Occupational Medicine: State of the Art Reviews: The Workplace and Cardiovascular Disease
Volume 15, Number 1.
Peter L. Schnall, Karen Belkic, Paul Landsbergis, and Dean Baker, eds. 352 pp.
Philadelphia, Penn: Hanley and Belfus; 2000.
US rates: $36.00 for a single issue; $ 96.00 for the series (4 issues).
On the same day that I rather hastily reviewed this book, 2 other experiences highlighted its main message: today’s workplace and the strains that are imposed on most working people are major contributors to cardiovascular disease in general and to hypertension in particular. The first of these experiences was riding in a taxi through Manhattan to New York LaGuardia airport, and the second was viewing Boiler Room, a movie about a group of young men selling worthless securities over the phone to naïve buyers (including physicians). Seeing the frenzy, the physical and psychological stress, and the frustrations of the cabdriver and the stockbroker, people on the 2 extremes of American occupations, brought home the reality of what is described in this book.
As the 4 editors and 34 other contributors repeatedly document, we are all threatened by Karoski: the Japanese term for death from overwork (as described in the chapters on Working Life in Japan). It’s really not so much overwork but “job strain” that seems to be doing us in. Throughout the 300 plus pages, this message comes through loud and clear. To the authors’ credit, every aspect of the role of job strain in causing cardiovascular disease is covered, including both theoretical and practical solutions to the problem.
This subject deserves more attention. This book is a well-referenced, up-to-date portrayal of the field. However, it’s more like viewing a painting by Kandinsky than a Monet. The coverage is chaotic, repetitive, and disorganized. But it’s unlikely that anything important in the relationship between job strain and cardiovascular disease/hypertension is not covered. Some really heavy editing would have helped. Even better, if the 4 editors, singly or together had done all of the writing, the book would serve more as a textbook and guide to the outsider who is just learning about the subject than a hard to follow and rather rambling presentation of everything that is known for those who are knowledgeable about this field.
Norman M. Kaplan
Clinical Professor of Medicine
University of Texas - Southwestern Medical Center