Cardiovascular disease is an umbrella term for all illnesses of the heart and circulatory system and is a leading cause of death – approximately 31 per cent of all deaths worldwide could be attributed to cardiovascular disease in 2012 according to the World Health Organization):
Coronary heart disease (CHD) causes the death of 94,000 people a year in the UK. It occurs when arteries that supply the heart with oxygen-enriched blood become narrowed by fatty deposits building up on their walls. As the arteries narrow they reduce the amount of oxygen-enriched blood reaching the heart and this can cause pains, known as angina. In the UK, one in seven men and one in eleven women die from coronary heart disease. If part of the fatty deposit breaks down, a blood clot can form and block the artery completely causing a heart attack or stroke. An estimated 640,000 men and nearly 275,000 women living in the UK have survived a heart attack.
Heart failure affects about 900,000 people in the UK and occurs when the weakened heart is unable to pump enough blood to meet the body’s needs.
Heart valve disease affects one or more valves of the heart and restricts the heart from pumping blood properly.
Hypertensive heart disease results when high blood pressure causes excessive strain on the heart.
Congenital heart disease is a problem with the working of the heart from birth.
Cardiac arrhythmia is an irregular heartbeat. There are many different types of irregularity ranging from those that are minor and require no treatment through to those that are serious and life threatening.
Cardiomyopathy is commonly an inherited heart disease in which the heart becomes enlarged, thick or rigid.
Coronary heart disease
Coronary heart disease is the leading cause of death in the UK and worldwide. Symptoms can vary in severity and type but commonly they include chest pain or ‘pressure’, which can be experienced with or without pain in the arms, neck, jaw or stomach. Associated symptoms include:
- nausea or vomiting;
- irregular heartbeat.
Causes of heart disease can vary but the onset and severity of the condition can be influenced by workplace and lifestyle factors.
Workplace factors affecting the onset of heart disease:
- A number of toxins used in the workplace have been identified as increasing the risk of heart disease, for example methylene chloride, an ingredient of many commonly-used paint removers, carbon monoxide in car park attendants and furnace workers, and carbon disulphide in the viscose rayon manufacturing industry.
- Physical hazards at work can also increase the risk of heart disease. Extreme temperatures, such as the heat of a foundry or mine or the chill of a freezer or winter weather, can put pressure on the heart and make pre-existing heart problems worse.
- The psychological impact of the working environment may also contribute to the development of heart disease. There is considerable evidence to support the role of job strain (a combination of high work demands and low job control) as a risk factor for heart disease. Shift work may increase the risk of cardiovascular disease, but probably only slightly.
- Sedentary work in modern offices combined with less active lifestyles can make workers less fit and more vulnerable to heart disease.
Lifestyle factors affecting the onset of coronary heart disease:
Lifestyle choices outside work can have a fundamental impact on someone’s vulnerability to heart disease.
Smoking: Smokers are twice as likely to have a heart attack as non-smokers. Smoking damages the lining of the arteries and leads to the build-up of fatty deposits. The carbon monoxide in the smoke reduces the amount of oxygen in the blood which means the heart has to pump harder to get enough oxygen around the body.
Poor diet, alcohol consumption and lack of exercise can lead to weight gain and obesity which are bad for the heart by raising blood cholesterol levels and blood pressure and increasing the risk of developing type 2 diabetes. Diabetes is caused by high levels of glucose in the blood which can affect the walls of the arteries and increase the build-up of fatty deposits. Drinking too much alcohol and having too much salt in your diet can also lead to high blood pressure.
Simple changes to diet and exercise can make a profound impact on your health and vulnerability to heart disease. Once heart disease has been diagnosed, lifestyle changes can also help to manage the condition.
Heart conditions and work
In some cases the working environment can exacerbate symptoms in those with poor cardiac health. However there are steps that can be taken by employees and employers to reduce the risks within and outside the workplace, and many people continue work or return to work after discovering they have a heart condition.
Employees: GPs will help with advice but it’s worth asking yourself some key questions around the number of days you think you can work, whether or not you could return to your current job with adjustments to your job role, and whether you can manage the journey to work, etc. Help is also available from the Fit for Work advice line on 0800 032 6235 (English) or 0800 032 6233 (Welsh). Employed people in England and Wales who have been off work for four weeks or more due to ill health but want to return to work can ask their GP or employer for a referral to Fit for Work. See fitforwork.org for more information. Those in Scotland can call 0800 019 2211 or visit fitforworkscotland.scot.
Employers: Many people return to work after being diagnosed with a heart problem and continue to work productively and effectively. Employers can help by offering flexible hours or different duties, or could offer the services of an occupational health expert. Anyone who has been off work for four weeks or more due to ill health can be referred to Fit for Work by their employer for a free occupational health review. Visit fitforwork.org/employer and click ‘refer an employee.’ Those in Scotland can call 0800 019 2211 or visit fitforworkscotland.scot.
For advice on heart conditions in the workplace and your responsibilities as an employer, call the Fit for Work advice line on 0800 032 6235 (English) or 0800 032 6233 (Welsh). Those in Scotland can call 0800 019 2211.