On Risk Factors for Premature Myocardial Infarction in Middle-aged Building Construction Workers

Abstract

On risk factors for premature myocardial infarction in middle-aged building construction workers. A comparison with other selected illnesses. Theorell, T., Askergren, A., Olsson, A., and Åkerstedt, T. (Dept. of Medicine, Serafimerlasarettet, Foundation for Industrial Safety and Health in the Construction Industry, and the Laboratory for Clinical Stress Research, Stockholm, Sweden). This study was carried out in order to define readily available indicators of elevated risk of imminent myocardial infarction in middle-aged building construction workers in Stockholm and also provided an opportunity for comparing the risk of myocardial infarction with that of gastric or duodenal ulcer and “social illness”. Univariate and multivariate analysis showed that the risk of myocardial infarction was associated with relative overweight, short stature, elevated blood pressure and elevated psychosocial discord index, whereas excessive cigarette smoking was associated with a risk of myocardial infarction in the univariate analysis only. Excessive cigarette smoking was associated with ulcer and “social illness”. Elevated blood pressure was associated with risk of ulcer and elevated heart rate with risk of “social illness”. The target population consisted of all male 41–61-year-old members of the union of building-construction workers in Greater Stockholm ( n=8973). They were all asked to fill out a psychosocial questionnaire from which a “discord index” was calculated. Non-responders (25%) were comparable to responders with regard to a number of crude social characteristics. In order to establish somatic characteristics for the participants, the investigators utilized a standardized health check-up ( Bygghälsan—building workers' health scheme) in which 55% of the participants had taken part. Official registers were utilized during the follow-up (12–27 months) in order to find instances of (1) myocardial infarction (2) gastric or duodenal ulcer, and (3) prolonged neurosis or non-illness death (“social illness”). Subjects who had been absent from work because of similar illness during the preceding year were excluded from the followup. Three roughly equal-sized diagnostic groups ( n = 22–26) were formed. They were compared with a contrast group ( n = 194) which was selected from the population in a representative way.