Work-related stress caused by job strain and an “imbalance between efforts applied versus rewards received” may increase the risk of developing atrial fibrillation (AF), as per new research published recently in the Journal of the American Heart Association.
Previous research has linked high job strain and effort-reward imbalance at work with an increased risk of coronary heart disease—but this latest research is the first to examine the adverse effect of both psychosocial stressors at work on AF, said the study’s senior author Xavier Trudel (Laval University, Quebec City, Canada).
“Our study suggests that work-related stressors may be relevant factors to include in preventive strategies,” Trudel stated. “Recognising and addressing psychosocial stressors at work are required to foster healthy work environments that benefit both individuals and the organisations where they work.”
Trudel and colleagues set out to study the impact of job strain—which refers to a work environment in which employees face high job demands, such as a heavy workload and tight deadlines, and low control over their work with little say in decision-making and how they execute their tasks. Another factor assessed in the study was the effort-reward imbalance. This occurs when employees invest significant effort into their work but perceive the rewards they get in return—such as salary, recognition or job security—as insufficient or unequal to their performance.
Researchers collected data through the PROspective Quebec (PROQ) Study on Work and Health, which started in the Quebec region in 1991–1993 and recruited white-collar workers from 19 public and semi-public organisations. A total of 5,926 workers (49% men, 51% women), with an average age of 45 years at the beginning of the study and 65 years by the end of follow-up in December 2018, were included in this analysis. The majority of study participants were white adults.
The analysis involved examination of medical database records across 18 years of follow-up, measuring work-related stressors through self-reported questionnaires specifically on job strain and effort-reward imbalance, and controlling for a broad list of socioeconomic characteristics, health risks and lifestyle factors.
Trudel and colleagues identified a total of 186 AF cases and, among that group, 19% of people reported high job strain; 25% said they perceived effort-reward imbalance; and 10% reported experiencing both stressors simultaneously. More than one-third of participants had been diagnosed with coronary heart disease or heart failure before their AF incidence, the researchers report.
Key findings from their analysis are as follows:
- Employees who said they experienced high job strain had an 83% higher risk of developing AF compared to workers unaffected by the stressors
- Those who perceived an effort-reward imbalance had a 44% greater risk, compared to workers who did not report this imbalance
- Combined perceptions of high job strain and effort-reward imbalance were associated with a 97% increased risk of AF
“The effectiveness of workplace interventions to reduce psychosocial stressors that may also reduce the risk of AF should be investigated in future research efforts,” Trudel said. “Our research team previously conducted an organisational intervention designed to reduce psychosocial stressors at work, which was shown to effectively reduce blood pressure levels. Examples of organisational changes implemented during the intervention included slowing down the implementation of a large project to prevent increased workload; implementing flexible work hours; and holding meetings between managers and employees to discuss day-to-day challenges.”
According to the researchers, limitations of the present study include the fact that participants were all white-collar workers encompassing managerial, professional and office workers in Canada—meaning results may not apply to other types of workers or to workers in other countries.
