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Myocardial infarction among male bus, taxi, and lorry drivers in middle Sweden
P Gustavsson1, L Alfredsson, H Brunnberg
1Department of Occupational Health, Karolinska Hospital, Stockholm, Sweden.
Objectives:
The aim of the present case-referent study was to investigate the incidence of myocardial infarction among male professional drivers, taking the type of vehicles and area of residence into account.
Methods:
The study base comprised all men aged 30-74 in five counties in middle Sweden during 1976-81 or 1976-84. Incident cases of the first episode of myocardial infarction were identified from registers of hospital admissions and causes of deaths. Referents were selected randomly from the study base. Information about occupation was obtained from the national censuses in 1970 and 1975. The possible impact from tobacco smoking and overweight were evaluated by simulations in combination with indirect data on these factors.
Results:
The incidence of myocardial infarction was increased among bus drivers in Stockholm (relative risk (RR) = 1.53, 95% confidence interval (95% CI) 1.15-2.05), and among taxi drivers both in Stockholm (RR 1.65, 95% CI 1.30-2.11) and in the surrounding rural counties (RR 1.82, 95% CI 1.17-2.82). A smaller increase was found among long distance lorry drivers, whereas the relative risk among short distance lorry drivers was close to unity. Indirect comparisons make it unlikely that the excess among bus drivers in Stockholm could be explained by uncontrolled confounding from tobacco smoking or overweight. A very high proportion (more than 80%) of urban bus drivers in Sweden report a combination of high psychological demands and low control at work.
Conclusions:
Different types of drivers are at different risk of myocardial infarction. Bus drivers in urban areas seem to be at an increased risk, which is unlikely to be explained by uncontrolled confounding from tobacco smoking or overweight. Psychosocial work conditions may play a part in the increased incidence of myocardial infarction among urban bus drivers and should be investigated further.
Insights
Professional drivers, especially urban bus drivers, face a higher risk of myocardial infarction. Psychosocial factors at work may contribute to this increased risk, warranting further investigation into occupational health.
Area of Science:
- Occupational health
- Cardiovascular epidemiology
- Public health
Background:
- Professional drivers are a significant occupational group.
- Myocardial infarction (MI) is a leading cause of mortality.
- Previous studies have suggested links between occupation and cardiovascular disease.
Purpose of the Study:
- To investigate the incidence of myocardial infarction (MI) among male professional drivers.
- To examine the influence of vehicle type and area of residence on MI risk.
- To explore potential confounding factors such as smoking and overweight.
Main Methods:
- A case-referent study design was employed.
- The study included men aged 30-74 from five Swedish counties.
- MI cases were identified from hospital admissions and death registers; referents were randomly selected.
Main Results:
- Bus drivers in Stockholm (RR 1.53) and taxi drivers (RR 1.65-1.82) showed increased MI incidence.
- Long-distance lorry drivers had a smaller increase; short-distance drivers had near-normal risk.
- High psychological demands and low job control were reported by over 80% of urban bus drivers.
Conclusions:
- Different driver occupations present varying risks for myocardial infarction.
- Urban bus drivers exhibit an elevated MI risk, not attributable to smoking or overweight.
- Psychosocial work conditions are a potential factor in MI risk for urban bus drivers and require further study.