Have a heart for workers' cardiac health - and the company's budget

05 August 2009 8:39am

Heart attacks are often work-related, and can be compensable, but employers can take steps to eliminate the "triggers" that aggravate heart disease - and reduce their liability, according to new international research.

While a person must have a pre-existing heart disease for a heart attack to occur, most workers' compensation schemes require employers to accept "a worker as he is", say Dr Mervyn Gotsman and Judge Stephen Adler (of the Israeli National Labour Court) in Under What Circumstances can an Acute Myocardial Infarction be regarded as a Work-Related Accident?

"Coronary heart disease may be aggravated by unusual physical exertion or mental stress, resulting in a myocardial infarct (heart attack)," they say.

"When a heart attack is triggered by an unusual strain or stress at work, it should be recognised as a work accident."

But for the attack to be considered compensable, they note, the trigger must generally be found to be an unexpected or unusual event - such as a personal conflict, a sudden change to daily routine or excessive physical exertion - that indicates the attack did not occur in the course of the "person's normal life".

Gotsman and Adler outline a number of cases in Israel where heart attacks were ruled to be work-related injuries, including:

a worker who developed an acute myocardial infarction after he was forced to carry the load of two other employees (who had taken sick leave) for a 12-hour period;

an airline manager who had a heart attack after flights were overbooked and he became involved in a verbal and physical altercation with disgruntled patrons;

a worker who had an attack after the first day of a new schedule in which his workload was increased in an effort to improve output; and

a television director who developed an acute infarction after arguing with a senior presenter who arrived late for a broadcast and then refused to go on air.

There have been similar cases in Australia.

As reported in HR Daily's associate publication, OHS Alert, the South Australian Workers Compensation Tribunal awarded a widow compensation after it accepted her husband's heart attack was linked to his transfer to a stressful managerial role.

Also in South Australia, another widow was awarded compensation after WorkCover failed to prove that her husband's heart attack was not connected to his exposure to forklift gas.

And in Victoria, a worker was granted leave to apply for damages for impaired heart function after a judge found his condition was linked to three hours of strenuous work, even though he had experienced chest pain the night before.

Train workers and eliminate liability

While proving the link between a heart attack and work is difficult, it is in an employer's interests to show it has initiated programs that support employee health and reduce the likelihood of a myocardial infarction occurring, says FCB Workplace Lawyers partner Alistair Salmon.

"Employers must ensure the health, safety and welfare of employees," he says, referring to NSW legislation. And all other Australian jurisdictions have similar requirements.

Workplace policies should address issues such as work/life balance and flexibility to ensure people aren't over-worked, Salmon says, and employees must be trained to avoid or deal with stressful situations.

Bank tellers, for instance, should be trained to cope with bank robberies and other unusual events, such as bomb threats, he says.

"Employers," he says, "must understand all the risks and do something about them."

In August 2007, the Queensland coroner recommended that employers train staff in CPR and purchase and train workers in the operation of a defibrillator.

Reduce heart attack rates

According to Gotsman and Adler, it is possible to reduce the occurrence of heart attacks by "modulating the environmental stressors".

While it is almost impossible to prevent all emotional conflicts, they say, roles that require "time-urgent mental activities" and foster stress must be studied and modified.

Other work-related links to heart attacks include circadian variation (due to changes in the temporal pattern of the job), sudden anger, running and other forms of irregular physical exertion.

"Workers should be protected from unusual physical activity, such as sudden lifting of unusual heavy weights," they say.

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