Sex and gender differences in the associations between psychosocial stressors at work and coronary heart disease incidence: An 18-year longitudinal study of 5192 Canadian workers
Bibliographic record
Abstract
Background: Psychosocial stressors at work (PSW) are modifiable occupational stressors associated with an increased coronary heart disease (CHD) incidence. While systematic reviews suggest differences between women and men, there has been limited examinations of potential effect modifiers. This study aimed to explore the effect modifications of characteristics related to sex (biological) and gender (sociocultural) in the associations between PSW and CHD incidence over an 18-year follow-up. Methods: This study relied on a prospective cohort of 5192 white-collar workers (50 % women) from 19 public and semi-public enterprises in Quebec, Canada. PSW, defined according to the job strain and effort-reward imbalance (ERI) models, were assessed using self-administered, validated questionnaires. Incident CHD cases were identified from medico-administrative databases using validated algorithms. Cox proportional hazard models were used to estimate hazard ratios (HR) and 95 % confidence intervals (CI) for the associations between PSW and CHD incidence, stratified by sex, and characteristics related to sex (age) and gender (education level, occupational position, and children load). Results: Associations between PSW and CHD incidence differed by sex. In men, being exposed to both job strain and ERI was associated with a 2-fold increased CHD risk (HR: 2.01, 95 % CI: 1.52-2.65), rising to a 2.80-fold risk among those aged 60 and older (HR: 2.80, 95 % CI: 1.90-4.13). Amplified associations were also observed in men with lower education (HR: 3.23, 95 % CI: 1.73-6.03) and a low children load (HR: 2.48, 95 % CI: 1.74-3.54). In women, the association between ERI and CHD was stronger, although it remained marginally non-significant, among those under 60 years-old (HR: 1.57, 95 % CI: 0.96-2.57), with a lower education level (HR: 1.84, 95 % CI: 0.95-3.56) and with an intermediate to high children load (HR: 1.72, 95 % CI: 0.96-3.10). Conclusions: This study reinforces the importance of considering sex- and gender-related characteristics - such as age, education, and caregiving responsibilities - when examining the associations between PSW and CHD incidence. However, the findings observed among women require replication in larger prospective cohorts.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.003 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".