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European Heart Journal 1999 20(5):338-343; doi:10.1053/euhj.1998.1189
Copyright © 1999 by the European Society of Cardiology.
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Sudden death in the working population; a collaborative study in Central Japan

T. Kawamuraf1, H. Kondo, M. Hirai, K. Wakai, A. Tamakoshi, T. Terazawa, S. Osugi, M. Ohno, N. Okamoto, T. Tsuchida, Y. Ohno and J. Toyama

Department of Preventive Medicine, First Department of Internal Medicine, Nagoya University School of Medicine, Nagoya, Japan
Department of Circulation, Research Institute of Environmental Medicine.>Nagoya University, Nagoya, Japan

Received June 9, 1998; accepted June 19, 1998

Abstract

Aim

Few epidemiological data are available describing the sudden death of persons in their prime. This study aims to elucidate when and how sudden death occurs among employees.

Methods

A total of 196775 employees from 10 workplaces in Central Japan were surveyed for non-traumatic sudden death during 1989–1995. Demographic data and information regarding onset were collected by their workplace healthcare professionals.

Results

We identified 251 male and 13 female cases of sudden death. The annual incidence was 21·9 (for men) and 5·7 (for women) per 100000 population. Sudden death occurred more frequently in April when the new business year starts (risk ratio [95% confidence interval], 1·62 [0·94–2·79]) than in other months, without seasonality. Sudden death peaked on Sundays (risk ratio, 1·90 [1·20–2·99]) and Saturdays (risk ratio, 1·36 [0·83–2·21]) as compared with weekdays, and was likely to occur in the small hours (risk ratio, 1·71 [0·94–3·10] at 00–0300h and 1·47 [0·79–2·72] at 0300–0600h vs at 0900–1200h. Only 17% of employees died at work, which was significantly less than expected (P<0·001).

Conclusion

These findings differed from those of elderly people and suggest that sudden death of persons in their prime is related to occupational stress and its relief.

Key Words: Sudden death • employee • monthly variation • daily variation • circadian variation • activity

f1 Correspondence: Dr Takashi Kawamura, Department of Preventive Medicine, Nagoya University School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan.

E, Braunwald

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