RESUMEN
OBJECTIVE: Identify a risk threshold for sudden incapacitation for safety critical positions in transportation industries supporting medical fitness for duty standards. METHODS: Systematic literature searches were performed examining acceptable risk criteria for medically related incapacitation using PubMed Central and Google Scholar databases. Websites for professional societies and national and international governmental agencies were also accessed. Article abstracts were reviewed and exhaustive searches were performed. RESULTS: International regulatory bodies have adopted definitions of acceptable risk typically with a threshold of 1% to 2% absolute risk of sudden incapacitation per annum. Several "risk-of-harm" models have been proposed that incorporate factors modulating an absolute risk constant derived from epidemiological studies. CONCLUSION: A 1% absolute annual risk of sudden incapacitation should be adopted as the threshold for determining medical fitness for duty among employees in safety critical positions in transportation industries.
Asunto(s)
Transportes , HumanosAsunto(s)
Causalidad , Enfermedades Profesionales/epidemiología , Enfermedades Profesionales/etiología , Salud Laboral , Traumatismos Ocupacionales/epidemiología , Traumatismos Ocupacionales/etiología , Métodos Epidemiológicos , Humanos , Anamnesis , Enfermedades Profesionales/diagnóstico , Exposición Profesional/análisis , Salud Laboral/legislación & jurisprudencia , Traumatismos Ocupacionales/diagnóstico , Literatura de Revisión como Asunto , Incertidumbre , Lugar de TrabajoRESUMEN
OBJECTIVE: Identify an evidence-based paradigm for the determination of causation of occupational injury and illness litigation. METHODS: The Westlaw and LexisNexis databases were used to identify legal principles governing the admissibility of scientific evidence in legal proceedings. The Medline database was referenced to identify evidence-based methods for the determination of causation complying with legal precepts for the admissibility of scientific testimony. RESULTS: Expert witness testimony must be relevant and reliable. Testimony must be sufficiently based on reliable facts and data. Testimony must be the product of reliable principles or methods. The witness must have reliably applied the principles and methods to the facts of the case. CONCLUSIONS: Conscientious application of the National Institute for Occupational Safety and Health Guide for the Determination of Work-Relatedness of Disease, as adapted, comforts with legal prerequisites for the admissibility of scientific evidence in medicolegal proceedings.