The importance of exercise testing in occupational cardiovascular assessment for high-hazard professions

In the setting of high-hazard work, occupational medicine is principally concerned with risk assessment. Cardiovascular risk assessment must consider interactions of the body with the environment of the work in order to accurately estimate event rates. Aircrew, emergency service workers, and miners, for example, face heterogeneous physiological and psychological challenges including hypoxia, sustained acceleration, thermal stress, high physical workload, disorientation, fear and sensory overload. One can readily appreciate how these environmental factors might influence cardiac output, increase myocardial oxygen demand, lead to electrolyte shifts, and alter the balance of autonomic activity, such that the threshold for arrhythmia, ischaemia, and acute heart failure is reduced. Furthermore, the effects of specific therapies: drugs, devices, coronary stenting and ablation must also be considered in the context of occupational role and environmental exposure.
Source: European Heart Journal - Category: Cardiology Source Type: research