Risk Factor Levels for Various Conditions.docx
DOCX document 18 KB Posted
- Attached to
- Occupational Health Services
- Solicitation number
- 99SWC-S2474
- Issued by
- Churchill County, Nevada
About this file
This document outlines the risk factor levels for various health conditions according to guidelines established by the American Heart Association (AHA) and National Heart, Lung, and Blood Institute (NHLBI). It covers recommended levels for blood pressure, cholesterol, triglycerides, HDL, fasting blood glucose, body mass index (BMI), waist circumference, and nicotine. The document provides specific thresholds and required actions for each of these health metrics. This information is relevant to the Occupational Health Services contract opportunity in the state of Nevada.
The Occupational Health Services contract involves the provision of comprehensive occupational health services. Bidders would be expected to address the health screening and monitoring requirements detailed in this document, which are likely to be part of the scope of work. The contract term, award date, and other specifics of the opportunity are not provided in the given information.
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Text version
RISK FACTOR LEVELS FOR VARIOUS CONDITIONS –
PER THE AMERICAN HEART ASSOCIATION (AHA) AND NATIONAL HEART LUNG AND BLOOD INSTITUTE (NHLBI)
BLOOD PRESSURE LEVELS
| CATEGORY |
| SYSTOLIC |
DIASTOLIC
| Elevated |
| 120-129 |
| or |
| Less than 80 |
| Stage 1 Hypertension |
| 130-139 |
| or |
| 80-89 |
Stage 2 Hypertension
| Over 140 or Higher |
| or |
| 90 or Higher |
130/80 AND HIGHER MUST BE ORDERED TO CORRECT/LOWER
CHOLESTEROL LEVELS
VARIOUS LEVELS INDICATE WHEN TO ORDER TO CORRECT/LOWER
Total Cholesterol Levels
| Total Cholesterol Level |
| Category |
| Less than 200 mg/dl |
| Desirable |
| 200 – 239 mg/dl |
| Borderline High |
| 240 mc/dl and above |
| High |
Total Cholesterol Levels:
200 – 239 MUST BE ORDERED TO CORRECT/LOWER WHEN LOW-DENISTY LIPOPROTEIN (LDL), HIGH-DENSITY LIPOPROTEIN (HDL) OR TRIGLYCERIDES ARE NOT AT DESIRABLE LEVELS.
240 AND HIGHER MUST BE ORDERED TO CORRECT/LOWER.
LDL Levels
| LDL Cholesterol Level |
| Category |
| Less than 100 mg/dl |
| Optimal |
| 100 – 129 mg/dl |
| Near optimal |
| 130 – 159 mg/dl |
| Borderline High |
| 160 – 189 mg/dl |
| High |
| 190 mg/dl and above |
| Very High |
LDL Levels:
100 AND HIGHER MUST BE ORDERED TO CORRECT/LOWER WHEN THERE IS CHD OR CHD RISK EQUIVALENTS AND/OR DIABETES
130 AND HIGHER MUST BE ORDERED TO CORRECT/LOWER
IF 2 OR MORE RISK FACTORS PRESENT
160 AND HIGHER MUST BE ORDERED TO CORRECT/LOWER WHEN THERE IS ZERO TO 1 RISK FACTOR PRESENT
Triglycerides Levels
| Triglycerides Level |
| Category |
| Less than 150 mg/dl |
| Normal |
| 150 – 199 mg/dl |
| Borderline High |
| 200 – 499 mg/dl |
| High |
| 500 mg/dl and above |
| Very High |
Triglycerides Levels:
150 AND HIGHER MUST BE ORDERED TO CORRECT/LOWER WHEN THERE IS ELEVATED LDL, LOW HDL AND/OR OTHER RISK FACTORS PRESENT
HDL Levels
| HDL Levels |
| Category |
| Over 40 |
| Men |
| Over 50 |
| Women |
HDL Levels:
LESS THAN 40 IN MEN MUST BE ORDERED TO CORRECT/RAISE
LESS THAN 50 IN WOMEN MUST BE ORDERED TO CORRECT/RAISE
FASTING BLOOD GLUCOSE
| Fasting Blood Glucose |
| Category |
| 70 – 99 mg/dl |
| Normal fasting glucose |
| 100 – 125 mg/dl |
| Impaired fasting glucose (pre diabetes) |
| 126 mg/dl and above |
| Diabetes |
Fasting Blood Glucose Levels:
100 AND HIGHER MUST BE ORDERED TO CORRECT/LOWER
DIABETES – A1C, BLOOD PRESSURE, LDL, HDL AND TRIGLYCERIDES LEVELS PER THE AMERICAN DIABETES ASSOCIATION (ADA) AND AMERICAN COLLEGE OF ENDOCRINOLOGY (ACE)
| Values |
| ADA |
| ACE |
| A1C |
| Less than 7% |
| Less than 6.5% |
| Before Meals |
| 90 – 130 mg/dl |
| Less than 110 mg/dl |
| 1-2 hours After Meals |
| Less than 180 mg/dl |
| Less than 140 mg/dl |
| Blood Pressure |
| Less than 130/88 mmHg |
| Less than 130/85 mmHg |
| LDL Cholesterol |
| Less than 100 mg/dl |
| Less than 100 mg/dl |
| Triglycerides |
| Less than 150 mg/dl |
| Less than 150 mg/dl |
| HDL Cholesterol |
| Greater than 40 mg/dl |
| Greater than 45 mg/dl |
BODY MASS INDEX (BMI) AND WAIST CIRCUMFERENCE LEVELS
BMI
| 18.5 – 24.9 |
| Normal Weight |
| 25.0 – 29.9 |
| Overweight |
| 30.0 – 39.9 |
| Obese |
| 40.0 and above |
| Extreme Obesity |
Waist Circumference
| Men |
| 40 inches and higher |
| Women |
| 35 inches and higher |
FOR MEN:
BMI OF 25 – 29 THE EMPLOYEE MUST BE ORDERED TO LOSE WEIGHT TO BRING THEIR BMI DOWN TO A NORMAL WEIGHT. IF THE BMI IS ELEVATED DUE TO MUSCLE MASS THAT MUST BE IDENTIFIED.
BMI OF 30 AND HIGHER AND WAIST CIRCUMFERENCE OF 40 AND HIGHER WILL BE IDENTIFIED AS BEING OBESE AND MUST BE ORDERED TO LOSE WEIGHT AND SEEK MEDICAL ATTENTION FROM THE PERSONAL HEALTH CARE PROVIDER
FOR WOMEN:
BMI OF 25 – 29 THE EMPLOYEE MUST BE ORDERED TO LOSE WEIGHT TO BRING THEIR BMI DOWN TO A NORMAL WEIGHT. IF THE BMI IS ELEVATED DUE TO MUSCLE MASS THAT MUST BE IDENTIFIED.
BMI OF 30 AND HIGHER AND WAIST CIRCUMFERENCE OF 35 AND HIGHER WILL BE IDENTIFIED AS BEING OBESE AND MUST BE ORDERED TO LOSE WEIGHT AND SEEK MEDICAL ATTENTION FROM THE PERSONAL HEALTH CARE PROVIDER
AHA/NHLBI RECOMMENDS THAT THE METABOLIC SYNDROME BE IDENTIFIED AS PRESENCE OF THREE OF MORE OF THESE COMPONENTS:
| Risk Factor |
| Defining Level |
| Elevated Waist Circumference |
| Men – Equal to or greater than 40 Inches |
| Elevated Waist Circumference |
| Women – Equal to or greater than 35 inches |
| Elevated Triglycerides |
| Equal to or greater than 150 mg/dl |
| Reduced HDL |
| Men – Less than 40 mg/dl |
| Reduced HDL |
| Women – Less than 50 mg/dl |
| Elevated Blood Pressure |
| Equal to or greater than 130/85 mm Hg |
| Elevated Fasting Blood Glucose |
| Equal to or greater than 100 mg/dl |
IF AN EMPLOYEE IS IDENTIFIED WITH THREE OF MORE OF THE ABOVE COMPONENTS IT MUST BE DOCUMENTED THAT THEY ARE AT RISK FOR METABOLIC SYNDROME AND THEY MUST BE ORDERED TO SEEK APPROPRIATE TREATMENT THROUGH THEIR PERSONAL HEALTH CARE PROVIDER.
NICOTINE LEVELS
A COMBINED TOTAL OF URINE NICOTINE AND COTININE CONCENTRATIONS GREATER THAN 200 NG/ML INDICATES ACTIVE USE OF A NICOTINE CONTAINING PRODUCT (TOBACCO OR SMOKING CESSATION PRODUCT).
AN EMPLOYEE WITH A POSITIVE NICOTINE AND COTININE LEVEL OF OVER 200 NG/ML MUST BE ORDERED TO STOP THE USE OF ALL TOBACCO PRODUCTS EVEN IF THEY ARE USING SMOKING CESSATION PRODUCTS. IF THEY ARE USING SMOKING CESSATION PRODUCTS THEY MUST BE ORDERED TO BE OFF ALL NICOTINE PRODUCTS BY THEIR NEXT PHYSICAL.
URINE CONCENTRATIONS LESS THAN 200 NG/ML COULD BE CONSISTENT WITH PASSIVE EXPOSURE TO TOBACCO SMOKE.
AN EMPLOYEE WITH A POSITIVE NICOTINE AND COTININE LEVEL OF LESS THAN 200 NG/ML AND HAVE ANSWERED YES TO SMOKING OR USING SMOKING CESSATION PRODUCTS MUST BE ORDERED TO STOP THE USE OF ALL TOBACCO/NICOTINE PRODUCTS. IF THEY ARE USING SMOKING CESSATION PRODUCTS THEY MUST BE ORDERED TO BE OFF ALL NICOTINE PRODUCTS BY THEIR NEXT PHYSICAL.
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