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[IDENTIFICATION OF OCCUPATIONAL RISK FOR ARTERIAL HYPERTENSION. REPORT II: ELIMINATION OF THE MODIFYNG INFLUENCE OF

S A Maksimov, A E Skripchenko, A P Mikhailuts

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    |July 20, 2016
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    Summary

    This study refines occupational risks for arterial hypertension (AH) by accounting for the healthy worker effect (HWE), revealing true occupational risks. The healthy recruitment effect (EHR) significantly modifies these risks.

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    Area of Science:

    • Occupational Health
    • Epidemiology
    • Cardiovascular Disease Research

    Context:

    • Investigates occupational risks for arterial hypertension (AH) in 13 worker groups.
    • Builds upon previous work that excluded traditional cardiovascular risk factors.
    • Focuses on isolating occupational factors by addressing the healthy worker effect (HWE).

    Purpose:

    • To identify and eliminate the influence of HWE components (healthy recruitment effect - EHR, and healthy worker persisting to work effect - EHWPW) on AH occupational risks.
    • To determine true occupational risks for AH by removing confounding effects.
    • To analyze the modifying impact of HWE on occupational AH risks.

    Summary:

    • Developed novel methodological approaches to analytically adjust standardized prevalence rates of AH for age and obesity.
    • Quantified EHR by analyzing AH prevalence in young workers (<31 years) and adjusted AH rates using occupational and reference group comparisons.
    • Assessed EHWPW by comparing AH frequency in near-retirement workers and adjusted overall AH prevalence rates.

    Impact:

    • Successfully isolated true occupational risks for AH by accounting for HWE components.
    • Demonstrated that cardiovascular risk factors and HWE significantly modify occupational AH risks, sometimes leading to risk inversion.
    • Highlighted the paramount importance of the EHR in modifying occupational risks for arterial hypertension.