Occupational constraints and all-cause mortality: Results for men and women from an 18-year follow-up prospective cohort: The VISAT study

Background Substantial social inequalities persist in all-cause mortality in several countries. The exposure to different occupational constraints is suspected to explain them. However, little is known concerning the consequences of completed occupational tasks on all-cause mortality. Objectives The aim of this study was to determine the predictive value of large occupational constraints on all-cause mortality after a median follow-up of 18 years, in men and in women. Methods From the VISAT cohort study, 32, 42, 52 and 62 year-old men and women were included. Past and current occupational exposures (classified into physical, organizational, psychological and others work-related categories) were collected through self-questionnaires, and vital status was assessed 18 years later. Proportional-hazard Cox regression models were performed to analyze the impact of each occupational constraints separately and together in the same model, without and with adjustments to the main cardiovascular risks, for men and women. Results Data from 3139 participants (1607 men and 1532 women) were analyzed. After adjustments by age, smoking status and diabetes and/or high blood pressure, only permanent night work among men and exposure to loud noises and/or harsh weather conditions among women increased all-cause mortality risk [HR 2.42 (1.39–4.22) and HR 1.97 (1.14–3.38), respectively]. Working more 48 h/week, being unemployed and an early start of the first job increased the risk of all-cause mortality, but not significantly after adjustments. Conclusion Few occupational constraints, but widely spread in industrial world, have an independent impact on all-cause mortality, while the main known cardiovascular risks factors explained the link between some OC and mortality.