{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T13:03:47Z","timestamp":1784293427868,"version":"3.55.0"},"reference-count":40,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T00:00:00Z","timestamp":1784246400000},"content-version":"unspecified","delay-in-days":16,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,6,11]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Myocardial infarction (MI) is a major contributor to global disease burden with societal impact among survivors. This study aimed to estimate the population-level prevalence of MI among working-age adults in Spain and to examine associated sociodemographic, lifestyle, clinical and occupational factors focusing on sex differences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Two-phase population-based study using data from the 2020 Spanish European Health Interview Survey, including adults of working age. First, weighted estimates were used to calculate the population-level prevalence and describe sociodemographic characteristics. Second, a matched cross-sectional analysis was performed to examine associations between MI and sociodemographic, lifestyle, clinical and occupation-related factors using logistic regression models, including sex-stratified analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Population-based study in Spain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>A total of 400 participants from the Spanish European Health Interview Survey were included, of whom 80 reported MI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>Primary outcomes were the prevalence of self-reported MI and its association with sociodemographic characteristics, lifestyle behaviours, comorbidities and working conditions; secondary outcomes included healthcare utilisation and employment-related absences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>80 participants reported having a history of MI, corresponding to an estimated 137\u2009646 working-age adults in Spain and a prevalence of 5.45 per 1000 population (95%\u2009CI 5.44 to 5.48), predominantly affecting men (74.2%) with a mean age of 52.7 years. MI prevalence was higher among individuals with lower educational attainment (OR 0.50; 95%\u2009CI 0.25 to 1); however, no employment-related factors remained associated with MI after adjustment. Sex-stratified analyses revealed that depression (OR 6.75;\u2009CI 2.23 to 20.4), obesity (OR 6.36; 95%\u2009CI 1.62 to 24.9) and COPD (OR 27.7; 95%\u2009CI 4.21 to 749) were more strongly associated with MI among women, while anxiety (OR 8.65; 95%\u2009CI 3.09 to 26.8)\u2009and hypertension (OR 4.11; 95%\u2009CI 2.24 to 7.62) among men.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>MI among working-age adults in Spain is uncommon but concentrated among men with lower levels of education. The absence of independent associations with employment conditions and the presence of sex-specific comorbidity patterns highlight the need for gender-sensitive cardiovascular prevention strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2026-119497","type":"journal-article","created":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T12:20:28Z","timestamp":1784290828000},"page":"e119497","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Occupational factors and sex differences after myocardial infarction in working-age adults in Spain: a population-based cross-sectional study"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0399-0532","authenticated-orcid":false,"given":"Caterina","family":"Checa","sequence":"first","affiliation":[{"name":"Nursing Department, Faculty of Medicine, Universitat Aut\u00f2noma de Barcelona, Bellaterra, Barcelona, Spain"},{"name":"Fundaci\u00f3 Institut Universitari per a la Recerca a l\u2019Atenci\u00f3 Prim\u00e0ria de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carles","family":"Falces","sequence":"additional","affiliation":[{"name":"Institut d\u2019Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS), Barcelona, Spain"},{"name":"Hospital Cl\u00ednic de Barcelona, Cardiovascular Institute, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosalia","family":"Santesmases","sequence":"additional","affiliation":[{"name":"Fundaci\u00f3 Institut Universitari per a la Recerca a l\u2019Atenci\u00f3 Prim\u00e0ria de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain"},{"name":"School of Nursing, Hospital de la Santa Creu i Sant Pau, Universitat Aut\u00f2noma de Barcelona (UAB), Barcelona, Spain"},{"name":"Nursing Care Research, Institut de Recerca Sant Pau (IR Sant Pau), Sant Quint\u00ed 77-79, 08041, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis","family":"Gonz\u00e1lez-de Paz","sequence":"additional","affiliation":[{"name":"Institut d\u2019Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS), Barcelona, Spain"},{"name":"Consorci d'Atenci\u00f3 Prim\u00e0ria de Salut Barcelona Esquerra (CAPSBE), Barcelona, Spain"},{"name":"Nursing Department of Public Health, Mental Health and Mother and Child Health, Universitat de Barcelona (UB), Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,7,17]]},"reference":[{"key":"2026071705201646000_16.7.e119497.1","doi-asserted-by":"crossref","DOI":"10.1186\/s12872-023-03231-w","article-title":"The global prevalence of myocardial infarction: a systematic review and meta-analysis","volume":"23","author":"Salari","year":"2023","journal-title":"BMC Cardiovasc Disord"},{"key":"2026071705201646000_16.7.e119497.2","unstructured":"OECD . 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