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Influence of Workplace Cardiovascular Screening on Cardiovascular Risk Detection among Formal-Sector Workers in Nigeria

Abstract

Cardiovascular diseases remain a major public health concern in Nigeria and contribute substantially to illness, disability, premature mortality, and economic losses among adults. Formal-sector workers may be exposed to several cardiovascular risk factors, including physical inactivity, unhealthy dietary patterns, obesity, hypertension, diabetes mellitus, tobacco use, alcohol consumption, prolonged sitting, work-related stress, and other lifestyle and occupational factors. Many cardiovascular risk factors may remain undetected because they do not always produce noticeable symptoms during their early stages. Early detection of cardiovascular risk is important for identifying individuals who require lifestyle modification, medical assessment, treatment, monitoring, and preventive intervention. Workplace cardiovascular screening provides an opportunity to bring preventive health services directly to formal-sector workers through organized workplace health programmes, periodic medical examinations, health fairs, occupational health clinics, and employee wellness initiatives. Such screening may include blood pressure measurement, blood glucose testing, body mass index assessment, cholesterol testing, cardiovascular risk assessment, and other appropriate health evaluations. However, limited employer support, inadequate screening facilities, insufficient trained healthcare personnel, concerns about confidentiality, irregular screening schedules, and low worker participation may reduce the effectiveness of workplace cardiovascular screening programmes in Nigeria. Against this background, this study investigates the influence of workplace cardiovascular screening on cardiovascular risk detection among formal-sector workers in Nigeria. The study will be anchored on the Health Belief Model, Social Ecological Model, and Occupational Health Theory. The Health Belief Model explains how workers' perceptions of susceptibility to cardiovascular diseases, perceived severity, perceived benefits of screening, perceived barriers, and cues to action may influence participation in workplace cardiovascular screening. The Social Ecological Model emphasizes the interaction between individual, interpersonal, organizational, community, and policy-level factors in shaping health behaviours and preventive healthcare utilization. Occupational Health Theory focuses on protecting and promoting workers' physical, mental, and social well-being through workplace-based preventive health measures and healthy working environments. Collectively, these theoretical perspectives provide a suitable framework for explaining how workplace cardiovascular screening may influence cardiovascular risk detection among formal-sector workers in Nigeria. The study will adopt a quantitative cross-sectional analytical or quasi-experimental research design. The study population will comprise formal-sector workers employed in selected public and private organizations across Nigeria. A multistage sampling technique will be used to select states, organizations, institutions, departments, and eligible workers. Workplace cardiovascular screening will be measured using indicators such as availability of workplace screening programmes, frequency of screening activities, blood pressure assessment, blood glucose testing, body mass index assessment, cholesterol testing, cardiovascular risk assessment, availability of trained healthcare personnel, availability of screening equipment, health education, and referral arrangements. Cardiovascular risk detection will be assessed using indicators such as newly identified hypertension, elevated blood glucose, abnormal cholesterol levels, overweight and obesity, tobacco use, cardiovascular risk scores, physical inactivity, and other relevant cardiovascular risk factors identified during screening. Data will be collected using structured questionnaires, workplace screening registers, occupational health records, laboratory reports, medical examination records, and relevant organizational documents. Descriptive statistics will be used to summarize workers' characteristics, screening coverage, cardiovascular risk factors, and detection patterns. Inferential statistical techniques, including chi-square tests, correlation analysis, and logistic or multiple regression analysis, will be used to determine the influence of workplace cardiovascular screening on cardiovascular risk detection. Where appropriate, cardiovascular risk detection before and after implementation of workplace screening programmes may be compared to determine changes associated with the intervention. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that workplace cardiovascular screening has a significant positive influence on cardiovascular risk detection among formal-sector workers in Nigeria. Workers who participate in workplace cardiovascular screening are expected to have a higher likelihood of having previously undetected cardiovascular risk factors identified than workers without access to such services. Routine assessment of blood pressure, blood glucose, cholesterol, body mass index, and other cardiovascular risk indicators may facilitate early identification of workers at increased risk of cardiovascular disease. Early detection may provide opportunities for lifestyle modification, nutritional counselling, physical activity interventions, medical evaluation, treatment, and continued monitoring. Conducting screening within the workplace may reduce time and accessibility barriers associated with seeking preventive healthcare outside working hours. Workplace screening may also enable employers to identify common cardiovascular risk patterns and strengthen employee wellness initiatives. Conversely, inadequate screening coverage, limited resources, concerns about confidentiality, low worker participation, insufficient employer support, and weak referral and follow-up systems may reduce the effectiveness of workplace cardiovascular screening. The study therefore expects accessible, regular, and comprehensive workplace cardiovascular screening to contribute significantly to improved detection of cardiovascular risk among formal-sector workers in Nigeria. The study is expected to contribute to the literature on workplace cardiovascular screening, cardiovascular risk detection, occupational health, employee wellness, cardiovascular disease prevention, workplace health promotion, preventive healthcare, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, Federal Ministry of Labour and Employment, employers, human resource managers, occupational health practitioners, workplace health and safety officers, healthcare providers, trade unions, development partners, and policymakers regarding strategies for improving cardiovascular health among formal-sector workers. The study will also provide evidence-based recommendations for expanding workplace cardiovascular screening programmes, increasing access to regular blood pressure and cardiovascular risk assessment, strengthening employee health education, improving availability of screening equipment and trained personnel, ensuring confidentiality of screening results, strengthening referral and follow-up systems, encouraging healthy workplace environments, and integrating cardiovascular disease prevention into comprehensive workplace health promotion programmes across Nigeria.

Keywords: Workplace cardiovascular screening, cardiovascular risk detection, formal-sector workers, cardiovascular diseases, hypertension, diabetes mellitus, occupational health, employee wellness, workplace health promotion, preventive healthcare, Nigeria, public health.