Nurses and doctors may be the healthiest workers in the U.S. labor force. But no field other than firefighters and law enforcement has worse health and eating habits than healthcare aides, 40% of whom are nursing home caregivers. 

That’s according to findings published in the April American Journal of Preventative Medicine. Investigators studied clinical measures and behavioral risk factors behind cardiovascular disease in more than 6,000 workers over age 45.

When factoring in so-called “optimal” behavioral health habits that include diet, smoking and exercise, nursing aides, therapy aides and assistants, and phlebotomists scored the worst, according to a research team from the National Institute for Occupational Safety and Health and the University of Alabama at Birmingham.

Nearly three-quarters of the healthcare support workers surveyed had a poor diet, while slightly more than half had a higher-than-optimal body mass index. 

Moreover, more than 11% of all healthcare support workers smoked cigars or pipes — the highest level among all workforce categories. Support workers scored notably better in terms of exercise, blood glucose and cholesterol levels.

To reverse the disturbing trends, researchers suggested public health programs on targeting cardiovascular disease, universal smoke-free policies, restrictions on mandatory overtime and more paid sick leave.