Warning: a bad boss may be dangerous to your health

Sick and tired of your lousy boss?

It's more than a mere irritation. It could kill you.

Swedish researchers report today that workers saddled for four years with managers who were inconsiderate, opaque, uncommunicative, and poor advocates were about 60 percent more likely to suffer a heart attack or other life-threatening cardiac condition. By contrast, employees whose managers exhibited robust leadership skills were roughly 40 percent less likely to suffer heart emergencies.

And the boss effect appeared to trump other considerations, including workload and whether the employee smoked, exercised, or had weight problems, researchers found.

The study, which tracked more than 3,100 Swedish men for the better part of a decade, adds to an expanding body of research showing that what happens on the job doesn't stay on the job. It can, instead, potentially wreak havoc deep in our arteries, with blood pressure soaring and stress-spawned hormones surging.


"For all of those who work under managers who they perceive behave strangely, or in any way they don't understand and they feel stressed, the study confirms this might actually be a health risk," said Anna Nyberg, a psychologist at the Karolinska Institute in Stockholm and lead author of the study appearing in the Journal of Occupational and Environmental Medicine. "And they should take it seriously."

One Boston cardiologist, Dr. Christopher Cannon of Brigham and Women's Hospital, said he found the study so persuasive -- and disturbing -- that he planned immediately to begin quizzing his patients more extensively about their on-the-job experiences.

"Now, we'll ask what is your job like? Are you happy in your job? Is your boss difficult to work with?" Cannon said. "I guess Dilbert would fit in here. Dilbert's looking at an early heart attack, given that he has very little control over his life and doesn't seem to have a very nice boss."

The findings about the dangers of bad bosses emerged, appropriately enough, from a study that goes by the acronym WOLF. It stands for Work, Lipids, and Fibrinogen Stockholm study.

Starting in 1992, workers between the ages of 19 and retirement were screened, with information about medical history gathered and standard cardiovascular tests such as blood pressure and cholesterol readings performed.

The workers, who tended to be better educated and have slightly better access to healthcare than the typical Swede, were also asked to evaluate their bosses' behavior, responding to statements such as, "My boss is good at pushing through and carrying out changes," "I have a clear picture of what my boss expects of me," and "I have sufficient power in relation to my responsibilities."

Over the next decade, the total number of heart attacks, unstable angina, and other serious cardiac emergencies was not alarmingly high: There were 74 such episodes.

But the researchers said they found an unmistakable trend: The longer workers toiled for feckless bosses -- think Mr. Burns of "Simpsons" fame -- the more likely they were to be felled by heart disease. That was a greater negative effect than if the employee smoked, didn't get enough exercise or was overweight, or had high cholesterol.

Dr. Robert Bonow chief of cardiology at Northwestern University's Feinberg School of Medicine, said he believed that the study had, in fact, identified true health consequences related to management skills, but cautioned against overstating the effect.

"It wasn't like this was happening as an epidemic -- it wasn't like these people were dropping over" in huge numbers, Bonow said.

Still, specialists said, there are plausible biological explanations for the phenomenon.

Studies have repeatedly demonstrated, for example, that stress can cause blood pressure to spike and the heart to race. At the same time, stress can cause the release of certain biochemical agents, including hormones, that can cause blood clots to form and make arteries more prone to thickening and brittleness.

That, Bonow said, was helpful for cave men staring down a saber tooth tiger. "You'd want your adrenaline to give you this heightened reactivity," he said, adding that clotting was desirable, too, "so that when the saber tooth tiger bites you, you don't bleed as much." That primordial response isn't nearly so helpful in modern humans, though.

Workers today can face a different kind of menace, in the form of uncaring and even hostile managers. While challenging specifics of the Swedish study, a human-resources consultant acknowledged that there is an "undisputed" relationship between a manager's leadership style and workers' productivity and mental health.

"A manager needs to be sincere and care about his or her employees from an individual standpoint and know what motivates them, and understand what their skills and competencies are," said Dawn Hatterer, principal of the Consulting Authority in Frederick, Md. Managers, she said, also should know what employees "want to be when they grow up. That's what keeps people engaged at work, from a management standpoint."

At Winchester Hospital, rated as the best place to work in Massachusetts in a Globe survey released recently, managers undergo two or three days of training together each year and must spend an additional 24 hours engaged in leadership development, said Kathy Schuler, vice president for patient care. The hospital has even hired executive coaches to work with subpar managers.

"People join an organization for a variety of reasons -- salary, job position," Schuler said. "But people leave because of their relationship with their direct supervisor."

As for Nyberg, she said she's always worked for good bosses -- in part, because she's known which ones to avoid.

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