Workplace bullying and workplace violence as risk factors for cardiovascular disease : a multi-cohort study

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Xu , T , Magnusson Hanson , L L , Lange , T , Starkopf , L , Westerlund , H , Madsen , I E H , Rugulies , R , Pentti , J , Stenholm , S , Vahtera , J , Hansen , A M , Virtanen , M , Kivimäki , M & Rod , N H 2019 , ' Workplace bullying and workplace violence as risk factors for cardiovascular disease : a multi-cohort study ' , European Heart Journal , vol. 40 , no. 14 , pp. 1124-+ .

Title: Workplace bullying and workplace violence as risk factors for cardiovascular disease : a multi-cohort study
Author: Xu, Tianwei; Magnusson Hanson, Linda L.; Lange, Theis; Starkopf, Liis; Westerlund, Hugo; Madsen, Ida E. H.; Rugulies, Reiner; Pentti, Jaana; Stenholm, Sari; Vahtera, Jussi; Hansen, Ase M.; Virtanen, Marianna; Kivimäki, Mika; Rod, Naja H.
Contributor organization: Clinicum
University of Helsinki
Faculty of Medicine
Date: 2019-04-07
Language: eng
Number of pages: 12
Belongs to series: European Heart Journal
ISSN: 0195-668X
Abstract: Aims To assess the associations between bullying and violence at work and cardiovascular disease (CVD). Methods and results Participants were 79201 working men and women, aged 18-65years and free of CVD and were sourced from three cohort studies from Sweden and Denmark. Exposure to workplace bullying and violence was measured at baseline using self-reports. Participants were linked to nationwide health and death registers to ascertain incident CVD, including coronary heart disease and cerebrovascular disease. Study-specific results were estimated by marginal structural Cox regression and were combined using fixed-effect meta-analysis. Nine percent reported being bullied at work and 13% recorded exposure to workplace violence during the past year. We recorded 3229 incident CVD cases with a mean follow-up of 12.4years (765 in the first 4years). After adjustment for age, sex, country of birth, marital status, and educational level, being bullied at work vs. not was associated with a hazard ratio (HR) of 1.59 [95% confidence interval (CI) 1.28-1.98] for CVD. Experiencing workplace violence vs. not was associated with a HR of 1.25 (95% CI 1.12-1.40) for CVD. The population attributable risk was 5.0% for workplace bullying and 3.1% for workplace violence. The excess risk remained similar in analyses with different follow-up lengths, cardiovascular risk stratifications, and after additional adjustments. Dose-response relations were observed for both workplace bullying and violence (P-trend <0.001). There was only negligible heterogeneity in study-specific estimates. Conclusion Bullying and violence are common at workplaces and those exposed to these stressors are at higher risk of CVD.
Subject: Workplace
Cardiovascular disease
Psychosocial stress
Occupational health
3121 General medicine, internal medicine and other clinical medicine
3142 Public health care science, environmental and occupational health
Peer reviewed: Yes
Usage restriction: openAccess
Self-archived version: publishedVersion

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