# Examining the Association Between Occupational Strain and Risk of Angina Pectoris Among Older Working Adults in India Using Karasek’s Job Demand Control Model

## TL;DR

This study explores how job stress affects the risk of heart-related chest pain in older Indian workers, finding that certain job conditions may lower the risk.

## Contribution

The study applies Karasek’s JDC model to examine occupational strain and angina risk in older Indian workers, a population with limited prior research.

## Key findings

- Active and passive job roles were associated with a significantly lower likelihood of angina pectoris.
- Early labor force participation and poor self-rated health increased angina risk.
- Regional differences in angina risk were significant, but socioeconomic factors were not after adjustment.

## Abstract

Occupational strain is a well-known predictor of cardiovascular diseases (CVDs), yet limited evidence exists for older workers in India. Using the Job Demand–Control (JDC) model, this study examines the association between job strain and the risk of Angina Pectoris (AP) among older workers, focusing on psychosocial workplace conditions linked to later life AP risk.

We used Wave 1 (2017–18) of the Longitudinal Aging Study in India (LASI), a nationwide survey, focusing on working older adults (n = 66,331). Occupational strain was conceptualised using the JDC model (high strain, active, passive, low strain), while AP was assessed using the Rose Angina Questionnaire. We employed a multivariable logistic regression model to examine the association between job strain and AP while adjusting for socioeconomic and health-related variables.

After adjusting for socioeconomic and health factors, individuals in both active (OR=0.77, 95% CI: 0.64–0.92) and passive jobs (OR=0.84, 95% CI: 0.74–0.96) exhibited a significantly lower likelihood of AP, whereas low-strain jobs showed a marginally protective but non-significant association compared to high-strain jobs. Early labour force participation (before age 14) and poorer self-rated health were associated with a higher risk of AP. Regional variation was significant, while socioeconomic variables were not significant after adjustment.

This study highlights the role of psychosocial conditions, including occupational strain, in the development of angina in later life. The findings point to the need for better work environments that allow employees more control, decision-making autonomy, and greater skill discretion in their roles. At the same time, early identification and management of job stress and burnout may reduce the burden of angina and other cardiac events among India’s aging workforce.