Occupational Medicine: State of the Art Reviews; Chapter 7: Assessment of the Cardiovascular System at the Workplace Authors: Peter Schnall, Karen Belkic, Tom Pickering
The obstacles and challenges of obtaining a cardiovascular disease history at the workplace are explored including the use and limitations of symptom data, the issue of false negatives and false positives, as well as the need for caution to avoid bias if symptoms are reported together with the self-report about exposure. A discussion of the various techniques of blood pressure (bp) measurement at the workplace is presented, including casual, self-measured, and ambulatory monitoring, their advantages and limitations, and their particular utility for the workplace. A new protocol for obtaining point estimates of bp at the worksite is outlined and its feasibility as an alternative to traditional measures of casual bp or ambulatory bp monitoring is assessed. In addition, other clinically-relevant endpoints which are sensitive, stress-mediated and measurable by ambulatory electrocardiographic monitoring are described.