Worksite health screening programs for predicting the development of Metabolic Syndrome in middle-aged employees: a five-year follow-up study

<p>Abstract</p> <p>Background</p> <p>Metabolic syndrome (MetS) management programs conventionally focus on the adults having MetS. However, risk assessment for MetS development is also important for many adults potentially at risk but do not yet fulfill MetS criteria at screening. Therefore, we conducted this follow-up study to explore whether initial screening records can be efficiently applied on the prediction of the MetS occurrence in healthy middle-aged employees.</p> <p>Methods</p> <p>Utilizing health examination data, a five-year follow-up observational study was conducted for 1384 middle-aged Taiwanese employees not fulfilling MetS criteria. Data analyzed included: gender, age, MetS components, uric acid, insulin, liver enzymes, sonographic fatty liver, hepatovirus infections and lifestyle factors. Multivariate logistic regression was used to estimate the adjusted odds ratios (OR) and 95% confidence interval (CI) of risk for MetS development. The synergistic index (SI) values and their confidence intervals of risk factor combinations were calculated; and were used to estimate the interacting effects of coupling MetS components on MetS development.</p> <p>Results</p> <p>Within five years, 13% (175 out of 1384) participants fulfilled MetS criteria. The ORs for MetS development among adults initially having one or two MetS components were 2.8 and 7.3, respectively (both p < 0.01), versus the adults having zero MetS component count at screening. Central obesity carried an OR of 7.5 (p < 0.01), which far exceeded other risk factors (all ORs < 2.7). Synergistic effects on MetS development existed between coupling MetS components: 1. High blood pressure plus low-HDL demonstrated an OR of 11.7 (p < 0.01) for MetS development and an SI of 4.7 (95% CI, 2.1-10.9). 2. High blood pressure plus hyperglycemia had an OR of 7.9 (p < 0.01), and an SI of 2.7 (95% CI, 1.2-6.4).</p> <p>Conclusion</p> <p>MetS component count and combination can be used in predicting MetS development for participants potentially at risk. Worksite MetS screening programs simultaneously allow for finding out cases and for assessing risk of MetS development.</p

Rad u smjenama i rak - znanstvene spoznaje i praktične posljedice

In 2007, an expert Working Group convened by the IARC Monographs Programme concluded that shift work that involves circadian disruption is probably carcinogenic to humans (Group 2A). We scrutinised the epidemiological basis for this conclusion, with a focus on, but not limited to, breast and prostate cancers. We further considered practical consequences for shift workers in our industry against the background of new findings. We carried out a literature search including the epidemiological studies cited by IARC and newer available literature on shift work and cancer. Since the IARC assessment, eleven new studies have emerged, ten of which have already been published, with inconclusive results. Heterogeneity of exposure metrics and study outcomes and emphasis on positive but non-signifi cant results make it diffi cult to draw general conclusions. Also, several reviews and commentaries, which have been published meanwhile, came to equivocal results. Published evidence is widely seen as suggestive but inconclusive for an adverse association between night work and breast cancer, and limited and inconsistent for cancers at other sites and all cancers combined. At this point in time it can not be ruled out that shift work including night work may increase the risk for some cancers in those who perform it. However, shift schedules can be organised in ways that minimise the associated health risks, and the risks may be further reduced through the implementation of structured and sustained health promotion programs specifi cally tailored to the needs of shift workers.Stručna radna skupina, koju je okupio Program monografija Međunarodne agencije za istraživanje raka (eng. International Agency for Research on Cancer, krat. IARC), 2007. godine zaključila je da je rad u smjenama, koji uključuje prekid cirkadijurnoga ritma, najvjerojatnije kancerogen za ljude (skupina 2A). Procijenili smo epidemiološku osnovu takvoga zaključka i usredotočili se na rak dojke i rak prostate između ostalih malignih bolesti. Nadalje, razmatrali smo praktične posljedice koje rad u smjenama ima na radnike u kemijskoj kompaniji BASF u okvirima novih spoznaja na tom području. Istražili smo literaturu, uključujući i epidemiološka istraživanja studije koje citira IARC kao i noviju literaturu o povezanosti rada u smjenama i raku. Od zaključka IARC-a nastalo je jedanaest novih istraživanja, a deset ih je već objavljeno. Njihovi rezultati ipak ne dovode do konačnoga i jednoznačnoga zaključka. Heterogenost mjerenja izloženosti i ishoda istraživanja i naglasak na pozitivne, ali ne uvijek i značajne rezultate, otežavaju postavljanje općih zaključaka. Jednako tako u nekoliko nedavno objavljenih recenzija i komentara ne iznose se jednoznačni rezultati. Objavljeni znanstveno utemeljeni dokazi samo upućuju, ali ne dovode u očiglednu vezu noćni rad i rak dojke. Nadalje, ograničeni su i nedosljedni za malignome na drugim lokacijama u tijelu, kao i za sve malignome zajedno. U ovom trenutku nije moguće odbaciti hipotezu da smjenski rad (uključujući noćni rad) može povećati rizik nastanka određenih malignih bolesti. Međutim, raspored smjena se može organizirati na način da se opasnosti za zdravlje svedu na najmanju moguću mjeru. Rizici se također mogu dodatno smanjiti provedbom strukturiranih programa promicanja održivoga zdravlja koji bi bili posebno osmišljeni prema potrebama radnika