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Stressful jobs are associated with a higher risk of heart rhythm disorders

The most stressful jobs are psychologically demanding but give employees little control

June 4, 2018

Science Daily/European Society of Cardiology

Having a stressful job is associated with a higher risk of a heart rhythm disorder called atrial fibrillation, according to new research.

 

The most stressful jobs are psychologically demanding but give employees little control over the work situation -- for example, assembly line workers, bus drivers, secretaries, and nurses.

 

The study found that being stressed at work was associated with a 48% higher risk of atrial fibrillation, after adjustment for age, sex, and education.

 

Dr Eleonor Fransson, study author and associate professor of epidemiology, School of Health and Welfare, Jönköping University, Sweden, said: "We need people to do these jobs but employers can help by making sure staff have the resources required to complete the assigned tasks. Bosses should schedule breaks and listen to employees' ideas on how the work itself and the work environment can be improved."

 

Atrial fibrillation is the most common heart rhythm disorder (arrhythmia). Symptoms include palpitations, weakness, fatigue, feeling light headed, dizziness, and shortness of breath.

 

Atrial fibrillation causes 20-30% of all strokes and increases the risk of dying prematurely.2 One in four middle-aged adults in Europe and the US will develop atrial fibrillation. It is estimated that by 2030 there will be 14-17 million patients with atrial fibrillation in the European Union, with 120,000-215,000 new diagnoses each year.

 

Dr Fransson said: "Atrial fibrillation is a common condition with serious consequences and therefore it is of major public health importance to find ways of preventing it. Little is known about risk factors for the disease and especially the role of the work environment."

 

This study assessed the link between work stress and atrial fibrillation. The study included 13,200 participants enrolled into the Swedish Longitudinal Occupational Survey of Health (SLOSH) in 2006, 2008, or 2010. Participants were employed and had no history of atrial fibrillation, heart attack, or heart failure. At study inclusion, participants completed postal surveys on sociodemographics, lifestyle, health, and work-related factors.

 

Work stress was defined as job strain, which refers to jobs with high psychological demands combined with low control over the work situation. The survey included five questions on job demands and six on control -- for example: Do you have to work very hard or very fast? Are there conflicting demands in your work? Do you have enough time to complete your work tasks? Does your work include a lot of repetition? Can you decide how and what to do at work?

 

During a median follow-up of 5.7 years, 145 cases of atrial fibrillation were identified from national registers.

 

Dr Fransson said: "In the general working population in Sweden, employees with stressful jobs were almost 50% more likely to develop atrial fibrillation. The estimated risk remained even after we took into account other factors such as smoking, leisure time physical activity, body mass index, and hypertension."

 

The authors then pooled their results with two other studies on the same topic, and found that job strain was associated with a 37% increased risk of atrial fibrillation. "Across studies there was a consistent pattern of work stress being a risk factor for atrial fibrillation," said Dr Fransson.

 

She concluded: "Work stress has previously been linked with coronary heart disease. Work stress should be considered a modifiable risk factor for preventing atrial fibrillation and coronary heart disease. People who feel stressed at work and have palpitations or other symptoms of atrial fibrillation should see their doctor and speak to their employer about improving the situation at work."

 

European guidelines on the prevention of cardiovascular disease state that stress at work contributes to the risk of developing cardiovascular disease and having a worse prognosis.3 Assessment of psychosocial risk factors is recommended in people who have, or are at risk of developing, cardiovascular disease.

https://www.sciencedaily.com/releases/2018/06/180604172750.htm

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Workplace stress can take a toll on your brain surgeon, too

February 9, 2018

Science Daily/University of Southern California - Health Sciences

When it comes to workplace stress, even doctors aren't immune to its effects. For doctors training to become neurosurgeons, burnout is common, and certain workplace stressors -- like unrewarding mentor relationships, difficult coworkers and not getting enough exposure to the operating room -- can lead to it, according to a new study from the Keck School of Medicine of USC.

 

Building the skills needed to treat complex neurological conditions like stroke, brain tumors or spinal cord injuries requires a highly demanding, seven-year training program. The pressure of that training can sometimes lead to emotional exhaustion, an inability to connect with others or feeling unaccomplished, which are components of burnout. Understanding what factors influence burnout can be a powerful catalyst for change.

 

"As a patient, you don't want your doctor to be depressed or demoralized when they're working on you, because they're not their best self," says the study's lead author Frank Attenello, MD, MS, assistant professor of clinical neurological surgery at the Keck School. "And as a society, we don't want to discourage people from becoming neurosurgeons, because we have a rapidly aging population in need of neurosurgeons' skills."

 

While research on burnout is gaining steam in many fields, not much attention has been paid to it in neurosurgery until now, Attenello explains.

 

To better understand it, Attenello and his colleagues surveyed 346 neurosurgery residents across the United States. Using an 86-item questionnaire, the team explored everything from whether residents felt satisfied with different aspects of their training to whether they were considering quitting training or leaving medicine entirely. Burnout was assessed using the Maslach Burnout Inventory, a validated tool that has been used to measure burnout both in health care and other professions.

 

The study, published today in the Journal of Neurosurgery, found that 81 percent of residents were satisfied with their career, but 41 percent had given serious thought to quitting neurosurgery at some point. The overall burnout rate was 67 percent -- more than double the estimated rate of burnout among American workers overall. Predictors of burnout included inadequate exposure to the operating room, hostile faculty, unsatisfactory relationships with mentors and social stressors outside of work.

 

"Some of the most impressive and energetic medical students enter neurosurgery," Attenello says. "When they encounter burnout, it limits their considerable potential, both with their patient care and possibly in their academic and research achievements for the field as a whole."

 

To help reduce the risk of burnout, Attenello and others at the Keck School have already implemented a new model for mentorship. This year, new residents in the Department of Neurological Surgery will choose their mentors, and the school will assign a backup mentor for additional support.

 

"Our study provided some valuable insights to the prevalence of burnout and some of the pain points in training neurosurgeons," says study co-author Steven L. Giannotta, MD, chair and professor of neurological surgery at the Keck School. "Recognizing that burnout exists and finding ways to address it are important steps educational institutions can take to mitigate it."

https://www.sciencedaily.com/releases/2018/02/180209100655.htm

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