Objective To investigate the significance of serum interleukin-1β,interleukin-2,interleukin-6,TNF-α,erythrocyte sedimentation rate(ESR),c-reactive protein(CRP),IgA,IgG and IgM in patients with ankylosing spondylitis(AS),and to analyze their relationship with the Bath ankylosing spondylitis disease activity index (BASDAI). Methods Participants of this study included 45 AS patients(patient group)and 30 healthy subjects (control group).The patient group was further divided into an active subgroup and an inactive subgroup based on the disease activity assessed by using BASDAI.Then serum levels of IL-1β,IL-2,IL-6,TNF-α,ESR,CRP,IgA,IgC and IgM were tested in all the subjects,and the values were compared between different groups.In addition,the relationship between various parameters and those with BASDAI were also evaluated. Results The serum levels of ESR,CRP,IgA,lgM,IgG,IL-1β,IL-2,IL-6 and TNF-α in patients with AS were significantly higher than those in the healthy controls(P<0.05).The serum level of CRP,IL-2 and IL-6 were significantly different between the active and inactive subgroups(P<0.05).There was a positive correlation between CRP and IL-6,IL-6 and IL-2,as well as IgA and IgG levels.The IL-2,IL-6 and CRP levels were positive correlated with BASDAI.Conclusion It was suggested that the serum levels of IL-2,IL-6 and CRP can be used to assess the disease activity in patients with AS.

OBJECTIVETo investigate the relationship between work in shifts and occupational stress.

METHODSA total of 5338 employees from 13 companies were investigated by cluster sampling, and occupational stress measuring tools, job content questionnaire, and effort-reward imbalance questionnaire were used to investigate occupational stress factors, stress reaction, and the condition of work in shifts.

RESULTSThe employees who worked in shifts accounted for 46.6%. The condition of work in shifts varied significantly across different companies, employees with different individual features (including sex, job title, degree of education, age, working years, smoking, and drinking), and employees with different weekly working times(P<0.01 or P<0.05); health status was associated with work in shifts(P<0.01); compared with the employees who did not work in shifts, those who worked in shifts had significantly lower scores of technology utilization, work control level, psychological need, reward, social support, and job satisfaction(P<0.01 or P<0.05), as well as significantly higher scores of physical demands, effort, depressive symptoms, and negative affectivity(P<0.01).

CONCLUSIONWork in shifts can affect health status, and is associated with occupational stress.

Depression ; Health Status ; Humans ; Job Satisfaction ; Occupational Diseases ; epidemiology ; Smoking ; Social Support ; Stress, Psychological ; Surveys and Questionnaires ; Work Schedule Tolerance

Objective: To investigate self-esteem status of train drivers. Methods: By using cluster sampling method, a cross-sectional study was conducted in 1 413 train drivers (including passenger train drivers 301, freight train drivers683, passenger shunting train drivers350, and high speed train drivers79) from a railway bureau. The occupational stressors, strains, self-esteem and personalities were measured using occupational stress instruments and effort-reward imbalance questionnaire. Results: The level of self-esteem is medium ofthe train drivers. Sself-esteem scores among different among different job category (job title) , marry status, age, length of service groups were statistical significance (P<0.01) . Differences of self-esteem among different educational level, exercise, smoking and drinking groups weren’t statistical significance (P>0.05) . Correlation analysis revealed that self-esteem score was related positively to job satisfaction (r=0.300) , reward (r=0.842) , working stability (r=0.243) , promotion opportunities (r=0.493) , positive affectivity (r=0.216) , responsibility for human beings (r=0.112) and responsibility for things scores (r=0.108) (P<0.01) , negatively to sleep quality (r=-0.103) , social support (r=-0.212) , role conflict (r=-0.007) , role ambiguity (r=-0.169) , physiological needs (r=-0.115) , daily stress (r=-0.150) , negative affectivity (r=-0.252) , depressive symptoms scores (r=-0.215) (P<0.01) . Nonparametric test found that train drivers of group with low self-esteem score reported higher scores for physiological need, role conflict, role ambiguity, social sleep quality, depressive symptoms, negative affectivity, social support and daily stress scores than the medium and higher groups (P<0.01 or<0.05) . But reword, job satisfaction, positive affectivity, copping stratgy, working stability and promotion opportunities scores were lower than the group of medium and higher groups (P<0.01) . Inter-group conflict scores were insignificance (P>0.05) . Multivariate logistic regression analysis revealed that low low self-esteem for drivers occured the risk of job dissatisfaction about 1.5 times as high as that of drivers with higher self-esteem (OR=1.476) Conclusion Different types of locomotive drivers get different level of self-esteem. Self-esteem was affected by occupational stress largely.

Objective: To explore relationship between depressive symptoms and occupational stress in locomotive drivers. Methods: By using cluster sampling method, a cross-sectional study was conducted in 1413 train drivers (including passenger train drivers301, freight train drivers 683, passenger shunting train drivers350, and high speed train drivers79) from a railway bureau. The individual factors, depression, occupational stress, strains, personalities, coping strategy and social support were measured using occupational stress instruments, job content questionnaire and effort-reward imbalance questionnaire. Results: CThe differences of depression scores between take exercise and don't exercise groups were statistical significance (P<0.01) . The differences of depression scores among different age, length of service, job category, educational status,marital status, smoking and drinking groups were`t statistical significance (P>0.05) .Correlation analysis revealed that depression score was related negatively to reward, job satisfaction, self-esteem, promotion opportunities, working stability and positively emotions score (P<0.01) , related positively to sleep disorders, effort, physiological needs, psychological need, daily stress, negative emotions, social support, esponsibility for person, responsibility for thing, conflict in the group, role conflict, role ambiguity score (P<0.01) . Nonparametric test analysis found that train drivers with high depression score reported higher psychological need, effort, promotion opportunities, role ambiguity, role conflict, conflict between groups, responsibility for person, responsibility for thing, physiological needs, daily stress, negative emotions, social support and copping strategies than those with moderate and lower depression score (P<0.01) , but the scores of job satisfaction, reword, self-esteem, working stability, positive emotions were lower than other groups those with moderate and lower depression score (P<0.01) . Multivariate logistic regression analysis revealed the risk of depression for drivers with more sleep disorder, low social support more than three times as high as that for drivers with few sleep disorder, hing social support (OR=3.615,3.266) .High negative emotions, more psychological need, high daily stress were more than twice times as high as that for drivers with low negative emotions, few psychological need, low daily stress (OR:2.444、2.489、2.065) . Conclusion sleep disorder, low social support and job stress had larger effect on depression. To improve sleep, social support, self-esteem and decrease job stress and negative emotions are main measures of decrease depression for train drivers.

Objective: To investigate the influencing factors for job satisfaction in train drivers. Methods: In March 2012, cluster sampling was used to conduct a cross-sectional survey in 1413 male train drivers (including 301 passenger train drivers, 683 freight train drivers, 350 passenger shunting train drivers, and 79 high-speed train drivers) from a locomotive depot of a railway bureau. The occupational stress instruments, job content questionnaire, and effort-reward imbalance questionnaire were used to analyze job satisfaction, occupational stress factors, stress reaction, individual characteristics, coping strategies, and social support. Results: There were significant differences in job satisfaction score between the drivers with different posts, working years, ages, smoking status, and drinking status (P<0.01). The correlation analysis revealed that job satisfaction score was positively correlated with reward, working stability, promotion opportunity, positive emotion, social support, self-esteem, and coping strategy scores (P<0.01) and negatively correlated with sleep disorders, effort, role conflict, intergroup conflict, responsibility for persons, responsibility for things, psychological needs, physiological needs, daily stress, negative emotion, and depressive symptom scores (P< 0.01). The analysis of variance showed that compared with the moderate and low job satisfaction groups, the high job satisfaction group had significantly higher reward, positive emotion, promotion opportunity, and role ambiguity scores (P<0.01) , as well as significantly lower scores of responsibility for persons and responsibility for things (P<0.01). Compared with the moderate and high job satisfaction groups the low job satisfaction group had significantly higher scores of psychological needs, effort, role conflict, sleep disorders, daily stress, depressive symptom, negative emotion, drug use, intragroup conflict, and social support (P<0.01) , and the moderate job satisfaction group had a significantly higher score of self-esteem than the other two groups (P<0.05). The logistic regression analysis showed that the risk of job dissatisfaction in the drivers with low so-cial support and high daily stress was more than 2 times that in those with high social support and low daily stress (OR=2.176 and 2.171) , and sleep disorders, effort, depressive symptom, low self-esteem, and role conflict were risk factors for job dissatisfaction (OR=1.48-1.625). Conclusion Occupational stress, stress re-sponse, emotion, individual characteristics, and social support have great influence on job satisfaction. Im-proving social support, increasing positive emotion, and reducing occupational stress are main measures for increasing job satisfaction in train drivers.

Objective: To investigate sleep quality status of train drivers. Methods: By using cluster sampling method, a cross-sectional study was conducted in 1413 train drivers (including passenger train drivers 301, freight train drivers 683, passenger shunting train drivers 350, and high speed train drivers 79) from a railway bureau. The occupational stressors, strains, personalities and sleep quality were measured using occupational stress instruments and effort-reward imbalance questionnaire. Results: The train drivers of poor sleep quality was 48.34%. Sleep quality scores among different among different job category (job title) , exercise, smoking and drinking were statistical significance (P<0.01) . Differences of sleep quality among different educational level, marry status, age, length of service groups weren’t statistical significance (P>0.05) . Correlation analysis revealed that sleep quality score was related negatively to job satisfaction, reward, working stability, promotion opportunities, positive affectivity, esteem and self-esteem scores (r: -0.454, -0.207, -0.329,-0.170, -0.291, -0.103, -0.139, P<0.01 or P<0.05) , positively to social support, effort, role conflict, conflict between groups, conflict in groups, responsibility for person, responsibility for thing, psychological needs, physiological needs, daily stress, negative affectivity, depressive symptoms scores (r: 0.338, 0.524, 0.226, 0.094, 0.182, 0.210, 0.247, 0.190, 0.615, 0.550, 0.345, 0.570, P<0.01) . Nonparametric test found that train drivers of group with high sleep quality score reported higher scores for physiological need, psychological need, effort, role conflict, conflict between groups, social support, daily stress, depressive symptoms, responsibility for person, responsibility for thing, negative affectivity and coping scores than the group of lower sleep quality score (P<0.01) . But reword, job satisfaction, positive affectivity, self-esteem working stability and Promotion opportunities scores were lower than the group of lower sleep quality score (P<0.01) . Multivariate logistic regression analysis revealed the risk for more physiological needs, more effort, more depressive symptoms and more daily stress for drivers occured the risk of poor sleep quality were more than two times as high as that of drivers with less physiological needs, less effort, less depressive symptoms and less daily stress (OR=2.905~2.005) . Conclusions Different types of locomotive drivers get different level of sleep quality. Sleep quality was affected by occupational stress largely. Reducing the occupational stress may contribute to improve the sleep quality of train drivers.

OBJECTIVETo explore depressive symptoms and influencing factors in employees from 13 enterprises.

METHODSA total of 6711 workers from 13 enterprises were investigated by cluster sampling, and data were collected anonymously between November 2008 and June 2009. Job satisfaction, occupational stressors, strains, coping strategy, and social support were measured using occupational stress instruments, job content questionnaire, and effort-reward imbalance questionnaire.

RESULTSMedian and P25~P75 values of depression score were 14 and 9~21, respectively. The depression score of male workers (16.31 ± 10.12) was significantly higher than that of female workers(14.50 ± 9.08) (Z=4.09, P<0.01). The depression score of managers was lowest (12.89 ± 8.70), and the front-line workers scored highest (16.02 ± 9.94), with a significant difference between the two groups (χ² =9.90, P<0.01). The depression score of shift workers (16.79 ± 9.974) was significantly higher than that of non-shift workers (14.81 ± 9.63) (Z=53.43, P<0.01). The depression scores of workers with weekly job times of ≤ 40 h, ~50 h, ~59 h, and ≥ 60 h were (14.70 ± 9.94), (15.76 ± 9.84), (15.46 ± 9.91), and (19.70 ± 10.67), respectively (χ² = 31.79, P <0.01). Correlation analysis revealed that depression score was negatively correlated with the scores of job control (r=-0.236, P <0.01), reward (r=-0.443, P<0.01), job satisfaction (r=-0.418, P<0.01), positive affectivity (r=-0.307, P <0.01), superior support (r=-0.287, P<0.01), colleague support (r=-0.235, P<0.01), and coping strategy (r=-0.208, P<0.01), but positively correlated with the scores of external effort (r=0.225, P<0.01), inherent effort (r=0.248, P<0.01), psychological demands (r = 0.246, P <0.01), physical demands (r=0.246, P<0.01), and negative affectivity (r=0.525, P<0.01). Multivariate logistic regression analysis revealed that the risk of depressive symptoms in workers with high negative affectivity was about four times as high as that in workers with low negative affectivity. The risks of depressive symptoms in workers with low reward, having disease in the past six months, and with high inherent effort were 1.62, 1.50, and 1.48 times, respectively, as high as those for their counterparts.

CONCLUSIONOccupational stress, individual factors, health status, and shift work affect the depressive symptoms of workers. Reducing negative affectivity and increasing rewards are main measures to relieve depressive symptoms.

Adaptation, Psychological ; Depression ; epidemiology ; Female ; Health Status ; Humans ; Job Satisfaction ; Male ; Occupational Health ; Social Support ; Stress, Psychological ; Surveys and Questionnaires ; Work Schedule Tolerance

Objective:To investigate association between genetic polymorphism in the grainyhead-like 2 gene (GRHL2)and noise-induced hearing loss (NIHL)in the Chinese population.Methods:A matched case-control association study was employed,In which,3 790 workers exposed to continuous and steady-state occupational noise in a steel factory participated.The questionnaires were adopted to col-lect individual features and audiometry tests performed.In the sstudy,286 subjects were diagnosed as ca-ses,Which were each designated on the basis of the matched criterion,and 286 paired samples were se-lected finally.Noise intensity was measured according to the standards given in ‘Measurement of Noise in the Workplace’(Occupational Health Standard of the People’s Republic of China,GBZ /T1 89.8 -2007).Cumulative noise exposure (CNE)was calculated,according to monitoring data on A-weighed sound pressure level and employment time.Genomic DNA was obtained from peripheral blood samples using 2 mL DNA extraction Kit following the manufacturer’s protocol.Five single nucleotide polymor-phisms (SNPs)of GRHL2 were genotyped by multiplex SNP genotyping kit.The continuous variables and categorical variables were analyzed by t-test and chi-square test respectively.Multivariate Logistic re-gression was used to test the association between genetic frequency and disease status,with adjustments for the possible confounding variables.The haplotypes were established and their frequencies in the two groups were assessed by haploview and phase softwares.Results:All the five SNPs (rs373571 3, rs3824090,rs373571 4,rs373571 5 and rs61 1 41 9)were in Hardy-Weinberg equilibrium (HWE)(P >0.05).The subjects carrying rs373571 5 GG genotype had a higher NIHL risk than those carrying the GA genotype under the co-dominant model (OR =0.644,95% CI:0.442 -0.939,P =0.022)after ad-justment for height,blood pressure,drinking status and smoking status.After being stratified by CNE,in the CNE ≥ 98 dB (A)group,rs373571 5 polymorphism was associated with the NIHL under the co-dominant model (OR =0.509,95% CI:0.281 -0.923,P =0.026)after adjustment for height,blood pressure,drinking status and smoking status as well.However,no statistical significant difference was found in variant genotypes of the other SNPs between the case and control subjects.Four-locus (rs373571 3,rs3824090,rs373571 4 and rs373571 5)haplotypes were constructed,and no risk or protec-tive haplotypes was identified.Conclusion:It is suggested that GRHL2 polymorphisms may be associated with development of NIHL.

Objective: To investigate the social support status of train drivers. Methods: Using cluster sampling, a cross-sectional study was conducted in 1 413 male train drivers (including 301 passenger train drivers, 683 freight train drivers, 85 guest scheduling train drivers, 265 cargo adjustable drivers, and 79 high-speed train drivers) from a railway bureau depot. The survey included individual factors, social support, occupational stressors, strains, personalities, and coping strategy using occupational stress instruments and effort-reward imbalance questionnaire. We compared the difference in social support scores between different drivers, who were divided according to job type and age. Additionally, the correlation between social support score and job strain-related factors was analyzed. The influence of depressive symptoms and job satisfaction were analyzed using a non-conditional logistic multivariate model. Results: The overall average age P₅₀ (P₂₅,P₇₅) of 1 413 train drivers was 33.92 (27.83,43.58) years. The overall average length of service 12.25 (5.25,22.75) years. A significant difference in social support scores was observed according to job type (H=23.23, P<0.001). The specific scores were passenger driver(27 (23,32)), freight train driver (26 (22,30)), guest scheduling driver (27 (24,30)), cargo adjustable driver (26 (22,31)), and high-speed train driver (30 (26,36)) (P₅₀(P₂₅,P₇₅)). Additionally, social support scores among different age groups were significantly different (H=6.64, P=0.036). The specific scores were ≤30 years (26 (22,31)), 30-40 years (27 (23,33)), and >40 years (27 (22,31)). Correlation analysis revealed that the social support score was negatively associated with job satisfaction (r=-0.43), reward (r=-0.22), working stability (r=-0.23), promotion opportunities (r=-0.12), positive affectivity (r=-0.31), esteem (r=-0.21), and self-esteem (r=-0.20) scores (P<0.001). The social support score was positively associated with sleep disorders (r=0.33), external effort (r=0.21), pay within (r=0.12), role conflict (r=0.20), conflict between groups (r=0.17), conflict in groups (r=0.06), responsibility for the others (r=0.06), responsibility for things (r=0.08), physiological needs (r=0.39), psychological needs (r=0.19), daily stress (r=0.29), negative affectivity (r=0.23), and depressive symptoms (r=0.44) scores (P<0.05). Multivariate logistic regression analysis revealed social support had a great influence on depressive symptoms and low job satisfaction. Compared with high social support, low social support resulted in depressive symptoms (OR=4.12, 95% CI:3.19-5.33) and low job satisfaction (OR=2.18, 95%CI:1.65-2.88). Conclusion Train drivers obtained various levels of social support. Social support greatly affected occupational stress. High social support was related to reduction in the occurrence of occupational stress, depressive symptoms, and low job satisfaction. Social support is related to mental health of train drivers.

Objective: To analyze the change of level of occupational stress between 1996 and 2012 among train engine drivers. Methods: the cross-section investigation was conducted by using cluster sampling method, subjects included 1 116 and 1 002 passenger train engine drivers and freight train engine drivers respectively in 1996 and in 2012;occupational stressors, strains, personalities, buffering factors and individual factors were investigated by using Occupational Stress Instruments. Unconditional logistic regression analyses were performed to estimate the associations between job stressors, personalities, buffering factors and individual factors and strains. Multivariate OR(95%CI) were derived from the logistic regression models. Results: From 1996 to 2012, for the passenger train engine drivers the scores of role ambiguity (17.67±5.30 vs.14.11±4.66) increased 25.32%, mental load (10.41±3.56 vs. 16.29±2.08) and physical environment (3.61±2.18 vs. 7.03±1.65) scores decreased 36.10% and 48.64% respectively, sleep disorders (18.04±9.20 vs. 13.35±4.00) and negative affectivity (2.76±1.86 vs. 2.14±1.86) scores increased 33.14% and 28.97% respectively, the differences were statistical significant (P<0.001) . For the freight train engine drivers the scores of sleep disorders (20.33±8.17 vs. 12.47±4.12) and negative affectivity (2.95±1.70 vs. 1.87±1.81) scores increased 57.75% and 60.03% respectively, positive affectivity (2.17±1.60 vs. 2.91±1.50) score decreased 25.43%, the differences were statistical significant (P<0.001) . In general, scores varies in factors related to occupational stress among freight train engine drivers were larger than those among passenger train engine drivers. The risk factor of job dissatisfaction among passenger train drivers in 1996 was insufficient superior support (OR=3.77, 95%CI: 2.23-6.37) , the risk factors in 2012 were insufficient superior support (OR=3.35, 95%CI:1.56-7.17) , poor physical environment (OR=3.61, 95%CI: 1.91-6.80), and fewer positive affectivity (OR=3.47, 95%CI: 1.75-6.82). The risk factor of job dissatisfaction among freight train drivers in 1996 and in 2012 were insufficient superior support (OR (95%CI) were 3.11 (2.31-4.19), 2.59 (1.84-3.65) , respectively). Conclusion The level of occupational stress among train engine drivers in 2012 was larger than that in 1996, the level of occupational stress among freight train drivers was larger than passenger train drivers, the interventions aimed at reducing occupational stress in the Chinese train engine drivers should take into account promotion for design of job organization and contents and organization management style.