LONDON, July 25: While you daydream about strangling your boss, beware: It's more likely that your employer is killing you.

A study of British civil servants suggests that a feeling of little or no control at work explains why employees have a greater risk of heart disease 50 per cent higher than the people in the executive suite.

The study published in The Lancet, a British medical journal, was directed by Professor Michael Marmot of the International Center for Health and Society at University College, London.

It used data from a study of 7,372 men and women employed in the British civil service who were tracked from 1985 to 1993.

``The issue of control I think is a relatively new idea but certainly one that makes a lot of sense,'' said Dr Robert Carney, professor of medical physiology at Washington University in St Louis.

Asked if bosses are a big source of job stress, Dr Carney said: ``Oh, absolutely.''

A study of British bureaucrats started in the 1960s found that those in low-status jobs had a significantly higher risk of heart disease. In general, their health was worse and they died sooner. They were more likely to smoke and less likely to exercise.

In the recent study, Prof Marmot's team looked at the effect of smoking, inactivity, high blood pressure and feeling of powerlessness on workers' health.

When they adjusted to neutralise the effect of feeling out of control, the increased risk of heart disease among low-status workers dropped to 18 per cent, making that the largest single risk factor identified in the study.

The feeling of powerlessness was reported by 8.7 per cent of the men and 10.1 per cent of the women at the top of the civil service power structure, while at the bottom the figures shot up to 77.9 per cent for men and 75.3 per cent of women.

``Low control, but not high demand, at work is associated with increased incidence of (heart disease) independently of measures of socio-economic status,'' the study said.

The feeling of low control was associated with higher concentrations of plasma fibrinogen, a protein which binds blood cells together to form clots. Higher levels of fibrinogen can increase the risk of a heart attack.

Dr Carney said stress hormones can trigger higher levels of fibrinogen. They also can raise the pulse, and make the heart less flexible.

``If the higher risk of heart disease was simply a product of low social and economic status, there are few remedies short of a revolution,'' said Leonard Syme and Jennifer Balfour of the School of Public Health at the University of California, Berkeley.

However, they wrote in a separate report in The Lancet, ``there are more opportunities to intervene on control''. ``For example, if by control we mean learning to deal with the forces that impinge on people's lives, it is possible to help people to do that more effectively.''

Eric Brunner, a research fellow at University College, who worked with Prof Marmot on the study, said the villain is more likely to be a rigid organisation than a single tyrannical boss.

``It would be foolish always to blame the organisation, but the organisation has to provide a framework for people who do have problems, maybe even to help them into other jobs,'' Brunner said in a telephone interview.

Dr Carney said he urges his own patients ``to take as much control over your life as possible''. Stand up to the boss, perhaps, or get another job.

And spare a thought for the boss. ``It can happen to bosses as well as people in the lower echelons,'' Carney said. ``If you feel you don't have options, it can be a very stressful,'' he added.

Copyright © 1997 Indian Express Newspapers (Bombay) Ltd.