Driving up CVD event risk in diabetes

By Sally Robertson, B.Sc.Nov 2 2012

Professional drivers who have diabetes are at a significantly increased risk for a cardiovascular disease (CVD) event compared with individuals with other occupations, report researchers.

Apart from treating established CVD risk factors in these individuals, physicians should also look into addressing occupational factors, say Claire Quah (Ministry of Manpower, Singapore) and colleagues.

In a cross-sectional comparative study of 6536 diabetes patients attending the Changi General Hospital from January 2004 through December 2010, 342 professional drivers (99% male), aged a mean of 53 years, were identified.

Most of the men (44%) were taxi drivers, 15% were delivery drivers, and 9% were bus drivers, with the remainder in other driving occupations.

Logistic regression analyses showed that compared with 684 matched nondrivers, the professional drivers were at a significantly increased risk for a CVD event, at an odds ratio (OR) of 1.92, after adjustment for age, gender, CVD risk factors, and duration of diabetes.

Even after adjustment for ischemic heart disease (IHD), the risk for a CVD event was significantly higher in drivers versus nondrivers, at an OR of 1.85.

"In providing for passengers, and unpredictable traffic situations, drivers experience high psychological demands and low control (termed job strain), which has been associated with IHD," note the researchers.

"Furthermore, drivers have long working hours, shift work, and low physical activity at work, which have each been linked with increased IHD risk. Increased exposure to nitrous oxide, carbon monoxide and traffic noise exposure have also been linked with IHD and stroke," they add.

Quah and colleagues say that, while clinicians recognise the need to screen and control risk factors for people with diabetes, occupation as a risk factor is often overlooked.

"Apart from occupational professional drivers, physicians should also be aware of patients in other occupations who may experience increased job strain, long working hours, shift work and a sedentary job," they suggest.

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