Occupational and lifestyle factors associated with SCORE-2 cardiovascular risk among emergency healthcare workers

This study aimed to examine the associations between occupational characteristics, lifestyle behaviors, sleep quality, and 10-year cardiovascular risk estimated using SCORE-2 algorithm among ambulance emergency medical services (EMS) and emergency department healthcare workers.

This cross-sectional study included 300 healthcare workers employed in ambulance EMS (n = 122) and emergency departments (n = 178). Sociodemographic variables, occupational characteristics, lifestyle behaviors, and clinical data were collected using a structured questionnaire. Sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI), and cardiovascular risk was estimated using SCORE-2. Group comparisons were performed using the Mann-Whitney U and chi-square tests. Associations were evaluated with Spearman correlation, and independent predictors of SCORE-2 were identified using multivariable linear regression analysis.

The median SCORE-2 value was 2.8% (IQR: 1.6-4.7), with no significant difference between ambulance EMS and emergency department workers (p = 0.855). Participants aged ≥ 50 years had significantly higher SCORE-2 values compared with those aged 40-49 years (p < 0.001). Alcohol consumption was associated with higher SCORE-2 levels (p < 0.001) and remained an independent predictor in multivariable analysis (B = 1.41, 95% CI: 0.60-2.22). Age and sex were also independently associated with SCORE-2. Although sleep quality showed a weak positive correlation with SCORE-2 (r = 0.166, p = 0.004), this association was not significant after adjustment.

In emergency healthcare workers, SCORE-2-estimated cardiovascular risk is mainly driven by age, sex, and alcohol consumption rather than work setting or shift characteristics. These findings suggest that incorporating occupational and lifestyle factors alongside SCORE-2 may improve cardiovascular risk assessment in shift-working healthcare professionals.