Occupational factors, fatigue, and cardiovascular disease.
OBJECTIVE
Briefly identify the epidemiological evidence, propose pertinent mechanisms, and discuss physical therapy practice as well as research implications of a causal association between occupational factors and cardiovascular disease.


CONCLUSIONS
There is evidence that occupational metabolic demands and work organizations characterized by reduced worker control are associated with increased risk of cardiovascular disease. It is biologically plausible that these two factors interact to create a preclinical, intermediate state of fatigue (burnout) that is a critical component in the causal path from occupational factors to CVD. Physical therapists are uniquely qualified to contribute to an understanding of these mechanisms and their resultant implications for work organization, rehabilitation, and health promotion. Statement of Recommendations: Physical therapists engaged in ergonomic job analysis should consider work related metabolic demands, worker control, and fatigue in their assessment of risk for injury and illness, in recommendations for return to work, and in the prescription of health promotion leisure time physical activity.
Collins
Sean
S
Department of Physical Therapy, Research Associate, Kerr Ergonomics Institute, University of Massachusetts Lowell.
Eur J Appl Physiol. 2003 Aug;89(6):536-47
12728324
Psychol Bull. 2006 May;132(3):327-53
16719565
Atherosclerosis. 2007 Oct;194(2):490-7
16979645
Acta Physiol Scand Suppl. 1997;640:153-4
9401630
Cad Saude Publica. 2007 Nov;23(11):2749-55
17952267
Occup Environ Med. 2003 Jun;60 Suppl 1:i62-70
12782749
J Occup Environ Med. 2000 Feb;42(2):127-35
10693072
Am J Ind Med. 1994 Nov;26(5):597-612
7832208
Sports Med. 1998 Jul;26(1):1-16
9739537
Ergonomics. 2002 Mar 15;45(4):280-9
12028725
Phys Ther. 2002 Apr;82(4):383-403
11922854
Scand J Work Environ Health. 2004 Apr;30(2):85-128
15127782
Am J Epidemiol. 1996 May 1;143(9):870-80
8610700
Am J Epidemiol. 1990 Oct;132(4):612-28
2144946
Am J Ind Med. 2005 Sep;48(3):182-93
16094616
Scand J Work Environ Health. 2007 Dec;33(6):405-24
18327509
Occup Environ Med. 2003 Jun;60 Suppl 1:i88-92
12782753
J Appl Psychol. 2006 Mar;91(2):330-50
16551187
Hypertension. 2007 May;49(5):e33
17339530
Pflugers Arch. 2002 Nov;445(2):267-72
12457247
Clin Physiol Funct Imaging. 2004 Jan;24(1):10-8
14717743