Cardiorespiratory fitness testing and cardiovascular disease risk in male steelworkers.
BACKGROUND
The workplace has been advocated as a setting to perform cardiovascular disease (CVD) risk assessments. These risk assessments usually focus on traditional risk factors rather than cardiorespiratory fitness (CRF) despite established associations between CRF and CVD. The lack of guidance on interpreting health-related CRF values has been suggested as a barrier to utilizing CRF in practice.


OBJECTIVE
To assess the merits of CRF testing in the workplace and explore whether a CRF value identified male individuals above the recommended threshold for further clinical investigation.


METHODS
Cross-sectional analysis of male steelworkers from Carmarthenshire, South Wales, UK who completed a workplace-based CVD risk assessment with an added CRF protocol based on heart rate responses (Chester Step Test). Receiver operating characteristic (ROC) analysis was undertaken to explore the possibility of a CRF value to identify individuals at an increased 10-year risk of CVD (QRISK2 ≥ 10%).


RESULTS
There were 81 participants. ROC analysis revealed that a CRF level of 34.5ml/kg/min identified those individuals above the ≥10% QRISK2 threshold with the best sensitivity (0.800) and specificity (0.687) to discriminate against true- and false-positive rates. Further analysis revealed that individuals with either 'Average' or 'Below Average' CRF would be five times more likely to have a 10-year CVD risk above the ≥10% QRISK2 threshold than individuals with an 'Excellent' or 'Good' level of fitness [OR 5.10 (95% CI 1.60-16.3)].


CONCLUSIONS
This study suggests CRF assessments are a useful addition to a workplace CVD assessment and could identify male individuals at increased predicted risk of the condition.
Policy, Research and International Development, Public Health Wales, Cardiff CF10 4BZ, UK, Benjamin.Gray@wales.nhs.uk.
B J
BJ
Gray
Diabetes Research Group, College of Medicine, Swansea University, Singleton Park, Swansea SA2 8PP, UK.
J W
JW
Stephens
TATA Steel Packaging Recycling, Trostre, Llanelli, Carmarthenshire SA14 9SD, UK.
S P
SP
Williams
TATA Steel Packaging Recycling, Trostre, Llanelli, Carmarthenshire SA14 9SD, UK.
C A
CA
Davies
Red Bull North America, Santa Monica, CA 90404, USA.
D
D
Turner
Diabetes Research Group, College of Medicine, Swansea University, Singleton Park, Swansea SA2 8PP, UK.|Applied Sports Technology Exercise and Medicine (A-STEM) Research Centre, College of Engineering, Swansea University (Bay Campus), Swansea SA1 8EN, UK.
R M
RM
Bracken
D000328:Adult; D000368:Aged; D000072599:Cardiorespiratory Fitness; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology*; D003430:Cross-Sectional Studies; D006801:Humans; D008297:Male; D000072499:Manufacturing and Industrial Facilities / Q000458:organization & administration / Q000706:statistics & numerical data; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D013232:Steel; D014852:Wales / Q000453:epidemiology; D000078329:Workforce
D013232:Steel
Cardiovascular diseases; coronary heart disease; exercise test; physical fitness; primary prevention; risk assessment; workplace health promotion.