Significant Impacts of Work-Related Cerebrovascular and Cardiovascular Diseases among Young Workers: A Nationwide Analysis

Background : While occupational factors linked to the onset of cerebrovascular and cardiovascular diseases (CVDs) have been reported among workers, much remains unknown about the impacts that occupation has on the onset of CVDs in various age groups. We attempted to describe temporal trends in total and work-related CVDs (WRCVDs) rates stratified by age and year and explore the relative contributions of work to the CVD risk. Methods : This study was conducted using two populations from the Labor Insurance Database as the working population and the National Health Insurance Research Database as the general population. We included all people aged 15–75 years from 2006 to 2013. All CVD events and WRCVD events were identified. A Poisson regression was used to estimate the morbidity rate ratio (RR) stratified by age and period, and an RR adjusted for residual confounding was also used. Results : Incident CVD rates increased with aging in the general population (from 1113.55 to 1853.32 per 100,000 persons), and WRCVD rates increased in the working population over time (from 2.10 in 2006 to 8.60 in 2013 per 100,000 persons). In the age and period analysis, CVD attacks showed disparities in different populations. The RR of the WRCVD risk was mainly in the working population aged >45 years, and the RR of the CVD risk occurred in the oldest group (aged 55–64 years) of the general population. The population-attributable risk of working exposure was 13.5%. After eliminating residual confounding factors, higher population attributed risk (PAR) work-related excessive CVD risk mainly occurred in workers aged 25–34 and 35–44 years. A decreasing PAR trend was found in the age groups as follows: 15–24, 25–34, 35–44, 45–54, and 55–64 years, with percentages of 17.64%, 16.89%, 16.46%, 10.6%, and 0.65%, respectively. Conclusions : There is evidence that period and age trends of CVD rates differed between the working population and general population. Relative effects attributed to work were more severe in younger workers, particularly in workers aged <55 years.