Current knowledge about the occupational causes of cardiovascular disease suggests that it may be possible to influence the risk of these diseases through work design measures (work organisation and workplace design).

In terms of prevention, that is avoiding disease, delaying its onset and ensuring a healthy return to work following illness, work design measures and personal lifestyle changes play an important role. Several BauA projects focus on workplace design issues related to cardiovascular health.

Workplace prevention

For the prevention of cardiovascular diseases in the workplace, it is important that all parties in the company –employers, employees, company doctors and safety specialists – are sufficiently aware of and informed regarding the subject of work and cardiovascular health. Measures to prevent cardiovascular disease among employees can apply various approaches and all stakeholders and employees should be involved in their planning.

Risk assessment

Risk assessment is an important tool for prevention. Various occupational risk factors (e.g., stress, long working hours, noise, excessive or insufficient physical demands) can contribute to the development of cardiovascular disease. In this context, there are a number of different methods that are relevant for assessing the risk of mental and physical strain.

Workplace health promotion and occupational healthcare

Occupational healthcare programmes can assess the risk of cardiovascular disease, identify risk factors or detect existing disease.

Workplace cardiovascular risk factors, such as shift work, can be assessed by company physicians who can evaluate factors that can increase the risk of having a heart attack – blood pressure, blood lipids, family history and lifestyle factors – in order to provide timely information and intervention if necessary.

The process of updating and improving the guidelines on the health aspects and organisation of night and shift work (Gesundheitliche Aspekte und Gestaltung von Nacht- und Schichtarbeit) involved summarising the scientific knowledge regarding the effects of night work and shift work on workers` health, including the cardiovascular system. Occupational health advice is recommended for shift workers who already suffer from high blood pressure and/or coronary or vascular disease. Employees who work nights, as defined by the Working Hours Act (ArbZG), are entitled to an occupational health examination every three years, and yearly after the age of 50 years.

Preventive occupational health measures also include strengthening health literacy, e.g. through (lifestyle) counselling. Offering healthy and sustainable meals at the workplace can also have a positive impact on cardiovascular health. In addition, active or movement breaks and other programmes that promote physical activity can help prevent sedentary behaviour at work. Not only a lack of physical activity, but long periods of sitting are also associated with an increased risk of cardiovascular disease. Rising digitalisation is increasing the amount of time spent sitting at the workplace (sedentary work). Working from home rather than commuting can also play a role. Research project F 2499 is investigating the sedentary behaviour and physical activity of desk workers while working in the workplace  or working from home.

Workplace reintegration management

In many cases, people can continue working after heart disease or heart surgery. To avoid early retirement, it is very important to provide support for people returning to work.

Despite improvements in medical care for cardiac patients, their reintegration and career prospects have not improved much in recent decades. Returning to work after an illness is very important for those affected, as work provides financial security and social participation., Especially in times of skilled labour shortages, companies also benefit. Both personal and occupational factors play a role in the success of the reintegration process.

Reintegration support

According to Germany’s national disease management guidelines for chronic coronary heart disease (Nationale Versorgungsleitlinie Chronische KHK), care for people with coronary heart disease includes personalised, needs-based advice and support for occupational and social reintegration.

For instance, as part of cardiac rehabilitation, people are offered workplace reintegration measures designed to promote permanent reintegration into working life, which can help prevent the need for a disability pension.

Workplace design also plays a key role in the return-to-workWorkplace design also plays a key role in the return-to-work process. High physical demands, stress and psychosocial strain can make it harder for people to return to work permanently. Workplace support programmes, for example as part of workplace reintegration management (Betriebliches Eingliederungsmanagement, BEM), offer the opportunity to adapt working conditions for the benefit of those affected and to support their permanent reintegration. The legal requirement, since 2004, to offer workplace integration management for employees who have been on sick leave longer can help to maintain their fitness for work and promote their return to the workplace.

BAuA project F 2354 found that rehabilitation programmes consisting of a combination of counselling and physical activity led to slightly higher return rates among patients with coronary heart disease in the six months following their treatment.