The impact of occupation on self-reported cardiovascular morbidity in western Germany: gender differences.

BACKGROUND

In Germany, research is sparse on the associations between occupation and cardiovascular risk factors and disease or whether such associations differ for men and women.

METHODS

We analyzed the data from 12,093 males and 12,125 females aged 40-69 years, who participated in three regional and national health surveys that were conducted in western Germany between 1984-1991 as part of the German Cardiovascular Prevention Study. Hypertension, total and HDL cholesterol levels, and obesity were based on standardized measurements, whereas smoking, diabetes, and history of myocardial infarction, stroke, and angina pectoris were based on self-report, using standardized questionnaires. Occupations were categorized into 13 (males) or 12 (females) groups as proposed by Blossfeld, as well as according to the 30 most frequent specific occupations. Multiple logistic regression analyses were used to adjust for age, cardiovascular risk factors, and socio-economic status (SES).

RESULTS

Among males, after adjusting for age, cardiovascular risk factors and SES, all 12 occupational groups had significantly elevated odds rations for the prevalence of cardiovascular disease when compared with the reference category of professionals. Among females, no significant increase in cardiovascular disease was found in any of the 11 main occupational groups. Teachers were used as the reference category for the 30 most frequent occupations. In males, five occupations (carpenter, locksmith, warehouse clerk, doorman, and driver) yielded significantly elevated age-adjusted odds ratios for the prevalence of self-reported cardiovascular disease. In females, we found significant associations with cardiovascular disease only for two occupations (kindergarten-teacher and cook).

CONCLUSION

The findings suggest that certain aspects of the workplace and its culture, particularly in blue-collar occupations, influence the cardiovascular risk in men to a greater extent than in women.