The proposal of the Italian Committee on Occupational Cardiology

Abstract

This paper describes a protocol of assessing specific working fitness of post-myocardial infarction patients proposed by the Italian Committee on Occupational Cardiology. After cardiovascular (cross-sectional echocardiography, Holter monitoring and maximal symptom-limited ergometric test) and psychological evaluation (CBA-2.0), two ambulatory ECGs were used during work to confirm the first judgement of specific work fitness expressed by occupational specialists. The preliminary results obtained in 106 uncomplicated male patients (mean age 49 +/- 8 years) show that: (i) return to work (89.6%) at 117 +/- 51 days after the acute event is mainly related to socio-occupational variables rather than to cardiovascular status; (ii) the results of the ambulatory monitoring usually confirm the first judgment of specific work fitness; (iii) heart rate responses recorded during work are unrelated to the judgment of fitness; and (iv) the repeatability of the results observed during the two ambulatory ECGs at work is good.

Prevalence and determinants of return to work after various coronary events: meta-analysis of prospective studies

“…RTW pooled prevalence estimates after a coronary event were significantly different (P < 0.001, I 2 = 99.7%, PI [23.2%; 100%]) according to the follow-up periods expressed in months: ≤ 3 22 , 25 – 27 , 36 , 46 – 49 , 55 , 58 , 60 , 62 , ]3–6] 23 , 26 , 27 , 30 , 36 , 41 , 42 , 44 , 53 , 62 , 63 , ]6–12] 24 , 25 , 27 , 32 – 35 , 37 – 40 , 46 – 50 , 52 , 55 , 56 , 58 , 59 and > 12 21 , 28 , 29 , 31 , 45 , 47 , 49 , 51 , 54 , 59 . Patients were more likely to return to work after 3 months following the coronary event: 47.3% [41.7; 52.8] (PI [26.6; 68.4]) of the patients had returned to work before 3 months, 88% [79.9; 94.3] (PI [50.1; 100]) between 3 and 6 months.…”

“…To analyze the effect of the method to measure RTW, studies were dichotomized (Table 1 and Supplementary Fig. S7 online): studies based on self-report 21 – 23 , 25 – 39 , 41 – 46 , 48 , 50 – 54 , 57 , 58 , 60 – 63 and studies using administrative or employer databases or occupational medicine consultation 24 , 40 , 47 , 49 , 55 , 56 , 59 , and no significant difference was noticed (respectively, 80.5% and 83.9%, P = 0.610, I 2 = 99.1%, PI [41.2%; 100%], no evidence for small study effects).…”