Occupational Cardiovascular Disease

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2021-01-18

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Occupational cardiovascular disease is disease of the heart or blood vessels that are caused by working conditions, making them a form of occupational illness. Cardiovascular disease is the leading cause of death in the US. 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, and occupational stress. Other occupational hazards potentially related to cardiovascular disease include noise exposure at work, shift work, and physical activity at work.

Non-chemical risk factors

A 2015 SBU-report including a systematic review of non-chemical risk factors for occupation cardiovascular disease found an association between certain occupational risk factors and developing cardiovascular disease in those:

Psychosocial stress
Frequent stimulation of the sympathetic nervous system
With mentally stressful work with a lack of control of their own working situation — with an effort-reward imbalance
Who experience low social support at work; who experience injustice or experience insufficient opportunities for personal development; or those who experience job insecurity
Those who work night schedules; or have long working weeks
Those who are exposed to noise
Specifically the risk of stroke was also increased by exposure to ionizing radiation
Sleep disorders, such as OSA, SWSD, restless leg syndrome, and insomnia

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

Chemical risk factors

A 2017 SBU report found evidence that workplace exposure to silica dust, engine exhaust or welding fumes is associated with heart disease. Associations also exist for exposure to arsenic, benzopyrenes, lead, dynamite, carbon disulphide, carbon monoxide, metalworking fluids and occupational exposure to tobacco smoke. Working with the electrolytic production of aluminum or the production of paper when the sulphate pulping process is used is associated with heart disease. 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.

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.

Occupations at higher risk

Firefighters
Police officers
NFL Players
Long-haul truck drivers

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. About 90% of CVD in firefighters is attributed to coronary heart disease. 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. 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).

CVD risk factors in firefighting