PurposeThe purpose of this study was to investigate the association between apnea-hypopnea index (AHI) and metabolic markers and whether the elevated risk of Metabolic Syndrome (MetS) is related to Obstructive Sleep Apnea (OSA).MethodsThis cross-sectional study recruited 246 male bus drivers from one transportation company in Taiwan. Each participant was evaluated by a polysomnography (PSG) test and by blood lipids examination. Severity of OSA was categorized according to the apnea-hypopnea index (AHI).ResultsThe results showed that a 73.3% prevalence of MetS in OSA (AHI > 15) and a 80.0% prevalence of MetS in severe OSA (AHI > 30) were found. After adjusting for confounding variables, an increased level of Body-Mass Index (BMI) and two non-MetS cardiovascular risk factors, total cholesterol/HDL-C ratio and TG/HDL-C ratio was significantly associated with AHI in subjects with severe OSA. MetS was about three times to be present in subjects with severe OSA, even adjusted for BMI.ConclusionsThe findings showed a high prevalence of MetS in OSA among professional drivers, especially in the severe group category. BMI was the major contributing factor to OSA. However, the present study did not find a sensitive clinical marker of a detrimental metabolic profile in OSA patients.
Background:
Two main job stress models—the Demand-Control-Support (DC) model and the Effort-Reward Imbalance (ERI) model have been used to assess the impact of psychosocial work-related factors for cardiovascular disease (CVD). Limited evidence elaborates the independent and combined effects on CVD events, especially for professional drivers. This study assesses the independent and combined effects of DC and ERI models on an 8-year risk of CVD among professional drivers.
Methods:
The Taiwan Bus Driver Cohort Study recruited 1650 professional drivers from a large bus company in 2005. The subjects were interviewed in person and completed the two job stress questionnaires. Researchers found 94 new cases of CVD (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM]: 390–459) from 2006 to 2012. A Cox proportional hazards model was performed to estimate the hazard ratio (HR) for CVD events.
Results:
Occupational drivers with high overcommitment scores (thresholds of 15) had an elevated risk for CVD (HR = 1.71; 95% CI = 1.04, 2.82). Regarding target disease, overcommitment had an increased risk for CVD (not including hypertensive disease) (HR = 1.27; 95% CI = 1.05, 1.54) and ischemic heart disease (HR = 1.32; 95% CI = 1.05–1.65).
Conclusion:
Overcommitment, which is associated with job stress, appears to be associated with CVD risk in professional drivers.
Atherosclerosis is an inflammatory disease. The study was aimed to investigate the association between job strain and inflammation markers and to examine factors contributing to high strain. The long-haul bus drivers (n = 825) were recruited from a Taiwanese transportation company. The psychosocial work environment was measured by a validated job content questionnaire (JCQ). Plasma high sensitivity C-reactive protein (hs-CRP) and homocysteine (Hcy) were analyzed as inflammation markers. Job strain effects and its interaction with age were analyzed by logistic regression. Explained variance (Nagelkerke R square) was applied to select important stressors. The crude and adjusted odds ratio (OR) for the effect of high strain on high hs-CRP and Hcy were not significant. However, there was significant interaction between job strain and age (p = .014). The significantly increased risk of high strain on high hs-CRP was found among drivers younger than 35 years old (OR = 2.71), but not in driver groups age 35 to 49 and older than 50. The contributing factors to high strain were varied among the 3 age groups. The 3 stressors found for young drivers were having rest time less than 8 hours between 2 shifts, being physically inactive during leisure time, and frequent driving more than 12 hours a day. Job strain interacted with age influenced hs-CRP levels. The risk of inflammatory disease markers only increased in high strained group of young drivers. Appropriate work shift systems should be implemented to increase off-duty time, reduce sleep restrictions, and increase physical activity during leisure time.
This study showed that an increase in the 6-year risk of RTC was associated with objective measurement of ODI for a sign of sleep-disordered breathing (SDB), but was not associated with self-reported sleeping quality or daytime sleepiness. Therefore, the overnight pulse oximeter is an effective sleep assessment tool for assessing the risk of RTC. Further research should be conducted regarding measures to prevent against SDB among professional drivers.
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