Influence of shift work on coronary high risk status among a natural gas field workers

The association between shift work and coronary high risk status [CHRS] is still unclear. The present work was designed to study the influence of shift work in a gas field petroleum company in Dakahlia on CHRS; as well as, to investigate its possible mechanisms. A cross-sectional approach was used and a systematic random technique was applied to select 200 shift workers and 200 non-shift workers. Both study groups were subjected to interview questionnaire about personal, social, smoking, occupational and medical histories. Clinical examination, including general and cardiovascular examinations, was done. Height, weight and waist circumference were measured and bpd MTia-ss-jndex [BMI Kg/m[2] was calculated. Laboratory investigations included measurements of fasting blood glucose, lipid profile and uric acid; as well as, electrocardiograph examination [ECG]. Coexistence of more than 2 conventional risk factors or diabetes mellitus [DM] or new and old coronary artery disease [CAD] defined CHRS. Vanillyl mandelic acid [VMA] was measured in 24 hours urine samples as a stress indicator for a randomly selected sub-sample from those with CHRS [25 shift and 25 non-shift workers]. The R-R deep breathing variability test on the resting ECG as a measure for autonomic function was done for the same group. The study revealed that 42.5% of shift workers were complaining of deterioration in performance and concentration during work. In addition, 35.5% of shift workers had the desire to change shift work. Among shift workers, 36% were smokers in comparison to 26.5% of non-shift workers with a statistically significant difference [p = 0.04]. Rates of hypertension, hypercholesterolemia, high LDL-cholesterol, low HDL-cholesterol, hypertriglyceridemia, obesity and DM showed a statistically significant increase among shift workers than non-shift workers [p < 0.05]. The overall rate of CHRS was significantly higher among shift workers [p = 0.001]. Multiple logistic regression analysis of coronary high risk status as the dependant variable revealed that shift work kept a significant effect on CHRS even after adjustment for other confounders [p= 0.002]. Mean level of urinary VMA was significantly higher for shift workers than non-shift workers [p= 0.0001]; meanwhile, significantly lower R-R variability indices were recorded among shift workers than non-shift workers [p < 0.05]. The present study revealed that shift work has a significant impact on CHRS that might be related to sympathetic over-activity. It is recommended to screen for coronary risk factors in pre-placement and periodic medical examinations of shift workers with implementation of special preventive programs. Urinary VMA and R-R variability testing in ECG could be used as stress indicators among CHRS shift workers. Cases of CAD should be excluded from shift work

Cost-benefit analysis of ergonomic program for management of low back problems among office workers

Low back problems are emerging as important work-related health disorders especially among computer office workers with substantial cost. The most prominent feature, of these conditions, is low back pain [LBP].The present study was designed to investigate low back problems among office workers in relation to ergonomic factors at work and to analyze cost-benefit of a suggested ergonomic program for management of this problem. A cross-sectional study was conducted in the office work department in a petroleum company in the Western desert. The study included 120 office workers. All participants were subjected to a predesigned questionnaire emphasizing occupational history, clinical examination, anthropometric measurements, and ergonomic checklist for subjective assessment. The LBP was defined whether non-specific, radiating, persistent specific, or chronic. A parallel objective assessment of the computer desk workstations [n = 62], which were shared by workers, was carried out by experienced ergonomists with the same previous checklist. Medical records were reviewed for assessment of the cost of low back problems in the years [2007-2009]. The cost of a suggested ergonomic program was calculated for 3 years according to the market price in order to calculate cost-benefit ratio of such a program in prevention of LBP. Results showed that 61% of the examined workers gave history of LBP within the previous 3 years and clinical signs were detected in 32% of the workers. There were no significant differences between subjective and objective assessments of the different items scores of the ergonomic checklist. The lowest mean scores were reported for the chair and the work habits and training; both were negatively correlated with LBP intensity and duration. The suggested ergonomic program entails correction of the defective items to meet the standard ergonomic healthy criteria, provision of 6 periodic ergonomic training programs and enforcement of healthy work and life style habits. The final cost-benefit ratio of the ergonomic program for management of LBP among office workers of the present study was 1: 3.67 which is considered cost beneficial. Properly designed ergonomic programs are cost beneficial in management of LBP among office workers

Risk prediction of coronary artery disease among naval forces

Coronary artery disease [CAD] risk factors seem to cluster in some occupational groups. The present study was designed to investigate CAD risk factors among naval forces as an example of a high risk sector and to construct a risk prediction model for the disease. A case control study was carried out at the general naval hospital [GNH] in Alexandria. The study included 250 male consecutive naval CAD cases with a control group of 250 males matches for age, occupational level, sociodemographic characteristics and, free from CAD. All participants were subjected to a questionnaire about personal data, occupational history and exposures, occupational and leisure physical activity, dietary habits, smoking, and medical history. Anthropometric measurements, sifting blood pressure, and lipid profile were determined by the standard methods. Results revealed that occupational sedentary activity and perceived occupational noise were the significantly reported special occupational characteristics together with other conventional risk factors among CAD naval cases verses controls [p< 0.000 and < 0.009 respectively]. Logistic regression analysis with the dependent variable as being a CAD case showed independently significant effects for family history of premature CAD, history of hypertension, smoking, history of diabetes mellitus, body mass index [BMI], leisure physical activity, fish consumption, and HDL-cholesterol. A risk prediction model utilizing these variables was constructed with an overall correct percent of 74.6%. Application of the model expresses the risk of having CAD in an individual eligible with criteria of the study population. These results are of special importance for design of preventive programs for CAD in similar high risk occupational groups

Trends and determinants among cardiac disabled workers in Alexandria

The present study was designed to investigate the trend and determinant factors among cardiac disabled workers presented in the years 2003-2005 at Health Insurance Committee for disability rating in Alexandria and to compare the currently used system with others. A retrospective study was conducted to review complete records for those below the age 65 years. The available data were coded to include age, gender, job title, disabling symptoms, presence or absence of abnormal findings in resting electrocardiogram and chest X-ray. Extra-investigations were considered by the committee in some cases including echocardiography, cardiac stress test and coronary angiography. Therapeutic interventions were coded and etiological diagnosis was classified into ischemic heart disease [IHD], rheumatic heart disease [RHD], hypertension [HT] and cardiomyopathies [CM]. The functional diagnosis was reported as presence or absence of heart failure and disability was rated as partial or total. Results revealed that rates of disabling dyspnoea, CM and heart failure were significantly increasing from year to year [p=0.038, 0.039 and 0.023 respectively]. The most common etiological diagnosis for the presented cases was IHD with high rates ranging from 69.7% to 73.6% across the 3 years. Logistic regression with total disability as the dependent variable showed that heart failure and additional information by echocardiography were the independent determinants [p= 0.020 and 0.004 respectively]. Simplified comparison between current cardiac disability rating system and American medical Association impairment classification was given. The present disability rating system lack standardization and quantification. It is recommended to integrate the metabolic equivalent [METs] measurement with the current system. Also to emphasize cardiovascular preventive programs to control cardiac disability

Influence of free radicals on cardiovascular risk due to occupational exposure to mercury

This study was designed to investigate the relation between occupational exposure to mercury and cardiovascular risk, as well as free radicals. The study subjects included 30 male workers exposed to mercury from a fluorescent lamp plant in Alexandria after exclusion of 12 workers with conditions that may bias the results. A matched control group of 20 male subjects were selected from a food industrial plant. The participants were subjected to interview, clinical examination, electrocardiograph and R-R deep breathing variability test as a measure of cardiac autonomic function. Spot urine and venous blood samples were collected to measure mercury levels. Free radicals related markers were measured in serum namely lipid peroxide, superoxide dismutase [SOD] activity, catalase activity and glutathione S-transferase. Results showed significant longer electrocardiographic Q-T[c] interval, which is corrected to heart rate, in exposed workers than in controls [p=0.002]. The R-R deep breathing variability indices were significantly increased among exposed workers in comparison to controls [maximal variation [MV] ratio, p=0.024 and MV rate, p=0.019]. The mercury levels in both urine and blood of exposed workers were significantly higher than controls [p<0.0001], with mean levels exceeding the permissible limits. Free radicals related markers revealed significant higher level of lipid peroxide, as well as significant lower levels of SOD activity, catalase activity and glutathione S-transferase among exposed workers than among controls [p<0.0001 for all]. Independent relations were observed between Q-T[c] and lipid peroxide, and between MV rate and SOD and catalase activities among exposed workers after adjustment for the confounders by multivariate regression analyses. These findings may suspect a cardiac autonomic dysfunction probably related to free radicals in mercury exposed workers. Also, it may through light on some preventive implications

Environmental factors and health probems among workers of the national project in Toshka

The National Project in Toshka is a recognized agricultural one, as well as a comprehensive developmental project. The present study was carried out to investigate environmental factors and health problems among workers in this National Project. Environmental levels of vibration, noise, heat stress, total suspended particulates and respirable dust were measured in the different activities of the project during May 2000. The health records of Behera Company Incorporation, the project main implementing contractor, in the period 1997-1999 were analyzed. Workers were classified according to the nature of occupational exposure into three groups namely; earth workers, concrete workers, and services and administration workers. Records of occupational accidents of the same group of workers and in the same period were analyzed as well. Results showed that all the measured environmental factors were within the permissible levels of exposure in the different project activities. Workers showed a significant lower rate of total health problems in the last studied year [1999] as compared to the previous two years [1997-1998] [p=0.001]. Prevalence rates of musculoskeletal disorders, urinary tract troubles, ear-nose-throat [ENT] problems and chest problems were significantly higher in earth and concrete workers than in services and administration workers [p=0.001, 0.011, 0.036 and 0.044, respectively]. Both occupational accident frequency and severity rates were very low in comparison to other major construction projects such as the High Dam. These rates showed decreasing trends throughout the studied years; however, relatively higher rates were observed among earth workers than the other groups. Miscellaneous wounds were the commonest presentation of occupational injuries among the three occupational groups. In conclusion, the current use of modern technology accounted for the low levels of environmental exposure factors, as well as the high safety standards. Workers showed a significant degree of acclimatization to work in this region; therefore, inhabitants and workers should be encouraged to engage this new community. The low rates of health problems among workers observed in this study reflected a satisfactory level of medical services. Preplacement and periodic medical examinations of construction workers aught to consider musculoskeletal, urinary tract, ENT and chest conditions among them

Validity of threshold limit value of malathion for chronically exposed industrial workers in Egypt

This study aimed to evaluate the currently applied threshold limit value [TLV] of malathion as a safe level for chronic exposure. This cross sectional study included all exposed workers in a factory producing malathion in Alexandria and a corresponding control group of 30 male individuals. All participants were subjected to questionnaire, clinical examination concerning cardio-neurological manifestations, ECG and measurement of RBC, plasma and total activity of cholinesterase. Air samples were analyzed by gas-liquid chromatography for malathion. Environmental air levels of malathion were below TLV. Difficulty in concentration, emotional outbursts and tremors were significant manifestations in relation to both exposure and low cholinesterase activity. A significant reduction of RBC, plasma and total activity of cholinesterase was observed for workers exposed to 8.35 mg/m3 in comparison with those exposed to other levels and controls