title: A worksite intervention to reduce the cardiovascular risk: proposal of a study design easy to integrate within Italian organization of occupational health surveillance.
abstract: BACKGROUND
  Despite the substantial amount of knowledge on effectiveness of worksite health promotion (WHP) in reducing cardiovascular disease (CVD) risk, WHP programs are not systematically applied in Italy. The aim was to design an intervention easy to integrate within the Italian organization of workplace health surveillance.
  
  
  METHODS
  We used the "pretest-posttest design". Workers were employed in multiple occupations and resident in Veneto region, Italy. Occupational physicians (OPs) performed all examinations, including laboratory evaluation (capillary blood sampling and measure of glycaemia and cholesterolemia with portable devices), during the normal health surveillance at worksite. CVD risk was computed based on sex, age, smoking habit, diabetes, systolic pressure and cholesterol level. After excluding those with <40 years of age, missing consent, CVD diagnosis or current therapy for CVD, missing information, CVD risk <5%, out of 5,536 workers 451 underwent the intervention and 323 male workers were re-examined at 1 year. CVD risk was the most compelling argument for changing lifestyle. The counseling was based on the individual risk factors. Individuals examined at posttest were a small fraction of the whole (6% = 323/5,536). In these workers we computed the ratio pretest/posttest of proportions (such as percent of subjects with cardiovascular risk >5%) as well as the exact McNemar significance probability or the exact test of table symmetry.
  
  
  RESULTS
  CVD risk decreased by 24% (McNemar p = 0.0000) after the intervention; in a sensitivity analysis assuming that all subjects lost to follow-up kept their pretest cardiovascular risk value, the effect (-18%) was still significant (symmetry p < 0.0000). Each prevented CVD case was expected to cost about 5,700 euro.
  
  
  CONCLUSIONS
  The present worksite intervention promoted favorable changes of CVD risk that were reasonably priced and consistent across multiple occupations.
authors.affiliation: Department of Cardiac Thoracic and Vascular Sciences, University of Padua, Via Giustiniani 2, 35128, Padua, Italy. giuseppe.mastrangelo@unipd.it.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Mastrangelo
authors.affiliation: Health and Safety at Work Department (SPSAL), Local Health Authority No.20, Veneto Region, Via Salvo D'Acquisto 7, 37122, Verona, Italy. gianluca_marangi@yahoo.it.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Marangi
authors.affiliation: National Association of Occupational Physicians (Associazione Nazionale dei Medici D'Azienda e Competenti, ANMA Veneto), Via Nazareth 2, 35128, Padova, Italy. danilo.bontadi@studiogomi.it.
authors.forename: Danilo
authors.initials: D
authors.lastname: Bontadi
authors.affiliation: Department of Cardiac Thoracic and Vascular Sciences, University of Padua, Via Giustiniani 2, 35128, Padua, Italy. emanuelafadda8@gmail.com.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Fadda
authors.affiliation: Department of Cardiac Thoracic and Vascular Sciences, University of Padua, Via Giustiniani 2, 35128, Padua, Italy. luca.cego@gmail.com.
authors.forename: Luca
authors.initials: L
authors.lastname: Cegolon
authors.affiliation: Department of Philosophy, Sociology, Education and Applied Psychology, University of Padua, Piazza Capitaniato 3, I-35139, Padova, Italy. melania.bortolotto@unipd.it.
authors.forename: Melania
authors.initials: M
authors.lastname: Bortolotto
authors.affiliation: Regional Epidemiology Service, Veneto Region, Passaggio Luigi Gaudenzio 1, 35131, Padua, Italy. ugo.fedeli@regione.veneto.it.
authors.forename: Ugo
authors.initials: U
authors.lastname: Fedeli
authors.affiliation: Health and Safety at Work Department (SPSAL), Local Health Authority No.20, Veneto Region, Via Salvo D'Acquisto 7, 37122, Verona, Italy. luciano.marchiori@ulss20.verona.it.
authors.forename: Luciano
authors.initials: L
authors.lastname: Marchiori
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008019:Life Style; D059012:Lost to Follow-Up; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology* / Q000517:prevention & control; D016272:Occupational Health / Q000592:standards*; D009787:Occupational Medicine / Q000379:methods; D040242:Risk Reduction Behavior; D017132:Workplace