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Relationship between all-cause mortality and cumulative working life course psychosocial and physical exposures in the United States labor market from 1968 to 1992.

Psychosomatic Medicine

Male, Adult, Aged, Cause of Death, Cohort Studies, Female, Health Surveys, Humans, Internal-External Control, Longitudinal Studies, Middle Aged, Occupational Diseases, etiology, mortality, Occupational Exposure, adverse effects, Risk Factors, Stress, Psychological, complications, Survival Analysis, United States, epidemiology

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      To examine the relationship between cumulative exposures to psychosocial and physical work conditions and mortality in a nationally representative sample. A working cohort was created using the U.S. Panel Study of Income Dynamics. Information on psychosocial and physical work conditions were imputed using the Job Characteristics Scoring System exposure matrix for the period 1968 through 1991 to construct working life courses. Deaths were ascertained from 1970 through 1992. Working in low-control jobs for a working life was associated with a 43% increase in the chance of death (OR, 1.43, 1.13-1.81) assuming a 10-year time lag. No significant effect was found for high-strain work (ie, high psychosocial job demands and low job control), but a relationship was found between passive work (ie, low psychosocial job demands and low job control) and mortality (OR, 1.35, 1.06-1.72). No significant risk of death was found for psychosocial or physical job demands, job security, or work-related social support. Retirement (OR, 2.85, 1.59-5.11) and unemployment (OR, 2.26, 1.65-3.10) transitions and baseline disability (OR, 1.38, 1.06-1.79) predicted mortality. The results support the importance of job control to health. The passive work effect suggests that job content may be important in shaping a worker's health over the life course. Future research should focus on modeling stressors over the life course to capture the dynamic interplay of life transitions, stressor intensity and duration and the role of health in the interplay.

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