Workplace Sexual Harassment Tied to Higher Risk of CVD, T2D in Men and Women

Exposure to workplace sexual harassment was associated with a higher risk for developing cardiovascular disease (CVD) and type 2 diabetes (T2D), according to a study published in the European Journal of Preventive Cardiology.

The risk for developing CVD and T2D was highest among individuals who frequently experienced the behavior in the workplace, added authors of the prospective cohort study of nearly 89 000 Swedish workers.

“Workplace sexual harassment is a problem affecting all occupations, sectors, and countries around the globe. It is a widespread but under-reported phenomenon,” first author Prakash KC, PhD, MPH, faculty member in the unit of health sciences at Tampere University in Tampere, Finland, and colleagues wrote. They noted that although workplace sexual harassment has been shown to be a risk factor for several behavioral and emotional outcomes (eg, depression, anxiety, chronic drinking), less is known about its association with CVD and T2D.

To further explore this gap in research, investigators tracked the cardiometabolic outcomes of 88 904 adults in Swedin (52% women; mean age, 43.2 years) aged 16 to 64 years who participated in the Swedish Work Environment Survey from 1995 to 2015 and who were free from cardiometabolic diseases at baseline. They collected 989 512 person-years of data on the study population, and the mean follow-up was 11 years, according to the study.

Participants were given a brief definition of sexual harassment, which was described as “undesirable advances or offensive references to what is generally associated with sexual relations,” and then they were asked 2 questionnaire items related to workplace sexual harassment: (1) whether they were subjected to sexual harassment from superiors or fellow workers, or (2) if they experienced sexual harassment from other individuals, such as patients, clients, passengers, or students. The response format was a 7-point Likert-type scale ranging from not at all during the previous 12 months to every day. To account for potential confounders, investigators adjusted for sociodemographic factors as well as work-related psychological and physical exposures.

Findings

Overall, 4.8% (n=4300) of respondents reported exposure to workplace sexual harassment in the preceding 12 months, with a larger proportion of women than men reporting the experience (7.5% vs 1.9%). Additionally, 1.5% reported sexual harassment from superiors or fellow workers, and 3.8% were exposed to the behavior by other people, including patients, clients, passengers, and students.

Researchers reported that participants exposed to workplace sexual harassment were more likely to be women, unmarried, and younger than those were not exposed. Also, a slightly higher proportion of participants born outside Sweden reported sexual harassment exposure compared with those born in Sweden (5.8% vs 4.7%).

Risk for CVD and T2D. At follow-up, 4.7% (n=4218) of the cohort were diagnosed with CVD at a rate of 4.3 cases per 1000 person-years, and 4% (n=3624) were diagnosed with T2D at a rate of 3.6 cases per 1000 person-years, according to researchers.

In the fully adjusted analysis, workplace sexual harassment was associated with an increased incidence of CVD (HR 1.25, 95% CI 1.03-1.51) and an even greater increased incidence of T2D (HR 1.45, 95% CI 1.21-1.73). Excess risk of CVD was observed among participants who were exposed to sexual harassment by superiors or their fellow workers (HR 1.57, 95% CI 1.15-2.15), but the risk when looking at sexual harassment from other individuals did not meet statistical significance (HR 1.16, 95% CI 0.93-1.45). The risk for T2D persisted whether it was by superiors and coworkers (HR 1.85, 95% CI 1.39-2.46) or other persons (HR 1.39, 95% CI 1.13-1.7).

In addition, an exposure-response analysis showed that frequent exposure to workplace sexual harassment increased the risk for developing CVD (HR 1.31, 95% CI 0.95-1.54) and T2D (HR 1.72, 95% CI 1.3-2.28), whereas the risks associated with occasional exposure did not meet significance, according to investigators.

“This study supports prospective association between workplace sexual harassment and increased risk of cardiometabolic diseases,” KC and colleagues concluded. “Given the importance of this association from the public health point of view, future research is warranted to clarify the causality and mechanisms behind these associations considering the severity of sexual harassment at workplace.”

Reference: KC P, Madsen IEH, Rugulies R. et al. Exposure to workplace sexual harassment and risk of cardiometabolic disease: a prospective cohort study of 88 904 Swedish men and women. Eur J Prev Cardiol. Published online June 14, 2024. doi:10.1093/eurjpc/zwae178