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Using additional information on working hours to predict coronary heart disease: a cohort study.
Kivimäki M., Batty G. D., Hamer M., Ferrie J. E., Vahtera J., Virtanen M., Marmot M. G., Singh-Manoux A., Shipley M. J.
Annals of Internal Medicine 154, 7 (2011) 457-63 - http://www.hal.inserm.fr/inserm-00672633
Using additional information on working hours to predict coronary heart disease: a cohort study.
Mika Kivimäki () 1, G David Batty1, Mark Hamer1, Jane Ferrie1, Jussi Vahtera2, Marianna Virtanen3, Michael Marmot1, Archana Singh-Manoux1, 4, Martin Shipley1
1 :  Department of Epidemiology and Public Health
University College of London (UCL)
1-19 Torrington Place London WC1E 6BT
2 :  Department of Public Health
University of Turku – Turku University Hospital
3 :  Finnish Institute of Occupational Health
Finnish Institute of Occupational Health
Topeliuksenkatu 41A 00250 Helsinki
4 :  CESP - Centre de recherche en épidémiologie et santé des populations
INSERM : U1018 – Hôpital Paul Brousse – Assistance publique - Hôpitaux de Paris (AP-HP) – Université Paris XI - Paris Sud – Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)
16 avenue Paul Vaillant Couturier 94807 Villejuif Cedex, France
Working hours and CHD risk prediction
BACKGROUND: Long working hours are associated with increased risk for coronary heart disease (CHD). Adding information on long hours to traditional risk factors for CHD may help to improve risk prediction for this condition. OBJECTIVE: To examine whether information on long working hours improves the ability of the Framingham risk model to predict CHD in a low-risk, employed population. DESIGN: Cohort study with baseline medical examination performed between 1991 and 1993 and prospective follow-up for incident CHD performed until 2004. SETTING: Civil service departments in London (the Whitehall II study). PARTICIPANTS: 7095 adults (2109 women and 4986 men) aged 39 to 62 years working full-time without CHD at baseline. MEASUREMENTS: Working hours and the Framingham risk score were measured at baseline. Coronary death and nonfatal myocardial infarction were ascertained from medical screenings every 5 years, hospital data, and registry linkage. RESULTS: 192 participants had incident CHD during a median 12.3-year follow-up. After adjustment for their Framingham risk score, participants working 11 hours or more per day had a 1.67-fold (95% CI, 1.10- to 2.55-fold) increased risk for CHD compared with participants working 7 to 8 hours per day. Adding working hours to the Framingham risk score led to a net reclassification improvement of 4.7% (P = 0.034) due to better identification of persons who later developed CHD (sensitivity gain). LIMITATION: The findings may not be generalizable to populations with a larger proportion of high-risk persons and were not validated in an independent cohort. CONCLUSION: Information on working hours may improve risk prediction of CHD on the basis of the Framingham risk score in low-risk, working populations. PRIMARY FUNDING SOURCE: Medical Research Council; British Heart Foundation; Bupa Foundation; and the National Heart, Lung, and Blood Institute and National Institute on Aging of the National Institutes of Health.
Sciences du Vivant/Santé publique et épidémiologie

Articles dans des revues avec comité de lecture
Annals of Internal Medicine (Ann Intern Med)
Publisher American College of Physicians
ISSN 0003-4819 (eISSN : 1539-3704)

Coronary heart disease – prevention – primary prevention – public health – risk assessment – risk factors
Adult – Coronary Disease – Female – Humans – Incidence – Male – Middle Aged – Risk Factors – Work Schedule Tolerance
Sources of Funding: Medical Research Council; British Heart Foundation; Wellcome Trust; Health and Safety Executive; Department of Health; Agency for Health Care Policy Research, UK; John D and Catherine T MacArthur Foundation Research Networks on Successful Midlife Development and Socio-economic Status and Health; National Heart, Lung and Blood Institute and National Institute on Aging, NIH, US; Academy of Finland, Finland; EU New OSH ERA Research Programme and European Science Foundation. MK and JV are supported by the Academy of Finland. GDB is a Wellcome Trust Fellow. GDB is a Wellcome Trust Fellow. MM is a MRC professor. MJS is supported by the British Heart Foundation, AS-M is supported by a "European Young Investigator Award" from the European Science Foundation, and JEF is supported by the Medical Research Council, UK.
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kivimaki_M10-1425_R2_MANUSCRIP_REVISION.doc(101 KB)
kivimaki_M10-1425_R2_ONLINE_APPENDIX.doc(98.5 KB)
kivimaki_M10-1425_R2_TABLES_REVISION.doc(116 KB)
kivimaki_M10-1425_R2_MANUSCRIP_REVISION.pdf(205.7 KB)
kivimaki_M10-1425_R2_ONLINE_APPENDIX.pdf(239.1 KB)
kivimaki_M10-1425_R2_TABLES_REVISION.pdf(120.2 KB)