Systematic review of work-related risks of cardiovascular diseases

Abstract

Cardiovascular diseases (CVDs) remain a leading cause of morbidity and mortality globally, and there is increasing recognition that occupational exposures contribute substantially to this burden. The objectives were to map work-related CVD risk factors, assess the strength of associations between occupational exposures and CVD outcomes, identify high-risk sectors, occupations and worker groups, and highlight key research gaps relevant for policy-making. A systematic search of peer-reviewed and grey literature (2010–2025) identified 22,030 references; 164 studies met the inclusion criteria on exposure, outcomes and quality. Data extraction followed a standardised template, classifying work-related CVD risk factors using EU-OSHA categories and grouping outcomes by ICD-based CVD groups. Healthcare, mining and construction emerged as consistently high-risk sectors, characterised by shift and night work, noise, chemical hazards and psychosocial stressors such as job strain and effort–reward imbalance. Elevated risks varied across worker populations and organisational settings (e.g., self-employed, larger organisations), indicating that not all workers are equally affected. Significant gaps were found regarding biological risks, rheumatic heart disease, and systematic assessment of chemical and ergonomic exposures. The review recommends prioritising prevention in high-risk sectors, integrating psychosocial and physical risk management, and improving harmonised, stratified data collection to better protect vulnerable worker groups and guide EU-OSHA’s future CVD prevention strategies.