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Perceived job insecurity as a risk factor for incident coronary heart disease: systematic review and meta-analysis.

Marianna Virtanen 1 Solja Nyberg 1 G David Batty 2, 3 Markus Jokela 4 Katriina Heikkilä 1 Eleonor Fransson 5, 6, 7 Lars Alfredsson 5, 8 Jakob Bjorner 9 Marianne Borritz 10 Hermann Burr 11 Annalisa Casini 12 Els Clays 13 Dirk de Bacquer 14 Nico Dragano 15 Marko Elovainio 16 Raimund Erbel 17 Jane Ferrie 2, 18 Mark Hamer 2 Karl-Heinz Jöckel 19 France Kittel 12 Anders Knutsson 20 Markku Koskenvuo 21 Aki Koskinen 1 Thorsten Lunau 15 Ida Madsen 9 Martin Nielsen 10 Maria Nordin 22 Tuula Oksanen 1 Krista Pahkin 2 Jan Pejtersen 23 Jaana Pentti 1 Reiner Rugulies 9, 24 Paula Salo 1, 25 Martin Shipley 2 Johannes Siegrist 15 Andrew Steptoe 2 Sakari Suominen 26, 27, 28 Töres Theorell 7 Salla Toppinen-Tanner 1 Ari Väänänen 1 Jussi Vahtera 27, 29, 30 Peter Westerholm 7 Hugo Westerlund 7 Natalie Slopen 31, 32 Ichiro Kawachi 31 Archana Singh-Manoux 33, 2 Mika Kivimäki 1, 2, 4
Abstract : To determine the association between self reported job insecurity and incident coronary heart disease. A meta-analysis combining individual level data from a collaborative consortium and published studies identified by a systematic review. We obtained individual level data from 13 cohort studies participating in the Individual-Participant-Data Meta-analysis in Working Populations Consortium. Four published prospective cohort studies were identified by searches of Medline (to August 2012) and Embase databases (to October 2012), supplemented by manual searches. Prospective cohort studies that reported risk estimates for clinically verified incident coronary heart disease by the level of self reported job insecurity. Two independent reviewers extracted published data. Summary estimates of association were obtained using random effects models. The literature search yielded four cohort studies. Together with 13 cohort studies with individual participant data, the meta-analysis comprised up to 174,438 participants with a mean follow-up of 9.7 years and 1892 incident cases of coronary heart disease. Age adjusted relative risk of high versus low job insecurity was 1.32 (95% confidence interval 1.09 to 1.59). The relative risk of job insecurity adjusted for sociodemographic and risk factors was 1.19 (1.00 to 1.42). There was no evidence of significant differences in this association by sex, age (<50 v ≥ 50 years), national unemployment rate, welfare regime, or job insecurity measure. The modest association between perceived job insecurity and incident coronary heart disease is partly attributable to poorer socioeconomic circumstances and less favourable risk factor profiles among people with job insecurity.
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Marianna Virtanen, Solja Nyberg, G David Batty, Markus Jokela, Katriina Heikkilä, et al.. Perceived job insecurity as a risk factor for incident coronary heart disease: systematic review and meta-analysis.. BMJ / BMJ (CLINICAL RESEARCH ED); Br Med J; British Medical Journal; Brit Med J, 2012, 347, pp.f4746. ⟨10.1136/bmj.f4746⟩. ⟨inserm-01154089⟩

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