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PubMed2005

[Automobile driving and implantable defibrillators].

The consequences of implanting an automatic cardioverter defibrillator (ICD) on vehicle driving in France are poorly known. This retrospective study examined the behaviour at the wheel of ICD recipients who were recommended to abstain from driving for 3 to 6 months after device implantation. The study population included 98 patients (mean age = 59.5 +/- 14.8 years) followed for a mean of 24. +/- 23.9 months, who underwent ICD implant for ventricular tachycardia (65% of patients ventricular fibrillation (15%), syncope (8%), as part of a research protocol of myocardial cell transplantation 6%, or for primary prevention (5%). The underlying heart disease was ischemic in 59% of patients dilated cardiomyopathy in 11%,hypertrophic cardiomyopathy in 8%, valvular in 6%. Brugada syndrome in 4%, right ventricular arrhythmogenic cardiomyopathy in 2%, and miscellaneous disorders in 9% of patients. Five patients died without post mortem interrogation of the ICD. Only 28% of drivers remembered, and 13% observed, the recommended driving limitations. However, 45% (the oldest) claimed to drive prudently. During follow-up, 47% of patients received an ICD shock. Their mean it ventricular ejection fraction was 34 +/- 14%, versus 43 +/- 18% in patients who received no ICD therapy (p = 0.015). Syncope occurred in 16% who received ICD shocks. Shocks were delivered during driving in 6 patients, without consequent accident. Despite their non-observance of recommended driving limitations. ICD recipients suffered few traffic accidents. Legislation in France should reproduce the guidelines issued by European professional societies and enacted by the British laws.

Accidents, Traffic↗
PubMed1992

Follow-up study among model and pattern makers in an automobile company in the Federal Republic of Germany.

The follow-up of a cohort of 528 model makers and a control group of 2273 tool makers shows an unusual pattern of mortality in the model makers' cohort. In contrast to the usual ranking, malignant neoplasms are the most frequent group of cause of death followed by diseases of the cardiovascular system. The rate ratio (RR) for malignant tumors is significantly increased among model makers compared with tool makers RR = 1.8, (95% confidence level [CL] = 1.3-2.7). The sites affected by excess cancer were stomach, the genitourinary organs, and the brain. In contrast to other studies, no tumors of the large intestine have been observed. Furthermore, there is a remarkable underrepresentation of tumors of the respiratory organs. Because these results are based on a rather small number of cases, further follow-up of the cohort is warranted to draw more profound conclusions.

Adolescent↗