Study Of Occupational Stress And Hypertension Related Genetic Susceptibility Of Oil-workers In Xinjiang

Objective: Cohort study was combined with molecular biology to explore the relationship between occupational stress,ABCA1,AGT gene polymorphisms and hypertension of oil-workers in Xinjiang,providing a scientific basis for improving oil workers’ s physical and mental health.Methods: 1.A prospective follow-up was conducted to observe the baseline cohort of Xinjiang oil-workers that was established at 2013,Occupational stress inventory recised edition(OSI-R)and Effort-reward imbalance(ERI)questionnaires were used for carrying out epidemiological investigation.2.The genotypes of ABCA1 and AGT genes in hypertensionand control groups(153 cases each)were detected by the PCR-RFLP,and the relationship between occupational stress,ABCA1,AGT polymorphism and hypertension was analyzed.Resurts: 1.At the end of the follow-up observing in 2017,the number of the cohort is 1,156,and the rate of queue retention was 77.1%;Among them more males than females,Han nationality more than ethnicminorities,and the most number of people aged30~45years,over 15 working years,shift,degree of education in college or above,married and non-smokers.2.Compared to the domestic norm,the follow-up cohort’s scores of role ambiguity,work environment and personal strain questionnaire were higher,the scores of role overload,responsibility,physical strain reaction and personal resources questionnaire were lower(P<0.05).Compared with the baseline cohort,the follow-up cohort’s scores of leisure,occupational role questionnaire,personal resources questionnaire and its sub-items were higher(P<0.05).3.The distribution of gender,age,working year,shift,educational level,marital status,smoking and drinking in the different occupational stress groups were different(P<0.05),and the scores of males in occupational role questionnaire,role conflict,responsibility and physical stress reaction were higher than females,however,the scores of role overload and personal resources questionnaire were lower than females(P<0.05);The score of people whose working year less than 15 years was higher than others in the occupational role questionnaire and personal strain questionnaire(P<0.05);The score of shift workers was higher than day shift workers(P<0.05);The score of college degree and above was higher than technical secondary school and below in occupational role questionnaire,personal strain questionnaire and personal resources questionnaire(P<0.05);Compared with married persons,unmarried person had higher scores in the occupational role stress,role discomfort,and role conflict and work environment,divorced and widowed people have higher score in role discomfort.4.The difference of ERI<1 and ERI≥1 among oil-workers cohort was statistically significant in the sex,age,working type,smoking and alcohol consumption(P<0.05);In the term of external pay and overload,male was higher than females,drilled workers higher than oil production and output workers,regularly smokers higher than never or occasionally smokers,and regularly drinking workers is higher than occasionally or non-drinkers(P<0.05);The internal reward score of 30~45years old person was higher than age ≥45 years old(P<0.05);After controlling confounding factors such as age,nationality,gender,educational,type of work,length of service,shift,marriage,monthly income,smoking and drinking,the results showed that there was positive relationship between occupational role questionnaire,personal strain questionnaire and external,internal,overloaded(P<0.05);There was a positive correlation between resource and intrinsic return and overload(P<0.05).5.The cumulative incidence of this study was 14.91%,the incidence of hypertension increased along with the increasing of age and seniority,the people who are male,oil-producing workers,secondary education and below,married and monthly income less than3,500 yuan,smoking and drinking have higher risk of hypertension(P<0.05);The incidence of hypertension in cohort increased along with increasing of occupational stress(P<0.05);The hypertension incidence of ERI≥1 group was higher than ERI<1(P<0.05);The score of occupational role questionnaire and personal strain questionnairewere higher than those in the control group(P<0.05);There was statistically significant between case and control group in external pay,BMI,GOT,GGT,gluten ratio,GLU(P<0.05);Binary logistic regression model shows that monthly income,discomfort,work environment and external effort are risk factors for hypertension,responsibility,psychological stress reaction and gluten ratio are the protective factors for hypertension.6.The genotype and allele frequencies of AGT M235 T,ABCA1 V825 I and R219 K were significantly different between the case and control groups(P<0.05).SHEsis software analysis showed that I-G of ABCA1 and T-T of AGT are risk haplotypesforhypertension,V-A of ABCA1 and T-M of AGT are protective haplotypes for hypertension(P<0.05).The genotypes VI and II of V825 I,GG of R219 K and TT of M235 T are all increasing the risk of hypertension(P<0.05);The results of SHEsis software analysis showed that the I-G of ABCA1 gene was a risk factor for hypertension,and the V-A of AGT gene was a protective factor.T-M is a protective factor,and T-T is a riskfactor(P<0.05).7.The interaction of V825 I and M235 T increased the risk of hypertension(OR=2.599,95%CI: 1.281-5.275).The interaction of M235 T and T174 M reduced the risk of hypertension(OR=0.142,95%CI: 0.036-0.566).Interaction of R219 K and occupational stress,V825 I and ERI all increased the risk of hypertension(OR1=1.009,95%CI: 1.002-1.016;OR2=3.358,95%CI: 1.228-9.185).Conclusions: 1.Compared with the general population,occupational stress of oil-field workersin Xinjiang is higher,but there is a downward trend in recent years;2.The more errort-reward imbalance was sensed by the oil-workers,the higher occupational stress suffered by them;3.Monthly income,job discomfort,work environment and external pay are the risk factors for hypertension,and responsibility,psychological stress reaction and cereal gluten ratio are the protective factors for hypertension;4.II+VI genotype of ABCA1 V825 I,GG genotype of R219 K and TT of AGT M235 T are susceptible genotypes of hypertension;5.The Interaction of V825 I and M235 T,R219K and occupational stress,V825 I and effort-reward imbalance increased the risk of hypertension,interaction between M235 T and T174 M reduced the risk of hypertension.