Effect of family responsibilities and job strain on ambulatory blood pressure among white-collar women

Associations between strain in domestic work and self-rated health: a study of employed women in Sweden

AIM

The aim of this study was to analyse the association between strain in domestic work and self-rated health among employed women in Sweden, using two different methods of measuring strain in domestic work.

METHODS

Questionnaire data were collected on health and living conditions in paid and unpaid work for employed women (n=1,417), aged 17-64 years. "Domestic job strain'' was an application of the demand-control model developed by Karasek and Theorell, and "Domestic work equity and marital satisfaction'' was measured by questions on the division of and responsibility for domestic work and relationship with spouse/cohabiter. Self-rated health was measured using the SF-36 Health Survey. Associations were analysed by bivariate and multivariate linear regression analyses, and reported as standardized regression coefficients.

RESULTS

Higher strain in domestic work was associated with lower self-rated health, also after controlling for potential confounders and according to both strain measures. "Domestic work equity and marital satisfaction'' showed for example negative associations with mental health beta -0.211 (p<0.001), vitality beta -0.195 (p<0.001), social function -0.132 (p<0.01) and physical role beta -0.115 (p<0.01). The highest associations between "Domestic job strain'' and SF-36 were found for vitality beta -0.156 (p<0.001), mental health beta -0.123 (p<0.001).

CONCLUSIONS

Strain in domestic work, including perceived inequity in the relationship and lack of a satisfactory relationship with a spouse/cohabiter, was associated with lower self-rated health in this cross-sectional study. Future research needs to address the specific importance of strain in domestic work as a contributory factor to women's ill-health.

Job strain, decision latitude and α2B-adrenergic receptor polymorphism significantly interact, and associate with higher blood pressures in men

BACKGROUND

Job strain (high demands and low decision latitude) and the DD genotype of an I/D polymorphism in the adrenergic alpha2B-receptor have been associated with hypertension, respectively. We hypothesized that the I/D polymorphism interacts with external stress, such as job strain, in the development of hypertension.

METHODS

A sample of 3045 employed men and women from the population cohort of Malmö Diet and Cancer Study, n = 28 098, with baseline data regarding work characteristics and cardiovascular risk factors, were genotyped for the adrenergic alpha2B-receptor I/D polymorphism. This was possible in 1302 men and 1662 women, and these individuals formed the study group.

RESULTS

The age-adjusted systolic blood pressure (SBP) for men with the DD polymorphism and job strain (n = 26) was 147.0 +/- 3.4 mmHg, whereas for men with the DD polymorphism but without job strain (n = 184), the SBP was 138.2 +/- 1.4 mmHg (P = 0.018). Similar findings were made regarding diastolic blood pressures (DBP) in men. Job strain and the I/D polymorphism in the adrenergic alpha2B-receptor gene significantly interacted in men [P = 0.008 for SBP, P = 0.03 for DBP, adjusted for age, body mass index, occupational status and nationality (Model 1)]. Increasing latitude score was inversely correlated with SBP (beta -0.17, P = 0.03, Model 1) in DD men, but not in men with the I-allele; interaction significance for genotype x latitude score, P = 0.02 for SBP (Model 1). In women, there were no significant interactions between genotype and work characteristics (P = 0.32 for SBP, and P = 0.60 for DBP).

CONCLUSION

For the first time, a significant interaction between a genetic factor and work environment, resulting in elevated blood pressures, has been described.

High Job Strain and Ambulatory Blood Pressure in Middle-Aged Men and Women From the Belgian Job Stress Study

OBJECTIVE

The aim of this study was to assess whether job strain is associated with 24-hour ambulatory blood pressure measurements within a subsample of the Belgian Job Stress Project (BELSTRESS) population.

METHODS

A group of 89 middle-aged male and female workers perceiving high job strain and an equally large group of workers perceiving no high job strain wore an ambulatory blood pressure monitor for 24 hours on a regular working day.

RESULTS

Mean ambulatory blood pressure at work, at home, and while asleep was significantly higher in workers with job strain as compared with others. The associations between job strain and ambulatory blood pressure were independent from the covariates.

CONCLUSIONS

Within this study, high job strain was an important independent risk factor for higher ambulatory blood pressure at work, at home, and during sleep in a group of men and women.

Daily worry is related to low heart rate variability during waking and the subsequent nocturnal sleep period

Stress and anxiety are risk factors for cardiovascular (CV) disease. Worry might be a mediator of their risks by prolonging their cognitive representation and concomitant CV activity. We hypothesized that daily stressors and worry, and trait anxiety and trait worry would be associated with high heart rate (HR) and low heart rate variability (HRV) during waking and the subsequent nocturnal sleep period, and that worry would mediate the effects of daily stressors. Low HRV and high HR are physiological risk factors for CV disease. Using an hourly diary, stressors, worry frequency and duration, and biobehavioral variables were measured during one day in 52 healthy subjects. During this time and the subsequent nocturnal sleep period, ambulatory ECG was measured. Stressors, worry and traits were related to higher HR and lower HRV during waking, and the effects of stressors and worry were extended into the sleeping period. Worry duration mediated the effects of stressors. The results were largely independent of biobehavioral variables including sleep quality. The results support the notion that worry, by prolonging CV activity, is a mediator of the CV risks of stress. They also imply a role for unconscious cognitive representation of stress.

Psychosocial factors at home and at work and levels of salivary cortisol

BACKGROUND

Salivary cortisol as a physiological measure of stress has attracted great interest in recent years.

METHOD

A 55 women and 28 men, all healthy volunteers, were included in a study on psychosocial factors at work and at home and salivary cortisol. General linear models, univariate and repeated measures, respectively, were used to evaluate the associations between psychosocial factors and cortisol excretion measured six times during a working day. Age, physical activity, tobacco use and the time of the first saliva sample were used as covariates.

RESULTS

In the women, high degrees of time pressure, effort and effort reward imbalance were significantly associated with higher levels of cortisol. In the men, high degrees of effort, effort reward imbalance and overcommitment were significantly associated with higher levels of cortisol.

CONCLUSION

Psychosocial factors are of significance to the level of salivary cortisol. The study emphasises the benefits of taking physiological measurements of stress in epidemiological studies.

Prolonged stress-related cardiovascular activation: Is there any?

BACKGROUND

Prolonged physiological activation before or after stressors has gained recognition as a decisive element in theories that explain the link between stress and disease, specifically cardiovascular (CV) disease. This view is opposed to the conventional reactivity hypothesis that emphasizes responses during stressors.

PURPOSE

Prolonged activity has not often been an explicit research goal of real-life stress studies. Nevertheless, a growing number of these studies have provided evidence for prolonged activity, often as a secondary research goal.

METHODS

An overview of this evidence is lacking and is provided in this article.

RESULTS

The combined data from the reviewed studies suggest that discrete and chronic stress sources, as well as negative emotional episodes and dispositions, are related to prolonged CV activity of various durations, including sleep periods. On the other hand, evidence supporting the assumption that prolonged stress-related activation predicts disease is still very modest.

CONCLUSIONS

In this article we suggest that future research of prolonged activation should give priority to (a) the establishment of clear beginnings and endings of stressful events, (b) the prediction of disease by prolonged activation, and (c) potential psychological mediators of stress-related prolonged activation. These mediators may include, for example, worry and rumination, or other processes characterized by perseverative cognition, including unconscious processes.

Job constraints and arterial hypertension: different effects in men and women: the IHPAF II case control study

AIMS

To examine, in a working population of men and women, the relation between organisational job constraints (job strain, passive and active jobs) and incident hypertension and the buffering effect of social support at work on this relation.

METHODS

A nested case control study was designed within the IHPAF (Incidence of Hypertension in a French Working Population) cohort study. The 20 worksite physicians participating in the study enrolled 203 cases and matched each case for age (SD 10 years) and sex with two normotensive subjects attending the follow up screening immediately after him or her. As a result, 426 men and 183 women were included in the study.

RESULTS

Mean age was 41.8 (SD 7.8) years in men and 43.5 (SD 7.5) years in women. Relations between job constraints and hypertension were stronger in women than in men. Odds ratios (OR) were 3.20 (95% CI 0.92 to 11.12) in women and 2.60 (95% CI 1.15 to 5.85) in men for job strain, 4.73 (95% CI 1.36 to 16.42) in women and 2.30 (95% CI 1.01 to 5.26) in men for passive jobs, and 4.51 (95% CI 1.24 to 16.43) in women and 2.39 (95% CI 1.10 to 5.18) in men for active jobs. Low social support at work was not related to hypertension and did not decrease the association with organisational risk factors. In both hypertensive men and women, obesity was related to hypertension (OR = 13.20 (95% CI 3.34 to 52.14) in women and 6.54 (95% CI 2.99 to 14.29) in men) and the prevalence of recent stressful life events was significantly lower in hypertensive women (OR = 0.32 (95% CI 0.12 to 0.89)) and men (OR = 0.37 (95% CI 0.20 to 0.67) compared with normotensives. Alcohol consumption was a significant risk factor for hypertension in women (OR = 3.47 (95% CI 1.18 to 10.25)).

CONCLUSION

A stronger relation between job constraints and hypertension was observed in women compared with men. These findings emphasise the need of addressing more sex-specific concepts of work related stress on the one hand, and of understanding the direct and indirect mechanisms linking psychosocial factors and hypertension in both sexes on the other hand.

Psychosocial Work Characteristics Predict Cardiovascular Disease Risk Factors and Health Functioning in Rural Women: The Wisconsin Rural Women's Health Study

BACKGROUND

The aim of the present study is to investigate the association between psychosocial work characteristics and health functioning and cardiovascular disease risk factors among rural women of central Wisconsin and compare psychosocial work characteristics between farm and nonfarm women.

METHODS

Stratified sampling was used to select a random sample (n = 1500) of farm and nonfarm women aged 25 to 71 years from the Central Marshfield Epidemiologic Study Area. The baseline examination included measurements of blood pressure, height, weight, and fasting blood lipids, glucose, and insulin. Psychosocial job condition was measured with the Karasek Job Content Questionnaires (JCQ). Health functioning was assessed by the Short Form-36 Health Survey.

RESULTS

The analysis of JCQ showed that nonfarm residents were more likely to have jobs with high demand and high decision latitude compared to farm residents. Also, the farm residents (40.3%) were more likely to be occupied in passive jobs (jobs with low levels of demand and control) than the nonfarm residents (26.9%). Among farm residents, psychological job demand was associated with HDL level (beta = 0.17), triglycerides (beta = 0.0), their ratio (beta = 0.005), and blood insulin level (beta = 0.014), and among nonfarm residents, psychological job demand was associated with diastolic blood pressure (beta = 0.17) and total cholesterol level (beta = 0.002).

CONCLUSION

Our results showed that rural farm residents had a higher prevalence of CVD risk factors and were more likely to be occupied in jobs with low levels of demand and control. Job stress predicted more CVD risk factors among farm residents compared to nonfarm residents. Therefore, interventions reducing job strain among rural farm residents are timely and necessary.

The influence of low job control on ambulatory blood pressure and perceived stress over the working day in men and women from the Whitehall II cohort

OBJECTIVE

Work stress contributes to risk of coronary heart disease and hypertension. This study tested the influence of job control on ambulatory blood pressure, and ratings of perceived stress and happiness in men and women systematically sampled by socio-economic status from the Whitehall II epidemiological cohort.

PARTICIPANTS

A total of 227 men and women aged 47-59 years sampled from higher, intermediate and lower employment grades.

OUTCOME MEASURES

Ambulatory blood pressure and ratings of stress, perceived control and happiness.

METHODS

Participants completed standard measures of job demands and job control, and undertook ambulatory monitoring with measures of blood pressure and subjective state every 20 min from early in the working day until going to bed.

RESULTS

Systolic and diastolic blood pressure were greater in participants reporting low rather than high job control (means 125.7/81.5 versus 122.4/78.6 mmHg, P < 0.05), independently of gender, employment grade, body mass index, age, smoking status, and physical activity. Differences persisted into the evening after work. Job demands and job strain (high demand/low control) were not associated with blood pressure. Participants reporting low job control experienced stress more frequently over the working day than did those with high job control. Higher socio-economic status participants and women were more stressed by low job control than were men and people of lower socio-economic status.

CONCLUSIONS

Job control plays an important role in modulating cardiovascular and affective responses over the working day, and these responses may contribute to increased cardiovascular disease risk.

Job strain and physiological stress responses in nurses and nurse's aides: predictors of daily blood pressure variability

BACKGROUND

Job strain has been implicated in risk of cardiovascular disease, and there is evidence for increased blood pressure among men with job strain. It is unclear, however, to what degree job strain affects blood pressure in women. This study examined the relationships between job strain, norepinephrine and epinephrine excretion in the workplace, and ambulatory blood pressure variability during waking hours in women working as nurses or nurse's aides in Hilo, Hawaii.

METHODS

Women from two ethnic groups, Filipino-Americans (n = 36) and Euro-Americans (n = 23), were measured on a workday, urinary catecholamine excretion and ambulatory blood pressure being measured over a 4-h period at work and home, and overnight over an 8-h period. The rates of catecholamine excretion were measured in timed urine samples using high-performance liquid chromatography with electrochemical detection, and ambulatory blood pressure was measured at 15-min intervals using a SpaceLabs 90207 monitor. The women filled out the Job Content Questionnaire prior to the physiological measurements.

RESULTS

Scores on the Job Content Questionnaire were not significantly associated with the physiological measures, although correlations were higher for Euro-American participants than Filipino-Americans. Catecholamine excretion rates in the workplace were significantly related to blood pressure variability throughout the day and to systolic blood pressure means, but catecholamine excretion rates in other daily settings were not significantly related to blood pressure.

CONCLUSIONS

These results support the idea that stress in the workplace has special significance for the prediction of cardiovascular health risk, and that catecholamine excretion at work is significantly associated with increased blood pressure variability during the day. Job strain, as measured by subscales from the Job Content Questionnaire, was not associated with any of the physiological measures. This lack of association may be the result of ethnic and circumstantial bias in the questionnaire, suggesting that job strain should be evaluated in a more critical manner in populations differing from the ones in which the concept was developed.

Job strain, ethnicity, and sympathetic nervous system activity

Several studies have demonstrated that blacks have heightened pressor sensitivity in response to the alpha-agonist, phenylephrine. However, studies examining whether psychosocial factors contribute to this difference are scarce. We examined the effects of job strain on pressor sensitivity in 76 whites and 46 blacks who were enrolled in a study of stress, sleep, and blood pressure. Responses to phenylephrine were examined at an inpatient clinical research center. After a 3-minute baseline period, a 100-microgram phenylephrine bolus was administered to participants intravenously. To measure catecholamines, 24-hour urine samples were also collected from participants. There was a significant relationship between job strain and pressor sensitivity, such that individuals with low decisional control and high job demands experienced a greater increase in diastolic pressure after receiving phenylephrine. Low decisional control was also associated with decreased baroreflex sensitivity. There was an interaction between ethnicity and job control on blood pressure responses to phenylephrine and on 24-hour urinary norepinephrine levels. Blacks who perceived less control experienced a greater increase in diastolic pressure after receiving phenylephrine and had elevated norepinephrine levels. These findings suggest possible mechanisms by which job strain may be associated with cardiovascular disease.

Job characteristics, occupational status, and ambulatory cardiovascular activity in women

BACKGROUND

Prior research concerning the effects of occupational status and work stress on ambulatory blood pressure (AmBP) has seldom included women, and available results are equivocal. Moreover, the concurrent effects of occupational status and job characteristics have rarely been investigated. Some research is consistent with the idea that stressful job characteristics are especially detrimental to health in low-status workers, creating a cumulative physiological burden.

PURPOSE

To examine the independent and joint effects of occupational status and perceived demands, control, and social support at work on AmBP and heart rate (HR) in women.

METHODS

One hundred eight women (M age = 41.07 years) wore an AmBP monitor for 2 days and completed a self-report assessment of job control, demands, and support (i.e., Karesek et al.'s Job Content Questionnaire).

RESULTS

After controlling for numerous potential confounds, occupational status and job characteristics accounted for 18% and 22% of the inter-individual variability in ambulatory systolic blood pressure (SBP) and HR, respectively. Occupational status independently predicted ambulatory cardiovascular activity and interacted with job characteristics, particularly in relation to SBP.

CONCLUSIONS

Inasmuch as ambulatory SBP and HR predict future cardiovascular morbidity and mortality, women with both lower status occupations and stressful job circumstances could be at disproportionately high cardiovascular risk.

Physical Exposures in Work Commonly Done by Women

The North American workforce is still highly sex-segregated, with most members of each sex in jobs composed primarily of workers of the same sex. This division is accentuated when jobs involve physical demands. Women have traditionally been assigned to tasks whose physical demands are considered to be light. Nevertheless, these tasks can have biological effects, sometimes serious. Phenomena related to physical demands of women's work can be considered in three categories: (a) musculoskeletal and cardiovascular demands of tasks often assigned to women in factories and service work; (b) sex- and gender-specific effects of toxic substances found in the workplace; and (c) interactions between work and the domestic responsibilities of many women. These phenomena are described, using examples recently gathered from workplaces. Effects of biological sex are distinguished, as far as possible, from effects of gender (social roles). Keywords: ergonomics, gender, occupation, anthropometry, toxicity, repetitive movements, static effort

Measuring job stress and family stress in Chinese working women: a validation study focusing on blood pressure and psychosomatic symptoms

Psychometric properties of a questionnaire measuring psychosocial work-related stress in terms of effort-reward imbalance and a short family stress scale were examined in a population sample of 421 working women from four work sites in Beijing, China. The internal consistency of the scales was satisfactory, and the theoretically postulated structure of scales of the work stress questionnaire was replicated. The criterion validity of the scales was tested using psychosomatic symptoms and blood pressure. Combined exposure to work and family- related stress was associated with an adjusted mean 6.4 mmHg increase in systolic blood pressure. Recurrent sleeping problems were also associated with the two stress measures. In conclusion, standardized measures of psychosocial stress in terms of effort-reward imbalance and of family stress can be used in occupational health research in China, with particular relevance for working women.

La place des femmes dans les priorités de recherche en santé au travail au Québec

Nous avons analysé le rapport annuel produit en 1999 par l’Institut de recherche Robert-Sauvé en santé et en sécurité du travail du Québec et nous avons constaté que, dans les professions et secteurs concernés par les études financées, le pourcentage moyen de femmes est de 15 % (comparé à 45 % de femmes parmi la population au travail). Douze populations étudiées sont équilibrées ou composées en majorité de femmes, et 76 sont composées d’hommes à plus de deux tiers. Le montant moyen accordé aux études sur une population équilibrée ou majoritairement composée de femmes était de 86 339 $ comparativement à 114 480 $ pour les autres. Nous considérons plusieurs hypothèses d’explication de ces différences. Nous concluons que, peu importe la cause, un effort soutenu de recherche ciblée vers les emplois des femmes est essentiel, en plus d’une analyse différenciée en santé au travail.

Be the fairest of them all: challenges and recommendations for the treatment of gender in occupational health research

BACKGROUND

Both women's and men's occupational health problems merit scientific attention. Researchers need to consider the effect of gender on how occupational health issues are experienced, expressed, defined, and addressed. More serious consideration of gender-related factors will help identify risk factors for both women and men.

METHODS

The authors, who come from a number of disciplines (ergonomics, epidemiology, public health, social medicine, community psychology, economics, sociology) pooled their critiques in order to arrive at the most common and significant problems faced by occupational health researchers who wish to consider gender appropriately.

RESULTS

This paper describes some ways that gender can be and has been handled in studies of occupational health, as well as some of the consequences. The paper also suggests specific research practices that avoid errors. Obstacles to gender-sensitive practices are considered.

CONCLUSIONS

Although gender-sensitive practices may be difficult to operationalize in some cases, they enrich the scientific quality of research and should lead to better data and ultimately to well-targeted prevention programs.

Creating safer and healthier workplaces: role of organizational factors and job characteristics

BACKGROUND

A comprehensive understanding of workplace organizational risk factors for illness and injury and interventions to alleviate these factors is important for workplace prevention efforts.

METHODS

We summarize the evidence for the role of workplace organizational factors and work factors in occupational health and safety (OHS). To the extent possible, we concentrate on factors at the level of the workplace, rather than the level of the individual.

RESULTS

Three types of outcomes are considered: injuries, ill-health, and musculoskeletal problems; and we note the evidence for their relationship to work. We review workplace interventions intended to alleviate each type of outcome and note methodological limitations of previous research.

CONCLUSIONS

Despite the methodological limitations, the balance of the literature supports the work-relatedness of the three types of outcomes, although questions remain about exact mechanisms and the effectiveness of specific interventions. We discuss barriers to and incentives for creating safer and healthier workplaces.

Marriage and health: his and hers

This review focuses on the pathway leading from the marital relationship to physical health. Evidence from 64 articles published in the past decade, particularly marital interaction studies, suggests that marital functioning is consequential for health; negative dimensions of marital functioning have indirect influences on health outcomes through depression and health habits, and direct influences on cardiovascular, endocrine, immune, neurosensory, and other physiological mechanisms. Moreover, individual difference variables such as trait hostility augment the impact of marital processes on biological systems. Emerging themes in the past decade include the importance of differentiating positive and negative dimensions of marital functioning, the explanatory power of behavioral data, and gender differences in the pathways from the marital relationship to physiological functioning. Contemporary models of gender that emphasize self-processes, traits, and roles furnish alternative perspectives on the differential costs and benefits of marriage for men's and women's health.

Job control, perceptions of control, and cardiovascular activity: an analysis of ambulatory measures collected over the working day

OBJECTIVE

To assess the influence of job control as a personal characteristic, and momentary perceptions of lack of control, on blood pressure and heart rate monitored over the working day.

METHODS

The study was carried out with a sample of 122 school teachers (45 men, 77 women), divided into high and low job control groups on a standard questionnaire. Blood pressure and heart rate were measured every 20 min using ambulatory techniques, and ratings of concurrent perceived control were also obtained. Energy expenditure was assessed using accelerometers. Cardiovascular measures associated with low perceived control were averaged for each individual, as were readings associated with high perceived control.

RESULTS

Low perceived control ratings were infrequent overall. However, in the participants who reported episodes of both high and low perceived control, systolic and diastolic blood pressure and heart rate were significantly greater during episodes of low control. These effects were independent of concurrent energy expenditure, gender, and time of day. High and low job control groups did not differ in cardiovascular responses to episodes of low perceived control. But low job control was associated with more frequent episodes of low perceived control and fewer periods of high perceived control.

CONCLUSION

The results suggest that laboratory observations concerning the impact of lack of control on cardiovascular activity are corroborated by naturalistic measures in everyday life. Differences in exposure to periods of low perceived control rather than differences in reactivity to uncontrollable situations may contribute to the elevation in cardiovascular risk associated with low job control.

Persistent high job demands and reactivity to mental stress predict future ambulatory blood pressure

OBJECTIVE

To test the hypothesis that work stress (persistent high job demands over 1 year) in combination with high reactivity to mental stress predict ambulatory blood pressure.

DESIGN

Assessment of cardiovascular responses to standardized behavioural tasks, job demands, and ambulatory blood pressure over a working day and evening after 12 months.

PARTICIPANTS

We studied 81 school teachers (26 men, 55 women), 36 of whom experienced persistent high job demands over 1 year, while 45 reported lower job demands.

METHODS

Participants were divided on the basis of high and low job demands, and high and low systolic pressure reactions to an uncontrollable stress task. Blood pressure and concurrent physical activity were monitored using ambulatory apparatus from 0900 to 2230 h on a working day.

RESULTS

Cardiovascular stress reactivity was associated with waist/hip ratio. Systolic and diastolic pressure during the working day were greater in high job demand participants who were stress reactive than in other groups, after adjustment for age, baseline blood pressure, body mass index and negative affectivity. The difference was not accounted for by variations in physical activity.

CONCLUSIONS

Cardiovascular stress reactivity and sustained psychosocial stress may act in concert to increase cardiovascular risk in susceptible individuals.

Do the daily experiences of healthy men and women vary according to occupational prestige and work strain?

OBJECTIVE

This study evaluated the influence of occupational prestige and work strain on mood, the occurrence of interpersonal conflict, and ambulatory blood pressure and heart rate.

METHODS

Participants were 50 men and 50 women matched for occupational prestige who were healthy and middle-aged and who completed measures of mood and conflict simultaneously with measures of ambulatory blood pressure and heart rate recorded every 30 minutes during waking hours of two workdays and one nonworkday; at the end of each day, overall ratings were made. Work strain was assessed by the Work Section of the Self-Evaluation and Social Support Interview Schedule. Multiple level random regression coefficients analyses were conducted.

RESULTS

Men and women with low-prestige occupations experienced more interpersonal conflict, b = -0.03, p = .04, and higher ambulatory heart rate, b = -4.83, p = .004, throughout the three days of the study. Relative to those with low work strain, those reporting high work strain experienced negative emotion, b = -0.41, p < .0001, and boredom, b = -0.17, p < .0004. End of the day ratings of negative mood were more influenced by work strain among men than among women. No effects of occupational prestige or work strain were obtained for ambulatory blood pressure readings after adjustment for physical activity, posture, and location.

CONCLUSIONS

Individuals in low-prestige occupations experience greater exposure to interpersonal conflict and arousal as indexed by heart rate, which might increase risk for stress-related illnesses often associated with social class. Individuals who report work strain experience negative mood and boredom, both at work and at home. The absence of work effects on ambulatory blood pressure may be due to the participants being healthy.

Job strain and anger expression predict early morning elevations in salivary cortisol

OBJECTIVE

The objectives of this study were to test the hypothesis that high job demands and low job control (job strain) are associated with elevated free cortisol levels early in the working day and with reduced variability across the day and to evaluate the contribution of anger expression to this pattern.

METHODS

One hundred five school teachers (41 men and 64 women) classified 12 months earlier as high (N = 48) or low (N = 57) in job strain according to the demand/control model sampled saliva at 2-hour intervals from 8:00 to 8:30 hours to 22:00 to 22:30 hours on a working day. Anger expression was assessed with the Speilberger State-Trait Anger Expression Inventory, and negative affect was also measured.

RESULTS

Free cortisol was significantly elevated at 8:00 to 8:30 hours in the high job strain group but not at later times of the day or evening. After adjustment for age and negative affect, cortisol was an average of 21.7% higher early in the working day in the high job strain group. This effect was significantly greater in high job strain teachers, who also reported high anger-out. The cortisol decline from morning to evening was greater in the high than low job strain individuals. Independently of job strain, women had a higher cortisol concentration at 8:00 to 8:30 hours than men, whereas cortisol concentration was greater in men than women in the middle of the working day between 12:00 and 16:30 hours.

CONCLUSIONS

Job strain is associated with elevated free cortisol concentrations early in the working day but not with reduced cortisol variability. The interaction with outward anger expression suggests that individual characteristics modulate the impact of chronic work stress on the hypothalamic-pituitary-adrenocortical system.