1,720,966 research outputs found
Working against the biological clock: A review for the occupational physician
No full textThe master clock of the biological rhythm, located in the suprachiasmatic nucleus of the anterior hypothalamus, synchronizes the molecular biological clock found in every cell of most peripheral tissues. The human circadian rhythm is largely based on the light-dark cycle. In night shift workers, alteration of the cycle and inversion of the sleep-wake rhythm can result in disruption of the biological clock and induce adverse health effects. This paper offers an overview of the main physiological mechanisms that regulate the circadian rhythm and of the health risks that are associated with its perturbation in shift and night workers. The Occupational Physician should screen shift and night workers for clinical symptoms related to the perturbation of the biological clock and consider preventive strategies to reduce the associated health risks
Shift work and cardiometabolic risk
No full textShift work is frequently associated with coronary heart disease. Medical research indicate metabolic disturbance among shift workers, which is characterized by associated modifications in the concentration of serum glucose and serum lipids, hypertension and obesity, especially addominal weight. Atrasversal study has been carried out: 193 (126 females and 67 males) healthcare shift workers were compared with 221 (160 females and 61 males) day workers. Medical history, health examination including anthropometric and arterial blood pressure measurements were assessed. All participants were submitted a standardized questionnaire on health-related behaviours and biochemical determinations (fasting plasma glucose, HDL-cholesterol, triglycerides). Job seniority of shift work resulted at 13.5 +/- 8.2 among shift workers and 19.0 +/- 11.3 among day workers. Assessment of the metabolic syndrome relevance was defined according to the criterions proposed by the International Diabetes Federation. The 20% shift workers (33% males and 13% females) was affected by metabolic syndrome against 12% non shift workers (20% males and 9% females). The most frequently altered parameter, apart from metabolic syndrome, was high abdominal obesity, which occurred in 64% of the sample (70% shift workers vs 58% day workers). The results of multiple logistic regression attested the presence of a higher relative risk among shift workers regarding both the prevalence of a metabolic syndrome (OR 2,1 - 95% Cl 1.15-3.86) and the excess in abdominal obesity (OR 1.8 - 95% Cl 1.16-3.25). After adjusting confusing factors such as smoke, age, alchool, consumption, physical activity, scholastic degree, a OR 2.9 - 95%Cl 1,53-5.53 and a OR 1.9 - 95%.Cl 1.32-3.86 were confirmed
Assessment of plasma homocysteine levels in shift healthcare workers
No full textPrevious studies have indicated an association between shift work and cardiovascular disease. Increased plasma homocysteine levels has been proposed as a cardiovascular risk factor independent of other conventional risk factors.
Our aim is to verify the usefulness of plasma homocysteine as a screening test to prevent cardiovascular diseases in shift workers.
Thirty rotating shift nurses and 28 daytime nurses have been submitted during 18 months to regular taking of arterial pressure and body weight. Venous blood was drawn to measure glycaemia, triglycerides, plasma cortisol level, HDL cholesterol, blood cell count, alanine-aminotransferase, aspartate-aminotransferasi, gamma-GT, and plasma homocysteine.
No increase in average plasma homocysteine in rotating shift nurses, nor a higher frequency in hyperomocisteinemia than in daytime workers was found. A significant difference was observed in body weight and systolic blood pressure (p<0.05), which resulted higher in rotating shift workers than in daytime workers. A significant increase was observed in alanine-aminotransferase (ALT) among shift workers (p<0.05).
Plasma homocysteine measurement should not be employed as a screening test for the prevention of cardiovascular disease in rotating shift workers
Hymenoptera stings in forestry department agents: evaluation of risk
No full textIn sensitized subjects Hymenoptera stings may provoke the awakening of mediated systemic reactions of I type IgE, which can sometimes be serious. Considering the type of work performed activity and the high frequency of reported hymenoptera sting episodes, a sample of 206 Forestry Department agents was surveyed who worked outside urban areas in the Marche Region.
The aim of the study was to analyse the prevalence of stings and their possible systemic reactions, as well as to evaluate the type of occupational risks involved.
A total of 206 agents were examined and questioned about the number of stings suffered during work and about the kind of subsequent skin and systemic reactions; they were then classified according to the method proposed by H.L. Mueller.
179 agents reported having suffered from hymenoptera stings and, of these, 53 subjects (29,6%) remembered that one episode at least occurred during work. Among 175 operators (98%), 4 had a regular reaction, with appearance of a generalized urticaria and uneasiness. In the remaining 4 agents (2%) there was a local extensive reaction, which was not associated with systemic reactions and they were all referred to allergological examination. 19 agents (10,6%) suffered more than 5 stings altogether, but none developed a systemic reaction. 87% of the subjects practised self-medication, 7% reported to the casualty department of the local hospital or to their own doctor, and 6% undertook no cure at all.
Epidemiological studies agree in recognizing that, in the general population, the percentage of systemic reactions after one or more hymenoptera stings varies from 0,15% to 3,3%. In categories of workers occupationally at risk, the prevalence of systemic reactions varies from 4,5% to 26%. The prevalence of systemic reactions in Forestry Department agents was 2%, which is similar to the prevalence in the general population. Therefore, rather than occupational risk, there appeared to be a generic risk made more serious by working conditions for Forestry Department agents due to their possible exposure to hymenoptera stings. The occupational health physician needs to monitor these events, due to the fact that frequent exposure to stings, above all occurring within a short period of time (less than two months) favours an increase in the tendency to develop systemic reactions, with a more serious prognosis, especially when working in isolated conditions
Usefulness of a questionnaire and RAST in screening of health care workers allergic to latex
No full textThe prevalence of latex mediated IgE allergy in health care workers varies, according to the various studies, from 0.5% to 16.7%. The onset of latex allergy involves aspects concerning the worker's health, the need for job transfer and possible retraining. In any case, the use of latex gloves in health care environments cannot be discarded, since they offer more efficacious protection from biological agents, compared to gloves of different materials.
Our objectives were to verify the prevalence of latex allergy in a sample of 515 health care workers and evaluate the usefulness of RAST and a questionnaire especially organized to identify potentially allergic subjects, at the same time limiting the number of false positive and false negative results.
515 health care workers of the ASUR Zone7-Ancona local health unit accepted to answer to a questionnaire and to undergo a RAST testfor latex. Those with positive responses to the questionnaire or to RAST were later invited to undergo further allergological tests (prick and prick by prick). The questionnaire was revised according to the results obtained, thus increasing its positive predictiveness.
Prevalence of latex allergy in our sample was 1,7%, positive predictiveness of RAST was rather low (31.3%), but increased considerably if combined with the modified questionnaire (62.5%). The Prick by Prick test gave more specific results than the Prick test.
The proposed questionnaire can reduce the number of false positive workers needing to undergo further allergological tests and may be usefully applied in the screening of latex mediated IgE allergy in health care workers
Role of waist circumference in the diagnosis of metabolic syndrome and assessment of cardiovascular risk in shift workers
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Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
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