The sense of coherence, occupation and the risk of coronary heart disease in the Helsinki Heart Study

The risk of coronary heart disease (CHD) was studied in 4405 Finnish middle -aged working men in different occupations according to their sense of cohe rence (SOC). The study design was prospective and the follow-up time was ei ght years. Clinical findings such as total cholesterol, systolic blood pres sure and body-mass index showed differences when comparing blue and white c ollar workers. Lifestyle factors such as smoking also differed, but leisure time physical activity depended on SOC. In the white collar work environme nt the low SOC tertile had a high CHD incidence of 20.1 per 1000 person-yea rs; the incidences in the medium and high SOC tertiles were 10.9 and 12.3, respectively. A similar effect was not observed in the blue collar work env ironment. There, contrary to theoretical expectations, the low SOC tertile had the: lowest incidence of CHD. The difference in the CHD incidence patte rn depended on the blue and white collar dichotomy and not on the branch (s tate agencies vs. industry). The SOC had a salutogenic effect among white c ollar workers, but failed to have any consequent effect on the health of bl ue collar workers. Further study is needed to look at the psychosocial fact ors among blue collar workers. (C) 1999 Elsevier Science Ltd. All rights re served.