Introduction/framework/objectives

It is not uncommon for a worker to report having Epilepsy during the Occupational Health exam, a fact that, in certain work contexts, may imply a risk of an eventual serious accident, sometimes arising some doubts on how to classify aptitude, maintaining confidentiality and simultaneously informing the employer/management/human resources which tasks should be avoided.

Methodology

This is a Bibliographic Review, initiated through a search carried out in January 2022 in the databases “CINALH plus with full text, Medline with full text, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Nursing and Allied Health Collection: comprehensive, MedicLatina and RCAAP”.

Contents

In Epilepsy, the existence of abnormal electrical activity in the brain is verified; it is a dysfunction of the central nervous system, episodic and unpredictable, although controllable in the majority. The epileptic seizure may lead to loss of consciousness and/or intense and involuntary muscle contraction. Some side effects of the drugs used can contribute to the abandonment of therapy or, at least, the omission of some doses. The unemployment and underemployment rate is higher in these individuals; not only because of the stigma associated with the crisis and risk of accident, but also because of the side effects of drugs, such as drowsiness, vertigo, headache and/or cognitive changes, which can reduce work performance. In addition, unemployment can be further exacerbated by a decrease in self-esteem, lower qualifications (in terms of qualifications and professional experience), not having a driver license and because there is little information about the disease (from colleagues and employer). Assessing an epileptic's ability to work is a complex task, especially when there are reasonably recent seizures. Aptitude will vary from case to case, considering the type of Epilepsy, frequency and intensity of seizures, control provided by medication and possible side effects, as well as work tasks themselves. Due to discrimination, some workers prefer to hide the pathology from the employer and the occupational physician. The determining factor for employability (access and maintenance of jobs) is crisis control.

Discussion and Conclusions

There are no consensually accepted Guidelines about Epileptic workers; in some countries and/or specific professional sectors there are short specific indications. It will be up to the Occupational Physician/Nurse and Safety Technician to act on a case-by-case basis, to guarantee the best working conditions. It seems to be consensual that at least two years without seizures may allow for the assumption that the recurrence rate will be reasonably low. In case of doubt, the Health and Safety elements may rely on the written opinion of the assistant neurologist, to have a technical and legal safeguard, in view of the aptitude classification and/or timing for reassessment.

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