Occupational cardiovascular disease: Difference between revisions

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combined headings on risk-factors (non-chemical and chemical) to work-related risk factors; added to the list of risk factors and provided citations
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added entire section with citations - "United States trends in cardiovascular disease deaths and the impact of work"
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'''Occupational cardiovascular diseases''' are diseases of the [[heart]] or [[blood vessel]]s caused by working conditions, making them a form of [[Occupational disease|occupational illness]]. These diseases include [[Coronary artery disease|coronary heart disease]], [[stroke]], [[cardiomyopathy]], [[Arrhythmia|arrythmia]], and [[heart valve]] or heart chamber problems. [[Cardiovascular disease]] is the leading cause of death in the United States and worldwide.<ref>{{Cite journal |date=2021-07-01 |title=National vital statistics report ; v. 70, no. 9 |url=https://doi.org/10.15620/cdc:107021 |language=en |doi=10.15620/cdc:107021}}</ref><ref>{{Cite web |title=The top 10 causes of death |url=https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death |access-date=2023-02-08 |website=www.who.int |language=en}}</ref> In the United States, cardiovascular diseases account for one out of four deaths.<ref name="pmid30700139">{{cite journal | vauthors = Benjamin EJ, Muntner P, Alonso A, Bittencourt MS, Callaway CW, Carson AP, etal | collaboration = American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee | title = Heart Disease and Stroke Statistics-2019 Update: A Report From the American Heart Association | journal = Circulation | volume = 139 | issue = 10 | pages = e56–e528 | date = March 2019 | pmid = 30700139 | doi = 10.1161/CIR.0000000000000659 | doi-access = free }}</ref>
'''Occupational cardiovascular diseases''' are diseases of the [[heart]] or [[blood vessel]]s caused by working conditions, making them a form of [[Occupational disease|occupational illness]]. These diseases include [[Coronary artery disease|coronary heart disease]], [[stroke]], [[cardiomyopathy]], [[Arrhythmia|arrythmia]], and [[heart valve]] or heart chamber problems. [[Cardiovascular disease]] is the leading cause of death in the United States and worldwide.<ref>{{Cite journal |date=2021-07-01 |title=National vital statistics report ; v. 70, no. 9 |url=https://doi.org/10.15620/cdc:107021 |language=en |doi=10.15620/cdc:107021}}</ref><ref>{{Cite web |title=The top 10 causes of death |url=https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death |access-date=2023-02-08 |website=www.who.int |language=en}}</ref> In the United States, cardiovascular diseases account for one out of four deaths.<ref name="pmid30700139">{{cite journal | vauthors = Benjamin EJ, Muntner P, Alonso A, Bittencourt MS, Callaway CW, Carson AP, etal | collaboration = American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee | title = Heart Disease and Stroke Statistics-2019 Update: A Report From the American Heart Association | journal = Circulation | volume = 139 | issue = 10 | pages = e56–e528 | date = March 2019 | pmid = 30700139 | doi = 10.1161/CIR.0000000000000659 | doi-access = free }}</ref> The 6th International Conference on Work Environment and Cardiovascular Diseases found that within the working age population about 10-20% of cardiovascular disease deaths can be attributed to work.<ref>{{Cite journal |last=Tsutsumi |first=Akizumi |date=2015 |title=Prevention and management of work-related cardiovascular disorders |url=https://pubmed.ncbi.nlm.nih.gov/26159941 |journal=International Journal of Occupational Medicine and Environmental Health |volume=28 |issue=1 |pages=4–7 |doi=10.2478/s13382-014-0319-z |issn=1896-494X |pmid=26159941}}</ref> Ten workplace stressors (shift work, job insecurity, high job demand, etc.) were estimated to be associated with 120,000 U.S. deaths each year and account for 5-8% of health care costs.<ref>{{Cite journal |last=Goh |first=Joel |last2=Pfeffer |first2=Jeffrey |last3=Zenios |first3=Stefanos A. |date=2016-02 |title=The Relationship Between Workplace Stressors and Mortality and Health Costs in the United States |url=http://pubsonline.informs.org/doi/10.1287/mnsc.2014.2115 |journal=Management Science |language=en |volume=62 |issue=2 |pages=608–628 |doi=10.1287/mnsc.2014.2115 |issn=0025-1909}}</ref>


Research related to the association between work and cardiovascular disease is on-going. Links have been established between cardiovascular disease risk and occupational exposure to chemicals, noise, psychosocial stressors, physical activity, and certain workplace organization factors. Additionally, work-related risk factors for cardiovascular disease may also increase the risk of other cardiovascular disease risk factors such as [[hypertension]]<ref>{{Cite journal |last=Bolm-Audorff |first=Ulrich |last2=Hegewald |first2=Janice |last3=Pretzsch |first3=Anna |last4=Freiberg |first4=Alice |last5=Nienhaus |first5=Albert |last6=Seidler |first6=Andreas |date=2020-01 |title=Occupational Noise and Hypertension Risk: A Systematic Review and Meta-Analysis |url=https://www.mdpi.com/1660-4601/17/17/6281 |journal=International Journal of Environmental Research and Public Health |language=en |volume=17 |issue=17 |pages=6281 |doi=10.3390/ijerph17176281 |issn=1660-4601 |pmc=PMC7504405 |pmid=32872306}}</ref><ref>{{Cite journal |last=Teixeira |first=Liliane R. |last2=Pega |first2=Frank |last3=Dzhambov |first3=Angel M. |last4=Bortkiewicz |first4=Alicja |last5=da Silva |first5=Denise T. Correa |last6=de Andrade |first6=Carlos A. F. |last7=Gadzicka |first7=Elzbieta |last8=Hadkhale |first8=Kishor |last9=Iavicoli |first9=Sergio |last10=Martínez-Silveira |first10=Martha S. |last11=Pawlaczyk-Łuszczyńska |first11=Małgorzata |last12=Rondinone |first12=Bruna M. |last13=Siedlecka |first13=Jadwiga |last14=Valenti |first14=Antonio |last15=Gagliardi |first15=Diana |date=2021-09-01 |title=The effect of occupational exposure to noise on ischaemic heart disease, stroke and hypertension: A systematic review and meta-analysis from the WHO/ILO Joint Estimates of the Work-Related Burden of Disease and Injury |url=https://www.sciencedirect.com/science/article/pii/S0160412021000118 |journal=Environment International |language=en |volume=154 |pages=106387 |doi=10.1016/j.envint.2021.106387 |issn=0160-4120 |pmc=PMC8204276 |pmid=33612311}}</ref>, [[diabetes]]<ref>{{Cite journal |last=Cosgrove |first=M. P. |last2=Sargeant |first2=L. A. |last3=Caleyachetty |first3=R. |last4=Griffin |first4=S. J. |date=2012-02-14 |title=Work-related stress and Type 2 diabetes: systematic review and meta-analysis |url=https://doi.org/10.1093/occmed/kqs002 |journal=Occupational Medicine |volume=62 |issue=3 |pages=167–173 |doi=10.1093/occmed/kqs002 |issn=0962-7480}}</ref><ref>{{Cite journal |last=Sui |first=Hua |last2=Sun |first2=Nijing |last3=Zhan |first3=Libin |last4=Lu |first4=Xiaoguang |last5=Chen |first5=Tuo |last6=Mao |first6=Xinyong |date=2016-08-11 |title=Association between Work-Related Stress and Risk for Type 2 Diabetes: A Systematic Review and Meta-Analysis of Prospective Cohort Studies |url=https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0159978 |journal=PLOS ONE |language=en |volume=11 |issue=8 |pages=e0159978 |doi=10.1371/journal.pone.0159978 |issn=1932-6203 |pmc=PMC4981307 |pmid=27513574}}</ref><ref>{{Cite journal |last=Krajnak |first=Kristine M. |date=2014-01 |title=Potential Contribution of Work-Related Psychosocial Stress to the Development of Cardiovascular Disease and Type II Diabetes: A Brief Review |url=http://journals.sagepub.com/doi/10.4137/EHI.S15263 |journal=Environmental Health Insights |language=en |volume=8s1 |pages=EHI.S15263 |doi=10.4137/EHI.S15263 |issn=1178-6302 |pmc=PMC4251185 |pmid=25525370}}</ref>, [[obesity]]<ref>{{Cite journal |last=Geda |first=Nigatu Regassa |last2=Feng |first2=Cindy Xin |last3=Yu |first3=Yamei |date=2022-03-29 |title=Examining the association between work stress, life stress and obesity among working adult population in Canada: findings from a nationally representative data |url=https://doi.org/10.1186/s13690-022-00865-8 |journal=Archives of Public Health |language=en |volume=80 |issue=1 |pages=97 |doi=10.1186/s13690-022-00865-8 |issn=2049-3258 |pmc=PMC8966340 |pmid=35351179}}</ref><ref name=":7">{{Cite journal |last=van den Berge |first=Mandy |last2=van der Beek |first2=Allard J. |last3=Türkeli |first3=Rukiye |last4=van Kalken |first4=Marike |last5=Hulsegge |first5=Gerben |date=2021-05-01 |title=Work-related physical and psychosocial risk factors cluster with obesity, smoking and physical inactivity |url=https://doi.org/10.1007/s00420-020-01627-1 |journal=International Archives of Occupational and Environmental Health |language=en |volume=94 |issue=4 |pages=741–750 |doi=10.1007/s00420-020-01627-1 |issn=1432-1246 |pmc=PMC8068657 |pmid=33409697}}</ref>, unhealthy diet<ref>{{Cite web |title=The effect of shift work on eating habits on JSTOR |url=https://www.jstor.org/stable/26567055 |access-date=2023-02-08 |website=www.jstor.org |language=en}}</ref>, leisure-time physical inactivity<ref name=":7" />, and [[Alcohol abuse|excessive alcohol use]]<ref>{{Cite journal |last=Frone |first=M. R. |date=1999 |title=Work stress and alcohol use |url=https://pubmed.ncbi.nlm.nih.gov/10890825 |journal=Alcohol Research & Health: The Journal of the National Institute on Alcohol Abuse and Alcoholism |volume=23 |issue=4 |pages=284–291 |issn=1535-7414 |pmc=6760381 |pmid=10890825}}</ref>. Work may also increase risk of [[Depression (mood)|depression]]<ref>{{Cite journal |last=Rugulies |first=Reiner |last2=Sørensen |first2=Kathrine |last3=Di Tecco |first3=Cristina |last4=Bonafede |first4=Michela |last5=Rondinone |first5=Bruna M. |last6=Ahn |first6=Seoyeon |last7=Ando |first7=Emiko |last8=Ayuso-Mateos |first8=Jose Luis |last9=Cabello |first9=Maria |last10=Descatha |first10=Alexis |last11=Dragano |first11=Nico |last12=Durand-Moreau |first12=Quentin |last13=Eguchi |first13=Hisashi |last14=Gao |first14=Junling |last15=Godderis |first15=Lode |date=2021-10-01 |title=The effect of exposure to long working hours on depression: A systematic review and meta-analysis from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury |url=https://www.sciencedirect.com/science/article/pii/S0160412021002543 |journal=Environment International |language=en |volume=155 |pages=106629 |doi=10.1016/j.envint.2021.106629 |issn=0160-4120}}</ref>, burnout<ref>{{Cite journal |last=Salvagioni |first=Denise Albieri Jodas |last2=Melanda |first2=Francine Nesello |last3=Mesas |first3=Arthur Eumann |last4=González |first4=Alberto Durán |last5=Gabani |first5=Flávia Lopes |last6=Andrade |first6=Selma Maffei de |date=2017-10-04 |title=Physical, psychological and occupational consequences of job burnout: A systematic review of prospective studies |url=https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0185781 |journal=PLOS ONE |language=en |volume=12 |issue=10 |pages=e0185781 |doi=10.1371/journal.pone.0185781 |issn=1932-6203 |pmc=PMC5627926 |pmid=28977041}}</ref>, sleeping problems<ref>{{Cite journal |last=Litwiller |first=Brett |last2=Snyder |first2=Lori Anderson |last3=Taylor |first3=William D. |last4=Steele |first4=Logan M. |date=2017-04 |title=The relationship between sleep and work: A meta-analysis. |url=http://doi.apa.org/getdoi.cfm?doi=10.1037/apl0000169 |journal=Journal of Applied Psychology |language=en |volume=102 |issue=4 |pages=682–699 |doi=10.1037/apl0000169 |issn=1939-1854}}</ref>, and physiological and cardiorespiratory stress mechanisms in the body which may also affect the risk for cardiovascular disease.
Little is known about occupational risks for heart disease, but links have been established between cardiovascular disease and certain toxins (including [[carbon disulfide]], [[nitroglycerin]], and [[carbon monoxide]]), extreme heat and cold, exposure to [[tobacco]] smoke, ultrafine particles, [[Depression (mood)|depression]], and [[occupational stress]]. Other [[occupational hazard]]s potentially related to cardiovascular disease include [[Industrial noise|noise exposure at work]], [[shift work]], and physical activity at work.<ref>{{Cite web|url=https://www.cdc.gov/niosh/programs/crcd/|title=CDC - NIOSH Program Portfolio : Cancer, Reproductive, and Cardiovascular Diseases: Program Description| work = The National Institute for Occupational Safety and Health (NIOSH) and the Centers for Disease Control and Prevention | publisher = U.S. Department of Health & Human Services |access-date=2016-04-21}}</ref>

==United States trends in cardiovascular disease and the impact of work==
Age-adjusted cardiovascular disease death rates in the U.S. are no longer declining, as they previously had been since the 1960s.<ref name=":8">{{Cite journal |last=Woolf |first=Steven H. |last2=Schoomaker |first2=Heidi |date=2019-11-26 |title=Life Expectancy and Mortality Rates in the United States, 1959-2017 |url=https://pubmed.ncbi.nlm.nih.gov/31769830 |journal=JAMA |volume=322 |issue=20 |pages=1996–2016 |doi=10.1001/jama.2019.16932 |issn=1538-3598 |pmc=7146991 |pmid=31769830}}</ref> Cardiovascular disease death rates are increasing in older (45-64 years) working-age people.<ref>{{Cite web |title=Trends in cancer and heart disease death rates among adults aged 45–64: United States, 1999–2017 |url=https://stacks.cdc.gov/view/cdc/78673 |access-date=2023-02-08 |website=stacks.cdc.gov}}</ref> In fact, death rates from all causes have been increasing since about 2012 in working-age people (25-64 years), primarily due to increases in drug (mainly opioid) overdoses, alcohol abuse, suicides, and chronic diseases, such as cardiovascular diseases, hypertension and diabetes.<ref name=":8" /> Between 2000-2015, the cardiovascular disease mortality gap between the U.S. and other wealthy countries has widened.<ref>{{Cite web |url=https://www.nationalacademies.org/ocga/testimony-before-congress/high-and-rising-mortality-rates-among-working-age-adults |access-date=2023-02-08 |website=www.nationalacademies.org}}</ref> These trends are occurring despite improvements in the medical treatment of cardiovascular diseases. Primary prevention of cardiovascular diseases, including workplace health promotion, is key to reducing death rates.

Related explanations for cardiovascular disease trends are increases in the prevalence of other stress-related (including work-related stress) conditions, obesity<ref name=":9">{{Cite journal |last=Tsao |first=Connie W. |last2=Aday |first2=Aaron W. |last3=Almarzooq |first3=Zaid I. |last4=Alonso |first4=Alvaro |last5=Beaton |first5=Andrea Z. |last6=Bittencourt |first6=Marcio S. |last7=Boehme |first7=Amelia K. |last8=Buxton |first8=Alfred E. |last9=Carson |first9=April P. |last10=Commodore-Mensah |first10=Yvonne |last11=Elkind |first11=Mitchell S.V. |last12=Evenson |first12=Kelly R. |last13=Eze-Nliam |first13=Chete |last14=Ferguson |first14=Jane F. |last15=Generoso |first15=Giuliano |date=2022-02-22 |title=Heart Disease and Stroke Statistics—2022 Update: A Report From the American Heart Association |url=https://www.ahajournals.org/doi/10.1161/CIR.0000000000001052 |journal=Circulation |language=en |volume=145 |issue=8 |doi=10.1161/CIR.0000000000001052 |issn=0009-7322}}</ref>, diabetes<ref name=":9" />, metabolic syndrome<ref name=":9" />, and short sleeping hours<ref>{{Cite journal |last=Sheehan |first=Connor M. |last2=Frochen |first2=Stephen E. |last3=Walsemann |first3=Katrina M. |last4=Ailshire |first4=Jennifer A. |date=2019-02-01 |title=Are U.S. adults reporting less sleep?: Findings from sleep duration trends in the National Health Interview Survey, 2004-2017 |url=https://pubmed.ncbi.nlm.nih.gov/30452725 |journal=Sleep |volume=42 |issue=2 |pages=zsy221 |doi=10.1093/sleep/zsy221 |issn=1550-9109 |pmc=6941709 |pmid=30452725}}</ref>. The age-adjusted prevalence of hypertension increased in the U.S. between 1988-2010 and increased again between 2010-2018 for most gender-race groups<ref name=":9" />. Mental health disorders, including depression and anxiety, are increasing globally and in the U.S.<ref>{{Cite journal |last=World Health Organization |date=2017 |title=Depression and other common mental disorders: global health estimates |url=https://apps.who.int/iris/handle/10665/254610 |language=en}}</ref><ref>{{Cite journal |last=Olfson |first=Mark |last2=Wang |first2=Shuai |last3=Wall |first3=Melanie |last4=Marcus |first4=Steven C. |last5=Blanco |first5=Carlos |date=2019-02-01 |title=Trends in Serious Psychological Distress and Outpatient Mental Health Care of US Adults |url=https://pubmed.ncbi.nlm.nih.gov/30484838 |journal=JAMA psychiatry |volume=76 |issue=2 |pages=152–161 |doi=10.1001/jamapsychiatry.2018.3550 |issn=2168-6238 |pmc=6439744 |pmid=30484838}}</ref>

A 2021 National Academy of Sciences report<ref>{{Cite journal |last=Harris |first=Kathleen Mullan |last2=Woolf |first2=Steven H. |last3=Gaskin |first3=Darrell J. |date=2021-05-25 |title=High and Rising Working-Age Mortality in the US: A Report From the National Academies of Sciences, Engineering, and Medicine |url=https://doi.org/10.1001/jama.2021.4073 |journal=JAMA |volume=325 |issue=20 |pages=2045–2046 |doi=10.1001/jama.2021.4073 |issn=0098-7484}}</ref> points out that “social, economic, and cultural changes that have undermined economic security, intergenerational mobility, and social support networks can adversely affect cardiometabolic health through stress-mediated biological pathways and reduced access to care”.

Recent research indicates working conditions that may be contributing to the cardiovascular disease trends in the U.S. include,

* increases in
** annual working hours
** job stressors, such as low job control, job strain, and work-family conflict<ref>{{Cite journal |last=Myers |first=Stephanie |last2=Govindarajulu |first2=Usha |last3=Joseph |first3=Michael |last4=Landsbergis |first4=Paul |date=2019-06 |title=Changes in work characteristics over 12 years: Findings from the 2002‐2014 US National NIOSH Quality of Work Life Surveys |url=https://onlinelibrary.wiley.com/doi/10.1002/ajim.22971 |journal=American Journal of Industrial Medicine |language=en |volume=62 |issue=6 |pages=511–522 |doi=10.1002/ajim.22971 |issn=0271-3586}}</ref>
** income inequality<ref>{{Cite web |title=State of Working America Wages 2019: A story of slow, uneven, and unequal wage growth over the last 40 years |url=https://www.epi.org/publication/swa-wages-2019/ |access-date=2023-02-08 |website=Economic Policy Institute |language=en-US}}</ref><ref name=":10">{{Cite web |title=Labor Day 2019 {{!}} Working people have been thwarted in their efforts to bargain for better wages by attacks on unions |url=https://www.epi.org/publication/labor-day-2019-collective-bargaining/ |access-date=2023-02-08 |website=Economic Policy Institute |language=en-US}}</ref>
** precarious employment<ref>{{Cite journal |last=Oddo |first=Vanessa M. |last2=Zhuang |first2=Castiel Chen |last3=Andrea |first3=Sarah B. |last4=Eisenberg-Guyot |first4=Jerzy |last5=Peckham |first5=Trevor |last6=Jacoby |first6=Daniel |last7=Hajat |first7=Anjum |date=2021-04-01 |title=Changes in precarious employment in the United States: A longitudinal analysis |url=https://pubmed.ncbi.nlm.nih.gov/33283874/ |journal=Scandinavian Journal of Work, Environment & Health |volume=47 |issue=3 |pages=171–180 |doi=10.5271/sjweh.3939 |issn=1795-990X |pmc=8126438 |pmid=33283874}}</ref> (such as temporary or contract work) that involves inadequate pay, job insecurity, changes in working-time arrangements, loss of workers' rights and protections, lack of collective organization (such as unionization)
* decreases in
** union membership<ref name=":10" />
** social mobility<ref>{{Cite journal |last=Chetty |first=Raj |last2=Grusky |first2=David |last3=Hell |first3=Maximilian |last4=Hendren |first4=Nathaniel |last5=Manduca |first5=Robert |last6=Narang |first6=Jimmy |date=2017-04-28 |title=The fading American dream: Trends in absolute income mobility since 1940 |url=https://www.science.org/doi/10.1126/science.aal4617 |journal=Science |language=en |volume=356 |issue=6336 |pages=398–406 |doi=10.1126/science.aal4617 |issn=0036-8075}}</ref> (movement of people upward or downward in society through job status, education level, income, etc.)
** work intensification through new technology and "lean production" (increasing efficiency, reducing waste) techniques<ref>{{Cite journal |last=Landsbergis |first=Paul A. |last2=Cahill |first2=Janet |last3=Schnall |first3=Peter |date=1999 |title=The impact of lean production and related new systems of work organization on worker health. |url=http://doi.apa.org/getdoi.cfm?doi=10.1037/1076-8998.4.2.108 |journal=Journal of Occupational Health Psychology |language=en |volume=4 |issue=2 |pages=108–130 |doi=10.1037/1076-8998.4.2.108 |issn=1939-1307}}</ref><ref>{{Cite journal |last=Zelnick |first=Jennifer R. |last2=Abramovitz |first2=Mimi |last3=Pirutinsky |first3=Steven |date=2022-08 |title=Managerialism: A workforce health hazard in human service settings |url=https://onlinelibrary.wiley.com/doi/10.1002/ajim.23395 |journal=American Journal of Industrial Medicine |language=en |volume=65 |issue=8 |pages=669–674 |doi=10.1002/ajim.23395 |issn=0271-3586}}</ref>


==Work-related risk factors for cardiovascular disease==
==Work-related risk factors for cardiovascular disease==
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* Long [[Working time|work hours]] (55 or more hours per week)<ref name=":6" /><ref>{{Cite journal |last=Virtanen |first=Marianna |last2=Kivimäki |first2=Mika |date=2018-10-01 |title=Long Working Hours and Risk of Cardiovascular Disease |url=https://doi.org/10.1007/s11886-018-1049-9 |journal=Current Cardiology Reports |language=en |volume=20 |issue=11 |pages=123 |doi=10.1007/s11886-018-1049-9 |issn=1534-3170 |pmc=PMC6267375 |pmid=30276493}}</ref><ref>{{Cite journal |last1=Pega |first1=Frank |last2=Náfrádi |first2=Bálint |last3=Momen |first3=Natalie C. |last4=Ujita |first4=Yuka |last5=Streicher |first5=Kai N. |last6=Prüss-Üstün |first6=Annette M. |last7=Descatha |first7=Alexis |last8=Driscoll |first8=Tim |last9=Fischer |first9=Frida M. |last10=Godderis |first10=Lode |last11=Kiiver |first11=Hannah M. |date=2021-09-01 |title=Global, regional, and national burdens of ischemic heart disease and stroke attributable to exposure to long working hours for 194 countries, 2000–2016: A systematic analysis from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury |url=http://dx.doi.org/10.1016/j.envint.2021.106595 |journal=Environment International |volume=154 |pages=106595 |doi=10.1016/j.envint.2021.106595 |pmid=34011457 |pmc=8204267 |issn=0160-4120}}</ref>
* Long [[Working time|work hours]] (55 or more hours per week)<ref name=":6" /><ref>{{Cite journal |last=Virtanen |first=Marianna |last2=Kivimäki |first2=Mika |date=2018-10-01 |title=Long Working Hours and Risk of Cardiovascular Disease |url=https://doi.org/10.1007/s11886-018-1049-9 |journal=Current Cardiology Reports |language=en |volume=20 |issue=11 |pages=123 |doi=10.1007/s11886-018-1049-9 |issn=1534-3170 |pmc=PMC6267375 |pmid=30276493}}</ref><ref>{{Cite journal |last1=Pega |first1=Frank |last2=Náfrádi |first2=Bálint |last3=Momen |first3=Natalie C. |last4=Ujita |first4=Yuka |last5=Streicher |first5=Kai N. |last6=Prüss-Üstün |first6=Annette M. |last7=Descatha |first7=Alexis |last8=Driscoll |first8=Tim |last9=Fischer |first9=Frida M. |last10=Godderis |first10=Lode |last11=Kiiver |first11=Hannah M. |date=2021-09-01 |title=Global, regional, and national burdens of ischemic heart disease and stroke attributable to exposure to long working hours for 194 countries, 2000–2016: A systematic analysis from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury |url=http://dx.doi.org/10.1016/j.envint.2021.106595 |journal=Environment International |volume=154 |pages=106595 |doi=10.1016/j.envint.2021.106595 |pmid=34011457 |pmc=8204267 |issn=0160-4120}}</ref>
* Exposure to loud [[Occupational noise|noise]]<ref name=":2" /><ref>{{Cite journal|last1=Kerns|first1=Ellen|last2=Masterson|first2=Elizabeth A.|last3=Themann|first3=Christa L.|last4=Calvert|first4=Geoffrey M.|date=2018|title=Cardiovascular conditions, hearing difficulty, and occupational noise exposure within US industries and occupations|journal=American Journal of Industrial Medicine|volume=61|issue=6|pages=477–491|doi=10.1002/ajim.22833|issn=1097-0274|pmc=6897488|pmid=29537072}}</ref>
* Exposure to loud [[Occupational noise|noise]]<ref name=":2" /><ref>{{Cite journal|last1=Kerns|first1=Ellen|last2=Masterson|first2=Elizabeth A.|last3=Themann|first3=Christa L.|last4=Calvert|first4=Geoffrey M.|date=2018|title=Cardiovascular conditions, hearing difficulty, and occupational noise exposure within US industries and occupations|journal=American Journal of Industrial Medicine|volume=61|issue=6|pages=477–491|doi=10.1002/ajim.22833|issn=1097-0274|pmc=6897488|pmid=29537072}}</ref>
* The risk of [[stroke]] has also been found to be associated with exposure to [[ionizing radiation]]<ref name=":2" />
* Exposure to [[ionizing radiation]]<ref name=":2" />


Hypertension develops more often in those who experience job strain and who have shift-work.<ref name=":2" /> Differences between women and men in risk are small, however men risk having and dying of [[heart attack]]s or stroke twice as often as women during working life.<ref name=":2">{{Cite web|url=http://www.sbu.se/en/publications/sbu-assesses/occupational-exposures-and-cardiovascular-disease/ |title=Occupational Exposures and Cardiovascular Disease |publisher = Statens beredning för medicinsk och social utvärdering (SBU); Swedish Agency for Health Technology Assessment and Assessment of Social Services |language=en |access-date=2017-06-01 |date=2015-08-26 }}</ref>
Hypertension develops more often in those who experience job strain and who have shift-work.<ref name=":2" /> Differences between women and men in risk are small, however men risk having and dying of [[heart attack]]s or stroke twice as often as women during working life.<ref name=":2">{{Cite web|url=http://www.sbu.se/en/publications/sbu-assesses/occupational-exposures-and-cardiovascular-disease/ |title=Occupational Exposures and Cardiovascular Disease |publisher = Statens beredning för medicinsk och social utvärdering (SBU); Swedish Agency for Health Technology Assessment and Assessment of Social Services |language=en |access-date=2017-06-01 |date=2015-08-26 }}</ref>

Revision as of 21:04, 8 February 2023

Occupational cardiovascular disease
SpecialtyCardiology

Occupational cardiovascular diseases are diseases of the heart or blood vessels caused by working conditions, making them a form of occupational illness. These diseases include coronary heart disease, stroke, cardiomyopathy, arrythmia, and heart valve or heart chamber problems. Cardiovascular disease is the leading cause of death in the United States and worldwide.[1][2] In the United States, cardiovascular diseases account for one out of four deaths.[3] The 6th International Conference on Work Environment and Cardiovascular Diseases found that within the working age population about 10-20% of cardiovascular disease deaths can be attributed to work.[4] Ten workplace stressors (shift work, job insecurity, high job demand, etc.) were estimated to be associated with 120,000 U.S. deaths each year and account for 5-8% of health care costs.[5]

Research related to the association between work and cardiovascular disease is on-going. Links have been established between cardiovascular disease risk and occupational exposure to chemicals, noise, psychosocial stressors, physical activity, and certain workplace organization factors. Additionally, work-related risk factors for cardiovascular disease may also increase the risk of other cardiovascular disease risk factors such as hypertension[6][7], diabetes[8][9][10], obesity[11][12], unhealthy diet[13], leisure-time physical inactivity[12], and excessive alcohol use[14]. Work may also increase risk of depression[15], burnout[16], sleeping problems[17], and physiological and cardiorespiratory stress mechanisms in the body which may also affect the risk for cardiovascular disease.

United States trends in cardiovascular disease and the impact of work

Age-adjusted cardiovascular disease death rates in the U.S. are no longer declining, as they previously had been since the 1960s.[18] Cardiovascular disease death rates are increasing in older (45-64 years) working-age people.[19] In fact, death rates from all causes have been increasing since about 2012 in working-age people (25-64 years), primarily due to increases in drug (mainly opioid) overdoses, alcohol abuse, suicides, and chronic diseases, such as cardiovascular diseases, hypertension and diabetes.[18] Between 2000-2015, the cardiovascular disease mortality gap between the U.S. and other wealthy countries has widened.[20] These trends are occurring despite improvements in the medical treatment of cardiovascular diseases. Primary prevention of cardiovascular diseases, including workplace health promotion, is key to reducing death rates.

Related explanations for cardiovascular disease trends are increases in the prevalence of other stress-related (including work-related stress) conditions, obesity[21], diabetes[21], metabolic syndrome[21], and short sleeping hours[22]. The age-adjusted prevalence of hypertension increased in the U.S. between 1988-2010 and increased again between 2010-2018 for most gender-race groups[21]. Mental health disorders, including depression and anxiety, are increasing globally and in the U.S.[23][24]

A 2021 National Academy of Sciences report[25] points out that “social, economic, and cultural changes that have undermined economic security, intergenerational mobility, and social support networks can adversely affect cardiometabolic health through stress-mediated biological pathways and reduced access to care”.

Recent research indicates working conditions that may be contributing to the cardiovascular disease trends in the U.S. include,

  • increases in
    • annual working hours
    • job stressors, such as low job control, job strain, and work-family conflict[26]
    • income inequality[27][28]
    • precarious employment[29] (such as temporary or contract work) that involves inadequate pay, job insecurity, changes in working-time arrangements, loss of workers' rights and protections, lack of collective organization (such as unionization)
  • decreases in
    • union membership[28]
    • social mobility[30] (movement of people upward or downward in society through job status, education level, income, etc.)
    • work intensification through new technology and "lean production" (increasing efficiency, reducing waste) techniques[31][32]

Work-related risk factors for cardiovascular disease

Hypertension develops more often in those who experience job strain and who have shift-work.[37] Differences between women and men in risk are small, however men risk having and dying of heart attacks or stroke twice as often as women during working life.[37]

A 2017 SBU report found evidence that workplace exposure to silica dust, engine exhaust or welding fumes is associated with heart disease.[45] Associations also exist for exposure to arsenic, benzopyrenes, lead, dynamite, carbon disulphide, carbon monoxide, metalworking fluids and occupational exposure to tobacco smoke.[45] Working with the electrolytic production of aluminum or the production of paper when the sulphate pulping process is used is associated with heart disease.[45] An association was also found between heart disease and exposure to compounds which are no longer permitted in certain work environments, such as phenoxy acids containing TCDD(dioxin) or asbestos.[45]

Workplace exposure to silica dust or asbestos is also associated with pulmonary heart disease. There is evidence that workplace exposure to lead, carbon disulphide, phenoxy acids containing TCDD, as well as working in an environment where aluminum is being electrolytically produced, is associated with stroke.[45]

Occupations at higher risk for cardiovascular disease

  • Firefighters[46]
  • Police officers[46]
  • NFL Players[46]
  • Long-haul truck drivers[46]

Occupational cardiovascular disease in firefighters

Given the many hazards present during career firefighting, firefighters are at a greater risk for occupational cardiovascular disease. CVD is the leading most cause of death in firefighters, and accounts for 45% of on-duty deaths.[47] About 90% of CVD in firefighters is attributed to coronary heart disease.[33] Other researchers have found that blood plasma volume decreases after just minutes of firefighting which increases blood pressure and causes the heart to work harder to distribute blood systemically. Firefighting has also shown to increase arterial stiffness and overall cardiovascular strain.[40] In a study by Barger, et al., a positive screening for a sleep disorder increased the odds a firefighter would also have cardiovascular disease (OR = 2.37, 95% CI 1.54-3.66, p < 0.0001).[48]

Group of firefighters in gear carrying a long hose to the fire scene
Group of firefighters in gear carrying a long hose to the fire scene.

CVD risk factors in firefighting

See also

References

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