Prognostic Model of Cardiovascular Risk Stratification as a Tool for Optimizing Periodic Medical Examinations of Metallurgical Workers

Vollständiger Abstract

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Introduction: Cardiovascular diseases remain the leading cause of death among industrial workers, particularly in the metallurgical industry, where exposure to occupational hazards induces the development of cardiometabolic disоeases. The elaboration of simple and reliable screening tools for stratifying workers into low- and high-risk groups in order to exclude apparently healthy individuals is a pressing issue in preventive medicine. Objective: To develop a prognostic model for cardiovascular risk stratification as a tool for optimizing periodic medical examinations of metallurgical workers. Materials and Methods: A cross-sectional study was conducted using retrospective data from periodic medical examinations of 1,562 male workers in core occupations at metallurgical enterprises in the Sverdlovsk Region for the year 2019. Cholesterol levels, years of current employment under harmful working conditions, and anthropometric parameters were analyzed with the calculation of the body mass, roundness, shape, and conicity indices. Statistical analysis was performed using the Student’s t-test, the Mann–Whitney U test, correlation analysis, and logistic regression with ROC analysis. Results: The prevalence rates of abdominal obesity and cardiovascular diseases in the sample were 40.7 % and 14.2 %, respectively. With increasing age, anthropometric indices, cholesterol levels, and the frequency of cardiovascular diseases rose significantly among the workers. The model created using data on employees of a steel pipe factory (n = 247) showed that the body roundness index (OR = 1.74; 95 % CI: 1.22–2.48) and duration of occupational exposure (OR = 1.10; 95 % CI: 1.05–1.16) were independent predictors of cardiovascular diseases. The model demonstrated high specificity (99.4 %) but low sensitivity (19.1 %). Conclusions: The developed model has high specificity, making it a useful tool for screening out healthy workers during preventive medical examinations, thereby reducing the burden of in-depth cardiovascular examination. Its low sensitivity renders the model unsuitable for screening diseased individuals and necessitates confirmation of positive results using instrumental methods.