Effects of Occupation-Specific Vocal Stress on the Mental Health of Day Care Teachers.

INTRODUCTION: Kindergarten teachers are exposed to numerous kinds of strains, such as noise, which can negatively affect their voices. This cross-sectional study investigates whether and to what extent the profession-specific high vocal demand is associated with the educators' mental health. METHODS: One hundred and ninety-two kindergarten teachers from Magdeburg, Germany and its surrounding areas aged 43.4 ± 12.8 years, voluntarily participated in a survey. Vocal demand and vocal demand response, general strain factors, and mental health were assessed by using questionnaires (self-check on voice demands, Rudow checklist, General Health Questionnaire, and Maslach Burnout Inventory). The statistical analyses were carried out using SPSS. RESULTS: The interviewed educators felt stressed by the excessive number of work tasks and children in each class, noisy work environment, and loud conversations. In addition, educators complained of headaches and neck pain (66%), while 28% of them experienced hoarseness and a burning throat. The mental health of 39 of the educators was impaired, and nine were at an increased risk of burnout. Self-reported voice effort correlated low with mental health (r = 0.287; p < 0.001) and burnout risk (r = 0.306; p < 0.001). CONCLUSION: The vocal demands on educators in day care settings are very high, which is a major associated factor for the development of burnout syndrome and is also associated with headaches and neck pain. Measures for the prevention of occupational voice disorders and voice training should be a mandatory part of the educators' training and must be offered as in-service training.

[Working in the Operating Theatre - What does the Surgeon Need to Know About Occupational Medicine?] / Arbeitsplatz OP-Saal ­ Was muss der Chirurg über die Arbeitsmedizin wissen?

Surgery is associated with numerous health hazards for the staff.The aim of this article is to show the risks to the health and ability to work of surgical staff and the possibilities for improving occupational health and safety in terms of behavioural and situational prevention, as well as secondary and tertiary prevention, especially with regard to cooperation with the occupational physician.The brief narrative overview is based on the author's own occupational medicine, surgery and interdisciplinary experience from daily practice and selective references from the current medical-scientific literature, using the example of the operating theatre work area.The possible activity-related health hazards and the risks to the working ability of medical staff as well as the possibilities for occupational health and safety in the sense of behavioural and situational prevention are an important matter in the interdisciplinary status of surgery that should not be underestimated (since it is also partly determined by law). Above all, this discipline must responsibly dedicate itself to the points of contact with occupational medicine (in addition to acquiring its own knowledge from the surgical side).

[Relationship between Burnout Risk and Individual Stress Processing Strategies in Kindergarten Teachers]. / Zusammenhang zwischen dem Burnout-Risiko und individuellen Stressverarbeitungsstrategien bei Kindergartenerzieherinnen.

Kindergarten teachers are exposed to a variety of stresses that can lead to psychological impairments and illnesses. A balance between stress and resources is necessary for performance and well-being. The aim of the study was to examine correlations between the risk of burnout and human resources in order to derive approaches for preventive measures. A total of 200 teachers from Magdeburg and the surrounding area took part in the study (age: 43.6±12.6 years). The MBI-GS inventory was used to determine the burnout risk. Stress processing strategies as personal resources were recorded using the stress processing form (SVF). A risk of burnout was found in nine (4.5%) teachers, 68 (34%) suffered from at least some burnout symptoms. There were significantly more negative stress processing strategies among educators at risk of burnout. As a preventive measure, a resource-oriented approach should be strengthened in order to maintain the health of the teachers and to prevent development of burnout syndrome.

[Influence of Sex and Age on Contrast Sensitivity Subject to the Applied Method]. / Einfluss von Geschlecht und Alter auf die Kontrastempfindlichkeit in Abhängigkeit der verwendeten Methodik.

AIM: The aim of the study was to detect gender and age differences in both photopic and mesopic contrast sensitivity with different methods in relation to German driver's license regulations (Fahrerlaubnisverordnung; FeV). METHODS: We examined 134 healthy volunteers (53 men, 81 women) with an age between 18 and 76 years, that had been divided into two groups (AG I < 45 years old, AG II ≥ 45 years old). Mesopic contrast sensitivity was determined with the Mesotest II. Optovist EU and Rodatest 302 as test devices and VISTECH and Mars charts under standardized illumination were applied for photopic contrast sensitivity. RESULTS: We could not find any gender differences. When evaluating age, there were no differences between the two groups for the Mars charts nor in the Rodatest. In all other tests, the younger volunteers achieved significantly better results. CONCLUSION: For contrast vision, there exists age-adapted cut-off-values. Concerning the driving safety of traffic participants, sufficient photopic and mesopic contrast vision should be focused on, independent of age. Therefore, there is a need to reconsider the age-adapted cut-off-values.

[Prevalence of symptoms of posttraumatic stress disease in police officers in relation to job-specific requirements]. / Prävalenz von Symptomen einer Posttraumatischen Belastungsstörung bei Polizeibeamten in Bezug auf dienstspezifische Anforderungen.

The professional activity of policemen is connected to psychological and physical stress. The aim of this study was to identify the work specific requirements and stress as well as to deter-mine the exact circumstances of the experience of traumatic events and their coping. Additionally the occurrence of potentially traumatising situations during operations and the prevalence of PTSD symptoms were investigated in detail using questionnaires. As traumatising events severe traffic accidents, use of firearms, but also non-specific operations resulting in death, e. g. the killing of a child, were listed by the policemen. The knowledge of the psychological stress and its sources as well as the analysis of the exact circumstances of traumatic events are helpful in preventing PTSDs more efficiently, e. g. by special trainings for coping with stress and conflicts, in faster identification and treatment using professional support.

Is there a link between heart rate variability and cognitive decline? A cross-sectional study on patients with mild cognitive impairment and cognitively healthy controls.

BACKGROUND: Given that, up to date, there is no effective strategy to treat dementia, a timely start of interventions in a prodromal stage such as mild cognitive impairment (MCI) is considered an important option to lower the overall societal burden. Although autonomic functions have been related to cognitive performance, both aspects have rarely been studied simultaneously in MCI. OBJECTIVE: The aim of the present study was to investigate cardiac autonomic control in older adults with and without MCI. METHODS: Cardiac autonomic control was assessed by means of heart rate variability (HRV) at resting state and during cognitive tasks in 22 older adults with MCI and 29 healthy controls (HCs). Resting HRV measurement was performed for 5 minutes during a sitting position. Afterwards, participants performed three PC-based tasks to probe performance in executive functions and language abilities (i.e., Stroop, N-back, and a verbal fluency task). RESULTS: Participants with MCI showed a significant reduction of HRV in the frequency-domain (high frequency power) and nonlinear indices (SD2, D2, and DFA1) during resting state compared to HCs. Older individuals with MCI exhibited decreases in RMSSD and increases in DFA1 from resting state to Stroop and N-back tasks, reflecting strong vagal withdrawal, while this parameter remained stable in HCs. CONCLUSION: The results support the presence of autonomic dysfunction at the early stage of cognitive impairment. Heart rate variability could help in the prediction of cognitive decline as a noninvasive biomarker or as a tool to monitor the effectiveness of therapy and prevention of neurodegenerative diseases.

ANTECEDENTES: Como não existe até o momento uma estratégia eficaz para tratar a demência de comprometimento cognitivo leve (MCI, na sigla em inglês), as intervenções em um estágio prodrômico são consideradas uma opção. Embora as funções autonômicas tenham sido relacionadas ao desempenho cognitivo, ambos os aspectos raramente foram estudados simultaneamente no MCI. OBJETIVO: Investigar o controle autonômico cardíaco em idosos com e sem MCI. MéTODOS: O controle autonômico cardíaco foi avaliado por meio da variabilidade da frequência cardíaca (HRV, na sigla em inglês) em repouso e durante tarefas cognitivas, em 22 idosos com MCI e 29 controles saudáveis (HCs, na sigla em inglês). A medida da HRV de repouso foi realizada por 5 minutos na posição sentada. Os participantes realizaram três tarefas executadas em computador para testar o desempenho em funções executivas e habilidades de linguagem (o teste de cores e palavras - Stroop, Tarefa N-back auditiva e uma tarefa de fluência verbal). RESULTADOS: Em pacientes com MCI, observou-se uma redução significativa da HRV no domínio da frequência (potência de alta frequência) e índices não lineares (SD2, D2 e DFA1) durante o estado de repouso em comparação com os HCs. Indivíduos mais velhos com MCI exibiram diminuições em RMSSD e aumentos em DFA1 do estado de repouso para Stroop e tarefas N-back, refletindo forte recessão vagal, enquanto este parâmetro permaneceu estável em HC. CONCLUSãO: Observou-se disfunção autonômica na fase inicial da neurodegeneração. A HRV pode ajudar na previsão do declínio cognitivo, como um biomarcador não invasivo, ou como uma ferramenta para monitorar a eficácia da terapia e prevenção de doenças neurodegenerativas.

[Assessment of Psychological Stress in Kindergarten Teachers with Varying Degrees of Overcommitment]. / Beurteilung psychischer Beanspruchung bei Kindergartenerzieherinnen mit unterschiedlichem Overcommitment.

OBJECTIVE: Nursery school teachers are exposed to psycho-emotional stress in their profession, which can lead to health problems. The aim of the study was to examine whether and to what extent increased work commitment (overcommitment, OC) affects the health of educators. METHODS: 163 nursery school teachers (age 44.5 ±â€Š12.4 years) were recruited for the study. OC, mental health and the risk of burnout were assessed using standardized questionnaires. ECG recordings over 24 h served as a basis for the calculation of heart rate variability (HRV). RESULTS: 121 teachers showed normal OC and 42 teachers increased OC. In nursery school teachers with elevated OC, self-reported mental health is impaired and vagal mediated HRV (RMSSD and HF) is reduced. CONCLUSION: Since the subjectively assessed mental health of nursery school teachers with elevated OC deteriorates and HRV is reduced, preventive measures must be taken to maintain the health of nursery school teachers.

Work Ability and Analysis of Stress-Relevant Coping With Demands of Teachers-A Cross-Sectional Comparative Study in Germany and Ukraine.

OBJECTIVE: The aim of this study was to identify strain factors and compare work ability and stress-relevant coping with demands for German and Ukrainian teachers. METHODS: Data from 147 German and 291 Ukraine teachers were examined. A professional history questionnaire, the Work Ability Index, and a questionnaire for the analysis of stress-relevant coping with demands (inability to recover subscale) were used. The differences among the age groups in the two countries were evaluated. RESULTS: German teachers reported more demands than Ukrainian teachers did. The Work Ability Index score indicates a moderate level of work ability for both groups of teachers. German teachers are more unable to recover than Ukrainian teachers are ( P < 0.001), and older German teachers are significantly less able to recover than their Ukrainian counterparts are. CONCLUSIONS: Health intervention and promotion are necessary, especially for older teachers.

Activation of the stress response among the cardiac surgical residents: comparison of teaching procedures and other (daily) medical activities.

BACKGROUND: The aim of this Pilot study was to investigate the cardiac surgical residents' workload during different surgical teaching interventions and to compare their stress levels with other working time spent in the intensive care unit or normal ward. METHODS: The objective stress was assessed using two cardiac surgical residents' heart rate variability (HRV) both during surgical activities (32 selected teaching operations (coronary artery bypass graft n = 26 and transcatheter aortic valve implantation n = 6), and during non-surgical periods. Heart rate, time and frequency domains as well as non-linear parameters were analyzed using the Wilcoxon test. RESULTS: The parasympathetic activity was significantly reduced during the surgical phase, compared to the non-surgical phase: Mean RR (675.7 ms vs. 777.3 ms), RMSSD (23.1 ms vs. 34.0 ms) and pNN50 (4.7% vs. 10.6%). This indicates that the residents had a higher stress level during surgical activities in comparison to the non-surgical times. The evaluation of the Stress Index during the operations and outside the operating room (8.07 vs. 10.6) and the parasympathetic nervous system index (- 1.75 to - 0.91) as well as the sympathetic nervous system index (1.84 vs. 0.65) confirm the higher stress level during surgery. This can be seen too used the FFT Analysis with higher intraoperative LF/HF ratio (6.7 vs. 3.8). CONCLUSION: HRV proved to be a good, objective method of identifying stress among physicians both in and outside the operating room. Our results show that residents are exposed to high psychological workloads during surgical activities, especially as the operating surgeon.

Heart Rate Variability in Different Levels of Burnout-Cross-Sectional Study of Different Occupational Groups Heart Rate Variability and Burnout.

OBJECTIVES: The aim of this study was a subjective and objective stress analysis of occupational groups. METHODS: The study examined 414 employees with patients or children contact on work. The age ranged from 22 to 63 years. Subjective stress was measured using the Maslach Burnout Inventory and objective stress with heart rate variability (HRV). RESULTS: Twenty-one percent of subjects showed a high level of exhaustion, 12.9% a high level of cynicism and low performance. There were significant group differences between cynicism levels in meanNN (P = .008) and meanHR (P = .002). There were no significant differences in HRV for exhaustion and professional efficacy. CONCLUSIONS: The health-impairing manifestations of the three dimensions of the burnout syndrome are not associated with the lower HRV. However, healthy subjects from a "screening" study who had not been clinically diagnosed with burnout were examined here.

Age-Related Differences in Cardiac Autonomic Control at Resting State and in Response to Mental Stress.

Our goal was to investigate age-related differences in cardiac autonomic control by means of heart rate variability (HRV). For this purpose, 30 healthy older and 34 younger adults were studied during three different conditions: (i) during resting state, (ii) during the execution of two cognitive tasks, and (iii) during the subsequent recovery phase. Mean heart rate and HRV parameters were higher in younger compared to older participants during all three conditions. While the mean heart rate was higher in older adults during the cognitive tasks compared to the resting state, it did not change in younger adults. In contrast, the change in HRV during the three conditions did not differ between age groups. Our results suggest decreased parasympathetic activity reflecting declined cardiac autonomic control with aging. In conclusion, HRV analysis could support the assessment of normal age-related alterations in cardiac autonomic control at resting state and in response to cognitive demands.

Evaluation of Stress Levels of Trainee Cardiac Surgery Residents during Training Interventions Using Physiological Stress Parameters.

BACKGROUND: This study analysed the psychological and psycho-emotional stress in cardiac surgery. Using heart rate variability (HRV) analysis, it is possible to record intraoperative objective stress responses in surgeons. The aim of the study was to assess with the help of HRV parameters the postulated increased stress levels of cardiac surgeons in training compared to experienced senior cardiothoracic surgeons in exactly the same work situation in order to make qualification-differentiated statements about physiological stress during surgical interventions. METHODS: During surgical teaching procedures, long-term ECG data (n = 15 each) for two operating residents and their assisting senior physicians were recorded. Time and frequency domain HRV parameters were analysed. RESULTS: The time-related parasympathetic-dominated HRV parameters RMSSD (19.5 ms vs. 28.1 ms), NN50 (297.67 vs. 693.40), and cardiac interval mean RR (692.8 ms vs. 737.3 ms) indicate a higher stress level in the operating residents compared to the experienced surgeons. The higher stress index (11.61 vs. 8.86) confirms this. CONCLUSION: Compared to experienced surgeons, operating residents showed lower parasympathetic activity and higher stress levels during cardiac surgery training procedures.

Multimodal measurement approach to identify individuals with mild cognitive impairment: study protocol for a cross-sectional trial.

INTRODUCTION: The diagnosis of mild cognitive impairment (MCI), that is, the transitory phase between normal age-related cognitive decline and dementia, remains a challenging task. It was observed that a multimodal approach (simultaneous analysis of several complementary modalities) can improve the classification accuracy. We will combine three noninvasive measurement modalities: functional near-infrared spectroscopy (fNIRS), electroencephalography and heart rate variability via ECG. Our aim is to explore neurophysiological correlates of cognitive performance and whether our multimodal approach can aid in early identification of individuals with MCI. METHODS AND ANALYSIS: This study will be a cross-sectional with patients with MCI and healthy controls (HC). The neurophysiological signals will be measured during rest and while performing cognitive tasks: (1) Stroop, (2) N-back and (3) verbal fluency test (VFT). Main aims of statistical analysis are to (1) determine the differences in neurophysiological responses of HC and MCI, (2) investigate relationships between measures of cognitive performance and neurophysiological responses and (3) investigate whether the classification accuracy can be improved by using our multimodal approach. To meet these targets, statistical analysis will include machine learning approaches.This is, to the best of our knowledge, the first study that applies simultaneously these three modalities in MCI and HC. We hypothesise that the multimodal approach improves the classification accuracy between HC and MCI as compared with a unimodal approach. If our hypothesis is verified, this study paves the way for additional research on multimodal approaches for dementia research and fosters the exploration of new biomarkers for an early detection of nonphysiological age-related cognitive decline. ETHICS AND DISSEMINATION: Ethics approval was obtained from the local Ethics Committee (reference: 83/19). Data will be shared with the scientific community no more than 1 year following completion of study and data assembly. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov, NCT04427436, registered on 10 June 2020, https://clinicaltrials.gov/ct2/show/study/NCT04427436.

Relationship between Resting State Heart Rate Variability and Sleep Quality in Older Adults with Mild Cognitive Impairment.

Sleep problems can be caused by psychological stress but are also related to cardiovascular and neurodegenerative diseases. Improving lifestyle behaviors, such as good sleep hygiene, can help to counteract the negative effects of neurodegenerative diseases and to improve quality of life. The purpose of this cross-sectional study was to investigate the relationship between subjectively reported measures of sleep quality (via Pittsburgh Sleep Quality Index (PSQI)) and objective measures of cardiac autonomic control (via resting state heart rate variability (HRV)) among individuals with mild cognitive impairment (MCI). The PSQI and resting state HRV data of 42 MCI participants (69.0 ± 5.5; 56-80 years) were analyzed. Nineteen of the participants reported poor sleep quality (PSQI score > 5). Good sleepers showed higher resting heart rate than bad sleepers (p = 0.037; ES = 0.670). Correlation analysis showed a significant correlation between the parameter HF nu and sleep efficiency, contrasting the expected positive association between reduced HRV and poor sleep quality in healthy and individuals with specific diseases. Otherwise, there were no significances, indicating that measures of subjective sleep quality and resting HRV were not related in the present sample of MCI participants. Further research is needed to better understand the complex relationship between HRV and lifestyle factors (e.g., sleep) in MCI.

[Associations of Work-Related Strain with Subjective Sleep Quality and Individual Daytime Sleepiness]. / Zusammenhang von arbeitsbezogenen psychischen Beanspruchungsfolgen mit subjektiver Schlafqualität und individueller Tagesschläfrigkeit.

INTRODUCTION: Mental strain at the work place involves high potential hazard for health and quality of life. The aim of this study was to examine the relationships between strain consequences of psychological strain and subjective sleep quality as well as daytime sleepiness. METHODS: A cross-sectional study with 84 included participants was conducted. Work-related strain consequences were evaluated by means of the 3 scales Cognitive Irritation (CI), Emotional Irritation (EI) and Global Irritation (GI) of the Irritation Scale for Assessing Work-Related Strain Consequences (IS), sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) and daytime sleepiness was measured with the Epworth Sleepiness Scale (ESS). RESULTS: Regarding the assessed socio-demographical and medical data subjects with good sleep quality did not differ from subjects with poor sleep quality. In all 3 scales of the IS and in the ESS poor sleepers reached unfavourable higher scores, but the difference with respect to the ESS was not significant. Higher scores in all 3 scales of the IS correlated with higher PSQI scores but only higher scores in the EI of the IS correlated with higher ESS scores as well. DISCUSSION, CONCLUSIONS: Work-related strain consequences and subjective sleep quality have an interrelationship with great importance in today's world of work. Considerable aspects here are job insecurity and constant availability.

Is there a link between heart rate variability and cognitive decline? A cross-sectional study on patients with mild cognitive impairment and cognitively healthy controls / Existe uma ligação entre a variabilidade da frequência cardíaca e o declínio cognitivo? Um estudo transversal em pacientes com deficiência cognitiva leve e controles cognitivos saudáveis

Abstract Background Given that, up to date, there is no effective strategy to treat dementia, a timely start of interventions in a prodromal stage such as mild cognitive impairment (MCI) is considered an important option to lower the overall societal burden. Although autonomic functions have been related to cognitive performance, both aspects have rarely been studied simultaneously in MCI. Objective The aim of the present study was to investigate cardiac autonomic control in older adults with and without MCI. Methods Cardiac autonomic control was assessed by means of heart rate variability (HRV) at resting state and during cognitive tasks in 22 older adults with MCI and 29 healthy controls (HCs). Resting HRV measurement was performed for 5 minutes during a sitting position. Afterwards, participants performed three PC-based tasks to probe performance in executive functions and language abilities (i.e., Stroop, N-back, and a verbal fluency task). Results Participants with MCI showed a significant reduction of HRV in the frequency-domain (high frequency power) and nonlinear indices (SD2, D2, and DFA1) during resting state compared to HCs. Older individuals with MCI exhibited decreases in RMSSD and increases in DFA1 from resting state to Stroop and N-back tasks, reflecting strong vagal withdrawal, while this parameter remained stable in HCs. Conclusion The results support the presence of autonomic dysfunction at the early stage of cognitive impairment. Heart rate variability could help in the prediction of cognitive decline as a noninvasive biomarker or as a tool to monitor the effectiveness of therapy and prevention of neurodegenerative diseases.

Resumo Antecedentes Como não existe até o momento uma estratégia eficaz para tratar a demência de comprometimento cognitivo leve (MCI, na sigla em inglês), as intervenções em um estágio prodrômico são consideradas uma opção. Embora as funções autonômicas tenham sido relacionadas ao desempenho cognitivo, ambos os aspectos raramente foram estudados simultaneamente no MCI. Objetivo Investigar o controle autonômico cardíaco em idosos com e sem MCI. Métodos O controle autonômico cardíaco foi avaliado por meio da variabilidade da frequência cardíaca (HRV, na sigla em inglês) em repouso e durante tarefas cognitivas, em 22 idosos com MCI e 29 controles saudáveis (HCs, na sigla em inglês). A medida da HRV de repouso foi realizada por 5 minutos na posição sentada. Os participantes realizaram três tarefas executadas em computador para testar o desempenho em funções executivas e habilidades de linguagem (o teste de cores e palavras - Stroop, Tarefa N-back auditiva e uma tarefa de fluência verbal). Resultados Em pacientes com MCI, observou-se uma redução significativa da HRV no domínio da frequência (potência de alta frequência) e índices não lineares (SD2, D2 e DFA1) durante o estado de repouso em comparação com os HCs. Indivíduos mais velhos com MCI exibiram diminuições em RMSSD e aumentos em DFA1 do estado de repouso para Stroop e tarefas N-back, refletindo forte recessão vagal, enquanto este parâmetro permaneceu estável em HC. Conclusão Observou-se disfunção autonômica na fase inicial da neurodegeneração. A HRV pode ajudar na previsão do declínio cognitivo, como um biomarcador não invasivo, ou como uma ferramenta para monitorar a eficácia da terapia e prevenção de doenças neurodegenerativas.

Comparing the effectiveness of karate and fitness training on cognitive functioning in older adults-A randomized controlled trial.

BACKGROUND: Recent studies demonstrate a slowdown in deterioration of cognitive functioning in old age through aerobic training. There is evidence that the combination of aerobic, balance, and coordination exercises leads to an improvement or maintenance of cognitive functions. Such age-related exercises can especially be found in East Asian martial arts. The purpose of the current study is to verify whether karate training for older adults improves cognitive functioning and, if an improvement can be found, which cognitive fields are influenced. METHODS: Eighty-nine older women and men (mean age: 70 years) participated in this study. The participants were randomized into 2 intervention groups (karate group and fitness group, duration of intervention: 5 months) and a control group. All participants had to accomplish a cognitive test battery before and after the intervention. In a secondary study the karate group had an additional intervention for another 5 months. RESULTS: The results show that there is a significant improvement in motor reactivity, stress tolerance, and divided attention only after the 5-month karate training period. Additionally, the results of the secondary study indicate further improvements after 10 months. CONCLUSION: The 5-month karate training can help to enhance attention, resilience, and motor reaction time, but a training period of 10 months is even more efficient.

Early effects of long-term neurotoxic lead exposure in copper works employees.

The situation of exposure in a copper works facility in Germany enabled early lead-induced neurotoxic effects to be investigated in the workers. The aim of the investigation was to study the long-term effects of small doses of lead on psychometric/psychophysiological performance of workers. The study involved 70 male lead exposed workers and 27 male controls with no neurotoxic exposure. All test persons were subjected to the method of investigation involving performance data, physiological strain data, and the subjective state. It was found that of the psychometric performance parameters, only the mainly motor performance parameters had a potential for being neurotoxic early indicators. Preferably centrally influenced performance parameters were found to be less suitable early indicators. The lead-exposed subjects exhibited a slowed poststrain resetting behaviour of the vegetative nervous system, which correlated with the individual blood lead level. This was attributed to vagus depression, which had already started in the prevailing situation of exposure and was reflected by diminished cardiac phase duration variability. Our results indicate that it is necessary to more critically choose the lead level standards in the air on the working area. Heart rate variability may be affected even at small lead concentration.