Dr. Barry Franklin, director of the cardiac rehabilitation and exercise laboratories at William Beaumont Hospital in Detroit, holds adjunct faculty appointments as, among others, clinical professor of exercise science at Oakland University and professor of physiology at the Wayne State University School of Medicine.
In light of the tremendous amounts employers spend on the treatment and lost productivity associated with heart attacks, Dr. Franklin details for EBN readers the most effective and cost-saving cardiac rehab methods — as well as keeping workers from becoming patients again. Cardiovascular disease remains the top killer of Americans and its annual cost is expected to approach $1 trillion in 20 to 25 years.
EBN: What can employers do to get employees back to work as safely and quickly as possible?
Franklin: Several things. In my humble opinion, the worksite environment is an ideal setting to help people make healthier lifestyle changes and to reduce or eliminate risk factors that can lead to cardiovascular disease.
New studies suggest that, compared with 20 years ago, we’re spending more time at the workplace — one estimate I read said on average compared with two decades ago, 170 hours more per year. So, that’s point No. 1: Go to where people are.
Specifically, what can they do? Although I must admit in full disclosure, I run a big cardiac rehabilitation program at William Beaumont Hospital, but the first thing I would encourage employers to do is allow patients to participate in a supervised, medically oriented, exercised-based cardiac rehabilitation program. Most of these programs typically last six to eight weeks and the employee [participates] for one hour, three days a week. So, it’s not an inordinate amount of time that the employee is away from work.
Secondly, I believe that employers should aggressively support employees getting involved in risk-reduction programs, for example, smoking cessation, diabetes education — so certainly the program would have to be tailored to the individual employee. I think an important point for your readers is to recognize that 75%-90% of all cardiac events are attributed to traditional risk factors — that’s huge.
So if you say to me, ‘Barry, what are those risk factors you’re talking about?’ In a nutshell they include diabetes, cigarette smoking, hypertension, elevated blood cholesterol, obesity and physical inactivity.
If you say, where’s the biggest bang for the buck, it’s identifying those risk factors and I should emphasize to you that I see patients on a day-to-day basis who have no clue that they’re diabetic. I’ll say, ‘Are you diabetic?’ No. We take their blood sugar and it’s 160 [milligrams per deciliter]. So, simply screening for glucose abnormalities, diabetes, hypertension and so on and so forth would go a long way.
And then lastly, in terms of mechanics, I want to promote the [American Heart Association]. The AHA has a program called Start, it really is worksite wellness. It encourages worksites to promote a healthy environment by offering employees more healthy, nutritional choices, more options for physical activity – some employers may encourage people to take the stairwell… and promoting a wellness culture.
Employees should be CPR trained, there should be inexpensive (and these now run about $1,500) automated external defibrillators, there should be no smoking on site, unquestionably, and a lot of employers, including my own, are recently saying ‘We’re not going to hire smokers in the future.’
Be sure to read EBN January for more comments from Dr. Franklin, including what features a typical cardiac rehab program includes.
