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Chinichian M, Mehrdad R, Moradi M, Pouryaghoub G, Davarpasand T, Kassiri N. Factors That Predict Early Return to Work After Myocardial Infarction: Importance of Coworker Support. KARDIOLOGIIA 2023; 63:60-65. [PMID: 38156491 DOI: 10.18087/cardio.2023.12.n2310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 11/25/2022] [Indexed: 12/30/2023]
Abstract
Aim Myocardial infarction (MI) affects the working-age group and cause many absences and lost days of work. Some occupational factors effect in the prognosis of MI patients. The objective of this study was to determine predictors of early, late and no return to work (RTW) after MI.Material and methods In this cohort study, 240 pre-employed, male patients with MI from April 2020 through February 2022 provided data about their demographic, occupational, psychosocial, and medical information. Data was also collected about the treatment they received as patients, their feelings about socioeconomic support, and RTW time. RTW within two weeks after MI was defined as early RTW. The relationships of these variables and with early RTW and with late or no RTW were analyzed.Results Ninety-four patients (39.6 %) returned to work within two weeks after MI, whereas 207 patients (87.3 %) returned to work by the end of six months. Many variables, including coworker support, were associated with early RTW in a univariate analysis. Regression analysis revealed that age, coworker support, marital status, the patient's own estimated RTW time, the number of the vessels with occlusion, and comorbidity were predictors of early RTW. Of these factors, only coworker support would be subject to modification.Conclusions This study indicates that improving support from coworkers can increase early RTW after MI.
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Affiliation(s)
| | - Ramin Mehrdad
- Tehran University of Medical Sciences, Center for Research on Occupational Disease
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Candura SM, Vanoli D, Mazzanti A, D'Amato L, Priori SG, Scafa F. Brugada syndrome and job fitness: report of three cases. INDUSTRIAL HEALTH 2023; 61:455-461. [PMID: 36724992 PMCID: PMC10731415 DOI: 10.2486/indhealth.2022-0205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 01/27/2023] [Indexed: 06/18/2023]
Abstract
Brugada syndrome (BrS) is an inherited arrhythmogenic disorder predisposing patients to a high risk of sudden cardiac death. Specific guidelines on the health surveillance of BrS workers are lacking. We report here three cases requiring assessment of specific job capacity, investigated with an interdisciplinary protocol including 24-h Holter electrocardiography with modified precordial leads, pharmacological test with ajmaline, molecular genetic analysis, electrophysiological study with ventricular stimulation, risk stratification, and occupational medicine evaluation: (1) a female 42-yr-old company manager with positive ajmaline test and CACNA1C gene mutation (judged fit for the job with limitations regarding work-related stress); (2) a male 44-yr-old welder with positive ajmaline test, SCN5A gene mutation, and associated OSAS (obstructive sleep apnea syndrome), who was advised to refrain from night shifts and driving company vehicles; (3) a male 45-yr-old electrical technician with inducible ventricular tachyarrhythmia, who was implanted with a biventricular cardioverter defibrillator, and therefore recommended to avoid exposure to electromagnetic fields and working at heights. We conclude that the collaboration between the cardiologist and the occupational physician allows defining the functional capabilities and the arrhythmogenic risk of BrS workers, to optimize job fitness assessment.
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Affiliation(s)
- Stefano M Candura
- Occupational Medicine Unit, Department of Public Health, Experimental and Forensic Sciences, University of Pavia, Italy
- Istituti Clinici Scientifici Maugeri IRCCS, Occupational Medicine Unit of Pavia Institute, Italy
| | - Daniela Vanoli
- Occupational Medicine Unit, Department of Public Health, Experimental and Forensic Sciences, University of Pavia, Italy
| | - Andrea Mazzanti
- Istituti Clinici Scientifici Maugeri IRCCS, Molecular Cardiology of Pavia Institute, Italy
- Department of Molecular Medicine, University of Pavia, Italy
- Molecular Cardiology, Centro Nacional de Investigaciones Cardiovasculares (CNIC), Spain
| | - Luca D'Amato
- Occupational Medicine Unit, Department of Public Health, Experimental and Forensic Sciences, University of Pavia, Italy
| | - Silvia G Priori
- Istituti Clinici Scientifici Maugeri IRCCS, Molecular Cardiology of Pavia Institute, Italy
- Department of Molecular Medicine, University of Pavia, Italy
| | - Fabrizio Scafa
- Istituti Clinici Scientifici Maugeri IRCCS, Occupational Medicine Unit of Pavia Institute, Italy
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Scafa F, Gallozzi A, Forni G, Candura SM. Work resumption after invasive heart procedures, rehabilitation and ergonomic evaluation: from the hospital to the workplace. Monaldi Arch Chest Dis 2023. [PMID: 37667891 DOI: 10.4081/monaldi.2023.2689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 07/31/2023] [Indexed: 09/06/2023] Open
Abstract
Our Institute adopts a multidisciplinary protocol named "CardioWork" for work resumption after invasive cardiac procedures and subsequent rehabilitation: after evaluation of the cardiac functional profile, the occupational physician analyses the work activity prior to the cardiopathological event, identifies the presumed task energy requirement (from specific, published tables), and compares it with the exercise test results. Indications regarding timing and modality of returning to work are formulated accordingly. To verify the reliability of the indications thus provided, we carried out a clinical-functional follow-up study in the workplace, with Holter ECG and Armband measurement of actual energy expenditure. Over the course of two years, we enrolled 36 patients (mostly males, aged between 30 and 70 years), hospitalized after coronary revascularization, valve replacement or cardiac defibrillator implant. After rehabilitation, instrumental diagnostics (Holter ECG, echocardiography, exercise test) showed discrete functional conditions, with better values with regard to cardiac function than exercise capacity and effort tolerance. All subjects were judged fit for the job, in most cases with limitations concerning ergonomic factors, working timetable and/or stress. They returned to work quickly, with good adherence to the indications provided. Workplace Holter ECG did not show appreciable differences compared to the hospital evaluation. In one case, the average energy expenditure measured while working was higher than that inferred from the tables; in the remaining subjects, the actual expenditure coincided with what was expected or was lower. In a minority of cases (39%), the measured average expenditure slightly exceeded the optimal value (35% of the maximal value at the exercise test) recommended at the time of hospital discharge. At the end of the workplace evaluation, it was not necessary to formulate new indications. The study provides further evidence of the effectiveness of the CardioWork protocol in promoting return to work after invasive heart procedures. Though they need continuous updating, the published estimates of presumed task energy requirement remain reliable. In particularly complex cases, it is however advisable to carry out a field check of the ergometric assessments performed at the end of rehabilitation.
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Affiliation(s)
- Fabrizio Scafa
- Occupational Medicine Unit, Department of Public Health, Experimental and Forensic Sciences, University of Pavia; Occupational Medicine Unit, ICS Maugeri IRCCS, Pavia.
| | - Alessia Gallozzi
- Occupational Medicine Unit, Department of Public Health, Experimental and Forensic Sciences, University of Pavia; Occupational Medicine Unit, ICS Maugeri IRCCS, Pavia.
| | - Giovanni Forni
- Rehabilitation Cardiology Unit, ICS Maugeri IRCCS, Pavia.
| | - Stefano M Candura
- Occupational Medicine Unit, Department of Public Health, Experimental and Forensic Sciences, University of Pavia; Occupational Medicine Unit, ICS Maugeri IRCCS, Pavia.
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An Analysis of the Work Resumption in China under the COVID-19 Epidemic Based on Night Time Lights Data. ISPRS INTERNATIONAL JOURNAL OF GEO-INFORMATION 2021. [DOI: 10.3390/ijgi10090614] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Public emergencies often have an impact on the production and operation of enterprises. Timely and effective quantitative measurement of enterprises’ offline resumption of work after public emergencies is conducive to the formulation and implementation of relevant policies. In this study, we analyze the level of work resumption after the coronavirus disease 2019 (COVID-19)-influenced Chinese Spring Festival in 2020 with night time lights remote sensing data and Baidu Migration data. The results are verified by official statistics and facts, which demonstrates that COVID-19 has seriously affected the resumption of work after the Spring Festival holiday. Since 10 February, work has been resuming in localities. By the end of March, the work resumption index of most cities exceeded 70% and even Shanghai, Nanjing and Suzhou had achieved complete resumption of work. Wuhan only started to resume work in the last week of March due to the more severe outbreak. Although the level of work resumption is gradually increasing in every area, the specific situation of resumption of work varies in different regions. The process of work resumption in coastal areas is faster, while the process is relatively slow in inland cities.
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Reibis R, Salzwedel A, Abreu A, Corra U, Davos C, Doehner W, Doherty P, Frederix I, Hansen D, Christine Iliou M, Vigorito C, Völler H. The importance of return to work: How to achieve optimal reintegration in ACS patients. Eur J Prev Cardiol 2019; 26:1358-1369. [DOI: 10.1177/2047487319839263] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The vocational reintegration of patients after an acute coronary syndrome is a crucial step towards complete convalescence from the social as well as the individual point of view. Return to work rates are determined by medical parameters such as left ventricular function, residual ischaemia and heart rhythm stability, as well as by occupational requirement profile such as blue or white collar work, night shifts and the ability to commute (which is, in part, determined by physical fitness). Psychosocial factors including depression, self-perceived health situation and pre-existing cognitive impairment determine the reintegration rate to a significant extent. Patients at risk of poor vocational outcomes should be identified in the early period of rehabilitation to avoid a reintegration failure and to prevent socio-professional exclusion with adverse psychological and financial consequences. A comprehensive healthcare pathway of acute coronary syndrome patients is initiated by cardiac rehabilitation, which includes specific algorithms and assessment tools for risk stratification and occupational restitution. As the first in its kind, this review addresses determinants and legal aspects of reintegration of patients experiencing an acute coronary syndrome, and offers practical advice on reintegration strategies particularly for vulnerable patients. It presents different approaches and scientific findings in the European countries and serves as a recommendation for action.
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Affiliation(s)
- Rona Reibis
- Center of Rehabilitation Research, University of Potsdam, Germany
- Cardiac Outpatient Clinic Park Sanssouci, Potsdam, Germany
| | - Annett Salzwedel
- Center of Rehabilitation Research, University of Potsdam, Germany
| | - Ana Abreu
- Department of Cardiology, Hospital de Santa Marta, Portugal
| | - Ugo Corra
- Cardiologic Rehabilitation Department, Istituti Clinici Scientifici Salvatore Maugeri, Italy
| | | | - Wolfram Doehner
- BIH Center for Regenerative Therapies (BCRT), Charité Universitätsmedizin Berlin, Germany
- Department of Cardiology (Virchow Klinikum), Charité Universitätsmedizin Berlin, Germany
- German Centre for Cardiovascular Research (DZHK), partner site Berlin, Germany
| | | | - Ines Frederix
- Faculty of Medicine and Life Sciences, Hasselt University, Belgium
- Faculty of Medicine and Health Sciences, Antwerp University, Antwerp, Belgium
- Department of Cardiology, Jessa Hospital, Hasselt, Belgium
| | | | | | - Carlo Vigorito
- Internal Medicine and Cardiac Rehabilitation, University of Naples Federico II, Italy
| | - Heinz Völler
- Center of Rehabilitation Research, University of Potsdam, Germany
- Klinik am See, Rehabilitation Center for Internal Medicine, Germany
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Scafa F, Calsamiglia G, Cadei P, Pettenuzzo E, Forni G, Candura SM. {Health and work after invasive heart procedures, rehabilitation and occupational evaluation]. LA MEDICINA DEL LAVORO 2018; 109:219-24. [PMID: 29943753 PMCID: PMC7689795 DOI: 10.23749/mdl.v109i3.6451] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 02/26/2018] [Indexed: 11/17/2022]
Abstract
«Health and work after invasive heart procedures, rehabilitation and occupational evaluation».
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Quality of work experience after angioplasty or heart surgery: a monocentric cohort study. Int Arch Occup Environ Health 2017; 91:337-348. [DOI: 10.1007/s00420-017-1282-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 11/28/2017] [Indexed: 11/25/2022]
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Gordois AL, Toth PP, Quek RG, Proudfoot EM, Paoli CJ, Gandra SR. Productivity losses associated with cardiovascular disease: a systematic review. Expert Rev Pharmacoecon Outcomes Res 2016; 16:759-769. [PMID: 27831848 DOI: 10.1080/14737167.2016.1259571] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
INTRODUCTION People with cardiovascular disease (CVD) often require time off work to recover from illness or surgery; for example, following a myocardial infarction (MI) or stroke. These individuals incur income losses, work-related productivity is reduced for employers, and output is reduced for the wider economy. Productivity impacts to the economy also arise due to CVD-related mortality. Areas covered: A systematic literature review was conducted to identify and collate studies that report the magnitude of work-related productivity losses associated with CVD generally or specific cardiovascular (CV) events or conditions (coronary heart disease, MI, stroke, transient ischemic attack, angina, heart failure, peripheral artery disease, coronary revascularization). The search was conducted using Medline, Embase, the Cochrane Library, and Google to find studies published from January 2004 to January 2015. In total, 60 studies were identified, including 20 studies conducted in the USA, 25 studies conducted in Europe, and 18 studies conducted in other countries (three studies were conducted in multiple regions). The studies differed by the scope of losses assessed (absenteeism, presenteeism, early retirement, premature mortality) and CVD conditions/events included. Studies reported either average patient or population losses, and generally used a human capital rather than friction cost method. Outcomes were standardized and adjusted to 2015 US dollars where possible. Expert commentary: The review demonstrates that CVD imposes substantial morbidity- and mortality-related productivity costs. The studies identified in the review may be used to inform and populate societal economic evaluations in CVD, with the most appropriate source study being that most closely matching the context of the evaluation.
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Affiliation(s)
- Adam L Gordois
- a Covance Market Access Services Inc. , Sydney , Australia
| | - Peter P Toth
- b University of Illinois College of Medicine , Peoria , IL , USA.,c Ciccarone Center for the Prevention of Cardiovascular Disease , Johns Hopkins University School of Medicine , Baltimore , MD , USA
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Şahan C, Demiral Y, Kılıç B, Aslan Ö. Changes in Employment Status after Myocardial Infarction among Men. Balkan Med J 2016; 33:419-25. [PMID: 27606138 DOI: 10.5152/balkanmedj.2016.150611] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 09/01/2015] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND According to the Turkey Burden of Disease Study, 10% of the national burden of disease is attributed to cardiovascular diseases. Although the standardized coronary heart disease (CHD) rate is falling in general, CHD prevalence among young people is rising. On the other hand, as a result of increased life expectancy and higher retirement ages, the CHD rate among workers is also increasing. Therefore, work ability and return to work after diagnosis are important for population health and well-being. Socioeconomic factors and working conditions may play a key role as well as clinical conditions described in the literature that affect returning to work. AIMS The aims of this qualitative study are exploring the changes in employment and working conditions of the patients after acute myocardial infarction (AMI) and affecting factors such as socioeconomic, personal and environmental. STUDY DESIGN Qualitative research. METHODS The research population are fifty-three patients who are engaged in paid employment when the people have been diagnosed with myocardial infarction for the first time between 2011 and 2012 at a university hospital coronary care unit. We intended to reach the whole population. Twenty-seven patients were contacted whose phone numbers were accessible from the hospital records. Semi-structured in-depth interviews were conducted with twelve patients in a meeting room at the hospital. The interviews were tape-recorded accompanied by note-taking and the content analysis method were evaluated. RESULTS While many of the participants continued to work at the same job by working less, one third of them said that they were thinking about getting an easier job if they have the opportunity. On the other hand, in most cases, there were neither assessments about their work ability, nor changes to their working conditions after AMI. They had to cope with their conditions, such as economic or psychosocial, without any support. CONCLUSIONS While the patients have to return to work for economic and social reasons, they expressed uncertainty about working after a diagnosis of AMI and could not reach professional support to assess their work abilities. Therefore, specific algorithms and assessment tools to manage the return to work of AMI patients would be useful.
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Affiliation(s)
- Ceyda Şahan
- Department of Public Health, Dokuz Eylül University School of Medicine, İzmir, Turkey
| | - Yücel Demiral
- Department of Public Health, Dokuz Eylül University School of Medicine, İzmir, Turkey
| | - Bülent Kılıç
- Department of Public Health, Dokuz Eylül University School of Medicine, İzmir, Turkey
| | - Özgür Aslan
- Department of Cardiology, Dokuz Eylül University School of Medicine, İzmir, Turkey
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Worcester MU, Elliott PC, Turner A, Pereira JJ, Murphy BM, Le Grande MR, Middleton KL, Navaratnam HS, Nguyen JK, Newman RW, Tatoulis J. Resumption of Work After Acute Coronary Syndrome or Coronary Artery Bypass Graft Surgery. Heart Lung Circ 2014; 23:444-53. [DOI: 10.1016/j.hlc.2013.10.093] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Revised: 10/04/2013] [Accepted: 10/22/2013] [Indexed: 11/26/2022]
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