Buerger’s Disease and Fitness for Work in a Flight Personnel: A Case Report

Abstract

Buerger’s disease, also called thromboangiitis obliterans (TAO), is an inflammatory disease affecting small and medium size blood vessels of the limbs. Several risk factors are strongly associated with this disease. In fact, heavy smokers represent 99% of patients diagnosed with Buerger’s disease and smoking cessation can slow down the progression of the pathology. Ulcers and gangrene are very common complications and TAO may also cause a vasculitis as well as ischemic damage to the distal part of the limbs that can eventually lead to limb amputation. Here, we report the case of a 43 years old patient, a flight personnel working in a Tunisian airline company who consults for a lesion of the left toe that appeared 2 weeks ago. He is a chronic inveterate smoker with 36 pack-years. The diagnosis of TAO was made based on the clinical presentation and the results of the Doppler Ultrasound of the left toe. This disease has a major impact on the quality of life due to the risk of necrotic ulcers and amputation. Navigation is a profession that requires a high level of physical and mental fitness. According to the international and Tunisian standards, the applicant or the holder of medical certificate must not have a cardiovascular condition that may affect the safety of the exercise.