Factors That Predict Early Return to Work After Myocardial Infarction: Importance of Coworker Support.

Aim    Myocardial infarction (MI) affects the working-age group and cause many absences and lost days of work. Some occupational factors effect in the prognosis of MI patients. The objective of this study was to determine predictors of early, late and no return to work (RTW) after MI.Material and methods    In this cohort study, 240 pre-employed, male patients with MI from April 2020 through February 2022 provided data about their demographic, occupational, psychosocial, and medical information. Data was also collected about the treatment they received as patients, their feelings about socioeconomic support, and RTW time. RTW within two weeks after MI was defined as early RTW. The relationships of these variables and with early RTW and with late or no RTW were analyzed.Results    Ninety-four patients (39.6 %) returned to work within two weeks after MI, whereas 207 patients (87.3 %) returned to work by the end of six months. Many variables, including coworker support, were associated with early RTW in a univariate analysis. Regression analysis revealed that age, coworker support, marital status, the patient's own estimated RTW time, the number of the vessels with occlusion, and comorbidity were predictors of early RTW. Of these factors, only coworker support would be subject to modification.Conclusions    This study indicates that improving support from coworkers can increase early RTW after MI.

Disparities in the prevalence of metabolic syndrome between Iranian industrial workers and university staff.

Background: Is there a difference in the prevalence of metabolic syndrome between employee service jobs and industrial jobs in Iran? In this study, we tried to answer this question. For this purpose, we compared the two populations of employees and workers. We compared the staff of the University of Medical Sciences as a service employees population (clinical and office work) to the industrial workers of a large automotive company (often with industrial occupations). Method: In this cross-sectional study conducted in Tehran in 2020, the prevalence of metabolic syndrome among 4,372 people employed by the university and 3,899 automotive industry employees was examined and compared. The prevalence of metabolic syndrome was assessed based on two criteria, National Cholesterol Education Program Adult Treatment Panel III (ATP III) and International Diabetes Federation (IDF). Results: The results showed that the prevalence of metabolic syndrome among university staff was higher than the automotive industrial workers. According to ATP III criteria, the former and latter showed the prevalence of metabolic syndrome of 13.1% among and 6.1%, respectively among. Also, based on IDF criteria, the prevalence of metabolic syndrome was 23.3% and 12.6% in two groups mentioned. Conclusion: Based on the findings of this study, the prevalence of metabolic syndrome in university staff was almost double that in industry workers. At first glance, the physical activity of most automotive, industrial workers seems to be the main reason for this difference; however, a prevalence of about twice implies further factors. According to the authors, the legal implementation of monitoring, promotion, and surveillance programs of occupational health, in industrial environments can be a factor accounting for a significant difference in the prevalence of metabolic syndrome between the two populations observed. The authors suggest implementing similar programs for Iranian public sector employees to enhance their health status.

Exposure to ambient gaseous air pollutants and adult lung function: a systematic review.

Exposure to hazardous air pollutants is identified as most obvious premature mortality factors in the world. Numerous epidemiological studies have estimated exposure to air pollutants may cause pulmonary toxicity and the incidence of respiratory diseases including chronic obstructive pulmonary disease (COPD), chronic bronchitis and asthma. The currently research was performed to evaluation the association between gaseous pollutants and lung function in healthy adults. Articles related to this study were selected from researches of Scopus, PubMed, and Web of Science databases. A total of 2,644 articles were retrieved and 39 records were reviewed after removing duplicates and excluding irrelevant studies. The result of this systematic review indicated that there is some evidence on decreasing lung function with exposure to gaseous air pollutants (NO2, SO2, and O3) which can have negative effects on human health. Although according to the evidence changes in lung function are mostly linked to the exposure to environmental pollutants including CO, O3, NO2 and SO2, the results should be interpreted with caution considering some following issues discussed in this review. Therefore, further studies are required considering well-designed studies in large scales to strengthen the evidence.

Prevalence of uncorrected distance refractive errors and associated risk factors in employees of an academic centre.

BACKGROUND: Uncorrected refractive error (RE) may affect the work performance of adults in the workplace. The aim of current study was to determine the prevalence of corrected and uncorrected RE, and the determinants of uncorrected RE in adult employees of a university. METHODS: This was a cross-sectional study of Tehran University Medical Sciences' staff. Besides demographic and some specific questionnaires, ophthalmic examinations including the measurement of uncorrected visual acuity (UCVA), best spectacles corrected visual acuity (BCVA), and presenting visual acuity were performed for all participants. The need for spectacles was defined as UCVA worse than 6/12 in the better eye that could be corrected to better than 6/12 with spectacles based on subjective refraction. RESULTS: In total, 4460 individuals with mean age of 42.32 ± 8.80 were included in the study. The VA of the better eye was 0.01 ± 0.05 logMAR for BCVA, 0.13 ± 0.26 for UCVA, and 0.05 ± 0.12 for presenting VA. Prevalence of RE was 15.7%, including uncorrected RE of 5% and spectacles coverage (corrected RE) of 10.7%. The proportion of individuals with elementary education and poor-fair status of general health were 1.62 times higher in the uncorrected group. In the univariate analysis, type of occupation (office versus non-office workers), socioeconomic status, and insurance of employees were not related to uncorrected RE (all P > 0.4). Myopia was the only factor associated with uncorrected RE in logistic regression analysis (odds ratio = 2.73, 95%CI = 1.02-7.31, P = 0.04). CONCLUSION: The prevalence of uncorrected RE and spectacle coverage were 5% and 10.7%, respectively. Myopia was almost three times more likely to be associated among employees with uncorrected RE.

Effects of Simultaneous Exposure to Smoking and Welding Fume on Pulmonary Function Tests in Spot Welders.

BACKGROUND: The respiratory effects of fume exposure during spot welding may aggravate some environmental risk factors such as tobacco smoking. Fume exposure and smoking have negative effects on pulmonary function tests (PFTs). This study assessed the simultaneous effects of smoking and welding fume on spirometry tests in spot welders. MATERIALS AND METHODS: This cross-sectional study was conducted on 667 spot welders and 1000 assemblers in an automotive manufacturing plant. Spirometry was carried out on all the participants under standard conditions and according to the American Thoracic Society Clinical Practice Guidelines and indices including FEV1, FVC, FEV1/FVC, FEF 25-75, and PEF were measured and compared between two groups of the study population including workers of spot welding and assembling. RESULTS: It was found that the effect of simultaneous exposure to smoking and welding fume was aggravated on the PFT indices including the FEV1 percent, FEV1/FVC, the FEV1/FVC percent, the PEF percent, FEF25-75, and the FEF25-75 percent, but not on indices such as FVC, the FVC percent, and PEF. CONCLUSION: Simultaneous exposure to smoking and welding fume resulted in a reduction in some spirometry indices, causing respiratory airway obstruction in the spot welders. Occupational safety and regular medical examinations with shorter intervals in smoking spot welders can prevent acute respiratory effects of exposure to smoking and welding fume.

Body impedance analyzer and anthropometric indicators; predictors of metabolic syndrome.

Aim: Metabolic syndrome is one of the outcomes of a sedentary lifestyle in the modern world. In this study, we want to introduce the predictors of metabolic syndrome using anthropometric indices and Bio-Electrical Impedance Analysis (BIA) test values. Method: This cross-sectional study was performed on 2284 employees of Tehran University of Medical Sciences in different job categories. Metabolic syndrome was determined according to IDF criteria. Anthropometric dimensions, para-clinical tests, basic information were collected from the participants. Also, the body analysis of the participants was performed using a BIA method. Result: The prevalence of metabolic syndrome in this study was 23.2% based on IDF criteria, which was 21% and 26.6% in men and women, respectively. The most important factor among the components of IDF criteria was HDL deficiency. In this study, neck circumference, fat mass, visceral fat, muscle mass percentage and waist to height ratio were observed as predictors of metabolic syndrome. Conclusion: This study realized that there is association between fat mass, fat-free mass, visceral fat and muscle mass which all are some elements of body composition analysis and metabolic syndrome as a major health issue.

Miniscleral Contact Lens in Pediatric Age Group: Indications, Safety, and Efficacy.

OBJECTIVE: To report indications, fitting feasibility, and safety of miniscleral design (MSD) lenses in children. METHODS: Medical records of patients aged <18 years at the time of referral to Contact Lens Clinic of Farabi Eye Hospital, because of inadequate spectacle-corrected visual acuity, rigid gas-permeable or soft contact lens intolerance, and ocular surface disease were reviewed. Uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), best-corrected vision with the lens (CCVA), lens parameters, and comfortable daily wearing time (CDWT) were documented. RESULTS: Seventy-two eyes of 52 pediatric patients were fitted with MSD lens over a 9-year period. The indications for MSD lens fitting were keratoconus (29 eyes), corneal scarring from ocular trauma (16 eyes), ocular surface diseases (25 eyes), and postkeratitis corneal scar (2 eyes). The average UCVA and the mean difference between CCVA and BSCVA were 1.20 and 0.55 logarithm of the minimal angle of resolution, respectively, which shows statistically significant improvement. This significant increase in vision was even seen in those who were referred for the management of ocular surface diseases. The mean CDWT for most patients was 10 hr/day. CONCLUSION: Miniscleral design lens can be used as a safe and helpful modality to provide good vision and comfort in children experiencing ectatic disorders, traumatic corneal scars, and ocular surface diseases.

Manual material handling in the Tehran Grand Bazaar, a type of traditional heavy work with musculoskeletal effects.

BACKGROUND: Manual Material Handling (MMH) is a type of heavy work that causes a wide variety of musculoskeletal disorders (MSDs). Porters constitute a poor socioeconomic group of workers who are faced with these risk factors. This study focuses on porters who push and pull loads of goods on handcarts inside and outside the Tehran Grand Bazaar. OBJECTIVES: This study was conducted to investigate the prevalence of MSDs in porters of the Tehran Grand Bazaar. METHODS: Based on official registries, more than 5000 porters work in the Tehran Grand Bazaar. In total, 398 porters were selected using the simple random sampling method. The prevalence of MSDs was assessed using the Standardized Nordic Questionnaire for the Analysis of Musculoskeletal Symptoms. The tasks of the porters were analyzed during walk-through surveys in the Tehran Grand Bazaar. RESULTS: The prevalence of MSDs in at least one body part was 53.8% in the last 12 months and 45.2% in the last 7 days. The most prevalent symptoms in the last 12 months were low-back pain (29.6%) and knee pain (19.6%). Symptoms were associated with age, height, weight, waist circumference, work duration, number of children, and manually handling goods heavier than 20 kg. CONCLUSIONS: The prevalence of MSDs is high in the porters of the Tehran Grand Bazaar, likely due to heavy MMH.

Predictive factors for return to work after lumbar discectomy.

Background. Lower back pain (LBP) is one of the most common complaints leading to disability and work absence. This study was performed to determine the rate and contributing factors of return to work in the postoperative phase after lumbar discectomy. Methods. This cohort study was performed among 142 patients attending the orthopedics spine clinic of a teaching hospital during 2016. Initially, the demographic and occupational characteristics and Oswestry disability index (ODI) were fulfilled, and patients were followed with regard to time off, work return and type of job after surgery. Results. 113 participants (79.5%) returned to work in 3 months. Male gender, higher literacy, non-manual job, less physical activity, non-smoking, formal work agreement, lower working hours and higher income were associated with return to previous work. Also, shorter preoperative duration of LBP, longer hospital stay, lower severity of LBP, lower ODI score and poor perceived prognosis of return to work were associated with return to previous work. Conclusions. Return to work after discectomy is seen in more than two-thirds of patients and is related to factors such as pain intensity and body mass index. However, return to previous versus modified job is a multifactorial issue.

Neck pain associated with smartphone overuse: cross-sectional report of a cohort study among office workers.

PURPOSE: The aim of the current study was to investigate the extent of smartphone use, possible correlation with neck pain and/or psychological impairment in office workers. METHOD: A convenience sample of 1,602 office workers who were using smartphone for prolonged periods (≥ 4 years) participated in a cross-sectional report of a cohort study, assessing demographic, abnormal symptoms of pain in the neck, physical activity, and psychological behavior characteristics. Participants were assessed using a short version of the Smartphone Addiction Scale (SAS-SV), Depression, Anxiety and Stress Scales (DASS-42) questionnaire, as well as International Physical Activity Questionnaire-Short Form (IPAQ-SF). Multiple logistic regression model was conducted to evaluate the adjusted effect of smartphone overuse on nuchal symptoms. RESULTS: The prevalence of neck pain among the office workers was 30.1%. Significantly more female (33.3% vs. 24.5%) and younger (42.2 vs. 43.2 years) employees reported to have neck pain. Overall in 326 (20.3%, 95% CI: 18.4%-22.4%) of studied subjects had, SAS score ≥ 31 and ≥ 33 for male and females, respectively, and so smartphone overuse (SO) was diagnosed. The results of multiple logistic regression model revealed that those with SO were approximately 6 times more likely to have neck pain (95% CI: 4.44-8.09, P < 0.001). CONCLUSIONS: Smartphone overuse in office workers significantly increases the chance of neck pain by 6 times. Hence SO has been associated with, not only somatic complaints, but also psychological distress such as anxiety, stress, and depression. This may necessitate adherence to neck-school, when smartphone use is associated with neck pain.

Prospective cohort study on the social determinants of health: Tehran University of Medical Sciences employees` cohort (TEC) study protocol.

BACKGROUND: In this study, the association between the social determinants of health (SDH) as well as other health risk factors and outcomes will be evaluated at different socioeconomic layers. METHODS/DESIGN: This is a prospective cohort study that was launched in January 2018 on Tehran University of Medical Sciences' employees. The initial enrolment phase will continue up to March 2021, or until a sample size of 5500 is reached. In addition to annual phone-calls, the participants will be followed thrice at 5-year intervals. Data are collected through blood and urine samples, complete physical examination, anthropometric evaluation, and the completion of questionnaires related to SDH, such as socioeconomic status and social capital, history of diseases, lifestyle (including, nutrition, physical activity, cigarette and hookah smoking), occupational exposures (including psychosocial factors at work and work-family conflicts), and different aspects of physical, mental and occupational health as health outcomes. The association between independent variables and health (objective or subjective) are examined using multiple models and by controlling the confounding effects. Moreover, the trend in lifestyle changes and its impact on health are evaluated. DISCUSSION: Our study will explore the key social determinants as well as other factors including socioeconomic status and social capital, history of diseases, lifestyle and occupational exposures that affect health. This will provide social and occupational health decision-makers and stakeholders with new and valuable evidence in an era in which we are witnessing huge changes in lifestyle.

Using multiple self-regulated learning measures to understand medical students' biomedical science learning.

CONTEXT: Understanding self-regulated learning (SRL) is complicated due to the different measures used to identify the key SRL processes. There is a growing trend in applying event measures of SRL (microanalysis and trace) but aptitude measures (questionnaires) continue to be widely used in medical education. A major concern is whether aptitude measures are a valid approach to capture the dimensions of SRL processes. This study examined correlations between SRL microanalysis, SRL trace and the Motivated Strategies for Learning Questionnaire (MSLQ) and how these measures were associated with biomedical science performance. METHODS: An SRL microanalysis assessment interview was administered to 76 first-year medical students individually when performing a biomedical science learning task. All written materials by students were collected for further trace analysis. Students completed an MSLQ 2 weeks before completing their biomedical science course. Correlation analyses were used to determine the correlations between the three SRL assessment measures. Bivariate and multiple analyses were conducted to compare students on different course or task performance using the three SRL assessment measures. RESULTS: Microanalytic metacognitive monitoring (κ = 0.30, P < .001) and causal attributions (κ = 0.17, P = .009) had statistically significant correlations with use of the SRL trace strategy. MSLQ self-efficacy correlated with microanalytic self-efficacy (r = .39, P = .001). Bivariate tests showed that microanalytic metacognitive monitoring, causal attributions and adaptive inferences, and SRL trace strategy use had significant associations with task performance (P < .05). Microanalytic self-efficacy, metacognitive monitoring and causal attributions, SRL trace strategy use and MSLQ self-efficacy had significant associations with course performance (P < .05). Measures of use of the SRL trace strategy and MSLQ subscales did not show significant associations with task and course outcomes in multiple analyses (P > .05). CONCLUSIONS: Event measures, specifically SRL microanalysis, had greater associations with both task and course outcomes compared with the MSLQ measure. The SRL microanalysis is recommended for the assessment of SRL in biomedical science learning. However, to fully understand medical students' SRL a multidimensional assessment approach that combines event and aptitude measures should be used.

A Burden Assessment of Occupational Exposures in Iran, 1990-2010: Findings from the Global Burden of Disease Study 2010.

BACKGROUND: The present study describes the burden of occupational diseases in Iran based on the results of the Global Burden of Disease study conducted in 2010 (GBD 2010). This study aimed to determine the burden of occupational diseases in Iran based on the results of GBD 2010. It is a cross-sectional study. METHODS: Disability-adjusted life years (DALYs) of occupational diseases were calculated based on the prevalence rates obtained through model estimation, as well as GBD 2010 disability weights and mortality rates obtained from different data registry systems of Iran. Causal association criteria application to select risk outcome pairs, estimation of exposure to each risk factor in the population, estimation of etiological effect size, selection of a counterfactual exposure distribution, risk assessment, and identification of burden attributable to each risk factor were the main conducted statistical steps. RESULTS: There was an increasing trend of DALYs (710.08/100,000 people in 1990 and 833.00/100,000 people in 2005) followed by a slight decrease (833.00/100,000 in 2005-784.55/100,000 people in 2010). A total of 50.4% and 36% of total DALYs per 100,000 people were due to the adverse effects of musculoskeletal disorders and work-related injuries, respectively. CONCLUSIONS: Musculoskeletal disorders and work-related injuries are the most important adverse consequences of work-related risks that require urgent interventions to be controlled. Male workers (15-25 years and over 60) with the highest DALYs and mortality rates need more training programs, safety regulations, and higher level of protection support. In spite the decreasing trend of occupational disease related DALYs and death rates in Iran in recent years, a long-term effort is required to maintain the currently decreasing trend.

Association between Metabolic Syndrome and Job Rank.

BACKGROUND: The occupation of the people can influence the development of metabolic syndrome. OBJECTIVE: To determine the association between metabolic syndrome and its determinants with the job rank in workers of a large car factory in Iran. METHODS: 3989 male workers at a large car manufacturing company were invited to participate in this cross-sectional study. Demographic and anthropometric data of the participants, including age, height, weight, and abdominal circumference were measured. Blood samples were taken to measure lipid profile and blood glucose level. Metabolic syndrome was diagnosed in each participant based on ATPIII 2001 criteria. The workers were categorized based on their job rank into 3 groups of (1) office workers, (2) workers with physical exertion, and (3) workers with chemical exposure. The study characteristics, particularly the frequency of metabolic syndrome and its determinants were compared among the study groups. RESULTS: The prevalence of metabolic syndrome in our study was 7.7% (95% CI 6.9 to 8.5). HDL levels were significantly lower in those who had chemical exposure (p=0.045). Diastolic blood pressure was significantly higher in those who had mechanical exertion (p=0.026). The frequency of metabolic syndrome in the office workers, workers with physical exertion, and workers with chemical exposure was 7.3%, 7.9%, and 7.8%, respectively (p=0.836). CONCLUSION: Seemingly, there is no association between metabolic syndrome and job rank.

Medical radiation workers' knowledge, attitude, and practice to protect themselves against ionizing radiation in Tehran Province, Iran.

BACKGROUND: Medical radiation workers are potentially at a risk of unwanted ionizing radiation exposures. This study assessed the radiation protection knowledge, attitude, and practice (RP-KAP) of health-care workers who are occupationally exposed to radiation regarding protecting themselves from radiation. MATERIALS AND METHODS: This study was cross-sectional in design and was carried out in 16 hospitals affiliated to the Tehran University of Medical Sciences between May and September 2014. Total health-care workers who were occupationally exposed to radiation comprising 670 individuals were included in the study based on census sampling method. In total, 413 individuals consented to complete an anonymous 32-item questionnaire comprising single best choice questions with a numerical value assigned to each correct answer. Each set of RP-KAP questions was scored and categorized as poor, medium, and good. The effect of independent variables for prediction of RP-KAP was explored using linear regression analyses. RESULTS: A significant number of participants had poor RP-knowledge (78.9%), RP-attitude (70.7%), and RP-practice (32.4%). Based on linear regression analyses, it was found that field of study (ß = 0.1, P = 0.001), marital status (ß = -0.14, P = 0.01), and level of education (ß = 0.2, P < 0.001) were the predictors of higher RP-knowledge. In-service RP-training (ß = 0.1, P = 0.04) was associated with an increased RP-attitude. Being a woman (ß = 0.2, P < 0.001) and longer years of experience with radiation (ß = 0.2, P < 0.001) were significantly related to better practice. CONCLUSION: In-service training with appropriate qualified and up-to-date materials based on radiation workers' educational needs and approved protocols and guidelines is recommended.

Noise-Induced hearing loss among professional musicians.

OBJECTIVES: After presbycusis, noise exposure is considered the second cause of sensorineural hearing loss. Due to exposure to high-intensity sounds, musicians may be at risk of noise-induced hearing loss (NIHL). Given the importance of good hearing in music career, this study aimed to investigate the frequency of hearing loss and use of protective measures among Iranian musicians. METHODS: In this cross-sectional study, 125 musicians, including 21 women (16.8%) and 104 men (83.2%), with at least five years of work experience were recruited. All participants underwent clinical and audiometric examinations. Demographic data, complaints about hearing loss, and information about the use of protective devices were collected through interviews. RESULTS: Audiometric notch in either one or both ears and bilateral hearing loss were present in respectively 42.4% and 19.2% of the participants. The history of tinnitus after performance and ear pain during performance was reported by 64 (51%) and 35 (28%) individuals, respectively. Less than 2% of the participants used hearing protection devices. CONCLUSIONS: Long-term exposure to loud sounds puts musicians at risk of hearing loss. However, due to their inadequate knowledge, most musicians never use protective devices to prevent damage to their auditory system.

Prevalence of Low Back Pain in Health Care Workers and Comparison with Other Occupational Categories in Iran: A Systematic Review.

BACKGROUND: There are few research studies evaluating the significance of low back pain (LBP) in Iran, even though the majority of locally published surveys are written in the Persian language. In the present review study, we aimed at appraising published articles related to the burden of LBP and its divergence among different jobs. METHODS: A comprehensive search was conducted in all accessible national and international electronic databases from 1948 to mid-2012. The international electronic databases were MEDLINE (PubMed), Web of Sciences, Google Scholar, Scopus, CINAHL, and the Iranian equivalents were SID, IRANDOC, IranMedex, and Magiran. The main search terms were musculoskeletal disorders, musculoskeletal symptoms, low back pain, back pain, and Iran. All keywords were searched electronically by three Boolean operators. The inclusion criteria were age ≥10 years, study focus on LBP prevalence, inclusion of both genders, and no limitation to the study design. A dedicated STROBE questionnaire was developed as a critical appraisal tool and the quality of the identified literature was examined according to the 5-point Linker scale. Articles scoring ≥3 on the Linker scale were appraised. Each literature was screened by four reviewers independently and possible disagreements were streamlined in a joint review meeting. The extracted data were entered into a dedicated table using Microsoft Office Excel program. Data were analyzed for homogeneity using the STATA software (version 11). RESULTS: Of the 51 articles that were included in the present review study, 35 articles reported 1-year LBP with Nordic questionnaire and 3 articles reported point prevalence of LBP. The calculated global prevalence of 1-year LBP in workers was 25% and LBP was the most prevalent issue among health care workers. There was no association between the prevalence of LBP and job classification among workers. CONCLUSION: LBP is the most common issue among health care workers. It is recommended that future research should focus on this job category for investigating LBP prevalence. This allows parameters that increase the frequency of LBP to be assessed and subsequently permits the reduction or elimination of such factors.

Predictors of early return to work after a coronary artery bypass graft surgery (CABG).

OBJECTIVES: Identifying factors predictive of early return to work in patients who underwent a coronary artery bypass graft surgery (CABG). MATERIAL AND METHODS: Two hundred twenty-six working patients who volunteered and underwent a primary coronary artery bypass surgery between September 2013 and May 2014 were selected for the study and followed up for 6 months. Predictors of early return to work (RTW) (within 2 months) were analyzed from variables in a prospectively collected database and the 36-Item Short Form Health Survey (SF-36) questionnaire carried out in the hospital and rehabilitation center as well as from the follow-up performed via the phone. RESULTS: One hundred and two (45.1%) and 155 (68.9%) patients returned to work within 2 and 3 months after the surgery, respectively. Furthermore, 196 patients (87.1%) returned to work within 6 months after the surgery. In the univariate analysis, demographic or socioeconomic factors (such as age, level of education, income), occupational factors (such as occupation type, working hours per week, duration of the preoperative absence from work), psychological factors (such as a patient's concern about adverse health effects of RTW, feeling depressed, a patient's attitude towards his/her ability to RTW and a patient's perception of his/her job stress level) and medical factors (such as serum troponin T and creatine kinase MB (CKMB) level, pump time in surgery, co-surgery and dyslipidemia history) had a statistically significant correlation with early return to work. The patients who early returned to work had significantly higher scores in 3 domains on the SF-36 questionnaire (used for assessing the patients' quality of life), compared to those who did not return to work early (including physical functioning, role limitations due to physical health and pain). CONCLUSIONS: In the present study we identified 4 new medical factors that could be used as predictors of early return to work after CABG. These factors are: normal serum troponin T level, shorter pump time in surgery, normal mean arterial pressure (MAP) before the surgery and higher serum magnesium (Mg) levels. Int J Occup Med Environ Health 2016;29(6):947-957.

Effect of Acute Noise Exposure on Salivary Cortisol: A Randomized Controlled Trial.

Cardiovascular adverse effects are interesting aspects of occupational noise exposure. One possible mechanism of these effects is an alternation in hypothalamic-pituitary-adrenal axis. Our aim was to measure salivary cortisol response to relatively high-intensity noise exposure in a controlled randomized trial study. We exposed 50 male volunteers to 90 dBA noise for 20 minutes and compared their level of salivary cortisol with 50 non-exposed controls. Salivary samples obtained before and after exposure. Before intervention means (SD) salivary cortisol level were 3.24 (0.47)ng/ml and 3.25 (0.41)ng/ml for exposed and non-exposed groups respectively. Mean salivary cortisol level increased to 4.17 ng/mlafter intervention in exposure group. This increment was statistically significant (P=0.00). Mean salivary cortisol level of the non-exposed group had statistically non-significant decrement after this period (0.2 ng/ml). The difference between salivary cortisol level of non-exposed and exposed groups after the intervention was statistically significant. Noise exposure may affect the hypothalamic-pituitary-adrenal axis activity, and this may be one of the mechanisms of noise exposure cardiovascular effects.

Association between upper extremity musculoskeletal disorders and mental health status in office workers.

BACKGROUND: Musculoskeletal Disorders (MSDs) can lead to potential adverse consequences for individuals and their organizations, and in various research, its relationship to physical and mental health of workforce has been studied. OBJECTIVE: The purpose of this study was to determine the prevalence of MSDs of upper extremities among office workers and its association with mental health status. METHODS: In this cross sectional study, 1488 out of 1630 office workers completed the Standardized Nordic Musculoskeletal Disorders Ques-tionnaire and General Health Questionnaire (GHQ-28) (response rate = 91.3%). RESULTS: Upper extremity MSDs were reported in 410 (27.5%) office workers, including 269 (18.1%) shoulder, 79 (5.3%) elbow and 207 (13.9%) hand/wrist symptoms. Based on GHQ-28, 254 (17.1%) participants were found to be at risk of developing a psychiatric disorder that were observed in 26.7% of workers with MSDs symptoms. Shoulder (p < 0.001), elbow (p < 0.001) and hand/wrist (p < 0.001) MSDs were associated with poor mental health. Among the four GHQ-28 subscales (somatic symptoms, anxiety/insomnia, social dysfunction, and depression), anxiety/insomnia was strongly correlated with shoulders (P < 0.001), elbows (P = 0.002), and hands/wrists (P < 0.001) symptoms. CONCLUSION: Office workers with upper extremity MSDs were more likely to be experiencing mental distress. This indicates a need for greater emphasis on preventive programs at workplace to support their psychological well-being.