Risk of Cardiovascular Disease According to Standard Industrial Sectors: A Nationwide Longitudinal Study

Cardiovascular disease (CVD) is a leading global cause of morbidity and mortality, with occupational factors significantly contributing to risk. However, industry-specific CVD risks in Asia remain understudied. This study evaluates CVD and all-cause mortality risks across industrial sectors in Republic of Korean (South Korea) using a nationally representative dataset.

This study examined middle-aged paid workers (aged 40-59 years) using data from the National Health Insurance Service database, which integrates biennial health screening data with insurance claims. We included individuals who underwent health examinations between 2009 and 2010 and followed them to identify CVD events through insurance claims records. Age-standardized incidence ratios were calculated using indirect standardization with the entire population as the control group, and 95% confidence intervals (CIs) were estimated using the Poisson distribution, with results stratified by sex. Population-attributable fractions were calculated to estimate each sector's contribution to the CVD burden.

Among males, the highest standardized incident ratios for CVD were observed in the "A. Agriculture, Forestry and Fishing" (1.20; 95% CI, 1.10-1.31) and "H. Transportation and Storage" (1.19; 1.17-1.21) sectors. For females, elevated standardized incidence ratios were found in the "D. Electricity, Gas, Steam and Air Conditioning Supply" (1.31; 1.09-1.57) and "H. Transportation and Storage" (1.15; 1.10-1.20) sectors. The "H. Transportation and Storage" sector showed the highest population-attributable fraction for males (3.34%), while the "I. Accommodation and Food Service Activities" sector led for females (1.64%).

This study provides the first comprehensive analysis of industry-specific CVD risks in Asia, highlighting elevated risks in transportation possibly due to long working hours, sedentary behavior, and occupational stress. Targeted interventions are needed to address these occupational health disparities.