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Time trends in incidence of myocardial infarction in male and female dominated occupations in Stockholm, Sweden

Division of International Health (IHCAR), Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden, piroska.ostlin{at}ki.se

Kristina Klerdal

Department of Epidemiology, Stockholm Centre for Public Health, Stockholm, Sweden

Niklas Hammar

Department of Epidemiology, Stockholm Centre for Public Health, Stockholm, Sweden, Division of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden

Aims: To investigate time trends in first acute myocardial infarction (MI) incidence in male and female dominated occupations in Stockholm during 1977—1996. Methods: Population-based case-control study, where all first events of acute MI among participants aged 40—69 in Stockholm 1977—1996 were identified, using registers of hospital discharges and deaths. Controls were selected randomly using national population registers. There were 16,531 male and 4382 female cases and 117,015 male and 102,083 female controls. In all, 222 female cases worked in male dominated occupations and 844 male cases worked in female dominated occupations. Results: Both women and men in male dominated occupations showed an elevated relative risk of first MI compared to other employees during the study period. Between 1985—1996, when there was a general decline in MI incidence in Sweden, women in male dominated occupations tended to show an increasing trend. Women in female dominated high and intermediate occupations had a lower relative risk of MI compared to other women in the same socioeconomic group. In male dominated and non-manual female dominated occupations a decline in the incidence of MI was seen during 1985—1996 in men but not in women. Conclusions: Work in male dominated occupations appears to be associated with an increased risk of MI in both genders. There is a need to investigate possible work related or other factors that may be driving this elevated risk.

Key Words: Myocardial infarction • case-control study • trend analysis • male dominated occupations • female dominated occupations

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