Does working while ill trigger serious coronary events? The Whitehall II study.

• OBJECTIVE: Working while ill has been found to predict coronary heart disease. We tested if this association was due to triggering. METHODS: We used a nested case-control study in an occupational cohort to examine sickness absences during a 2-year period immediately before the first coronary event for 133 cases and 928 matched controls without a history of coronary events. Working while ill was defined as no absence despite being unhealthy (suboptimal self-rated health or psychological distress). RESULTS: The odds of a coronary event were not higher for cases who worked while ill than for correspondingly unhealthy controls who took >0 to 14 days of absence per year (OR = 0.62; 95% CI = 0.28 to 1.38). These results were little affected by multiple adjustments. CONCLUSIONS: We found no evidence that working while ill acts as a short-term trigger for coronary events.

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