DECISION LATITUDE, JOB STRAIN, AND MYOCARDIAL-INFARCTION - A STUDY OFWORKING MEN IN STOCKHOLM

Objectives. This study examined the role of decision latitude and job strain in the etiology of a first myocardial infarction. Methods. Elig ible case patients were all full-time working men 45 to 64 years of ag e who suffered a first myocardial infarction during the period January 1992 to January 1993 in the greater Stockholm region. Referents were selected from the general population. Participation rates were 82% (ca se patients) and 75%. (referents). Results. Both inferred and self-rep orted low decision latitude were associated with increased risk of a f irst myocardial infarction? although this association was weakened aft er adjustment for social class. A decrease in inferred decision latitu de during the 10 years preceding the myocardial infarction was associa ted with increased risk after all adjustments, including chest pain an d social class. The combination of high self-reported demands and low self-reported decision latitude was an independent predictor of risk a fter all adjustments.Conclusions. Both negative change in inferred dec ision latitude and self-reported job strain are important risk indicat ors in men less than 55 years of age and in blue-collar workers.