The importance of taking heart health seriously in the construction industry and steps that can be taken to minimize it.

Reducing cardiovascular disease

By Gianni Scarcello

February is commonly recognized as American Heart Month in the United States. Since 1950, heart disease has been the leading cause of death for Americans. Risk factors that increase these odds are high blood pressure, high cholesterol, smoking, diabetes, overweight/obesity, unhealthy diet, low physical activity, and excessive alcohol use. According to the CDC, heart disease accounted for 695,547 deaths in 2023, and men specifically had a 61.9% higher rate of heart disease deaths than women.

Heart health is crucial for everyone, including construction workers who often have the key risk factors mentioned above. Approximately 211,000 construction workers in the U.S. have been diagnosed with cardiovascular disease, according to the American Heart Association. These jobs often involve physically demanding tasks, exposure to various environmental conditions, not to mention stressful deadlines and working environments.

Approximately 211,000 construction workers in the U.S. have been diagnosed with cardiovascular disease.

A healthy heart for a physically demanding job

Work can be physically demanding, requiring strength, endurance, and cardiovascular fitness. A healthy heart ensures the body can meet the job’s demands without undue stress. We all know how demanding these jobs can be physically. But do we understand how our heart works during these tasks and why we must keep it healthy?

The heart plays a crucial role in providing oxygen and nutrients to the body, especially during physically demanding tasks. Physically demanding tasks require more energy, which means increased muscle oxygen demand. The heart responds to this demand by pumping more oxygenated blood and nutrients to the working muscles. The heart rate increases to supply more oxygen-rich blood to the muscles, which occurs when the heart beats at a higher frequency per minute. The amount of blood ejected with each heartbeat may increase stroke volume; this allows the heart to pump a larger volume of blood with each contraction. Blood is redirected from less critical areas, such as the digestive system, to the active working muscles. This redistribution ensures that the working muscles receive a sufficient oxygen and nutrient supply to perform appropriately. Blood vessels supplying the muscles may undergo vasodilation, expanding to allow a greater volume of blood flow. Doing this facilitates increased oxygen and nutrient delivery to the muscles. Working muscles extract oxygen more efficiently from the blood to support energy production during physical exertion; this is achieved through improved oxygen utilization by the muscles. During this time, the heart maintains adequate blood pressure to ensure proper blood flow throughout the body, especially to the active muscles.

Another factor we often have to grapple with in construction is working in extreme temperatures and conditions. If we work outside, we will likely be exposed to extreme heat and cold weather at some point. During these times, the heart has to work even harder because it is the primary mechanism in thermoregulation, keeping our body at its desired temp of 97.5F to 98.9F degrees. If you have lived in Wisconsin long enough to go through one winter, you have heard someone probably say, “Shoveling snow can cause a heart attack.” A similar phenomenon can occur when working in the cold in construction-related environments. The weather starts to bring the body temperature down; our body then responds by activating the sympathetic nervous system (think fight-or-flight response). When this event occurs, it triggers specific mechanisms to preserve as much heat as possible. One of these mechanisms is called vasoconstriction, which is when the muscles in blood vessel walls narrow to prevent heat loss. We know this happens when it is cold because we can feel our skin and extremities becoming cold to the touch; that is because the warm blood is being pulled back to keep our internal organs warmer during cold weather events. During these cold environments where we experience this, our blood pressure can increase. When we experience increased blood pressure, it forces the heart to work harder to circulate our blood. The strain that this causes can increase heart attacks or cardiac-related events.

Not only can working in the cold negatively impact our heart, but the heat can negatively impact our heart’s ability to function properly in extreme temperatures. During hot weather, our body responds to increased core temps by attempting to cool the body off. The body will cool off with increased blood flow to the skin. When this occurs, the increased blood flow will help the skin release sweat through the sweat glands, and evaporative cooling will decrease the body temperature. Problems can occur during the hot weather because our heart has to work harder to pump the blood to cool off our skin. An article by Harvard Health highlighted that our heart has to pump two to four times more blood per minute than it would in normal “comfortable” weather. If you add in preexisting issues such as arterial clogs, your heart forcing itself to push blood through already constricted arteries is only setting you up for a potentially significant cardiovascular episode, like a heart attack.

Stresses of the job

Our bodies can do remarkable things. One thing that we are hard-wired to do is respond appropriately to stress through the release of chemicals from our brains. In small doses, your body will react to stress accordingly by producing a hormone called cortisol. However, when stress is constant, the body may produce too much cortisol, which can have ill effects such as increased blood pressure, cholesterol, triglycerides (fat found in your blood), and blood sugar. Unfortunately, with stress often comes self-coping mechanisms, which can worsen your heart’s health. Smoking, drinking, and unhealthy habits are often methods we may use to cope with our stresses in life. These actions can not only exacerbate our heart issues, but they can also negatively affect our mental well-being. Finding healthy coping mechanisms and outlets for our stress can not only help us handle the situations better, therefore causing less cortisol production in the long term, but it can also create healthy habits that can benefit our heart health. Finding ways to mentally and physically deal with your stress in healthy ways can create great habits that help our hearts stay healthy.

  • Identify your stressors – Whatever is affecting you negatively, write it all down, then take time to reflect on how you might respond to each situation in a healthier way.
  • Practice relaxation techniques – Simple meditations, mindfulness, and ground techniques (deep breathing) can help calm your stressed body/mind. If you are unsure where to start, the good news is that the internet is full of videos and articles that can show you what to do. There is nothing macho or bravado about keeping in your stress. Dealing with stress positively makes you an even better version of yourself.
  • Set aside time for things you enjoy – If you enjoy alone time, time with friends/family, or your hobbies. Setting aside more time to accomplish these things can help you feel like you are doing things you want.
  • Maintain some regular physical exercise routine – not only does this give you something else to focus on, but it will also help your heart health (see the connection there).

Keeping hearts healthy

Having identified what factors at work can cause issues with our cardiovascular health, we can look to identify ways to keep our hearts healthy. Aside from a healthy diet, one of the most common things we can do is add physical activity. In conjunction with diet and exercise, getting a yearly physical with your primary care physician to check your vitals is essential. Also, before starting a workout regimen, it is recommended that you check with your physician as well, remember to take things slow in the beginning, and listen to your body.

It is well known that physical exercise can positively affect heart health. Various ways that exercise can protect our hearts are:

  • Lower blood pressure
  • Lower risk of developing diabetes
  • Helps to maintain a healthy body weight
  • Can help to reduce inflammation
  • It improves the muscles’ ability to pull oxygen out of the blood, reducing the need for the heart to work harder to pump more blood
  • Can help to reduce stress

The American Heart Association and the American College of Sports Medicine both recommend combining aerobic exercise (jogging, swimming, biking) with resistance training (moderate weightlifting). Together, these two categories of exercise produce the most significant benefit for preventing and managing heart disease.

Adding a healthy diet to physical activity can make positive impacts on your heart even greater. There are several steps we can take to make healthy choices.

  • Portion sizes – Overeating can cause an excess increase in calories. Tips to control portion size can be as simple as using a smaller plate or bowl to control portions. Eating more low-calorie, nutrient-rich foods (fruits/veggies). Limit high-calorie, high-sodium foods or refined foods. The recommended number of servings per food group may vary depending on your diet or guidelines.
  • Increasing the intake of fruits and veggies – Not only are these foods a good source of vitamins and minerals, but they can be effortless to add to meals. Eating fruits and vegetables that are higher in water retention can also help you increase your water intake, which will help keep you from being dehydrated when working in hot temperatures during the summer months.
  • Add in whole grains – These foods are good sources of fiber and other nutrients. Increasing your fiber intake can help you to feel fuller for longer. Look for 100% whole-wheat or 100% whole-grains.
  • Lean protein is your friend – Lean meats, poultry, fish, and low-fat dairy options are some of the best protein sources available.

As shown by the National Institutes of Health, out-of-hospital-cardiac arrests (OHCA) are very commonplace. This is not surprising given the fact that heart disease is so common across the United States. Each year, around 350,000 people suffer from OHCA. Unfortunately, the survival rate is only about 10% in these cases, according to the American Heart Association. Because these events are most likely to occur in settings such as your residence or a public setting (work), it is imperative to learn CPR. Not only will this make you confident and potentially able to help in a life-saving scenario where a cardiac episode has occurred, but the alternative of standing by and not knowing what to do is far too grim. I would implore you to speak with your teams and work with ABC of Wisconsin safety staff to get yourself, and your teams/employees trained in CPR/AED use.

Summary

The importance of heart health cannot be understated. With it continuing to be the leading cause of death, we need to ask ourselves what we can do to help improve our heart and cardiovascular health. By implementing changes through lifestyle and dietary tweaks, we must continue to look at ways to work towards being healthier. Not only will this help to keep us from having major heart-related episodes, but it will also help us stick around a lot longer to do the things we love with the people we love. As always, we can continue to enjoy almost all things in moderation. Often, even making small changes towards bettering your heart health can go a long way towards influencing decisions down the road. When these small changes become habits, they positively impact your life. You owe it to yourself and your loved ones to do what you can to make healthy choices.

Gianni Scarcello is a Safety and Compliance Specialist with ABC member Bevara Building Services and a member of the ABC of Wisconsin Safety Committee.

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