Study On The Relationship Between Occupational Stress,Gene Polymorphism And Their Interaction On Job Burnout In Coal Chemical Enterprises' Workers

Objective:To investigate the current situation of occupational stress and job burnout.Analyzing their relationship and the influencing factors of job burnout among coal chemical enterprises'workers in Xinjiang.Then detecting the changes of neuroendocrine and immunological indicators to reveal the relationship between occupational stress and job burnout.Besides,to explore the relationship between gene polymorphism of 5-HTT?SLC6A4??NET?SLC6A2??DRD2 and GR?NR3C1?,occupational stress and job burnout from the molecular biological level.While exploring the main effect of gene,we also analysis the interaction of gene-gene and gene-environment on job burnout.Then discussing the causes of occupational psychological problems from the perspective of objective physiological change,genetic susceptibility and the interaction of gene-environment,which could erich and complete the study data of occupational stress and helth among different occupational population in Xinjiang.And to provide a scientific evdence for prevention and treatment of physical and mental health status of coal chemical enterprises'workers in Xinjiang.Methods:1)This research take the cluster sampling method to extract 1791 coal chemical enterprises'workers as the research objects from a city of Xinjiang.And they were all asked by a questionnaire consisted of occupational stress?OSI-R?,effort-reward imbalance?ERI?and job burnout?MBI-GS?;2)Randomly extracting 20%of the questionnaire survey objects,and using ELISA to detect the content of neurotransmitters?5-HT?NE?DA?,endocrine hormones?ACTH?Cor?and interleukin?IL-1?IL-2?in the plasma.3)Selecting 30%of the questionnaire survey objects,and using im LDR^TM method to detect the nine gene loci's polymorphisms of 5-HTT gene SLC6A4 locus?5-HTTLPR,rs11080122,rs3794808?,NET gene SLC6A2 locus?rs2242446,rs4783899?,DRD2gene?rs6277?rs2242592?,and GR gene NR3C1 locus?rs41423247?258747?.Results:1.A total of 1,791 questionnaires were issued and 1,653 questionnaires were collected,of which 1,472 were valid questionnaires,and the valid rate was 89.05%.1)The scores of OSI-R and occupational stress levels were different in different individual characteristics groups,and the differences were statistically significant?P<0.05?.The occupational stress scores and degree of male,single,junior college and bachelor education degree,urban,low working age,day shift and double-shift work,mixed occupational hazards,smoking and drinking workers were higher than the others?P<0.05?.And the comparison of ERI scores and effort-reward imblance levels in different individual characteristics groups were consistent with the results of OSI-R.Besides,the proportion of high effort and low reward workers of high occupational stress group was significantly higher than that of low and medium occupational stress groups,and the scores of effort,over-commitment and ERI index were also significantly higher than that of low and medium occupational stress groups?P<0.05?.The correlations between occupational role,personal strain,effort and over-commitment were positive,and differences were statistically significant?P<0.001?.2)The number of high job burnout was 465,31.59%of the total.The job burnout scores and degree of different sex,marriage status,education degree,working age,monthly income,work shifts,occupational health status,smoking and alcohol consumption were significant difference?P<0.05?.The job burnout scores and degree of male,single,junior high school and below education degree,high working age,high monthly income,double-shift work,abnormal occupational health,smoking and drinking workers were higher than the others?P<0.05?.3)The proportions of high job burnout of high occupational stress group and high effort and low reward group were significantly higher than that of low and medium occupational stress groups,and non-high effort and low reward group,the differences were statistically significant?P<0.05?.The each dimension and total scores of job burnout of high occupational stress and high effort and low reward groups were significantly higher that of low and medium occupational stress groups,and non-high effort and low reward group?P<0.05?.4)The results of multiple liner regression showed that working years,personal resources,personal strain,occupational role,marriage status,monthly income and effort were the influencing factors for job burnout.The working age,personal strain,occupational role,marriage status,monthly income and effort were positively related to job burnout,and personal resources was negatively related to job burnout.2.1)The individual characteristics have effects on neurotransmitter,endocrine hormone and immune factor in coal chemical enterprises workers.The 5-HT content were different in different gender,living area and somking status groups,the DA and Cor contents were different in different living area groups,the Cor content were different in different working years groups,the ACTH contenwere different in different shift workers,The IL-2 content were different in different education and working years groups,and the IL-1 content were different in different working years groups,and all the differences were statistically significant?P<0.05?.2)By controlling the individual characteristics,then to compare the neurotransmitter,endocrine hormone and cytokine content of the workers,and the results showed that the 5-HT,NE,ACTH and Cor contents of plasma of high occupational stress group were all significantly higher than those of low and medium occupational stress groups?P<0.05?.But there were no significant difference on the comparison of the IL-1and IL-2 contents of different occupational stress groups?P>0.05?.The DA,NE and IL-2 contents of plasma of high effort-low reward group were all significantly higher than those of non-high effort and low reward group?P<0.05?.But there were no significant difference on the comparison of the 5-HT,ACTH,Cor and IL-1 contents of different effort-reward groups?P>0.05?.The 5-HT,NE and Cor contents of plasma of high job burnout group were all significantly higher than those of low job burnout groups?P<0.05?.But there were no significant difference on the comparison of the DA,ACTH,IL-1 and IL-2 contents of different job burnout groups?P>0.05?.The results of binary logistic regression showed that sex,marriage status,working age,effort,personal strain,5-HT,NE,Cor and IL-2 were the influencing factors for job burnout.The marriage status,working age,effort and personal strain were positively related to job burnout,which means they were risky factors for job burnout,and sex,Cor and IL-2 were negatively related to job burnout,which means they were protective factors for job burnout.Based on the result of structural equation model of occupation stress-physiological indexes-job burnout,we found that occupational stress and physiological response have a direct impact on job burnout,and occupational stress has a direct effect on the physiological response,which indicated that physiological response were more likely to the mediating factors of occupational stress how to impact job burnout.3.1)To test the status of job burnout and gene polymorphism in the study objects,and the results showed that the job burnout of different sex,marriage status,working age,monthly income,occupational stress and effort-reward groups were significantly different?P<0.05?.The distribution of each gene locus of different individual characteristics were no significant difference,and consistent with the Hardy-Weinberg genetic equilibrium test,which indicated that every gene locus was in a state of genetic equilibrium in this study population.2)5-HTT gene:the LL genotype,SL genotype and L allele of 5-HTTLPR had higher risks for high occupational stress and job burnout.There were no statistically correlation between rs11080122,rs3794808 locus and occupational stress andjob burnout?P>0.05?.NET gene:the CT genotype of rs2242446 and GT genotype of rs4783899 had higher risk for high occupational stress and job burnout.?DRD2gene:There were no correlation between rs6277,rs2242592 locus and job burnout?P>0.05?.GR gene:the CC genotype of rs41423247 locus had higher risk for high occupational stress and job burnout.Beside,the CG genotype and C allele of rs 41423247 locus,and theCT genotype and T allele?OR=1.579,95%CI:1.159-2.151?of rs258747had higher risk for high job burnout.3)Analysis the relationship between the haplotype and job burnout found that the haplotype of LCC and LTC of 5-HTTLPR gene were risk for job burnout,and STC was the protective haplotype for job burnout;the haplotype of TG of NET gene was protective haplotype for job burnout;the haplotypes of DRD2gene was not found correlation with job burnout;the haplotype of TG and CG of GR gene were risk for job burnout,and TC was the protective haplotype for job burnout.4)GMDR software analysis found that the interaction model of 5-HTTLPR and rs2242446 were the best gene-gene model.Then leading into occupational stress and ERI,then the interaction model of 5-HTTLPR,rs41423247 and occupational stress was the best gene-environmet model.At last,the logistic regression analysis showed that the interaction of 5-HTTLPR,rs41423247 and occupational stress could obviously increased the risk of high job burnout?OR=7.565,95%CI:1.967-29.085?.Conclusion:This study investigated the effect of occupational stress on occupational burnout in Xinjiang coal chemical enterprises'workers and discussed the effect of occupational stress in occupational burnout for the first time.1)The incidence of high job burnout was 31.59%in this study,which was slightly higher than the results of general population reported in China and abroad,indicating that it should be taken into account.Occupational stress bring from occupational stress factors,stress response,and stress response resources had different correlations with the degree of job burnout,and the degree of job burnout was increasing with occupational stress level.In addition to occupational stress,the other influencing factors of job burnout also include seniority,marriage and economic income.We suggested that the enterprises and health services should cooperate actively,and according to the characteristics and influence factors of job burnout to take the target intervention.To prevent the prevalence of physical and mental diseases by reducing occupational stress,increasing coping resources and strengthening workers'physical and mental health awareness.2)Further study to analysis the correalation between occupational stress,physiological reaction and job burnout by constructing structural equation model,andthe result suggested that physiological reaction in the occupational stress effects on job burnout existed an intermediary effect,and the effect were mainly reflected in neurotransmitter 5-HT and NE.Although the mediating role of hormones and immune factors in stress and burnout has not been found,the results of univariate and multivariate analysis showed the statisticallydifferences,so it is worth further study.In future studies,objective physiological indicators can be used to objectively analyze and evaluate occupational stress and job burnout.3)Further study and analysis from the genetic level,and the results suggest that the 5-HTT gene 5-HTTLPR locus,NET gene rs2242446 and rs4783899 locus,and the GR gene rs41423247 locus were susceptible genotypes of occupational stress and job burnout.And the SNPs of 5-HTT,NET and GR genes could affact job burnout by haplotype.On this basis,the further analyze from gene-gene to gene-environment interaction on the effect of job burnout,the results showed that the interaction between 5-HTTLPR,rs41423247gene and occupational stress could obviously increase the job burnout degree of coal chemical enterprise's workers in Xinjiang.Therefore,the individuals with genetic susceptibility should avoid external stimulating risk factors in order to prevent mental diseases.And the job burnout as a eraly mental health problem,If we can make early detection and intervention,it could be effectively controlled and reduced the prevalence of major psychological,physiological and behavioral problems in the occupational population,so it has important theoretical and practical significance.