Scafa F, Calsamiglia G, Pala G, Perotti M R, Colombi R, Candura S M
Scuola di Specializzazione in Medicina del Lavoro, Università degli Studi di Pavia.
G Ital Med Lav Ergon. 2007 Jul-Sep;29(3 Suppl):441-3.
To evaluate the opportunity of exercise electrocardiography (ECG) in the sanitary surveillance of workers with physical strain, we estimated the energy consumption of the duties of 22 electrical workers (males; age: 35-56 years). They subsequently underwent Treadmill exercise ECG, determining for each worker the maximal METs (multiples of basal metabolism) and the critical potency (P(CRIT)). In one subject, myocardial ischemia arose 9 minutes after the beginning of the test. The others interrupted the test after 7-13 minutes for tiring; 5 of them showed ventricular extra systoles, paired or isolated. Twelve subjects presented arterial hypertension, at rest and/or during exercise. Ergonomic analysis revealed that the occupational duties were between 1.5 and 8.0 METs. The energy consumption of the job on the whole was 4-6 METs (medium intensity). The maximal METs reached by the examined subjects were between 8.8 and 15.6; however, only 11 workers went reassuringly over the 4 METs required by duty analysis at P(CRIT). One subject was declared unfit for the job, and a judgement of partial idoneity was expressed for 3 workers. Preventive and therapeutic indications were given to 12 subjects. Aerobic training was suggested to 10 workers. The study indicates that an ergonomic evaluation is advisable for the most energy consuming occupational duties. In such cases, the sanitary surveillance should include a cardiologic assessment with exercise ECG, reproducing the physical strain of the specific job.
为评估运动心电图（ECG）在体力劳动者卫生监督中的应用机会，我们估算了22名电气工人（男性；年龄：35 - 56岁）工作时的能量消耗。他们随后进行了平板运动心电图检查，为每位工人测定最大代谢当量（METs，基础代谢的倍数）和临界功率（P(CRIT)）。在一名受试者中，试验开始9分钟后出现心肌缺血。其他受试者在7 - 13分钟后因疲劳中断试验；其中5人出现成对或孤立的室性早搏。12名受试者在静息和/或运动时出现动脉高血压。人体工程学分析显示，职业任务的代谢当量在1.5至8.0之间。整体工作的能量消耗为4 - 6 METs（中等强度）。受试对象达到的最大METs在8.8至15.6之间；然而，在P(CRIT)时，只有11名工人超过了任务分析所需的4 METs，令人放心。一名受试者被判定不适合该工作，3名工人被判定部分合格。对12名受试者给出了预防和治疗建议。建议10名工人进行有氧训练。该研究表明，对于能量消耗最大的职业任务，进行人体工程学评估是可取的。在这种情况下，卫生监督应包括进行运动心电图的心脏评估，以再现特定工作的体力消耗。
