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Chronic stress at work and the metabolic syndrome: prospective study
Open accessAbstract
OBJECTIVES: To investigate the association between stress at work and the metabolic syndrome. [table: see text]. DESIGN: Prospective cohort study investigating the association between work stress and the metabolic syndrome. PARTICIPANTS: 10 308 men and women, aged 35-55, employed in 20 London civil service departments at baseline (the Whitehall II study); follow-up was an average of 14 years. MAIN OUTCOME MEASURES: Work stress based on the iso-strain model, measured on four occasions (1985-99). Biological measures of the metabolic syndrome, based on the National Cholesterol Education Program definition, measured in 1997-9. RESULTS: A dose-response relation was found between exposure to work stressors over 14 years and risk of the metabolic syndrome, independent of other relevant risk factors. Employees with chronic work stress (three or more exposures) were more than twice as likely to have the syndrome than those without work stress (odds ratio adjusted for age and employment grade 2.25, 95% confidence interval 1.31 to 3.85). CONCLUSIONS: Stress at work is an important risk factor for the metabolic syndrome. The study provides evidence for the biological plausibility of the link between psychosocial stressors from everyday life and heart disease.
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“stress is an independent risk factor for illness and even mortality [5–7].”
From A pilot randomised trial comparing a mindfulness-based stress reduction course, a locally-developed stress reduction intervention and a waiting list control group in a real-life municipal health care setting (2020) · cites this paper as [6]
Experimental — accuracy not yet measuredIn the citing paper
“psychological stressors that are persistently present in some contemporary work environments, such as those characterized by high job demand and low control, can cause physiologic changes155 that disrupt the ability for glucocorticoids to effectively down-regulate inflammatory activity due to decreased sensitivity caused by chronic elevation in cortisol, leading in turn to SCI and poor health156”
From Chronic inflammation in the etiology of disease across the life span (2019) · cites this paper as [155]
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Barrett, T. M., Liebert, M. A., Eick, G. N., Ridgeway‐Diaz, J. G., Madimenos, F. C., Blackwell, A. D., Cepon‐Robins, T. J., Urlacher, S. S., Sugiyama, L. S., & Snodgrass, J. J. (2025) · American Journal of Human Biology · doi:10.1002/ajhb.70063 · Cited by 2
Liu, X.-Y., & Yao, K. (2025) · Mediators of Inflammation · doi:10.1155/mi/1989715 · Cited by 2
Diloretto, D. A., Sarode, G., Thai, P. N., Lee, J.-H., Navar, E., Park, J. E., Khadilkar, C., Zong, N., Dong, Y.-J., Duda, A., et al. (2025) · Journal of Molecular and Cellular Cardiology · doi:10.1016/j.yjmcc.2025.07.008 · Cited by 2
Kayadibi, İ., & Uslu, O. (2025) · Scientific Reports · doi:10.1038/s41598-025-18647-x · Cited by 2
Komulainen, K., Niemi, R., Gutvilig, M., Cachón-Alonso, L., Hakulinen, C. A., & Elovainio, M. J. (2025) · Journal of Epidemiology & Community Health · doi:10.1136/jech-2025-224665 · Cited by 3
Occupational stress, burnout, and depression: an exploration from a network analysis perspective
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Lustig, R. H. (2010) · Endocrine updates · doi:10.1007/978-1-4419-7034-3_1 · Cited by 2
Study on the Relationship between Obesity Factors and NK Cell Activity in White-Collar Females
Sung, H.-H., Song, C.-S., Choi, K.-M., & Park, C.-E. (2016) · Korean Journal of Clinical Laboratory Science · doi:10.15324/kjcls.2016.48.3.196 · Cited by 2
Metadata
- Authors
- Chandola, T., Brunner, E., & Marmot, M.
- Affiliations
- University College London (GB)
- Corresponding author
- Chandola, Tarani
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 2006-01-20
- Volume
- 332
- Issue
- 7540
- Pages
- 521-525
- ISSN
- 0007-1447 (ISSN-L)
- 0959-8138
- 1468-5833
- PMC
- PMC1388129
- OpenAlex
- W2140275529
- Cited by
- 1,075
- References
- 26
- Citations by year
- 2026: 32 · 2025: 26 · 2024: 33 · 2023: 36 · 2022: 54 · 2021: 38 · 2020: 63 · 2019: 63 · 2018: 68 · 2017: 59 · 2016: 63 · 2015: 55 · 2014: 78 · 2013: 69 · 2012: 53
- FWCI
- 110.80
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- BMJ (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- HighWire Press Open Archive (submittedVersion)
- Research Explorer (The University of Manchester) (submittedVersion)
- Funders
- John D. and Catherine T. MacArthur Foundation (HS06516)
- British Heart Foundation (HS06516)
- Health and Safety Executive
- National Institutes of Health
- Agency for Healthcare Research and Quality (HS06516)
- Medical Research Council (HS06516)
- Economic and Social Research Council
- National Institute on Aging (AG 13196)
- National Heart, Lung, and Blood Institute (HL36310, R01HL036310)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Workplace Health and Well-being
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Keywords
- chronic occupational stress, metabolic syndrome, psychosocial stressors, dose-response relationship, cardiovascular risk factors, heart disease, civil service employees, Whitehall II study
- MeSH terms
- Adult, Chronic Disease, Female, Follow-Up Studies, Heart Diseases, Humans, Male, Middle Aged, Occupational Diseases, Prospective Studies, Stress, Psychological, Cohort Studies, Metabolic Syndrome
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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