Is there a benefit in the follow-up of medical emergencies in the occupational medicine on-site office?

Abstract Background : Medical emergencies (ME) occur frequently in the Occupational Medicine (OM) office and sometimes require immediate treatment, disrupting the flow of current activities. The objective of this prospective observational study is to document the evolution of patients previously presented with ME, the factors that influence it, the impact of initial major ME and recurrent ones, towards optimizing individualized medical management. Materials and methods : Subjects presented between January and June 2023 with ME in the on-site office of a pharmaceutical company, 137 patients, were followed up for 1 year, resulting 2 groups(G): those who returned with ME(G1 – 53 patients, 38.7%) and G2 – the rest of the patients, who did not return (84 employees,61.3%). ME that required ambulance/treatment (etiological/symptomatic) were noted, along with the disease categories corresponding to the reason for presentation, work ability, professional exposures, vital status. Results : During the follow-up period of the 137 included subjects (mean age 41 years, female predominance-66.4%), 53 (38.7%) returned to the office, a mean of 1.8 returns/patient. In G1, digestive, cardiovascular, respiratory, infectious and psychological MEs were frequent. The majority received symptomatic treatment(67%), and 20%-etiological. Current work ability is influenced by the history of conditional work ability (p=0.049,RR=2.1) and initial major ME (p=0.04,RR=1.8). Initial major UMs were associated with both the need for intervention upon return (p=0.041), and the number of interventions required (p ≈ 0.0003). Conclusions : Employees with ME frequently return to the OM office (approximately 40%). Most ME require medical intervention, significantly influencing the occurrence of subsequent ME and work ability. Most recurrent MEs were digestive and cardiovascular in nature, without highlighting a causal relationship with OE. A percentage of 37.7% of patients returned with the same category of conditions, which suggests that monitoring the evolution could contribute to the identification of undiagnosed or insufficiently controlled diseases.