Heart disease and work.

Correspondence to: Dr Anne E Price, Linden House, Wennington Road, Abbots Ripton, Cambridgeshire, PE29 2LP, UK; anne.price@ hinchingbrooke.nhs.uk _________________________ H eart disease is common both in the population at large but also in the population of working age. It is estimated that heart disease, including stroke and high blood pressure, is responsible for more costs than any other disease or injury. The cost in occupational terms of cardiovascular disease (CVD) is, however, harder to quantify but is likely to be similarly high. Heart disease can claim the ultimate cost as the most common cause of death. CVD is the main cause of death in the UK, accounting for over 245 000 deaths per year. The main forms of CVD are coronary heart disease (CHD) and stroke. Death before retirement age is commonly attributed to CVD, accounting for 36% of premature deaths in men and 27% of premature deaths in women. CHD is responsible for 120 000 deaths a year in the UK and is responsible for 23% of deaths before the age of 65 years in men and 13% in women. Significant advances in acute medical care have, however, brought reductions in mortality from CHD over the last 10 years or more. Morbidity rates have not seen that same fall; in fact, rates have risen, especially in older individuals over the last 20 years. Two million people in the UK suffer from angina, 680 000 people have heart failure, and 270 000 will suffer a heart attack each year— highlighting the significance of CVD as a cause of morbidity. A recent study of self reported work related illness in 2001–2 shows that record numbers of workers feel that they have an illness that was caused by or made worse by their work, equating to 2.3 million people and 33 million working days lost. These figures show a prevalence estimate for CVD caused or made worse by work of 80 000 during the study year, with each person reporting work related illness taking an average of 23 days off through sickness in the year. This equates to 1.84 million days lost to work related CVD, with associated costs to industry of approximately £120 million. In essence, the issue of heart disease and work is a very significant one in terms of individuals affected, industry, health service resource, and national resource.