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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Published in:European heart journal Vol. 40; no. 14; p. 1124
Main Authors: 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
Language:English
Published: England 07.04.2019
Subjects:
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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Summary: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.
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ISSN:1522-9645
1522-9645
DOI:10.1093/eurheartj/ehy683