Work related stress and blood glucose levels.

AIM: The aim of the study is to evaluate work-related subjective stress in a group of workers on a major Italian company in the field of healthcare through the administration of a valid "questionnaire-tool indicator" (HSE Indicator Tool), and to analyze any correlation between stress levels taken from questionnaire scores and blood glucose values. MATERIAL AND METHODS: We studied a final sample consisting of 241 subjects with different tasks. The HSE questionnaire - made up of 35 items (divided into 7 organizational dimensions) with 5 possible answers - has been distributed to all the subjects in occasion of the health surveillance examinations provided by law. The questionnaire was then analyzed using its specific software to process the results related to the 7 dimensions. These results were compared using the Pearson correlation and multiple linear regression with the blood glucose values obtained from each subject. RESULTS: From the analysis of the data the following areas resulted critical, in other words linked to an intermediate (yellow area) or high (red area) condition of stress: sustain from managers, sustain from colleagues, quality of relationships and professional changes. A significant positive correlation (p <0.05) between the mean values of all critical areas and the concentrations of glucose values have been highlighted with the correlation index of Pearson. Multiple linear regression confirmed these findings, showing that the critical dimensions resulting from the questionnaire were the significant variables that can increase the levels of blood glucose. CONCLUSION: The preliminary results indicate that perceived work stress can be statistically associated with increased levels of blood glucose.

Work-related stress in healthcare workers.

BACKGROUND: In the assessment of work-related stress it is crucial to find the factors that generate and increase it in order to identify categories of individuals at risk, to plan interventions for prevention, elimination or reduction of risk. The aim of the study is to assess the subjective stress in 68 workers of a large Italian company dealing with human health, through the use of a questionnaire-indicating tool, elaborated by the Italian National Institute for insurance against accidents at work (INAIL) and developed by the Health and Safety Executive (HSE). METHODS: We studied a final sample of 68 individuals (34 drivers/rescuers and 34 video display unit (VDU) operators). The questionnaire consists of 35 items (divided into six areas) with five possible answers each, that cover working conditions considered potential causes of stress. RESULTS: The drivers/rescuers had a better performance than the VDU operators, especially in the areas "demand", "relationships" and "role". We compared men and women in the two groups, finding that, in VDU operators, women had a better performance than men in all areas, except "role" and "changes", in which the overall scores were the same in men and women. In the drivers/rescuers women showed more critical scores in the items "relationships" and "change". CONCLUSION: The results show that: the questionnaire-indicating tool is useful, with a demonstrated effectiveness for the occupational physician during the visits and proven validity; additional future efforts should focus on understanding the psycho-social, organizational and individual problems related to stress and the consequent implementation of preventive measures.

Ballet and stress. A pilot study.

BACKGROUND: Work-related stress is a complex problem requiring a work environment-based assessment. Artists like dancers represent a category of atypical workers potentially at high risk for work-related stress. Aim of our pilot study is to evaluate organizational stress in a population of professional dancers, using the HSE Indicator Tool for Work Related Stress. METHODS: We administered the Italian version of the HSE Indicator Tool to 38 ballet dancers, males and females. The questionnaire evaluates 7 key organizational dimensions: demand, control, managers' support, peer support, relationships, role and change. RESULTS: The standards required-ideal conditions are achieved in none of the above-mentioned dimensions. Change is the only dimension for which results fall between the 20th and the 50th percentile, while for other dimensions results fall below the 20th percentile suggesting the need for immediate corrective action. In male dancers an acceptable situation is highlighted for the dimension "change" compared to female dancers. In both sexes there is a high frequency of subjects complaining of verbal abuse, bullying and harassment. CONCLUSIONS: Despite the small sample size, our pilot study highlights the presence of heightened levels of organizational stress. Preventive measures targeted towards improving communication between managers and dancers and aimed at team building should be implemented.

Work related etiology of amyotrophic lateral sclerosis (ALS): a meta-analysis.

BACKGROUND: The aim of this meta-analysis was to evaluate the association between ALS and occupational exposure to physical (ELF-EMF) and chemicals (solvents, heavy metals and pesticides) agents. METHODS: We considered articles published from 1980 up to April 2013; in total, 750 publications were evaluated. The studies had to satisfy the following criteria: 1) cohort or case-control studies; 2) the presence of individual exposures; 3) clinical diagnosis of sporadic ALS or sporadic ALS on the death certificate. We followed the evaluation of quality in two steps. The first step classified studies according to a rating system based on a mix of criteria developed by scientific organizations, especially developed for studies of risk factors for ALS. The ratings obtained range from I (highest) to V (lowest). The data on risk factors derived from studies with Armon ratings of I, II, and III can reach levels of evidence A (established risk factor), B (likely risk factor), or C (possible risk factor). The second step evaluated the exposure and a score from 1 to 4 was assigned to each item; an exposure with a score of 3 or 4 was considered sufficient. Different analyses were performed on ALS and exposure to metals, solvents, pesticides and electromagnetic fields. In our study the heterogeneity was assessed both by χ2-based Q-tests and through the index of inconsistency I² while the measure RR/OR and CI of 95% to estimate the relationship between ALS and the various considered risk factors was employed. RESULTS: The association between exposure to pesticides and ALS as a whole is weak and not significant. With regard to the results of individual studies the following critical synthesis can be reported: 1) the selected studies showed a low level of association between ALS and electromagnetic fields; 2) as regards the solvents, the association with ALS in some studies is combined with a slightly increased risk, particularly in women, and in others a slight but significant linear association is observed; 3) for the metals, in some cases there was a stronger association in women than in men; for individual metals, there was an association especially with chromium and lead; 4) lastly, with regard to the products of agricultural pesticides in general, there was an association with ALS in men but not in women, with a dose-response relationship. CONCLUSIONS: The lack of statistically significant association between occupational exposure and ALS is mainly due to the methodological diversity of the studies and the lack of prospective studies at the workplace.

Occupational exposure to urban stressors and effects on atrial natriuretic peptide: preliminary results.

PURPOSE: The aim of this pilot study is to evaluate whether occupational exposure to low doses of pollutants present in the air of the city selected for the study could cause alterations in the concentration of atrial natriuretic peptide (ANP) in workers from the Municipal Police with outdoor tasks, compared to those with indoor tasks. METHODS: A total of 208 non-smoking male and female subjects were enrolled and divided on the basis of whether their tasks were mainly outdoors or indoors. The dosage of plasma ANP was carried out on all workers included in the study. Differences between means and frequencies were compared using student's t-test for unpaired data and chi-square test with Yates' correction, and they were considered significant when the p value was <0.05. RESULTS: Even after the subdivision of the total sample on the basis of sex, mean plasma levels of ANP were higher but not statistically significant in traffic police compared with controls. CONCLUSIONS: The preliminary results suggest that further studies should be conducted before the influence of urban pollution on ANP could be confirmed or rejected.

Urinary hydroxypyrene and estradiol in an occupationally exposed "outdoor" population.

BACKGROUND: Polycyclic aromatic hydrocarbons (PAHs) are widely present in the air pollution. The urinary hydroxypyrene (1-HOPu) is considered the main biological biomarker currently available to measure the exposure to PAH. It is supposed responsible of an increase of estradiol levels in males. Aim of this study is to verify whether there is a relation between 1-HOPu and plasmatic estradiol in non-smoker male workers. METHODS: The study was conducted on a sample of 122 non-smoker policemen in a large Italian city; we monitored their levels of 1-HOPu and the values of estradiol. The sample was divided into three groups according to the levels of urinary hydroxypyrene. The indices of correlation (r) and multiple linear regression (ß), between levels of 1-HOPu and estradiol were calculated. It was also calculated the student's t-test among the groups to check the differences. RESULTS: We found statistically significant correlations and multivariate linear regressions between 1-HOPu and estradiol in the total sample and in group III (levels of 1-HOPu above the 75th percentile). The average levels of estradiol in group III was statistically and significantly higher than in the group I (levels of 1-HOPu below the 25th percentile) and group II (levels 1-HOPu between 25th and the 75th percentile). CONCLUSIONS: 1-HOPu in non-smoker male workers is related with an increase of plasmatic estradiol. We believe that PAHs, of which 1-HOPu is the main biomarker, can interact with the hypothalamic-pituitary axis. The preliminary results suggest that the topic needs further research on male and female as well.

Liver damage in automotive and industrial workers of the glass.

OBJECTIVE: High doses of organic solvents can cause hepatic disease. We investigated whether exposure to low doses of solvents in automotive and industrial workers may lead to changes in liver tests. METHODS: We studied the liver parameters (glutamic oxaloacetic transaminase (GOT), glutamic-pyruvic transaminase (GPT), gamma-glutamyl-traspeptidasi (γ-GT), alkaline phosphatase (PHA), total (TB) and direct bilirubin (DB) of 24 workers exposed to organic solvents and of 30 unexposed controls. RESULTS: A significant increase of GOT, GPT and γ-GT was found in exposed workers compared to unexposed controls workers. The ratio GPT/GOT was significantly higher among the exposed compared to controls. CONCLUSIONS: The results confirmed the hypothesis that exposure to low doses of solvents may determine a liver damage.

Thyroid hormones in male workers exposed to urban stressors.

BACKGROUND: The occupational exposure to urban pollution may induce adverse effects on the human health. METHODS: Plasma levels of thyrotropin stimulating hormone (TSH), free thyroxine (FT4) and free triiodothyronine (FT3) of 50 outdoor workers and 50 indoor workers were compared. RESULTS: In the outdoor workers the TSH levels were significantly higher than in the control subjects (p =0.02) while the average of FT3 and FT4 values, was not significantly different compared to the controls (p > 0.05). CONCLUSIONS: The differences found for TSH levels between outdoor and indoor workers, though not high, suggest that, due to greater exposure to environmental pollutants, the outdoor workers are more susceptible to the development of function abnormalities of the thyroid gland compared to indoor workers.

Correlation between urinary nickel and testosterone plasma values in workers occupationally exposed to urban stressors.

BACKGROUND: The purpose of this study is to assess whether occupational exposure to low doses of nickel (Ni) present in urban air can cause alterations in the concentration of plasma testosterone in workers of the Municipal Police of a large Italian city assigned to different types of outdoor tasks. METHODS: 359 male subjects were included in the study and divided on the basis of job, age, length of service and smoking habits. The dosage of the atmospheric Ni was performed by personal dosimetries on a sample of the workers included in the study. For each worker included in the study the dosage of whole blood Ni and of the plasma testosterone was carried out. The total sample was subjected to the independent-samples T-test and the Mann-Whitney U test for variables with 2 modes (smoking cigarette) and the ANOVA test and the Kruskal Wallis test for variables with more than 2 modes (age, length of service and job function). The correlation of Pearson with p at 2 wings between the variables was evaluated in the total sample and after subdivision on the basis of smoking and on the basis of the job. After taking into account the major confounding factors the multiple linear regression was performed on the total sample and after breakdown by tasks. RESULTS: The correlation between the values of urinary Ni and the values of plasma testosterone on the total sample and for all classes of subdivision was found constantly negative. These results were confirmed by multiple linear regression, which indicated the Ni as the only significant variable that can contribute to the alterations of the testosterone. CONCLUSIONS: Based on the results, the Authors suggest that occupational exposure to low doses of Ni present in the urban environment is able to influence some lines of the hypothalamic-pituitary-gonadal axis in exposed workers.

Workers of the printing industry and hepatic damage.

BACKGROUND: Typesetting industry is still the primary instrument of communication, despite the development of new technological systems. This study focuses on the analysis of the hepatic effects induced by the use of some organic solvents employed in the printing industry. METHODS: We studied a group of 194 workers: 93 exposed and 101 not exposed. The level of the exposure to chemical pollutants were assessed through the environmental monitoring of blood concentrations and the analysis of airborne substances. The health survey was performed through the collection of the medical history and the use of hepatic tests, which were evaluated by calculating Mean, Standard Deviation, Student's t-test and X² test with Yates Correction, to investigate statistically significant differences in some hepatic parameters: AST, ALT, ALP, GGT, fractional and total bilirubin. The environmental data sometimes exceeded the TLV-TWA. RESULTS: The clinical evaluation of the hepatic parameters showed statistically significant differences as to the hematic concentrations of AST, ALT, GGT. CONCLUSIONS: The results we obtained support the hypothesis of a risk among the printing industrial workers attributable to the hepatotoxic solvents. This risk seems to be related to the use of a mixture of solvents, although at low doses, and the analysis of the results obtained confirms the validity of the investigation for the health screening protocol adopted in order to identify subjects and/or population at risk of hepatotoxicity.

Evaluation of some cardiovascular risk parameters in health professionals exposed to night work.

BACKGROUND: Shift work and night work in particular represent a risk factor for the health of exposed workers; aim of our study is to evaluate whether night work may cause alteration of some cardiovascular risk parameters in health workers. MATERIALS AND METHODS: The research was carried out on 415 health workers, 163 exposed to night work and 252 not exposed. A blood sample was taken from each worker, between 8.00 a.m. and 10.00 a.m. before lunch time, to test total cholesterol, HDL cholesterol, and triglycerides. Blood pressure and heart rate were also measured. Workers with cardiovascular diseases, thyroid diseases, diabetes mellitus, dyslipidemia, those who made use of antihypertensive drugs, hypoglycemic and/or lipid-lowering drugs, subjects with body mass index (BMI) (kg/m2) higher than 30 were excluded. RESULTS: In the group of exposed compared to controls, increasing values of arterial pressure and heart rate, were not significant. The mean values of total cholesterol and triglycerides were significantly higher in exposed compared to controls while values of HDL cholesterol were significantly lower. CONCLUSIONS: Night workers have clinically significant changes in blood levels of total cholesterol, HDL cholesterol and triglycerides, such alterations are presumably related to poor food hygiene and to psychosocial stressors.

Relationship between occupational exposure to cadmium, transaminases and γ-GT in workers exposed to urban stressors.

BACKGROUND: The exposure to Cd has been linked to many disease and liver is the major target organ of Cd toxicity following acute or chronic exposure.No study has ever evaluated the association between liver function tests and exposure to Cd present in urban air in outdoor workers. MATERIALS AND METHODS: In order to assess the relationship between the exposure to urban Cd and the associated changes in liver functionality markers, we conducted a study on 110 municipal policemen divided into 2 groups according to their tasks: 60 traffic policemen and 50 drivers, underwent tests for the determination of the urinary values of Cd correlated with the blood levels of transaminases and ?-GT. Moreover we investigated the exposure to Cd in the air through a personal dosimetry on a subgroup of 40 subjects (20 traffic policemen 20 police drivers). RESULTS: The results showed that the average personal exposure to air Cd was significantly higher in traffic policemen than drivers. Furthermore, in the subset of 40 subjects and in the total sample of 110 subjects, the mean values of urinary Cd were significantly higher in traffic policemen rather than in the police drivers. No significant difference was observed in the mean values of liver functionality in both groups. CONCLUSIONS: Due to the few studies on the effects of the exposure to Cd in big cities, the results of the present study offers useful information about occupational exposure to Cd on the road and in the car and the lack of effects on liver function.

Exposure to solvents in health care workers: assessment of the hepatic effects.

OBJECTIVES: The use of organic solvents has been linked to pathologies of different apparatuses. The purpose of this study is to analyze the liver damage induced by organic solvents. MATERIALS AND METHODS: We analyzed 556 workers, 278 exposed to organic solvents (group 1) and 278 not exposed to organic solvents (group 2). The exposed group was further divided into 2 subgroups: group 1A (139 workers exposed to considerable doses) and group 1B (139 workers exposed to negligible doses). Mean and standard deviation of some liver parameters was calculated. Statistically significant differences between the liver parameters in the different groups and subgroups were detected using the t-test. Multiple linear regression models were used to examine the associations between laboratory parameters and the independent variable. RESULTS: The data so far obtained showed the existence of statistically significant differences with regard to the total protein, total bilirubin, transaminase GOT and GPT, Gamma Glutamyl Transferase (gamma-GT). CONCLUSIONS: Our results confirm that exposure to solvents can alter some liver parameters. The blood tests we used can be useful tool for the assessment of the actual occupational hazards and to verify the effectiveness of the measures taken for the prevention and protection.

Dynamic blood pressure in workers exposed to urban stressors.

BACKGROUND: The occupational exposure to urban pollution may induce adverse effects on the cardiovascular system. METHODS: Basal blood pressure, electrocardiogram (ECG) and the dynamic blood pressure monitoring during the work shift of 16 policemen (outdoors workers) and 16 administrative employees (indoor workers) were compared. RESULTS: The mean value of all the diastolic blood pressure surveys in policemen (84,53 ± 10,78) is significantly higher (p = 0,014) than the mean value of all the diastolic blood pressure surveys in indoor workers (82,74 ± 11.52). CONCLUSIONS: The results of our study suggest that the occupational exposure to urban stressors may induce an increase of the diastolic blood pressure in workers during the working hours.

Liver function in workers exposed of the cosmetics industry.

BACKGROUND: The purpose of this study is to assess whether occupational exposure to substances used in the cosmetic factories may cause effects on the liver and blood counts in exposed workers. METHODS: The study included 48 exposed workers and 86 unexposed controls. All workers included in the study underwent blood count, white blood count, total, direct and indirect bilirubin, transaminases, alkaline phosphatase and cholinesterase. The differences between the means and frequencies were compared using the Student's t-test and chi-square test with Yates correction and were considered significant when the p value was <0.05. RESULTS: The analysis of the results shows that 35.4% of workers in the cosmetics industry had liver test values above the range. We noted a statistically significant higher prevalence of GPT (p <0.05) and total bilirubin (p <0.05) in the workers of the cosmetics industry compared with the control group. CONCLUSIONS: The results obtained suggest that occupational exposure to low doses of substances used in the cosmetic industry is able to influence some liver parameters in occupationally exposed workers.

[Meta analysis blood and urinary values in urban pollution exposed workers]. / Meta-analisi di indicatori di effetto in lavoratori esposti ad inquinamento urbano.

INTRODUCTION: Aim of this study is evaluating alteration of neuro-immune-endocrine parameters in exposed workers and estimating whether urban pollution can modify them. METHODS: Literature research. Different categories of exposed workers were included in the study (7287) and compared with controls (8054). To calculate results Effect Size (ES) and confidence interval were used. RESULTS: A correlation between urban pollution exposition and some neurogenic mediators and metabolites alterations was demonstrated; blood values can be alterated by toxicity of benzene and by xenobiotic metabolites' mechanism; follicle stimulating hormone is significantly increased in exposed versus controls. CONCLUSIONS: High heterogeneity and literature limitations, together with results of this meta analysis, induce to believe that is necessary to deepen the research about urban pollution effects on these parameters.

[Meta analysis indices of genotoxic damage in urban pollution exposed workers]. / Meta analisi degli indici di danno genotossico in lavoratori esposti a inquinamento urbano.

OBJECTIVES: The aim of this study is to examine if urban pollution can modify indices of genotoxic damage. METHODS: Research of articles inherent in the evaluation of these alterations. Differents categories of exposed workers are included in the study (cases, in number of 7287) and compaired with no exposed workers (controls, in number of 8054). To calculate the result of meta-analysis the Effect Size (ES) was used and the confidence interval was calculated. RESULTS: In this category we evaluated 54 studies and we observed significantly differences in the complex. CONCLUSIONS: Starting from the individual variables analysis investigated, between exposed and not exposed group, we underline the utility to deepen the studies concerning of these parameters, to appreciate their benefits and to safeguard health of exposed workers.

Perceived stress and stress-related parameters.

BACKGROUND: The purpose of this study is to evaluate, using a questionnaire developed by our research group, whether occupational exposure to physical, chemical and psychosocial urban stressors can lead to alterations in perceived stress in a group of both male and female outdoor workers. The study also examines possible correlations between the levels of stress as inferred from the scores of the questionnaire and the levels of certain stress-related parameters (prolactin levels, consumption of coffee, chocolate, alcohol and cigarette smoking). METHODS: We evaluated a final sample of 480 subjects (342 male and 138 female). All workers included in the study were divided into three groups on the basis of scores of the questionnaire. RESULTS: About 60% of workers showed a moderate or severe stress condition, with a statistically significant prevalence of female workers and younger subjects. There was a statistically significant correlation between the questionnaire score and the mean levels of stress-related parameters. The increase of perceived stress increases significantly the mean levels of prolactin and the consumption of coffee, chocolate and cigarettes. There was no statistically significant differences for alcohol consumption. CONCLUSIONS: The results show that exposure to chemical physical and psycho-social urban stressors can influence perceived stress in outdoor workers. The questionnaire used in our research could be an useful instruments for physicians during the health surveillance visits

[Dietary intervention programs in the workplace: an effective prevention strategy]. / I programmi di intervento nutrizionale nei luoghi di lavoro: una interessante strategia preventiva.

The main purpose of our meta-analysis was to investigate the effect of workplace dietary intervention on several variables. We made a systematic literature search by selecting articles published up to September 2009. Only 18 studies were deemed suitable for inclusion criteria considered in our meta-analysis. Among the dietary variables there was significant difference between the two groups after the administration of nutritional intervention programs. A significant improvement was also observed between the anthropometric and metabolic variables. No significant change was instead documented in relation to functional variables (systolic and diastolic pressure). Workplace dietary intervention, improving nutritional, anthropometrical and metabolic variables, can be identified as effective prevention strategy toward chronic diseases.

[Phlebopathies and workers]. / Flebopatie e lavoratori.

The few studies in literature about the relationship between venous diseases and work show that the posture assumed while working could promote the occurrence of venous disease in lower limbs. We compared male workers belonging to different occupational categories, matched for age, BMI and traditional risk factors for venous diseases, in order to assess the prevalence of venous disease and occupational and not-occupational postural risk factors. We found that maintaining a standing position for more than 50% of the shift appears the most important occupational risk factor in provoking the observed higher prevalence of venous disease in the workers studied. It can be assumed the venous diseases are often determined by occupational factors which could be main or concomitant causes. The identification of preventive measures to apply in workplaces, such as better organization of work, targeted examinations and therapeutic indications as the prescription of elastic stockings, is very important.