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Bad Bosses Are Hard on the Heart

Study ties work woes to fatal cardiovascular events in men

TUESDAY, Nov. 25 (HealthDay News) -- Burdened by an overbearing boss? Your heart may pay the price, according to new research.

The Swedish study found that workers' risks for angina, heart attack and death rose along with the reported incompetence of their bosses.

"This study is the first to provide evidence of a prospective, dose-response relationship between concrete managerial behaviors and objectively assessed heart disease among employees," said lead researcher Anna Nyberg, from the department of public health sciences at the Karolinska Institute, and Stress Research Institute at Stockholm University.

"Enhancing managers' skills -- regarding providing employees with information, support, power in relation to responsibilities, clarity in expectations, and feedback -- could have important stress-reducing effects on employees and enhance the health at workplaces," Nyberg said.

The report was published in the Nov. 25 online edition of Occupational and Environmental Medicine.

According to the researchers, being a good boss includes consideration for employees, setting clear goals, setting realistic expectations, communicating and giving feedback, managing change, including people in decision-making and delegating authority.

For the study, Nyberg's team collected data on more than 3,100 Swedish men who participated in the Work, Lipids, and Fibrinogen Stockholm study. The men, 19 to 70 years of age, had their hearts checked at work between 1992 and 1995. The researchers then matched these men with hospital records for heart disease illness and death up to 2003.

During the follow-up period, there were 74 cases of fatal and nonfatal heart attacks or angina or death from heart disease, the researchers found.

Nyberg's group found that the more competent the men thought their bosses were, the lower their risk of developing heart disease. In contrast, the poorer men rated their boss's leadership ability, the higher the risk for heart disease. In fact, the risk increased the longer someone worked in the same stressful environment.

"Stress-related diseases are a large problem in our society," Nyberg said. "The workplace is one area in which stress occurs and thus can be reduced. This study suggests that managers have key roles in determining stress-related factors at work, which means that psychosocial work environment interventions could be directed towards managers in order to reduce stress in employees," she said.

Dr. Gregg C. Fonarow is a professor of cardiology at the University of California, Los Angeles. He said a number of studies have suggested that stressful work environments boost workers' risk for cardiovascular events.

"However, none of these studies have demonstrated causality, and it remains entirely unknown whether making these types of changes in the workplace would produce favorable effects on cardiovascular health," Fonarow said.

A related report -- this time in the Nov. 25 online edition of the Journal of Epidemiology and Community Health -- finds that taking sick leave from your job for mental health raises your risk of an early death.

"People who take medically certified absence spells of one week or more have a 60 percent excess risk of early death," said lead researcher Jane Ferrie, from the Department of Epidemiology and Public Health at University College London, U.K. "This excess risk is associated with some of the commonest diagnoses for sickness absence, in particular mental disorders," she said.

For the study, Ferrie's group collected data on more than 19,000 French public utility workers, aged 37 to 51, who took part in the GAZEL study.

The researchers found that from 1993 to 2007, 902 people died, 144 of them women. From 1990 to 1992, there were about 12,500 medically certified sick leaves lasting seven or more working days, involving 41 percent of the employees. These employees were 60 percent more likely to die early, Ferrie noted.

Women took sick leave more frequently than men. The data showed that, for both men and women, mental ill health and digestive and circulatory diseases in men were associated with the risk of dying early.

"Workers with medically certified absence for mental diagnoses should be considered a population at a higher risk of fatal disease," Ferrie concluded. "These diagnoses include mental health problems, often viewed as the diagnosis most likely to be used as an excuse for skiving."

But Dr. David L. Katz, director of the Prevention Research Center at Yale University School of Medicine noted again that this research did not prove causality.

"It may be that workers who are ill are less apt to be satisfied," Katz said. "But it is not unreasonable that dissatisfaction at work could translate into great risk for ill health, and even premature death," he said.

It stands to reason that how we interact with others in the workplace is important to our health and quality of life, Katz said. "Given how much time we spend at work, relationships there clearly count. Intervention studies that aim to optimize the interaction between employee and manager and test for health outcomes would clearly make sense," he said.

More information

For more on work stress, visit the U.S. Centers for Disease Control and Prevention .

SOURCES: Anna Nyberg, department of public health sciences, Karolinska Institute, and Stress Research Institute, Stockholm University, Sweden; Jane Ferrie, Ph.D., Department of Epidemiology and Public Health, University College London, U.K.; Gregg C. Fonarow, M.D., professor, cardiology, University of California, Los Angeles; David L. Katz, M.D., M.P.H., director, Prevention Research Center, Yale University School of Medicine, New Haven, Conn.; Nov. 25, 2008, online edition, Occupational and Environmental Medicine; Journal of Epidemiology and Community Health

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