Re: Effort–Reward Imbalance at Work and Incident Coronary Heart Disease
We would like to know whether the association between ERI and coronary heart disease is consistent or not across several alternative operations of ERI in the study.
On the other hand, the authors made the very informative decision of testing the associations of ERI components, effort, and reward (dichotomized at their medians) with coronary heart disease (CHD). Reward, but not effort, was significantly associated with CHD (1.18 hazard ratio). According to the original ERI model, reward is composed of three variables: income, respect, and status. To better develop specific intervention and prevention strategies, we believe it would be even more informative to test the independent associations of the three types of rewards with CHD as well. We think it would be possible at least in the three cohorts–GAZEL (GAZ et Electricité), HNR (Heinz Nixdorf Recall Study), WOLF-F (Work, Lipids, Fibrinogen) study) of the IPD-Work Consortium (Individual-Participant-Data meta-analysis in Working Populations) where the original ERI questionnaire was used.