Workplace bullying and workplace violence as risk factors for cardiovascular disease: a multi-cohort study

To assess the associations between bullying and violence at work and cardiovascular disease (CVD). Participants were 79 201 working men and women, aged 18-65 years and free of CVD and were sourced from three cohort studies from Sweden and Denmark. Exposure to workplace bullying and violence was meas...

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Veröffentlicht in:	European heart journal Jg. 40; H. 14; S. 1124
Hauptverfasser:	Xu, Tianwei, Magnusson Hanson, Linda L, Lange, Theis, Starkopf, Liis, Westerlund, Hugo, Madsen, Ida E H, Rugulies, Reiner, Pentti, Jaana, Stenholm, Sari, Vahtera, Jussi, Hansen, Åse M, Virtanen, Marianna, Kivimäki, Mika, Rod, Naja H
Format:	Journal Article
Sprache:	Englisch
Veröffentlicht:	England 07.04.2019
Schlagworte:	Adult Bullying Cardiovascular Diseases - epidemiology Cohort Studies Denmark - epidemiology Female Follow-Up Studies Humans Male Middle Aged Registries Risk Factors Sweden - epidemiology Workplace Violence - statistics & numerical data Denmark Sweden Bullying Cardiovascular disease Occupational health Workplace Violence Psychosocial stress
ISSN:	1522-9645, 1522-9645
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Abstract	To assess the associations between bullying and violence at work and cardiovascular disease (CVD). Participants were 79 201 working men and women, aged 18-65 years and free of CVD and were sourced from three cohort studies from Sweden and Denmark. Exposure to workplace bullying and violence was measured at baseline using self-reports. Participants were linked to nationwide health and death registers to ascertain incident CVD, including coronary heart disease and cerebrovascular disease. Study-specific results were estimated by marginal structural Cox regression and were combined using fixed-effect meta-analysis. Nine percent reported being bullied at work and 13% recorded exposure to workplace violence during the past year. We recorded 3229 incident CVD cases with a mean follow-up of 12.4 years (765 in the first 4 years). After adjustment for age, sex, country of birth, marital status, and educational level, being bullied at work vs. not was associated with a hazard ratio (HR) of 1.59 [95% confidence interval (CI) 1.28-1.98] for CVD. Experiencing workplace violence vs. not was associated with a HR of 1.25 (95% CI 1.12-1.40) for CVD. The population attributable risk was 5.0% for workplace bullying and 3.1% for workplace violence. The excess risk remained similar in analyses with different follow-up lengths, cardiovascular risk stratifications, and after additional adjustments. Dose-response relations were observed for both workplace bullying and violence (Ptrend < 0.001). There was only negligible heterogeneity in study-specific estimates. Bullying and violence are common at workplaces and those exposed to these stressors are at higher risk of CVD.
AbstractList	To assess the associations between bullying and violence at work and cardiovascular disease (CVD).AIMSTo assess the associations between bullying and violence at work and cardiovascular disease (CVD).Participants were 79 201 working men and women, aged 18-65 years and free of CVD and were sourced from three cohort studies from Sweden and Denmark. Exposure to workplace bullying and violence was measured at baseline using self-reports. Participants were linked to nationwide health and death registers to ascertain incident CVD, including coronary heart disease and cerebrovascular disease. Study-specific results were estimated by marginal structural Cox regression and were combined using fixed-effect meta-analysis. Nine percent reported being bullied at work and 13% recorded exposure to workplace violence during the past year. We recorded 3229 incident CVD cases with a mean follow-up of 12.4 years (765 in the first 4 years). After adjustment for age, sex, country of birth, marital status, and educational level, being bullied at work vs. not was associated with a hazard ratio (HR) of 1.59 [95% confidence interval (CI) 1.28-1.98] for CVD. Experiencing workplace violence vs. not was associated with a HR of 1.25 (95% CI 1.12-1.40) for CVD. The population attributable risk was 5.0% for workplace bullying and 3.1% for workplace violence. The excess risk remained similar in analyses with different follow-up lengths, cardiovascular risk stratifications, and after additional adjustments. Dose-response relations were observed for both workplace bullying and violence (Ptrend < 0.001). There was only negligible heterogeneity in study-specific estimates.METHODS AND RESULTSParticipants were 79 201 working men and women, aged 18-65 years and free of CVD and were sourced from three cohort studies from Sweden and Denmark. Exposure to workplace bullying and violence was measured at baseline using self-reports. Participants were linked to nationwide health and death registers to ascertain incident CVD, including coronary heart disease and cerebrovascular disease. Study-specific results were estimated by marginal structural Cox regression and were combined using fixed-effect meta-analysis. Nine percent reported being bullied at work and 13% recorded exposure to workplace violence during the past year. We recorded 3229 incident CVD cases with a mean follow-up of 12.4 years (765 in the first 4 years). After adjustment for age, sex, country of birth, marital status, and educational level, being bullied at work vs. not was associated with a hazard ratio (HR) of 1.59 [95% confidence interval (CI) 1.28-1.98] for CVD. Experiencing workplace violence vs. not was associated with a HR of 1.25 (95% CI 1.12-1.40) for CVD. The population attributable risk was 5.0% for workplace bullying and 3.1% for workplace violence. The excess risk remained similar in analyses with different follow-up lengths, cardiovascular risk stratifications, and after additional adjustments. Dose-response relations were observed for both workplace bullying and violence (Ptrend < 0.001). There was only negligible heterogeneity in study-specific estimates.Bullying and violence are common at workplaces and those exposed to these stressors are at higher risk of CVD.CONCLUSIONBullying and violence are common at workplaces and those exposed to these stressors are at higher risk of CVD. To assess the associations between bullying and violence at work and cardiovascular disease (CVD). Participants were 79 201 working men and women, aged 18-65 years and free of CVD and were sourced from three cohort studies from Sweden and Denmark. Exposure to workplace bullying and violence was measured at baseline using self-reports. Participants were linked to nationwide health and death registers to ascertain incident CVD, including coronary heart disease and cerebrovascular disease. Study-specific results were estimated by marginal structural Cox regression and were combined using fixed-effect meta-analysis. Nine percent reported being bullied at work and 13% recorded exposure to workplace violence during the past year. We recorded 3229 incident CVD cases with a mean follow-up of 12.4 years (765 in the first 4 years). After adjustment for age, sex, country of birth, marital status, and educational level, being bullied at work vs. not was associated with a hazard ratio (HR) of 1.59 [95% confidence interval (CI) 1.28-1.98] for CVD. Experiencing workplace violence vs. not was associated with a HR of 1.25 (95% CI 1.12-1.40) for CVD. The population attributable risk was 5.0% for workplace bullying and 3.1% for workplace violence. The excess risk remained similar in analyses with different follow-up lengths, cardiovascular risk stratifications, and after additional adjustments. Dose-response relations were observed for both workplace bullying and violence (Ptrend < 0.001). There was only negligible heterogeneity in study-specific estimates. Bullying and violence are common at workplaces and those exposed to these stressors are at higher risk of CVD.
Author	Lange, Theis Hansen, Åse M Stenholm, Sari Vahtera, Jussi Magnusson Hanson, Linda L Kivimäki, Mika Pentti, Jaana Virtanen, Marianna Rugulies, Reiner Starkopf, Liis Xu, Tianwei Madsen, Ida E H Westerlund, Hugo Rod, Naja H
Author_xml	– sequence: 1 givenname: Tianwei surname: Xu fullname: Xu, Tianwei organization: National Research Centre for the Working Environment, Lersø Parkallé 105, DK-2100 Copenhagen, Denmark – sequence: 2 givenname: Linda L surname: Magnusson Hanson fullname: Magnusson Hanson, Linda L organization: Division for Epidemiology, Stress Research Institute, Stockholm University, SE-10691, Stockholm, Sweden – sequence: 3 givenname: Theis surname: Lange fullname: Lange, Theis organization: Centre for Statistical Science, Peking University, No. 5 Yiheyuan Road, Beijing CN-100871, China – sequence: 4 givenname: Liis surname: Starkopf fullname: Starkopf, Liis organization: Section of Biostatistics, Department of Public Health, University of Copenhagen, Øster Farimagsgade 2A, DK-1353 Copenhagen, Denmark – sequence: 5 givenname: Hugo surname: Westerlund fullname: Westerlund, Hugo organization: Division for Epidemiology, Stress Research Institute, Stockholm University, SE-10691, Stockholm, Sweden – sequence: 6 givenname: Ida E H surname: Madsen fullname: Madsen, Ida E H organization: National Research Centre for the Working Environment, Lersø Parkallé 105, DK-2100 Copenhagen, Denmark – sequence: 7 givenname: Reiner surname: Rugulies fullname: Rugulies, Reiner organization: Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, DK-1353 Copenhagen, Denmark – sequence: 8 givenname: Jaana surname: Pentti fullname: Pentti, Jaana organization: Department of Public Health, University of Turku and Turku University Hospital, FI-20014 Turku, Finland – sequence: 9 givenname: Sari surname: Stenholm fullname: Stenholm, Sari organization: Department of Public Health, University of Turku and Turku University Hospital, FI-20014 Turku, Finland – sequence: 10 givenname: Jussi surname: Vahtera fullname: Vahtera, Jussi organization: Department of Public Health, University of Turku and Turku University Hospital, FI-20014 Turku, Finland – sequence: 11 givenname: Åse M surname: Hansen fullname: Hansen, Åse M organization: Section of Social Medicine, Department of Public Health, University of Copenhagen, Gothersgade 160, DK-1123 Copenhagen, Denmark – sequence: 12 givenname: Marianna surname: Virtanen fullname: Virtanen, Marianna organization: Department of Public Health and Caring Sciences, University of Uppsala, Husargatan 3, Uppsala, Sweden – sequence: 13 givenname: Mika surname: Kivimäki fullname: Kivimäki, Mika organization: Clinicum, Faculty of Medicine, PO Box 63, FI-00014 University of Helsinki, Helsinki, Finland – sequence: 14 givenname: Naja H surname: Rod fullname: Rod, Naja H organization: Division for Epidemiology, Stress Research Institute, Stockholm University, SE-10691, Stockholm, Sweden
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Keywords	Bullying Cardiovascular disease Occupational health Workplace Violence Psychosocial stress
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References	33069312 - Lancet Psychiatry. 2020 Nov;7(11):937. doi: 10.1016/S2215-0366(20)30439-9. 30452605 - Eur Heart J. 2019 Apr 7;40(14):1135-1137. doi: 10.1093/eurheartj/ehy728.
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Snippet	To assess the associations between bullying and violence at work and cardiovascular disease (CVD). Participants were 79 201 working men and women, aged 18-65... To assess the associations between bullying and violence at work and cardiovascular disease (CVD).AIMSTo assess the associations between bullying and violence...
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SubjectTerms	Adult Bullying Cardiovascular Diseases - epidemiology Cohort Studies Denmark - epidemiology Female Follow-Up Studies Humans Male Middle Aged Registries Risk Factors Sweden - epidemiology Workplace Violence - statistics & numerical data
Title	Workplace bullying and workplace violence as risk factors for cardiovascular disease: a multi-cohort study
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