职业人群工作紧张对高血压患病影响的横断面研究

目的探讨职业人群工作紧张与高血压患病的关系,为高血压的预防提供依据。方法采用横断面研究方法,调查上海城区2 458名20~63岁职业人群。工作紧张评估采用中文版工作内容问卷(JDC)与工作付出-回报(ERI)问卷,同时调查社会人口与行为因素。多因素非条件logistic回归分析工作紧张与高血压患病的关系。结果在控制了年龄、受教育程度、职业、高血压家族史、吸烟、饮酒、锻炼与活动状况、BMI潜在混杂因素后,男性高工作紧张、高工作付出-回报失衡是高血压患病的危险因素;女性低工作控制、高工作付出、中/高工作付出-回报失衡是高血压患病的危险因素。职业分层分析结果显示:教师、社区医护人员、研究人员、公交车驾驶员高血压患病更易受工作紧张的影响。结论工作紧张可能增大职业人群高血压患病的风险,某些职业人群高血压患病更易受职业紧张影响。     

高出生体重对儿童期血压影响的队列研究

目的 探讨高出生体重对儿童期血压的影响。方法对无锡市1993—1995年建立的高出生体重(暴露组)队列于2005-2007年进行随访,每个暴露对象按“出生日期±2个月”、“性别”匹配一个非暴露(正常体重儿)。共随访到1435对研究对象,对其进行问卷调查,测量身高、体重、血压。结果 高出生体重组的收缩压中位数为100mmHg(Q₁一Q₃：90—110lnmHg),舒张压为64nlnlHg(Q₁～Q₃：60一70mlTlHg);正常体重儿组的收缩压为100inn]Hg(Q₁～Q,：90—108 rnrnHg),舒张压为62mmHg(Q₁～Q,：60。70i/lmHg),两组相比差异均无统计学意义。暴露组“血压升高”(高血压前期和高血压)的比例为13.66%非暴露组为11.57%(P=0.055)。调整儿童期体重指数、性别、儿童随访时年龄、母亲生育年龄、孕龄、婴儿喂养方式、儿童期是否有挑食习惯、儿童期运动时间的多因素二项式回归模型显示,高出生体重导致血压升高的RR值为1.06(0.92～1.21),未达到统计学显著水平。结论 未发现高出生体重与儿童期血压有显著关联。     

职业紧张对长途客车司机血压的影响

为探讨职业紧张对长途客车司机血压的影响,我们以某市长途客车司机为对象,以同一客运站汽车维修工为对照,进行一般状况及患病调查,测定血压和血脂。采用ＮＩＯＳＨ一般工作紧张问卷,调查职业紧张因素、中间调解因素及紧张反应。调查表明,司机组工作冲突、工作责任、工作需求、工作控制得分均大于对照组,应付策略得分低于对照组。司机组高血压患病率（１９．７％）高于对照组（９．８％）,躯体焦虑得分也高于对照组。结果提示     

职业紧张对职业人群心血管功能的影响

目的 探讨职业紧张对职业人群血压和心电图的影响。方法 用一般工作紧张问卷对某市4种职业人群共839例进行了职业紧张调查、心血管疾病危险因素调查，同时进行了血压、血糖、血脂、心电图检查。结果 血压随年龄、工龄的增高，4种职业中，教师血压水平最高，人群血压异常率为21．69％；心电图异常无年龄、工龄和工种差别，异常率为19.07％。影响收缩压、舒张压的主要紧张因素为工作控制、工作需求、工作责任、工作角色、倒班。工作冲突多、参与机会少、工作负荷重是职业人群原发性高血压的危险因素。工作责任事故、工作责任、工作角色是异常心电图产生的危险因素。自尊感和工作之外的其他活动是心脏功能良好的调节因素。结论 职业紧张对心血管功能有一定程度的影响。     

职业人群工作紧张对工作耗竭影响的流行病学研究

目的探讨职业人群工作紧张对工作耗竭的影响。方法采用横断面研究方法,调查上海城区7种职业2 458名20～63岁职业人群。工作紧张评估采用工作要求与控制(JDC)、工作付出—回报(ERI)问卷,同时调查个体特征与行为因素,工作耗竭选用李超平教授在国内修订的MBI-GS,多因素非条件logistic回归方法分析社会心理因素对肌肉骨格症状患病的影响。结果教师、社区医护工作、公交车驾驶员情感耗竭、人格解离的评分明显高于其他职业人群,且工作耗竭的阳性率较高。工作耗竭与高工作紧张、低社会支持、高工作付出—回报不平衡、低工作回报存在联系。结论从事社会服务的职业人群工作耗竭阳性率较高,工作紧张可能是预测城市职业人群工作耗竭的危险因素。     

职业紧张与工作条件对男性警察糖尿病发病影响前瞻性研究

目的 探讨职业紧张与工作条件对男性警察糖尿病(DM)发病的影响。方法 采用前瞻性队列研究方法,以天津市6 075名男性警察为研究对象,调查其DM危险因素、职业紧张水平及工作条件,跟踪随访队列DM发病情况,采用多因素Cox回归分析职业紧张与工作条件对警察DM发病的影响。结果 2008-2011年对队列人群进行定期随访,随访中位时间为2.61年,随访期间发现DM患者179例(3.1%);交警DM发病风险明显高于其他警种,HR值及其95%CI为2.89(2.12~3.93);相对于适度职业紧张组,具有缺乏职业紧张、高度职业紧张的警察DM发病的HR值及其95%CI为3.12(1.81~5.38)、1.97(1.34~2.91);相对于适度紧张反应组,具有中度紧张反应、高度紧张反应的警察DM发病的HR值及其95%CI为1.66(1.12~2.44)、2.57(1.34~4.92);将危险因素重新定义并采用Cox回归分析发现,具有缺乏职业紧张、中度职业紧张、高度职业紧张、中度紧张反应和高度紧张反应的交警人群相对于其他警察DM发病的HR值及其95%CI分别为4.62(2.39～8.90)、2.44(1.65～3.60)、3.30(2.20～4.94)、3.11(1.93～5.03)、4.48(1.83～10.98)。结论 职业紧张和工作条件在影响警察DM发病过程中起着重要作用,交警和缺乏、中度、高度职业紧张和中度、高度紧张反应是其独立危险因素。     

老年人群血压水平与日常活动能力失能风险的前瞻性队列研究

目的 探讨老年人群血压与日常活动能力失能风险的相关性.方法 前瞻性队列研究中国老年健康影响因素跟踪调查(Chinese Longitudinal and Health Longevity Study,CLHLS)2008～2018年随访数据,随访结局为日常活动能力(Activities of daily living,...     

2013—2015年新疆油田工人职业紧张与心理障碍关系的队列研究

目的探求油田工人职业紧张与心理障碍的关系。方法将2013年采用分层整群抽样抽取新疆某地区1485名心理正常的油田工人为基线,于2015年对其进行队列随访,采用调查问卷的方法,基线和随访调查时均采用职业紧张问卷和症状自评量表对其进行职业紧张和心理状况的调查。结果随访出现心理障碍结局的共556人,发生率为40.29%。职业紧张水平程度低-高(基线-随访)组(RR=2.689,95%CI 1.342~5.391)和中-高组(RR=2.878,95%CI 1.205~6.875)发生心理障碍的风险高于低-低组,个体紧张反应水平低-中组(RR=2.500,95%CI 1.700~3.763)和低-高组(RR=3.907,95%CI 1.955~7.651)、中-中组(RR=2.141,95%CI 1.016~4.512)发生心理障碍的风险高于低-低组,不饮酒(RR=0.779,95%CI 0.622~0.976)是心理障碍发生的保护因素。结论职业紧张、饮酒是心理障碍发生的危险因素,多次测量职业紧张暴露水平发现的心理障碍比单次测量更符合实际。     

中老年人群中吸烟与血压关联的前瞻性队列研究

目的 吸烟是重要的心血管事件危险因素,但部分研究却发现吸烟与高血压无关,甚至吸烟者血压水平更低。吸烟与血压的关联还需要更多纵向研究证据。本研究基于中国健康与养老追踪调查（China Health and Retirement Longitudinal Survey,CHARLS）数据探索45～80岁中老年人群中吸烟对血压的影响。方法 研究对象来源于CHARLS研究中完成2011年基线和2013、2015年随访的人群。纳入完成3次调查的研究对象,采用多水平线性回归分析吸烟对血压的影响,采用含时依变量的Cox回归分析吸烟对高血压发生风险的影响,同时调整性别、年龄、文化程度、婚姻状况、BMI和饮酒。结果 本研究共纳入6 667名无心血管疾病的研究对象,平均年龄58.8岁,男性占46.3%。多水平线性回归分析显示,在调整协变量后,相对于不吸烟者,吸烟者的SBP高1.81 mmHg（95% CI：0.55～3.07 mmHg,P<0.05）,DBP高0.85 mmHg（95% CI：0.10～1.60 mmHg,P<0.05）。Cox回归分析显示,吸烟与高血压发生风险的关联无统计学意义（HR=1.11,95% CI：0.89～1.38,P>0.05）。结论 在中老年人群中,吸烟与血压水平升高相关联。吸烟与高血压发生风险的关系有待进一步研究证实。     

脑血管病危险因素干预实验——37661队列人群的血压变化

本研究报告分析了在中国七个大城市进行的脑血管病危险因素干预实验对队列人群血压的影响.37661名35岁以上市区居民分为干预组和对照组.研究结果显示;干预组收缩压和舒张压均值复查比基线时有所下降.而对照组正好相反,都有所上升.干预组确诊高血压的比例从基线时的18.4%降至复查时的15.5%,而对照组则从17 5%上升至17.7%.在基线血压正常且以往无高血压史者中,干预组男性与女性确诊高血压的发病率分别为6.5%和4.9%,都低于对照组的7.6%和8.0%.脑卒中的发病率随血压(收缩压或舒张压)的增高而上升,几乎在各个血压等级中,干预组脑卒中发病率都低于对照组.上述干预组和对照组之间的差别都具有统计学显著意义.     

Association between diastolic blood pressure and cumulative work time

Diastolic blood pressure was viewed as a generic indicator of aging, and its association with cumulative work time was studied after controlling for age as a potential confounding factor. The study was conducted among production line workers at a Brazilian tannery in July 1993. The association between diastolic blood pressure and cumulative work time was verified by fitting a second-order linear regression model, where diastolic blood pressure was a function of worker's age and cumulative work time. By fitting the model, one can predict that, from the beginning of working life at the tannery, on average each 1-year period is associated with an increase of about 1. 5 mmHg in diastolic blood pressure. The fit obtained highlights a component directly associated with work as part of the rate of pressure increase in the study group. This component is twice as high as that directly associated with age.     

Effect of environmental stress on blood pressure during the work shift

OBJECTIVE: To evaluate blood pressure (BP) and heart rate (HR) behavior in individuals during the working journey in two environments with different work stressors. METHODS: The study comprised 46 male individuals working in a wood processing factory in Botucatu, Brazil. Twenty seven (27.4+/-5.4 yrs, mean+/-SD) worked in the production line performing intense physical activity (G1) at high room temperatures and noise levels. Nineteen (33.2+/-7.6 yrs old) performed managerial tasks mostly comfortably seated at low noise, air-conditioned offices (G2). After anthropometric measurements (obesity, total and local adiposity) and blood biochemistry analyses (glucose, triglycerides and cholesterol), their BP and HR were registered during three consecutive days at 3 different time of the day: in the beginning, in the middle and at the end of the working journey. RESULTS: There were similar BP and HR changes during the journey for G1 and G2, but G1 showed higher rates. Due to the wide variability of BP responses within each group, participants were divided in two subgroups: responders (GR1 and GR2) with BP increase >10%, and non-responders (GN1 and GN2). Both subgroups showed similar anthropometric and biochemical patterns differing only in their BP response and, in the case of GR1,family history for hypertension. GR1 showed higher BP and HR than GR2. CONCLUSIONS: Individual changes of BP and HR responses to environmental stressors during the working journey indicates that these factors should be considered while evaluating BP measurements and might be considered as potential factors for hypertension.     

警务工作对公安干警血压的影响

对148名公安干警进行高血压病患病调查,提示警务工作对公安干警的血压有明显的影响。     

Systolic blood pressure in relation to occupation and perceived work stress

This paper outlines the methods used in a five-year prospective study of 4,607 Australian government employees and presents initial cross-sectional results examining associations between systolic blood pressure, occupation, and subjects' perceptions of work stress as ascertained in a questionnaire survey. The questionnaire items were grouped by means of principal component analysis into six factors representing adverse job characteristics. There were appreciable occupational differences in the mean scores for all six factors and in systolic blood pressure. The differences in systolic blood pressure among men from different occupational categories could not be explained by variation in the level of occupational stress perceived and reported by the subjects. Age, occupation, body mass index, and level of perceived stress arising from financial problems were significantly associated with systolic blood pressure level. A multiple linear regression model was used to determine the relationship between systolic blood pressure, age, and occupation after adjustment for the effects of the other variables.     

Chronic perceived work stress and blood pressure among Australian government employees

Prospective data on 2634 Australian government employees over five years were examined for the effects of chronic perceived work stress on blood pressure change. The study sample (2100 men and 534 women) represented 57% of the original volunteers, or 75% of those eligible after exclusion criteria were met. Data on perceived stress were obtained by questionnaire, and a principal component analysis produced six components: qualitative demands, quantitative demands, job control, future control, work support, and outside stress. Multiple linear regression, which controlled for determinants of blood pressure, tested the main effects and specific two-way interaction effects of the chronicity scores of the six components and 30 items. Many items but only some components were associated with blood pressure change. Sex and age differences were observed. The observed interactions between job demands and control provided equivocal support for the Karasek job-strain model. The women responded to work-based support, but not necessarily as predicted.     

The effect of occupational stress on blood pressure of miners in ore mines

It was tried to analyse the influence of occupational load on the blood pressure reaction of miners. 200 miners at the age of 25-45 years with a large number of simultaneously affecting loadings at the place of work were examined with regard to the incidence of hypertension within a period of 5 years. The incidence of hypertension was 0.90%. To investigate the blood pressure reactions during an eight-hour shift we chose 2 technologies of mining differing concerning the loading factors, especially the intensity of physical load. In each case 5 miners of the technologies propulsion and mining were examined before the descent, during the eight-hour shift and after having finished the shift and the blood pressure was taken paying attention to standard conditions. The systolic blood pressure taken during an underground mining shift was significantly lower than the systolic blood pressure before the descent and after the shift, while a slight ascent of the diastolic blood pressure was insignificant. In spite of the different physical load we found no signs for a relevant displacement of the blood pressure level. A influence of working on the blood pressure reaction was found neither in the incidence of hypertension nor in the measurements of the blood pressure during an eight-hour miner's shift.     

Life styles and blood pressure: the protective effect of apple-eating habits on high blood pressure in a high-salt population

Prospective epidemiological studies of blood pressure in a high-salt population in northeastern Japan were investigated along with dietary habits such as miso soup, rice, apple, fish, milk and sake consumption as well as smoking habits. Blood pressures of the populations in 3 villages were determined once or twice a year by mass surveys from 1954, 1957 or 1958 through 1975. The means and transitions of the personal blood pressure were calculated by regression analysis of the data obtained during each entire period. The number of persons was 1127 males and 1369 females and the response rate was 98.7 percent. The average number of times of determination of blood pressure for a person was 12.9. Stepwise multiple regression analyses were run with the means and transitions of systolic and diastolic blood pressure as the dependent variables and the life styles of the population in 1958 as an independent variable based on data of persons whose blood pressures were determined 5 or more times during the entire period. According to the backward stepwise method this study confirmed the positive relationship of age and sake drinking and the negative relationship of apple eating habits to blood pressure.