Objectives: This study was to examine the association between job stress and coronary heart disease (CHD) in a Chinese population. Methods: The 388 participants aged 30 to 70 yr who received coronary angiography for suspected or known ischemic heart disease were enrolled in this series, which included 292 CHD cases and 96 controls. The job stress before CHD onset was measured by the effort-reward imbalance (ERI) model. Results: In the results, compared with the baseline, high ERI, high extrinsic effort or high overcommitment increased the risk of CHD with odds ratios (OR) of 2.8, 2.7 and 2.8 respectively after adjustment for the traditional CHD risk factors, such as age, gender, primary hypertension, diabetes mellitus, hyperlipidemia, smoking, body mass index, CHD family history, educational level, and marital status. The combination of high ERI and high overcommitment led to the highest risk of CHD with adjusted OR 5.5. However, high reward reduced the risk of CHD with an adjusted OR of 0.4 in comparison to low reward. Dose-response relationships were also observed. Conclusions: Job stress evaluated by the ERI model significantly increased the risk of CHD, and it may be an important risk factor independent of the traditional risk factors of CHD in the Chinese population.

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Objectives: To investigate the relationships between the self-reported prevalence of musculoskeletal symptoms in the neck, upper back and low back and certain individual, work-related physical and psychosocial factors. Methods: We conducted a cross-sectional survey using a descriptive questionnaire, which was distributed to 2000 office workers in 54 workplaces, in Bangkok, registered at the Social Security Office of Thailand. Results: Returns were 1,428 (71%) questionnaires, and after screening for exclusion criteria, 1,185 office workers were found to be eligible for the study. For the head/neck region, frequently working in an uncomfortable posture increased the risk of experiencing head/neck symptoms (adjusted OR=1.81, 95% CI=1.35-2.44). For the upper back region, frequent trunk bending during work increased the risk of experiencing upper back symptoms (adjusted OR=1.80, 95% CI=1.32-2.44) whereas working in a job that required little interaction with others decreased the risk of experiencing upper back symptoms (adjusted OR=0.42, 95% CI=0.25-0.68). For the low back region, working for >8 h a day showed an elevated risk for low back symptoms (adjusted OR=1.66, 95% CI=1.25-2.22). Conclusions: Some biopsychosocial factors were associated with the prevalence of musculoskeletal symptoms in the spine among office workers. Further research should focus on these factors in order to develop specific strategies to reduce the occurrence of such symptoms in the office environment.

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Objectives: The purpose of this longitudinal study was to investigate the effects of burnout on risk factors for arteriosclerotic disease. Methods: Baseline data were collected from 442 male middle managers working for a manufacturing company in Japan. All participants had a physical health check-up and completed the Japanese Maslach Burnout Inventory-General Survey. We calculated the Japanese-specific cut-off points of the MBI-GS and applied "exhaustion +1" criterion to define subjects as healthy or burnout at baseline. Follow-up measures were collected 4-5 yr later for 383 middle managers. Changes in the subjects' waist circumference, body weight, body mass index (BMI), blood pressure, total cholesterol, triglycerides, HDL cholesterol, LDL cholesterol, fasting blood sugar, fasting insulin, HOMA-R, and HbA1c over a time period of 4 to 5 yr were compared between the healthy and burnout groups. New cases of large waist circumference, high BMI, metabolic syndrome, hypertension, hypercholesterolemia, high triglycerides, low HDL cholesterol, high LDL cholesterol, and impaired fasting glucose were detected at follow-up. Results: Changes in waist circumference, body weight, and BMI were significantly greater in burned-out managers than in healthy managers. Furthermore, compared to other variables (age and health behaviors such as smoking), burnout was a significant explanatory variable. The odds ratio of the burnout group was 2.80 for hypercholesterolemia with statistical significance after adjusting for age. After adjusting for age, health behaviors, and baseline total cholesterol, the results were similar. Conclusions: Burnout, which results from prolonged exposure to chronic work stress, may be associated with risk factors for arteriosclerotic disease.

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Objectives: As an occupational injury, percutaneous injury (PI) can result in chronic morbidity and death for healthcare workers (HCWs). A pilot surveillance system for PIs using the Chinese version of Exposure Prevention Information Network (EPINet) was introduced in Taiwan in 2003. We compared data from EPINet and recall of PIs using a cross-sectional survey for rates to establish the reliability of the new system. Methods: HCWs from hospitals that had implemented EPINet for ≥12 months completed a survey for recall of contaminated PIs sustained between October 2004 and September 2005, type of item involved, and reasons for reporting or not reporting the PI. Comparative data from EPINet for the same period were analyzed. Results: The EPINet rate, 36.1/1,000 HCW (95%CI 31.8-41.1) was almost 5 times lower (p<0.0001) than the PI recall rate for 2,464 HCWs of 170/1,000 HCWs (95%CI 155.4-185.5). Approximately 2.5 PIs were recalled for every 1,000 bed-days of care. The recall rate by physicians was 268.3/1,000, 188.5/1,000 for nurses, 88.9/1,000 for medical technologists and 81.3/1,000 for support staff. Hollow-bore needle items most commonly recorded on EPINet includ, disposable needles and syringes were underreported by 81%, vacuum tube holder/needles by 67%, and arterial blood gas needles by 75%. Nearly 63% of the reasons for underreporting were related to the complexity of the reporting process, while 37% were associated with incorrect knowledge about the risks associated with PIs. Conclusions: EPINet data underestimates a commonplace occupational injury with nearly four in five PIs not reported. Addressing the real barriers to reporting must begin with hospital administrators impressing on HCWs that reporting is essential for designing appropriate safety interventions.

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Objectives: Workplaces are suitable for screening for periodontal disease effectively. However, the majority of workplaces do not have a screening program. One possible reason may be that pocket probing, which is commonly used for the screening, needs qualified examiners and is time-consuming. In this study, the validity of a self-reported questionnaire was assessed for screening of periodontitis in 50- to 59-yr-old male employees in Japan. Methods: A total of 250 people were asked to complete a self-administered questionnaire regarding signs and symptoms of periodontal disease, and experience of periodontal treatment, followed by a clinical examination by a dentist. Subjects with at least one tooth having a clinical attachment loss of 7 mm or more were defined as periodontitis patients. Results: Thirteen percent of the subjects were diagnosed as having periodontitis. Logistic regression selected 4 questions, "Are you a current or past smoker?", "Have your gums bled recently?", "Do you think that you can see more roots of teeth than in the past?", and "Have you ever been told that you need periodontal or gum treatment?" as potential predictors of periodontitis. When subjects with at least 3 "yes" responses to the 4 questions were separated from the others, the subjects with periodontitis were separated most effectively (showing the highest sensitivity + specificity: 1.524) from those without. The area under the receiver operating characteristic curve was 0.81. Conclusions: These results suggest that the self-reported questions are useful for screening of periodontitis in 50- to 59-yr-old Japanese workers.

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Objectives: Studies have shown that interpersonal relations at work are important for several health related outcomes. The aim of the present study was to investigate whether low social support, serious conflict, exclusion by superiors or by co-workers at work may be determinants of depression. Methods: In a representative Swedish cohort study data were obtained in two waves three years apart. 4,040 women and men who did not change their jobs between the waves were chosen for the study. Exposure and confounders were obtained at Time 1 and outcome, depression according to Bech's MDI at Time 2. Previous depression was controlled for by adjusting for depression at Time 1. Data were analyzed using multiple logistic regression analyses. Results: Odds-ratios adjusted for possible confounders and depression at base-line showed significant effects for all four exposures on depression (adjusted OR, low social support 1.5 CI 95% 1.1-2.0, serious conflict 1.4 CI 95% 1.1-1.9, exclusion by superiors 1.6 CI 95% 1.2-2.1 and exclusion by co-workers 1.7 CI 95% 1.2-2.3). Conclusions: The present results support the conclusion that problematic interpersonal relationships at work can be determinants of depression. These prospective findings may be of relevance for prevention and when rehabilitating depressed patients.

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Objectives: The purpose of this study was to examine the effects of noise exposure on spatial learning and memory and associated mechanisms in the hippocampus (HIP). Methods: Forty-eight male SD rats were grouped as: A, control; B, Morris water maze (MWM) training group; C, noise exposure group; and D, noise exposure followed by MWM training group. The influence of noise stress on spatial learning and memory in rats was assessed in hidden platform acquisition training and probe trial testing in MWM. Changes in morphology of Nissl bodies were observed in the CA1, CA3 and DG regions of HIP. In order to understand the possible mechanisms behind noise stress-induced changes, the concentration of amino acid neurotransmitters and the expression of NMDAR2B (NR2B) in HIP were also evaluated. Results: After noise exposure, the performance of spatial learning and memory in group D was decreased significantly compared to group B. The concentration of glutamate was significantly increased in groups C and D, whereas GABA decreased markedly. The mean optical density of Nissl bodies in groups C and D was reduced in the CA1, DG and CA3 regions. The expression of NR2B was significantly decreased in the CA1, CA3 and DG regions in group C, and in the CA1 and CA3 regions in group D as compared with groups A and B. Conclusions: Excitotoxicity, impaired Nissl bodies and reduced expression of NR2B in rat HIP induced by chronic noise exposure might have caused the impairment of spatial learning and memory.

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