1.Mediating role of psychological resilience between depression and humoral immunological biomarkers in medical staff
Yunyun MA ; Yanshuan WEI ; Lili QIAN ; Xiufeng ZUO ; Dechao WANG ; Shanfa YU
Journal of Environmental and Occupational Medicine 2025;42(4):427-435
Background At present, high level of depression is a serious problem in medical staff and may affect their immune function. The role of psychological resilience between depression and immunity cannot be ignored. However, it is still lack of research report in this area. Objective To explore the mediating effect of psychological resilience on the association between depression and humoral immunological biomarkers in medical staff. Methods A total of 108 medical staff from a tertiary hospital in Henan Province were selected using stratified cluster sampling from September 2022 to December 2022. The Connor-Davidson Resilience Scale and Patient Health Questionnaire-9 were used to evaluate their psychological resilience and depression. Serum immunoglobulin (Ig) M (IgM), IgG, IgA, complement 3 (C3), and complement 4 (C4) were detected in fasting venous blood samples. Mann-Whitney U test, Kruskal-Wallis H test, independent-samples t-test, and One-way ANOVA were used for comparisons among different demographic groups. Spearman correlation was used to evaluate correlations among measured variables. PROCESS plug-in was used to verify potential mediating effect of psychological resilience on the relationship between depression and humoral immunological biomarkers. Results The M (P25, P75) score of psychological resilience was 65.50 (53.25, 75.00) in the participating medical staff. The ratios of low, medium, and high levels of psychological resilience were 2.78% (3/108), 51.85% (56/108), and 45.37% (49/108), respectively. The M (P25, P75) score of depression was 6.00 (2.00, 8.00). The positive rate of depression was 61.11% (66/108). The correlation analysis results showed that psychological resilience was negatively correlated with depression and serum complement C3 (r=−0.416 and −0.309, P<0.01), positively correlated with serum IgG and serum IgA (r=0.302 and 0.517, P<0.01); optimism, self-improvement, and resilience were negatively correlated with depression (r=−0.387, −0.446, and −0.312, P<0.01), positively correlated with IgG (r=0.194, 0.284, and 0.239, P<0.05), and positively correlated with IgA (r=0.377, 0.378, and 0.444, P<0.01), respectively; resilience was negatively correlated with C3 (r=−0.304, P<0.01), and depression was negatively correlated with serum IgG and serum IgA (r=−0.516 and −0.522, P<0.01), positively correlated with serum complement C3 (r=0.195, P<0.05). The mediating effect test showed that psychological resilience showed mediating effects on the relationship between depression and serum IgA and serum complement C3, with mediating effect values of −0.148 (95%CI: −0.051, −0.012) and 0.111 (95%CI: 0.001, 0.010), and their mediating effect ratios were 28.30% and 56.92%. Conclusion The mental health status of the target medical staff is not optimistic. Depression is associated with changes in some humoral immunological biomarkers. Psychological resilience can mediate the correlations between depression and humoral immunological biomarkers. The managers should take measures to improve the levels of psychological resilience and promote the physical and mental health of medical staff.
2.Research progress on occupational hazards in lithium battery industry and their health risks
Haozheng LI ; Shanfa YU ; Hongna ZHANG ; Yuxin ZHENG
Journal of Environmental and Occupational Medicine 2024;41(5):579-585
Lithium batteries are widely used in energy storage, power, and other fields due to their advantages such as high performance and low cost. With the rapid development of the lithium battery industry, its production is constantly growing. However, the identification of occupational hazards and assessment of their health risks in lithium battery industry has rarely been reported. The composition of lithium batteries is complex and involves large numbers of compounds. Besides the traditional occupational hazards, workers may be exposed to many emerging chemicals throughout the production of raw materials, assembly and disassembly of lithium batteries. Therefore, this paper introduced the process chain of lithium battery production, analyzed the underlying occupational hazards in the industry, reviewed the health impacts of typical occupational hazards, and proposed the future research needs according to the current status of research on occupational exposure and health hazards in the lithium battery industry.
3.Study on the biological exposure limit of whole blood chromium in occupational hexavalent chromium compounds exposed population
Guiping HU ; Yali ZHANG ; Shiyi HONG ; Zekang SU ; Qiaojian ZHANG ; Li WANG ; Tiancheng WANG ; Shanfa YU ; Guang JIA
China Occupational Medicine 2024;51(2):129-137
ObjectiveTo analyze the exposure-response relationship of peripheral whole blood chromium level and lung function as well as genetic toxicity indicators in workers exposed to hexavalent chromium [Cr(Ⅵ)] compounds, and to propose a biological exposure limit of whole blood chromium for soluble Cr(Ⅵ) compounds-exposed workers. Methods A total of 515 workers from a dynamic occupational Cr(Ⅵ) compounds-exposed cohort in an enterprise from 2010 to 2017 were selected as the research subjects using a retrospective cohort study. A total of 918 followed-up results of research subjects and baseline data of a cohort were analyzed based on bibliometric analysis. The results include lung function tests, whole blood chromium level detected by inductively coupled plasma-mass spectrometry, urinary 8-hydroxy-2′-deoxyguanosine (8-OHdG) detected by high performance liquid chromatography-tandem mass spectrometry, peripheral micronuclei frequency (MNF) detected by cytokinesis-block micronucleus assay, and mitochondrial DNA copy number (mtCN) detected by real-time fluorescence quantitative polymerase chain reaction. Results The results of bibliometric analysis showed that domestic and foreign studies on biological monitoring of Cr(Ⅵ) compounds increased year by year in the past 30 years, and whole blood chromium levels had a good correlation with the occupational Cr(Ⅵ) compounds exposure. The geometric mean of whole blood chromium levels in males and females among the occupational Cr(Ⅵ) compounds exposure cohort was 2.77 and 1.79 μg/L, respectively. A turning point appeared in 6.00 μg/L chromium in whole blood of the exposure-response curve of whole blood chromium levels with lung function indicators and genetic toxicity indicators. For each unit increase in the natural logarithm-transformed whole blood chromium level, the forced expiratory volume in one second (FEV1) decreased by 0.05 L, the FEV1/forced-vital-capacity decreased by 0.67%, the peak expiratory flow decreased by 0.15 L/s, the maximal mid-expiratory flow decreased by 0.09 L/s, the MNF increased by 0.149‰, the urinary 8-OHdG increased by 0.090 μg/g, and the mtCN increased by 0.013. When the whole blood chromium level was >6.00 μg/L, there was a significant increase in urinary 8-OHdG, MNF, and mtCN (all P<0.01). Conclusion The level of whole blood chromium can be used as a biomarker for occupational exposure to soluble Cr(Ⅵ) compounds. The preliminary biological exposure limit is set at 6.00 μg/L for whole blood chromium in workers exposed to soluble Cr(Ⅵ) compounds.
4.Understanding of job burnout hazards and active promotion of scientific research based prevention and control strategy
Journal of Environmental and Occupational Medicine 2023;40(4):369-373
Job burnout is rampant in workplaces and has become an important global public health concern. It is one of the top occupational health problems to be addressed in the workplace in Europe and America. The prevalence rate of job burnout is also at a high level in China, and cannot be ignored for its associated health loss and economic impact of occupational population, so we should deepen the understanding of job burnout hazards, promote relevant scientific research, and develop associated prevention and control programs. This paper introduced the epidemic status of job burnout, health hazards and economic impact, development stage, influencing factors, conceptual models, measurement and evaluation methods, and prevention and control measures, and proposed scientific research directions as well as prevention and control strategies of job burnout in the future.
5.Problems and improvement suggestions for job burnout measurement tools and their application
Journal of Environmental and Occupational Medicine 2023;40(4):374-381
Job burnout is a hot topic in occupational health psychology research at home and abroad. This paper reviewed the concept and development of job burnout, introduced the common tools measuring job burnout, indicated the problems reported in the measurement tools of job burnout, proposed suggestions on the introduction, translation, development and use of burnout measurement tools, summarized the new trend of research on job burnout abroad, and prospected the future research work of job burnout in China.
6.Current situation and influencing factors of job burnout in express industry in Xinxiang City, Henan Province
Jia MA ; Hui WU ; Sanqiao YAO ; Shanfa YU
Journal of Environmental and Occupational Medicine 2023;40(4):413-419
Background Job burnout is common among working populations. The current situation and influencing factors of job burnout have been studied in workers of many industries at home and abroad, except the express industry in China. Objective To understand the current situation of job burnout in express industry in a city of China, and to provide a scientific basis for developing measures to reduce the occurrence of job burnout. Methods In 2022, 432 express delivery workers in a city were selected by cluster random sampling, and their job burnout, anxiety symptoms, and depressive symptoms were evaluated by using the General Burnout Scale, Generalized Anxiety Disorder-7, and Patient Health Questionnaire-9. Chi-square test was used to compare inter-group positive rates of job burnout. Spearman correlation analysis was used to analyze the correlation between selected variables. Positive job burnout, high level of exhaustion, and high level of cynicism were selected as dependent variables. Single-factor analysis was firstly carried out to identify statistically significant variables for subsequent logistic regression analysis. Results A total of 460 questionnaires were distributed and 432 valid questionnaires were recovered, with an effective recovery rate of 93.9%. There were 286 (66.2%) express delivery workers reporting job burnout. The positive rate of anxiety symptoms was 41.0%, and the positive rate of depressive symptoms was 34.0%. The job burnout score of the express industry workers [M (P25, P75)] was 1.8 (1.0, 2.5); the scores [M (P25, P75)] of exhaustion, cynicism, and professional efficacy were 1.0 (0.0, 2.6), 1.0 (0.0, 2.2), and 3.5 (1.2, 5.8), respectively; the score [M (P25, P75)] of anxiety symptoms was 1.5 (0.0, 7.0); the score [M (P25, P75)] of depressive symptoms was 1.0 (0.0, 8.0). There were statistical differences in the positive rates of job burnout among the express industry workers grouped by gender, education, monthly income, work shift system, overtime, anxiety symptoms, and depressive symptoms (P<0.05). The Spearman correlation analysis showed that there were significant positive correlations between the score of anxiety symptoms and the scores of job burnout, exhaustion, and cynicism (rs=0.596, 0.689, 0.600, P<0.001); the score of depressive symptoms was also positively correlated with the scores of job burnout, exhaustion, and cynicism (rs=0.601, 0.680, 0.607, P<0.001). The logistic regression analysis showed that women had a lower risk of job burnout than men (OR=0.458, 95%CI: 0.273, 0.768), and the risk of reporting positive job burnout was 3.140 times higher for those who worked overtime than those who did not (OR=3.140, 95%CI: 1.732, 5.693). Conclusion The current situation of job burnout in express industry is serious. Gender, education, monthly income, and overtime are the main influencing factors. Measures should be developed to reduce the occurrence of job burnout.
7.Current situation of job burnout and its influencing factors among workers in a chemical fiber factory in Xinxiang City, Henan Province
Jia MA ; Hui WU ; Sanqiao YAO ; Shanfa YU
Journal of Environmental and Occupational Medicine 2023;40(4):420-425
Background Job burnout is prevalent among the occupational population, which may lead to individual physical and mental discomfort and affect the quality of life and productivity of suffered workers. Most current chemical fiber factory workers are engaged in hazardous tasks with high frequency and high repetition, which are highly associated with anxiety and depressive symptoms, and subsequently lead to job burnout. Objective To understand the current situation and influencing factors of job burnout in workers of a chemical fiber factory in Xinxiang City of Henan Province, and to provide empirical evidence for preventing and reducing the occurrence of job burnout in target workers. Methods In 2022, the workers of a chemical fiber factory in Xinxiang City were selected by cluster random sampling. The Chinese versions of the Burnout Scale, Generalized Anxiety Disorder-7, and Patient Health Questionnaire-9 were used to conduct a survey. SPSS 25.0 software was used for rank sum test, correlation analysis, and logistic regression analysis. Results A total of 1463 valid questionnaires were collected, with an effective recovery rate of 90.0%. The positive rate of mild and moderate job burnout in the chemical fiber factory employees was 39.4%, and the positive rate of serious job burnout was 14.3%. There were statistical differences in the positive rates of job burnout among the workers by gender, age, education level, position, work shift system, anxiety symptom severity, and depressive symptom severity (P<0.05). The results of Spearman correlation analysis showed that the score of anxiety symptoms was positively correlated with the total score of job burnout, as well as the dimensional scores of exhaustion and cynicism, and negatively correlated with the dimensional score of professional efficacy (r=0.671, 0.764, 0.673, −0.097; P<0.01). The score of depressive symptoms was also positively correlated with the total score of job burnout, as well as the dimensional scores of exhaustion and cynicism, and negatively correlated with the dimensional score of professional efficacy (r=0.688, 0.791, 0.723, −0.087; P<0.01). The results of logistic regression analysis showed that men had a higher risk of serious job burnout than women (OR=1.698, 95%CI: 1.163-2.479); workers aged ≤ 40 years old had a higher probability of serious job burnout than those aged 51 to 60 years old (OR=2.587, 95%CI: 1.310-5.109); non-assembly line production workers and assembly line production workers were more prone to serious job burnout than administrative management and logistics personnel (OR=6.511, 9.707, 95%CI: 1.539-27.548, 2.260-41.700); compared with other shift systems (three shifts and night shifts), the probability of serious job burnout was lower (OR=0.375, 95%CI: 0.254-0.553) in regular day shift workers; compared with frequent overtime work, those reporting no overtime work and occasional overtime work showed a lower risk of serious job burnout, with OR (95%CI) values of 0.114 (0.068-0.192) and 0.331 (0.194-0.564), respectively. Conclusion The positive rate of job burnout among the employees of the chemical fiber factory is high, and the anxiety symptoms and depressive symptoms are positively correlated with job burnout. Adjustment of work should be strengthened at multiple levels to improve anxiety symptoms and depressive symptoms of employees, and reduce the occurrence of job burnout.
8.Effect of resilience on association between job burnout and sleep disorders among workers in a petrochemical company
Hui WU ; Di WU ; Qingwei LYU ; Guizhen GU ; Wenhui ZHOU ; Shanfa YU
Journal of Environmental and Occupational Medicine 2023;40(4):426-432
Background The risks of unhealthy working mood and physical and mental health problems are high in the workers of petrochemical enterprises. Resilience is a positive psychological factor, which can provide positive ability to manage stress and job burnout, relieve tension, depression, anxiety, and other psychological discomfort. Objective To explore the moderating or mediating effect of resilience on the association between job burnout and sleep disorders in workers of petrochemical enterprises. Methods A survey with questionnaire of general information, resilience, job burnout (including exhaustion, cynicism, and professional efficacy), and sleep disorders was conducted among 1087 workers who were selected by cluster sampling from a petrochemical enterprise in Henan Province in April 2022. Mann-Whitney U test and Kruskal-Wallis H test were used to test the differences of scores among different demographic groups. Resilience, job burnout (including exhaustion, cynicism, and professional efficacy), and sleep disorder scores were analyzed by partial correlation analysis. The moderating effect of resilience was examined by linear regression analysis, and the mediating effect of resilience by Bootstrap method. Results A total of 861 questionnaires were collected, of which 857 were effective, and the effective rate was 99.5%. The M (P25, P75) of job burnout score was 1.24 (0.65, 2.22) and the incidence of job burnout was 36.4% (312/857); the scores [M (P25, P75)] of exhaustion, cynicism, and professional efficacy were 1.40 (0.80, 3.00), 1.00 (0.20, 1.60), and 5.50 (4.00, 6.00), respectively. The M (P25, P75) of resilience score was 36.00 (30.00, 41.00). The M (P25, P75) of sleep disorder score was 11.00 (7.00, 15.00). The partial correlation analysis results showed that job burnout, exhaustion, and cynicism were negatively correlated with resilience (r=−0.387, −0.248, −0.247, P<0.01), and positively correlated with sleep disorders (r=0.455, 0.445, 0.357, P<0.01); professional efficacy was positively correlated with resilience (r=0.366, P<0.01) and negatively correlated with sleep disorders (r=−0.184, P<0.01); resilience was negatively correlated with sleep disorders (r=−0.349, P<0.01). The linear regression analysis results found that job burnout, exhaustion, and cynicism elevated the risk of sleep disorders (P<0.01), resilience lowered the risk of sleep disorders (P<0.01); but the relationship between job burnout (exhaustion, cynicism, and professional efficacy) and sleep disorders was not moderated by resilience (P>0.05). The mediating effect test showed that resilience played a partial mediating role in the associations of job burnout, exhaustion, cynicism, and professional efficacy with sleep disorders, the mediating effects were 0.522 (95%CI: 0.283-0.777), 0.310 (95%CI: 0.188-0.453), 0.364 (95%CI: 0.228-0.524), −0.542 (95%CI: −0.741-−0.366) and the mediating effects accounted for 17.31%, 14.12%, 19.24%, and 64.72% of the total effects, respectively. Conclusion The relationship between job burnout and sleep disorders is partially mediated by resilience among workers in the selected petrochemical company, but no moderating effect is found.
9.Study on influencing factors of work-related musculoskeletal disorders in neck-shoulder-back of manufacturing workers
Nanyu JIANG ; Xu JIN ; Wenchu HUANG ; Jingyun LI ; Shanfa YU ; Sheng WANG ; Zhongbin ZHANG ; Yun WANG ; Lihua HE
China Occupational Medicine 2023;50(6):657-665
{L-End}Objective To investigate the influencing factors of work-related musculoskeletal disorders (WMSDs) that affect neck-shoulder-back among manufacturing workers. {L-End}Methods A total of 8 250 front-line workers from 27 manufacturing enterprises in Henan Province and Hubei Province were selected as the research subjects using cluster sampling method. The Musculoskeletal Disorders Questionnaire was used to investigate the prevalence of neck-shoulder-back (include neck, shoulder, upper back, and lower back) WMSDs in the past year. The log-binomial model, principal component analysis (PCA) and multivariate logistic regression analysis were used to analyze the influencing factors of WMSDs in the neck-shoulder-back. {L-End}Results The prevalence of WMSDs was 77.2%. The prevalence of neck-shoulder-back WMSDs was 50.9%. The prevalence ratios of WMSDs were relatively higher among the neck, shoulder, and upper back (all P<0.05). The results of PCA improved logistic regression analysis showed that the influencing factors of neck-shoulder-back WMSDs were individual factors, biomechanical factors, psychosocial factors and environmental factors. In terms of individual factors, the risk of neck-shoulder-back WMSDs was higher in females than in males (P<0.05). With the increase of age, length of service, and education level, the risk of neck-shoulder-back WMSDs increased among manufacturing workers (all P<0.05). The risk of neck-shoulder-back WMSDs of workers in textile, clothing, shoes and hats manufacturing industry was relatively lower than that in the other nine industries (all P<0.05). In terms of the biomechanical factors, spending a lot of effort to operate tools/machines, sitting for a long time at work,bending greatly bending and turning at the same time, neck leaning forward or maintaining this posture for a long time, neck twisting or maintaining this posture for a long time and uncomfortable position resulting in difficulty exerting exertion were all risk factors of neck-shoulder-back WMSDs among manufacturing workers (all P<0.05) Bending slightly for a long time was a protective factor for neck-shoulder-back WMSDs among manufacturing workers (P<0.05). In terms of the psychosocial factors, doing the same work every day, self-determination in resting time between works staff shortage, and frequent overtime work were risk factors for neck-shoulder-back WMSDs among manufacturing workers (all P<0.05). Adequate resting time was a protective factor for neck-shoulder-back WMSDs among manufacturing workers (P<0.01). In terms of environmental factors, working under cold or fluctuating temperature, having nothings to lean on, and soles slipping or falling at work were all risk factors for neck-shoulder-back WMSDs among manufacturing workers (all P<0.05). {L-End}Conclusion Manufacturing workers are prone to suffer from neck-shoulder-back WMSDs. The influencing factors include individual factors, biomechanical factors (force load and static load), psychosocial factors and environmental factors.
10.The interaction between social psychology and workload factors of neck work-related musculoskeletal disorders
Yu PENG ; Xu JIN ; Wenchu HUANG ; Jingyun LI ; Shanfa YU ; Lihua HE
China Occupational Medicine 2023;50(6):666-670
{L-End}Objective To explore the interaction between social psychology and workload factors on neck work-related musculoskeletal disorders (WMSDs) in manual workers. {L-End}Methods Manual workers in Henan Province and Hubei Province were selected as the research subjects using typical sampling method. The Chinese Musculoskeletal Questionnaire was used to investigate the prevalence of neck WMSDs in the research subjects. A total of 4 327 workers with neck WMSDs were selected as the case group, and 4 327 workers without neck WMSDs were selected as the control group in a 1∶1 pairing. Conditional logistic regression analysis was used to compare the relevant risk factors in the two groups, and the additive interaction model was established to analyze the interactions between the risk factors. {L-End}Results The univariate conditional logistic analysis results showed that dynamic load, static load, power load and psychosocial factors increased the risk of neck WMSDs in manual workers (all P<0.05). In terms of the social psychological factors, insufficient rest time had the greatest impact workers, with the odds ratio (OR) and 95% confidence interval (CI) of 1.799 (1.647-1.965). In terms of dynamic load, static load and power load, repeated similar movements of the head per minute (bending, twisting), forward bending of the neck or maintaining this posture for a long time, and lifting heavy objects>20 kg had the greatest impact, with the OR and 95%CI of 1.599 (1.470-1.739), 1.984 (1.805-2.181) and 1.241 (1.093-1.408), respectively. There was a synergistic interaction between insufficient rest time and forward bending of the neck or maintaining this posture for a long time, and the relative excess risk due to interaction (95%CI) and attributable proportion (95%CI) were 0.420 (0.187-0.652) and 0.171 (0.066-0.276), respectively. There is no interaction between insufficient rest time and repeated similar movements of the head per minute (bending, twisting), and lifting heavy objects >20 kg. {L-End}Conclusion The interaction between insufficient rest time and forward bending of the neck or maintaining this posture for a long time (static load) can increase the risk of neck WMSDs in manual workers, which is an additive synergistic effect.

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