The impact of bystanding to workplace bullying on symptoms of depression among women and men in industry in Sweden: an empirical and theoretical longitudinal study.

BACKGROUND: Prospective studies on bystanding to workplace bullying and the health outcomes are scarce. AIM: To investigate the work environmental risk factors of depressive symptoms among bystanders to bullying in both women and men in four large industrial organizations in Sweden. METHOD: The number of respondents at four large industrial enterprises with more than one year at the workplace at T1: n = 2,563 (Women: n = 342; Men: n = 2,227). Bystanders to bullying at T1: n = 305 (Women: n = 30; Men: n = 275). The total number of those with symptoms of depression at T2: Women: n = 30; Men: n = 161. Two thousand one hundred and seventy-seven employees answered the questionnaire on T1 and T2 with an 18-month interval. "To have depressive symptoms" was defined as not having depressive symptoms at T1 but having depressive symptoms at T2. RESULTS: The number of men who were bystanders to bullying was larger compared to women. However, the proportion of women who were bystanders to bullying and developed depressive symptoms 18 months later was higher in comparison with men (33.3 and 16.4 %, respectively). Further, "Being a bystander to bullying" 1.69 (1.13-2.53), "Rumors of changes in the workplace" 1.53 (1.10-2.14), "Reduced role clarity" 2.30 (1.21-4.32), "Lack of appreciation of being in the group" 1.76 (1.22-2.53) increased the risk of future symptoms of depression. "Job Strain" was not an adjusted risk factor for depression. CONCLUSION: Our results support previous findings that bystanding to workplace bullying is related to future depressive symptoms.

Employee effects of an educational program for managers at an insurance company.

BACKGROUND: Possible health effects for employees of efforts to improve the psychosocial competence of managers have not been studied scientifically in the past. OBJECTIVE: To explore how efforts to improve management will change the work environment and health of the employees. METHODS: Managers of the experimental department in a large insurance corporation underwent 2-hour biweekly training sessions for 1 year-altogether, 60 hours. A control group of employees in other departments in the corporation not affected by the modification was followed with the same assessments. Morning blood samples for the assessment of serum cortisol were collected both at baseline and after 1 year in 155 participants in the experimental group and in 147 subjects in the control group. Liver enzymes and lipids were also assessed. In the questionnaire part of the 1-year follow-up study, there were 119 participants in the experimental group and 132 in the control group. RESULTS: When repeated-measures ANOVA was used, a significant interaction effect was found for the level of serum cortisol; serum cortisol levels were decreased in the intervention group and were unchanged in the control group (ANOVA two-way interaction, p =.02; after exclusion of the managers, p =.005). A significant interaction effect was also observed for decision authority, with increased decision authority in the intervention group and, conversely, a decreased level in the control group (p =.001; after exclusion of managers, p =.02). CONCLUSIONS: The study indicates that a moderately intensive psychosocial manager program lasting for 1 year can be beneficial for the employees with regard to both lowered serum cortisol and improved authority over decisions.

Electrocortical signs of arousal in response to darkness and the assessment of Type A behavior in professional drivers with and without cardiovascular disease.

BACKGROUND AND AIMS: In night driving, the fatal accident rate is about four times that in daytime. There is a lack of published studies of the effect of darkness on electrocortical responses in professional drivers (PD). AIM: Assessing relations between electroencephalographic (EEG) reactions to enforced darkness reminiscent of night driving, and untoward behavioral response patterns, notably Type A behavior. METHODS: PD: 13 with ischemic heart disease, 12 hypertensives (HTN), 10 borderline hypertensives and 34 normotensives, and 23 non-PD controls. Five minutes of electroencephalographic recording with eyes closed, and subsequently 3 minutes exposure to darkness. EEG parameters were: alpha abundance, amplitude and frequent. Type A behavior (TAB) was assessed by observation and by questionnaire. RESULTS: Alpha abundance diminished significantly for darkness compared to spontaneous recording for all groups. No between-group differences were found for EEG. There were no significant differences in EEG between drivers with IHD or HTN taking versus not taking centrally active beta-blockers. Drivers with IHD were the only group to show significant increase in dominant alpha frequency at darkness. The IHD group also had the highest TAB questionnaire scores and the heaviest exposure to professional driving. Type A scores were significantly correlated with dominant alpha frequency during darkness. Low availability of attachment and special driving hazards best predicted TAB scores in driven. There was a significance between group difference with respect to Symbolic Aversiveness at the work place comparing each driver group with the non-PD control group. CONCLUSIONS: Exposure to darkness reminiscent of night driving can elicit central arousal, in conflict with circadian rhythm, and in combination with other driving hazards which contribute to symbolic aversiveness, the essence of driving. And low availability of social attachment could contribute to sustained arousal, and in turn to the development of Type A behavior in professional drivers.

What prevents professional drivers from following physicians' cardiologic advice?

BACKGROUND: There is a scarcity of published studies of the effects of cardiac counselling among professional drivers (PD). Aims of the study were: (1) to examine explanatory variables for two classical 'driver' risk factors - body mass index (BMI), and smoking - and to analyse the interrelations among smoking cessation, losing weight and work-related life changes; (2) to assess the effectiveness of risk factor counselling after 6 months, and (3) to gain insight into possible discrepancies between PD perception of needed changes and compliance with the physician's advice. METHODS: There were 4 groups of male PD: 13 with ischemic heart disease, 12 hypertensives, 10 borderline hypertensives and 34 normotensives. Baseline cardiovascular risk factors as well as occupational and behavioral data were assessed via questionnaire. The counselling was aimed at smoking cessation, weight loss and promoting leisure-time physical activity. Qualitative methods were used to assess PD perceptions about the work environment and health promotion. RESULTS: Baseline smoking intensity was best predicted by the total burden of occupational stress and number of smoking years. Baseline BMI was best predicted by long work hours behind the wheel, low availability of attachment outside work and low self-reported job strain. Self-initiated smoking cessation was best predicted by few smoking years, low coffee intake and admitting fear during driving. Physical activity was significantly increased after 6 months. Losing weight was associated with: quitting or diminishing smoking and making other, work-related, life changes. None of the heavy smokers decreased their daily number of cigarettes after 6 months, although expressing the need to do so in self-generated statements. CONCLUSIONS: Exposure to occupational stressors, mainly, long work hours and the concomitant denial of job strain, in combination with low availability of social attachment outside work, could contribute to maintenance of maladaptive behavior in PD. These findings could serve as a basis for designing standardized intervention trials and suggest that modification of the work environment, with participation of the drivers, is a needed component of such trials. Particular attention should be paid to the length and scheduling of work shifts.

Occupational profile and cardiac risk: possible mechanisms and implications for professional drivers.

There has been at least forty empirical investigations concerning cardiovascular disease (CVD) among professional drivers (PDs). Standard cardiac risk factor status does not consistently distinguish PDs from other lower risk groups. PDs showed more than twice the overall exposure to stressful work factors compared to referents. They also showed lower maximum bicycle exercise level with a higher double product and higher diastolic blood pressure at the end of exercise compared to controls. Catecholamine excretion has been reported to be elevated during driving. Ambulatory measurements showed higher systolic and diastolic blood pressure in drivers before, during and after driving shifts. Using spectral analysis, the low to high frequency ratio was more than doubled towards the end of a 4-hour drive compared to the early one and a linear increase in 0.1 heart rate variability as a function of distance driven. Reactivity to headlight glare has been shown to roughly parallel the degree of CVD severity in PDs with IHD, essential and borderline hypertension. It was postulated that PDs with IHD form a powerful association between the exposure to glare and the stressfulness of driving and this association was resistant to extinction. The occupational medicine specialist "should have the authority to check the patient regularly in the workplace itself (to ascertain whether or not) the decision to return to work is still valid". An integrated diagnostic approach for PDs might entail using exercise stress testing, with evaluation of silent myocardial ischaemia and heart rate variability during work as well as laboratory tests which simulate aspects of their work environment, with catecholamines measured in relation to these procedures. Assessment of left ventricular mass and further evaluation of atherogenic biochemical abnormalities would be of value for further untangling the mechanisms of cardiac risk among PDs.

Psychophysiologic sensitization to headlight glare among professional drivers with and without cardiovascular disease.

Previous studies have shown that young, healthy professional drivers show heightened central nervous system arousal and cardiovascular hyperreactivity to simulated headlight glare. Electroencephalographic and cardiovascular response and recovery to simulated headlight glare (the glare pressor test) were examined in 4 groups of male professional drivers (age 25-52 years)--12 with ischemic heart disease (IHD), 12 with hypertension (HTN), 10 with borderline hypertension (BHTN), and 34 who were healthy--and in 23 non-professional driver controls--with the aim of assessing sensitization to this night driving stressor in relation to degree of cardiovascular disease severity. After glare exposure the IHD drivers showed the most pronounced alpha blockade, a rise in diastolic blood pressure (DBP; p < .05), and, unlike the other groups, a persistent fall in finger pulse volume (p < .02). The BHTN group reacted initially with DBP rise and finger pulse drop (ps < .05 and .02, respectively), mainly without central nervous system arousal. The DBP remained constant in normotensive professional drivers older than 40. The drivers' cardiovascular responses to glare were inversely related to reported stressors and subjective experience. Anxiety trait and long work hours were associated with heightened central arousal to glare in professional drivers. The results suggest that there may be progressive degrees of sensitization to glare exposure in these samples, with the least among normotensive professional drivers older than 40, moderate levels in borderline hypertensives, and the most severe in drivers with IHD.

Cardiovascular dysfunction related to threat, avoidance, and vigilant work: application of event-related potential and critique.

An integrative approach is suggested to track symbolically simulated work environment stressors, as an act to burden higher cortical function in the exposed groups. ERP would be made together with measurement of end organ stress responses as well as measurements of perceived conditions. Field studies would be the necessary complement. The following conclusions are culled from the reviewed literature: among the pilots, cardiovascular problems are the most important cause of loss of licence in Europe and North America. Interactions with coworkers for air traffic controllers have been associated with cardiovascular disability. Comparing various degrees of heart disease severity among professional drivers, the IHD drivers showed the smallest N2 amplitudes and the greatest diastolic blood pressure reactivity. P300 target amplitude showed an inverse correlation with number of work hours behind the wheel. The IHD drivers were envisioned in a phase of disturbance of the selective attentional process. An interrelation has been found between Event-Related Slow Potential ERSP and midinterval heart rate acceleration associated with displeasure and arousal. A positive correlation has been found between the amplitude of the ERSP and ventricular arrhythmia rate in cardiac patients. Lowering of arrhythmia rate in response to antiarrhythmic agents was associated with a significant attenuation of the ERSP. Either acceleration or deceleration is associated with the appearance of the late CNV to the aversive noise burst. There might be a "common generator behind both anticipatory heart rate responses and cortical events." CNV might be related to frontally mediated stress mechanisms.

Electrocortical responses to ecologically relevant visual stimuli among professional drivers with and without cardiovascular disease.

Electrocortical responses were assessed using two simulated aspects of visual signals encountered in traffic: the Glare Pressor Test (GPT) and Event-Related Potential Avoidance Task (ERPAT) among four groups of male professional drivers: 12 with ischemic heart disease (IHD), 12 hypertensives, 10 borderline hypertensives, 34 who were apparently healthy and 23 nonprofessional driver healthy control subjects. The blood pressure (BP) responses immediately after the ERPAT were also measured. There was a significant between groups effect for the amplitude of the target N2 component in the ERPAT (p = 0.02), with the lowest means among the drivers with IHD and the highest among those with hypertension. Drivers with IHD also showed the highest diastolic BP reactivity to the ERPAT. Significantly more than the expected number of drivers with IHD failed to recover alpha activity after the first glare impulse of the GPT. Professional drivers who failed to recover baseline levels of alpha activity after the GPT showed a significantly smaller N2 amplitude compared to those who recovered (p = 0.01). There was a positive correlation between abundance of alpha activity at rest with P300 amplitude (p = 0.02). An inverse relation was found between number of work hours behind the wheel and the amplitude of the target P300 (p = 0.04). Results are interpreted in light of recent advances concerning integrative mechanisms of defence versus vigilance response patterns. The findings in this study justify further applications of these psychophysiologic methods to assess the relationship between simulated signals of the work environment and mechanisms of cardiac risk in this occupational group.