Risk factors for myocardial infarction among Swedish railway engine drivers during 10 years follow-up

Background Railway engine drivers have had an increased risk of myocardial infarction which could be due to reported low decision latitude and low soc ial support but not to elevated somatic risk factors. Objective To study somatic and psychosocial risk factors for myocardial inf arction among railway engine drivers prospectively. Design A prospective study of 2318 drivers followed for 10 years. Methods Risk factors were surveyed in conjunction with periodic health chec ks at 15 different centres but with common methodology and commonly used qu estionnaires. Questionnaire and register information on myocardial infarcti on during follow-up was recorded. Results Within this group of engine drivers, age, family history of myocard ial infarction, systolic blood pressure and low body height were independen t predictors of myocardial infarction, but diabetes, elevated serum cholest erol and smoking were not. Neither were a longer time in the occupation or work-related psychosocial factors. The drivers were all at the lower end of the decision authority and latitude scale and had low social support. With this limited span, it may be difficult to detect these variables as risk f actors within this group. Conclusions Several well-known, somatic risk factors for myocardial infarct ion were documented in this study, whereas psychosocial working conditions, which were common to all the drivers, were not significantly related to ou tcome. (C) 2000 Lippincott Williams & Wilkins.