Different Approaches to Estimate Exposure to Work Stressors, Using Repeated Measurements, and the Association With Cardiovascular Disease

Objective: To explore the stability of exposure to work stressors over time and to examine the impact of different approaches of estimating exposure on the cardiovascular disease (CVD) risk estimation. Methods: The Maastricht Cohort Study Work Stressor Score was used to assess work stressors at three consecutive time points among 6154 employees participating in the Maastricht Cohort Study. Incident CVD was assessed with questionnaires. Five approaches were used to estimate exposure as, for example, cumulative exposure above a cutoff point, total exposure, and average exposure. Results: The correlation between the Work stressor scores assessed at the first and third time point was 0.58. Employees with a stable exposure above the highest quartile had a fully adjusted hazard ratio of 1.58 (95% confidence interval, 0.93 to 2.72). Conclusion: Employees with a stable exposure above the highest quartile score during a minimum of 2 years might have the highest relative CVD risk.