Endocrine markers during a job intervention

An intervention consisting of a thorough examination of the psychological worksite problems and a follow-up with feedback and recommendations was made in four different office worksites. One of the sites («active» group) was more organizational change-oriented than the others («passive» group). The course was followed before, three times during the 3 months of the intervention, and 4 months after the end of it, by means of three endocrine plasma markers: cortisol, prolactin and testosterone. In both study groups the prolactin levels increased in women during the starting phase of the intervention, whereas in men prolactin levels remained stable with a tendency (p=0.06) towards lowered prolactin levels during the end phase of the intervention in the active group. Cortisol levels increased markedly in the passive group and tended to decrease in the active group during the intervention (two-way interaction p=0.003), particularly in men. These findings may be indicative of feelings of uneasiness. Testosterone increased in the active group only, particularly at the beginning of the intervention and particularly in women, and also increased in a non-intervention control group. Testosterone levels are associated with anabolic activity. An increase may be indicative of a «placebo effect» of the intervention. Testosterone changes were still clearly observable after 4 months.     

The psychosocial work environment of district nurses in Sweden

Data were collected from a stratified sample of district nurses in the greater Stockholm area on four occasions during one year using questionnaire techniques (to assess psychosocial working conditions and social networks, and self-reported health sums); as well as physiological measurement techniques. Three groups of district nurses were compared: group A, those working independently in the 'traditional' role but outside primary health care centres; group B, those working independently in the 'traditional' role but in primary health care centres; and group C, those working in the model role as part of primary health care teams. The study focused on the effects of these different work environments on the district nurse's psychological and somatic health, and their physiological state.

The data suggested that district nurses in the primary care teams (group C) had a lower objective work load than those working in the more traditional role. Despite this, they reported a less favourable balance (ratio) of work demands to decision latitude. They reported more 'problems' and 'conflicts' at work than did the other district nurses. However, such 'problems' were diminishing during the study period, which could mean that successive adaptation to the 'new' situation was occurring. The 'conflicts', on the other hand, remained. This may indicate that despite this adaptation, the district nurses in the primary care teams were struggling with their new work roles. It points to the need for organizational support during this important change process. The district nurses in group B (traditional role but in a primary health care centre) had the highest objective work load and showed physiological reactions in terms of elevated plasma cortisol levels in the morning, high systolic blood pressure and sleep disturbances.     

Endocrinological and immunological variables sensitive to psychosocial factors of possible relevance to work-related musculoskeletal disorders

Research has indicated that energy mobilization in the body is associated with lowered anabolism, which promotes the repair and restoration of damaged or worn out tissues. Problems may arise when adversity requires energy mobilization for a long period of time. Increased tissue vulnerability can be anticipated. There is evidence that growth hormone has anabolic activity, as do the male and female hormones testosterone and oestradiol and a precursor of both these anabolic steroids, dehydroepiandrosterone sulphate (DHEA-s). The levels of these in serum/plasma may be lowered during periods of adversity. It can therefore be hypothesized that due to the lowering of anabolic activity, tissues are at risk during periods of stress (part of the 'anabolic hypothesis') and that this will be reflected in musculoskeletal symptoms. Furthermore, low anabolic activity predicts more long-lasting illness/disability. In the present study, blood samples were drawn from representative groups of men and women with musculoskeletal disorders. The participants, who were engaged in various occupations in the Norrtälje area of Stockholm, Sweden, were followed up at 3 and 6 months, and development with regard to disability and pain was related to the hormone levels at the acute phase. Results indicated that a low level of DHEA-s was associated with persistent disability in women with acute low-back pain, which partially supports the hypothesis that low anabolic activity predicts more long-lasting illness (the second part of the 'anabolic hypothesis'). Also, a low concentration of g endorphin, which indicates activity of the pain regulation system, was found to be associated with long-lasting disability in this group.     

Stress,health and the working environment of Swedish prison staff

Abstract

A random stratified sample of just over 2000 was drawn from staff working in 67 different prisons in Sweden. Questionnaires on working conditions and symptoms of ill health were administered and subjects were given health examinations. Morning plasma Cortisol and gamma glutamyltransferase (g GT) levels were measured and factual information on the prisons was collected for use in the analyses.

There were differences between prisons in terms of both objective and self-reported working conditions which appeared to affect health status, physiological state and sick leave rate. Cardiovascular and hypertensive conditions were found more often among prison staff than among a large reference group made up of many different occupations. Sick leave rates among prison staff, especially those over 45 years old, were very high compared with this reference group. The situation appeared particularly difficult in prisons with a high proportion of drug abusing inmates.

The data allowed the identification of several factors which might counteract the effects of stress at work: a proactive management style, goal consensus among staff, a high degree of decision latitude, satisfaction with work performance and a supportive psychosocial climate.     

Health

Social Indicators Research -     

The impact of sense of coherence and high-demand/low-control job environment on self-reported health,burnout and psychophysiological stress indicators

Sense of Coherence (SOC) is a new concept belonging to a salutogenic paradigm, proposing to explain health as contrasted to disease, a pathogenic paradigm. The Job Demand-Control (JDC) model of job stress suggests that the combination of high job demands and low job control, defined as job strain, is strongly associated with adverse health consequences. The aim of this study was to evaluate the relationship between SOC and the JDC model in assessment of negative job effects within three pathogenically defined contexts: self-reported health, burnout and psychophysiological stress indicators, assessing the explanatory value of SOC for such variables. The study was conducted with 103 employees of social-welfare and social-insurance agencies in Sweden. A questionnaire related to job conditions, health and burnout was administered, and blood samples were collected and analysed for serum concentrations of cortisol, prolactin and immunoglobulin G. Multiple-regression models were calculated including variables from all three contexts. In the analyses, a distinction was made between emotional job strain and quantitative job strain. The SOC interacted with emotional job strain, but the interaction also increased the independent effect of emotional job strain. The independent effect of SOC disappeared in most models when interaction was included. It is concluded that studies of job strain-effects according to the JDC model should include the SOC as an interaction factor.     

The crying infant: understandable only in a multidisciplinary perspective

The parents' perception of how much their infant cries does not always correspond to the objective amount. The purpose of this study was to examine the correlation between the parents' perception of the infants' crying and the objective amount of crying and to explore the factors of conceivable importance to the perception of infant crying as well as to the measurable amount of crying. The group studied consisted of 122 infants and their parents. According to the mothers' perception — responses to a questionnaire — 86 of these were non-crying and 36 crying infants. According to the mothers, 22 non-crying infants cried as much as or more than those who were considered as crying. Nine categorized by their mothers as crying infants cried less than those categorized as non-crying. Thus, there was a mismatch between subjective and objective crying and non-crying. One factor found to be relevant for the mother's experience of the infant's crying was the explanations the parents gave about crying in their infant. Objective crying differed significantly between the families who had 0–1 siblings and those who had two siblings or more. Correlated with objective crying were the father's age, the father's perception of his wife's recent delivery and the mother's emotional feelings recorded in diaries during the observation weeks. Correlated with subjective crying in the infant were pain relief during delivery and the mother's emotional feelings.