Incidence of acute myocardial infarction in the workforce: Findings from the Occupational Disease Surveillance System

Abstract

Background Increased risks of acute myocardial infarction (AMI) may be attributable to the workplace, however, associations are not well‐established. Using the Occupational Disease Surveillance System (ODSS), we sought to estimate associations between occupation and industry of employment and AMI risk among workers in Ontario, Canada. Methods The study population was derived by linking provincial accepted lost‐time workers' compensation claims data, to inpatient hospitalization records. Workers aged 15–65 years with an accepted non‐AMI compensation claim were followed for an AMI event between 2007 and 2016. Adjusted Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for each industry and occupation group, compared to all other workers in the cohort. Sex‐stratified analyses were also performed. Results In all, 24,514 incident cases of AMI were identified among 1,502,072 Ontario workers. Increased incidence rates of AMI were found across forestry (HR 1.37, 95% CI 1.19–1.58) and wood processing (HR 1.50, 1.27–1.77) job‐titles. Elevated rates were also detected within industries and occupations both broadly related to mining and quarrying (HR 1.52, 1.17–1.97), trucking (HR 1.32, 1.27‐1.38), construction (HR 1.32, 1.14–1.54), and the manufacturing and processing of metal (HR 1.41, 1.19–1.68), textile (HR 1.41, 1.07–1.88), non‐metallic mineral (HR 1.30, 0.82–2.07), and rubber and plastic (HR 1.42, 1.27–1.60) products. Female food service workers also had elevated AMI rates (HR 1.36, 1.23–1.51). Conclusion This study found occupational variation in AMI incidence. Future studies should examine work‐related hazards possibly contributing to such excess risks, like noise, vibration, occupational physical activity, shift work, and chemical and particulate exposures.

Acute myocardial infarctions identified in the Manitoba Occupational Disease Surveillance System: A linkage of worker's compensation and provincial health data

“…These types of exposures may explain some of the findings in our study. Similar to other studies, a variety of transportation occupations were identified with higher rates of AMI 16,27 . Exposures in this industry could include long hours, sedentary behavior, and pollutants such as carbon monoxide and vehicle exhaust 27 .…”

“…Other groups have employed similar methodologies to investigate the association between AMI and work. A large study from Ontario also found that a variety of transportation occupations had elevated risks of AMI 16 . Similarly, they also found that female but not male chefs and cooks had an increased risk of AMI.…”

“…Cases were included if they occurred after the WCB record injury date until end of coverage, either through moving out of the province, age 65, death, or the end of the study period (March 1, 2020). This definition is similar to that used in previous work 16 …”

“…This definition is similar to that used in previous work. 16 Occupation and industry were abstracted from the WCB file.…”

“…5 Traditional modifiable risk factors such as hypertension, 6,7 hypercholesterolemia, 8 obesity, 9 smoking, 10 diabetes, 11 and sedentary behaviors 12 explain a considerable portion of the risk of disease. However, workplace exposures to occupational stress, 13 certain chemicals, 14 sedentary work, 12 noise, 15,16 high occupational physical activity, 17,18 and other potential factors either acting directly or indirectly through traditional risk factors may lead to increased risk of myocardial infarctions in certain industry/job classifications. The purpose of this study was to identify jobs or industries that may be associated with increased or decreased risk of having a myocardial infarction to provide greater understanding of the relationship between work and heart disease and potentially identify work areas that may benefit from educational efforts and further research.…”