Occupational class and incidence rates of cardiovascular events in middle aged men in Japan

Relation of Cognitive Reserve Indicator to Heart Disease and Cardiac Structure and Function: A Large Community-Based Longitudinal Study

BACKGROUND

High cognitive reserve (CR) has been related to lower dementia risk, but its association with heart disease (HD) is unknown. We aimed to explore the relation of CR to HD and cardiac structure and function.

METHODS AND RESULTS

Within the UK Biobank, 349 907 HD-free participants were followed up. A composite CR indicator involving education/occupation attainment/television viewing time/confiding frequency/social connection frequency/variety of leisure activities was generated, and further categorized into low/moderate/high levels. Incident HD, including coronary HD, cardiac arrhythmia, and heart failure, was ascertained on the basis of medical records. During the follow-up, a subsample (n=31 182) underwent cardiac magnetic resonance imaging to assess ventricular structure and function. Data were analyzed using Cox regression, Laplace regression, and linear regression. Compared with low CR, the hazard ratio and 95% CI of any HD for high CR was 0.78 (0.75-0.80) (including 0.68 [0.66-0.71] for coronary HD, 0.91 [0.87-0.95] for cardiac arrhythmia, and 0.63 [0.58-0.68] for heart failure). Furthermore, high CR was associated with delayed HD onset by 1.59 (95% CI, 1.37-1.82) years compared with low CR. In cardiac magnetic resonance imaging data analysis, compared with low CR, high CR was associated with larger left ventricular end-diastolic volume (β, 0.13 [95% CI, 0.09-0.17]), left ventricular end-systolic volume (β, 0.05 [95% CI, 0.01-0.10]), left ventricular stroke volume (β, 0.16 [95% CI, 0.12-0.21]), and left ventricular ejection fraction (β, 0.08 [95% CI, 0.03-0.13]).

CONCLUSIONS

High CR is associated with favorable HD health. Our findings suggest that the beneficial effect of CR is not limited to dementia but also HD.

The Association between Occupational Categories and Incidence of Cardiovascular Events: A Cohort Study in Iranian Male Population

BACKGROUND

Besides the traditional cardiovascular risk factor, some novel risk factors like occupation and career can play an important role in cardiovascular disease (CVDs) incidence.

OBJECTIVE

To assess the association between occupational categories and their positions with cardiovascular events (CVEs) in an Iranian male population.

METHODS

We followed 2134 men aged 35-65 years for 14 years during the Isfahan Cohort Study (2001-2015) for CVEs including ischemic heart disease and stroke. Firstly, Occupations were classified into 10 categories of International Standard Classification of Occupation (ISCO). Each category was then classified into one of the 4 pre-specified categories, namely high/low skilled white collars and high/low skilled blue collars. White-collar workers referred to managerial and professional workers in contrast with blue collar workers, whose job requires manual labor.

RESULTS

The mean age of studied participants was 46.9 (SD 8.3) years. 286 CVE incidents were recorded; unstable angina had the highest rate (46%); fatal stroke, the lowest (3%). There were no significant difference was observed between white and blue collars in terms of CVE incidence, as well as their high and low skilled subgroups. Hazard ratio analysis indicated a significantly higher risk of CVEs only for low-skilled white-collar workers (crude HR 1.47, 95% CI 1.01 to 2.13); this was not significant after adjustment for confounding variables.

CONCLUSION

There is no association between occupational categories and incidence of cardiovascular events among Iranian male population.

Occupational categories and cardiovascular diseases incidences: a cohort study in Iranian population

Introduction

In spite of traditional cardiovascular risk factor, the different occupations can play an important role in cardiovascular disease (CVDs) incidence. We aimed to assess the correlation between the occupational classes, based on the International Standard Classification of Occupation (ISCO), and CVDs in Iran as a developing country.

Methods

We followed the 2440 men, aged 35-65 years and without history of CVDs over fourteen years; 2001 to 2015 during the Isfahan Cohort Study. ISCO was used to classify occupations into 10 categories. Incidence rates of ischemic heart diseases and stroke were recorded. Socioeconomic demographic data including marital state, income and place of living and metabolic risk factors were also recorded.

Results

The mean age was 46.97 ± 8.31 years old. 272 cardiovascular events (CVEs) were recorded that unstable angina was the highest recorded with 49% prevalence and the fatal stroke had the lowest outbreak (1%). The unemployed/jobless group and elementary occupations (9th ISCO category) had higher and lower relative frequency in CVEs respectively. There was non-significant decrease in CVEs in all of categories except of 4^th (clerical support workers) and 10th (armed forces) groups in comparison to unemployed/jobless subjects (P > 0.05). After considering of the group 7 as a reference group (most absolute CVEs frequency), in fully adjustment analysis group 4 had significant risk for CVEs (P = 0.04).

Conclusions

This study indicates that working as clerical support workers (4^th ISCO category) is associated with higher significant risk for IHD and stroke incidence in comparison to craft and related trades workers (7^th group of ISCO).

Metabolic outcomes of workers according to the International Standard Classification of Occupations in Korea

BACKGROUND

Occupation influences the risk for developing chronic metabolic diseases.

METHODS

We compared the prevalence of MetS by International Standard Classification of Occupations using the nationally representative data in Korea (KNHANES). We enrolled 16,763 workers (9,175 males; 7,588 females) who had measurements for the National Cholesterol Education Program criteria III and other variables. OR and 95%CIs for MetS and its components were estimated according to occupation using the multiple logistic regression models.

RESULTS

The occupational groups with the highest age-standardized prevalence of MetS were lower skilled white-collar men (31.1 ± 2.4%) and green-collar women (24.2 ± 2.9%). Compared with the unskilled male blue-collar group, which had the lowest prevalence of MetS, the OR (95%CIs) of MetS in men were 1.77 (1.45-2.15) in higher skilled white-collar, 1.82 (1.47-2.26) in lower-skilled white-collar, 1.63 (1.32-2.01) in pink-collar and 1.37 (1.13-1.66) in skilled blue-collar workers in final logistic regression model.

CONCLUSIONS

MetS and its components vary by occupational category and gender in ways that may guide health interventions. Am. J. Ind. Med. 59:685-694, 2016. © 2016 Wiley Periodicals, Inc.

Occupation and risk of sudden death in a United States community: a case-control analysis

OBJECTIVE

Work environment is said to influence cardiovascular risk. We assessed whether nature of occupation affects risk of sudden cardiac death (SCD) in the general population.

METHODS

In the ongoing, prospective Oregon Sudden Unexpected Death Study (catchment population 1 million), working-age SCD cases (18-65 years) were compared with controls who died from any cause. Usual occupation obtained from death certificates was classified using the US Census Bureau standard occupational classification descriptions and categorised as white collar, blue collar or homemaker. Odds ratio (OR) for SCD by occupation category was obtained and clinical profile of SCD cases was compared by occupation type.

RESULTS

Among SCD cases (n=646; 74% male) compared to controls (n=622; 73.6% male), the proportion of white collar workers was higher among male SCD cases (52.7% vs 43.7%; p=0.01); the difference in females was smaller (59.5% vs 55%; p=0.62). Adjusting for race and smoking status, male white collar workers had a higher risk of SCD compared to blue collar workers (OR=1.67, (1.26 to 2.23), p<0.001). A similar, non-significant trend was observed among females (OR 1.49 (0.81 to 2.75); p=0.20). White collar SCD cases were less likely to be current smokers (34.7% vs 45.3%, p=0.008), drug misusers (13.1% vs 18.5%) or have diabetes (21.4% vs 28.2%, both p=0.07) compared to blue collar workers. Other cardiac risk factors were similar.

CONCLUSIONS

A white collar occupation was associated with increased risk of SCD, when compared to blue collar occupations. Since differences in conventional risk factors did not explain this elevated risk, work-related behavioural and psychosocial stressors warrant a closer evaluation.