News Articles & Press Releases
The Cost of Cardiac Arrest in
In our studies, a death costs the employer 175 percent of
that worker's annual salary, just for replacement.
Cardiac arrest, the equal opportunity killer, took 1,261
Americans' lives yesterday, most of them before they reached the
hospital. Many of the deaths happened at work. Each death
yesterday will cost employers, employees, and their families
today and for the foreseeable near future.
Many people don't know the difference between "cardiac
arrest" and a "heart attack." We hear about heart attacks every
day in the media, partly because medical technology has improved
for heart attack prevention. A heart attack is when the heart
muscle dies because of a lack of blood supply. A heart attack
can be a slow progression of events that produces warning signs
and symptoms. The dead area of the heart causes pain that
typically radiates to the left arm and jaw. There are many other
symptoms: shortness of breath, sweating, nausea, and angina.
Because the heart attack victim experiences symptoms, treatment
is possible, and many survive.
Cardiac arrest is a fatal malfunction of the heart's
electrical system. Cardiac arrest has no warning signs; the
event of death is the first and only symptom. When a person has
a cardiac arrest, the heart rhythm converts, most of the time,
to a rapid fluttering of the heart called ventricular
tachycardia and then quickly turns into the chaotic,
unproductive ventricular fibrillation (VF). VF moves no blood
around the body; the victim loses consciousness, loses pulse and
breathing, and then passes out. All of these happen within just
a brief moment of time.
How the Problem Affects You
According the American Heart Association, 400,000 to 460,000 die each
year of cardiac arrest, and 13 percent of these deaths are in the
As a respectful comparison, more people die of cardiac arrest every
three days than died on 9/11. But unlike 9/11, these deaths are not
happening together in one swift action. Rather, they are spread out
among the people across this great land--1,261 are dying every day from
cardiac arrest, silently, one at time, all over the country. So the
impact can never be experienced in the same fashion as with a single
Should each victim continue to tolerate this burden alone, or is it
time to mobilize as a nation and fight cardiac arrest?
Since 1975 women diagnosed with cardiac issues have been outpacing
men, and since 1991 their rate of diagnosis continues to grow at a rapid
rate as men are leveling off. So women are at a greater risk. Other risk
factors such as age, cholesterol, blood pressure, inactivity, and
ethnicity play small roles. Essentially, cardiac arrest is an equal
opportunity killer; one in every 2.6 of us will die from cardiac
Cardiac arrest costs Americans $2.2 billion in direct hospital costs;
the indirect costs to the family and employer are multiples of this.
These deaths cost the workplace in insurance premiums, lost
productivity, and actual and indirect costs. In our studies, a death
costs the employer 175 percent of that worker's annual salary, just for
Insurance premiums, a direct cost, will rise when claims increase;
this affects the insurance rates a minimum of one year after the
insurance claims have been reduced. All employees' premiums increase for
one renewal period, which is one year after the increased claim usage.
The inverse of this is also true: Health insurance premiums can be
reduced with reduced claims. Life insurance premiums are reduced as
death rates are reduced. Worker's compensation premiums also may decline
as claims decrease, but the rates stay elevated for three years after
the increased claim activity and compare against the rest of your
Productivity, another direct cost, is affected, just as a pebble
affects a still lake. After the death of a co-worker, there are many
workplace problems and issues that can reduce productivity: stress,
resentments, fear, trauma, personal crisis, job performance
dysfunctions, negative attitudes, divisiveness, miscommunication,
grievances, rumors, and gossip. These problems can cause low morale,
poor customer service, and unhappy workers. Each of these issues can
hurt your company's productivity. The death of a co-worker can reduce
productivity with all sorts of health ailments, as well: migraine
headaches, back pain, allergies, and depression. Depression is among the
most costly because depressed people still show up for work, but their
performance may be substantially reduced while at work.
A new study published in the Journal of the American Medical
Association estimates the impact of depression in the workplace at
$44 billion. "If companies do effective intervention, education,
screenings, and things like that, for every dollar they spend, they're
going to save somewhere between $2.50 and $5 in treatment costs per
person," according to this source. Not only that, but productivity tends
to go up as a result.
There is a solution to this costly epidemic. A new technology has
been developed and heavily tested that determines your risk of having a
cardiac arrest in the near future. The non-invasive test identifies your
risk of a life-threatening heart rhythm disturbance that leads to
cardiac arrest. The test is quick, inexpensive, and completely painless.
It looks for beat-to-beat variations in a portion of your
electrocardiogram, or ECG. When visible on the ECG, these variations
have long been associated with increased likelihood of a
life-threatening heart rhythm. (Unfortunately, most of the time the
variations are not visible to the naked eye during routine ECG testing.)
The test is designed for measurement of the ECG at the microvolt level
(one millionth of a volt), allowing this condition to be identified
before it becomes life-threatening.
Because sudden cardiac death is the first and only symptom of cardiac
arrest, Americans have had to rely on reactive measures such as CPR and
AEDs to attempt to save a life. But with this test offered proactively,
we can reduce the need for these reactive measures and actually cost
your company less with much higher survival rates.
The test can help your company avoid the cost and impact of the
problem by detecting the cardiac arrest before it happens. When detected
early, cardiac arrest can be reduced and possibly avoided through common
medical solutions. This proactive solution has been made available only
The Los Angeles International Airport Study
The Citizen Safety Institute contracted a local mobile testing
company to use the test on all employees of the Los Angeles
International Airport. In Phase One, the 2,500 employees LAX were sent
an e-mail and an announcement attached to their paycheck by project
coordinator Jackie Adams informing them the test would be available to
all employees with 12 days for the testing. Testing would be first come,
first served. Employees called to schedule the appointments personally
and confidentially. Testing was scheduled by appointment every 20
minutes during the contracted hours of testing.
Space was not available in the airport buildings, so a mobile testing
unit was used. This also maintained consistent study conditions. Each
employee was prepped to ensure the best quality of electrode contact,
and 14 electrodes were connected on the chest and back. Manufacturers'
protocols were used, collecting data for five minutes. Data were
analyzed immediately after testing and reviewed with each employee. Only
one copy of the test results was printed; it was immediately given to
the employee, maintaining strict confidentiality.
In Phase One, 409 employees were tested and more than 100 were placed
on the waiting list who wanted to be tested but were unable to fit into
the scheduled times. This represents 16.4 percent of the employees at
LAX. The results of the testing were that 15 percent of the men (37
total) and 25.9 percent of the women (42 total) tested "positive," which
means they have a significant risk of having a cardiac arrest within the
next two years.4 A total of 19 percent of the entire LAX staff tested
positive. After learning of the risk, each employee is encouraged to
seek out treatment solutions with his or her medical pWe calculated this
testing saved LAX $4,175,382 in total cost savings and avoidance,
producing a 25,522 percent return on investment.
As documented in this study, 19 percent were found to have a
significant risk of having a cardiac arrest. The impressive ROI calls
out to other organizations that cardiac arrest testing is a good use of
funds. But more important, yet more difficult to define, is the human
impact. Cost savings aside, this form of testing may be able to offer a
greater solution than the reactive measures employed to date. If we can
reduce cardiac arrest proactively and save considerable amounts of money
in the meantime, is there any reason not to try?
1. Heart Disease & Stroke Statistics--2004 Update, American Heart
4. Cambridge Heart, Inc.
5. Journal of the American Medical Association, Walter F.
Stewart, Ph.D., MPH, with Geisinger Health Systems in Danville, Pa.
This article appeared in the September 2004 issue of Occupational
Health & Safety.
Professor of Emergency Medicine and Assistant Professor of
Cardiology, Robert Ambrose
specializes in emergency cardiology and is the executive director of the
Citizen Safety Institute of Manhattan Beach, Calif. He is an educator,
inventor, author, and a leading expert in emergency cardiology. He
reported hundreds of doctors around the country have the test discussed
in this article, the Cardiac Arrest Test (CAT). The CAT is CSI's
trademark for the Microvolt T-Wave Alternans test as performed by
Cambridge Heart's HeartWave. To contact him, phone
310-545-4191 or 800-277-3333, fax 310-546-2921, e-mail email@example.com,
or visit www.citizensafety.org.