More developments from the battlefront on the war with stress. Unfortunately, it looks like "stress" is winning the PR war...

Stressful jobs that involve a lack of control and decision-making from the worker are linked to increased risks of heart attacks, a new study has found, that has been published in the latest edition of The Lancet. This of course, is nothing particulalrly new, other than the results eminate from a meta-analysis of the data from over a dozen high-quality large-sized cohort studues in the field. Research in this area is often faced with a wall of indifference - on one hand the results state the obvious, which turns off many lay-readers from looking beyond the headlines. Yet on the other hand the results are important in terms of public health promotion, but still become over-shadowed by the authors' own assertions in the very same article that the health effects are minimal compared to those of smoking.

The paper, led by Mika Kivimaki, was a combined effort from researchers at many top-level research institues, and does indeed show strong evidence of the links between those jobs with little freedom, autonomy and worker-choice and heart attack episodes. Sensibly the authors also address their data seperately, taking account of the publication bias that often exists, resulting in published papers demonstrating larger effects (numbers of heart attcks) than those in un-published papers. All-in, the researchers found strong links that show decision-poor jobs have an odds-ratio of 1.23 (23% increased likelihood) of heart attacks than jobs which involve worker decision-making (based on workers' own self-rated questionnaire responses).

The researchers state that "Our findings suggest that prevention of workplace stress might decrease disease incidence; however, this strategy would have a much smaller effect than would tackling of standard risk factors, such as smoking." This statement, while providing balance and setting the results in context, also delivers an own goal to those who campaign for improved and healthier work environments.

We should not infer from this important piece of work that improving workplaces and the quality of working lives is neither impossible or pointless relative to other hazards, but we should also accept that making working lives better for millions of people will also contribute to reducing the exposure to hazards such as smoking and drinking. There will be an additive effect.

Improving workplace conditions, health promotion possibilities and work-life balance will reduce the wilfull exposure to other recreational hazards for millions of workers. What's that you say? You want a meta-analysis to prove it? OK.....