Alcohol consumption and drinking habits among Finnish doctors were studied as part of a survey of stress and burnout. A questionnaire containing 99 questions or groups of questions was sent to all 3496 practising doctors aged under 66 randomly selected from the registry of the Finnish Medical Association. Altogether 2671 doctors (76%) responded; this sample was representative of the Finnish medical profession. The average weekly consumption of alcohol during the past year and various aspects ofdrinking behaviour were assessed, and the presence or absence of symptoms and diseases often encountered among heavy drinkers and addicts was determined. The data were analysed separately for men and women, for those aged -40 and >40, and for the men with high and low alcohol consumption and with high and low scores on the index of drinking habits. Selected variables related to work, stress, and coping were correlated with alcohol consumption and drinking behaviour.The median consumption of alcohol among male doctors was 4876 g (6.2 litres) and among female doctors 2226 g (2.8 litres) of absolute alcohol per person per year and was higher in those aged over 40. Beer was most commonly drunk by men and wine by women. Increased alcohol consumption was associated with older age, disappointment with career, heavy smoking, use of benzodiazepines, stress and burnout symptoms, suicidal thoughts, general dissatisfaction, and diseases related to alcohol. Drinking habits were heavier among doctors working in community health centres, those taking long sick leaves, younger doctors disappointed with their careers or the atmosphere at work, and older doctors immersed in their work.Alcohol consumption among doctors seems to be higher than that ofthe general population in Finland, and heavy drinking seems to be associated with stress and burnout. this group, giving 3496 subjects. A questionnaire containing 99 questions or groups ofquestions was sent with a letter describing the aims of the study to all doctors selected to participate. Total anonymity was assured, and the questionnaires did not contain any questions or codes that could possibly identify the responder.Average weekly consumption of alcohol during the past year was assessed separately for beer, wine, and spirits. Each was scaled according to the number of bottles or glasses consumed, and these scales were transformed into grams of absolute alcohol. The amount of alcohol consumed does not, however, give a full picture of drinking behaviour: the manner in which alcohol is used is another important aspect. Scores for 12 questions measuring various aspects of drinking behaviour were summed for each subject to obtain an index of drinking habits (

To obtain reference values for blood and serum manganese levels, blood specimens were collected from 29 men and 36 women. Mn in blood showed a normal distribution; its upper 97.5% limit in blood was 0.38 mumol/l. Mn in serum showed a skewed distribution, which did not differ from the normal one after logarithmic transformation. The respective reference limit was 19 nmol/l. In both specimens, the levels of Mn were significantly lower in men than in women. To obtain reference values for Mn in urine, midday urine specimens were collected from 58 men and 96 women. Mn in urine also showed a skewed distribution, and the upper 97.5% limit was 38 nmol/l. The levels of Mn in blood and urine were statistically significantly higher in manual metal arc (MMA) welders of mild steel (MS) than in the reference populations. Five MMA/MS welders were subjected to a further study in which the ambient intramask Mn levels and urinary Mn excretion were monitored throughout a full working week. For two welders the correlation of Mn in urine specimens voided in the afternoon was good with the before noon Mn concentrations in the hygienic measurements; for the rest the correlation was minimal. Mn in diurnal urine specimens collected in six portions showed fluctuation if specific gravity or creatinine in urine was used to standardize for the urinary flow, but it was less evident for urinary Mn excretion rate. Our results seem to indicate that the measurement of Mn in urine or blood may be used for monitoring Mn exposure in MMA/MS welders only at the group level.

, MD1OLKINUORA M. Alcoholism and occupation. Scand J Work Environ Health 10 (1984) 51 1-5 15. Occupational roles are a dominant force in many aspects of social life. Occupation signifies a complex of social and psychological factors that reflect intelligence, education, personality, ambition, social status, and life-style. The consumption of alcohol and alcoholism have many correlations with occupational roles. Mortality from cirrhosis of the liver reflects the per capita consumption of alcohol. In certain occupations such mortality rates are clearly above average. The highest risk is found in occupations associated with the serving of food and beverages. A Finnish study has shown that the alcohol-related use of health services among males is the highest among unskilled workers, painters, seamen, and construction workers and the lowest among executives and farmers. Many population studies have shown that bluecollar workers and laborers have the highest level of drinking. This pattern is not necessarily true among females. The risk factors associated with occupation include the availability of alcohol at work, social pressure to drink on the job, separation from normal social relationships, and freedom from supervision. The opportunity to obtain alcoholic beverages relatively inexpensively, when combined with social pressure by peers to drink heavily, is an especially powerful explanation for high rates of alcoholism within an occupation.

and work. Scand J Work Environ Health 19 (1984) 501-504. Psychogenic epidemics cover various forms of collective behavior and include mass hysteria, mass psychogenic illness, and hysterical contagion for which no physical explanation can be found. The typical course of a psychogenic epidemic at a workplace progresses from sudden onset, often with dramatic symptoms, to a rapidly attained peak that draws much publicity and is followed by quick disappearance of the symptoms. Over 90 % of the affected persons are women, and the symptoms range from dizziness, vomiting, nausea, and fainting to epileptic-type seizures, hyperventilation, and skin disorders. The background mechanisms are thought to be generalized beliefs and triggering events which create a sense of threat that leads to a physiological state of arousal. This state, in turn, creates new beliefs which give meaning to the sense of arousal. The new belief spreads through sociometric channels. Predisposing factors include boredom, pressure to produce, physical stressors, poor labor-management relations, and impaired interpersonal communications, and lack of social support. It is important that a thorough investigation be carried out in all instances. Investigation is not only necessary for diagnosis, but it also reassures the management, the employees, and the press that physical factors are unlikely to be responsible for the disease.

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