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Blue-collar, service workers in US more likely to report history of CHD, stroke
Among United States workers aged younger than 55 years, those in blue-collar and service jobs are more likely to report a history of CHD or stroke compared with those in white-collar jobs.
In addition, adults aged younger than 55 years who are not in the labor force had a higher prevalence of CHD or stroke compared with adults who are employed or unemployed, according to an analysis by CDC officials.
Workers in two industries had prevalence ratios of CHD or stroke that were significantly higher than average. Those industries were administrative/support/waste management/remediation services and accommodation/food service.
Workers in the sectors and industries with a higher prevalence of CHD and stroke “might especially benefit from a Total Worker Health approach to reducing the risk for CHD/stroke,” Sara E. Luckhaupt, MD, and Geoffrey M. Calvert, MD, both from the division of surveillance, hazard evaluations and field studies for the CDC’s National Institute for Occupational Safety and Health, wrote in Morbidity and Mortality Weekly Report.
The researchers analyzed data from the National Health Interview Survey between 2008 and 2012.
Among adults aged younger than 55 years, 1.9% of those employed, 2.5% of those unemployed and 6.3% of those not in the labor force reported a history of CHD or stroke. Unemployed adults were defined as those looking for work, while adults not in the labor force were defined as those who were homemakers, stopped looking for work, retired or disabled.
For all adults aged younger than 55 years, the prevalence of CHD and stroke was 2.8%, the prevalence of CHD was 2% and the prevalence of stroke was 1%. Prevalence increased with age, and workers with a college education were less likely to report a history of CHD or stroke compared with workers without one.
Differences by sector
Occupations were stratified into four groups: white collar, service, blue collar and farm. After the researchers adjusted for sex and age, workers in the service (adjusted prevalence ratio=1.53; 95% CI, 1.27-1.85) and blue-collar (adjusted prevalence ratio=1.4; 95% CI, 1.19-1.65) sectors were more likely to report a history of CHD or stroke than those in white-collar jobs.
Workers were also classified into 21 industries. Of those, two were associated with higher prevalence of CHD and stroke among workers aged younger than 55 years: administrative/support/waste management/remediation services (adjusted prevalence ratio=1.47; 95% CI, 1.11-1.96) and accommodation/food service (adjusted prevalence ratio=1.37; 95% CI, 1.03-1.81).
Those working in administrative/support/waste management/remediation services may have higher risk because of increased rates of job insecurity, which is a cause of job stress. Those working in accommodation/food service may have higher risk because they are more likely to work alternative shifts and to smoke, according to Luckhaupt and Calvert.
Occupational risk factors
Higher prevalence of CHD and stroke may be caused in part by occupational risk factors, but the prevalence of preexisting illness or risk factors among people in different industries or sectors is unknown, the researchers wrote.
“Occupational CHD/stroke risk factors can include work stress, shift work, exposure to particulate matter, noise and secondhand smoke,” Luckhaupt and Calvert wrote. “Health professionals and employers should take these factors into account when planning workplace interventions to prevent CHD/stroke. These factors might have both direct physiologic effects on [CV] health and indirect effects by influencing behavioral risk factors such as smoking and obesity.”
Previous research indicated that those in lower-income households may be more susceptible to CHD/stroke risk related to workplace hazards “perhaps because of an interaction with adverse exposures in the community, combined with fewer health-enhancing opportunities,” they wrote.
There is evidence that the Total Worker Health approach, which are “workplace interventions that integrate health protection with health promotion,” may be effective at reducing CHD and stroke risk, according to the researchers.
They recommended that clinicians “take their patients’ work status, workplace and occupation type into account when developing prevention and treatment plans.”
Disclosure: Luckhaupt and Calvert report no relevant financial disclosures.