Validity and Reliability of a Work History Questionnaire Derived From the Job Content Questionnaire Paul A. Landsbergis, PhD, MPH Peter L. Schnall, MD, MPH Thomas G. Pickering, MD, DPhil Joseph E. Schwartz, PhD Job design risk factors for hypertension and heart disease have often been assessed by the Job Content Questionnaire (JCQ). Job characteristics are typically assessed only once, however, which can result in misclas- sification and bias results toward the null. Newer approaches, which assess job characteristics over a working life, are hampered by the need to ask numerous questions about each job, increasing survey length and potentially reducing response rates. Participants in the Work Site Blood Pressure Study, a prospective study of psychosocial factors and ambu- latory blood pressure, completed the JCQ about their current jobs. At later dates, 213 employed men, a subset of the original cohort, retrospectively completed the Work History Questionnaire (WHQ), a short version of the JCQ, for each past job. The WHQ exhibited moderate validity for assessing past job characteristics, a weak association with systolic blood pressure, and expected patterns of change over time. Thus, it may be a valuable tool for measuring the health effects of historical job charac- teristics, which often change over time. ( J Occup Environ Med. 2002; 44:1037–1047) J ob strain, defined as the combination of high psychological job demands and low job decision latitude or low job control, has been shown to be a risk factor for cardiovascular disease (CVD), and for blood pressure (BP) elevation, when BP is measured with an ambulatory (portable) monitor. 1–3 Many studies likely underestimate the effect of job strain since, in most studies, however, job strain was measured at only one point in time. 2,3 It is hypothesized that chronic biological arousal due to sus- tained job strain contributes to the development of essential hyperten- sion. 4 Use of current exposure as a surrogate for lifetime exposure is inaccurate, in part, since people often gain skills with time and age, may be promoted, may select out of “high strain” jobs, or their job characteris- tics may change even within the same job title. Many participants with a lengthy history of job strain might thus be currently classified as having no job strain because of re- cent promotions or other job changes. Use of inaccurate measures of job strain exposure can result in nondifferential misclassification and bias results toward the null hypothe- sis. Measurement of job characteris- tics over the course of a person’s work life would reduce misclassifi- cation and allow us to test hypothe- ses about the temporal association between job strain and BP elevation. What is the effect of duration of exposure on job strain? Are induc- tion periods long or short? After From the Department of Community and Preventive Medicine, Mount Sinai School of Medicine, New York, NY (Dr Landsbergis); Division of Cardiology, Department of Medicine, Mount Sinai School of Medicine, New York, NY (Dr Pickering); Center for Occupational and Environmental Medicine, University of California, Irvine, CA (Dr Schnall); Department of Psychiatry and Behavioral Science, State University of New York at Stony Brook, Stony Brook, NY (Dr Schwartz). Address correspondence to: Paul Landsbergis, Department of Community and Preventive Medicine, Mount Sinai School of Medicine, Box 1043, One Gustave L. Levy Place, New York, NY, 10029-6574; paul.landsbergis@mssm.edu Copyright © by American College of Occupational and Environmental Medicine DOI: 10.1097/01.jom.0000038321.36316.82 JOEM • Volume 44, Number 11, November 2002 1037