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Issue title: Physical Employment Standards
Guest editors: Gemma S. Milligan, Sam D. Blacker, Pieter E.H. Brown and Andrew G. Siddall
Article type: Research Article
Authors: Yee, Elizabeth B.a | Macpherson, Alisona | Gledhill, Normana | Gledhill, Scottb | Jamnik, Veronicaa; *
Affiliations: [a] School of Kinesiology, York University, Toronto, Ontario, Canada | [b] The Medcan Clinic, Toronto, Ontario, Canada
Correspondence: [*] Address for correspondence: Veronica Jamnik, PhD, Associate Professor, Room 358, Norman Bethune College, York University, School of Kinesiology and Health Science, Faculty of Health, Toronto, Ontario, M3J 1P3, Canada. Tel.: +1 416 736 2100 22995; E-mail: [email protected].
Abstract: OBJECTIVE:The purpose of this study was to examine the impact of applying six commonly-used and two proposed resting blood pressure (BP) cut-points to clear individuals for maximal exercise in non-clinical health, wellness, commercial fitness agencies and physically demanding occupation test sites. METHODS:Participants (n = 1670) completed the Physical Activity Readiness Questionnaire for Everyone (PAR-Q+) and had their resting BP measured. Individuals with a BP >160/90 mmHg were further screened for contraindications to exercise using the ePARMed-X+ (www.eparmedx.com), all 1670 were cleared. There were no adverse events during or post exercise. RESULTS:The percentages of participants cleared for each BP cut-point were: <130/80 mmHg (85.3%), <140/90 mmHg (93.4%), <144/90 mmHg (94.6%), <144/94 mmHg (96.3%), <150/100 mmHg (98.6%), <160/90 mmHg (95.6%), <160/94 mmHg (97.8%) and <160/100 mmHg (99.5%). Individuals who would not have been cleared without further screening were significantly older, had a higher BMI, or had a lower maximal oxygen consumption. CONCLUSIONS:Conservative or lower resting BP cut-points currently applied to clear individuals for maximal exercise provide an unnecessary barrier. For individuals categorized as low-to- moderate risk by evidence-based screening tools such as the PAR-Q+ and ePARmed-X+, we recommend a resting BP cut-point of <160/94 mmHg to clear for maximal exercise until sufficient evidence is amassed to support the increase to <160/100 mmHg.
Keywords: Risk stratification, adverse events, blood pressure screening, physically demanding occupations
DOI: 10.3233/WOR-192952
Journal: Work, vol. 63, no. 4, pp. 635-642, 2019
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