Physical constraints prevent return to work after coronary episode

Among people who suffer a coronary event, return to work (RTW) is hindered by occupational physical constraints, a recent study has found.

Drawing from the online databases of PubMed, Web of Science, and Cochrane, the researchers retrieved 43 prospective studies for meta-analysis, totaling 34,964 patients. Coronary events assessed included myocardial infarction, acute coronary syndrome, and angina pectoris. Determinants of RTW were follow-up duration, occupational factors, and date of recruitment, among others.

The overall RTW rate was 81.1 percent, with substantial heterogeneity of evidence. Stratifying according to coronary events showed that RTW was highest for stable angina and elective interventions, at 83.6 percent, followed by acute events, which yielded an RTW rate of 80.3 percent. When the event was not clearly defined, the resulting RTW was 77.4 percent.

White-collar workers were more likely to return to work than blue-collared counterparts, though the difference was not significant (81.2 percent vs 65.0 percent). Similarly, RTW was higher among those with low physical workloads than in patients whose jobs were physically demanding (78.3 percent vs 64.1 percent).

“Given the few studies investigating the stress conditions at the workstation, this occupational factor should be considered in future research to identify patients in need of psychosocial assistance to support them with appropriate interventions. Physical constraints should also be systematically examined in future studies,” the researchers said.

“We note the need to implement further studies to determine the occupational conditions which could play a role in earlier work resumption,” they added.