职业消防员的24小时轮班、工作要求增加与血压升高。
Twenty-four-hour work shifts, increased job demands, and elevated blood pressure in professional firefighters.
作者信息
Choi BongKyoo, Schnall Peter, Dobson Marnie
机构信息
Center for Occupational and Environmental Health, University of California, Irvine, 100 Theory, Suite 100, Irvine, CA, 92617, USA.
Program in Public Health, University of California, Irvine, Irvine, CA, USA.
出版信息
Int Arch Occup Environ Health. 2016 Oct;89(7):1111-25. doi: 10.1007/s00420-016-1151-5. Epub 2016 Jul 1.
PURPOSE
To investigate whether working conditions (number of 24-h shifts, number of calls, sedentary work, job strain, effort-reward imbalance, and physical demands) are associated with elevated blood pressure and hypertension among professional firefighters.
METHODS
A total of 330 (321 males and 9 females) firefighters were chosen for this study among the Southern California firefighters who participated in a work and obesity project. Working conditions were measured with a firefighter-specific occupational health questionnaire. Blood pressure was clinically assessed, and hypertension was defined according to the contemporary standard classification.
RESULTS
About 11 % of the firefighters had hypertension. Fifty percent of the hypertensive firefighters (mostly mild hypertensive) had uncontrolled high blood pressure. Hypertension was more prevalent in male, older, and high-rank firefighters and firefighter who reported low numbers of daily calls. In male firefighters who were normotensive or hypertensive without taking anti-hypertensive medication, additional 24-h shifts in the past month increased the risk of elevated diastolic blood pressure (DBP) than those who reported a standard work schedule (eight to eleven 24-h shifts). Particularly, firefighters who reported sixteen 24-h shifts had 5.0 mmHg higher DBP (p < 0.01). Body mass index attenuated the association between number of shifts and blood pressure to some extent. Firefighters who reported "increased job demands over the past years" had 3.0 mmHg (p = 0.06) higher systolic blood pressure. Other working conditions were not associated with elevated blood pressure and hypertension.
CONCLUSIONS
Many additional 24-h shifts and increased job demands were risk factors for elevated blood pressure in male firefighters. Optimal collective and individual workload and improved hypertension management are warranted for enhancing the cardiovascular health of firefighters.
目的
调查工作条件（24小时轮班次数、呼叫次数、久坐工作、工作压力、努力-回报失衡和体力需求）是否与职业消防员的血压升高和高血压有关。
方法
在参与一项工作与肥胖项目的南加州消防员中，共选取了330名（321名男性和9名女性）消防员进行这项研究。使用特定于消防员的职业健康问卷来测量工作条件。对血压进行临床评估，并根据当代标准分类定义高血压。
结果
约11%的消防员患有高血压。50%的高血压消防员（大多为轻度高血压）血压控制不佳。高血压在男性、年龄较大、职级较高以及每日呼叫次数较少的消防员中更为普遍。在未服用抗高血压药物的血压正常或高血压男性消防员中，过去一个月额外增加的24小时轮班比报告标准工作时间表（8至11个24小时轮班）的消防员增加了舒张压升高的风险。特别是，报告有16个24小时轮班的消防员舒张压高5.0 mmHg（p<0.01）。体重指数在一定程度上减弱了轮班次数与血压之间的关联。报告“过去几年工作需求增加”的消防员收缩压高3.0 mmHg（p = 0.06）。其他工作条件与血压升高和高血压无关。
结论
额外增加的多个24小时轮班和工作需求增加是男性消防员血压升高的危险因素。为了增强消防员的心血管健康，有必要优化集体和个人工作量，并改善高血压管理。
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