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ABSTRACT: A cross-sectional study design was applied on 273 nurses to investigate associations of physical job demands, age, and musculoskeletal disorders (MSDs) in nursing. Concurrently, participants reported on various physical job demands with a standardized questionnaire for Hospital Work. As a special contribution, this investigation illustrates findings on MSDs provided by a standardized physical examination to questionnaire data. MSD located in the lower back (8.7%) had the highest frequency, followed by the neck (7.3%), the shoulders (6.9%), and the knees (2.2%). There were significant differences in the frequencies of MSD between the young/middle age-group and the old age-group in most locations, while the only significant difference between the young and the middle age-group was found for shoulder-MSD. Furthermore high levels of physical job demands increased the risk of MSD significantly (OR = 5.7, 1.55-20.96) in all age-groups. The study provides further indication for development of age-adapted preventive measures.
Applied ergonomics 02/2013; · 1.11 Impact Factor
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ABSTRACT: AIMS: (1) To explore 'successful ageing' strategies in terms of selection, optimization and compensation in nursing; (2) To develop a scale that measures these strategies in nursing; (3) To investigate the association between these strategies in nursing and work ability of nurses and the moderating effects of age on this relationship. BACKGROUND: Studies indicate impaired work ability of older nurses. Research is needed to examine if 'successful ageing' strategies can promote the work ability especially in older nurses. DESIGN: The investigation applied a mixed method design: Study (1) Semi-structured interviews were conducted to explore selection, optimization and compensation in nursing; (Study 2) A cross-sectional survey was used to test the association between selection, optimization and compensation in nursing and work ability. METHODS: Data were collected in 2010 and 2011. Study 1: 17 nurses ≥45 years were interviewed; Study 2: 438 nurses (21-63 years) participated. A selection, optimization and compensation-in-nursing-scale was applied that was developed on the basis of study 1. Work ability was measured with the Work Ability Index (Dimension 1). RESULTS: Study 1, the majority of reported ageing strategies were identified as selection, optimization and compensation in nursing. Study 2, selection, optimization, and compensation in nursing was positively related with work ability. The positive relationship was stronger for older nurses. CONCLUSION: Selection, optimization and compensation in nursing contributes positively to work ability, particularly in older nurses. This finding is relevant for the development of measures that promote work ability of nurses over the course of their professional careers.
Journal of Advanced Nursing 10/2012; · 1.48 Impact Factor
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ABSTRACT: Unemployment is associated with reduced physical and psychological well-being. Perceived health is an important factor influencing health outcomes as well as successful returns to work. This study aims to determine the extent to which perceived health correlates with mental health, various health risk characteristics and socio-demographic characteristics in a setting-selected sample of long-term unemployed persons.
Using SF-12, 365 long-term unemployed persons were assessed for self-perceived health and various socio-demographic and health characteristics. Perceived health data of the sample was compared to the German SF-12 reference population. Bivariate analyses and multiple linear regression models were applied to identify those variables significantly associated with perceived health.
The study population reported poorer perceived health compared with the general population. Analyses showed that perceived mental health was significantly worse in women, among persons with heightened depression and anxiety scores, and in participants reporting reduced levels of physical activity. Perceived physical health was significantly lower among older persons, participants with a higher BMI, and participants with heightened depression and anxiety scores. Both mental and physical health were worse among the unemployed assigned to an employment center as compared to those engaged in the secondary labor market. In total, 36% of the variance in the SF-12 mental score and 20% of the variance in the SF-12 physical score were explained by the factors included in the final multiple linear regression models.
Perceived health among a select group of long-term unemployed is reduced to a clinically relevant extent compared to the general population. The preliminary findings underline an association between mental health and perceived health. Negative self-perceptions of health were also associated with the labor market setting and some of the socio-demographic and health behavior variables. Further research is needed to determine risk factors leading to reduced perceived health in the unemployed. The strong association between mental health and perceived health suggests interventions targeting mental health are urgently needed to positively influence perceived health, a key determinant of individuals' chances to successfully return to work.
BMC Public Health 06/2012; 12:485. · 2.00 Impact Factor
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ABSTRACT: The study investigates the long-term effects of accumulated working conditions on depressive symptoms in junior doctors. Drawing on the Job Demand-Control-Support model, this study aims to identify personal and job-related determinants for self-reported depression in junior doctors-a professional group that is vulnerable to depression.
We conducted a prospective cohort study with measures of work characteristics and depressive symptoms over three time-points among hospital doctors during postgraduate specialty training in Germany. Participants were 415 junior doctors with full-time contract (47.5% women; mean age, 30.5 years). The outcome was depressive symptoms assessed with the Spielberger State-Depression Scale. Odds ratios (OR) were computed to analyse the cumulative effect of initial depressive symptoms scores, demographic variables, and working characteristics across T1 and T2 on subsequent depressive symptoms at T3.
The percentage of junior doctors reporting depressive symptoms scores above a critical value varied between 12.0% at T1, 10.4% at T2, and 13.3% at T3; N = 34 doctors (8.19%) were classified as incident cases during the observation period. Elevated depressive symptoms at T3 were positively predicted by depressive symptoms scores across T1 and T2 (OR: 1.37; 95% confidence interval: 1.25-1.50) and negatively by professional tenure (0.54; 0.31-0.96), free weekends (0.52; 0.28-0.97), and job autonomy (0.35; 0.18-0.65).
After controlling for demographic and working time influences, findings suggest that junior doctors' perceived job autonomy is negatively associated with future depressive symptoms. Enhancing job control emerges as a promising strategy to lower the risk of depression during first years of professional practice.
Archiv für Gewerbepathologie und Gewerbehygiene 09/2011; 85(5):559-70. · 1.89 Impact Factor
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ABSTRACT: Leader consideration has long been suggested to be conducive to quality of working life experienced by employees. The present study links this classic leadership dimension with more recent research on idiosyncratic deals, referring to personalized conditions workers negotiate in their employment relationships. A two-wave survey study (N = 159/142) among German hospital physicians suggests that authorizing idiosyncratic deals is a manifestation of employee-oriented leader behavior. Consideration had consistent positive effects on idiosyncratic deals regarding both professional development and working time flexibility. These two types had differential effects on two indicators of the quality of working life. Development related positively to work engagement, flexibility related negatively to work-family conflict. Cross-lagged correlations supported the proposed direction of influence between consideration and idiosyncratic deals in a subsample of repeating responders (n=91). The relation between development and engagement appeared to be reciprocal. Longitudinal results for the association between flexibility and work-family conflict were inconclusive.
Psychological Reports 02/2011; 108(1):59-74. · 0.44 Impact Factor
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ABSTRACT: To examine the long-term effects of a stress management intervention (SMI) based on the effort-reward imbalance (ERI) model, on psychological and biological reactions to work stress.
174 lower or middle management employees (99% male) were randomly assigned to an intervention or a waiting control group. The programme comprised 24 × 45 min group sessions (2 full days followed by two 4 × 45 min sessions within the next 8 months) on individual work stress situations. The primary endpoint was perceived stress reactivity (Stress Reactivity Scale, SRS), while secondary endpoints were salivary cortisol and α-amylase, anxiety and depression, and ERI. Assessments were repeated in 154 participants 1 year later.
SRS score decreased in both groups. A two-factor ANOVA with repeated measures showed a significant time × group effect (F=5.932; p=0.016) with the greater reduction in the intervention group. For SRS, the effect size (Cohen's d) after 1 year was d=0.416 in the intervention and d=0.166 in the control group. α-Amylase as a measure of sympathetic nervous system activation, decreased more strongly in the intervention group (area under the daytime curve and daytime slope: time × group effect p=0.076 and p=0.075). No difference was observed for cortisol. For depression, anxiety and ERI, improvements were higher in the intervention group but did not reach statistical significance.
SMI based on work stress theory, is effective in reducing perceived stress reactivity and sympathetic activation in lower and middle management employees. Other mental health parameters and ERI show a tendency towards improvement. These beneficial effects are present 1 year later.
Occupational and environmental medicine 02/2011; 68(2):126-33. · 3.64 Impact Factor
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ABSTRACT: BACKGROUND Interruptions of hospital doctors' workflow are a frequent stressor, eventually jeopardising quality of clinical performance. To enhance the safety of hospital doctors' work, it is necessary to analyse frequency and circumstances of workflow interruptions. AIM To quantify workflow interruptions among hospital doctors, identify frequent sources and relate sources to doctors' concurrent activities. METHODS Within a typical hospital, 32 participant observations of doctors' full work shifts were carried out. Time-motion information was collected on types of workflow interruption and doctors' activities and analysed with logit-linear analyses. RESULTS The frequency of workflow interruptions was high, especially on the intensive care unit and emergency ward. Telephones and bleepers were the most frequently recorded type of work interruption. The combined analysis of doctors' activities and concurrent workflow interruptions revealed that the likelihood of the occurrence of certain types of interruption depended on the tasks being carried out by the doctor. CONCLUSION The present method may be useful for quantifying and distinguishing sources of hospital doctors' workflow interruptions and useful in raising awareness of organisational circumstances.
BMJ quality & safety 01/2011; 20(6):491-7.
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ABSTRACT: Apron controllers (ACs) determine the taxiways for aircraft entering the apron area until they reach their parking positions and vice versa. The aims of this study were to identify age-sensitive job requirements of apron control (Study 1), and to investigate the relationship between age of ACs and their workload (Study 2).
Study 1: There were 14 experienced ACs who assessed the job requirements of apron control with the Fleishman-Job Analyses Survey. Additionally, during one shift, the number of parallel processed traffic data sets (indicating memory-load) and the number of delivered radio messages (indicating processing speed requirements) were assessed. Study 2: There were 30 ACs (age: 23-51 yr) who volunteered for trials during late shifts at an international airport. ACs assessed their subjective workload (NASA-Task Load Index) at four times during the shift and carried out an attention test (d2) before and after the shift. Moreover, their heart rate was assessed during the shift and in a reference period.
Study 1: Results indicate that apron control requires especially high levels of memory-load and processing speed. Study 2: Hierarchical regression analyses revealed a u-shaped relationship between age and subjective workload (beta = 0.59) as well as heart rate (beta = 0.33). Up to the age of about 35-37 yr, workload and heart rate decreased with age, but afterwards the relationship became positive. There was no association between chronological age and attention performance.
There is a need for age adequate job design in apron control that should especially aim at the reduction of memory-load and processing speed.
Aviation Space and Environmental Medicine 01/2011; 82(1):26-33. · 0.88 Impact Factor
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ABSTRACT: This study examines the relationship between pupillary unrest (PU) and cognitive load.
PU represents a measure of reduced central nervous tonic arousal (sleepiness). A loss of tonic arousal can be associated with difficulties in maintaining the required level of performance. Thus, the measurement of tonic arousal in occupational contexts can help to prevent overload or errors.
We compared a group with high cognitive load (30 apron controllers of an international airport) with a control group with low cognitive load (63 healthy people during their free time) in a non-randomized experimental design with pre- and post-test assessment of PU. PU was scanned by an infrared sensor with a frequency of 25 Hz and a resolution of .05 mm. To control for circadian effects, measurements for both groups were taken at the same time of the day.
High PU at the start of the shift correlated with high perceived load during the shift. There were no indications of reverse effects. Analyses of group x time effects with generalized linear models (repeated measures) revealed that cognitive load did in no way affected PU.
Initially low tonic arousal (indicated by high PU) may predict subsequent workload, but being exposed to high cognitive load does not influence tonic arousal after the end of the shift. With that, the study contributes to valid interpretations of pupillary unrest measurements in occupational contexts.
Archiv für Gewerbepathologie und Gewerbehygiene 10/2010; 84(5):561-7. · 1.89 Impact Factor
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ABSTRACT: Two established approaches to work redesign are formal top-down interventions and proactive bottom-up job crafting. Top-down approaches are limited in their ability to create individually optimized work characteristics, whereas bottom-up processes are constrained by the latitude workers have to modify their own jobs. Following recent research on the idiosyncratic deals (i-deals) individuals negotiate with their employer, task i-deals customizing job content are suggested as a third approach to work redesign. Hypotheses on antecedents and consequences of task i-deals were tested in two studies conducted in the United States and Germany using structural equation modeling. LMX related positively to the extent of successfully negotiated task i-deals, which, in turn, was associated with a more positive evaluation of work characteristics—specifically, higher complexity and control and lower stressors. Work characteristics mediated positive indirect effects of task i-deals on employee initiative and work engagement. Denied requests for task i-deals were associated with a more negative assessment of work characteristics. We conclude with theoretical, practical, and research implications for better understanding and implementing work redesign through i-deals. Copyright copyright 2010 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR] Copyright of Journal of Organizational Behavior is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Journal of Organizational Behavior. 02/2010; 31(2/3):187-215.
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ABSTRACT: Abstract
Background
Work related stress is associated with a range of debilitating health outcomes. However, no unanimously accepted assessment tool exists for the early identification of individuals suffering from chronic job stress. The psychological concept of self-perceived stress reactivity refers to the individual disposition of a person to answer stressors with immediate as well as long lasting stress reactions, and it could be a valid indicator of current as well as prospective adverse health outcomes. The aim of this study was to determine the extent to which perceived stress reactivity correlates with various parameters of psychosocial health, cardiovascular risk factors, and parameters of chronic stress and job stress in a sample of middle-aged industrial employees in a so-called "sandwich-position".
Methods
In this cross-sectional study, a total of 174 industrial employees were assessed for psychosocial and biological stress parameters. Differences between groups with high and low stress reactivity were analysed. Logistic regression models were applied to identify which parameters allow to predict perceived high versus low stress reactivity.
Results
In our sample various parameters of psychosocial stress like chronic stress and effort-reward imbalance were significantly increased in comparison to the normal population. Compared to employees with perceived low stress reactivity, those with perceived high stress reactivity showed poorer results in health-related complaints, depression, anxiety, sports behaviour, chronic stress, and effort-reward imbalance. The educational status of employees with perceived low stress reactivity is higher. Education, cardiovascular complaints, chronic stress, and effort-reward imbalance were moderate predictors for perceived stress reactivity. However, no relationship was found between stress reactivity and cardiovascular risk factors in our sample.
Conclusions
Job stress is a major burden in a relevant subgroup of industrial employees in a middle management position. Self-perceived stress reactivity seems to be an appropriate concept to identify employees who experience psychosocial stress and associated psychological problems at the workplace.
BMC Public Health. 01/2010;
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ABSTRACT: Work related stress is associated with a range of debilitating health outcomes. However, no unanimously accepted assessment tool exists for the early identification of individuals suffering from chronic job stress. The psychological concept of self-perceived stress reactivity refers to the individual disposition of a person to answer stressors with immediate as well as long lasting stress reactions, and it could be a valid indicator of current as well as prospective adverse health outcomes. The aim of this study was to determine the extent to which perceived stress reactivity correlates with various parameters of psychosocial health, cardiovascular risk factors, and parameters of chronic stress and job stress in a sample of middle-aged industrial employees in a so-called "sandwich-position".
In this cross-sectional study, a total of 174 industrial employees were assessed for psychosocial and biological stress parameters. Differences between groups with high and low stress reactivity were analysed. Logistic regression models were applied to identify which parameters allow to predict perceived high versus low stress reactivity.
In our sample various parameters of psychosocial stress like chronic stress and effort-reward imbalance were significantly increased in comparison to the normal population. Compared to employees with perceived low stress reactivity, those with perceived high stress reactivity showed poorer results in health-related complaints, depression, anxiety, sports behaviour, chronic stress, and effort-reward imbalance. The educational status of employees with perceived low stress reactivity is higher. Education, cardiovascular complaints, chronic stress, and effort-reward imbalance were moderate predictors for perceived stress reactivity. However, no relationship was found between stress reactivity and cardiovascular risk factors in our sample.
Job stress is a major burden in a relevant subgroup of industrial employees in a middle management position. Self-perceived stress reactivity seems to be an appropriate concept to identify employees who experience psychosocial stress and associated psychological problems at the workplace.
BMC Public Health 01/2010; 10:252. · 2.00 Impact Factor
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ABSTRACT: Hospital physicians' time is a critical resource in medical care. Two aspects are of interest. First, the time spent in direct patient contact - a key principle of effective medical care. Second, simultaneous task performance ('multitasking') which may contribute to medical error, impaired safety behaviour, and stress. There is a call for instruments to assess these aspects. A preliminary study to gain insight into activity patterns, time allocation and simultaneous activities of hospital physicians was carried out. Therefore an observation instrument for time-motion-studies in hospital settings was developed and tested.
35 participant observations of internists and surgeons of a German municipal 300-bed hospital were conducted. Complete day shifts of hospital physicians on wards, emergency ward, intensive care unit, and operating room were continuously observed. Assessed variables of interest were time allocation, share of direct patient contact, and simultaneous activities. Inter-rater agreement of Kappa = .71 points to good reliability of the instrument.
Hospital physicians spent 25.5% of their time at work in direct contact with patients. Most time was allocated to documentation and conversation with colleagues and nursing staff. Physicians performed parallel simultaneous activities for 17-20% of their work time. Communication with patients, documentation, and conversation with colleagues and nursing staff were the most frequently observed simultaneous activities. Applying logit-linear analyses, specific primary activities increase the probability of particular simultaneous activities.
Patient-related working time in hospitals is limited. The potential detrimental effects of frequently observed simultaneous activities on performance outcomes need further consideration.
BMC Health Services Research 07/2009; 9:110. · 1.66 Impact Factor
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ABSTRACT: Firefighters face a highly increased risk of sudden cardiac death during fire suppression. Medical examinations and physical performance tests are used to screen endangered firefighters. The aim of this study was to determine cardiocirculatory and thermal strain during fire suppression in firefighters and compare it with the strain during medical and performance evaluations. Forty-nine young professional male firefighters were studied during a 30-minute fire operation (FO) in a large fire simulation plant. Measurements were obtained immediately before, during, and after the FO. During the FO, maximum heart rates of 177 +/- 23 beats/min were recorded on average, with 7 subjects exceeding the age-predicted maximum. Body core temperature increased by 0.9 +/- 0.5 degrees C (p <0.001), body weight decreased by 0.6 +/- 0.2 kg (p <0.001), and blood parameters changed accordingly. Sixteen percent of subjects developed asymptomatic postural hypotension. In an exercise stress test as part of the mandatory medical examination, subjects were limited to heart rates of 176 +/- 3.3 beats/min. They reached 155 +/- 13 beats/min during the annual aerobic exercise in turnout gear. During the FO, maximum heart rate was higher than during the stress test in 66% and higher than during the aerobic exercise in 84% of subjects. In conclusion, fire suppression caused an extreme cardiocirculatory strain, with high heart rates that were not sufficiently tested in medical examinations. To increase the yield of screening for firefighters at risk of death during fire suppression, the exercise should equal requirements in a real emergency; in other words, be limited by exhaustion or age-predicted maximum heart rate.
The American journal of cardiology 01/2009; 102(11):1551-6. · 3.58 Impact Factor
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ABSTRACT: Measurement of exhaled nitric oxide is widely used in respiratory research and clinical practice, especially in patients with asthma. However, interpretation is often difficult, due to common interfering factors, and little is known about interactions between factors. We assessed the influences and interactions of factors such as smoking, respiratory tract infections and respiratory allergy concerning exhaled nitric oxide values, with the aim to derive a scheme for adjustment. We studied 897 subjects (514 females, 383 males; mean age+/-standard deviation 34.5+/-13.0 years) with and without respiratory allergy (allergic rhinitis and/or asthma), smoking and respiratory tract infection. Logarithmic nitric oxide levels were described by an additive model comprising respiratory allergy, smoking, respiratory tract infection, gender and height (p0.001 each), without significant interaction terms. Geometric mean was 17.5ppb in a healthy female non smoker of height 170cm, whereby respiratory allergy corresponded to a change by factor 1.50, smoking 0.63, infection 1.24, male gender 1.17, and each 10cm increase (decrease) in height to 1.11 (0.90). Factors were virtually identical when excluding asthma and using the category allergic rhinitis instead of respiratory allergy (n=863). Within each category formed by combinations of these different predictors, the range of residual variation was approximately constant. We conclude that the factors influencing exhaled nitric oxide, which we analyzed, act independently of each other. Thus, circumstances such as smoking and respiratory tract infection do not appear to affect the usefulness of exhaled nitric oxide, provided that appropriate factors for adjustment are applied.
Respiratory Medicine 08/2008; 102(7):962-9. · 2.47 Impact Factor
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ABSTRACT: Bronchial asthma, COPD and extrinsic allergic alveolitis are respiratory diseases that can be also acquired through occupational exposure. However, the definitive identification of an occupational disease is difficult because the symptoms do not exclusively appear in direct connection with noxious workplace substances but rather also appear in the leisure time. It is still important to make an early and clear correlation in order to establish preventive measures at the workplace if necessary.
MMW Fortschritte der Medizin 01/2008; 149(49-50):37-40.
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ABSTRACT: Adipocytokines are under investigation as mediators of cardiovascular risk. In 142 non-diabetic postmenopausal women, we investigated whether plasma levels of adiponectin and leptin are associated with changes in carotid intima-media thickness (IMT) and distensibility as assessed by high-resolution ultrasound. Adiponectin but not leptin correlated weakly with baseline measures of IMT and distensibility. After 12 months, carotid IMT showed a significant progression [0.023 mm (95% CI, 0.014-0.031 mm)] whereas stiffness was unaltered. A threshold was identified for the relation of adiponectin with both progression of IMT and stiffness. Age-adjusted adiponectin levels in the lowest quartile versus second to fourth quartile were related to progression of IMT (odds ratio, 2.99; 95% CI, 1.81-5.09) and stiffness (odds ratio, 1.71; 95% CI, 1.19-4.07). Adjustment for possible confounding factors and intermediates weakened this association only to a minor degree. No such associations were observed for leptin. We conclude that low levels of adiponectin are associated with adverse changes in morphology and function of central arteries over time independently of other cardiovascular risk factors in postmenopausal non-diabetic women.
Atherosclerosis 11/2007; 194(2):e147-53. · 3.79 Impact Factor
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ABSTRACT: The study aimed to clarify whether cognitive and psychomotor performance, which are important for occupational and traffic safety, are impaired by working permanent night shifts (NSs) compared with early-late two shifts (TSs) and whether age and chronobiological type influences the relationship between shift and performance.
The study included 44 male automobile workers, 20 working TSs and 24 working NSs. Chronobiological type was determined by questionnaire (D-MEQ). Each subject was tested at the beginning and end of the shift for alertness [by a visual analogue scale (VAS)]; feeling of well-being (Basler); concentration and accuracy (d2); reaction speed, orientation and reaction to stress (Vienna System).
TS workers were more frequently morning types whereas the NS workers were more frequently evening types. In the performance tests, the TS and NS workers did not differ at shift start or shift end. Over the course of the shift, concentration and accuracy improved in both groups, as did reaction to stress. Chronobiological type alone or in combination with shift type had no effect on performance.
The results of this study indicate that-if chosen voluntarily-working NSs has no immediate negative effects on cognitive and psychomotor performance when compared with working TSs. There was no indication of an increased risk of accidents after working NSs. The unequal distribution of the circadian types in the shift groups may indicate selection.
Archiv für Gewerbepathologie und Gewerbehygiene 04/2005; 78(2):109-16. · 1.89 Impact Factor
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ABSTRACT: A new technique to prevent fires is continuous exchange of oxygen with nitrogen which leads to an oxygen concentration of between 15% and 13% in the ambient air. This paper reviews the effect of short-term, intermittent hypoxia on health and performance of people working in such atmospheres.
We reviewed the effect of ambient air hypoxia on human health in the literature using Medline, as well as reference lists of articles and handbooks. Articles were assessed from the perspective of working conditions in fire-protected rooms.
Oxygen reduced to 15% and 13% in normobaric atmospheres is equivalent to the hypobaric atmospheres found at 2,700 and 3,850-m altitudes. When acutely exposed, a healthy person responds within minutes to hours with increased ventilation, stimulation of the sympathetic system, increased heart rate, increased pulmonary-circulation resistance, reduced plasma volume, and stimulation of erythropoesis. Acute mountain sickness occurs frequently at these oxygen partial pressures, but the full syndrome is rare if continuous exposure is limited to 6 h. Mood, cognitive, and psychomotor functions may be mildly impaired in these conditions, but data are inconclusive. Persons suffering from cardiac, pulmonary, or hematological diseases should consult a specialist in order for their individual risk to be assessed, and medical screening for any of these diseases is strongly recommended prior to exposure.
Preliminary evidence suggests that working environments with low oxygen concentrations to a minimum of 13% and normal barometric pressure do not impose a health hazard, provided that precautions are observed, comprising medical examinations and limitation of exposure time. However, evidence is limited, particularly with regard to workers performing strenuous tasks or having various diseases. Therefore, close monitoring of the health problems of people working in low oxygen atmospheres is necessary.
Archiv für Gewerbepathologie und Gewerbehygiene 04/2003; 76(2):87-102. · 1.89 Impact Factor
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ABSTRACT: Intervention trials in postmenopausal women with coronary artery disease have failed to demonstrate beneficial effects of hormone replacement therapy (HRT) on the course of disease, potentially due to pro-inflammatory effects of conjugated equine estrogens. We characterized the effects of 48 weeks treatment with two estradiol-based HRT regimens on nonspecific (high sensitivity C-reactive protein [hs-CRP], blood sedimentation rate [BSR], fibrinogen) and specific endothelial markers (cell adhesion molecules: ICAM-1, VCAM-1, E-selectin).
Postmenopausal women randomly received either 1 mg 17beta-estradiol daily plus 25 microg gestodene for the last 12 days of each 28 day cycle (=standard dose progestin; n=65), or gestodene added each third cycle only (=low dose progestin; n=65), or no HRT (n=73). Both HRT regimens reduced levels of ICAM-1 (-9%), VCAM-1 (-9%), E-selectin (-11%), fibrinogen (-12%), BSR (-5%). No effect was observed on hs-CRP levels in any group. In smokers, E-selectin remained unchanged whereas ICAM-1 and VCAM-1 were lowered. Subjects on antihypertensive or lipid lowering medication showed effects comparable to the whole cohort. Effects of low and standard dose progestin were not different.
We conclude that a combination therapy with 1 mg 17beta-estradiol favourably affects the vascular inflammation processes as indicated by a neutral effect on hs-CRP and reduction of cell adhesion molecules.
Atherosclerosis 01/2003; 165(2):301-7. · 3.79 Impact Factor
