Yu Shan-fa, Zhou Wen-hui, Gu Gui-zhen, Wu Yan-yan, Qiu Ying, Wang Sheng
Henan Provincial Institute of Occupational Health, Zhengzhou 450052, China.
Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2009 Dec;27(12):706-10.
To explore the effect of occupational stress on hypertension.
498 workers whose accumulative length of service was more than two years were investigated with questionnaire by method of cluster sampling from a thermal power plant in Henan province in China; 446 respondents returned qualified questionnaire including 281 male and 165 female Han People. After the patients with secondary hypertension, diabetes patients, and patients with liver or kidney disease were excluded, 84 workers (58 males and 26 females) were diagnosed as hypertension. The occupational stressors, personalities, buffering factors and occupational strain were measured by using the Job Demand-control Model, the Effort-reward Imbalance Model questionnaires and Occupational Stress Measurement Scale. Main risk factors for the development of hypertension such as heredity, body mass index, high salt diet, alcohol use, smoking habit and lack of physical activity were investigated. 498 whole blood samples were collected from workers in field epidemiologic survey. All of the samples were detected TG, CHO and FPG by common biochemistry methods. Multivariate logistic regression analysis were used to determine the relationship between occupational stressors and prevalence rate of hypertension. The difference of morbidity of hypertension between different stress level subjects was analyzed by chi2 test.
(1) Logistic regression analysis of the hypertension by all occupational stressors and risk factors of hypertension indicated that not only some common factors such as parents' hypertensive history, BMI, alcohol use and TG, but also responsibility for person, work locus of control and social support were significantly correlated with elevated risks of hypertension. (2) Logistic regression analysis of the hypertension by main dimensions of effort-reward imbalance model and risk factors of hypertension indicated that parents' hypertensive history, BMI, alcohol use, TG, and effort were significantly correlated with elevated risks of hypertension. Logistic regression analysis indicated the risk of hypertension had an effect on the FRI and effort (OR was 1.71 and 2.43 respectively). (3) For the job strain model, results indicated that parents' hypertensive history, UMI, alcohol use, TG, work locus of control and social support were significantly correlated with elevated risks of hypertension. But the main dimensions of job strain model (job demands and decision latitude) didn't enter regression equation. (4) The difference of prevalence of hypertension between high- and low stress level groups in male was statistically significant (OR = 3.13, P < 0.01), but the case was not the same in female (P > 0.05).
Occupational stress might be risk factor of hypertension; The predictive power of effort-reward imbalance model for the development of hypertension would be larger than that of job strain model.
探讨职业压力对高血压的影响。
采用整群抽样的方法，对中国河南省某火力发电厂累计工龄超过两年的498名工人进行问卷调查；446名受访者返回了合格问卷，其中包括281名男性和165名女性汉族人。排除继发性高血压患者、糖尿病患者以及肝脏或肾脏疾病患者后，84名工人（58名男性和26名女性）被诊断为高血压。采用工作需求-控制模型、努力-回报失衡模型问卷和职业压力测量量表对职业压力源、人格、缓冲因素和职业紧张进行测量。调查高血压发生的主要危险因素，如遗传、体重指数、高盐饮食、饮酒、吸烟习惯和缺乏体育活动等。在现场流行病学调查中采集了498名工人的全血样本。所有样本均采用常规生化方法检测甘油三酯（TG）、总胆固醇（CHO）和空腹血糖（FPG）。采用多因素logistic回归分析确定职业压力源与高血压患病率之间的关系。采用χ2检验分析不同压力水平受试者高血压发病率的差异。
（1）对所有职业压力源和高血压危险因素进行高血压的logistic回归分析表明，不仅父母高血压病史、体重指数、饮酒和甘油三酯等一些常见因素，而且个人责任、工作控制点和社会支持等因素与高血压风险升高显著相关。（2）对努力-回报失衡模型的主要维度和高血压危险因素进行高血压的logistic回归分析表明，父母高血压病史、体重指数、饮酒、甘油三酯和努力程度与高血压风险升高显著相关。logistic回归分析表明高血压风险对FRI和努力程度有影响（OR分别为1.71和2.43）。（3）对于工作紧张模型，结果表明父母高血压病史、UMI、饮酒、甘油三酯、工作控制点和社会支持与高血压风险升高显著相关。但工作紧张模型的主要维度（工作需求和决策自由度）未进入回归方程。（4）男性高压力水平组和低压力水平组高血压患病率的差异有统计学意义（OR = 3.13，P < 0.01），但女性情况不同（P > 0.05）。
职业压力可能是高血压的危险因素；努力-回报失衡模型对高血压发生的预测能力大于工作紧张模型。
