title: Driving and working with syncope.
abstract: Syncope is usually addressed in the Emergency Department (ED) by the doctor in charge of the clinical picture, i.e. the patient's risk is stratified, a diagnostic work-up is done and a prognosis is set. Patients are ultimately admitted to hospital or discharged. However, other aspects related to syncope may deeply affect their daily lives. These include how and when to return to work and to driving, the feelings about a recent loss of consciousness, and the potential relapse of syncope. This is particularly significant if the work setting is intrinsically hazardous. These patients need adequate clinical and psychological support. For patients with syncope, two main parameters should be considered regarding returning to work and to driving. The first is to evaluate the risk of syncope recurrence and the second is to consider the expected harm if syncope does indeed occur during these activities. In the present paper we detail the problem of driving (including professional driving) and work after syncope. We propose a new quantitative model that will guide the physician in stratifying the risk for patients who have had a previous syncope event. The new model considers the syncope recurrence risk, the job task duration, and features that facilitate a syncope during work. On the basis of these variables, the global risk index for a worker is calculated. Following appropriate validation, this method might help ED and occupational physicians in their decision-making process with the goal of safely readmitting syncope patients to the workplace.
authors.affiliation: Internal Medicine, BIOMETRA Department, Humanitas Clinical and Research Center, Rozzano (MI), University of Milan, Italy. Electronic address: franca.barbic@humanitas.it.
authors.forename: Franca
authors.initials: F
authors.lastname: Barbic
authors.affiliation: Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Casazza
authors.affiliation: Internal Medicine, BIOMETRA Department, Humanitas Clinical and Research Center, Rozzano (MI), University of Milan, Italy; Department of Physical Therapy, Federal University of Sao Carlos, Brazil.
authors.forename: Antonio Roberto
authors.initials: AR
authors.lastname: Zamunér
authors.affiliation: Division of Medicine and Pathophysiology, Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Costantino
authors.affiliation: Internal Medicine, BIOMETRA Department, Humanitas Clinical and Research Center, Rozzano (MI), University of Milan, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Orlandi
authors.affiliation: Internal Medicine, BIOMETRA Department, Humanitas Clinical and Research Center, Rozzano (MI), University of Milan, Italy.
authors.forename: Franca
authors.initials: F
authors.lastname: Dipaola
authors.affiliation: Internal Medicine, BIOMETRA Department, Humanitas Clinical and Research Center, Rozzano (MI), University of Milan, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Capitanio
authors.affiliation: Internal Medicine, BIOMETRA Department, Humanitas Clinical and Research Center, Rozzano (MI), University of Milan, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Achenza
authors.affiliation: Department of Cardiac Sciences, University of Calgary, Canada.
authors.forename: Robert
authors.initials: R
authors.lastname: Sheldon
authors.affiliation: Internal Medicine, BIOMETRA Department, Humanitas Clinical and Research Center, Rozzano (MI), University of Milan, Italy.
authors.forename: Raffaello
authors.initials: R
authors.lastname: Furlan
mesh_terms: D001334:Automobile Driving; D004651:Employment; D006801:Humans; D008962:Models, Theoretical; D012306:Risk; D013575:Syncope / Q000175:diagnosis
keywords: Driving; Occupational safety; Syncope; Working