Peter L. Schnall

Job characteristics in relation to the prevalence of myocardial infarction in the US Health Examination Survey (HES) and the Health and Nutrition Examination Survey (HANES).

Associations between psychosocial job characteristics and past myocardial infarction (MI) prevalence for employed males were tested with the Health Examination Survey (HES) 1960-61, N = 2,409, and the Health and Nutrition Examination Survey (HANES) 1971-75, N = 2,424. A new estimation method is used which imputes to census occupation codes, job characteristic information from national surveys of job characteristics (US Department of Labor, Quality of Employment Surveys). Controlling for age, we find that employed males with jobs which are simultaneously low in decision latitude and high in psychological work load (a multiplicative product term isolating 20 per cent of the population) have a higher prevalence of myocardial infarction in both data bases. In a logistic regression analysis, using job measures adjusted for demographic factors and controlling for age, race, education, systolic blood pressure, serum cholesterol, smoking (HANES only), and physical exertion, we find a low decision latitude/high psychological demand multiplicative product term associated with MI in both data bases. Additional multiple logistic regressions show that low decision latitude is associated with increased prevalence of MI in both the HES and the HANES. Psychological workload and physical exertion are significant only in the HANES.

The patterning of psychological attributes and distress by “job strain” and social support in a sample of working men

As a test of the “job strain” (job demands-control) model, 297 healthy men aged 30–60 were recruited at eight New York City worksites. The association among job demands and control, social support, and psychological outcomes was tested using both ANCOVA and moderated multiple regression, controlling for demographic variables. The job strain model was supported by various psychological outcome measures, with workers in “active” jobs reporting the highest level of Type A behavior, job involvement, and positive attributional style, workers in “low-strain” jobs reporting the lowest job dissatisfaction and trait anxiety, workers in “passive” jobs reporting the most external locus of control and trait anxiety, and workers in “high-strain” jobs reporting the highest job dissatisfaction. Low social support was associated with greater symptomatology, and a significant three-way interaction (demands×control×support) for job dissatisfaction was observed. While selection of subjects into jobs may partially explain these findings, the results support the hypothesis that working conditions influence psychological attributes and distress.

The effect of work environments on blood pressure : evidence from seven New York organizations

The prevalence of hypertension defined according to National Health and Nutrition Examination Survey II (NHANES II) criteria (140/90 mmHg and/or taking antihypertensive medication) was analyzed cross-sectionally at seven worksites in New York City (n = 4274; 2616 men and 1648 women), in order to assess whether exposure to different work environments and occupations contributes to blood pressure variation. The prevalence of hypertension across worksites was 26% among men and 12% among women. Blood pressure was significantly different across worksites even after controlling for known risk factors using analysis of covariance. Of the variation in systolic pressure, 34% was predicted significantly by eight variables; after adjusting for upper-arm circumference, age and body mass index, higher pressures were associated with worksite differences (9.0 mmHg), being male (7.2 mmHg), lacking a high-school education (4.3 mmHg), having a clerical occupation (2.9 mmHg) and being unmarried (1.8 mmHg). Similar results for diastolic pressure suggest that researchers should consider worksite and job characteristics as important predictors of blood pressure differences in working populations.