Being treated unfairly at work may, quite literally, cause heartache. In a Finnish study, published Oct. 24 in Archives of Internal Medicine, men who perceived a low level of justice at work were more likely to suffer angina, heart attack or death from coronary artery disease than those who perceived a high level of justice.

For the study, over 6,400 men ages 35 to 55 responded to a questionnaire about job strain and effort-reward imbalance. The interviews took place from 1985 to 1990. The men were then followed to track heart problems through 1999.

Men who perceived higher levels of justice were more likely to be older and married, and have better jobs and education. They were less likely to be fat. But even after adjusting for these factors and others, the correlation remained between a sense of injustice and symptoms of increased coronary disease.

The incidence of heart problems was 30 percent lower among those who perceived a high level of justice at work than in those who did not. This, said Mika Kivimaki, the lead author on the study and a professor of psychology at the University of Helsinki, suggests that justice at work can be protective.

Dr. Kivimaki acknowledged that the results were based on observational data rather than a controlled experiment, but he did have some suggestions for employers.

"Increasing fair decision-making procedures that include input from affected parties and are consistently applied, unbiased, open, correctable and ethical may be beneficial for heart health among employees," Dr. Kivimaki said. "I believe that efforts to follow such principles in workplaces do not contradict sound business practices."