The association between insomnia and cardiovascular risk factors in bus drivers in Iran

Risk factors and prevalence of work-related musculoskeletal disorders in metropolitan bus drivers: An assessment of whole body and hand-arm transmitted vibration

BACKGROUND

Metropolitan bus drivers have higher prevalence of work-related musculoskeletal disorders (WMSDs) due to their nature of work and working environment.

OBJECTIVE

To identify the prevalence of WMSDs and associated risk factors and to conduct real-time testing to evaluate Whole Body Vibration (WBV) and Hand-Arm Vibration (HAV) in buses based on the ISO standards to assess the vibrations levels at different speeds.

METHODS

Participants in this study were 370 full-time male bus drivers from the north and south zones of 13 depots of Bengaluru Metropolitan Transport Corporation (BMTC), Bengaluru, south India. Information regarding WMSDs symptoms during the previous 7 days and 12 months were collected by Modified Nordic Musculoskeletal Questionnaire (MNMQ). WBV and HAV testing was performed and vibration levels were compared with ISO-2631-1 (1997) and ISO-5349-1-2001 standards. It was found that 68.7% of participants reported WMSDs.

RESULTS

Several individuals and work-related factors were found to be statistically significant with WMSDs. From the Gini impurity measure, vibration and road types (Asphalt pavement and Rough road) were considered as vital risk factors associated with WMSDs.

CONCLUSION

From the WBV and HAV evaluations, it was found that for buses on asphalt pavement at > 60 km/h, the vibration level was higher compared to a lower speed. The vibration level exceeded the Exposure Action Value (EAV) on rough roads at all speeds (20km/h, 40km/h and 60km/h) and in several situations considered based on assumptions the vibration level exceeded the Exposure Limiting Value (ELV).

Prevalence of metabolic syndrome and its associated factors among Iranian steel workers

BACKGROUND

Metabolic syndrome (MetS) is composed of a collection of risk factors for heart diseases and diabetes. In recent decades, metabolic syndrome has been identified as one of the important risk factors leading to the development of work-related diseases.

OBJECTIVE

Since few studies have been conducted on evaluating the prevalence of MetS among Iranian workers, this cross-sectional study aimed at assessing the prevalence of MetS and the factors affecting it among Iranian steel workers.

METHODS

This study was carried out on 510 employees working in a large steel producing company. The data pertaining to blood pressure, triglycerides, cholesterol, glucose, and demographic information were collected and the Adult Treatment Panel (ATP III) criteria were implemented to diagnose MetS.

RESULTS

The prevalence of Mets was obtained equal to 13% and a significant positive relationship was observed between age and the prevalence of metabolic syndrome. From among MetS elements, low HDL cholesterol and increased waist circumference were recognized as the most and the least frequently involved elements with 39.3% and 6.5% prevalence, respectively. Chi-square test was run and the results showed that the prevalence of MetS and some of its components rose at higher BMI values. It was also indicated that MetS and its components had no significant relationship with shift work.

CONCLUSION

The current findings revealed that the prevalence of MetS increased with aging. Low HDL and high triglycerides levels were among the main risk factors for MetS. Therefore, considering these risk factors, it should be attempted to develop relevant strategies at workplace to encourage workers to go for a healthier lifestyle so that they can prevent the incidence of MetS.

Sources of Sleep Disturbances and Psychological Strain for Hospital Staff Working during the COVID-19 Pandemic

Hospital staff members reported increased stress-related workload when caring for inpatients with COVID-19 (“frontline hospital staff members”). Here, we tested if depression, anxiety, and stress were associated with poor sleep and lower general health, and if social support mediated these associations. Furthermore, we compared current insomnia scores and general health scores with normative data. A total of 321 full-time frontline hospital staff members (mean age: 36.86; 58% females) took part in the study during the COVID-19 pandemic. They completed a series of questionnaires covering demographic and work-related information, symptoms of depression, anxiety, stress, social support, self-efficacy, and symptoms of insomnia and general health. Higher symptoms of depression, anxiety, and stress were associated with higher symptoms of insomnia and lower general health. Higher scores of depression, anxiety, and stress directly predicted higher insomnia scores and lower general health scores, while the indirect effect of social support was modest. Compared to normative data, full-time frontline hospital staff members had a 3.14 higher chance to complain about insomnia and a significantly lower general health. Symptoms of insomnia and general health were unrelated to age, job experience, educational level, and gender. Given this background, it appears that the working context had a lower impact on individuals’ well-being compared to individual characteristics.

Treating sleep disorders to improve blood pressure control and cardiovascular prevention: a dream come true?-a narrative review

Hypertension is one of the primary risk factors for heart disease and stroke, the leading causes of death worldwide. Current evidence supports the treatment of high blood pressure (BP) values in order to obtain a substantial reduction of cardiovascular burden. Sleep plays an important role in maintaining nocturnal BP control and nocturnal hypertension which, in turn, can be affected by the presence of sleep disorders. Whilst respiratory disturbances have been extensively studied and their causal role in the development of nocturnal hypertension has been demonstrated in both cross sectional and prospective studies, less is known about the impact of other sleep disorders such as insomnia. In this review, we aim to describe the role of sleep disorders in the development of nocturnal and diurnal hypertension. Furthermore, we aim to discuss the potential impact of the treatment of such sleep disorders on BP values as an adjunct treatment for patients with hypertension.

Risk factors for obstructive sleep apnea among train drivers

BACKGROUND

The screening of risk factors for sleep apnea among drivers with safety-sensitive jobs is considered as an issue of utmost importance in a safe transportation system.

OBJECTIVE

This study was conducted to assess the risk factors of sleep apnea among locomotive drivers.

METHODS

The present research is a cross-sectional study conducted in Baharloo Hospital, Tehran University of Medical Sciences, Iran. The study population included 281 locomotive drivers referred for their annual physical examination. Demographic characteristics, Epworth Sleepiness Scale (ESS), blood pressure, body mass index (BMI), neck circumference, and laboratory measurements including fasting blood sugar (FBS), cholesterol, high density lipoprotein, and low-density lipoprotein were recorded for each participant. Blood pressure ≥140/90 mmHg, history of drug use, BMI > 35 kg/m2, age >50 years, and neck circumference >40 cm were defined as risk factors for obstructive sleep apnea (OSA-RFs).

RESULTS

All participants were male with a mean age of 43±10 years. The mean BMI was 26.9±3.9 kg/m2. Also, the mean FBS and Total cholesterol of participants was 96.9±24.9 and 181.7±41.8, respectively. Among participants, 166 (59.9%) drivers had two or more risk factors of obstructive sleep apnea (OSA-RFs)CONCLUSIONS:The findings of this study indicated a high prevalence of obstructive sleep apnea among locomotive drivers. Therefore, further research is warranted to re-evaluate the current screening regulations of diagnosing sleep apnea among locomotive drivers.

Comparing the effect of aromatherapy with peppermint and lavender on the sleep quality of cardiac patients: a randomized controlled trial

Background

Sleep disorder is a critical problem in cardiac patients. This study aimed to compare the effects of aromatherapy ‌with peppermint and lavender essential oils on the sleep quality of cardiac patients.

Methods

A total of 105 patients were randomly allocated to three groups of peppermint essential oil, lavender essential oil, and control. In each experimental group, the patients inhaled three drops of lavender and peppermint essential oils, whereas the control group received aromatic distilled water. Data were collected using the Pittsburgh Sleep Quality Index (PSQI). The participants completed PSQI before and after the intervention.

Results

There was a significant difference in the mean score of PSQI in each of the experimental groups before and after the intervention; however, the difference was not statistically significant between the experimental groups.

Conclusion

Aromatherapy with lavender and peppermint essential oils can improve the sleep quality of cardiac patients. Therefore, use of this non-pharmacological intervention, as an effective and simple approach, is recommended for cardiac patients.

Trial registration

IRCT, IRCT201601244736N10. Registered 4 November 2016.

Prevalence of work related musculoskeletal disorders among occupational bus drivers of Karnataka, South India

BACKGROUND

Work-related health problems result in an economic loss of 4-6% in GDP (Gross domestic Product) of the most countries. In the industrialized countries, 1/3rd of the health-related absence to duty are due to musculoskeletal disorders. Professional driving is one such occupation which looks like sedentary occupation, but involves many risk factors that contribute to work-related musculoskeletal disorders (WMSD) due to its nature of working and work environment. This research describes the various risk factors associated with WMSDs and their effects on drivers health.

OBJECTIVE

To assess the prevalence of WMSD and its associated risk factors among the bus drivers of Karnataka State Road Transport Corporation (KSRTC), Karnataka.

METHODS

Subjects considered in this study are 301 full-time bus drivers from the central division KSRTC which consists of 6 depots in Bengaluru. Information regarding reported WMSD symptoms during immediate past 7 days to 12 months, the intervention of WMSD in their day-to-day life and the overall comfort of the body are determined through Standardized Nordic Questionnaire and also by direct observation. The survey questionnaire is conducted by face to face interview.

FINDINGS

From the statistical analysis, it is found that around 55.8% of the study population has experienced WMSD. The prevalence of WMSD is most common in the age group of 29-39 years (53.5%) followed by the age group of >40 years.

CONCLUSION

In this study, some of the work-related and lifestyle/health-related factors show significant association with WMSD in bus drivers of Karnataka. Musculoskeletal disorders can be prevented by designing the driver's workspace ergonomically so that the design suits to all sorts of drivers and the drivers should also be trained on basics of vehicle ergonomics (posture, seat adjustments, in-vehicle controls adjustments).

INTERPRETATION

KSRTC should educate drivers on the basics of vehicle ergonomics, harmful use of tobacco/alcohol, unhealthy food habits and also to involve in physical exercise at least 75-150 mins weekly. If not, the trend of drivers suffering from WMSD belonging to mid-age will increase exponentially.

SCOPE FOR FUTURE WORK

Statistical result and direct observation insist on undertaking further studies on ergonomic interventions at driver's cabin, lifestyle/occupational health factors which mitigate WMSD in different parts of the body during driving.

A healthy dietary pattern may be associated with primary insomnia among Iranian adults: A case-control study

Objective: While it has been reported that both foods and nutrients for individuals are connected with sleep, there is no evidence regarding the association of dietary patterns, identified by factor analysis, with primary insomnia. The present study sought to evaluate the association between major dietary patterns and the chance of having primary insomnia. Methods: The present case-control study was performed using 444 people (111 cases and 333 control), aged 18 to 60 years, referred to Isfahan health centers. Dietary intake was assessed via a food frequency questionnaire in a case-control study in Isfahan, Iran. Principal component analysis was used to determine major dietary patterns. The presence of primary insomnia was measured via the insomnia severity index questionnaire, and the subjects were grouped as healthy or insomniac. Results: Three major dietary patterns were recognized, and named; Western, Iranian Traditional and Healthy, respectively. The cumulative percentage of variance explained by three dietary patterns was 48.2%. Those in second (OR = 0.30; 95%CI: 0.2-0.46) and third (OR = 0.22; 95%CI: 0.15-0.35) tertiles of healthy dietary pattern were less likely suffer with insomnia. This association remained significant only in the highest tertile after adjusting potential confounders (OR = 0.45; 95%CI: 0.32-0.95). We found no significant association between greater adherence to Western or Iranian traditional dietary patterns and primary insomnia. Conclusions: The findings showed that although no statistically significant association was observed between both Western and Iranian traditional dietary patterns with primary insomnia, people with greater adherence to the healthy dietary pattern are less likely to have primary insomnia.

Factors associated with sleep quality of Thai intercity bus drivers

This study aimed to describe sleep quality and explore factors associated with poor sleep quality in Thai intercity bus drivers. A cross-sectional design was employed with a sample of intercity bus drivers from 4 bus transportation companies. The Thai-PSQI was used to identify sleep quality, and the Thai Berlin Questionnaire used to assess sleep apnea risk. Data analysis included descriptive statistics and logistic regression. A total of 338 surveys were analyzed. All bus drivers were male; almost 66% of the bus drivers were defined as poor sleepers, and 18.1% were assessed as being at high risk for obstructive sleep apnea. Working night shifts (OR=20.6), rotating day or night shifts (OR=17.0), alcohol consumption (OR=2.7), being married (OR=3.1), and not exercising (OR=2.3) were related to poor sleep quality. The majority of the Thai intercity bus drivers in our study reported poor sleep quality indicating that action is required at both company and individual levels to encourage the adoption of healthy lifestyles and improvement of working conditions.

Insomnia and hypertension: A systematic review

Insomnia is a prevalent sleep disorder that is associated with a multitude of health consequences. Particularly, insomnia has been associated with cardiovascular disease and its precursors, such as hypertension and blood pressure (BP) non-dipping. The present systematic review aimed to summarize the evidence on the concurrent and prospective associations between insomnia and hypertension and/or BP. Using electronic search engines (PubMed, SCOPUS, PsycINFO), 5,618 articles published from January 1970 to December 2017 were identified, and 64 met the inclusion criteria (26 to 162,121 participants; age range: 18-100; 46.4% male). Insomnia was based on diagnostic or non-diagnostic criteria. Hypertension was based on self-or physician-reports, antihypertensive medication use, and/or measured BP. Findings indicate that when insomnia is frequent, chronic, and/or accompanied with short sleep duration or objective markers of arousal, there is a strong association with hypertension/BP. Based on limited studies, hypertension did not significantly predict future insomnia in middle-aged adults, but did in older adults. Based on a majority of case-control studies, no differences in BP were found between participants with and without insomnia. Further research is needed to identify putative pathophysiological mechanisms underlying the link between insomnia and hypertension. The impact of insomnia therapy on BP should also be further examined in the future.