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OSHA standards; environmental problems such as dust, fumes, mists and noise; chemical exposures; carcinogens and the costly and timeconsuming efforts spent in an attempt "to operate within compliance" seem to drain all the resources of the employee health and safety services of most companies today. Admittedly these are very important issues but we should not lose sight of the fact that chronic diseases are far more costly to the company and employees. For every employee dying from an industrial hazard or accident more than fifty die from cardiovascular disease. Just because it doesn't go on the OSHA log is no indication that the incident isn't costly, disrupting to production, and causing emotional and financial stress to the employee and his family.
One of the leading causes of cardiovascular accidents is hypertension, and in reviewing the high group insurance costs of our company it became apparent that attention should be focused on a hypertension control program.
Management was receptive to the proposal by the Medical Director to try a pilot program. Plans were started in early 1974. The Company Medical Director was a member of the Board of the local chapter of the American Heart Association. They, too, were enthusiastic when approached about a High Blood Pressure Detection and Control Program in Industry.
The model I am now going to present is different from most because it is basically a nurse-administered program (Figure 1). We began with a pilot program in five plants. First, management was approached and all were anxious to endorse the program. An educational program for all employees, including supervisors, was planned.
Additional education for the nurses was outlined and developed by a hypertension specialist from Bowman Gray School of Medicine and his nurse practitioner who had a great deal of responsibility in the management of a hypertension clinic.
The doctor in charge of the clinic, who was also a Board member of the local Heart Association, agreed to contact the county medical societies in the areas where these five plants were located to inform them of our plans and ask for their cooperation.
The Heart Association made available educational materials for the employees and record forms to use during the checking of blood pressures and for referral to local physicians. They were...