Working while ill increases risk of heart attack

Men who never take a sick day even though they're not in good health may be setting themselves up for a heart attack, according to a new study.

Dr. Mika Kivimaki from the Finnish Institute of Occupational Health in Helsinki and colleagues used a study of 5000 British male civil servants ages 35 to 55 to examine the relationship between sickness absenteeism, "sickness presenteeism" - that is, working while ill - and the rate of serious coronary events, including fatal and non-fatal heart attacks.

At the start of the study, the participants rated their health as very good, good, average, or worse. The investigators analyzed the men's absentee records for the next three years, and documented a first heart attack or serious coronary event occurring after three years.

Among participants in the study who rated themselves as unhealthy, "no absence" was associated with double the risk of serious a coronary event, the team reports in the American Journal of Public Health. That risk remained high even when coronary risk factors were taken into account.

"The fact that the incidence of serious coronary events is twice as high among unhealthy employees with no sickness absenteeism as among unhealthy employees with moderate levels of sickness absenteeism probably reflects the adverse consequences of working while ill - that is, sickness presenteeism," the researchers conclude.

"This risk was not explained by baseline differences in conventional coronary risk factors, but it seemed to relate to lack of short-term periods of absence," Kivimaki commented to Reuters Health. "In my opinion, physicians, employers, and employees should be aware of the potential harmful effects caused by sickness presenteeism."

Kivimaki pointed out that "our study related to men," adding that it will be important to also examine the associated risk between working while ill and coronary events among women.

SOURCE: American Journal of Public Health, January 2005.