Cardiovascular disease (CVD) is an overall term to describe a disease of the heart or blood vessels which causes a reduced blood flow to the heart muscle, brain or body. This reduced blood flow can be as a result of a blood clot, or build-up of fatty deposits inside an artery leading to arterial hardening and narrowing.
There are four main types of CVD: Coronary heart Disease (CHD), stroke, peripheral artery disease and aortic disease.
This article is specifically about heart problems, their frequency, how they may affect the workplace and how employers can support someone in the workplace with CHD or returning to work following a recent diagnosis of a heart problem. The most common of these conditions include heart attack, heart failure, angina and abnormal heart rhythms.
Cardiovascular Disease is the leading cause of death both in the UK and worldwide with over 1.6 million men and over 1 million women affected by chronic heart disease in the UK alone.
Research by the BHF shows that there were 80,000 deaths from CHD in 2010 with most deaths being caused by heart attacks although it is noted that death rates from heart attacks have halved since 2002.
In the UK death rates from CHD are greatest in Scotland, while within England they are greatest in the North West with the lowest being in the South West and South East. In 2009 CHD cost the UK economy over £19billion.
Risk factors for coronary heart disease include: age, sex, family history of heart disease, ethnic origin, smoking, alcohol, drug abuse, high cholesterol, high blood pressure, lack of exercise and obesity, diabetes and a previous history of heart disease.
Multiple diagnostic techniques are used to detect heart disease including measurements of the heart rhythm and electrical activity, scans to show the different structures of the heart, blood tests which can show if a heart attack has taken place and angiography in which a dye is injected into the arteries of the heart to identify any narrowing.
The majority of these tests will need to be done in a hospital however certain tests such as the 24-hour ECG in which a portable device is worn for 24 hours to monitor the heart activity for that time can be worn in most workplaces.
Heart Disease can be treated a variety of different ways. Many common conditions will be controlled using a variety of medications, some of which may have implications in the workplace as they cause a variety of side effects such as fatigue.
Other conditions require surgery including heart bypass or even heart transplant while others may need less invasive treatments such as insertion of a pacemaker or stent (metal mesh that holds the artery open). Occasionally someone may suffer a serious abnormality of heart rhythm which requires insertion of an Implantable Cardioversion Defibrillator (ICD). These devices identify any life-threatening rhythms and deliver a small electrical shock to return the rhythm to normal. These devices can be affected by magnets, electro-magnets and other equipment such as arc welders and car ignition systems so advice will be needed from a specialist before returning to work.
Most people can return to work following diagnosis of heart disease depending on the stability of the condition, control of symptoms, how quickly the recovery has been following major events such as a heart attack and the type of work undertaken. Work itself can be important to our general health and wellbeing so can be a significant part of the recovery process itself.
The GP and Specialist will help decide whether someone is fit to return to work; your Occupational Health servicewill be able to advise on any workplace adjustments that may be necessary such as reduced hours initially, change in workload or suggest workplace changes due to issues associated with insertion of an ICD or pacemaker.
Typically someone who has had a heart attack would be expected to be fit to return to work after 12 weeks, the time at home spent gradually increasing exercise tolerance and attendance at a cardiac rehabilitation programme. Regular follow ups at cardiac clinics and at the GP are likely.
Following heart bypass surgery the Royal College of Surgeons states that “If you do a job which involves only light physical exertion – i.e. it does not involve you standing for periods of more than 20 minutes, or lifting more than 5kg at a time – you can usually return to work 6-8 weeks after your operation. Certainly, most people will find themselves fit to work by two to three months after the operation”.
There will be some people who will be advised by their doctors not to return to their previous jobs, this could be because the previous job was too demanding physically, however this does not mean people are unable to work, just that an alternative kind of work may be more suitable. The Occupational Health Service, in conjunction with advice from specialists and GPs, can help advise in this situation.
Employers may wish to consider implementation of a workplace wellbeing plan to provide lifestyle information to staff to help reduce the likelihood of heart conditions occurring.
Information used in this article can be found at:
- The British Heart Foundation (https://www.bhf.org.uk)
- NHS Choices (http://www.nhs.uk/Pages/HomePage.aspx)
- Net Doctor (http://www.netdoctor.co.uk/)
- The British Cardiac Patients Association (http://www.bcpa.co.uk/)
- The Royal College of Surgeons (http://www.rcseng.ac.uk/)
For further advice on dealing with heart problems in the work place please contact us at:
Telephone: 023 8047 5000