Work and other factors influencing coronary health and sickness absence

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Abstract
Two major problems encountered in studies of the impact of work on health are the determination of which diseases and health states may be affected, and the separation of work from other factors affecting health. The greatest burden of ill-health may be due to the psychosocial work environment, rather than exposure to traditionally studied environmental agents. A common concern is with coronary heart disease (CHD). The author and his colleagues have been studying CHD, mental health and sickness absence, this last as a measure which combines social, psychological and physical functioning. Two longitudinal studies were conducted on civil servants, with the major aim of investigating the effect on health of occupational and other socioeconomic influences on white-collar workers. It was found that the lowest risk of CHD was in administrators, and the highest risk in the lower socioeconomic groups. Type A behaviour was higher in higher grades of worker. Lower-grade workers had less healthy lifestyle habits. It may not be possible to separate the effect of work from other influences on an individual, and it could be that the point of intervention should be not the individual but the environment.