Assessment Of Work Capacity Research Articles

SPIROERGOMETRY TESTS OF PROFESSIONAL SOCCER PLAYERS TERMINATED AT MEDICAL INDICATIONS

Football is a functional sport requires speed, endurance, combinability and many others specific skills. In order to evaluate physical condition of professional football players different medical, sports and pedagogical, and functional tests are applied. Tests with loading are used for assessment of physical working capacity and the adaptation to physical loading. Spiroergometry tests give additional information about the condition of cardiovascular system and the aerobic capacity of the sportsmen.The aim of the study was to analyze results from spiroergometry tests of professional soccer players in Bulgaria.A group of 26 healthy professional soccer players, age 18-25 years, voluntary underwent spiroergometry test with veloergometer, with stepwise incremental physical loading on system AT-104 (Schiller, Switzerland). During investigation the heat rate (b. p. m.), levels of the systolic and the diastolic arterial blood pressure (mmHg), oxygen consumption (VO2, l/min), the volume of exhaled carbon dioxide (VCO2, l/min), and other functional indices were monitored. After the termination of each test the subject remains on the veloergometer for five minutes with 10% of the peak loading in order to recover the heart rate, levels of the arterial blood pressure, breathing rate etc. The anaerobic threshold (AT, calculated by VE/VCO2 slope method) and the heart rate recovery after physical loading were terminaed using software. The results of the tests were divided in two groups – the test was terminaed at the subject’s request (N, 15 tests), and test terminated at hypertonic blood pressure reaction (HR, 8 tests). Three tests were terminated at other medical indications. Results were presented as X±SD. An independent samples t test was used (SPSS, v. 13).Surprising 42% of the tests in present study were terminated at medical indications. The major reason for medical termination of the test was hypertonic blood pressure reaction - 72%. There were no differences in the body mass index between the groups. The loading at the range of the AT, heart rate at AT and blood pressure at the level of the AT between the groups were without significant differences. The recovery period was normal in both groups. VO2, the heart rate, levels of the systolic and the diastolic blood pressure at the different levels of physical loading were similar in group N and HR. We found out lower age of group N as compared with group HR (20.36±1.63 vs. 22.63±4.37 years, P<0.05), and higher maximal levels of the systolic and the diastolic blood pressure in HR (P<0.05).Regardless of the good physical condition of the professional soccer players 42% of the tests in the study were terminated at medical indications. Despite the little difference in the age between the groups it was significant. The basic functional indices were similar in each step of physical loading. Diseases were not found in the participants. Results of our study confirm necessary of applying functional tests. The data pay attention at the influence of the age and quality medical care in professional sport.

Interpretative accounts of work capacity assessment policy for young adults with disabilities

Young adults with disabilities are a specific target of the welfare-to-work policy introduced by many OECD countries over the past decade. The implementation of these policies is a significant concern for service delivery organisations and advocates in Australia and internationally due to complex intersecting structural barriers that persist for many young adults with disabilities. A particular focus of this article is work capacity assessments. Drawing on socio-political theories and interpretive policy analysis, the 22 in-depth interviews with personnel from service delivery organisations and advocacy organisations reveal how the deemed capacity to work process is not only interpreted as flawed, but the current policy approach disables young adults, perpetuates stigma, and creates division between service users and service providers. The accounts reinforce the need to contest such assessments and instead turn towards a rights-based capability approach permitting young adults with disability self-determination over their education-to-employment pathway.

The capacity to work puzzle: a qualitative study of physicians\u2019 assessments for patients with common mental disorders

BackgroundEntitlement to sickness benefits is a legal process requiring health-related reduced work capacity confirmed by a physician via a sickness certificate. However, there is a knowledge gap concerning physicians’ clinical practice of work capacity assessments for patients with common mental disorders (CMD). Physicians claim more knowledge and skills in how to actually do the assessments. The aim of this study was to explore physicians’ tacit knowledge of performing assessments of capacity to work and the need for sickness absence in patients with depression and anxiety disorders.MethodsWe performed a qualitative study with open-ended interviews and a short video vignette of a physician and a patient with depression as stimuli. Participating physicians (n = 24) were specialized in general practice, occupational health or psychiatry and experienced in treating patients with depression and anxiety. Interviews were audio-recorded and transcribed verbatim. Inductive content analysis was used as the analytical tool.ResultsFive categories were identified. Category 1 identified work capacity assessment as doing a jigsaw puzzle without any master model. The physicians both identified and created the pieces of the puzzle, mainly by facilitating strategies to make the patient a better supplier of essential information. The finished puzzle made up a highly individualized comprehensive picture required for adequate assessment. Categories 2–4 identified the particular essential pieces of information the participants used, relating to the patient’s disorder, capacity in the work place and contextual everyday life. For the sickness absence assessment, apart from decreased work capacity, the physicians also took particulars of the work place into account; e.g. could the work place handle an employee with reduced capacity.ConclusionsPhysicians’ tacit knowledge of assessing work capacity and the need for sickness absence for patients with CMD was identified as doing a jigsaw puzzle. The physicians became identifiers and creators of the pieces of the puzzle using a broad palette of essential information. Our findings contribute to the knowledge gap on clinical assessment and can be used as an educational tool. Because they are based on the professions’ tacit knowledge, acceptance of the model can be expected to be high.

Where is Occupational Medicine Going?

Occupational medicine, Occupational and Environmental medicine, Industrial Hygiene, Occupational and Sports medicine, Protection at Work, whatever it is called in different countries, this is an extraordinary important branch of preventive medicine. In some European countries, occupational medicine as a scientific study lost its recognition, starting from health centres to medical schools. The question to be asked is whether such an automatic negation of a new danger is positive, not only for the reason of the lost dignity, but also because of endangering community and environment. For a long while now we witness the results of low rating and significance of the occupational medicine. The traffic accidents and misuse of firearms have increased, as well as sudden deaths of young athletes at sports events, the number of work injuries and professional illnesses. Further question is the growing privatization and tendency of the total privatization of primary and specific healthcare, i.e. the whole health system except partially hospitals. The occupational medicine specialist at the open market losses the much needed neutrality and in order to keep the clients and survive, panders to contracted firms or to the workers. Furthermore, psychologists and psychiatrists that make a compulsory part of the occupational medicine teams, do inadequate work capacity assessments by overlooking specificity of the workplace. It is necessary to return dignity and independency to occupational medicine, so that it can achieve its primary task – assessment of work capacity, without any type of pressure. Trends of the modern occupational health services, visiting of work places, questioning and screenings have to be conducted but at the strong stationary Occupational medicine centres, preferably at scientific educational institutions.

Estimation of occupational safety risks at energetic sector of Iron and Steel Works

Modern methods of estimation of working conditions at the metallurgical enterprise are considered on the occupational safety due to European standards. The main approaches are identified in determination of hazards at work, assessing of technological risks and injuries as an example for one of the Iron and Steel Works,Mariupol,Ukraine. The purpose of this work is to analyze the effectiveness of the introduction of international methods in the field of health safety, assess the effectiveness of the safety management system at an industrial enterprise. The analysis of the process of implementing European standards in the field of the health safety at industrial enterprises is a prerequisite for their further successful application, reducing the level of injuries. The procedures for drawing up the matrix of risk assessment (HAZID method), assessment of working capacity of technological processes (HAZOP method), and safety assessment of works (ISA method) are considered. The analysis of the efficiency of measures to increase of health safety in the energy (gas) sector at the enterprise was carried out. A graph of the dynamics of the decline in industrial injuries in five years is shown. The main statistical indicators that are used to account for industrial injuries at an industrial enterprise are given.

Assessing work disability for social security benefits: international models for the direct assessment of work capacity

Purpose: It has been argued that social security disability assessments should directly assess claimants’ work capacity, rather than relying on proxies such as on functioning. However, there is little academic discussion of how such assessments could be conducted.Method: The article presents an account of different models of direct disability assessments based on case studies of the Netherlands, Germany, Denmark, Norway, the United States of America, Canada, Australia, and New Zealand, utilising over 150 documents and 40 expert interviews.Results: Three models of direct work disability assessments can be observed: (i) structured assessment, which measures the functional demands of jobs across the national economy and compares these to claimants’ functional capacities; (ii) demonstrated assessment, which looks at claimants’ actual experiences in the labour market and infers a lack of work capacity from the failure of a concerned rehabilitation attempt; and (iii) expert assessment, based on the judgement of skilled professionals.Conclusions: Direct disability assessment within social security is not just theoretically desirable, but can be implemented in practice. We have shown that there are three distinct ways that this can be done, each with different strengths and weaknesses. Further research is needed to clarify the costs, validity/legitimacy, and consequences of these different models.Implications for rehabilitationIt has recently been argued that social security disability assessments should directly assess work capacity rather than simply assessing functioning – but we have no understanding about how this can be done in practice.Based on case studies of nine countries, we show that direct disability assessment can be implemented, and argue that there are three different ways of doing it.These are “demonstrated assessment” (using claimants’ experiences in the labour market), “structured assessment” (matching functional requirements to workplace demands), and “expert assessment” (the judgement of skilled professionals).While it is possible to implement a direct assessment of work capacity for social security benefits, further research is necessary to understand how best to maximise validity, legitimacy, and cost-effectiveness.

Are there patient-related factors that influence sickness certification in patients with severe subjective health complaints? A cross-sectional exploratory study from different European countries

ObjectivesTo develop hypotheses about whether there are patient-related factors that influence physicians’ decision-making that can explain why some patients with severe subjective health complaints (SHCs) are more likely to be...

Generic work capacity assessment tool for working conditions in India: Preliminary results of development and standardization

BACKGROUND: The work capacity assessment (WCA) tool is a new tool developed specifically to assess worker suitability for working conditions in India. This study presents the preliminary results of reliability (interrater) and internal consistency of the WCA tool. AIMS: The aim of this study is to develop a work capacity tool for working conditions in India. MATERIALS AND METHODS: The steps for instrument development were followed stringently. The newly developed tool addressed three categories of work: heavy manual labor, sustained labor, and sedentary work. Four participants in heavy manual labor, five in sustained labor, and five in sedentary work performed activities specified by the new scale; videography was done simultaneously. STATISTICAL ANALYSIS: Internal consistency between the items in the scale was ascertained by Cronbach's alpha. Spearman's rank correlation coefficient was calculated for intertester reliability. RESULTS AND CONCLUSIONS: Some items in each of the three categories were removed from the final tool due to lack of variance between participants. After omitting these items, alpha was 0.65 and 1 in heavy manual labor, 0.95 and −0.14 in sustained labor, and 0.83 in sedentary work. All test items with the exception of isometric strength and posture sustainability in heavy manual labor correlated well with other items (>0.7). The final tool is fairly robust in terms of internal consistency and reliability. This is a preliminary report, and the tool needs to be further validated before clinical use on a larger and heterogeneous population.

Physicians’ work with assessment of work capacity in sickness certification – a review

Physicians’ work with assessment of work capacity in sickness certification – a review

Determinants of Grip Strength in Tunisian Nurses: A Bicentric Study.

BackgroundGrip muscle force has always been used to assess functional limitations in elderly. Its use as a tool to assess work capacity has never been described in the literature.ObjectiveTo describe the patent determinants of grip strength and the usefulness of its measurement in assessing workability index in the healthcare sector.MethodsThis is a cross-sectional study conducted in a sample of 293 healthcare workers representative of 1181 based on a comprehensive questionnaire about socio-professional characteristics and on an 8-item work capacity evaluation (WAI). Besides, Body mass index was measured and muscle strength was assessed by JAMAR hydraulic dynamometer.ResultsHandgrip Strength was stronger in male nurses (p < 0.001), with low perceived physical load (p = 0.0001) and working on a night shift (p = 0.001). It decreased with a greater duration of household work (p < 0.0001) and increased with a greater BMI (p = 0.015) and a better workability index (p < 0.0001). After removal of all the variables that were not independently associated with the muscle strength force, factors accounting for 52.6% of the variance in nurses handgrip strength were gender (p < 0.001), workability index (p < 0.001), duration of household work (p = 0.021), BMI (p = 0.002), perceived physical load (p < 0.001) and work schedule (p = 0.002).ConclusionGrip Strength Test is a useful tool to assess strength and functional capacity at work in healthcare workers. Further longitudinal studies are required to confirm this hypothesis.

МОРФОФУНКЦИОНАЛЬНАЯ ХАРАКТЕРИСТИКА МОНОЦИТОВ ПЕРИФЕРИЧЕСКОЙ КРОВИ И ИХ ПРЕДШЕСТВЕННИКОВ У ПОТОМСТВА САМОК КРЫС С АУТОИММУННЫМ ПОРАЖЕНИЕМ ПЕЧЕНИ

Aim. The aim is to study overall and special working capacity in skilled kickboxers at two stages of pre-contest conditioning. Research organization and methods. The study was conducted using Schiller ergospirometric device (Switzerland) and Oxycon Pro (Mobile) telemetry unit (Germany). Results. The assessment of overall working capacity in kickboxers revealed significant reserves of anaerobic threshold, pulmonary volume, respiratory rate, and lung ventilation. Gas exchange factor was between от 0.837 (at rest) and 0.94 (when anaerobic threshold was reached); at the maximum load this factor was 1.10. Systolic pressure values indicated high cardiovascular stress in athletes during the functional test. Special endurance assessment involved analysis of oxygen consumption and carbon dioxide production charts. Conclusion. At the conditioning stage immediately prior to competitions we observed higher rate of lactic acid neutralization in the working muscles which indicated the higher rate of adaptation to the applied loads.

Obstetricians/Gynecologists' Problems in Sickness Certification Consultations: Two Nationwide Surveys.

Objective. To explore experiences by physicians working in obstetrics, gynecology, or maternal healthcare (O/Gs) of problems in sickness certification consultations and differences between two years. Material and Methods. Answers by O/Gs to two Swedish nationwide surveys, in 2008 (n = 1037) and 2012 (n = 992), were analyzed for frequencies and severity of problems and organizational support in sickness certification consultations. Results. One-third of O/Gs found sickness certifications problematic every week. The most frequent problem was patients requesting sick notes for reasons other than work incapacity due to disease/injury (2008: 21%; 2012: 16%). The most problematic were assessing work capacity (2008 and 2012: 52%) and having different opinion from that of the patient about need for sick leave (2008: 51%; 2012: 46%). In 2012, 27% used the national sickness certification guidelines weekly, compared to 9% in 2008. A larger proportion in 2012 than 2008 reported that the guidelines facilitated contacts with patients and different stakeholders. Conclusions. Although O/Gs perceived sickness certification as problematic, there was less perceived severity of problems in 2012 compared to 2008, possibly because interventions regarding sickness certification have been introduced in Sweden recent years. Still, more organizational support, for example, time and supervision, are needed to enhance O/Gs' sickness certification practices.

Relevant Patient Data for Health Information Exchange: A Delphi Method Study among Occupational Health Professionals

Objective: To examine which data on patients’ primary care visits are considered relevant for documentation in the electronic records of occupational health services, to enable health information exchange between occupational health care professionals, the employee, employer, other health care professionals, and social insurance system actors. Methods: We used the Delphi method to evaluate which electronic health data are considered relevant for patient health information exchange by 37 occupational health team members (physicians, nurses, physiotherapists, and psychologists). The surveys were conducted in three rounds. The response rates to the consecutive electronic questionnaires were 76%, 73% and 73%. We used content analysis to analyze the data. Results: The most relevant electronic patient data for health information exchange were individual action plans and their follow-ups, work-related primary care visits, professional assessment of employee's work capacity and the ability to cope at work, and work-related diseases and reported symptoms. Conclusion: The results show that occupational health professionals considered structurally documented electronic health records relevant for patient health information exchange between occupational health services and the employee, employer, other health care professionals and social insurance system actors. The National Patient Data Repository (Kanta) was considered one means with which to implement electronic health records in occupational health services. These results can be used in the further development of data structures and information exchange in occupational health services.

Metodologija istraživanja profesionalnog stresa kod radnika zaposlenih na radnim mestima sa povećanim rizikom po zdravlje

Introduction: Some professions are somewhat more exposed to stress and their working conditions are a subject of research for a long time, along with the occurrence of stress and its impact on their health. Research on professional stress among employees at workplaces with special health risks is of special importance. The aim of the paper is to point out the methodological approach to the research of professional stress among workers employed in workplaces with increased health risk. Methods: We analyzed the data and literature in the field of occupational medicine, internal medicine, psychology, neuropsychiatry, public health, quality of life and health statistics in the part relating to the impact of stress on human health, with particular emphasis on the methodology to be applied in pursuance these investigations. Results and discussion: Law on safety and health at work ('Official Gazette of the Republic of Serbia', No 101/05) and Rule book on the manner and procedure of risk assessment at the workplace and working environment ('Official Gazette of the Republic of Serbia', No 72/06) still do not have a measurement of the level of stress at work among the existing methods for risk assessment. The fact is that concern for the mental health of employees is not a luxury but a professional obligation of employers. Methods used to evaluate stress at work can be subjective, objective and intermediate. Subjective methods are questionnaires or self-evaluation, where workers evaluate the level of their own problems, demands and the weight of their work, interpersonal relations, etc. Objective methods include determining the level of cortisol and catecholamines in urine. Intermediate methods are partly subjective and include talking with other workers, the analysis of sick leaves, analysis of workplaces with increased risk, productivity analysis, injuries at work, the most common diseases among a group of employees, an interview with superiors, company management and others. To assess the subjective experience of stress in the workplace and identify stressors, many types of questionnaires are being used. In all studies, it is necessary to take basic data about the respondents, and appropriate questionnaires already designed, so-called Respondents' Basic Demographic Indicators Questionnaire. In addition, it is necessary to use the Work Ability Index Questionnaire, which is a good instrument for the assessment of work capacity. IRS Questionnaire is used for assessing the sources of stress at work. General Health Questionnsire - GHQ (Goldberg, D, Williams, P, 1991) measures the feeling of anxiety, depression, inability to defend, insomnia based on anxiety, lack of self-confidence and self-esteem and other symptoms of psychological disorders functioning. Copenhagen Burnout Inventory (CBI) is a questionnaire that includes tests relating to personal burnout, burnout at work and client burnout. Study is based on modern methods of statistical data processing. The use of these questionnaires provides a comparison of our results with the results of the research of other domestic and foreign researchers. Conclusion: It is necessary that specific working conditions, the occurrence of stress and its impact on health become a subject of more extensive research, with specially designed questionnaires. Not all questionnaires can be used in any working population, because the factors that cause stress differ in type, scale and duration. It is necessary to adapt the set of questionnaires to respective type of activity, so that those that provide accurate results when assessing stress in certain professions can be used next to the general questionnaires. Usage of the appropriate sets of questionnaires in research of professional stress among workers employed in workplaces with increased health risk enables getting valid results and allows comparison of the obtained results with the results of relevant domestic and foreign research.

Correspondence in Stakeholder Assessment of Health, Work Capacity and Sick Leave in Workers with Comorbid Subjective Health Complaints? A Video Vignette Study

Purpose The purpose of this study is to test if there is correspondence in stakeholders’ assessments of health, work capacity and sickness certification in four workers with comorbid subjective health complaints based on video vignettes. Methods A cross sectional survey among stakeholders (N = 514) in Norway in 2009/2010. Logistic regression and multinomial logistic regression was used to obtain the estimated probability of stakeholders choosing 100 % sick leave, partial sick leave or work and the estimation of odds ratio of stakeholder assessment compared to the other stakeholders for the individual worker. Results The supervisors were less likely to assess poor health and reduced work capacity, and more likely to suggest partial sick leave and full time work compared to the GPs for worker 1. The public was less likely to assess comorbidity and reduced work capacity, and 6 and 12 times more likely to suggest partial sick leave and full time work compared to the GPs for worker 1. Stakeholders generally agreed in their assessments of workers 2 and 3. The public was more likely to assess poor health, comorbidity and reduced work capacity, and the supervisors more likely to assess comorbidity and reduced work capacity, compared to the GPs for worker 4. Compared to the GPs, all other stakeholders were less likely to suggest full time work for this worker. Conclusions Our results seem to suggest that stakeholders have divergent assessments of complaints, health, work capacity, and sickness certification in workers with comorbid subjective health complaints.

Problems with sickness certification tasks: experiences from physicians in different clinical settings. A cross-sectional nationwide study in Sweden.

BackgroundMany physicians find sickness certification of patients problematic. The aims were to explore problems that physicians in different clinical settings experience with sickness certification tasks in general and with assessment of function, work capacity, and need for sick leave, as well as handling of sick-leave spells of different durations.MethodsData from a questionnaire sent to 33 144 physicians aged <68 years, living and working in Sweden in 2012 were analysed. The response rate was 57.6 %. The study group comprised the 12 933 responders who had sickness certification tasks. Frequencies and odds ratios with 95 % confidence intervals were calculated for questions concerning how problematic the physicians experienced different assessments related to patients’ function, work capacity, and need for sick leave, as well as handling sick-leave spells of different durations.ResultsThere were large differences between clinical settings regarding how often and to what extent sickness certification consultations were perceived as problematic. Physicians working in primary health care (PHC) had the highest proportions experiencing sickness certification consultations as problematic at least once a week (49.5 %) and as very or fairly problematic (56.6 %), followed by physicians working in psychiatry, pain management, or orthopaedics. More than half of the responders found it very or fairly problematic to assess patients’ work capacity (57.8 %), to make a long-term prognosis about patients’ future work capacity (55.7 %), and to handle long-term or very long-term sickness certifications (51.9 % and 51.8 %). The proportions were highest among physicians working in PHC, rheumatology, neurology, or psychiatry.ConclusionsThe rates of physicians finding sickness certification task problematic varied much with clinical setting, and were highest among physicians in PHC. More knowledge is needed about the work conditions and prerequisites for optimal handling of sickness certification in different clinical settings.

Effect of theme preview-case study on clinical training for nursing students in Cardiology Department

Objective To discuss the effect of theme preview-case study on clinical training for nursing students in Cardiology Department. Methods A total of 56 clinical nursing interns of cardiology in January 2013 to December 2013 were selected as observation group, 54 clinical nursing interns of cardiology in January 2012 to December 2012 were selected as control group. The students of the control group underwent traditional infusion teaching method, while students of the observation group received theme preview-case study based on traditional method. We compared the comprehensive ability of nursing students, the satisfaction of clinical teachers to nursing students and the satisfaction of nursing students to clinical teachers after training. Results After training, (93.4±3.5) scores had been acquired in the observation group, which was higher than (84.8±4.6) in the control group (t=-3.898, P 0.05), but had statistical significance at work attitude, learning enterprise, errors, work capacity and total assessment (P<0.05); the nursing teaching method, occupational teaching contents, teaching attitudes and total scores had statistical significance (P<0.05). Conclusions The theme preview-case study teaching method can improve the comprehensive ability and learning interesting of nursing students in Cardiology Department, and improve the interns′ job satisfaction and the interns′ satisfaction for teacher′s job. Key words: Teaching method; Cardiology Department; Teaching effect

Impact of legal regulations and administrative policies on persons with SCI: identifying potential research priorities through expert interviews

Purpose: To identify research gaps and potential research priorities regarding the impact that legal regulations and administrative policies might have on people with spinal cord injury (SCI) living in Switzerland. Method: We conducted semi-structured interviews with 14 healthcare professionals working for or being associated with the largest SCI clinic in Switzerland. The transcribed interviews were content analyzed, involving qualitative description, and thematic analysis techniques. Results: Four interrelated clusters of issues were corroborated: (1) social insurance, (2) caregiving, (3) work integration, and (4) aging. In addition, two overarching themes were identified: (1) fairness considerations and (2) unavailability of systematic empirical evidence. Work capacity assessment and family caregiving were deemed to be the most pressing research priority areas. Conclusions: Legal frameworks do play both a direct and an indirect role in the lives of people with SCI in Switzerland. This is particularly true with regard to various issues related to the social insurance system, such as family caregiving and work capacity assessment. The salience of these topics is closely related to major sociodemographic and political driving forces, i.e. aging and social insurance reforms. Research directly involving people with SCI is needed to further substantiate and refine the findings of this study.Implications for RehabilitationWhen dealing with issues related to work reintegration, aging, social insurance, and caregiving, rehabilitation professionals should take existing legal frameworks into account.Eligibility criteria for disability benefits may influence the therapy motivation of rehabilitation clients.

The algorithm for the assessment of functional work capacity of railway workers with chronic obstructive pulmonary disease (COPD)

The assessment of functional work capacity based on the biological function of the body and a specific job demands and job characteristics, determine whether a person is capable to do the job or group of jobs. Evaluation of work capacity (EWC) railway workers is conducted according to the program of Regulations for the former and periodic examinations of employees in workplaces with high risk published in the Official Gazette of RS no. 120/ 07 and 655. Regulations on health conditions to be met by railway workers, who are directly involved in railway transport. One of the most common chronic diseases during EWC is chronic obstructive pulmonary disease (COPD). The definition of contraindications for use of railway employees with COPD given by Ordinance 655 is in very general terms, trying to make it easier and improve the quality of assessment of work capacity, we have developed an algorithm for the assessment of work ability among these workers. When doubt the existence of COPD should first prove that the disease exists, according to GOLD (Global Initiative for Chronic Obstructive Lung Disease) guidelines, and for occupational medicine we considered important to clarify and standardize the assessment criteria for EWC, which resulting in a diagnostic algorithm for EWC. It is also important to know which type of job will worker to do. Application of a diagnostic algorithm in EWC will allow optimal assessment of disease severity in railway and other workers suffering of COPD working at the workplace with an increased risk efficacy treatment evaluation; assess compensation of functional defects and determine schedule of periodical examination.

Physical fitness profile of professional Italian firefighters: Differences among age groups

Firefighters perform many tasks which require a high level of fitness and their personal safety may be compromised by the physiological aging process. The aim of the study was to evaluate strength (bench-press), power (countermovement jump), sprint (20 m) and endurance (with and without Self Contained Breathing Apparatus – S.C.B.A.) of 161 Italian firefighters recruits in relation to age groups (<25 yr; 26–30 yr; 31–35 yr; 36–40 yr; 41–42 yr). Descriptive statistics and an ANOVA were calculated to provide the physical fitness profile for each parameter and to assess differences (p < 0.05) among age groups. Anthropometric values showed an age-effect for height and BMI, while performances values showed statistical differences for strength, power, sprint tests and endurance test with S.C.B.A. Wearing the S.C.B.A., 14% of all recruits failed to complete the endurance test. We propose that the firefighters should participate in an assessment of work capacity and specific fitness programs aimed to maintain an optimal fitness level for all ages.