Derivation and calibration of a cardiovascular risk score for occupational medicine

Cardiovascular disease (CVD) is one of the most prevalent causes of long-term sickness absence from work, and the working environment can contribute to its impact on workers' health. The aim of this study is to develop, validate, and compare scores to measure the risk of diagnosis of unsuitability for work. A cohort of workers employed by the municipalities of Naples was examined, as part of their scheduled occupational health surveillance, at the occupational health outpatient clinic of the Department of Public Health of the University of Naples”Federico II” between January 2006 and December 2016. Cox proportional hazards models were used in the cohort to derive risk equations for the assessment of the 10-year risk of diagnosis of unsuitability for work. Two models were developed: (i) Model A, including all the variables of the Multivariable Cox Model, and (ii) Model B, with only the variables statistically significant at the.05. The Akaikes Information Criterion was used to compare fit and performance of the different models in the derivation cohort. The above analysis proved that the model B was the better predictor of diagnosis of unsuitability for work and should be used as a clinical tool for the assessment of fitness for work in health surveillance.