Estimating relative physical workload using heart rate monitoring: a validation by whole-body indirect calorimetry

Measuring physical workload in occupational medicine is fundamental for risk prevention. An indirect measurement of total and relative energy expenditure (EE) from heart rate (HR) is widely used but it has never been validated. The aim of this study was to validate this HR-estimated energy expenditure (HREEE) method against whole-body indirect calorimetry. Twenty-four-hour HR and EE values were recorded continuously in a calorimetric chambers for 52 adult males and females (19–65 years). An 8-h working period was retained, comprising several exercise sessions on a cycloergometer at intensities up to 65% of the peak rate of oxygen uptake. HREEE was calculated with reference to cardiac reserve. A corrected HREEE (CHREEE) was also calculated with a modification to the lowest value of cardiac reserve. Both values were further compared to established methods: the flex-HR method, and the use of a 3rd order polynomial relationship to estimate total and relative EE. No significant difference was found in total EE when measured in a calorimetric chamber or estimated from CHREEE for the working period. A perfect linear and identity relationship was found between CHREEE and energy reserve values for intensities ranging from 15% to 65%. Relative physical workload can be accurately assessed from HR recordings when expressed in CHREEE between 15% to 65%, and EE can be accurately estimated using the CHREEE method.     

A European perspective on intravascular catheter-related infections: report on the microbiology workload, aetiology and antimicrobial susceptibility (ESGNI-005 Study)

The laboratory workload, microbiological techniques and aetiology of catheter-related infections in European hospitals are mostly unknown. The present study (ESGNI-005) comprised a 1-day (22 October 2001), laboratory-based, point-prevalence survey based on a questionnaire completed by microbiology laboratories in European (European Union (EU) and non-EU) hospitals. Also included were questions requesting retrospective information for the year 2000. In total, 151 hospitals from 26 European countries participated, of which 78.1% were teaching institutions. Overall, the estimated population served by these institutions was 121,363,800, and the estimated number of admissions during 2000 was 6,712,050. The total number of catheter tips processed during 2000 was 142,727, or 21/1,000 admissions, of which 23.7% were considered to be positive in the institutions using semiquantitative or quantitative techniques. Overall, EU centres received significantly more catheter tip samples/1,000 admissions and had a significantly higher rate of 'positivity' (p < 0.0001) than non-EU centres. Of the institutions surveyed, 11.4% (7.2% in EU countries and 23.7% in non-EU countries; p 0.04) used only qualitative techniques for catheter tip sample processing. On the day of the study, 167 microorganisms were recovered from significant catheter tip cultures (122 patients), of which Gram-positive bacteria represented 70.7%, Gram-negative bacteria 22.2%, and yeasts 7.2%. The five most common microorganisms were coagulase-negative staphylococci, Staphylococcus aureus, Candida spp., Enterococcus spp. and Pseudomonas spp. Overall, 19% of catheter tip cultures were polymicrobial. In the case of S. aureus, 40% of isolates were resistant to oxacillin, as were 63.4% of coagulase-negative staphylococcus isolates. Of 37 Gram-negative isolates, 35% were resistant to cefotaxime, 31% to ceftazidime, and 27% to ciprofloxacin. Imipenem and cefepime had the lowest reported rates of resistance (11%).     

Work factors facilitating working beyond state pension age: Prospective cohort study with register follow-up

Objectives:The demographic changes in Europe underline the need for an extension of working lives. This study investigates the importance of physical work demands and psychosocial work factors for working beyond the state pension age (65 years).Methods:We combined data from three cohorts of the general working population in Denmark (DWECS 2005 and 2010, and DANES 2008), where actively employed workers aged 55–59 years replied to questionnaires about work environment and were followed until the age of 66 years in the Danish AMRun register of paid employment. Using logistic regression analyses, we calculated prevalence ratios (PR) and 95% confidence intervals (CI) for the association between physical and psychosocial work factors and working beyond state pension age, adjusted for age, sex, cohort, cohabiting, sector, income, vocational education, working hours, lifestyle, and previous sickness absence.Results:Of the 2884 workers aged 55–59 years, 1023 (35.5%) worked beyond the state pension age. Higher physical work demands was associated with a lower likelihood (PR 0.69, 95% CI 0.58–0.82) and a good psychosocial work environment was associated with higher likelihood (average of 7 items: PR 1.81, 95% CI 1.49–2.20) of working beyond state pension age. Stratified analyses did not change the overall pattern, ie, a good overall psychosocial work environment – as well as several specific psychosocial factors – increased the likelihood of working beyond state pension age, both for those with physically active and seated work.Conclusion:While high physical work demands was a barrier, a good psychosocial work environment seems to facilitate working beyond state pension age, also for those with physically active work.     

The SIMULTEST approach for testing mutagens in the Salmonella microtitre fluctuation assay

The concept of combining several histidine-dependent Salmonella strains in a single test, the SIMULTEST, has been applied to the microtitre fluctuation test. The activity of five mutagens was determined in strains TA97, TA98, TA100, and TA102 individually as well as in a SIMULTEST mixture. All five compounds were mutagenic in the SIMULTEST, demonstrating the utility of this time and labour-saving approach of combining strains for testing with this method. The microtitre fluctuation SIMULTEST results were quantitatively comparable to those of the SIMULTEST Salmonella/microsome plate test. The microtitre fluctuation test compared with the plate incorporation assay generally showed more favourable "sensitivity" and "quantity" indices in that four of the five chemicals tested in the fluctuation test were mutagenic at lower doses than in the plate test.     

The quest for interaction: studies on combined exposure

Summary A literature review was performed on the subject of combined exposure to stressors in the working situation. A general, dynamic model of workload served as the theoretical framework for the study. In this model, every factor that triggers a physiological or psychological response in the worker is regarded as a stressor. Decision latitude plays an important role in the model. A quantitative and qualitative analysis was performed on the available literature. It was concluded that the stressors that appear in studies on combined exposure stem mostly from the physical, chemical and biological environment. The task contents, the labor conditions, social relationships at work and the decision latitude are considerably less often studied in relation to combined exposure. It is concluded that important concepts in the study of combined exposure (e.g. interaction, independence, synergism, antagonism) are often quite carelessly mentioned in the literature. Explicit definition of these concepts is lacking in many publications. Establishment of maximum exposure levels is not yet possible for most stressor combinations. Examples are given of combinations that do allow more or less definite conclusions. It is recommended that more studies should be interdisciplinary organized. More studies are necessary in the field, studying effects of long exposure periods in the working population instead of studying students in laboratory situations. Exposure of susceptible groups, such as older workers and partially disabled workers, deserves special attention.     

心率变异性在脑力负荷评价中的应用

目的探讨用心率变异性(HRV)来评价脑力负荷的可行性。方法受试者在计算机前输入随机数字,模拟脑力劳动。采用Holter8800型动态心电图分析仪连续记录其心电信号,并将心电信号转变为数字信号,应用Holter分析软件分析HRV频域指标:总功率(TP)、低频(LF)、高频(HF)、LFHF。结果输入数字的速度随时间的延长而逐渐增加,输入正确率却逐渐下降。输入速度与HRV的TP和LF呈明显的正相关(r值分别为0.851和0.827,P<0.05),并呈现剂量-反应关系,而HF和LFHF与输入速度之间没有明显相关。休息和脑力劳动开始时HRV各指标的值分别为:TP:(2745.4±1301.6)、(686.2±420.7)ms2Hz;HF:(670.6±393.8)、(202.6±171.7)ms2Hz;LF:(870.5±553.7)、(206.0±187.9)ms2Hz。脑力劳动时HRV各指标与休息时相比,均明显降低,这是一个总的趋势。然后它们在低水平上随着负荷量(强度和时间)的增加而波动且有逐渐升高的趋势。结论心率变异性可以用作脑力劳动负荷的评价指标,但其变化规律有待于进一步的研究。