[Suitability for work in the heart patient: assessing physical and psycho-social risks]

Cardiovascular diseases are the main cause of death and disability in all industrialized countries, including Italy. Advances in acute phase treatment and increasingly effective rehabilitation programs have determined higher survival rates and a subsequent rise in disease prevalence in working age population. Hence the need for implementing social reintegration programs, including interventions aimed specifically at aiding the process of returning to work, in which the occupational physician plays a crucial role by means of assessing the compatibility between the workers residual clinical and functional capabilities and the characteristics of their job profile. On the basis of recent literature data, particular attention must be paid to occupational risks towards which cardiopathic patients are particularly susceptible, i.e. environmental risks (physical effort), organizational and psycho-social risks (workload and time pressure, shifts, job demand and control). A close collaboration between the occupation physician and the cardiologist to ensure an effective return to work process is highly recommended, as well as periodic re-evaluations of job placement adequacy that can also include clinical examinations, performed during working hours, of the degree of cardiovascular adaptation to working conditions.