New research on work-related cardiovascular diseases

A new report from the Swedish Work Environment Authority suggests the main risk factors for work-related cardiovascular disease are engine exhaust emissions, tobacco smoke, stress and shift work. The report examined the link to occupational exposure and to what extent the work environment is an underlying factor in cardiovascular disease and stroke, and how risks are increased by unhealthy lifestyle choices such as smoking, a poor diet and physical inactivity.

About the study

A recent study, Arbetsmiljöns bidrag till hjärt-kärlsjukdom (1.88Mb PDF), commissioned by the Swedish Work Environment Authority (AV), investigated the extent to which the working environment is an underlying factor in the prevalence of cardiovascular disease and stroke in Sweden. The study follows a previous systematic review on work-related deaths (in Swedish, 405Kb PDF) in Sweden from 2010, which revealed that cardiovascular disease alone accounted for the majority of deaths in 2007 (see table).

Causes of work-related deaths, 2007

Cause of death

Number of cases

Cardiovascular disease




Respiratory diseases




Note: Estimated number of work-related deaths from cancer, cardiovascular disease and respiratory disease in 2007, persons 25–74 years-old

Source: Järvholm et al (2010)

Against this background, the new study aimed to identify the industries and professions in which employees were most at risk of developing cardiovascular disease. A secondary aim was to find out to what extent the causes of cardiovascular disease could be attributed to occupational exposure in Sweden. The report also forecasts the development of work-related cardiovascular diseases over the next 5–10 years.

The study considered factors such as the strain of working in a particular job, shift work, exhaust gases, chemical exposure and passive smoking. Other issues investigated included risk factors for heart attacks such as noise.

Key findings

The report found the main risk factors for cardiovascular disease were:

  • engine exhaust emissions;
  • tobacco smoke;
  • stress (in the form of high demands and low job control);
  • shift work.

In addition the report highlighted the increased risks among people with unhealthy lifestyles such as those who smoked, had a poor diet and were physically inactive.

Shift work has increased in many sectors, though irregular working hours were commonest in the youngest age group (that is, those less than 29 years-old). The amount of shift work was broadly similar between male and female employees, but varied between industries.

Almost half of all women in the healthcare sector worked shifts, while night work was most common among men in the manufacturing/process, transport and healthcare sectors.

Those who work in enclosed or partially enclosed areas where there are motor vehicles (such as mining and tunnel workers) are most heavily exposed to exhaust gases. The proportion of people exposed to passive smoking was highest among those working in the construction or transport sectors.

According to the report’s findings, people in the healthcare sector are more likely than others to suffer from work-related cardiovascular disease. Healthcare workers have a relatively higher exposure to job strain and shift work.

Future developments

The apparent significant increase in the job strain factor in the education sector may mean that people working in this sector have a higher risk of suffering from work-related cardiovascular disease in the future.

The overall morbidity and mortality rates from these diseases have dropped significantly over the past 10 years, and both the number of patients and the number of deaths from work-related cardiovascular disease are predicted to continue to decline. The decrease can in part be explained by different types of preventative work, but the report concludes that the reduction of mortality is also likely to be attributable to improved treatment for those who fall ill.


Not only do heart attacks and strokes have devastating effects and consequences for the sufferers’ lives, but these diseases also cost society large amounts of money in lost production, sick pay and medical expenses. A prerequisite for effective prevention is the knowledge of where efforts should be made, which is why the findings of this report and others like it are so important.


Järvholm, B., Bystedt, J. and Reuterwall, C. (2010), Arbetsrelaterade dödsfall i Sverige – Arbetsrelaterad dödlighet i cancer, hjärt-kärlsjukdomar och lungsjukdomar i Sverige (405Kb PDF), Report 2010:3, Arbetsmiljö Verket, Stockholm.

Järvholm, B. and Reuterwall, C. (2012), Arbetsmiljöns bidrag till hjärt-kärlsjukdom (1.88Mb PDF), Report 2012:9, Arbetsmiljö Verket, Stockholm.

Johanna Linderoth and Mats Kullander, Oxford Research

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