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Um, Choi, Lee, Oh, Yi, Yoon, and Han: Risk Assessment for Cardiovascular Diseases in Male Workers: Comparing KOSHA Guidelines and the Framingham Risk Score System
Original Article
Korean Journal of Occupational and Environmental Medicine

Korean Journal of Occupational and Environmental Medicine 2012; 24(4): 365-374.

Published online: 31 December 2012

DOI: https://doi.org/10.0000/kjoem.2012.24.4.365

Risk Assessment for Cardiovascular Diseases in Male Workers: Comparing KOSHA Guidelines and the Framingham Risk Score System

In-Yong Um, Won-Jun Choi, Deul Lee, Jae-Seok Oh, Min-Kee Yi, Jong-Wan Yoon, Sang-Hwan Han

Department of Occupational & Environmental Medicine, Gachon University Gil Medical Center, Korea.

Corresponding author (hansh@gachon.ac.kr)

Received 29 August 2012       Revised 17 October 2012       Accepted 18 October 2012

Copyright © 2012 The Korean Society of Occupational and Environmental Medicine

Abstract

Objectives

This study aimed to investigate the 10-year risk of cardiovascular disease (CVD) by Framingham risk score (FRS) who classified as "healthy group" by Korean Occupational Safety and Health Agent (KOSHA)' s cardiovascular risk assessment.

Methods

The subjects of this study were 1,781 male workers in a large steel company. Health status was obtained periodically through medical examinations and questionnaires. We assessed cardiovascular risk using KOSHA guidelines and calculated the 10-year risk of cardiovascular disease using the Framingham risk score for those categorized to the "healthy group" by KOSHA guideline. A closer examination of cardiovascular risk factors was performed in 62 subjects paradoxically placed in the "healthy group" by KOSHA guidelines and the "high-risk group" by FRS.

Results

Among the "healthy group" by KOSHA's cardiovascular risk assessment, 230(15.8%) subjects had more than 3 CVD risk factors and 62(4.2%) subjects were high risk group (more than 20%) in 10-years risk of CVD by Framingham risk score. Modifiable risk factors included cigarette smoking (96.8%), high serum total cholesterol (82.3%), high serum triglyceride (66.1%), insufficient physical activity (66.1%), and obesity (58.1%).

Conclusions

Among subjects with normal blood pressure, it seems that KOSHA guidelines underestimate CVD risk, identified by the Framingham risk score. For the effective prevention and management of CVD, modifiable risk factors, such as cigarette smoking, dyslipidemia, and obesity, need to be constructively controlled.

Keywords: Cardiovascular diseases, KOSHA's cardiovascular risk assessment, Framingham risk score

Figures and Tables

Table 1
General characteristics of the subjects (N=1,781)
kjoem-24-365-i001

*systolic blood pressure >140 mmHg or diastolic blood pressure >90 mmHg or under treatment for hypertension.

†fasting blood sugar >126 mg/dL or under treatment for diabetes mellitus.

‡cardiovascular diseases before 50.

§physical activity for 30 minutes or more per a time, 3 times or more per week.

Table 2
CVD risk assesment by KOSHA guidelines and Framingham risk score according to the age group
kjoem-24-365-i002

*FRS, 10-year risk of CVD by Framingham risk score.

Table 3
10-year risk of CVD by Framingham risk score according to the CVD risk factors among subjects who classified as "healthy group" in CVD risk assesment by KOSHA guidelines (n=1,459)
kjoem-24-365-i003

*FRS, 10-years risk of CVD by Framingham risk score.

†cardiovascular diseases before 50.

‡physical activity for 30 minutes or more per a time, 3 times or more per week.

Table 4
Characteristics of the subjects who classified as high risk group by FRS among healthy group by KOSHA guidelines (n=62)
kjoem-24-365-i004

*cardiovascular diseases before 50.

†physical activity for 30 minutes or more per a time, 3 times or more per week.

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