Beware-Intimidation at work place may lead to Heart attack

According to the largest prospective observational study, People who experience intimidation or violence at work are at higher risk of cardiovascular diseases including heart attack and stroke. The study has appeared in the European Heart Journal.

The researchers feel that their results have important implications for employers may it be in any sector and national governments.

Ms Tianwei Xu at the University of Copenhagen, Denmark and her colleagues analysed data from 79,201 working men and women in Denmark and Sweden, aged 18 to 65, with no history of cardiovascular disease (CVD), who were participants in three studies that started between 1995 and 2011; the participants have been followed up ever since. All the participants were asked about bullying and violence in the workplace and how frequently they experienced each of them. The information related to the number of cases of heart and brain blood vessel disease and deaths was obtained from nationwide registries.

Ms Xu and her colleagues also took account of other factors that could affect whether or not the participants were affected by CVD, such as body mass index, alcohol consumption, smoking, mental disorders and other pre-existing health conditions, shift working and occupation.

In the study, nine percent of participants reported being bullied at work and 13% reported experiencing violence or threats of violence at work in the past year. The researchers found that those who were bullied or experienced violence at work had a 59% and 25% higher risk of CVD respectively compared to people who were not exposed to bullying or violence.

It was found that as compared with people who did not suffer bullying, people who reported being bullied frequently in the past 12 months had 120% higher risk of CVD, while those who were exposed most frequently to workplace violence had a 36% higher risk of CVD such as stroke than those not exposed to violence, but there did not appear to be a corresponding increase in heart disease.

Ms Xu lead author said: "Workplace bullying and workplace violence are distinct social stressors at work. Only 10-14% of those exposed to at least one type of exposure was suffering from the other at the same time. These stressful events are related to a higher risk of cardiovascular disease in a dose-response manner - in other words,author said the exposure to bullying or violence, the greater the risk of cardiovascular disease.

"From this study, we cannot conclude that there is a causal relation between workplace bullying or workplace violence and cardiovascular disease, but we provide empirical evidence in support of such a causal relation, especially given the plausible biological pathway between workplace major stressors and cardiovascular disease. This is further supported by the dose-response trend and the robustness of the results in various sensitivity analyses. Experimental studies on violence and bullying would be highly unethical and our study thus provides the best evidence of this association.

"The effect of bullying and violence on the incidence of cardiovascular disease in the general population is comparable to other risk factors, such as diabetes and alcohol drinking, which further highlights the importance of workplace bullying and workplace violence in relation to cardiovascular disease prevention.

"It is important to prevent workplace bullying and workplace violence from happening, as they constitute major stressors for those exposed. It is also important to have policies for intervening if bullying or violence occurs."

The researchers believe that high blood pressure is likely to be involved as it is known already that severe stress can increase blood pressure. In addition, exposure to bullying and violence may lead to anxiety and depression which, in turn, can lead to over-eating and excessive alcohol consumption. Stress-induced changes to metabolism could also be involved.

Other interesting findings from the research included the fact that bullying in the workplace occurred mostly from colleagues (79%) rather than from people outside the organization (21%), whereas violence or threats of violence at work originated mainly from people outside the organization (91%) than from within (9%).

There are several limitations of the study including the fact that workplace bullying and violence was measured only once; and some information, such as the use of tobacco other than smoking, personality traits, genetic factors and other stressors like the marital conflict was not available.

Therefore experts feel that the findings of study need to be carefully and cautiously interpreted. The study could not possibly bifurcate the stress and pre-existing psychological problems due to events in a person's early life and that due to workplace events. So how much the increased CVD incidence was driven by workplace interventions could not be assessed.