Heart disease is affecting millions of people globally, and the workplace is no exception. As we enter American Heart Month and National Wear Red Day, it’s crucial to take a closer look at the state of heart disease in the workplace.
With more than 80% of jobs in the US mostly involving sedentary activities, workers are exposed to long sitting hours and a lifetime of physically inactive behaviors. Additionally, many workplaces offer unhealthy food and drink options, making it easy for employees to fall into unhealthy habits.
The global economic slowdown and record-high inflation of the past year have also added stress to the mix, making it even more crucial for employers to take action in promoting cardiovascular health (CVH) among their workforce.
Employers have the opportunity to make a lasting impact on the well-being of their employees by implementing heart-healthy initiatives and mitigating the risk of heart disease.
What are Cardiovascular Diseases?
Cardiovascular disease is the leading cause of death for both men and women in the United States. According to the American Heart Association, it accounted for over 860,000 deaths in 2017 alone. In the United States, almost half of all adults have at least one form of heart disease.
Cardiovascular diseases (CVDs) are conditions affecting the heart or blood vessels . CVDs are commonly linked with a build-up of fatty deposits within the arteries, known as atherosclerosis, and an increased risk of blood clots (thrombosis).
According to the AHA, are six main types of cardiovascular diseases (CVDs):
- heart attack
- heart failure
- valve disease
- heart rhythm disorders
- peripheral artery and vein disease (PAD and PVD).
While CVD is one of the leading causes of death and disability in the US, it can often be prevented or improved by leading a healthy lifestyle.
Heart Disease in the Workplace: Risk Factors
Cardiovascular disease is a global epidemic, responsible for 32% of all deaths worldwide. As such, CVDs pose possibly the biggest threat to the health and well-being of employees.
It is widely recognized that certain occupational factors can contribute to, or even cause, cardiovascular disease (CVD). These exposures can range from common occurrences in the workplace to rare instances.
Physical Impacts & Heart Disease
- Noise – Noise pollution, with prolonged exposure to levels exceeding 80Db, has been linked to increased blood pressure.
- Physical activity – Physical inactivity is strongly correlated with cardiovascular disease (CVD), and heavy lifting has been associated with an increased risk of a heart attack.
- Extreme temperatures – Working in extreme temperatures, whether extreme heat or cold, has been linked to an increased risk of CVD, particularly in individuals with pre-existing CVD.
- Vibration – Whether it affects a specific body part or the whole body, vibration can negatively impact the cardiovascular system.
Chemical Hazards & Heart Disease
- Carbon monoxide (CO) – Carbon monoxide exposure, commonly found in furnaces, boilers, vehicle exhaust, and areas with poor air circulation, can have detrimental effects on the heart by reducing the amount of oxygen carried by blood.
- Nitrate esters – Chemicals found in explosives used in construction, demolition, and mining, can lead to withdrawal symptoms such as the constriction of blood vessels, increasing the risk of cardiovascular disease (CVD).
- Carbon Disulfide (CS2) – Commonly found in the production of rayon or cellophane, solvents for rubber and oils, pesticides, fumigants, and microelectronics, exposure to Carbon Disulfide can affect enzyme function in the body, leading to high cholesterol, blood pressure, and aneurysms.
- Heavy Metals (Lead, Cobalt, Arsenic/Arsine) – Exposure to heavy metals such as lead, cobalt, and arsenic/arsine, commonly found in construction, smelting, manufacturing, production of metal alloys, and arsenical insecticides, has been linked to hypertension and damage to the heart.
- Certain Solvents – Solvents, such as those found in degreasing, paint stripping, refrigeration, air conditioning propellants, and hazardous waste sites, can increase the risk of arrhythmias.
Psychosocial Factors & Heart Disease
- Stress – Prolonged stress can have a significantly impact the body by altering hormone levels and affecting how the cardiovascular and nervous systems function. Additionally, it can lead to unhealthy coping mechanisms that increase the risk of cardiovascular disease (CVD).
- Shift work – Those who work outside of traditional daytime hours may be at an increased risk for CVD, as studies have shown a correlation between shift work and conditions such as high blood pressure.
Heart Disease Symptoms & Diagnosis
Cardiovascular diseases – often referred to as the “silent killers” – can be particularly deadly because they often have no visible symptoms. In fact, many people are not even aware that they have a problem with their blood vessels until it’s too late.
Furthermore, the symptoms of a heart attack, heart failure, or arrhythmia can vary greatly, making it even more difficult to identify early signs.
For example, a heart attack can present symptoms such as chest pain or discomfort, upper back or neck pain, extreme fatigue, upper body discomfort, dizziness, and shortness of breath.
On the other hand, an arrhythmia may cause fluttering feelings in the chest, also known as palpitations. And with heart failure, a person may experience shortness of breath, fatigue, or swelling of the feet, ankles, legs, abdomen, or neck veins.
Unfortunately, early research on heart attacks primarily focused on male subjects, leading to a narrow understanding of the symptoms of heart attacks in women – which are often thought to be chest pain and discomfort in the left arm.
However, women may experience “atypical” symptoms, such as nausea and general discomfort. As a result, studies have shown that women are 50% more likely to be misdiagnosed following a heart attack and are also more likely to die from a heart attack than men.
Screening and Diagnoses
Understanding how CVDs affect men and women is crucial in preventing delayed diagnosis and treatment. Several screens and tests, which can be done at an annual physical, can determine if an individual has a CVD or is at risk of developing one, such as:
- Blood pressure: High blood pressure is a leading risk factor for CVDs.
- Cholesterol: High cholesterol levels in the blood can increase the risk of CVDs.
- Blood glucose: High blood sugar levels can lead to diabetes, a risk factor for CVDs.
- Body weight: Being overweight or obese can increase the risk of CVDs.
Cardiologists can do the following tests to determine and diagnose the heart condition:
- Electrocardiogram (ECG)
- Holter monitoring
- Cardiac catheterization
- CT scan
By understanding the various screens and tests available, individuals can take an active role in their health and detect CVDs early on.
Despite the prevalence of heart diseases, it is often seen as shocking when it affects individuals who appear to be in good health. One reason for this may be due to the tendency to overlook the impact of stress, a significant risk factor that is often underestimated.
Heart Disease & Stress at Work
Long working hours, pressing deadlines, and the expectation to maintain a high level of performance can lead to excessive stress levels for employees. The detrimental effects of work-related stress, such as insomnia, burnout, and decreased productivity, are well-known.
Furthermore, it can also exacerbate mental health conditions like anxiety and depression.
However, the question remains, can the stress caused by work be so severe that it causes a heart attack?
According to recent research, work-related stressors, such as high job demands and prolonged working hours, have moderately increased the risk of developing coronary heart disease and stroke.
The excess risk for individuals exposed to these stressors is estimated to be between 10-40% compared to those without such stressors. Importantly, this association is found to apply to both men and women, as well as employees of different ages and socioeconomic backgrounds.
Many might not realize it, but workplace culture can also have a substantial effect on heart health. Workplace conditions, such as job pressures, discrimination, microaggressions, and sedentary activity, can significantly impact employees’ cardiovascular and emotional responses throughout the day.
Chronic exposure to these forms of workplace stress can trigger the “fight or flight response,” releasing cortisol and triggering an inflammatory response that accelerates the thickening or hardening of the arteries. This is known as the “atherosclerotic process” and is a major contributor to heart attacks.
Undoubtedly, heart disease and work stress are closely linked, with many studies showing that chronic stress can increase the development of cardiovascular disease risks. Not only is this a concern for employees, but also for employers who are facing rising healthcare costs and lost productivity due to this debilitating condition.
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Costs of Heart Disease and Strokes in the Workplace
Improving productivity and employee health go hand in hand. When employees are healthy, they tend to be more productive, have lower healthcare costs, fewer health-related limitations on their work, higher retention, and fewer absences.
As the leading cause of death in the United States, heart disease and strokes ake a toll on individuals their loved ones, and the workplace. The human and financial costs of these conditions can be staggering, leaving employers with a responsibility to address this pressing issue.
Human Costs: Employees with Heart Conditions
One of the most critical issues facing employees with CVDs is heart failure and returning to work. Heart disease and strokes take a toll on employees’ physical and emotional well-being and significantly impact their ability to work.
Work’s physical and mental demands can be challenging for someone recovering from a heart attack or dealing with heart failure, and many employees may not be able to return to work at all. This can lead to prolonged absence from work, increased medical expenses, and a lower quality of life for the affected employee.
Employees with heart conditions often have to take time off for medical appointments and treatments and may even have to take extended leave if their condition worsens. This affects the employee’s productivity and puts a strain on their colleagues, caregivers, and the business as a whole.
Business Costs: Employer Responsibility for Employees with Heart Diseases
The direct medical costs of CVD are expected to triple to over $800 billion by 2030, and employers bear a significant portion of these costs through employee health insurance and disability payments. However, for employersheart disease and stroke costs are not limited to healthcare expenses.
The financial burden also includes indirect costs from lost productivity, absenteeism, and short-term disability. In the first month alone, employers may see a cost increase of over $1,119 due to employee absenteeism and short-term disability.
Although the first month following a cardiovascular event has the highest cost, it can continue for up to three years, as employees may require additional time off for recovery and rehabilitation.
Employers can take certain steps to reduce the cost of heart disease in the workplace. Encouraging healthy lifestyle choices and providing access to preventative care can help prevent the onset of heart conditions and reduce the financial burden on the business.
Heart Disease Risks Prevention
Coronary heart disease is a complex condition influenced by a combination of factors, some of which individuals have no control over. For example, family history, ethnic background, and even complications during pregnancy can all play a role in cardiovascular disease development.
One of the most significant risk factors for heart disease is high blood pressure, which can be caused or exacerbated by lifestyle factors such as:
- Unhealthy diet
- Excessive alcohol use
- Physical inactivity
In fact, cardiovascular health research has shown that nearly half of all people in the United States (47%) have at least one of these three risk factors. What’s more, these risk factors are cumulative, meaning that the more of them you have, the greater your risk becomes.
The good news is that individuals can take steps to reduce their risk of heart disease, even if they can’t control certain factors. By avoiding tobacco use, maintaining a healthy weight, being physically active, and following a nutritious diet, individuals can reduce their risk of coronary artery disease and sudden cardiac death by an impressive 80%.
One of the most alarming scenarios for employees with heart conditions is the possibility of a heart attack at work. This not only puts the employee’s health at risk but also raises important questions about employer responsibility for employee heart attacks.
Employers must provide a safe working environment for all employees, including taking appropriate measures to prevent heart disease in the workplace. Some of these measures include providing access to regular health screenings, promoting healthy lifestyles, and providing accommodations for employees with heart conditions.
Working with a Heart Condition
Working with a heart condition can be a difficult challenge for both employees and employers. Congestive heart failure, in particular, can come with strict work restrictions limiting an individual’s ability to perform specific tasks or work in certain environments.
However, employers are required to abide by the Americans with Disabilities Act (ADA), which prohibits discrimination against employees with heart conditions that qualify as a disability under federal law.
Employers should also make reasonable accommodations to help employees manage their condition, such as flexible scheduling, providing parking close to the office, and time off for medical appointments.
To help mitigate these challenges of working with congestive heart failure, individuals with heart conditions can take steps to manage their condition and improve their chances of finding and keeping a job.
For example, they can work with their healthcare provider to develop a care plan that includes regular check-ups, a disease management program enrollment, and lifestyle changes such as diet and exercise.
They can also seek out resources such as the CDC stroke prevention program, which provides information and support for individuals at risk of stroke or heart attack.
Promoting Heart Wellness at Work
With the majority of American adults spending more time at work than any other activity, companies must take steps to improve their employees’ overall health and well-being.
One effective way to promote heart wellness at work is through incentives. Giving employees economic incentives to lead a healthier lifestyle can be a powerful approach to increase adherence to lifestyle recommendations.
However, it’s essential to consider the potential downsides and tailor incentives to individual workers to maximize benefits. For example, workers with chronic illnesses or very high body indices may be unable to reach certain health goals, which would penalize them compared to their healthier peers.
Another important aspect of promoting heart wellness at work is recognizing that there isn’t a one-size-fits-all approach. The AHA recommends an incremental approach for companies starting wellness or workplace health programs. Such efforts should be focused on the following:
- Smoking cessation or prevention
- Increasing physical activity through training programs
- Managing and reducing stress
- Promoting healthy eating through nutrition programs
- Managing weight and disease management
- Educating workers about cardiovascular disease
- Encouraging employees to utilize cardiovascular health programs
- Structuring the workplace to encourage healthy behaviors and promote occupational health and safety
Investing in the cardiovascular health of employees benefits not only the employees themselves but also the employer. Heart-healthy employees save employers money, have better morale, and are more productive than less healthy employees. It’s a win-win situation for both the employee and the employer.
In conclusion, heart disease in the workplace is a significant health concern that affects many individuals. It is imperative that companies prioritize heart health and create a culture of well-being not just during American Heart Month, but every day. Maintaining a heart-healthy workforce requires consistent and daily effort.
- Work Stress as a Risk Factor for Cardiovascular Disease (Pubmed)
- Preventing Heart Disease (Harvard)
- About Heart Disease (CDC)
- Disability Discrimination Based on Heart Conditions (pcwlawfirm)
- Prevalence of Uncontrolled Risk Factors for Cardiovascular Disease: (CDC)
- Know Your Risk for Heart Disease (CDC)
- Heart disease and work (NCBI)
- Opportunities to improve cardiovascular health in the new American workplace (ScienceDirect)
- 2021 Heart Disease and Stroke Statistics Update Fact Sheet (AHA)