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Assessment of work capacity in patients with ischaemic heart disease: methods and practices.

https://arctichealth.org/en/permalink/ahliterature232201
Source
Eur Heart J. 1988 Nov;9 Suppl L:67-73
Publication Type
Article
Date
Nov-1988
Author
T. Kavanagh
V. Matosevic
Author Affiliation
University of Toronto, Ontario, Canada.
Source
Eur Heart J. 1988 Nov;9 Suppl L:67-73
Date
Nov-1988
Language
English
Publication Type
Article
Keywords
Canada
Coronary Disease - rehabilitation
Exercise Test
Humans
Male
Middle Aged
Rehabilitation, Vocational
Telemetry
Work Capacity Evaluation
Work Schedule Tolerance
Abstract
Analysis of 1150 post-infarct and post-aorto-coronary bypass graft patients referred to the Toronto Rehabilitation Centre revealed that approximately 10% have not returned to work six months after the acute event. White-collar workers are more successful than blue-collar workers in resuming work, as are those medically treated as compared with the surgically treated. The reasons for prolonged unemployment were more frequently non-medical than medical. Detailed assessment is required where there is doubt about the patient's work capacity, or where legislation and/or trade practices demand it. The simplest procedure is an exercise test with energy cost matching. Telemetry during simulated work tasks or while on work stations in the Centre allows more flexibility, with actual observation and telemetry on the job site the only recourse in certain situations.
PubMed ID
3243301 View in PubMed
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On-site evaluation of bus drivers with coronary heart disease.

https://arctichealth.org/en/permalink/ahliterature205357
Source
J Cardiopulm Rehabil. 1998 May-Jun;18(3):209-15
Publication Type
Article
Author
T. Kavanagh
V. Matosevic
L. Thacker
R. Belliard
R J Shephard
Author Affiliation
Toronto Rehabilitation Centre, Department of Medicine, University of Toronto, Ontario, Canada.
Source
J Cardiopulm Rehabil. 1998 May-Jun;18(3):209-15
Language
English
Publication Type
Article
Keywords
Adult
Automobile Driving
Canada
Coronary Artery Bypass
Disability Evaluation
Electrocardiography
Exercise Test
Humans
Male
Middle Aged
Myocardial Infarction - physiopathology
Occupational Health
Risk assessment
Abstract
Bus drivers with ischemic heart disease have been denied normal employment, although they satisfy Canadian Cardiovascular Society (CCS) Guidelines. To show the safety of their reemployment, we compared their responses when driving buses with those seen during graded exercise testing.
Twenty-two male city bus drivers, aged 48.1 +/- 5.6 years (19 had a myocardial infarction, 2 had coronary artery bypass graft, 1 had documented ischemic heart disease) were referred for work evaluation. After a CCS cardiopulmonary exercise test, they were accompanied by a physician and a therapist/technician on a normal shift. Note was kept of symptoms, signs, electrocardiogram (telemetry), blood pressure (ambulatory recording unit), and Borg rating of effort throughout.
Average values for peak heart rate (101 +/- 12.5 versus 148.2 +/- 17.2 beats/min), peak systolic pressure (150.0 +/- 20.8 versus 198.9 +/- 25.7 mm Hg), peak rate-pressure product (15,259 +/- 3,369 versus 29,500 +/- 5,283 units), peak Borg RPE (9.9 +/- 1.4 versus 17.4 +/- 3.0 units), and peak ST-segmental depression (-0.03 +/- 0.07 versus -0.07 +/- 0.09 mV) during the shift were only about a half of average values reached during the graded stress test. Moreover, peak values were reached at the end of the shift, when carrying the loaded fare box, rather than when driving.
Cardiovascular strain during bus driving is much less than during the CCS stress test for drivers. Using CCS methodology, the risk that a sudden cardiovascular incident will cause injury or death of others in the first year after recovery from myocardial infarction is estimated at 1 in 50,000 driver-years. Thus, those satisfying CCS requirements can return to full driving duties promptly, with minimal risk to themselves, passengers, or other road users.
Notes
Erratum In: J Cariopulm Rehabil 1998 Jan-Feb;19(1):66
PubMed ID
9632322 View in PubMed
Less detail