Statistically, cardiovascular diseases (CVDs) of the heart and blood vessels are still the leading causes of illness and death in Germany. According to data from Germany’s Federal Statistical Office, CVDs are responsible for about 33%of all deaths in the country. In addition, they are linked to considerable personal consequences and cause high sickness costs for society. Besides genetic and lifestyle factors, certain working conditions can also increase the risk for developing CVDs.

The range of cardiovascular diseases

CVDs can be genetic or acquired. They can be grouped into three categories:

• diseases of the (arterial) system leading away from the heart,
• diseases of the (venous and lymphatic) system leading to the heart, and
• diseases of the heart, e.g., cardiac insufficiency and cardiac arrhythmia.

Diseases of the arteries, which transport oxygen to the peripheral organs, can often lead to significant narrowing of the arteries through the build-up of deposits and plaque. This is known as arteriosclerosis and can, for instance, lead to peripheral arterial occlusive disease, coronary heart disease (e.g. angina or heart attack) or stroke.

Diseases of the veins, which transport blood to the heart, are often the result of venous insufficiency. Vascular dilation is caused by a slackening or relaxation of the muscles in the vascular walls. Varicose veins, phlebitis and thrombosis are examples of venous diseases.

Significance and spread of cardiovascular diseases

The incidence of CVD increases significantly from middle age onwards and, with the exception of venous disease, is lower in women than in men. The most common CVDs are coronary heart disease, high blood pressure (hypertension), myocarditis, and cardiac arrhythmia.

Incapacity to work and cardiovascular diseases

Incapacity to work resulting from CVDs occurs to varying degrees in all occupational groups. The BAuA project F 2255  "Occupation-specific risk for sick leave due to musculoskeletal disorders or cardiovascular diseases – identifying occupational groups and occupations of particular relevance for prevention" investigated the frequency of CVD-related sick leave using data from nearly all of the statutory health insurance funds in Germany. The results show that employees with lower and medium qualification levels are affected more by CVD-related work absence. CVD-related work absence is also more common in production and services than in administration. These findings apply to both men and women.

Work-related and non-work-related causes

According to the findings of large German and international studies (Gutenberg Health Study (GHS), INTERHEART study), along with genetic disposition, the following factors, increase the risk of cardiovascular diseases:

• smoking
• alcohol consumption
• physical inactivity
• unhealthy eating habits
• obesity
• high blood lipid levels
• high blood pressure
• diabetes
• psychosocial factors (stress)

Most findings regarding the connection between work-related risk factors and cardiovascular disease relate to psychosocial stress factors in the workplace. The following psychosocial stress workplace factors can influence the risk of cardiovascular disease:

• high job demands combined with low decision latitude
• effort-reward-imbalance (i.e., a disparity between perceived occupational demands and experienced or promised recognition)
• shift work
• overly long working hours

These risk factors can also alter health behaviour. Thus, these risk factors can also contribute indirectly to an increased health risk.

Occupational exposure to particulates and cardiotoxic substances can also increase the risk of cardiovascular disease. Physical risk factors such as noise, heat, and physical demands are also discussed in connection with cardiovascular disease. Physical demands include both heavy manual labour and insufficient physical demands due to long periods of sitting or standing.