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Justice at work and metabolic syndrome: the Whitehall II study
  1. David Gimeno1,2,3,
  2. Ádám G Tabák2,4,
  3. Jane E Ferrie2,
  4. Martin J Shipley2,
  5. Roberto De Vogli2,
  6. Marko Elovainio2,5,
  7. Jussi Vahtera6,
  8. Michael G Marmot2,
  9. Mika Kivimäki2,6
  1. 1The University of Texas School of Public Health, Health Science Center at Houston, Division of Environmental and Occupational Health Sciences, San Antonio, Texas, USA
  2. 2Department of Epidemiology and Public Health, UCL Medical School, London, UK
  3. 3The Institute for Work and Health, Toronto, Canada
  4. 4Semmelweis University Faculty of Medicine, 1st Department of Internal Medicine, Budapest, Hungary
  5. 5National Research and Development Centre of Welfare and Health (STAKES), Helsinki, Finland
  6. 6Finnish Institute of Occupational Health, Helsinki, Finland
  1. Correspondence to David Gimeno, Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK; d.gimeno{at}


Objectives Growing evidence shows that high levels of justice are beneficial for employee health, although biological mechanisms underlying this association are yet to be clarified. We aim to test whether high justice at work protects against metabolic syndrome.

Methods A prospective cohort study of 20 civil service departments in London (the Whitehall II study) including 6123 male and female British civil servants aged 35–55 years without prevalent coronary heart disease at baseline (1985–1990). Perceived justice at work was determined by means of questionnaire on two occasions between 1985 and 1990. Follow-up for metabolic syndrome and its components occurring from 1990 to 2004 was based on clinical assessments on three occasions over more than 18 years.

Results Cox proportional hazard models adjusted for age, ethnicity and employment grade showed that men who experienced a high level of justice at work had a lower risk of incident metabolic syndrome than employees with a low level of justice (HR 0.75; 95% CI 0.63 to 0.89). There was little evidence of an association between organisational justice and metabolic syndrome or its components in women (HR 0.88; 95% CI 0.67 to 1.17).

Conclusions Our prospective findings provide evidence of an association between high levels of justice at work and the development of metabolic syndrome in men.

  • Coronary heart disease
  • psychosocial factors
  • risk factors
  • epidemiology
  • cohort
  • work organisation

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  • Funding The Whitehall II study was supported by grants from the Medical Research Council (MRC); Economic and Social Research Council; British Heart Foundation (BHF); Health and Safety Executive; Department of Health; National Heart Lung and Blood Institute (HL36310), US, NIH; National Institute on Ageing (AG13196), US, NIH; Agency for Health Care Policy Research (HS06516); and the John D and Catherine T MacArthur Foundation Research Network on Successful Midlife Development and Socioeconomic Status and Health. DG and RDV are supported by the NIA (grant AG13196); JEF by the MRC (grant G8802774); MK, ME and JV by the Academy of Finland (grants 117604, 124271, 124322 and 129262); MJS by the BHF; and MGM is supported by an MRC research professorship.

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the University College London Medical School Committee on the Ethics of Human Research.

  • Provenance and peer review Not commissioned; externally peer reviewed.