Work life, inflammation, and cardiovascular disease - a Nordic biobank study (Inflamm@work)

Research problem and purpose: Cardiovascular disease (CVD) is the most common cause of death in Sweden. Work-related exposures have been associated with inflammation and increased risk of CVD.

However, our understanding of the effects of single exposures remains limited, and the complex relationships between multiple simultaneous occupational and other exposures are not available today.

This kind of information is crucial for a targeted preventive approach including establishing occupational exposure limits, and thus decreasing inflammation and risk of CVD.

The Inflamm@Work project will explore:Exposure-response relationships between four occupational exposures (dust, shift work, job stress, noise) and inflammation.How combinations of occupational, environmental, and lifestyle factors (working life exposome) may cause inflammation.Associations between inflammation and the risk of CVD.Further, we will establish an internationally unique research infrastructure for studying work life, biological mechanisms, and chronic diseases.Data and methods: The study comprises 4,400 workers who participated in 11 studies on the health effects of dust, shift work, job stress, or noise during 1992–2023.

For these workers, we will combine i) measurements of the participants´ work environments, ii) questionnaire data on lifestyle factors, iii) registry data on work history and medical history, iv) quantitative job exposure matrices and assessment of air pollution and traffic noise, and v) analysis of biomarkers of inflammation and CVD in serum.

We will analyse exposure-response relations for each of the four occupational exposures and inflammation, and for the combined effects of occupational, environmental, and lifestyle factors (exposome approach). Finally, we investigate inflammation and risk of CVD.

An identical sister project with 6,044 participants is granted in Denmark and the overall statistical power will be high.Societal relevance and utilization: This innovative approach will provide new knowledge about health effects of the working life exposome, and open new avenues for preventing CVD and other chronic diseases.

The results of Inflamm@Work have the potential to allow government agencies and employers to mitigate important risks.Plan for project realisation: We will identify and select samples, retrieve registry data, harmonise data, and analyse biomarkers (year 1). We will perform statistical analysis (years 2-3) and disseminate the results (year 3).