Stroke, Small‐Vessel Disease, and Occupation: Systematic Review and Data Analysis

In simple terms, our systematic review found limited and inconsistent evidence linking occupation and stroke, with no studies investigating associations with strokes of small and large vessels of the brain.

This highlights an important gap in the evidence base, and provided a rationale for investigating further whether certain occupations involving hazardous substances, such as chemicals, dusts, gases and fumes are linked to disease of the small vessels of the brain, and subsequent small-vessel strokes, especially as traditional stroke risk factors such as heart disease, smoking and diabetes do not fully explain the risk of developing small-vessel strokes.

Small vessel disease is important because it is linked to stroke risk, cognitive decline, and dementia. Our findings suggest long-term workplace exposures may contribute to subtle but clinically meaningful changes in the small vessels of the brain, even if they are not directly associated with stroke events in our study. Overall, this work underlines the need for further research into the effects of occupation, alongside traditional stroke risk factors and other influences such as mental health and medication adherence, on the small vessels of the brain across a lifespan.