Background: The present study was designed to investigate the trend and determinant factors among cardiac disabled workers presented in the years 2003-2005 at Health Insurance Committee for disability rating in Alexandria and to compare the currently used system with others. Methods: A retrospective study was conducted to review complete records for those below the age 65 years. The available data were coded to include age, gender, job title, disabling symptoms, presence or absence of abnormal findings in resting electrocardiogram and chest X-ray. Extrainvestigations were considered by the committee in some cases including echocardiography, cardiac stress test and coronary angiography. Therapeutic interventions were coded and etiological diagnosis was classified into ischemic heart disease (IHD), rheumatic heart disease (RHD), hypertension (HT) and cardiomyopathies (CM). The functional diagnosis was reported as presence or absence of heart failure and disability was rated as partial or total. Results: The results revealed that rates of disabling dyspnoea, CM and heart failure were significantly increasing from year to year (p=0.038, 0.039 & 0.023 respectively). The most common etiological diagnosis for the presented cases was IHD with high rates ranging from 69.7% to 73.6% across the 3 years. Logistic regression with total disability as the dependent variable showed that heart failure and additional information by echocardiography were the independent determinants (p= 0.020 & 0.004 respectively). Simplified comparison between current cardiac disability rating system and American medical Association impairment classification was given. Conclusion: The present disability rating system lack standardization and quantification. It is recommended to integrate the metabolic equivalent (METs) measurement with the current system and to emphasize cardiovascular preventive programs to control cardiac disability. INTODUCTION: There is a global observation of increasing burden of cardiovascular diseases especially in developing countries. Although, cardiovascular mortality is still high, yet it witnessed some reduction due to preventive efforts and possibly due to improvement in management. However, the cardiovascular disability with its economic and social cost is increasing. (1) Cardiac disability rating is frequently
Background: The association between shift work and coronary high risk status (CHRS) is still unclear. The present work was designed to study the influence of shift work in a gas field petroleum company in Dakahlia on CHRS; as well as, to investigate its possible mechanisms. Methods: A cross-sectional approach was used and a systematic random technique was applied to select 200 shift workers and 200 non-shift workers. Both study groups were subjected to interview questionnaire about personal, social, smoking, occupational and medical histories. Clinical examination, including general and cardiovascular examinations, was done. Height, weight and waist circumference were measured and body mass index (BMI Kg/m 2) was calculated. Laboratory investigations included measurements of fasting blood glucose, lipid profile and uric acid; as well as, electrocardiographic examination (ECG). Coexistence of more than 2 conventional risk factors or diabetes mellitus (DM) or new and old coronary artery disease (CAD) defined CHRS. Vanillyl mandelic acid (VMA) was measured in 24 hours urine samples as a stress indicator for a randomly selected sub-sample from those with CHRS (25 shift and 25 non-shift workers). The R-R deep breathing variability test on the resting ECG as a measure for autonomic function was done for the same group. Results: The study revealed that 42.5% of shift workers were complaining of deterioration in performance and concentration during work. In addition, 35.5% of shift workers had the desire to change shift work. Among shift workers, 36% were smokers in comparison to 26.5% of non-shift workers with a statistically significant difference (p = 0.04). Rates of hypertension, hypercholesterolemia, high LDLcholesterol, low HDL-cholesterol, hypertriglyceridemia, obesity and DM showed a statistically significant increase among shift workers than non-shift workers (p < 0.05). The overall rate of CHRS was significantly higher among shift workers (p = 0.001). Multiple logistic regression analysis of coronary high risk status as the dependant variable revealed that shift work kept a significant effect on CHRS even after adjustment for other confounders (p= 0.002). Mean level of urinary VMA was significantly higher for shift workers than non-shift workers (p= 0.0001); meanwhile, significantly lower R-R variability indices were recorded among shift workers than non-shift workers (p < 0.05). Conclusion and Recommendations: The present study revealed that shift work has a significant impact on CHRS that might be related to sympathetic over-activity. It is recommended to screen for coronary risk factors in pre-placement and periodic medical examinations of shift workers with implementation of special preventive programs. Urinary VMA and R-R variability testing in ECG could be used as stress indicators among CHRS shift workers. Cases of CAD should be excluded from shift work.
Low back problems are emerging as important work-related health disorders especially among computer office workers with substantial cost. The most prominent feature, of these conditions, is low back pain (LBP).The present study was designed to investigate low back problems among office workers in relation to ergonomic factors at work and to analyze cost-benefit of a suggested ergonomic program for management of this problem. A cross-sectional study was conducted in the office work department in a petroleum company in the Western desert. The study included 120 office workers. All participants were subjected to a predesigned questionnaire emphasizing occupational history, clinical examination, anthropometric measurements, and ergonomic checklist for subjective assessment. The LBP was defined whether non-specific, radiating, persistent specific, or chronic. A parallel objective assessment of the computer desk workstations (n = 62), which were shared by workers, was carried out by experienced ergonomists with the same previous checklist. Medical records were reviewed for assessment of the cost of low back problems in the years (2007)(2008)(2009).The cost of a suggested ergonomic program was calculated for 3 years according to the market price in order to calculate cost-benefit ratio of such a program in prevention of LBP. Results showed that 61% of the examined workers gave history of LBP within the previous 3 years and clinical signs were detected in 32% of the workers. There were no significant differences between subjective and objective assessments of the different items scores of the ergonomic checklist. The lowest mean scores were reported for the chair and the work habits and training; both were negatively correlated with LBP intensity and duration. The suggested ergonomic program entails correction of the defective items to meet the standard ergonomic healthy criteria, provision of 6 periodic ergonomic training programs and enforcement of healthy work and life style habits. The final cost-benefit ratio of the ergonomic program for management of LBP among office workers of the present study was 1: 3.67 which is considered cost beneficial. Properly designed ergonomic programs are cost beneficial in management of LBP among office workers.
Electromagnetic field (EMF) exposure at low frequencies may cause some health problems. The present study was designed to test the effect of a comprehensive physical activity program on some fitness aspects of exposed workers with emphasis on cardio-autonomic control. A pre-test post-test experimental design was adopted. A representative sample of 30 workers exposed to low frequency EMF from Abou Qir electrical power station, Alexandria, were included in the study after fulfilling eligible criteria. Each one of the workers was subjected to a predesigned questionnaire including inquiries about sleep pattern subjective symptoms, and work and health satisfaction. Measurements of anthropometric indices, resting heart rate and blood pressure were done. Resting 12 lead ECG and R-R variability test during deep breathing were performed. A venous blood sample was taken for serum cholesterol and complete blood count determination. All these parameters were measured for the participants before and after implementation of a standardized physical activity program (PAP) for 12 weeks. Results revealed significant improvement of some subjective and general complaints, and work and health satisfaction (p<0.05 for all). Heart rate, systolic blood pressure and R-R variability indices showed significant favorable effect of the PAP in the direction of augmenting the protective parasympathetic tone. In conclusion, PAP for workers exposed to EMF seems to be a good tool to improve their fitness and to ameliorate some health risks, emphasizing its importance in preventive implications.
A cross-sectional study was carried out to study the conventional cardiovascular risk profile with special emphasis on hypertension and the relation to physical activity type of work, in Siwa community, as an example of underserved locations. A community based study targeting adult population of Siwa (25 years old and above) was conducted by members of the health convoy prepared by HIPH to Siwa Oasis. A cluster sampling technique was adopted randomly covering all districts of Siwa. The study included 202 respondents. The participants were interviewed using a predesigned questionnaire including personal and long term enquiry of medical data, and dietary habits. Using standard methods, blood pressure was measured and blood samples were taken to test for the levels of cholesterol and thyroid stimulating hormone (TSH). Results showed that 48% of the studied population were hypertensives and 64% had less active work. Multiple regression models, with systolic blood pressure (SBP) and diastolic blood pressure (DBP) as quantitative dependent variables, showed that the physical type of work was a significant independent factor in both models (p=0.003). Significant higher percents of smokers, overweight and obese, hyper-cholesterolemics, and hypothyroid cases were reported among less active work, in comparison to active work (p= 0.006, 0.0001, 0.002, and 0.004, respectively). In conclusion, cardiovascular risk factors are emerging at high rates in this community. Type of work physical activity seems to be an important risk factor that should be considered in preventive programs.
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