirement survey. Occup Environ Med 2006; 63(10): 683-7.

28. Siegrist J., Dragano N. Psychosocial stress and disease risks in occupational life. Results of international studies on the demand-control and the effort-reward imbalance models. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2008;51(3): 305-12.