Using the National Occupational Mortality Surveillance system, proportionate mortality ratio (PMR) analyses were used to examine the association between occupation and ischaemic heart disease among 16- to 60-year-old males in the United States. Data from 1982-1992 were collected from 27 states. Separate analyses were conducted for blue-collar and white-collar occupations. Among the blue-collar occupations with the highest PMRs for ischaemic heart disease mortality were sheriffs, correctional institution officers, policemen, fire-fighters and machine operators. Physicians (blacks only) and clergy (both races) were among the white-collar occupations with the highest PMRs for ischaemic heart disease. Although more study is needed, consideration should be given to the targeting of high-PMR occupations, with improvement in work organization to reduce occupational stress and promotion of healthy lifestyles through cardiovascular disease prevention programmes.

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