Occupation and risk of sudden death in a United States community: a case-control analysis.
Occupation and risk of sudden death in a United States community: a case-control analysis.
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美国社区的职业和猝死风险：病例对照分析。
DOI：
10.1136/bmjopen-2015-009413
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发表时间：
2015
期刊：
影响因子：
2.9
通讯作者：
Chugh,SumeetS
中科院分区：
文献类型：
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作者：
Zhang,Lin;Narayanan,Kumar;Suryadevara,Vallabh;Teodorescu,Carmen;Reinier,Kyndaron;Uy-Evanado,Audrey;Chugh,Harpriya;Zheng,Zhi-Jie;Gunson,Karen;Jui,Jonathan;Chugh,SumeetS
据说工作环境会影响心血管风险。我们评估是否性质的职业影响心脏性猝死（SCD）在一般population.MethodsIn正在进行的，前瞻性的俄勒冈州突发意外死亡研究（集水区人口1万），工作年龄SCD病例（18-65岁）与控制谁死于任何原因进行了比较。 根据美国人口普查局的标准职业分类描述，从死亡证明中获得的职业被分类为白色领、蓝领或家庭主妇。获得不同职业类型SCD的优势比（OR），并比较不同职业类型SCD病例的临床特征。（n=646; 74%男性）与对照组相比（n=622; 73.6%男性），男性SCD病例中白色领工人的比例较高（52.7% vs 43.7%; p=0.01）;女性的差异较小（59.5% vs 55%; p=0.62）。调整种族和吸烟状况后，男性白色领工人比蓝领工人有更高的SCD风险（OR=1.67，（1.26至2.23），p<0.001）。在女性中观察到类似的非显著趋势（OR 1.49（0.81 - 2.75）; p=0.20）。与蓝领工人相比，白色白领SCD病例不太可能是当前吸烟者（34.7% vs 45.3%，p=0.008）、药物滥用者（13.1% vs 18.5%）或糖尿病患者（21.4% vs 28.2%，均p=0.07）。其他心脏病的危险因素是similar.ConclusionsA白色领职业与SCD的风险增加，相比，蓝领职业。由于传统风险因素的差异并不能解释这种高风险，与工作有关的行为和心理社会压力值得更密切的评价。
ObjectiveWork environment is said to influence cardiovascular risk. We assessed whether nature of occupation affects risk of sudden cardiac death (SCD) in the general population.MethodsIn the ongoing, prospective Oregon Sudden Unexpected Death Study (catchment population 1 million), working-age SCD cases (18–65 years) were compared with controls who died from any cause. Usual occupation obtained from death certificates was classified using the US Census Bureau standard occupational classification descriptions and categorised as white collar, blue collar or homemaker. Odds ratio (OR) for SCD by occupation category was obtained and clinical profile of SCD cases was compared by occupation type.ResultsAmong SCD cases (n=646; 74% male) compared to controls (n=622; 73.6% male), the proportion of white collar workers was higher among male SCD cases (52.7% vs 43.7%; p=0.01); the difference in females was smaller (59.5% vs 55%; p=0.62). Adjusting for race and smoking status, male white collar workers had a higher risk of SCD compared to blue collar workers (OR=1.67, (1.26 to 2.23), p<0.001). A similar, non-significant trend was observed among females (OR 1.49 (0.81 to 2.75); p=0.20). White collar SCD cases werelesslikely to be current smokers (34.7% vs 45.3%, p=0.008), drug misusers (13.1% vs 18.5%) or have diabetes (21.4% vs 28.2%, both p=0.07) compared to blue collar workers. Other cardiac risk factors were similar.ConclusionsA white collar occupation was associated with increased risk of SCD, when compared to blue collar occupations. Since differences in conventional risk factors did not explain this elevated risk, work-related behavioural and psychosocial stressors warrant a closer evaluation.