CHAPTER 38 Occupational and Regulatory Aspects of Heart Disease
This chapter deals with socioeconomic aspects of heart disease. First, the recent evidence linking occupational factors and heart disease is discussed. Subsequent sections review guidelines and regulations governing the socioeconomic integration of patients following cardiac events or procedures. These guidelines and regulations—published by cardiology societies and other authorities—aim to assist the physician in determining the ability of patients to safely resume normal activities and return to work, particularly when that work impacts public safety. Main issues discussed are private and professional driving and ability of the cardiac patient to travel by air. Guidelines on driving published by the European Society of Cardiology are compared with the comprehensive recommendations put forward by the Canadian Society of Cardiology, and recent modifications of previous guidelines of the American Heart Association. Guidelines on air travel have been published by the Canadian Society of Cardiology and the US Aerospace Medical Association. Guidelines are presented relating to different cardiac conditions and controversial issues are discussed. Regulations for medical licensing of professional pilots have been published by national authorities, the European Joint Aviation Authorities and the European Aviation Safety Agency, and, most recently, the International Civil Aviation Organization.
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