Vasovagal Syncope at Work: A Narrative Review for an Occupational Management Proposal

Syncope is a complex clinical manifestation that presents considerable diagnostic difficulties and, consequently, numerous critical issues regarding fitness for work, especially for high-risk tasks. To date, it is impossible to quantify the exact impact of syncope on work and public safety since it...

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Bibliographic Details
Published in:	International journal of environmental research and public health Vol. 20; no. 8; p. 5460
Main Authors:	Corvino, Anna Rita, Russo, Vincenzo, Monaco, Maria Grazia Lourdes, Garzillo, Elpidio Maria, Guida, Daniele, Comune, Angelo, Parente, Erika, Lamberti, Monica, Miraglia, Nadia
Format:	Journal Article
Language:	English
Published:	Switzerland MDPI AG 11-04-2023 MDPI
Subjects:	Accidents Blood pressure Cardiovascular disease Consciousness Construction equipment Diagnosis Disease prevention Driving ability Electrocardiography Emergency medical care Employment Fainting Fireworks Flow charts Fludrocortisone Heart Humans Hypoxia Literature reviews Occupational accidents Occupational exposure Occupational Health Older people Pacemaker, Artificial - adverse effects Pacemakers Patients Public safety Public transportation Quality of life Review Risk levels Safety and security measures Syncope Syncope - complications Syncope, Vasovagal - diagnosis Syncope, Vasovagal - etiology Transportation Trauma Vasovagal syncope vasovagal syncope occupational safety risk return to work worker management
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Summary:	Syncope is a complex clinical manifestation that presents considerable diagnostic difficulties and, consequently, numerous critical issues regarding fitness for work, especially for high-risk tasks. To date, it is impossible to quantify the exact impact of syncope on work and public safety since it is highly improbable to identify loss of consciousness as the fundamental cause of work or driving-related accidents, especially fatal injuries. Working at high-risk jobs such as public transport operators, in high elevations, or with exposure to moving parts, construction equipment, fireworks, or explosives demand attention and total awareness. Currently, no validated criteria or indicators are available for occupational risk stratification of a patient with reflex syncope to return to work. By drawing inspiration from the updated literature, this narrative review intends to summarise the leading knowledge required regarding the return to work for subjects affected by syncope. According to the available data, the authors highlighted some key findings, summarised in macro-items, such as defined risk stratification for vasovagal accidents, return to work after a critical event, and a focus on pacemaker (PM) implementation. Lastly, the authors proposed a flowchart for occupational physicians to help them manage the cases of workers affected by syncope and exposed to levels of risk that could represent a danger to the workers' health.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-3 content type line 23 ObjectType-Review-1 These authors contributed equally to this work.
ISSN:	1660-4601 1661-7827 1660-4601
DOI:	10.3390/ijerph20085460