Screening for risk factors of arteriosclerosis in occupational medicine with special consideration of serum lipids: implications for health policy.
Increasing emphasis is being placed on preventive medicine, which has been neglected in the past, compared to curative medicine. Occupational medicine is destined to play a major role in this advance of preventive medicine. One area which requires more involvement is the performance of screening examinations for risk factors (RFs) at the workplace--not only related to effects of potentially hazardous materials or working conditions, but also to the employee's general health state, directly associated with long-term work performance. Cardiovascular diseases, especially arteriosclerotic coronary artery disease (CAD), is responsible for considerable morbidity and the majority of deaths in industrialized countries. Screening programs in occupational medicine involving RFs in this area should be improved in the future. Screening procedures for the major RFs: hypertension, diabetes and nicotine abuse, are generally better understood and implemented than those for hyperlipoproteinemia, although the latter is probably highest on the list of major RFs of CAD. To clarify this issue we studied 350 persons, using an oral fat tolerance test applied after fasting. Results showed that fasting and postprandial serum total cholesterol (TC), low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) concentrations remain essentially unchanged after a fat-rich meal, while triglyceride (TG) levels vary considerably, from no change to great increases, different and characteristic for each individual. The practical significance for screening programs in occupational medicine is that lipid screening tests needs to concentrate only on TC, LDL-C and HDL-C, need not include TG, and do not require employees to be in a fasting state, but can be carried out at any time.
Schmahl
F W
FW
Department of Occupational and Social Medicine, University of Tübingen, Germany.
Kahle
P F
PF
D003324:Coronary Artery Disease / Q000097:blood / Q000453:epidemiology / Q000517:prevention & control*; D005215:Fasting; D006291:Health Policy; D006801:Humans; D008055:Lipids / Q000097:blood*; D008403:Mass Screening; D009786:Occupational Health Services; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood
D008055:Lipids; D014280:Triglycerides