People who are bullied or exposed to violence in their workplaces may be at an increased risk of developing heart disease, heart attacks and stroke, according to a study published recently in the European Heart Journal.
Researchers analyzed data from more than 79,000 workers living in Denmark and Sweden who had participated in three studies that started between 1995 and 2011. The participants ranged in age from 18 to 64, and none had a history of heart disease when they joined the studies. Slightly more than half (53 percent) were women.
At the start of each study, the participants were asked about bullying and violence at their workplace and how often they had experienced each within the previous 12 months. Nine percent reported being bullied at work (defined as “repeated or enduring psychologically aggressive behaviors at work”), and 13 percent said they had been exposed to on-the-job violence (defined as “the intentional use of physical force or threats of such actions at work”).
Interestingly, most (79 percent) of the bullying came from co-workers or bosses, while most (91 percent) of the violence or threats of violence came from clients or other people outside the workplace.
The participants were followed for an average of 12 years. At the end of that period, 3,229 — or about 4 percent — had been diagnosed with heart disease or hospitalized for a related event, such as a heart attack or stroke.
A significant association
The study found that people who had reported being bullied at work were 59 percent more likely to have developed heart disease or been hospitalized for heart attack or stroke than individuals who said they hadn’t been bullied. For people who said they had experienced workplace violence, the risk was 25 percent higher.
The more frequent the bullying or exposure to violence, the greater the risk. Participants who had said they were bullied frequently (the equivalent of almost every day) were 120 percent more likely to have developed heart disease at the end of the study than people who hadn’t reported being bullied. And individuals who had reported the most frequent exposure to workplace violence were 36 percent more likely to have had a stroke.
“The effect of bullying and violence on the incidence of cardiovascular disease in the general population is comparable to other risk factors, such as diabetes and alcohol drinking,” said Tianwei Xu, the study’s lead author and a Ph.D. student at the University of Copenhagen, in a released statement.
The elimination of bullying and violence from the workplace could result in a 5 percent and 3 percent drop, respectively, in all new cases of cardiovascular disease, she added.
Plenty of caveats
The study is observational and therefore can show only an association, not a direct cause-and-effect link, between workplace bullying and violence and an increased risk of heart disease. Also, the study involved people living in two Nordic countries where, as Xu and her colleagues point out, “workplace bullying and violence are well-established.”
“Caution is needed when generalizing the results to other cultural settings, where individuals may perceive workplace bullying and violence differently,” they add.
Furthermore, although the researchers adjusted their findings to account for factors that can affect the development of heart disease, such as body mass index, alcohol consumption, smoking, psychological disorders, shift work and several pre-existing medical conditions, they were unable to address other important confounding factors, including genetics.
Still, Xu and her colleagues say their study’s results are “robust” — and biologically plausible.
Workplace bullying and violence can be major stressors in people’s lives and, as such, may increase blood pressure, heart rate and insulin sensitivity, the researchers point out. Stress can also trigger anxiety and depression, which can lead to overeating, excessive alcohol use, smoking and other behaviors associated with an increased risk of heart disease.
“It is important to prevent workplace bullying and workplace violence from happening, as they constitute major stressors for those exposed,” Xu and her colleagues conclude. “It is also important to have policies for intervening if bullying or violence occurs.”
In a 2015 survey of U.S. workers, one in five respondents said they were exposed to hostile or threatening behaviors at work.
FMI: The study can be found on the European Heart Journal’s website.