Twenty Years on Loud Job Sites: A Health Risk Profile of a 44-Year-Old Construction Superintendent
Student Name
American College of Education
NUR4073: Health Promotion
Module 2 Assignment
Instructor Name
November 9, 2026
The Data
The client is a 44-year-old man who has worked in commercial construction for twenty-two years, the last six as a site superintendent. He and his details are composites written for this assignment. He came for a workplace wellness screening offered by his employer and agreed to a follow-up conversation. He has no diagnosed conditions and takes no regular medications. His father survived a heart attack at 52, and his mother was diagnosed with type 2 diabetes in her sixties. He was a daily smoker for twenty-four years, roughly twenty cigarettes a day, and stopped two years ago. He drinks ten to twelve beers a week, mostly on weekends, and walks the job site for much of the day but does no other planned exercise.
Measurements at the screening were a blood pressure of 136/86 mm Hg on two readings, a body mass index of 31 with a waist circumference of 104 cm, total cholesterol of 232 mg/dL, HDL cholesterol of 38 mg/dL and a hemoglobin A1c of 5.9 percent. He reports trouble following conversations in noisy restaurants and ringing in both ears after long days on site, and he says he wears earplugs only when he remembers. He works outdoors in all seasons, rarely uses sunscreen and has never had a skin examination. None of these findings is alarming on its own; together they describe a man whose next twenty years depend heavily on the next two.
Cardiovascular Risk
Several of the findings point to cardiovascular disease: a blood pressure in the elevated range, low HDL cholesterol, a waist circumference above 102 cm, an A1c in the prediabetes range, a long smoking history that ended only two years ago and a father with a heart attack before 55. The joint cardiology guideline on primary prevention published in 2019 treats a family history of premature atherosclerotic disease and the features of metabolic syndrome as risk-enhancing factors that should inform prevention decisions beyond a calculated score (Arnett et al., 2019).
Calculated risk needs careful reading at this age. The American Heart Association's PREVENT equations estimate both ten-year and thirty-year risk of cardiovascular disease for adults aged 30 to 79, using age, sex, cholesterol, blood pressure, diabetes status, smoking, kidney function and body mass index; they were developed and validated in data from more than six million adults (Khan et al., 2024). For a 44-year-old, the ten-year estimate is often low even with several risk factors, simply because age dominates the calculation. The thirty-year estimate is the more honest measure of what this client faces. A low ten-year number at 44 can be read as reassurance, when it is really a statement that most of the risk has not yet had time to happen. For this client, the profile supports discussion of the thirty-year estimate and of lifestyle changes now, rather than a conclusion that his risk is low.
Metabolic Risk
An A1c of 5.9 percent falls in the range used to define prediabetes, and his body mass index, waist circumference and mother's diabetes add to the likelihood of progression. His age and weight put him squarely in the group that federal preventive guidance says should have blood glucose checked, with anyone found to have prediabetes referred to a proven prevention program (U.S. Preventive Services Task Force [USPSTF], 2021). The metabolic and cardiovascular risks share their main modifiable causes, abdominal weight, inactivity and alcohol, which means the same changes address both.
His drinking deserves separate attention. Ten to twelve drinks a week, concentrated on weekends, is likely to include episodes of five or more drinks in a day, which the national guidance treats as heavy drinking for men. Alcohol adds calories, raises blood pressure and triglycerides, and interacts with sleep, all of which bear on the risks already described. A brief structured screen at the follow-up visit would establish whether his pattern meets the threshold for counseling.
Occupational Risks: Noise and Sun
The client's work adds two risks that a general health screening can miss. The first is noise. Kerns et al. (2018) analyzed national survey data on United States workers and found that 25 percent had a history of occupational noise exposure, and that noise-exposed workers had a higher prevalence of hearing difficulty, hypertension and elevated cholesterol; they estimated that 58 percent of hearing difficulty among workers could be attributed to occupational noise. His difficulty following conversation in noisy places and his ringing ears after long days are consistent with early noise-induced hearing damage, which is permanent once established and preventable with consistent hearing protection. The association the study found between noise and cardiovascular risk factors does not prove that noise raised his blood pressure, but it adds a reason to take both seriously together.
The second is sun. Twenty-two years of outdoor work with little sun protection is a substantial cumulative exposure to ultraviolet radiation, the main modifiable risk factor for skin cancer. He has never had a skin examination and has no one who looks at his back. At minimum, the profile supports teaching him to use sunscreen and protective clothing on site and to ask his primary care provider to examine any changing or new lesions.
Ranking the Risks
The risks can be ranked by combining their consequences with how much can still be changed. First is the cluster of cardiovascular and metabolic risk: it carries the most serious long-term consequences, and it is highly modifiable through weight, activity, alcohol and possibly medication. Second is noise exposure, because hearing loss from noise is irreversible, the client already reports symptoms and the fix, consistent hearing protection and a baseline audiogram through his employer's program, is simple. Third is sun exposure, which matters over decades and responds to low-cost habits. Fourth is the need to maintain his success in stopping smoking, since relapse would raise several risks at once.
This ranking is not only clinical. The client said during the conversation that he would do almost anything to avoid what happened to his father. That motivation belongs in the profile, because it tells the nurse which risk to lead with in the next conversation: his heart, with his hearing as a quick practical win alongside it.
Conclusion
A health risk profile built from age, history and habits is only useful if it goes beyond listing factors. This client's profile shows how a single set of findings can raise several risks at once, how a low ten-year cardiovascular estimate can understate the long-term picture in a man in his forties and how occupational exposures can add risks a general screening misses. Ranked by consequence and modifiability, and connected to what matters to him, the profile becomes the starting point for a health promotion plan rather than a record of what might go wrong.
A profile is also a baseline. The follow-up plan records the values that will show whether the next two years change anything: blood pressure, waist circumference, HDL cholesterol and A1c at six and twelve months, a baseline audiogram through the employer's hearing conservation program, weekly drink count and continued abstinence from smoking. Measuring the same factors at set points turns the profile from a snapshot into a record of change the client can see.
References
Arnett, D. K., Blumenthal, R. S., Albert, M. A., Buroker, A. B., Goldberger, Z. D., Hahn, E. J., Himmelfarb, C. D., Khera, A., Lloyd-Jones, D., McEvoy, J. W., Michos, E. D., Miedema, M. D., Munoz, D., Smith, S. C., Jr., Virani, S. S., Williams, K. A., Sr., Yeboah, J., & Ziaeian, B. (2019). 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation, 140(11), e596-e646. https://doi.org/10.1161/CIR.0000000000000678
Kerns, E., Masterson, E. A., Themann, C. L., & Calvert, G. M. (2018). Cardiovascular conditions, hearing difficulty, and occupational noise exposure within US industries and occupations. American Journal of Industrial Medicine, 61(6), 477-491. https://doi.org/10.1002/ajim.22833
Khan, S. S., Matsushita, K., Sang, Y., Ballew, S. H., Grams, M. E., Surapaneni, A., Blaha, M. J., Carson, A. P., Chang, A. R., Ciemins, E., Go, A. S., Gutierrez, O. M., Hwang, S.-J., Jassal, S. K., Kovesdy, C. P., Lloyd-Jones, D. M., Shlipak, M. G., Palaniappan, L. P., Sperling, L., . . . Coresh, J. (2024). Development and validation of the American Heart Association's PREVENT equations. Circulation, 149(6), 430-449. https://doi.org/10.1161/CIRCULATIONAHA.123.067626
U.S. Preventive Services Task Force. (2021). Screening for prediabetes and type 2 diabetes: US Preventive Services Task Force recommendation statement. JAMA, 326(8), 736-743. https://doi.org/10.1001/jama.2021.12531
How this NUR 4073 Module 2 example is structured
NUR 4073 Module 2 typically builds a risk profile on a composite adult from age, history and habits; your classroom's instructions set the template and whether a risk calculator is required. This example gathers the data first, then groups it by the health outcome each factor affects rather than by where it came from, because one habit can raise several risks. Each risk area names its evidence, and the section on cardiovascular risk explains why a 44-year-old's ten-year estimate can mislead. The profile ends with the risks ranked by modifiability and urgency, which is what turns a list of factors into a health promotion plan.
NUR4073 Module 2 questions, answered
What does NUR4073 Module 2 usually ask for?
NUR4073 Module 2 typically asks students to build a health risk profile for a composite adult from age, family history, measurements and habits, and to identify and rank the health risks those factors raise. Some sections require a risk calculator. Your classroom's instructions decide the client, the template and whether screening recommendations must be included.
Should a risk profile include occupational exposures?
Yes, when the client's work plausibly affects health. Noise, sun, chemicals, lifting and shift work can raise risks that a standard screening misses. Name the exposure, cite evidence on its effects, and connect it to findings in the client's history, such as hearing difficulty or skin changes, rather than listing it separately.
How should I rank the risks in a health risk profile?
Combine seriousness with modifiability. Risks with severe consequences that can still be changed usually come first, followed by irreversible harms with simple prevention, then long-term exposures. Include the client's own priorities, since they shape which risk to address first in a health promotion conversation.
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