Cardiovascular load assessment in the workplace: A systematic review

Cardiovascular disease (CVD) is the leading cause of death worldwide. Health and safety hazards and risk factors in the workplace are associated with occupational CVD, though inconsistent evidence of causal associations represents a knowledge gap. The assessment of physical load on the cardiovascular system in relation to work different risk factors and occupational groups is necessary, if preventative measures for occupational CVD are to be better tailored to workers' needs. The pertinent literature reports the use of different objective and subjective metrics to evaluate the cardiovascular load (CVL). We aimed to identify how cardiovascular stress is assessed in the workplace and to bring together related evidence-based recommendations for preventative measures. Hence, we systematically searched the Google Scholar database for corresponding publications to a) gather metrics used to assess CVL, b) summarize the related risk factors investigated, c) report the occupational groups and activities targeted in these studies, and d) compile recommendations resulting from these studies. The majority of studies reported objective measures, mostly Relative Heart Rate. The identified risk factors included work environment factors, general job features (such as the number of working hours), task-related factors and individual characteristics of the worker. Most studies focused on the industrial sector, namely, the manufacturing industry and construction were the two most frequent occupational groups, due to high exposure to risk factors. Few evidence-based recommendations were identified, though guidelines to promote safety and productivity were proposed. Our results encourage further research on CVL, occupational risk and CVD.