[Syncope and professional driving: the role of the occupational physician].
BACKGROUND
Road traffic injuries constitute one of the main causes of death and disability in Italy and in the European Union. Although much scientific evidence exists on the important role of complete loss of consciousness in the dynamics of motor vehicle accidents, at present there is no specific legislation in Italy. Occupational medicine should take particular care in this field, because every year a large number of accidents with fatal outcomes occur among truck drivers. Via health surveillance, the occupational physician can play an important role in the prevention of such events.


OBJECTIVE
The aim of this article is to discuss some possible strategies of health surveillance, comparing the current Italian regulations with the recent guidelines of the European Society of Cardiology (ESC) Task Force regarding the association of syncope and road transport.


CONCLUSIONS
Current Italian legislation does not include specific prescriptions in case of syncope in truck drivers. This deficiency leads to a lack of information for occupational physicians in order to define unanimous judgements of work fitness. The authors attempted to apply the ESC guidelines on syncope and truck driving to the Italian situation. Four cases of syncope were described, in which the judgement of work fitness for truck drivers proved to be especially complex and stressed the need for cooperation between occupational health physicians and cardiologists.
Rosso
G L
GL
Dipartimento di Malattie Cardiovascolari, Ospedale Santa Croce-Carle, Cuneo. rossogl@libero.it
Zanelli
R
R
Bruno
Santina
S
Feola
M
M
D000062:Accidents, Occupational / Q000517:prevention & control* / Q000706:statistics & numerical data; D000063:Accidents, Traffic / Q000517:prevention & control* / Q000706:statistics & numerical data; D000328:Adult; D001334:Automobile Driving / Q000331:legislation & jurisprudence / Q000592:standards; D053840:Brugada Syndrome / Q000150:complications; D002309:Cardiology; D017115:Catheter Ablation; D003937:Diagnosis, Differential; D004198:Disease Susceptibility; D017408:Guidelines as Topic; D006801:Humans; D007400:Interprofessional Relations; D007558:Italy; D008004:Licensure / Q000331:legislation & jurisprudence* / Q000592:standards; D008193:Lyme Disease / Q000150:complications / Q000188:drug therapy; D008297:Male; D018986:Motor Vehicles; D009787:Occupational Medicine; D010819:Physician's Role; D012008:Recurrence; D018570:Risk Assessment; D012955:Societies, Medical; D013575:Syncope / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D019462:Syncope, Vasovagal / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D013617:Tachycardia, Supraventricular / Q000150:complications / Q000601:surgery; D014938:Work Capacity Evaluation