2007, Piran, Slovenia
2007, Piran, Slovenia 2007, Piran, Slovenia
Environmental Ergonomics XII Igor B. Mekjavic, Stelios N. Kounalakis & Nigel A.S. Taylor (Eds.), © BIOMED, Ljubljana 2007 PHYSIOLOGICAL REACTION TO WORK IN AIRCRAFT MAINTENANCE STAFF Elzbieta Gadzicka, 1 Alicja Bortkiewicz 1 , Teresa Makowiec-Dabrowska 1 , Wieslaw Szymczak 2 1 Department of Work Physiology and Ergonomics, 2 Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, Lodz, Poland Contact person: elag@imp.lodz.pl INTRODUCTION Occupational activities of licensed airline ground staff are accompanied by a specific set of load factors which are characteristic for that professional group. They are exposed to high noise and adverse climatic conditions (low or high temperatures, large temperature variations, draughts, rain or snow, high ambient air humidity), insufficient illumination. The necessity to perform various maintenance procedures within very limited space, assuming awkward postures and supporting or carrying very heavy objects cause that the workload may be high. All those factors may result in adverse health effects associated with disturbed function of the circulatory and musculoskeletal systems. Very few data are available in the relevant literature on the health effects in that professional group in airline ground staff, in contrast to the aircraft flying personnel. This is rather surprising when we remember that the maintenance workers accounts for ca. 70% of all aviation workers (DeHart R.L. 1990). The aim of the study was to assess age-related changes in job tolerance among the airline ground staff. METHODS Subjects. The study was performed among 50 aircraft maintenance staff (Table 1) employed in shift work system 6.00-18.00 (12 h) morning shift and 18.00-6.00 (12 h) night shift. As it was necessary to compare the data describing circulatory function, and considering that the latter shows circadian variations, examinations were performed at the same time of the day in all subjects, during afternoon hours, in workers taking up their duties before the night shift. Table 1. Characteristics of subjects (BMI (body mass index ) = body mass /height 2 [kg/m 2 ]). Number of workers 50 Age (years) 40.8±10.8 Period of employment (years) 18.4±11.6 Diseases diagnosed -Hypertension -Diabetes mellitus type II -Subjective cardiovascular symptoms 11 (22%) 0 31 (62%) BMI * 27.6±3.5 No. of smokers (>10 cigarettes a day) 13 (26%) Medical examination: (1) general medical examination with office blood pressure measurement; (2) an interview oriented towards the risk of cardiovascular diseases, including family history of metabolic and cardiovascular diseases; (3) questionnaire for evaluation of fatigue CIS20R (Checklist Individual Strength) (Vercoulen et al. 1994) and subjective symptoms of musculoskeletal disorders; (4) ambulatory blood pressure monitoring (ABPM). 24-h ABPM was performed during night shift, sleep and daily activities of the workers, using Medilog DX ABPM System. The measurements were carried out automatically, every half hour. Mean systolic (BPS) and diastolic (BPD) blood pressure and heart rate (HR), during 24 h (O), professional activity (D) and sleep (N) were calculated, with the Staessen's standards of 554
Working Environment BP as the reference values (Staessen 1990). The BP activity/sleep ratios were determined for systolic and diastolic blood pressure (BPSD/BPSN, BPDD/BPDN) and for heart rate (HRD/HRN). Subjects without a physiological decrease in blood pressure during sleep (with BP ratio lower than 10%) are called non-deepers and the subjects with BP drop greater than 20% are called extreeme deepers. Mean BP load (the percentage of the measurement values above the normal value) was also calculated. It should be within 20% of all values measured during 24-h period. RESULTS Overweight was found in as much as 70% of the study group. Irregular food intake, declared by 60% of the subjects, was probably one of the cause wich could be associated with the character of the duties (shift work). Besides, the subjects in the test group had low level of physical activity during their leisure time. Among the 50 workers, 31 people (62%) reported cardiovascular symptoms, such as breathlesness, pain, discomfort in the chest or irregular heart rhythm. This is the highest proportion of the symptoms compared to other groups exposed to various occupational factors, studied by ourselves (Bortkiewicz et al. 1995, Bortkiewicz et al. 2001). A history of arterial hypertension was reported by 11 subjects (22%). During the medical examination, arterial hypertension was reported in total by 56% of the patients. Our results differ considerably from results of a study of 7000 Air France workers. The French study covers the group of airline ground workers and shows that their arterial blood pressure was highest (3.9%) compared to aircraft flying personnel (pilots and navigators 1.%, stewardesses 0.41%), while all those results were considerably lower than the results for our group (Bisseliches et al. 1990). In our study using ABPM, mean arterial blood pressure in all monitoring periods was normal (Table 2). AVG STD BPS (O) 127.9 10.1 BPD (O) 80.4 7.2 Table 2. ABPM results in aircraft ground staff. HR BPS BPD HR BPS BPD HR (O) (D) (D) (D) (N) (N) (N) [mm Hg] 78.3 131.5 83.3 81.3 112.9 67.6 66.3 9.2 10.4 7.4 9.8 12.0 8.9 10.0 BPSD/ BPSN 1.17 0.08 BPDD/ BPDN 1.24 0.11 Table 3. The percentage of subjects with elevated arterial blood pressure in periods BPSD BPSN BPSO BPDD BPDN BPDO Group 18% 16% 18% 14% 12% 14% The percentage was higher than in the group of the GSM operators or workers occupationally exposed to fine-particulate dust, but it was lower than in the people occupationally exposed to 50 Hz or UHF/VHF electromagnetic fields (EMF) (Gadzicka et al. 1997) as well as in air traffic controllers ( Sega et al. 1998). Mean BP load of both systolic and diastolic blood pressures in the study group was higher than normal, 28% and 24%, respectively. In 50% subjects the systolic BP load, and in 44% subjects the diastolic BP load was higher than normal. Table 4 gives the percentages of non-deepers and extreeme deepers in the study group. Table 4. Percentages of people with disturbed BP control. BPSN BPDN Non-deepers 18% 6% Extreemedeepers 36% 62% HRD/ HRN 1.24 0.14 555
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Working Environment<br />
BP as the reference values (Staessen 1990). The BP activity/sleep ratios were determined for<br />
systolic and diastolic blood pressure (BPSD/BPSN, BPDD/BPDN) and for heart rate<br />
(HRD/HRN). Subjects without a physiological decrease in blood pressure during sleep (with<br />
BP ratio lower than 10%) are called non-deepers and the subjects with BP drop greater than<br />
20% are called extreeme deepers. Mean BP load (the percentage of the measurement values<br />
above the normal value) was also calculated. It should be within 20% of all values measured<br />
during 24-h period.<br />
RESULTS<br />
Overweight was found in as much as 70% of the study group. Irregular food intake, declared<br />
by 60% of the subjects, was probably one of the cause wich could be associated with the<br />
character of the duties (shift work). Besides, the subjects in the test group had low level of<br />
physical activity during their leisure time. Among the 50 workers, 31 people (62%) reported<br />
cardiovascular symptoms, such as breathlesness, pain, discomfort in the chest or irregular<br />
heart rhythm. This is the highest proportion of the symptoms compared to other groups<br />
exposed to various occupational factors, studied by ourselves (Bortkiewicz et al. 1995,<br />
Bortkiewicz et al. 2001). A history of arterial hypertension was reported by 11 subjects<br />
(22%). During the medical examination, arterial hypertension was reported in total by 56% of<br />
the patients. Our results differ considerably from results of a study of 7000 Air France<br />
workers. The French study covers the group of airline ground workers and shows that their<br />
arterial blood pressure was highest (3.9%) compared to aircraft flying personnel (pilots and<br />
navigators 1.%, stewardesses 0.41%), while all those results were considerably lower than the<br />
results for our group (Bisseliches et al. 1990). In our study using ABPM, mean arterial blood<br />
pressure in all monitoring periods was normal (Table 2).<br />
AVG<br />
STD<br />
BPS<br />
(O)<br />
127.9<br />
10.1<br />
BPD<br />
(O)<br />
80.4<br />
7.2<br />
Table 2. ABPM results in aircraft ground staff.<br />
HR BPS BPD HR BPS BPD HR<br />
(O) (D) (D) (D) (N) (N) (N)<br />
[mm Hg]<br />
78.3 131.5 83.3 81.3 112.9 67.6 66.3<br />
9.2 10.4 7.4 9.8 12.0 8.9 10.0<br />
BPSD/<br />
BPSN<br />
1.17<br />
0.08<br />
BPDD/<br />
BPDN<br />
1.24<br />
0.11<br />
Table 3. The percentage of subjects with elevated arterial blood pressure in periods<br />
BPSD BPSN BPSO BPDD BPDN BPDO<br />
Group 18% 16% 18% 14% 12% 14%<br />
The percentage was higher than in the group of the GSM operators or workers occupationally<br />
exposed to fine-particulate dust, but it was lower than in the people occupationally exposed to<br />
50 Hz or UHF/VHF electromagnetic fields (EMF) (Gadzicka et al. 1997) as well as in air<br />
traffic controllers ( Sega et al. 1998). Mean BP load of both systolic and diastolic blood pressures<br />
in the study group was higher than normal, 28% and 24%, respectively. In 50% subjects the<br />
systolic BP load, and in 44% subjects the diastolic BP load was higher than normal. Table 4<br />
gives the percentages of non-deepers and extreeme deepers in the study group.<br />
Table 4. Percentages of people with disturbed BP control.<br />
BPSN BPDN<br />
Non-deepers 18% 6%<br />
Extreemedeepers<br />
36% 62%<br />
HRD/<br />
HRN<br />
1.24<br />
0.14<br />
555