Do you know if anyone is using this questionnaire to screen for workers who
need medical who might need medical follow-up tests (such as checking blood
pressure and resting heart rate)? A few years ago I read that employees who
report high stress levels are more likely to be hypertensive (suffering from high
blood pressure) than those who do not (Capriotti et al, 2000). A US study that
looked at "a midsize corporation" found that almost all of the employees (96%
of those tested) assumed their blood pressures were normal but blood pressure
tests revealed that in reality 30% of them were hypertensive. This shows that
despite widespread publicity about the dangers of cardiovascular disease there
is a need for a population-wide detection program. The prevention of
hypertension should be a high priority goal for preventive health care
At around the same time a survey of an English university community (Getliffe
et al, 2000) found that 30% of the respondents had not had their blood
pressure measured in the previous two years and 51% of the known
hypertensives were not adequate getting medical treatment to control their
condition. The authors concluded that improvements in detecting and
controlling hypertension will be needed if we want to reach current public
health targets for reducing the incidence of heart disease and stroke are to be
achieved. They suggested that worksite screening programmes would be
helpful. Has that happened?
Recent news stories suggest that these have not been effective (if they
happened at all). A recent UK press release ("40 Percent Of UK Population
Have High Blood Pressure", 14 Feb 2008) reported that the BPA’s "Know Your
Numbers" campaign checked the blood pressure of about5 250,000 volunteers
and found that in some areas of England (such as Yorkshire, Humberside and
the West Midlands) 45% of the people tested were suffering from hypertension.
The HSE report on health and ageing "Working for a healthier tomorrow"
(Report No HSL/2005/20, 2008) has made some admirable recommendations on
improving public health generally and improving the health of the workforce in
particular. See Working for a healthier tomorrow.
It has highlighted the huge cost of sickness and disability amongst ageing
people who are still "of working age". The authors assume that this lasts until
pension age (i.e 65 for men). But is this a reasonable assumption? A recent
article on East Glasgow in The Times noted that "Glasgow East is a hard place
to live, and a grotesquely easy place to die. In parts of the constituency, male
life expectancy is 54, lower than The Gambia, nearly a decade lower than
Bangladesh, and about 24 years below the national average. Move just a few
miles to leafy Bearsden and you will live, on average, 30 years longer. ...
Glasgow East has the highest proportion of voters on incapacity benefit or
disability allowance ... and, in parts, unemployment has reached 50 per cent."
See http://www.timesonline.co.uk/tol/news/politics/article4318994.ece or
Inside Glasgow East, where Gordon Brown's a cursed name - Times Online
There appears to be a huge scope for improvement. If we do not detect and
control hypertension in our middle aged workforce we have not advanced very
far since the dark ages. Research at the medieval Danish village of Tirup
showed that before the advent of modern medicine people were lucky to live
past 50. In those days a third of the people in Tirup died in their fifties, much
as they doing in modern Glasgow.
[The basic differences in the mortality patterns of medieval Danes
and "contemporary" Danes are clearly illustrated in Figure 1.]
In Australia and Japan life expectancy is increasing and these reductions in
mortality are mainly due to improvements in cardiovascular health - see
Life expectancy, males or www.aihw.gov.au/publications/phe/ihhac/ihhac-
Even in the UK the average person born in 1951 near the height of the post-
war baby boom can expect to live to 75 (Gallop, 2002). This could create
economic problems if workers retire due to ill health or cannot save enough so
that they can retire to live a life of affluent leisure (Bloom et al, 2007). It
follows that we need to make a greater effort to insure that people remain
healthy until the end of their expected working life.
We can only hope that governments will fund workplace stress research
programs that leads to practical improvements in the health of the workforce!
I would be interested to hear your take on this.
David McFarlane MAppSc (Ergonomics)
Ergonomist, WorkCover NSW
Capriotti T, Kirby LG, Smeltzer S, (2000), " Unrecognized high blood pressure.
A major public health issue for the workplace", AAOHN J, 2000 Jul, 48, (7), pp
Getliffe KA, Crouch R, Gage H, Lake F, Wilson S, (2000), "Hypertension
awareness, detection and treatment in a university community: results of a
worksite screening", Public Health, 2000 Sep, 114, (5), pp 361-6.
Adrian Gallop, (2002), "Ageing in the United Kingdom ". See
D Bloom, D Canning and Michael Moore, (2007), "Optimal Retirement and
Saving with Healthy Aging", 17 September 2007. Harvard Initiative for Global
Optimal Retirement and Saving with Healthy Aging
According to the Shaw Trust nearly one in five people of working age (6.9
million, or 19%) in Great Britain are disabled and there are currently 1.2 million
disabled people in the UK who are available for and want to work. See
http://www.shaw-trust.org.uk/page/6/89/. Can you tell me if people of
working age with general ill health such as cardiovascular health problems are
classified as "disabled"?
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