216630 Associations of occupation, job control, and job demands with intima-media thickness: The Multi-Ethnic Study of Atherosclerosis (MESA)

Monday, November 8, 2010 : 12:30 PM - 12:45 PM

Kaori Fujishiro, PhD , Division of Surveillance, Hazard Evaluation, and Field Studies, National Institute for Occupational Safety and Health, Cincinnati, OH
Ana V. Diez Roux, MD, PhD , Department of Epidemiology, Center for Integrative Approaches to Health Disparities, University of Michigan, Ann Arbor, MI
Paul Landsbergis, PhD , School of Public Health, SUNY-Downstate Medical Center, Brooklyn, NY
Sherry L. Baron, MD MPH , Coordinator Occupational Health Disparities, National Institutes for Occupational Safety and Health, CDC, Cincinnati, OH
R. Graham Barr, MD, DrPH , Department of Medicine, Columbia University, New York, NY
Joel D. Kaufman, MD, MPH , Occupational and Environmental Medicine, University of Washington, Seattle, WA
Joseph F. Polak, MD , Radiology, Tufts Medical Center, Boston, MA
Karen Hinckley-Stukovsky, MS , Collaborative Health Studies Coordinating Center, University of Washington, Seattle, WA
     
Occupation has been linked to cardiovascular disease (CVD) incidence and mortality, but few studies have investigated occupation in relation to early atherosclerotic disease. This study examined associations between various occupational characteristics and carotid artery intima-media thickness (IMT) in a multi-ethnic sample. The Multi-Ethnic Study of Atherosclerosis (MESA) recruited 6814 adults 45 - 84 years of age, free of clinical CVD. Questionnaire data were used to determine occupational group (managerial/professional, sales/office, service, blue-collar jobs), psychosocial job characteristics (i.e., job demands, job control), and other sociodemographic information. Common carotid artery (CCA) IMT was greater for blue-collar jobs than for management/professional jobs (mean difference =0. 012 mm, p=0.049) after adjustment for age, sex, race, place of birth (U.S.- or foreign-born), and CVD risk factors. Compared to management/professional jobs, internal carotid artery (ICA) IMT was greater for sales/office, service, and blue-collar jobs (mean difference =0.071 mm, p<0.001; 0.057 mm, p=0.009; and 0.110 mm, p<0.001, respectively) after adjustment for age, sex, race, and place of birth. The difference between blue-collar jobs and management/professional remained significant after additional adjustment for CVD risk factors, income and education (mean difference =0.048 mm, p=0.045). Higher levels of control at work were associated with thinner CCA IMT (mean difference =-0.009 mm, p=0.016, adjusted for age, sex, race, and place of birth) but not with ICA IMT. Job demands had no significant association with IMT. Occupation, especially blue-collar jobs, and low levels of job control were associated with subclinical atherosclerosis.

Learning Areas:
Chronic disease management and prevention
Epidemiology
Occupational health and safety
Social and behavioral sciences

Learning Objectives:
1. Explain the importance of examining subclinical cardiovascular disease. 2. Differentiate the role of occupation as an indicator of socioeconomic status and as a proxy for occupational exposure. 3. Identify gaps in current research on occupation and CVD from the occupational health disparity perspective.

Keywords: Stress, Social Class

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I conduct occupational health research projects focusing on health disparities, chronic disease, stress, and work organization.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 3232.0: Updates in Occupational Epidemiology