Imbalances of effort versus reward are among job factors that can lead to coronary
Poor work design and organisation can contribute to heart disease, according
to research sponsored by the Health and Safety Executive.
A stressful environment where there are high job demands, low job control
and imbalance in effort versus reward can all lead to coronary heart disease,
said the study Whitehall II.
It looked at the health of more than 10,000 British civil servants and found
that coronary heart disease in the workplace could not be totally explained
away by conventional risk factors such as smoking, being overweight or high
The situation was exacerbated by the fact that when workloads changed,
higher job demands, less direct control and reduced support all led to a
deterioration in mental health.
While previous reports have linked working conditions with self-reported
heart disease, the Whitehall II study has given a clearer picture because
reports were verified against medical records, said the HSE.
Even moderate alcohol consumption was related to a risk of sickness absence
because of injury, as well as "binge" drinking and alcohol
But the work factors measured, with the exception of an effort-reward
imbalance, were not generally associated with Type 2 diabetes, said the HSE.
Prof Sir Michael Marmot, director of the study, said: "Stress at work
is not simply a matter of having too much to do, but also results from too
little control over the work and from insufficient reward for the effort
"The way to address the problem of stress at work is to look hard at
the organisation of the workplace."
Elizabeth Gyngell, senior policy manager on stress at the HSE, added:
"Employers need to realise just how serious the effects of work-related
stress can be, and take action to prevent it."
The results of the study were applicable to a much wider group of workers
than just civil servants, the HSE said.