Does a stressful psychosocial work environment mediate the effects of shift work on cardiovascular risk factors?
OBJECTIVES: Associations between shift work, chronic psychosocial work stress, and 2 important cardiovascular risk factors, hypertension and atherogenic lipids were studied. The hypothesis was tested that psychosocial work stress, as defined by the model of effort-reward imbalance, mediates the effects of shift work on cardiovascular risk. METHODS: Altogether 2288 male participants aged 30-55 years in the baseline screening of the Swedish WOLF (work organization, lipids, and fibrinogen) study underwent a clinical examination and answered a standardized questionnaire measuring shiftwork schedules, effort-reward imbalance at work, and health-adverse behavior. RESULTS: In addition to the direct effects of shift work on cardiovascular risk, mediating effects of effort-reward imbalance at work were found. The respective odds ratios (OR) ranged from 2.18 to 2.27 for hypertension and from 1.34 to 1.45 for atherogenic lipids. While the effects remained significant after extensive confounder co
