Workplace bullying, violence boosts victims’ CVD risk by up to 59%

Employees who are bullied on the job or experience workplace violence see between a 25 and 59 percent increased risk for cardiovascular disease in their lifetime, researchers reported in the European Heart Journal.

Adverse working conditions—anything from burnout to effort-reward imbalance to long hours—affect our hearts, first author Tianwei Xu, a PhD candidate at the University of Copenhagen, and colleagues wrote in EHJ. Scientists have known that for awhile, and they’re also aware workplace bullying and violence can lead to at least a moderately higher risk of type 2 diabetes. What they don’t know, though, is how bullying or violence relate to CVD as risk factors.

“As social stressors, both workplace bullying and violence may contribute to lowered self-esteem and loss of coping resources,” Xu and coauthors wrote. “They may also elicit a range of coping-oriented behavioral changes, such as overeating and excessive alcohol consumption, and induce a variety of negative emotions. It has been hypothesized that these coping-oriented behaviors and negative emotions increase CVD risk, along with various stress-related physiological reactions.”

Those behaviors can also result in reduced insulin sensitivity, increased platelet aggregation and endothelial dysfunction, the authors said.

To gain a better understanding of the problem in 2018, Xu and colleagues pulled data for 79,201 working men and women from three Swedish and Danish cohort studies. Participants self-reported their experiences with bullying or workplace violence at the study’s baseline, and Xu’s team matched enrollees to nationwide health and death registries to ascertain incident CVD.

Nine percent and 13 percent of participants reported workplace bullying or violence, respectively, the authors reported. Over nearly 12 and a half years of follow-up, the researchers recorded 3,229 incident cases of CVD.

After adjusting for age, sex, marital status and education, being bullied at work correlated with a 59 percent increased risk of CVD, while workplace violence was linked to a 25 percent increased risk of CVD. The population attributable risk was 5 percent for workplace bullying and 3.1 percent for workplace violence—numbers comparable to those for standard risk factors, like diabetes or risky drinking.

“The dose-response relation was evident for both workplace bullying and violence, with the highest risk observed among those exposed on a weekly/daily basis,” Xu et al. wrote. “We observed no heterogeneity between study-specific estimates, and there were no sex differences in the results.”

Results were robust for different follow-up periods, adjustments and cardiovascular risk stratifications, they said. Future studies will need to focus on whether preventive measures against bullying and violence could reduce CVD events.

“Bullying and violence are common workplace stressors,” the team wrote. “Our study sheds light on their association with a higher risk of cardiovascular events. If the association is causal, eliminating workplace bullying and violence would prevent a sizable number of CVD events from happening.”

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After graduating from Indiana University-Bloomington with a bachelor’s in journalism, Anicka joined TriMed’s Chicago team in 2017 covering cardiology. Close to her heart is long-form journalism, Pilot G-2 pens, dark chocolate and her dog Harper Lee.

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