48-hour ambulatory electrocardiography in dynamite workers and controls.

ABSTRACT Sudden deaths and chronic cardiovascular diseases have been reported in excess frequency from the explosives industry. Forty-two active dynamite workers and 43 healthy, unexposed workers have been studied by ambulatory electrocardiographic monitoring during two 24-hour periods covering an exposed shift and the “abstinence phase,” 40-64 hours after the last exposure to dynamite. To achieve comparability the non-exposed individuals were screened for risk factors of heart disease in the same way as those employed in exposed work. No statistically significant differences were found between the groups concerning the mean individual number of ventricular or supraventicular ectopic beats per hour or per 10 000 heart beats during the whole recorded time. Among those who showed only ectopic beats in one of the two periods dynamite workers tended to have more ectopic beats in the second period. “Complicated” ventricular ectopic beats (multifocal, bigemeny, or coupled) were seen in six dynamite workers and four controls. The only observed period of ventricular tachycardia was seen in a dynamite worker on Monday morning. The mean individual corrected QT-time was similar between the two groups, and there was no tendency towards longer QT-times among the dynamite workers during the abstinence period. Continuous monitoring detected several cases with pronounced ventricular arrhythmias despite normal short-time ECG and may be used to investigate the heart rhythm in active workers.