Association Between Reported Long Working Hours and History of Stroke in the CONSTANCES Cohort

Background and Purpose— Long working hours (LWHs) are a potential risk factor for stroke. The aim of this study was to investigate this association in a large general population cohort. Methods— We used the French population-based cohort, CONSTANCES (Cohorte des Consultants des Centres d'Examens de Santé), to retrieve information on age, sex, smoking, and working hours from the baseline, self-administered questionnaire. Other cardiovascular risk factors and previous occurrence of stroke were taken from a parallel medical interview. We defined LWH as working time >10 hours daily for at least 50 days per year. Participants with primarily part-time jobs were excluded as were those with stroke before LWH exposure. We used logistic models to estimate the association between LWH and stroke, stratified by age, sex, and occupation. In additional modeling, we excluded subjects whose stroke occurred within 5 years of the first reported work exposure. Results— Among the 143 592 participants in the analyses, there were 1224 (0.9%) strokes, 42 542 (29.6%) reported LWH, and 14 481 (10.1%) reported LWH for 10 years or more. LWH was associated with an increased risk of stroke: adjusted odds ratio of 1.29 (95% CI, 1.11–1.49). Being exposed to LWH for 10 years or more was more strongly associated with stroke, adjusted odds ratio of 1.45 (95% CI, 1.21–1.74). The association showed no differences between men and women but was stronger in white-collar workers under 50 years of age. Conclusions— This large analysis reveals a significant association between stroke and exposure to LWH for 10 years or more. The findings are relevant for individual and global prevention.