[Metabolic syndrome and work: identification of populations at risk]. / Sindrome metabolica e attività lavorativa: identificazione della popolazione a rischio.

OBJECTIVE: To assess whether shift work has a cause-effect nexus with the incidence of metabolic syndrome. DESIGN: Retrospective follow-up study, case-control type. RESEARCH METHODS AND PROCEDURES: A total of 202 female and male nurses, aged 23-60 years, having a 1 year minimal follow-up, and without any metabolic syndrome criterion at the first visit were evaluated. The ATP modified criteria were applied for the diagnosis of metabolic syndrome. Moreover smoking habitus, alcohol consumption, educational level and physical activity were considered as bias factors. The sample was divided in two groups doing or not night shifts. RESULTS: The metabolic syndrome incidence resulted significantly greater in shift workers than in other workers (OR: 4.10, 95% CI 1.34-12.55, p = 0.01). The difference was more evident in subjects aged < 40 years (OR = 6.6, 95% CI 1.05-40.85, p = 0.04) the different metabolic syndrome incidence between two groups was detectable even after the multivariate analyse, which considered all the bias factors evaluated. CONCLUSIONS: This study shows for the first time that the night shift work is associated with a greater risk to develop metabolic syndrome in workers healthy in baseline conditions.

[Metabolic syndrome in visual display units users]. / Sindrome metabolica e attività lavorativa al videoterminale.

BACKGROUND: Reports about medical consequences from sedentary work are contradictory. It might be associated with the metabolic syndrome (MS), a collection of cardiovascular risk factors including hypertension, dyslipidemia, insulin resistance and central obesity. No data are currently available on workers using visual display units (VDIU), a potential high risk group, given the sedentariness inherent in this work. PATIENTS AND METHODS: We evaluated MS prevalence in 1547 VDU users with a mean age of 29.7 years and in a control group of 892 individuals with a mean age of 30.2 years who performed non-sedentary work, selected on the basis of similar demographic data. Physical examination and laboratory tests useful for MS diagnosis were performed. RESULTS: MS prevalence was 3.10% in VDU users vs 2.01% in controls (OR 2.048, 95% CI 1.169 to 3.587, p = 0.012). Significance persisted after controlling for confounding factors (e.g, smoking and leisure activity) in a multivariate analysis (OR 1.555, 95% CI 1.03 to 2.690, p < 0.05). CONCLUSIONS: MS should carefully considered when performing health surveillance programmes in VDU users.

[Institute for preventive medicine and health promotion for a population based on university students]. / Centro di medicina preventiva e promozione della salute in una popolazione di studenti universitari.

During academic year 2006-2007 we have been trying to restart the Institute for Preventive Medicine of Università Cattolica in Milan for all university students. Thanks to a co-operation between Milan Università Cattolica Health Centre and the Postgraduate School in Medicine for Work of Università Cattolica of Rome, we have studied with the utmost care the structural and functional background of the Health Centre. Through questionnaires we have calculated all students' needs and if they felt quality in the service. In addition to that, we moved on and we investigated all ideas relating to future projects in order to restart all Institutes for Preventive Medicine in each University without additional costs for all University administrations.

Shift work and autoimmune thyroid disorders.

Stress induces autoimmune disorders by affecting the immune response modulation. Recent studies have shown that shift work stress may enhance the onset of the autoimmune Graves hyperthyroidism. On the other hand, the possible association between occupational stress and autoimmune hypothyroidism has not yet been investigated. In order to detect the possible association between shift work and subclinical autoimmune hypothyroidism we investigated the prevalence of isolated anti-peroxidase thyroid (TPO) autoantibodies in 220 shift workers and in 422 day-time workers. Subclinical autoimmune hypothyroidism was diagnosed by the concomitant presence of high anti-TPO values and TSH levels higher than 2.51 mU/l. Anti TPO antibodies were measured by chemiluminescent technology (Advia Centaur) (a value above 60 IU/l was considered altered). Subclinical autoimmune hypothyroidism was diagnosed in 7.7 percent shift workers and in 3.8 percent day-time workers with a statistically significant difference: Odds Ratio (OR) 2.12, 95 percent Confidence Interval (CI) 1.05 to 4.29; p=0.03. The difference persisted after multivariate analysis taking into account age, sex, smoking habits, alcohol intake, familial history of autoimmune thyroid disease and exposure to radiation as possible confounders: OR. 2.24, 95 percent CI.1.01 to 4.94, p 0.05. Altered anti- TPO autoantibodies were found in 13.6 percent shift workers and in 8.6 percent day-time workers OR. 1.64, 95 percent CI.1.03 to 2.74, p=0.05. The significant difference was still detectable after multivariate analysis: OR. 1.95, 95 percent CI. 1.09 to 3.48, p=0.02. Our data show a significant association between shift work and autoimmune hypothyroidism. This finding may have implications in the health surveillance programs.