Background: The present study was designed to investigate the trend and determinant factors among cardiac disabled workers presented in the years 2003-2005 at Health Insurance Committee for disability rating in Alexandria and to compare the currently used system with others. Methods: A retrospective study was conducted to review complete records for those below the age 65 years. The available data were coded to include age, gender, job title, disabling symptoms, presence or absence of abnormal findings in resting electrocardiogram and chest X-ray. Extrainvestigations were considered by the committee in some cases including echocardiography, cardiac stress test and coronary angiography. Therapeutic interventions were coded and etiological diagnosis was classified into ischemic heart disease (IHD), rheumatic heart disease (RHD), hypertension (HT) and cardiomyopathies (CM). The functional diagnosis was reported as presence or absence of heart failure and disability was rated as partial or total. Results: The results revealed that rates of disabling dyspnoea, CM and heart failure were significantly increasing from year to year (p=0.038, 0.039 & 0.023 respectively). The most common etiological diagnosis for the presented cases was IHD with high rates ranging from 69.7% to 73.6% across the 3 years. Logistic regression with total disability as the dependent variable showed that heart failure and additional information by echocardiography were the independent determinants (p= 0.020 & 0.004 respectively). Simplified comparison between current cardiac disability rating system and American medical Association impairment classification was given. Conclusion: The present disability rating system lack standardization and quantification. It is recommended to integrate the metabolic equivalent (METs) measurement with the current system and to emphasize cardiovascular preventive programs to control cardiac disability. INTODUCTION: There is a global observation of increasing burden of cardiovascular diseases especially in developing countries. Although, cardiovascular mortality is still high, yet it witnessed some reduction due to preventive efforts and possibly due to improvement in management. However, the cardiovascular disability with its economic and social cost is increasing. (1) Cardiac disability rating is frequently

Background: Work-related musculoskeletal disorders (WRMSDs) are serious occupational health problems among workers worldwide. Aim of the study: evaluate urinary C-terminal telopeptide of collagen type II (CTX-II) as a biomarker for early diagnosis of osteoarthritis and compare results with those obtained by the routinely used m ethods. Subjects and methods: One hundred and eighty workers from the outpatient clinics of rehabilitation center in Cairo performing physically demanding and office jobs. One hundred and twenty three workers diagnosed with knee OA (Group I) and 57 workers were healthy (Group II). Clinical examination, X-rays and questionnaire were done. Erythrocyte sedimentation rate, high sensitive C reactive protein and human CTX -II were measured. Results: No statistical significant difference between CTX-II in osteoarthritis workers and age, residence, smoking status and sport practice. Marked increase of urinary CTX-II level was found in osteoarthritis workers compared to healthy group. A high significance difference between CTX-II level and Western Ontario and Mcmaster Universities Arthritis Index (WOMAC) index scores in osteoarthritis workers, in addition high levels were found among grade 4 osteoarthritis. Mean urinary level of CTX-II in osteoarthritis workers increased with increased work duration and total working hours. Conclusion: Urinary CTX-II can predict clinical diagnostic criteria and x-ray progression in osteoarthritis, so it can be used as a tool for diagnosis of knee OA

Background: The association between shift work and coronary high risk status (CHRS) is still unclear. The present work was designed to study the influence of shift work in a gas field petroleum company in Dakahlia on CHRS; as well as, to investigate its possible mechanisms. Methods: A cross-sectional approach was used and a systematic random technique was applied to select 200 shift workers and 200 non-shift workers. Both study groups were subjected to interview questionnaire about personal, social, smoking, occupational and medical histories. Clinical examination, including general and cardiovascular examinations, was done. Height, weight and waist circumference were measured and body mass index (BMI Kg/m 2) was calculated. Laboratory investigations included measurements of fasting blood glucose, lipid profile and uric acid; as well as, electrocardiographic examination (ECG). Coexistence of more than 2 conventional risk factors or diabetes mellitus (DM) or new and old coronary artery disease (CAD) defined CHRS. Vanillyl mandelic acid (VMA) was measured in 24 hours urine samples as a stress indicator for a randomly selected sub-sample from those with CHRS (25 shift and 25 non-shift workers). The R-R deep breathing variability test on the resting ECG as a measure for autonomic function was done for the same group. Results: The study revealed that 42.5% of shift workers were complaining of deterioration in performance and concentration during work. In addition, 35.5% of shift workers had the desire to change shift work. Among shift workers, 36% were smokers in comparison to 26.5% of non-shift workers with a statistically significant difference (p = 0.04). Rates of hypertension, hypercholesterolemia, high LDLcholesterol, low HDL-cholesterol, hypertriglyceridemia, obesity and DM showed a statistically significant increase among shift workers than non-shift workers (p < 0.05). The overall rate of CHRS was significantly higher among shift workers (p = 0.001). Multiple logistic regression analysis of coronary high risk status as the dependant variable revealed that shift work kept a significant effect on CHRS even after adjustment for other confounders (p= 0.002). Mean level of urinary VMA was significantly higher for shift workers than non-shift workers (p= 0.0001); meanwhile, significantly lower R-R variability indices were recorded among shift workers than non-shift workers (p < 0.05). Conclusion and Recommendations: The present study revealed that shift work has a significant impact on CHRS that might be related to sympathetic over-activity. It is recommended to screen for coronary risk factors in pre-placement and periodic medical examinations of shift workers with implementation of special preventive programs. Urinary VMA and R-R variability testing in ECG could be used as stress indicators among CHRS shift workers. Cases of CAD should be excluded from shift work.

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