Factors of Cardiovascular Risk in Drivers of Locomotive Crews of Railway Transport with Ventricular Arrhythmias

Abstract

AIM: This study aimed to assess cardiovascular risk factors in drivers and assistant drivers of railway engine crews with ventricular rhythm disorders.

MATERIALS AND METHODS: The study included 120 patients aged 39 to 61 years (mean age M ± SD: 50.4 ± 4 years), who were distributed into two groups with and without ventricular rhythm disorders. All participants underwent 12-lead daily ECG monitoring with assessment of noninvasive markers of myocardial electrical instability (circadian profile, QT interval, late ventricular potentials, T-wave alternation, rhythm variability). Traditional factors of cardiovascular risk, the employment period in the profession, and the level of personal and situational anxiety on Spielberger’s state-trait anxiety inventory (STAI) were evaluated.

RESULTS: In Group 1, in comparison with Group 2, significant differences were revealed in the duration of the PQ interval (during the day and at night) and the indicators of late ventricular potentials (RMS 40 and TotQRSF). When analyzing risk factors, elevated indices of total blood cholesterol were registered in both groups, and the risk on the SCORE scale was at a moderate level. In the group of workers with ventricular rhythm disorders, higher indicators of total blood cholesterol and the frequency of smoking and alcohol consumption were established. In individuals with ventricular rhythm disorders, a significant relationship was detected between the number of registered single monomorphic ventricular extrasystoles and the age of the employee (r = −0.3, р < 0.05), and blood pressure level (r = 0.3, р < 0.05), and the relationship between the level of anxiety and the registration of single supraventricular extrasystoles was established (r = −0.3, р < 0.05). In the Group 2, a significant correlation was revealed between the number of registered single supraventricular extrasystoles and age (r = 0.2, р < 0.05), the employment period in the profession of a driver (r = 0.2, р < 0.05), the blood pressure level (r = 0.2, р < 0.05), and the level of anxiety on the STAI (r = 0.3, р < 0.05).

CONCLUSIONS: Drivers of railway engine crews with ventricular rhythm disorders are characterized by a higher level of total blood cholesterol and a higher frequency of smoking and alcohol consumption. They have significant changes in the duration of the PQ interval (during the day and at night) and indicators of late ventricular potentials (RMS 40 and TotQRSF) according to Holter monitoring. The relationship of the number of ventricular rhythm disorders with age and the office values of systolic and diastolic blood pressure is noted in drivers of engine crews of railway transport.

Keywords

risk factors for cardiovascular disease / ventricular rhythm disorders / Holter monitoring / ventricular late potentials / workers of engine crews

References

[1] Shlyakhto EV, Arutyunov GP, Belenkov YuN, et al. Natsional'nye rekomendatsii po opredeleniyu riska i profilaktike vnezapnoi serdechnoi smerti. 2-e izdanie. Moscow: Medpraktika-M, 2018. 247 p. (In Russ.).

[2] Шляхто Е.В., Арутюнов Г.П., Беленков Ю.Н., и др. Национальные рекомендации по определению риска и профилактике внезапной сердечной смерти. 2-е издание. Москва: Медпрактика-М, 2018. 247 с.

[3] Priori SG, Blomström-Lundqvist C, ESC Scientific Document Group, et al. 2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: The Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology (ESC). Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC). Eur Heart J. 2015;36(41):2793–2867. DOI: 10.1093/eurheartj/ehv316

[4] Priori S.G., Blomström-Lundqvist C., ESC Scientific Document Group, et al. 2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: The Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology (ESC). Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC) // Eur Heart J. 2015. Vol. 36, No. 41. P. 2793–2867. DOI: 10.1093/eurheartj/ehv316

[5] Sutton NR, Banerjee S, Cooper MM, et al. Coronary Artery Disease Evaluation and Management Considerations for High Risk Occupations: Commercial Vehicle Drivers and Pilots. Circ Cardiovasc Interv. 2021;14(6):e009950. DOI: 10.1161/CIRCINTERVENTIONS.120.009950

[6] Sutton N.R., Banerjee S., Cooper M.M., et al. Coronary Artery Disease Evaluation and Management Considerations for High Risk Occupations: Commercial Vehicle Drivers and Pilots // Circ Cardiovasc Interv. 2021. Vol. 14, No. 6. ID e009950. DOI: 10.1161/CIRCINTERVENTIONS.120.009950

[7] Saraei M, Najafi A, Heidarbagi E. Risk factors for obstructive sleep apnea among train drivers. Work. 2020;65(1):121–125. DOI: 10.3233/WOR-193064

[8] Saraei M., Najafi A., Heidarbagi E. Risk factors for obstructive sleep apnea among train drivers // Work. 2020. Vol. 65, No. 1. P. 121–125. DOI: 10.3233/WOR-193064

[9] Iridiastadi H. Fatigue in the Indonesian rail industry: A study examining passenger train drivers. Appl Ergon. 2021;92:103332. DOI: 10.1016/j.apergo.2020.103332

[10] Iridiastadi H. Fatigue in the Indonesian rail industry: A study examining passenger train drivers // Appl Ergon. 2021. Vol. 92. ID 103332. DOI: 10.1016/j.apergo.2020.103332

[11] Zhidkova EA, Naigovzina NB, Kalinin MR, et al. The Analysis of the Causes of Sudden Deaths Among Workers of Locomotive Crews. Kardiologiia. 2019;(6):42–47. (In Russ.) DOI: 10.18087/cardio.2019.6.2552

[12] Жидкова Е.А., Найговзина Н.Б., Калинин М.Р., и др. Результаты анализа причин внезапной смерти среди работников локомотивных бригад // Кардиология. 2019. № 6. С. 42–47. DOI: 10.18087/cardio.2019.6.2552

[13] Zdrenghea D, Poantă L, Gaita D. Cardiovascular risk factors and risk behaviors in railway workers. Professional stress and cardiovascular risk. Rom J Intern Med. 2005;43(1-2):49–59.

[14] Zdrenghea D., Poantă L., Gaita D. Cardiovascular risk factors and risk behaviors in railway workers. Professional stress and cardiovascular risk // Rom J Intern Med. 2005. Vol. 43, No. 1-2. P. 49–59.

[15] Piros S, Karlehagen S, Lappas G, Wilhelmsen L. Risk factors for myocardial infarction among Swedish railway engine drivers during 10 years follow-up. J Cardiovasc Risk. 2000;7(5):395–400. DOI: 10.1177/204748730000700513

[16] Piros S., Karlehagen S., Lappas G., Wilhelmsen L. Risk factors for myocardial infarction among Swedish railway engine drivers during 10 years follow-up // J Cardiovasc Risk. 2000. Vol. 7, No. 5. P. 395–400. DOI: 10.1177/204748730000700513

[17] Makarov LM, Komolyatova VN, Kupriyanova OA, et al. National russian guidelines on application of the methods of holter monitoring in clinical practice. Russian Journal of Cardiology. 2014;(2):6–71. (In Russ.). DOI: 10.15829/1560-4071-2014-2-6-71

[18] Макаров Л.М., Комолятова В.Н., Куприянова О.О., и др. Национальные российские рекомендации по применению методики холтеровского мониторирования в клинической практике // Российский кардиологический журнал. 2014. № 2. С. 6–71. DOI: 10.15829/1560-4071-2014-2-6-71

[19] Vasilenko VS, Bondarev SA. Coronary heart disease risk factors in people working under constant professional psychoemotional strain. The scientific notes of the Pavlov University. 2012;19(1):54–58. (In Russ.).

[20] Василенко В.С., Бондарев С.А. Заболеваемость сердечно-сосудистой системы у лиц, испытывающих хроническое профессиональное перенапряжение // Ученые записки СПбГМУ им. акад. И.П. Павлова. 2012. Т. 19, № 1. С. 54–58.

[21] Nikiforov VS, Metso KV. Electrocardiographic predictors of sudden cardiac death. Consilium Medicum. 2018;20(5):29–33. (In Russ.). DOI: 10.26442/2075-1753_2018.5.29-33

[22] Никифоров В.С., Метсо К.В. Электрокардиографические предикторы внезапной сердечной смерти // Consilium Medicum. 2018. Т. 20, № 5. С. 29–33. DOI: 10.26442/2075-1753_2018.5.29-33

[23] Latfullin IA, Kim ZF, Teptin GM. Late ventricular potentials. Journal of arrhythmology. 2008;(53):44–55. (In Russ.)

[24] Латфуллин И.А., Ким З.Ф, Тептин Г.М. Поздние потенциалы желудочков // Вестник Аритмологии. 2008. № 53. С. 44–55.

[25] Makarov LM. Sudden death in young athletes. Kardiologiia. 2010;50(2):78–83. (In Russ.)

[26] Макаров Л.М. Внезапная смерть у молодых спортсменов // Кардиология. 2010. Т. 50, № 2. C. 78–83.

[27] Zhidkova EA, Gutor EM, Kalinin MR, et al. Analysis of factors associated with the incidence of members of locomotive crews. Cardiovascular Therapy and Prevention. 2019;18(1):102–106. (In Russ.). DOI: 10.15829/1728-8800-2019-1-102-106

[28] Жидкова Е.А., Гутор Е.М., Калинин М.Р., и др. Анализ факторов, ассоциированных с заболеваемостью работников локомотивных бригад // Кардиоваскулярная терапия и профилактика. 2019. Т. 18, № 1. С. 102–106. DOI: 10.15829/1728-8800-2019-1-102-106

RIGHTS & PERMISSIONS

Metso K.V., Nikiforov V.S.