Qualidade de vida e excesso de peso em trabalhadores em turnos alternantes

Resumo Objetivo: identificar a percepção dos trabalhadores de turnos alternantes de uma mineradora da região dos Inconfidentes, Minas Gerais, sobre sua qualidade de vida (QV) e analisar sua associação com indicadores de excesso de adiposidade corporal. Métodos: estudo transversal com 437 trabalhadores em turnos alternantes com um ou mais fatores de risco cardiovascular. Dados sociodemográficos e clínicos foram analisados. A QV foi avaliada com o questionário SF-36 e a adiposidade corporal estimada a partir das medidas antropométricas e de composição corporal. Resultados: a pontuação para os domínios da QV variou de 67 a 100, no entanto, o aumento de gordura corporal apresentou correlação negativa com os domínios saúde geral, vitalidade e capacidade funcional. Foi observada, por análise de cluster, a formação de dois agrupamentos, um composto pelos domínios da QV e o outro constituído pelos indicadores de composição corporal. Não foi identificada associação entre os escores estimados de QV dos trabalhadores de turno e o tempo de trabalho. Conclusão: o declínio da QV apresentou associação com o excesso de adiposidade corporal. Recomenda-se a adoção de medidas visando reduzir o excesso de adiposidade corporal e melhorar a qualidade de vida dos trabalhadores em turno alternante da mineração

Hypovitaminosis D is associated with visceral adiposity, high levels of low-density lipoprotein and triglycerides in alternating shift workers.

Background: Studies suggest that there is a strong association between low vitamin D levels and cardiovascular disease (CVD) and its risk factors (RFs). Hypovitaminosis D (25(OH)D < 30 ng/mL or 75 nmol/L) is a recent public health problem that has reached different populations. The objective of the study was to investigate whether hypovitaminosis D is an additional mechanism to explain the disturbances in the lipid profile as well as the excess of abdominal fat presented by alternating shift workers of a mining company in the region of Inconfidentes, Minas Gerais, Brazil. Methods: A cross-sectional study was conducted in a sample of 391 adult males, aged 20 - 57 years old and working alternating shifts, who had at least one risk criterion for CVD. Demographic, behavioral, clinical, and anthropometric and body composition variables were obtained. A blood sample was drawn for determining 25(OH) D, parathyroid hormone intact molecule, lipid profile, blood glucose, insulin, C-reactive protein, and adipokines. Results: The average age of the 391 study participants was 36.1 ± 7.3 years. The percentage of hypovitaminosis D and dyslipidemia was 73% and 74.2%, respectively. Excess visceral fat was significant in the hypovitaminosis D group, with an odds ratio (OR) of 2.4 (95% confidence interval (CI): 1.1 - 5.2). Dyslipidemia showed 25(OH)D levels significantly lower (OR: 2.7, 95% CI: 1.6 - 4.3) than in individuals with normal levels of cholesterol and fractions, and triglycerides. After adjusted the analysis by age and seasonality, the vitamin levels had a significant inverse association and dose-dependent with lowdensity lipoprotein (OR: 5.9), triglycerides (OR: 2.3) and visceral fat area (OR: 2.4). Conclusion: Hypovitaminosis D and dyslipidemia were found in the majority of our mining company shift workers. Furthermore, excess visceral adiposity, hypertriglyceridemia and high low-density lipoprotein cholesterol levels are strong predictors of hypovitaminosis D

Association of Hypovitaminosis D with Sleep Parameters in Rotating Shift Worker Drivers

Objective To evaluate the association between sleep parameters and hypovitaminosis D in rotating shift drivers. Material and Methods We conducted a cross-sectional study on 82 male rotating shift workers (24–57 years old) with at least one cardiovascular risk factor (such as hyperglycemia, dyslipidemia, abdominal obesity, physical inactivity, hypertension, and smoking). Polysomnography was used to evaluate sleep parameters. Logistic regression was used to model the association between hypovitaminosis D and sleep parameters after adjustment for relevant covariates. Results Hypovitaminosis D (< 20 ng/mL) was seen in 30.5% of the workers. Shift workers with hypovitaminosis D had lower sleep efficiency (odds ratio [OR]: 3.68; 95% confidence interval [CI]: 1.95–5.53), lower arterial oxygen saturation (OR: 5.35; 95% CI: 3.37–6.12), and increased microarousal index (OR: 3.85; 95% CI: 1.26–5.63) after adjusting. Conclusion We suggest that hypovitaminosis D is associated with greater sleep disturbances in rotating shift workers

The predictive values of BOAH and No-apnea score for screening obstructive sleep apnea in rotating shift worker drivers

Objective: To evaluate the BOAH (Body mass index, Observed apnea, Age, and Hypertension) and No-apnea score's diagnostic values for detecting obstructive sleep apnea (OSA) risk in shift workers. Methods: Cross-sectional study with male rotating shift workers and drivers of heavy off-road machinery. The BOAH score is based on body mass index, witnessed apneas during sleep, age, and hypertension. The No-apnea score is based on neck circumference and age. Based on the apnea-hypopnea index (AHI), the severity of OSA was categorized as least mild OSA (AHI ≥5/h), moderate to severe OSA (AHI ≥15/h), and severe OSA (AHI ≥30/h). Sensitivity, specificity, positive predictive value, negative predictive value, and areas under the curve (AUC) were calculated. Results: Among 119 workers evaluated, 84.0% had AHI ≥5, 46.2% had AHI ≥15, and 14.3% had AHI ≥30. BOAH score with 2 points for AHI ≥5, the AUC was 0.679, and sensitivity and specificity were 41.0% and 94.7%, respectively. No-apnea score with 3 points AHI ≥5, the AUC was 0.692, and sensitivity and specificity were 70.0% and 68.4%, respectively. Furthermore, using at least one of the positive scores, the AUC was higher when compared to the single tests for AHI ≥5 (AUC = 0.727). And when both scores were positive, the AUC was higher for AHI ≥30 (AUC = 0.706). Conclusion: In rotating shift workers and drivers of heavy off-road machinery, BOAH, and No-apnea scores can be helpful tools in identifying individuals at risk for sleep apnea. In addition, matching the scores may increase the prediction of OSA

Evolution over Time of Ventilatory Management and Outcome of Patients with Neurologic Disease∗

OBJECTIVES: To describe the changes in ventilator management over time in patients with neurologic disease at ICU admission and to estimate factors associated with 28-day hospital mortality. DESIGN: Secondary analysis of three prospective, observational, multicenter studies. SETTING: Cohort studies conducted in 2004, 2010, and 2016. PATIENTS: Adult patients who received mechanical ventilation for more than 12 hours. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Among the 20,929 patients enrolled, we included 4,152 (20%) mechanically ventilated patients due to different neurologic diseases. Hemorrhagic stroke and brain trauma were the most common pathologies associated with the need for mechanical ventilation. Although volume-cycled ventilation remained the preferred ventilation mode, there was a significant (p &lt; 0.001) increment in the use of pressure support ventilation. The proportion of patients receiving a protective lung ventilation strategy was increased over time: 47% in 2004, 63% in 2010, and 65% in 2016 (p &lt; 0.001), as well as the duration of protective ventilation strategies: 406 days per 1,000 mechanical ventilation days in 2004, 523 days per 1,000 mechanical ventilation days in 2010, and 585 days per 1,000 mechanical ventilation days in 2016 (p &lt; 0.001). There were no differences in the length of stay in the ICU, mortality in the ICU, and mortality in hospital from 2004 to 2016. Independent risk factors for 28-day mortality were age greater than 75 years, Simplified Acute Physiology Score II greater than 50, the occurrence of organ dysfunction within first 48 hours after brain injury, and specific neurologic diseases such as hemorrhagic stroke, ischemic stroke, and brain trauma. CONCLUSIONS: More lung-protective ventilatory strategies have been implemented over years in neurologic patients with no effect on pulmonary complications or on survival. We found several prognostic factors on mortality such as advanced age, the severity of the disease, organ dysfunctions, and the etiology of neurologic disease