Contextual factors are associated with risks of cardiovascular disease (CVD) perceived by personnel employed in small-medium-sized workplaces. In an ecological model, data collection and analysis were undertaken, stratified by intrapersonal, interpersonal, and organizational contexts of blue-collar workers. Data were collected in face-to-face (n = 36) and focus group (n = 4) interviews and subjected to qualitative content analysis, to generate three main themes, 10 generic categories and 18 sub-categories. At the intrapersonal level, "physical burden", "burn out due to overtime work", "no time to take care of health because of family responsibility", and "lack of recognition and knowledge of CVD risks" were derived from the individual interviews. At the interpersonal level, "stress of possible job losses", "dislike of stigmatization of unhealthy persons", "smoking and drinking to reduce relationship stress", and "unhealthy work environment" differed by level of risk perception. "Preferred economic value" and "lack of understanding about importance of CVD management of an employer" emerged at the organizational level. Factors that influence CVD risks among workers in small-medium-sized business were present at the multiple levels. Therefore, healthcare providers in the field of occupational health should consider CVD risks in the context of blue-collar workers and organizational level for health-promotion programs.
Keywords: cardiovascular diseases; occupational health; qualitative research; risk factors; small–medium business.