Jovica Jovanović

Associations between the Occupational Stress Index and Hypertension, Type 2 Diabetes Mellitus, and Lipid Disorders in Middle-Aged Men and Women

INTRODUCTION Retrospective and prospective studies show that stress at work is linked to an increased risk of hypertension, diabetes mellitus, and coronary heart disease. However, the nature of the contributory job stressors and biological mechanisms need further elucidation. OBJECTIVES The study is aimed to determine the associations between aspects of the occupational stress index (OSI) and arterial hypertension, diabetes mellitus (DM) type 2, and lipid disorders in working middle-aged men and women. METHODS The cross-sectional study involved 989 middle-aged men and women in different occupations. The OSI was calculated by using standardized questionnaires. The total participation rate was 93%. Occupational stressors were divided into seven groups: High Demands, Strictness, Underload, Extrinsic Time Pressure, Noxious Exposure, Avoidance, and Conflict/Uncertainty. Serum lipid levels, glucoregulation, blood pressure, and cardiovascular risk factors were measured. RESULTS For both women and men, the total OSI score associated significantly with DM (women: odds ratio [OR] 2.4, 95% confidence intervals [CI] 1.67-3.45; men: 1.21, 1.15-1.45), any type of dyslipidemia (women: 1.54, 1.17-2.03; men: 1.31, 1.24-1.39), and arterial hypertension (women: 1.15, 1.10-1.21; men: 1.58, 1.49-1.68). The group as a whole showed associations between total OSI and low high-density lipoprotein (HDL) cholesterol, high total cholesterol, and high triglyceride levels. Of the OSI aspects, Underload associated significantly in both men and women with arterial hypertension (women: 3.48, 1.91-6.31; men: 2.71, 1.96-3.75) and dyslipidemia (women: 3.26, 2.13-4.99; men: 2.11, 1.76-2.52). Underload was also associated with several lipid abnormalities in the group as a whole. It associated with DM in women only (4.7, 2.84-7.81). All remaining OSI aspects also associated significantly and positively with DM in women only. Conversely, in male workers, but not female workers, High Demand, Conflict/Uncertainty, and Extrinsic Time Pressure associated significantly with arterial hypertension. Strictness and Conflict/Uncertainty associated positively with dyslipidemia in women only. Noxious Exposures associated positively with DM and arterial hypertension in women only. CONCLUSIONS The study provides evidence for the association of work stress with metabolic disorders and hypertension. Total OSI associated significantly with DM type 2, arterial hypertension, and dyslipidemia in both genders. Different OSI aspects associated with these health issues in gender- and occupational-specific patterns. Underload, which represents lack of social communication, simple task preparation, and underestimation of working results, associated most strongly of all OSI aspects with disease in both the sexes.

Occupational stress and arterial hypertension

INTRODUCTION Arterial hypertension is an important medical, social and economic problem in the working population. Factors of occupational exposure lead to a much faster and more frequent occurrence of this disease and its consequential complications. Among these factors the following take an important place: noise, carbon monoxide, job dissatisfaction, microclimate conditions, chemical agents, shift work night work monotonous work and so on. The purpose of this study was to analyze working conditions, working environment, work demands and identification of occupational stressors and their influence on development of arterial hypertension. MATERIAL AND METHODS This investigation included 3470 workers and it examined technological processes, working time, job sastisfaction, interpersonal relations and physical and chemical hazards of their workplaces. The exposed group consisted of 2270 workers occupationally exposed to stressors. Control group included 1200 workers whose workplaces were without stressors. Workers of exposed group were divided into 14 subgroups in regard to presence of occupational hazards. RESULTS Arterial hypertension was established in 39.9% of workers of exposed group, which is statistically significantly more than in controls (25.7%). The highest prevalence of arterial hypertension was at workers who were dissatisfied with the job and who were at the same time occupationally exposed to noise and carbon monoxide. Family predisposition and smoking have cumulative effects with occupational hazards. DISCUSSION Possible mechanisms of arterial hypertension development include activation of adrenergic nervous system, renin-angiotensin aldosterone system, higher concentrations of steroids, catecholamines and free radicals caused by occupational hazards. CONCLUSION Occupational stressors are significant factors in development of arterial hypertension of exposed workers. The most important stressors are noise, carbon monoxide and job dissatisfaction.

Predicting the Biological Effects of Mobile Phone Radiation Absorbed Energy Linked to the MRI-obtained Structure

The nature of an electromagnetic field is not the same outside and inside a biological subject. Numerical bioelectromagnetic simulation methods for penetrating electromagnetic fields facilitate the calculation of field components in biological entities. Calculating energy absorbed from known sources, such as mobile phones when placed near the head, is a prerequisite for studying the biological influence of an electromagnetic field. Such research requires approximate anatomical models which are used to calculate the field components and absorbed energy. In order to explore the biological effects in organs and tissues, it is necessary to establish a relationship between an analogous anatomical model and the real structure. We propose a new approach in exploring biological effects through combining two different techniques: 1) numerical electromagnetic simulation, which is used to calculate the field components in a similar anatomical model and 2) Magnetic Resonance Imaging (MRI), which is used to accurately locate sites with increased absorption. By overlapping images obtained by both methods, we can precisely locate the spots with maximum absorption effects. This way, we can detect the site where the most pronounced biological effects are to be expected. This novel approach successfully overcomes the standard limitations of working with analogous anatomical models.

The impact of occupational stress factors on temporary work disability related to arterial hypertension and its complications

Aim. To determine which specific groups of occupational stress factors influence the duration of temporary work disability related to arterial hypertension and joint complications/co-morbidities. Methodology. Workers (n = 1398; 1009 in the exposed group, 389 in the control group) with arterial hypertension who worked at one workplace for a minimum of 10 years were divided into 10 subgroups, depending on the presence of joint complications/co-morbidities. The intensity of seven groups of occupational stress factors, the total score of Occupational Stress Index (OSI) and the average number of lost working days during 1 year were analysed. Results. The number of lost working days due to arterial hypertension and joint complications/co-morbidities was significantly higher in the exposed group. In all subgroups of the exposed group there was a high correlation between the number of lost working days and the total OSI score. Specific occupational stress factors were associated with specific complications: High Demands with chronic myocardial infarction, Strictness with cerebral haemorrhage, Conflict/Uncertainty with cerebral infarction, Extrinsic Time Pressure with acute myocardial infarction, and Avoidance/Symbolic Aversiveness with non-insulin-dependent diabetes. Conclusion. There are specific groups of occupational stress factors which can influence the duration of work disability associated with certain complications and co-morbidities of arterial hypertension.

OCCUPATIONAL DISEASES INDUCED BY VIBRATIONS

Vibration is physical noxiousness which is present in different branches of industry. Vibration disease is the disease caused by professional vibrations. The disorders caused by acute and chronic, local or general exposure are numerous and very nonspecific. Vibration disease signs are expressed late during natural course of disease, and diagnosis is made with significant delay. The occupational disorders caused by vibration represents important segment in occupational medicine and occupational protection. Pathogenetic factors are microtrauma, spasm of arterial blood vessels and ischemia. The vibration damages all tissues but the cardiovascular, muscular, nervous system and bones are specially damaged. High frequent vibration damages cardiovascular system and low frequent vibration damages bones. Vibrations may represent contributing factor in development of occupational accidents. In the estimation of working ability the demands of workplaces, noxiousness, health state, functional state, motivation, length of working must be examined. The preventive steps include technical, organisational, and medical procedures as well as using of personal protective means. The vibrational disease has great impact on workers’ health and demand further research and permanent labor regulation adjustment in this field.