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Work-related Cardiovascular Diseases

Causes and Burden of Disease

Cardiovascular diseases (CVD) comprise all diseases of the heart and the vascular system. Besides non-occupational risk factors certain working conditions can play a part in their emergence. Find out here what they are.

Diseases of the heart and the vascular system are still the leading causes of illness and death in Germany. According to data from the Robert Koch Institute, they are responsible for about 40 per cent of all deaths in the country. In addition, they are linked to considerable personal consequences and cause high sickness costs for society.

The range of CVD

Cardiovascular diseases can be genetic or acquired. They can be divided into three categories:

  • diseases of the (arterial) system leading away from the heart,
  • diseases of the (venous) system leading to the heart, and
  • diseases of the heart, e.g. cardiac insufficiency and cardiac arrhythmia.

Diseases of the arterial system often lead to progressive artery constriction, referred to as arteriosclerosis. This can cause, for example, angina, peripheral arterial occlusive disease, coronary heart disease or stroke.

Diseases of the veins, which transport blood to the heart, are often the result of vascular dilation, which is a consequence of the slackening of the vascular wall muscles. Varicose veins, phlebitis and thromboses are examples of venous diseases.

Disease Burden of CVD

Cardiovascular diseases linked with arteriosclerosis are common and occur more frequently with age. As early as from the age of 40, that is, working age, these diseases contribute to the disease burden in Germany, above all among men. Significant diagnoses are:

  • high blood pressure (hypertonia),
  • angina pectoris,
  • acute myocardial infarction and
  • stroke.

According to data from the Robert Koch Institute (2015), in Germany CVD cause about 40 per cent of deaths. In employees up to the age of 65, CVD are responsible for approximately 10 per cent of early retirements and just about a quarter of all premature deaths (source: German Federal Statistical Office 2013; Deutsche Rentenversicherung 2011).

Work absence and CVD

Work absence resulting from CVD occurs with varying frequency in all occupational groups. This variability is influenced by both working and living conditions.

The number of work absence days per employee varies between the branches of industry. A particularly high share of CVD can be observed in the metalworking industry, in other vehicle construction and in transport companies (BKK Dachverband, 2013). In the work absence statistics of the statutory health insurance providers, CVD are significant, along with musculo-skeletal diseases, infectious diseases, mental disorders and diseases of the digestive system.

The frequency of work absence resulting from CVD was examined in the Federal Institute for Occupational Safety and Health's (BAuA) project F 2255 (see Links). It is clear that employees with lower and middle level qualifications are more heavily affected by work absence. Work absence is also more frequent in production and services than in administration. This applies to both women and men.

Work-related and non-work-related general causes of CVD

According to the findings of major international studies (INTERHEART study), along with a genetic disposition the following general factors increase the risk of cardiovascular diseases:

  • smoking,
  • consumption of alcohol,
  • physical inactivity,
  • unhealthy eating habits in combination with obesity,
  • high blood lipid levels,
  • high blood pressure,
  • diabetes,
  • psychosocial factors (stress).

As occupational causes, along with physical risk factors such as noise and heat, physical demands are also discussed as causes of CVD. These demands include heavy physical labour as well as insufficient physical demands over long periods of sitting or standing at work. Airborne particulate matter and cardiotoxic substances also play a part. However, most findings regarding the connection between work-related risk factors and CVD refer to psychosocial stress factors at the workplace. According to this, the following psychosocial stress factors can influence the risk of a CVD:

  • high job demands combined with low decision latitude,
  • effort-reward-imbalance (i.e. a disparity between perceived occupational demands and experienced or promised recognition),
  • shift work,
  • overly long working hours.

These work-related risk factors for CVD can also alter health behaviour and in this way contribute to an increased risk. Some of BAuA's research projects in recent years have examined the interrelation between work and/or occupational risk factors and cardiovascular diseases. You can download the respective research reports in the link section.

Development of CVD

Physiological processes, for example hormone production, immune defence and the activity of the vegetative nervous system are changing under the influence of occupational and external risk factors. Hypertension and an increased plasma lipid concentration may develop. Subsequently plaques may occur on and in the vascular walls, for example fat, blood clots, inflammatory cells. These lead to stenosis and hardening of the vessels with subsequent inadequate circulation or total occlusion of important arteries. This reduces or completely interrupts the supply of oxygen to the downstream organ or tissue.

Research Projects

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