Hypertension is a major risk factor for cardiovascular disease and other leading causes of death, and now a new study has found that some hospital workers have significantly higher risk of developing the disease.
Hospital workers have an 18% greater chance of dying from hypertensive disease as someone in the general population, according to the Centers for Disease Control and Prevention’s (CDC’s) workplace safety data.1
However, when researchers, using the 2010 National Health Interview Survey, recently compared hypertension by profession they saw a slightly different picture: nurses, physicians, and pharmacists reported hypertension at a rate quite similar to the general population. But significantly higher rates of the disease were reported by staff in health care support positions, including nursing assistants, phlebotomists, pharmacy assistants, and medical transcriptionists, says Haripriya Kaur, MPH, PhD-candidate, an instructor at the University of Nebraska Medical Center in Omaha. Kaur worked with CDC investigators on the recently published study.
"We looked at hypertension and four factors: worried about being unemployed, being threatened or harassed on the job, working long hours, and having difficulty balancing work and family responsibilities," Kaur explains. "Our study found that hypertension was higher among workers worried about becoming unemployed and among those working in hostile environments."
Investigators concluded that the stress associated with job insecurity or a hostile work environment should be addressed by employers to improve workers’ health.2
Employee health programs should address both individual and workplace factors that contribute to hypertension, Kaur suggests. "More in-depth studies are needed," she adds. "We think there is a need to consider workplace interventions aimed at reducing hypertension, as well as addressing individual behaviors involving diet and exercise."
For instance, a hospital could provide counseling for employees who say they are experiencing a hostile work environment or stressful shift work, Kaur says.
"There definitely is a lot of stress in the hospital with people working odd shifts and night shifts," she says. "A changing sleep pattern can be responsible for those things. It has been shown that night shift workers have a higher risk of hypertension, and they might smoke more or have a higher intake of caffeine."
Employee health directors can educate staff to report workplace problems that cause them stress. "This question needs to be asked more," Kaur says.
There was no hypertension association with those reporting long work hours and having difficulty balancing family life and work. Job insecurity also was associated with higher risk for hypertension, and this could also be a problem more for lower-level hospital workers than for nurses, pharmacists, and physicians.
"We cannot say why there was a higher risk among lower level health care workers," Kaur says. "Possible reasons could be their lower level socioeconomic status and their working more odd shifts."
Researchers did not take into account shift work, although other studies have found an association between shift work and hypertension, she says. "So that could be a reason," Kaur says. "Shift and night work interfere with cortisol levels and could be a reason why these workers have increased stress."
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Workplace Safety & Health Topics: Proportionate mortality for cardiovascular, neurodegenerative, & renal diseases by industry for health care & social assistance sector. Centers for Disease Control and Prevention. Available online: http://1.usa.gov/1tEc2eT.
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Kaur H, Luckhaupt SE, Li J, et al. Workplace psychosocial factors associated with hypertension in the U.S. workforce: A cross-sectional study based on the 2010 National Health Interview Study. Am J Ind Med 2014;57(9):1011-1021.
