Excessive work and risk of haemorrhagic stroke: A nationwide case-control study

Beom Joon Kim, Seung Hoon Lee, Wi Sun Ryu, Chi Kyung Kim, Jong Won Chung, Dohoung Kim, Hong Kyun Park, Hee Joon Bae, Byung Joo Park, Byung Woo Yoon

Research output: Contribution to journalArticlepeer-review

17 Citations (Scopus)


Background: Adverse effect of excessive work on health has been suggested previously, but it was not documented in cerebrovascular diseases. Aim: The authors investigated whether excessive working conditions would associate with increased risk of haemorrhagic stroke. Methods: A nationwide matched case-control study database, which contains 940 cases of incident haemorrhagic stroke (498 intracerebral haemorrhages and 442 sub-arachnoid haemorrhages) with 1880 gender- and age- (±5-year) matched controls, was analysed. Work-related information based on the regular job situation, including type of occupation, regular working time, duration of strenuous activity during regular work and shift work, was gathered through face-to-face interviews. Conditional logistic regression analyses were used for the multivariable analyses. Results: Compared with white-collar workers, blue-collar workers had a higher risk for haemorrhagic stroke (odds ratio, 1·33 [95% confidence interval, 1·06-1·66]). Longer regular working time was associated with increased risk of haemorrhagic stroke [odds ratio, 1·38 (95% confidence interval, 1·05-1·81) for 8-12h/day; odds ratio, 1·95 (95% confidence interval, 1·33-2·86) for ≥13h/day; compared with ≤4h/day]. Exposure to ≥8h/week of strenuous activity also associated haemorrhagic stroke risk [odds ratio, 1·61 (95% confidence interval, 1·26-2·05); compared with no strenuous activity]. Shift work was not associated with haemorrhagic stroke (P=0·98). Positive associations between working condition indices and haemorrhagic stroke risk were consistent regardless of haemorrhagic stroke sub-types and current employment status. Conclusions: Blue-collar occupation, longer regular working time and extended duration of strenuous activity during work may relate to an increased risk of haemorrhagic stroke.

Original languageEnglish
Pages (from-to)56-61
Number of pages6
JournalInternational Journal of Stroke
Issue number100 A
Publication statusPublished - 2013


  • Haemorrhagic stroke
  • Intracerebral haemorrhage
  • Occupation
  • Sub-arachnoid haemorrhage
  • Working condition
  • Working hour

ASJC Scopus subject areas

  • Neurology


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