Workmen's compensation for the cardiac: Relationship of work to heart disease

Abstract

An attempt is made to discuss the question of whether ordinary work over a period of years may cause heart disease. It is pointed out that heart disease, as it is generally considered, cannot be caused by work, but atherosclerosis of the coronary arteries which eventually leads to heart disease may partly be caused by prolonged work over many years. The pathogenesis of the early phases of coronary atherosclerosis appears to be related to the hemodynamic changes in the coronary arteries. These may conceivably be influenced by intermittent alterations caused by work; by nonphysical activity associated with some forms of work; by emotional disturbances accompanying certain occupational pursuits; and by psychologic effects of monotony associated with work at automatic machinery in our modern industrial system. Inasmuch as the possible effects of work on the pathogenesis of coronary atheromatosis is gradual and there are undoubtedly a great many other factors which contribute to the pathogenesis of the disease, work cannot be considered causally related to the chronic pathologic process from a legal viewpoint. It is the acute phase of coronary disease which enters into the problem of causal relationship.