Australia National Standard for Health Assessment of Rail Safety Workers 2024 4.2: Cardiovascular conditions: identify, assess and manage cardiovascular disease that could cause sudden incapacity (Category 1) or impair concentration and control through chest pain, palpitations or breathlessness (Categories 1 and 2); for Category 1 workers aged 30 and over calculate the Australian cardiovascular disease risk score from the required data and manage by score with the actions in Table 7, observe the minimum non-working periods after events and interventions in Table 8, and apply the condition-specific criteria in Table 9 covering ischaemic heart disease, arrhythmias, pacemakers and defibrillators, valve disease, heart failure, hypertension, aneurysms, anticoagulation and congenital disease; manage return to work after acute events

What does 4.2 require?

Cardiovascular conditions threaten Safety Critical Work through sudden incapacity from heart attack or arrhythmia, which bears especially on Category 1, and through chest pain, palpitations or breathlessness that disturb concentration and control, which bears on both categories; disease may be silent until infarction, cardiac arrest or stroke, and the demands of emergency responses can raise heart rate and blood pressure in those with ischaemic disease. The Standard therefore seeks to identify, assess and manage workers with cardiovascular disease and, for Category 1 workers, to predict and manage future risk: the data in Table 6 (including the non-fasting cholesterol results, blood pressure, diabetes status, smoking and age) feed the Australian cardiovascular disease risk calculator for workers aged 30 and over, with the management of each risk band for Category 1 set out in Table 7, and workers at high risk actively investigated and managed. After acute cardiac events and interventions Category 1 workers observe the minimum non-working periods in Table 8 before return to duty, and the fitness criteria in Table 9 set, condition by condition and by category, when a worker is not Fit for Duty Unconditional and the conditions for Fit for Duty Subject to Review, covering acute coronary syndromes, angina, revascularisation, arrhythmias including atrial fibrillation, pacemakers and implantable defibrillators, valve disease and surgery, cardiomyopathy and heart failure, hypertension, aortic and other aneurysms, anticoagulant therapy and congenital and other conditions, generally resting on specialist opinion and periodic review.