OPAM Workshop: Basic Course in Occupational and Environmental Medicine, Part I-I - Occupational Cardiology

Video Transcription

Video Summary

Dr. Naomi Wriston, with 20 years' experience in family and occupational medicine, discusses cardiovascular disease (CVD) and its occupational relevance, emphasizing its significance in high-risk jobs like firefighting. CVD causes approximately 877,000 U.S. deaths annually, with sudden cardiac death leading firefighter on-duty fatalities (45%). Factors such as obesity, hypertension, smoking, shift work, physical strain, stress, and environmental pollutants increase occupational risk. Firefighters must meet a fitness level of 12 METs to safely perform duties; annual medical exams and fitness programs are recommended despite pushback from employers and employees worried about job security. Dr. Wriston highlights modifiable risk factors (e.g., smoking, diet, hypertension, obesity, stress, shift work) and non-modifiable ones (age, genetics). She reviews occupational exposures harmful to the heart, including carbon monoxide, carbon disulfide, organic nitrates, hydrocarbons, insecticides, arsine, cadmium, cobalt, lead, and noise, explaining their mechanisms and clinical relevance. For instance, arsine causes hemolysis leading to hyperkalemia and cardiac arrest. She underscores the importance of thorough occupational histories, understanding workplace culture, and collaboration among employer, employee, and physician to support worker health and public safety. Ultimately, protecting cardiovascular health in occupational medicine reduces healthcare costs, improves productivity, and protects employees, employers, and the public alike.

Keywords

occupational health and safety

dermatosis

NIOSH

OSHA permissible exposure limits

Bernardo Ramazzini

cardiovascular disease

occupational medicine

firefighting

cardiac risk factors

occupational exposures

fitness requirements

modifiable risk factors

worker health