This systematic review evaluates and summarizes the evidence of association between work-related factors and heart rate variability (HRV) in workers. We reviewed English articles indexed in MEDLINE under the key words: work, worker, occupational, industrial, and heart rate variability. Studies were included if one or more of the dependent variables was one of the time- or frequency-domain indexes of HRV [standard deviation of all normal-to-normal (NN) intervals (SDNN), mean of the 5-min standard deviations of NN intervals calculated over several hours (SDNN index), the root mean squared differences of successive NN intervals (RMSSD), integrated spectral powers of high (HF, > 0.15 Hz) and low frequency (LF, 0.04-0.15 Hz) HRV, and the LF/HF ratio] as recommended by the European Society of Cardiology and the North American Society of Pacing Electrophysiology. Physical and chemical work environments (i.e. exposure to occupational toxicants and hazardous environments), psychosocial workload (i.e. job stressors), and working time (i.e. shift work) had been examined and identified as having associations with low HF power. These findings may indicate that research into parasympathetic nervous system activity should be focused to protect cardiovascular health at work. We also propose the use of very low and ultralow frequency HRV components in autonomic research for workers' health.
We assessed the exposure levels of noise, estimated prevalence, and identify risk factors of noise-induced hearing loss (NIHL) among male workers with a cross-sectional study in a liquefied petroleum gas cylinder infusion factory in Taipei City. Male in-field workers exposed to noise and administrative controls were enrolled in 2006 and 2007. Face-to-face interviews were applied for demographics, employment history, and drinking/smoking habit. We then performed the measurements on noise levels in field and administration area, and hearing thresholds on study subjects with standard apparatus and protocols. Existence of hearing loss > 25dBHL for the average of 500 Hz, 1 kHz, and 2 kHz was accordingly determined for NIHL. The effects from noise exposure, predisposing characteristics, employment-related factors, and personal habits to NIHL were estimated by univariate and multivariate logistic regressions. A total of 75 subjects were involved in research and 56.8% of in-field workers had NIHL. Between the in-field and administration groups, hearing thresholds on the worse ear showed significant differences at frequencies of 4 k, 6 k, and 8 kHz with aging considered. Adjusted odds ratio for field noise exposure (OR=99.57, 95%CI: 3.53, 2,808.74) and frequent tea or coffee consumption (OR=0.03, 95%CI: 0.01, 0.51) were found significant. Current study addressed NIHL in a specific industry in Taiwan. Further efforts in minimizing its impact are still in need.
The aim of this study was to assess whether body mass index (BMI) was associated with abnormal results of other tests related to metabolic disorders in the periodic health checkup, and determine whether changes in BMI were associated with changes in these other tests. We surveyed 2,392 Japanese male workers, aged 19-59 who have received regular health checkups in 2003 and 2004. During the mandatory workplace health checkup, the following are tested: BMI, systolic and diastolic blood pressure, and the levels of total cholesterol, triglyceride, high density lipoprotein cholesterol, hemoglobin A1C, aspartate aminotransferase, alanine aminotransferase, and gammaglutamyl transpeptidase. These parameters were measured in 2003 and 2004. The receiver operating characteristic (ROC) curve was used to determine the efficacy of BMI in screening for abnormal results in 2003. The areas under the ROC curves for hypertension, dyslipidemia, diabetes, and liver dysfunction were 0.68-0.89, 0.65-0.67, and 0.51-0.67 for 19-39, 40-49, and 50-59 yr olds, respectively. Multiple regression analysis revealed that changes in BMI were significantly associated with changes in the respective items in one year. The BMI predicts metabolic disorders to a certain extent, especially in younger workers, and BMI monitoring may be a useful indicator of change in other annual health checkup items.
Falling accidents caused by slipping represent a high proportion of all accidents and are cost intensive in industry as well as in the private sphere. To prevent such accidents, the slip resistance of flooring must be evaluated. Therefore, measurement methods are necessary. These methods must provide results that comply with an individual's perception of when a floor is slippery. This article describes the analysis of human walking motion to derive essential parameters and estimate their values for measuring the slip resistance of flooring. Human walking motion of 22 persons is analysed to discover the critical phases for slipping. The heel strike was extracted as the critical phase for falling accidents caused by slipping. A model of the friction between the shoe and flooring is set up to describe the conditions in that phase. Heel strike velocity, requirements quotient and contact pressure are extracted as essential parameters from the friction model. With the biomechanical gait analyses of the walking of more than 170 single steps made by 22 test persons, values for these parameters are derived. Suggestions are made to adopt these values as test parameters for slip resistance test devices.
To estimate the prevalence of psychological morbidity among health care workers in military hospitals in Taiwan and studies the association between psychological morbidity and quality of life. We sent surveys to 1,269 health care workers working in military hospitals. Participants completed structured questionnaires that included the General Health Questionnaire (GHQ), and the WHO Quality of Life Questionnaire (WHO-QOL). The survey was completed by 65 physicians, 416 nurses, and 304 other specialists. Nurses had the highest GHQ scores (nurses 32.1% vs. physicians 28.3% and other 22.4%). On the WHOQOL, nurses had worse psychological and environment domain scores (12.7 and 13.1, respectively) and physicians scored the worst for the physical and social domain as compared to nurses and other specialists. The younger, hypnotic drug use and life events had higher percentage in psychological morbidity group (Odds Ratio 1.04, 12.5, 2.38; p=0.008, 0.028 and 0.014, respectively). In regression analysis, job category, life event and hypnotic drug use could predict GHQ; age and GHQ could predict QOL (p<0.001). The GHQ might be a mediating factor to QOL. Programs should be developed to educate younger health care workers with psychological morbidity to adjust the stressors associated with their jobs to improve their QOL.
Ten young male participants were recruited to test their maximum symmetric and asymmetric isoinertial lifting capabilities from floor to the knuckle height in different container dimensions varied in both width and length. The results showed that the order from the highest to lowest lifting capability for the lifting modes was symmetric lifting, asymmetric lifting with leg rotation and asymmetric lifting with trunk rotation, and for the container dimensions was 50 × 35 × 15 cm, 70 × 35 × 15 cm and 50 × 50 × 15 cm. Participants' lifting capabilities differed significantly (p<0.05) among lifting modes and container dimensions. This study recommends that asymmetric lifting with leg rotation should be encouraged as compared with asymmetric lifting with trunk rotation when performing heavy asymmetric lifting tasks.
The possible associations of intragroup and intergroup conflict at work with psychological distress and work engagement were investigated in a cross-sectional study in a manufacturing factory in Japan. A self-administered questionnaire was sent to all employees, and 255 responses were returned (a response rate of 84%). Data from 247 workers (187 males and 60 females) with no missing values were analyzed. Intragroup and intergroup conflict at work, psychological distress, and work engagement were measured by the NIOSH-GJSQ, K6, and Utrecht Work Engagement Scale (UWES-9), respectively. An ANCOVA was conducted to compare K6 and UWES-9 scores among the tertiles on intragroup conflict or intergroup conflict scores, adjusting for demographic and occupational variables as well as worksite social support, separately for males and females. Intragroup conflict was associated with greater psychological distress for males (p for trend=0.009). Intergroup conflict was marginally significantly associated with psychological distress for both males and females (p for trend=0.050 and 0.051, respectively). Contrary to expectation, intergroup conflict was significantly associated with greater work engagement for females (p for trend=0.024). For males, intragroup and intergroup conflict at work may increase psychological distress; for females, intergroup conflict may increase both psychological distress and work engagement.
To improve the management of depression and the prevention of suicide, we investigated associations between lifestyle, working environment, depressive symptoms and suicidal ideation. Variables measured included job stressors, working hours, overtime work, smoking status, alcohol consumption, sleep, exercise, meals, and family factors. Original items were used to measure working on holidays, number of confidants, use of stress reduction techniques, and suicidal ideation. A total of 4,118 employees (2,834 men, 1,284 women) in eleven cities and districts across Japan were analyzed. On stepwise multivariate logistic regression analysis, variables associated with depressive symptoms were exposure to high job stress, problem drinking, a feeling of insufficient sleep, absence of confidants, and no use of stress reduction techniques in both sexes. Further, problem drinking and absence of confidants were associated with suicidal ideation in both sexes. The prevalence of workers who had no confidants and who did not use stress reduction techniques was unexpectedly high. Given their clear association with depressive symptoms, greater attention to these factors should improve measures aimed at the prevention of suicide.
The aim of this study was to establish a set of occupational safety and health (OSH) issues and development policies suitable for adoption in Taiwan. A survey was conducted on a sample of 102 experts and 235 industrial work safety personnel in Taiwan for statistical analysis of the general consensus, with the results showing such consensus in 104 individual policy indicators. Our results reveal that the most appropriate targets were considered to be annual 10% reductions in the ‘occupational accident disability rate’, ‘occupational accident injury rate’ and ‘occupational diseases before 2010’. Responding to the specific question of the appropriate method of achieving a reduction in the number of accidents in Taiwan, the primary consideration for 13.4% of the experts and 10.6% of the industry personnel was ‘promoting OSH awareness and enhancing the overall safety culture’. As regards the current OSH policy focus, 11.2% of the experts considered ‘improving OSH legislation, standards and systems’ to be the most important, whilst 8.9% of the industry personnel felt that ‘recognizing work stress, overwork and emerging OSH issues’ were the most important.
Via a large scale cross-sectional study among Japanese white color workers, the authors aimed to elucidate: (1) the distributions of Sense of Coherence (SOC), which reflect stress coping abilities, (2) the distributions of the Brief Scale for Coping Profile (BSCP) which reflect coping profiles for stressors; (3) and the association between SOC and BSCP. Anonymous self-administered questionnaires were sent to 20,742 employees at educational and research institutions in Tsukuba Research Park City. A total of 12,009 (57.9%) workers completed and returned the questionnaire; 10,317 workers without missing data were analyzed. SOC scale scores and BSCP subscale scores differed by gender, age, and other demographic features. Among the BSCP subscales, workers whose SOC scale scores were higher tended to adopt a problem-focused coping profile, whereas workers whose SOC scale scores were lower adopted an emotion-focused coping profile. The coping profile that workers adopted depended on their background and demographic characteristics. Stronger SOC allowed one to adopt a problem-focused coping profile that allows for better coping with work-related stressors.
The aim of this study is to assess the number of workers potentially at risk of bladder cancer in Italy. A detailed list of codes of economic activities entailing bladder cancer risk was developed on the basis of the excess risk resulting from two different pooled analysis (separately for men and women) in Europe. Firms and the number of blue-collars potentially at risk were selected from the ISPESL (National Institute for Occupational Safety and Prevention) database of enterprises. The number of blue-collars likely exposed to bladder cancer risk in Italy is about 443,849 (67.88% men). This evaluation, based on administrative sources rather than on direct measures of exposure, is likely to overestimate potential exposure to carcinogenic agents. ISPESL database of enterprises, which permits the identification and territorial localization of each local unit, is helpful to characterize the current situations at risk for the health of workers.
Lead (Pb) is widely used because of its useful properties and it is ubiquitous in human environment. There are various lead based industries and several workers who are working in these industries without the knowledge of the ill effects of lead and hence not taking proper precautions while handling lead. Many a times, these workers who have accumulated lead in their blood and body organs, are not properly diagnosed and might receive only symptomatic treatment. We describe a thirty-two-year old male, who was working in an unorganized lead based industry for 3 yr, developed severe lead poisoning leading to wrist drop. Since one year the patient received only symptomatic treatment for abdominal pain. His laboratory investigation showed elevated blood lead levels. The chelation therapy using D-Penicillamine brought down his blood lead levels and is on follow up presently. It is required to take proper history about the occupation of the patient, exposed to potentially hazardous levels of lead in the workplace and medically evaluate them.
The reactive airway dysfunction syndrome (RADS) is a type of occupational asthma without a latency period, and it is induced by irritating vapour, fume, or smoke. Although the onset of RADS has been related to over 30 different agents, it has not been previously associated with acute exposure to iodine, aluminium iodide, or hydrogen iodide. The diagnosis was based on exposure data, clinical symptoms and signs, as well as respiratory function tests and bronchoscopy. A 48-yr-old non-atopic, never-smoking female chemistry teacher developed respiratory symptoms immediately after a demonstration of oxidation-reduction reactions in a school classroom. Spirometry showed bronchial obstruction, and the histamine challenge test revealed bronchial hyperresponsiveness. These findings were still evident seven years after the incident. The prognosis of RADS was unfavourable: the patient had to quit her job as a teacher. A case of RADS following acute exposure to mixed iodine compounds is presented for the first time. Demonstrations of potentially dangerous chemical reactions should always be carried out in a fume cupboard, and appropriate personal protective equipment should be worn.
To grasp the clinical characteristics, treatment and prognosis of trichloroethylene medicamentose-like dermatitis, seven hospitalized cases were analyzed in detail. The disease has various manifestations, among them, those accompanied by hepatitis or renal diseases are crucial. Adequate dose of corticosteroid hormone in earlier period could effectively control the patient's condition. Besides paying close attention to changes of the patient's skin, we should also keep an eye for the changes of the liver and kidneys and their relevant indices, as different patients have different prognoses.
Guidelines for occupational physicians are increasing in number. Their quality and content is varied and they may even provide conflicting recommendations. Earlier studies show that guidelines directed at professionals in occupational health use scientific evidence unsystematically or inadequately. This article assesses the guidelines of the Finnish Institute of Occupational Health (FIOH). We selected a random sample of 29 guidelines from all those published by FIOH, which were assessed by four people individually using the AGREE instrument. The items were scored in six domains: scope and purpose of the guideline, stakeholder involvement, rigour of guideline development, clarity and presentation, application, and editorial independence. Mean domain scores were calculated according to AGREE instructions. The guidelines presented their scope and purpose well; the mean domain score was 62%. Their clarity and presentation was fairly good, mean domain score 47%. The stakeholder involvement's mean domain score was 33%. The other domains scored low: applicability domain, 15%, rigour of guideline development, 9%, and editorial independence, 7% only. The rigour and reporting of guideline development seems to be the main challenge for future guideline production in FIOH. A common structure for guideline preparation is needed.