In a new study, researchers found that people who are bullied at work or experience violence at work are at higher risk of heart and brain blood vessel problems, including heart attacks and stroke,
This is the largest prospective study to investigate the link.
The study is observational and, therefore, cannot show that workplace bullying or violence cause cardiovascular problems, only that there is an association.
But the researchers say their results are robust and have important implications for employers and national governments.
In the study, the researchers looked at data from 79,201 working men and women in Denmark and Sweden, aged 18 to 65, with no history of cardiovascular disease (CVD).
These people were participants in three studies that started between 1995 and 2011; the participants have been followed up ever since.
When they joined the studies, the participants were asked about bullying and violence in the workplace and how frequently they experienced each of them.
Information on the number of cases of heart and brain blood vessel disease and deaths was obtained from nationwide registries.
The team 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.
About 9% 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 (or threats of violence) at work had a 59% and 25% higher risk of CVD respectively compared to people who were not exposed to bullying or violence.
The more bullying or violence that was encountered, the greater the risk of CVD.
Compared with people who did not suffer bullying, people who reported being bullied frequently (the equivalent to being bullied almost every day) in the past 12 months had a 120% higher risk of CVD
But those who were exposed most frequently to workplace violence had a 36% higher risk of cerebrovascular disease (such as stroke) than those not exposed to violence, but there did not appear to be a corresponding increase in heart disease.
The researchers suggest that 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, the greater 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 are currently investigating what mechanisms, behavioral and biological, may be involved in increasing the risk of CVD in people who experience workplace bullying or violence.
They 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%).
This, combined with the fact that those exposed most frequently to workplace violence were not more likely to suffer from heart disease, suggests that workers may have received training about how to deal with violence they encounter as part of their jobs and may be better equipped to deal with it and avoid long-term consequences.
Ms Tianwei Xu, a Ph.D. student at the University of Copenhagen, Denmark, led the study.
The study is published in the European Heart Journal.
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Source: University of Sydney.