dissenting.
I respectfully dissent. OCGA § 34-9-1 (4) provides that “injury” or “personal injury” within the meaning of the Workers’ Compensation Act shall not include heart disease or heart attack “unless it is shown by a preponderance of competent and credible evidence that any of such conditions were attributable to the performance of the usual work of employment.” There is no contention that Warren’s heart attack was brought on by exertion required by his employment, and the claim that his employment required a lifestyle which predisposed him to heart attack is unsupported by the evidence. I would find that there was no evidence to support the finding of the Board and that the evidence in the record, particularly the testimony of *66Warren’s cardiologist, demands a reversal.
The majority correctly states that Warren’s cardiologist initially saw Warren in 1982 with a suspected heart attack. The cardiologist additionally noted: “[a]t that time we had long discussions about risk factors and he has totally ignored them for the last nine years. . . . He has been totally noncompliant with regard to risk factors and even seeking help during his acute illness.” In his deposition, the cardiologist expressly declined to make a connection between Warren’s work and his heart attack: “that’s something that a medical doctor can’t really comment on as an expert witness because that’s a subjective choice by an individual. A person who smokes cigarettes and eats high cholesterol food and doesn’t exercise has a higher risk of heart disease, unquestionably.” (Emphasis supplied.) “I can certainly establish the link between cigarette smoking and heart disease. But as the smoking relates to his job — or not his job — or working at home or working on the road, I can’t make that association.” He testified that Warren had all but one of the known “risk factors” for heart attack, including family history of heart disease, obesity, hypertension, and smoking. He testified that these risk factors were well known: “they’re on television every night.”1 Finally, he agreed that Warren, with all his risk factors, would have had a heart attack whether he worked at all or not.
There is no evidence of a causal connection between Warren’s employment and his heart disease. While Warren contends that he was “forced” by his employment to smoke, eat unhealthy foods, and take no exercise, the record does not support this contention. There is no showing that smoking, diet, or lack of exercise formed part of the usual duties of Warren’s employment, or that his employer controlled his personal habits. Warren testified that he had smoked two to three packs of cigarettes a day for forty years, approximately fifteen years before he became an over-the-road truck driver and thirty-five years before he began working for this employer. There was no evidence that Warren’s employer controlled his diet; he could have eaten at the salad bars which have appeared recently in many chain restaurants,2 or he could have carried healthful low-cholesterol food and drink from home in the refrigerator installed in his truck. Sedentary employment for long hours does not inevitably foreclose opportunities to exercise,3 and the record indicates that Warren did not exercise even *67when he was at home.
Finally, the Interstate Commerce Commission has enacted comprehensive regulations intended to prevent excessive fatigue and stress in motor carrier drivers by limiting the number of hours they may drive, and requiring that drivers keep an elaborate logbook showing their hours of service. 49 CFR 395.1 et seq. It is apparent from the record that Warren’s employer reprimanded him repeatedly for logbook violations, including failure to total his hours and driving in excess of the maximum number of hours permitted. Like Warren’s decision to smoke up to three packs of cigarettes a day, eat excessive amounts of fatty foods, and take no exercise, this was a personal choice, and it was in fact counter to the express instructions of his employer. In short, there was no evidence that Warren’s personal habits and resulting heart attack were “attributable to the performance of the usual work of employment” within the meaning of OCGA § 34-9-1 (4).
Contrary to the assertion in Judge Blackburn’s special concurrence, the transcript does not support a finding that Warren’s employment contributed to his injury. When Warren began feeling ill, he believed that it was a hernia. His brother-in-law was running with him at the time, and urged him to go to the hospital, but he refused. When he called his dispatcher from Alabama his first report was that a water pump had started leaking on his truck. He also told the dispatcher that “my chest and stomach was hurting.” Asked why he reported the pain to the dispatcher, he responded, “Well, it really didn’t serve no purpose, except for me to tell him and let him know that I was hurting. Because I was still thinking it was a hernia hurting. And I was intending to try and go ahead and deliver my load of freight that I had.”
The dispatcher attempted to arrange another truck to take Warren’s load in Alabama, but that truck did not show up. Only then did the dispatcher direct Warren to Calhoun, Georgia. Warren went home and went to sleep. The next morning he went to his doctor, who misdiagnosed his condition as “the hernia acting up again.” He filled his doctor’s prescription, which he felt “eased me a little bit,” went home and went back to bed, got up several hours later and then collapsed.
There is no evidence that Warren’s heart attack was “attributable to the performance of the usual work of employment” within the meaning of OCGA § 34-9-1 (4). The dispatcher made two attempts to accommodate Warren’s request for another driver, which was based at least in part on Warren’s report of a leaky water pump. Warren ignored his brother-in-law’s appeals to seek medical assistance and continued to drive. Short of requiring a dispatcher to make a medical diagnosis over the telephone which Warren’s own doctor was apparently unable to make in person, we cannot construe the employer’s *68attempts to accommodate Warren as instructions to him to continue “working through” a heart attack. Warren’s injury was not attributable to his usual work, but to his being “totally noncompliant with regard to risk factors and even seeking help during his acute illness,” as his cardiologist observed. Therefore, I believe that the record does not support a finding that Warren’s employment contributed to his heart attack.
Decided April 1, 1994 Reconsideration denied April 27, 1994 Irwin, Bladen, Baker & Russell, B. A. Bladen, Ed Russell, for appellants. Mundy & Gammage, E. Lamar Gammage, Jr., for appellee.For these reasons, I would reverse the award of the Board. I am authorized to state that Presiding Judge McMurray, Judge Andrews and Judge Johnson join in this dissent.
The recognition by the medical profession of adverse consequences from improper diet and lack of exercise is not of recent origin. See Benjamin Rush, Sermons to Gentlemen Upon Temperance and Exercise (1772).
An observant traveler on the interstate highways will have noted that many roadside restaurants now provide both salad bars and truck parking.
Exercise manuals for the sedentary and desk-bound have proliferated in recent years. See, e.g., Time-Life Books, Quick Workouts: Fitness Anytime, Anywhere (1987).