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焊工心率变异性的昼夜变化。

Circadian variation of heart rate variability among welders.

机构信息

Harvard School of Public Health, Department of Environmental Health, Environmental and Occupational Medicine and Epidemiology Program, 665 Huntington Ave, FXB-103, Boston, MA 02115, USA.

出版信息

Occup Environ Med. 2010 Oct;67(10):717-9. doi: 10.1136/oem.2010.055210. Epub 2010 Aug 26.

Abstract

OBJECTIVE

To compare the circadian variation of hourly heart rate variability (HRV) on work and non-workdays among boilermaker construction workers.

METHOD

A panel study of 18 males monitored by 24-h ambulatory ECG over 44 observation-days on paired work and non-workdays was conducted. ECGs were analysed and the SD of normal-to-normal beats index (SDNN(i)) was calculated from 5-min data and summarised hourly. SDNN(i)s over work and non-workdays were compared using linear mixed-effects models to account for repeated measures and harmonic regression to account for circadian variation.

RESULTS

Both work and non-work hourly HRV exhibited circadian variation with an increase in the evening and a decrease in the afternoon. SDNN(i) was lower on workdays as compared with non-workdays with the largest, statistically significant differences observed between 10:00 and 16:00, during active working. Lower SDNN(i), albeit smaller yet statistically significant differences, was also observed in the evening hours following work (17:00-21:00) and early morning (4:00). In regression models using all time periods, an average workday SDNN(i) was 8.1 ms (95% CI -9.8 to -6.3) lower than non-workday SDNN(i). The circadian pattern of HRV exhibited two peaks which differed on work and non-workdays.

CONCLUSION

While workday and non-workday HRV followed a circadian pattern, decreased HRV and variation of the circadian pattern were observed on workdays. Declines and changes in the circadian pattern of HRV is a concern among this exposed population.

摘要

目的

比较锅炉制造工人工作日和非工作日每小时心率变异性(HRV)的昼夜变化。

方法

对 18 名男性进行了一项面板研究,他们在 44 个观察日中,通过 24 小时动态心电图监测,在配对的工作日和非工作日进行监测。对心电图进行分析,并从 5 分钟数据中计算出正常-正常心跳指数(SDNN(i))的标准差,并按小时进行总结。使用线性混合效应模型比较工作日和非工作日的 SDNN(i),以考虑重复测量,使用谐波回归以考虑昼夜变化。

结果

工作日和非工作日的每小时 HRV 均表现出昼夜变化,傍晚时增加,下午时减少。SDNN(i)在工作日比非工作日低,最大的统计学差异出现在活跃工作期间的 10:00 至 16:00 之间。在工作日后的傍晚(17:00-21:00)和清晨(4:00),SDNN(i)也较低,但统计学差异较小。在使用所有时间段的回归模型中,工作日的平均 SDNN(i)比非工作日的 SDNN(i)低 8.1ms(95%CI-9.8 至-6.3)。HRV 的昼夜节律模式显示出两个峰值,在工作日和非工作日之间存在差异。

结论

虽然工作日和非工作日的 HRV 呈现昼夜模式,但在工作日观察到 HRV 降低和昼夜模式的变化。在这种暴露人群中,HRV 的昼夜节律模式的下降和变化令人担忧。

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