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26-09-2011 | Cardiology | Article

VTE risk linked to occupation, socioeconomic status

Abstract

Free abstract

MedWire News: The risk for venous thromboembolism (VTE) varies by occupation and socioeconomic status, research suggests.

Specifically, blue-collar workers, farmers, and the unemployed have higher risks for VTE compared with white-collar workers and professionals, report the investigators.

Furthermore, advanced age, surgery, oral contraceptives, hormone replacement therapy, pregnancy, obesity, comorbid disease, among others, all increase the risk for VTE.

The results suggest that "psychosocial and occupational factors appear to affect the risk of suffering from VTE," write Bengt Zöller (Lund University, Malmö, Sweden) and colleagues in the journal Thrombosis Research.

Psychosocial factors have been implicated in the risk for cardiovascular disease, but less is known about the role of these factors in the development of VTE. Past studies have shown that psychosocial factors might play a role in increased risk for blood clotting and decreased fibrinolysis, which might be important in the processes involved in VTE.

In the present study, Zöller and colleagues examined the association between hospitalization for VTE and socioeconomic and occupational factors in 43,603 individuals hospitalized over a 17-year period.

Education was implicated in the risk for VTE, with individuals having more than 12 years of schooling having a lower risk for VTE compared with those who completed high school only. Those with less than 9 years of education were at a significantly increased risk for VTE compared with those with the highest levels.

Based on the standardized incidence ratio, farmers, individuals currently unemployed, and blue-collar workers had a respective 21%, 14%, and 5% increased risk for VTE.

Male farmers, miners, quarry workers, food manufacturers, packers, loaders, warehouse workers, and public safety and protection employees were all at an increased risk for VTE.

For women, risks for VTE were highest for assistant nurses, farmers, mechanics, and iron workers, as well as cooks, stewards, and home-helpers.

The self-employed, professionals, and white-collar workers, on the other hand, had a 9%, 12%, and 6% lower risk for VTE, respectively.

The risks for VTE were lowest for male technical, chemical, physical, and biological workers, physicians, dentists, teachers, religious, judicial, and social science-related workers, and sales agents.

A similar association was observed between these occupations and the risk for VTE in women. Psychosocial stress and coagulation activation might explain the difference in risk between occupations, and other factors, such as smoking, exercise, and diet, which the researchers were unable to control for, might also influence VTE risk in different jobs.

"It remains to be determined which specific factors are responsible for the observed differences in socioeconomic and occupational risks for VTE," write Zöller and colleagues.

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