A Cardiovascular Risk Score for Use in Occupational Medicine

Abstract

Cardiovascular disease is one of the most frequent causes of long-term sickness absence from work. The study aims to develop and validate a score to assess the 10-year risk of unsuitability for work accounting for the cardiovascular risk. The score can be considered as a prevention tool that would improve the cardiovascular risk assessment during health surveillance visits under the assumption that a high cardiovascular risk might also translate into high risk of unsuitability for work. A total of 11,079 Italian workers were examined, as part of their scheduled occupational health surveillance. Cox proportional hazards regression models were employed to derive risk equations for assessing the 10-year risk of a diagnosis of unsuitability for work. Two scores were developed: the CROMA score (Cardiovascular Risk in Occupational Medicine) included age, sex, smoking status, blood pressure (systolic and diastolic), body mass index, height, diagnosis of hypertension, diabetes, ischemic heart disease, mental disorders and prescription of antidiabetic and antihypertensive medications. The CROMB score was the same as CROMA score except for the inclusion of only variables statistically significant at the 0.05 level. For both scores, the expected risk of unsuitability for work was higher for workers in the highest risk class, as compared with the lowest. Moreover results showed a positive association between most of cardiovascular risk factors and the risk of unsuitability for work. The CROMA score demonstrated better calibration than the CROMB score (11.624 (p-value: 0.235)). Moreover, the CROMA score, in comparison with existing CVD risk scores, showed the best goodness of fit and discrimination.

International Symposium on Occupational Safety and Hygiene: Proceedings Book of the SHO2023

“…Ao nível metabólico, o sedentarismo está associado ao risco de diabetes mellitus, hipertensão arterial, obesidade e dislipidemia (Park et al, 2020). Os factores de risco cardiovasculares, para além de serem causa frequente de ausência ao trabalho por doença prolongada, também se associam a maior risco de inaptidão para o trabalho (Affinito et al, 2021). A introdução de políticas de promoção da saúde adaptadas ao teletrabalho nas empresas pode ser a chave para a redução da doença crónica.…”

“…Para a avaliação do risco cardiovascular está validado o SCORE (Systematic Coronary Risk Evaluation), que permite a estratificação do risco, com posterior orientação da necessidade terapêutica (Visseren et al, 2022). A aplicação de ferramentas que sejam capazes de integrar a previsão do risco de inaptidão para o trabalho, de acordo com os factores cardiovasculares, permitirá atuar na prevenção e adequar o programa de vigilância da saúde (Affinito et al, 2021). Sendo a prevenção um dos pilares da Medicina do Trabalho, programas de ginástica laboral, de caminhadas durante a pausa de almoço e de alternância da atitude de trabalho na secretária entre a posição sentada e em ortostatismo devem ser implementados (EU-OSHA, 2022).…”

Occupational Medicine and Prevention of Chronic and Infectious Diseases

“…The study by Affinito and coll. [ 8 ] aimed to validate a new scale to determine and improve the risk of unfitness for work for cardiovascular risk determinants during health surveillance visits. The score, named “Cardiovascular Risk in Occupational Medicine” (CROM), was also confronted with the CVD risk scores already found in the literature.…”