Cardiovascular Disease Risk Screening for Commercial Drivers Examined in Occupational Practice: Implementing Evidence-Based Practice to Champion the Health of Essential Workers

Abstract

Background: Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality in the United States, with 20% of deaths in adults under age 65. Commercial drivers have an increased CVD incidence rate of 50% compared to 30% for the general population, yet one third of drivers will not be screened for risk factors due to a lack of insurance or primary care. With approximately 3.5 million commercial drivers nationally and correlation of CVD to increased motor vehicle accidents, fatalities, and excessive healthcare costs, addressing the care gap for this high-risk population is imperative. Methods: An evidence-based practice (EBP) project synthesized the literature and implemented CVD risk screening for commercial drivers examined in an occupational practice setting. Using the non-laboratory Framingham CVD risk score calculator, over 90% of drivers were screened during mandated medical examinations and provided education regarding modifiable risk factors during a 2-month period. Findings: Over 40% of commercial drivers were at high risk for CVD with 25% uninsured and 32% without primary care. The average CVD risk score was twice the general population’s risk score, with obesity, hypertension, and smoking being the most common risk factors discussed. Conclusions/Application to Practice: Incorporating CVD risk screening and education during opportune encounters is logical, efficient, and financially prudent. The EBP change supports occupational professionals’ standards, and ongoing review of CVD screening guidelines with integration into practice provides health promotion and promotes public safety for these essential workers.