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					Work Physiology A.H. Mehrparvar, M.D. Yazd University of Medical Sciences Department of Occupational Medicine Metabolism A set of chemical processes allowing cells to live  Nutrients: carbohydrates, lipids, proteins  ATP:      energy currency of the body exists in all cells Two energetic bonds Each mole: 12000 calories Metabolism Two kinds:  Anaerobic (only for carbohydrates):   Phosphagen system    Glycolysis (for 1 m.)    Reserved ATP (for 1-2s) Phosphocreatine (for 5-8s) Each molecule of glucose: 2 ATP Each molecule of glycogen: 3 ATP Aerobic (carbohydrates, lipids, proteins) Comparing different systems  Endurance:    Phosphagen:8-10 s Glycogen: 1-2m Aerobic: unlimited  ATP production in unit time:    Phosphagen: 4 moles Glycogen: 2.5 moles Aerobic: 1 mole Anaerobic metabolism At the biginning of the activity  Low concentration of O2  1 mole glucose: 24000 calories (3%)  Glucose → pyrovic acid → lactic acid  Aerobic metabolism (carbohydrates) Oxidative metabolism  Glucose → pyrovic acid + 2 ATP  Pyrovic acid → acetyl coA + H2O + CO2  Acetyl coA → CO2 + H + 2 ATP (Krebs cycle)  Oxidation of hydrogens (oxidative phosphorylation): 30 ATP  1 mole glucose: 686000 calories  1 mole glucose: 38 ATP (456000 calories)  Aerobic metabolism More than 95% of energy  For short-time contractions: 50% from carbohydrates  For long-time contractions: mostly from lipids  Metabolic rate Heat produced by chemical reactions  In average 27% of the energy of nutrients is used (73% produces heat)  Energy units:    calorie (gram calorie): energy needed to 1°C increase the temperature of 1g water Calorie (KC): 1000 calories  Energy sources:     Carbohydrates: 45% Lipids: 40% Proteins: 15% Energy requirements: BMR + ADL + leisure activities + work activities  BMR = 1650 KC: dependent on:       Height and weight Age Gender Hormones Temperature sleep + Eating: 1850 KC  + sitting: 2000-2250 KC  Heavy working: 6000-7000 KC  BMR: 65-79 KC/h  Sitting: 100 KC/h  Standing: 105 KC/h  Typing: 140 KC/h  Walking: 200 KC/h  Running: 570 KC/h  Climbing stairs: 1100 KC/h  Musculoskeletal system during work Maximum muscle power reduces during work  E.g.:   About 50% after 1 minute Muscle endurance:  Dependent on:    Muscle glycogen Consuming carbohydrates Metabolic systems in muscles (phosphagen, glycogen, aerobic)  Reconstruction of systems:  PK → ATP  Glycogen → PK and ATP  Aerobic → glycogen PK and ATP  O2 debt → aerobic   1. 2. 3. 4. 5. At the biginning of activity: Anaerobic metabolism Aerobic metabolism of carbohydrates Aerobic metabolism of lipids (after 4-5 h) Aerobic metabolism of proteins Anearobic metabolism Respiratory system during work Average O2 consumption during rest: 250 mL/min.  Activity: ↑ rate and depth of respiration  Average O2 consumption during activity: 3600-5000 mL/min.  Diffusion capacity of O2 during rest: 23 mL/min.  Diffusion capacity of O2 during activity: 80 mL/min.  Respiratory system is not limiting during activities Cardiovascular system during work Blood flow to muscles (rest): 3.6 mL/min  Blood flow to muscles (work): 90 mL/min  Cardiac output (rest): 5.5 L  Cardiac output (work): 30 L  During work:  ↑ Blood flow to muscles  ↑ stroke volume (50%)  ↑ heart rate (270%)  Maximum heart rate: 220 – age  Effect of activity on maximum heart rate: ?  Measurement of metabolism  Direct calorimetry   Measurement of heat produced Indirect calorimetry     Measurement of consumed O2 Consumption of O2 an estimate of consumed energy More than 95% of energy from aerobic metabolism 1L consumed O2 → 4825 c energy (energy equivalent of O2) Physical capacity Aerobic capacity: an estimate of physical capacity  Maximum heart rate: an estimate of aerobic capacity esp. in average activities  Maximum heart rate is not appropriate for light or heavy work  Maximum aerobic capacity: VO2max  VO2 max  Amount of O2 consumed in the point of maximal aerobic metabolism Units:  1 Met = 3.5 ml/Kg/min  1 Met = 1 Kcal/Kg/hour   Sedentary work (<2 met)   Light work (2-3 met)   Lifting less than 4.5 kg, office work, work with light objects Lifting less than 9 kg, frequent lifting of objects <4.5 kg Medium work (4-5 met)  Lifting less than 23 kg, frequent lifting of objects <11 kg  Heavy work (6-8 met)   Lifting less than 45 kg, frequent lifting of objects <23 kg Very heavy work  Lifting more than 45 kg, frequent lifting of objects >23 kg
 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
									 
                                             
                                             
                                             
                                             
                                             
                                             
                                             
                                             
                                             
                                             
                                            