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The authors examined the associations of shiftwork with overweight and abdominal obesity through a cross-sectional study of 1206 employees 18 to 50 yrs of age who were working on a production line in a poultry processing plant. Night-shift workers (n = 800) were considered exposed, whereas day shiftworkers (n = 406) were considered nonexposed. Overweight was defined as a body mass index ≥ 25 kg/m(2) and abdominal obesity as a waist circumference ≥ 88 cm in women and ≥ 102 cm in men. The mean age of the workers was 30.5 yrs (standard deviation = 8.7 yrs), and 65.2% were women. Nightshift workers compared to dayshift workers showed higher prevalences of overweight (42.2% vs. 34.3%; p=?.020) and abdominal obesity (24.9% vs. 19.5%; p =?.037). After adjusting for sociodemographics, parental overweight status, behavioral characteristics, and sleep characteristics, including hours of sleep, the prevalence ratios for overweight and abdominal obesity were 1.27 (95% confidence interval [ CI]: 1.00-1.61) and 1.45 (95% CI: 1.10-1.92), respectively, for the nightshift workers compared to the dayshift workers. A consistent finding in our study was the independent contribution of night shiftwork to overweight and abdominal obesity among Brazilian workers. Further studies are needed to understand the biological mechanisms involved and the complex behavioral and social adaptations experienced by night-shift workers.  相似文献   

3.
The authors examined the associations of shiftwork with overweight and abdominal obesity through a cross-sectional study of 1206 employees 18 to 50 yrs of age who were working on a production line in a poultry processing plant. Night-shift workers (n?=?800) were considered exposed, whereas day shiftworkers (n?=?406) were considered nonexposed. Overweight was defined as a body mass index ≥25?kg/m2 and abdominal obesity as a waist circumference ≥88?cm in women and ≥102?cm in men. The mean age of the workers was 30.5 yrs (standard deviation?=?8.7 yrs), and 65.2% were women. Nightshift workers compared to dayshift workers showed higher prevalences of overweight (42.2% vs. 34.3%; p?=?.020) and abdominal obesity (24.9% vs. 19.5%; p?=?.037). After adjusting for sociodemographics, parental overweight status, behavioral characteristics, and sleep characteristics, including hours of sleep, the prevalence ratios for overweight and abdominal obesity were 1.27 (95% confidence interval [ CI]: 1.00–1.61) and 1.45 (95% CI: 1.10–1.92), respectively, for the nightshift workers compared to the dayshift workers. A consistent finding in our study was the independent contribution of night shiftwork to overweight and abdominal obesity among Brazilian workers. Further studies are needed to understand the biological mechanisms involved and the complex behavioral and social adaptations experienced by night-shift workers. (Author correspondence: )  相似文献   

4.
Molecular mechanisms underlying the negative health effects of shift work are poorly understood, which remains a barrier to developing intervention strategies to protect the long-term health of shift workers. We evaluated genome-wide differences in DNA methylation (measured in blood) between 111 actively employed female nightshift and 86 actively employed female dayshift workers from the Seattle metropolitan area. We also explored the effect of chronotype (i.e., measure of preference for activity earlier or later in the day) on DNA methylation among 110 of the female nightshift workers and an additional group of 131 male nightshift workers. Methylation data were generated using the Illumina Infinium HumanMethylation450 BeadChip (450K) Array. After applying the latest methylation data processing methods, we compared methylation levels at 361,210 CpG loci between the groups using linear regression models adjusted for potential confounders and applied the false-discovery rate (FDR) ≤ 0.05 to account for multiple comparisons. No statistically significant associations at the genome-wide level were observed with shift work or chronotype, though based on raw P values and absolute effect sizes, there were suggestive associations in genes that have been previously linked with cancer (e.g., BACH2, JRK, RPS6KA2) and type-2 diabetes (e.g., KCNQ1). Given that our study was underpowered to detect moderate effects, examining these suggestive results in well-powered independent studies or in pooled data sets may improve our understanding of the pathways underlying the negative health effects of shift work and the influence of personal factors such as chronotype. Such an approach may help identify potential interventions that can be used to protect the long-term health of shift workers.  相似文献   

5.
This article reviews the published studies on urinary 1-hydroxypyrene (1-OHP) as a biomarker of exposure to polycyclic aromatic hydrocarbons (PAHs) in work environments. Sampling and analysis strategies as well as a methodology for determining biological exposure indices (BEIs) of 1-OHP in urine for different work environments are proposed for the biological monitoring of occupational exposure to PAHs. Owing to the kinetics of absorption of pyrene by different exposure routes and excretion of 1-OHP in urine, in general, 1-OHP urinary excretion levels increase during the course of a workday, reaching maximum values 3-9 h after the end of work. When the contribution of dermal exposure is important, post-shift 1-OHP excretion can however be lower than pre-shift levels in the case where a worker has been exposed occupationally to PAHs on the day prior to sampling. In addition, 1-OHP excretion levels in either pre-shift, post-shift or evening samples increase during the course of a work-week, levelling off after three consecutive days of work. Consequently, ideally, for a first characterization of a work environment and for an indication of the major exposure route, considering a 5-day work-week (Monday to Friday), the best sampling strategy would be to collect all micturitions over 24 h starting on Monday morning. Alternatively, collection of pre-shift, post-shift and evening urine samples on the first day of the work-week and at the end of the work-week is recommended. For routine monitoring, pre-shift samples on Monday and post-shift samples on Friday should be collected when pulmonary exposure is the main route of exposure. On the other hand, pre-shift samples on Monday and Friday should be collected when the contribution of skin uptake is important. The difference between beginning and end of work-week excretion will give an indication of the average exposure over the workweek. Pre-shift samples on the first day of the work-week will indicate background values, and, hence, reflect general environment exposure and body burden of pyrene and/or its metabolites. On the other hand, since PAH profile can vary substantially in different work sites, a single BEI cannot apply to all workplaces. A simple equation was therefore developed to establish BEIs for workers exposed to PAHs in different work environments by using a BEI already established for a given work environment and by introducing a correction factor corresponding to the ratio of the airborne concentration of the sum of benzo(a)pyrene (BaP) equivalent to that of pyrene. The sum of BaP equivalent concentrations represents the sum of carcinogenic PAH concentrations expressed as BaP using toxic equivalent factors. Based on a previously estimated BEI of 2.3 μmol 1-OHP mol-1 creatinine for coke-oven workers, BEIs of 4.4, 8.0 and 9.8 μmol 1-OHP mol-1 creatinine were respectively calculated for vertical pin Söderberg workers, anode workers and pre-bake workers of aluminium plants and a BEI of 1.2 μmol 1-OHP mol-1 creatinine was estimated for iron foundry workers. This approach will allow the potential risk of cancer in individuals occupationally exposed to PAHs to be assessed better.  相似文献   

6.
Occupational medicine is a key component of a comprehensive occupational health and safety program in support of laboratory animal research and production facilities. The mission of the department is to maximize employee health and productivity utilizing a population health management approach, which includes measurement and analysis of health benefits utilization. The department works in close cooperation with other institutional health and safety professionals to identify potential risks from exposure to physical, chemical, and biological hazards in the workplace. As soon as exposures are identified, the department is responsible for formulating and providing appropriate medical surveillance programs. Occupational medicine is also responsible for targeted delivery of preventive and wellness services; management of injury, disease, and disability; maintenance of medical information; and other clinic services required by the institution. Recommendations are provided for the organization and content of occupational medicine programs for animal research facilities.  相似文献   

7.
The objective of this study was to examine the association of age with chronotype and sleep duration in day workers and rotating shift workers, including night shift work. Between October 2012 and February 2015, a cross-sectional study was conducted in a German chemical company. Using the “Munich ChronoType Questionnaire” (MCTQ), data about sleep onset and sleep offset during workdays and work-free days were retrieved and the chronotype was computed during regular voluntary occupational health check-ups. Associations between age and chronotype, as well as sleep duration, were assessed using linear regression analyses. Potential effect modification by the working time system was examined. Within the study period, 4,040 employees (82.3% and 17.7% were engaged in day work and rotating shift work, respectively) completed the questionnaire. Study participants were on average 41.8 years old (Min = 18.0, Max = 65.0, SD = 10.2) and predominantly male (75.4%). Mean chronotype and overall sleep duration was 03:22 (SD = 54 min) and 7.2 h (SD = 1.0 h) respectively. Older age was associated with earlier chronotype and reduced overall sleep duration in both day workers and rotating shift workers (p < 0.001 for all models). Compared to day workers, employees whom engaged in rotating shift work were later chronotypes and had overall a longer sleep duration. With older age, the difference between day and rotating shift workers regarding chronotype increased, while the difference regarding overall sleep duration decreased (pinteraction<0.005 for both models). This finding could indicate that both changes in circadian physiology and exposure to certain work schedules contribute to the age-related changes. Older rotating shift workers, with early chronotypes may have issues with night shifts, while day work and morning shifts may be best compatible to earlier chronotypes. Differences in sleep timing across age groups, might indicate that the same work hours will affect shift workers differently, dependent on their age, suggesting that more flexible and chronotype-adapted work hours could provide useful; especially for older employees. Sleep education in the form of courses and health campaigns could be a way to raise awareness of the importance of a healthy sleep pattern. This could be achieved by learning strategies to better adjust individual sleep patterns to work hours.  相似文献   

8.
The authors studied whether melatonin administration improves adaptation of workers to nightshift and if its beneficial effect is enhanced by attenuation of morning sunlight exposure. Twelve nightshift nurses received three treatments: Placebo (Pla), Melatonin (Mel), and Melatonin with Sunglasses (Mel-S). Each treatment procedure was administered for 2 d of different 4d nightshifts in a repeated measures crossover design. In Pla, nurses were treated with placebo before daytime sleep and allowed exposure to morning sunlight. In Mel, 6 mg of melatonin was similarly administered before daytime sleep with morning sunlight permitted. In Mel-S, 6 mg of melatonin was given as in Mel, with sunglasses worn in the morning to attenuate sunlight exposure. Placebo or melatonin was administered during days 2 and 3 when the first and second daytime sleep occurred. Nocturnal alertness and performance plus daytime sleep and mood states were assessed during all three treatments. The sleep period and total sleep times were significantly increased by melatonin treatments; yet, nocturnal alertness was only marginally improved. There were no differences between Mel and Mel-S. Performance tests revealed no difference between Pla and melatonin treatments. Melatonin exerted modest benefit in improving the adaptation of workers to nightshift, and its effect was not enhanced by attenuation of morning sunlight exposure.  相似文献   

9.
The authors studied whether melatonin administration improves adaptation of workers to nightshift and if its beneficial effect is enhanced by attenuation of morning sunlight exposure. Twelve nightshift nurses received three treatments: Placebo (Pla), Melatonin (Mel), and Melatonin with Sunglasses (Mel-S). Each treatment procedure was administered for 2 d of different 4d nightshifts in a repeated measures crossover design. In Pla, nurses were treated with placebo before daytime sleep and allowed exposure to morning sunlight. In Mel, 6 mg of melatonin was similarly administered before daytime sleep with morning sunlight permitted. In Mel-S, 6 mg of melatonin was given as in Mel, with sunglasses worn in the morning to attenuate sunlight exposure. Placebo or melatonin was administered during days 2 and 3 when the first and second daytime sleep occurred. Nocturnal alertness and performance plus daytime sleep and mood states were assessed during all three treatments. The sleep period and total sleep times were significantly increased by melatonin treatments; yet, nocturnal alertness was only marginally improved. There were no differences between Mel and Mel-S. Performance tests revealed no difference between Pla and melatonin treatments. Melatonin exerted modest benefit in improving the adaptation of workers to nightshift, and its effect was not enhanced by attenuation of morning sunlight exposure.  相似文献   

10.
To evaluate the impact of day-and-night rotating shift work (RSW) on liver health, we performed a retrospective analysis of the association between long-term RSW exposure and the normalization of plasma alanine transaminase (ALT) levels over a five-year period. The data from physical examinations, blood tests, abdominal sonographic examinations, personal histories, and occupational records were collected from a cohort of workers in a semiconductor manufacturing company. The sample population was divided into three subgroups for analysis, according to self-reported shift work status over the five-year interval: persistent daytime workers, workers exposed intermittently to RSW (i-RSW), and workers exposed persistently to RSW (p-RSW). Records were analyzed for 1196 male workers with an initial mean age of 32.5 years (SD 6.0 years), of whom 821 (68.7%) were identified as rotating shift workers, including 374 i-RSW (31.3%) and 447 p-RSW workers (37.4%). At the beginning of the follow-up, 275 were found to have elevated ALT (e-ALT): 25.1% daytime workers, 23.0% i-RSW workers, and 21.3% p-RSW workers (p?=?0.098). Of those with e-ALT at the beginning, 101 workers showed normalized serum ALT levels at the end of five-year follow-up: 40 (10.7%) of 375 daytime workers, 32 (8.6%) of 374 i-RSW workers, and 29 (6.5%) of 447 p-RSW workers (p?=?0.016). Compared with the workers having persistent e-ALT at the end of follow-up, the workers normalized serum ALT levels had significantly lesser exposures to RSW during follow-up. By performing multivariate logistic regression analyses, and comparing with the persistent daytime co-workers, after controlling for confounding variables (age, occupational factors, educational levels, lifestyle factors, metabolic syndrome, hepatovirus infection, and fatty liver), analysis indicated that the workers exposed to p-RSW were 46% less likely (OR, 0.54; 95% CI, 0.30–0.95; p?=?0.03) to attain normal ALT levels within a five-year interval. These observations demonstrate that persistent day-and-night RSW pose a vigorous obstacle to the normalization of e-ALT among workers with preexisting abnormal liver function. We suggest that workers and managers approach with caution the consideration of assigning or accepting long-term day-and-night RSW when an employee health screening shows evidence of abnormal liver function.  相似文献   

11.
Biological processes are organized in time as innate rhythms defined by the period (τ), phase (peak [Φ] and trough time), amplitude (A, peak-trough difference) and mean level. The human time structure in its entirety is comprised of ultradian (τ < 20 h), circadian (20 h > τ < 28 h) and infradian (τ > 28 h) bioperiodicities. The circadian time structure (CTS) of human beings, which is more complicated than in lower animals, is orchestrated and staged by a brain central multioscillator system that includes a prominent pacemaker – the suprachiasmatic nuclei of the hypothalamus. Additional pacemaker activities are provided by the pineal hormone melatonin, which circulates during the nighttime, and the left and right cerebral cortices. Under ordinary circumstances this system coordinates the τ and Φ of rhythms driven by subservient peripheral cell, tissue and organ clock networks. Cyclic environmental, feeding and social time cues synchronize the endogenous 24 h clocks and rhythms. Accordingly, processes and functions of the internal environment are integrated in time for maximum biological efficiency, and they are also organized and synchronized in time to the external environment to ensure optimal performance and response to challenge. Artificial light at night (ALAN) exposure can alter the CTS as can night work, which, like rapid transmeridian displacement by air travel, necessitates realignment of the Φ of the multitude of 24 h rhythms. In 2001, Stevens and Rea coined the phrase “circadian disruption” (CD) to label the CTS misalignment induced by ALAN and shift work (SW) as a potential pathologic mechanism of the increased risk for cancer and other medical conditions. Current concerns relating to the effects of ALAN exposure on the CTS motivated us to renew our long-standing interest in the possible role of CD in the etiopathology of common human diseases and patient care. A surprisingly large number of medical conditions involve CD: adrenal insufficiency; nocturia; sleep-time non-dipping and rising blood pressure 24 h patterns (nocturnal hypertension); delayed sleep phase syndrome, non-24 h sleep/wake disorder; recurrent hypersomnia; SW intolerance; delirium; peptic ulcer disease; kidney failure; depression; mania; bipolar disorder; Parkinson’s disease; Smith–Magenis syndrome; fatal familial insomnia syndrome; autism spectrum disorder; asthma; byssinosis; cancers; hand, foot and mouth disease; post-operative state; and ICU outcome. Poorly conceived medical interventions, for example nighttime dosing of synthetic corticosteroids and certain β-antagonists and cyclic nocturnal enteral or parenteral nutrition, plus lifestyle habits, including atypical eating times and chronic alcohol consumption, also can be causal of CD. Just as surprisingly are the many proven chronotherapeutic strategies available today to manage the CD of several of these medical conditions. In clinical medicine, CD seems to be a common, yet mostly unrecognized, pathologic mechanism of human disease as are the many effective chronotherapeutic interventions to remedy it.  相似文献   

12.
The status and phases of the circadian timing system (CTS) can be ascertained through measuring several biological functions. Of those measurements, rest-activity rhythm is considered as a reliable circadian biomarker to evaluate the function of CTS among oncology population. Its amenable non-invasive monitoring over longitudinal time scale makes it more appropriate and convenient. Its use as reference rhythm for timing the medications is widely accepted in cancer and sleep clinics. Current mini review highlights the present knowledge on different actigraphy devices used for the measurement of circadian rest-activity rhythm. Further, this review presents recent data dealing with the status of circadian rest-activity rhythm in cancer patients and discusses its association with health-related patients’ quality of life. Application of this concept supports that the interventions with abilities to reverse CTS dysfunction in cancer patients might prolong their survival with improved and acceptable level of health-related quality of life.  相似文献   

13.
《Chronobiology international》2013,30(8):1029-1048
Routine exposure to artificial light at night (ALAN) in work, home, and community settings is linked with increased risk of breast and prostate cancer (BC, PC) in normally sighted women and men, the hypothesized biological rhythm mechanisms being frequent nocturnal melatonin synthesis suppression, circadian time structure (CTS) desynchronization, and sleep/wake cycle disruption with sleep deprivation. ALAN-induced perturbation of the CTS melatonin synchronizer signal is communicated maternally at the very onset of life and after birth via breast or artificial formula feedings. Nighttime use of personal computers, mobile phones, electronic tablets, televisions, and the like – now epidemic in adolescents and adults and highly prevalent in pre-school and school-aged children – is a new source of ALAN. However, ALAN exposure occurs concomitantly with almost complete absence of daytime sunlight, whose blue-violet (446–484?nm λ) spectrum synchronizes the CTS and whose UV-B (290–315?nm λ) spectrum stimulates vitamin D synthesis. Under natural conditions and clear skies, day/night and annual cycles of UV-B irradiation drive corresponding periodicities in vitamin D synthesis and numerous bioprocesses regulated by active metabolites augment and strengthen the biological time structure. Vitamin D insufficiency and deficiency are widespread in children and adults in developed and developing countries as a consequence of inadequate sunlight exposure. Past epidemiologic studies have focused either on exposure to too little daytime UV-B or too much ALAN, respectively, on vitamin D deficiency/insufficiency or melatonin suppression in relation to risk of cancer and other, e.g., psychiatric, hypertensive, cardiac, and vascular, so-called, diseases of civilization. The observed elevated incidence of medical conditions the two are alleged to influence through many complementary bioprocesses of cells, tissues, and organs led us to examine effects of the totality of the artificial light environment in which humans reside today. Never have chronobiologic or epidemiologic investigations comprehensively researched the potentially deleterious consequences of the combination of suppressed vitamin D plus melatonin synthesis due to life in today’s man-made artificial light environment, which in our opinion is long overdue.  相似文献   

14.
《Chronobiology international》2013,30(10):1152-1159
Shift work have been thought to restrict participation in leisure time activities, but the knowledge about physical activity in rotating night shift nurses has been limited so far. We investigated the associations between the rotating night shift work and physical activity using data from a cross-sectional study among nurses and midwives. This study included 354 nurses and midwives (aged 40–60) currently working rotating night shifts and 371 ones working days only. The information on the work characteristics and potential covariates was collected via a personal interview. Weight and height were measured and BMI was calculated. Physical activity was assessed according to the international questionnaire on physical activity – IPAQ, and four domains: leisure time, occupational, transport related and household were analyzed. Women who reported none leisure time activity were defined as recreationally “inactive”. The associations were examined with multiple linear or logistic regression models adjusted for age, season of the year, number of full term births, marital status and BMI. Total and occupational physical activity was significantly higher among nurses working rotating night shifts. However, leisure time activity was significantly affected among rotating night shift nurses and midwives, compared to women working during the days only, with increased odds ratio for recreational “inactivity” (OR?=?1.57, 95% CI: 1.11–2.20). Rotating night shift work among nurses and midwives is associated with higher occupational physical activity but lower leisure time activity. Initiatives supporting exercising among night shift workers are recommended.  相似文献   

15.
In order to improve the monitoring system, watching influence of toxic metals on human health in industrial plants, indicator properties of different biosubstances were compared. Four types of samples (whole blood, plasma, urine, and hair) from 263 workers of the “Khimprom” chemical plant (Novocheboksarsk, Russia) were subjected to multielement analysis by ICP-AES/ICP-MS. 19–25 chemical elements, including main toxic metals (Cd, Hg, Pb, etc.) were determined. The results were calculated with regard to workers’ individual data on occupational exposure to chemical elements. Hair was found to be the most sensitive to toxic and conditionally toxic trace metals: Pb, Mn, Cr, Be, Ni, while occupational contact with macro elements (Na, P), trace metalloids (Si, B) and some other metals (Zn) was not reflected in hair. Whole blood relatively weakly indicated a moderate occupational level of metals except Pb and Mn, but effectively reflected deficiencies of essential elements: I, Cr, and shifts in K/Na ratio, which are likely to be secondary effects of harmful occupational factors. Blood plasma reflected only contact with Be, P; urine – only with Ni. In both whole blood and plasma the changes for the absolute majority of elements were similar. Thus, hair analysis is useful for monitoring the occupational exposure to toxic and conditionally toxic chemical elements, while a general estimation of occupational harmful influence on mineral metabolism requires simultaneous investigation of two biosubstances: hair and whole blood, or hair and blood plasma, with whole blood being more preferable. Analysis of urine is appropriate for monitoring particular chemical elements, e.g. nickel.  相似文献   

16.
ABSTRACT

Chronotype is the behavioral manifestation of an individual’s underlying circadian rhythm, generally characterized by one’s propensity to sleep at a particular time during the 24 hour cycle. Evening chronotypes (“night owls”) generally suffer from worse physical and mental health compared to morning chronotypes (“morning larks”) – for reasons that have yet to be explained. One hypothesis is that evening chronotypes may be more susceptible to circadian disruption, a condition where the coordinated timing of biologic processes breaks down. The role of chronotype as an independent or modifying risk factor for cancer has not been widely explored. The objective of the current study was to evaluate the risk of breast cancer associated with chronotype in a case-control study nested within the California Teachers Study (CTS) cohort. The study population consisted of 39686 post-menopausal CTS participants who provided information on chronotype by completing a questionnaire in 2012–2013. 2719 cases of primary invasive breast cancer diagnosed from 1995/1996 through completion of the chronotype questionnaire were identified by linkage of the CTS to the California Cancer Registry. 36967 CTS participants who had remained cancer-free during this same time period served as controls. Chronotype was ascertained by responses to an abbreviated version of the Horne-Ostberg Morningness-Eveningness Questionnaire (MEQ) and was characterized into five categories: definite morning, more morning than evening, neither morning or evening, more evening than morning, definite evening. Multivariable unconditional logistic regression analyses were performed to estimate the odds ratios (ORs) and 95% confidence intervals (95% CIs) for each of the chronotypes, adjusted for established breast cancer risk factors. Compared to definite morning types, definite evening types had an increased risk of breast cancer with elevated ORs that were statistically significant in both the crude (OR = 1.24, 95% CI: 1.10–1.40) and fully-adjusted models (OR = 1.20, 95% CI: 1.06–1.35). The risk estimates in the fully-adjusted model for all other chronotypes did not significantly differ from one. These results suggest that evening chronotype may be an independent risk factor for breast cancer among a population of women who are not known to have engaged in any substantial night shift work. Further research in other populations of non-shift workers is warranted.  相似文献   

17.
Dielectric heaters and sealers present the most common source of occupational exposure to excessive radio frequency (RF) fields. These systems are used industrially to heat or melt dielectric materials. Nowadays, the effects of high frequency electromagnetic (EM) fields on the health have been discussed frequently but there are few health studies done for workers around dielectric heaters and sealers. In this study, the leakage fields around dielectric heaters and sealers (27.12?MHz) were measured in MKE – Mechanical and Chemical Industry Corporation, Gazi Rocket Factory and evaluated in terms of standards. It has been observed that operators exposed to same RF fields with occupational exposure limits. Many workers have health complaints, such as elevated body temperatures in the factory. Safe distances or areas for workers should be recommended in these systems. Protective measures could be implemented to minimize these exposures. Further measurements and occupational exposure studies of RF exposed women and men are needed to demonstrate the levels of exposed Radio Frequency Radiation (RFR). Precautions should therefore be taken either to reduce the leakage fields or minimise the exposed fields.  相似文献   

18.
A.R. Bainborough 《CMAJ》1986,134(9):985-986
Fitness-to-work examinations require an objective assessment of the physical and mental health of employees in relation to the requirements and working conditions of specific jobs, to ensure that the workers will not be a hazard to themselves or others. Whether conducted by specialists in occupational medicine or other physicians, the proper performance of these examinations requires a clear understanding of the types of examinations and their purposes and how to serve and protect the interests of all three parties: employee, employer and physician. The circumstances in which fitness-to-work examinations are required are listed, and a method to help physicians in judging fitness to work is described. This method balances the rights and obligations of both employee and employer without compromising the physician''s need to practise medicine skillfully and ethically.  相似文献   

19.
The mammalian circadian timing system (CTS) exerts endogenous temporal control over virtually every biochemical, physiological, and neurobiological process. Recent studies have suggested an interrelationship between the neurovestibular system, specifically the macular otoconial gravity receptors, and the CTS. To test for a functional relationship between these 2 seemingly disparate neuronal systems, the authors performed a study to evaluate the influence of the vestibular system on 3 fundamental properties of the CTS: entrainment, photic modulation, and period. The present study used a nonrecombinant mutant mouse, the head-tilt mouse (abbr. het), which lacks otoconia and hence gravity reception, to evaluate CTS function in mice lacking vestibular inputs. Circadian rhythms of body temperature (Tb) and locomotor activity (ACT) were recorded continuously by biotelemetry in het mice as well as wild-type (PWT) controls during exposure to 4 photic regimens: 12:12 LD, DD (0 micromoles s(-1) m(-2)), constant bright light (LL(B); 0.5 micromoles s(-1) m(-2)), and constant dim light (LL(D); 0.02 micromoles s(-1) m(-2)). In DD, the circadian period of the Tb and ACT rhythms was significantly longer (p < 0.001) in het than in PWT mice. In addition, the circadian period of Tb and ACT was significantly longer (p < 0.01) in LL(B) than in DD for both the het and PWT groups, although increasing ambient illuminance (i.e., DD to LL(B)) had a significantly greater (p < 0.01) period-lengthening effect in the PWT group than in the het group. The results of the present study demonstrate for the first time that the vestibular macular gravity receptors influence 2 fundamental properties of the mammalian CTS: (1) the intrinsic circadian pacemaker period and (2) the period-altering response to changes in tonic light intensity. The results of the present study thus provide the first neurobehavioral evidence for a vestibular-circadian interrelationship as well as suggest a novel mechanism underlying the signaling of activity-based nonphotic stimuli to the CTS.  相似文献   

20.
People employed in the shoe manufacture and repair industry are at an increased risk for cancer, the strongest evidence being for nasal cancer and leukaemia. A possible causal role for formaldehyde is likely for cancer of the buccal cavity and nasopharynx. Exfoliated buccal cells are good source of tissue for monitoring human exposure to inhaled and ingested occupational and environmental genotoxicants. To assess the cytogenetic damage related to occupational exposure to airborne chemicals during shoe-making and the processes in pathology and anatomy laboratories, the micronuclei (MN) count per 3000 cells was measured in buccal smears from shoe-workers (group I, n = 22) exposed to mainly n-hexane, toluene and methyl ethyl ketone (MEK) and from anatomy and pathology staff (group II, n = 28) exposed to formaldehyde (FA). Eighteen male university staff were used as controls. The mean time-weighted average (TWA) concentrations of n-hexane, toluene and MEK in 10 small shoe workshops were 58.07 p.p.m., 26.62 p.p.m. and 11.39 p.p.m., respectively. The measured air concentrations of FA in the breathing zone of the anatomy and pathology laboratory workers were between 2 and 4 p.p.m. Levels of 2,5-hexadione (2,5-HD) and hippuric acid (HA), metabolic markers of n-hexane and toluene exposure, respectively, were significantly higher in the urine of workers in group I than in control subjects (p < 0.001 and p < 0.01, respectively). The mean (+/- SD) MN (0/00) [corrected] frequencies in buccal mucosa cells from workers in group I, group II and controls were 0.62 +/- 0.45%, 0.71 +/- 0.56% and 0.33 +/- 0.30%, respectively (p < 0.05 and p < 0.05 compared with controls for group I and group II, respectively). The effects of smoking, age and duration of exposure on the frequency of micronucleated buccal cells from workers in all three groups studied were also evaluated. Overall, the results suggest that occupational exposure to organic solvents, mainly n-hexane, toluene, MEK and FA, may cause cytogenetic damage in buccal cells and that use of exfoliated buccal cells seems to be appropriate to measure exposure to organic solvents.  相似文献   

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