According to a new study, job strain and effort-reward imbalance at work are linked to an increased risk of developing an irregular cardiac rhythm problem.
Work-related stress caused by job strain and an imbalance between efforts applied vs. rewards received may increase the risk of developing atrial fibrillation, according to new research published today in the Journal of the American Heart Association, the organization’s open-access, peer-reviewed publication.
Atrial fibrillation, often known as AFib or AF, is the most prevalent type of arrhythmia—an irregular heart rhythm. It can result in a stroke, heart failure, or other cardiovascular issues. The American Heart Association’s 2024 heart disease and stroke statistics predict that more than 12 million persons in the United States will have AFib by 2030.
Previous studies have connected high workplace stress and effort-reward imbalance at work to an increased risk of coronary heart disease. This study is the first to look at the negative impact of both psychosocial stressors at work on atrial fibrillation, according to the study’s principal author, Xavier Trudel, Ph.D., an occupational and cardiovascular epidemiologist and associate professor at Laval University in Quebec City, Quebec, Canada.
Our study suggests that work-related stressors may be relevant factors to include in preventive strategies. Recognizing and addressing psychosocial stressors at work are required to foster healthy work environments that benefit both individuals and the organizations where they work.
Xavier Trudel
“Our study suggests that work-related stressors may be relevant factors to include in preventive strategies,” Trudel said. “Recognizing and addressing psychosocial stressors at work are required to foster healthy work environments that benefit both individuals and the organizations where they work.”
Trudel and his team investigated the impact of job strain, which refers to a work environment in which employees encounter high job demands, such as a heavy workload and tight deadlines, as well as little control over their work, with minimal say in decision-making and task execution.
Another element considered in the study was the effort-reward mismatch. This happens when people put in a lot of effort at work but believe the rewards they get in return – such as pay, recognition, or job security — are insufficient or unequal to their performance.
Researchers examined medical database records for nearly 6,000 adults in white-collar jobs in Canada, with 18 years of follow-up data. The analysis found that:
- employees who said they experienced high job strain had an 83% higher risk of developing AFib compared to workers unaffected by the stressors;
- those who perceived an effort-reward imbalance had a 44% greater risk, compared to workers who did not report this imbalance; and
- combined perceptions of high job strain and effort-reward imbalance were associated with a 97% increased risk of AFib.
“The effectiveness of workplace interventions to reduce psychosocial stressors that may also reduce the risk of AFib should be investigated in future research efforts,” according to Trudel.
“Our study team previously undertook an organizational intervention targeted to alleviate psychosocial stressors at work, which was found to effectively lower blood pressure levels. Examples of organizational adjustments done during the intervention included slowing down the execution of a significant project to avoid additional workload, establishing flexible work hours, and having meetings between managers and staff to discuss day-to-day issues.”
Limitations of the study include that participants were all white-collar workers encompassing managers, professional and office workers in Canada which means results may not apply to other types of workers or to workers in other countries.
Study details, background or design:
- Researchers collected data through the PROspective Quebec (PROQ) Study on Work and Health, which started in the Quebec region in 1991-1993 and recruited white-collar workers from 19 public and semi-public organizations.
- A total of 5,926 workers (49% men, 51% women) were included in this analysis. Their average age was 45 at the beginning of the study (1999-2001) and 65 at the end of the follow-up (Dec. 2018). Most study participants were white adults.
- Work stress was assessed from self-reported questionnaires.
- The investigation found 186 AFib instances, with 19% reporting severe job strain, 25% reporting effort-reward imbalance, and 10% experiencing both stresses at the same time.
- More over one-third of the patients had been diagnosed with coronary heart disease or heart failure prior to developing AFib.
- The study measured work-related stressors using self-reported questionnaires, focusing on job strain and effort-reward imbalance while controlling for a wide range of socioeconomic characteristics (sex and education), health risks (diabetes and high blood pressure), and lifestyle factors (smoking and alcohol).
