Personal resources for addressing the work demands of Ukrainian oncologists in stressful crisis situations.

BACKGROUND: Many work-related stresses are experienced by oncologists. Ukraine is currently undergoing numerous crises, including the SARS-CoV-2 pandemic and military conflicts, which represent stressful situations. The aim of this study was to explore the personal resources that Ukrainian oncologists use to cope with work demands in a situation featuring manifold crises. This study identified the ways in which people deal with stressful situations and the roles that they play in shaping the challenging situations that they encounter (work-related behavior) as well as how they cope with stress (stress management). METHODS: Forty oncologists (18 men and 22 women) working in a clinic in Kharkiv (Ukraine) with an average age of 46.3 ± 13.37 years (ranging from 26 to 74 years) participated in this study. The occupational psychological survey consisted of the Work-Related Behavior and Experience Patterns (German: Arbeitsbezogenes Verhaltens- und Erlebensmuster, AVEM) questionnaire, which was developed by Schaarschmidt and Fischer, and the Differential Stress Inventory (DSI), which was developed by Léfevre and Kubinger. RESULTS: 65% of oncologists exhibited AVEM risk pattern A or B. No gender differences were observed with regard to the distribution of AVEM patterns. Women obtained significantly higher scores than did men on only one dimension: experience of social support (4.86 vs. 3.44; p = 0.045). When the DSI categories were differentiated by gender, no significant differences were observed. Spearman's correlation analysis revealed a medium-sized correlation between perfection striving and palliative coping (ρ = 0.404). CONCLUSIONS: Few gender-based differences in work-related behaviors, experiences, and stress management strategies are evident among oncologists. AVEM risk patterns are more prevalent among Ukrainian oncologists than among comparable occupational groups, and interventions in the context of health management are recommended.

Workplace-related risk of tick bites in military personnel stationed in Northern Germany.

PURPOSE: There are more than 500,000 employees in Germany alone who are at risk of being bitten by a tick at their workplace and thus also at risk of being infected with Borrelia burgdorferi s.l. or the tick-borne meningoencephalitis virus. So far, there are only a small number of studies on the risk of tick bites in Central Europe, in particular, for military personnel during relevant training activities. METHODS: During a total of 36 months of training in 2008/2009 and from 2012 to 2014, the number of tick bites and any resulting diseases of 1156 recruits under comparable conditions of exposure and prevention were documented based on their medical records. The incidence of tick bites was calculated with each recruit's individual exposure time for field training. RESULTS: There were a total of 66 tick bites during an exposure time of 317,059 h of field training (0.21 tick bites per 1000 h of training). The risk of tick bites was found to have a seasonal dependency. In 6 out of the 66 cases in which someone was bitten, the patients consulted a physician for a follow-up examination, and in one of these cases the bite resulted in an infection requiring treatment. CONCLUSIONS: It turns out that there is a rather low but relevant risk of being exposed to tick bites for military personnel during their field training. Under the given study conditions, months with a high risk of tick bites can be distinguished from months with a low risk of tick bites, which is of vital importance, in particular, for guidance and prevention.

[Hazard assessment and occupational safety measures in surgery : Relevant knowledge on occupational medicine]. / Gefährdungsbeurteilung und Arbeitsschutzmaßnahmen in der Chirurgie : Relevantes Wissen über die Arbeitsmedizin.

Surgeons routinely work in an environment with occupational risks and hazards about which they are often uninformed. Based on the currently available scientific literature this review article describes the various hazards in the operating theater and their effects on personnel, particularly from the surgical perspective. A further aim of this article is to describe the occupational safety measures to reduce the burdens and to maintain the long-term health of personnel. Ultimately, surgeons should be equipped with the necessary knowledge for implementing hazard assessments according to the German Occupational Health and Safety Act. Surgeons are exposed to increased risks and hazards by working in awkward positions with a high risk for musculoskeletal pain and injuries. They are also commonly exposed to inhalational anesthetics, surgical smoke, radiation, noise and infectious agents. Furthermore, the mental and emotional stress associated with these activities is also high. Meaningful occupational safety measures for reduction of burdens are from a technical aspect the installation of effective air extraction systems, measures to reduce exposure to radiation and noise and the use of safer instruments to prevent needle stick injuries. Furthermore, individual occupational safety measures, such as the use of personal protective equipment (e.g. radiation protective clothing and double gloves) must be observed. The consistent implementation and also adherence to these described occupational safety measures and regulations can reduce the burden on operating theater personnel and contribute to maintaining health. Furthermore, periodic preventive healthcare controls and health checks by the company medical officer and individually initiated additional prevention measures can be a sensible augmentation to these safety measures.

[Measurement of contrast vision: mesopic or photopic vision? : Comparison of different methods for measuring contrast sensitivity within the framework of driving licence regulations]. / Kontrastsehen messen: mesopisch oder photopisch? : Ein Vergleich verschiedener Verfahren zur Messung der Kontrastempfindlichkeit im Rahmen der Fahrerlaubnisverordnung.

BACKGROUND: Since 2011 the regulations for occupational driving licences make the examination of contrast vision sensitivity obligatory; however, apart from mesopic procedures no uniform regulations are available for methods and minimum requirements. OBJECTIVE: By comparing different mesopic and photopic contrast sensitivity tests this study analyzed whether these could be equivalently used and lead to the same results. MATERIAL AND METHODS: Contrast vision sensitivity was determined in 150 subjects with emmetropia using five different methods, i.e. the mesopic test device Mesotest II as the reference method, Rodatest 302 and Optovist as photopic test devices and two photopic test charts (Vistech chart and Mars charts). The results of passing the tests were compared and Cohens κ was determined to quantify the conformity between the tests. RESULTS: Poor agreement was found between Mesotest II and Optovist as well as between Mesotest II and the Vistech chart. There was no agreement between Rodatest 302 or Mars charts and Mesotest II; nevertheless, the contrast vision sensitivity measured with Optovist, Rodatest 302 and the Vistech chart showed good correlation (0.46 ≤ r ≤ 0.69). CONCLUSION: Apart from a few limitations, the reference method Mesotest II as well as Optovist and the Vistech chart are suitable for testing contrast vision sensitivity, whereas Rodatest 302 and Mars charts cannot be recommended based on the current criteria for minimum requirements. The minimum requirements must be urgently adapted and strict regulations for measurement must be formulated. In addition, due to the poor agreement between the methods an amendment of the driving licence regulations should be considered, which requires examination of both mesopic and photopic contrast vision or alternatively mesopic contrast vision alone.

Injuries caused during military duty and leisure sport activity.

BACKGROUND: Physical demands on soldiers in mission have increased in the past decades. Physical fitness training is included into duty schedules in most armies in order to achieve and maintain a high physical fitness level, but at the same time involving the risk of sport injuries and subsequent sick days. OBJECTIVE: Due to missing data concerning soldiers' sport injuries during duty and leisure time, epidemiology data is required for adequate prevention and therapy. METHODS: A prospective and descriptive epidemiology study has been conducted. All soldiers with sport injuries caused by duty sport (DS) or by sport during leisure time (LTS) were recorded over three years in a German Army tank brigade. RESULTS: 673 injuries during DS and 600 injuries during LTS were analysed. While on duty, most of the injuries occurred during soccer (35.2%) and long distance running (30.2%). Ankle joint (27.3%) and knee (24.1%) were most affected. Soldiers with injuries to knee, ankle joint, shoulder or hand were absent from duty for a longer period of time. Similar results were found during LTS: Soccer (66.0%) was the most frequent cause for injuries and ankle joint (22.8%) and knee (20.3%) were the most affected body parts. CONCLUSIONS: Duty and leisure time sport mainly caused injuries to the lower limb. These injuries caused long absence from duty. Therefore, profound knowledge of physical examination, medical treatment and rehabilitation is necessary for the military physician in order to provide an adequate therapy.

[Influence of post-traumatic stress disorder on heart rate variability as marker of the autonomic nervous system - a systematic review]. / Einfluss einer posttraumatischen Belastungsstörung auf die Herzfrequenzvariabilität als Marker des autonomen Nervensystems - eine systematische Literaturübersicht.

INTRODUCTION: PTSD is associated with comprehensive disruption of several neurobiological regulation mechanisms and with a disruption in the parasympathetic-sympathetic balance. This can be measured with the heart rate variability (HRV). METHODS: A systematic review in PubMed using the keywords "hrv" or "heart rate variability" and "PTSD" or "posttraumatic stress disorder" was performed. RESULTS: Overall 15 original studies were identified. In most cases a significant relationship of PTSD for reduction of HRV was demonstrated (9 studies) or, respectively, a reduction by trends was shown in 3 studies. Limitations were discussed. DISCUSSION: In spite of the limitations, most of the studies have shown a relationship between PTSD and HRV. However, an assessment of this potential marker as a supplement for clinical diagnosis and therapy follow-up in patients with PTSD seems to be premature on the basis of the data obtained so far. Further research is required.

[Analysis of heart rate variability. Mathematical description and practical application]. / Analyse der Herzfrequenzvariabilität. Mathematische Basis und praktische Anwendung.

The analysis of heart rate variability (HRV) has recently become established as a non-invasive measurement for estimation of demands on the cardiovascular system. The HRV reflects the interaction of the sympathetic and parasympathetic nervous systems and allows the influence of the autonomic nervous system on the regulation of the cardiovascular system to be mathematically described. This review explicates the analysis method of HRV for time, frequency and non-linear methods as well as the range of parameters and the demand on acquisition time. The necessity and possibilities of artefact correction and advice for the selection of a reasonable acquisition period are discussed and standard values for selected HRV parameters are presented.

[Risk factors for accidents during sports while serving in German armed forces]. / Risikofaktoren für Sportverletzungen beim Dienstsport in der Bundeswehr.

In the German Armed Forces sports activities should bring the benefits of good health and trained fitness which are the hallmarks of sportsmen. In order to achieve this aim it is important to avoid accidents which negate the benefit of sports. Until today there appear to be no studies in existence which demonstrate the risk factors of sports activities undertaken while in military service. Equivalent studies on civilian sport activities are scarcely comparable. To find out risk factors for accidents with any period of recovery we followed sports accidents while on duty in a German barracks with 4,300 soldiers over a two-year period. Additionally we asked about the time needed for recovery from each accident, parameters of lifestyle, the body mass index and the possibility of a nightshift before each accident. We examined a minimum of 410 accidents. We found associations between the accidents studied and particular risk factors, including doing sports more than two times a week, being active in a fitness or sports club, having the accident together with another sportsman and doing a nightshift before the day of the accident. Bad ground conditions contributed to a large number of accidents. A body mass index of 25 and higher had a significantly prolonged time for recovery. To avoid accidents, sport and ground conditions should be adapted to each other. In addition, overweight people are not only compromised for cardiovascular and neurological diseases but also have a higher risk of needing a prolonged time for recovery, thus it is important that overweight should be avoided and not only just be treated.

[Dynamic vision of sportsmen with different requirement profiles for the visual apparatus]. / Dynamisches Sehen von Sportlern mit unterschiedlichem Anforderungsprofil an den visuellen Apparat.

AIM OF STUDY: In particular, in the quick ball and racket games a good dynamic seeing is required . The afferent dynamic seeing occurs via the retiina which mediates the stimuli for efferent dynamic seeing . The aim of this study was to examine the dynamic visual acuity of sportsmen from sports with different demands on their dynamic seeing (DS). METHODS: 19 sports students took part in the study. 10 subjects participated in coached team sports (group I) and 9 remaining performed individual sports (group II). The DS was assessed by means of the Düsseldorfer test for dynamic seeing of Wist which was performed twice on one day. RESULTS: The DS of the two groups in the first study did not differ (right eye 95.7 ± 10.6 % in group I vs. 94.3 ± 6.9 % in group II and left eye 97.6 ± 4.8 % vs. 95.3 ± 5.6 %; p ≥ 0.05). Also the second study there was no different in DS for the two groups (right eye 98.3 ± 2.6 % vs. 93.8 ± 8.0 % and left eye 99.3 ± 1.2 % vs. 95.6 ± 7.0 %; p ≥ 0.05). DISCUSSION: Our hypothesis about a different DS in players of ball games compared with non-ball sport players could not be proved. It is to be critically noted that a generalization is not possible due to the small sample numbers. Because DS is a necessary precondition in ball games further studies should be concentrated on its trainability.

[Color vision testing in patients with diabetes mellitus and arterial hypertension]. / Farbsehuntersuchung bei Patienten mit Diabetes mellitus und arterieller Hypertonie.

BACKGROUND: This study aimed to discover the influence of the chronic diseases diabetes mellitus and arterial hypertension on color vision. METHODS: The study included 96 voluntary participants age 19-65 years. They were divided into four groups. Group I consisted of patients with arterial hypertension; group II included those with both arterial hypertension and diabetes mellitus; those in group III had diabetes mellitus; and group IV consisted of healthy individuals. RESULTS: The duration of diabetes in group II correlated with the Rayleigh calculation. Those in group III showed significant differences when the maximum brightness setting (Moreland) and the minimum anomalous quotient (Raleigh) were used. The duration of diabetes had correlations at some parameters of the Rayleigh and Moreland calculation. CONCLUSION: In conclusion, we are able to say that the all-color anomaloscope is useful for determining alterations in color vision in patients with diabetes mellitus.

[Results of a cardiovascular disease prevention study among administrative employees of a large city]. / Ergebnisse einer Herz-Kreislauf-Präventionstudie bei Angestellten einer Grossstadtverwaltung.

In parallel with the demographic changes in an increasingly ageing German population, cardiovascular diseases (HKE) are becoming increasingly frequent and thus more and more important. The main aim of this work is to derive individual preventive measures on the basis of classic risk factors. This study was performed on 101 administrative employees of a large city (71 women and 30 men). The tests included a general investigation of medical status [current individual and family case history, body mass index (BMI)] as well as the determination of the following laboratory values: glucose, HDL and LDL cholesterol. In addition, the study was completed by a job analysis, including a survey of individual health behaviour. Referring to the PROCAM study, ten traditional risk factors for cardiovascular disease (arterial blood pressure >140/90 mmHg, BMI > or =25 kg/m (2), family disposition etc.) were probed. On the basis of these results individual risk profiles for each participant were rated. A vulnerable person received individually tailored prevention recommendations, which were adapted to the individual health behaviour of the subjects. Each of the 101 study participants received a personal results and prevention bulletin with individual test results and prevention suggestions. This high effort promises a better implementation as general advice for prevention in terms of classic risk factors.

Psychological effects of occupational exposure to organic solvent mixtures on printers.

PURPOSE: Neuropsychiatric symptoms associated with long-term exposure to organic solvents have been investigated for a long time in many occupational studies. The aim of our study was to identify preclinical effects of low-level chronic solvent exposure on the cognitive performance of silk-screen printers. METHODS: A cross-sectional study was conducted including 38 printers which were exposed to organic solvent mixtures and 45 controls without neurotoxic exposure. The psychometric test battery included nine tests and two questionnaires. RESULTS: The sum of scales or the total score of the PNF was also significantly (p <0.001) higher in the exposed group than in the non-exposed. The printers performed worse in some psychometric tests than did controls. Cross validation with the psychometric performances resulted in 69.6% of participants being correctly classified (55.9% printers and 80% controls). Highly significant differences (p<0.001) between both groups of exposed and non-exposed workers were found for the mean values of the multidimensional psychometric score. CONCLUSIONS: These results of our study proved not only that chronic exposure to organic solvent mixtures could induce a psychological effect but also that the psychological/psychometrical tests performed in this study were capable of predicting neurotoxicity.

[Influence of long term occupational exposure to solvents on colour vision]. / Einfluss langjähriger beruflicher Lösemittelexposition auf das Farbensehen.

BACKGROUND: The study was designed to determine the influence of chronic occupational exposition of organic solvent mixtures on colour vision of car painters. SUBJECTS AND METHODS: The 123 subjects (2 groups differing in organic solvents exposure and 1 control group) were examined using Ishihara-Panel, Lanthony Desaturated Panel D-15, Velhagen-Panel, and Tritan-Album. RESULTS: In the Velhagen-Panel 3% of the probands currently exposed to organic solvents, and 11% of formerly exposed probands developed a blue/yellow vision defect for the right eye. All control subjects perfectly finished this panel. In the Tritan-Album 3% of currently exposed subjects and 26% of formerly exposed painters expressed a blue/yellow vision defect for the right eye, but also 7% of controls showed anomalies. Similar results were found for both panels with the left eye. The CCI difference in the D-15 test was significant between all three groups. CONCLUSION: The impaired colour vision may also be an important indicator of neuro-ophthalmological effects after long-term occupational exposure to organic solvents.

The psychological effects of exposure to mixed organic solvents on car painters.

PURPOSE: Interest in diseases of the nervous system resulting from occupational exposure to mixed organic solvents has greatly increased. The aim of our study was to identify preclinical effects of low-level chronic solvent exposure on the central nervous system in car painters by assessing their cognitive performance. METHODS: This psychological study involved 169 clinically healthy male volunteers (84 car painters and 85 controls) and is part of a comprehensive study investigating effects of solvent exposure. The test battery included paper-pencil tests (vocabulary test, block design test, c.i., d2 test), computer-based tests (digit span test, simple-choice reaction time test), and a questionnaire to assess the participants' mental state. RESULTS: Car painters with long-term exposure to solvents showed psychological deviations such as deficits in concentration, memory and reaction time compared to unexposed subjects. The significant differences between the two groups were confirmed by multivariate statistical analysis. CONCLUSIONS: Our study displayed psychological effects associated with long-term solvent exposure in concentrations below German threshold limit values. These findings emphasize the necessity to promote the resolute compliance with occupational safety and health regulations in affected companies.

[Inclusion of psychopathologic methods for diagnosis of early neurotoxic effects from lead and organic solvent mixtures]. / Einbeziehung psychopathologischer Verfahren zur Objektivierung von neurotoxischen Früheffekten durch Blei und Lösemittelgemische.

To verify occupational neurotoxic effects it will be necessary to enlist the help of clinical psychologists and psychiatrists. However, no unified professional test battery exists to date. 119 healthy workers (26 lead-exposed, 45 exposed to mixed organic solvents, and 48 controls) were tested using uniformly standardised psychological and psychiatric methods. Long-term lead-exposed employees showed an increased number of psychoneurovegetative symptoms and deficits in attention performance according to the results of the Seeber-PNF and the Brickenkamp-d2-tests. There was no difference between the control group and persons exposed to the organic solvents test. Many parameters correlated to the dose of the toxic agent in the lead-exposed group. SCL-90-R, AMDP, and HAMD merely hinted at differences between the exposed subjects and the controls. Psychological and pathopsychological methods are necessary but will not suffice to detect early effects after long-term exposure to lead or organic solvents.

Vegetative function diagnosis for early detection of lead intoxication.

In the search for the early effects of neurotoxic lead poisoning, vegetative function diagnosis is a potential approach, focusing on the behaviour of the cardiac rhythm. Four groups of male subjects (109 copper workers exhibiting mean lead levels in blood of 31.2 micrograms/dl after long-term lead exposure; 27 control subjects having a similar job in the iron and steel industry without neurotoxic exposure; 35 reference subjects from Magdeburg University Hospital without neurotoxic exposure, and 5 subjects to whom benefits have been awarded for disability resulting from lead intoxication) were studied. All subjects underwent the same psychometric test battery. Special attention was paid to the restoration of vegetative tone after exposure. The more extensive the exposure to lead, the longer was the delay in restoration. This effect seems to be reversible, as workers heavily exposed to lead, but otherwise healthy, were more affected than the patients included in this investigation. Simply comparing the cardiac rhythm of exposed and non-exposed subjects at rest is not sufficient for early detection of lead intoxication. The behaviour of cardiac rhythm in humans at rest is the result of long-term influence by a wide range of factors, of which lead exposure is only one.