Night work, total occupational burden and cancer/cardiovascular risk factors in physicians

Department of Oncology/Pathology, Karolinska Institute, Stockholm, Sweden.
Medicinski pregled 01/2013; 65(11-12):461-9.
Source: PubMed


INTRODUCTION. Lifestyle-related risk factors: smoking, obesity, sedentariness and excess alcohol intake are among the most important known causes of cancer and cardiovascular disease. The aim of this study is to examine the relationship between these lifestyle-related risk factors for cancer/cardiovascular disease and working conditions among surgeons/anesthesiologists and other physicians. MATERIAL AND METHODS. The study was carried out among physicians aged 35 to 60, without diagnosed coronary heart disease or other structural heart disease, who were employed at the Novi Sad University Hospital. The participation rate was high (> 90%). The physicians completed the Occupational Stress Index. Low lifestyle-related cancer/cardiovascular risk was defined as: not a current smoker, body mass index < 28, regular recreational physical activity and not consuming alcohol every day. Analysis of covariance was performed. RESULTS. Of 191 physicians included in this study only 23 (12.0%) had a low lifestyle-related cancer/cardiovascular risk. Surgeons/anesthesiologists faced a heavier total work stressor burden than physicians in other profiles (87.7 +/- 8.8 versus 74.1 +/- 10.5, p=0.000). Among the 56 surgeons/anesthesiologists, lower nightshift work scores were associated with low lifestyle-related cancer/cardiovascular risk (F=4.19, p=0.046). A lower overall work stressor burden was associated with low risk among the other 135 physicians (F=4.06, p=0.046). CONCLUSION. Specific workplace intervention strategies are urgently needed. Among the surgeons/anesthesiologists these should include reduction in the frequency of night call and improvement of the overall conditions of nightshift work. Among other physicians, the total occupational burden needs to be diminished.

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Available from: Olesja Nedic, May 16, 2014
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    ABSTRACT: Health care workers constitute a high-risk occupational category owing to the character of their work that includes high-risk environment, shift work and mental as well as physical stress. In occupational medicine, caring for their health condition should be a priority and include measures aimed at preventing cardiovascular diseases. The study aimed at determining the prevalence of cardiovascular disease (CVD) risk factors in employees of a large hospital and assessing their effect on the incidence of cardiovascular events. The group comprised 3124 employees with a mean age of 36.1 years (SD = 11.4), out of whom 562 were males (mean age of 37.1 years, range: 18-72; SD = 12.26) and 2562 were females (mean age of 35.9 years, range: 18-68; SD = 11.24). At their initial examination, the employees filled in a questionnaire on basic CVD risk factors (according to valid recommendations). This was supplemented with objective data to determine the risk of CVD using valid charts. From this group, a subset of persons at a high or intermediate risk was selected, comprising 247 individuals with a mean age of 54.1 years (SD = 5.73). After 5-9 years (mean 7.24±1.38 years), they either underwent another examination or their health status was ascertained by phone or in a computer database. The end point was the incidence of cardiovascular events (sudden death, acute myocardial infarction, unstable angina pectoris, percutaneous coronary intervention, cardiac failure, stroke or transient ischemic attack). The end point was noted in a total of 15 males (6.07%) and 6 females (2.42%), being statistically significantly present in managers (males p < 0.00007, females p < 0.00001), male physicians/surgeons (p < 0.025), tertiary-educated males (p < 0.0095), female smokers (p < 0.015), male ex-smokers (p < 0.007), overweight or obese males (p < 0.02) and those with the waist-to-hip ratio above 1.0 (p < 0.005). Cardiovascular events are most likely to occur in obese male physicians/surgeons holding managerial positions and in female managers.
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