Bus drivers frequently encounter difficulty in returning to their former employment after recovery from myocardial infarction. The risk that a recurrence of myocardial infarction may cause a personal-injury accident is analyzed.
The Cumulative Medical Index and Current Contents was searched systematically from 1980 to date, accepting papers irrespective of language. Relevant earlier material was drawn from the author's published reviews on bus driving and myocardial infarction and vehicle accidents. One hundred twenty-three articles were included in the database, of which 110 were used in the review.
The risk of a personal injury accident or fatality from a sudden cardiovascular incident is calculated as the product of typical driving time per day (Td = 0.167), vehicle characteristics (V) (a low factor of 0.167 for an urban bus because of slow speed and use of reserved curb lanes), the risk of recurrence of a sudden cardiovascular incident (SCI) (.015, somewhat greater in bus drivers than in the general population), and the risk that such an incident will cause a personal-injury accident (Ac) (at 0.005, probably lower than in the general population because of low vehicle speeds and the bus driver's experience in defensive driving).
The overall risk is 0.00002, 1 in 50,000 driver-years, is lower than accepted for passenger-car operators, and only slightly greater than for the older symptom-free adult. Bus drivers who meet the current standards of the Canadian Cardiovascular Society should be encouraged to return to their former employment.
The influence of acculturation to a sedentary lifestyle upon the growth and development of lung volumes has been studied in Inuit children aged 9-19 years. Surveys were conducted in the circumpolar community of Igloolik (69 degrees 40'N, 81 degrees W) in 1969/70, 1979/80 and 1989/90. Over this period, the children showed little change of height or body mass at any given age, but a progressive loss of what initially had been a high level of health-related fitness. The sample for each survey comprised about 70% of children in the chosen age range: in the most recent study 87 males and 65 females. Respiratory data included forced vital capacity, one-second forced expiratory volume, maximal mid-expiratory flow rate (second and third surveys only), smoking habits and respiratory health. In each of the 3 surveys, many of the older children in the community were regular smokers. The average cigarette consumption currently rises progressively to 13 +/- 8 cigarettes/day in 87% of males and 11 +/- 7 cigarettes/day in 95% of females over 17 years of age. Nevertheless, lung volumes show the anticipated increase as a logarithmic function of stature. Furthermore, statistically fitted curves show only minor inter-survey differences in volumes for a given standing height. We thus conclude that the deterioration in other aspects of health-related fitness has not yet influenced the growth and development of respiratory function within this Inuit population.
Three surveys (1969/1970, 1979/1980 and 1989/1990) have examined the impact of acculturation to a sedentary lifestyle on the pulmonary function of a circumpolar native Inuit community. The sample comprised more than 50% of those aged 20-60 yrs, most recently 119 males and 92 females. Forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and maximal mid-expiratory flow (MMEF) were measured by standard spirometric techniques, and information was obtained on smoking habits and health. Multiple regression equations showed that lung function was affected by height and age, but usually not by age squared. Cross-sectional age coefficients for FVC and FEV1 increased over the period 1969/1970 to 1989/1990. Parallel longitudinal trends were seen in FEV1 (males only). Multiple analysis of variance (MANOVA) showed age-decade*cohort effects for FVC and FEV1 (males but not females). Almost all of the population now smoke (mean +/- SD males 13 +/- 8 cigarettes.day-1; females 11 +/- 7 cigarettes.day-1). However, smoking bears little relationship to lung function perhaps due to limited variance in consumption. About a third of the community have physician-diagnosed and/or radiographically visible chest disease, but with little effect upon pulmonary function. We conclude that an apparent secular trend to a faster ageing of lung function in men is not explained by disease or domestic air pollution. Possible factors include increased lung volumes in young adults, greater pack-years of cigarette exposure, nonspecific respiratory disease, increased inspiration of cold air or altered chest mechanics due to operation of high-speed snowmobiles, and loss of physical fitness.
The present review examines the impact of basic recruit training on health and lifestyle. Many of those recruited begin training with a less than optimal lifestyle with respect to fitness, smoking habits, alcohol consumption, drug abuse, and exposure to sexually transmitted diseases. Thus, there is scope to enhance training programs that address fitness and lifestyle, minimizing potential losses in health and efficiency from upper respiratory infections, musculoskeletal injuries, cardiac catastrophes, mental disturbances, and adverse responses to extreme environments.
The current status of the Canadian Home Fitness Test is reviewed. This simple procedure was originally conceived for the mass testing of fitness levels and for home use as a motivational tool in exercise programmes. The test is carried out on a double 8 inch step (such as a domestic staircase) at an age and sex-specific rhythm set by a long-playing record. Fitness is assessed from a combination of test-duration and the radial or carotid pulse count immediately following exercise. Use of the procedure by upwards of 500,000 Canadians is reviewed in relaltion to its safety, validity and practicality. To date, there have been no serious complications. In home use, there is inevitably limited precision, although with practice subjects can learn to count their pulse rate and step in time to the music; further, the test seems well received, achieving its prime objective of stimulating an interest in physical activity and endurance fitness. When the procedure is carried out by a paramedical worker, with e.c.g. recording of the exercise heart rate, it provides at least as good an estimate of maximum oxygen intake as other sub-maximal procedure; the main area of current controversy is interpretation of abnormal stress e.c.g. records, and it is suggested this problem could be resolved by the appropriate training and certification of interested family physicans and paramedical workers.
Cites: Bull World Health Organ. 1968;38(5):757-645303329
Cites: JAMA. 1970 Mar 9;211(10):1663-75467085
Cites: J Sports Med Phys Fitness. 1970 Dec;10(4):206-105507758
Cites: Med Sci Sports. 1971 Fall;3(3):110-75113681
Cites: Prev Med. 1974 Jun;3(2):225-364827718
Cites: Can Med Assoc J. 1977 Aug 20;117(4):346-9890630
Cites: Can J Public Health. 1975 Nov-Dec;66(6):465-71081902
Cites: Can Med Assoc J. 1976 Apr 17;114(8):662, 664, 67956978
Cites: Can Med Assoc J. 1976 Apr 17;114(8):675-956979
Cites: Can Med Assoc J. 1976 Apr 17;114(8):680-21260614
Cites: Med Sci Sports. 1976 Winter;8(4):246-521011964
Cites: Can Med Assoc J. 1974 Jul 6;111(1):25-304841237