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Ramadan MA, Mohammed RS, Safwat Saif Eldin A. Assessment of ventilatory functions and associated inflammatory markers among workers in slaughterhouses. Int Arch Occup Environ Health 2024:10.1007/s00420-024-02094-8. [PMID: 39150528 DOI: 10.1007/s00420-024-02094-8] [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: 05/17/2024] [Accepted: 07/12/2024] [Indexed: 08/17/2024]
Abstract
OBJECTIVE Meat processing is among the most extensive industries globally. However, data on the effects of occupational exposure on the pulmonary health of slaughterhouse workers is limited. Ascertaining the impact of the slaughterhouse atmosphere on the breathing habits of laborers exposed to it and the inflammatory markers associated with it was the aim of the current investigation. METHODS A cross-sectional study was performed on 82 non-smoker subjects of 41 male workers working in one of the major slaughterhouses in Cairo, Egypt, matched to 41 controls of administrative personnel. An elaborate questionnaire encompassing medical and occupational history was administered to each participant in the research. General and local systemic examinations and ventilatory function tests were carried out, and serum levels of interleukin 6 (IL-6) and high-sensitivity C-reactive protein (hsCRP) were measured. RESULTS Respiratory symptoms were more prevalent with a statistically significant decline in ventilatory function parameters (FVC%, FEV1%, FEV1/FVC, FEF 25%, FEF 50%, FEF 75%, and PEF%) among the exposed group compared to those of control. In addition, there was a significantly higher serum level of inflammatory markers (IL-6 and hsCRP) among the exposed group compared to the control group, with a negative correlation with ventilatory functions. Moreover, there was a positive association between levels of serum IL-6 and hsCRP and the age and duration of employment of workers. CONCLUSION There was a notable increase in the prevalence of respiratory disorders and inflammatory markers among slaughterhouse workers. Additionally, there was a substantial decrease in ventilatory function parameters, which could be attributed to the bioaerosols they encountered in the workplace.
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Affiliation(s)
- Mona Abdallah Ramadan
- Department of Occupational and Environmental Medicine, Faculty of Medicine, Cairo University, Giza, Egypt.
| | - Rateba Said Mohammed
- Department of Occupational and Environmental Medicine, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Aisha Safwat Saif Eldin
- Department of Occupational and Environmental Medicine, Faculty of Medicine, Cairo University, Giza, Egypt
- College of Health and Rehabilitation Sciences, Princess Nora Bint Abul Rahman University, Riyadh, Saudi Arabia
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2
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Bennett N, Lawrence-Wood E, McFarlane A. Is inflammatory change associated with psychological risk and resilience in high-risk military personnel? BMJ Mil Health 2024:e002725. [PMID: 39043474 DOI: 10.1136/military-2024-002725] [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: 03/15/2024] [Accepted: 05/30/2024] [Indexed: 07/25/2024]
Abstract
INTRODUCTION In military populations, the potential for under-reporting of Post-traumatic Stress Disorder (PTSD) symptoms and challenges in recognising early changes can make it difficult to detect an emerging disorder. However, early identification of PTSD symptoms would improve opportunities for intervention, and potentially reduce the likelihood of chronic mental health problems. METHOD This study explored if changes in levels of inflammation, measured by C reactive protein (CRP) and interleukin 6 (IL-6), were associated with the onset of psychological symptoms associated with PTSD. It also examined if changes in inflammation over time contributed to psychological risk and resilience, which was defined by psychological reactivity to deployment-related combat exposures. Participants were special forces personnel who completed psychological self-report questionnaires and had measures of CRP and IL-6 taken pre and post deployment. Regression analysis was used to examine how psychological symptoms predicted change in inflammation, and Analysis of Variance (ANOVA) were used to examine differences between identified subgroups. RESULTS Results identify this population as having high levels of combat and trauma exposures, with low-level psychological symptoms. The results also identified a decrease in CRP and an increase in IL-6 over time. A significant difference in inflammation was identified between subgroups (p<0.05). An association between inflammatory markers and subthreshold symptoms related to anger (p<0.01) and sleep (p<0.05) was also identified. CONCLUSION These preliminary findings suggest inflammatory markers may help to identify adaptive responses post deployment. In addition, low-level increases in inflammatory markers may be associated with subthreshold PTSD symptoms. These findings offer potential insights for prevention, early identification and treatment in military and veteran populations.
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Affiliation(s)
- Neanne Bennett
- The University of Adelaide Faculty of Health and Medical Sciences, Adelaide, South Australia, Australia
- Department of Defence, Defence People Group, Canberra, Australian Capital Territory, Australia
| | - E Lawrence-Wood
- Phoenix Australia Centre for Post-traumatic Mental Health, Carlton, Victoria, Australia
| | - A McFarlane
- The University of Adelaide Faculty of Health and Medical Sciences, Adelaide, South Australia, Australia
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3
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Pando M, Yang R, Dimitrov G, Chavez R, Garza T, Trevino AV, Gautam A, Stark TR, Hammamieh R, Clifford J, Sosanya NM. Identifying Stress-Exacerbated Thermal-Injury Induced MicroRNAs. THE JOURNAL OF PAIN 2023; 24:2294-2308. [PMID: 37468024 DOI: 10.1016/j.jpain.2023.07.013] [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: 01/23/2023] [Revised: 06/26/2023] [Accepted: 07/12/2023] [Indexed: 07/21/2023]
Abstract
Using a model of combat and operational stress reaction (COSR), our lab recently showed that exposure to an unpredictable combat stress (UPCS) procedure prior to a thermal injury increases pain sensitivity in male rats. Additionally, our lab has recently shown that circulating extracellular vesicle-microRNAs (EV-miRNAs), which normally function to suppress inflammation, were downregulated in a male rat model of neuropathic pain. In this current study, male and female rats exposed to UPCS, followed by thermal injury, were evaluated for changes in circulating EV-miRNAs. Adult female and male Sprague Dawley rats were exposed to a UPCS procedure for either 2 or 4 weeks. Groups consisted of the following: nonstress (NS), stress (S), NS + thermal injury (TI), and S + TI. Mechanical sensitivity was measured, and plasma was collected at baseline, throughout the UPCS exposure, and post-thermal injury. EV-miRNA isolation was performed, followed by small RNA sequencing and subsequent data analysis. UPCS exposure alone resulted in mechanical allodynia in both male and female rats at specific time points. Thermal-injury induction occurring at peak UPCS resulted in increased mechanical allodynia in the injured hind paw compared to thermal injury alone. Differential expression of the EV-miRNAs was observed between the NS and S groups as well as between NS + TI and S + TI groups. Consistent differences in EV-miRNAs are detectable in both COSR as well as during the development of mechanical sensitivity and potentially serve as key regulators, biomarkers, and targets in the treatment of COSR and thermal-injury induced mechanical sensitivity. PERSPECTIVE: This article presents the effects of unpredictable combat stress and thermal injury on EV-contained microRNAs in an animal model. These same mechanisms may exist in clinical patients and could be future prognostic and diagnostic biomarkers.
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Affiliation(s)
- Miryam Pando
- US Army Institute of Surgical Research (USAISR), JBSA Ft Sam Houston, San Antonio, Texas
| | - Ruoting Yang
- Medical Readiness Systems Biology Branch, Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, Maryland
| | - George Dimitrov
- Medical Readiness Systems Biology Branch, The Geneva Foundation, Tacoma, Washington
| | - Roger Chavez
- US Army Institute of Surgical Research (USAISR), JBSA Ft Sam Houston, San Antonio, Texas
| | - Thomas Garza
- US Army Institute of Surgical Research (USAISR), JBSA Ft Sam Houston, San Antonio, Texas
| | - Alex V Trevino
- US Army Institute of Surgical Research (USAISR), JBSA Ft Sam Houston, San Antonio, Texas
| | - Aarti Gautam
- Medical Readiness Systems Biology Branch, Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, Maryland
| | - Thomas R Stark
- US Army Institute of Surgical Research (USAISR), JBSA Ft Sam Houston, San Antonio, Texas
| | - Rasha Hammamieh
- Medical Readiness Systems Biology Branch, The Geneva Foundation, Tacoma, Washington
| | - John Clifford
- US Army Institute of Surgical Research (USAISR), JBSA Ft Sam Houston, San Antonio, Texas
| | - Natasha M Sosanya
- US Army Institute of Surgical Research (USAISR), JBSA Ft Sam Houston, San Antonio, Texas
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Ross JA, Heebner NR. No pain, no gain: The military overtraining hypothesis of musculoskeletal stress and injury. Physiother Theory Pract 2023; 39:2289-2299. [PMID: 35695302 DOI: 10.1080/09593985.2022.2082346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 04/16/2022] [Accepted: 05/21/2022] [Indexed: 10/18/2022]
Abstract
The purpose of this manuscript is to present a model of military overtraining and subsequent injury, discharge, and disability. Military training and combat operations are physically and physiologically demanding, placing great strain on the musculoskeletal system of warfighters. Non-battle musculoskeletal injuries (MSKI) are common and present a serious threat to operational readiness in today's military. MSKI risk stratification and prevention are an active area of research and is steeped in the background of sports science. Here, a model is proposed that incorporates the theory of General Adaptation Syndrome to describe how military training stressors may exceed that of training in traditional athletics and may induce sub-optimal training stressors. Positive feedback loops are discussed to explain how military overtraining (MOT) creates a system of ever-increasing stressors that can only be fully understood in the greater context of all environmental factors leading to overtraining. The Military Overtraining Hypothesis (MOTH) is proposed as a model that encapsulates the elevated MSKI risk in combat arms and other operational military personnel as an effort to broaden understanding of multifactorial military MSKI etiologies and as a tool for researchers and commanders to contextualize MSKI research and risk mitigation interventions.
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Affiliation(s)
- Jeremy A Ross
- Sports Medicine Research Institute, University of Kentucky, Lexington USA
| | - Nicholas R Heebner
- Sports Medicine Research Institute, University of Kentucky, Lexington USA
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Singh J, Carleton RN, Neary JP. Cardiac function and posttraumatic stress disorder: a review of the literature and case report. Health Promot Chronic Dis Prev Can 2023; 43:472-480. [PMID: 37991890 PMCID: PMC10753899 DOI: 10.24095/hpcdp.43.10/11.05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
INTRODUCTION Posttraumatic stress disorder (PTSD) can induce an elevation in sympathetic tone; however, research pertaining to the cardiac cycle in patients with PTSD is limited. METHODS A literature review was conducted with PubMed, MEDLINE and Web of Science. Articles discussing changes and associations in echocardiography and PTSD or related symptoms were synthesized for the current review. We have also included data from a case report of a male participant aged 33 years experiencing potentially psychologically traumatic events, who wore a noninvasive cardiac sensor to assess the timing intervals and contractility parameters of the cardiac cycle using seismocardiography. The intervals included systolic time, isovolumic contraction time (IVCT) and isovolumic relaxation time (IVRT). Calculations of systolic (IVCT/systole), diastolic (IVRT/systole) and myocardial [(IVCT+IVRT)/systole] performance indices were completed. RESULTS The review identified 55 articles, 14 of which assessed cardiac function using echocardiography in patients with PTSD symptoms. Cardiac dysfunction varied across studies, with diastolic and systolic impairments found in patients with PTSD. Our case study showed that occupational stress elevated cardiac performance indices, suggesting increased ventricular stress and supporting results in the existing literature. CONCLUSIONS The literature review results suggest that a controlled approach to assessing cardiac function in patients with PTSD is required. The case study results further suggest that acute bouts of stress can alter cardiac function, with potential for sustained occupational stress to induce changes in cardiac function. Cardiac monitoring can be used prospectively to identify changes induced by potentially psychologically traumatic event exposures that can lead to the development of PTSD symptoms.
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Affiliation(s)
- Jyotpal Singh
- Faculty of Kinesiology and Health Studies, University of Regina, Regina, Saskatchewan, Canada
| | - R Nicholas Carleton
- Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
| | - J Patrick Neary
- Faculty of Kinesiology and Health Studies, University of Regina, Regina, Saskatchewan, Canada
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Pratt AA, Sadler AG, Thomas EBK, Syrop CH, Ryan GL, Mengeling MA. Incidence and risk factors for postpartum mood and anxiety disorders among women veterans. Gen Hosp Psychiatry 2023; 84:112-124. [PMID: 37433239 DOI: 10.1016/j.genhosppsych.2023.06.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 06/15/2023] [Accepted: 06/23/2023] [Indexed: 07/13/2023]
Abstract
BACKGROUND Our aim was to determine rates of postpartum mood and anxiety disorders (PMADs) among U.S. women Veterans and the overlap among PMADs. We further sought to identify PMAD risk factors, including those unique to military service. METHODS A national sample of women Veterans completed a computer-assisted telephone interview (N = 1414). Eligible participants were aged 20-45 and had separated from service within the last 10 years. Self-report measures included demographics, general health, reproductive health, military exposures, sexual assault, childhood trauma, and posttraumatic stress disorder (PTSD). The PMADs of interest were postpartum depression (PPD), postpartum anxiety (PPA) and postpartum PTSD (PPPTSD). This analysis included 1039 women Veterans who had ever been pregnant and who answered questions about PPMDs related to their most recent pregnancy. RESULTS A third (340/1039, 32.7%) of participants were diagnosed with at least one PMAD and one-fifth (215/1039, 20.7%) with two or more. Risk factors common for developing a PMAD included: a mental health diagnosis prior to pregnancy, a self-report of ever having had a traumatic birth experience, and most recent pregnancy occurring during military service. Additional risk factors were found for PPD and PPPTSD. CONCLUSION Women Veterans may be at an increased risk for developing PMADs due to high rates of lifetime sexual assault, mental health disorders, and military-specific factors including giving birth during military service and military combat deployment exposures.
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Affiliation(s)
- Alessandra A Pratt
- Center for Access & Delivery Research and Evaluation (CADRE), Iowa City VA Health Care System, 601 Highway 6 West, Building 42, Iowa City, IA 52246, USA.
| | - Anne G Sadler
- Center for Access & Delivery Research and Evaluation (CADRE), Iowa City VA Health Care System, 601 Highway 6 West, Building 42, Iowa City, IA 52246, USA; VA Office of Rural Health (ORH), Veterans Rural Health Resource Center-Iowa City (VRHRC-IC), Iowa City VA Health Care System, 601 Highway 6 West, Iowa City, IA 52246, USA; Department of Psychiatry, University of Iowa Carver College of Medicine, 200 Hawkins Drive, Iowa City, IA 52242, USA
| | - Emily B K Thomas
- VA Office of Rural Health (ORH), Veterans Rural Health Resource Center-Iowa City (VRHRC-IC), Iowa City VA Health Care System, 601 Highway 6 West, Iowa City, IA 52246, USA; Department of Psychological and Brain Sciences, University of Iowa College of Liberal Arts and Sciences, 340 Iowa Ave, Iowa City, IA 52246, USA
| | - Craig H Syrop
- Department of Obstetrics and Gynecology, University of Iowa Carver College of Medicine, 200 Hawkins Drive, Iowa City, IA 52242, USA
| | - Ginny L Ryan
- Puget Sound VA Healthcare System, 1660 S Columbian Way, Seattle, WA 98108, USA; University of Washington Medical Center, 1959 NE Pacific Street, Box 356460, Seattle, WA 98195, USA
| | - Michelle A Mengeling
- Center for Access & Delivery Research and Evaluation (CADRE), Iowa City VA Health Care System, 601 Highway 6 West, Building 42, Iowa City, IA 52246, USA; VA Office of Rural Health (ORH), Veterans Rural Health Resource Center-Iowa City (VRHRC-IC), Iowa City VA Health Care System, 601 Highway 6 West, Iowa City, IA 52246, USA; Department of Internal Medicine, University of Iowa Carver College of Medicine, 200 Hawkins Drive, Iowa City, IA 52242, USA
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Van Puyvelde M, Van Herck J, Van den Bossche J, Goethals F, Gijbels D, Detaille F, Pattyn N. Walk the line: a systemic perspective on stress experienced by emergency medical personnel by comparing military and civilian prehospital settings. Front Public Health 2023; 11:1136090. [PMID: 37441639 PMCID: PMC10335750 DOI: 10.3389/fpubh.2023.1136090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 03/15/2023] [Indexed: 07/15/2023] Open
Abstract
Introduction Emergency Medicine (EM) personnel in both military and civilian prehospital settings are often exposed to stressful and extreme events. Therefore, a cross-pollination between both contexts in terms of coping strategies may generate new information for purposes of training, prevention, and support programs. In the current study, we aimed at comparing both contexts to understand the type of stress events personnel experience; whether experience differs between civilian and military personnel; and how they cope with it. Methods We used a mixed method approach, combining the results of a quantitative questionnaire and a thematic analysis of 23 in-depth semi-structured interviews to gain additional qualitative information. Results Whereas the questionnaire pointed to a significant preference for task-oriented coping over avoidant and emotion-oriented coping, the interviews offered a more nuanced insight, showing a constant aim to position themselves on a continuum between emotional disconnection from the patient to preserve operationality on the one hand; and remaining enough empathic to preserve humanity on the other hand. We further identified an ambivalent awareness regarding emotions and stress, a vulnerable disbalance between an excessive passion for the job with the sacrifice of own's personal life (for a growing volatile and dangerous working environment) and a lack of recognition from both the patient and organizational environment. The combination of these factors may carry the risk for moral injury and compassion fatigue. Therefore, mutual trust between the organizational level and EM personnel as well as among team members is crucial. Discussion The results are discussed from a systemic SHELL perspective, indicating how the specific profile of EM personnel relates to the software, hardware, environmental and liveware components of their professional and private life. Trainings on stress- and risk awareness should be approached both on an individual and systemic level, knowing that there is clearly no "one-size-fits-all" manner.
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Affiliation(s)
- Martine Van Puyvelde
- Vital Signs and PERformance Monitoring (VIPER) Research Unit, LIFE Department, Royal Military Academy, Brussels, Belgium
- Brain, Body and Cognition, Department of Psychology, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium
- Clinical and Lifespan Psychology, Department of Psychology, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium
- Faculty of Science, School of Natural Sciences and Psychology, Liverpool John Moores University, Liverpool, United Kingdom
| | - Jolien Van Herck
- Clinical and Lifespan Psychology, Department of Psychology, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | | | - Frederic Goethals
- Comd Centre for Mental Health of the Military Hospital Queen Astrid, Brussels, Belgium
| | - Daisy Gijbels
- Vital Signs and PERformance Monitoring (VIPER) Research Unit, LIFE Department, Royal Military Academy, Brussels, Belgium
| | - Frederic Detaille
- Vital Signs and PERformance Monitoring (VIPER) Research Unit, LIFE Department, Royal Military Academy, Brussels, Belgium
| | - Nathalie Pattyn
- Vital Signs and PERformance Monitoring (VIPER) Research Unit, LIFE Department, Royal Military Academy, Brussels, Belgium
- MFYS-BLITS, Human Physiology Department, Vrije Universiteit Brussel, Brussels, Belgium
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, CIUSSS NÎM, Montreal, QC, Canada
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Seol JH, Sohn YW, Yoo M, Park Y. Decent Work, Posttraumatic Stress Disorder, and Posttraumatic Growth From the Psychology of Working Perspective: A Three-Wave Study of Military Personnel. JOURNAL OF CAREER ASSESSMENT 2023. [DOI: 10.1177/10690727231163321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2023]
Abstract
Scholarly interest in the relationship between decent work and mental health based on the Psychology of Working Theory has recently increased. This study evaluated the indirect effects of survival, social contribution, and self-determination needs satisfaction on the relationship between decent work and trauma-related mental health among military personnel. We conducted a three-wave survey over 1 year. Results showed that decent work predicted satisfaction of the three basic needs. Additionally, survival needs directly predicted posttraumatic stress disorder symptoms, while social contribution and self-determination needs directly predicted posttraumatic growth. Finally, decent work had a significant indirect effect on posttraumatic stress disorder symptoms via survival needs, whereas decent work had significant indirect effects on posttraumatic growth via social contribution and self-determination needs. Our findings suggest that the more military personnel perceive their work as decent and feel that their three basic needs are fulfilled, the more posttraumatic stress disorder symptoms diminish, and posttraumatic growth increases. We discuss the implications and need for follow-up studies.
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Affiliation(s)
- Jeong Hoon Seol
- Department of Psychology, Yonsei University, Seoul, Republic of Korea
| | - Young Woo Sohn
- Department of Psychology, Yonsei University, Seoul, Republic of Korea
| | - Minjun Yoo
- Department of Humanities, R.O.K Naval Academy, Changwon, Republic of Korea
| | - Yonguk Park
- Department of Psychology, Yonsei University, Seoul, Republic of Korea
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Alves S, Vaz J, Fernandes A. Exploring Clinical Trials to Manage Firefighters' Sleep Quality: A PRISMA Compliant Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3862. [PMID: 36900873 PMCID: PMC10001586 DOI: 10.3390/ijerph20053862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 02/08/2023] [Accepted: 02/15/2023] [Indexed: 06/18/2023]
Abstract
Sleep research has grown over the past decades and investigators are deeply involved in studying sleep and its impact on human health and body regulation. Despite the understanding that insufficient sleep is strongly linked to the development of several disorders, unsatisfactory sleep exposes health and safety to innumerous risks. The present study aims to review and analyze the main results of clinical trials, registered at ClinicalTrials.gov and ICTRT databases, and developed construct strategies to improve sleep quality on firefighters and enhance professionals' sleep and health conditions. The protocol was registered in PROSPERO under number CRD42022334719. Trials registered between first registry and 2022 were included. We retrieved 11 registered clinical trials; seven met eligibility criteria and were included in the review. A relation between sleep disorders, shift work, and occupational health problems was found, and retrieved trials showed that sleep education programs can improve sleep quality and sleep hygiene. Science has already recognized sleep's importance for metabolic functioning and survivorship. Nevertheless, it continues to play a major role in discovering methods to diminish the problems faced. Strategies contemplating sleep education, or intervention, should be presented to fire services to tackle this problem and promote healthier and safer environments.
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Affiliation(s)
- Sara Alves
- Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-253 Bragança, Portugal
- Institute of Health Sciences, Universidade Católica Portuguesa (UCP), 4169-005 Porto, Portugal
| | - Josiana Vaz
- Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-253 Bragança, Portugal
- Centro de Investigação de Montanha (CIMO), Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-253 Bragança, Portugal
- Laboratório Associado para a Sustentabilidade e Tecnologia em Regiões de Montanha (SusTEC), Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-253 Bragança, Portugal
| | - Adília Fernandes
- Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-253 Bragança, Portugal
- Unidade de Investigação em Ciências da Saúde: Enfermagem (UICISA: E), Escola Superior de Saúde de Coimbra, 3000-232 Coimbra, Portugal
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Ellis J, Korman MB. Development of an Evidence-Informed Solution to Emotional Distress in Public Safety Personnel and Healthcare Workers: The Social Support, Tracking Distress, Education, and Discussion CommunitY (STEADY) Program. Healthcare (Basel) 2022; 10:1777. [PMID: 36141388 PMCID: PMC9498760 DOI: 10.3390/healthcare10091777] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/25/2022] [Accepted: 09/06/2022] [Indexed: 02/08/2023] Open
Abstract
Public safety personnel (PSP) and healthcare workers (HCWs) are frequently exposed to traumatic events and experience an increased rate of adverse mental health outcomes compared to the public. Some organizations have implemented wellness programming to mitigate this issue. To our knowledge, no programs were developed collaboratively by researchers and knowledge users considering knowledge translation and implementation science frameworks to include all evidence-informed elements of posttraumatic stress prevention. The Social Support, Tracking Distress, Education, and Discussion Community (STEADY) Program was developed to fill this gap. It includes (1) peer partnering; (2) distress tracking; (3) psychoeducation; (4) peer support groups and voluntary psychological debriefing following critical incidents; (5) community-building activities. This paper reports on the narrative literature review that framed the development of the STEADY framework and introduces its key elements. If successful, STEADY has the potential to improve the mental well-being of PSP and HCWs across Canada and internationally.
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Affiliation(s)
- Janet Ellis
- Department of Evaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, ON M4N 3M5, Canada
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada
| | - Melissa B. Korman
- Department of Evaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, ON M4N 3M5, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, ON M5T 2S8, Canada
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Zundel CG, Price K, Grasso CM, Spiro A, Heeren T, Sullivan K, Krengel MH. The impact of neurotoxicant exposures on posttraumatic stress disorder trajectories: The Ft. Devens Gulf War Veterans Cohort. J Trauma Stress 2022; 35:955-966. [PMID: 35150175 PMCID: PMC9541763 DOI: 10.1002/jts.22802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 12/08/2021] [Indexed: 11/10/2022]
Abstract
Gulf War veterans (GWVs) were exposed to neurotoxicants, including sarin nerve gas, anti-nerve agent pills, pesticides, oil well fires, and fumes from unvented tent heaters, all of which have been associated with subsequent adverse health. Posttraumatic stress disorder (PTSD) symptoms have also been associated with GW deployment; however, associations between exposures and PTSD symptoms have not been investigated. We assessed PTSD symptom trajectories and associations with neurotoxicant exposures in Ft. Devens Cohort (FDC) veterans (N = 259) who endorsed trauma exposure during deployment and completed the PTSD Checklist at three follow-ups (1992-1993, 1997-1998, 2013-2017). Results indicate that among veterans with more severe initial PTSD symptoms, symptoms remained significantly higher across follow-ups, Bs = -1.489-1.028, whereas among those with low initial PTSD symptoms, symptom severity increased significantly over time, Bs = 1.043-10.304. Additionally, neurotoxicant exposure was associated with a significant increase in PTSD symptoms, Bs = -1.870-9.003. Significant interactions between time and exposures were observed for PTSD symptom clusters, suggesting that among participants with high initial PTSD symptom, unexposed veterans experienced symptom alleviation, whereas exposed veterans' PTSD symptoms remained high. In GWVs with low initial PTSD symptoms, both unexposed and exposed veterans experienced PTSD symptom exacerbations over time; however, this occurred at a faster rate among exposed veterans. These findings suggest that in the years following deployment, GWVs who were exposed to both traumatic events and neurotoxicants may experience more severe and chronic PTSD symptoms than those without neurotoxicant exposures.
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Affiliation(s)
- Clara G. Zundel
- Research ServiceVA Boston Healthcare SystemBostonMassachusettsUSA,Behavioral Neuroscience ProgramBoston University School of MedicineBostonMassachusettsUSA
| | - Kathryn Price
- Research ServiceVA Boston Healthcare SystemBostonMassachusettsUSA,Department of PsychologyUniversity of Massachusetts–BostonBostonMassachusettsUSA
| | | | - Avron Spiro
- Massachusetts Veterans Epidemiology Research and Information CenterVA Boston Healthcare SystemBostonMassachusettsUSA,Department of EpidemiologyBoston University School of Public HealthBostonMassachusettsUSA,Department of PsychiatryBoston University School of MedicineBostonMassachusettsUSA
| | - Timothy Heeren
- Department of BiostatisticsBoston University School of Public HealthBostonMassachusettsUSA
| | - Kimberly Sullivan
- Department of Environmental HealthBoston University School of Public HealthBostonMassachusettsUSA
| | - Maxine H. Krengel
- Research ServiceVA Boston Healthcare SystemBostonMassachusettsUSA,Department of NeurologyBoston University School of MedicineBostonMassachusettsUSA
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Wright HM, Fuessel-Hermann D, Pazdera M, Lee S, Ridge B, Kim JU, Konopacki K, Hilton L, Greensides M, Langenecker SA, Smith AJ. Preventative Care in First Responder Mental Health: Focusing on Access and Utilization via Stepped Telehealth Care. FRONTIERS IN HEALTH SERVICES 2022; 2:848138. [PMID: 36925868 PMCID: PMC10012773 DOI: 10.3389/frhs.2022.848138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 03/31/2022] [Indexed: 11/13/2022]
Abstract
First responders are at high risk for disorders that arise from repeat exposure to stress and trauma (Post Traumatic Stress Disorder, depression, and problematic alcohol use). Although mental health treatments are available, first responders often do not access them, anchored by barriers that include: lack of knowledge, stigma, negative experience with mental health providers, and time-based burdens. In this study, we designed an intervention to address these barriers, extending a Planned-Action framework. Step 1 involved self-report screening for four mental health risks (PTSD, depression, anxiety, and alcohol use risk), delivered to all personnel electronically, who were free to either consent and participate or opt-out. The detection of risk(s) in Step 1 led to scheduling a Step 2 telehealth appointment with a trained clinician. We report descriptive statistics for participation/attrition/utilization in Steps 1 and 2, rates of risk on four mental health variables, and rate of adherence to follow-up treatment recommendations. Step 1: In total, 53.3% of personnel [229 of 429 full-time employees (221 males; eight females; 95% White; 48% paramedic or Emergency Medical Technician; 25% captain; 19% engineer; 7% other)] initially opted-in by consenting and completing the brief remote screening survey. Among those who opted-in and completed (n = 229), 43% screened positive for one or more of the following mental health risks: PTSD (7.9%); depression (9.6%); anxiety (13.5%); alcohol use (36.7%). Step 2: A maximum of three attempts were made to schedule "at risk" individuals into Step 2 (n = 99). Among the 99 who demonstrated a need for mental health treatment (by screening positive for one or more risk), 56 (56.6%) engaged in the telehealth appointment. Of the 56 who participated in Step 2 clinical appointments, 38 were recommended for further intervention (16.6% of full-time personnel who participated). Among the 38 firefighters who were recommended to seek further mental health services, 29 were adherent/followed through (76.3% of those who received recommendations for further services). Taken together, evidence-based, culturally conscious, stepped care models delivered via the virtual/telehealth medium can promote access, utilization, and cost-effective mental health services for first responders. Implications are for informing larger, more rigorous dissemination and implementation efforts.
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Affiliation(s)
- Hannah M Wright
- Department of Psychiatry, University of Utah School of Medicine, Huntsman Mental Health Institute, Salt Lake City, UT, United States
| | | | - Myah Pazdera
- Department of Psychiatry, University of Utah School of Medicine, Huntsman Mental Health Institute, Salt Lake City, UT, United States
| | - Somi Lee
- Department of Psychiatry, University of Utah School of Medicine, Huntsman Mental Health Institute, Salt Lake City, UT, United States
| | - Brook Ridge
- Department of Psychiatry, University of Utah School of Medicine, Huntsman Mental Health Institute, Salt Lake City, UT, United States
| | - Joseph U Kim
- Department of Psychiatry, University of Utah School of Medicine, Huntsman Mental Health Institute, Salt Lake City, UT, United States.,Salt Lake City Veterans Affairs (VA) Medical Center, Salt Lake City, UT, United States
| | - Kelly Konopacki
- Department of Psychiatry, University of Utah School of Medicine, Huntsman Mental Health Institute, Salt Lake City, UT, United States
| | - Layne Hilton
- United Fire Authority, Salt Lake City, UT, United States
| | | | - Scott A Langenecker
- Department of Psychiatry, University of Utah School of Medicine, Huntsman Mental Health Institute, Salt Lake City, UT, United States
| | - Andrew J Smith
- Department of Psychiatry, University of Utah School of Medicine, Huntsman Mental Health Institute, Salt Lake City, UT, United States.,Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, NH, United States.,Lyda Hill Institute for Human Resilience, University of Colorado, Colorado Springs, CO, United States
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13
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Hilton NZ, Ricciardelli R, Shewmake J, Rodrigues NC, Seto MC, Ham E. Perceptions of Workplace Violence and Workplace Stress: A Mixed Methods Study of Trauma among Psychiatric Workers. Issues Ment Health Nurs 2021; 42:797-807. [PMID: 33835903 DOI: 10.1080/01612840.2021.1899350] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Posttraumatic stress disorder (PTSD) among psychiatric workers is related to workplace violence and work-specific stress. We used quantitative and qualitative approaches to survey PTSD symptoms, critical events, chronic exposures, and occupational stress in 84 psychiatric workers. All but three had directly experienced critical events, over half experienced someone's life being in danger, and 14% screened positive for PTSD. Symptoms correlated with critical events and perceived threat to life. Respondents described emergency codes, direct involvement, and repeated exposure as most stressful. Symptoms also correlated with nonviolent stressors, replicating previous research and indicating need to reduce both violence and workplace stress.
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Affiliation(s)
- N Zoe Hilton
- Waypoint Research Institute, Waypoint Centre for Mental Health Care, Penetanguishene, Ontario, Canada.,University of Toronto, Toronto, Ontario, Canada
| | | | | | - Nicole C Rodrigues
- The Royal Ottawa Health Care Group, Brockville Mental Health Centre, Ottawa, Ontario, Canada
| | - Michael C Seto
- The Royal Ottawa Health Care Group, Brockville Mental Health Centre, Ottawa, Ontario, Canada
| | - Elke Ham
- Waypoint Research Institute, Waypoint Centre for Mental Health Care, Penetanguishene, Ontario, Canada
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14
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Development and Validation of an Instrument to Measure Work-Related Stress among Rescue Workers in Traumatic Mass-Casualty Disasters. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168340. [PMID: 34444094 PMCID: PMC8392681 DOI: 10.3390/ijerph18168340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 08/04/2021] [Accepted: 08/05/2021] [Indexed: 11/16/2022]
Abstract
Rescue workers are a population at high-risk for mental problems as they are exposed to work-related stress from confrontation with traumatic events when responding to a disaster. A reliable measure is needed to assess rescue workers’ work-related stress from their surveillance of a disaster scene to help prevent severe PTSD and depressive symptoms. The purpose of this study was to develop and validate the Work-Related Stress Scale (WRSS) designed to measure stress in rescue workers after responding to traumatic mass-casualty events. An exploratory sequential mixed methods procedure was employed. The qualitative phase of the item generation component involved in-depth interviews of 7 experienced rescue workers from multiple specialties who had taken part in 1 or 2 mass-casualty events: the 2018 Hualien earthquake or the 2016 Tainan earthquake. In the quantitative phase, a modified Delphi approach was used to achieve consensus ratings by the same 7 raters on the items and to assess content validity. Construct validity was determined by confirmatory factor analysis using a broader sample of 293 rescue workers who had taken part in 1 of 2 mass-casualty events: the 2018 Hualien earthquake or the 2021 Hualien train derailment. The final WRSS consists of 16 items total and 4 subscales: Physical Demands, Psychological Response, Environmental Interruption, and Leadership, with aggregated alphas of 0.74–0.88. The WRSS was found to have psychometric integrity as a measure of stress in rescue workers after responding to a disaster.
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O’Toole K, Brown CA. Evaluating the quality of resilience apps for military members and public safety personnel. JOURNAL OF MILITARY, VETERAN AND FAMILY HEALTH 2021. [DOI: 10.3138/jmvfh-2020-0002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
LAY SUMMARY A growing number of smartphone apps are being recommended to help build resilience. It is important to test whether these apps are of good quality and evidence-based. This study systematically evaluated 12 popular resilience-related apps for military and public service personnel and found that the majority were of high quality.
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Affiliation(s)
- Kaitlin O’Toole
- Department of Occupational Therapy, University of Alberta, Edmonton, Alberta, Canada
| | - Cary A. Brown
- Department of Occupational Therapy, University of Alberta, Edmonton, Alberta, Canada
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16
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Schuhmann BB, Henderson SN, Black RA, Van Hasselt VB, Klimley Margres K, Masias EV, LeDuc TJ. A Behavioral-Analytic Model for Assessing Stress in Firefighters. Behav Modif 2021; 46:267-293. [PMID: 33435721 DOI: 10.1177/0145445520986137] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Research has documented a number of acute and chronic stressors unique to the fire service. Due to the rise in mental health concerns in firefighters, there has been increased awareness of the negative effects of unmanaged stress. The present study employed a behavioral-analytic model to construct a brief screening measure of stress for this population: the Firefighter Assessment of Stress Test (FAST). Psychometric properties of the FAST were evaluated using data from active-duty firefighters throughout the United States. Results indicated the FAST has good internal reliability (α = 0.89), as well as good convergent and discriminant validity. Also, the factor structure of the FAST revealed three significant subscales reflective of stress associated with responding to calls, administrative difficulties, and being overworked. Scoring and interpretation guidelines were established to suggest when further assessment is warranted. The FAST offers a brief and valid method of self-assessment of current stress levels in firefighters. Information obtained from the FAST (i.e., overall stress level and domains) has the potential to facilitate more immediate identification and recognition of stress in firefighters than what has been possible to date. Moreover, heightened awareness of stress and its effects will hopefully culminate in expanded efforts directed toward stress reduction and intervention for firefighters and their families.
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Affiliation(s)
| | | | - Ryan A Black
- Nova Southeastern University, Fort Lauderdale, FL, USA
| | | | | | | | - Todd J LeDuc
- Broward Sheriff's Office (Ret.), Fort Lauderdale, FL, USA
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17
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Ashworth ET, Cotter JD, Kilding AE. Methods for improving thermal tolerance in military personnel prior to deployment. Mil Med Res 2020; 7:58. [PMID: 33248459 PMCID: PMC7700709 DOI: 10.1186/s40779-020-00287-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 11/10/2020] [Indexed: 12/16/2022] Open
Abstract
Acute exposure to heat, such as that experienced by people arriving into a hotter or more humid environment, can compromise physical and cognitive performance as well as health. In military contexts heat stress is exacerbated by the combination of protective clothing, carried loads, and unique activity profiles, making them susceptible to heat illnesses. As the operational environment is dynamic and unpredictable, strategies to minimize the effects of heat should be planned and conducted prior to deployment. This review explores how heat acclimation (HA) prior to deployment may attenuate the effects of heat by initiating physiological and behavioural adaptations to more efficiently and effectively protect thermal homeostasis, thereby improving performance and reducing heat illness risk. HA usually requires access to heat chamber facilities and takes weeks to conduct, which can often make it impractical and infeasible, especially if there are other training requirements and expectations. Recent research in athletic populations has produced protocols that are more feasible and accessible by reducing the time taken to induce adaptations, as well as exploring new methods such as passive HA. These protocols use shorter HA periods or minimise additional training requirements respectively, while still invoking key physiological adaptations, such as lowered core temperature, reduced heart rate and increased sweat rate at a given intensity. For deployments of special units at short notice (< 1 day) it might be optimal to use heat re-acclimation to maintain an elevated baseline of heat tolerance for long periods in anticipation of such an event. Methods practical for military groups are yet to be fully understood, therefore further investigation into the effectiveness of HA methods is required to establish the most effective and feasible approach to implement them within military groups.
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Affiliation(s)
- Edward Tom Ashworth
- Sports Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, 17 Antares Place, Rosedale, Auckland, 0632 New Zealand
| | - James David Cotter
- School of Physical Education, Sport and Exercise Sciences, University of Otago, Dunedin, Otago 9016 New Zealand
| | - Andrew Edward Kilding
- Sports Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, 17 Antares Place, Rosedale, Auckland, 0632 New Zealand
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18
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Dickerson AS, Wu AC, Liew Z, Weisskopf M. A Scoping Review of Non-Occupational Exposures to Environmental Pollutants and Adult Depression, Anxiety, and Suicide. Curr Environ Health Rep 2020; 7:256-271. [PMID: 32533365 PMCID: PMC7483936 DOI: 10.1007/s40572-020-00280-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE OF REVIEW Despite a call for better understanding of the role of environmental pollutant influences on mental health and the tremendous public health burden of mental health, this issue receives far less attention than many other effects of pollutants. Here we summarize the body of literature on non-occupational environmental pollutant exposures and adult depression, anxiety, and suicide-in PubMed, Embase, Web of Science, and PsychINFO through the end of year 2018. RECENT FINDINGS One hundred twelve articles met our criteria for further review. Of these, we found 88 articles on depression, 33 on anxiety, and 22 on suicide (31 articles covered multiple outcomes). The earliest article was published in 1976, and the most frequent exposure of interest was air pollution (n = 33), followed by secondhand smoke (n = 20), metals (n = 18), noise (n = 17), and pesticides (n = 10). Other exposures studied less frequently included radiation, magnetic fields, persistent organic pollutants (POPs), volatile organic compounds, solvents, and reactive sulfur compounds. The current literature, although limited, clearly suggests many kinds of environmental exposures may be risk factors for depression, anxiety, and suicide. For several pollutants, important limitations exist with many of the studies. Gaps in the body of research include a need for more longitudinal, life-course studies, studies that can measure cumulative exposures as well as shorter-term exposures, studies that reduce the possibility of reverse causation, and mechanistic studies focused on neurotoxic exposures.
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Affiliation(s)
- Aisha S Dickerson
- Departments of Epidemiology and Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Alexander C Wu
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Zeyan Liew
- Department of Environmental Health Sciences, Center for Perinatal Pediatric, and Environmental Epidemiology, Yale School of Public Health, New Haven, CT, 06510, USA
| | - Marc Weisskopf
- Departments of Epidemiology and Environmental Health, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Building 1, Suite 1402, Boston, MA, 02115, USA.
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19
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Waddell E, Lawn S, Roberts L, Henderson J, Venning A, Redpath P. "Why do you stay?": The lived-experience of partners of Australian veterans and first responders with Posttraumatic Stress Disorder. HEALTH & SOCIAL CARE IN THE COMMUNITY 2020; 28:1734-1742. [PMID: 32291885 DOI: 10.1111/hsc.12998] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 02/19/2020] [Accepted: 03/18/2020] [Indexed: 06/11/2023]
Abstract
This study examined the multidimensional nature of experiences of being an intimate partner of an Australian veteran or emergency service first responder (ESFR) with posttraumatic stress disorder (PTSD). Using a qualitative phenomenological approach, inductive thematic analysis was undertaken on data collected in 2017-2018 through individual interviews with a purposive sample of 22 partners of veterans, paramedics, fire and police officers living in Australia. Analysis revealed that the key concern of the participants was to protect their family unit and the intimate relationship, highlighting the ways in which they adapted, managed and coped with the changes that PTSD brought to the relationship. However, lack of understanding by healthcare providers, government, military and emergency service organizations of their daily lives, and of the strength of commitment to their relationship, resulted in a sense of invisibility and was revealed as the key barrier to the support they crave. The findings underscore the importance of recognizing the significance of the intimate relationship in trauma recovery and of responding to the support needs of the intimate partner.
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Affiliation(s)
- Elaine Waddell
- Paramedic Unit, College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia
| | - Sharon Lawn
- Paramedic Unit, College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia
| | - Louise Roberts
- Paramedic Unit, College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia
| | - Julie Henderson
- College of Nursing and Health Sciences, Flinders University, Bedford Park, SA, Australia
| | - Anthony Venning
- Paramedic Unit, College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia
| | - Paula Redpath
- Paramedic Unit, College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia
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20
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Meina M, Ratajczak E, Sadowska M, Rykaczewski K, Dreszer J, Bałaj B, Biedugnis S, Węgrzyński W, Krasuski A. Heart Rate Variability and Accelerometry as Classification Tools for Monitoring Perceived Stress Levels-A Pilot Study on Firefighters. SENSORS (BASEL, SWITZERLAND) 2020; 20:E2834. [PMID: 32429383 PMCID: PMC7285091 DOI: 10.3390/s20102834] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 05/03/2020] [Accepted: 05/09/2020] [Indexed: 12/18/2022]
Abstract
Chronic stress is the main cause of health problems in high-risk jobs. Wearable sensors can become an ecologically valid method of stress level assessment in real-life applications. We sought to determine a non-invasive technique for objective stress monitoring. Data were collected from firefighters during 24-h shifts using sensor belts equipped with a dry-lead electrocardiograph (ECG) and a three-axial accelerometer. Levels of stress experienced during fire incidents were evaluated via a brief self-assessment questionnaire. Types of physical activity were distinguished basing on accelerometer readings, and heart rate variability (HRV) time series were segmented accordingly into corresponding fragments. Those segments were classified as stress/no-stress conditions. Receiver Operating Characteristic (ROC) analysis showed true positive classification as stress condition for 15% of incidents (while maintaining almost zero False Positive Rate), which parallels the amount of truly stressful incidents reported in the questionnaires. These results show a firm correspondence between the perceived stress level and physiological data. Psychophysiological measurements are reliable indicators of stress even in ecological settings and appear promising for chronic stress monitoring in high-risk jobs, such as firefighting.
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Affiliation(s)
- Michał Meina
- Faculty of Physics, Astronomy and Informatics, Department of Applied Informatics, Nicolaus Copernicus University in Toruń, Grudziądzka 5, 87-100 Torun, Poland;
| | - Ewa Ratajczak
- Faculty of Physics, Astronomy and Informatics, Department of Applied Informatics, Nicolaus Copernicus University in Toruń, Grudziądzka 5, 87-100 Torun, Poland;
- Faculty of Philosophy and Social Sciences, Institute of Psychology, Nicolaus Copernicus University in Toruń, Podmurna 74, 87-100 Torun, Poland; (M.S.); (J.D.); (B.B.)
- Centre for Modern Interdisciplinary Technologies, Nicolaus Copernicus University in Toruń, Wileńska 4, 87-100 Torun, Poland;
| | - Maria Sadowska
- Faculty of Philosophy and Social Sciences, Institute of Psychology, Nicolaus Copernicus University in Toruń, Podmurna 74, 87-100 Torun, Poland; (M.S.); (J.D.); (B.B.)
| | - Krzysztof Rykaczewski
- Centre for Modern Interdisciplinary Technologies, Nicolaus Copernicus University in Toruń, Wileńska 4, 87-100 Torun, Poland;
| | - Joanna Dreszer
- Faculty of Philosophy and Social Sciences, Institute of Psychology, Nicolaus Copernicus University in Toruń, Podmurna 74, 87-100 Torun, Poland; (M.S.); (J.D.); (B.B.)
| | - Bibianna Bałaj
- Faculty of Philosophy and Social Sciences, Institute of Psychology, Nicolaus Copernicus University in Toruń, Podmurna 74, 87-100 Torun, Poland; (M.S.); (J.D.); (B.B.)
| | - Stanisław Biedugnis
- Institute of Safety Engineering, The Main School of Fire Service, Słowackiego 52/54, 01-629 Warsaw, Poland;
| | - Wojciech Węgrzyński
- Fire Research Department, Building Research Institute (ITB), 00-611 Warsaw, Poland;
| | - Adam Krasuski
- Institute of Safety Engineering, The Main School of Fire Service, Słowackiego 52/54, 01-629 Warsaw, Poland;
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Watkins ER, Walker A, Mol E, Jahnke S, Richardson AJ. Women Firefighters' Health and Well-Being: An International Survey. Womens Health Issues 2019; 29:424-431. [PMID: 30930075 DOI: 10.1016/j.whi.2019.02.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 02/07/2019] [Accepted: 02/22/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES This study aimed to identify specific health and well-being issues that women firefighters may experience as part of their daily working practices. Issues identified from this under-represented population can drive future research, education, and strategy to guide safety and health practices. METHODS A total of 840 women firefighters from 14 separate countries (255 United Kingdom and Ireland, 320 North America, 177 Australasia, and 88 mainland Europe) completed the survey over a 4-month period. Questions related to general health and well-being and role-specific health concerns, gender-related issues, and available exercise facilities. RESULTS Women firefighters in North America reported a higher prevalence of lower back (49%) and lower limb (51%) injuries than all other groups. North American respondents reported more heat illnesses (45%) than respondents from other places (36%). Although many participants did not respond, of those who did, 39% thought the menstrual cycle (199/512) or menopause (55/151) affected their work, and 36% were concerned for their ability to meet future job demands. Sixteen percent felt confident they could complete the role after 60 years of age. Women firefighters identified a lack of strength and conditioning support (50%) or lack of gym access (21%). There appears to be poor availability of female-specific personal protective equipment, with availability greatest in the United Kingdom (66%) compared with the sample as a whole (42%). CONCLUSIONS There is a need for female-specific strength and conditioning support and facilities to decrease injury and illness risk and improve longevity. Research and education into gynecological issues, heat exposure, and their effects on women firefighters' fertility and cancer risk is required.
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Affiliation(s)
- Emily R Watkins
- Extreme Environments Lab, University of Brighton, Welkin Laboratories, Eastbourne, East Sussex, UK
| | - Anthony Walker
- University of Canberra Research Institute for Sports and Exercise, University of Canberra, Canberra, Australia
| | - Eric Mol
- Experts in Firefighting Performance, Dutch Safety Board, Baarn, The Hague, The Netherlands
| | - Sara Jahnke
- Center for Fire, Rescue & EMS Health Research, National Development & Research Institutes, Leawood, Kansas
| | - Alan J Richardson
- Extreme Environments Lab, University of Brighton, Welkin Laboratories, Eastbourne, East Sussex, UK.
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22
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Shin YC, Kim SM, Kim H, Min KJ, Yoo SK, Kim EJ, Jeon SW. Resilience as a Protective Factor for Depressive Mood and Anxiety among Korean Employees. J Korean Med Sci 2019; 34:e188. [PMID: 31293112 PMCID: PMC6624414 DOI: 10.3346/jkms.2019.34.e188] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 07/01/2019] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND This study aimed to investigate resilience as a protective factor for depressive mood and anxiety among Korean employees. METHODS Participants were employees of eight private and local government organizations in Korea, aged 19 to 65 years. A self-report questionnaire that included items on resilience, job stress, levels of depression and anxiety, and socio-demographic factors, was administered to 1,079 Korean employees, with 1,076 valid responses. We performed hierarchical linear regression analyses with the levels of depression and anxiety scores as dependent variables. RESULTS Being women and having a high level of job stress were associated with greater depressive mood and anxiety. In contrast, resilience was negatively related to depressive mood and anxiety, after adjusting for demographic variables and the level of job stress. Among the five factors for resilience, "support" and "hardiness" were protective factors for depressive mood and anxiety after adjusting for demographic variables and the level of job stress. CONCLUSION Based on the results of the current study, we suggest that focusing on the resilience of employees, especially on "support" and "hardiness," factors as well as developing and engaging in interventions that increase resilience in the workplace, can protect against depressive mood and anxiety, especially for those with high levels of job stress.
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Affiliation(s)
- Young Chul Shin
- Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
- Workplace Mental Health Institute, Kangbuk Samsung Hospital, Seoul, Korea
| | - Sun Mi Kim
- Department of Psychiatry, Chung-Ang University Medical Center, Chung-Ang University College of Medicine, Seoul, Korea.
| | - Hyeri Kim
- Department of Psychiatry, Chung-Ang University Medical Center, Chung-Ang University College of Medicine, Seoul, Korea
| | - Kyoung Joon Min
- Department of Psychiatry, Chung-Ang University Medical Center, Chung-Ang University College of Medicine, Seoul, Korea
| | - Seo Koo Yoo
- School of Social Welfare, Soongsil University, Seoul, Korea
| | - Eun Jin Kim
- Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
- Workplace Mental Health Institute, Kangbuk Samsung Hospital, Seoul, Korea
| | - Sang Won Jeon
- Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
- Workplace Mental Health Institute, Kangbuk Samsung Hospital, Seoul, Korea
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Lewis-Schroeder NF, Kieran K, Murphy BL, Wolff JD, Robinson MA, Kaufman ML. Conceptualization, Assessment, and Treatment of Traumatic Stress in First Responders: A Review of Critical Issues. Harv Rev Psychiatry 2019; 26:216-227. [PMID: 29975339 PMCID: PMC6624844 DOI: 10.1097/hrp.0000000000000176] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
First responders are regularly confronted with exposure to traumatic events, including potentially life-threatening situations as well as the grave injuries and deaths of colleagues and civilians. Evidence indicates that the prevalence of posttraumatic stress disorder (PTSD) is substantially higher among first responders than the general population. This article provides information about the outpatient trauma services at McLean Hospital's LEADER (Law Enforcement, Active Duty, Emergency Responder) program to assist clinicians who encounter these first responders in their practices or who are specifically interested in working with this patient population. We begin by synthesizing the literature on the prevalence of PTSD in first responders following work-related exposure to traumatic stress, and by addressing the occupation-specific risk factors and the third-variable risk factors that may contribute to potentiated risk. We then discuss assessment strategies and treatment options used in our program, which is tailored for individuals who are dealing with mental health issues stemming from occupation-specific traumatic-stress exposure. We also address the unique challenges of treating traumatized first responders with more complex issues such as traumatic stress exposure across the lifespan and safety issues, including acute suicidality. We conclude by discussing notable gaps in the literature, including the need to investigate why and how women present with different PTSD symptoms than men and how these differences need to be taken into account in determining appropriate treatment for women.
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Affiliation(s)
- Nina F Lewis-Schroeder
- From Harvard Medical School (Drs. Lewis-Schroeder, Murphy, Robinson, and Kaufman) and McLean Hospital, Belmont, MA (all)
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24
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Watkins ER, Hayes M, Watt P, Richardson AJ. The acute effect of training fire exercises on fire service instructors. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2019; 16:27-40. [PMID: 30277854 DOI: 10.1080/15459624.2018.1531132] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Fire service instructors (FSI) regularly experience different types of fire exercises, however the strain experienced from these scenarios is not well understood. This study aims to identify the physiological and perceptual strain of Fire Service Instructors (FSI) to three training exercises: DEMO, ATTACK, COMPARTMENT, and the different roles performed: SETTER, INSTRUCTOR. The study also aims to assess the effect that different exercise patterns over a day (BOX, MULTI, COMBINATION) have on immunological responses. Sixteen FSI (age: 41 ± 8 years, body mass: 83.7 ± 6.7 kg, height: 177.0 ± 6.7 cm) were recruited, with 10 FSI completing the three exercises. Physiological and perceptual measures were collected prior to and immediately post each exercise. Venous blood samples were collected at the beginning and end of each day. One-way analysis of variance (ANOVA) were conducted to assess differences in physiological variables between exercise types, independent samples t-tests were conducted between roles. Day changes in hematological variables were assessed by paired sample t-tests and analyzed by one-way ANOVAs to identify differences between exercise patterns. The COMPARTMENT exercise resulted in a greater change in rectal temperature (ΔTre) (0.49 ± 0.28 °C) than both the DEMO (0.23 ± 0.19 °C, p = 0.045) and ATTACK (0.27 ± 0.22 °C, p = 0.016). Within the COMPARTMENT exercise, the SETTER resulted in a greater ΔTre and rating of perceived exertion than the INSTRUCTOR (0.67 ± 0.29 °C vs. 0.43 ± 0.18 °C, p = 0.027 and 14 ± 2 vs. 11 ± 2, p = 0.001, respectively). Following a day of fire exercises white blood cells (WBC), neutrophils, lymphocytes (LYMPH), monocytes (MONO), platelets (PLT), mean platelet volume (MPV), Interleukin (IL)-6, and cardiac troponin T (cTnT) all increased (p < 0.05). Exercise patterns containing a COMPARTMENT exercise resulted in greater PLT, MPV, and IL-6. Total daily variation in ΔTre was correlated with post-exercise WBC, MONO, and LYMPH. COMPARTMENT exercises produce the greatest physiological strain, with the SETTER role within this exercise causing the greatest ΔTre. Although predominately physiological responses remain within safe limits. Exercise patterns that include a COMPARTMENT exercise also generate a greater inflammatory response.
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Affiliation(s)
- Emily R Watkins
- a Environmental Extremes Laboratory , University of Brighton , Eastbourne , UK
| | - Mark Hayes
- a Environmental Extremes Laboratory , University of Brighton , Eastbourne , UK
| | - Peter Watt
- a Environmental Extremes Laboratory , University of Brighton , Eastbourne , UK
| | - Alan J Richardson
- a Environmental Extremes Laboratory , University of Brighton , Eastbourne , UK
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Paul MA, Love RJ, Jetly R, Richardson JD, Lanius RA, Miller JC, MacDonald M, Rhind SG. Blunted Nocturnal Salivary Melatonin Secretion Profiles in Military-Related Posttraumatic Stress Disorder. Front Psychiatry 2019; 10:882. [PMID: 31866882 PMCID: PMC6910089 DOI: 10.3389/fpsyt.2019.00882] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 11/08/2019] [Indexed: 12/16/2022] Open
Abstract
Background: Sleep disturbances are a hallmark of posttraumatic stress disorder (PTSD), yet few studies have evaluated the role of dysregulated endogenous melatonin secretion in this condition. Methods: This study compared the sleep quality and nocturnal salivary melatonin profiles of Canadian Armed Forces (CAF) personnel diagnosed with PTSD, using the Clinician Administered PTSD Scale (CAPS score ≥50), with two healthy CAF control groups; comprising, a "light control" (LC) group with standardized evening light exposure and "normal control" (NC) group without light restriction. Participants were monitored for 1-week using wrist actigraphy to assess sleep quality, and 24-h salivary melatonin levels were measured (every 2h) by immunoassay on the penultimate day in a dim-light (< 5 lux) laboratory environment. Results: A repeated measures design showed that mean nocturnal melatonin concentrations for LC were higher than both NC (p = .03) and PTSD (p = .003) with no difference between PTSD and NC. Relative to PTSD, NC had significantly higher melatonin levels over a 4-h period (01 to 05 h), whereas the LC group had higher melatonin levels over an 8-h period (23 to 07 h). Actigraphic sleep quality parameters were not different between healthy controls and PTSD patients, likely due to the use of prescription sleep medications in the PTSD group. Conclusions: These results indicate that PTSD is associated with blunted nocturnal melatonin secretion, which is consistent with previous findings showing lower melatonin after exposure to trauma and suggestive of severe chronodisruption. Future studies targeting the melatonergic system for therapeutic intervention may be beneficial for treatment-resistant PTSD.
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Affiliation(s)
- Michel A Paul
- Defence Research & Development Canada, Toronto Research Centre, Operational Health and Performance Section, Toronto, ON, Canada
| | - Ryan J Love
- Defence Research & Development Canada, Toronto Research Centre, Operational Health and Performance Section, Toronto, ON, Canada
| | - Rakesh Jetly
- Directorate of Mental Health, Canadian Forces Health Services, Ottawa, ON, Canada
| | - J Donald Richardson
- Department of Psychiatry, Western University, London, ON, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.,Operational Stress Injury Clinic, Parkwood Institute, London, ON, Canada.,MacDonald Franklin Operational Stress Injury Research Centre, Lawson Research Institute, London, ON, Canada
| | - Ruth A Lanius
- Department of Psychiatry, Western University, London, ON, Canada.,Department of Neuroscience, Western University, London, ON, Canada
| | - James C Miller
- Department of Life Sciences, Texas A&M University Corpus Christi, Corpus Christi, TX, United States
| | - Michael MacDonald
- Directorate of Mental Health, Canadian Forces Health Services, Ottawa, ON, Canada
| | - Shawn G Rhind
- Defence Research & Development Canada, Toronto Research Centre, Operational Health and Performance Section, Toronto, ON, Canada
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Watkins ER, Hayes M, Watt P, Richardson AJ. Fire service instructors' working practices: A UK survey. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2018; 74:322-330. [PMID: 29621422 DOI: 10.1080/19338244.2018.1461601] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 04/02/2018] [Indexed: 06/08/2023]
Abstract
Analysis of Fire Service Instructors (FSI) working practices and health is needed to minimise health risks related to heat illness, cardiovascular events and immunological stress. Online surveys were distributed to UK FSI and Firefighters (FF). One hundred and thirty FSI (age: 43 ± 7yrs) and 232 FF (age: 41 ± 8yrs) responded. FSI experienced 2-10 live fires per week, with 45% of FSI reporting management does not set a limit on the number of exposures. Few FSI followed hydration guidelines, or cooling methods. New symptoms of ill health were reported by 41% of FSI and 21% of FF. FSI with ≥11 Breathing Apparatus exposures per month were 4.5 times (95% CI 1.33-15.09) more likely to experience new symptoms. A large proportion of FSI are experiencing new symptoms of illness after starting their career, and guidelines on exposure and hydration are not universally in place to reduce the risk of future health problems.
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Affiliation(s)
- Emily R Watkins
- Environmental Extremes Laboratory, Sport and Exercise Science and Medicine (SESaME) Research Group, Welkin Laboratories, University of Brighton, Denton Road, Eastbourne, UK
| | - Mark Hayes
- Environmental Extremes Laboratory, Sport and Exercise Science and Medicine (SESaME) Research Group, Welkin Laboratories, University of Brighton, Denton Road, Eastbourne, UK
| | - Peter Watt
- Environmental Extremes Laboratory, Sport and Exercise Science and Medicine (SESaME) Research Group, Welkin Laboratories, University of Brighton, Denton Road, Eastbourne, UK
| | - Alan J Richardson
- Environmental Extremes Laboratory, Sport and Exercise Science and Medicine (SESaME) Research Group, Welkin Laboratories, University of Brighton, Denton Road, Eastbourne, UK
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Sleep Disorders in Patients With Posttraumatic Stress Disorder. Chest 2018; 154:427-439. [PMID: 29684315 DOI: 10.1016/j.chest.2018.04.007] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 03/27/2018] [Accepted: 04/03/2018] [Indexed: 02/05/2023] Open
Abstract
A growing body of evidence supports a bidirectional relationship between posttraumatic stress disorder (PTSD) and sleep disturbances. Fragmented sleep induced by sleep-related breathing disorders, insomnia, and nightmares impacts recovery and treatment outcomes and worsens PTSD symptoms. Despite recent attention, management of these disorders has been unrewarding in the setting of PTSD. This review summarizes the evidence for empirically supported treatments of these sleep ailments, including psychotherapeutic and pharmacologic interventions, as it relates to PTSD. Recent advances in positive airway pressure technology have made treatment of OSA more acceptable; however, adherence to CPAP therapy presents a substantial challenge. Concomitant insomnia, which engenders psychiatric and medical conditions, including depression, suicide, and alcohol and substance abuse, can be managed with cognitive behavioral therapy. Hypnotic agents are considered an alternative therapy, but concerns about adverse events and lack of high-level evidence supporting their efficacy in PTSD treatment have limited their use to resistant cases or as adjuncts to behavioral therapy when the response is less than desirable. Intrusion of nightmares can complicate PTSD treatment and exert serious strain on social, occupational, and marital relations. Imagery rehearsal therapy has shown significant reduction in nightmare intensity and frequency. The success of noradrenergic blocking agents has not been consistent among studies, with one-half reporting treatment failure. An integrated stepped care approach that includes components of both behavioral and pharmacologic interventions customized to patients' sleep-maladaptive behaviors may offer a solution to delivering accessible, effective, and efficient services for individuals with PTSD.
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Work Intensity, Low-Grade Inflammation, and Oxidative Status: A Comparison between Office and Slaughterhouse Workers. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2018; 2018:2737563. [PMID: 29849876 PMCID: PMC5932461 DOI: 10.1155/2018/2737563] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 03/11/2018] [Indexed: 12/19/2022]
Abstract
Limited knowledge exists about the impact of physical workload on oxidative stress in different occupational categories. Thus, we aimed to investigate the oxidative and inflammatory status in employees with different physical workloads. We enrolled a total of 79 male subjects, 27 office workers (mean age 38.8 ± 9.1 years) and 52 heavy workers, in a slaughterhouse (mean age 40.8 ± 8.2 years). Fasting blood was drawn from an antecubital vein in the morning of the midweek before an 8-hour or 12-hour work shift. The antioxidative capacity was assessed measuring total antioxidant capacity (TAC), uric acid, total polyphenols (PPm), and endogenous peroxidase activity (EPA). Total peroxides (TOC), malondialdehyde (MDA), and myeloperoxidase (MPO) were analyzed as prooxidative biomarkers, and an oxidative stress index (OSI) was calculated. In addition, hsCRP, interleukin-6 (IL-6), MDA-LDL IgM antibodies, galectin-3, adrenocorticotropic hormone (ACTH), and the brain-derived neurotrophic factor (BDNF) were measured as biomarkers of chronic systemic inflammation and emotional stress. TOC (p = 0.032), TAC (p < 0.001), ACTH (p < 0.001), OSI (p = 0.011), and hsCRP (p = 0.019) were significantly increased in the heavy workers group, while EPA, BDNF (p < 0.001), and polyphenols (p = 0.004) were significantly higher in office workers. Comparison between 8 and 12 h shifts showed a worse psychological condition in heavy workers with increased levels for hsCRP (p = 0.001) and reduced concentration of BDNF (p = 0.012) compared to office workers. Oxidative stress and inflammation are induced in heavy workers and are particularly pronounced during long working hours, that is, 12-hour versus 8-hour shifts.
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Speer K, Upton D, Semple S, McKune A. Systemic low-grade inflammation in post-traumatic stress disorder: a systematic review. J Inflamm Res 2018; 11:111-121. [PMID: 29606885 PMCID: PMC5868606 DOI: 10.2147/jir.s155903] [Citation(s) in RCA: 98] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Studies examining post-traumatic stress disorder (PTSD) have either emphasized a relationship between PTSD and a systemically pro-inflammatory state or identified a link between PTSD and chronic disease. The aim of this study was to evaluate the evidence for a relationship between individuals with PTSD and systemic low-grade inflammation that has been proposed to underlie chronic disease development in this population. The authors conducted a systematic review of the literature (January 2006 to April 2017) in accordance with the PRISMA statement in the following four databases: PubMed, MEDLINE, PsycINFO, and SPORTDiscus with Full Text. The search strategy was limited to articles published in peer-reviewed journals and to human studies. Nine studies measuring systemic inflammation and discussing its role in chronic disease development were selected for inclusion in this review. The association between markers of systemic inflammation and PTSD was evaluated by the measurement of a variety of systemic inflammatory markers including acute-phase proteins, complement proteins, pro- and anti-inflammatory cytokines, natural killer cells, and white blood cells. In general, systemic inflammatory biomarkers were elevated across the studies in the PTSD groups. There is evidence that PTSD is underpinned by the presence of a systemic low-grade inflammatory state. This inflammation may be the mechanism associated with increased risk for chronic disease in the PTSD population. From this, future research should focus on interventions that help to reduce inflammation, such as exercise.
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Affiliation(s)
- Kathryn Speer
- Discipline of Sport and Exercise Science, Faculty of Health, University of Canberra, Canberra, ACT, Australia
| | - Dominic Upton
- Faculty of Health, University of Canberra, Canberra, ACT, Australia
| | - Stuart Semple
- Discipline of Sport and Exercise Science, Faculty of Health, University of Canberra, Canberra, ACT, Australia.,Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia
| | - Andrew McKune
- Discipline of Sport and Exercise Science, Faculty of Health, University of Canberra, Canberra, ACT, Australia.,Faculty of Health, University of Canberra, Canberra, ACT, Australia.,Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia.,Discipline of Biokinetics, Exercise and Leisure Sciences, School of Health Sciences, University of KwaZulu Natal, Durban, South Africa
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Cumulative exposure to work-related traumatic events and current post-traumatic stress disorder in New York City's first responders. Compr Psychiatry 2017; 74:134-143. [PMID: 28161583 PMCID: PMC5359025 DOI: 10.1016/j.comppsych.2016.12.003] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 11/17/2016] [Accepted: 12/15/2016] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Cumulative exposure to work-related traumatic events (CE) is a foreseeable risk for psychiatric disorders in first responders (FRs). Our objective was to examine the impact of work-related CE that could serve as predictor of posttraumatic stress disorder (PTSD) and/or depression in FRs. DESIGN Cross-sectional examination of previous CE and past-month PTSD outcomes and depression in 209 FRs. METHODS Logistic (probable PTSD; probable depression) and Poisson regressions (PTSD score) of the outcomes on work-related CE indexes, adjusting for demographic variables. Differences across occupational groups were also examined. Receiver operating characteristic analysis determined the sensitivity and specificity of CE indexes. RESULTS All indexes were significantly and differently associated with PTSD; associations with depression were non-significant. The index capturing the sheer number of different incidents experienced regardless of frequency ('Variety') showed conceptual, practical and statistical advantages compared to other indexes. In general, the indexes showed poor to fair discrimination accuracy. CONCLUSIONS Work-related CE is specifically associated with PTSD. Focusing on the variety of exposures may be a simple and effective strategy to predict PTSD in FRs. Further research on sensitivity and specificity of exposure indexes, preferably examined prospectively, is needed and could lead to early identification of individuals at risk.
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Hemmatjo R, Motamedzade M, Aliabadi M, Kalatpour O, Farhadian M. The effect of practical cooling strategies on physiological response and cognitive function during simulated firefighting tasks. Health Promot Perspect 2017; 7:66-73. [PMID: 28326286 PMCID: PMC5350552 DOI: 10.15171/hpp.2017.13] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 01/19/2017] [Indexed: 11/09/2022] Open
Abstract
Background: Firefighters often perform multiple tasks during firefighting operations under unknown and unpredictable conditions in hot and hostile environments. Methods: In this interventional study each firefighters engaged in 4 conditions: namely (1) no cooling device; control (NC), (2) cooling gel (CG), (3) cool vest (CV), and (4) CG+CV. Cooling effects of the employed interventions were evaluated based on heart rate (HR), temporal temperature (TT), reaction time (RT), and the correct response (CR). Results: HR and TT values for use of CG+CV (147.47 bpm [SD 4.8]; 37.88°C [SD 0.20]) and CV bpm (147.53 [SD 4.67]; 37.90°C [SD 0.22]) were significantly lower than the CG (153.67 bpm [SD 4.82]; 38.10°C [SD 0.22]) and NC (154.4 bpm [SD 4.91]; 38.11°C [SD 0.23]) at the end of the activity. RT and CR for use of CG + CV (389.87 ms [SD 6.12]; 143.53 [SD 1.24]) and CV (389.53 ms [SD 6.24]; 143.47 [SD 1.18]) were significantly higher than the CG (385.73 [SD 7.25] ms; 143.07 [SD 0.88]) and NC (385.67 ms [SD 7.19]; 143.00 [SD 0.84]) at the end of the activity. Conclusion: It is concluded that CV was more effective than the CG in attenuating physiological responses and cognitive functions during firefighting operations. Furthermore, combining CV with CG provides no additional benefit.
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Affiliation(s)
- Rasoul Hemmatjo
- Department of Occupational Health, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Majid Motamedzade
- Department of Ergonomics, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mohsen Aliabadi
- Department of Occupational Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Omid Kalatpour
- Department of Occupational Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Maryam Farhadian
- Department of Biostatistics, Hamadan University of Medical Sciences, Hamadan, Iran
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