Objectives Occupation has been linked to cardiovascular disease (CVD) incidence and mortality, but few studies have investigated occupation in relation to early atherosclerotic disease. This study examined associations between various occupational characteristics and carotid artery intima-media thickness (IMT) in a multi-ethnic sample.
Methods The Multi-Ethnic Study of Atherosclerosis (MESA) recruited 6814 adults aged 45–84 years and free of clinical CVD (response rate 60%, 51% female). Questionnaire data were used to determine occupational group (managerial/professional, sales/office, service, blue-collar), psychosocial job characteristics (ie, job demands, job control) and other sociodemographic information.
Results Common carotid artery (CCA)-IMT was greater for blue-collar jobs than for management/professional jobs (mean difference=0.012 mm, p=0.049) after adjustment for age, sex, race, place of birth (US or foreign born) and CVD risk factors. Compared to management/professional jobs, internal carotid artery (ICA)-IMT was greater for sales/office, service and blue-collar jobs (mean difference=0.071 mm, p<0.001; 0.057 mm, p=0.009; and 0.110 mm, p<0.001, respectively) after adjustment for age, sex, race and place of birth. The difference between blue-collar jobs and management/professional jobs remained significant after additional adjustment for CVD risk factors, income and education (mean difference=0.048 mm, p=0.045). Higher levels of control at work were associated with thinner CCA-IMT (mean difference=−0.009 mm, p=0.016, adjusted for age, sex, race and place of birth) but not with ICA-IMT. Job demands had no significant association with IMT.
Conclusions Blue-collar jobs and low levels of job control were associated with the development of subclinical atherosclerosis.
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Disclaimer: The findings and conclusion in this report are those of the authors and do not necessarily represent the views of the National Institute for Occupational Safety and Health.
Funding MESA is supported by contracts N01-HC-95159 through N01-HC-95165 and N01-HC-95169 from the National Heart, Lung, and Blood Institute. Occupational coding was supported by the National Institute for Occupational Safety and Health (NORA FY08 CRN SLB8). Joel Kaufman was supported by NIEHS (K24ES013195).
Competing interests None.
Ethics approval This study was conducted with the approval of the National Heart, Lung and Blood Institute, Columbia University, Johns Hopkins University, the National Institute for Occupational Safety and Health, the University of Minnesota, the University of California, Los Angeles, Northwestern University and Wake Forest University.
Provenance and peer review Not commissioned; externally peer reviewed.
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