The Cohort Study And Establishing Predictive Models For Occupational Stress And Psychological Disorders In Desert Oil Workers In Xinjiang

OBJECTIVE: A prospective cohort study was conducted to reveal the causal relationship between occupational stress and psychological disorders.To explore the relationship between DRD2,COMT,NR3C1,FKBP5,BDNF and MAOA gene polymorphisms and psychological disorders.To explore the role of DNA methylation in the promoter region of MAOA gene in the correlation between occupational stress and psychological disorders.Establish a predictive model of mental health status of desert oil workers in Xinjiang.To provide scientific basis for preventing and curing occupational stress hazards to mental health,as well as for further improving the quality of occupational life of workers and establishing a healthy,stable and harmonious working environment.Methods: 1)In this study,a stratified cluster sampling method was used to conduct a cohort study of 1573 desert oilfield workers,using the Occupational Stress Assessment Scale and the SCL-90 Symptom Checklist.2)726 subjects were randomly selected and stratified,the polymorphisms of 9 loci of the DRD2 receptor(rs1799732,rs1800497),COMT(rs4680),NR3C1(rs17209237,rs41423247),BDNF(rs6265),FKBP5(rs1360780)and MAOA(rs6323,rs1137070)were detected by iMLDR technology.3)MethylTarget technology was used to detect the degree of DNA methylation in the promoter region of MAOA.4)Apply the artificial neural network model to establish a mental health prediction model.Result: 1)There were 1573 baseline participants in the cohort,and 1360 participants were included.After 5 years of follow-up,149 participants were lost to follow-up,and 1211 participants completed the follow-up,the cohort retention rate was 89.0%.2)The scores of the occupational task questionnaire and the individual stress response questionnaire of desert oilfield workers were higher than the national norm(P < 0.05);after the follow-up,except for the sense of responsibility,working environment,business stress response and individual response resource questionnaire scores,the other items were all higher than those of baseline data(P<0.05);the scores of occupational task questionnaires and individual stress response questionnaires of different genders,job titles,shifts,length of service and smoking status were statistically different(P < 0.05);the scores of individual stress response questionnaire of drilling type were higher than those of oil and heat injection operation type(P<0.05);the scores of occupational task questionnaire of undergraduate and above group were higher than those of junior college and below group(P<0.05);divorced or widowed people had higher task ambiguity and interpersonal stress response scores than Unmarried and married(P<0.05).3)The total score of SCL-90,total average score,somatization,depression,anxiety,terror and psychotic factors of desert oilfield workers were higher than the national norm(P<0.05);after follow-up,the total score of SCL-90 and each item score of desert oilfield workers were higher than the baseline data(P<0.05);the total score of mental health and each factor score of different working years and occupational stress levels were compared statistically(P<0.05);the scores of somatization,obsessive symptoms,interpersonal sensitivity,anxiety,terror and paranoia in women were higher than those in men(P<0.05);the scores of mental health,anxiety,hostility,terror and paranoid factors of undergraduate and above group were higher than junior college and below(P<0.05);In addition to interpersonal sensitivity,hostility and paranoia,the scores of other factors in senior professional titles were higher than the intermediate and primary(P<0.05);the scores of the other factors except the hostility,terror and paranoia for inverted team were higher than the fixed white shift(P<0.05);the scores of somatization factors in divorced or widowed groups were higher than those in married and unmarried(P<0.05);the scores of somatization,obsessive symptoms,anxiety,hostility,terror and paranoia in smoking group were higher than those in non-smoking group(P<0.05).4)At the end of the follow-up,361(29.6%)patients with mental disorders were found,the incidence of mental disorders was different among different gender,age,length of service,shift work,smoking status and occupational stress(P<0.05);the scores of tasks overweight,task conflict,responsibility,work environment,business stress response,psychological stress response,interpersonal tension response,physical tension reaction and social support for the psychological disorder group was higher than that of the group without psychological disorder(P<0.05).5)The risk of mental disorder in men is 1.914 times that of women,the risk of mental disorder in the shift group is 1.497 times that of the fixed white group,the risk of mental disorder in highly occupational stress is 3.591 times that of the low-level occupational stress;The risk of mental disorder in high-high occupational stress group is 2.418 times higher than that in low-low group,the risk of mental disorder in the low-high interpersonal tension response group is 2.277 times that of the low-low group;If occupational stress is controlled,the incidence of psychological disorder in high-high occupational stress group and low-high interpersonal tension response group can be reduced by 17.96% and 16.54% respectively.6)Mental health genetic susceptibility analysis: DRD2 rs1800497 AA genotype(OR=1.907,95% CI:1.186-3.066)is a susceptible genotype of mental disorders,A allele(OR=1.293,95% CI:1.042-1.605)can increase the risk of mental disorders;COMT rs4680 GA genotype(OR=1.605,95% CI:1.441-1.832)and mutation(GA+AA)(OR=1.643,95% CI: 1.475-1.871)is the susceptible genotype of mental disorder,Allele A(OR=1.759,95% CI: 1.594-1.971)can increase the risk of mental disorder;NR3C1 gene rs41423247 GC genotype(OR=2.376,95% CI: 1.052-5.364),CC genotype(OR=1.348,95% CI: 1.186-3.950)and mutant(GC+CC)(OR=1.594,95% CI: 1.438-1.805)are the risk of mental disorder,C allele(OR=1.684,95% CI: 1.242-2.285)can increase the risk of mental disorders;MAOA gene rs6323 locus TT genotype(OR=1.505,95% CI: 1.044-2.171)is a susceptible genotype to mental disorders,and T allele(OR=1.302,95% CI: 1.047-1.620)can increase the risk of mental disorders.7)There were significant differences in methylation levels of different DNA methylation sites of MAOA gene in different mental health status groups(P<0.05),The methylation level of psychological disorder group was lower than that of normal psychological group;among women,The methylation levels of CpG4,CpG5,CpG10,CpG11,CpG20,CpG23,CpG26,CpG27,CpG29,CpG30 and CpG31 in the different mental health status groups were statistically significant(P<0.05),the methylation level of mental disorder group was lower than that of normal group;the methylation levels of CpG12,CpG15 and CpG22 were significantly different among different tension groups(P<0.05),and the methylation level of high tension group was higher than that of low tension group.8)The prediction error map of GA-BP neural network shows that most of the data prediction errors are between 0 and 2 points,the established prediction model can basically predict the mental health of desert oil workers.Conclusion: 1)The occupational stress level of oilfield workers is higher than the national norm,the occupational stress level of male,minority,drilling type,working age of 10-20 years,undergraduate and above,junior title,shift group,married and smoking group is higher.2)The mental health level of desert oilfield workers is lower than that of the general population.Men,30-40 years old group,oil production,shift work group,smokers and high occupational stress group had higher incidence of psychological disorders.3)Male,shift,higher scores of overweight tasks,higher scores of task conflict and high occupational stress are risk factors for psychological disorders,while higher scores of rational behavior are the protective factors for psychological disorders.4)The incidence of psychological disorders will increasing with the degree of occupational stress increased.5)DRD2 gene rs1800497 locus AA genotype,COMT gene rs4680 locus GA genotype and mutant GA+AA genotype,NR3C1 gene rs41423247 locus GC genotype,CC genotype and MAOA gene rs6323 locus TT genotype are susceptible genotypes of psychological disorders.6)MAOA gene rs6323 locus TT genotype,NR3C1 gene rs41423247 locus GC genotype,DRD2 gene rs1800497 locus GA and AA genotype and COMT gene rs4680 locus GA genotype and occupational stress interaction can increase the risk of mental disorder.7)DNA methylation level in the promoter region of MAOA gene has a certain regulatory role in the correlation between occupational stress and psychological disorders.8)GA-BP neural network with 15-20-1 network structure can better predict the mental health status of workers in desert oilfields.