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Cao B, Li Y, Xu J, Zhang Y, Wang C. Dynamic changes of complete blood cell count parameters among airport workers during the COVID-19 pandemic in Chongqing, China: A retrospective longitudinal study. Heliyon 2024; 10:e32734. [PMID: 39183824 PMCID: PMC11341334 DOI: 10.1016/j.heliyon.2024.e32734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 06/07/2024] [Accepted: 06/07/2024] [Indexed: 08/27/2024] Open
Abstract
Background and aims This study aimed to examine the dynamic changes in the complete blood counts of airport staff from 2019 to 2021 and assess the impact of the coronavirus disease 2019 (COVID-19) on their overall health status during the first pandemic wave. Materials and methods A total of 2144 airport staff members from Chongqing Jiangbei International Airport who underwent health examinations for three consecutive years from 2019 to 2021 were recruited for this study. Venous blood samples were collected for a complete blood cell count. Results Changes were observed in blood routine parameters from airport staff over three consecutive years. After adjusting for age, body mass index, and systolic blood pressure, the red blood cell count decreased consecutively during the COVID-19 pandemic. Hemoglobin and basophil counts decreased significantly during COVID-19 year 1. Lymphocyte and platelet counts decreased, whereas the monocyte-to-lymphocyte ratio increased in COVID-19 year 2. However, the white blood cell count, neutrophil count, neutrophil-to-lymphocyte ratio, and eosinophil count did not change from 2019 to 2021. Conclusion This study showed changes in complete blood counts in frontline airport workers, especially men, during the COVID-19 pandemic. Therefore, paying more attention to the overall health conditions and immune function of airport staff engaged in intensive work is necessary.
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Affiliation(s)
- Baige Cao
- Department of Endocrinology & Metabolism, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Yingchao Li
- Department of Endocrinology & Metabolism, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China
- Department of First Aid Center, Chongqing Jiangbei International Airport, Chongqing, China
| | - Jinfang Xu
- Department of Health Statistics, Second Military Medical University, Shanghai, China
| | - Yinan Zhang
- The Metabolic Disease Biobank, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Congrong Wang
- Department of Endocrinology & Metabolism, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China
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2
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Nijs J, Wyns A, Hendrix J. The importance of stress in the paradigm shift from a tissue- and disease-based pain management approach towards multimodal lifestyle interventions for chronic pain. Braz J Phys Ther 2024; 28:101061. [PMID: 38603919 PMCID: PMC11015500 DOI: 10.1016/j.bjpt.2024.101061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 03/19/2024] [Indexed: 04/13/2024] Open
Affiliation(s)
- Jo Nijs
- Pain in Motion Research Group (PAIN), Department of Physical Therapy, Human Physiology and Anatomy, Faculty of Physical Education & Physical Therapy, Vrije Universiteit Brussel, Belgium; Chronic pain rehabilitation, Department of Physical Medicine and Physical Therapy, University Hospital Brussels, Belgium; Department of Health and Rehabilitation, Unit of Physical Therapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden.
| | - Arne Wyns
- Pain in Motion Research Group (PAIN), Department of Physical Therapy, Human Physiology and Anatomy, Faculty of Physical Education & Physical Therapy, Vrije Universiteit Brussel, Belgium
| | - Jolien Hendrix
- Pain in Motion Research Group (PAIN), Department of Physical Therapy, Human Physiology and Anatomy, Faculty of Physical Education & Physical Therapy, Vrije Universiteit Brussel, Belgium; Department of Public Health and Primary Care, Centre for Environment & Health, KU Leuven, Leuven, Belgium; Flanders Research Foundation - FWO, Belgium
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3
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Marruganti C, Gaeta C, Romandini M, Ferrari Cagidiaco E, Parrini S, Discepoli N, Grandini S. Multiplicative effect of stress and poor sleep quality on periodontitis: A university-based cross-sectional study. J Periodontol 2024; 95:125-134. [PMID: 37477025 DOI: 10.1002/jper.23-0209] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 07/07/2023] [Accepted: 07/16/2023] [Indexed: 07/22/2023]
Abstract
BACKGROUND The aim of this study was to evaluate the association of perceived stress and poor sleep quality with periodontitis in a university-based cohort of individuals. METHODS A total of 235 individuals were included in this cross-sectional study. Perceived stress and sleep quality were evaluated through validated questionnaires, while periodontitis was identified with a full-mouth periodontal examination protocol using both European Federation of Periodontology/American Academy of Periodontology (EFP/AAP) and Centers for Disease Control and Prevention (CDC)/AAP case definitions. Simple and multiple linear and ordinal logistic regression analyses were performed to evaluate the association between perceived stress and sleep quality with periodontitis prevalence and severity. RESULTS Stage III/IV periodontitis resulted associated with both moderate/high perceived stress (odds ratio [OR] = 5.4; 95% confidence interval [CI]: 2.2-13.5; p < 0.001) and poor sleep quality (OR = 3.0; 95% CI: 1.2-7.4; p < 0.05). The interaction between moderate/high perceived stress and poor sleep quality presented a multiplicative association with stage III/IV periodontitis (EFP/AAP; OR = 5.8; 95% CI: 1.6-21.3; p < 0.001). Multiple linear regression analyses indicated a similar trend of association also with linear periodontal parameters, that is, mean clinical attachment level (CAL) and mean probing pocket depth (PPD). CONCLUSIONS The findings from the present study suggest that stress and poor sleep quality may exert a multiplicative effect on periodontitis prevalence and severity.
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Affiliation(s)
- Crystal Marruganti
- Unit of Periodontology, Endodontology and Restorative Dentistry, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Carlo Gaeta
- Unit of Periodontology, Endodontology and Restorative Dentistry, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Mario Romandini
- Department of Periodontology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Edoardo Ferrari Cagidiaco
- Unit of Periodontology, Endodontology and Restorative Dentistry, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Stefano Parrini
- Unit of Oral Surgery, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Nicola Discepoli
- Unit of Periodontology, Endodontology and Restorative Dentistry, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Simone Grandini
- Unit of Periodontology, Endodontology and Restorative Dentistry, Department of Medical Biotechnologies, University of Siena, Siena, Italy
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Rodríguez-Aragón M, Barranco-Rodríguez D, de Mora-Martín M, Sánchez-Jorge S, Varillas-Delgado D, Valle-Benítez N. The effects of global postural re-education on sleep quality and stress in university women lecturers: a randomized controlled trial. Front Psychiatry 2024; 14:1321588. [PMID: 38298929 PMCID: PMC10829090 DOI: 10.3389/fpsyt.2023.1321588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 12/27/2023] [Indexed: 02/02/2024] Open
Abstract
Objective The present study aimed to evaluate the effect of global postural re-education (GPR) on sleep quality and stress in female health science lecturers. Methods A total of 24 female university lecturers were allocated in this randomized controlled trial into intervention (n = 12) and control (n = 12) groups. The intervention group underwent familiarization and training on the therapy to execute an 8-week treatment with GPR. Data collected on sleep quality were analyzed using 24-h accelerometry (Actigraphy GT3X+) in addition to the Pittsburgh Sleep Quality Index (PSQI) questionnaire score as well as the State-Trait Anxiety Inventory (STAI) anxiety questionnaire. Data on stress were collected by measuring salivary cortisol. Results After comparing the GPR of the groups, there was a main effect of the group (F = 5.278, p = 0.044) for PSQI. The post-hoc analysis revealed that both groups decreased scores between pre- and post-treatment. Additionally, post-treatment, there were differences between groups. For sleep latency, there were main effects of group (F = 6.118, p = 0.031) and score × group (F = 9.343, p = 0.011) interactions. The post-hoc analysis revealed that treatment groups decreased scores between pre- and post-treatment, and there were differences between groups (all p < 0.050). Conclusion The self-administered GPR improves sleep quality in female university lecturers, providing a valuable self-regulation tool for enhanced sleep quality and enhanced academic performance. Further study may help to develop this as a potential tool to help university lecturers' job performance.
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Affiliation(s)
| | | | | | | | | | - Noelia Valle-Benítez
- Faculty of Experimental Sciences, Universidad Francisco de Vitoria, Madrid, Spain
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5
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Adkins AM, Colby EM, Kim WK, Wellman LL, Sanford LD. Stressor control and regional inflammatory responses in the brain: regulation by the basolateral amygdala. J Neuroinflammation 2023; 20:128. [PMID: 37244986 PMCID: PMC10225081 DOI: 10.1186/s12974-023-02813-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 05/20/2023] [Indexed: 05/29/2023] Open
Abstract
Increasing evidence has connected the development of certain neuropsychiatric disorders, as well as neurodegenerative diseases, to stress-induced dysregulation of the immune system. We have shown that escapable (ES) and inescapable (IS) footshock stress, and memories associated with ES or IS, can differentially alter inflammatory-related gene expression in brain in a region dependent manner. We have also demonstrated that the basolateral amygdala (BLA) regulates stress- and fear memory-induced alterations in sleep, and that differential sleep and immune responses in the brain to ES and IS appear to be integrated during fear conditioning and then reproduced by fear memory recall. In this study, we investigated the role of BLA in influencing regional inflammatory responses within the hippocampus (HPC) and medial prefrontal cortex (mPFC) by optogenetically stimulating or inhibiting BLA in male C57BL/6 mice during footshock stress in our yoked shuttlebox paradigm based on ES and IS. Then, mice were immediately euthanized and RNA extracted from brain regions of interest and loaded into NanoString® Mouse Neuroinflammation Panels for compilation of gene expression profiles. Results showed differential regional effects in gene expression and activated pathways involved in inflammatory-related signaling following ES and IS, and these differences were altered depending on amygdalar excitation or inhibition. These findings demonstrate that the stress-induced immune response, or "parainflammation", is affected by stressor controllability and that BLA influences regional parainflammation to ES or IS in HPC and mPFC. The study illustrates how stress-induced parainflammation can be regulated at the neurocircuit level and suggests that this approach can be useful for uncovering circuit and immune interactions in mediating differential stress outcomes.
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Affiliation(s)
- Austin M. Adkins
- Sleep Research Laboratory, Eastern Virginia Medical School, P.O. Box 1980, Norfolk, VA 23507 USA
- Center for Integrative Neuroscience and Inflammatory Diseases, Eastern Virginia Medical School, P.O. Box 1980, Norfolk, VA 23507 USA
- Pathology and Anatomy, Eastern Virginia Medical School, P.O. Box 1980, Norfolk, VA 23507 USA
| | - Emily M. Colby
- Sleep Research Laboratory, Eastern Virginia Medical School, P.O. Box 1980, Norfolk, VA 23507 USA
- Center for Integrative Neuroscience and Inflammatory Diseases, Eastern Virginia Medical School, P.O. Box 1980, Norfolk, VA 23507 USA
- Pathology and Anatomy, Eastern Virginia Medical School, P.O. Box 1980, Norfolk, VA 23507 USA
| | - Woong-Ki Kim
- Center for Integrative Neuroscience and Inflammatory Diseases, Eastern Virginia Medical School, P.O. Box 1980, Norfolk, VA 23507 USA
- Microbiology and Molecular Cell Biology, Eastern Virginia Medical School, P.O. Box 1980, VA 23507 Norfolk, USA
| | - Laurie L. Wellman
- Sleep Research Laboratory, Eastern Virginia Medical School, P.O. Box 1980, Norfolk, VA 23507 USA
- Center for Integrative Neuroscience and Inflammatory Diseases, Eastern Virginia Medical School, P.O. Box 1980, Norfolk, VA 23507 USA
- Pathology and Anatomy, Eastern Virginia Medical School, P.O. Box 1980, Norfolk, VA 23507 USA
| | - Larry D. Sanford
- Sleep Research Laboratory, Eastern Virginia Medical School, P.O. Box 1980, Norfolk, VA 23507 USA
- Center for Integrative Neuroscience and Inflammatory Diseases, Eastern Virginia Medical School, P.O. Box 1980, Norfolk, VA 23507 USA
- Pathology and Anatomy, Eastern Virginia Medical School, P.O. Box 1980, Norfolk, VA 23507 USA
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Kaltenegger HC, Becker L, Rohleder N, Nowak D, Quartucci C, Weigl M. Associations of technostressors at work with burnout symptoms and chronic low-grade inflammation: a cross-sectional analysis in hospital employees. Int Arch Occup Environ Health 2023:10.1007/s00420-023-01967-8. [PMID: 37148328 PMCID: PMC10163295 DOI: 10.1007/s00420-023-01967-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 02/25/2023] [Indexed: 05/08/2023]
Abstract
OBJECTIVE Despite the increasing scholarly interest in the phenomenon technostress, associated biological effects on employee health are under-researched. Chronic low-grade inflammation is suggested as a central pathway linking stress experience to disease development. The aim of this study was to assess associations of technology-related work stressors (technostressors) with low-grade inflammation and burnout symptoms. METHODS N = 173 (74.6% women, Mage = 31.0 years) university hospital employees participated in a cross-sectional study. Self-report questionnaires were used for the assessment of general psychosocial working conditions (work overload, job control, social climate), a range of different technostressors, burnout symptoms, and relevant confounders. Participants provided capillary blood samples, and high-sensitivity C-reactive protein (hs-CRP) as an inflammatory biomarker was analyzed from dried blood spots. RESULTS Based on a factor analysis, we identified four underlying dimensions of technostressors: techno- and information overload, techno-complexity, interruptions and multitasking as well as usability and technical support. In multivariate linear regressions, techno-/information overload and techno-complexity were associated with core (exhaustion, mental distance) and secondary (psychosomatic complaints) symptoms of burnout. Techno-/information overload was a significant predictor of burnout core symptoms, even when general work overload was controlled for. The technostressors were not associated with hs-CRP. CONCLUSION This is the first study on technology-related stress at work and chronic low-grade inflammation. The results suggest that (information) overload caused by digital technology use is a distinct work stressor with genuine consequences for psychological health. To what extent these effects also manifest on a physiological level needs to be subjected to future studies, ideally with prospective designs.
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Affiliation(s)
- Helena C Kaltenegger
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstr. 1, 80336, Munich, Germany.
| | - Linda Becker
- Institute of Psychology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Nicolas Rohleder
- Institute of Psychology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Dennis Nowak
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstr. 1, 80336, Munich, Germany
| | - Caroline Quartucci
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstr. 1, 80336, Munich, Germany
- Bavarian Health and Food Safety Authority, Institute for Occupational Health and Product Safety, Environmental Health, Munich, Germany
| | - Matthias Weigl
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstr. 1, 80336, Munich, Germany
- Institute for Patient Safety, University Hospital Bonn, Bonn, Germany
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7
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Eguchi H, Watanabe K, Kawakami N, Ando E, Imamura K, Sakuraya A, Sasaki N, Inoue A, Tsuno K, Otsuka Y, Inoue R, Nishida N, Iwanaga M, Hino A, Shimazu A, Tsutsumi A. Work-related psychosocial factors and inflammatory markers: A systematic review and meta-analysis. J Psychosom Res 2023; 170:111349. [PMID: 37187013 DOI: 10.1016/j.jpsychores.2023.111349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 03/08/2023] [Accepted: 04/30/2023] [Indexed: 05/17/2023]
Abstract
OBJECTIVE We conducted a systematic review and meta-analysis to evaluate the prospective effect of adverse work-related psychosocial factors on increases in inflammatory markers. METHODS A systematic literature search was conducted in PubMed, Embase, PsycINFO, PsycARTICLES, and the Japan Medical Abstracts Society database. Studies were eligible for inclusion if they examined associations between work-related psychosocial factors and inflammatory markers (interleukin-6, tumor necrosis factor-alpha, and C-reactive protein), used longitudinal or prospective cohort designs, were conducted among workers, were original articles written in English or Japanese, and were published up to 2017 for the first search, October 2020 for the second, and November 2022 for the third. A meta-analysis was conducted using a random-effects model to assess the pooled effect size for the associations. A meta-regression analysis was used to estimate the association between length of follow-up and effect size. The ROBINS-I tool was used to assess risk of bias. RESULTS Of the 11,121 studies identified in the first search, 29,135 studies from the second, and 9448 studies from the third, eleven were eligible for this review and meta-analysis. The pooled coefficient between adverse work-related psychosocial factors and inflammatory markers was significant and positive (β = 0.014, 95% confidence interval: 0.005-0.023). However, a clear association was only observed for interleukin-6, and all the studies included had serious risks of bias. Meta-regression showed the effect size decreased depending on the follow-up period. CONCLUSION This study revealed a weak positive association between adverse work-related psychosocial factors and increases in inflammatory markers. TRIAL REGISTRATION PROSPERO CRD42018081553 (https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=81553).
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Affiliation(s)
- Hisashi Eguchi
- Department of Mental Health, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu-shi, Fukuoka 807-8555, Japan
| | - Kazuhiro Watanabe
- Department of Public Health, Kitasato University School of Medicine, 1-15-1 Kitazato, Minami-ku, Sagamihara-shi, Kanagawa 252-0374, Japan
| | - Norito Kawakami
- Department of Digital Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Emiko Ando
- Center for Public Health Sciences, National Cancer Center Japan, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
| | - Kotaro Imamura
- Department of Digital Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Asuka Sakuraya
- Department of Digital Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Natsu Sasaki
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Akiomi Inoue
- Institutional Research Center, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu-shi, Fukuoka 807-8555, Japan
| | - Kanami Tsuno
- School of Health Innovation, Kanagawa University of Human Services, 3-25-10 Tono-machi, Kawasaki-ku, Kawasaki-shi, Kanagawa 210-0821, Japan
| | - Yasumasa Otsuka
- Faculty of Human Sciences, University of Tsukuba, 3-29-1 Otsuka, Bunkyo-ku, Tokyo 112-0012, Japan
| | - Reiko Inoue
- Department of Public Health, Kitasato University School of Medicine, 1-15-1 Kitazato, Minami-ku, Sagamihara-shi, Kanagawa 252-0374, Japan
| | - Norimitsu Nishida
- Nidec Corporation, 338 Kuzetonoshiro-cho, Minami-ku, Kyoto 601-8205, Japan
| | - Mai Iwanaga
- Department of Psychiatric Nursing, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Ayako Hino
- Department of Mental Health, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu-shi, Fukuoka 807-8555, Japan
| | - Akihito Shimazu
- Faculty of Policy Management, Keio University, 5322 Endo, Fujisawa-shi, Kanagawa 252-0882, Japan
| | - Akizumi Tsutsumi
- Department of Public Health, Kitasato University School of Medicine, 1-15-1 Kitazato, Minami-ku, Sagamihara-shi, Kanagawa 252-0374, Japan.
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Sanford LD, Wellman LL, Adkins AM, Guo ML, Zhang Y, Ren R, Yang L, Tang X. Modeling integrated stress, sleep, fear and neuroimmune responses: Relevance for understanding trauma and stress-related disorders. Neurobiol Stress 2023; 23:100517. [PMID: 36793998 PMCID: PMC9923229 DOI: 10.1016/j.ynstr.2023.100517] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 12/30/2022] [Accepted: 01/19/2023] [Indexed: 01/24/2023] Open
Abstract
Sleep and stress have complex interactions that are implicated in both physical diseases and psychiatric disorders. These interactions can be modulated by learning and memory, and involve additional interactions with the neuroimmune system. In this paper, we propose that stressful challenges induce integrated responses across multiple systems that can vary depending on situational variables in which the initial stress was experienced, and with the ability of the individual to cope with stress- and fear-inducing challenges. Differences in coping may involve differences in resilience and vulnerability and/or whether the stressful context allows adaptive learning and responses. We provide data demonstrating both common (corticosterone, SIH and fear behaviors) and distinguishing (sleep and neuroimmune) responses that are associated with an individual's ability to respond and relative resilience and vulnerability. We discuss neurocircuitry regulating integrated stress, sleep, neuroimmune and fear responses, and show that responses can be modulated at the neural level. Finally, we discuss factors that need to be considered in models of integrated stress responses and their relevance for understanding stress-related disorders in humans.
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Affiliation(s)
- Larry D. Sanford
- Sleep Research Laboratory, Center for Integrative Neuroscience and Inflammatory Diseases, Pathology and Anatomy, Eastern Virginia Medical School, Norfolk, VA, USA
| | - Laurie L. Wellman
- Sleep Research Laboratory, Center for Integrative Neuroscience and Inflammatory Diseases, Pathology and Anatomy, Eastern Virginia Medical School, Norfolk, VA, USA
| | - Austin M. Adkins
- Sleep Research Laboratory, Center for Integrative Neuroscience and Inflammatory Diseases, Pathology and Anatomy, Eastern Virginia Medical School, Norfolk, VA, USA
| | - Ming-Lei Guo
- Drug Addiction Laboratory, Center for Integrative Neuroscience and Inflammatory Diseases, Pathology and Anatomy, Eastern Virginia Medical School, Norfolk, VA, USA
| | - Ye Zhang
- Sleep Medicine Center, Department of Respiratory and Critical Care Medicine, Mental Health Center, Translational Neuroscience Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Rong Ren
- Sleep Medicine Center, Department of Respiratory and Critical Care Medicine, Mental Health Center, Translational Neuroscience Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Linghui Yang
- Sleep Medicine Center, Department of Respiratory and Critical Care Medicine, Mental Health Center, Translational Neuroscience Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Xiangdong Tang
- Sleep Medicine Center, Department of Respiratory and Critical Care Medicine, Mental Health Center, Translational Neuroscience Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
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9
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Jali IM. Sick Leave Patterns in Common Rheumatological Diseases. Cureus 2023; 15:e34034. [PMID: 36814744 PMCID: PMC9940451 DOI: 10.7759/cureus.34034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2023] [Indexed: 01/22/2023] Open
Abstract
Objectives The study aims to analyze the patterns and determinants of sick leaves (SL) associated with the most common rheumatological diseases and estimate the associated productivity loss cost (PLC). Method A retrospective study reviewed all SLs that were issued from a rheumatology outpatient clinic between 2016 and 2019 for the following diagnoses: low back pain (LBP), knee osteoarthritis (OA), rheumatoid arthritis (RA), and disc disorders. The duration of each sick leave was captured and analyzed by patients' age category, gender, and diagnosis. The human capital method was used to estimate the PLC. Result One thousand and two SLs have been issued during the study period, for a cumulative 4,649 days. The majority of the patients were female (86.3%), and the mean (SD) age was 42.01 (10.71) years. SL durations ranged from 2 to 14 days. The most frequent diagnosis was RA (34.3%), followed by LBP (30.1%). Disc disorder, knee OA, and RA were independently associated with 2.01 (p=0.014), 9.07 (p<0.001), and 7.75 (p<0.001) odd ratios for long SL (≥7 days), by reference to LBP. The average PLC was estimated at $235.29 per day of sick leave, for a total cumulative cost of $235,755.30. Conclusion Rheumatological diseases are responsible for approximately 4.5 days of SL prescribing per day in our clinic, with an average yearly cost of $58,938.83. Monitoring the pattern of sick leave and identifying the interplay between their cofactors are essential to developing a comprehensive approach to enable evidence-based clinical practices along with advancements in work-based protective measures and policies.
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Affiliation(s)
- Ibtisam M Jali
- Internal Medicine and Rheumatology Department, King Abdulaziz University Hospital, Jeddah, SAU
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10
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He W, Ma P, Li X, Wang Y, Zhang Y. Comparison of peripheral blood T, B, and NK lymphocytes between frontline medical workers for treating patients of COVID-19 and normal outpatient and emergency medical workers in China. Front Psychiatry 2023; 14:1165614. [PMID: 37151983 PMCID: PMC10155498 DOI: 10.3389/fpsyt.2023.1165614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 03/30/2023] [Indexed: 05/09/2023] Open
Abstract
The outbreak of the novel coronavirus disease 2019 (COVID-19) has led to significant mental stress for frontline medical workers treating patients with confirmed COVID-19 in China. Psychological stress has an impact on the immune system. The number and percentage of lymphocyte subsets are standard indicators of cellular immune detection. Here, we reported the differences in CD3, CD4, CD8, CD19, and CD56 lymphocytes between 158 frontline medical workers and 24 controls from medical staffs of the outpatient and emergency departments. We found that frontline medical workers had significantly lower absolute values and percentages of CD19+ B cells, especially in the female and the aged ≥40 years subgroup. Stratification analysis showed that the absolute values of CD4+ T cells were significantly lower in the aged <40 years subgroup, while percentages of CD8+ T cells were lower and percentages of CD56+ NK cells were higher in the aged ≥40 years subgroup. In summary, this study suggests paying more attention to frontline medical workers' mental health and immune function, and properly providing them with psychological interventions and measures of care.
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Affiliation(s)
- Weijian He
- China-Japan Union Hospital of Jilin University, Changchun, China
- The Third Norman Bethune Clinical College of Jilin University, Changchun, China
| | - Piyong Ma
- Department of Critical Care Medicine, China–Japan Union Hospital of Jilin University, Changchun, China
| | - Xiuying Li
- Scientific Research Center, China–Japan Union Hospital of Jilin University, Changchun, China
| | - Yali Wang
- Department of Blood Transfusion, China–Japan Union Hospital of Jilin University, Changchun, China
- *Correspondence: Yucheng Zhang, ; Yali Wang,
| | - Yucheng Zhang
- Scientific Research Center, China–Japan Union Hospital of Jilin University, Changchun, China
- *Correspondence: Yucheng Zhang, ; Yali Wang,
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Dayya D, O'Neill OJ, Huedo-Medina TB, Habib N, Moore J, Iyer K. Debridement of Diabetic Foot Ulcers. Adv Wound Care (New Rochelle) 2022; 11:666-686. [PMID: 34376065 PMCID: PMC9527061 DOI: 10.1089/wound.2021.0016] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 07/23/2021] [Indexed: 01/29/2023] Open
Abstract
Diabetic foot ulcerations have devastating complications, including amputations, poor quality of life, and life-threatening infections. Diabetic wounds can be protracted, take significant time to heal, and can recur after healing. They are costly consuming health care resources. These consequences have serious public health and clinical implications. Debridement is often used as a standard of care. Debridement consists of both nonmechanical (autolytic, enzymatic) and mechanical methods (sharp/surgical, wet to dry debridement, aqueous high-pressure lavage, ultrasound, and biosurgery/maggot debridement therapy). It is used to remove nonviable tissue, to facilitate wound healing, and help prevent these serious outcomes. What are the various forms and rationale behind debridement? This article comprehensively reviews cutting-edge methods and the science behind debridement and diabetic foot ulcers.
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Affiliation(s)
- David Dayya
- Division of Undersea and Hyperbaric Medicine, Department of Surgery, Phelps Hospital Northwell Health, Sleepy Hollow, New York, USA
- Department of Allied Health Sciences, University of Connecticut, Storrs, Connecticut, USA
- Department of Community Medicine, University of Connecticut, Storrs, Connecticut, USA
- Department of Emergency Medicine, SUNY – Upstate Medical University, Syracuse, New York, USA
- Department of Family Medicine, University of Vermont College of Medicine, Burlington, Vermont, USA
- Department of Medicine, Greenwich Hospital, Greenwich, Connecticut, USA
- Department of Medicine, Norwalk Hospital, Norwalk, Connecticut, USA
| | - Owen J. O'Neill
- Division of Undersea and Hyperbaric Medicine, Department of Surgery, Phelps Hospital Northwell Health, Sleepy Hollow, New York, USA
- Department of Emergency Medicine, SUNY – Upstate Medical University, Syracuse, New York, USA
- Department of Medicine, New York Medical College, Valhalla, New York, USA
| | - Tania B. Huedo-Medina
- Department of Allied Health Sciences, University of Connecticut, Storrs, Connecticut, USA
- Department of Community Medicine, University of Connecticut, Storrs, Connecticut, USA
| | - Nusrat Habib
- Department of Allied Health Sciences, University of Connecticut, Storrs, Connecticut, USA
- Department of Community Medicine, University of Connecticut, Storrs, Connecticut, USA
| | - Joanna Moore
- Department of Medicine, Norwalk Hospital, Norwalk, Connecticut, USA
| | - Kartik Iyer
- Department of Medicine, Norwalk Hospital, Norwalk, Connecticut, USA
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Sasaki N, Kuroda R, Tsuno K, Imamura K, Kawakami N. The effect of job strain and worksite social support on reported adverse reactions of COVID-19 vaccine: A prospective study of employees in Japan. J Occup Health 2022; 64:e12356. [PMID: 36271320 PMCID: PMC9587126 DOI: 10.1002/1348-9585.12356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 08/19/2022] [Accepted: 08/23/2022] [Indexed: 11/05/2022] Open
Abstract
Objectives This prospective study aimed to examine the association of psychosocial working conditions with adverse reactions after receiving COVID‐19 vaccination in a sample of employees in Japan. Methods The data were retrieved from an online panel of full‐time employees (E‐COCO‐J). The analysis included participants who were employed and were not vaccinated at baseline (June 2021) but received vaccination at a 4‐month follow‐up (October 2021). An 11‐item scale measured the adverse reactions. Four types of psychosocial working conditions (i.e., job demands, job control, and supervisor and coworker support) were measured using the Brief Job Stress Questionnaire. Multiple linear regression analyses were conducted to examine the relationship between the psychosocial working conditions and adverse reactions of COVID‐19 vaccines, adjusting for socioeconomic variables, chronic disease, the number of vaccination, type of vaccine, anxiety for adverse reactions, fear and worry about COVID‐19, and psychological distress at baseline. Results Overall, 747 employees were included in the analysis. The average number of adverse reactions was 3.8 (standard deviation = 2.2): Arm pain (81.1%), fatigues (64.1%), muscle pains (63.3%), and fever (37.5°C+) (53.5%) were reported more frequently. Coworker support score was significantly and negatively associated with the numbers of adverse reactions (standardized β = −0.100, P = .023). Women, young age, second‐time vaccination, Moderna, and high psychological distress were significantly associated with adverse reactions. Conclusions Employees with low coworker support may be more likely to have adverse reactions after vaccinations. The findings of this study could support that increasing workplace support may reduce adverse reactions.
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Affiliation(s)
- Natsu Sasaki
- Department of Mental Health, Graduate School of MedicineThe University of TokyoTokyoJapan
| | - Reiko Kuroda
- Division for Environment, Health, and SafetyThe University of TokyoTokyoJapan
| | - Kanami Tsuno
- School of Health InnovationKanagawa University of Human ServicesKawasakiKanagawaJapan
| | - Kotaro Imamura
- Department of Mental Health, Graduate School of MedicineThe University of TokyoTokyoJapan
| | - Norito Kawakami
- Department of Mental Health, Graduate School of MedicineThe University of TokyoTokyoJapan
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Kaltenegger HC, Weigl M, Becker L, Rohleder N, Nowak D, Quartucci C. Psychosocial working conditions and chronic low-grade inflammation in geriatric care professionals: A cross-sectional study. PLoS One 2022; 17:e0274202. [PMID: 36107874 PMCID: PMC9477283 DOI: 10.1371/journal.pone.0274202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 08/23/2022] [Indexed: 11/18/2022] Open
Abstract
Background
Chronic low-grade inflammation has been suggested as a key factor in the association between stress exposure and long-term health. Care work is recognized as a profession with a high degree of job stress and health risks. However, for care professionals, the study base on inflammatory activity due to adverse working conditions is limited.
Objective
The aim of this study was to explore associations between self-reported psychosocial working conditions and care professionals’ biomarkers of systemic low-grade inflammation.
Methods
N = 140 geriatric care professionals (79.3% females, mean age = 44.1 years) of six care facilities were enrolled in a cross-sectional study consisting of standardized medical examinations and employee surveys. Standardized questionnaires were used for evaluation of psychosocial work characteristics (work overload, job autonomy, social support) based on Karasek’s job strain model. Blood samples were drawn for two biomarkers of inflammatory activity: C-reactive protein (CRP) and leukocyte count. Analyses comprised uni- and multivariate logistic and linear regression analyses.
Results
We determined a proportion of 5.4% of care professionals with increased low-grade inflammation. We further observed a relationship between job autonomy and CRP, such that reports of high job autonomy were associated with increased levels of CRP (adjusted OR = 4.10, 95% CI [1.10, 15.26], p = .035), which was robust in additional analyses on further potential confounders. No significant associations with participants’ leukocyte numbers were found.
Conclusions
This exploratory study contributes to the research base on links between workplace stress and ensuing illness in care professionals. Our findings may help to identify risk and protective factors of the work environment for chronic low-grade inflammation. The results require further scrutiny, and future prospective studies on associations of psychosocial working conditions, low-grade inflammation and long-term health outcomes in care professionals are needed.
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Affiliation(s)
- Helena C. Kaltenegger
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany
- * E-mail:
| | - Matthias Weigl
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany
- Institute for Patient Safety, University Hospital Bonn, Bonn, Germany
| | - Linda Becker
- Chair of Health Psychology, Institute of Psychology, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Nicolas Rohleder
- Chair of Health Psychology, Institute of Psychology, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Dennis Nowak
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Caroline Quartucci
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany
- Bavarian Health and Food Safety Authority, Institute for Occupational Health and Product Safety, Environmental Health, Munich, Germany
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14
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Wang W, Guo T, Guo H, Chen X, Ma Y, Deng H, Yu H, Chen Q, Li H, Liu Q, Shan A, Li Y, Pang B, Shi J, Wang X, Chen J, Deng F, Sun Z, Guo X, Wang Y, Tang N, Wu S. Ambient particulate air pollution, blood cell parameters, and effect modification by psychosocial stress: Findings from two studies in three major Chinese cities. ENVIRONMENTAL RESEARCH 2022; 210:112932. [PMID: 35176316 DOI: 10.1016/j.envres.2022.112932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 01/04/2022] [Accepted: 02/07/2022] [Indexed: 06/14/2023]
Abstract
The associations between particulate matter (PM) exposure, psychosocial stress and blood cell parameters are bringing novel insights to characterize the early damage of multiple diseases. Based on two studies conducted in three Chinses cities using cross-sectional (Beijing, 425 participants) and panel study (Tianjin and Shanghai, 92 participants with 361 repeated measurements) designs, this study explored the associations between short-term exposure to ambient PM and blood cell parameters, and the effect modification by psychosocial stress. Increasing PM2.5 exposure was significantly associated with decreases in red blood cell (RBC) count and mean corpuscular hemoglobin concentration (MCHC), and increases in mean corpuscular volume (MCV), platelets count (PLT) and platelet hematocrit (PCT) in both studies. For instance, a 10 μg/m3 increment in PM2.5 concentration was associated with a 1.04% (95%CI: 0.16%, 1.92%) increase in PLT (4-d) and a 1.09% (95%CI: 0.31%, 1.87%) increase in PCT (4-d) in the cross-sectional study, and a 0.64% (95%CI: 0.06%, 1.22%) increase in PLT (1-d) and a 0.72% (95%CI: 0.33%, 1.11%) increase in PCT (1-d) in the panel study, respectively. In addition, stronger increases in MCV, PLT, and PCT associated with PM2.5 exposure were found in higher psychosocial stress group compared to lower psychosocial stress group (p for interaction <0.10), indicating that blood cell parameters of individuals with higher psychosocial stress might be more susceptible to the early damages of PM2.5 exposure.
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Affiliation(s)
- Wanzhou Wang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Tongjun Guo
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Huaqi Guo
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xi Chen
- Department of Occupational and Environmental Health, Tianjin Key Laboratory of Environment, Nutrition and Public Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yating Ma
- Institute of Social Psychology, School of Humanities and Social Sciences, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Hongyan Deng
- Qinglongqiao Community Health Service Center, Haidian District, Beijing, China
| | - Hengyi Yu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qiao Chen
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Hongyu Li
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Qisijing Liu
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Anqi Shan
- Department of Occupational and Environmental Health, Tianjin Key Laboratory of Environment, Nutrition and Public Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yaoyan Li
- Department of Occupational and Environmental Health, Tianjin Key Laboratory of Environment, Nutrition and Public Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Bo Pang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Jiazhang Shi
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Xinmei Wang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Juan Chen
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Furong Deng
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Zhiwei Sun
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing, China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, China
| | - Xinbiao Guo
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Yan Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China; The Ninth People's Hospital of Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Naijun Tang
- Department of Occupational and Environmental Health, Tianjin Key Laboratory of Environment, Nutrition and Public Health, School of Public Health, Tianjin Medical University, Tianjin, China.
| | - Shaowei Wu
- Department of Occupational and Environmental Health, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China; Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, Xi'an, Shaanxi, China; Key Laboratory of Trace Elements and Endemic Diseases in Ministry of Health, Xi'an, Shaanxi, China.
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15
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Within subject rise in serum TNFα to IL-10 ratio is associated with poorer attention, decision-making and working memory in jockeys. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2022; 10:100131. [PMID: 35755205 PMCID: PMC9216657 DOI: 10.1016/j.cpnec.2022.100131] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 03/18/2022] [Accepted: 03/18/2022] [Indexed: 12/12/2022] Open
Abstract
Jockeys work in high-risk environments that rely heavily on attention- and decision-making to perform well and safely. Workplace stress literature has often overlooked the impact of stress on cognition, and designs that include physiological measures are rare. This study assessed the prospective concurrent relationships between workplace stress, depression symptoms and low-grade inflammation with cognitive performance among professional jockeys. Professional jockeys (N = 35, Mage = 32.29) provided information on workplace stress and depression symptoms, with serum levels of inflammatory cytokines (IL-6, IL-10, TNFα) and cytokine balance (IL-6: IL-10, TNFα: IL-10) quantified with SIMOA, and cognitive performance with CogSport computer-based testing battery. These measures were repeated after a twelve-month interval. Increased workplace stress between testing intervals was associated to an increased cytokine imbalance (β = 0.447, p = .015) after controlling for age and gender. Increases in cytokine imbalance occurred in unison with decreases in attention (β = 0.516, p = .002), decision-making (β = 0.452, p = .009) and working memory (β = 0.492, p = .004). These preliminary findings suggest the underlying mechanisms linking workplace stress and reduced cognitive performance may be influenced by measures of low-grade inflammation and specifically a cytokine imbalance. Our findings suggest a measure of cytokine balance may explain the heterogenous findings in previous studies that have focussed solely on the association of workplace stress with pro-inflammatory cytokines. Future work is needed however, to provide a broader evidence-base for our claims to better inform designs to intervene in the higher workplace stress-poorer cognition relationship. Increases in workplace stress are associated with increased cytokine imbalance. Increased cytokine imbalance is associated with reduced cognitive performance. Workplace stress better predicts cytokine imbalance than individual cytokines. Cytokine imbalance better predicts cognition than individual cytokines.
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16
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Santana AIC, das Merces MC, de Souza MC, de Carvalho Lima BG, Galdino MJQ, de Carvalho Félix ND, Magalhães LBNC, Coelho JMF, Barbosa PJB, Dias Gomes ÉV, Pimentel RFW, de Sousa AR, de Oliveira MAF, de Queiroz AM, Florencio RMS, Cavalcante Neto JL, Gomes AMT, Souza Santos TB, Vieira SL, de Sousa DG, da Silva Thiengo de Andrade PC, de Negreiros Nogueira Maduro IP, Fernandes SL, Damasceno KSM, da Silva DAR, D'Oliveira Júnior A. Interaction between Work and Metabolic Syndrome: A Population-Based Cross-Sectional Study. Healthcare (Basel) 2022; 10:544. [PMID: 35327022 PMCID: PMC8953470 DOI: 10.3390/healthcare10030544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 02/22/2022] [Accepted: 03/11/2022] [Indexed: 11/16/2022] Open
Abstract
Metabolic syndrome (MS) is a clinical condition and a relevant risk factor in the development of cardiovascular diseases; it occurs as a result of lifestyle factors, e.g., work. The aim of this research was to estimate the interaction between work and MS among primary health care (PHC) nursing professionals in the state of Bahia, Brazil. A sectional multicentered study carried out in 43 municipalities in Bahia, whose study population consisted of nursing professionals. The exposure variables were occupation, professional exhaustion, and working time, and the outcome variable was MS. Interaction measures based on the additivity criteria were verified by calculating the excess risks due to the interactions and according to the proportion of cases attributed to the interactions and the synergy index. The global MS prevalence is 24.4%. There was a greater magnitude in the exposure group regarding the three investigated factors (average level occupation, professional exhaustion, and working time in PHC for more than 5 years), reaching an occurrence of 44.9% when compared to the prevalence of 13.1% in the non-exposure group (academic education, without professional burnout, and working time in PHC for up to 5 years). The study's findings showed a synergistic interaction of work aspects for MS occurrence among PHC nursing professionals.
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Affiliation(s)
- Amália Ivine Costa Santana
- Health Sciences Postgraduate Program, School of Medicine, Federal University of Bahia (UFBA), Salvador 40026-010, Bahia, Brazil
| | - Magno Conceição das Merces
- Health Sciences Postgraduate Program, School of Medicine, Federal University of Bahia (UFBA), Salvador 40026-010, Bahia, Brazil
- Department of Life Sciences, State University of Bahia (UNEB), Salvador 41150-000, Bahia, Brazil
- FTC University Center (UniFTC), Federal University of Bahia (UFBA), Salvador 41741-590, Bahia, Brazil
| | - Marcio Costa de Souza
- Department of Life Sciences, State University of Bahia (UNEB), Salvador 41150-000, Bahia, Brazil
| | - Bruno Gil de Carvalho Lima
- FTC University Center (UniFTC), Federal University of Bahia (UFBA), Salvador 41741-590, Bahia, Brazil
- Department of Pathology and Forensic Medicine, School of Medicine, Federal University of Bahia (UFBA), Salvador 40026-010, Bahia, Brazil
| | - Maria José Quina Galdino
- Department of Nursing, State University of Northern Paraná (UENP), Bandeirantes 86360-000, Paraná, Brazil
| | - Nuno Damácio de Carvalho Félix
- Health Sciences Center, Federal University of Recôncavo of Bahia (UFRB), Santo Antônio de Jesus 44574-490, Bahia, Brazil
| | - Lucelia Batista Neves Cunha Magalhães
- FTC University Center (UniFTC), Federal University of Bahia (UFBA), Salvador 41741-590, Bahia, Brazil
- Department of Family Health, School of Medicine, Federal University of Bahia (UFBA), Salvador 40026-010, Bahia, Brazil
| | | | | | - Érica Velasco Dias Gomes
- Department of Life Sciences, State University of Bahia (UNEB), Salvador 41150-000, Bahia, Brazil
| | - Rodrigo Fernandes Weyll Pimentel
- Health Sciences Postgraduate Program, School of Medicine, Federal University of Bahia (UFBA), Salvador 40026-010, Bahia, Brazil
- Department of Life Sciences, State University of Bahia (UNEB), Salvador 41150-000, Bahia, Brazil
- Brazilian Association of Nutrition (ABRAN), Catanduva 15801-150, São Paulo, Brazil
| | - Anderson Reis de Sousa
- School of Nursing, Federal University of Bahia (UFBA), Salvador 40231-300, Bahia, Brazil
| | | | | | | | | | - Antonio Marcos Tosoli Gomes
- School of Nursing, State University of Rio de Janeiro (UERJ), Rio de Janeiro 20551-030, Rio de Janeiro, Brazil
| | | | - Silvana Lima Vieira
- Department of Life Sciences, State University of Bahia (UNEB), Salvador 41150-000, Bahia, Brazil
| | | | | | - Isolda Prado de Negreiros Nogueira Maduro
- Brazilian Association of Nutrition (ABRAN), Catanduva 15801-150, São Paulo, Brazil
- Department of Clinical Nutrition, State University of Amazonas (UEA), Manaus 69850-000, Amazonas, Brazil
| | | | - Kairo Silvestre Meneses Damasceno
- Health Sciences Postgraduate Program, School of Medicine, Federal University of Bahia (UFBA), Salvador 40026-010, Bahia, Brazil
- Department of Life Sciences, State University of Bahia (UNEB), Salvador 41150-000, Bahia, Brazil
| | | | - Argemiro D'Oliveira Júnior
- Health Sciences Postgraduate Program, School of Medicine, Federal University of Bahia (UFBA), Salvador 40026-010, Bahia, Brazil
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Rahangdale RR, Tender T, Balireddy S, Pasupuleti M, Hariharapura RC. The Interplay Between Stress and Immunity Triggers Herpes Zoster Infection in COVID-19 Patients: A Review. Can J Microbiol 2022; 68:303-314. [PMID: 35167378 DOI: 10.1139/cjm-2021-0242] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Coronavirus disease 2019 (COVID-19) is a potential health threat in the highly mobile society of the world. Also, there are concerns regarding the co-infections occurring in COVID-19 patients. Herpes zoster (HZ) is now being reported as a co-infection in COVID-19 patients. It is a varicella-zoster virus induced viral infection affecting older people and immunocompromised individuals. Reactivation of HZ infection in COVID-19 patients are emerging and the mechanism of reactivation is still unknown. A most convincing argument would be, increased psychological and immunological stress leading to HZ in COVID-19 patients, and this review justifies this argument.
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Affiliation(s)
- Rakesh Ravishankar Rahangdale
- Manipal Academy of Higher Education, 76793, Manipal College of Pharmaceutical Sciences, Department of Pharmaceutical Biotechnology, Manipal, India;
| | - Tenzin Tender
- Manipal Academy of Higher Education, 76793, Manipal College of Pharmaceutical Sciences, Department of Pharmaceutical Biotechnology, Manipal, India;
| | - Sridevi Balireddy
- Manipal Academy of Higher Education, 76793, Manipal College of Pharmaceutical Sciences, Department of Pharmaceutical Biotechnology, Manipal, India;
| | - Mukesh Pasupuleti
- Central Drug Research Institute, 30082, Microbiology Division, Lucknow, India;
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Kononova OV, Timokhina TO, Borysenko AV. CHANGES IN IMMUNOLOGICAL INDICATORS UNDER THE INFLUENCE OF TREATMENT OF GENERALIZED PERIODONTITIS IN PATIENTS WITH MANIFESTATIONS OF PSYCHOEMOTIONAL STRESS. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2022; 75:1529-1533. [PMID: 35907228 DOI: 10.36740/wlek202206118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE The aim: The aim of investigation was to determine the effect of the proposed treatment of patients with generalized periodontitis and psychoemotional stress on changes in the immune system of patients. PATIENTS AND METHODS Materials and methods: The clinical and laboratory investigations were conducted to revealed the effectiveness of the proposal complex of adrenoblockers in complex treatment of generalized periodontitis in 40 patients with psychoemotional stress. To assess the effectiveness of the treatment, the level of cortisol in saliva was determined. 40 patients with chronic course of generalized periodontitis I-II grade were divided into two subgroups: main and control. For the treatment of main subgroup patients used a modified enhanced complex of adrenoblockers to suppress the manifestations of psychoemotional stress. RESULTS Results: The effectiveness of usage of the proposed complex of adrenoblockers were revealed after treatment of main group patients. The complex of adrenoblockers lead to stabilization of the generalized periodontitis in patients with psychoemotional stress. Such combination of adrenoblockers oppresses main symptoms of psychoemotional stress in with generalized periodontitis as evidenced by the decrease of cortisol levels in the patients saliva. CONCLUSION Conclusions: As a result of researches the obtained data testify to achievement of stabilization of pathological process in a periodontium. All this together demonstrates the beneficial effect of the proposed complex of adrenoblockers on the dystrophic-inflammatory process in the periodontium. Decreased levels of cortisol in saliva indicate a decrease in the manifestations of psychoemotional stress in patients with generalized periodontitis.
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Anisman H, Kusnecov AW. Stress, immunity, and cancer. Cancer 2022. [DOI: 10.1016/b978-0-323-91904-3.00017-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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20
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Widaty S, Oktarina C, Suling PL, Niode NJ, Miranda E, Andriani A, Amin S, Yenny SW, Bramono K. Mucocutaneous mycoses in people living with human immunodeficiency virus in Indonesia. Mycoses 2021; 65:323-330. [PMID: 34902221 DOI: 10.1111/myc.13414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 12/08/2021] [Accepted: 12/11/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND To date, integrated care for people living with human immunodeficiency virus (PLHIV) has improved. However, although the management of mucocutaneous mycosis cases has improved, disease progression might be different in immunocompromised patients, which leads to variable clinical manifestations. OBJECTIVES To describe the characteristics of mucocutaneous mycosis cases in the PLHIV population and its associated factors in Indonesia. METHODS This retrospective study was conducted from January 2014 to December 2018 in four academic hospitals. Data were acquired from medical records with the inclusion of mucocutaneous mycosis patients with concurrent HIV infection. Analysis with the chi-squared test was performed using Statistical Package for the Social Sciences (SPSS) version 20.0. RESULTS A total of 1,796 cases of mucocutaneous mycoses were identified in 1782 PLHIV. The most common types of infection were candidiasis (63%), followed by dermatophytosis (35.1%), and malasseziosis (1.9%), which were significantly higher in PLHIV with CD4 level <200 cells/mm3 . The proportions of male gender (78.6% vs. 56.3%, p < .001), high level of education (48.0% vs. 64.1%, p < .001), office workers (73.8% vs. 64.1%, p < .001), combination of topical and systemic antifungal agents (59.1% vs. 48.5%, p = .006) and not receiving antiretroviral therapy (63.2% vs. 7.8%, p < .001) were significantly higher in PLHIV with a CD4 level <200 cells/mm3 . CONCLUSION In Indonesia, the most common fungal infection in PLHIV is candidiasis. This study also addressed the important matters regarding mucocutaneous mycoses in PLHIV. Education is an important measure to prevent the incidence of cutaneous mycoses in PLHIV, especially in high-risk groups.
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Affiliation(s)
- Sandra Widaty
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia - dr. Cipto Mangunkusumo National Central General Hospital, Central Jakarta, Jakarta, Indonesia.,Indonesian Dermatomycosis Study Group - Indonesian Society of Dermatology and Venereology, Jakarta, Indonesia
| | - Caroline Oktarina
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia - dr. Cipto Mangunkusumo National Central General Hospital, Central Jakarta, Jakarta, Indonesia.,Indonesian Dermatomycosis Study Group - Indonesian Society of Dermatology and Venereology, Jakarta, Indonesia
| | - Pieter Levinus Suling
- Indonesian Dermatomycosis Study Group - Indonesian Society of Dermatology and Venereology, Jakarta, Indonesia.,Department of Dermatology and Venereology, Faculty of Medicine, Universitas Samratulangi - Prof. Dr. Kandou General Hospital, R. W. Monginsidi (Malalayang), Manado, Indonesia
| | - Nurdjannah Jane Niode
- Indonesian Dermatomycosis Study Group - Indonesian Society of Dermatology and Venereology, Jakarta, Indonesia.,Department of Dermatology and Venereology, Faculty of Medicine, Universitas Samratulangi - Prof. Dr. Kandou General Hospital, R. W. Monginsidi (Malalayang), Manado, Indonesia
| | - Eliza Miranda
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia - dr. Cipto Mangunkusumo National Central General Hospital, Central Jakarta, Jakarta, Indonesia.,Indonesian Dermatomycosis Study Group - Indonesian Society of Dermatology and Venereology, Jakarta, Indonesia
| | - Anni Andriani
- Indonesian Dermatomycosis Study Group - Indonesian Society of Dermatology and Venereology, Jakarta, Indonesia.,Department of Dermatology and Venereology, Faculty of Medicine, Hasanuddin University - dr. Wahidin Sudirohuosodo General Hospital, Makassar, Indonesia
| | - Safruddin Amin
- Indonesian Dermatomycosis Study Group - Indonesian Society of Dermatology and Venereology, Jakarta, Indonesia.,Department of Dermatology and Venereology, Faculty of Medicine, Hasanuddin University - dr. Wahidin Sudirohuosodo General Hospital, Makassar, Indonesia
| | - Satya Widya Yenny
- Indonesian Dermatomycosis Study Group - Indonesian Society of Dermatology and Venereology, Jakarta, Indonesia.,Department of Dermatology and Venereology, Faculty of Medicine, Andalas University - M. Djamil General Hospital, Perintis Kemerdekaan, Padang, Indonesia
| | - Kusmarinah Bramono
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia - dr. Cipto Mangunkusumo National Central General Hospital, Central Jakarta, Jakarta, Indonesia.,Indonesian Dermatomycosis Study Group - Indonesian Society of Dermatology and Venereology, Jakarta, Indonesia
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21
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Khanijahani A, Iezadi S, Gholipour K, Azami-Aghdash S, Naghibi D. A systematic review of racial/ethnic and socioeconomic disparities in COVID-19. Int J Equity Health 2021; 20:248. [PMID: 34819081 PMCID: PMC8611382 DOI: 10.1186/s12939-021-01582-4] [Citation(s) in RCA: 265] [Impact Index Per Article: 88.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 10/30/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Preliminary evidence from the COVID-19 pandemic shows the presence of health disparities, especially in terms of morbidity and mortality. This study aimed to systematically review the evidence on the association of racial/ethnic and socioeconomic status (SES) with health outcomes and access to healthcare services during the COVID-19 pandemic. METHODS We retrieved published evidence from late December 2019 through March 1, 2021. The target population was the population of the countries during the COVID-19 pandemic. The exposures were defined as belonging to racial/ethnic minority groups and/or low SES. The primary outcomes of interest include (1) death from COVID-19, (2) COVID-19 incidence/infection, (3) COVID-19 hospitalization, (4) ICU admission, (5) need for mechanical ventilation, (6) confirmed diagnosis, and (7) access to testing. We systematically synthesized the findings from different studies and provided a narrative explanation of the results. RESULTS After removing the duplicate results and screening for relevant titles and abstracts, 77 studies were selected for full-text review. Finally, 52 studies were included in the review. The majority of the studies were from the United States (37 studies). Despite the significant incongruity among the studies, most of them showed that racial/ethnic minority groups had higher risks of COVID-19 infection and hospitalization, confirmed diagnosis, and death. Additionally, most of the studies cited factors such as low level of education, poverty, poor housing conditions, low household income, speaking in a language other than the national language in a country, and living in overcrowded households as risk factors of COVID-19 incidence/infection, death, and confirmed diagnosis. However, findings in terms of the association of lack of health insurance coverage and unemployment with the outcome measures as well as the association of requiring mechanical ventilation, ICU admission, and access to testing for COVID-19 with race/ethnicity were limited and inconsistent. CONCLUSION It is evident that racial/ethnic minority groups and those from low SES are more vulnerable to COVID-19; therefore, public health policymakers, practitioners, and clinicians should be aware of these inequalities and strive to narrow the gap by focusing on vulnerable populations. This systematic review also revealed a major incongruity in the definition of the racial/ethnic minority groups and SES among the studies. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42020190105.
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Affiliation(s)
- Ahmad Khanijahani
- Department of Health Administration and Public Health, John G. Rangos School of Health Sciences, Duquesne University, Pittsburgh, PA, USA
| | - Shabnam Iezadi
- Hospital Management Research Center, Iran University of Medical Sciences, Tehran, Iran.
| | - Kamal Gholipour
- Social Determinants of Health Research Center, Department of Health Service Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Saber Azami-Aghdash
- Tabriz Health Services Management Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Deniz Naghibi
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
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22
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Acute Response of Stress System in Multiple Sclerosis. ARCHIVES OF NEUROSCIENCE 2021. [DOI: 10.5812/ans.115781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: It has long been suspected that exposure to stress is a major factor that can increase the risk of Multiple Sclerosis (MS) and exacerbate it, as a stress-related disorder. Therefore, we conducted this study to investigate the response of the hypothalamic-pituitary-adrenal (HPA) axis and sympathetic-adrenal-medullar (SAM) system to acute social stress. Methods: A total of 46 MS patients and 23 age-sex-matched healthy controls were recruited in the study. The Trier Social Stress Test (TSST) was used to induce acute psychosocial stress. We measured salivary cortisol (SC) to evaluate the HPA axis. In addition, electrocardiography (ECG) was recorded to evaluate the SAM system based on the linear and non-linear features of Heart Rate Variation (HRV). Then, SC and HRV were measured before and after the stress exposure. We also used the Depression Anxiety Stress Scale (DASS) and Emotional Visual Analog Scale (EVAS) to conduct the psychometric assessment and evaluate the perceived stress level, respectively. Results: The mean age of the MS group was 35.38 ± 15 years, with a mean disease duration of 7.4 ± 60. Besides, the HC group's mean age was 35.8 ± 9 years. There were no significant differences in demographic features and DASS scores between the two groups. In response to TSST, both MS and healthy individuals showed a significant increase in the SC levels and EVAS scores, as well as changes in the HRV indices. Notably, significant differences were also found between the two groups regarding the basic and post-stress SC levels, EVAS score, and HRV indices. Unlike the HC group, the SC level returned to its baseline after recovery in the MS group, and the sympathetic tone was more sensitive. Conclusions: Our results indicated that both MS and healthy individuals respond to acute stress regarding neuroendocrine assessment; however, patients with multiple sclerosis show some impairments in this response.
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The Value of a Complete Blood Count (CBC) for Sepsis Diagnosis and Prognosis. Diagnostics (Basel) 2021; 11:diagnostics11101881. [PMID: 34679578 PMCID: PMC8534992 DOI: 10.3390/diagnostics11101881] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 10/08/2021] [Accepted: 10/10/2021] [Indexed: 12/28/2022] Open
Abstract
Sepsis represents an important global health burden due to its high mortality and morbidity. The rapid detection of sepsis is crucial in order to prevent adverse outcomes and reduce mortality. However, the diagnosis of sepsis is still challenging and many efforts have been made to identify reliable biomarkers. Unfortunately, many investigated biomarkers have several limitations that do not support their introduction in clinical practice, such as moderate diagnostic and prognostic accuracy, long turn-around time, and high-costs. Complete blood count represents instead a precious test that provides a wealth of information on individual health status. It can guide clinicians to early-identify patients at high risk of developing sepsis and to predict adverse outcomes. It has several advantages, being cheap, easy-to-perform, and available in all wards, from the emergency department to the intensive care unit. Noteworthy, it represents a first-level test and an alteration of its parameters must always be considered within the clinical context, and the eventual suspect of sepsis must be confirmed by more specific investigations. In this review, we describe the usefulness of basic and new complete blood count parameters as diagnostic and prognostic biomarkers of sepsis.
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24
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Pega F, Náfrádi B, Momen NC, Ujita Y, Streicher KN, Prüss-Üstün AM, Descatha A, Driscoll T, Fischer FM, Godderis L, Kiiver HM, Li J, Magnusson Hanson LL, Rugulies R, Sørensen K, Woodruff TJ. Global, regional, and national burdens of ischemic heart disease and stroke attributable to exposure to long working hours for 194 countries, 2000-2016: A systematic analysis from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury. ENVIRONMENT INTERNATIONAL 2021; 154:106595. [PMID: 34011457 PMCID: PMC8204267 DOI: 10.1016/j.envint.2021.106595] [Citation(s) in RCA: 131] [Impact Index Per Article: 43.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 04/16/2021] [Accepted: 04/20/2021] [Indexed: 05/21/2023]
Abstract
BACKGROUND World Health Organization (WHO) and International Labour Organization (ILO) systematic reviews reported sufficient evidence for higher risks of ischemic heart disease and stroke amongst people working long hours (≥55 hours/week), compared with people working standard hours (35-40 hours/week). This article presents WHO/ILO Joint Estimates of global, regional, and national exposure to long working hours, for 194 countries, and the attributable burdens of ischemic heart disease and stroke, for 183 countries, by sex and age, for 2000, 2010, and 2016. METHODS AND FINDINGS We calculated population-attributable fractions from estimates of the population exposed to long working hours and relative risks of exposure on the diseases from the systematic reviews. The exposed population was modelled using data from 2324 cross-sectional surveys and 1742 quarterly survey datasets. Attributable disease burdens were estimated by applying the population-attributable fractions to WHO's Global Health Estimates of total disease burdens. RESULTS In 2016, 488 million people (95% uncertainty range: 472-503 million), or 8.9% (8.6-9.1) of the global population, were exposed to working long hours (≥55 hours/week). An estimated 745,194 deaths (705,786-784,601) and 23.3 million disability-adjusted life years (22.2-24.4) from ischemic heart disease and stroke combined were attributable to this exposure. The population-attributable fractions for deaths were 3.7% (3.4-4.0) for ischemic heart disease and 6.9% for stroke (6.4-7.5); for disability-adjusted life years they were 5.3% (4.9-5.6) for ischemic heart disease and 9.3% (8.7-9.9) for stroke. CONCLUSIONS WHO and ILO estimate exposure to long working hours (≥55 hours/week) is common and causes large attributable burdens of ischemic heart disease and stroke. Protecting and promoting occupational and workers' safety and health requires interventions to reduce hazardous long working hours.
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Affiliation(s)
- Frank Pega
- Department of Environment, Climate Change and Health, World Health Organization, Geneva, Switzerland.
| | - Bálint Náfrádi
- Labour Administration, Labour Inspection and Occupational Safety and Health Branch, International Labour Organization, Geneva, Switzerland
| | - Natalie C Momen
- Department of Environment, Climate Change and Health, World Health Organization, Geneva, Switzerland
| | - Yuka Ujita
- Labour Administration, Labour Inspection and Occupational Safety and Health Branch, International Labour Organization, Geneva, Switzerland
| | - Kai N Streicher
- Department of Environment, Climate Change and Health, World Health Organization, Geneva, Switzerland
| | - Annette M Prüss-Üstün
- Department of Environment, Climate Change and Health, World Health Organization, Geneva, Switzerland
| | - Alexis Descatha
- UNIV Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, Angers, France; AP-HP (Paris Hospital), Occupational Health Unit, Poincaré University Hospital, Garches, France; Versailles St-Quentin Univ-Paris Saclay Univ (UVSQ), UMS 011, UMR-S 1168, France; Inserm, U1168 UMS 011, Villejuif, France
| | - Tim Driscoll
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Frida M Fischer
- Department of Environmental Health, School of Public Health, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Lode Godderis
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | | | - Jian Li
- Department of Environmental Health Sciences, Fielding School of Public Health, School of Nursing, University of California Los Angeles, Los Angeles, CA, USA
| | | | - Reiner Rugulies
- National Research Centre for the Working Environment, Copenhagen, Denmark; Department of Public Health, University of Copenhagen, Copenhagen, Denmark; Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Kathrine Sørensen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Tracey J Woodruff
- Program on Reproductive Health and the Environment, University of California San Francisco, San Francisco, CA, USA
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25
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Abstract
BACKGROUND Psychosocial and physical stressors can elicit the stress response, co-ordinated by interactions between neuroendocrine and inflammatory processes. The central role of the immune system, specifically low-grade systemic inflammation, is sometimes overlooked in work-related stress research. OBJECTIVE To review evidence that work-related psychosocial and physical stressors can stimulate a low-grade systemic inflammation which, through interactions with the neurohormonal systems, may impact on the well-being and productivity of workers. METHODS Literature searches were performed by databases and by hand. Databases used included Interface - EBSCOhost Research Databases; PsycINFO; Academic Search Complete; Africa-Wide Information; CINAHL; E-Journals; MEDLINE and PsycARTICLES. RESULTS Psychosocial stressors, infections, poor indoor air quality, musculoskeletal injuries and chemicals can stimulate a low-grade systemic inflammation that may adversely affect workers' mental and physical health, as well as productivity. The psychological and physical effects caused by infection-induced inflammation are generally referred to as sickness behaviour and those caused by poor indoor air quality as sick building syndrome. CONCLUSIONS Stressor-induced low-grade systemic inflammation can be a causal factor in the physical and behavioural symptoms of work-related stress. It is therefore important that those involved with the health of workers be cognisant of inappropriate or chronic low-grade inflammation as a potential health hazard.
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Affiliation(s)
- Margaretha Viljoen
- Department of Psychiatry, University of Pretoria, Pretoria, South Africa
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26
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Cui J, Ren YH, Zhao FJ, Chen Y, Huang YF, Yang L, You XM. Cross-Sectional Study of the Effects of Job Burnout on Immune Function in 105 Female Oncology Nurses at a Tertiary Oncology Hospital. Med Sci Monit 2021; 27:e929711. [PMID: 33941757 PMCID: PMC8106256 DOI: 10.12659/msm.929711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Nurses who work in hospitals experience a high level of burnout and the relationship between immune variables and burnout syndrome has yet to be elucidated. The aim of the present study was to investigate the effects of job burnout on immune function in female oncology nurses in a tertiary oncology hospital in Guangxi, China. The aspects of the human immune system evaluated were humoral and cellular immunity and complement components 3 (C3) and 4 (C4). Material/Methods We administered the Maslach Burnout Inventory-General Survey (MBI-GS), which includes scales for emotional exhaustion, depersonalization (DP), and personal accomplishment (PA), to measure variables related to immune function in 105 female nurses in a tertiary oncology hospital in Guangxi, China. Levels of humoral immunity and C3 and C4 were detected with immune turbidimetry. Cellular immunity was assessed with indirect immunofluorescence. Results A Spearman rank correlation analysis revealed that levels of C3, C4, and CD4- and CD8-positive T cells were significantly associated with burnout symptoms (P<0.05, P<0.01, and P<0.05, respectively). Furthermore, there was a correlation between demographic data and humoral and cellular immunity (both P<0.05). Multivariable linear regression analysis showed that C4 levels were closely related to DP (P<0.05) and that CD4 and CD8 levels were closely related to PA (P<0.01). Conclusions These results suggest that DP and PA have an impact on immune function, and that timely psychological and behavioral interventions can be used to reduce the degree of job burnout among nurses and regulate their immunity, thus enabling them to better serve patients.
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Affiliation(s)
- Jing Cui
- Nursing Department, Guangxi Medical University Affiliated Cancer Hospital, Nanning, Guangxi, China (mainland)
| | - Yun-Hong Ren
- Nursing Department, Guangxi Medical University Affiliated Cancer Hospital, Nanning, Guangxi, China (mainland)
| | - Feng-Juan Zhao
- Nursing Department, Guangxi Medical University Affiliated Cancer Hospital, Nanning, Guangxi, China (mainland)
| | - Ying Chen
- Nursing Department, Guangxi Medical University Affiliated Cancer Hospital, Nanning, Guangxi, China (mainland)
| | - Ying-Fan Huang
- Nursing Department, Guangxi Medical University Affiliated Cancer Hospital, Nanning, Guangxi, China (mainland)
| | - Ling Yang
- Nursing Department, Guangxi Medical University Affiliated Cancer Hospital, Nanning, Guangxi, China (mainland)
| | - Xue-Mei You
- Nursing Department, Guangxi Medical University Affiliated Cancer Hospital, Nanning, Guangxi, China (mainland)
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27
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Tondokoro T, Nakata A, Otsuka Y, Yanagihara N, Anan A, Kodama H, Satoh N. Effects of participatory workplace improvement program on stress-related biomarkers and self-reported stress among university hospital nurses: a preliminary study. INDUSTRIAL HEALTH 2021; 59:128-141. [PMID: 33487626 PMCID: PMC8010166 DOI: 10.2486/indhealth.2020-0176] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 01/19/2021] [Indexed: 06/12/2023]
Abstract
Although participatory workplace improvement programs are known to provide favorable effects on high stress occupations like nursing, no studies have confirmed its effect using biomarkers. The aim of this study was to determine whether a participatory workplace improvement program would decrease stress-related symptoms as evaluated by biomarkers and self-reported stress among hospital nurses. Three actions to alleviate job stress, which were determined through focus group interviews and voting, were undertaken for two months. A total of 31 female Japanese nurses underwent measurement of inflammatory markers, autonomic nervous activity (ANA), and perceived job stress (PJS) at three-time points; before the program (T1), within a week after the completion of the program (T2), and three months after the program (T3). A series of inflammatory markers (Interferon-γ, Interleukin (IL)-6, and IL-12/23p40) decreased significantly at T2, and IL-12/23p40 and IL-15 significantly decreased at T3 compared to T1, while ANA and PJS remained unchanged. Our participatory program exerted beneficial effects in reducing inflammatory responses, but not for ANA and PJS. Further investigations with a better study design, i.e., a randomized controlled trial, and a larger sample size are warranted to determine what exerted beneficial effects on inflammatory markers and why other outcomes remained unchanged.
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Affiliation(s)
- Tsukumi Tondokoro
- Graduate School of Medicine, International University of Health and Welfare, Japan
| | - Akinori Nakata
- Graduate School of Medicine, International University of Health and Welfare, Japan
| | | | - Nobuyuki Yanagihara
- Faculty of Food Science and Nutrition, Kyushu Nutrition Welfare University, Japan
| | - Ayumi Anan
- School of Health Sciences, University of Occupational and Environmental Health, Japan
| | - Hiromi Kodama
- School of Health Sciences, University of Occupational and Environmental Health, Japan
| | - Noriaki Satoh
- Shared-Use Research Center, University of Occupational and Environmental Health, Japan
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Wolter C, Santa Maria A, Georg S, Lesener T, Gusy B, Kleiber D, Renneberg B. Relationships between effort-reward imbalance and work engagement in police officers: taking a salutogenic perspective. J Public Health (Oxf) 2021. [DOI: 10.1007/s10389-019-01112-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Sluiter F, Incollingo Rodriguez AC, Nephew BC, Cali R, Murgatroyd C, Santos HP. Pregnancy associated epigenetic markers of inflammation predict depression and anxiety symptoms in response to discrimination. Neurobiol Stress 2020; 13:100273. [PMID: 33344726 PMCID: PMC7739167 DOI: 10.1016/j.ynstr.2020.100273] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 11/16/2020] [Accepted: 11/16/2020] [Indexed: 02/06/2023] Open
Abstract
Latina mothers, who have one of the highest fertility rates among ethnic groups in the United States (US), often experience discrimination. Psychosocial influences during pregnancy, such as discrimination stress, promotes inflammation. However, the role of epigenetic markers of inflammation as a mediator between, and predictor of, maternal discrimination stress and neuropsychiatric outcomes has not been extensively studied. The current study investigates the role of DNA methylation at FOXP3 Treg-cell-specific demethylated region (TSDR), as a marker of regulatory T (Treg) cells that are important negative regulators of inflammation, and the promoter of tumour necrosis factor-alpha (TNF-α) gene, an important pro-inflammatory cytokine, in relation to discrimination stress during pregnancy and depression and anxiety symptomatology. A sample of 148 Latina women residing in the US (mean age 27.6 years) were assessed prenatally at 24–32 weeks’ gestation and 4–6 weeks postnatally for perceived discrimination exposure (Everyday Discrimination Scale, EDS), emotional distress (depression, anxiety, perinatal-specific depression), acculturation, and acculturative stress. DNA methylation levels at the FOXP3 and TNFα promoter regions from blood samples collected at the prenatal stage were assessed by bisulphite pyrosequencing. Regression analyses showed that prenatal EDS associated with postnatal emotional distress, depression and anxiety symptoms only in those individuals with higher than mean levels of FOXP3 TSDR and TNFα promoter methylation; no such significant associations were found in those with lower than mean levels of methylation for either. We further found that these relationships were mediated by TNFα only in those with high FOXP3 TSDR methylation, implying that immunosuppression via TNFα promoter methylation buffers the impact of discrimination stress on postpartum symptomatology. These results indicate that epigenetic markers of immunosuppression and inflammation play an important role in resilience or sensitivity, respectively, to prenatal stress.
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Affiliation(s)
- Femke Sluiter
- Department of Life Sciences, Manchester Metropolitan University, Manchester, United Kingdom
| | | | - Benjamin C Nephew
- Department of Biology and Biotechnology, Worcester Polytechnic Institute, Worcester, MA, United States
| | - Ryan Cali
- University of Massachusetts Medical School, Worcester, MA, United States
| | - Chris Murgatroyd
- Department of Life Sciences, Manchester Metropolitan University, Manchester, United Kingdom
| | - Hudson P Santos
- Biobehavioral Laboratory, School of Nursing, University of North Carolina at Chapel Hill, North Carolina, United States
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30
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Kaltenegger HC, Becker L, Rohleder N, Nowak D, Weigl M. Association of working conditions including digital technology use and systemic inflammation among employees: study protocol for a systematic review. Syst Rev 2020; 9:221. [PMID: 32988415 PMCID: PMC7523305 DOI: 10.1186/s13643-020-01463-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 08/21/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND With the dynamic advancement of digitalization, working environments are changing and risk for employee stress may be increasing. Work stress has been associated with a dysregulation of inflammatory processes as a component of immune function. Systemic low-grade inflammation is discussed as a key player in the relation between stress exposure and chronic illness, such as cardiovascular diseases. The objective of this investigation will be to evaluate the association of working conditions including digital technology use and systemic inflammation among employees. METHODS We designed and registered a study protocol for a systematic review of randomized controlled trials and prospective non-randomized studies (e.g., cohort, interrupted time series, or before-after studies). We will include studies conducted among adult workers reporting associations of working conditions and inflammatory activity. The outcome will be biomarkers of systemic low-grade inflammation on cell, plasma molecule and intracellular level, such as C-reactive protein, or different types of leukocytes, cytokines, etc. Literature searches will be conducted in several electronic databases (from January 1982 onwards), including PubMed/MEDLINE, Embase, PsycINFO, Web of Science, and CENTRAL. Two reviewers will independently screen all retrieved records, full-text articles, and extract data. The study methodological quality (or bias) will be appraised using appropriate tools. Our results will be described qualitatively. Random effects meta-analysis will be conducted, if feasible and appropriate. Additional analyses will be performed to explore potential sources of heterogeneity. DISCUSSION This systematic review and meta-analysis will provide a synthesis of studies evaluating the association of working conditions and systemic inflammation. We anticipate our findings to identify knowledge gaps in the literature that future research should address. Moreover, results of our review may provide implications for corporate and public policy action for employee health promotion and prevention of occupational stress. SYSTEMATIC REVIEW REGISTRATION PROSPERO ID: CRD42020166887.
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Affiliation(s)
- Helena C. Kaltenegger
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, Ludwig-Maximilians-University of Munich, Ziemssenstraße 1, 80336 München, Germany
| | - Linda Becker
- Chair of Health Psychology, Institute of Psychology, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Nicolas Rohleder
- Chair of Health Psychology, Institute of Psychology, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Dennis Nowak
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, Ludwig-Maximilians-University of Munich, Ziemssenstraße 1, 80336 München, Germany
| | - Matthias Weigl
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, Ludwig-Maximilians-University of Munich, Ziemssenstraße 1, 80336 München, Germany
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31
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Li J, Pega F, Ujita Y, Brisson C, Clays E, Descatha A, Ferrario MM, Godderis L, Iavicoli S, Landsbergis PA, Metzendorf MI, Morgan RL, Pachito DV, Pikhart H, Richter B, Roncaioli M, Rugulies R, Schnall PL, Sembajwe G, Trudel X, Tsutsumi A, Woodruff TJ, Siegrist J. The effect of exposure to long working hours on ischaemic heart disease: A systematic review and meta-analysis from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury. ENVIRONMENT INTERNATIONAL 2020; 142:105739. [PMID: 32505014 PMCID: PMC7339147 DOI: 10.1016/j.envint.2020.105739] [Citation(s) in RCA: 84] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 04/06/2020] [Accepted: 04/11/2020] [Indexed: 05/20/2023]
Abstract
BACKGROUND The World Health Organization (WHO) and the International Labour Organization (ILO) are developing Joint Estimates of the work-related burden of disease and injury (WHO/ILO Joint Estimates), with contributions from a large network of experts. Evidence from mechanistic data suggests that exposure to long working hours may cause ischaemic heart disease (IHD). In this paper, we present a systematic review and meta-analysis of parameters for estimating the number of deaths and disability-adjusted life years from IHD that are attributable to exposure to long working hours, for the development of the WHO/ILO Joint Estimates. OBJECTIVES We aimed to systematically review and meta-analyse estimates of the effect of exposure to long working hours (three categories: 41-48, 49-54 and ≥55 h/week), compared with exposure to standard working hours (35-40 h/week), on IHD (three outcomes: prevalence, incidence and mortality). DATA SOURCES We developed and published a protocol, applying the Navigation Guide as an organizing systematic review framework where feasible. We searched electronic databases for potentially relevant records from published and unpublished studies, including MEDLINE, Scopus, Web of Science, CISDOC, PsycINFO, and WHO ICTRP. We also searched grey literature databases, Internet search engines and organizational websites; hand-searched reference lists of previous systematic reviews; and consulted additional experts. STUDY ELIGIBILITY AND CRITERIA We included working-age (≥15 years) workers in the formal and informal economy in any WHO and/or ILO Member State but excluded children (aged < 15 years) and unpaid domestic workers. We included randomized controlled trials, cohort studies, case-control studies and other non-randomized intervention studies which contained an estimate of the effect of exposure to long working hours (41-48, 49-54 and ≥55 h/week), compared with exposure to standard working hours (35-40 h/week), on IHD (prevalence, incidence or mortality). STUDY APPRAISAL AND SYNTHESIS METHODS At least two review authors independently screened titles and abstracts against the eligibility criteria at a first stage and full texts of potentially eligible records at a second stage, followed by extraction of data from qualifying studies. Missing data were requested from principal study authors. We combined relative risks using random-effect meta-analysis. Two or more review authors assessed the risk of bias, quality of evidence and strength of evidence, using Navigation Guide and GRADE tools and approaches adapted to this project. RESULTS Thirty-seven studies (26 prospective cohort studies and 11 case-control studies) met the inclusion criteria, comprising a total of 768,751 participants (310,954 females) in 13 countries in three WHO regions (Americas, Europe and Western Pacific). The exposure was measured using self-reports in all studies, and the outcome was assessed with administrative health records (30 studies) or self-reported physician diagnosis (7 studies). The outcome was defined as incident non-fatal IHD event in 19 studies (8 cohort studies, 11 case-control studies), incident fatal IHD event in two studies (both cohort studies), and incident non-fatal or fatal ("mixed") event in 16 studies (all cohort studies). Because we judged cohort studies to have a relatively lower risk of bias, we prioritized evidence from these studies and treated evidence from case-control studies as supporting evidence. For the bodies of evidence for both outcomes with any eligible studies (i.e. IHD incidence and mortality), we did not have serious concerns for risk of bias (at least for the cohort studies). No eligible study was found on the effect of long working hours on IHD prevalence. Compared with working 35-40 h/week, we are uncertain about the effect on acquiring (or incidence of) IHD of working 41-48 h/week (relative risk (RR) 0.98, 95% confidence interval (CI) 0.91 to 1.07, 20 studies, 312,209 participants, I2 0%, low quality of evidence) and 49-54 h/week (RR 1.05, 95% CI 0.94 to 1.17, 18 studies, 308,405 participants, I2 0%, low quality of evidence). Compared with working 35-40 h/week, working ≥55 h/week may have led to a moderately, clinically meaningful increase in the risk of acquiring IHD, when followed up between one year and 20 years (RR 1.13, 95% CI 1.02 to 1.26, 22 studies, 339,680 participants, I2 5%, moderate quality of evidence). Compared with working 35-40 h/week, we are very uncertain about the effect on dying (mortality) from IHD of working 41-48 h/week (RR 0.99, 95% CI 0.88 to 1.12, 13 studies, 288,278 participants, I2 8%, low quality of evidence) and 49-54 h/week (RR 1.01, 95% CI 0.82 to 1.25, 11 studies, 284,474 participants, I2 13%, low quality of evidence). Compared with working 35-40 h/week, working ≥55 h/week may have led to a moderate, clinically meaningful increase in the risk of dying from IHD when followed up between eight and 30 years (RR 1.17, 95% CI 1.05 to 1.31, 16 studies, 726,803 participants, I2 0%, moderate quality of evidence). Subgroup analyses found no evidence for differences by WHO region and sex, but RRs were higher among persons with lower SES. Sensitivity analyses found no differences by outcome definition (exclusively non-fatal or fatal versus "mixed"), outcome measurement (health records versus self-reports) and risk of bias ("high"/"probably high" ratings in any domain versus "low"/"probably low" in all domains). CONCLUSIONS We judged the existing bodies of evidence for human evidence as "inadequate evidence for harmfulness" for the exposure categories 41-48 and 49-54 h/week for IHD prevalence, incidence and mortality, and for the exposure category ≥55 h/week for IHD prevalence. Evidence on exposure to working ≥55 h/week was judged as "sufficient evidence of harmfulness" for IHD incidence and mortality. Producing estimates for the burden of IHD attributable to exposure to working ≥55 h/week appears evidence-based, and the pooled effect estimates presented in this systematic review could be used as input data for the WHO/ILO Joint Estimates.
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Affiliation(s)
- Jian Li
- Department of Environmental Health Sciences, Fielding School of Public Health, School of Nursing, University of California, Los Angeles, United States.
| | - Frank Pega
- Environment, Climate Change and Health Department, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland.
| | - Yuka Ujita
- Labour Administration, Labour Inspection and Occupational Safety and Health Branch, International Labour Organization, Route des Morillons 4, 1211 Geneva, Switzerland.
| | - Chantal Brisson
- Centre de Recherche du CHU de Québec, Université Laval, 1050 Chemin Ste-Foy, Quebec City G1S 4L8, Quebec, Canada.
| | - Els Clays
- Department of Public Health and Primary Care, Ghent University, Campus University Hospital Ghent (4K3 - entrance 42), 4K3, Corneel Heymanslaan 10, B-9000 Ghent, Belgium.
| | - Alexis Descatha
- AP-HP (Paris Hospital), Occupational Health Unit, Poincaré University Hospital, Garches, France; Inserm Versailles St-Quentin Univ - Paris Saclay Univ (UVSQ), UMS 011, UMR-S 1168, Villejuif, France; Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-49000 Angers, France.
| | - Marco M Ferrario
- Research Centre EPIMED, University of Insubria, Via O Rossi 9, 21100 Varese, Italy.
| | - Lode Godderis
- Centre for Environment and Health, KU Leuven, Leuven, Belgium; KIR Department (Knowledge, Information & Research), IDEWE, External Service for Prevention and Protection at Work, Leuven, Belgium.
| | - Sergio Iavicoli
- Inail, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Via Fontana Candida 1, 00078 Monte Porzio Catone (Rome), Italy.
| | - Paul A Landsbergis
- SUNY-Downstate Health Sciences University, School of Public Health, 450 Clarkson Ave., Brooklyn, NY 11238, United States.
| | - Maria-Inti Metzendorf
- Cochrane Metabolic and Endocrine Disorders Group, Institute of General Practice, Medical Faculty of the Heinrich-Heine-University, Düsseldorf, Germany.
| | - Rebecca L Morgan
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Health Sciences Centre, Hamilton, Canada.
| | - Daniela V Pachito
- Hospital Sírio-Libanês and Disciplina de Economia e Gestão em Saúde, Universidade Federal de São Paulo, 412 Barata Ribeiro, Sao Paulo, Brazil.
| | - Hynek Pikhart
- Institute of Epidemiology and Health Care, University College London, 1-19 Torrington Place, London WC1E 6BT, United Kingdom.
| | - Bernd Richter
- Cochrane Metabolic and Endocrine Disorders Group, Institute of General Practice, Medical Faculty of the Heinrich-Heine-University, Düsseldorf, Germany.
| | - Mattia Roncaioli
- Research Centre EPIMED, University of Insubria, Via O Rossi 9, 21100 Varese, Italy.
| | - Reiner Rugulies
- National Research Centre for the Working Environment, Lersø Parkallé 105, DK-2100 Copenhagen, Denmark; Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, DK-1014 Copenhagen, Denmark; Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, DK-1353 Copenhagen, Denmark.
| | - Peter L Schnall
- Center for Occupational and Environmental Health, University of California-Irvine, 100 Theory Way, Irvine, CA, United States.
| | - Grace Sembajwe
- Department of Occupational Medicine, Epidemiology and Prevention (OMEP), Donald and Barbara Zucker School of Medicine at Hofstra University, 175 Community Drive, NY 11021, United States; Department of Environmental, Occupational, and Geospatial Health Sciences, CUNY Graduate School of Public Health and Health Policy, 55 W 125th Street, New York, NY 10027, United States.
| | - Xavier Trudel
- Centre de Recherche du CHU de Québec, Université Laval, 1050 Chemin Ste-Foy, Quebec City G1S 4L8, Quebec, Canada.
| | - Akizumi Tsutsumi
- Department of Public Health, School of Medicine, Kitasato University, 1-15-1 Kitasato, Minami, Sagamihara 252-0374, Japan.
| | - Tracey J Woodruff
- Program on Reproductive Health and the Environment, University of California San Francisco, San Francisco, United States.
| | - Johannes Siegrist
- Life Science Centre, University of Düsseldorf, Merowingerplatz 1a, Düsseldorf 40225, Germany.
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Descatha A, Sembajwe G, Pega F, Ujita Y, Baer M, Boccuni F, Di Tecco C, Duret C, Evanoff BA, Gagliardi D, Godderis L, Kang SK, Kim BJ, Li J, Magnusson Hanson LL, Marinaccio A, Ozguler A, Pachito D, Pell J, Pico F, Ronchetti M, Roquelaure Y, Rugulies R, Schouteden M, Siegrist J, Tsutsumi A, Iavicoli S. The effect of exposure to long working hours on stroke: A systematic review and meta-analysis from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury. ENVIRONMENT INTERNATIONAL 2020; 142:105746. [PMID: 32505015 DOI: 10.1016/j.envint.2020.105746] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 04/14/2020] [Accepted: 04/14/2020] [Indexed: 05/21/2023]
Abstract
BACKGROUND The World Health Organization (WHO) and the International Labour Organization (ILO) are developing joint estimates of the work-related burden of disease and injury (WHO/ILO Joint Estimates), with contributions from a large network of individual experts. Evidence from mechanistic data and prior studies suggests that exposure to long working hours may cause stroke. In this paper, we present a systematic review and meta-analysis of parameters for estimating the number of deaths and disability-adjusted life years from stroke that are attributable to exposure to long working hours, for the development of the WHO/ILO Joint Estimates. OBJECTIVES We aimed to systematically review and meta-analyse estimates of the effect of exposure to long working hours (three categories: 41-48, 49-54 and ≥55 h/week), compared with exposure to standard working hours (35-40 h/week), on stroke (three outcomes: prevalence, incidence, and mortality). DATA SOURCES A protocol was developed and published, applying the Navigation Guide to systematic reviews as an organizing framework where feasible. We searched electronic databases for potentially relevant records from published and unpublished studies, including Ovid MEDLINE, PubMed, EMBASE, Scopus, Web of Science, CISDOC, PsycINFO, and WHO ICTRP. We also searched grey literature databases, Internet search engines, and organizational websites; hand-searched reference lists of previous systematic reviews; and consulted additional experts. STUDY ELIGIBILITY AND CRITERIA We included working-age (≥15 years) individuals in the formal and informal economy in any WHO and/or ILO Member State but excluded children (aged < 15 years) and unpaid domestic workers. We included randomized controlled trials, cohort studies, case-control studies and other non-randomized intervention studies with an estimate of the effect of exposure to long working hours (41-48, 49-54 and ≥55 h/week), compared with exposure to standard working hours (35-40 h/week), on stroke (prevalence, incidence or mortality). STUDY APPRAISAL AND SYNTHESIS METHODS At least two review authors independently screened titles and abstracts against the eligibility criteria at a first review stage and full texts of potentially eligible records at a second stage, followed by extraction of data from qualifying studies. Missing data were requested from principal study authors. We combined relative risks using random-effects meta-analysis. Two or more review authors assessed the risk of bias, quality of evidence and strength of evidence, using the Navigation Guide and GRADE tools and approaches adapted to this project. RESULTS Twenty-two studies (20 cohort studies, 2 case-control studies) met the inclusion criteria, comprising a total of 839,680 participants (364,616 females) in eight countries from three WHO regions (Americas, Europe, and Western Pacific). The exposure was measured using self-reports in all studies, and the outcome was assessed with administrative health records (13 studies), self-reported physician diagnosis (7 studies), direct diagnosis by a physician (1 study) or during a medical interview (1 study). The outcome was defined as an incident non-fatal stroke event in nine studies (7 cohort studies, 2 case-control studies), incident fatal stroke event in one cohort study and incident non-fatal or fatal ("mixed") event in 12 studies (all cohort studies). Cohort studies were judged to have a relatively low risk of bias; therefore, we prioritized evidence from these studies, but synthesised evidence from case-control studies as supporting evidence. For the bodies of evidence for both outcomes with any eligible studies (i.e. stroke incidence and mortality), we did not have serious concerns for risk of bias (at least for the cohort studies). Eligible studies were found on the effects of long working hours on stroke incidence and mortality, but not prevalence. Compared with working 35-40 h/week, we were uncertain about the effect on incidence of stroke due to working 41-48 h/week (relative risk (RR) 1.04, 95% confidence interval (CI) 0.94-1.14, 18 studies, 277,202 participants, I2 0%, low quality of evidence). There may have been an increased risk for acquiring stroke when working 49-54 h/week compared with 35-40 h/week (RR 1.13, 95% CI 1.00-1.28, 17 studies, 275,181participants, I2 0%, p 0.04, moderate quality of evidence). Compared with working 35-40 h/week, working ≥55 h/week may have led to a moderate, clinically meaningful increase in the risk of acquiring stroke, when followed up between one year and 20 years (RR 1.35, 95% CI 1.13 to 1.61, 7 studies, 162,644 participants, I2 3%, moderate quality of evidence). Compared with working 35-40 h/week, we were very uncertain about the effect on dying (mortality) of stroke due to working 41-48 h/week (RR 1.01, 95% CI 0.91-1.12, 12 studies, 265,937 participants, I2 0%, low quality of evidence), 49-54 h/week (RR 1.13, 95% CI 0.99-1.29, 11 studies, 256,129 participants, I2 0%, low quality of evidence) and 55 h/week (RR 1.08, 95% CI 0.89-1.31, 10 studies, 664,647 participants, I2 20%, low quality of evidence). Subgroup analyses found no evidence for differences by WHO region, age, sex, socioeconomic status and type of stroke. Sensitivity analyses found no differences by outcome definition (exclusively non-fatal or fatal versus "mixed") except for the comparison working ≥55 h/week versus 35-40 h/week for stroke incidence (p for subgroup differences: 0.05), risk of bias ("high"/"probably high" ratings in any domain versus "low"/"probably low" in all domains), effect estimate measures (risk versus hazard versus odds ratios) and comparator (exact versus approximate definition). CONCLUSIONS We judged the existing bodies of evidence for human evidence as "inadequate evidence for harmfulness" for all exposure categories for stroke prevalence and mortality and for exposure to 41-48 h/week for stroke incidence. Evidence on exposure to 48-54 h/week and ≥55 h/week was judged as "limited evidence for harmfulness" and "sufficient evidence for harmfulness" for stroke incidence, respectively. Producing estimates for the burden of stroke attributable to exposures to working 48-54 and ≥55 h/week appears evidence-based, and the pooled effect estimates presented in this systematic review could be used as input data for the WHO/ILO Joint Estimates. PROTOCOL IDENTIFIER: https://doi.org/10.1016/j.envint.2018.06.016. PROSPERO REGISTRATION NUMBER CRD42017060124.
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Affiliation(s)
- Alexis Descatha
- UNIV Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-49000 Angers, France; AP-HP (Paris Hospital), Occupational Health Unit, Poincaré University Hospital, Garches, France; Versailles St-Quentin Univ-Paris Saclay Univ (UVSQ), UMS 011, UMR-S 1168, France; Inserm, U1168 UMS 011, Villejuif, France.
| | - Grace Sembajwe
- Department of Occupational Medicine Epidemiology and Prevention, Zucker School of Medicine at Hofstra University, Feinstein Institutes for Medical Research, Northwell Health, NY, USA.
| | - Frank Pega
- Environment, Climate Change and Health Department, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland.
| | - Yuka Ujita
- Labour Administration, Labour Inspection and Occupational Safety and Health Branch, International Labour Organization, Route des Morillons 4, 1211 Geneva, Switzerland.
| | - Michael Baer
- AP-HP (Paris Hospital), SAMU92, Poincaré University Hospital, Garches, France.
| | - Fabio Boccuni
- Inail, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Via Fontana Candida 1, 00078 Monte Porzio Catone (Rome), Italy.
| | - Cristina Di Tecco
- Inail, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Via Fontana Candida 1, 00078 Monte Porzio Catone (Rome), Italy.
| | - Clement Duret
- AP-HP (Paris Hospital), Occupational Health Unit, Poincaré University Hospital, Garches, France.
| | - Bradley A Evanoff
- Division of General Medical Sciences, Washington University School of Medicine, Campus Box 8005, 660 South Euclid Ave, St. Louis, MO 63110, United States.
| | - Diana Gagliardi
- Inail, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Via Fontana Candida 1, 00078 Monte Porzio Catone (Rome), Italy.
| | - Lode Godderis
- Environment and Health, Kapucijnenvoer 35 blok d - box 7001, 3000 Leuven, Belgium; IDEWE, External Service for Prevention and Protection at Work, Interleuvenlaan 58, 3001 Leuven, Belgium.
| | - Seong-Kyu Kang
- Department of Occupational and Environmental Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea.
| | - Beon Joon Kim
- Seoul National University Bundang Hospital, Bundang-gu, Republic of Korea.
| | - Jian Li
- Department of Environmental Health Sciences, Fielding School of Public Health, School of Nursing, University of California, Los Angeles, United States.
| | | | - Alessandro Marinaccio
- Inail, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Via Fontana Candida 1, 00078 Monte Porzio Catone (Rome), Italy.
| | - Anna Ozguler
- AP-HP (Paris Hospital), SAMU92, Poincaré University Hospital, Garches, France; Inserm UMS 011, Villejuif, France.
| | - Daniela Pachito
- Núcleo de Avaliação de Tecnologias em Saúde, Hospital Sírio-Libanês, 142 Barata Ribeiro, Sao Paulo, Brazil.
| | - John Pell
- Hunter College Libraries, Social Work and Public Health Library, 2180 3rd Avenue, 110D, New York, NY 10035, United States.
| | - Fernando Pico
- Neurology and Stroke Unit, Versailles Hospital, Le Chesnay, France.
| | - Matteo Ronchetti
- Inail, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Via Fontana Candida 1, 00078 Monte Porzio Catone (Rome), Italy.
| | - Yves Roquelaure
- UNIV Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-49000 Angers, France.
| | - Reiner Rugulies
- National Research Centre for the Working Environment, Lersø Parkallé 105, DK-2100 Copenhagen, Denmark; Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, DK-1014 Copenhagen, Denmark; Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, DK-1353 Copenhagen, Denmark.
| | - Martijn Schouteden
- IDEWE, External Service for Prevention and Protection at Work, Interleuvenlaan 58, 3001 Leuven, Belgium.
| | - Johannes Siegrist
- Life Science Centre, University of Düsseldorf, Merowingerplatz 1a, Düsseldorf 40225, Germany.
| | - Akizumi Tsutsumi
- Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara 252-0374, Japan.
| | - Sergio Iavicoli
- Inail, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Via Fontana Candida 1, 00078 Monte Porzio Catone (Rome), Italy.
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Khalatbari-Soltani S, Cumming RC, Delpierre C, Kelly-Irving M. Importance of collecting data on socioeconomic determinants from the early stage of the COVID-19 outbreak onwards. J Epidemiol Community Health 2020; 74:620-623. [PMID: 32385126 PMCID: PMC7298202 DOI: 10.1136/jech-2020-214297] [Citation(s) in RCA: 163] [Impact Index Per Article: 40.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 04/21/2020] [Accepted: 04/24/2020] [Indexed: 12/18/2022]
Abstract
Disadvantaged socioeconomic position (SEP) is widely associated with disease and mortality, and there is no reason to think this will not be the case for the newly emerged coronavirus disease 2019 (COVID-19) that has reached a pandemic level. Individuals with a more disadvantaged SEP are more likely to be affected by most of the known risk factors of COVID-19. SEP has been previously established as a potential determinant of infectious diseases in general. We hypothesise that SEP plays an important role in the COVID-19 pandemic either directly or indirectly via occupation, living conditions, health-related behaviours, presence of comorbidities and immune functioning. However, the influence of socioeconomic factors on COVID-19 transmission, severity and outcomes is not yet known and is subject to scrutiny and investigation. Here we briefly review the extent to which SEP has been considered as one of the potential risk factors of COVID-19. From 29 eligible studies that reported the characteristics of patients with COVID-19 and their potential risk factors, only one study reported the occupational position of patients with mild or severe disease. This brief overview of the literature highlights that important socioeconomic characteristics are being overlooked when data are collected. As COVID-19 spreads worldwide, it is crucial to collect and report data on socioeconomic determinants as well as race/ethnicity to identify high-risk populations. A systematic recording of socioeconomic characteristics of patients with COVID-19 will be beneficial to identify most vulnerable groups, to identify how SEP relates to COVID-19 and to develop equitable public health prevention measures, guidelines and interventions.
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Affiliation(s)
- Saman Khalatbari-Soltani
- Faculty of Medicine and Health, The University of Sydney School of Public Health, Sydney, Australia .,ARC Centre of Excellence in Population Ageing Research (CEPAR), The University of Sydney, Sydney, Australia
| | - Robert C Cumming
- The University of Sydney School of Public Health, Sydney, Australia.,ARC Centre of Excellence in Population Ageing Research (CEPAR), The University of Sydney Faculty of Medicine and Health, Sydney, Australia
| | - Cyrille Delpierre
- LEASP, Université Toulouse III Paul Sabatier, Toulouse, France.,Umr 1027, Inserm, Toulouse, France
| | - Michelle Kelly-Irving
- LEASP, Université Toulouse III Paul Sabatier, Toulouse, France.,Umr 1027, Inserm, Toulouse, France.,IFERISS, Université de Toulouse, Toulouse, France
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34
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Network between Cytokines, Cortisol and Occupational Stress in Gas and Oilfield Workers. Int J Mol Sci 2020; 21:ijms21031118. [PMID: 32046214 PMCID: PMC7037782 DOI: 10.3390/ijms21031118] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 01/30/2020] [Accepted: 02/06/2020] [Indexed: 01/10/2023] Open
Abstract
To test whether gas and oil field work is accompanied by stress and altered immune function, the perception of workplace stress, levels of salivary cortisol, plasma levels, and mononuclear cell production of cytokines were examined in 80 healthy workers recruited among a population of operators on gas and oilfields. Specific questionnaires for determining the perception of anxiety, occupational stress, and subjective symptoms were administered. Salivary cortisol and cytokines plasma levels were evaluated by Elisa and to investigate immune function, both spontaneous and PHA- or LPS-induced expression and production of cytokines were assessed by qRT-PCR. Workers showed medium stress levels at work, with growth and increased motivation for work, and based on salivary cortisol concentrations, were divided into two groups of ≤10 ng/mL (n = 31) or >10 ng/mL (n = 49). Statistically significant higher plasma levels of IL-6, while lower TNFα, were detected in workers with cortisol >10 ng/mL. Also, BMI, DL, JD and Job strain were significantly higher in workers with cortisol >10 ng/mL. Thus, even modest variations of cortisol might have a role in the modulation of immune response and worker’s vulnerability to health imbalance.Thus, the evaluation of immune status, in addition to cortisol levels, could be useful to prevent illnesses; exacerbation of pre-existing conditions; morbidity; and consequent absences from work, with economic repercussions.
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35
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Munshi S, Loh MK, Ferrara N, DeJoseph MR, Ritger A, Padival M, Record MJ, Urban JH, Rosenkranz JA. Repeated stress induces a pro-inflammatory state, increases amygdala neuronal and microglial activation, and causes anxiety in adult male rats. Brain Behav Immun 2020; 84:180-199. [PMID: 31785394 PMCID: PMC7010555 DOI: 10.1016/j.bbi.2019.11.023] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 11/25/2019] [Accepted: 11/26/2019] [Indexed: 12/25/2022] Open
Abstract
A link exists between immune function and psychiatric conditions, particularly depressive and anxiety disorders. Psychological stress is a powerful trigger for these disorders and stress influences immune state. However, the nature of peripheral immune changes after stress conflicts across studies, perhaps due to the focus on few measures of pro-inflammatory or anti-inflammatory processes. The basolateral amygdala (BLA) is critical for emotion, and plays an important role in the effects of stress on anxiety. As such, it may be a primary central nervous system (CNS) mediator for the effects of peripheral immune changes on anxiety after stress. Therefore, this study aimed to delineate the influence of stress on peripheral pro-inflammatory and anti-inflammatory aspects, BLA immune activation, and its impact on BLA neuronal activity. To produce a more encompassing view of peripheral immune changes, this study used a less restrictive approach to categorize and group peripheral immune changes. We found that repeated social defeat stress in adult male Sprague-Dawley rats increased the frequencies of mature T-cells positive for intracellular type 2-like cytokine and serum pro-inflammatory cytokines. Principal component analysis and hierarchical clustering was used to guide grouping of T-cells and cytokines, producing unique profiles. Stress shifted the balance towards a specific set that included mostly type 2-like T-cells and pro-inflammatory cytokines. Within the CNS component, repeated stress caused an increase of activated microglia in the BLA, increased anxiety-like behaviors across several assays, and increased BLA neuronal firing in vivo that was prevented by blockade of microglia activation. Because repeated stress can trigger anxiety states by actions in the BLA, and altered immune function can trigger anxiety, these results suggest that repeated stress may trigger anxiety-like behaviors by inducing a pro-inflammatory state in the periphery and the BLA. These results begin to uncover how stress may recruit the immune system to alter the function of brain regions critical to emotion.
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Affiliation(s)
- Soumyabrata Munshi
- Department of Foundational Sciences and Humanities, Cellular and Molecular Pharmacology, Rosalind Franklin University of Medicine and Science, 3333 Green Bay Road, North Chicago, IL 60064, USA.,Department of Foundational Sciences and Humanities, Neuroscience, Rosalind Franklin University of Medicine and Science, 3333 Green Bay Road, North Chicago, IL 60064, USA
| | - Maxine K. Loh
- Department of Foundational Sciences and Humanities, Cellular and Molecular Pharmacology, Rosalind Franklin University of Medicine and Science, 3333 Green Bay Road, North Chicago, IL 60064, USA.,Center for Neurobiology of Stress Resilience and Psychiatric Disorders, Rosalind Franklin University of Medicine and Science, 3333 Green Bay Road, North Chicago, IL 60064, USA
| | - Nicole Ferrara
- Department of Foundational Sciences and Humanities, Cellular and Molecular Pharmacology, Rosalind Franklin University of Medicine and Science, 3333 Green Bay Road, North Chicago, IL 60064, USA.,Center for Neurobiology of Stress Resilience and Psychiatric Disorders, Rosalind Franklin University of Medicine and Science, 3333 Green Bay Road, North Chicago, IL 60064, USA
| | - M. Regina DeJoseph
- Department of Foundational Sciences and Humanities, Physiology and Biophysics, Rosalind Franklin University of Medicine and Science, 3333 Green Bay Road, North Chicago, IL 60064, USA.,Center for Neurobiology of Stress Resilience and Psychiatric Disorders, Rosalind Franklin University of Medicine and Science, 3333 Green Bay Road, North Chicago, IL 60064, USA
| | - Alexandra Ritger
- Department of Foundational Sciences and Humanities, Neuroscience, Rosalind Franklin University of Medicine and Science, 3333 Green Bay Road, North Chicago, IL 60064, USA.,Center for Neurobiology of Stress Resilience and Psychiatric Disorders, Rosalind Franklin University of Medicine and Science, 3333 Green Bay Road, North Chicago, IL 60064, USA
| | - Mallika Padival
- Department of Foundational Sciences and Humanities, Cellular and Molecular Pharmacology, Rosalind Franklin University of Medicine and Science, 3333 Green Bay Road, North Chicago, IL 60064, USA.,Center for Neurobiology of Stress Resilience and Psychiatric Disorders, Rosalind Franklin University of Medicine and Science, 3333 Green Bay Road, North Chicago, IL 60064, USA
| | - Matthew J. Record
- Department of Foundational Sciences and Humanities, Cellular and Molecular Pharmacology, Rosalind Franklin University of Medicine and Science, 3333 Green Bay Road, North Chicago, IL 60064, USA
| | - Janice H. Urban
- Department of Foundational Sciences and Humanities, Physiology and Biophysics, Rosalind Franklin University of Medicine and Science, 3333 Green Bay Road, North Chicago, IL 60064, USA.,Center for Neurobiology of Stress Resilience and Psychiatric Disorders, Rosalind Franklin University of Medicine and Science, 3333 Green Bay Road, North Chicago, IL 60064, USA
| | - J. Amiel Rosenkranz
- Department of Foundational Sciences and Humanities, Cellular and Molecular Pharmacology, Rosalind Franklin University of Medicine and Science, 3333 Green Bay Road, North Chicago, IL 60064, USA.,Center for Neurobiology of Stress Resilience and Psychiatric Disorders, Rosalind Franklin University of Medicine and Science, 3333 Green Bay Road, North Chicago, IL 60064, USA.,Corresponding Author: J. Amiel Rosenkranz, Ph.D., Center for Neurobiology of Stress Resilience and Psychiatric Disorders, Rosalind Franklin University of Medicine and Science, 3333 Green Bay Road, North Chicago, IL 60064, USA., Telephone: 847-578-8680; Fax: 847-578-3268,
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Lippert AM, Damaske S. Finding Jobs, Forming Families, and Stressing Out? Work, Family, and Stress among Young Adult Women in the United States. SOCIAL FORCES; A SCIENTIFIC MEDIUM OF SOCIAL STUDY AND INTERPRETATION 2019; 98:885-914. [PMID: 38872728 PMCID: PMC11174137 DOI: 10.1093/sf/soy117] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2024]
Abstract
AbstractThe transition to adulthood is increasingly characterized by complex paths into the world of work and family, especially for young women. Yet how work and family combine to influence stress among young adult women is not well understood. Using data from the National Longitudinal Study of Adolescent to Adult Health, we leverage new extensions to latent class analysis (LCA) to identify common combinations of work and family circumstances among young adult women, their earlier life and contemporaneous correlates, and associations with two stress measures: a multi-item Perceived Stress Scale (PSS) and Epstein–Barr Viral (EBV) antibody titers, a well-validated biomarker of stress-related immunity impairments. We identify seven different common combinations of latent work–family combinations among young adult women ranging from well-compensated professional workers with and without children, mothers without paid employment, and delayed transitions to work and family. Completing a college degree was associated with a higher likelihood of membership in classes marked by professional work irrespective of motherhood, while being raised in a community with greater female labor opportunities was generally associated with membership in child-free classes. Mothers and child-free women in “pink-collar” work with low wages and decision-marking freedom reported higher stress compared to women in “white-collar” work with higher wages and decision-making freedom. These differences are mostly attenuated following adjustments for poverty-related stressors and work–family conflict. While prior work has emphasized the health benefits for women of combining work and family, our research suggests these benefits may be limited to women of higher socioeconomic status with flexible, well-compensated jobs.
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Affiliation(s)
- Adam M. Lippert
- University of Colorado Denver, Sociology Department, Denver, CO USA
| | - Sarah Damaske
- Pennsylvania State University, Labor and Employment Relations Department, University Park, PA USA
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Jahangard L, Hedayati M, Abbasalipourkabir R, Haghighi M, Ahmadpanah M, Faryadras M, Mikoteit T, Sadeghi Bahmani D, Brand S. Omega-3-polyunsatured fatty acids (O3PUFAs), compared to placebo, reduced symptoms of occupational burnout and lowered morning cortisol secretion. Psychoneuroendocrinology 2019; 109:104384. [PMID: 31382171 DOI: 10.1016/j.psyneuen.2019.104384] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 07/11/2019] [Accepted: 07/17/2019] [Indexed: 01/06/2023]
Abstract
BACKGROUND Occupational burnout is both a serious health concern at both public and individual levels. Treatment options are psychopharmacological, psychological and physical activity-related interventions. Here, we tested whether, compared to placebo, omega-3-polyunsaturated fatty acids (O3PUFAs) have a positive impact on burnout and morning cortisol secretion. METHOD A total of 43 individuals (mean age: 38.4 years, 76.7% females) took part in the present double-blind and placebo-controlled intervention. Participants were randomly assigned either to the O3PUFA or to the placebo condition. At baseline and again eight weeks later, participants completed the Maslach Burnout Inventory and collected morning saliva samples for analysis of the cortisol awakening response (CAR). RESULTS Emotional exhaustion and depersonalization decreased, and sense of personal accomplishment increased over time, but more so in the O3PUFA condition than in the placebo condition. Likewise, CAR decreased over time, but again more so in the O3PUFA condition than in the placebo condition. CONCLUSIONS The present pattern of results suggests that, compared to placebo, administration of daily omega-3-polyunsaturated fatty acids for eight consecutive weeks positively influences both psychological and physiological markers of occupational burnout.
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Affiliation(s)
- Leila Jahangard
- Research Center for Behavioral Disorders and Substance Abuse, Hamadan University of Medical sciences, Hamadan, Iran
| | - Mahmoud Hedayati
- Research Center for Behavioral Disorders and Substance Abuse, Hamadan University of Medical sciences, Hamadan, Iran
| | | | - Mohammad Haghighi
- Research Center for Behavioral Disorders and Substance Abuse, Hamadan University of Medical sciences, Hamadan, Iran
| | - Mohammad Ahmadpanah
- Research Center for Behavioral Disorders and Substance Abuse, Hamadan University of Medical sciences, Hamadan, Iran
| | - Mohammad Faryadras
- Department of Biostatistics and Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Thorsten Mikoteit
- University of Basel, Psychiatric Clinics, Center for Affective, Stress and Sleep Disorders, Basel, Switzerland; University of Basel, Psychiatric Hospital Solothurn, Solothurn, Switzerland
| | - Dena Sadeghi Bahmani
- University of Basel, Psychiatric Clinics, Center for Affective, Stress and Sleep Disorders, Basel, Switzerland; Kermanshah University of Medical Sciences (KUMS), Substance Abuse Prevention Research Center, Kermanshah, Iran; Kermanshah University of Medical Sciences (KUMS), Sleep Disorders Research Center, Kermanshah, Iran; Isfahan University of Medical Sciences, Neurosciences Research Center, Alzahra Research Institute, Isfahan, Iran
| | - Serge Brand
- University of Basel, Psychiatric Clinics, Center for Affective, Stress and Sleep Disorders, Basel, Switzerland; Kermanshah University of Medical Sciences (KUMS), Substance Abuse Prevention Research Center, Kermanshah, Iran; Kermanshah University of Medical Sciences (KUMS), Sleep Disorders Research Center, Kermanshah, Iran; University of Basel, Department of Sport, Exercise and Health, Division of Sport Science and Psychosocial Health, Basel, Switzerland.
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Li J, Atasoy S, Fang X, Angerer P, Ladwig KH. Combined effect of work stress and impaired sleep on coronary and cardiovascular mortality in hypertensive workers: The MONICA/KORA cohort study. Eur J Prev Cardiol 2019; 28:220–226. [PMID: 33838034 DOI: 10.1177/2047487319839183] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 02/26/2019] [Indexed: 01/29/2023]
Abstract
BACKGROUND Although work stress and impaired sleep are established risk factors for cardiovascular disease (CVD) among healthy individuals, their impact on hypertensive workers is largely unknown. DESIGN Prospective cohort study design. METHODS Hypertensive workers (N = 1959), derived from the population-based MONICA/KORA study in Southern Germany, who were free of any cardiovascular disease and diabetes were interviewed at baseline for work stress (high demand plus low control) and impaired sleep (difficulties falling asleep and/or maintaining sleep). Hazard ratios and 95% confidence intervals (CIs) were estimated by multivariate Cox proportional hazards models with adjustment for relevant covariates. RESULTS During a mean follow-up of 17.8 years covering 34,900 person-years, 134 fatal CVD and 73 coronary heart disease (CHD) events were observed. In comparison to participants with low work stress and non-impaired sleep, participants with work stress (hazard ratio (HR) 1.56, 95% CI 0.81-2.98), or impaired sleep (HR 1.76, 95% CI 0.96-3.22) had an increased risk of CVD, while participants with both work stress and impaired sleep had the highest risk of CVD mortality (HR 2.94, 95% CI 1.18-7.33). Participants with both risk conditions had an absolute CVD mortality risk of 7.13 cases per 1000 person-years in comparison to 3.05 cases per 1000-person years in the reference group. Similar risk patterns were found for CHD mortality. CONCLUSIONS Our findings add a new piece of evidence that work stress together with impaired sleep increase risk of coronary and cardiovascular mortality in hypertensive workers.
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Affiliation(s)
- Jian Li
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Germany.,Department of Environmental Health Sciences, Fielding School of Public Health, School of Nursing, University of California Los Angeles, USA
| | - Seryan Atasoy
- Institute of Epidemiology II, Helmholtz Zentrum München, German Research Centre for Environmental Health, Neuherberg, Germany
| | - Xioayan Fang
- Institute of Epidemiology II, Helmholtz Zentrum München, German Research Centre for Environmental Health, Neuherberg, Germany.,Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Peter Angerer
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Germany
| | - Karl-Heinz Ladwig
- Institute of Epidemiology II, Helmholtz Zentrum München, German Research Centre for Environmental Health, Neuherberg, Germany.,Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.,Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK), Partnersite Munich, Germany
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Watanabe K, Sakuraya A, Kawakami N, Imamura K, Ando E, Asai Y, Eguchi H, Kobayashi Y, Nishida N, Arima H, Shimazu A, Tsutsumi A. Work-related psychosocial factors and metabolic syndrome onset among workers: a systematic review and meta-analysis. Obes Rev 2018; 19:1557-1568. [PMID: 30047228 DOI: 10.1111/obr.12725] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 05/14/2018] [Accepted: 05/31/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Work-related psychosocial factors have been associated with metabolic syndrome. However, no systematic reviews or meta-analyses have evaluated this association. METHODS A systematic literature search was conducted, using PubMed, Embase, PsycINFO, PsycARTICLES and the Japan Medical Abstracts Society. Eligible studies included those that examined the previously mentioned association; had a longitudinal or prospective cohort design; were conducted among workers; provided sufficient data for calculating odds ratios, relative risks or hazard ratios with 95% confidence intervals; were original articles in English or Japanese; and were published no later than 2016. Study characteristics, exposure and outcome variables and association measures of studies were extracted by the investigators independently. RESULTS Among 4,664 identified studies, 8 were eligible for review and meta-analysis. The pooled risk of adverse work-related stress on metabolic syndrome onset was significant and positive (RR = 1.47; 95% CI, 1.22-1.78). Sensitivity analyses limiting only the effects of job strain and shift work also indicated a significant positive relationship (RR = 1.75; 95% CI, 1.09-2.79; and RR = 1.59; 95% CI, 1.00-2.54, P = 0.049 respectively). CONCLUSION This study reveals a strong positive association between work-related psychosocial factors and an elevated risk of metabolic syndrome onset. The effects of job strain and shift work on metabolic syndrome appear to be significant.
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Affiliation(s)
- K Watanabe
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - A Sakuraya
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - N Kawakami
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - K Imamura
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - E Ando
- Department of Social and Environmental Health, Division of Environmental Medicine and Population Sciences, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Y Asai
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - H Eguchi
- Department of Public Health, Kitasato University School of Medicine, Sagamihara-shi, Kanagawa, Japan
| | | | - N Nishida
- Kyoto Industrial Health Association, Kyoto, Japan
| | - H Arima
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - A Shimazu
- Center for Human and Social Sciences, Kitasato University College of Liberal Arts and Sciences, Sagamihara-shi, Kanagawa, Japan
| | - A Tsutsumi
- Department of Public Health, Kitasato University School of Medicine, Sagamihara-shi, Kanagawa, Japan
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Diderichsen F, Augusto LGDS, Perez B. Understanding social inequalities in Zika infection and its consequences: A model of pathways and policy entry-points. Glob Public Health 2018; 14:675-683. [PMID: 30301438 DOI: 10.1080/17441692.2018.1532528] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The health consequences of arbovirus infections such as dengue fever (DENV), Chikungunya (CHIKV) and Zika (ZIKV) has in recent years become a public health challenge, due to failure of prevention followed by increased incidence and pronounced social inequality in occurrence and consequences. This motivates a more systematic analysis of the potential mechanisms and pathways that generate these inequalities. We present in the paper a model that delineates five possible mechanisms driving the inequality of ZIKV and congenital Zika syndrome (CZS). They include differential exposure to bad housing and sanitary conditions, differential exposure to vector density and virus, differential vulnerability to the health effects of exposure to virus, differential intrauterine susceptibility to the teratogenic effects of ZIKV infection and differential social consequences of caring for a disabled child. For each mechanism, we present empirical evidence or need for more research as well as a discussion about policy implications.
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Affiliation(s)
- Finn Diderichsen
- a Department of Public Health, University of Copenhagen, Copenhagen , Denmark.,b Oswaldo Cruz Foundation, IAM-FIOCRUZ/PE , Recife , Brazil
| | | | - Bernadete Perez
- c Departamento de Medicina Social, Federal University , Recife , Brazil
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Milot M, Borkenhagen E. Job stress in users of an Employee Assistance Program and association with presenting status. JOURNAL OF WORKPLACE BEHAVIORAL HEALTH 2018. [DOI: 10.1080/15555240.2018.1502044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Marc Milot
- WorkReach Solutions, APAS Laboratory Inc., Montreal, Canada
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Descatha A, Sembajwe G, Baer M, Boccuni F, Di Tecco C, Duret C, Evanoff BA, Gagliardi D, Ivanov ID, Leppink N, Marinaccio A, Magnusson Hanson LL, Ozguler A, Pega F, Pell J, Pico F, Prüss-Üstün A, Ronchetti M, Roquelaure Y, Sabbath E, Stevens GA, Tsutsumi A, Ujita Y, Iavicoli S. WHO/ILO work-related burden of disease and injury: Protocol for systematic reviews of exposure to long working hours and of the effect of exposure to long working hours on stroke. ENVIRONMENT INTERNATIONAL 2018; 119:366-378. [PMID: 30005185 DOI: 10.1016/j.envint.2018.06.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 06/12/2018] [Accepted: 06/13/2018] [Indexed: 05/12/2023]
Abstract
BACKGROUND The World Health Organization (WHO) and the International Labour Organization (ILO) are developing a joint methodology for estimating the national and global work-related burden of disease and injury (WHO/ILO joint methodology), with contributions from a large network of experts. In this paper, we present the protocol for two systematic reviews of parameters for estimating the number of deaths and disability-adjusted life years from stroke attributable to exposure to long working hours, to inform the development of the WHO/ILO joint methodology. OBJECTIVES We aim to systematically review studies on occupational exposure to long working hours (called Systematic Review 1 in the protocol) and systematically review and meta-analyse estimates of the effect of long working hours on stroke (called Systematic Review 2), applying the Navigation Guide systematic review methodology as an organizing framework, conducting both systematic reviews in tandem and in a harmonized way. DATA SOURCES Separately for Systematic Reviews 1 and 2, we will search electronic academic databases for potentially relevant records from published and unpublished studies, including Medline, EMBASE, Web of Science, CISDOC and PsychINFO. We will also search electronic grey literature databases, Internet search engines and organizational websites; hand-search reference list of previous systematic reviews and included study records; and consult additional experts. STUDY ELIGIBILITY AND CRITERIA We will include working-age (≥15 years) workers in the formal and informal economy in any WHO and/or ILO Member State, but exclude children (<15 years) and unpaid domestic workers. For Systematic Review 1, we will include quantitative prevalence studies of relevant levels of occupational exposure to long working hours (i.e. 35-40, 41-48, 49-54 and ≥55 h/week) stratified by country, sex, age and industrial sector or occupation, in the years 2005-2018. For Systematic Review 2, we will include randomized controlled trials, cohort studies, case-control studies and other non-randomized intervention studies with an estimate of the relative effect of a relevant level of long working hours on the incidence of or mortality due to stroke, compared with the theoretical minimum risk exposure level (i.e. 35-40 h/week). STUDY APPRAISAL AND SYNTHESIS METHODS At least two review authors will independently screen titles and abstracts against the eligibility criteria at a first stage and full texts of potentially eligible records at a second stage, followed by extraction of data from qualifying studies. At least two review authors will assess risk of bias and the quality of evidence, using the most suited tools currently available. For Systematic Review 2, if feasible, we will combine relative risks using meta-analysis. We will report results using the guidelines for accurate and transparent health estimates reporting (GATHER) for Systematic Review 1 and the preferred reporting items for systematic reviews and meta-analyses guidelines (PRISMA) for Systematic Review 2. PROSPERO registration number: CRD42017060124.
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Affiliation(s)
- Alexis Descatha
- AP-HP (Paris Hospital "Assistance Publique Hôpitaux de Paris"), Occupational Health Unit, University Hospital of West Suburb of Paris, Poincaré Site, Garches, France; Versailles St-Quentin Univ - Paris Saclay Univ (UVSQ), UMS 011, UMR-S 1168, France; Inserm, U1168 (VIMA: Aging and chronic diseases. Epidemiological and public health approaches,), UMS 011 (Population-based Epidemiologic Cohorts Unit), Villejuif, France.
| | - Grace Sembajwe
- Department of Environmental, Occupational, and Geospatial Health Sciences, CUNY Graduate School of Public Health and Health Policy, CUNY Institute for Implementation Science in Population Health, New York, NY, United States of America.
| | - Michael Baer
- AP-HP (Paris Hospital "Assistance Publique Hôpitaux de Paris"), SAMU92, Poincaré University Hospital, Garches, France.
| | - Fabio Boccuni
- Inail, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Rome, Italy.
| | - Cristina Di Tecco
- AP-HP (Paris Hospital "Assistance Publique Hôpitaux de Paris"), SAMU92, Poincaré University Hospital, Garches, France.
| | - Clément Duret
- AP-HP (Paris Hospital "Assistance Publique Hôpitaux de Paris"), Occupational Health Unit, Poincaré University Hospital, Garches, France; Versailles St-Quentin Univ - Paris Saclay Univ (UVSQ), France; Inserm, U1168 UMS 011, Villejuif, France
| | - Bradley A Evanoff
- Washington University School of Medicine, St. Louis, MO, United States of America.
| | - Diana Gagliardi
- Inail, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Rome, Italy.
| | - Ivan D Ivanov
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland.
| | - Nancy Leppink
- Labour Administration, Labour Inspection and Occupational Safety and Health Branch, International Labour Organization, Geneva, Switzerland.
| | - Alessandro Marinaccio
- Inail, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Rome, Italy.
| | | | - Anna Ozguler
- AP-HP (Paris Hospital "Assistance Publique Hôpitaux de Paris"), SAMU92, Poincaré University Hospital, Garches, France; Inserm UMS 011 (Population-based Epidemiologic Cohorts Unit), Villejuif, France.
| | - Frank Pega
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland.
| | - John Pell
- Hunter College Libraries, Social Work and Public Health Library, New York, NY, United States of America.
| | - Fernando Pico
- Neurology and Stroke Unit, Versailles Hospital, Le Chesnay, France.
| | - Annette Prüss-Üstün
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland.
| | - Matteo Ronchetti
- Inail, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Rome, Italy.
| | - Yves Roquelaure
- Irset - Inserm UMR 1085 - Equipe Ester, UFR Santé, Département de Médecine, Angers Cedex, France.
| | - Erika Sabbath
- Boston College School of Social Work, Chestnut Hill, MA, United States of America.
| | - Gretchen A Stevens
- Department of Information, Evidence and Research, World Health Organization, Geneva, Switzerland.
| | - Akizumi Tsutsumi
- Kitasato University School of Medicine, Minami, Sagamihara, Japan.
| | - Yuka Ujita
- Labour Administration, Labour Inspection and Occupational Safety and Health Branch, International Labour Organization, Geneva, Switzerland.
| | - Sergio Iavicoli
- Inail, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Rome, Italy.
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Li J, Brisson C, Clays E, Ferrario MM, Ivanov ID, Landsbergis P, Leppink N, Pega F, Pikhart H, Prüss-Üstün A, Rugulies R, Schnall PL, Stevens G, Tsutsumi A, Ujita Y, Siegrist J. WHO/ILO work-related burden of disease and injury: Protocol for systematic reviews of exposure to long working hours and of the effect of exposure to long working hours on ischaemic heart disease. ENVIRONMENT INTERNATIONAL 2018; 119:558-569. [PMID: 30125833 DOI: 10.1016/j.envint.2018.06.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 06/18/2018] [Accepted: 06/18/2018] [Indexed: 05/12/2023]
Abstract
BACKGROUND The World Health Organization (WHO) and the International Labour Organization (ILO) are developing a joint methodology for estimating the national and global work-related burden of disease and injury (WHO/ILO joint methodology), with contributions from a large network of experts. In this paper, we present the protocol for two systematic reviews of parameters for estimating the number of deaths and disability-adjusted life years of ischaemic heart disease from exposure to long working hours, to inform the development of the WHO/ILO joint methodology. OBJECTIVES We aim to systematically review studies on occupational exposure to long working hours (Systematic Review 1) and systematically review and meta-analyse estimates of the effect of long working hours on ischaemic heart disease (Systematic Review 2), applying the Navigation Guide systematic review methodology as an organizing framework. The selection of both, the exposure and the health outcome is justified by substantial scientific evidence on adverse effects of long working hours on ischaemic heart disease risk. DATA SOURCES Separately for Systematic Reviews 1 and 2, we will search electronic academic databases for potentially relevant records from published and unpublished studies, Medline, EMBASE, Web of Science, CISDOC and PsychINFO. We will also search electronic grey literature databases, Internet search engines and organizational websites; hand-search reference list of previous systematic reviews and included study records; and consult additional experts. STUDY ELIGIBILITY AND CRITERIA We will include working-age (≥15 years) workers in the formal and informal economy in any WHO and/or ILO Member State, but exclude children (<15 years) and unpaid domestic workers. For Systematic Review 1, we will include quantitative prevalence studies of relevant levels of exposure to long working hours (i.e. 35-40, 41-48, 49-54 and ≥55 h/week) stratified by country, sex, age and industrial sector or occupation. For Systematic Review 2, we will include randomized controlled trials, cohort studies, case-control studies and other non-randomized intervention studies with an estimate of the relative effect of relevant level(s) of long working hours on the prevalence of, incidence of or mortality from ischaemic heart disease, compared with the theoretical minimum risk exposure level (i.e. 35-40 h/week). STUDY APPRAISAL AND SYNTHESIS METHODS At least two review authors will independently screen titles and abstracts against the eligibility criteria at a first stage and full texts of potentially eligible records at a second stage, followed by extraction of data from qualifying studies. At least two review authors will assess risk of bias and the quality of evidence, using the most suited tools currently available. For Systematic Review 2, if feasible, we will combine relative risks using meta-analysis. We will report results using the guidelines for accurate and transparent health estimates reporting (GATHER) for Systematic Review 1 and the preferred reporting items for systematic reviews and meta-analyses guidelines (PRISMA) for Systematic Review 2. PROSPERO registration number: CRD42017084243.
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Affiliation(s)
- Jian Li
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Universitätsstraße 1, Düsseldorf 40225, Germany.
| | - Chantal Brisson
- Centre de Recherche du CHU de Québec, Université Laval, 1050 Chemin Ste-Foy, Quebec City, G1S 4L8, Quebec, Canada.
| | - Els Clays
- Department of Public Health, Ghent University, Campus University Hospital, 4K3, De Pintelaan 185, B-9000 Ghent, Belgium.
| | - Marco M Ferrario
- Research Centre EPIMED, University of Insubria, Via O Rossi 9, 21100 Varese, Italy.
| | - Ivan D Ivanov
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland.
| | - Paul Landsbergis
- State University of New York-Downstate School of Public Health, 450 Clarkson Ave., Brooklyn, NY 11238, United States of America.
| | - Nancy Leppink
- Labour Administration, Labour Inspection and Occupational Safety and Health Branch, International Labour Organization, Route des Morillons 4, 1211 Geneva, Switzerland.
| | - Frank Pega
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland.
| | - Hynek Pikhart
- Institute of Epidemiology and Health Care, University College London, 1-19 Torrington Place, London WC1E 6BT, United Kingdom.
| | - Annette Prüss-Üstün
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland.
| | - Reiner Rugulies
- National Research Centre for the Working Environment, Lersø Parkallé 105, DK-2100 Copenhagen, Denmark; Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, DK-1014 Copenhagen, Denmark; Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, DK-1353 Copenhagen, Denmark.
| | - Peter L Schnall
- Center for Occupational and Environmental Health, University of California-Irvine, 100 Theory Way, Irvine, CA, United States of America.
| | - Gretchen Stevens
- Department of Information, Evidence and Research, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland.
| | - Akizumi Tsutsumi
- Department of Public Health, School of Medicine, Kitasato University, 1-15-1 Kitasato, Minami, Sagamihara 252-0374, Japan.
| | - Yuka Ujita
- Labour Administration, Labour Inspection and Occupational Safety and Health Branch, International Labour Organization, Route des Morillons 4, 1211 Geneva, Switzerland.
| | - Johannes Siegrist
- Life Science Centre, University of Düsseldorf, Merowingerplatz 1a, Düsseldorf 40225, Germany.
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Qiao S, Li X, Zhou Y, Shen Z, Stanton B. Attitudes toward evidence-based practices, occupational stress and work-related social support among health care providers in China: A SEM analysis. PLoS One 2018; 13:e0202166. [PMID: 30096206 PMCID: PMC6086451 DOI: 10.1371/journal.pone.0202166] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Accepted: 07/30/2018] [Indexed: 12/20/2022] Open
Abstract
Individuals' attitudes toward evidence-based practices (EBP) are critical in adopting, implementing and maintaining the EBP in clinical settings. Multiple empirical studies have examined how work context may shape perceptions and attitudes towards EBP. The current study aims to further explore how both work and family contexts, as assessed by three psychosocial indicators (i.e., occupational stress, work-related social support from coworkers, and work-related social support from family), may affect attitudes toward EBP among health care providers in HIV clinics in China. We analyzed cross-sectional survey data from 357 health care providers recruited from 40 HIV clinics across 16 cities/counties in Guangxi China. Structural equation model (SEM) was constructed to test the hypothesized relationships among key study variables. Occupational stress was negatively associated with work-related social support from coworkers (β = -.19, 95%CI = [-.31,-.12]), which in turn was positively associated with attitudes toward EBP (β = .17, 95%CI = [.04, .30]). Similarly, occupational stress was negatively related to work-related social support from family (β = -.34, 95%CI = [-.42,-.25]), which in turn was positively related to attitudes toward EBP (β = .23, 95%CI = [.12, .35]). Occupational stress was negatively associated with attitudes toward EBP, but the magnitude of association did not reach statistical significance at α = .05. Work-related social support from family partially mediated the association between occupational stress and attitudes toward EBP (Sobel's z = 3.27, p < .05). Our findings suggest the importance of integrating work and family contexts, especially family support into the strategies of facilitating the adoption and implementation of EBP. The current study also underscores the needs to reduce occupational stress and enhance work-related social support among health care providers who are in frequent contact with HIV patients. In addition, lack of work-related family support may be a main barrier preventing health care providers from developing a positive attitude toward EBP. Therefore, the interventions aiming for promoting adoption and utilization of EBP need to involve specific strategies to resolve work-family conflicts and improve family members' understanding and support for health care providers in China, especially those who work in a stressful work context such as HIV care.
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Affiliation(s)
- Shan Qiao
- Department of Health Promotion, Education, and Behavior, South Carolina SmartState Center for Healthcare Quality (CHQ), University of South Carolina Arnold School of Public Health, Columbia, South Carolina, United States of America
| | - Xiaoming Li
- Department of Health Promotion, Education, and Behavior, South Carolina SmartState Center for Healthcare Quality (CHQ), University of South Carolina Arnold School of Public Health, Columbia, South Carolina, United States of America
| | - Yuejiao Zhou
- Guangxi Center of Disease Control and Prevention, Nanning, Guangxi, China
| | - Zhiyong Shen
- Guangxi Center of Disease Control and Prevention, Nanning, Guangxi, China
| | - Bonita Stanton
- Hackensack-Meridian School of Medicine, Seton Hall University, South Orange, New Jersey, United States of America
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Ciavarra RP, Machida M, Lundberg PS, Gauronskas P, Wellman LL, Steel C, Aflatooni JO, Sanford LD. Controllable and uncontrollable stress differentially impact pathogenicity and survival in a mouse model of viral encephalitis. J Neuroimmunol 2018; 319:130-141. [PMID: 29580714 DOI: 10.1016/j.jneuroim.2018.02.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 02/20/2018] [Accepted: 02/21/2018] [Indexed: 01/08/2023]
Abstract
Intranasal instillation of vesicular stomatitis virus (VSV) into mice given controllable stress (modeled by escapable foot shock, ES) resulted in enhanced pathogenicity and decreased survival relative to infected mice given uncontrollable stress (modeled by inescapable foot shock, IS) and non-shocked control mice. Survival likely reflected differential cytokine gene expression that may have been regulated by miR146a, a predicted stress-responsive upstream regulator. Controllability also enhanced the accumulation of brain T resident memory cells that persisted long after viral clearance. The unexpected facilitatory effect of ES on antiviral neuroimmune responses and pathogenicity may arise from differential immunoactivating and immunosuppressive effects of uncontrollable and controllable stress.
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Affiliation(s)
- Richard P Ciavarra
- Department of Microbiology and Molecular Cell Biology, Eastern Virginia Medical School, Norfolk, VA 23501, United States; Department of Microbiology and Molecular and Cell Biology, Eastern Virginia Medical School, 700 W Olney Road, Norfolk, VA 23501, United States.
| | - Mayumi Machida
- Sleep Research Laboratory, Department of Pathology and Anatomy, Eastern Virginia Medical School, Norfolk, VA 23501, United States
| | - Patric S Lundberg
- Department of Microbiology and Molecular Cell Biology, Eastern Virginia Medical School, Norfolk, VA 23501, United States
| | - Phillip Gauronskas
- Department of Microbiology and Molecular Cell Biology, Eastern Virginia Medical School, Norfolk, VA 23501, United States
| | - Laurie L Wellman
- Sleep Research Laboratory, Department of Pathology and Anatomy, Eastern Virginia Medical School, Norfolk, VA 23501, United States
| | - Christina Steel
- Department of Microbiology and Molecular Cell Biology, Eastern Virginia Medical School, Norfolk, VA 23501, United States
| | - Justin O Aflatooni
- Department of Microbiology and Molecular Cell Biology, Eastern Virginia Medical School, Norfolk, VA 23501, United States
| | - Larry D Sanford
- Sleep Research Laboratory, Department of Pathology and Anatomy, Eastern Virginia Medical School, Norfolk, VA 23501, United States
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Effort-Reward Imbalance at Work and Incident Coronary Heart Disease: A Multicohort Study of 90,164 Individuals. Epidemiology 2018; 28:619-626. [PMID: 28570388 PMCID: PMC5457838 DOI: 10.1097/ede.0000000000000666] [Citation(s) in RCA: 176] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Supplemental Digital Content is available in the text. Background: Epidemiologic evidence for work stress as a risk factor for coronary heart disease is mostly based on a single measure of stressful work known as job strain, a combination of high demands and low job control. We examined whether a complementary stress measure that assesses an imbalance between efforts spent at work and rewards received predicted coronary heart disease. Methods: This multicohort study (the “IPD-Work” consortium) was based on harmonized individual-level data from 11 European prospective cohort studies. Stressful work in 90,164 men and women without coronary heart disease at baseline was assessed by validated effort–reward imbalance and job strain questionnaires. We defined incident coronary heart disease as the first nonfatal myocardial infarction or coronary death. Study-specific estimates were pooled by random effects meta-analysis. Results: At baseline, 31.7% of study members reported effort–reward imbalance at work and 15.9% reported job strain. During a mean follow-up of 9.8 years, 1,078 coronary events were recorded. After adjustment for potential confounders, a hazard ratio of 1.16 (95% confidence interval, 1.00–1.35) was observed for effort–reward imbalance compared with no imbalance. The hazard ratio was 1.16 (1.01–1.34) for having either effort–reward imbalance or job strain and 1.41 (1.12–1.76) for having both these stressors compared to having neither effort–reward imbalance nor job strain. Conclusions: Individuals with effort–reward imbalance at work have an increased risk of coronary heart disease, and this appears to be independent of job strain experienced. These findings support expanding focus beyond just job strain in future research on work stress.
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Gajewski PD, Boden S, Freude G, Potter GG, Claus M, Bröde P, Watzl C, Getzmann S, Falkenstein M. Executive control, ERP and pro-inflammatory activity in emotionally exhausted middle-aged employees. Comparison between subclinical burnout and mild to moderate depression. Psychoneuroendocrinology 2017; 86:176-186. [PMID: 28972891 DOI: 10.1016/j.psyneuen.2017.09.017] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 09/01/2017] [Accepted: 09/14/2017] [Indexed: 01/11/2023]
Abstract
Burnout is a syndrome occurring mainly in individuals with long-term stressful work. The main complaints are emotional exhaustion and reduced performance. Burnout also largely overlaps with depression. Both are characterized by increased incidence of infections due to dysregulation of the immune system, overexpression of pro-inflammatory cytokines and cognitive deficits, particularly related to executive functions. To distinguish between burnout and depression already at the pre-clinical stage, the present double-blinded study compared immunological and cognitive parameters in seventy-six employees from emotionally demanding occupations who were post-hoc subdivided into two groups scoring low (EE-) and high (EE+) in emotional exhaustion and low (DE-) and high (DE+) in depression. Immunological parameters were measured from blood samples. Executive functions were studied by analyzing event-related brain potentials (ERPs) and performance during a task switching paradigm. Psychosocial job parameters were measured with standardized questionnaires. Burnout and mild to moderate depression largely overlapped. However, several subjects showed burnout without depressive symptoms. Higher levels of the pro-inflammatory cytokines IL-6 and IL-12 were correlated with burnout severity and depressive symptoms in male individuals. In the switch task a trend for lower performance in the EE+ vs. EE- group and no difference between DE+ and DE- groups were found. In the ERPs, however, differences were observed which distinguished between subclinical burnout and depression: the terminal contingent negative variation (CNV), indicating preparatory activity and the P3b, related to allocation of cognitive resources were generally reduced in EE+ vs. EE-, whereas no differences were found in the DE+ vs. DE- groups. The frontal P3a was selectively reduced in switch trials in the EE+ vs. EE- group and showed only a trend in DE+ vs. DE-, indicating impairment of executive control in subclinical burnout. Taken together, the results unveil specific immunological changes and declines in brain functions in employees with subclinical burnout that are not apparent in persons with moderate depression. Hence, the combination of immunological, behavioral and ERP methods renders a promising method for distinguishing both syndromes and for improving an early diagnosis of burnout before a clinical stage is reached.
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Affiliation(s)
- Patrick D Gajewski
- Leibniz Research Centre for Working Environment and Human Factors (IfADo) at TU Dortmund, Dortmund, Germany1.
| | - Sylvia Boden
- Leibniz Research Centre for Working Environment and Human Factors (IfADo) at TU Dortmund, Dortmund, Germany1
| | - Gabriele Freude
- Federal Institute for Occupational Safety and Health (BAuA), Berlin, Germany
| | - Guy G Potter
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
| | - Maren Claus
- Leibniz Research Centre for Working Environment and Human Factors (IfADo) at TU Dortmund, Dortmund, Germany1
| | - Peter Bröde
- Leibniz Research Centre for Working Environment and Human Factors (IfADo) at TU Dortmund, Dortmund, Germany1
| | - Carsten Watzl
- Leibniz Research Centre for Working Environment and Human Factors (IfADo) at TU Dortmund, Dortmund, Germany1
| | - Stephan Getzmann
- Leibniz Research Centre for Working Environment and Human Factors (IfADo) at TU Dortmund, Dortmund, Germany1
| | - Michael Falkenstein
- Leibniz Research Centre for Working Environment and Human Factors (IfADo) at TU Dortmund, Dortmund, Germany1; Institute for Working, Learning and Aging, Bochum, Germany
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Work stress, anthropometry, lung function, blood pressure, and blood-based biomarkers: a cross-sectional study of 43,593 French men and women. Sci Rep 2017; 7:9282. [PMID: 28839130 PMCID: PMC5570902 DOI: 10.1038/s41598-017-07508-x] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 06/28/2017] [Indexed: 12/29/2022] Open
Abstract
Work stress is a risk factor for cardio-metabolic diseases, but few large-scale studies have examined the clinical profile of individuals with work stress. To address this limitation, we conducted a cross-sectional study including 43,593 working adults from a French population-based sample aged 18–72 years (the CONSTANCES cohort). According to the Effort-Reward Imbalance model, work stress was defined as an imbalance between perceived high efforts and low rewards at work. A standardized health examination included measures of anthropometry, lung function, blood pressure and standard blood-based biomarkers. Linear regression analyses before and after multivariable adjustment for age, socioeconomic status, depressive symptoms, health-related behaviours, and chronic conditions showed that work stress was associated with higher BMI, waist circumference, waist-hip ratio, alanine transaminase, white blood cell count and lower high-density lipoprotein cholesterol in men, and with higher BMI and white blood cell count in women (differences 0.03–0.06 standard deviations, P < 0.05 between individuals with and without work stress). No robust associations were observed with lung function, haemoglobin, creatinine, glucose levels or resting blood pressure measures. This indicates that work stress is associated altered metabolic profile, increased systemic inflammation, and, in men, poorer liver function, which is a marker of high alcohol consumption.
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Han Y, Zhang A, Sun H, Zhang Y, Meng X, Yan G, Liu L, Wang X. High-throughput ultra high performance liquid chromatography combined with mass spectrometry approach for the rapid analysis and characterization of multiple constituents of the fruit ofAcanthopanax senticosus(Rupr. et Maxim.) Harms. J Sep Sci 2017; 40:2178-2187. [DOI: 10.1002/jssc.201601445] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Revised: 03/17/2017] [Accepted: 03/17/2017] [Indexed: 11/08/2022]
Affiliation(s)
- Yue Han
- Sino-America Chinmedomics Technology Collaboration Center; National TCM Key Laboratory of Serum Pharmacochemistry; Chinmedomics Research Center of State Administration of TCM; Laboratory of Metabolomics; Department of Pharmaceutical Analysis; Heilongjiang University of Chinese Medicine; Harbin China
| | - Aihua Zhang
- Sino-America Chinmedomics Technology Collaboration Center; National TCM Key Laboratory of Serum Pharmacochemistry; Chinmedomics Research Center of State Administration of TCM; Laboratory of Metabolomics; Department of Pharmaceutical Analysis; Heilongjiang University of Chinese Medicine; Harbin China
| | - Hui Sun
- Sino-America Chinmedomics Technology Collaboration Center; National TCM Key Laboratory of Serum Pharmacochemistry; Chinmedomics Research Center of State Administration of TCM; Laboratory of Metabolomics; Department of Pharmaceutical Analysis; Heilongjiang University of Chinese Medicine; Harbin China
| | - Yingzhi Zhang
- Sino-America Chinmedomics Technology Collaboration Center; National TCM Key Laboratory of Serum Pharmacochemistry; Chinmedomics Research Center of State Administration of TCM; Laboratory of Metabolomics; Department of Pharmaceutical Analysis; Heilongjiang University of Chinese Medicine; Harbin China
| | - Xiangcai Meng
- Sino-America Chinmedomics Technology Collaboration Center; National TCM Key Laboratory of Serum Pharmacochemistry; Chinmedomics Research Center of State Administration of TCM; Laboratory of Metabolomics; Department of Pharmaceutical Analysis; Heilongjiang University of Chinese Medicine; Harbin China
| | - Guangli Yan
- Sino-America Chinmedomics Technology Collaboration Center; National TCM Key Laboratory of Serum Pharmacochemistry; Chinmedomics Research Center of State Administration of TCM; Laboratory of Metabolomics; Department of Pharmaceutical Analysis; Heilongjiang University of Chinese Medicine; Harbin China
| | - Liang Liu
- State Key Laboratory of Quality Research in Chinese Medicine; Macau University of Science and Technology; Taipa Macau
| | - Xijun Wang
- Sino-America Chinmedomics Technology Collaboration Center; National TCM Key Laboratory of Serum Pharmacochemistry; Chinmedomics Research Center of State Administration of TCM; Laboratory of Metabolomics; Department of Pharmaceutical Analysis; Heilongjiang University of Chinese Medicine; Harbin China
- State Key Laboratory of Quality Research in Chinese Medicine; Macau University of Science and Technology; Taipa Macau
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The Effectiveness of Mindfulness-Integrated Cognitive Behavior Therapy on Depression, Anxiety, and Stress in Females with Multiple Sclerosis: A Single Blind Randomized Controlled Trial. IRANIAN RED CRESCENT MEDICAL JOURNAL 2017. [DOI: 10.5812/ircmj.44566] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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