Professional drivers and cardiovascular risk: APPTIV cohort

Background

Professional drivers have a high risk of morbidity, including myocardial infarction. Bus, taxi and truck drivers have most often constituted the studied populations. However, if the transport sector faces road risk, 70% of employees in all activity sectors are exposed to this risk in France. Most often studied by the analysis of global working time, the real driving time and the distance travelled are rarely taken into account, whereas they are potentially modifiable factors.

Purpose

To assess the associations between exposure to road risk by taking into account driving time and the number of kilometers travelled professionally and certain cardiovascular risk factors, in different sectors of professional activity.

Method

Based on the APPTIV cohort, data from 984 men and women employees from 94 companies in France was collected from 2018 to 2019, during occupational health medical visits focused on road risk. The number of Kms / month (<400 (ref); <1600; ≥1600) and the duration of driving (hours / d <1 (ref); <4; ≥4) were studied according to the respective tertiles. A variable with 9 classes was created. Logistic regressions adjusted for age, gender and activity sectors were carried out to explain the associations with certain cardiovascular factors (Hypertension, overweight (≥25 kg/m2), obesity (30 kg/m2) Hypertriglyceridemia (≥1.7 mmol/l), Hypercholesterolemia, HypoHDLemia).

Results

The population studied came from 23.30% of the transport sector, 23.30% of the construction sector, 26.75 of the public administration and 4.78% of the trade sector. After adjustments, the estimated risks of hypertension according to the driving time or the number of km travelled are not significant. Driving between 1 and 4 hours and more than 4 hours per day increases the risk of obesity, by: OR: 1.85 (1.22–2.80); 1.85 (1.19–2.86), the risk of hypertriglyceridemia of 1.39 (1.0–1.95); 1.54 (1.09–2.18). Traveling more than 1600 km / m increases the risk of hypertriglyceridemia by 1.5. People driving between 400 and 1600 km / m with a driving time between 1 and 4 h / d or those covering more than 1600 km with long driving times (>4 h / d) have an estimated risk of obesity at 1.82 (1.05–3.14) and 1.87 (1.13–3.11) respectively. Those traveling over 1600 km / m with long driving times (>4 hrs / day) have a 1.5 times risk of hypertriglyceridemia.

Conclusion

Taking into account the number of hours of driving and the kilometers travelled professionally, this study highlighted some employee profiles with high cardiovascular risk, accessible to medical and professional prevention measures.

Funding Acknowledgement

Type of funding source: None

[Excitatory amino acid receptors]

Glutamate, aspartate and possibly other excitatory acidic amino acids are thought to be, neurotransmitters at the majority of excitatory synapses in the vertebrate CSN. The synaptic response elicited by excitatory amino acids is mediated by at least four (probably five) different receptor subtypes. These were known as the N-methyl-D-aspartate, quisqualate, kainate and L-AP4 receptor subtypes. More recently a fifth receptor subtype has been discovered that is linked to phosphoinositol metabolism. The most well characterized excitatory amino acid receptor subtype is the NMDA receptor. This receptor consists of a recognition site for NMDA, a cation-selective ion channel and binding site for glycine, Zn2+ and phencyclidine-like compounds. In addition the channel can be blocked by Mg2+. New and selective ligands and radioligands have facilitated mapping the distribution of the major excitatory receptor subtypes in normal and diseased brain, examines allosteric interactions within the NMDA receptor, searching for novel therapeutic agents and determining drugs mechanisms.