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Work Stress and the Long QT Syndrome: High Job Strain and Effort–Reward Imbalance at Work Associated With Arrhythmic Risk in the Long QT Syndrome

Hintsa, Taina PhD; Määttänen, I. MSc; Hintsanen, M. PhD; Swan, H. PhD; Toivonen, L.; Kontula, K.; Keltikangas-Järvinen, L.

Journal of Occupational and Environmental Medicine: December 2013 - Volume 55 - Issue 12 - p 1387–1393
doi: 10.1097/JOM.0000000000000026
Original Articles

Objectives: To examine whether work stress is associated with a symptomatic status of the long QT syndrome (LQTS).

Methods: The sample comprised 173 KCNQ1, KCNH2, or SCN5A gene mutation carriers (70 symptomatic) and control groups of 203 relatives without the family mutation, and of 1209 population-based young Finns control subjects. Work stress was assessed using the Job Content Questionnaire and Occupational Stress Questionnaire.

Results: We found an association between the occurrence of symptoms in the LQTS and high work stress, higher job demands/effort, lower job control, and lower rewards compared with control subjects. We also found that symptomatic LQTS mutation carriers had higher work stress than asymptomatic LQTS mutation carriers.

Conclusions: Higher work stress is related to arrhythmic risk in the LQTS. It may be useful to incorporate assessment of work conditions and stress interventions into management of high-risk patients.

From the Institute of Behavioural Sciences (Dr Hintsa and Mr Määttänen, Mr Hintsanen, and Ms Keltikangas-Järvinen), Helsinki Collegium for Advanced Studies (Ms Hintsanen), Department of Cardiology, Helsinki University Central Hospital (Mr Swan and Ms Toivonen), and Department of Medicine (Mr Kontula), University of Helsinki, Helsinki, Finland.

Address correspondence to: Taina Hintsa, PhD, Institute of Behavioural Sciences, University of Helsinki, PO Box 9, University of Helsinki, FIN-00014 Helsinki, Finland (

The study was supported by grants from the Academy of Finland, project 132729, and Ella and Georg Ehrnrooth Foundation (TH); Finnish Foundation for Cardiovascular Research (HS and KK); and the Sigrid Juselius Foundation (KK).

Authors Hintsa, Määttänen, Hintsanen, Swan, Toivonen, Kontula, and Keltikangas-Järviven have no relationships/conditions/circumstances that present potential conflict of interest.

The JOEM editorial board and planners have no financial interest related to this research.

Copyright © 2013 by the American College of Occupational and Environmental Medicine