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Cardiovascular mortality among seafarers: a Danish nationwide cohort study
  1. Anna Uhd Bøge1,
  2. Sören Möller2,3,
  3. Rune Lindahl-Jacobsen4,5,
  4. Lisa Loloma Froholdt1,
  5. Kimmo Herttua1,
  6. Linda Juel Ahrenfeldt6
  1. 1 Department of Public Health, Center of Maritime Health and Society, University of Southern Denmark, Esbjerg, Denmark
  2. 2 Department of Clinical Research, The OPEN Research Unit, University of Southern Denmark, Odense, Denmark
  3. 3 Open Patient Data Explorative Network, Odense University Hospital, Odense, Denmark
  4. 4 Department of Public Health, Unit for Epidemiology, Biostatistics, and Biodemography, University of Southern Denmark, Odense, Denmark
  5. 5 Department of Public Health, Interdisciplinary Center on Population Dynamics, University of Southern Denmark, Odense, Denmark
  6. 6 Department of Public Health, Research Unit for General Practice, University of Southern Denmark, Esbjerg-Odense, Denmark
  1. Correspondence to Anna Uhd Bøge; anub@health.sdu.dk

Abstract

Objectives Cardiovascular disease (CVD) is the leading cause of death globally and the second most frequent cause of death in Denmark. Due to their unique occupational environment, seafarers are exposed to numerous risk factors for CVD including lifestyle and work-related factors. This study aims to investigate CVD mortality among Danish seafarers by comparing them to the economically active reference population.

Methods This register-based cohort study included data on all Danish seafarers from 1993 to 2016 and compared them with the economically active Danish population not working as seafarers. The seafarers’ mortality was calculated using piecewise stratified Cox regression adjusting for potential confounders. Mortality was further analysed by diagnosis groups, vessel type and employment duration.

Results Among 52 861 seafarers, 4226 deaths were observed, with 866 (20.5%) of these attributed to CVD. Male seafarers had higher all-cause mortality in age groups 18–44 years (HR 1.46, 95% CI 1.33 to 1.62), 45–64 years (HR 1.43, 95% CI 1.37 to 1.50) and 65+ years (HR 1.32, 95% CI 1.26 to 1.39) compared with the reference population. CVD mortality was increased for male seafarers aged 45–64 years (HR 1.27, 95% CI 1.13 to 1.42) and 65+ years (HR 1.34, 95% CI 1.21 to 1.48). The mortality was higher for male seafarers for ischaemic heart diseases, other forms of heart diseases, cerebrovascular diseases and diseases of arteries, arterioles and capillaries. CVD mortality was also observed based on vessel type.

Conclusions The study provides evidence of elevated CVD mortality among Danish seafarers. Future research should focus on identifying effective strategies to improve the cardiovascular health of seafarers.

  • Mortality
  • Occupational Health
  • Epidemiology
  • Cardiology

Data availability statement

No data are available.

https://doi.org/10.1136/oemed-2024-109885

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    Data availability statement

    No data are available.

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    Footnotes

    • Contributors Conceptualisation: AUB, RL-J, KH and LJA. Methodology: AUB, SM, RL-J, KH and LJA. Data analysis: AUB, SM and LJA. Writing: AUB and LJA. Review and editing: AUB, SM, RL-J, LLF and LJA. Guarantor: AUB.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.