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Introduction

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Cardiovascular diseases (CVDs) are among the most common causes of illness and death in the working population, particularly in industrialized countries. They are also increasing in developing countries (Wielgosz 1993). In the industrialized countries, 15 to 20% of all working people will suffer from a cardiovascular dis- order sometime during their working lives and the frequency climbs sharply with age. Among those between 45 to 64 years of age, more than a third of the deaths among men and more than a quarter of deaths among women are caused by this group of diseases (see table 1). In recent years, CVDs have become the most frequent cause of death among post-menopausal women.

Table 1. Mortality from cardiovascular diseases in 1991 and 1990 in the age groups 45-54 and 55-64 for selected countries.

Country

Men

Women

 

45-54 Years

55-64 Years

45-54 Years

55-64 Years

 

Rate

%

Rate

%

Rate

%

Rate

%

Russia**

528

36

1,290

44

162

33

559

49

Poland**

480

38

1,193

45

134

31

430

42

Argentina*

317

40

847

44

131

33

339

39

Britain**

198

42

665

47

59

20

267

32

USA*

212

35

623

40

83

24

273

31

Germany**

181

29

597

38

55

18

213

30

Italy*

123

27

404

30

41

18

148

25

Mexico**

128

17

346

23

82

19

230

24

France**

102

17

311

22

30

12

94

18

Japan**

111

27

281

26

48

22

119

26

*1990. **1991. Rate=Deaths per 100,000 inhabitants. % is from all causes of death in the age group.

Because of their complex aetiology, only a very small pro- portion of the cases of cardiovascular disease are recognized as occupational. Many countries, however, recognize that occu- pational exposures contribute to CVDs (sometimes referred to as work-related diseases). Working conditions and job demands play an important role in the multifactorial process that leads to these diseases, but ascertaining the role of the individual causal com- ponents is very difficult. The components interact in close, shifting relationships and often the disease is triggered by a combination or accumulation of different causal factors, including those that are work related.

The reader is referred to the standard cardiology texts for details of the epidemiology, pathophysiology, diagnosis and treatment of cardiovascular diseases. This chapter will focus on those aspects of cardiovascular disease that are particularly relevant in the workplace and are likely to be influenced by factors in the job and work environment.

 

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