Assessment of cardiac risk involves clinical assessment for category 1 and 2 rail safety workers, as well as calculation of cardiac risk score for Category 1 workers.
Clinical assessment includes the evaluation of information such as:
symptoms, such as chest pain or palpitations that may cause distraction from Safety Critical Work, as well as being a harbinger of possible collapse
family history, such as first-degree relatives having cardiovascular events in midlife
past history
comorbidities such as obesity, inactivity, obstructive sleep apnoea and depression
work factors such as exposure to climatic extremes in course of work
You will be requested to provide a Treating Doctor report if you have any of the following:
ECG changes at your rail safety worker health assessment
Known diagnosed cardiac conditions such as Ischaemic Heart Disease, disorder of heart rate, rhythm and conduction, vascular disease, Cardiac arrest, pacemaker, Coronary artery bypass grafting, angina, atrial fibrillation.
Clinical findings of concern at the rail safety worker health assessment.
The Chief Medical Officer will request written reports from your Treating GP to address the following:
The date when this person first consulted your practice?
Any continuing prescribed medications (please include the prescribed dose, frequency, when commenced, and last changed).
A Cardiologist opinion (a new or previous report, please provide a referral if a cardiologist is not already involved in the worker’s care).
Over the last three months, do you consider this worker’s health "stable"? Yes / No.
Following this review, have any strategies been recommended to improve this patient’s health and wellbeing? (please detail, or explicitly state "none required").
Cardiac Risk Score
If there is a finding of a raised cardiac risk score at assessment you will be referred to the GP for investigation and management. This may be in the form of a Cardiologist referral to have a Stress ECG.
The risk score calculator includes the following:
age and sex;
whether or not the individual smokes cigarettes;
blood pressure measurement;
Total Cholesterol:HDL ratio - calculated based on fasting blood measurement for total cholesterol (TC) and high-density lipoprotein (HDL); and
whether diabetic (a worker is diabetic if under treatment for diabetes or if diabetes confirmed on HbA1c testing - refer Section 12.2.4. Cardiovascular.
