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Psychosocial and organizational work factors and incidence of arterial hypertension among female healthcare workers: results of the Organisation des Soins et Santé des Soignants cohort

Lamy, Sébastiena,b; De Gaudemaris, Régisc,d; Lepage, Benoita,b; Sobaszek, Anniee,f; Caroly, Sandrineg,h; Kelly-Irving, Michellea,b; Lang, Thierrya,b

doi: 10.1097/HJH.0000000000000155

Background: Many studies have supported the role of organizational work factors (OWFs) on the risk of cardiovascular diseases (CVDs) and CVD risk factors, including arterial hypertension. However, a little information is available concerning the role of collective stressors deriving from work organization on nurse's risk of hypertension. This study aimed to test the independent longitudinal relationships linking the 2-year incidence of arterial hypertension to collective stressors at the work unit level, among baseline normotensive female hospital registered nurses and nursing assistants, after adjusting for known individual predictors of CVDs and for occupational stress.

Method: Arterial hypertension was defined as the intake of antihypertensive drug or as blood pressure (BP) measures higher than 140 mmHg (SBP) or 90 mmHg (DBP) at both the clinical visit and 1 month later. We analyzed the effect of OWFs at the work unit level, constraints related to the physical work environment and the individual perception of the work environment in 2006 on the risk of arterial hypertension in 2008 among 1882 initially normotensive female healthcare workers followed in the French Organisation des soins et santé des soignants (ORSOSA) cohort.

Results: We showed that OWFs at the work unit level may influence the 2-year risk of arterial hypertension independently of work factors at the worker level, baseline BP, age and BMI. In this study, OWFs affected 2-year risk of arterial hypertension only through direct effects.

Conclusion: Our results pointed out the possibility of a primary prevention of arterial hypertension through interventions based at the work unit level among healthcare workers.

aINSERM, UMR 1027, Maladies Chroniques, Pratiques de Soins et Facteurs Socio-économiques

bUniversité Paul Sabatier, UMR 1027, Toulouse

cCNRS, UMR 5525, Laboratoire TIMC-IMAG, Equipe Environnement et Prédiction de la Santé des Populations

dUniversité Joseph Fourier, UMR 5525, Grenoble

eCHRU Lille, Clinique de Santé Publique, Médecine du Travail et Pathologies Professionnelles

fUniversité Lille 2, Lille

gCNRS, UMR 5194, Laboratoire PACTE (Politiques Publiques, Action Publique, Territoires),

hUniversité Joseph Fourier, UMR 5194, Grenoble, France

Correspondence to Sébastien Lamy, INSERM UMR 1027, Faculté de Médecine, 37 allées Jules Guesde, 31062 Toulouse Cedex, France. Tel: +0033561145635; fax: +0033562264240; e-mail:

Abbreviations: BP, blood pressure; CVDs, cardiovascular diseases; ERI, effort-reward imbalance; NWI-EO, nursing work index-extended organization; OWFs, organizational work factors

Received 16 September, 2013

Revised 28 January, 2014

Accepted 28 January, 2014

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins