Irregular working times and metabolic disorders among truck drivers: a review

A number of studies to better understand the complex physiological mechanism involved in regulating body weight have been conducted. More specifically, the hormones related to appetite, leptin and ghrelin, and their association to obesity have been a focus of investigation. Circadian patterns of these hormones are a new target of research. The behaviour of these hormones in individuals subject to atypical working times such as shiftwork remains unclear. Shiftwork is characterized by changes in biological rhythms and cumulative circadian phase changes, being associated with high rates of obesity and metabolic syndrome. Truck drivers, who work irregular shifts, frequently present a high prevalence of obesity, which might be associated with work-related factors and/or lifestyle. In this context, the aim of this paper was to discuss the relationship of body mass index, appetite-related hormones and sleep characteristics in truck drivers who work irregular shifts compared with day workers.     

Keep time, stay healthy

Recent studies reveal that sleep loss in humans leads to metabolic disorders. A new study reports the development of metabolic syndrome in mice with altered circadian timing brought about by a mutation in a gene that functions in the biological clock. An intriguing and unanswered question is the relation between a healthy biological clock and normal appetite and weight regulation.     

A work in progress: the metabolic syndrome

Metabolic syndrome refers to a constellation of risk factors for cardiovascular disease. They include elevated plasma glucose concentrations, dyslipidemia, hypertension, and abdominal obesity. These conditions typically occur during middle age or later in life. Although there is no clear consensus on the diagnosis of metabolic syndrome, it is a potentially important entity to recognize and manage once traditional cardiovascular risk factors, such as smoking, hypertension, dyslipidemia, and diabetes, have been treated individually. This Perspective summarizes our current knowledge of the metabolic syndrome. Lifestyle change, including diet and exercise, is probably the best available option for treating the metabolic syndrome. However, rigorous lifestyle interventions are difficult to implement outside of a clinical trial setting, especially among elderly patients.     

Daily rhythm of salivary IL-1ß, cortisol and melatonin in day and night workers

Shiftwork-induced sleep deprivation and circadian disruption probably leads to an increase in the production of cytokines and dysregulation of innate immune system, respectively. This project aims evaluating changes in salivary IL-1 beta, cortisol, and melatonin in night workers. Method. Two day and three night healthy workers participated in this study. Sleep was evaluated by actimetry and activity protocols. Saliva was collected at waking and bedtime the last workday and the following two days-off and was analyzed by ELISA. Results. Neither sleep duration nor efficiency showed any association with salivary IL-1beta. IL-1beta levels were higher at waking than at bedtime during working days for all workers, but only one day and one night-worker maintained this pattern and hormone rhythms during days off. For this night worker, melatonin levels were shifted to daytime. A second one presented clear alterations in IL-1beta and hormone rhythms on days-off. Conclusions. Our preliminary results suggest that night work can disturb the variation pattern of salivary IL-1beta. No association of this variation with sleep was observed. It seems that disruption in hormone rhythms interfere with salivary IL-1beta production. IL- 1beta production pattern seems to be maintained when rhythms are present, in spite of a shift in melatonin secretion.     

Metabolic syndrome and the menopause

The metabolic syndrome consists of a combination of risk factors that include abdominal obesity, atherogenic dyslipidaemia, hypertension and insulin resistance. It increases the risk of cardiovascular disease and type 2 diabetes. The increased risk of cardiovascular disease is higher in women than in men. The first manifestation of metabolic syndrome may occur in pregnancy presenting as gestational diabetes or preeclampsia. Both conditions are associated with increased insulin resistance. Also metabolic syndrome is more common in polycystic ovarian syndrome. It has been suggested that there is a metabolic syndrome resulting from the menopause due to estrogen deficiency, as many of the risk factors are more prevalent in postmenopausal women. Also estrogen replacement improves insulin sensitivity and reduces the risk of diabetes. The key elements in managing the metabolic syndrome are weight reduction, increasing physical activity and diet modification. If blood pressure, lipid and glycaemic control are not achieved through these interventions then pharmacological therapy will be required.     

Effects of androgens in men with the metabolic syndrome

The metabolic syndrome is well recognized as the association between obesity, elevated blood lipids, hypertension, hepatic steatosis, impaired glucose tolerance/diabetes mellitus type II and increased risk for cardiovascular disease. Recently, several publications have demonstrated that uisceral accumulation of fat seems to be more important than general obesity and that several endocrine disturbances should be included in this syndrome. The first observations concerning the importance of body fat distribution and endocrine disturbances, however, were made in the 1940s and later confirmed by further research. Concerning the endocrine disturbances, we have specifically found that abdominal, i.e. visceral, type of obesity is associated with low levels of sex steroids in both men and women, increased Cortisol activity as well as a blunted growth hormone action. In several hormonal intervention studies, we have also demonstrated favorable effects on visceral obesity, insulin sensitivity, blood lipids and blood pressure. Furthermore, recent results from our research group have indicated that this complex of signs and diseases is associated with psychiatric signs such as mental stress, signs of melancholy and decreased life satisfaction. In order to explain better the possible pathogenesis of these risk factors and diseases, the term ‘the neuroendocrine syndrome’ seems to be more adequate. This article willfocus on important biological mechanisms in hormonal intervention strategies, especially androgen treatment, for patients with this syndrome.     

Hypogonadotrophic hypogonadism in type 2 diabetes

Recent work shows a high prevalence of low testosterone and inappropriately low luteinizing hormone (LH) and follicle stimulating hormone (FSH) concentrations in type 2 diabetes. This syndrome of hypogonadotrophic hypogonadism (HH) is associated with obesity in patients with type 2 diabetes. However, the duration of diabetes or HbA1c are not related to HH. Furthermore, recent data show that HH is not associated with type 1 diabetes. C-reactive protein concentrations have been shown to be elevated in patients with HH and are inversely related to plasma testosterone concentrations. This inverse relationship between plasma free testosterone and C- reactive protein concentrations in patients with type 2 diabetes suggests that inflammation may play an important role in the pathogenesis of this syndrome. This is of interest since inflammatory mechanisms may have a cardinal role in the pathogenesis of insulin resistance. It is also relevant that in the mouse, deletion of the insulin receptor in neurons leads to HH in addition to a state of systemic insulin resistance. It has also been shown that insulin facilitates the secretion of gonadotrophin releasing hormone (GnRH) from neuronal cell cultures. Thus, HH may be the result of insulin resistance at the level of the GnRH secreting neuron. Low testosterone concentrations are also related to an increase in total and regional adiposity. This review discusses these issues and attempts to make the syndrome relevant as a clinical entity. Clinical trials are required to determine whether testosterone replacement alleviates insulin resistance and inflammation. In addition, low testosterone levels are associated with an increase in cardiovascular events. Testosterone therapy may therefore, reduce cardiovascular risk. This important aspect requires further investigation.     

STILL FEELING PROUD TO BE WORKING FOR YOUR EMPLOYER? LONGITUDINAL CHANGES IN WHITE COLLAR EMPLOYEES' MORALE IN A TIME OF ORGANIZATIONAL RESTRUCTURING

Using two panels of employer-employee matched datasets, this study investigates the changes in work morale for white-collar employees—managerial, professional, and technical (MPT) workers—and how such changes are related to organizational restructuring. Findings suggest little changes in work morale of white-collar workers—more MPT workers in the 2002 data strongly agreed that they “feel proud to be working for their employers” than did their counterparts in 1991, but fewer of them agreed to the statement. Moreover, managerial employees have been increasingly akin to the tall organizational hierarchy, but display some resentment toward teamwork. In contrast, work morale of professional/technical workers is not related to the changes in organizational hierarchy and teamwork, but their positive reaction to internal labor markets has significantly declined from 1991 to 2002. The conclusion section summarizes major findings and discusses implications for future studies on this subject.     

Advances in the Conceptualization of Personality Disorders: Issues Affecting Social Work Practice and Research

This article provides a review of the research that has informed the proposed changes to the DSM-5 conceptualization of personality psychopathology with a focus on implications for social work practice and research. A paradigm shift to a dimensional model is likely to replace the current categorical model of personality disorders and will have profound implications for the profession. While establishing a diagnostic system that is grounded in empirical knowledge is the primary benefit, this tool will also be more consistent with social work’s orienting theories and values. Social workers should gain knowledge about the proposed changes and actively participate in the review process.     

Shift Work and Work to Family Fit: Does Schedule Control Matter?

We used the 2008 National Study of the Changing Workforce to investigate the effects of shift work on individuals. We investigated if shift workers would have poorer work to family fit than workers with regular day schedules or flexible schedules. We also investigated if control of work schedule would moderate the possible negative effects of shift work. Results indicate that shift work is associated with increased work to family conflict, especially for women. In addition, the results indicate that women have greater work to family conflict compared to men when workers have more work schedule control. Implications of the findings are discussed.     

Shift work--problems and its impact on female nurses in Udaipur, Rajasthan India

Abstract : There is good evidence that shift work has negative effects on workers health, safety and performance. It is quite appropriate that attention is paid to this very important feature of socio-technical systems, which may adversely affect mental and physical health, social life and safety of shift workers. Research into the impact of shift work on professionals has consistently identified a range of negative outcomes in physical, psychological, and social domains (Akerstedt, 1988; Costa, Lievore, Casaletti, Gaffuri, & Folkard, 1989; Kogi, 2005; Paley & Tepas, 1994). Hospitals, the biggest employer in the health care field, employ more night shift workers than any other industry. It can therefore be inferred that in medical domain high percentage of workforce may be affected by problems related to shift work. Thus the present study will provide knowledge base for the problems faced by the female nurses. The present study was undertaken with an objective of getting an insight into the problems faced by female nurses in shift work. . It was found that the female nurses in India worked on roaster pattern of change in shift every seven days. They did not have a say in the change of duties, it could only be done on mutual grounds. Partners of younger group did not much adjust to their shift pattern this created stress among the nurses.The results showed that the female nurses in both the age groups i.e. 30-45 years and 45-60 years faced many problems related to health and well being, fatigue, social and domestic situations. They could not give much time to their children in particular. Travelling in nights was risky for them. Common problem was the insufficient sleep during night shifts. The nurses had to cater to the needs of the family, children in particular along with the adjustments to be made due to shift work. They had to sometimes do the night duties and attend social functions as a part of their duty. Children and husband in some cases did not cooperate this lead to frustration. When asked as to whether they would could shift job if they get regular one more than 50 % said yes this means that there need to be come training and intervention for the shift workers and their family so that the problems faced and their impact on personal health of the female nurses could be reduced.     

Beyond Individualised Approaches to Diabetes Type 2

Explanations for type 2 diabetes are broadened beyond the individual body and ‘bad lifestyles’ to include major institutions, the social and material contexts of food and eating, and employment. Precarious employment, a social determinant of health, encourages changes to food practices, lowers working conditions, worsens health, can bring poverty and increases shift work, a causal risk factor for diabetes. Scientists have played a part in revolutionising foods and technologies which minimise labour and movement. There are excess additives in processed food. Genetic explanations for the higher rates of diabetes in First Nations peoples give way to social explanations: colonial history, British/Euro‐American cuisine, food insecurity, trauma and social conditions resulting in chronic stress. Self‐management education takes a ‘nutritionist’ approach towards food and eating and tends to minimise the social context and skills of those with the condition particularly women workers in poorer social groups who have higher rates of diabetes (T2DM).     

Does Metabolic Syndrome Impair Sexual Functioning in Adults With Overweight and Obesity?

Objectives: Obesity is a growing public health concern worldwide, and results in increased risk of cardiovascular disease, type 2 diabetes, metabolic syndrome, insulin resistance, dyslipidemia, hypertension, and reduced sex hormone production. Previous research suggests that obesity may contribute to sexual dysfunction. This review aims to determine the relationship between obesity and sexual dysfunction, and ascertain the associated cardiometabolic conditions that may contribute to impaired sexual functioning in individuals with obesity. Methods: Literature searches were conducted through PubMed and Embase from 1980 to 2016, to identify original research articles, reviews including systematic reviews and meta-analyses, using the search terms: obese, obesity, overweight, sexual function, sexual dysfunction, metabolic syndrome, CVD, T2D, hormones and weight loss. Results: This review found that individuals with obesity and cardiometabolic comorbidities were more likely to report the greatest degree or sexual dysfunction and/or reduction in sexual quality of life, compared to those without. Conclusions: Current evidence supports an association between sexual dysfunction and factors associated with obesity, such as reduced insulin sensitivity, dyslipidaemia, hypertension, and low oestrogen or testosterone. To establish efficacious treatments, research examining the impact of weight loss on the conditions associated with obesity, such as hypertension, reduced insulin sensitivity, dyslipidaemia, and low sex hormones and sexual functioning in individuals with overweight and obesity should be a priority.     

A cross-sectional study on the shift work and metabolic syndrome in Japanese male workers

Introduction.?Shift work has been reported to be associated with an increase in the metabolic syndrome (MetS). To clarify the association between the type of shift work and the risk of MetS, a cross-sectional field survey was conducted after adjusting for age and lifestyle factors.

Methods.?The subjects were 3007 Japanese males, aged 34–64 years old, who were employees (1700 day and 1307 shift workers) of a car-manufacturing company. The standard Japanese criteria for the diagnosis of MetS was used. Age, smoking habit, drinking habit, sleeping habit and exercise habit were used as the independent variables.

Results.?The prevalence of MetS in the day workers, two-shift workers, and three-shift workers were 13.8% (234/1700), 10.7% (120/1125) and 17.6% (32/182), respectively. There was a significant difference in the prevalence between the two-shift workers and the day workers. Estimation of the odds ratios (95% confidence intervals) of age, two-shift work and habitual exercise for MetS were 1.03 (1.01–1.04), 0.77 (0.61–0.98) and 0.64 (0.51–0.81), respectively.

Conclusion.?Two-shift work was associated with lower risk of MetS, which is not in accordance with past reports. This finding should therefore be re-analysed, including investigation of the job content in each group.     

ISA,ISSAM, EAU,EAA and ASA recommendations: investigation,treatment and monitoring of late-onset hypogonadism in males

Abstract

Hypogonadism or Testosterone Deficiency (TD) in adult men as defined by low levels of serum testosterone accompanied by characteristic symptoms and/or signs as detailed further on can be found in long-recognized clinical entities such as Klinefelter syndrome, Kallmann syndrome, pituitary or testicular disorders, as well as in men with idiopathic, metabolic or iatrogenic conditions that result in testosterone deficiency. These recommendations do not encompass the full range of pathologies leading to hypogonadism (testosterone deficiency), but instead focus on the clinical spectrum of hypogonadism related to metabolic and idiopathic disorders that contribute to the majority of cases that occur in adult men.     

Frequency of job stressors,difficulty unwinding after work,and sleep problems among urban transit operators

Poor sleep quality is associated with numerous physical and mental health problems. The purpose of this study is to analyze the occupational and demographic factors associated with sleep problems among a sample of urban transit operators. The sample consists of 676 workers (44% female, 67% African American) at a Northern California public transit agency who participated in a cross-sectional worksite tobacco survey. Approximately 27% of the sample reported that they often had trouble going to sleep or staying asleep in the past 12?months. Results of multivariate logistic regression analysis showed that frequency of job stressors (e.g., equipment problems, road or traffic problems, poor access to bathrooms) and amount of time needed to unwind and relax after work were significantly associated with often experiencing insomnia symptoms (odds ratio [OR]?=?1.76 and 2.44, respectively). Younger workers, females, and nicotine-dependent smokers were more likely to report often experiencing sleep problems than older workers, males, and nonsmokers. Employment length and work shift were not associated with the outcome. The findings indicate that transit operators experience elevated prevalence of past-year sleep problems, and occupational factors play a role in their occurrence. Future research should explore if policies that help reduce frequency of job stressors can mitigate poor sleep quality among this occupational group.     

Administrative rationality and coping strategies in shift work

Shift work (SW) can affect worker health and productivity. Working at night, workers often accumulate fatigue and are less productive. In Brazil, laws have been drafted aiming to reduce night work and rotating shift hours. In order to slash costs, companies have been looking for new arrangements to improve productivity under these conditions. The purpose of this study was to examine management changes and their outcomes in a large glass factory located in an industrial region of Brazil. The results show that the management, seeking equal productivity among shifts, focused its efforts mainly on distributing employee expertise. The arrangement resulted in 12 different groups that combine to serve three fixed shifts. A same shift can be served by more than one group, and the members of a same group share days off on different days. There was no statistically significant productivity difference among the three shifts. The on-site examination showed that part of the production was held by the workers and transferred to the next shift in order for them to be able to meet the management's performance rate requirements. The finding shows how a Brazilian cultural trait (resistance without conflict) is used to drive coping in SW.     

Minor psychiatric disorders among nursing workers--is there an association with current or former night work?

We aimed at analyzing whether Minor Psychiatric Disorders (MPD) is associated to night work either currently or in the past. A cross-sectional study was conducted at three public hospitals in Brazil, with female nursing workers. Data collection (N=1,134) was based on a comprehensive questionnaire that included the self-reported questionnaire (SRQ-20) for screening of MPD. Former night workers were subdivided into three groups according to their reasons for leaving night work: (i) directly related to work, (ii) related to better reconcile with studies or another job, and (iii) related to health, sleep, fatigue or stress. Binomial logistic regression was performed, with adjustment for potential confounders. A dose response gradient was observed between current night work and MPD (OR=1.5; 95% CI: 1.1-2.2 and OR=2.1; 95%CI: 1.5-3.1 for those who worked up to five nights and six or more nights per 2-week span, respectively). Potential detrimental effects of night work were confirmed. The association between working at night and MPD was not restricted to current night workers as workers who left night work for health/fatigue/sleep/strain also showed higher chances of reporting MPD (OR=1.8;95%CI:1.14-2.90). Results contribute to the scientific debate on the impact of night work on health and wellbeing.     

Migrant women farm workers in the occupational health literature

Little attention has been given to the vulnerable populations of migrant women agricultural workers. A systemic review in PubMed was carried out (1990-2008) using terms related to migrant agricultural workers, with specific focus on women. Case studies from Lebanon and California are presented to highlight key physical, psychosocial, and cultural risk factors among these working populations. The review revealed a host of potential problems that span from pesticide exposure and musculoskeletal disorders to socio-cultural barriers. Comprehensive exposure-outcome and intervention studies focusing specifically on migrant women in agriculture are lacking. In depth studies focusing on the work environment of migrant women workers in the agricultural sector are needed. Personal and environmental factors that influence health should be considered in any effective intervention aiming to influence policy making and have a positive impact on these vulnerable working populations.     

Risk factors for incident carpal tunnel syndrome: results of a prospective cohort study of newly-hired workers

Carpal tunnel syndrome is one of the most costly upper extremity disorders in the working population. Past literature has shown an association between personal and work factors to a case definition of carpal tunnel syndrome but little is known about the combined effects of these factors with the development of this disorder. Few studies have examined these associations in longitudinal studies. The purpose of this paper is to identify risk factors for incident carpal tunnel syndrome in a longitudinal study of workers across a wide range of occupations.