The study of 13,779 Swedish employees selected randomly focuses on exploring how one’s working environment can affect their cardiovascular disease (CVD) prevalence. It is found that CVD prevalence can be greatly influenced by self reported work control, job demands, and social support from colleagues combined. The prevalence ratio (PR) is 2.17 (95% CI-1.32,3.56) for those who were under a working environment of high demand, low control, and low social support after adjusted by age compare against the workers of a low demand, high control, and high social support. With having age and other 11 possible confounders in consideration and consecutively controlling them, the PRs are about 2.0 in this group. What else to notice is that the age-adjusted PSs was higher for blue collar men. Unfortunately, no causal inferences can be made because of the very nature of the cross-sectional study design. The methodology used and the weakness of the work stress field are discussed in the context. We also will discuss the limitation of this design and what we can do today to improve the accuracy of this study, which would help more patients suffer from CVD. It is a major application of effect modifier.
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