Psychosocial risk factors for coronary heart disease: a consensus statement from the National Heart Foundation of Australia

In 2003, the National Heart Foundation of Australia published a position statement on psychosocial risk factors and coronary heart disease (CHD). This consensus statement provides an updated review of the literature on psychosocial stressors, including chronic stressors (in particular, work stress), acute individual stressors and acute population stressors, to guide health professionals based on current evidence. It complements a separate updated statement on depression and CHD.

Perceived chronic job strain and shift work are associated with a small absolute increased risk of developing CHD, but there is limited evidence regarding their effect on the prognosis of CHD. Evidence regarding a relationship between CHD and job (in)security, job satisfaction, working hours, effort-reward imbalance and job loss is inconclusive.

Expert consensus is that workplace programs aimed at weight loss, exercise and other standard cardiovascular risk factors may have positive outcomes for these risk factors, but no evidence is available regarding the effect of such programs on the development of CHD.

Social isolation after myocardial infarction (MI) is associated with an adverse prognosis. Expert consensus is that although measures to reduce social isolation are likely to produce positive psychosocial effects, it is unclear whether this would also improve CHD outcomes. Acute emotional stress may trigger MI or takotsubo ("stress") cardiomyopathy, but the absolute increase in transient risk from an individual stressor is low. Psychosocial stressors have an impact on CHD, but clinical significance and prevention require further study.

Awareness of the potential for increased cardiovascular risk among populations exposed to natural disasters and other conditions of extreme stress may be useful for emergency services response planning. Wider public access to defibrillators should be available where large populations gather, such as sporting venues and airports, and as part of the response to natural and other disasters.

Patterns and perceptions of physical activity and sedentary time in male transport drivers working in regional Australia

 Abstract

Objective: To objectively measure physical activity (PA) patterns and sedentary time, and explore perceptions of workplace PA opportunities in regional male transport workers.

Methods: A multi-method study involving 28 drivers (52.4±9.69years) working at a bus company in South-East Queensland, Australia. PA was measured using accelerometers (n=23) to determine the proportion of time spent in sedentary (<150 cpm), light (151–2,689 cpm) and moderate+ (≥2,690 cpm) intensity categories. Paired sample t-tests were used to evaluate differences between categories on a workday/off-workday (n=16), and during work/non-work time (n=15). Interviews were conducted with 28 drivers and six managers to explore perceptions and ideas relating to workplace PA opportunities.

Results: Sedentary time was significantly higher on off-work (64% of wear time) than work (52%) days (p<0.05), while the opposite was the case for light intensity time (off-workday=33%; workday=44%; p<0.05). On workdays, sedentary time was significantly lower when employees were working (44%) than when not working (60%; p<0.05). No significant differences were found for time spent in moderate+ PA. Driver perceptions indicated that PA opportunities (walking club and corporate gym membership) were being adopted by some drivers. However, at this depot, perceived health issues and organisational barriers (shift work and irregular driving routines), tended to preclude some drivers from engaging with these opportunities.

Conclusions: Findings contest the notion that a sedentary occupation such as driving necessitates an inactive work environment.

Implications: This research informs ongoing intervention efforts to target inactive drivers who are struggling to take advantage of existing workplace-related PA opportunities.

Psychosocial and other working conditions in relation to body mass index in a representative sample of Australian workers

Background The aim of the study was to examine the relationship between psychosocial and other working conditions and body-mass index (BMI) in a working population. This study contributes to the approximately dozen investigations of job stress, which have demonstrated mixed positive and negative results in relation to obesity, overweight and BMI. Methods A cross-sectional population-based survey was conducted among working Australians in the state of Victoria. Participants were contacted by telephone from a random sample of phone book listings. Information on body mass index was self-reported as were psychosocial work conditions assessed using the demand/control and effort/reward imbalance models. Other working conditions measured included working hours, shift work, and physical demand. Separate linear regression analyses were undertaken for males and females, with adjustment for potential confounders. Results A total of 1101 interviews (526 men and 575 women) were completed. Multivariate models (adjusted for socio-demographics) demonstrated no associations between job strain, as measured using the demand/control model, or ERI using the effort/reward imbalance model (after further adjustment for over commitment) and BMI among men and women. Multivariate models demonstrated a negative association between low reward and BMI among women. Among men, multivariate models demonstrated positive associations between high effort, high psychological demand, long working hours and BMI and a negative association between high physical demand and BMI. After controlling for the effort/reward imbalance or the demand/control model, the association between physical demand and working longer hours and BMI remained. Conclusion Among men and women the were differing patterns of both exposures to psychosocial working conditions and associations with BMI. Among men, working long hours was positively associated with higher BMI and this association was partly independent of job stress. Among men physical demand was negatively associated with BMI and this association was independent of job stress.

Symptoms of fatigue and coping strategies in maritime pilotage

Background:
Little is known regarding the symptoms of fatigue that maritime pilots experience during shift work. Moreover, the strategies these individuals use to cope with the onset of fatigue are also unknown. The current study explored the symptoms of fatigue and coping strategies experienced by maritime pilots when on-shift.

Material and methods:
Fifty maritime pilots were recruited via an advertisement in the national association’s quarterly newsletter (Mage = 51.42; SD = 9.81). Participants responded to a modified version of the questionnaire used with aviation pilots that assessed overall fatigue, and the symptoms pilots associated with fatigue on duty. Methods pilots used to cope with fatigue before shift and when on the bridge were also assessed.

Results:
There were significant effects for pilot vitality on 4 categories of fatigue: cognitive dysfunction; emotional disturbance; mean physical effects; and sleepiness. There were no significant effects for vitality on any of the self-reported coping strategy factors.

Conclusions:
The findings indicated that maritime pilots experience a variety of physical, behavioural, and cognitive fatigue symptoms when on shift. Some of these symptoms are similar to those reported by aviation pilots. However, unlike aviation pilots, maritime pilots reported utilising self-sufficient coping strategies to deal with the experience of fatigue.

Fighting fire and fatigue: sleep quantity and quality during multi-day wildfire suppression

This study examined firefighters' sleep quantity and quality throughout multi-day wildfire suppression, and assessed the impact of sleep location, shift length, shift start time and incident severity on these variables. For 4 weeks, 40 volunteer firefighters' sleep was assessed using wrist actigraphy. Analyses revealed that the quantity of sleep obtained on fire days was restricted, and pre- and post-sleep fatigue ratings were higher, compared to non-fire days. On fire days, total sleep time was less when: (i) sleep location was in a tent or vehicle, (ii) shifts were greater than 14 h and (iii) shifts started between 05:00 and 06:00 h. This is the first empirical investigation providing objective evidence that firefighters' sleep is restricted during wildfire suppression. Furthermore, sleep location, shift length and shift start time should be targeted when designing appropriate controls to manage fatigue-related risk and preserve firefighters' health and safety during wildfire events. Practitioner Summary: During multi-day wildfire suppression, firefighters' sleep quantity was restricted, and pre- and post-sleep fatigue ratings were higher, compared to non-fire days. Furthermore, total sleep time was less when: (i) sleep occurred in a tent/vehicle, (ii) shifts were >14 h and (iii) shifts started between 05:00 and 06:00 h.

Sleep quantity and quality is not compromised during planned burn shifts of less than 12 h

Planned burning is a preventative strategy aimed at decreasing fuel loads to reduce the severity of future wildfire events. During planned burn operations, firefighters can work long shifts. Furthermore, remote burning locations may require firefighters to sleep away from home between shifts. The existing evidence surrounding firefighters' sleep during such operations is exclusively anecdotal. The aims of the study were to describe firefighters' sleep during planned burn operations and evaluate the impact of the key operational factors (shift start time, shift length and sleeping location) that may contribute to inadequate sleep. Thirty-three salaried firefighters were recruited from Australia's fire agencies and sleep was measured objectively using wrist actigraphy for four weeks. All variables were examined in two conditions: (1) burn days, and (2) non-burn days. Time in bed, total sleep time, sleep latency and sleep efficiency were evaluated objectively. Subjective reports of pre- and post-sleep fatigue, sleep location, sleep quality, sleep quantity, number of times woken and sleep timing were also recorded. Analyses revealed no differences in measures of sleep quantity and quality when comparing non-burn and burn days. Total sleep time was less when planned burn shifts were >12 h. However, on burn days, work shift start time as well as sleeping location did not impact firefighters' sleep quantity. Self-reported levels of pre- and post-sleep fatigue were greater on burn days compared to non-burn days. These findings indicate that sleep quantity and quality are not compromised during planned burn operations <12 h in duration.

Turno de trabalho, cronotipo e desempenho de memória e atenção de profissionais da área da saúde de dois serviços de emergência da cidade de Porto Alegre/RS/BRASIL

Trabalhadores forçados a alterar o ciclo sono/repouso em função do turno de trabalho tendem a dessincronizar seus ritmos fisiológicos (endógenos) em relação aos do meio ambiente (exógenos) acarretando transtornos na organização dos sistemas fisiológicos. Os objetivos deste estudo foram avaliar a relação do turno de trabalho (manhã, noite e rotativo) e perfil cronobiológico e seus efeitos sobre desempenho em testes de atenção e memória de profissionais (médicos, enfermeiros e técnicos/auxiliares de enfermagem) dos serviços de emergência de dois hospitais de Porto Alegre (RS/Brasil). Uma amostra aleatória de 140 profissionais, de ambos os sexos e idade entre 25 e 60 anos, foi avaliada num estudo transversal. Os sujeitos que relataram presença de doença (clínica, neurológica ou psiquiátrica), transtornos do sono prévios ao emprego atual, e uso de benzodiazepínicos nas 6 horas anteriores à testagem foram excluídos. Padrão cronobiológico (matutinidade/vespertinidade) foi definido pelo questionário de Hidalgo-Chaves (2002). Os testes de atenção e memória foram span de dígitos, span palavras, stroop, memória lógica, e Wisconsin Card Sorting Test (versão computadorizada). Déficit de atenção foi definido pela combinação de testes positivos (50%+1). Não se observou associação significativa entre cronotipo e turnos de trabalho. A freqüência de desempenho abaixo do ponto de corte em diversos testes foi maior no turno da noite. Déficit de atenção/memória foi observado em 51% dos profissionais do turno da noite, 21% do turno da manhã, e 22% do rotativo. O desempenho nos testes de atenção/memória entre os sujeitos distribuídos por cronotipo (tanto no total, como entre coincidentes com o turno de trabalho) não mostrou diferença estatisticamente significativa. Em conclusão, a discordância entre turno de trabalho e cronotipo pode ser explicada por diferentes motivos como a falta de opção para escolher o turno, questões financeiras, e desconhecimento quanto às características relacionadas ao perfil cronobiológico. Os déficits observados podem expressar efeitos de longo prazo do trabalho em turnos e especialmente no noturno.

Qualidade de sono e qualidade de vida em trabalhadores submetidos a diferentes esquemas de trabalho de uma empresa petroquímica

One of the largest problems of the present time resulting from the economic globalization and the modern technology, of the point of view of the biological rhytms of our organism, it is offering services and production of goods available in 24 o'clock, that it demands organized workers in several work schedules besides the hours of the day. Those schedules cause a series of biopsychosocial consequences in the worker's health, in function of circadian, homeostatic and psychosocial alterations. Accordingly, the aim of this study was to accomplish an evaluation of the effects of several works schedules in the pattern of the sleep wake cycle, anxiety, stress and in the health. We counted with a sample of 274 workers subdivided in 49 daytime worker groups and 225 workers in different shift work schedules with different speeds (rotating shift group, slower day shift group, faster day shift group). From the results analysis it is verified irregularities of the daily activities, stress and alterations in the workers' health in all schedules. It was also verified thata the workers thata presented irregularities in the daily activities were the mroe stressed. On the other hand, the shift works were considered more ansious and associated with bad sleep quality. It was verified that the workers with bad sleep quality were those presented larger levels of dispocional anxiety. There was no statistically significant correlation between bad sleep quality and irregular daily lifestyle. However, it can be affirmed thata shift work schendules doesn't are the main determinant for the circadian alterations, but the answers of the individuals to the shifts work; and that the inadequate behavioural strategies to work with the effects of the shift schedules. In conclusion, individual strategies related to the coping of the work in shift (adaptation and tolerance) should be extolled as indispensable tool in the ergonomic evaluation of the work

O efeito da dessincronização circadiana sobre o metabolismo

The lost of phase relationship between rhythms and behaviour can, and often do, undesirable consequences. The purpose os study was to ascertain the effect of circadian desynchronization in T22 about metabolism of wistar rats. The subjects consisted of 24 animals separated in two groups: control (n=12) T24 with 8 weeks of aged and experimental group (n=12) T22, also with 8 weeks of aged. Both the groups were subject to register of locomotor actitivity, body temperature, body weight and food intake in all the experiment. And more, both the groups were subject to food deprivation, running in treadmill and forced swimming. The results show rhythm of locomotor activity and body temperature desynchronized. Dont exist diference in body weight between both the groups (T24 = 386,75±40,78g e T22 380,83±44,28g) . However, the food intake was different between the phases, light and dark, in intergroup and intragroup. The body temperature was not different in food deprivation. The same ocurred for running in treadmill and forced swimming. Since similar alterations occur in shift workers, it is proposed that the experimental paradigm presented in this manuscript is a useful model of shift work. That is, alterations in activity/rest cycles and consummatory behavior can affect the health of organism

Sono e percepção visuoespacial em trabalhadores de uma empresa petroquímica submetidos a esquemas de trabalho em turnos alternantes

Shift work consists of an array of unusual work hours, such as evenings and weekends, and increasing workload, in order to meet the uninterrupted production, which leads to changes in the quality, duration and regularity of sleep. Research indicates that sleep alteration cause cognitive processes to become slower, unstable and prone to errors, leading to loss of cognitive functions such as visuospatial perception. In this sense, this research aimed to evaluate sleep quality and its relation to visuospatial perception in workers in alternating shifts. Participants were 21 panel operators in a petrochemical company, male, aged 19-53 years. All participants were subjected to schedules of alternating shifts (day and night) of 12 nonstop hours and data were collected from 10 workers who were assigned to the day shift and 11 workers assigned to the night shift. For the sleep evaluation were used the Sleep Diary, the Sleep Habits Questionnaire, the Chronotype Identification Questionnaire and the Pittsburgh Sleep Quality Index (PSQI). The visuospatial skills were assessed using the Rey Complex Figure Test and attention was assessed using a portable version of the Psychomotor Vigilance Task (PVT). The results showed that the general sample of workers obtained poor sleep quality on working days and good sleep quality during the work break. There was shortened sleep duration in the work week and appropriate duration in the work break. No losses were found in the workers visuospatiality, but the good quality of sleep during the work break was correlated to adequate visuospatial performance, for the day shift workers. The attention performance oscillated throughout the work hours, especially on the night shift. It is concluded that the alternating shifts work scheme can be detrimental to the sleep quality workers and a good sleep quality can contribute to a better visuospatial performance

Percepção dos efeitos do trabalho em turnos sobre a saúde e a vida social em funcionários da enfermagem em um hospital universitário do Estado de São Paulo

O trabalho em turnos existe desde o início da vida social dos homens, sendo utilizado em diferentes setores, como na indústria de produção de bens de consumo e de serviços. A área da saúde exige o sistema em turnos para manutenção de atividades durante 24 horas. Teve-se como objetivo identificar os sistemas de turnos em funcionários de enfermagem em um hospital universitário, avaliar a percepção sobre os prováveis efeitos do trabalho em turnos em sua saúde e vida social e o grau de participação desses funcionários na forma de organização de sua jornada. Trata-se de uma pesquisa descritiva e exploratória, cujos resultados foram obtidos mediante questionário aplicado a 348 funcionários da enfermagem do Hospital de Clínicas da Faculdade de Medicina de Botucatu, São Paulo. Dentre os resultados, observou-se que, em sua maioria, eles tinham menos de 40 anos, eram casados, do sexo feminino, com um filho pelo menos, cumprindo uma escala de turnos alternados, com freqüência de revezamento superior a quinze dias e referindo queixas de caráter neuro-psíquico, gastrintestinal e cardiovascular. Houve ainda queixas sobre relacionamento e tempo de convivência. Na maioria das vezes, era pouca a participação do funcionário na forma de organização de sua escala de trabalho.

Trabalho em turnos nas empresas de Botucatu, São Paulo: estudo descritivo

Em face da inexistência de dados sobre esquema de trabalho em turnos em empresas de Botucatu, solicitaram-se delas informações sobre ramo de atividade, número de funcionários e esquema de trabalho. Às que registraram tal ocorrência, enviou-se um questionário visando à caracterização da forma de organização da jornada de trabalho. Das 66 empresas participantes da pesquisa, 14 referiram a existência de trabalho em turnos, englobando 6.541 funcionários, de um total de 9.502, sendo 2.346 de setores da produção. Nesses setores, os sistemas contínuo alternado e descontínuo permanente predominaram. em oito empresas os sistemas eram alternados, cinco delas com esquemas apresentando freqüência de revezamento de seis ou mais dias. São descritas outras formas de organização encontradas. Conclui-se que, com o quadro descrito, torna-se possível estudar as relações entre trabalho em turnos, saúde e vida social dos trabalhadores.

Qualidade de vida do trabalhador de enfermagem de um hospital Estadual

The search for quality of life (QOL) is now an ideal among thousands of people worldwide and is currently the subject has been studied in different areas of knowledge. Thus, one can perceive it in different dimensions, each with its due importance to people's lives. The verification of quality indexes of work life (QWL) may provide information on factors that directly interfere with the satisfaction and personal motivation and collective, with reflections on the structure and excellent service. To this end, we carried out a study to know the characacteristics of quality of life of nursing professionals in a state hospital in São Paulo State, based on short range of quality of life of the World Health Organization (WHOQOL-BREF). This work is a study with a quantitative approach, cross-sectional descriptive and exploratory data analysis using descriptive statistics, involving a sample of 281 nurses who answered the scale for measuring quality of life, composed of four areas: physical, psychological, social relationships and environment. In the study, these areas were related to the professional position, and shift work. There was a satisfactory quality of life in the study population in different areas of WHOQOL-BREF. There was no statistically significant changes in quality of life among the variables. It follows that the population presented data consistent with an adequate quality of life, thus making relevant to addressing the quality of life of nursing in a healthcare organization which has as fundamental to the pursuit of quality through the accreditation process second hospital established by the National Accreditation Organization (ONA) that aims at establishing and implementing a process of improving health care, thereby stimulating the services to achieve higher standards of quality