Il ruolo svolto dall'attività lavorativa sull'ipertensione arteriosa

BACKGROUND: Arterial blood pressure, both systolic (SAP) or diastolic (DAP), has been widely investigated and some studies have shown an association between an increase in these parameters and mortality. The most frequently studied risk factors of arterial hypertension are use of alcohol, smoking and ethnic origin referred to both genetic differences and nutritional habits, while professional factors have been rarely and less deeply considered although significant differences have been found in mean arterial pressure in subjects conducting different professional activities. It seems in fact that "blue collar" workers are more at risk that "white collar" ones. OBJECTIVES. Our aim is to evaluate if work conditions or job strain related to professional activity or to life styles represent a risk factor for arterial hypertension and whether this effect of hypertension is independent of age. In fact, specific factors that may explain this connection have still not been clearly defined. METHODS. Our research method was similar to french inquiries ESTEV (Derriennic, Touranchet, Volkoff) and VISAT (Marquie, Jansou) applied in 6 Italian Regions and involved workers employed in different productive sectors and belonging to 5 age cohorts: 32, 37, 42, 47, 52 years. Information were obtained by occupational health physicians, using 3 questionnaires: - working conditions (exposure to certain risks or job strain); - life styles and self evaluation of health (Nottingham Health Profile); - objective information on health status. The present work consider only parameters that in other studies have been found associated with CVD morbidity, including: 1) working conditions, 2) subjective assessment of work, 3) specific job strain perceived. Hypertension was considered as SAP ≥160 mm/Hg and/or DAP ≥90 mm/Hg, or current antihypertensive treatment. RESULTS. The results refer to 1104 workers, 76% men and 24% women. Prevalence of hypertension was found to be higher among the men than women (33% Vs 22%) and was higher with advancing age. Risk estimation showed a statistically significam association with certain work-related factors such as: shift work (O.R. 1.33), awkward posture (O.R. 1.71), exposure heat (O.R. 1.43), sitting work (O.R.1.48), doing several tasks contemporarily (O.R. 1.41), being interrupted at work (O.R. 1.35), not being able to take eyes off work (O.R. 1.61). The multivariate analysis by logistic regression showed that the variables refered to cognitive aspects and work organization tended to be associated to arterial hypertension even when exposure ceased. CONCLUSIONS. We observed that both some physical aspects of work and cognitive organisation aspects, are strongly associated with arterial hypertension. An important element was found to be the subjective assessment that workers give to their work From an intervention point of view, this aspects should be considered as possible reducible risk factor.