on February 28, 2008
Published online before print February 28, 2008, doi: 10.1161/STROKEAHA.107.495523
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Submitted on June 4, 2007
From CHESS, Stockholm University/Karolinska Institute, Stockholm, Sweden. * To whom correspondence should be addressed. E-mail: susanna.toivanen{at}chess.su.se.
Background and Purpose—The main purpose of this study was to test whether the impact of job control on stroke mortality is independent of socioeconomic factors. Methods—This was a register-based cohort study of nearly 3.5 million working people (25 to 64 years of age in the 1990 Swedish Census) with a 5-year follow-up for stroke mortality. Job control was aggregated to the data from a secondary data source (job exposure matrix). Gender-specific Poisson regressions were performed. Results—Compared with high job control occupations, low job control was significantly related to hemorrhagic (relative risk, 1.54; 95% CI, 1.10 to 2.17) and all-stroke mortality (relative risk, 1.50; 95% CI, 1.11 to 2.03) in women but not in men. The significance of job control in women was independent of all confounders included (marital status, education level, and occupational class). Class-specific analyses indicated a consistent effect of job control for most classes (significant for female lower nonmanuals). However, low job control did not increase the risk of stroke mortality in upper nonmanuals. Conclusions—Job control was significantly related to hemorrhagic and all-stroke mortality in women but not in men.
Revised on August 20, 2007
Accepted on August 28, 2007
Is the Impact of Job Control on Stroke Independent From Socioeconomic Status?. A Large-Scale Study of the Swedish Working Population
Susanna Toivanen PhD* and Örjan Hemström PhD
Key words: epidemiology • job control • mortality • occupational class • stroke
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