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  Specific
risk factors responsible for occupational disorders can be identified in
the working environment. However, many other agents exist at work that
are able to disturb the equilibrium and wellbeing of man, creating social
maladjustement phenomena and stress. These can be followed by
non-specific diseases that are, however, definitely linked to work. In
the genesis of such disturbances a very important role is certainly
played by the social and organizational characteristics of the job that
interact with the psychological and personality components of the single
individuals.
In dealing with problems of physiology and psychology at work, the
physician is faced with a complex system, where three components interact
with each other: man, work and the environment.
Any stressing agent interacting with man can cause two kinds of reaction:
a positive regenerative reaction (eustress) and a negative reaction
(distress) that may lead to psychical psychosomatic pathologies,
depending on whether the subject is able to find the personal resources
to cope with the emergency situation. Stress is, basically, the answer to
a situation in which the subject is aware of the discrepancy between the
external demands and his/her subjective and objective characteristics. Therefore,
stress can be seen as the consequence of the judgement regarding the need
to employ greater energy than usual.
Any condition disturbing the equilibrium of the man-work-environment
system can be seen as a stress factor and the alterations that follow are
decribed by the term strain. Schematically, the relationship
stress-strain can be represented by the combination of a weight and a
spring, where the weight represents the load stress and the stretching
represents the deformation undergone by the spring (strain). If the
weight overcomes the springiness or the breaking load of the spring, then
the deformation is irreversible.
The stress syndrome may present itself in different clinical variants
that have the following characteristics in common:
- The
physiopathological response is non-specific, therefore different
stimuli can lead to similar clinical pictures;
- The
course of the disease is uniform and is characterized by the
succession of an alarm phase, a resistance phase and, finally, a
burn-out and/or adaptation phase;
- The
mediators of the stress-strain reactions are represented by the
endocrine system, the vegetative nervous system and the immune
system;
- An
essential characteristic of the strain manifestations is represented
by the twofold valence of the answer to environmental factors, which
is both somatic and behavioural. Therefore, it is possible to
alternatively observe psychological reactions, somatization
phenomena, integrated psychosomatic reactions.
Individual reactions vary depending on the subject's psychology,
however, as far as the health personnel is concerned, it is possible to
describe three main types of reaction:
- behavioural
disorders,
- psychophysiological
disorders,
- burn
out syndrome.
Behavioural disorders include alcohol abuse, tabagism and an
increased number of alimentary disorders (hypo or hyper alimentation).
The psychophysiological disorders include an increase in sleep
disturbances, an increase in cardiovascular symptoms associated with
anxiety (palpitations, hypertension, dyspnoea, hiperhidrosis), a
generalized muscular tension linked with psychomotor restlessness and
incapacity to relax.
Burn out syndrome is an emotional exhaustion syndrome characterized by:
- feelings
of dissatisfaction and professional incompetence,
- apathetic
attitudes and depersonalization.
The subject feels deprived of the emotional and personal resources
that had led him/her towards the professional choice and he/she is
pervaded with the feeling of not having anything more to give.
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