Strokes are the third largest cause of
death in the United Kingdom after cancers and heart disease, and
have the potential to cause a greater range of disabilities than
any other condition.
Types of stroke
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A stroke, also known as cerebrovascular disease, occurs when
blood flow to the brain is interrupted, usually because a blood
vessel bursts or is blocked by a blood clot. This causes damage to
brain cells because they stop getting the oxygen and nutrients they
need to function. The impact of a stroke depends on the level of
damage caused to the brain. A severe stroke can cause physical
disablement, mental impairment and in some cases, sudden death.
During a stroke a person might not be able to ask for help or
understand what is happening. The person might become vulnerable
and cause a risk to themselves or others, depending on the task and
activity they were performing at the onset of a stroke.
Types of stroke
Strokes can happen to anyone and are usually classified in
major categories; ischaemic stroke and haemorrhagic stroke.
Ischaemic strokes represent about 80 per cent
of stroke cases and are caused by a blood clot that blocks a blood
supply to the brain. This usually happens in one of two ways:
• Embolic stroke – a blood clot that has formed somewhere else
in the body travels through the bloodstream to the brain, and gets
stuck in a small blood vessel, blocking blood flow.
• Thrombotic stroke – A clot forms in blood vessels that are
clogged by fatty deposits. These deposits usually clog major blood
vessels in the neck and reduce blood flow to the brain.
Haemorrhagic stroke is caused by a blood vessel
in the brain that breaks, leaking blood into the brain. These types
of stroke account for about 20 percent of all strokes and usually
happen in one of two ways:
• Intracerebral haemorrhage – In this type of stroke, a blood
vessel in the brain bursts and spills blood into the brain
tissue, damaging cells. Brain tissues in the surrounding area also
get deprived of blood and are also damaged.
• Subarachnoid haemorrhage – In this type of stroke, bleeding
starts in a blood vessel on or near the surface of the brain and
spills blood into the space between the surface of the brain and
There is also a related condition known as a
transient ischaemic attack (TIA), often known as a mini
stroke. This is caused due to a brief delay or decrease in
the supply of blood to the brain. Like an ischaemic stroke, a TIA
occurs when a clot or debris interrupts or blocks blood flow to a
certain part of the brain. It often goes unrecognised as the
symptoms are slight and last for a short period of time. The
cumulative effect of several TIAs can be as disabling as a severe
The main symptoms
of a stroke are sudden weakness or numbness of the face, arm,
or leg (especially on one side of the body). Other symptoms include
sudden confusion, slurred speech and vision, difficulty walking,
dizziness, loss of balance or coordination, severe headache,
fainting or unconsciousness. Immediate medical attention is
essential to help save lives and limit long term disability
problems from a stroke.
The best treatment for a stroke is prevention. Making healthy
choices and exercise in everyday life reduces the risk of a stroke.
There are several risk factors that increase the chances of having
a stroke, such as; genetics, age, weight, high blood pressure,
heart disease, smoking, diabetes and high blood cholesterol
Each year, approximately 150,000 people suffer from stroke in
the UK, resulting in around 53,000 deaths. It accounts for 13 per
cent of all deaths in women and 9 per cent of deaths in men. 25 per
cent of stroke victims are people under the age of 65 years and are
therefore at working age. In England alone, it costs the economy an
estimated £8 billion per year.
The Health and
Safety at Work etc Act 1974 requires employers to secure the
health, safety and welfare of employees at work. This includes
providing a safe place of work, safe systems of work, information
The Management of Health and Safety at Work Regulations 1999 (as
amended) require suitable and sufficient assessments of health
and safety risks at work to be carried out.
Workplace (Health, Safety and Welfare) Regulations 1992 require
employers to provide adequate welfare for their employees.
The Equality Act
2010 imposes a duty on employers to make reasonable adjustments
and provide legal defence against discrimination on the grounds of
disability, including disability relating to stroke.
The law places duties on the employer to assess risks posed to
their workers and, where necessary, to take action to safeguard
health and safety, including health surveillance if appropriate.
This could be achieved by carrying out a comprehensive
Although no one can predict when a stroke might occur or to who,
it would be sensible to consider what to do if one occurred to one
of your employees or visitors.
If an employee has suffered a stroke, the employer needs to
arrange a phased return to work, once they have recovered. It may
also be necessary to make some reasonable adjustments (such as
changes to their working pattern, changes to a work station or
location or time off for physiotherapy or occupational therapy) so
that an employee who has developed a disability from a stroke might
be able to return to work. The employer should discuss these issues
with the individual once they are well enough and before they
return to work. Some of the leaflets and links in the following
section might be useful.
Leaflets and factsheets
Getting more help
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Non work related conditions