Document 9Zjdok54Mm00Gz2D4RKj8Dy3

372 INDUSTRIAL HYGIENE AND OCCUPATIONAL MEDICINE entire period, regardless of whether the functional classification remained the same, improved or changed for the worse. The majority of the patients were classified throughout as better than 2C. > Most of the patients in the age group 35-54 had been followed in the clinic for five to 10 years. The majority were classified as 2C or better, although not infre quently the functional and therapeutic classification changed for the worse, usually from 2C to 3C. The majority of those whose functional classification remained the same or improved worked the entire period. Practically, all those whose functional and therapeutic classification changed for the worse worked at least 50 per cent of the time. The proportion of the time worked did not bear any relationship to the length of time their heart disease had been known. Most of the patients 55 and over in 1949 had been followed in the clinic less than five years and were originally classified as 2B and worse. A majority of those whose original classification was 3C and worse stopped work and never returned after their heart disease had been diagnosed--a course much less commonly followed by Table 6.--Percentage of Time Worked Since the Discovery of Heart Disease of 580 Patients, by Age at Discovery of Heart Disease Age at Discovery of Heart Disease Under 19................................ . 20-34................................ .... 35-54......................................... 55 and over............................ Patients Who Had Never Worked, Patients Who Had Worked Owing to Given Percentage of Time A f Cardiac Other ________________________________________ A__________;___________ f Under Reasons Reasons 25% 25-49% 50-74% 75-99% 100% 0 0 0 2 3 22 56 20 5 11 10 9 10 53 2 9 36 17 96 5 8 54 12 74 Total..................................... 95 . 16 8 19 102 61 279 Total % 83 75 186 236 580 patients in the younger age groups. A change for the better in functional and thera peutic classification did not appear to. affect the working status of these older patients. A change for the worse caused many to stop working and a few to continue working on a limited basis. - Table 7 shows in detail the change in occupational status of 115 patients whose functional and therapeutic classification changed for the worse and who were work ing at the time. Most of the patients continued full time in the same occupation, and 20 per cent continued in the same occupation but limited themselves in respect to physical exertion. A neglible number changed to a less taxing occupation, and 19 per cent stopped work and did not return. Most of those who limited themselves were housewives working at home, and a majority of those who stopped work com pletely had been employed previously as unskilled workers. The same type of change in occupational status occurred in the group of those who suffered a cardiovascular episode, such as an attack of rheumatic .activity, heart failure, cerebral hemorrhage or coronary occlusion (table 8). The majority con tinued in the same occupation full time, aud,a smaller proportion limited themselves in the same job or stopped working and never returned. Most of those who stopped work completely had previously been doing unskilled work, and most of those who limited themselves were housewives.