Marital status and cardiovascular risk in French and Swedish automotive industry workers--cross sectional results from the Renault-Volvo Coeur study

The emotional heart: prospective associations of anger, depression, and anxiety as risk factors for myocardial infarction in a 22-year follow-up of a working cohort of middle-aged men

Aim

The study aim was to further clarify the relationship between psychological factors and myocardial infarction (MI) by simultaneously examining anger, depression, and anxiety as risk factors for incident MI in a healthy working sample.

Subject and method

Baseline measurements of psychological variables were assessed through a self-reported questionnaire in a healthy cohort of 968 middle-aged men working at the Volvo Corporation. Single-item questions assessed depression and anxiety. Anger was assessed by the Trait Anger subscale of the Spielberger State-Trait Anger Expression Inventory. The endpoint was incident MI verified by national registers or medical records with follow up after 22 years. The main outcome was computed through logistic regression, reported as odds ratios. Additional correlation analyses were performed between psychological variables and coronary risk factors.

Results

None of the psychological variables was significantly associated with the outcome; thus, the results failed to show an association between anger, depression, or anxiety and incident MI in this sample. There were some significant, but weak, correlations between psychological factors and negative health behaviors. Other components of traditional risk scoring instruments did not correlate with the psychological factors.

Conclusion

A cohort restricted to middle-age healthy men limits applicability. However, our failure to replicate earlier results of population samples suggests a need for further research on associations between psychological factors and MI in healthy samples.

Prospective associations between ECG abnormalities and death or myocardial infarction in a cohort of 980 employed, middle-aged Swedish men

Background

In 1993, 1000 randomly selected employed Swedish men aged 45–50 years were invited to a nurse-led health examination with a survey on life style, fasting lab tests, and a 12-lead ECG. A repeat examination was offered in 1998. The ECGs were classified according to the Minnesota Code. Upon ethical approval, endpoints in terms of MI and death over 25 years were collected from Swedish national registers with the purpose of analyzing the independent association of ECG abnormalities as risk factors for myocardial infarction and death.

Results

Seventy-nine of 977 participants had at least one ECG abnormality 1993 or 1998.

One hundred participants had a first MI over the 25 years. Odds ratio for having an MI in the group that had one or more ECG abnormality compared with the group with two normal ECGs was estimated to 3.16. 95%CI (1.74; 5.73), p value 0.0001.

One hundred fifty-seven participants had died before 2019. For death, similarly no statistically significant difference was shown, OR 1.52, 95%CI (0.83; 2.76).

Conclusions

Our study suggests that presence of ST- and R-wave changes is associated with an independent 3–4-fold increased risk of MI after 25 years follow-up, but not of death. A 12-lead resting ECG should be included in any MI risk calculation on an individual level.

Supplementary Information

The online version contains supplementary material available at 10.1186/s43044-020-00114-9.

Myocardial infarction and death findings from a 22-year follow-up of a cohort of 980 employed Swedish men

OBJECTIVES

In this article, we present death and myocardial infarction (MI) incidences over 22 years in relation to possible risk factors and their explanatory value.

STUDY DESIGN

In 1993, 980 middle-aged Swedish men in an automotive industry were surveyed at a health checkup as part of the Renault-Volvo Coeur project. The Swedish cohort was revisited in 2015.

METHODS

In 2015, incident MIs were identified using postal questionnaires, hospital records, and the Swedish national MI and death registers. The statistical results were given as odds ratios (ORs) and pseudo-R² (PR²), showing the proportion of variation in risk explained by logistic models.

RESULTS

One hundred and four deaths (4.6 per 1000 person-years) and 89 first MIs (4.2 per 1000 person-years) were identified. The Framingham risk index showed the strongest association with MI (OR = 23; 95% confidence interval [CI] = 5.42, 96.9), comparing the fifth quintile with the first. The all-cause death showed an OR of 3.2 (95% CI = 1.65, 6.08), with a suggested U-shape over quintiles. The percentages of PR² for MI and death were 8.8% and 6.6%, respectively. All risk factors together explained 22% of the variation in risk of MI. Comparing mortality in men living alone with those married yielded an OR of 3.78, which was found to be statistically significant. The corresponding OR for MI was not significant.

CONCLUSIONS

Traditional risk factors were confirmed but explained a modest proportion of the risk variation.

Health promotion across occupational groups: one size does not fit all

BACKGROUND

Although several studies have examined the link between specific working conditions and health behaviours, very few have comparatively assessed the health behaviours of different occupational groups.

AIMS

To compare protective and risky health behaviours among police officers, ambulance workers, hospital staff (doctors and nurses) and office workers, prompted by the need to identify key areas for interventions tailored to the needs of different occupational groups.

METHODS

A cross-sectional postal survey using the Health Behaviours Inventory, assessing health behaviours which are risky (alcohol intake, smoking, coffee consumption, fast food meals and painkiller consumption) and protective (physical activity, eating breakfast and hours of sleep).

RESULTS

The sample consisted of 1451 employees. Ambulance workers smoked the most cigarettes per day (F (4, 1405) = 8.63, P < 0.01), while doctors consumed twice as many fast food meals as any other occupational group (F (4, 1415) = 78.45, P < 0.01) and had the highest daily caffeine consumption (F (4, 1440) = 11.17, P < 0.01). Ambulance workers and doctors reported the highest frequency of alcohol consumption per week (F (4, 1421) = 10.13, P < 0.01). In regard to protective health behaviours, office workers reported the highest number of breakfast meals per week (F (4, 1431) = 5.7, P < 0.01) and sleeping hours per night (F (4, 1438) = 170.34, P < 0.01), while police officers and ambulance workers exercised more frequently (F (4, 1420) = 5.764, P < 0.01).

CONCLUSIONS

The results of the study highlight key priorities for health promotion for different occupational groups which need to be taken into consideration in policy making and developing workplace interventions.

Effects of short duration stress management training on self-perceived depression, anxiety and stress in male automotive assembly workers: a quasi-experimental study

To examine the effects of short duration stress management training (SMT) on self-perceived depression, anxiety and stress in male automotive assembly workers, 118 male automotive workers from Pekan, Pahang (n = 60, mean age = 40.0 years, SD = 6.67) and Kota Bharu, Kelantan (n = 58, mean age = 38.1 years, SD = 5.86) were assigned to experimental and control group, respectively. A SMT program consisting of aerobic exercise, stress management manual, video session, lecture, question and answer session, and pamphlet and poster session were conducted in the experimental group. A validated short-form Malay version of the Depression Anxiety Stress Scales (DASS-21) were self-administered before and after the intervention program in the experimental and control group and their time and group interaction effects were examined using the repeated measure ANOVA test. Results indicated that the mean (SD) scores for DASS-Depression (p = 0.036) and DASS-Anxiety (p = 0.011) were significantly decreased, respectively, after the intervention program in the experimental group as compared to the control group (significant time-group interaction effects). No similar effect was observed for the mean (SD) scores for DASS-Stress (p = 0.104). However, the mean (SD) scores for subscales of DASS-Depression (Dysphoria, p = 0.01), DASS-Anxiety (Subjective Anxiety, p = 0.007, Situational Anxiety, p = 0.048), and DASS-Stress (Nervous Arousal, p = 0.018, Easily Upset, p = 0.047) showed significant time and group interaction effects. These findings suggest that short duration SMT is effective in reducing some aspects of self-perceived depression, anxiety and stress in male automotive workers.

Self-perceived depression, anxiety, stress and their relationships with psychosocial job factors in male automotive assembly workers

Depression, anxiety and stress have been recognized as important mental outcome measures in stressful working settings. The present study explores the prevalence of self-perceived depression, anxiety and stress; and their relationships with psychosocial job factors. A cross-sectional study involving 728 male automotive assembly workers was conducted in two major automotive assembly plants in Malaysia using the validated Malay versions of the Depression Anxiety Stress Scales (DASS) and Job Content Questionnaire (JCQ). Based on the DASS cut-off of > or =78 percentile scores, the prevalence of self-perceived depression, anxiety and stress was 35.4%, 47.2% and 31.1%, respectively. Four (0.5%), 29 (4.0%) and 2 (0.3%) workers, respectively, reported extremely severe self-perceived depression, anxiety and stress. Multiple linear regression analyses, controlling for age, education, salary, duration of work and marital status, revealed that psychological job demand, job insecurity and hazardous condition were positively associated with DASS-Depression, DASS-Anxiety and DASS-Stress; supervisor support was inversely associated with DASS-Depression and DASS-Stress. We suggest that reducing psychological job demand, job insecurity and hazardous condition factors may improve the self-perceived depression, anxiety and stress in male automotive assembly workers. Supervisor support is protective for self-perceived depression and stress.

Marital status and smoking in Korea: the influence of gender and age

Few studies have examined the influence of marriage on health-related behavior in Asian populations. The present study examined the effect of marital status on smoking in Korea. Data from two rounds of a nationally representative survey (1999 and 2003) were analyzed (57,246 women and 52,769 men). Marital status-specific prevalence ratios for smoking were estimated using log binomial regression after adjusting for age, survey year, occupation and education level. Smoking prevalence declined with age for men, but rose for women. Smoking rates were higher for unmarried men and women compared to their married counterparts. However, the gap in smoking rates between unmarried and married women (especially younger women <45 years) was much greater than the gap between unmarried and married men. The study found that marital status had a stronger protective influence on smoking in women than men, which contrasts with the gender pattern reported previously in western studies. The findings suggest the influence of a culture which discourages married women from smoking, and "liberates" divorced women from cultural sanctions against smoking in marriage.

Relationship of psychosocial work factors and health-related quality of life in male automotive assembly workers in Malaysia

The present study investigates the relationship between psychosocial work factors and health-related quality of life (HRQOL) in male automotive assembly plant workers in Malaysia.

MATERIALS AND METHODS

A total of 728 male workers were recruited in March-July 2005 from 2 major automotive assembly plants in Selangor and Pahang. In this cross-sectional study, information on socio-demography, psychosocial work factors using the 97-item Job Content Questionnaire (JCQ) and an abbreviated 26-item version of the World Health Organization Quality of Life-Brief Version (WHOQOL-BREF) questionnaire containing 4 domains (physical health, psychological, social relationship, and environment) was self-administered to all workers involved.

RESULTS AND CONCLUSION

The prevalence of reported good or very good overall HRQOL and general health was 64.9% and 53.7%, respectively. Multiple linear regression analysis indicated that created skill was positively associated with physical health and psychological domains; whilst, skill discretion was positively associated with social relationship and environment domains. Social support was positively associated with physical health and environment domains; whilst, co-worker support was positively associated with psychological and social relationship domains. Job insecurity and hazardous condition were negatively associated with all domains, whilst psychological job demands was negatively associated with the environment domain of HRQOL.

Official marital status, cohabiting, and self-rated health—time trends in Finland, 1978–2001

BACKGROUND

Married persons are healthier and live longer than single, divorced, and widowed persons. Time trends in self-rated health (SRH) by marital status and cohabitation have remained largely unstudied. We aim to assess the levels and trends of SRH by official marital status and cohabitation, and to study the causes of these differences.

METHODS

Two nationally representative cross-sectional surveys were conducted 20 years apart in Finland. Data on self-reported marital status, SRH, education, smoking, and long-standing illness were collected from Finns aged 30-64 years in 1978-80 (Mini-Finland Health Survey, N = 6102, response rate 96%) and 2000-01 (Health 2000 Survey, N = 5871, response rate 92%).

RESULTS

SRH has improved in the last 20 years, but differences between marital status groups have not reduced. In 2000-01, non-married persons reported worse SRH than married persons. Among men, single [cumulative odds ratio (COR) = 1.55; 95% confidence interval (95% CI) 1.22-1.99] and divorced (COR = 1.55; 95% CI 1.17-2.05) persons showed the poorest SRH, while among women widows (1.53; 95% CI 1.04-2.26) were the most disadvantaged group. The SRH of cohabiting persons did not significantly differ from that of married persons. Differences in educational structure, smoking, and the prevalence of long-term illness explain part of the marital status differences in SRH among men, but less so among women. Among both single men and women as well as among widowed women, SRH had improved slightly less than in the other groups.

CONCLUSION

The challenges on public health posed by growing numbers of currently not married people are likely to increase.