Study population

The study is a part of the FINALE programme (Holtermannet al. 2010), and data were obtained from baseline in
an intervention study conducted in 2007/2008. Detailed information about recruitment and study population has
previously been described (Jrgensen et al. 2010). In brief, cleaners were recruited from large cleaning
companies and businesses in the Zealand region of Denmark. The participants in the study all had at least 20
weekly working hours with cleaning as the main job task.
Within each workplace, all cleaners were more or less performing the same type of work.
From 9 workplaces, 758 employees were identified according to the managers lists of employees.
Of those, 589 answered a screening questionnaire [279 Danes (47%), 280 immigrants (48%) and 30 with
unknown ethnicity (5%)].
A total of 394 cleaners consented to participate and were invited to answer a questionnaire (Jrgensen et al.
2010).
Three hundred and thirty cleaners answered the questionnaire (84%), and 339 participated in the physiological
tests (86%). After excluding immigrants from Western countries (n=12), cleaners with unknown origin (n=6)
and cleaners with missing information on either the dependent or background variables (n=48), the study
sample constituted 285 cleaners (137of non-Western and 148 of Danish origin).
The questionnaire was in Danish language but to overcome reading or language barriers, it was distributed at
questionnaire sessions, where assistance was available from research personnel. The participants gave their
written informed consent before entering the study, and all procedures were performed according to the
Declaration of Helsinki.
Ethics approval was received from the local ethics committee (H-C-2007-0033), and the intervention trial was
registered with a unique trial registration number (ISRCTN96241850).
Measurement of hypertension
Hypertension was defined as a binary variable as having 140 mmHg systolic blood pressure and/or 90 mmHg
diastolic blood pressure and/or currently using antihypertensive medicine (Sehestedt et al. 2007). Blood pressure
was measured using a UA-779 blood pressure monitor (A&D Instruments LTD, Abingdon, UK) in sitting
relaxed posture in a quiet room after at least 10-min rest (Kronborg et al. 2009). The blood pressure was
measured 3 times, and the average of the two latest measures was calculated. The measurements were taken by
trained clinical personnel (medical laboratory technicians, physiotherapists and physiologists). Concerning the
use of antihypertensive medicine, the participants answered the question:
Do you use blood pressure reducing medicine or heart
medicine,
with
response
categories
yes
and
no.
Measurement of psychosocial work environment
Psychosocial work environment was measured with scales
using The Copenhagen Psychosocial Questionnaire
(COPSOQ) (Pejtersen et al. 2010). The psychometric properties
of
the
COPSOQ
have
been
tested
comprehensively
(Thorsen
and Bjrner
2010;
Pejtersen
et
al. 2010), and is
widely used in Danish and international studies (Pejtersen
et al. 2010). Each factor used in this analysis belongs to one
of the Wve domains. The domain of Demands at work
includes the factors Work pace, Quantitative demands and

Emotional demands. The domain of Work organization and

job contents includes the factors InXuence, Possibilities for
development and Meaning of work. The domain of Interpersonal
relations
and leadership
includes
Predictability,
Recognition,
Role
clarity,
Quality
of
leadership,
Social support from supervisors and Social support from colleagues.
The domain of Work-individual interface includes Job satisfaction.
And
Wnally,
the
domain
of
Values
at workplace
includes
Trust
regarding
management
and
Justice.
Except
for
Job
satisfaction,
which
was
measured
by
a
single
variable,
all psychosocial
factors
were
measured
with
two
items
combined
into
one
scale
(see
Pejtersen
et
al. 2010 for
detailed description). The possible range of scores went
from 0 to 100, with 100 representing the highest degree of
the measured psychosocial factor and 0 representing the
lowest. For the Wrst 3 listed factors belonging to the domain
of Demands at work, Work pace, Quantitative demands and

Emotional demands, a low score is considered desirable

(Pejtersen et al. 2010). For the rest of the scales, a high
score is considered desirable.
Immigrant status
The participants reported their country of birth. The classiWcation
of
Danish
and
non-Western
immigrants
followed
that
of
Statistics
Denmark
(Statistics
Denmark
2010).
Cleaners
from
Denmark,
The Faeroe Islands
and
Greenland
were
considered
Danish.
Cleaners
from
West-European
countries,
EU
countries,
North
America,
Australia
and
New
Zealand
were considered
Western
immigrants.
Remaining
cleaners
were
considered
non-Western
immigrants.
Measurement of other covariates
Age is a continuous self-reported variable. Sex is a binary
self-reported variable. Body mass index (BMI) is a continuous
variable
calculated
from
the
measured
height
and body
weight

(body
weight/height
2

). Smoking is a binary variable

based on self-reported current smoking or not. Selfreported
physical
work
exertion
was
measured
with
the
Borg
scale
ranging
from
6 to
20.
The
value
6 indicates
no
exertion
at all, while
20
indicates
the
highest
possible
exertion
(Borg
1970).
Sample characteristics
In Table 1 is given descriptives of the variables considered
as potential confounders and consequently adjusted for in
the regression models. The results are stratiWed by immigrant
status.
As can be seen from Table 1, the sample characteristics
diVered between the two groups of cleaners. The Danes
were approximately 5 years older than their non-Western
immigrant colleagues, and a higher proportion of the immigrants
were men. The lifestyle
variables
also
diVered,
as
the
BMI
was
slightly
higher
for
non-Western
immigrants,
and
a
higher
proportion
of
the

Danes
were
current
smokers.
However,
the
level
of
self-reported
physical
work
exertion
was
approximately
the
same
for
the
two
groups.
Statistics
All calculations were made using SAS 9.2 software. The
sample was stratiWed into Danish and non-Western immigrant
cleaners,
and
binary
logistic
regressions
were
performed
with hypertension
as
the dependent
variable
and
the
COPSOQ
scales
as
the independent
variables.
Separate
models
were applied
for
each individual
COPSOQ
scale.
Therefore,
the
COPSOQ
scales
were
not
mutually
adjusted
for
each
other.

Covariates
were added
with
stepwise
entry
for
each
psychosocial
factor. Eventually
separate
models
were
estimated
with
the
full
population
of
cleaners
testing
the
association
between
psychosocial
work
environment
and
hypertension
for
the
interaction
of
ethnicity. The level
of
statistical
signiWcance
was
set
to p
<0.05.