Hot Topic : The Tokyo Declaration on...

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Adopted by the Plenary of the Sixth ICOH International Conference on Work Environment and Cardiovascular Diseases under the auspices of the ICOH Scientific Committee on Cardiology in Occupational Health in Tokyo, Japan on March 30th 2013.

Cardiovascular disorders (CVDs) constitute a major burden for health of working populations throughout the world with as much as 50% of all causes of death and at least 25% of work disability. According to research data about 10 to 20% of all causes of CVD deaths among the working age populations can be attributed to work, i.e. are work-related. The loss of work days and work ability is likely to be substantially greater.

While CVD mortality is declining in developed countries, trends in incidence and prevalence are not parallel across age- and gender-groups, geographical areas, sectors of the economy or among certain occupational groups. In industrialized countries, while CVD mortality and myocardial infarction incidence are decreasing, some data indicate that if the acute coronary syndrome are included in the endpoint, the trends get flat, having as a net effect the increase in prevalence of the chronic forms of the disease, with its consequences in terms of returns to work.

Also there are some changes in CVD incidence among occupational classes. This is mainly due to the new types of work-related causes of morbidity associated with the recent developments in global work life; particularly in the industrialized countries, which give rise to psychosocial and physical risk factors in the work environment such as growing competition and time pressures, productivity pressures, continuous organisational changes, re-engineering and downsizing, lean production, job insecurity and threat of unemployment, introduction of new technologies and increase of sedentary work, changing patterns of working hours and partially extensive working hours. Meanwhile, in the developing countries or those in transition (e.g., Eastern Europe), CVD mortality is increasing due to major socioeconomic changes, the demographic transition and rapid industrialisation and urbanisation all leading to growing challenges to cardiovascular health.

Ageing of working populations and life style risk factors such as low-level physical activity during leisure time enhance the risk of CVDs and are often in complex interaction with the work-related factors. For example, certain working conditions may be important determinants of obesity, due to sedentary labour and promotion of unhealthy behaviours at work (e.g., stress-related eating) and through them, determinants of workers’ cardiovascular health as well.

Available research data suggest that about 80% of CVD mortality is preventable if the existing knowledge could be effectively used for system-wide implementation of prevention and health promotion programmes. Some countries have shown convincing examples of such system- wide impact.

The obstacles of achieving such wide-scale impact are less due to lack of knowledge or standardised methods than to lack of awareness, lack of policies and their implementation into practice and shortage of infrastructures and human resources needed for wide-scale and long-term programme implementation.

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