Occupational risk factors for cardiovascular and musculoskeletal disorders in German automotive workers

摘要

Background: Automotive workers are subjected to various occupational exposures. Workers mostly operate in shifts, potentially implying a disturbed circadian rhythm and negative effects on the cardiovascular system. Studies on shift work and hypertension are however inconclusive. Moreover, repetitive manual work through assembling of car parts using snap-fits has during the last decade increased. Snap-fits enable the parts to be pushed together by applying manual force, potentially with a negative effect on workers upper limb function. In a large German automotive company, we investigated shift workers on their hypertension risk, and the upper limb function of assembly workers subjected to a large-scale expansion of the use of snap-fits.ududMethods: Cross-sectional data from voluntary company check-ups and company registers provided workers’ demographics, cardiovascular status, upper limb functional status, shift work and snap-fit assembly exposure, and data on potential confounders. Associations between shift work and hypertension as well as between snap-fit assembly and upper limb functional limitations (ULFL) were analyzed by logistic regression adjusted for confounders. We additionally investigated mediation effects between shift work and hypertension by psychosocial, behavioral and physiological factors, and the potential of a dose-response relationship between snap-fit assembly and ULFL.ududResults: In 25353 workers, shift work without nights was statistically significantly associated with hypertension (OR=1.15 95% CI 1.02-1.30), potentially mediated by sleep disorders, high BMI and physical inactivity. In 10722 blue-collar production workers, exposure to snap-fit assembly at least 25 months showed increased odds of ULFL (OR=2.44 95% CI 1.52-3.92). No dose-response relationship between snap-fit duration and odds of ULFL was found.ududDiscussion/Conclusion: Shift work without nights may lead to hypertension, potentially via sleeping problems, higher BMI and physical inactivity. Further, the continuously increasing use of snap-fits in car assembling might constitute a novel occupational risk factor for ULFL. Despite the need for longitudinal studies, enabling causal inference regarding investigated associations, company physicians should recognize the potential negative effects from shift work and snap-fit assembly.