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J Occup Health year 2008 volume 50 number 1 page 31 - 40
Classification Originals 
Title Association of Physical Job Demands, Smoking and Alcohol Abuse with Subsequent Premature Mortality: A 9-year ollow-up Population-based Study
Author Eve BOURGKARD1, Pascal WILD1, Nicole MASSIN1, Jean-Pierre MEYER2, Carmen OTERO SIERRA3, Jean-Marc FONTANA1, Lahoucine BENAMGHAR3, Jean-Marie MUR1, 3, Jean-Francois RAVAUD4, Francis GUILLEMIN5, Nearkasen CHAU1, 6-8 and Lorhandicap Group6
Organization 1Institut National de Recherche et de Securite (INRS), WHO Collaborative Centre, Departement dfEpidemiologie en Entreprises, 2INRS, Departement Homme au Travail, 3INSERM, U420, WHO Collaborative Centre, 4INSERM, U750, CERMES, IFR25-IFRH, 5Universite Henri Poincare-Nancy 1, Faculte de Medecine, 6INSERM, U669, 7Univ Paris-Sud, U669 and 8Univ Paris Descartes, France
Keywords Job category, Physical job demands, Premature mortality, Cancer, Smoking, Alcohol, Gender
Correspondence N. Chau, Inserm, U669, 8 rue du Breuil, F- 54180 Heillecourt, France (e-mail: Nearkasen.Chau@wanadoo.fr)
Abstract Association of Physical Job Demands, Smoking and Alcohol Abuse with Subsequent Premature Mortality: A 9-year Follow-up Population-based Study: Eve BOURGKARD, et al. Institut National de Recherche et de Securite (INRS), WHO Collaborative Centre, Departement dfEpidemiologie en Entreprises, France-This study assessed the relationships of physical job demands (PJD), smoking, and alcohol abuse, with premature mortality before age 70 (PM-70) among the working or inactive population. The sample included 4,268 subjects aged 15 or more randomly selected in northeastern France. They completed a mailed questionnaire (birth date, sex, weight, height, job, PJD, smoking habit, alcohol abuse (Deta questionnaire)) in 1996 and were followed for mortality until 2004 (9 yr). PJD score was defined by the cumulative number of the following high job demands at work: hammer, vibrating platform, pneumatic tools, other vibrating hand tools, screwdriver, handling objects, awkward posture, tasks at heights, machine tools, pace, working on a production line, standing about and walking. The data were analyzed using the Poisson regression model. Those with PM-70 were 126 (3.81 per 1,000 personyears). The leading causes of death were cancers (46.4% in men, 57.1% in women), cardiovascular diseases (20.2% and 11.9%), suicide (9.5% and 7.1%), respiratory diseases (6.0% and 4.8%), and digestive diseases (2.4% and 4.8%). PJD>=3, smoker, and alcohol abuse had adjusted risk ratios of 1.71 (95% CI 1.02-2.88), 1.76 (1.08-2.88), and 2.07 (1.31-3.26) respectively for all-cause mortality. Manual workers had a risk ratio of 1.84 (1.00-3.37) compared to the higher socio-economic classes. The men had a twofold higher mortality rate than the women; this difference became non-significant when controlling for job, PJD, smoker and alcohol abuse. For cancer mortality the factors PJD>=3, smoker, and alcohol abuse had adjusted risk ratios of 2.00 (1.00-3.99), 2.34 (1.19-4.63), and 2.22 (1.17-4.20), respectively. Health promotion efforts should be directed at structural measures of task redesign and they should also concern lifestyle.