Occupational burnout in oncologists in Kazakhstan

BACKGROUND

Although burnout levels in oncologists are likely high, its predictors remain poorly understood.

AIMS

This study was aimed to verify the prevalence of occupational burnout in oncology doctors and nurses in the major cancer centre in Kazakhstan and to elucidate its predictors to plan future prevention activities.

METHODS

In the leading tertiary-level cancer centre in Kazakhstan, we recruited 256 subjects (67% doctors and 33% nurses, 62% women, median age 37.5 [interquartile range 15] years) and offered them Maslach Burnout Inventory to quantify emotional exhaustion (EE), depersonalization (DP) and personal accomplishment (PA). Demographics, fatigue, health-related quality of life with SF-8 and lifestyle were tested as predictors of burnout in multivariate logistic regression models.

RESULTS

Number of subjects with high EE was 121 (47%), high DP was 161 (63%) and high PA was 152 (59%). Fatigue, worse mental component score (MCS), being single and not exercising regularly predicted more burnout in EE. Fatigue, worse physical component score (PCS) and worse MCS predicted more burnout in DP. Finally, more burnout in PA was independently associated with fatigue, worse PCS, being married or divorced and having a university or academic degree.

CONCLUSIONS

The prevalence of occupational burnout in oncologists was high, necessitating early burnout prevention programmes, addressing, among other, fatigue reduction and regular exercise.

Gene-to-gene interactions and the association of TP53, XRCC1, TNFα, HMMR, MDM2 and PALB2 with breast cancer in Kyrgyz females

BACKGROUND

At present, little is known about the genetic background of breast cancer (BC) in Kyrgyz. Therefore, the aim of this study was to assess gene-to-gene interactions and the contribution of p.Arg72Pro (TP53 gene), p.Gln399Arg (XRCC1 gene), p.Arg194Trp (XRCC1 gene), g.4682G > A (TNFα gene), p.Val353Ala (HMMR gene), c.14 + 309 T > G (MDM2 gene) and g.38444 T > G (PALB2 gene) polymorphic loci in breast cancer (BC) risk in females of Kyrgyz ethnicity.

METHODS

The case-control study comprised 103 females with histologically verified BC and 102 controls with no cancer. We used polymerase chain reaction-based restriction fragment length polymorphism to genotype polymorphic loci.

RESULTS

Gln/Arg heterozygous variant of XRCC1 gene's p.Gln399Arg locus, as well as combined carriage of Arg/Gln//Arg/Pro of XRCC1/TP53; Arg/Gln//T/T of XRCC1/MDM2; Arg/Gln//G/G and Arg/Gln//G/A of XRCC1/TNFα, Arg/Gln//T/T of XRCC1/PALB2; Arg/Gln//Arg/Arg and Arg/Gln//Arg/Trp for p.Gln399Arg and p.Arg194Trp polymorphic loci of XRCC1 were associated with BC in Kyrgyz females.

CONCLUSION

TP53, XRCC1, TNFα, HMMR, MDM2 and PALB2 genes' polymorphic site combinations appear to be candidate markers of genetic predisposition to BC in Kyrgyz population and prompt targeted personalized care.

Occupational exposure and sarcoidosis: a case-control study in three countries

BACKGROUND

Preceding studies of environmental and occupational risk factors of sarcoidosis yielded inconsistent findings.

AIMS

We aimed to ascertain the occupational risk factors for sarcoidosis in a case-control study.

METHODS

A total of 237 sarcoidosis patients with a histologically confirmed diagnosis were matched with 474 controls for sex and age (median 49, interquartile range 37; 60 years) recruited from the university hospitals and outpatient centres in Belarus, Kazakhstan and the Russian Federation. Ever and cumulative (considering years and hours per week) exposure to 24 occupational factors were analysed using logistic regression.

RESULTS

In the overall sample of 711 subjects, 50% were females and any occupational exposure was more prevalent in cases compared to controls (60% versus 40%, P < 0.001). Current daily smoking as opposed to ex-smoking was associated with the lower risk of the outcome. Adjusted for smoking, age, sex and a few other exposures, ever-exposure to hay in agriculture (odds ratio (OR) 3.64 (95% confidence interval (CI) 1.26; 10.50)), engine exhausts (OR 2.94 (95% CI 1.14; 7.54)) and printing equipment (OR 1.66 (95% 1.03; 2.68)) was associated with sarcoidosis. The effect was also positive for cumulative exposure to hay in agriculture (OR 2.02 (95% CI 1.00; 4.07)), stone dust (OR 1.07 (95% CI 1.01; 1.14)) and engine exhausts (OR 1.18 (95% CI 1.03; 1.38)) and was stronger in never-smokers and subjects 40 years and older.

CONCLUSIONS

Widespread occupational exposures may increase the risk of sarcoidosis, but further research is needed to elucidate the complex interplay of environmental and occupational factors in the epidemiology of sarcoidosis.