Low job control and myocardial infarction risk in the occupational categories of Kaunas men, Lithuania.

STUDY OBJECTIVE: To determine the association between adverse psychosocial characteristics at work and risk of first myocardial infarction in the occupational categories of Kaunas men, Lithuania. DESIGN: The analysis was based upon a case-control study among full time working men in the general population of Kaunas. OUTCOME MEASURE: First non-fatal myocardial infarction diagnosed in 2001-2002. The Swedish version of the demand-control questionnaire was used to examine the effect of job control and demands. SETTING: Kaunas, the second largest city in Lithuania, a former socialist country in a transition market economy. PARTICIPANTS: Cases were 203 men 25-64 years of age with a first non-fatal myocardial infarction and controls were 287 men group randomly selected from the study base. MAIN RESULTS: Low job control had a significant effect on myocardial infarction risk in the general 25-64 year old Kaunas male population (OR = 2.68; 95% CI 1.68 to 4.28) after adjustment for age and socioeconomic status. Low job control was a risk factor in the occupational categories of the increased myocardial infarction risk (1st occupational category--legislators, senior officials and managers and the 8th--plant and machine operators and assemblers; OR = 2.78; 95% CI 1.31 to 5.93 and 2.72; 95% CI 1.56 to 4.89, respectively, after adjustment for age and socioeconomic status). Though the adjusted odds ratio estimates were significantly high for the rest of the occupational categories (2nd--professionals, 3rd--technicians and associate professionals, and 7th--craft and related trades workers). CONCLUSIONS: The association between low job control and first myocardial infarction risk was significant for all occupational categories of Kaunas men.

[The effect of risk factors on development of myocardial infarction among professional drivers in Kaunas]. / Vliianie nekotorykh faktorov riska na vozniknovenie infarkta miokarda u voditelei-professionalov Kaunasa.

We investigated effect of risk factors on elevated first myocardial infarction risk among professional drivers. We carried out case-control study among men aged 25-64 years in Kaunas in 1997-2000. We identified myocardial infarction cases (n=448) from the myocardial infarction hospital register (International Classification of Diseases, 10-th revision, code 121). Controls (n=1777) were selected on the basis of age, gender and city district of residence. We obtained information on sociodemographic, psychosocial and behavioral factors. We used the International Standard Classification of Occupations (ISCO) to code for occupations and conducted logistic regression analysis to evaluate association of risk factors with myocardial infarction in professional drivers. Compared with other occupations being a professional driver was associated with increased risk of first myocardial infarction with odds ratio (OR) adjusted for smoking, hypertension, presence of stress, obesity and educational status 1.42 and 95% confidence intervals (CI) 1.06-1.90. However additional adjustment for exposure to occupational vibration for 20 years or more eliminated effect of this occupation (OR 0.96, 95%CI 0.67-1.37). Among drivers exposure to occupational vibration for > or =20 years was most closely related to myocardial infarction (OR 3.01, 95% CI 1.54-5.89), while hypertension was associated with OR 2.80 (95% CI 1.58-4.96).

Myocardial infarction risk and occupational categories in Kaunas 25-64 year old men.

AIMS: To investigate the risk of a first time myocardial infarction (MI) among different occupational categories in 25-64 year old men in Kaunas, Lithuania, a country in a transition market economy. METHODS: Case-control study among men aged 25-64 who were residents in Kaunas between 1997 and 2000. First time, non-fatal MI cases (n = 448) were identified from the MI hospital register (International Classification of Diseases, 10th revision, code I21). Controls (n = 1777) were selected and matched on age, gender, and city district of residence. Information was obtained on occupation, smoking, hypertension, psychosocial, and behavioural factors. The International Standard Classification of Occupations (ISCO) was used to code for occupational categories. The relation between MI and occupational categories was evaluated by logistic regression analysis, adjusting for a number of selected risk factors. RESULTS: Legislators, senior officials, and managers (1st ISCO category) had a twofold increased risk for MI compared to craft and related trades workers (7th ISCO category) after adjustment for age, district, smoking, hypertension, obesity, stress, education, and employment duration. An increased risk for professionals (2nd ISCO category) and plant and machine operators and assemblers (8th ISCO category) was also observed. Employment duration in the last occupation for 20 years and more almost doubled the risk of MI in the whole population. We also found an increased risk for other traditional IHD risk factors such as smoking and arterial hypertension. CONCLUSIONS: Differences in first time MI risk among occupational categories were found. Legislators, senior officials, and managers (1st ISCO category), professionals (2nd ISCO category), and plant and machine operators and assemblers (8th ISCO category) were at an increased risk. Differences in psychosocial factors in transition market economy countries may contribute to observed results.