***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Study objectives : To investigate the association between job strain and components of the job strain model and  coronary heart disease ( CHD ) risk . Design : Prospect i ve cohort study ( Whitehall II study ) . At the first phase of the study ( 1985–1988 ) , data on self reported psychosocial work characteristics were collected from all participants . Participants were followed up until the end of phase 5 ( 1997–2000 ) , with mean length of follow up of 11 years . Setting : London based office staff in 20 civil service departments . Participants : 6895 male and 3413 female civil servants aged 35–55 . Outcome measures : Incident vali date d CHD . Main results : People with concurrent low decision latitude and high dem and s ( job strain ) were at the highest risk for CHD . High job dem and s , and , less consistently , low decision latitude , predicted CHD incidence . The effect of job strain on CHD incidence was strongest among younger workers , but there was no effect modification by social support at work , or employment grade . Conclusions : Job strain , high job dem and s , and , to some extent , low decision latitude , are associated with an increased risk of CHD among British civil servants OBJECTIVES : The impact of work on the risk of future  psychiatric disorder has been examined in few longitudinal studies . This was examined prospect ively in a large epidemiological study of civil servants . METHODS : In the Whitehall II study , a longitudinal , prospect i ve cohort study of 6895 male and 3413 female London based civil servants , work characteristics measured at baseline ( phase 1 : 1985 - 8 ) and first follow up ( phase 2 : 1989 ) were used to predict psychiatric disorder measured by a 30 item  general health question naire ( GHQ )  at phase 2 and phase 3 follow up ( phase 3 : 1991 - 3 ) .  Work characteristics and GHQ  were measured at all three phases . RESULTS : Low social support at work and low decision authority , high job dem and s and effort-reward imbalance were associated with increased risk of psychiatric disorder as assessed by the GHQ at follow up adjusting for age , employment grade , and baseline GHQ score . CONCLUSIONS : Social support and control at work protect mental health while high job dem and s and effort-reward imbalance are risk factors for future psychiatric disorder . Intervention at the level of work design , organisation , and management might have positive effects on mental health in working population Abstract Objective : To determine the association between adverse psychosocial characteristics at work and risk of coronary heart disease among male and female civil servants . Design : Prospect i ve cohort study ( Whitehall II study ) . At the baseline examination ( 1985 - 8 ) and twice during follow up a self report question naire provided information on psychosocial factors of the work environment and coronary heart disease . Independent assessment s of the work environment were obtained from personnel managers at baseline . Mean length of follow up was 5.3 years . Setting : London based office staff in 20 civil service departments . Subjects : 10 308 civil servants aged 35 - 55 were examined-6895 men ( 67 % ) and 3413 women ( 33 % ) . Main outcome measures : New cases of angina ( Rose question naire ) , severe pain across the chest , diagnosed ischaemic heart disease , and any coronary event . Results : Men and women with low job control , either self reported or independently assessed , had a higher risk of newly reported coronary heart disease during follow up . Job control assessed on two occasions three years apart , although intercorrelated , had cumulative effects on newly reported disease . Subjects with low job control on both occasions had an odds ratio for any subsequent coronary event of 1.93 ( 95 % confidence interval 1.34 to 2.77 ) compared with subjects with high job control at both occasions . This association could not be explained by employment grade , negative affectivity , or classic coronary risk factors . Job dem and s and social support at work were not related to the risk of coronary heart disease . Conclusions : Low control in the work environment is associated with an increased risk of future coronary heart disease  among men and women employed in government offices . The cumulative effect of low job control assessed on two occasions indicates that giving employees more variety in tasks and a stronger say in decisions about work may decrease the risk of coronary heart disease . Key messages Low job control in the work environment contributes to the development of coronary heart disease among British male and female civil servants The risk of heart disease is associated with both objective low job control and perceived low job control . Increase in job control over time decreases the risk of coronary heart disease . This suggests that policies giving people a stronger say in decisions about their work or providing them with more variety in work tasks may contribute to better cardiovascular OBJECTIVES This study examined a project design ed to improve the health and wellness of employees of Brabantia , a Dutch manufacturer of household goods , by means of lifestyle changes and changes in working conditions . METHODS The workers at one Brabantia site constituted the experimental group , and the workers from two other sites formed the  control group .  Biomedical variables , lifestyles , general stress reactions , and quality of work were measured identically in both groups at baseline and 1 , 2 , and 3 years later . During this period , there was continuous registration of absenteeism . RESULTS The interventions brought about favorable short-term changes in terms of health risks , and there were stable effects on working conditions ( especially decision latitude ) and absenteeism . CONCLUSIONS A combination of interventions directed at both lifestyles and the work environment can produce extensive and stable effects on health-related variables , wellness , and absenteeism The association between specific job characteristics and subsequent cardiovascular disease was tested using a large r and om sample of the male working Swedish population . The prospect i ve development of coronary heart disease ( CHD ) symptoms and signs was analyzed using a multivariate logistic regression technique . Additionally , a case-controlled study was used to analyze all cardiovascular-cerebrovascular ( CHD-CVD ) deaths during a six-year follow-up . The indicator of CHD symptoms and signs was vali date d in a six-year prospect i ve study of CHD deaths ( st and ardized mortality ratio 5.0 ; p less than or equal to .001 ) . A hectic and psychologically dem and ing job increases the risk of developing CHD symptoms and signs ( st and ardized odds ratio 1.29 , p less than 0.25 ) and premature CHD-CVD death ( relative risk 4.0 , p less than .01 ) . Low decision latitude-expressed as low intellectual discretion and low personal schedule freedom-is also associated with increased risk of cardiovascular disease . Low intellectual discretion predicts the development of CHD symptoms and signs ( SOR 1.44 , p less than .01 ) , while low personal schedule freedom among the majority of workers with the minimum statutory education increases the risk of CHD-CVD death ( RR 6.6 , p less than .0002 ) . The associations exist after controlling for age , education , smoking , and overweight OBJECTIVES The effects of a stress reduction program on Japanese blue-collar workers were investigated using a controlled trial design . METHODS Two blue-collar worksites that showed higher depression scores ( Zung self-rating depression score ) were selected for the  intervention  group , after a survey of a large electric company in 1985 . Three blue-collar worksites were selected as a reference group whose workers were matched with the workers of the interventive worksites by mean age , worksite size and mean depression scores . A 1-year stress reduction program was conducted in the intervention group from 1986 to 1987 by worksite supervisors . Effects of the stress reduction program were assessed by comparing the initial depression scores , length of sick leave , and systolic and diastolic blood pressures with those after the follow-up . RESULTS The depression scores decreased during the follow-up in the intervention group , while the scores were almost the same in the reference group . An analysis of covariance with repeated measurements indicated a statistically significant intervention ( group x time interaction ) effect after control for gender and age ( P = 0.035 ) . Sick leave in the past year decreased in 1988 only in the intervention group ; generalized logit analysis with repeated measurements indicated a statistically significant intervention effect after control for gender and age ( P = 0.034 ) . No statistically significant intervention effects were observed on systolic and diastolic blood pressures or selected work stressors . CONCLUSIONS A stress reduction program directed towards worksite supervisors can be used to reduce depressive symptoms and sick leave among Japanese blue-collar workers 
    Output:
    
Changes to the psychosocial work environment were found to have important and generally beneficial effects on health .