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Associations of Work Hours, Job Strain, and Occupation With Endothelial Function: The Multi-Ethnic Study of Atherosclerosis (MESA)

Charles, Luenda E. PhD, MPH; Fekedulegn, Desta PhD; Landsbergis, Paul PhD, MPH; Burchfiel, Cecil M. PhD, MPH; Baron, Sherry MD; Kaufman, Joel D. MD, MPH; Stukovsky, Karen Hinckley MS; Fujishiro, Kaori PhD; Foy, Capri G. PhD; Andrew, Michael E. PhD; Diez Roux, Ana V. MD, PhD

Journal of Occupational and Environmental Medicine: November 2014 - Volume 56 - Issue 11 - p 1153–1160
doi: 10.1097/JOM.0000000000000311
Original Articles

Objective: To investigate associations of work hours, job control, job demands, job strain, and occupational category with brachial artery flow-mediated dilation (FMD) in 1499 Multi-Ethnic Study of Atherosclerosis participants.

Methods: Flow-mediated dilation was obtained using high-resolution ultrasound. Mean values of FMD were examined across categories of occupation, work hours, and the other exposures using regression analyses.

Results: Occupational category was significantly associated with FMD overall, with blue-collar workers showing the lowest mean values—management/professional = 4.97 ± 0.22%; sales/office = 5.19 ± 0.28%; services = 4.73 ± 0.29%; and blue-collar workers = 4.01 ± 0.26% (adjusted P < 0.001). There was evidence of effect modification by sex (interaction P = 0.031)—significant associations were observed among women (adjusted P = 0.002) and nearly significant results among men (adjusted P = 0.087). Other exposures were not significantly associated with FMD.

Conclusions: Differences in endothelial function may account for some of the variation in cardiovascular disease across occupational groups.

From the Biostatistics and Epidemiology Branch (Drs Charles, Fekedulegn, Burchfiel, and Andrew), Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV; Department of Environmental and Occupational Health Sciences (Dr Landsbergis), State University of New York Downstate Medical Center, NY, and State University of New York Downstate School of Public Health, Brooklyn, NY; Division of Surveillance, Hazard Evaluation, and Field Studies (Drs Baron and Fujishiro), National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, OH; Department of Environmental and Occupational Health Sciences (Dr Kaufman), School of Public Health, University of Washington, Seattle, WA; Department of Biostatistics (Ms Stukovsky), School of Public Health, University of Washington, Seattle, WA; Department of Social Sciences and Health Policy (Dr Foy), Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC; and School of Public Health (Dr Diez Roux), Drexel University, Philadelphia, PA. Research was conducted at the Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan.

Address correspondence to: Luenda E. Charles, PhD, MPH, Biostatistics and Epidemiology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, HELD/BEB, MS L-4050, 1095 Willowdale Rd, Morgantown, WV 26505 (lcharles@cdc.gov).

Funding: MESA is supported by contracts N01-HC-95159 through N01-HC-95169 from the National Heart, Lung, and Blood Institute. Occupational coding was supported by the National Institute for Occupational Safety and Health (NORA FY08 CRN SLB8).

None of the authors have conflicts of interests.

NIOSH disclaimer: The findings and conclusions in this article are those of the authors and do not necessarily represent the views of the National Institute for Occupational Safety and Health.

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Copyright © 2014 by the American College of Occupational and Environmental Medicine