Helmert U, Shea S, Bammann K
Department of Health Policy, Occupational and Social Medicine, University of Bremen, Germany.
Rev Environ Health. 1997 Jan-Mar;12(1):25-42. doi: 10.1515/REVEH.1997.12.1.25.
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.
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).
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).
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.
在德国，关于职业与心血管危险因素及疾病之间的关联，以及此类关联在男性和女性中是否存在差异的研究较为稀少。
我们分析了12093名40至69岁男性和12125名40至69岁女性的数据，这些人参与了1984年至1991年间在德国西部进行的三项区域和全国性健康调查，作为德国心血管预防研究的一部分。高血压、总胆固醇和高密度脂蛋白胆固醇水平以及肥胖基于标准化测量，而吸烟、糖尿病以及心肌梗死、中风和心绞痛病史则基于自我报告，使用标准化问卷。职业按照布洛斯费尔德提议分为13组（男性）或12组（女性），同时也按照30种最常见的具体职业进行分类。采用多元逻辑回归分析来调整年龄、心血管危险因素和社会经济地位（SES）。
在男性中，在调整年龄、心血管危险因素和SES后，与专业人员这一参照类别相比，所有12个职业组的心血管疾病患病率的优势比均显著升高。在女性中，11个主要职业组中均未发现心血管疾病有显著增加。教师被用作30种最常见职业的参照类别。在男性中，有五种职业（木匠、锁匠、仓库管理员、门卫和司机）的自我报告心血管疾病患病率的年龄调整优势比显著升高。在女性中，仅发现两种职业（幼儿园教师和厨师）与心血管疾病有显著关联。
研究结果表明，工作场所及其文化的某些方面，尤其是在蓝领职业中，对男性心血管风险的影响程度大于女性。
