Associations of occupation categories with cardiovascular diseases and all-cause mortality: an analysis of NHANES 2005-2014

Background: Evidence on the effects of occupation categories on cardiovascular disease (CVD) progression and longevity has mostly come from cross-sectional studies, which limits our understanding of the pathogenesis of CVD. This study aimed to evaluate the associations of occupation categories with CVD and all-cause mortality in the American population. Methods: We analyzed data from the 2005–2014 U.S. National Health and Nutrition Examination Survey (NHANES), a large-scale public health survey representative of the U.S. population, linked to mortality data obtained in 2019. To evaluate the association between occupation categories and the risks of cardiovascular disease (CVD) and all-cause mortality, we estimated Cox proportional hazard ratios (HRs) with 95% confidence intervals (CIs). Results: Among 11,102 participants (aged 20–85 years, 53.99% male), 132 died from CVD among the total 478 deaths during a median follow-up of 9.9 years. In multivariable-adjusted models, the occupation categories were significantly associated with CVD mortality, with the hazard ratios (HRs) and 95% confidence intervals (95% CIs) of 3.95(1.94–8.04) for construction and clean-up industry, 2.51(1.15–5.52) for sales and service industry, 2.49(1.04–5.95) for business and management, and 2.98(1.56,5.71) for others. For all-cause mortality, only construction and clean-up industry and sales and service industry were positively associated with all-cause mortality, and HRs (95% CIs) were 2.05(1.33–3.16) and 1.64(1.12–2.41). Both working hours in the previous week and the number of months worked exhibited varying degrees of dose-response relationships with CVD and all-cause mortality. Conclusions: Occupation categories were found to be significantly associated with the risk of CVD and all-cause mortality. Future research could incorporate different work properties into specific prevention strategies for these outcomes.