Article Text

other Versions

PDF
Short Report
Incidence of myocardial infarction in Swedish chimney sweeps 1991–2005: a prospective cohort study
  1. Per Gustavsson1,2,
  2. Catarina Jansson3,
  3. Christer Hogstedt1
  1. 1Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
  2. 2Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden
  3. 3Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
  1. Correspondence to Professor Per Gustavsson, Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Norrbacka, SE-171 76 Stockholm, Sweden; per.gustavsson{at}ki.se

Abstract

Objectives Previous studies of chimney sweeps have shown an excess mortality from cardiovascular diseases, although the extent of confounding from tobacco smoking is uncertain. The present study used referents of similar socioeconomic background as the chimney sweeps in order to reduce confounding, included both lethal and surviving cases of myocardial infarction, and investigated dose–response in terms of duration of employment.

Methods A cohort of 4436 male chimney sweeps was identified from nationwide trade union records from 1918 to 2006. Myocardial infarctions during 1991–2005 were identified from the Swedish nationwide register of first-time myocardial infarctions. Standardised incidence ratios (SIRs) were estimated using skilled manual workers in the service sector in Sweden to calculate expected numbers.

Results There was a strong and statistically significant excess of myocardial infarction among the chimney sweeps, SIR 1.39 (95% CI 1.24 to 1.55). The excess was observed among both short- and long-term employed.

Conclusions While the excess of myocardial infarction among the short-term employed may be due to tobacco and, possibly, alcohol use, it is likely that the excess noted among the long-term employed was caused by the high exposure to combustion products, particles or metals still occurring among chimney sweeps. Preventive measures to reduce hazardous occupational exposures as well as smoking and alcohol use among chimney sweeps are urgently needed.

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.