Incidence of acute myocardial infarction in the workforce: Findings from the Occupational Disease Surveillance System

Troke N, Logar-Henderson C, DeBono N, Dakouo M, Hussain S, MacLeod JS, Demers PA. Incidence of acute myocardial infarction in the workforce: Findings from the Occupational Disease Surveillance System. Am J Ind Med. 2021;64(5):338-357. doi:10.1002/ajim.23241

Background: Increased risks of acute myocardial infarction (AMI) may be attributable to the workplace, however, associations are not well-established. Using the Occupational Disease Surveillance System (ODSS), we sought to estimate associations between occupation and industry of employment and AMI risk among workers in Ontario, Canada.

Methods: The study population was derived by linking provincial accepted lost-time workers’ compensation claims data, to inpatient hospitalization records. Workers aged 15–65 years with an accepted non-AMI compensation claim were followed for an AMI event between 2007 and 2016. Adjusted Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for each industry and occupation group, compared to all other workers in the cohort. Sex-stratified analyses were also performed.

Results: In all, 24,514 incident cases of AMI were identified among 1,502,072 Ontario workers. Increased incidence rates of AMI were found across forestry (HR 1.37, 95% CI 1.19–1.58) and wood processing (HR 1.50, 1.27–1.77) job-titles. Elevated rates were also detected within industries and occupations both broadly related to mining and quarrying (HR 1.52, 1.17–1.97), trucking (HR 1.32, 1.27-1.38), construction (HR 1.32, 1.14–1.54), and the manufacturing and processing of metal (HR 1.41, 1.19–1.68), textile (HR 1.41, 1.07–1.88), non-metallic mineral (HR 1.30, 0.82–2.07), and rubber and plastic (HR 1.42, 1.27–1.60) products. Female food service workers also had elevated AMI rates (HR 1.36, 1.23–1.51).

Conclusion: This study found occupational variation in AMI incidence. Future studies should examine work-related hazards possibly contributing to such excess risks, like noise, vibration, occupational physical activity, shift work, and chemical and particulate exposures.