[Occupational risk during pregnancy and sick leave in a cohort of workers from Parc de Salut Mar (Barcelona, Spain)].

PubMed

Villar, Rocío; Benavides, Fernando G; Serra, Laura; Serra, Consol

2018-06-15

To study the use of the Pregnancy occupational risk benefit (PORB) and non-work related sickness absence (NWSA) in a cohort of pregnant workers of Parc de Salut Mar, Barcelona (Spain). Retrospective cohort study of 428 pregnant workers between 2010 and 2014, who were followed-up until delivery. Absences from work, both PORB and NWSA were recorded until the beginning of their maternity leave. The sequence analysis identifies four trajectories, which are described according to workers demographic and job characteristics. Of the total cohort, 56 (13.1%) accessed only the PORB, representing 6.126 days of absence; 68 (15.9%) also accessed PORB, with 7.127 days of absence, but had previously accumulated 102 episodes of NWSA with 1.820 days of absence. The majority of pregnant workers in the sample (69.9%) took only one or several episodes of NWSA without using PORB, with 545 episodes and 26,337 days of absence. Most were active during the first quarter and it is from the second quarter that episodes of long-term NWSA appeared. During the last month of pregnancy more than 80% of the workers were absent from work. Pregnant workers remained at work for two thirds of their pregnancy. Absences were mainly due to episodes of NWSA. PORB represented one third of them. As in other similar countries, our results suggest a change in the management of social protection benefits for pregnant workers. Copyright © 2018 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Cancer mortality among US workers employed in semiconductor wafer fabrication.

PubMed

Boice, John D; Marano, Donald E; Munro, Heather M; Chadda, Bandana K; Signorello, Lisa B; Tarone, Robert E; Blot, William J; McLaughlin, Joseph K

2010-11-01

To evaluate potential cancer risks in the US semiconductor wafer fabrication industry. A cohort of 100,081 semiconductor workers employed between 1968 and 2002 was studied. Standardized mortality ratios and relative risks (RRs) were estimated. Standardized mortality ratios were similar and significantly low among fabrication and nonfabrication workers for all causes (0.54 and 0.54) and all cancers (0.74 and 0.72). Internal comparisons also showed similar overall cancer risks among fabrication workers (RR = 0.98), including process equipment operators and process equipment service technicians (OP/EST) employed in cleanrooms (RR = 0.97), compared with nonfabrication workers. Nonsignificantly elevated RRs were observed for a few cancer sites among OP/EST workers, but the numbers of deaths were small and there were no trends of increasing risk with duration of employment. Work in the US semiconductor industry, including semiconductor wafer fabrication in cleanrooms, was not associated with increased cancer mortality overall or mortality from any specific form of cancer. However, due to the young average age of this cohort and its associated relatively low numbers of deaths, regular mortality updates of this semiconductor worker cohort are warranted.

Estimates and Predictions of Coal Workers’ Pneumoconiosis Cases among Redeployed Coal Workers of the Fuxin Mining Industry Group in China: A Historical Cohort Study

PubMed Central

Han, Bing; Liu, Hongbo; Zhai, Guojiang; Wang, Qun; Liang, Jie; Zhang, Mengcang; Cui, Kai; Shen, Fuhai; Yi, Hongbo; Li, Yuting; Zhai, Yuhan; Sheng, Yang; Chen, Jie

2016-01-01

This research was aimed at estimating possible Coal workers’ pneumoconiosis (CWP) cases as of 2012, and predicting future CWP cases among redeployed coal workers from the Fuxin Mining Industry Group. This study provided the scientific basis for regulations on CWP screening and diagnosis and labor insurance policies for redeployed coal workers of resource-exhausted mines. The study cohort included 19,116 coal workers. The cumulative incidence of CWP was calculated by the life-table method. Possible CWP cases by occupational category were estimated through the average annual incidence rate of CWP and males’ life expectancy. It was estimated that 141 redeployed coal workers might have suffered from CWP as of 2012, and 221 redeployed coal workers could suffer from CWP in the future. It is crucial to establish a set of feasible and affordable regulations on CWP screening and diagnosis as well as labor insurance policies for redeployed coal workers of resource-exhausted coal mines in China. PMID:26845337

The Added Value of Collecting Information on Pain Experience When Predicting Time on Benefits for Injured Workers with Back Pain.

PubMed

Steenstra, Ivan A; Franche, Renée-Louise; Furlan, Andrea D; Amick, Ben; Hogg-Johnson, Sheilah

2016-06-01

Objectives Some injured workers with work-related, compensated back pain experience a troubling course in return to work. A prediction tool was developed in an earlier study, using administrative data only. This study explored the added value of worker reported data in identifying those workers with back pain at higher risk of being on benefits for a longer period of time. Methods This was a cohort study of workers with compensated back pain in 2005 in Ontario. Workplace Safety and Insurance Board (WSIB) data was used. As well, we examined the added value of patient-reported prognostic factors obtained from a prospective cohort study. Improvement of model fit was determined by comparing area under the curve (AUC) statistics. The outcome measure was time on benefits during a first workers' compensation claim for back pain. Follow-up was 2 years. Results Among 1442 workers with WSIB data still on full benefits at 4 weeks, 113 were also part of the prospective cohort study. Model fit of an established rule in the smaller dataset of 113 workers was comparable to the fit previously established in the larger dataset. Adding worker rating of pain at baseline improved the rule substantially (AUC = 0.80, 95 % CI 0.68, 0.91 compared to benefit status at 180 days, AUC = 0.88, 95 % CI 0.74, 1.00 compared to benefits status at 360 days). Conclusion Although data routinely collected by workers' compensation boards show some ability to predict prolonged time on benefits, adding information on experienced pain reported by the worker improves the predictive ability of the model from 'fairly good' to 'good'. In this study, a combination of prognostic factors, reported by multiple stakeholders, including the worker, could identify those at high risk of extended duration on disability benefits and in potentially in need of additional support at the individual level.

Influence of exposure assessment and parameterization on exposure response. Aspects of epidemiologic cohort analysis using the Libby Amphibole asbestos worker cohort.

PubMed

Bateson, Thomas F; Kopylev, Leonid

2015-01-01

Recent meta-analyses of occupational epidemiology studies identified two important exposure data quality factors in predicting summary effect measures for asbestos-associated lung cancer mortality risk: sufficiency of job history data and percent coverage of work history by measured exposures. The objective was to evaluate different exposure parameterizations suggested in the asbestos literature using the Libby, MT asbestos worker cohort and to evaluate influences of exposure measurement error caused by historically estimated exposure data on lung cancer risks. Focusing on workers hired after 1959, when job histories were well-known and occupational exposures were predominantly based on measured exposures (85% coverage), we found that cumulative exposure alone, and with allowance of exponential decay, fit lung cancer mortality data similarly. Residence-time-weighted metrics did not fit well. Compared with previous analyses based on the whole cohort of Libby workers hired after 1935, when job histories were less well-known and exposures less frequently measured (47% coverage), our analyses based on higher quality exposure data yielded an effect size as much as 3.6 times higher. Future occupational cohort studies should continue to refine retrospective exposure assessment methods, consider multiple exposure metrics, and explore new methods of maintaining statistical power while minimizing exposure measurement error.

Occupational variation in incidence of bladder cancer: a comparison of population-representative cohorts from Nordic countries and Canada.

PubMed

Hadkhale, Kishor; MacLeod, Jill; Demers, Paul A; Martinsen, Jan Ivar; Weiderpass, Elisabete; Kjaerheim, Kristina; Lynge, Elsebeth; Sparen, Pär; Tryggvadottir, Laufey; Anne Harris, M; Tjepkema, Michael; Peters, Paul A; Pukkala, Eero

2017-08-04

The objective of this study was to compare occupational variation of the risk of bladder cancer in the Nordic countries and Canada. In the Nordic Occupational Cancer study (NOCCA), 73 653 bladder cancer cases were observed during follow-up of 141.6 million person-years. In the Canadian Census Health and Environment Cohort (CanCHEC), 8170 cases were observed during the follow-up of 36.7 million person-years. Standardised incidence ratios with 95% CI were estimated for 53 occupations in the NOCCA cohort and HR with 95% CIs were estimated for 42 occupations in the CanCHEC. Elevated risks of bladder cancer were observed among hairdressers, printers, sales workers, plumbers, painters, miners and laundry workers. Teachers and agricultural workers had reduced risk of bladder cancer in both cohorts. Chimney-sweeps, tobacco workers and waiters had about 1.5-fold risk in the Nordic countries; no risk estimates for these categories were given from the CanCHEC cohort. We observed different occupational patterns in risk of bladder cancer in Nordic countries and Canada. The only occupation with similarly increased risk was observed among sales workers. Differences in smoking across occupational groups may explain some, but not all, of this variation. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Deaths and tumours among workers grinding stainless steel: a follow up.

PubMed Central

Jakobsson, K; Mikoczy, Z; Skerfving, S

1997-01-01

OBJECTIVE: To study cause specific mortality and cancer morbidity in workers exposed to the dust of grinding materials, grinding agents, and stainless steel, especially with regard to a possibly increased risk of respiratory, stomach, and colorectal cancer. METHODS: Retrospective cohort study, using reference cohorts of blue collar workers and population rates for comparison. The exposed cohort comprises workers with at least 12 months employment time at two plants, producing stainless steel sinks and saucepans (n = 727). Also, reference cohorts of other industrial workers (n = 3965) and fishermen (n = 8092) were analysed. The observation period began 15 years after the start of employment. Standardised mortality or incidence ratios (SMRs, SIRs; county reference rates) were calculated for cause-specific mortality between 1952 and 1993, and for cancer morbidity between 1958 and 1992. RESULTS: In the exposed cohort, overall mortality, cardiovascular mortality, and all malignant mortality and morbidity were slightly lower than expected. Also, the risk estimates for cancer in the upper and lower respiratory tracts and for stomach cancer were lower than expected. There was an increase in morbidity from colon cancer, which was explained by an excess of tumours in the sigmoid part only. Here, the risk estimates were higher in workers with long employment time (1-14 years: four observed cases, SIR 1.7, 95% confidence interval (95% CI) 0.4 to 4.5; > or = 15 years: three observed cases, SIR 4.3, 95% CI 0.9 to 13) and the increased risk was especially pronounced among those first employed before 1942. A slight nominal excess of rectal cancers (nine observed cases, SIR 1.4, 95% CI 0.6 to 2.6), and a significant excess of prostate cancer morbidity (36 observed cases, SIR 1.7, 95% CI 1.2 to 2.4) were found. These risk estimates did not, however, increase with employment time. CONCLUSIONS: The finding of an increased risk of cancer in the sigmoid part of the colon, which was not found in the reference cohorts, and with indication of a relation between duration of employment and response, is consistent with a causal relation. The limited size of the exposed cohort makes a detailed exposure-response analysis unstable, and the confidence limits are wide. Albeit slightly raised, the risk estimate for rectal cancer in the exposed cohort was not different from the estimate among the other industrial workers. PMID:9538356

A Validation Method to Determine Missing Years of Birth in a Cohort Study of Shipyard Workers Using Social Security Number.

PubMed

Cabasag, Citadel J; Ziogas, Argyrios; Shehata, Merna; Anton-Culver, Hoda

2016-06-01

The objective of the study is to evaluate the generalizability and feasibility of a prediction method developed by Block et al (1983) to estimate missing age of workers by using their Social Security Numbers (SSNs). Our study used a retrospective occupational cohort of about 15,000 workers from the Long Beach Naval Shipyard (1978 to 1985). Our results showed an 89.2% agreement (P < 0.0001) between the predicted and observed years of birth using Block's method. The correlation increased to 93.1% (P < 0.0001) after our modifications by removing workers with SSNs issued in U.S. territories. The method performed better in shipyard workers who obtained their SSNs after 1950. Although the method is useful in imputing missing age, the accuracy is dependent on the year, age, and location of SSN issuance.

Study protocol title: a prospective cohort study of low back pain.

PubMed

Garg, Arun; Hegmann, Kurt T; Moore, J Steven; Kapellusch, Jay; Thiese, Matthew S; Boda, Sruthi; Bhoyr, Parag; Bloswick, Donald; Merryweather, Andrew; Sesek, Richard; Deckow-Schaefer, Gwen; Foster, James; Wood, Eric; Sheng, Xiaoming; Holubkov, Richard

2013-03-07

Few prospective cohort studies of workplace low back pain (LBP) with quantified job physical exposure have been performed. There are few prospective epidemiological studies for LBP occupational risk factors and reported data generally have few adjustments for many personal and psychosocial factors. A multi-center prospective cohort study has been incepted to quantify risk factors for LBP and potentially develop improved methods for designing and analyzing jobs. Due to the subjectivity of LBP, six measures of LBP are captured: 1) any LBP, 2) LBP ≥ 5/10 pain rating, 3) LBP with medication use, 4) LBP with healthcare provider visits, 5) LBP necessitating modified work duties and 6) LBP with lost work time. Workers have thus far been enrolled from 30 different employment settings in 4 diverse US states and performed widely varying work. At baseline, workers undergo laptop-administered questionnaires, structured interviews, and two standardized physical examinations to ascertain demographics, medical history, psychosocial factors, hobbies and physical activities, and current musculoskeletal disorders. All workers' jobs are individually measured for physical factors and are videotaped. Workers are followed monthly for the development of low back pain. Changes in jobs necessitate re-measure and re-videotaping of job physical factors. The lifetime cumulative incidence of low back pain will also include those with a past history of low back pain. Incident cases will exclude prevalent cases at baseline. Statistical methods planned include survival analyses and logistic regression. Data analysis of a prospective cohort study of low back pain is underway and has successfully enrolled over 800 workers to date.

Benzene and leukemia, Pliofilm revisited: I. An historical review of the leukemia deaths among Akron Goodyear Tire and Rubber Company employees.

PubMed

Infante, Peter F

2013-01-01

The cohort study of Pliofilm workers exposed to benzene has been used as a primary data source to estimate quantitative dose response for benzene-leukemia. Little attention has focused on the undercounting of leukemia deaths used in the analyses, nor on the behavior of the company toward the Pliofilm workers who contracted leukemia. An historical review of documents related to the Akron portion of the cohort indicates that between two and five workers diagnosed with acute myelogenous leukemia (AML) could be added to the cohort for alternate dose response analyses. In the late 1950s and early 1960s, the company did not inform Pliofilm workers with AML that they had the disease, concealed from the workers, including those diagnosed with AML, and the treating hematologist that benzene was the solvent being used, and denied compensation for AML cases exposed to benzene until forced to do so by the State of Ohio in 1968.

Ischaemic heart disease mortality and years of work in trucking industry workers.

PubMed

Hart, Jaime E; Garshick, Eric; Smith, Thomas J; Davis, Mary E; Laden, Francine

2013-08-01

Evidence from general population-based studies and occupational cohorts has identified air pollution from mobile sources as a risk factor for cardiovascular disease. In a cohort of US trucking industry workers, with regular exposure to vehicle exhaust, the authors previously observed elevated standardised mortality ratios for ischaemic heart disease (IHD) compared with members of the general US population. Therefore, the authors examined the association of increasing years of work in jobs with vehicle exhaust exposure and IHD mortality within the cohort. The authors calculated years of work in eight job groups for 30,758 workers using work records from four nationwide companies. Proportional hazard regression was used to examine relationships between IHD mortality, 1985-2000, and employment duration in each job group. HRs for at least 1 year of work in each job were elevated for dockworkers, long haul drivers, pick-up and delivery drivers, combination workers, hostlers, and shop workers. There was a suggestion of an increased risk of IHD mortality with increasing years of work as a long haul driver, pick-up and delivery driver, combination worker, and dockworker. These results suggest an elevated risk of IHD mortality in workers with a previous history of regular exposure to vehicle exhaust.

Cancer Mortality through 2005 among a Pooled Cohort of U.S. Nuclear Workers Exposed to External Ionizing Radiation.

PubMed

Schubauer-Berigan, Mary K; Daniels, Robert D; Bertke, Stephen J; Tseng, Chih-Yu; Richardson, David B

2015-06-01

Nuclear workers worldwide have been studied for decades to estimate associations between their exposure to ionizing radiation and cancer. The low-level exposure of these workers requires pooling of large cohorts studied over many years to obtain risk estimates with appropriate latency and good precision. We assembled a pooled cohort of 119,195 U.S. nuclear workers at four Department of Energy nuclear weapons facilities (Hanford site, Idaho National Laboratory, Oak Ridge National Laboratory and Savannah River site) and at the Portsmouth Naval Shipyard. The cohort was followed at the start of the workers beginning their radiation work (at earliest, between 1944 and 1952) through 2005, and we compared its mortality to that of the U.S. We also conducted regression-modeling analysis to evaluate dose-response associations for external radiation exposure and outcomes: all cancers, smoking- and nonsmoking-related cancers, all lymphatic and hematopoietic cancers, leukemia (excluding chronic lymphocytic), multiple myeloma, cardiovascular disease and others. The mean dose observed among the cohort was 20 mSv. For most outcomes, mortality was below expectation compared to the general population, but mesothelioma and pleura cancers were highly elevated. We found an excess relative risk (ERR) per 10 mSv of 0.14% [95% confidence interval (CI): -0.17%, 0.48%] for all cancers excluding leukemia. Estimates were higher for nonsmoking-related cancers (0.70%, 95% CI: 0.058%, 1.5%) and lower for smoking-related cancers (-0.079%, 95% CI: -0.43%, 0.32%). The ERR per 10 mSv was 1.7% (95% CI: -0.22%, 4.7%) for leukemia, which was similar to the estimate of 1.8% (95% CI: 0.027%, 4.4%) for all lymphatic and hematopoietic cancers. The ERR per 10 mSv for multiple myeloma was 3.9% (95% CI: 0.60%, 9.5%). The ERR per 10 mSv for cardiovascular disease was 0.026% (-0.25%, 0.32%). Little evidence of heterogeneity was seen by facility, birth cohort or sex for most outcomes. The estimates observed here are similar to those found in previous large pooled nuclear worker studies and also (with the exception of multiple myeloma) to those conducted in the Life Span Study of Japanese atomic bomb survivors. The tendency of observed risks to persist many years after exposure for most outcomes illustrates the importance of continued follow-up of nuclear worker cohorts.

Detection of antibodies against Turkey astrovirus in humans.

PubMed

Meliopoulos, Victoria A; Kayali, Ghazi; Burnham, Andrew; Oshansky, Christine M; Thomas, Paul G; Gray, Gregory C; Beck, Melinda A; Schultz-Cherry, Stacey

2014-01-01

Astroviruses are a leading cause of gastroenteritis in mammals and birds worldwide. Although historically thought to be species-specific, increasing evidence suggests that astroviruses may cross species barriers. In this report, we used enzyme-linked immunosorbent assays to screen sera from three distinct human cohorts involved in influenza studies in Memphis, TN or Chapel Hill, NC, and Midwestern poultry abattoir workers for antibodies to turkey astrovirus type 2 (TAstV-2). Surprisingly, 26% of one cohort's population was TAstV-2 positive as compared to 0 and 8.9% in the other cohorts. This cohort was composed of people with exposure to turkeys in the Midwestern United States including abattoir workers, turkey growers, and non-occupationally exposed participants. The odds of testing positive for antibodies against turkey astrovirus among abattoir workers were approximately 3 times higher than the other groups. These studies suggest that people with contact to turkeys can develop serological responses to turkey astrovirus. Further work is needed to determine if these exposures result in virus replication and/or clinical disease.

The WISTAH hand study: a prospective cohort study of distal upper extremity musculoskeletal disorders.

PubMed

Garg, Arun; Hegmann, Kurt T; Wertsch, Jacqueline J; Kapellusch, Jay; Thiese, Matthew S; Bloswick, Donald; Merryweather, Andrew; Sesek, Richard; Deckow-Schaefer, Gwen; Foster, James; Wood, Eric; Kendall, Richard; Sheng, Xiaoming; Holubkov, Richard

2012-06-06

Few prospective cohort studies of distal upper extremity musculoskeletal disorders have been performed. Past studies have provided somewhat conflicting evidence for occupational risk factors and have largely reported data without adjustments for many personal and psychosocial factors. A multi-center prospective cohort study was incepted to quantify risk factors for distal upper extremity musculoskeletal disorders and potentially develop improved methods for analyzing jobs. Disorders to analyze included carpal tunnel syndrome, lateral epicondylalgia, medial epicondylalgia, trigger digit, deQuervain's stenosing tenosynovitis and other tendinoses. Workers have thus far been enrolled from 17 different employment settings in 3 diverse US states and performed widely varying work. At baseline, workers undergo laptop administered questionnaires, structured interviews, two standardized physical examinations and nerve conduction studies to ascertain demographic, medical history, psychosocial factors and current musculoskeletal disorders. All workers' jobs are individually measured for physical factors and are videotaped. Workers are followed monthly for the development of musculoskeletal disorders. Repeat nerve conduction studies are performed for those with symptoms of tingling and numbness in the prior six months. Changes in jobs necessitate re-measure and re-videotaping of job physical factors. Case definitions have been established. Point prevalence of carpal tunnel syndrome is a combination of paraesthesias in at least two median nerve-served digits plus an abnormal nerve conduction study at baseline. The lifetime cumulative incidence of carpal tunnel syndrome will also include those with a past history of carpal tunnel syndrome. Incident cases will exclude those with either a past history or prevalent cases at baseline. Statistical methods planned include survival analyses and logistic regression. A prospective cohort study of distal upper extremity musculoskeletal disorders is underway and has successfully enrolled over 1,000 workers to date.

[A retrospective cohort study on mortality among silicotic workers in Hong Kong with emphasis on lung cancer].

PubMed

Yu, Ignatius Ts; Tse, Lap Ah; Chi, Chiu-leung; Tze, Wai-wong; Cheuk, Ming-Tam; Alan, Ck-chan

2008-01-01

To investigate the relationship between silica or silicosis and lung cancer in a large cohort of silicotic workers in Hong Kong. All workers with silicosis in Hong Kong diagnosed between 1981 and 1998 were followed up till the end of 1999 to ascertain their vital status and causes of death, using the corresponding mortality rates of Hong Kong males of the same period as external comparison. Standardized mortality ratios (SMR) for lung cancer and other major causes of death were calculated. Person-year method was used. Axelson's indirect method was performed to adjust for the confounding effect of smoking. Penalized smoothing spline (p-spline) models were used to evaluate the exposure-response relationship between silica dust exposure and lung cancer mortality. A total of 2789 newly diagnosed cases of silicosis were included in the cohort, with an overall 24 992.6 person-years of observations. The loss-to-follow-up rate was only 2.9%. Surface construction workers (51%) and underground caisson workers (37%) constituted the major part of the cohort. There were 853 silicotics observed with an average age at death of 63.8 years. The SMR for all causes and all cancers increased significantly. The leading cause of death was non-malignant respiratory diseases. About 86 deaths were from lung cancer, giving a SMR of 1.69 (95% CI: 1.35 approximately 2.09). The risk of lung cancer death among workers in surface construction, underground caisson, and entire cohort was reduced to 1.12 (95% CI: 0.89 approximately 1.38), 1.09 (95% CI: 0.82 approximately 1.42) and 1.56 (95% CI: 0.98 approximately 2.36) respectively, after indirectly adjusting for smoking. from P-spline model did not show a clear exposure-response relationship between silica dust (CDE and MDC) and lung cancer mortality. This cohort study did not show an increased risk of lung cancer mortality among silicotic workers. P-spline model does not support an exposure-response relationship between silica dust exposure and lung cancer mortality.

Associations of rotational shift work and night shift status with hypertension: a systematic review and meta-analysis.

PubMed

Manohar, Sandhya; Thongprayoon, Charat; Cheungpasitporn, Wisit; Mao, Michael A; Herrmann, Sandra M

2017-10-01

The reported risks of hypertension (HTN) in rotating shift and night shift workers are controversial. The objective of this meta-analysis was to assess the association between shift work status and HTN. A literature search was performed using MEDLINE, EMBASE and Cochrane Database from inception through October 2016. Studies that reported odds ratios (OR) comparing the risk of HTN in shift workers were included. A prespecified subgroup analysis by rotating shift and night shift statuses were also performed. Pooled OR and 95% confidence interval (CI) were calculated using a random-effect, generic inverse variance method. The protocol for this study is registered with International Prospective Register of Systematic Reviews; no. CRD42016051843. Twenty-seven observational studies (nine cohort and 18 cross-sectional studies) with a total of 394 793 individuals were enrolled. The pooled ORs of HTN in shift workers in cohort and cross-sectional studies were 1.31 (95% CI, 1.07-1.60) and 1.10 (95% CI, 1.00-1.20), respectively. When meta-analysis was restricted only to cohort studies in rotating shift, the pooled OR of HTN in rotating shift workers was 1.34 (95% CI, 1.08-1.67). The data regarding night shift and HTN in cohort studies was limited. The pooled OR of HTN in night shift workers in cross-sectional studies was 1.07 (95% CI, 0.85-1.35). Based on the findings of our meta-analysis, shiftwork status may play an important role in HTN, as there is a significant association between rotating shift work and HTN. However, there is no significant association between night shift status and risk of HTN.

Risk factors for respiratory work disability in a cohort of pulp mill workers exposed to irritant gases

PubMed Central

2011-01-01

Background The association between chronic respiratory diseases and work disability has been demonstrated a number of times over the past 20 years, but still little is known about work disability in occupational cohorts of workers exposed to respiratory irritants. This study investigated job or task changes due to respiratory problems as an indicator of work disability in pulp mill workers occupationally exposed to irritants. Methods Data about respiratory symptoms and disease diagnoses, socio-demographic variables, occupational exposures, gassing episodes, and reported work changes due to respiratory problems were collected using a questionnaire answered by 3226 pulp mill workers. Information about work history and departments was obtained from personnel files. Incidence and hazard ratios for respiratory work disability were calculated with 95% confidence intervals (CI). Results The incidence of respiratory work disability among these pulp mill workers was 1.6/1000 person-years. The hazard ratios for respiratory work disability were increased for workers reporting gassings (HR 5.3, 95% CI 2.7-10.5) and for those reporting physician-diagnosed asthma, chronic bronchitis, and chronic rhinitis, when analyzed in the same model. Conclusions This cohort study of pulp mill workers found that irritant peak exposure during gassing episodes was a strong predictor of changing work due to respiratory problems, even after adjustment for asthma, chronic bronchitis, and chronic rhinitis. PMID:21896193

Preparation of Single-cohort Colonies and Hormone Treatment of Worker Honeybees to Analyze Physiology Associated with Role and/or Endocrine System.

PubMed

Ueno, Takayuki; Kawasaki, Kiyoshi; Kubo, Takeo

2016-09-06

Honeybee workers are engaged in various tasks related to maintaining colony activity. The tasks of the workers change according to their age (age-related division of labor). Young workers are engaged in nursing the brood (nurse bees), while older workers are engaged in foraging for nectar and pollen (foragers). The physiology of the workers changes in association with this role shift. For example, the main function of the hypopharyngeal glands (HPGs) changes from the secretion of major royal jelly proteins (MRJPs) to the secretion of carbohydrate-metabolizing enzymes. Because worker tasks change as the workers age in typical colonies, it is difficult to discriminate the physiological changes that occur with aging from those that occur with the role shift. To study the physiological changes in worker tissues, including the HPGs, in association with the role shift, it would be useful to manipulate the honeybee colony population by preparing single-cohort colonies in which workers of almost the same age perform different tasks. Here we describe a detailed protocol for preparing single-cohort colonies for this analysis. Six to eight days after single-cohort colony preparation, precocious foragers that perform foraging tasks earlier than usual appear in the colony. Representative results indicated role-associated changes in HPG gene expression, suggesting role-associated HPG function. In addition to manipulating the colony population, analysis of the endocrine system is important for investigating role-associated physiology. Here, we also describe a detailed protocol for treating workers with 20-hydroxyecdysone (20E), an active form of ecdysone, and methoprene, a juvenile hormone analogue. The survival rate of treated bees was sufficient to examine gene expression in the HPGs. Gene expression changes were observed in response to 20E- and/or methoprene-treatment, suggesting that hormone treatments induce physiological changes of the HPGs. The protocol for hormone treatment described here is appropriate for examining hormonal effects on worker physiology.

The course of work absenteeism involving neck pain: a cohort study of Ontario lost-time claimants.

PubMed

Van Eerd, Dwayne; Côté, Pierre; Kristman, Vicki; Rezai, Mana; Hogg-Johnson, Sheilah; Vidmar, Marjan; Beaton, Dorcas

2011-05-20

Cohort study. To describe the course of lost-time claims involving neck pain in workers compensated by the Ontario Workplace Safety and Insurance Board (WSIB). The prevalence of neck pain in workers varies from 27.1% to 47.8%. Very little is known about the course of work absenteeism related to neck pain. Our cohort included 5761 injured workers with an incident lost-time claim to the WSIB in 1997 and 1998. Claimants were followed for 2 years. We measured the cumulative time on lost-time benefits using the Kaplan-Meier method and described the number and duration of episodes on benefits. The median cumulative time-on-benefits for the cohort was 13 days (95% CI: 13-14). The cumulative time on benefits was shorter for men than women and for younger than older workers. 14.2% of claimants experienced multiple episodes of work absenteeism during the 2 years after the initial claim. The median time on benefits for claimants with a single episode was 11 days (95% CI: 10-11). The median length of the first episode on benefits was longer for claimants with multiple episodes (19-22 days) compared with those with a single episode (11 days). Age was positively associated with longer time-on-benefits in claimants with a single episode of work absenteeism. Most injured workers who make a workers' compensation claim that involves neck pain do not make a second claim in the subsequent 2 years. However, an important minority (14.2%) experience multiple episodes of work absenteeism and these workers accrue 40.4% of all lost-time days. Recurrent claims involving neck pain represent a significant burden of disability in Ontario.

Longitudinal and Cross-sectional Analyses of Lung Function in Toluene Diisocyanate Production Workers.

PubMed

Wang, Mei Lin; Storey, Eileen; Cassidy, Laura D; Doney, Brent; Conner, Patrick R; Collins, James J; Carson, Michael; Molenaar, Don

2017-12-01

The aim of this study was to investigate lung function among toluene diisocyanate (TDI) production workers. One hundred ninety-seven U.S workers performed spirometry from 2006 through 2012. Results were compared within the study cohort and with U.S. population measures. A mixed-effects model assessed factors affecting repeated forced expiratory volume in 1 second (FEV1) measurements. The cohort's mean FEV1 and forced vital capacity (FVC) percent reference values, although greater than 90%, were significantly lower and the prevalence of abnormal spirometry (predominantly restrictive pattern) was significantly higher than in the U.S. Differences in lung function among workers with higher cumulative TDI exposure were in the direction of an exposure effect, but not significant. We found little evidence of an adverse effect of TDI exposure on longitudinal spirometry in these workers. The association between TDI exposure and the increasing prevalence of a restrictive pattern needs further exploration.

Mortality (1950–1999) and cancer incidence (1969–1999) of workers in the Port Hope cohort study exposed to a unique combination of radium, uranium and γ-ray doses

PubMed Central

Zablotska, Lydia B; Lane, Rachel S D; Frost, Stanley E

2013-01-01

Objectives Uranium processing workers are exposed to uranium and radium compounds from the ore dust and to γ-ray radiation, but less to radon decay products (RDP), typical of the uranium miners. We examined the risks of these exposures in a cohort of workers from Port Hope radium and uranium refinery and processing plant. Design A retrospective cohort study with carefully documented exposures, which allowed separation of those with primary exposures to radium and uranium. Settings Port Hope, Ontario, Canada, uranium processors with no mining experience. Participants 3000 male and female workers first employed (1932–1980) and followed for mortality (1950–1999) and cancer incidence (1969–1999). Outcome measures Cohort mortality and incidence were compared with the general Canadian population. Poisson regression was used to evaluate the association between cumulative RDP exposures and γ-ray doses and causes of death and cancers potentially related to radium and uranium processing. Results Overall, workers had lower mortality and cancer incidence compared with the general Canadian population. In analyses restricted to men (n=2645), the person-year weighted mean cumulative RDP exposure was 15.9 working level months (WLM) and the mean cumulative whole-body γ-ray dose was 134.4 millisieverts. We observed small, non-statistically significant increases in radiation risks of mortality and incidence of lung cancer due to RDP exposures (excess relative risks/100 WLM=0.21, 95% CI <−0.45 to 1.59 and 0.77, 95% CI <−0.19 to 3.39, respectively), with similar risks for those exposed to radium and uranium. All other causes of death and cancer incidence were not significantly associated with RDP exposures or γ-ray doses or a combination of both. Conclusions In one of the largest cohort studies of workers exposed to radium, uranium and γ-ray doses, no significant radiation-associated risks were observed for any cancer site or cause of death. Continued follow-up and pooling with other cohorts of workers exposed to by-products of radium and uranium processing could provide valuable insight into occupational risks and suspected differences in risk with uranium miners. PMID:23449746

Modifiers of the healthy worker effect and expression of the internal healthy worker effect in a female nuclear worker cohort

NASA Astrophysics Data System (ADS)

Baillargeon, Jacques Guy

Though well-documented among numerous cohorts of male workers, little is known about how the healthy worker effect (HWE) and the internal HWE is expressed among cohorts of female workers. This investigation examines characteristics of the HWE and the internal HWE in a cohort of 12,668 female nuclear workers. The HWE, which was estimated by assessing SMRs for all causes of death combined, was found to be modified by race, occupational class and length of follow-up. Smaller variations in the HWE were observed for age at hire, occupational class, length of employment, monitored status, and interruption of monitoring. Examination of SMRs for all cancers combined revealed that the HWE was modified by race, occupational class, monitored status, interruption of monitoring, and length of follow-up. Smaller variations were observed for age at hire and length of employment. Investigators often try to circumvent the HWE by employing internal comparisons; that is, by directly comparing the mortality of subgroups within a defined occupational cohort with one another. However, internal comparisons are not necessarily free from certain biases related to the HWE. If employees are selected on the basis of health into subgroups which serve as the basis for internal comparisons, then a form of internal comparison bias, called the internal healthy worker effect (Stewart et al, 1991; Wilkinson, 1992) may occur. In this investigation, the expression of the internal HWE was examined by estimating the extent to which survival time was modified by the variables under study. Using the Cox PH model, time to death from all causes was found to be modified by occupational class and length of employment but not by race, age at hire, monitored status, or interruption of monitoring. Time to death from all cancers was found to be modified by race and interruption of monitoring but not by age at hire, occupational class, length of employment, or monitored status. These results are important because they may provide leads for other investigators to determine whether the exposure-disease relationships are confounded by characteristics of the employed female populations under study.

Study of two cohorts of workers exposed to methyl methacrylate in acrylic sheet production

PubMed Central

Tomenson, J; Bonner, S; Edwards, J; Pemberton, M; Cummings, T; Paddle, G

2000-01-01

OBJECTIVES—To study mortality among 4324 workers at two United Kingdom factories, Darwen, Lancashire and Wilton, Cleveland, producing polymethyl methacrylate (PMMA) sheet. The Darwen factory is still active, but the Wilton one was closed in 1970. Also, to investigate patterns of mortality after exposure to methyl methacrylate; in particular, mortality from colon and rectal cancer.
METHODS—All male employees at the Darwen factory with a record of employment in 1949-88 and all men ever employed at the Wilton factory (1949-70) were investigated. The vital status of both cohorts was ascertained on 31 December 1995. The exposure of 1526 subjects at the Darwen plant who were engaged from 1949 onwards could be characterised. The mean duration of exposure was 7.6 years at 13.2 ppm (8 hour time weighted average), although exposures in some work groups were as high as 100 ppm. It was not possible to calculate the cumulative exposure of workers first employed at the Darwen plant before 1949 or workers at the Wilton factory.
RESULTS—In the Darwen cohort, 622 deaths were identified and a further 700 deaths in the Wilton cohort. Mortalities for the cohort were compared with national and local rates and expressed as standardised mortality ratios (SMRs). In the subcohort of Darwen workers with more than minimal exposure to MMA, reduced mortalities compared with national and local rates, were found for all causes (SMR 94), and colorectal cancer (SMR 92), but mortality from all cancers was slightly increased (SMR 104). No relations were found with cumulative exposure to MMA. In the subcohort of Wilton workers, mortality from all causes of death was significantly reduced (SMR 89), but mortality from all cancers (SMR 103) and colorectal cancer (SMR 124) were increased. The excess of colorectal cancer was confined to employees with less than 1 year of employment.
CONCLUSION—The study provided no clear evidence that employment at the factories or exposure to MMA had adversely affected the mortalities of workers.


Keywords: methyl methacrylate; mortality PMID:11077009

The impact of asbestos exposure in Swedish construction workers.

PubMed

Järvholm, Bengt; Englund, Anders

2014-01-01

To study the occurrence of pleural mesothelioma as a measure of the impact on health from asbestos exposure in the construction industry. The occurrence of pleural mesothelioma in different occupations, time periods and birth cohorts was studied in a cohort of construction workers. They were prospectively followed after they had participated in health examinations between 1971 and 1993. The analysis was restricted to men and in total 367,568 men was included in the analysis. In total there were 419 cases of pleural mesotheliomas between 1972 and 2009. As expected the age adjusted incidence was high in insulation workers and plumbers (39 and 16 cases per 100,000 person-years, respectively). However, only 21% of the pleural mesotheliomas occurred in those occupational groups. Occupational groups with many cases of pleural mesothelioma were concrete workers (N = 56), wood workers (N = 55), painters (N = 32), electricians (N = 48), and foremen (N = 37). The highest risk was in birth cohorts born between 1935 and 1945. Between 1995 and 2009 around one-third of all male cases in the country occurred in this birth cohort. The risk seemed to decrease considerably in men born after 1955. In Sweden a considerable proportion of pleural mesotheliomas occur among construction workers; and not only in jobs traditionally associated with asbestos exposure such as insulators and plumbers but also among electricians, for example. The results shows that asbestos exposure occurs in many occupational groups, indicating that safe handling of asbestos is a very difficult or even impossible task in the construction industry. © 2013 Wiley Periodicals, Inc.

Prospective Cohort Study to Elucidate the Correlation between Occupational Stress and Hypertension Risk in Oil Workers from Kelamayi City in the Xinjiang Uygur Autonomous Region of China.

PubMed

Li, Rong; Gao, Xiaoyan; Liu, Bo; Ge, Hua; Ning, Li; Zhao, Junling; Liu, Jiwen

2016-12-22

The purpose of this study was to assess the major risk factors for hypertension in oil workers, and investigate the effect of occupational stress on the incidence of hypertension after controlling for other risk factors. A prospective cohort approach was used following enrollment of 1354 oil workers. The occupational stress experienced by oil workers was higher than for the general population in China. By the end of the cohort study, 231 new cases of hypertension among the oil workers had been diagnosed. The cumulative incidence of hypertension was 17.06%. There were 44, 112, and 75 workers who developed hypertension in the low, intermediate, and high occupational stress groups, which represented a 12.0%, 15.6%, and 20.3% cumulative incidence, respectively (chi-square value = 9.812, p < 0.01). Multivariate Cox proportional hazard model analysis showed that type of work, cigarette smoking, excess body weight, and obesity were risk factors for hypertension ( p < 0.05). After risk factors such as type of work, cigarette smoking, alcohol consumption, and body mass index (BMI) were controlled, the hypertension risk (hazard ratio, HR) in the high occupational stress group was 1.549 (1.072-2.236) compared to the low exposure group, and 2.337 (1.191-4.585) in female subjects. Our study indicated that an increase in occupational stress was associated with an increased risk of hypertension after other factors were adjusted.

Prospective Cohort Study to Elucidate the Correlation between Occupational Stress and Hypertension Risk in Oil Workers from Kelamayi City in the Xinjiang Uygur Autonomous Region of China

PubMed Central

Li, Rong; Gao, Xiaoyan; Liu, Bo; Ge, Hua; Ning, Li; Zhao, Junling; Liu, Jiwen

2016-01-01

The purpose of this study was to assess the major risk factors for hypertension in oil workers, and investigate the effect of occupational stress on the incidence of hypertension after controlling for other risk factors. A prospective cohort approach was used following enrollment of 1354 oil workers. The occupational stress experienced by oil workers was higher than for the general population in China. By the end of the cohort study, 231 new cases of hypertension among the oil workers had been diagnosed. The cumulative incidence of hypertension was 17.06%. There were 44, 112, and 75 workers who developed hypertension in the low, intermediate, and high occupational stress groups, which represented a 12.0%, 15.6%, and 20.3% cumulative incidence, respectively (chi-square value = 9.812, p < 0.01). Multivariate Cox proportional hazard model analysis showed that type of work, cigarette smoking, excess body weight, and obesity were risk factors for hypertension (p < 0.05). After risk factors such as type of work, cigarette smoking, alcohol consumption, and body mass index (BMI) were controlled, the hypertension risk (hazard ratio, HR) in the high occupational stress group was 1.549 (1.072–2.236) compared to the low exposure group, and 2.337 (1.191–4.585) in female subjects. Our study indicated that an increase in occupational stress was associated with an increased risk of hypertension after other factors were adjusted. PMID:28025517

Lung Cancer Risk from Plutonium: A Pooled Analysis of the Mayak and Sellafield Worker Cohorts.

PubMed

Gillies, Michael; Kuznetsova, Irina; Sokolnikov, Mikhail; Haylock, Richard; O'Hagan, Jackie; Tsareva, Yulia; Labutina, Elena

2017-12-01

In this study, lung cancer risk from occupational plutonium exposure was analyzed in a pooled cohort of Mayak and Sellafield workers, two of the most informative cohorts in the world with detailed plutonium urine monitoring programs. The pooled cohort comprised 45,817 workers: 23,443 Sellafield workers first employed during 1947-2002 with follow-up until the end of 2005 and 22,374 Mayak workers first employed during 1948-1982 with follow-up until the end of 2008. In the pooled cohort 1,195 lung cancer deaths were observed (789 Mayak, 406 Sellafield) but only 893 lung cancer incidences (509 Mayak, 384 Sellafield, due to truncated follow-up in the incidence analysis). Analyses were performed using Poisson regression models, and were based on doses derived from individual radiation monitoring data using an updated dose assessment methodology developed in the study. There was clear evidence of a linear association between cumulative internal plutonium lung dose and risk of both lung cancer mortality and incidence in the pooled cohort. The pooled point estimates of the excess relative risk (ERR) from plutonium exposure for both lung cancer mortality and incidence were within the range of 5-8 per Gy for males at age 60. The ERR estimates in relationship to external gamma radiation were also significantly raised and in the range 0.2-0.4 per Gy of cumulative gamma dose to the lung. The point estimates of risk, for both external and plutonium exposure, were comparable between the cohorts, which suggests that the pooling of these data was valid. The results support point estimates of relative biological effectiveness (RBE) in the range of 10-25, which is in broad agreement with the value of 20 currently adopted in radiological protection as the radiation weighting factor for alpha particles, however, the uncertainty on this value (RBE = 21; 95% CI: 9-178) is large. The results provide direct evidence that the plutonium risks in each cohort are of the same order of magnitude but the uncertainty on the Sellafield cohort plutonium risk estimates is large, with observed risks consistent with no plutonium risk, and risks five times larger than those observed in the Mayak cohort.

Long-term health outcomes of work-related injuries among construction workers--findings from the National Longitudinal Survey of Youth.

PubMed

Dong, Xiuwen Sue; Wang, Xuanwen; Largay, Julie A; Sokas, Rosemary

2015-03-01

This study examined the relationship between work-related injuries and health outcomes among a cohort of blue-collar construction workers. Data were from the National Longitudinal Survey of Youth, 1979 cohort (NLSY79; n = 12,686). A range of health outcomes among blue-collar construction workers (n = 1,435) were measured when they turned age 40 (1998-2006) and stratified by these workers' prior work-related injury status between 1988 and 2000. Univariate and multivariate analyses were conducted to measure differences among subgroups. About 38% of the construction cohort reported injuries resulting in days away from work (DAFW); another 15% were injured but reported no DAFW (NDAFW). At age 40, an average of 10 years after injury, those with DAFW injury had worse self-reported general health and mental health, and more diagnosed conditions and functional limitations than those without injury. This difference was statistically significant after controlling for major demographics. Adverse health effects from occupational injury among construction workers persist longer than previously documented. © 2015 Wiley Periodicals, Inc.

Effect of occupational exposure to vapors, gases, dusts, and fumes on COPD mortality risk among Swedish construction workers: a longitudinal cohort study.

PubMed

Torén, Kjell; Järvholm, Bengt

2014-05-01

The aim of the present study was to elucidate whether occupational exposure to vapors, gases, dusts, and fumes increases the mortality risk of COPD, especially among never smokers. The study population was a cohort of 354,718 male construction workers; of these, 196,329 were exposed to vapors, gases, dusts, and fumes, and 117,964 were unexposed. Exposure to inorganic dust, wood dust, vapors, fumes, gases, and irritants was based on a job-exposure matrix with a focus on exposure in the mid-1970s. The cohort was followed from 1971 to 2011. Relative risks (RRs) were obtained using Poisson regression models adjusting for age, BMI, and smoking habits. There were 1,085 deaths from COPD among the exposed workers, including 49 never smokers. Workers with any occupational exposure to vapors, gases, fumes, and dust showed an increased mortality due to COPD (RR, 1.32; 95% CI, 1.18-1.47). When comparing different exposure groups, there was a significantly increased mortality due to COPD among those exposed to fumes (RR, 1.20; 95% CI, 1.07-1.36) and inorganic dust (RR, 1.19; 95% CI ,1.07-1.33). Among never smokers, there was high mortality due to COPD among workers with any occupational airborne exposure (RR, 2.11; 95% CI, 1.17-3.83). The fraction of COPD attributable to occupational exposure was 0.24 among all workers and 0.53 among never-smoking workers. Occupational exposure to airborne pollution increases the mortality risk for COPD, especially among never smokers.

The Effect of Self-Efficacy on Return-to-Work Outcomes for Workers with Psychological or Upper-Body Musculoskeletal Injuries: A Review of the Literature.

PubMed

Black, Oliver; Keegel, Tessa; Sim, Malcolm R; Collie, Alexander; Smith, Peter

2018-03-01

Purpose Work absence can result in substantial losses to the economy and workers. As a result, identifying modifiable factors associated with return-to-work (RTW) following an injury or illness is the focus of many empirical investigations. Self-efficacy, the belief about one's ability to undertake behaviours to achieve desired goals, has been identified as an important factor in RTW for injured workers. This paper systematically reviewed the literature on the association between self-efficacy and RTW outcomes for workers with an upper-body musculoskeletal injury or psychological injury. Methods A systematic search was conducted across five databases using two main search concepts- 'self-efficacy' and 'RTW'. After removing duplicates, our search strategy identified 836 studies, which were screened for relevance using titles and abstracts. Results A two stage screening process reduced the study pool to six studies using psychological injury cohorts and three using upper-body musculoskeletal (UB-MSK) cohorts. Eight cohorts from seven prospective cohort studies and one sample from a randomised control trial (RCT) were subjected to a risk of bias assessment. Higher levels of self-efficacy appeared to have a consistent and positive association with RTW across return-to-work status and work absence outcomes, injury type and follow-up periods. Effect ratios ranged from 1.00 to 5.26 indicating a potentially large impact of self-efficacy on RTW outcomes. The relationship between self-efficacy and RTW strengthened as the domain of self-efficacy became more specific to RTW and job behaviours. Studies assessing workers with psychological injuries were of a lower quality compared to those assessing workers with UB-MSK injuries. Conclusions Higher self-efficacy had consistent positive associations with RTW outcomes. Further empirical research should identify the determinants of self-efficacy, and explore the processes by which higher self-efficacy improves RTW outcomes.

Mortality among aircraft manufacturing workers

PubMed Central

Boice, J. D.; Marano, D. E.; Fryzek, J. P.; Sadler, C. J.; McLaughlin, J. K.

1999-01-01

OBJECTIVES: To evaluate the risk of cancer and other diseases among workers engaged in aircraft manufacturing and potentially exposed to compounds containing chromate, trichloroethylene (TCE), perchloroethylene (PCE), and mixed solvents. METHODS: A retrospective cohort mortality study was conducted of workers employed for at least 1 year at a large aircraft manufacturing facility in California on or after 1 January 1960. The mortality experience of these workers was determined by examination of national, state, and company records to the end of 1996. Standardised mortality ratios (SMRs) were evaluated comparing the observed numbers of deaths among workers with those expected in the general population adjusting for age, sex, race, and calendar year. The SMRs for 40 cause of death categories were computed for the total cohort and for subgroups defined by sex, race, position in the factory, work duration, year of first employment, latency, and broad occupational groups. Factory job titles were classified as to likely use of chemicals, and internal Poisson regression analyses were used to compute mortality risk ratios for categories of years of exposure to chromate, TCE, PCE, and mixed solvents, with unexposed factory workers serving as referents. RESULTS: The study cohort comprised 77,965 workers who accrued nearly 1.9 million person-years of follow up (mean 24.2 years). Mortality follow up, estimated as 99% complete, showed that 20,236 workers had died by 31 December 1996, with cause of death obtained for 98%. Workers experienced low overall mortality (all causes of death SMR 0.83) and low cancer mortality (SMR 0.90). No significant increases in risk were found for any of the 40 specific cause of death categories, whereas for several causes the numbers of deaths were significantly below expectation. Analyses by occupational group and specific job titles showed no remarkable mortality patterns. Factory workers estimated to have been routinely exposed to chromate were not at increased risk of total cancer (SMR 0.93) or of lung cancer (SMR 1.02). Workers routinely exposed to TCE, PCE, or a mixture of solvents also were not at increased risk of total cancer (SMRs 0.86, 1.07, and 0.89, respectively), and the numbers of deaths for specific cancer sites were close to expected values. Slight to moderately increased rates of non-Hodgkin's lymphoma were found among workers exposed to TCE or PCE, but none was significant. A significant increase in testicular cancer was found among those with exposure to mixed solvents, but the excess was based on only six deaths and could not be linked to any particular solvent or job activity. Internal cohort analyses showed no significant trends of increased risk for any cancer with increasing years of exposure to chromate or solvents. CONCLUSIONS: The results from this large scale cohort study of workers followed up for over 3 decades provide no clear evidence that occupational exposures at the aircraft manufacturing factory resulted in increases in the risk of death from cancer or other diseases. Our findings support previous studies of aircraft workers in which cancer risks were generally at or below expected levels.   PMID:10615290

Mortality among aircraft manufacturing workers.

PubMed

Boice, J D; Marano, D E; Fryzek, J P; Sadler, C J; McLaughlin, J K

1999-09-01

To evaluate the risk of cancer and other diseases among workers engaged in aircraft manufacturing and potentially exposed to compounds containing chromate, trichloroethylene (TCE), perchloroethylene (PCE), and mixed solvents. A retrospective cohort mortality study was conducted of workers employed for at least 1 year at a large aircraft manufacturing facility in California on or after 1 January 1960. The mortality experience of these workers was determined by examination of national, state, and company records to the end of 1996. Standardised mortality ratios (SMRs) were evaluated comparing the observed numbers of deaths among workers with those expected in the general population adjusting for age, sex, race, and calendar year. The SMRs for 40 cause of death categories were computed for the total cohort and for subgroups defined by sex, race, position in the factory, work duration, year of first employment, latency, and broad occupational groups. Factory job titles were classified as to likely use of chemicals, and internal Poisson regression analyses were used to compute mortality risk ratios for categories of years of exposure to chromate, TCE, PCE, and mixed solvents, with unexposed factory workers serving as referents. The study cohort comprised 77,965 workers who accrued nearly 1.9 million person-years of follow up (mean 24.2 years). Mortality follow up, estimated as 99% complete, showed that 20,236 workers had died by 31 December 1996, with cause of death obtained for 98%. Workers experienced low overall mortality (all causes of death SMR 0.83) and low cancer mortality (SMR 0.90). No significant increases in risk were found for any of the 40 specific cause of death categories, whereas for several causes the numbers of deaths were significantly below expectation. Analyses by occupational group and specific job titles showed no remarkable mortality patterns. Factory workers estimated to have been routinely exposed to chromate were not at increased risk of total cancer (SMR 0.93) or of lung cancer (SMR 1.02). Workers routinely exposed to TCE, PCE, or a mixture of solvents also were not at increased risk of total cancer (SMRs 0.86, 1.07, and 0.89, respectively), and the numbers of deaths for specific cancer sites were close to expected values. Slight to moderately increased rates of non-Hodgkin's lymphoma were found among workers exposed to TCE or PCE, but none was significant. A significant increase in testicular cancer was found among those with exposure to mixed solvents, but the excess was based on only six deaths and could not be linked to any particular solvent or job activity. Internal cohort analyses showed no significant trends of increased risk for any cancer with increasing years of exposure to chromate or solvents. The results from this large scale cohort study of workers followed up for over 3 decades provide no clear evidence that occupational exposures at the aircraft manufacturing factory resulted in increases in the risk of death from cancer or other diseases. Our findings support previous studies of aircraft workers in which cancer risks were generally at or below expected levels.

Reported vague symptoms and at-risk status: the case of polyvinyl chloride workers in Louisville.

PubMed Central

Sands, R G; Greenberg, R A

1987-01-01

This study concerns the frequency of visits to the dispensary by workers with vague symptoms of physical illness at a polyvinyl chloride plant in Louisville, KY, where an outbreak of hepatic angiosarcoma occurred. The illness behavior of three cohorts of workers at three levels of risk--workers removed from the chemical plant to a pallet plant (PP) because their screening results indicated liver abnormalities; workers who had some positive test results (TP); and workers whose test results were negative (TN)--was studied before (time 1) and after (time 2) the angiosarcoma crisis. It was predicted that, during time 2, the groups' visits to the dispensary would increase in relation to their levels of risk (PP greater than TP greater than TN). Although there was an overall increase in the percentage of visits because of vague symptoms during time 2, the only cohort with different behavior was the group of TP workers: they reduced their use of the dispensary. These results are similar to those in a previous study in which all symptoms of illness were included. It is speculated that social and individual factors, as well as the labeling phenomenon, explain the results. Health care providers are encouraged to follow up with workers at risk who seem to avoid monitoring their health. PMID:3112857

Chronic Lymphocytic Leukemia in Chornobyl Cleanup Workers.

PubMed

Bazyka, Dimitry; Gudzenko, Natalya; Dyagil, Iryna; Goroh, Eugeny; Polyschuk, Oksana; Trotsuk, Natalya; Babkina, Nataly; Romanenko, Anatoly

2016-08-01

This paper describes the chronic lymphocytic leukemia (CLL) incidence in a cohort of 110,645 (enlarged later to 152,520) male Ukrainian cleanup workers of the Chornobyl (Chernobyl) accident who were exposed to a range of radiation doses over the 1986-1990 time period. The standardized incidence rates are presented for a 27-y period after the exposure. For 2007-2012 period, the authors have identified the incident CLL cases in an enlarged cohort of 152,520 persons by linkage of the cohort file with the Ukrainian National Cancer Registry (NCRU). CLL data for the previous period (1987-2006) were identified in a frame of the Ukrainian-American leukemia study in the original cohort of 110,645 male clean-up workers. A significant CLL incidence excess was shown for the entire study period 1987-2012, with more prominent levels for the earliest years (1987-1996) when the standardized incidence rate (SIR) value was estimated to be 3.61 with 95% confidence interval from 2.32 to 4.91. In 2007-2012, the CLL incidence decreased substantially but still exceeded the national level although not significantly. In parallel, the several studies were performed at the National Research Center for Radiation Medicine (NRCRM) to explore if any clinical and cytogenetic features of CLL existed in the clean-up workers. The clinical study included 80 exposed and 70 unexposed CLL cases. Among the major clinical differences of the CLL course in the clean-up workers were a shorter period of white blood cells (WBC) doubling (10.7 vs. 18.0; p<0.001), frequent infectious episodes, lymphoadenopathy and hepatosplenomegaly (37 vs. 16), higher expression for CD38, and lower expression for ZAP-70 antigen.

Respiratory health of two cohorts of terminal grain elevator workers studied 30 years apart.

PubMed

Dimich-Ward, Helen; Beking, Kris J; Dybuncio, Anne; Bartlett, Karen H; Karlen, Barbara J; Chow, Yat; Chan-Yeung, Moira

2011-04-01

We evaluated the respiratory health of two cohorts of grain terminal elevator workers who participated in one of either respiratory health surveys undertaken in 1978 and 2008. Questionnaire and spirometry data from 584 workers from the 1978 survey and 215 workers from the 2008 survey were compared using logistic regression and general linear modeling. The geometric means of area samples of grain dust averaged 8.28 mg/m(3) in 1978 and 2.06 mg/m(3) in 2008. Workers in the 1978 survey had a significantly higher prevalence of respiratory symptoms (with the largest adjusted odds ratio of 3.78, 95% CI 2.07-7.25, for shortness of breath), a lower prevalence of atopic conditions and lower mean lung function. Current grain workers had a lower risk of respiratory health consequences and a greater prevalence of atopic conditions than workers surveyed 30 years prior, most likely associated with reduced exposure to grain dust in the terminal elevator environment. Copyright © 2010 Wiley-Liss, Inc.

Leukemia risk associated with chronic external exposure to ionizing radiation in a French cohort of nuclear workers.

PubMed

Metz-Flamant, C; Samson, E; Caër-Lorho, S; Acker, A; Laurier, D

2012-11-01

Leukemia is one of the earliest cancer effects observed after acute exposure to relatively high doses of ionizing radiation. Leukemia mortality after external exposure at low doses and low-dose rates has been investigated at the French Atomic Energy Commission (CEA) and Nuclear Fuel Company (AREVA NC) after an additional follow-up of 10 years. The cohort included radiation-monitored workers employed for at least one year during 1950-1994 at CEA or AREVA NC and followed during 1968-2004. Association between external exposure and leukemia mortality was estimated with excess relative risk (ERR) models and time-dependent modifying factors were investigated with time windows. The cohort included 36,769 workers, followed for an average of 28 years, among whom 73 leukemia deaths occurred. Among the workers with a positive recorded dose, the mean cumulative external dose was 21.7 mSv. Results under a 2-year lag assumption suggested that the risk of leukemia (except chronic lymphatic leukemia) increased significantly by 8% per 10 mSv. The magnitude of the association for myeloid leukemia was larger. The higher ERR/Sv for doses received 2-14 years earlier suggest that time since exposure modifies the effect. The ERR/Sv also appeared higher for doses received at exposure rates ≥20 mSv per year. These results are consistent with those found in other studies of nuclear workers. However, confidence intervals are still wide. Further analyses should be conducted in pooled cohorts of nuclear workers.

Reducing healthy worker survivor bias by restricting date of hire in a cohort study of Vermont granite workers

PubMed Central

Applebaum, Katie M; Malloy, Elizabeth J; Eisen, Ellen A

2007-01-01

Objective To explore the healthy worker survivor effect (HWSE) in a study of Vermont granite workers by distinguishing “prevalent” from “incident” hires based on date of hire before or after the start of follow‐up. Methods Records of workers between 1950 and 1982 were obtained from a medical surveillance programme. Proportional hazards models were used to model the association between silica exposure and lung cancer mortality, with penalised splines used to smooth the exposure‐response relationship. A sensitivity analysis compared results between the original cohort and subcohorts defined by restricting date of hire to include varying proportions of prevalent hires. Results Restricting to incident hires reduced the 213 cases by 74% and decreased the exposure range. The maximum mortality rate ratio (MRR) was close to twofold in all subcohorts. However, the exposure at which the maximum MRR was achieved decreased from 4.0 to 0.6 mg‐year/m3 as the proportion of prevalent hires decreased from 50% in the original cohort to 0% in the subcohort of incident hires. Conclusion Despite loss in power and restricted exposure range, decreasing the relative proportion of prevalent to incident hires reduced HWSE bias, resulting in stronger evidence for a dose‐response between silica exposure and lung cancer mortality. PMID:17449560

Risk of sarcoidosis and seropositive rheumatoid arthritis from occupational silica exposure in Swedish iron foundries: a retrospective cohort study.

PubMed

Vihlborg, Per; Bryngelsson, Ing-Liss; Andersson, Lena; Graff, Pål

2017-07-20

To study the impact of occupational silica exposure on the incidence rates of sarcoidosis and rheumatoid arthritis (RA) in a cohort of exposed workers in Swedish iron foundries. The prevalence of sarcoidosis and RA in a cohort of silica exposed workers was compared with the prevalence in the general Swedish population in this register study. A mixed model was used to calculate silica exposure, and individual silica exposures were used to compute dose responses. Personnel records from 10 iron foundries were used to identify workers whose employment began before 2005 which was then linked to the national non-primary outpatient visits register. The final cohort consisted of 2187 silica-exposed male workers who had been employed for at least 1 year and were still alive without having emigrated when the follow-up study began. The cohort's employment period covers 23 807 person-years at risk. The presented results indicate that moderate to high levels of silica exposure increase risks for sarcoidosis and seropositive RA. Mean levels of airborne silica dust in the foundries decreased significantly between the 1970s and 2000s. Incidence rates of sarcoidosis (3.94; 95% CI 1.07 to 10.08) and seropositive RA (2.59; 95% CI 1.24 to 4.76) were significantly higher among highly exposed individuals. Our results reveal increased risks for sarcoidosis and seropositive RA among individuals with high exposure to silica dust (>0.048 mg/m 3 ) compared with non-exposed and less-exposed groups. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Unusual mortality pattern among short term workers in the perfumery industry in Geneva.

PubMed Central

Gubéran, E; Usel, M

1987-01-01

A cohort of 537 workers employed for less than one year between 1900 and 1964 in the Geneva perfumery industry was followed up from entry to the end of 1983. During the period of study, 251 workers died and 41 (8%) were lost to follow up. The standardised mortality ratio (SMR) was significantly above 100 for all causes (SMR = 120), all cancers (SMR = 127), lung cancer (SMR = 186), and violent death (SMR = 179). The highest SMR from all causes was associated with the shortest period of employment (less than two months) and it decreased significantly with longer duration. Such mortality excesses had not been recorded among the 1168 workers of the same industry employed one year or more, previously studied in similar fashion. Interviews among a random sample of 52 workers employed for less than two months seem to indicate that the prevalence of smoking, exposures to asbestos, and occupational accidents in other hazardous industries were higher for these workers than for the reference population. Furthermore, unmarried men were overrepresented among the study cohort. These findings support previous observations indicating that short term workers share atypical features related to high mortality from various causes. It is suggested that mortality in this subgroup should be analysed separately in occupational studies. PMID:3663526

Mortality in a Combined Cohort of Uranium Enrichment Workers

PubMed Central

Yiin, James H.; Anderson, Jeri L.; Daniels, Robert D.; Bertke, Stephen J.; Fleming, Donald A.; Tollerud, David J.; Tseng, Chih-Yu; Chen, Pi-Hsueh; Waters, Kathleen M.

2017-01-01

Objective To examine the patterns of cause-specific mortality and relationship between internal exposure to uranium and specific causes in a pooled cohort of 29,303 workers employed at three former uranium enrichment facilities in the United States with follow-up through 2011. Methods Cause-specific standardized mortality ratios (SMRs) for the full cohort were calculated with the U.S. population as referent. Internal comparison of the dose-response relation between selected outcomes and estimated organ doses was evaluated using regression models. Results External comparison with the U.S. population showed significantly lower SMRs in most diseases in the pooled cohort. Internal comparison showed positive associations of absorbed organ doses with multiple myeloma, and to a lesser degree with kidney cancer. Conclusion In general, these gaseous diffusion plant workers had significantly lower SMRs than the U.S. population. The internal comparison however, showed associations between internal organ doses and diseases associated with uranium exposure in previous studies. PMID:27753121

Aragon workers' health study - design and cohort description

USDA-ARS?s Scientific Manuscript database

Spain, a Mediterranean country with relatively low rates of coronary heart disease, has a high prevalence of traditional cardiovascular risk factors and is experiencing a severe epidemic of overweight/obesity. We designed the Aragon Workers' Health Study (AWHS) to characterize the factors associated...

Young adult conservation jobs and worker health

Treesearch

Kathleen L. Wolf; Elizabeth Housley

2017-01-01

Decades of research studies demonstrate links between healthy environment, healthy lifestyles, and healthy people. This study evaluated the correlations between young adult conservation workers’ perceived stress, personal effectiveness, and nature experience using quantitative and qualitative social science methods. The study cohort numbered nearly 300 individuals...

Study protocol title: a prospective cohort study of low back pain

PubMed Central

2013-01-01

Background Few prospective cohort studies of workplace low back pain (LBP) with quantified job physical exposure have been performed. There are few prospective epidemiological studies for LBP occupational risk factors and reported data generally have few adjustments for many personal and psychosocial factors. Methods/design A multi-center prospective cohort study has been incepted to quantify risk factors for LBP and potentially develop improved methods for designing and analyzing jobs. Due to the subjectivity of LBP, six measures of LBP are captured: 1) any LBP, 2) LBP ≥ 5/10 pain rating, 3) LBP with medication use, 4) LBP with healthcare provider visits, 5) LBP necessitating modified work duties and 6) LBP with lost work time. Workers have thus far been enrolled from 30 different employment settings in 4 diverse US states and performed widely varying work. At baseline, workers undergo laptop-administered questionnaires, structured interviews, and two standardized physical examinations to ascertain demographics, medical history, psychosocial factors, hobbies and physical activities, and current musculoskeletal disorders. All workers’ jobs are individually measured for physical factors and are videotaped. Workers are followed monthly for the development of low back pain. Changes in jobs necessitate re-measure and re-videotaping of job physical factors. The lifetime cumulative incidence of low back pain will also include those with a past history of low back pain. Incident cases will exclude prevalent cases at baseline. Statistical methods planned include survival analyses and logistic regression. Discussion Data analysis of a prospective cohort study of low back pain is underway and has successfully enrolled over 800 workers to date. PMID:23497211

Complete workplace indoor smoking ban and smoking behavior among male workers and female nonsmoking workers' husbands: a pseudo cohort study of Japanese public workers.

PubMed

Tabuchi, Takahiro; Hoshino, Takahiro; Hama, Hitomi; Nakata-Yamada, Kayo; Ito, Yuri; Ioka, Akiko; Nakayama, Tomio; Miyashiro, Isao; Tsukuma, Hideaki

2014-01-01

A pseudo cohort study using national cross-sections (2001, 2004, 2007, and 2010) was conducted to examine differences in smoking prevalence under different smoking ban policies such as a complete workplace indoor smoking ban (early or recent implementation) and a partial smoking ban among male public workers and husbands of female nonsmoking public workers. The effectiveness of smoking bans was estimated by difference-in-differences (DID) with age group stratification. The results varied considerably by age and implementation period. Although DID estimates (positive value of DID estimate represents smoking cessation percentage) for both smoking bans on total male smoking were not significant, the over-40 age group indicated a significant DID estimate of 5.0 (95% CI: 0.2, 9.8) for the recent smoking ban. For female workers' husbands' smoking, the over-40 age group indicated positive, but not significant, DID estimates for the early and recent smoking bans of 7.2 (-4.7, 19.2) and 8.4 (-2.0, 18.7), respectively. A complete indoor workplace smoking ban, particularly one recently implemented among public office workers aged over 40, may reduce male workers' smoking and female workers' husbands' smoking compared with a partial smoking ban, but the conclusion remains tentative because of methodological weaknesses in the study.

Complete Workplace Indoor Smoking Ban and Smoking Behavior among Male Workers and Female Nonsmoking Workers' Husbands: A Pseudo Cohort Study of Japanese Public Workers

PubMed Central

Hoshino, Takahiro; Hama, Hitomi; Nakata-Yamada, Kayo; Ito, Yuri; Ioka, Akiko; Nakayama, Tomio; Miyashiro, Isao; Tsukuma, Hideaki

2014-01-01

A pseudo cohort study using national cross-sections (2001, 2004, 2007, and 2010) was conducted to examine differences in smoking prevalence under different smoking ban policies such as a complete workplace indoor smoking ban (early or recent implementation) and a partial smoking ban among male public workers and husbands of female nonsmoking public workers. The effectiveness of smoking bans was estimated by difference-in-differences (DID) with age group stratification. The results varied considerably by age and implementation period. Although DID estimates (positive value of DID estimate represents smoking cessation percentage) for both smoking bans on total male smoking were not significant, the over-40 age group indicated a significant DID estimate of 5.0 (95% CI: 0.2, 9.8) for the recent smoking ban. For female workers' husbands' smoking, the over-40 age group indicated positive, but not significant, DID estimates for the early and recent smoking bans of 7.2 (−4.7, 19.2) and 8.4 (−2.0, 18.7), respectively. A complete indoor workplace smoking ban, particularly one recently implemented among public office workers aged over 40, may reduce male workers' smoking and female workers' husbands' smoking compared with a partial smoking ban, but the conclusion remains tentative because of methodological weaknesses in the study. PMID:24783199

Historic cohort study in Montreal's fur industry.

PubMed

Guay, D; Siemiatycki, J

1987-01-01

A historic cohort mortality study was carried out among two groups of male workers in the Montreal fur industry: 263 dressers and dyers and 599 fur garment manufacturers. The first group is exposed to a very wide variety of chemicals used in tanning, cleaning, and dyeing fur, including substances considered to be carcinogenic and/or mutagenic. The second group is exposed to residue from the dressing and dyeing stage and to respirable fur dust. The cohorts consisted of all active members of two unions as of January 1, 1966. The mean age of the workers was 43.2 and the mean number of years since first employment 14.1. The follow-up period was from January 1, 1966, to December 31, 1981; 95% of the workers were successfully traced. Observed deaths were compared with those expected based on mortality rates of the population of metropolitan Montreal. Standardized mortality ratios (SMRs) for the manufacturers were significantly low, probably because of the ethnic composition of the cohort and a healthy worker effect. SMRs for the dressers and dyers were also low, but not as low as for the manufacturers. When attention was restricted to the French Canadians in the cohort, the observed deaths were close to the expected; there was a noteworthy excess of colorectal cancer (four observed, 0.8 expected) for dressers and dyers. Apart from this weak suggestive evidence, the results did not indicate any excess mortality risks in the fur industry. However, because of the relatively small number of expected and observed deaths in the cohort and especially among the heavily exposed dressers and dyers, the confidence intervals around SMR estimates were wide and excess risks cannot be ruled out.

Cancer mortality risk among biology research workers in France: first results of two retrospective cohorts studies.

PubMed

Guseva Canu, Irina; Rogel, Agnès; Samson, Eric; Benhamou, Simone; Laplanche, Agnès; Tirmarche, Margot

2008-05-01

To investigate all-cause and cancer mortality of biological research laboratories workers of the French Atomic Energy Commission (CEA) and the National Institute of Health and Medical Research (INSERM). Two cohorts, bioCEA (N = 3,509) and bioINSERM (N = 4,966) were followed from 1968 to 1994 and 1980 to 1993, respectively. The mortality of each cohort was compared with that of the French population by computation of the standardized mortality ratio (SMR) with their 90% confidence interval (90% CI). Trend and heterogeneity tests were computed in order to study SMRs variation by job characteristics. In the bioCEA cohort individual dosimetry data being available, a trend test was also computed according to ionizing radiation cumulative dose. The SMRs were significantly below one in both cohorts for all-cause mortality (bioCEA: SMR = 0.52 [0.46-0.59], bioINSERM: SMR = 0.56 [0.46-0.67]) and for all-cancer mortality (bioCEA: SMR = 0.66 [0.54-0.80], bioINSERM: SMR = 0.55 [0.39-0.75]). There were some specific cancer sites for which the SMR was higher than 1, but not significantly. In the bioCEA cohort a positive trend was observed between ionizing radiation cumulative doses and all-cause as well as all-cancer SMRs. This study on two French cohorts of biological research workers found a favorable mortality pattern. These findings are consistent with recent publications. The positive trend of cancer mortality according to ionizing radiation exposure among bioCEA cohort needs to be confirmed with more precise assessment of exposures and information on individual risk factors.

Methodological, political and legal issues in the assessment of the effects of nanotechnology on human health.

PubMed

Guseva Canu, Irina; Schulte, Paul A; Riediker, Michael; Fatkhutdinova, Liliya; Bergamaschi, Enrico

2018-02-01

Engineered nanomaterials (ENMs) raise questions among the scientific community and public health authorities about their potential risks to human health. Studying a prospective cohort of workers exposed to ENMs would be considered the gold standard for identifying potential health effects of nanotechnology and confirming the 'no effect' levels derived from cellular and animal models. However, because only small, cross-sectional studies have been conducted in the past 5 years, questions remain about the health risks of ENMs. This essay addresses the scientific, methodological, political and regulatory issues that make epidemiological research in nanotechnology-exposed communities particularly complex. Scientific challenges include the array of physicochemical parameters and ENM production conditions, the lack of universally accepted definitions of ENMs and nanotechnology workers, and the lack of information about modes of action, target organs and likely dose-response functions of ENMs. Standardisation of data collection and harmonisation of research protocols are needed to eliminate misclassification of exposures and health effects. Forming ENM worker cohorts from a combination of smaller cohorts and overcoming selection bias are also challenges. National or international registries for monitoring the exposures and health of ENM workers would be helpful for epidemiological studies, but the creation of such a registry and ENM worker cohorts will require political support and dedicated funding at the national and international levels. Public authorities and health agencies should consider carrying out an ENM awareness campaign to educate and engage all stakeholders and concerned communities in discussion of such a project. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The WISTAH hand study: A prospective cohort study of distal upper extremity musculoskeletal disorders

PubMed Central

2012-01-01

Background Few prospective cohort studies of distal upper extremity musculoskeletal disorders have been performed. Past studies have provided somewhat conflicting evidence for occupational risk factors and have largely reported data without adjustments for many personal and psychosocial factors. Methods/design A multi-center prospective cohort study was incepted to quantify risk factors for distal upper extremity musculoskeletal disorders and potentially develop improved methods for analyzing jobs. Disorders to analyze included carpal tunnel syndrome, lateral epicondylalgia, medial epicondylalgia, trigger digit, deQuervain’s stenosing tenosynovitis and other tendinoses. Workers have thus far been enrolled from 17 different employment settings in 3 diverse US states and performed widely varying work. At baseline, workers undergo laptop administered questionnaires, structured interviews, two standardized physical examinations and nerve conduction studies to ascertain demographic, medical history, psychosocial factors and current musculoskeletal disorders. All workers’ jobs are individually measured for physical factors and are videotaped. Workers are followed monthly for the development of musculoskeletal disorders. Repeat nerve conduction studies are performed for those with symptoms of tingling and numbness in the prior six months. Changes in jobs necessitate re-measure and re-videotaping of job physical factors. Case definitions have been established. Point prevalence of carpal tunnel syndrome is a combination of paraesthesias in at least two median nerve-served digits plus an abnormal nerve conduction study at baseline. The lifetime cumulative incidence of carpal tunnel syndrome will also include those with a past history of carpal tunnel syndrome. Incident cases will exclude those with either a past history or prevalent cases at baseline. Statistical methods planned include survival analyses and logistic regression. Discussion A prospective cohort study of distal upper extremity musculoskeletal disorders is underway and has successfully enrolled over 1,000 workers to date. PMID:22672216

Two industrial cohorts: baseline characteristics and factors associated with obesity.

PubMed

Ott, Ulrike; Stanford, Joseph B; Thiese, Matthew S; Murtaugh, Maureen A; Greenwood, Jessica L J; Gren, Lisa H; Garg, Arun; Hegmann, Kurt T

2015-05-01

To describe demographic and health characteristics, and factors associated with obesity among production workers. This cross-sectional study analyzed baseline data from two occupational cohorts. Regression modeling was used to assess associations between worker characteristics and obesity. A total of 1974 subjects were included in these analyses. The mean body mass index was 29.5 kg/m (SD = 6.5). Having smoked in the past and currently smoking decreased the odds of being obese in the WISTAH Distal Upper Extremity cohort, whereas those feeling depressed had increased odds of being obese. Being a Pacific Islander/Native Hawaiian and married increased the odds of obesity in the BackWorks Low Back Pain cohort. Factors associated with obesity differed substantially between the two cohorts. Recognizing factors associated with obesity in specific work settings may provide opportunities for optimizing preventive workplace interventions.

Shared and unshared exposure measurement error in occupational cohort studies and their effects on statistical inference in proportional hazards models.

PubMed

Hoffmann, Sabine; Laurier, Dominique; Rage, Estelle; Guihenneuc, Chantal; Ancelet, Sophie

2018-01-01

Exposure measurement error represents one of the most important sources of uncertainty in epidemiology. When exposure uncertainty is not or only poorly accounted for, it can lead to biased risk estimates and a distortion of the shape of the exposure-response relationship. In occupational cohort studies, the time-dependent nature of exposure and changes in the method of exposure assessment may create complex error structures. When a method of group-level exposure assessment is used, individual worker practices and the imprecision of the instrument used to measure the average exposure for a group of workers may give rise to errors that are shared between workers, within workers or both. In contrast to unshared measurement error, the effects of shared errors remain largely unknown. Moreover, exposure uncertainty and magnitude of exposure are typically highest for the earliest years of exposure. We conduct a simulation study based on exposure data of the French cohort of uranium miners to compare the effects of shared and unshared exposure uncertainty on risk estimation and on the shape of the exposure-response curve in proportional hazards models. Our results indicate that uncertainty components shared within workers cause more bias in risk estimation and a more severe attenuation of the exposure-response relationship than unshared exposure uncertainty or exposure uncertainty shared between individuals. These findings underline the importance of careful characterisation and modeling of exposure uncertainty in observational studies.

Shared and unshared exposure measurement error in occupational cohort studies and their effects on statistical inference in proportional hazards models

PubMed Central

Laurier, Dominique; Rage, Estelle

2018-01-01

Exposure measurement error represents one of the most important sources of uncertainty in epidemiology. When exposure uncertainty is not or only poorly accounted for, it can lead to biased risk estimates and a distortion of the shape of the exposure-response relationship. In occupational cohort studies, the time-dependent nature of exposure and changes in the method of exposure assessment may create complex error structures. When a method of group-level exposure assessment is used, individual worker practices and the imprecision of the instrument used to measure the average exposure for a group of workers may give rise to errors that are shared between workers, within workers or both. In contrast to unshared measurement error, the effects of shared errors remain largely unknown. Moreover, exposure uncertainty and magnitude of exposure are typically highest for the earliest years of exposure. We conduct a simulation study based on exposure data of the French cohort of uranium miners to compare the effects of shared and unshared exposure uncertainty on risk estimation and on the shape of the exposure-response curve in proportional hazards models. Our results indicate that uncertainty components shared within workers cause more bias in risk estimation and a more severe attenuation of the exposure-response relationship than unshared exposure uncertainty or exposure uncertainty shared between individuals. These findings underline the importance of careful characterisation and modeling of exposure uncertainty in observational studies. PMID:29408862

Comparison of cancer incidence between production and office workers at a shipyard in Korea: a retrospective cohort study from 1992 to 2005.

PubMed

Jeong, Kyoung-Sook; Kim, Yangho; Kim, Moon-Chan; Yoo, Cheol-In

2011-09-01

Cancer is a major concern in shipbuilding. Since 1970s, shipbuilding and repair has been a strategic industry in Korea, which has become currently the world's largest shipbuilding country. The aim of this study is to investigate the cancer incidence in shipyard workers in Korea. The cohort comprised 30,288 male employees (20,647 production workers and 9,641 office workers) ever employed between 1992 and 2005 in a shipyard in Korea. The authors compared the cancer incidence between the groups using the participants' hospital medical records and data received from Korea National Cancer Incidence Database and Korean National Statistical Office. The total number of cancers was 135 among office workers and 519 among production workers in the shipyard. The age-standardized cancer rates among office and production workers were 136.2 and 179.7 per 100,000 person-years, respectively. The standardized rate ratios for stomach cancer, liver cancer, and lung cancer in production workers compared with office workers were 1.67 (95% CI: 1.12-2.49), 2.13 (95% CI: 1.37-3.36), and 3.71 (95% CI: 1.68-8.19), respectively. The observed increase in stomach, liver, and lung cancers among production workers suggests that some occupational factors in the shipyard might have contributed to the increased cancer risk. Further study is needed to clarify the risk of those cancers and to identify the specific factors involved. Copyright © 2011 Wiley-Liss, Inc.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Steven A. Belinsky, PhD

The molecular mechanisms that result in the elevated risk for lung cancer associated with exposure to radiation have not been well characterized. Workers from the MAYAK nuclear enterprise are an ideal cohort in which to study the molecular epidemiology of cancer associated with radiation exposure and to identify the genes targeted for inactivation that in turn affect individual risk for radiation-induced lung cancer. Epidemiology studies of the MAYAK cohort indicate a significantly higher frequency for adenocarcinoma and squamous cell carcinoma (SCC) in workers than in a control population and a strong correlation between these tumor types and plutonium exposure. Twomore » hypotheses will be evaluated through the proposed studies. First, radiation exposure targets specific genes for inactivation by promoter methylation. This hypothesis is supported by our recent studies with the MAYAK population that demonstrated the targeting of the p16 gene for inactivation by promoter methylation in adenocarcinomas from workers (1). Second, genes inactivated in tumors can serve as biomarkers for lung cancer risk in a cancer-free population of workers exposed to plutonium. Support for this hypothesis is based on exciting preliminary results of our nested, case-control study of persons from the Colorado cohort. In that study, a panel of methylation markers for predicting lung cancer risk is being evaluated in sputum samples from incident lung cancer cases and controls. The first hypothesis will be tested by determining the prevalence for promoter hypermethylation of a panel of genes shown to play a critical role in the development of either adenocarcinoma and/or SCC associated with tobacco. Our initial studies on adenocarcinoma in MAYAK workers will be extended to evaluate methylation of the PAX5 {alpha}, PAX5 {beta}, H-cadherin, GATA5, and bone morphogenesis 3B (BMP3B) genes in the original sample set described under Preliminary studies. In addition, studies will be initiated in SCC from workers and controls to identify genes targeted for inactivation by plutonium in this other common histologic form of lung cancer. We will examine methylation of the p16, O{sup 6}-methylguanine-DNA methyl-transferase (MGMT), and death associated protein kinase genes ([DAP-K], evaluated previously in adenocarcinomas) as well as the new genes being assessed in the adenocarcinomas. The second hypothesis will be tested in a cross-sectional study of cancer-free workers exposed to plutonium and an unexposed population. A cohort of 700 cancer-free workers and 700 unexposed persons is being assembled, exposures are being defined, and induced sputum collected at initial entry into the study and approximately 1-year later. Exposed and unexposed persons will be matched by 5-year age intervals and smoking status (current and former). The frequency for methylation of four genes that show the greatest difference in prevalence in tumors from workers and controls will be determined in exfoliated cells within sputum. These studies will extend those in primary tumors to determine whether difference in prevalence for individual or multiple genes are detected in sputum samples from high-risk subjects exposed to plutonium. Follow-up of this cohort offers the opportunity to validate these endpoints and future biomarkers as true markers for lung cancer risk.« less

The risk of cryptorchidism among sons of women working in horticulture in Denmark: a cohort study.

PubMed

Gabel, Pernille; Jensen, Morten Søndergaard; Andersen, Helle Raun; Baelum, Jesper; Thulstrup, Ane Marie; Bonde, Jens Peter; Toft, Gunnar

2011-11-14

Androgens are crucial for normal testicular descent. Studies show that some pesticides have estrogenic or antiandrogenic effects, and that female workers exposed to pesticides have increased risk of having a boy with cryptorchidism. The main objective of the present study was to investigate whether pregnant women exposed to pesticides due to their work in horticulture experience excess risk of having sons with cryptorchidism. We conducted a cohort study of pregnant women working in horticulture using four cohorts including one cohort established with data from the departments of occupational medicine in Jutland and Funen and three existing mother-child cohorts (n=1,468). A reference group was established from the entire Danish population of boys born in the period of 1986-2007 (n=783,817). Nationwide Danish health registers provided information on birth outcome, cryptorchidism diagnosis and orchiopexy. The level of occupational exposure to pesticides was assessed by expert judgment blinded towards outcome status. Risk of cryptorchidism among exposed horticulture workers compared to the background population and to unexposed horticulture workers was assessed by Cox regression models. Pesticide exposed women employed in horticulture had a hazard ratio (HR) of having cryptorchid sons of 1.39 (95% CI 0.84; 2.31) and a HR of orchiopexy of 1.34 (0.72; 2.49) compared to the background population. Analysis divided into separate cohorts revealed a significantly increased risk of cryptorchidism in cohort 2: HR 2.58 (1.07;6.20) and increased risk of orchiopexy in cohort 4: HR 2.76 (1.03;7.35), but no significant associations in the other cohorts. Compared to unexposed women working in horticulture, pesticide exposed women had a risk of having sons with cryptorchidism of 1.34 (0.30; 5.96) and of orchiopexy of 1.93 (0.24;15.4). The data are compatible with a slightly increased risk of cryptorchidism in sons of women exposed to pesticides by working in horticulture.

The risk of cryptorchidism among sons of women working in horticulture in Denmark: a cohort study

PubMed Central

2011-01-01

Background Androgens are crucial for normal testicular descent. Studies show that some pesticides have estrogenic or antiandrogenic effects, and that female workers exposed to pesticides have increased risk of having a boy with cryptorchidism. The main objective of the present study was to investigate whether pregnant women exposed to pesticides due to their work in horticulture experience excess risk of having sons with cryptorchidism. Methods We conducted a cohort study of pregnant women working in horticulture using four cohorts including one cohort established with data from the departments of occupational medicine in Jutland and Funen and three existing mother-child cohorts (n = 1,468). A reference group was established from the entire Danish population of boys born in the period of 1986-2007 (n = 783,817). Nationwide Danish health registers provided information on birth outcome, cryptorchidism diagnosis and orchiopexy. The level of occupational exposure to pesticides was assessed by expert judgment blinded towards outcome status. Risk of cryptorchidism among exposed horticulture workers compared to the background population and to unexposed horticulture workers was assessed by Cox regression models. Results Pesticide exposed women employed in horticulture had a hazard ratio (HR) of having cryptorchid sons of 1.39 (95% CI 0.84; 2.31) and a HR of orchiopexy of 1.34 (0.72; 2.49) compared to the background population. Analysis divided into separate cohorts revealed a significantly increased risk of cryptorchidism in cohort 2: HR 2.58 (1.07;6.20) and increased risk of orchiopexy in cohort 4: HR 2.76 (1.03;7.35), but no significant associations in the other cohorts. Compared to unexposed women working in horticulture, pesticide exposed women had a risk of having sons with cryptorchidism of 1.34 (0.30; 5.96) and of orchiopexy of 1.93 (0.24;15.4). Conclusions The data are compatible with a slightly increased risk of cryptorchidism in sons of women exposed to pesticides by working in horticulture. PMID:22082298

Lung cancer among glass fibre production workers: a case-control study.

PubMed Central

Gardner, M J; Magnani, C; Pannett, B; Fletcher, A C; Winter, P D

1988-01-01

A cohort study among 4734 employees at an English glass fibre plant previously reported no excess of lung cancer mortality either overall or when examined in broad occupational groups. To investigate occupation in more detail, and to test the hypothesis that processes producing or using finer (respirable) fibres may be related to a higher risk of lung cancer, a nested case-control study has now been carried out. Included are 73 cases of lung cancer and 506 matched controls, for whom jobs held and processes worked on have been blindly recorded in more detail than for the cohort study. Workers known to have been employed on processes containing respirable fibres had a relative risk of lung cancer of 1.2 (95% confidence interval 0.7-2.0) compared with other workers. There was no evidence of a relationship of lung cancer to fibre diameter, duration of exposure, or time since first exposure. The results by broad occupational group were similar to those of the cohort study, and although some of the many detailed occupational categories examined had significantly raised relative risks, these did not appear to be related to exposure to respirable glass fibre. Although the study has not indicated a differential risk of lung cancer among workers exposed to finer diameter glass fibres, the exposure levels were low and the number of cases small. PMID:3179236

[Mortality study of asbestos cement workers in Emilia-Romagna].

PubMed

Luberto, Ferdinando; Amendola, Plinio; Belli, Stefano; Bruno, Caterina; Candela, Silvia; Grignoli, Mario; Comba, Pietro

2004-01-01

The present study updates to 06/30/1998 the cohort mortality study of 3358 workers employed in 10 asbestos cement production plants in the Italian region Emilia-Romagna. The cohort includes 2712 males and 646 females. Overall mortality was significantly increased (SMR=131, IC95%:108-127). Excess mortality has been observed for all malignant neoplasms (SMR=131, IC95%: 115-149, 250 observed) and for respiratory diseases (SMR=153, IC: 105-216, 32 observed), 3 deaths due to asbestosis. Mortality for all respiratory tract neoplasms (SMR=179, IC: 148-215, 114 observed), pulmonary cancer (SMR=157, IC: 126-192, 90 observed) and pleural cancer (SMR=1922, IC: 1139-3038, 18 observed) are significantly increased. This study confirms the previous cohort study observation of increased mortality for all causes, all neoplasm and cancer affecting lungs and pleura.

Proceedings of the Conference on Environmental Toxicology (10th) Held in Dayton, Ohio on 13, 14, and 15 November 1979

DTIC Science & Technology

1980-04-01

workers: 6023 workers from 5 fibrous glass manufacturing plants and 1026 workers from 3 mineral wool plants. The total study will include almost 17,000...mortality rates for respiratory cancer did not increase with in- creasing duration of employment. For one mineral wool plant, there were 3 respiratory...expected. Another recent study by Robinson et al. (1979), has reported on a cohort of 596 workers from just one of the mineral wool plants included

A reanalysis of cancer mortality in Canadian nuclear workers (1956-1994) based on revised exposure and cohort data.

PubMed

Zablotska, L B; Lane, R S D; Thompson, P A

2014-01-07

A 15-country study of nuclear workers reported significantly increased radiation-related risks of all cancers excluding leukaemia, with Canadian data a major factor behind the pooled results. We analysed mortality (1956-1994) in the updated Canadian cohort and provided revised risk estimates. Employment records were searched to verify and revise exposure data and to restore missing socioeconomic status. Excess relative risks per sievert (ERR/Sv) of recorded radiation dose and 95% confidence intervals (CIs) were estimated using Poisson regression. A significant heterogeneity of the dose-response for solid cancer was identified (P=0.02), with 3088 early (1956-1964) Atomic Energy of Canada Limited (AECL) workers having a significant increase (ERR/Sv=7.87, 95% CI: 1.88, 19.5), and no evidence of radiation risk for 42,228 workers employed by three nuclear power plant companies and post-1964 AECL (ERR/Sv=-1.20, 95% CI: <-1.47, 2.39). Radiation risks of leukaemia were negative in early AECL workers and non-significantly increased in other workers. In analyses with separate terms for tritium and gamma doses, there was no evidence of increased risk from tritium exposure. All workers had mortality lower than the general population. Significantly increased risks for early AECL workers are most likely due to incomplete transfer of AECL dose records to the National Dose Registry. Analyses of the remainder of the Canadian nuclear workers (93.2%) provided no evidence of increased risk, but the risk estimate was compatible with estimates that form the basis of radiation protection standards. Study findings suggest that the revised Canadian cohort, with the exclusion of early AECL workers, would likely have an important effect on the 15-country pooled risk estimate of radiation-related risks of all cancer excluding leukaemia by substantially reducing the size of the point estimate and its significance.

A reanalysis of cancer mortality in Canadian nuclear workers (1956–1994) based on revised exposure and cohort data

PubMed Central

Zablotska, L B; Lane, R S D; Thompson, P A

2014-01-01

Background: A 15-country study of nuclear workers reported significantly increased radiation-related risks of all cancers excluding leukaemia, with Canadian data a major factor behind the pooled results. We analysed mortality (1956–1994) in the updated Canadian cohort and provided revised risk estimates. Methods: Employment records were searched to verify and revise exposure data and to restore missing socioeconomic status. Excess relative risks per sievert (ERR/Sv) of recorded radiation dose and 95% confidence intervals (CIs) were estimated using Poisson regression. Results: A significant heterogeneity of the dose–response for solid cancer was identified (P=0.02), with 3088 early (1956–1964) Atomic Energy of Canada Limited (AECL) workers having a significant increase (ERR/Sv=7.87, 95% CI: 1.88, 19.5), and no evidence of radiation risk for 42 228 workers employed by three nuclear power plant companies and post-1964 AECL (ERR/Sv=−1.20, 95% CI: <−1.47, 2.39). Radiation risks of leukaemia were negative in early AECL workers and non-significantly increased in other workers. In analyses with separate terms for tritium and gamma doses, there was no evidence of increased risk from tritium exposure. All workers had mortality lower than the general population. Conclusion: Significantly increased risks for early AECL workers are most likely due to incomplete transfer of AECL dose records to the National Dose Registry. Analyses of the remainder of the Canadian nuclear workers (93.2%) provided no evidence of increased risk, but the risk estimate was compatible with estimates that form the basis of radiation protection standards. Study findings suggest that the revised Canadian cohort, with the exclusion of early AECL workers, would likely have an important effect on the 15-country pooled risk estimate of radiation-related risks of all cancer excluding leukaemia by substantially reducing the size of the point estimate and its significance. PMID:24231946

Long-term health experience of jet engine manufacturing workers: IX. further investigation of general mortality patterns in relation to workplace exposures.

PubMed

Youk, Ada O; Marsh, Gary M; Buchanich, Jeanine M; Downing, Sarah; Kennedy, Kathleen J; Esmen, Nurtan A; Hancock, Roger P; Lacey, Steven E

2013-06-01

To evaluate mortality rates among a cohort of jet engine manufacturing workers. Subjects were 222,123 workers employed from 1952 to 2001. Vital status was determined through 2004 for 99% of subjects and cause of death for 95% of 68,317 deaths. We computed standardized mortality ratios and modeled internal cohort rates. Mortality excesses reported initially no longer met the criteria for further investigation. We found two chronic obstructive pulmonary disease-related mortality excesses that met the criteria in two of eight study plants. At the total cohort level, chronic obstructive pulmonary disease-related categories were not related to any factors or occupational exposures considered. A full evaluation of these excesses was limited by lack of data on smoking history. Occupational exposures received outside of work or uncontrolled positive confounding by smoking cannot be ruled out as reasons for these excesses.

Mortality among Coast Guard Shipyard workers: A retrospective cohort study of specific exposures.

PubMed

Rusiecki, Jennifer; Stewart, Patricia; Lee, Dara; Alexander, Melannie; Krstev, Srmena; Silverman, Debra; Blair, Aaron

2018-01-02

In a previous analysis of a cohort of shipyard workers, we found excess mortality from all causes, lung cancer, and mesothelioma for longer work durations and in specific occupations. Here, we expand the previous analyses by evaluating mortality associated with 5 chemical exposures: asbestos, solvents, lead, oils/greases, and wood dust. Data were gathered retrospectively for 4,702 workers employed at the Coast Guard Shipyard, Baltimore, MD (1950-1964). The cohort was traced through 2001 for vital status. Associations between mortality and these 5 exposures were calculated via standardized mortality ratios (SMRs). We found all 5 substances to be independently associated with mortality from mesothelioma, cancer of the respiratory system, and lung cancer. Findings from efforts to evaluate solvents, lead, oils/greases, and wood dust in isolation of asbestos suggested that the excesses from these other exposures may be due to residual confounding from asbestos exposure.

Return to work outcomes for workers with mental health conditions: A retrospective cohort study.

PubMed

Prang, Khic-Houy; Bohensky, Megan; Smith, Peter; Collie, Alex

2016-01-01

The aims of this study were to describe predictors of sustained return to work (RTW) among a cohort of workers with compensated work-related mental health conditions (MHCs); and to examine predictors of subsequent absences due to the same condition. This study was a retrospective analysis of compensation claims data in Victoria, Australia. We selected workers with an accepted wage replacement claim due to a work-related MHC from 1 January 2002 to 31 December 2009, with two years of follow-up data. We identified 8358 workers meeting our inclusion criteria. The median age of workers was 44 years (Interquartile range (IQR): 36-51) and 56% were female. In a multivariable Cox regression analysis, older age, being from a small organisation, working in some specific industry segments, consulting a psychiatrist or psychologist, using medications, and having a previous claim were all associated with a delayed RTW. Workers experiencing work pressure, assault/workplace violence or other mental stress factors, working in the public administration and safety industry and having a medical incapacity certification between 3-4 days and 5-7 days had a higher rate of multiple RTW attempts. This study identified a number of risk factors associated with a delayed RTW and multiple attempts at RTW. Predictors may help identify high-risk groups and facilitate the RTW process of workers with MHCs. Copyright © 2015 Elsevier Ltd. All rights reserved.

Sedentary lifestyle and its relation to cardiovascular risk factors, insulin resistance and inflammatory profile

USDA-ARS?s Scientific Manuscript database

The objective of this study is to analyze the association between sitting time and biomarkers of insulin resistance and inflammation in a sample of healthy male workers. A cross-sectional study was carried out in a sample of 929 volunteers belonging to the Aragon Workers' Health Study cohort. Sociod...

Depression associated with alcohol intake and younger age in Japanese office workers: a case-control and a cohort study.

PubMed

Ogasawara, Kazuyoshi; Nakamura, Yukako; Aleksic, Branko; Yoshida, Keizo; Ando, Katsuhisa; Iwata, Nakao; Kayukawa, Yuhei; Ozaki, Norio

2011-01-01

Depression influences a worker's productivity and health substantially. Recently, the Japanese society and government reported that working overtime is one of the primary causes of depression and suicide in workers. However, only a few studies have investigated the relation between overtime hours and mental health status, and conclusions vary. In addition, prior findings are inconsistent in terms of the relation between depression and lifestyle factors, including alcohol intake and smoking. Additional studies are required to clarify the relation between possible risk factors and depression in Japanese workers. We performed a case-control and a cohort study. Subjects were office workers in four Japanese companies. Diagnosis of depression was made by two psychiatrists who conducted independent clinical interviews using DSM-IV-TR criteria. There was no significant association between working overtime and the onset of depression. The frequency of alcohol intake was significantly related to the onset of depression. We also found a significant relation between younger age and depression onset. Body mass index and physical illness, including diabetes mellitus, had no significant association with depression onset. Data were self-reported and the number of included female workers was small. Reducing working hours alone is unlikely to be effective in preventing workers' depression. Additional countermeasures are needed, including a reduction in alcohol intake and work stress. Considerations for younger workers are also needed. Copyright © 2010 Elsevier B.V. All rights reserved.

Healthy Worker Survivor Bias in the Colorado Plateau Uranium Miners Cohort

PubMed Central

Keil, Alexander P.; Richardson, David B.; Troester, Melissa A.

2015-01-01

Cohort mortality studies of underground miners have been used to estimate the number of lung cancer deaths attributable to radon exposure. However, previous studies of the radon–lung cancer association among underground miners may have been subject to healthy worker survivor bias, a type of time-varying confounding by employment status. We examined radon-mortality associations in a study of 4,124 male uranium miners from the Colorado Plateau who were followed from 1950 through 2005. We estimated the time ratio (relative change in median survival time) per 100 working level months (radon exposure averaging 130,000 mega-electron volts of potential α energy per liter of air, per working month) using G-estimation of structural nested models. After controlling for healthy worker survivor bias, the time ratio for lung cancer per 100 working level months was 1.168 (95% confidence interval: 1.152, 1.174). In an unadjusted model, the estimate was 1.102 (95% confidence interval: 1.099, 1.112)—39% lower. Controlling for this bias, we estimated that among 617 lung cancer deaths, 6,071 person-years of life were lost due to occupational radon exposure during follow-up. Our analysis suggests that healthy worker survivor bias in miner cohort studies can be substantial, warranting reexamination of current estimates of radon's estimated impact on lung cancer mortality. PMID:25837305

Predicting return to work after low back injury using the Psychosocial Risk for Occupational Disability Instrument: a validation study.

PubMed

Schultz, I Z; Crook, J; Berkowitz, J; Milner, R; Meloche, G R

2005-09-01

This paper reports on the predictive validity of a Psychosocial Risk for Occupational Disability Scale in the workers' compensation environment using a paper and pencil version of a previously validated multimethod instrument on a new, subacute sample of workers with low back pain. A cohort longitudinal study design with a randomly selected cohort off work for 4-6 weeks was applied. The questionnaire was completed by 111 eligible workers at 4-6 weeks following injury. Return to work status data at three months was obtained from 100 workers. Sixty-four workers had returned to work (RTW) and 36 had not (NRTW). Stepwise backward elimination resulted in a model with these predictors: Expectations of Recovery, SF-36 Vitality, SF-36 Mental Health, and Waddell Symptoms. The correct classification of RTW/NRTW was 79%, with sensitivity (NRTW) of 61% and specificity (RTW) of 89%. The area under the ROC curve was 84%. New evidence for predictive validity for the Psychosocial Risk-for-Disability Instrument was provided. The instrument can be useful and practical for prediction of return to work outcomes in the subacute stage after low back injury in the workers' compensation context.

Cancers in concrete workers: results of a cohort study of 33 668 workers

PubMed Central

Knutsson, A.; Damber, L.; Jarvholm, B.

2000-01-01

OBJECTIVES—To study cancer morbidity patterns in concrete workers.
METHODS—A cohort of 33 503 concrete workers was enrolled in the study from 1971-86. The average duration of follow up was 19.4 years (582 225 person-years). The workers' cancer morbidity was compared with the morbidity of the general population.
RESULTS—A total of 3572 incident cancers were observed. Significantly increased standardised incidence ratios (SIRs) were found for all malignant neoplasms (SIR 107; 95% confidence interval (95%CI) 103 to 110), cancer of the lip (SIR 179; 95%CI 134 to 234), cancer of the stomach (SIR 139; 95%CI 122 to 158), cancer of the lung (SIR 125; 95%CI 114 to 137), and cancer of the prostate (SIR 108; 95%CI 101 to 116). Reduced risk was found for cancer of the large intestine (SIR 80; 95%CI 69 to 93) and cancer of the testis (SIR 50; 95%CI 26 to 87). Smoking was more prevalent among the concrete workers than in the general population (50% v 35%).
CONCLUSION—The study has shown a slightly increased overall risk of cancer among concrete workers. The increased risk of lung cancer could entirely be due to differences in smoking habits between concrete workers and the general population. There is a possibility that the smoking also has contributed to the increased risks of stomach cancer and lip cancer, but occupational factors may have contributed to these cancer sites.


Keywords: occupational diseases; constructions workers; smoking PMID:10810113

Enduring Mental Health Morbidity and Social Function Impairment in World Trade Center Rescue, Recovery, and Cleanup Workers: The Psychological Dimension of an Environmental Health Disaster

PubMed Central

Stellman, Jeanne Mager; Smith, Rebecca P.; Katz, Craig L.; Sharma, Vansh; Charney, Dennis S.; Herbert, Robin; Moline, Jacqueline; Luft, Benjamin J.; Markowitz, Steven; Udasin, Iris; Harrison, Denise; Baron, Sherry; Landrigan, Philip J.; Levin, Stephen M.; Southwick, Steven

2008-01-01

Background The World Trade Center (WTC) attacks exposed thousands of workers to hazardous environmental conditions and psychological trauma. In 2002, to assess the health of these workers, Congress directed the National Institute for Occupational Safety and Health to establish the WTC Medical Monitoring and Treatment Program. This program has established a large cohort of WTC rescue, recovery, and cleanup workers. We previously documented extensive pulmonary dysfunction in this cohort related to toxic environmental exposures. Objectives Our objective in this study was to describe mental health outcomes, social function impairment, and psychiatric comorbidity in the WTC worker cohort, as well as perceived symptomatology in workers’ children. Methods Ten to 61 months after the WTC attack, 10,132 WTC workers completed a self-administered mental health questionnaire. Results Of the workers who completd the questionnaire, 11.1% met criteria for probable post-traumatic stress disorder (PTSD), 8.8% met criteria for probable depression, 5.0% met criteria for probable panic disorder, and 62% met criteria for substantial stress reaction. PTSD prevalence was comparable to that seen in returning Afghanistan war veterans and was much higher than in the U.S. general population. Point prevalence declined from 13.5% to 9.7% over the 5 years of observation. Comorbidity was extensive and included extremely high risks for impairment of social function. PTSD was significantly associated with loss of family members and friends, disruption of family, work, and social life, and higher rates of behavioral symptoms in children of workers. Conclusions Working in 9/11 recovery operations is associated with chronic impairment of mental health and social functioning. Psychological distress and psychopathology in WTC workers greatly exceed population norms. Surveillance and treatment programs continue to be needed. PMID:18795171

A cohort mortality study of lead-exposed workers in the USA, Finland and the UK.

PubMed

Steenland, Kyle; Barry, Vaughn; Anttila, Ahti; Sallmén, Markku; McElvenny, Damien; Todd, A C; Straif, Kurt

2017-11-01

To investigate further whether inorganic lead is a carcinogen among adults, or associated with increased blood pressure and kidney damage, via a large mortality study. We conducted internal analyses via Cox regression of mortality in three cohorts of lead-exposed workers with blood lead (BL) data (USA, Finland, UK), including over 88 000 workers and over 14 000 deaths. Our exposure metric was maximum BL. We also conducted external analyses using country-specific background rates. The combined cohort had a median BL of 26 µg/dL, a mean first-year BL test of 1990 and was 96% male. Fifty per cent had more than one BL test (mean 7). Significant (p<0.05) positive trends, using the log of each worker's maximum BL, were found for lung cancer, chronic obstructive pulmonary disease (COPD), stroke and heart disease, while borderline significant trends (0.05≤p≤0.10) were found for bladder cancer, brain cancer and larynx cancer. Most results were consistent across all three cohorts. In external comparisons, we found significantly elevated SMRs for those with BLs>40 µg/dL; for bladder, lung and larynx cancer; and for COPD. In a small subsample of the US cohort (n=115) who were interviewed, we found no association between smoking and BL. We found strong positive mortality trends, with increasing BL level, for several outcomes in internal analysis. Many of these outcomes are associated with smoking, for which we had no data. A borderline trend was found for brain cancer, not associated with smoking. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Surveillance of musculoskeletal injuries and disorders in a diverse cohort of workers at a tertiary care medical center.

PubMed

Pompeii, Lisa A; Lipscomb, Hester J; Dement, John M

2008-05-01

The purpose of this study was to investigate the incidence of work-related musculoskeletal (MSK) injuries and disorders among a dynamic cohort of health care workers, including direct care providers and support services, employed at a tertiary care medical center. Human resources data were used to define the cohort and time at risk. Workers' compensation (WC) records (1997-2003) were utilized to identify work-related MSK claims. Poisson regression was used to generate gender specific rate ratios and 95% confidence intervals (CI) of MSK injuries among workgroups. MSK injuries resulted equally ( approximately 30% each) from lift/push/pull of equipment, patient handling, and slip/trip/falls. Injury rates and their mechanisms varied substantially by occupational group, gender, and race. Even with declining injury rates over time, black workers had rates 2.5 times higher than other workers and women had rates 1.8 times higher than men. Male and female nurses' aides, housekeepers, and radiology technicians had among the highest rates of injury, while lost workdays rates were highest for male and female nurses' aides, female housekeepers, and male patient transporters. Differential risk associated with work tasks in highly segregated work populations can contribute to disparities in health, and the patterns we observed partly reflect the high concentration of female and black workers in occupations with increased physical demands. While the greatest public health impact will be achieved by implementing prevention strategies among large workgroups with high injury rates, public health efforts must not ignore smaller, often segregated, workgroups identified in this study as high risk. (c) 2008 Wiley-Liss, Inc.

Examining lung cancer risks across different industries and occupations in Ontario, Canada: the establishment of the Occupational Disease Surveillance System.

PubMed

Jung, James K H; Feinstein, Saul G; Palma Lazgare, Luis; Macleod, Jill S; Arrandale, Victoria H; McLeod, Christopher B; Peter, Alice; Demers, Paul A

2018-05-07

The Occupational Disease Surveillance System (ODSS) was established in Ontario, Canada by linking a cohort of workers with data created from Workplace Safety and Insurance Board (WSIB) claims to administrative health databases. The aim of this study was to use ODSS to identify high-risk industry and occupation groups for lung cancer in Ontario. Workers in the WSIB lost time claims database were linked to the Ontario Cancer Registry using subjects' health insurance numbers, name, sex, birthdate and death date (if applicable). Several occupations and industries known to be at increased risk were outlined a priori to examine whether ODSS could replicate these associations. Age-adjusted, sex-stratified Cox proportional hazard models compared the risk of lung cancer within one industry/occupation versus all other groups in the cohort. Workers with a lung cancer diagnosis prior to cohort entry were excluded for analysis, leaving 2 187 762 workers for analysis. During the 1983 to 2014 follow-up, 34 661 workers in the cohort were diagnosed with lung cancer. Among expected high-risk industries, elevated risks were observed among workers in quarries/sand pits and construction industries for both sexes, and among males in metal mines, iron foundries, non-metallic mineral products industries and transportation industries. Excess risk was also observed among occupations in drilling/blasting, other mining/quarrying, mineral ore treating, excavating/grading/paving, truck driving, painting, bus driving and construction. This current surveillance system identified several established high-risk groups for lung cancer and could be used for ongoing surveillance of occupational lung cancer in Ontario. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Risk factors for neck pain in office workers: a prospective study.

PubMed

Hush, Julia M; Maher, Chris G; Refshauge, Kathryn M

2006-10-25

Persisting neck pain is common in society. It has been reported that the prevalence of neck pain in office workers is much higher than in the general population. The costs to the worker, employer and society associated with work-related neck pain are known to be considerable and are escalating. The factors that place office workers at greater risk of developing neck pain are not understood. The aim of this study is to investigate the incidence and risk factors of work-related neck pain in Australian office workers. We will conduct a prospective cohort study. A cohort of office workers without neck pain will be followed over a 12 month period, after baseline measurement of potential risk factors. The categories of risk factors being evaluated are physical (cervical spine posture, range of movement, muscle endurance and exercise frequency), demographic (age, sex), work environment (sitting duration, frequency of breaks) and psychosocial (psychological distress and psychosocial work factors). Cox regression analysis will be used to identify risk factors associated with work-related neck pain, and will be expressed as hazard ratios with 95% confidence intervals. The data will also enable the incidence of neck pain in this population to be estimated. In addition to clarifying the magnitude of this occupational health problem these data could inform policy in workplaces and provide the basis for primary prevention of neck pain in office workers, targeting the identified risk factors.

Effects of a peer support programme for youth social services employees experiencing potentially traumatic events: a protocol for a prospective cohort study

PubMed Central

Guay, Stephane; Tremblay, Nicole; Goncalves, Jane; Bilodeau, Henriette; Geoffrion, Steve

2017-01-01

Introduction The use of peer support programmes to help workers experiencing potentially traumatic events (PTE) has increased in high-risk organisations in the last decades. However, the scientific evidence of its effectiveness is still very limited. This paper aims to describe the protocol of a prospective cohort study that assesses the efficacy of a peer support programme among youth social services employees exposed to a PTE at work on psychological well-being, work functioning and needs of support. Methods and analysis This is a mixed-methods prospective study that will examine workers' evolution four times over a 12-month period in Canada. This study involves: (1) quantitative data obtained through self-administrated questionnaires among 222 workers, and (2) qualitative in-depth interviews with a subsample of 45 workers. This study will compare findings from a cohort who received the support of a peer following a PTE (peer support–experimental protocol) as part of the experimental protocol of the Montreal Youth Social Services-University Institute (MYSS-UI), the second group of workers did not ask for the peer support (no peer support-experimental protocol) but was part of MYSS-UI, and the third group received standard organisational support from the Monteregie Youth Social Services (MYSS) (standard organisational protocol). Ethics and dissemination The protocol and informed consent form complied with the ethics guidelines of the MYSS-UI. The Research Ethics Board of MYSS-UI and MYSS reviewed and accepted the protocol as required. The results of the study will be published in peer-reviewed journals, presented at research and general public conferences, disseminated via a public report for the institute that funded the project and for all workers. Results of this study will influence decision making regarding intervention policies following PTE and peer support interventions may be expanded throughout the youth social services in Canada and worldwide. PMID:28647721

CASE-COHORT STUDY OF STYRENE EXPOSURE AND ISCHEMIC HEART DISEASE INVESTIGATORS

EPA Science Inventory

Investigators examined workers exposed to styrene while working in styrene-butadiene polymer manufacturing plants between 1943 and 1982. Workers who had died from ischemic heart disease were compared to a subgroup of all men employed in two styrene-butadiene polymer manufac...

Update of the mortality study of workers exposed to polychlorinated biphenyls (Pcbs) in two Italian capacitor manufacturing plants.

PubMed

Pesatori, Angela Cecilia; Grillo, P; Consonni, D; Caironi, M; Sampietro, G; Olivari, Leonella; Ghisleni, Silvia; Bertazzi, P A

2013-01-01

PCB carcinogenicity to humans is still controversial. Cohort mortality studies in PCB-exposed workers reported elevated risks for the following causes of death: liver, stomach, digestive, brain, prostate cancers and non-Hodgkin lymphoma. The purpose of this study was to update as of December 2006 the mortality experience of two Italian cohorts of workers employed in the manufacture of capacitors impregnated with PCBs. Age-gender-and calendar period adjusted Standardized Mortality Ratios (SMRs) and 95% Confidence Intervals (CI) were calculated using regional rates. Analyses by duration of employment and time since first employment were performed Results: Vital status was ascertained for 98.9% of the study subjects. Mortality from biliary tract cancer among males (SMR 3.91; 95%CI 1.47-10.41), digestive cancer "not otherwise specified" in the whole cohort (SMR 2.54; 95%CI 1.21-5.34), and brain cancer in Plant I (SMR 2.13; 95%CI 1.02-4.48), were significantly increased. Increased risks were also observed for Hodgkin's and non-Hodgkin lymphoma. No linear associations between mortality and duration of employment or latency were observed for these cancers. Mortality from stomach cancer did not differ from expectation in the whole cohort, however an increasing risk with increasing duration of employment was detected (p for trend=0.02). The current update suggests possibly increased cancer risks in PCB-exposed workers, affecting in particular the digestive system, brain, and lymphohemopoietic tissue. However the limited sample size, the lack of clear trends with duration of employment or with latency period, preclude to derive definite conclusions about PCB exposure and the increased cancer risks.

Long-term health experience of jet engine manufacturing workers: VIII. glioblastoma incidence in relation to workplace experiences with parts and processes.

PubMed

Marsh, Gary M; Youk, Ada O; Buchanich, Jeanine M; Downing, Sarah; Kennedy, Kathleen J; Esmen, Nurtan A; Hancock, Roger P; Lacey, Steven E; Pierce, Jennifer S; Fleissner, Mary Lou

2013-06-01

To determine whether glioblastoma (GB) incidence rates among jet engine manufacturing workers were associated with workplace experiences with specific parts produced and processes performed. Subjects were 210,784 workers employed between 1952 and 2001. We conducted nested case-control and cohort incidence studies with focus on 277 GB cases. We estimated time experienced with 16 part families, 4 process categories, and 32 concurrent part-process combinations with 20 or more GB cases. In both the cohort and case-control studies, none of the part families, process categories, or both considered was associated with increased GB risk. If not due to chance alone, the not statistically significantly elevated GB rates in the North Haven plant may reflect external occupational factors or nonoccupational factors unmeasured in the current evaluation.

A cohort study of mortality among Ontario pipe trades workers

PubMed Central

Finkelstein, M; Verma, D

2004-01-01

Aims: To study mortality in a cohort of members of the United Association of Journeymen and Apprentices of the Plumbing and Pipe Fitting Industry of the United States and Canada and to compare results with two previous proportional mortality studies. Methods: A cohort of 25 285 workers who entered the trade after 1949 was assembled from records of the international head office. Mortality was ascertained by linkage to the Canadian Mortality Registry at Statistics Canada. Standardised mortality ratios were computed using Ontario general population mortality rates as the reference. Results: There were significant increases in lung cancer mortality rates (SMR 1.27; 95% CI 1.13 to 1.42). Increased lung cancer risk was observed among plumbers, pipefitters, and sprinkler fitters. Increased risk was observed among workers joining the Union as late as the 1970s. A random effects meta-analysis of this study and the two PMR studies found significant increases in oesophageal (RR 1.24; 95% CI 1.00 to 1.53), lung (RR 1.31; 95% CI 1.19 to 1.44), and haematological/lymphatic (RR 1.21; 95% CI 1.08 to 1.35) malignancies. Conclusions: The mortality pattern is consistent with the effects of occupational exposure to asbestos. Increased risk due to other respiratory carcinogens such as welding fume cannot be excluded. There are substantial amounts of asbestos in place in industrial and commercial environments. The education and training of workers to protect themselves against inhalation hazards will be necessary well into the future. PMID:15317913

Cancer incidence in a cohort of asbestos-exposed workers undergoing health surveillance.

PubMed

Barbiero, Fabiano; Zanin, Tina; Pisa, Federica E; Casetta, Anica; Rosolen, Valentina; Giangreco, Manuela; Negro, Corrado; Bovenzi, Massimo; Barbone, Fabio

2018-06-05

To compare a local cohort of 2488 men occupationally exposed to asbestos and enrolled in a public health surveillance program with the 1995-2009 cancer incidence of the general population of Friuli Venezia Giulia (FVG) region, Northeast Italy, we conducted a historical cohort study. Standardized incidence ratios (SIRs), with 95% confidence interval (95% CI), for specific cancer sites were estimated in the cohort and in subgroups of workers employed in shipbuilding between 1974 and 1994. For internal comparisons, we calculated incidence rate ratios (IRRs) for all cancers, lung cancer and mesothelioma, by level of exposure to asbestos and sector of employment adjusted for smoking habits and age at start of follow-up. Among cohort members the SIR was 8.82 (95% CI 5.95-12.61) for mesothelioma and 1.61 (95% CI 1.26-2.04) for lung cancer. In subgroup analyses, the SIR for lung cancer in subjects hired in shipbuilding between 1974 and 1984 was 2.09 (95% CI 1.32-3.13). In the overall cohort, a borderline increased incidence was also found for stomach cancer (SIR = 1.53 95% CI 0.96-2.31). Internal comparisons within the cohort show that among men with high asbestos exposure level the relative risk was almost threefold for lung cancer (IRR = 2.94 95% CI 1.01-8.57). This cohort experienced an excess in the incidence of both mesothelioma and lung cancer, showing increasing incidence rates at higher level of asbestos exposure. For lung cancer, the relative incidence was highest among workers hired in shipbuilding between 1974 and 1984.

Cancer mortality in a cohort of continuous glass filament workers.

PubMed

Pira, Enrico; Manzari, Marco; Gallus, Silvano; Negri, Eva; Bosetti, Cristina; Romano, Canzio; McLaughlin, Joseph K; Boffetta, Paolo; La Vecchia, Carlo

2009-02-01

To examine cancer mortality in continuous glass filament workers. A cohort of 936 continuous glass filament workers employed in a plant from northern Italy since January 1976 was followed-up through December 2003, for a total of 19,987 man-years. Overall, 144 deaths were observed compared with 160.8 expected based on regional death rates (standardized mortality ratio [SMR] = 0.90, 95% CI = 0.76 to 1.05). There were 53 deaths from all cancers (SMR = 1.01, 95% CI = 0.75 to 1.32), and 21 from lung cancer (SMR = 1.23, 95% CI = 0.76 to 1.89). There was no consistent relation with risk for age at first employment, time since first or last employment, or duration of employment for any of the causes considered. Although limited in size, this study provides no evidence that continuous glass filament workers experience a significant increased risk of cancer, including respiratory cancer.

[Application of cohort study in cancer prevention and control].

PubMed

Dai, Min; Bai, Yana; Pu, Hongquan; Cheng, Ning; Li, Haiyan; He, Jie

2016-03-01

Cancer control is a long-term work. Cancer research and intervention really need the support of cohort study. In the recent years, more and more cohort studies on cancer control were conducted in China along with the increased ability of scientific research in China. Since 2010, Cancer Hospital, Chinese Academy of Medical Sciences, collaborated with Lanzhou University and the Worker' s Hospital of Jinchuan Group Company Limited, have carried out a large-scale cohort study on cancer, which covered a population of more than 50 000 called " Jinchang cohort". Since 2012, a National Key Public Health Project, "cancer screening in urban China" , has been conducted in Jinchang, which strengthened the Jinchang cohort study. Based on the Jinchang cohort study, historical cohort study, cross-sectional study and prospective cohort study have been conducted, which would provide a lot of evidence for the cancer control in China.

LEUKEMIA, LYMPHOMA AND MULTIPLE MYELOMA MORTALITY (1950–1999) AND INCIDENCE (1969–1999) IN THE ELDORADO URANIUM WORKERS COHORT

PubMed Central

Zablotska, Lydia B.; Lane, Rachel S.D.; Frost, Stanley E.; Thompson, Patsy A.

2014-01-01

Uranium workers are chronically exposed to low levels of radon decay products (RDP) and gamma (γ) radiation. Risks of leukemia from acute and high doses of γ-radiation are well-characterized, but risks from lower doses and dose-rates and from RDP exposures are controversial. Few studies have evaluated risks of other hematologic cancers in uranium workers. The purpose of this study was to analyze radiation-related risks of hematologic cancers in the cohort of Eldorado uranium miners and processors first employed in 1932–1980 in relation to cumulative RDP exposures and γ-ray doses. The average cumulative RDP exposure was 100.2 working level months and the average cumulative whole-body γ-radiation dose was 52.2 millisievert. We identified 101 deaths and 160 cases of hematologic cancers in the cohort. Overall, male workers had lower mortality and cancer incidence rates for all outcomes compared with the general Canadian male population, a likely healthy worker effect. No statistically significant association between RDP exposure or γ-ray doses, or a combination of both, and mortality or incidence of any hematologic cancer was found. We observed consistent but non-statistically significant increases in risks of chronic lymphocytic leukemia (CLL) and Hodgkin lymphoma (HL) incidence and non-Hodgkin lymphoma (NHL) mortality with increasing γ-ray doses. These findings are consistent with recent studies of increased risks of CLL and NHL incidence after γ-radiation exposure. Further research is necessary to understand risks of other hematologic cancers from low-dose exposures to γ-radiation. PMID:24583244

Non-cancer mortality in workers in the meat and delicatessen departments of supermarkets (1950-2006).

PubMed

Jadhav, S; Chedjieu, I P; Faramawi, M F; Ndetan, H; Fischbach, L; Thapa, S; Johnson, E S

2015-10-01

We studied non-cancer mortality in 10,701 workers in the meat and delicatessen departments of supermarkets because they have increased exposure to a variety of microorganisms that infect and cause disease in food animals such as cattle, pigs, sheep, and poultry, to which subjects in the general population are also exposed, albeit to a lesser degree. These workers were also exposed to fumes from the wrapping machine. Standardized mortality ratios were estimated in the cohort as a whole and in race/sex subgroups, using the US population for comparison. Study subjects were followed up from January 1950 to December 2006. Significantly increased deaths from diabetes, ischemic heart disease, pulmonary embolism, chronic bronchitis, peritonitis, intracranial and intraspinal abscess, other bacterial diseases, and significantly decreased deaths from diffuse diseases of connective tissue, functional diseases of the heart, intracerebral hemorrhage, occlusion/stenosis of the precerebral and cerebral arteries, and various types of accidents were observed in certain race/sex subgroups or in the cohort as a whole. The observed increased risks of several infectious conditions suggest that the increased occupational exposure to microorganisms may be responsible for at least some of the observed excess deaths, while exposure to fumes may also contribute to the excess of chronic bronchitis. The findings are important not only for supermarket workers and other workers in the meat and poultry industries, but also because the general population is exposed to these microorganisms found in food animals and their products. Nested case-control studies within cohorts that include both workers in supermarkets and other sectors of the meat and poultry industries, are now needed to examine specific risks from occupational exposures while adequately controlling for confounding factors, so that the role of these infectious agents in the occurrence of these diseases in workers and in general population subjects can be adequately assessed. Copyright © 2015 Elsevier Inc. All rights reserved.

Mortality study of civilian employees exposed to contaminated drinking water at USMC Base Camp Lejeune: a retrospective cohort study.

PubMed

Bove, Frank J; Ruckart, Perri Zeitz; Maslia, Morris; Larson, Theodore C

2014-08-13

Two drinking water systems at U.S. Marine Corps Base Camp Lejeune, North Carolina were contaminated with solvents during 1950s-1985. We conducted a retrospective cohort mortality study of 4,647 civilian, full-time workers employed at Camp Lejeune during 1973-1985 and potentially exposed to contaminated drinking water. We selected a comparison cohort of 4,690 Camp Pendleton workers employed during 1973-1985 and unexposed to contaminated drinking water. Mortality follow-up period was 1979-2008. Cause-specific standardized mortality ratios utilized U.S. age-, sex-, race-, and calendar period-specific mortality rates as reference. We used survival analysis to compare mortality rates between Camp Lejeune and Camp Pendleton workers and assess the effects of estimated cumulative contaminant exposures within the Camp Lejeune cohort. Ground water contaminant fate/transport and distribution system models provided monthly estimated contaminant levels in drinking water serving workplaces at Camp Lejeune. The confidence interval (CI) indicated precision of effect estimates. Compared to Camp Pendleton, Camp Lejeune workers had mortality hazard ratios (HRs) >1.50 for kidney cancer (HR = 1.92, 95% CI: 0.58, 6.34), leukemias (HR = 1.59, 95% CI: 0.66, 3.84), multiple myeloma (HR = 1.84, 95% CI: 0.45, 7.58), rectal cancer (HR = 1.65, 95% CI: 0.36, 7.44), oral cavity cancers (HR = 1.93, 95% CI: 0.34, 10.81), and Parkinson's disease (HR = 3.13, 95% CI: 0.76, 12.81). Within the Camp Lejeune cohort, monotonic exposure-response relationships were observed for leukemia and vinyl chloride and PCE, with mortality HRs at the high exposure category of 1.72 (95% CI: 0.33, 8.83) and 1.82 (95% CI: 0.36, 9.32), respectively. Cumulative exposures were above the median for most deaths from cancers of the kidney, esophagus, rectum, prostate, and Parkinson's disease, but small numbers precluded evaluation of exposure-response relationships. The study found elevated HRs in the Camp Lejeune cohort for several causes of death including cancers of the kidney, rectum, oral cavity, leukemias, multiple myeloma, and Parkinson's disease. Only 14% of the Camp Lejeune cohort died by end of follow-up, producing small numbers of cause-specific deaths and wide CIs. Additional follow-up would be necessary to comprehensively assess drinking water exposure effects at the base.

Risk identification and prediction of coal workers' pneumoconiosis in Kailuan Colliery Group in China: a historical cohort study.

PubMed

Shen, Fuhai; Yuan, Juxiang; Sun, Zhiqian; Hua, Zhengbing; Qin, Tianbang; Yao, Sanqiao; Fan, Xueyun; Chen, Weihong; Liu, Hongbo; Chen, Jie

2013-01-01

Prior to 1970, coal mining technology and prevention measures in China were poor. Mechanized coal mining equipment and advanced protection measures were continuously installed in the mines after 1970. All these improvements may have resulted in a change in the incidence of coal workers' pneumoconiosis (CWP). Therefore, it is important to identify the characteristics of CWP today and trends for the incidence of CWP in the future. A total of 17,023 coal workers from the Kailuan Colliery Group were studied. A life-table method was used to calculate the cumulative incidence rate of CWP and predict the number of new CWP patients in the future. The probability of developing CWP was estimated by a multilayer perceptron artificial neural network for each coal worker without CWP. The results showed that the cumulative incidence rates of CWP for tunneling, mining, combining, and helping workers were 31.8%, 27.5%, 24.2%, and 2.6%, respectively, during the same observation period of 40 years. It was estimated that there would be 844 new CWP cases among 16,185 coal workers without CWP within their life expectancy. There would be 273.1, 273.1, 227.6, and 69.9 new CWP patients in the next <10, 10-, 20-, and 30- years respectively in the study cohort within their life expectancy. It was identified that coal workers whose risk probabilities were over 0.2 were at high risk for CWP, and whose risk probabilities were under 0.1 were at low risk. The present and future incidence trends of CWP remain high among coal workers. We suggest that coal workers at high risk of CWP undergo a physical examination for pneumoconiosis every year, and the coal workers at low risk of CWP be examined every 5 years.

Utility of Biomarkers for Early Detection of Malignant Mesothelioma in a High-risk Population — EDRN Public Portal

Cancer.gov

A prospective study to evaluate the utility of various biomarkers in the context of an MM Early Detection Program. The study cohort will be composed of workers at a company with known asbestos exposure. Historically, a considerable number of workers at this company have developed MM.

INTERNAL EXPOSURE TO URANIUM IN A POOLED COHORT OF GASEOUS DIFFUSION PLANT WORKERS

PubMed Central

Anderson, Jeri L.; Apostoaei, A. Iulian; Yiin, James H.; Fleming, Donald A.; Tseng, Chih-Yu; Chen, Pi-Hsueh

2015-01-01

Intakes and absorbed organ doses were estimated for 29 303 workers employed at three former US gaseous diffusion plants as part of a study of cause-specific mortality and cancer incidence in uranium enrichment workers. Uranium urinalysis data (>600 000 urine samples) were available for 58 % of the pooled cohort. Facility records provided uranium gravimetric and radioactivity concentration data and allowed estimation of enrichment levels of uranium to which workers may have been exposed. Urine data were generally recorded with facility department numbers, which were also available in study subjects’ work histories. Bioassay data were imputed for study subjects with no recorded sample results (33 % of pooled cohort) by assigning department average urine uranium concentration. Gravimetric data were converted to 24-h uranium activity excretion using department average specific activities. Intakes and organ doses were calculated assuming chronic exposure by inhalation to a 5-µm activity median aerodynamic diameter aerosol of soluble uranium. Median intakes varied between 0.31 and 0.74 Bq d−1 for the three facilities. Median organ doses for the three facilities varied between 0.019 and 0.051, 0.68 and 1.8, 0.078 and 0.22, 0.28 and 0.74, and 0.094 and 0.25 mGy for lung, bone surface, red bone marrow, kidneys, and liver, respectively. Estimated intakes and organ doses for study subjects with imputed bioassay data were similar in magnitude. PMID:26113578

Historical cohort study of US man-made vitreous fiber production workers: VIII. Exposure-specific job analysis.

PubMed

Quinn, M M; Smith, T J; Youk, A O; Marsh, G M; Stone, R A; Buchanich, J M; Gula, M J

2001-09-01

All jobs held by a cohort of US man-made vitreous fiber production workers were analyzed for airborne fiber exposure. This exposure-specific job analysis was part of an exposure assessment for an epidemiologic study of mortality patterns, with particular focus on respiratory cancer, among 35,145 workers employed in 10 fiberglass and five rock or slag wool plants. The exposure assessment was conducted from the start-up date of each plant (1917 to 1946) to 1990. For the job analysis, 15,465 crude department names and 47,693 crude job titles were grouped into 1668 unique department and job pairs (UDJobs), which represented a job title linked to a specific department within each plant. Every UDJob was evaluated according to a set of job elements related to airborne fiber exposure. The distribution of the cohort person-years by UDJob and the job-exposure elements was then evaluated. The results show the main departments and jobs that employed the workers for each plant. The distribution of person-years varies across the job-exposure elements. The same job title was used in different departments within and across plants. When job titles not linked to departments were evaluated, the values of the job-exposure elements varied considerably across all plants and within plant. (1) exposure misclassification could occur if job title alone were used for the exposure assessment; (2) the job-exposure elements analysis provides an efficient way to identify major job determinants of exposure without relying on the more detailed, resource-intensive task-based approach; and (3) the evaluation of the cohort person-years by UDJobs and job-exposure elements is an effective way to identify which plants, departments, and jobs have sufficient information for making precise risk estimates in the broader epidemiologic study.

VALIDATION AND EVALUATION OF BIOMARKERS IN WORKERS EXPOSED TO BENZENE IN CHINA

EPA Science Inventory

Qu and colleagues recruited 181 healthy workers in several factories in the Tianjin region of China. These subjects formed part of a cohort of thousands identified by the U.S. National Cancer Institute (NCI) and the China Academy of Preventive Medicine for a study to evalua...

A cohort mortality study of forestry workers exposed to phenoxy acid herbicides.

PubMed Central

Green, L M

1991-01-01

A cohort mortality study was undertaken of forestry workers at a public electrical utility who had worked for six months or more during 1950-82 and who were routinely exposed to herbicides including phenoxy acids. A total of 1222 men with 25 274 years at risk experienced 80 deaths. Ascertainment of vital state at the end of follow up was 95.5%. The male population of the province (Ontario) was used as the reference group. Overall, no excess mortality was found in this cohort relative to the reference population. A statistically significant increase in deaths occurred, however, due to suicide (SMR = 210, 95% confidence interval, 95% CI 105-376) for the cohort as a whole. No deaths were seen due to cancers such as soft tissue sarcoma and non-Hodgkin's lymphoma that have been cited by other authors as being associated with exposure to phenoxy acid herbicides. Although the cohort is not large, the absence of deaths due to these cancers is consistent with findings from other studies with sufficient numbers to allow examination of specific risks. The cohort is still young, however, and at the end of follow up most had not reached an age when increased incidence of cancer would normally be expected. PMID:2025588

Prediction of mesothelioma and lung cancer in a cohort of asbestos exposed workers.

PubMed

Gasparrini, Antonio; Pizzo, Anna Maria; Gorini, Giuseppe; Seniori Costantini, Adele; Silvestri, Stefano; Ciapini, Cesare; Innocenti, Andrea; Berry, Geoffrey

2008-01-01

Several papers have reported state-wide projections of mesothelioma deaths, but few have computed these predictions in selected exposed groups. To predict the future deaths attributable to asbestos in a cohort of railway rolling stock workers. The future mortality of the 1,146 living workers has been computed in term of individual probability of dying for three different risks: baseline mortality, lung cancer excess, mesothelioma mortality. Lung cancer mortality attributable to asbestos was calculated assuming the excess risk as stable or with a decrease after a period of time since first exposure. Mesothelioma mortality was based on cumulative exposure and time since first exposure, with the inclusion of a term for clearance of asbestos fibres from the lung. The most likely range of the number of deaths attributable to asbestos in the period 2005-2050 was 15-30 for excess of lung cancer, and 23-35 for mesothelioma. This study provides predictions of asbestos-related mortality even in a selected cohort of exposed subjects, using previous knowledge about exposure-response relationship. The inclusion of individual information in the projection model helps reduce misclassification and improves the results. The method could be extended in other selected cohorts.

Epidemiology of Late Health Effects in Ukrainian Chornobyl Cleanup Workers.

PubMed

Bazyka, Dimitry; Prysyazhnyuk, Anatoly; Gudzenko, Natalya; Dyagil, Iryna; Belyi, David; Chumak, Vadim; Buzunov, Volodymyr

2018-07-01

This article summarizes the results of 30 y of follow-up of cancer and noncancer effects in Ukrainian cleanup workers after the Chornobyl accident. The number of power plant employees and first responders with acute radiation syndrome under follow-up by the National Research Center for Radiation Medicine decreased from 179 in 1986-1991 to 105 in 2011-2015. Cancers and leukemia (19) and cardiovascular diseases (21) were the main causes of deaths among acute radiation syndrome survivors (54) during the postaccident period. Increased radiation risks of leukemia in the Ukrainian cohort of 110,645 cleanup workers exposed to low doses are comparable to those among survivors of the atomic bomb explosions in Japan in 1945. Additionally, an excess of chronic lymphocytic leukemia was demonstrated in the cleanup workers cohort for 26 y after the exposure. A significant excess of multiple myeloma incidence [standardized incidence rate (SIR) 1.61 %, 95% confidence interval (CI) 1.01-2.21], thyroid cancer (SIR 4.18, 95% CI 3.76-4.59), female breast cancer (SIR 1.57 CI 1.40-1.73), and all cancers combined (SIR 1.07; 95% CI 1.05-1.09) was registered. High prevalence was demonstrated for cardio- and cerebrovascular diseases and mental health changes. However, the reasons for the increases require further investigation. To monitor other possible late effects of radiation exposure in Chornobyl cleanup workers, analytical cohort and case-control studies need to include cardiovascular pathology, specifically types of potentially radiogenic cancers using a molecular epidemiology approach. Possible effects for further study include increased rates of thyroid, breast, and lung cancers and multiple myeloma; reduction of radiation risks of leukemia to population levels; and increased morbidity and mortality of cleanup workers from cardio- and cerebrovascular pathology.

Case-control study of male germ cell tumors nested in a cohort of car-manufacturing workers: Findings from the occupational history.

PubMed

Langner, Ingo; Schmeisser, Nils; Mester, Birte; Behrens, Thomas; Gottlieb, Andrea; Ahrens, Wolfgang

2010-10-01

To examine whether the previously observed excess risk of male germ cell cancer in a cohort of car-manufacturing workers can be attributed to occupational activities inside and/or outside the car industry. A nested case-control study among workers in six plants included 205 cases of germ cell cancer and 1,105 controls, individually matched by year of birth (±2 years). Job periods of the individual occupational histories were coded based on the International Standard Classification of Occupations (ISCO) and the industrial classification of economic activities (NACE). Odds ratios (ORs) and corresponding 95%-confidence intervals (CI) for ever-never and cumulative employment were calculated by conditional multivariate logistic regression adjusted for cryptorchidism. Significantly increased risks were observed for machinery fitters and assemblers (A) (OR = 1.8, 95% CI 1.25-2.53) and "workers not elsewhere classified" (OR = 2.10, 95% CI 1.27-3.54), but no trend was observed for employment duration in either occupational group. Stratification of job group A by metal-cutting and non-cutting jobs yielded ORs of 1.87 (95% CI 1.31-2.67) and of 1.24 (95% CI 0.68-2.28), respectively. Among "plumbers, welders, sheet & structural metal workers" (adjusted OR 1.4, 95% CI 0.99-1.95) only "structural metal preparers and erectors" showed a substantially increased risk (OR = 2.30; 95% CI 1.27-4.27). Our results do not fully explain the increased incidence of germ cell cancer in the cohort, but support previous findings showing increased risks among metal workers. These risks were most strongly pronounced in metal-cutting activities. © 2010 Wiley-Liss, Inc.

Social hazards on the job: workplace abuse, sexual harassment, and racial discrimination--a study of Black, Latino, and White low-income women and men workers in the United States.

PubMed

Krieger, Nancy; Waterman, Pamela D; Hartman, Cathy; Bates, Lisa M; Stoddard, Anne M; Quinn, Margaret M; Sorensen, Glorian; Barbeau, Elizabeth M

2006-01-01

This study documents the prevalence of workplace abuse, sexual harassment at work, and lifetime experiences of racial discrimination among the United for Health cohort of 1,202 predominantly black, Latino, and white women and men low-income union workers in the Greater Boston area. Overall, 85 percent of the cohort reported exposure to at least one of these three social hazards; exposure to all three reached 20 to 30 percent among black women and women and men in racial/ethnic groups other than white, black, or Latino. Workplace abuse in the past year, reported by slightly more than half the workers, was most frequently reported by the white men (69%). Sexual harassment at work in the past year was reported by 26 percent of the women and 22 percent of the men, with values of 20 percent or more in all racial/ ethnic-gender groups other than Latinas and white men. High exposure to racial discrimination was reported by 37 percent of the workers of color, compared with 10 percent of the white workers, with black workers reporting the greatest exposure (44%). Together, these findings imply that the lived--and combined-experiences of class, race, and gender inequities and their attendant assaults on human dignity are highly germane to analyses of workers' health.

Enduring health effects of asbestos use in Belgian industries: a record-linked cohort study of cause-specific mortality (2001–2009)

PubMed Central

Van den Borre, Laura; Deboosere, Patrick

2015-01-01

Objective To investigate cause-specific mortality among asbestos workers and potentially exposed workers in Belgium and evaluate potential excess in mortality due to established and suspected asbestos-related diseases. Design This cohort study is based on an individual record linkage between the 1991 Belgian census and cause-specific mortality information for Flanders and Brussels (2001–2009). Setting Belgium (Flanders and Brussels region). Participants The study population consists of 1 397 699 male workers (18–65 years) with 72 074 deaths between 1 October 2001 and 31 December 2009. Using a classification of high-risk industries, mortality patterns between 2056 asbestos workers, 385 046 potentially exposed workers and the working population have been compared. Outcome measures Standardised mortality ratios (SMRs) and 95% CIs are calculated for manual and non-manual workers. Results Our findings show clear excess in asbestos-related mortality in the asbestos industry with SMRs for mesothelioma of 4071 (CI 2327 to 6611) among manual workers and of 4489 (CI 1458 to 10 476) among non-manual workers. Excess risks in asbestos-related mortality are also found in the chemical industry, the construction industry, the electrical generation and distribution industry, the basic metals manufacturing industry, the metal products manufacturing industry, the railroad industry, and the shipping industry. Oral cancer mortality is significantly higher for asbestos workers (SMR 383; CI 124 to 894), railroad workers (SMR 192; CI 112 to 308), shipping workers (SMR 172; CI 102 to 271) and construction workers (SMR 125; CI 100 to 153), indicating a possible association with occupational asbestos exposure. Workers in all four industries have elevated mortality rates for cancer of the mouth. Only construction workers experience significantly higher pharyngeal cancer mortality (SMR 151; CI 104 to 212). Conclusions The study identifies vulnerable groups of Belgian asbestos workers, demonstrating the current-day health repercussions of historical asbestos use. Results support the hypothesis of a possible association between the development of oral cancer and occupational asbestos exposure. PMID:26109114

Risk factors for neck pain in office workers: a prospective study

PubMed Central

Hush, Julia M; Maher, Chris G; Refshauge, Kathryn M

2006-01-01

Background Persisting neck pain is common in society. It has been reported that the prevalence of neck pain in office workers is much higher than in the general population. The costs to the worker, employer and society associated with work-related neck pain are known to be considerable and are escalating. The factors that place office workers at greater risk of developing neck pain are not understood. The aim of this study is to investigate the incidence and risk factors of work-related neck pain in Australian office workers. Methods/design We will conduct a prospective cohort study. A cohort of office workers without neck pain will be followed over a 12 month period, after baseline measurement of potential risk factors. The categories of risk factors being evaluated are physical (cervical spine posture, range of movement, muscle endurance and exercise frequency), demographic (age, sex), work environment (sitting duration, frequency of breaks) and psychosocial (psychological distress and psychosocial work factors). Cox regression analysis will be used to identify risk factors associated with work-related neck pain, and will be expressed as hazard ratios with 95% confidence intervals. The data will also enable the incidence of neck pain in this population to be estimated. Discussion In addition to clarifying the magnitude of this occupational health problem these data could inform policy in workplaces and provide the basis for primary prevention of neck pain in office workers, targeting the identified risk factors. PMID:17062165

Cohort study on respiratory and neurological disorders among workers in a bone glue factory in Egypt.

PubMed

Al-Batanony, M A; Abdel-Rasoul, G M; Abu-Salem, M A; Al-Ahmar, I A; Al-Badry, A S

2012-04-01

Glues are strong, liquid adhesive derived from animal tissues. It has been shown that glue sniffing is associated with demyelinating polyneuropathy. The low molecular weight agents which cause occupational lung disease have generally included the isocyanates exposure to which could result in asthma among workers. Toluene is also used widely in glue and adhesive industry and households where toluene exposure and abuse can occur. To study some respiratory and neurological disorders that may arise in workers in a bone glue factory in Queisna industrial zone, Menoufyia governorate, Egypt. In a historical cohort study, the exposed participants (n = 50) were recruited from workers in a bone glue factory in Queisna industrial zone, Menoufyia governorate. The unexposed group was selected from workers' relatives who had never worked in glue industry. All participants completed a pre-designed questionnaire on personal and occupational histories. Pulmonary function tests as well as electromyography (EMG) were performed for all participants. Urinary hippuric acid was also measure in all participants. The prevalence of cough, asthmatic attacks and paresthesia were significantly higher among exposed than unexposed participants. Abnormal spirometric measurements (particularly towards obstruction), abnormal EMG and positive urinary hippuric acid were significantly more prevalent among exposed than unexposed group. Spirometry and EMG should be included in the periodic medical examination for exposed workers for early detection of respiratory and neurological disorders. Urinary hippuric acid could be a useful indicator of the nerve conduction abnormalities and should be measured periodically for these workers.

Potential risk factors for haematological cancers in semiconductor workers.

PubMed

Lee, K; Kim, S-G; Kim, D

2015-10-01

There has recently been increased interest in cancer incidence in electronics workers. To determine the cancer incidence ratio in electronics workers and the potential factors affecting the risk for development of cancer. Epidemiological study performed in electronics workers who were employed between 1999 and 2008 in South Korea. Cancer incidence ratio was analysed with respect to departments, divisions, job titles, gender, age, hepatitis B and C virus infection and work duration. We compared the incidence of haematological cancer in this cohort with that expected in the general population. The study population was 56283. Overall, the standardized incidence ratio (SIR) for haematological cancer was 0.85. In particular, the SIR for leukaemia was 0.86 and for non-Hodgkin lymphoma (NHL) was 0.93, which were not statistically significant. The SIR for NHL was significantly increased [SIR 5.23, 95% confidence interval (CI) 1.31-20.95] in female office workers. We also found that the SIR for NHL was significantly increased in female workers who tested positive for hepatitis virus infection (SIR 7.69, 95% CI 1.08-54.60). The raised SIR for NHL among female workers was due to potential risk factors such as hepatitis virus infection although additional research and an ongoing, long-term, prospective epidemiological cohort study is needed. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

The Diesel Exhaust in Miners Study: A Cohort Mortality Study With Emphasis on Lung Cancer

PubMed Central

Schleiff, Patricia L.; Lubin, Jay H.; Blair, Aaron; Stewart, Patricia A.; Vermeulen, Roel; Coble, Joseph B.; Silverman, Debra T.

2012-01-01

Background Current information points to an association between diesel exhaust exposure and lung cancer and other mortality outcomes, but uncertainties remain. Methods We undertook a cohort mortality study of 12 315 workers exposed to diesel exhaust at eight US non-metal mining facilities. Historical measurements and surrogate exposure data, along with study industrial hygiene measurements, were used to derive retrospective quantitative estimates of respirable elemental carbon (REC) exposure for each worker. Standardized mortality ratios and internally adjusted Cox proportional hazard models were used to evaluate REC exposure–associated risk. Analyses were both unlagged and lagged to exclude recent exposure such as that occurring in the 15 years directly before the date of death. Results Standardized mortality ratios for lung cancer (1.26, 95% confidence interval [CI] = 1.09 to 1.44), esophageal cancer (1.83, 95% CI = 1.16 to 2.75), and pneumoconiosis (12.20, 95% CI = 6.82 to 20.12) were elevated in the complete cohort compared with state-based mortality rates, but all-cause, bladder cancer, heart disease, and chronic obstructive pulmonary disease mortality were not. Differences in risk by worker location (ever-underground vs surface only) initially obscured a positive diesel exhaust exposure–response relationship with lung cancer in the complete cohort, although it became apparent after adjustment for worker location. The hazard ratios (HRs) for lung cancer mortality increased with increasing 15-year lagged cumulative REC exposure for ever-underground workers with 5 or more years of tenure to a maximum in the 640 to less than 1280 μg/m3-y category compared with the reference category (0 to <20 μg/m3-y; 30 deaths compared with eight deaths of the total of 93; HR = 5.01, 95% CI = 1.97 to 12.76) but declined at higher exposures. Average REC intensity hazard ratios rose to a plateau around 32 μg/m3. Elevated hazard ratios and evidence of exposure–response were also seen for surface workers. The association between diesel exhaust exposure and lung cancer risk remained after inclusion of other work-related potentially confounding exposures in the models and were robust to alternative approaches to exposure derivation. Conclusions The study findings provide further evidence that exposure to diesel exhaust increases risk of mortality from lung cancer and have important public health implications. PMID:22393207

Cancer mortality in cohorts of workers in the European rubber manufacturing industry first employed since 1975.

PubMed

Boniol, M; Koechlin, A; Świątkowska, B; Sorahan, T; Wellmann, J; Taeger, D; Jakobsson, K; Pira, E; Boffetta, P; La Vecchia, C; Pizot, C; Boyle, P

2016-05-01

Increased cancer risk has been reported among workers in the rubber manufacturing industry employed before the 1960s. It is unclear whether risk remains increased among workers hired subsequently. The present study focused on risk of cancer mortality for rubber workers first employed since 1975 in 64 factories. Anonymized data from cohorts of rubber workers employed for at least 1 year from Germany, Italy, Poland, Sweden, and the UK were pooled. Standardized mortality ratios (SMRs), based on country-specific death rates, were reported for bladder and lung cancer (primary outcomes of interest), for other selected cancer sites, and for cancer sites with a minimum of 10 deaths in men or women. Analyses stratified by type of industry, period, and duration of employment were carried out. A total of 38 457 individuals (29 768 men; 8689 women) contributed to 949 370 person-years. No increased risk of bladder cancer was observed [SMR = 0.80, 95% confidence interval (CI) 0.46; 1.38]. The risk of lung cancer death was reduced (SMR = 0.81, 95% CI 0.70; 0.94). No statistically significant increased risk was observed for any other cause of death. A reduced risk was evident for total cancer mortality (SMR = 0.81, 95% CI 0.76; 0.87). Risks were lower for workers in the tyre industry compared with workers in the general rubber goods sector. Analysis by employment duration showed a negative trend with SMRs decreasing with increasing duration of employment. In an analysis of secondary end points, when stratified by type of industry and period of first employment, excess risks of myeloma and gastric cancer were observed each due, essentially, to results from one centre. No consistent increased risk of cancer death was observed among rubber workers first employed since 1975, no overall analysis of the pooled cohort produced significantly increased risk. Continued surveillance of the present cohorts is required to confirm the absence of long-term risk. © The Author 2016. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Survival rates and worker compensation expenses in a national cohort of Mexican workers with permanent occupational disability caused by diabetes.

PubMed

Ascencio-Montiel, Iván de Jesús; Kumate-Rodríguez, Jesús; Borja-Aburto, Víctor Hugo; Fernández-Garate, José Esteban; Konik-Comonfort, Selene; Macías-Pérez, Oliver; Campos-Hernández, Ángel; Rodríguez-Vázquez, Héctor; López-Roldán, Verónica Miriam; Zitle-García, Edgar Jesús; Solís-Cruz, María Del Carmen; Velázquez-Ramírez, Ismael; Aguilar-Jiménez, Miriam; Villa-Caballero, Leonel; Cisneros-González, Nelly

2016-09-01

Permanent occupational disability is one of the most severe consequences of diabetes that impedes the performance of usual working activities among economically active individuals. Survival rates and worker compensation expenses have not previously been examined among Mexican workers. We aimed to describe the worker compensation expenses derived from pension payments and also to examine the survival rates and characteristics associated with all-cause mortality, in a cohort of 34,014 Mexican workers with permanent occupational disability caused by diabetes during the years 2000-2013 at the Mexican Institute of Social Security. A cross-sectional analysis study was conducted using national administrative records data from the entire country, regarding permanent occupational disability medical certification, pension payment and vital status. Survival rates were estimated using the Kaplan-Meier method. Multivariate Cox proportional hazard model was used to estimate adjusted hazard ratios (HR) and 95 % confidence intervals (95 % CI) in order to assess the cohort characteristics and all-cause mortality risk. Total expenses derived from pension payments for the period were accounted for in U.S. dollars (USD, 2013). There were 12,917 deaths in 142,725.1 person-years. Median survival time was 7.26 years. After multivariate adjusted analysis, males (HR, 1.39; 95 % CI, 1.29-1.50), agricultural, forestry, and fishery workers (HR, 1.41; 95 % CI, 1.15-1.73) and renal complications (HR, 3.49; 95 % CI, 3.18-3.83) had the highest association with all-cause mortality. The all-period expenses derived from pension payments amounted to $777.78 million USD (2013), and showed a sustained increment: from $58.28 million USD in 2000 to $111.62 million USD in 2013 (percentage increase of 91.5 %). Mexican workers with permanent occupational disability caused by diabetes had a median survival of 7.26 years, and those with renal complications showed the lowest survival in the cohort. Expenses derived from pension payments amounted to $ 777 million USD and showed an important increase from 2000 to 2013.

[Cohort study of ischemic heart disease among 1817 workers in a foundry].

PubMed

Lu, Yang; Zhang, Min

2012-09-01

To determine the risk of ischemic heart disease among foundry workers and the exposure-response relationship between the risk and foundry work and cumulative exposure to silica dust, and to establish a regression model to predict the risk for developing ischemic heart disease by a given length of employment and exposure to silica dust in foundry workers. Cohort study was conducted, following-up workers in an automobile foundry employed for more than one year during January 1, 1980 to December 31, 1996 as cohort members. In total, 30 years were followed to December 31, 2009. In cohort, workers exposed to pouring, sand preparation, cast shakeout and finishing, melting, overhead crane operation, moulding and core-making were in foundry group, and auxiliary workers at the same factory, such as electricians, fitters, and inspectors were in control group. The risk of ischemic heart disease among foundry workers and the exposure-response relationship between the risk and foundry work and cumulative exposure to silica dust were analyzed with cox regression model using SPSS software, and a logistic regression model was established for prediction of risk for developing ischemic heart disease at a given length of employment and exposure to silica dust in foundry workers. Totally, 1817 workers were followed-up for 45 553.05 person-years during 30 years, with 156 cases of ischemic heart disease and incidence of 342.46 per 100 000 person-years. And the average age at onset was 51.46 years and duration of employment at onset was 21.61 years. Results showed that male, smoking, alcohol drinking, age and duration of employment were risk factors for ischemic heart disease. Risk of ischemic heart disease in foundry workers positively correlated with cumulative silica exposure, and the risk of ischemic heart disease increased by 75.8 percent (RR = 1.758, 95% CI 1.221-2.532) with cumulative silica exposure of 1 mg/m3 x year, adjusted for smoking. And risk of ischemic heart disease was significantly higher in the exposed group than that in the control one. Compared with control group workers, risk of ischemic heart disease increased by 1.048 folds, 1.395 folds, 70.4 percent, 97.0 percent and 1.270 folds among workers exposed to sand preparation, cast shakeout and finishing, melting, moulding and core-making, respectively, adjusted for smoking. Based on the predictive of model, risk for developing ischemic heart disease increased with the length of employment and exposure to silica dust in foundry workers. Workers in foundry face high risk of ischemic heart disease. Risk of ischemic heart disease varies by job, which is higher in workers exposed to sand preparation, cast shakeout and finishing, melting, moulding and core-making. Both foundry work and cumulative exposure to silica are risk factors. The model for prediction of risk for developing ischemic heart disease at a given length of employment and exposure to silica dust in foundry workers resulted in a valid exposure-response relationship.

Lymphohematopoietic Cancer Mortality and Morbidity of Workers in a Refinery/Petrochemical Complex in Korea

PubMed Central

Kim, Tae-Woo; Yoon, Yong-Hoon; Shin, Kyung-Seok; Yoo, Seung-Won

2011-01-01

Objectives The purpose of this retrospective cohort study was to investigate the relationship between exposure of Korean workers to petrochemicals in the refinery/petrochemical industry and lymphohematopoietic cancers. Methods The cohort consisted of 8,866 male workers who had worked from the 1960s to 2007 at one refinery and six petrochemical companies located in a refinery/petrochemical complex in Korea that produce benzene or use benzene as a raw material. Standardized mortality ratios (SMRs) and standardized incidence ratios (SIRs) were calculated for 1992-2007 and 1997-2005 based on the death rate and cancer incidence rate of the Korean male population according to job title (production, maintenance, laboratory, and office workers). Results The overall mortality and most cause-specific mortalities were lower among these workers than those of the general Korean population. Increased SMRs were observed for leukemia (4/1.45; SMR 2.77, 95% CI: 0.75-7.09) and lymphohematopoietic cancers (5/2.51; SMR 2, 95% CI: 0.65-4.66) in production workers, and increased SIRs were also observed in leukemia (3/1.34; SIR 2.24, 95% CI: 0.46-6.54) and lymphohematopoietic cancers (5/3.39; SIR 1.47, 95% CI: 0.48-3.44) in production workers, but the results were not statistically significant. Conclusion The results showed a potential relationship between leukemia and lymphohematopoietic cancers and exposure to benzene in refinery/petrochemical complex workers. This study yielded limited results due to a short observational period; therefore, a follow-up study must be performed to elucidate the relationship between petrochemical exposure and cancer rates. PMID:22953184

Lymphohematopoietic cancer mortality and morbidity of workers in a refinery/petrochemical complex in Korea.

PubMed

Koh, Dong-Hee; Kim, Tae-Woo; Yoon, Yong-Hoon; Shin, Kyung-Seok; Yoo, Seung-Won

2011-03-01

The purpose of this retrospective cohort study was to investigate the relationship between exposure of Korean workers to petrochemicals in the refinery/petrochemical industry and lymphohematopoietic cancers. The cohort consisted of 8,866 male workers who had worked from the 1960s to 2007 at one refinery and six petrochemical companies located in a refinery/petrochemical complex in Korea that produce benzene or use benzene as a raw material. Standardized mortality ratios (SMRs) and standardized incidence ratios (SIRs) were calculated for 1992-2007 and 1997-2005 based on the death rate and cancer incidence rate of the Korean male population according to job title (production, maintenance, laboratory, and office workers). The overall mortality and most cause-specific mortalities were lower among these workers than those of the general Korean population. Increased SMRs were observed for leukemia (4/1.45; SMR 2.77, 95% CI: 0.75-7.09) and lymphohematopoietic cancers (5/2.51; SMR 2, 95% CI: 0.65-4.66) in production workers, and increased SIRs were also observed in leukemia (3/1.34; SIR 2.24, 95% CI: 0.46-6.54) and lymphohematopoietic cancers (5/3.39; SIR 1.47, 95% CI: 0.48-3.44) in production workers, but the results were not statistically significant. The results showed a potential relationship between leukemia and lymphohematopoietic cancers and exposure to benzene in refinery/petrochemical complex workers. This study yielded limited results due to a short observational period; therefore, a follow-up study must be performed to elucidate the relationship between petrochemical exposure and cancer rates.

Health care utilization and costs associated with adherence to clinical practice guidelines for early magnetic resonance imaging among workers with acute occupational low back pain.

PubMed

Graves, Janessa M; Fulton-Kehoe, Deborah; Jarvik, Jeffrey G; Franklin, Gary M

2014-04-01

To estimate health care utilization and costs associated with adherence to clinical practice guidelines for the use of early magnetic resonance imaging (MRI; within the first 6 weeks of injury) for acute occupational low back pain (LBP). Washington State Disability Risk Identification Study Cohort (D-RISC), consisting of administrative claims and patient interview data from workers' compensation claimants (2002-2004). In this prospective, population-based cohort study, we compared health care utilization and costs among workers whose imaging was adherent to guidelines (no early MRI) to workers whose imaging was not adherent to guidelines (early MRI in the absence of red flags). We identified workers (age>18) with work-related LBP using administrative claims. We obtained demographic, injury, health, and employment information through telephone interviews to adjust for baseline differences between groups. We ascertained health care utilization and costs from administrative claims for 1 year following injury. Of 1,770 workers, 336 (19.0 percent) were classified as nonadherent to guidelines. Outpatient and physical/occupational therapy utilization was 52-54 percent higher for workers whose imaging was not adherent to guidelines compared to workers with guideline-adherent imaging; utilization of chiropractic care was significantly lower (18 percent). Nonadherence to guidelines for early MRI was associated with increased likelihood of lumbosacral injections or surgery and higher costs for out-patient, inpatient, and nonmedical services, and disability compensation. © Health Research and Educational Trust.

Mortality from cancer and other causes in an Italian cohort of male rubber tire workers.

PubMed

Pira, Enrico; Pelucchi, Claudio; Romano, Canzio; Manzari, Marco; Negri, Eva; La Vecchia, Carlo

2012-03-01

To investigate mortality among workers of an Italian rubber tire factory employed between 1954 and 2008. This cohort study included 6246 men, totaling 190,512 man-years of observation. Employment data were obtained from personnel records, whereas vital status and causes of death were ascertained from local authorities. We computed standardized mortality ratios (SMRs) using national and regional death certification rates. Mortality was significantly lower than expected for all cancers (SMR = 79) and all causes (SMR = 85). The SMRs were 99 for cancer of stomach, 78 for lung, 121 for urinary bladder, 116 for lymphoma, and 89 for leukemia, none being significant. Decreased mortality emerged for cancers of the oral cavity and pharynx (SMR = 45), esophagus (SMR = 29), colorectum (SMR = 71), liver (SMR = 57), and kidney (SMR = 33). This study shows no excess cancer risk among male rubber tire workers employed after 1954.

Long-term health experience of jet engine manufacturing workers: VI: incidence of malignant central nervous system neoplasms in relation to estimated workplace exposures.

PubMed

Marsh, Gary M; Youk, Ada O; Buchanich, Jeanine M; Xu, Hui; Downing, Sarah; Kennedy, Kathleen J; Esmen, Nurtan A; Hancock, Roger P; Lacey, Steven E; Fleissner, Mary Lou

2013-06-01

To determine whether glioblastoma (GB) incidence rates among jet engine manufacturing workers were associated with specific chemical or physical exposures. Subjects were 210,784 workers employed from 1952 to 2001. We conducted a cohort incidence study and two nested case-control studies with focus on the North Haven facility where we previously observed a not statistically significant overall elevation in GB rates. We estimated individual-level exposure metrics for 11 agents. In the total cohort, none of the agent metrics considered was associated with increased GB risk. The GB incidence rates in North Haven were also not related to workplace exposures, including the "blue haze" exposure unique to North Haven. If not due to chance alone, GB rates in North Haven may reflect external occupational factors, nonoccupational factors, or workplace factors unique to North Haven unmeasured in the current evaluation.

Cancer risks in a population-based study of 70,570 agricultural workers: results from the Canadian census health and Environment cohort (CanCHEC).

PubMed

Kachuri, Linda; Harris, M Anne; MacLeod, Jill S; Tjepkema, Michael; Peters, Paul A; Demers, Paul A

2017-05-19

Agricultural workers may be exposed to potential carcinogens including pesticides, sensitizing agents and solar radiation. Previous studies indicate increased risks of hematopoietic cancers and decreased risks at other sites, possibly due to differences in lifestyle or risk behaviours. We present findings from CanCHEC (Canadian Census Health and Environment Cohort), the largest national population-based cohort of agricultural workers. Statistics Canada created the cohort using deterministic and probabilistic linkage of the 1991 Canadian Long Form Census to National Cancer Registry records for 1992-2010. Self-reported occupations were coded using the Standard Occupational Classification (1991) system. Analyses were restricted to employed persons aged 25-74 years at baseline (N = 2,051,315), with follow-up until December 31, 2010. Hazard ratios (HR) and 95% confidence intervals (CI) were modeled using Cox proportional hazards for all workers in agricultural occupations (n = 70,570; 70.8% male), stratified by sex, and adjusted for age at cohort entry, province of residence, and highest level of education. A total of 9515 incident cancer cases (7295 in males) occurred in agricultural workers. Among men, increased risks were observed for non-Hodgkin lymphoma (HR = 1.10, 95% CI = 1.00-1.21), prostate (HR = 1.11, 95% CI = 1.06-1.16), melanoma (HR = 1.15, 95% CI = 1.02-1.31), and lip cancer (HR = 2.14, 95% CI = 1.70-2.70). Decreased risks in males were observed for lung, larynx, and liver cancers. Among female agricultural workers there was an increased risk of pancreatic cancer (HR = 1.36, 95% CI = 1.07-1.72). Increased risks of melanoma (HR = 1.79, 95% CI = 1.17-2.73), leukemia (HR = 2.01, 95% CI = 1.24-3.25) and multiple myeloma (HR = 2.25, 95% CI = 1.16-4.37) were observed in a subset of female crop farmers. Exposure to pesticides may have contributed to increased risks of hematopoietic cancers, while increased risks of lip cancer and melanoma may be attributed to sun exposure. The array of decreased risks suggests reduced smoking and alcohol consumption in this occupational group compared to the general population.

End stage renal disease among ceramic workers exposed to silica.

PubMed

Rapiti, E; Sperati, A; Miceli, M; Forastiere, F; Di Lallo, D; Cavariani, F; Goldsmith, D F; Perucci, C A

1999-08-01

To evaluate whether ceramic workers exposed to silica experience an excess of end stage renal disease. On the basis of a health surveillance programme, a cohort of 2980 male ceramic workers has been enrolled during the period 1974-91 in Civitacastellana, Lazio, Italy. For each worker, employment history, smoking data, and x ray film readings were available. The vital status was ascertained for all cohort members. All 2820 people still alive and resident in the Lazio region as in June 1994 were searched for a match in the regional end stage renal diseases registry, which records (since June, 1994) all patients undergoing dialysis treatment in public and private facilities of the region. Expected numbers of prevalent cases from the cohort were computed by applying the rate of patients on dialysis treatment by the age distribution of the cohort. A total of six cases was detected when 1.87 were expected (observed/expected (O/E) = 3.21; 95% confidence interval (95% CI) 1.17 to 6.98). The excess risk was present among non-smokers (O = 2; O/E = 4.34) and smokers (O = 4; O/E = 2.83), as well as among workers without silicosis (O = 4; O/E = 2.78) and workers with silicosis (O = 2; O/E = 4.54). The risk was higher among subjects with < 20 years since first employment (O = 4; O/E = 4.65) than among those employed > 20 years. These results provide further evidence that exposure to silica dust among ceramic workers is associated with nephrotoxic effects.

Early life urban exposure as a risk factor for developing obesity and impaired fasting glucose in later adulthood: results from two cohorts in Thailand.

PubMed

Angkurawaranon, Chaisiri; Wisetborisut, Anawat; Rerkasem, Kittipan; Seubsman, Sam-Ang; Sleigh, Adrian; Doyle, Pat; Nitsch, Dorothea

2015-09-16

Obesity and obesity related conditions, driven by processes such as urbanization and globalization, are contributing to pronounced cardiovascular morbidity and mortality in developing countries. There is limited evidence on the influence of living in an urban environment in early life on obesity and obesity related conditions later in life in developing countries such as Thailand. We used data from two cohort studies conducted in Thailand, the Thai Cohort Study (TCS) and the Chiang Mai University (CMU) Health Worker Study, to investigate the association between early life urban (vs rural) exposure and the later development of obesity. We additionally explored the association between early life urban exposure and impaired fasting glucose in adulthood using data from the CMU Health Worker Study. Among 48,490 adults from the TCS, 9.1 % developed obesity within 4 years of follow-up. Among 1,804 initially non-obese adults from CMU Health worker study, 13.6 % developed obesity within 5 years of follow-up. Early life urban exposure was associated with increased risk of developing obesity in adulthood in both cohorts. Adjusting for age and sex, those who spent their early lives in urban areas were 1.21 times more likely to develop obesity in the TCS (OR 1.21, 95 % CI 1.12 to 1.31) and 1.65 times more likely in the CMU Health Worker study (OR 1.65, 95 % CI 1.23 to 2.20). These associations remained significant despite adjustment for later life urban exposure and current household income. No evidence for an association was found for impaired fasting glucose. Early life urban exposure was associated with increased risk of developing obesity in adulthood. These findings support public health intervention programs to prevent obesity starting from early ages.

Evolution of psychosocial factors at work in a French region.

PubMed

Bègue, C; Fouquet, N; Bodin, J; Ramond-Roquin, A; Huez, J-F; Bouton, C; Roquelaure, Y

2016-03-01

Psychosocial factors at work (PFW) can be defined as all non-physicochemical occupational risks. Several epidemiological models have been proposed to measure PFW, but one of the most widely used is Karasek's model. To determine whether psychosocial factors, evaluated by Karasek's questionnaire, had increased in a cohort of workers. A random sample of workers in the Pays de la Loire region of France, who could be considered representative of the region's population of salaried workers, filled in a self-administered questionnaire, including Karasek's self-administered questionnaire, in 2002-05 and 2007-09. Karasek's questionnaire can be used to study three psychosocial dimensions (psychological demand, decision latitude and social support in the workplace) in workers in order to define two high-risk situations for their health: 'Job Strain' and 'Iso Strain'. Changes in job strain and iso strain among workers were studied according to the workers' sociodemographic characteristics and their working conditions. In this sample of 2049 workers, the proportion with iso strain increased between the two periods from 12 to 16%, P < 0.001, mainly among manual workers. Deterioration of Karasek indicators was mainly explained by an increase of the 'low social support' dimension (38 versus 49%, P < 0.001). Working conditions such as temporary employment of colleagues and high perceived physical exertion were associated with higher PFW. This study, based on a quantitative and collective model, showed deterioration of working team environments and increased risk for individual mental health in this cohort of French workers in recent years. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Quantitative cancer risk assessment based on NIOSH and UCC epidemiological data for workers exposed to ethylene oxide.

PubMed

Valdez-Flores, Ciriaco; Sielken, Robert L; Teta, M Jane

2010-04-01

The most recent epidemiological data on individual workers in the NIOSH and updated UCC occupational studies have been used to characterize the potential excess cancer risks of environmental exposure to ethylene oxide (EO). In addition to refined analyses of the separate cohorts, power has been increased by analyzing the combined cohorts. In previous SMR analyses of the separate studies and the present analyses of the updated and pooled studies of over 19,000 workers, none of the SMRs for any combination of the 12 cancer endpoints and six sub-cohorts analyzed were statistically significantly greater than one including the ones of greatest previous interest: leukemia, lymphohematopoietic tissue, lymphoid tumors, NHL, and breast cancer. In our study, no evidence of a positive cumulative exposure-response relationship was found. Fitted Cox proportional hazards models with cumulative EO exposure do not have statistically significant positive slopes. The lack of increasing trends was corroborated by categorical analyses. Cox model estimates of the concentrations corresponding to a 1-in-a-million extra environmental cancer risk are all greater than approximately 1ppb and are more than 1500-fold greater than the 0.4ppt estimate in the 2006 EPA draft IRIS risk assessment. The reasons for this difference are identified and discussed. Copyright 2009 Elsevier Inc. All rights reserved.

Cancer incidence in cohorts of workers in the rubber manufacturing industry first employed since 1975 in the UK and Sweden.

PubMed

Boniol, M; Koechlin, A; Sorahan, T; Jakobsson, K; Boyle, P

2017-06-01

Increased cancer risks have been reported among workers in the rubber manufacturing industry employed before the 1960s, but it is unclear for workers hired subsequently. The present study focused on cancer incidence among rubber workers first employed after 1975 in Sweden and the UK. Two cohorts of rubber workers employed for at least 1 year were analysed. Standardised incidence ratios (SIRs), based on country-specific and period-specific incidence rates, were analysed for all cancers combined (except non-melanoma skin), bladder, lung, stomach cancer, leukaemia, non-Hodgkin's lymphoma and multiple myeloma. Exploratory analyses were conducted for other cancers with a minimum of 10 cases in both genders combined. 16 026 individuals (12 441 men; 3585 women) contributed to 397 975 person-years of observation, with 846 cancers observed overall (437 in the UK, 409 in Sweden). No statistically significant increased risk was observed for any site of cancer. A reduced risk was evident for all cancers combined (SIR=0.83, 95% CI (0.74 to 0.92)), lung cancer (SIR=0.74, 95% CI (0.59 to 0.93)), non-Hodgkin's lymphoma (SIR=0.67, 95% CI (0.45 to 1.00)) and prostate cancer (SIR=0.77, 95% CI (0.64 to 0.92)). For stomach cancer and multiple myeloma, SIRs were 0.93 (95% CI (0.61 to 1.43)) and 0.92 (95% CI 0.44 to 1.91), respectively. No increased risk of bladder cancer was observed (SIR=0.88, 95% CI (0.61 to 1.28)). No significantly increased risk of cancer incidence was observed in the combined cohort of rubber workers first employed since 1975. Continued surveillance of the present cohorts is required to confirm absence of long-term risk and confirmatory findings from other cohorts would be important. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Evaluation of the effect of shift work on serum cholesterol and triglyceride levels.

PubMed

Akbari, Hamed; Mirzaei, Ramazan; Nasrabadi, Tahereh; Gholami-Fesharaki, Mohammad

2015-01-01

Working outside daylight hours (7 am to 7 pm) is called shift work. Shift work is a common practice in many industries and factories such as steel industries, petroleum industries, power plants, and in some services such as medicine and nursing and police forces, in which professionals provide services during day and night. Considering the contradictory reports of different studies, we decided to evaluate the effect of shift work on cholesterol and triglyceride (TG) levels through a historical cohort on steel industry workers. This retrospective cohort study was performed on all the staff of Isfahan's Mobarakeh Steel Company between years 2002 and 2011. There were 5773 participants in this study. Data were collected from the medical records of the staff using the census method. For analysis of data, generalized estimating equation (GEE) regression was used. The results showed a significant difference in cholesterol levels between shift workers and day workers on the first observation (P < 0.001), yet no such difference was observed for TG (P = 0.853). Moreover, the results showed that the variables of age, work experience and BMI were not similar between shift workers and day workers. Therefore, to remove the effect of such variables, we used GEE regression. Despite the borderline difference of cholesterol between regular shift workers and day workers, this correlation was not statistically significant (P = 0.051). The results for TG also showed no correlation with shift work. According to the findings of this study, there is no relationship between shift work and changes in serum TG and cholesterol. The lack of relationship can be due to shift plans for shift workers, nutrition, or the "Healthy Heart project" at Isfahan Mobarakeh Steel Company.

Worker substance use, workplace problems and the risk of occupational injury: a matched case-control study.

PubMed

Spicer, Rebecca S; Miller, Ted R; Smith, Gordon S

2003-07-01

This study examines the tendency toward problem behavior as an explanation for the relationship between problem substance use and occupational injury. The authors used a matched case-control study nested in a cohort of 26,413 workers, in which cases (n = 3,994) were workers suffering an occupational injury. Five controls per case (n = 19,970) were selected from the cohort of workers active on the day of the injury and matched on job type. Conditional logistic regression modeled the association of problem substance use with occupational injury, controlling for problem behaviors and worker characteristics. Problem substance use was indicated indirectly if any of the following were alcohol/drug-involved during the comparison period: Employee Assistance Program visit, excused absence or disciplinary action. Discipline records identified minor (absenteeism) and serious (dishonesty, theft, assault, harassment, disrespect) problem behaviors during the comparison period. The odds of injury among workers with an indicator of problem substance use was 1.35 (p = .015) times greater than the odds among workers without an indicator, controlling for job type and demographics as well as adjusting for exposure. This ratio declined to 1.21 (p = .138) when problem behaviors were also controlled for. Minor and serious problem behaviors were significantly associated with occupational injury (odds ratio [OR] = 1.73, p < .001, and OR = 2.19, p < .001, respectively), controlling for demographics and substance use. The relationship of problem substance use with occupational injury was weak when problem behaviors were controlled for, suggesting that this relationship, observed in previous studies, may be explained by a workers tendency toward problem behaviors. Workplace injury prevention programs should address the expression of problem behaviors as a complement to drug and alcohol deterrent programs.

Health consequences of the 'Great Recession' on the employed: evidence from an industrial cohort in aluminum manufacturing.

PubMed

Modrek, Sepideh; Cullen, Mark R

2013-09-01

While the negative effects of unemployment have been well studied, the consequences of layoffs and downsizing for those who remain employed are less well understood. This study uses human resources and health claims data from a large multi-site fully insured aluminum company to explore the health consequences of downsizing on the remaining workforce. We exploit the variation in the timing and intensity of layoff to categorize 30 plants as high or low layoff plants. Next, we select a stably employed cohort of workers with history of health insurance going back to 2006 to 1) describe the selection process into layoff and 2) explore the association between the severity of plant level layoffs and the incidence of four chronic conditions in the remaining workforce. We examine four health outcomes: incident hypertension, diabetes, asthma/COPD and depression for a cohort of approximately 13,000 employees. Results suggest that there was an increased risk of developing hypertension for all workers and an increased risk of developing diabetes for salaried workers that remain at the plants with the highest level of layoffs. The hypertension results were robust to a several specification tests. In addition, the study design selected only healthy workers, therefore our estimates are likely to be a lower bound and suggest that adverse health consequences of the 2007-2009 recession may have affected a broader proportion of the population than previously expected. Copyright © 2013 Elsevier Ltd. All rights reserved.

Health Consequences of the ‘Great Recession’ on the Employed: Evidence from an Industrial Cohort in Aluminum Manufacturing

PubMed Central

Modrek, Sepideh; Cullen, Mark R.

2013-01-01

While the negative effects of unemployment have been well studied, the consequences of layoffs and downsizing for those who remain employed are less well understood. This study used human resources and health claims data from a large multi-site fully insured aluminum company to explore the health consequences of downsizing on the remaining workforce. We exploit the variation in the timing and intensity of layoff to categorize 30 plants as high or low layoff plants. Next, we select a stably employed cohort of workers with history of health insurance going back to 2006 to 1) describe the selection process into layoff and 2) explore the association between the severity of plant level layoffs and the incidence of four chronic conditions in the remaining workforce. We examined four health outcomes: incident hypertension, diabetes, asthma/COPD and depression for a cohort of approximately 13,000 employees. Results suggest that there was an increased risk of developing hypertension for workers that remain at the plants with the highest level of layoffs, and increased risk of developing diabetes for salaried workers that remain at the plants with the highest level of layoffs. The hypertension results were robust to a several specification tests. In addition, the study design selected only healthy workers, therefore our results are likely to be a lower bound and suggest that adverse health consequences of the current recession may affect a broader proportion of the population than previously expected. PMID:23849284

Leukemia and brain tumors in Norwegian railway workers, a nested case-control study.

PubMed

Tynes, T; Jynge, H; Vistnes, A I

1994-04-01

In an attempt to assess whether exposure to electromagnetic fields on Norwegian railways induces brain tumors or leukemia, the authors conducted a nested case-control study of railway workers based on incident cases from the Cancer Registry of Norway in a cohort of 13,030 male Norwegian railway workers who had worked on either electric or non-electric railways. The cohort comprised railway line, outdoor station, and electricity workers. The case series comprised 39 men with brain tumors and 52 men with leukemia (follow-up, 1958-1990). Each case was matched on age with four or five controls selected from the same cohort. The exposure of each study subject to electric and magnetic fields was evaluated from cumulative exposure measures based on present measurements and historical data. Limited information on potential confounders such as creosote, solvents, and herbicides was also collected; information on whether the subject had smoked was obtained by interviews with the subjects or work colleagues. The case-control analysis showed that men employed on electric railways, compared with non-electric ones, had an odds ratio for leukemia of 0.70 (adjusted for smoking) and an odds ratio for brain tumor of 0.87. No significant trend was shown for exposure to either magnetic or electric fields. These results do not support an association between exposure to 16 2/3-Hertz electric or magnetic fields and the risk for leukemia or brain tumors.

Occupational exposure to trichloroethylene and cancer risk for workers at the Paducah Gaseous Diffusion Plant.

PubMed

Bahr, Debra E; Aldrich, Timothy E; Seidu, Dazar; Brion, Gail M; Tollerud, David J; Muldoon, Susan; Reinhart, Nancy; Youseefagha, Ahmed; McKinney, Paul; Hughes, Therese; Chan, Caroline; Rice, Carol; Brewer, David E; Freyberg, Ronald W; Mohlenkamp, Adriane Moser; Hahn, Kristen; Hornung, Richard; Ho, Mona; Dastidar, Aniruddha; Freitas, Samantha; Saman, Daniel; Ravdal, Hege; Scutchfield, Douglas; Eger, Kenneth J; Minor, Steve

2011-03-01

The Paducah Gaseous Diffusion Plant (PGDP) became operational in 1952; it is located in the western part of Kentucky. We conducted a mortality study for adverse health effects that workers may have suffered while working at the plant, including exposures to chemicals. We studied a cohort of 6820 workers at the PGDP for the period 1953 to 2003; there were a total of 1672 deaths to cohort members. Trichloroethylene (TCE) is a specific concern for this workforce; exposure to TCE occurred primarily in departments that clean the process equipment. The Life Table Analysis System (LTAS) program developed by NIOSH was used to calculate the standardized mortality ratios for the worker cohort and standardized rate ratio relative to exposure to TCE (the U.S. population is the referent for ageadjustment). LTAS calculated a significantly low overall SMR for these workers of 0.76 (95% CI: 0.72-0.79). A further review of three major cancers of interest to Kentucky produced significantly low SMR for trachea, bronchus, lung cancer (0.75, 95% CI: 0.72-0.79) and high SMR for Non-Hodgkin's lymphoma (NHL) (1.49, 95% CI: 1.02-2.10). No significant SMR was observed for leukemia and no significant SRRs were observed for any disease. Both the leukemia and lung cancer results were examined and determined to reflect regional mortality patterns. However, the Non-Hodgkin's Lymphoma finding suggests a curious amplification when living cases are included with the mortality experience. Further examination is recommended of this recurrent finding from all three U.S. Gaseous Diffusion plants.

Leukemia, lymphoma and multiple myeloma mortality (1950-1999) and incidence (1969-1999) in the Eldorado uranium workers cohort.

PubMed

Zablotska, Lydia B; Lane, Rachel S D; Frost, Stanley E; Thompson, Patsy A

2014-04-01

Uranium workers are chronically exposed to low levels of radon decay products (RDP) and gamma (γ) radiation. Risks of leukemia from acute and high doses of γ-radiation are well-characterized, but risks from lower doses and dose-rates and from RDP exposures are controversial. Few studies have evaluated risks of other hematologic cancers in uranium workers. The purpose of this study was to analyze radiation-related risks of hematologic cancers in the cohort of Eldorado uranium miners and processors first employed in 1932-1980 in relation to cumulative RDP exposures and γ-ray doses. The average cumulative RDP exposure was 100.2 working level months and the average cumulative whole-body γ-radiation dose was 52.2 millisievert. We identified 101 deaths and 160 cases of hematologic cancers in the cohort. Overall, male workers had lower mortality and cancer incidence rates for all outcomes compared with the general Canadian male population, a likely healthy worker effect. No statistically significant association between RDP exposure or γ-ray doses, or a combination of both, and mortality or incidence of any hematologic cancer was found. We observed consistent but non-statistically significant increases in risks of chronic lymphocytic leukemia (CLL) and Hodgkin lymphoma (HL) incidence and non-Hodgkin lymphoma (NHL) mortality with increasing γ-ray doses. These findings are consistent with recent studies of increased risks of CLL and NHL incidence after γ-radiation exposure. Further research is necessary to understand risks of other hematologic cancers from low-dose exposures to γ-radiation. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

Organic solvent exposure and hearing loss in a cohort of aluminium workers.

PubMed

Rabinowitz, P M; Galusha, D; Slade, M D; Dixon-Ernst, C; O'Neill, A; Fiellin, M; Cullen, M R

2008-04-01

Organic solvent exposure has been shown to cause hearing loss in animals and humans. Less is known about the risk of hearing loss due to solvent exposures typically found in US industry. The authors performed a retrospective cohort study to examine the relationship between solvent exposure and hearing loss in US aluminium industry workers. A cohort of 1319 workers aged 35 years or less at inception was followed for 5 years. Linkage of employment, industrial hygiene and audiometric surveillance records allowed for estimation of noise and solvent exposures and hearing loss rates over the study period. Study subjects were classified as "solvent exposed" or not, on the basis of industrial hygiene records linked with individual job histories. High frequency hearing loss was modelled as both a continuous and a dichotomous outcome. Typical solvent exposures involved mixtures of xylene, toluene and/or methyl ethyl ketone (MEK). Recorded solvent exposure levels varied widely both within and between jobs. In a multivariate logistic model, risk factors for high frequency hearing loss included age (OR = 1.06, p = 0.004), hunting or shooting (OR = 1.35, p = 0.049), noisy hobbies (OR = 1.74, p = 0.01), baseline hearing level (OR = 1.04, p<0.001) and solvent exposure (OR = 1.87, p = 0.004). A multivariate linear regression analysis similarly found significant associations between high frequency hearing loss and age (p<0.001), hunting or shooting (p<0.001), noisy hobbies (p = 0.03), solvent exposure (p<0.001) and baseline hearing (p = 0.03). These results suggest that occupational exposure to organic solvent mixtures is a risk factor for high frequency hearing loss, although the data do not allow conclusions about dose-response relationships. Industries with solvent-exposed workers should include such workers in hearing conservation programs.

Mortality among Japanese construction workers in Mie Prefecture

PubMed Central

Sun, J; Kubota, H; Hisanaga, N; Shibata, E; Kamijima, M; Nakamura, K

2002-01-01

Aims: A historical cohort mortality study was conducted among 17 668 members of the Construction Workers' Health Insurance Society of Mie Prefecture in Japan, in order to verify the relation between occupations and mortality status. Methods: The cohort was followed from 2 April 1973 to 1 April 1998. Standardised mortality ratios (SMR) were calculated for all members and each job classification. Results: 98.7% of the members were traced successfully until the date when the follow up terminated. When all members were considered together, significant excess mortality was observed for "accidents and adverse effects". Significant excess mortalities were also observed for lung cancers among scaffold men and ironworkers, for cancer of the oesophagus among plumbers, and for "chronic liver disease and cirrhosis" among scaffold men and painters. Conclusion: Results suggest that more detailed investigations, which would include some minor job classifications should be undertaken. This is an updated cohort study which was partially completed in 1997. PMID:12151606

Does tinnitus, hearing asymmetry, or hearing loss predispose to occupational injury risk?

PubMed

Cantley, Linda F; Galusha, Deron; Cullen, Mark R; Dixon-Ernst, Christine; Tessier-Sherman, Baylah; Slade, Martin D; Rabinowitz, Peter M; Neitzel, Richard L

2015-02-01

To determine the relative contributions of tinnitus, asymmetrical hearing loss, low frequency hearing loss (pure tone average of 0.5, 1, 2, 3 kHz; PTA.5123), or high frequency hearing loss (pure tone average of 4, 6 kHz; PTA46), to acute injury risk among a cohort of production and maintenance workers at six aluminum manufacturing plants, adjusting for ambient noise exposure and other recognized predictors of injury risk. Retrospective analysis. The study considered 9920 workers employed during 2003 to 2008. The cohort consisted of 8818 workers (89%) whose complete records were available. Adjusting for noise exposure and other recognized injury predictors, a 25% increased acute injury risk was observed among workers with a history of tinnitus in conjunction with high-frequency hearing loss (PTA46). Low frequency hearing loss may be associated with minor, yet less serious, injury risk. We did not find evidence that asymmetry contributes to injury risk. These results provide evidence that tinnitus, combined with high-frequency hearing loss, may pose an important safety threat to workers, especially those who work in high-noise exposed environments. These at risk workers may require careful examination of their communication and hearing protection needs.

Mortality (1968-2008) in a French cohort of uranium enrichment workers potentially exposed to rapidly soluble uranium compounds.

PubMed

Zhivin, Sergey; Guseva Canu, Irina; Samson, Eric; Laurent, Olivier; Grellier, James; Collomb, Philippe; Zablotska, Lydia B; Laurier, Dominique

2016-03-01

Until recently, enrichment of uranium for civil and military purposes in France was carried out by gaseous diffusion using rapidly soluble uranium compounds. We analysed the relationship between exposure to soluble uranium compounds and exposure to external γ-radiation and mortality in a cohort of 4688 French uranium enrichment workers who were employed between 1964 and 2006. Data on individual annual exposure to radiological and non-radiological hazards were collected for workers of the AREVA NC, CEA and Eurodif uranium enrichment plants from job-exposure matrixes and external dosimetry records, differentiating between natural, enriched and depleted uranium. Cause-specific mortality was compared with the French general population via standardised mortality ratios (SMR), and was analysed via Poisson regression using log-linear and linear excess relative risk models. Over the period of follow-up, 131 161 person-years at risk were accrued and 21% of the subjects had died. A strong healthy worker effect was observed: all causes SMR=0.69, 95% CI 0.65 to 0.74. SMR for pleural cancer was significantly increased (2.3, 95% CI 1.06 to 4.4), but was only based on nine cases. Internal uranium and external γ-radiation exposures were not significantly associated with any cause of mortality. This is the first study of French uranium enrichment workers. Although limited in statistical power, further follow-up of this cohort, estimation of internal uranium doses and pooling with similar cohorts should elucidate potential risks associated with exposure to soluble uranium compounds. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Assessing the health effects associated with occupational radiation exposure in Korean radiation workers: protocol for a prospective cohort study.

PubMed

Seo, Songwon; Lim, Wan Young; Lee, Dal Nim; Kim, Jung Un; Cha, Eun Shil; Bang, Ye Jin; Lee, Won Jin; Park, Sunhoo; Jin, Young Woo

2018-03-30

The cancer risk of radiation exposure in the moderate-to-high dose range has been well established. However, the risk remains unclear at low-dose ranges with protracted low-dose rate exposure, which is typical of occupational exposure. Several epidemiological studies of Korean radiation workers have been conducted, but the data were analysed retrospectively in most cases. Moreover, groups with relatively high exposure, such as industrial radiographers, have been neglected. Therefore, we have launched a prospective cohort study of all Korean radiation workers to assess the health effects associated with occupational radiation exposure. Approximately 42 000 Korean radiation workers registered with the Nuclear Safety and Security Commission from 2016 to 2017 are the initial target population of this study. Cohort participants are to be enrolled through a nationwide self-administered questionnaire survey between 24 May 2016 and 30 June 2017. As of 31 March 2017, 22 982 workers are enrolled in the study corresponding to a response rate of 75%. This enrolment will be continued at 5-year intervals to update information on existing study participants and recruit newly hired workers. Survey data will be linked with the national dose registry, the national cancer registry, the national vital statistics registry and national health insurance data via personal identification numbers. Age-specific and sex-specific standardised incidence and mortality ratios will be calculated for overall comparisons of cancer risk. For dose-response assessment, excess relative risk (per Gy) and excess absolute risk (per Gy) will be estimated with adjustments for birth year and potential confounders, such as lifestyle factors and socioeconomic status. This study has received ethical approval from the institutional review board of the Korea Institute of Radiological and Medical Sciences (IRB No. K-1603-002-034). All participants provided written informed consent prior to enrolment. The findings of the study will be disseminated through scientific peer-reviewed journals and be provided to the public, including radiation workers, via the study website (http://www.rhs.kr/) and onsite radiation safety education. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Leukemia, lymphoma and multiple myeloma mortality (1950–1999) and incidence (1969–1999) in the Eldorado uranium workers cohort

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zablotska, Lydia B., E-mail: Lydia.Zablotska@ucsf.edu; Lane, Rachel S.D.; Frost, Stanley E.

Uranium workers are chronically exposed to low levels of radon decay products (RDP) and gamma (γ) radiation. Risks of leukemia from acute and high doses of γ-radiation are well-characterized, but risks from lower doses and dose-rates and from RDP exposures are controversial. Few studies have evaluated risks of other hematologic cancers in uranium workers. The purpose of this study was to analyze radiation-related risks of hematologic cancers in the cohort of Eldorado uranium miners and processors first employed in 1932–1980 in relation to cumulative RDP exposures and γ-ray doses. The average cumulative RDP exposure was 100.2 working level months andmore » the average cumulative whole-body γ-radiation dose was 52.2 millisievert. We identified 101 deaths and 160 cases of hematologic cancers in the cohort. Overall, male workers had lower mortality and cancer incidence rates for all outcomes compared with the general Canadian male population, a likely healthy worker effect. No statistically significant association between RDP exposure or γ-ray doses, or a combination of both, and mortality or incidence of any hematologic cancer was found. We observed consistent but non-statistically significant increases in risks of chronic lymphocytic leukemia (CLL) and Hodgkin lymphoma (HL) incidence and non-Hodgkin lymphoma (NHL) mortality with increasing γ-ray doses. These findings are consistent with recent studies of increased risks of CLL and NHL incidence after γ-radiation exposure. Further research is necessary to understand risks of other hematologic cancers from low-dose exposures to γ-radiation. - Highlights: • We analyzed long-term follow-up for hematologic cancers of the Eldorado uranium workers. • Workers were exposed to a unique combination of radon decay products (RDP) and gamma (γ) ray doses. • Exposures to RDP and γ-ray doses were not associated with significantly increased risks of cancers. • Radiation risks of chronic lymphocytic leukemia (CLL) and Hodgkin lymphoma were increased. • Study findings provide additional support for radiation-related risks of CLL.« less

The Impact of Workers' Compensation on Outcomes of Surgical and Nonoperative Therapy for Patients with a Lumbar Disc Herniation SPORT

PubMed Central

Atlas, Steven J.; Tosteson, Tor D.; Blood, Emily A.; Skinner, Jonathan S.; Pransky, Glenn S.; Weinstein, James N.

2010-01-01

Study Design Prospective randomized and observational cohorts. Objective To compare outcomes of patients with and without workers' compensation who had surgical and nonoperative treatment for a lumbar intervertebral disc herniation (IDH). Summary of Background Data Few studies have examined the association between worker's compensation and outcomes of surgical and nonoperative treatment. Methods Patients with at least 6 weeks of sciatica and a lumbar IDH were enrolled in either a randomized trial or observational cohort at 13 US spine centers. Patients were categorized as workers' compensation or nonworkers' compensation based on baseline disability compensation and work status. Treatment was usual nonoperative care or surgical discectomy. Outcomes included pain, functional impairment, satisfaction and work/disability status at 6 weeks, 3, 6, 12, and 24 months. Results Combining randomized and observational cohorts, 113 patients with workers' compensation and 811 patients without were followed for 2 years. There were significant improvements in pain, function, and satisfaction with both surgical and nonoperative treatment in both groups. In the nonworkers' compensation group, there was a clinically and statistically significant advantage for surgery at 3 months that remained significant at 2 years. However, in the workers' compensation group, the benefit of surgery diminished with time; at 2 years no significant advantage was seen for surgery in any outcome (treatment difference for SF-36 bodily pain [−5.9; 95% CI: −16.7–4.9] and physical function [5.0; 95% CI: −4.9–15]). Surgical treatment was not associated with better work or disability outcomes in either group. Conclusion Patients with a lumbar IDH improved substantially with both surgical and nonoperative treatment. However, there was no added benefit associated with surgical treatment for patients with workers' compensation at 2 years while those in the nonworkers' compensation group had significantly greater improvement with surgical treatment. PMID:20023603

Mental health of workers in Toulouse 2 years after the industrial AZF disaster: first results of a longitudinal follow-up of 3,000 people.

PubMed

Cohidon, Christine; Diène, Eloi; Carton, Matthieu; Fatras, Jean-Yves; Goldberg, Marcel; Imbernon, Ellen

2009-09-01

On September 21, 2001, the AZF petrochemical factory near Toulouse (France) exploded. A cross-sectional survey of Toulouse workers took place in 2002 and then, a cohort follow-up began in 2003. The aim of this paper is to study the associations between various factors describing exposure to the disaster, and anxiety and depressive symptoms, assessed at cohort inclusion 2 years afterwards. In 2003, 3,006 people were included in the cohort. Psychological distress was measured by the GHQ28 at inclusion. Factors related to exposure to the disaster, such as personal distance from the site, physical injury, immediate psychological symptoms, and material and social effects, came from the 2002 cross-sectional survey. The links between mental health symptoms and exposure were studied in multivariate analyses by logistic regression. The prevalence of psychological distress was 47% at inclusion in the cohort. It varied according to sex and occupational class: blue-collar workers and self-employed people were most highly affected. Factors such as a history of depression, injury to a close friend or family member, sick-leaves and immediate psychological symptoms were associated with psychological distress 2 years later. These associations differed according to sex. This study shows links between the industrial disaster and psychological distress 2 years afterwards. The results about risk factors differ according to sex, and identify particularly vulnerable populations. It should guide preventive interventions in such situation.

Effects of a peer support programme for youth social services employees experiencing potentially traumatic events: a protocol for a prospective cohort study.

PubMed

Guay, Stephane; Tremblay, Nicole; Goncalves, Jane; Bilodeau, Henriette; Geoffrion, Steve

2017-06-24

The use of peer support programmes to help workers experiencing potentially traumatic events (PTE) has increased in high-risk organisations in the last decades. However, the scientific evidence of its effectiveness is still very limited. This paper aims to describe the protocol of a prospective cohort study that assesses the efficacy of a peer support programme among youth social services employees exposed to a PTE at work on psychological well-being, work functioning and needs of support. This is a mixed-methods prospective study that will examine workers' evolution four times over a 12-month period in Canada. This study involves: (1) quantitative data obtained through self-administrated questionnaires among 222 workers, and (2) qualitative in-depth interviews with a subsample of 45 workers. This study will compare findings from a cohort who received the support of a peer following a PTE (peer support-experimental protocol) as part of the experimental protocol of the Montreal Youth Social Services-University Institute (MYSS-UI), the second group of workers did not ask for the peer support (no peer support-experimental protocol) but was part of MYSS-UI, and the third group received standard organisational support from the Monteregie Youth Social Services (MYSS) (standard organisational protocol). The protocol and informed consent form complied with the ethics guidelines of the MYSS-UI. The Research Ethics Board of MYSS-UI and MYSS reviewed and accepted the protocol as required. The results of the study will be published in peer-reviewed journals, presented at research and general public conferences, disseminated via a public report for the institute that funded the project and for all workers. Results of this study will influence decision making regarding intervention policies following PTE and peer support interventions may be expanded throughout the youth social services in Canada and worldwide. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Reanalysis of mortality from lung cancer among diatomaceous earth industry workers, with consideration of potential confounding by asbestos exposure.

PubMed Central

Checkoway, H; Heyer, N J; Demers, P A; Gibbs, G W

1996-01-01

OBJECTIVE: To evaluate the potential for confounding from asbestos exposure, primarily chrysotile, on the relation between crystalline silica and mortality from lung cancer among diatomaceous earth (diatomite) workers. METHODS: A reanalysis of a cohort mortality study of diatomite workers was performed to take into account quantitative estimates of asbestos exposure. The reanalysis was limited to a subset of the original cohort, comprising 2266 white men for whom asbestos exposure could be reconstructed with greatest confidence. Comparisons between mortality from lung cancer (standardised mortality ratios (SMR)) were made between rates for 1942-87 for United States white men, and workers cross classified according to cumulative exposures to crystalline silica and asbestos. Comparisons of internal rates, involving Poisson regression modeling, were conducted for exposure to crystalline silica, with and without adjustment for asbestos exposure. Exposures were lagged by 15 years to take into account disease latency. RESULTS: There was an overall excess of lung cancer (SMR 1.41; 52 observed). The SMRs for four categories of increasing crystalline silica among the workers not exposed to asbestos were 1.13, 0.87, 2.14, 2.00. An SMR of 8.31 (three observed) was found for workers with the highest cumulative exposure to both dusts. Internal analysis, after adjustment for asbestos exposure, yielded rate ratios for categories of exposure to crystalline silica: 1.00 (reference), 1.37, 1.80, and 1.79. CONCLUSIONS: Asbestos exposure was not an important confounder of the association between crystalline silica and mortality from lung cancer in this cohort. Although based on a small number of deaths from lung cancer, the data suggest possible synergy between these exposures. An extended follow up of this cohort is in progress and should enable better assessments of independent and combined effects on risk of lung cancer. PMID:8882123

A prospective cohort study of shift work and the risk of death from pancreatic cancer in Japanese men.

PubMed

Lin, Yingsong; Ueda, Junko; Yagyu, Kiyoko; Kurosawa, Michiko; Tamakoshi, Akiko; Kikuchi, Shogo

2013-07-01

There is mounting evidence that shift work involving night work increases cancer risk. We examined the relationship between working rotating shifts and the risk of death from pancreatic cancer on the basis of data from the Japanese Collaborative Cohort Study (JACC Study). The present analysis was restricted to 22,224 men who were 40-65 years of age at baseline (1988-1990) and who reported working full time or were self-employed in the JACC Study. The subjects were followed through 31 December 2009. Information on occupation and lifestyle factors was collected using a self-administered questionnaire. The Cox proportional hazards model was used to estimate the relative risk (RR) and 95% confidence interval (CI) for the risk of death from pancreatic cancer in relation to shift work. During the follow-up period, 127 pancreatic cancer deaths were observed. Overall, we found no statistically significant increase in the risk of death from pancreatic cancer associated with rotating shift work. As compared to day-shift workers, the RRs were 0.83 (95% CI 0.43-1.60) for rotating shift workers and 0.61 (95% CI 0.22-1.60) for fixed night-shift workers, after adjustment for potential confounding factors. The multivariable-adjusted RR was 1.34 (95% CI 0.66-2.75) among rotating shift workers in the analysis restricted to men who reported working full time at baseline. Our data did not support the hypothesis that shift work is significantly associated with the risk of death from pancreatic cancer in this cohort of Japanese men.

Occupational exposure to ionizing radiation and electromagnetic fields in relation to the risk of thyroid cancer in Sweden.

PubMed

Lope, Virginia; Pérez-Gómez, Beatriz; Aragonés, Nuria; López-Abente, Gonzalo; Gustavsson, Per; Floderus, Birgitta; Dosemeci, Mustafa; Silva, Agustín; Pollán, Marina

2006-08-01

This study sought to ascertain the risk of thyroid cancer in relation to occupational exposure to ionizing radiation and extremely low-frequency magnetic fields (ELFMF) in a cohort representative of Sweden's gainfully employed population. A historical cohort of 2 992 166 gainfully employed Swedish male and female workers was followed up from 1971 through 1989. Exposure to ELFMF and ionizing radiation was assessed using three job exposure matrices based on industrial branch or occupational codes. Relative risks (RR) for male and female workers, adjusted for age and geographic area, were computed using log-linear Poisson models. Occupational ELFMF exposure showed no effect on the risk of thyroid cancer in the study. However, female workers exposed to high intensities of ionizing radiation registered a marked excess risk (RR 1.85, 95% confidence interval (95% CI) 1.02-3.35]. This trend was not in evidence among the men. While the study confirms the etiologic role of ionizing radiation, with a higher incidence of thyroid cancer being recorded for the most-exposed female workers, our results do not support the possibility of occupational exposure to ELFMF being a risk factor for the development of thyroid cancer.

End stage renal disease among ceramic workers exposed to silica

PubMed Central

Rapiti, E.; Sperati, A.; Miceli, M.; Forastiere, F.; Di, L; Cavariani, F.; Goldsmith, D. F.; Perucci, C. A.

1999-01-01

OBJECTIVES: To evaluate whether ceramic workers exposed to silica experience an excess of end stage renal disease. METHODS: On the basis of a health surveillance programme, a cohort of 2980 male ceramic workers has been enrolled during the period 1974-91 in Civitacastellana, Lazio, Italy. For each worker, employment history, smoking data, and x ray film readings were available. The vital status was ascertained for all cohort members. All 2820 people still alive and resident in the Lazio region as in June 1994 were searched for a match in the regional end stage renal diseases registry, which records (since June, 1994) all patients undergoing dialysis treatment in public and private facilities of the region. Expected numbers of prevalent cases from the cohort were computed by applying the rate of patients on dialysis treatment by the age distribution of the cohort. RESULTS: A total of six cases was detected when 1.87 were expected (observed/expected (O/E) = 3.21; 95% confidence interval (95% CI) 1.17 to 6.98). The excess risk was present among non-smokers (O = 2; O/E = 4.34) and smokers (O = 4; O/E = 2.83), as well as among workers without silicosis (O = 4; O/E = 2.78) and workers with silicosis (O = 2; O/E = 4.54). The risk was higher among subjects with < 20 years since first employment (O = 4; O/E = 4.65) than among those employed > 20 years. CONCLUSION: These results provide further evidence that exposure to silica dust among ceramic workers is associated with nephrotoxic effects.   PMID:10492655

Health Care Utilization and Costs Associated with Adherence to Clinical Practice Guidelines for Early Magnetic Resonance Imaging among Workers with Acute Occupational Low Back Pain

PubMed Central

Graves, Janessa M; Fulton-Kehoe, Deborah; Jarvik, Jeffrey G; Franklin, Gary M

2014-01-01

Objective To estimate health care utilization and costs associated with adherence to clinical practice guidelines for the use of early magnetic resonance imaging (MRI; within the first 6 weeks of injury) for acute occupational low back pain (LBP). Data Sources Washington State Disability Risk Identification Study Cohort (D-RISC), consisting of administrative claims and patient interview data from workers’ compensation claimants (2002–2004). Study Design In this prospective, population-based cohort study, we compared health care utilization and costs among workers whose imaging was adherent to guidelines (no early MRI) to workers whose imaging was not adherent to guidelines (early MRI in the absence of red flags). Data Collection/Extraction Methods We identified workers (age >18) with work-related LBP using administrative claims. We obtained demographic, injury, health, and employment information through telephone interviews to adjust for baseline differences between groups. We ascertained health care utilization and costs from administrative claims for 1 year following injury. Principal Findings Of 1,770 workers, 336 (19.0 percent) were classified as nonadherent to guidelines. Outpatient and physical/occupational therapy utilization was 52–54 percent higher for workers whose imaging was not adherent to guidelines compared to workers with guideline-adherent imaging; utilization of chiropractic care was significantly lower (18 percent). Conclusions Nonadherence to guidelines for early MRI was associated with increased likelihood of lumbosacral injections or surgery and higher costs for out-patient, inpatient, and nonmedical services, and disability compensation. PMID:23910019

Cancer incidence in the workers cohort of textile manufacturing factory in Alytus, Lithuania.

PubMed

Kuzmickiene, Irena; Didziapetris, Remigijus; Stukonis, Mecys

2004-02-01

Altogether 14,650 workers employed at least for 1 year a the textile factory in Alytus, Lithuania, were included in the cohort and followed during the period from 1978 to 1997. The standardized incidence ratio (SIR) for men was 1.28. The incidence of esophagus cancer was significant higher (SIR 3.42). It increased only slightly for lung (SIR 1.35). In the women cohort, SIR was 1.05. However, there was a significant increase of the incidence of gallbladder cancer (SIR 3.19). Among textile-processing (spinning and weaving departments) women workers, we found elevated total cancer incidence (SIR 1.35), incidence of breast cancer (SIR 1.49), and cervical cancer (SIR 1.82). In this cohort increased SIR values were observed for more than 10 years since first exposure for all cancer (SIR 1.70) and cervical cancer (SIR 2.44).

Quantifying and Adjusting for Disease Misclassification Due to Loss to Follow-Up in Historical Cohort Mortality Studies.

PubMed

Scott, Laura L F; Maldonado, George

2015-10-15

The purpose of this analysis was to quantify and adjust for disease misclassification from loss to follow-up in a historical cohort mortality study of workers where exposure was categorized as a multi-level variable. Disease classification parameters were defined using 2008 mortality data for the New Zealand population and the proportions of known deaths observed for the cohort. The probability distributions for each classification parameter were constructed to account for potential differences in mortality due to exposure status, gender, and ethnicity. Probabilistic uncertainty analysis (bias analysis), which uses Monte Carlo techniques, was then used to sample each parameter distribution 50,000 times, calculating adjusted odds ratios (ORDM-LTF) that compared the mortality of workers with the highest cumulative exposure to those that were considered never-exposed. The geometric mean ORDM-LTF ranged between 1.65 (certainty interval (CI): 0.50-3.88) and 3.33 (CI: 1.21-10.48), and the geometric mean of the disease-misclassification error factor (εDM-LTF), which is the ratio of the observed odds ratio to the adjusted odds ratio, had a range of 0.91 (CI: 0.29-2.52) to 1.85 (CI: 0.78-6.07). Only when workers in the highest exposure category were more likely than those never-exposed to be misclassified as non-cases did the ORDM-LTF frequency distributions shift further away from the null. The application of uncertainty analysis to historical cohort mortality studies with multi-level exposures can provide valuable insight into the magnitude and direction of study error resulting from losses to follow-up.

Mortality study of civilian employees exposed to contaminated drinking water at USMC Base Camp Lejeune: a retrospective cohort study

PubMed Central

2014-01-01

Background Two drinking water systems at U.S. Marine Corps Base Camp Lejeune, North Carolina were contaminated with solvents during 1950s-1985. Methods We conducted a retrospective cohort mortality study of 4,647 civilian, full-time workers employed at Camp Lejeune during 1973–1985 and potentially exposed to contaminated drinking water. We selected a comparison cohort of 4,690 Camp Pendleton workers employed during 1973–1985 and unexposed to contaminated drinking water. Mortality follow-up period was 1979-2008. Cause-specific standardized mortality ratios utilized U.S. age-, sex-, race-, and calendar period-specific mortality rates as reference. We used survival analysis to compare mortality rates between Camp Lejeune and Camp Pendleton workers and assess the effects of estimated cumulative contaminant exposures within the Camp Lejeune cohort. Ground water contaminant fate/transport and distribution system models provided monthly estimated contaminant levels in drinking water serving workplaces at Camp Lejeune. The confidence interval (CI) indicated precision of effect estimates. Results Compared to Camp Pendleton, Camp Lejeune workers had mortality hazard ratios (HRs) >1.50 for kidney cancer (HR = 1.92, 95% CI: 0.58, 6.34), leukemias (HR = 1.59, 95% CI: 0.66, 3.84), multiple myeloma (HR = 1.84, 95% CI: 0.45, 7.58), rectal cancer (HR = 1.65, 95% CI: 0.36, 7.44), oral cavity cancers (HR = 1.93, 95% CI: 0.34, 10.81), and Parkinson’s disease (HR = 3.13, 95% CI: 0.76, 12.81). Within the Camp Lejeune cohort, monotonic exposure-response relationships were observed for leukemia and vinyl chloride and PCE, with mortality HRs at the high exposure category of 1.72 (95% CI: 0.33, 8.83) and 1.82 (95% CI: 0.36, 9.32), respectively. Cumulative exposures were above the median for most deaths from cancers of the kidney, esophagus, rectum, prostate, and Parkinson’s disease, but small numbers precluded evaluation of exposure-response relationships. Conclusion The study found elevated HRs in the Camp Lejeune cohort for several causes of death including cancers of the kidney, rectum, oral cavity, leukemias, multiple myeloma, and Parkinson’s disease. Only 14% of the Camp Lejeune cohort died by end of follow-up, producing small numbers of cause-specific deaths and wide CIs. Additional follow-up would be necessary to comprehensively assess drinking water exposure effects at the base. PMID:25115749

Return-to-work for multiple jobholders with a work-related musculoskeletal disorder: A population-based, matched cohort in British Columbia.

PubMed

Maas, Esther T; Koehoorn, Mieke; McLeod, Christopher B

2018-01-01

Multiple jobholders (MJHs) have a higher risk of injury compared to single jobholders (SJHs), but it is unknown if return-to-work (RTW) after a work injury is affected by multiple jobholding. This study examined the association between multiple versus single jobholding and time to RTW for workers with a work-related musculoskeletal disorder (MSD). We used administrative workers' compensation data to identify injured workers with an accepted MSD lost-time claim between 2010-2014 in British Columbia, Canada (n = 125,639 SJHs and 9,029 MJHs). The outcome was days until RTW during twelve months after the first day of time-loss. The MJH and SJH cohorts were balanced using coarsened exact matching that yielded a final matched cohort of 8,389 MJHs and 8,389 SJHs. The outcome was estimated with Cox regression, using piecewise models, and the hazard ratios were stratified by type of MSD, a serious injury indicator, gender, weekly workdays preceding MSD, and wage categories. MJHs were less likely to RTW compared to SJHs within the first six months after the first time-loss day, with greater and longer lasting effects for males, workers with a serious injury, and a higher wage. No difference between MJHs and SJHs was found for workers who had a six- or seven-day work week preceding MSD, for workers with dislocations, and for workers who were still off work after six months. Overall, MJHs with a workweek of maximum five days are disadvantaged compared to SJHs in terms of RTW following a work-related MSD within the first six months after the first time-loss day. This difference might be caused by more precarious job contracts for MJHs that challenges RTW because of lack of support for modified work, higher workload, and reduced likelihood that MJHs file a workers' compensation claim. Despite adjusting for type of MSD, severity of injury and occupation, the differences persisted for the vast majority of the study sample.

Inception cohort study of workers exposed to toluene diisocyanate at a polyurethane foam factory: initial one-year follow-up.

PubMed

Gui, Wei; Wisnewski, Adam V; Neamtiu, Iulia; Gurzau, Eugen; Sparer, Judith A; Stowe, Meredith H; Liu, Jian; Slade, Martin D; Rusu, Olivia A; Redlich, Carrie A

2014-11-01

Isocyanates are one of the most commonly reported causes of occupational asthma; however, the risks of developing isocyanate asthma in modern production facilities remain poorly defined. We evaluated TDI exposure and respiratory health among an inception cohort of workers during their first year of employment at a new polyurethane foam production factory. Forty-nine newly hired workers were evaluated pre-employment, 6-months, and 12-months post-employment through questionnaire, spirometry, and TDI-specific serology. Airborne TDI levels were monitored by fixed-point air sampling and limited personal sampling. Qualitative surface SWYPE™ tests were performed to evaluate potential sources of skin exposure. Airborne TDI levels overall were low; over 90% of fixed-point air measurements were below the limit of detection (0.1 ppb). Over the first year of employment, 12 of the 49 original workers (24.5%) were lost to follow-up, no additional workers were enrolled, and seven of the 49 original workers (14.2%) developed either new asthma symptoms (N = 3), TDI-specific IgG (N = 1), new airflow obstruction (N = 1) and/or a decline in FEV1  ≥ 15% (N = 3), findings that could indicate TDI-related health effects. The prevalence of current asthma symptoms was significantly higher in the workers lost to follow-up compared to those who completed the 12-month follow-up (25% vs. 2.7%; P = 0.04). The findings suggest possible early TDI-related health effects in a modern polyurethane production plant. These findings also highlight the need for further longitudinal evaluation of these workers and the challenges of studying workers at risk for isocyanate asthma. © 2014 Wiley Periodicals, Inc.

Inception Cohort Study of Workers Exposed to Toluene Diisocyanate at a Polyurethane Foam Factory: Initial One-Year Follow-up

PubMed Central

Gui, Wei; Wisnewski, Adam V.; Neamtiu, Iulia; Gurzau, Eugen; Sparer, Judith A.; Stowe, Meredith H.; Liu, Jian; Slade, Martin D.; Rusu, Olivia A.; Redlich, Carrie A.

2014-01-01

Background Isocyanates are one of the most commonly reported causes of occupational asthma; however, the risks of developing isocyanate asthma in modern production facilities remain poorly defined. We evaluated TDI exposure and respiratory health among an inception cohort of workers during their first year of employment at a new polyurethane foam production factory. Methods Forty-nine newly hired workers were evaluated pre-employment, 6-months, and 12-months post-employment through questionnaire, spirometry and TDI-specific serology. Airborne TDI levels were monitored by fixed-point air sampling and limited personal sampling. Qualitative surface SWYPE™ tests were performed to evaluate potential sources of skin exposure. Results Airborne TDI levels overall were low; over 90% of fixed-point air measurements were below the limit of detection (0.1 ppb). Over the first year of employment,12 of the 49 original workers (24.5%) were lost to follow-up, no additional workers were enrolled, and seven of the 49 original workers (14.2%) developed either new asthma symptoms (N=3), TDI-specific IgG (N=1), new airflow obstruction (N=1) and/or a decline in FEV1≥ 15% (N=3), findings that could indicate TDI-related health effects.The prevalence of current asthma symptoms was significantly higher in the workers lost to follow-up compared to those who completed the 12 month follow-up (25% vs.2.7%; p=0.04). Conclusions The findings suggest possible early TDI-related health effects in a modern polyurethane production plant. These findings also highlight the need for further longitudinal evaluation of these workers and the challenges of studying workers at risk for isocyanate asthma. PMID:25266741

Determinants of working until retirement compared to a transition to early retirement among older workers with and without chronic diseases: Results from a Dutch prospective cohort study.

PubMed

Sewdas, Ranu; van der Beek, Allard J; de Wind, Astrid; van der Zwaan, Lennart G L; Boot, Cécile R L

2018-05-01

The ageing society and recent policy changes may lead to an increase of older workers with chronic diseases in the workforce. To date, it is unclear whether workers with chronic diseases have specific needs while employed. The aim of this study is to explore the differences in determinants of working until retirement compared to a reference group who have transitioned to early retirement among workers with and without chronic diseases. Dutch workers aged 57-62 years ( n = 2445) were selected from an existing prospective cohort study, 'STREAM'. The potential determinants were categorized into: individual, health, work-related and social factors. Logistic regression analyses were performed to determine the associations between these determinants and working until retirement - once for workers with and once for those without chronic diseases. To test differences, we included an interaction term between the determinant and the covariate 'having a chronic disease yes/no' in the analyses of the total population. In total, 1652 (68%) persons were employed from 2011 to 2013. The majority of the determinants appeared to be similar for workers with or without a chronic disease; the interaction terms for these determinants and the covariate 'having a chronic disease' showed a p-value higher than 0.05, except for one individual factor (i.e. mastery) and one work-related factor (i.e. autonomy), which showed a p-value below 0.05. Higher mastery and higher autonomy were statistically significantly associated with working until retirement for those with chronic diseases, whereas they were not for those without chronic diseases. Differences between workers with and without chronic diseases may exist for working until a statutory retirement age. Interventions aimed at encouraging work participation of older workers should make a distinction between the two groups. Autonomy at work and mastery were found to be factors that may promote work participation until higher age, specifically for older workers with chronic diseases.

Polychlorinated dibenzo-p-dioxins and dibenzofurans and their association with cancer mortality among workers in one automobile foundry factory.

PubMed

Wang, Lihua; Weng, Shaofan; Wen, Sheng; Shi, Tingming; Sun, Gangtao; Zeng, Yuyu; Qi, Cheng; Chen, Weihong

2013-01-15

Polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) have been reported as possible carcinogenic hazards to humans. However, epidemiological studies on their carcinogenic roles are limited. The current study was designed to determine the concentrations and characteristics of PCDD/Fs and evaluate their association with cancer mortality in exposed workers in one automobile foundry factory. PCDD/F levels in factory and surrounding environment were analyzed through air and settling dust sampling. The cancer mortalities among workers in this foundry factory were calculated using data from a cohort study. The results showed that the PCDD/F concentrations of air in workplace ranged 0.36-2.25 pg World Health Organization-Toxic Equivalent (WHO-TEQ) Nm(-3) (average 1.01 pg WHO-TEQ Nm(-3)), which were 1.16-7.26 times higher than those outside the factory. The PCDD/F concentrations of settling dust in the workplace ranged 3.34-18.64 pg WHO-TEQ g(-1) (average 8.25 pg WHO-TEQ g(-1)), which were lower than those just outside the factory (average 16.13 pg WHO-TEQ g(-1)). Furthermore, a cohort study of workers in this factory with average follow-up of 24.52 years showed that cancer was the leading cause of death, with significant elevated mortality (standardized mortality ratio (SMR)=1.70, 95% confidence interval (CI): 1.35-2.13) among workers, when compared with Chinese national mortality. The cancer mortality among front-line workers was increased significantly (adjusted relative risk (RR)=1.73, 95% CI: 1.14-2.60), particularly among melting and casting workers, when compared with that among assistant workers. Our results indicated that there was a dose-response relationship between PCDD/F exposure and cancer mortality among foundry workers. Copyright © 2012 Elsevier B.V. All rights reserved.

Impact of Development and Accommodation Practices on Older Workers' Job Characteristics, Prolonged Fatigue, Work Engagement, and Retirement Intentions Over Time.

PubMed

Stynen, Dave; Jansen, Nicole W H; Slangen, Jos J M; Kant, IJmert

2016-11-01

The impact of development and accommodation practices on older workers' retirement intentions was investigated in this prospective study, together with potential pathways and the role of career stage. A subsample of full-time, older workers (n = 678) from the Maastricht Cohort Study was followed-up for 2 years. Regression analysis was conducted for three age groups. Development practices related positively with later retirement intentions in workers aged 55 to 59 years. The accommodation practice of demotion related negatively with later retirement intentions in worker aged at least 60 years. Decision latitude and work engagement were found to link development and accommodation practices with later retirement intentions in particular in workers aged 55 to 59 years. It was indicated in this prospective study that development and accommodation practices may be useful for prolonging working careers.

Return-to-work of sick-listed workers without an employment contract--what works?

PubMed

Vermeulen, Sylvia J; Tamminga, Sietske J; Schellart, Antonius Jm; Ybema, Jan Fekke; Anema, Johannes R

2009-07-14

In the past decade flexible labour market arrangements have emerged as a significant change in the European Union labour market. Studies suggest that these new types of labour arrangements may be linked to ill health, an increased risk for work disability, and inadequate vocational rehabilitation. Therefore, the objectives of this study were: 1. to examine demographic characteristics of workers without an employment contract sick-listed for at least 13 weeks, 2. to describe the content and frequency of occupational health care (OHC) interventions for these sick-listed workers, and 3. to examine OHC interventions as possible determinants for return-to-work (RTW) of these workers. A cohort of 1077 sick-listed workers without an employment contract were included at baseline, i.e. 13 weeks after reporting sick. Demographic variables were available at baseline. Measurement of cross-sectional data took place 4-6 months after inclusion. Primary outcome measures were: frequency of OHC interventions and RTW-rates. Measured confounding variables were: gender, age, type of worker (temporary agency worker, unemployed worker, or remaining worker without employment contract), level of education, reason for absenteeism (diagnosis), and perceived health. The association between OHC interventions and RTW was analysed with a logistic multiple regression analysis. At 7-9 months after the first day of reporting sick only 19% of the workers had (partially or completely) returned to work, and most workers perceived their health as fairly poor or poor. The most frequently reported (49%) intervention was 'the OHC professional discussed RTW'. However, the intervention 'OHC professional made and discussed a RTW action plan' was reported by only 19% of the respondents. The logistic multiple regression analysis showed a significant positive association between RTW and the interventions: 'OHC professional discussed RTW'; and 'OHC professional made and discussed a RTW action plan'. The intervention 'OHC professional referred sick-listed worker to a vocational rehabilitation agency' was significantly associated with no RTW. This is the first time that characteristics of a large cohort of sick-listed workers without an employment contract were examined. An experimental or prospective study is needed to explore the causal nature of the associations found between OHC interventions and RTW.

OCCUPATIONAL EXPOSURE TO TRICHLOROETHYLENE AND CANCER RISK FOR WORKERS AT THE PADUCAH GASEOUS DIFFUSION PLANT

PubMed Central

BAHR, DEBRA E.; ALDRICH, TIMOTHY E.; SEIDU, DAZAR; BRION, GAIL M.; TOLLERUD, DAVID J.; MULDOON, SUSAN; REINHART, NANCY; YOUSEEFAGHA, AHMED; MCKINNEY, PAUL; HUGHES, THERESE; CHAN, CAROLINE; RICE, CAROL; BREWER, DAVID E.; FREYBERG, RONALD W.; MOHLENKAMP, ADRIANE MOSER; HAHN, KRISTEN; HORNUNG, RICHARD; HO, MONA; DASTIDAR, ANIRUDDHA; FREITAS, SAMANTHA; SAMAN, DANIEL; RAVDAL, HEGE; SCUTCHFIELD, DOUGLAS; EGER, KENNETH J.; MINOR, STEVE

2016-01-01

Objective The Paducah Gaseous Diffusion Plant (PGDP) became operational in 1952; it is located in the western part of Kentucky. We conducted a mortality study for adverse health effects that workers may have suffered while working at the plant, including exposures to chemicals. Materials and Methods We studied a cohort of 6820 workers at the PGDP for the period 1953 to 2003; there were a total of 1672 deaths to cohort members. Trichloroethylene (TCE) is a specific concern for this workforce; exposure to TCE occurred primarily in departments that clean the process equipment. The Life Table Analysis System (LTAS) program developed by NIOSH was used to calculate the standardized mortality ratios for the worker cohort and standardized rate ratio relative to exposure to TCE (the U.S. population is the referent for age-adjustment). LTAS calculated a significantly low overall SMR for these workers of 0.76 (95% CI: 0.72–0.79). A further review of three major cancers of interest to Kentucky produced significantly low SMR for trachea, bronchus, lung cancer (0.75, 95% CI: 0.72–0.79) and high SMR for Non-Hodgkin's lymphoma (NHL) (1.49, 95% CI: 1.02–2.10). Results No significant SMR was observed for leukemia and no significant SRRs were observed for any disease. Both the leukemia and lung cancer results were examined and determined to reflect regional mortality patterns. However, the Non-Hodgkin's Lymphoma finding suggests a curious amplification when living cases are included with the mortality experience. Conclusions Further examination is recommended of this recurrent finding from all three U.S. Gaseous Diffusion plants. PMID:21468904

All cause mortality and incidence of cancer in workers in bauxite mines and alumina refineries.

PubMed

Fritschi, Lin; Hoving, Jan Lucas; Sim, Malcolm R; Del Monaco, Anthony; MacFarlane, Ewan; McKenzie, Dean; Benke, Geza; de Klerk, Nicholas

2008-08-15

Bauxite is a reddish clay that is refined to produce alumina, which is then reduced to aluminium. There have been studies examining the health of workers in aluminium smelters, but not workers in bauxite mining and alumina refining. A cohort of employees of 1 large aluminium company since 1983 was assembled (n = 6,485, 5,828 men). Deaths and incident cancers to 2002 were ascertained by linkage to national and state cancer and death registries. SIRs and SMRs were calculated compared to national rates standardizing for calendar year, sex and 5-year age group. The mortality from all causes (SMR 0.68, 95% CI: 0.60-0.77), and from circulatory and respiratory diseases, all cancers combined and injury in the male cohort were lower than in the Australian male population and were similar across work groups and with duration of employment. The only significant increased mortality risk was from pleural mesothelioma. The incidence of all cancers combined was similar to the Australian rate. The cohort had a lower risk of incident lymphohaematopoietic cancer (SIR 0.50, 95% CI: 0.31-0.88) and a higher risk of melanoma (SIR 1.30, 95% CI: 1.00-1.69) although no dose-responses were seen. There was also an increased risk of mesothelioma (SIR 3.49, 95% CI: 1.82-6.71), which was associated with exposures outside the aluminium industry. This study is the first to examine cancer and mortality amongst workers in bauxite mines and alumina refineries and found little evidence for increased cancer incidence or mortality in these workers. (c) 2008 Wiley-Liss, Inc.

Retrospective cohort study of a microelectronics and business machine facility.

PubMed

Silver, Sharon R; Pinkerton, Lynne E; Fleming, Donald A; Jones, James H; Allee, Steven; Luo, Lian; Bertke, Stephen J

2014-04-01

We examined health outcomes among 34,494 workers employed at a microelectronics and business machine facility 1969-2001. Standardized mortality ratio (SMR) and standardized incidence ratios were used to evaluate health outcomes in the cohort and Cox regression modeling to evaluate relations between scores for occupational exposures and outcomes of a priori interest. Just over 17% of the cohort (5,966 people) had died through 2009. All cause, all cancer, and many cause-specific SMRs showed statistically significant deficits. In hourly males, SMRs were significantly elevated for non-Hodgkin's lymphoma and rectal cancer. Salaried males had excess testicular cancer incidence. Pleural cancer and mesothelioma excesses were observed in workers hired before 1969, but no available records substantiate use of asbestos in manufacturing processes. A positive, statistically significant relation was observed between exposure scores for tetrachloroethylene and nervous system diseases. Few significant exposure-outcome relations were observed, but risks from occupational exposures cannot be ruled out due to data limitations and the relative youth of the cohort. © 2013 Wiley Periodicals, Inc.

Factors associated with psychoactive drug initiation in a sample of workers in France: results of the VISAT cohort study.

PubMed

Boeuf-Cazou, O; Niezborala, M; Marquie, J C; Lapeyre-Mestre, M

2010-03-01

To identify which psychosocial factors at work are associated with the initiation of psychoactive drug use in a cohort of healthy French workers. This study used data collected from the VISAT ('Vieillissement, Santé, Travail') cohort which included workers aged 32, 42, 52 and 62 years in 1996 with follow-ups conducted over the following 5 years. Data were collected through interviews and five standardized questionnaires in annual occupational medical examinations in 1996, 1999 and 2001. We defined new consumers of psychoactive drugs according to their answers during the follow-ups and compared their psychosocial and working characteristics to non-consumers. A multivariate logistic regression analysis was performed to investigate factors related to a psychoactive drug initiation. Among 1533 subjects, 5.4% began consuming psychoactive drugs during the follow-up with a twofold rate for women than for men. Factors related to psychoactive drug initiation were different according to gender. In men, initiation was mainly found in participants who were separated, showed high emotional reaction scores and were members of the white-collar working class. We did not find any other occupational factors associated to psychoactive drug initiation in men. By contrast, among women, drug initiation was more frequent in participants who were 52 years old and over, and whose job control-reward level was lower. Psychoactive drug initiation concerned 5.4% of workers within the 5-year interval in this study. The pressure of psychosocial environment was more important in men, whereas age and work-related psychosocial factors were the main factors associated with new consumption among women.

Long-term mortality in miners with coal workers' pneumoconiosis in The Netherlands: a pilot study.

PubMed

Meijers, J M; Swaen, G M; Slangen, J J; van Vliet, K; Sturmans, F

1991-01-01

In order to investigate whether the prolonged exposure to coal mine dust increases the cancer risk for coal miners, a pilot study in a selected cohort of 334 Dutch miners with coal workers' pneumoconiosis (CWP), followed from 1956 until 1983, was conducted. In total, 165 miners had died (49.4%); for 162 (98.2%) the cause of death was traced. In comparison to the general Dutch male population, total mortality in the cohort was statistically significantly increased (SMR: 153). This was in general due to the significantly higher than expected cancer mortality (SMR: 163), cancer of stomach and small intestine (SMR: 401) and nonmalignant respiratory disease (SMR: 426). The lung cancer mortality was within the expected range.

A retrospective cohort study of Parkinson's disease in Korean shipbuilders.

PubMed

Park, Jungsun; Yoo, Cheol-In; Sim, Chang Sun; Kim, Jae Woo; Yi, Yunjeong; Shin, Yong Chul; Kim, Dae-Hyun; Kim, Yangho

2006-05-01

We performed a retrospective cohort study in South Korea to clarify the role of occupational exposure, especially to welding, in the etiology of Parkinson's disease (PD). We constructed a database of subjects classified into an exposure group (blue-collar workers) and a non-exposure group (white-collar workers) in two shipbuilding companies. Jobs of blue-collar workers were categorized into the first group of welding, the second group of fitting, grinding and finishing, cutting, and the other group. To determine new cases of PD during the follow-up period (1992-2003), we used the physician billing claims database of the National Health Insurance Corporation. For the detected PD patients in the physician billing claims database, a neurologist in our research team confirmed the appropriateness of each diagnosis by reviewing medical charts. Based on the review, we confirmed the numbers of new cases of PD and calculated the relative risk (RR) and the 95% confidence intervals (CI) by Cox regression analysis. In a backward selection procedure, 'age' was a significant independent variable but exposure was not. Furthermore, the RR in welders (high exposure group) was also insignificant and less than that in others (very low exposure group). This longitudinal study of shipbuilding workers supports our previous case-control studies suggesting that exposure to manganese does not increase the risk of PD.

Leukemia mortality by cell type in petroleum workers with potential exposure to benzene.

PubMed Central

Raabe, G K; Wong, O

1996-01-01

Workers in the petroleum industry are potentially exposed to a variety of petrochemicals, including benzene or benzene-containing liquids. Although a large number of studies of petroleum workers have been conducted to examine leukemia and other cancer risks, few existing studies have investigated cell-type-specific leukemias. One of the major reasons for the lack of cell-type-specific analysis was the small number of deaths by cell type in individual studies. In the present investigation, all cohort studies of petroleum workers in the United States and the United Kingdom were combined into a single database for cell-type-specific leukemia analysis. The majority of these workers were petroleum refinery employees, but production, pipeline, and distribution workers in the petroleum industry were also included. The combined cohort consisted of more than 208,000 petroleum workers, who contributed more than 4.6 million person-years of observation. Based on a meta-analysis of the combined data, cell-type-specific leukemia risks were expressed in terms of standardized mortality ratios (meta-SMRs). The meta-SMR for acute myeloid leukemia was 0.96. The lack of an increase of acute myeloid leukemia was attributed to the low levels of benzene exposure in the petroleum industry, particularly in comparison to benzene exposure levels in some previous studies of workers in other industries, who had been found to experience an increased risk of acute myeloid leukemia. Similarly, no increase in chronic myeloid, acute lymphocytic, or chronic lymphocytic leukemias was found in petroleum workers (meta-SMRs of 0.89, 1.16, and 0.84, respectively). Stratified meta-analyses restricted to refinery studies or to studies with at least 15 years of follow-up yielded similar results. The findings of the present investigation are consistent with those from several recent case-control studies of cell-type-specific leukemia. Patterns and levels of benzene exposure in the petroleum industry are reviewed. The results of the present epidemiologic investigation are discussed in conjunction with recent advances in leukemogenesis from other scientific disciplines. PMID:9118924

Does Tinnitus, Hearing Asymmetry or Hearing Loss Predispose to Occupational Injury Risk?

PubMed Central

Cantley, Linda F; Galusha, Deron; Cullen, Mark R; Dixon-Ernst, Christine; Tessier-Sherman, Baylah; Slade, Martin D; Rabinowitz, Peter M; Neitzel, Richard L

2015-01-01

Objective To determine the relative contributions of tinnitus, asymmetrical hearing loss, low frequency hearing loss (pure tone average of .5, 1, 2, 3 kHz, PTA.5123), or high frequency hearing loss (pure tone average of 4, 6 kHz, PTA46), to acute injury risk among a cohort of production and maintenance workers at six aluminum manufacturing plants, adjusting for ambient noise exposure and other recognized predictors of injury risk. Design and Study Sample This retrospective analysis considered 9,920 workers employed during 2003 to 2008. The cohort consisted of 8,818 workers (89%) whose complete records were available. Results Adjusting for noise exposure and other recognized injury predictors, a 25% increased acute injury risk was observed among workers with a history of tinnitus in conjunction with high-frequency hearing loss (PTA46). Low frequency hearing loss may be associated with minor, yet less serious, injury risk. We did not find evidence that asymmetry contributes to injury risk. Conclusion These results provide evidence that tinnitus, combined with high-frequency hearing loss, may pose an important safety threat to workers, especially those who work in high-noise exposed environments. These at risk workers may require careful examination of their communication and hearing protection needs. PMID:25549168

Reconstruction of Internal Doses for the Alpha-Risk Case-Control Study of Lung Cancer and Leukaemia Among European Nuclear Workers.

PubMed

Bingham, Derek; Bérard, Philippe; Birchall, Alan; Bull, Richard; Cardis, Elisabeth; Challeton-de Vathaire, Cécile; Grellier, James; Hurtgen, Christian; Puncher, Matthew; Riddell, Anthony; Thierry-Chef, Isabelle

2017-05-01

The Alpha-Risk study required the reconstruction of doses to lung and red bone marrow for lung cancer and leukaemia cases and their matched controls from cohorts of nuclear workers in the UK, France and Belgium. The dosimetrists and epidemiologists agreed requirements regarding the bioassay data, biokinetic and dosimetric models and dose assessment software to be used and doses to be reported. The best values to use for uncertainties on the monitoring data, setting of exposure regimes and characteristics of the exposure material, including lung solubility, were the responsibility of the dosimetrist responsible for each cohort. Among 1721 subjects, the median absorbed dose to the lung from alpha radiations was 2.1 mGy, with a maximum dose of 316 mGy. The lung doses calculated reflect the higher levels of exposure seen among workers in the early years of the nuclear industry compared to today. © Crown copyright 2016.

Development of multiple chemical sensitivities in laborers after acute gasoline fume exposure in an underground tunneling operation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Davidoff, A.L.; Keyl, P.M.; Meggs, W.

1998-05-01

In this article, investigators report on the presence and nature of chemical sensitivities and other indices of illness in a cohort of workers excavating a new subway tunnel located under a former gasoline station. The workers were exposed to gasoline fumes for up to approximately 2 mo when they inadvertently dug into soil contaminated by gasoline. The cohort was unique in several ways: (a) contact with gasoline was made by the workers at a time when no one had complained of multiple chemical sensitivities syndrome; (b) all were males of low socioeconomic status; (c) the exposure was well documented; (d)more » the cohort could be considered naive because, at the time of the study, the men were not members of support groups and were not being seen by clinical ecologists, and they were not labeled, either by self or others, as having multiple chemical sensitivities syndrome or any related diagnosis; and (e) at the time of interview, all workers contacted appeared to be either gainfully employed or laid off temporarily and seeking gainful employment. The authors explored the health status of the workers at two different times: (1) soon after the tunnel was closed as a result of high, measured benzene-exposure levels and (2) 10--13 mo after the tunnel was closed. The workers were chronically overexposed to gasoline fumes, after which approximately one-fourth of their random sample of relatively naive, low-socio-economic-status male laborers--although neither disabled nor generally litigious--reported the new onset of chemical hypersensitivities and other characteristics that fit conservative criteria for multiple chemical sensitivities syndrome.« less

Investing in Prospective Cohorts for Etiologic Study of Occupational Exposures

PubMed Central

Blair, A.; Hines, C.J.; Thomas, K.W.; Alavanja, M.C.R.; Beane Freeman, L.E.; Hoppin, J.A.; Kamel, F.; Lynch, C.F.; Lubin, J.H.; Silverman, D.T.; Whelan, E.; Zahm, S. H.; Sandler, D. P.

2015-01-01

Prospective cohorts have played a major role in understanding the contribution of diet, physical activity, medical conditions, and genes to the development of many diseases, but have not been widely used for occupational exposures. Studies in agriculture are an exception. We draw upon our experience using this design to study agricultural workers to identify conditions that might foster use of prospective cohorts to study other occupational settings. Prospective cohort studies are perceived by many as the strongest epidemiologic design. It allows updating of information on exposure and other factors, collection of biologic samples before disease diagnosis for biomarker studies, assessment of effect modification by genes, lifestyle, and other occupational exposures, and evaluation of a wide range of health outcomes. Increased use of prospective cohorts would be beneficial in identifying hazardous exposures in the workplace. Occupational epidemiologists should seek opportunities to initiate prospective cohorts to investigate high priority, occupational exposures. PMID:25603935

Pathways to Educational Attainment and Their Effect on Early Career Development.

ERIC Educational Resources Information Center

Scott, Marc A.; Bernhardt, Annette

A study identified different educational and working paths that workers take, asked which paid off for long-term wage growth and career development, and tested whether educational pathways helped explain more of the variability in wage outcomes. It compared long-term wage growth for two cohorts of young white men: the original cohort that entered…

Low-Dose N,N-Dimethylformamide Exposure and Liver Injuries in a Cohort of Chinese Leather Industry Workers.

PubMed

Qi, Cong; Gu, Yiyang; Sun, Qing; Gu, Hongliang; Xu, Bo; Gu, Qing; Xiao, Jing; Lian, Yulong

2017-05-01

We assessed the risk of liver injuries following low doses of N,N-dimethylformamide (DMF) below threshold limit values (20 mg/m) among leather industry workers and comparison groups. A cohort of 429 workers from a leather factory and 466 non-exposed subjects in China were followed for 4 years. Poisson regression and piece-wise linear regression were used to examine the relationship between DMF and liver injury. Workers exposed to a cumulative dose of DMF were significantly more likely than non-exposed workers to develop liver injury. A nonlinear relationship between DMF and liver injury was observed, and a threshold of the cumulative DMF dose for liver injury was 7.30 (mg/m) year. The findings indicate the importance of taking action to reduce DMF occupational exposure limits for promoting worker health.

Epidemiological response to a suspected excess of cancer among a group of workers exposed to multiple radiological and chemical hazards

PubMed Central

Baysson, H; Laurier, D; Tirmarche, M; Valenty, M; Giraud, J

2000-01-01

OBJECTIVE—An excess of cancer was suspected by workers of the metallurgy department at the French Atomic Energy Commissariat (CEA) after several deaths from cancer were reported in 1983 and 1984. After a descriptive study performed by the CEA in 1985 the results of which were not conclusive enough to put an end to the controversy, the present cohort study was undertaken in 1989.
METHODS—As no specific exposure, or a precise cancer site was suspected, it was decided to include all subjects who had worked at the metallurgy department for at least 1 year between 1950 and 1968. The cohort was followed up to 31 December 1990. Individual occupational exposures were determined retrospectively for each year from 1950 to 1990, both qualitatively (annual job, and hazard records, and assistance from former workers) and quantitatively (for external radiation). On the basis of these exposures, three types of occupational tasks were identified: handling of chemicals, radionuclides, and external radiation. Standardised mortality ratios (SMRs) were calculated to estimate the risk of death, and the existence of an association between risk of cancer and each of the three tasks was tested.
RESULTS—The cohort included 356 workers, followed up for an average of 30 years (total of 10 820 person-years). The number of deaths from all causes and from all cancer sites were respectively 44 and 21. No excess of cancer deaths was found for the study period (SMR 0.77), nor was there a peak in 1983-4. The risk of death from all cancer sites increased with the duration of exposure to chemicals.
CONCLUSION—The results do not justify the workers' impression of an excess of cancer. They suggest, however, that the duration of work at some tasks that involved handling chemicals may be an indicator of risk of cancer. Communication to the workers during the study played an important part in reducing their concern, contributing to their better understanding of the results.


Keywords: epidemiology; cancer; mortality; cluster; occupational exposures PMID:10810101

Association between shift work history and performance on the trail making test in middle-aged and elderly humans: the EpiHealth study.

PubMed

Titova, Olga E; Lindberg, Eva; Elmståhl, Sölve; Lind, Lars; Schiöth, Helgi B; Benedict, Christian

2016-09-01

Shift work has been proposed to promote cognitive disturbances in humans; however, conflicting evidence is also present. By using data from 7143 middle-aged and elderly humans (45-75 years) who participated in the Swedish EpiHealth cohort study, the present analysis sought to investigate whether self-reported shift work history would be associated with performance on the trail making test (TMT). The TMT has been proposed to be a useful neuropsychological tool to evaluate humans' executive cognitive function, which is known to decrease with age. After adjustment for potential confounders (e.g., age, education, and sleep duration), it was observed that current and recent former shift workers (worked shifts during the past 5 years) performed worse on the TMT than nonshift workers. In contrast, performance on the TMT did not differ between past shift workers (off from shift work for more than 5 years) and nonshift workers. Collectively, our results indicate that shift work history is linked to poorer performance on the TMT in a cohort of middle-aged and elderly humans. Copyright © 2016 The Author(s). Published by Elsevier Inc. All rights reserved.

[Mortality study in a cohort of workers employed in the hot working processing of plastics and rubber].

PubMed

Gerosa, Alberto; Scarnato, Corrado; Marchesini, Bruno; Ietri, Evi; Pavone, Venere Leda Mara

2017-01-01

to study mortality rates among workers in companies manufacturing thermoplastic and rubber articles (excluding tyres). cohort study. the cohort includes 4,543 workers employed up to 2000 in 131 companies in the Province of Bologna (Emilia-Romagna Region, Northern Italy) exposed to emissions from hot processing of plastics (3,937) and rubber (606). general- and cause-specific Standardized Mortality Rates (SMR), with 95% confidence intervals; entire reference population resides in the Emilia-Romagna Region. excess mortality for all causes (116 Obs; SMR: 1.20; 95%CI 1.00-1.44) and for lung cancer (18 Obs; SMR: 1.67; 95%CI 1.05-2.65) in men of the rubber factories. Increased mortality rates for oesophageal cancers in women (3 Obs; SMR: 5.41; 95%CI 1.74-16.8) and in men (6 Obs; SMR: 2.16; 95%CI 0.97-4.81), for malignant tumours of pancreas (16 Obs; SMR: 1.65; 95%CI 1.01- 2.70), rectum (11 Obs; SMR: 2.17; 95%CI 1.20-3.92) and kidney (11 Obs; SMR: 1.98; 95%CI 1.10-3.58) in men occupied in plastic processing. in this study, we observed an excess of mortality rates for lung cancer in men of rubber factories and for malignant tumours of the digestive tract, pancreas, and kidney in workers employed in the production of plastic articles. Nevertheless, these results must be interpreted with caution, because exposures to non-occupational risk factors, like tobacco smoke or other occupational exposures outside the companies concerned, are not known. The results suggest to continue epidemiological surveillance.

Sex Work and Motherhood: Social and Structural Barriers to Health and Social Services for Pregnant and Parenting Street and Off-Street Sex Workers.

PubMed

Duff, Putu; Shoveller, Jean; Chettiar, Jill; Feng, Cindy; Nicoletti, Rachel; Shannon, Kate

2015-09-01

Our study documents the correlates of barriers to pregnancy and mothering among sex workers in Vancouver, Canada. We used baseline data from An Evaluation of Sex Workers' Health Access (AESHA), a prospective cohort of sex workers. Among the 399 sex workers who had ever been pregnant or had a child, 35% reported having ever experienced a barrier, with lower education, homelessness, and history of injecting drugs significantly correlated with pregnancy and mothering barriers. Our findings highlight a critical need for tailored and nonjudgmental services and supports, including improved programs to address intersecting aspects of poverty, health literacy, stigma, and substance use.

Organizational return to work support and sick leave duration: a cohort of Spanish workers with a long-term non-work-related sick leave episode.

PubMed

Sampere, Maite; Gimeno, David; Serra, Consol; Plana, Manel; Martínez, José Miguel; Delclos, George L; Benavides, Fernando G

2011-06-01

To analyze the association between organizational support and time to return to work (RTW) in workers with long-term non-work-related sick leave. Cohort participants were 571 workers, with a non-work-related sick leave episode of more than 15 days, recruited during the first visit in a health insurance company (mutua). Workers completed a baseline questionnaire regarding organizational RTW support measures and were followed until the end of the episodes. Return to work and time to RTW were established on the basis of the mutua's register. Multivariate Cox regression models were used. Workers in companies with an overall high organizational RTW support returned to work earlier. This effect was mainly due to workers in companies that provided specific RTW programs. Our findings suggest that companies play an important role in facilitating RTW for workers with long-term non-work-related sick leave episodes.

Screening employees of services for homeless individuals in Montréal for tuberculosis infection.

PubMed

Isler, M A; Rivest, P; Mason, J; Brassard, P

2013-06-01

The results of a tuberculin skin test (TST) screening program offered to employees of services for homeless people in Montréal from 1998 to 2005 were analyzed to assess the occupational risk of tuberculosis (TB) infection. Employees with no known contact with TB were selected among volunteer participants. They were followed in two dynamic cohorts: individuals with a negative two-step baseline TST (cohort A) and individuals with a negative single baseline TST (cohort B). We estimated the prevalences of initial positive TST, boosting effect, and conversion rate. The average age of the workers was 38.9 years. The prevalence of an initial positive TST was 12.9%. A booster effect was observed in 5.1% of workers who completed a two-step TST. The incidence of conversion was 2.3/100 person-years for cohort A (n=93) and 3.5/100 person-years for cohort B (n=221). The incidence of conversion was not significantly associated with any of the demographics or workplace factors investigated. Our findings are comparable to the rates reported among community workers, whose risk is higher than the average health worker. This suggests that there are occasional unidentified contagious cases among the homeless individuals of participating institutions. Copyright © 2013 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

Lung Cancer and Elemental Carbon Exposure in Trucking Industry Workers

PubMed Central

Laden, Francine; Hart, Jaime E.; Davis, Mary E.; Eisen, Ellen A.; Smith, Thomas J.

2012-01-01

Background: Diesel exhaust has been considered to be a probable lung carcinogen based on studies of occupationally exposed workers. Efforts to define lung cancer risk in these studies have been limited in part by lack of quantitative exposure estimates. Objective: We conducted a retrospective cohort study to assess lung cancer mortality risk among U.S. trucking industry workers. Elemental carbon (EC) was used as a surrogate of exposure to engine exhaust from diesel vehicles, traffic, and loading dock operations. Methods: Work records were available for 31,135 male workers employed in the unionized U.S. trucking industry in 1985. A statistical model based on a national exposure assessment was used to estimate historical work-related exposures to EC. Lung cancer mortality was ascertained through the year 2000, and associations with cumulative and average EC were estimated using proportional hazards models. Results: Duration of employment was inversely associated with lung cancer risk consistent with a healthy worker survivor effect and a cohort composed of prevalent hires. After adjusting for employment duration, we noted a suggestion of a linear exposure–response relationship. For each 1,000-µg/m3 months of cumulative EC, based on a 5-year exposure lag, the hazard ratio (HR) was 1.07 [95% confidence interval (CI): 0.99, 1.15] with a similar association for a 10-year exposure lag [HR = 1.09 (95% CI: 0.99, 1.20)]. Average exposure was not associated with relative risk. Conclusions: Lung cancer mortality in trucking industry workers increased in association with cumulative exposure to EC after adjusting for negative confounding by employment duration. PMID:22739103

Highly Pathogenic Avian Influenza A(H5N1) Virus Infection among Workers at Live Bird Markets, Bangladesh, 2009–2010

PubMed Central

Khan, Salah Uddin; Luby, Stephen P.; Gurley, Emily S.; Abedin, Jaynal; Zaman, Rashid Uz; Sohel, Badrul Munir; Rahman, Mustafizur; Hancock, Kathy; Levine, Min Z.; Veguilla, Vic; Wang, David; Holiday, Crystal; Gillis, Eric; Sturm-Ramirez, Katharine; Bresee, Joseph S.; Rahman, Mahmudur; Uyeki, Timothy M.; Katz, Jacqueline M.; Azziz-Baumgartner, Eduardo

2015-01-01

The risk for influenza A(H5N1) virus infection is unclear among poultry workers in countries where the virus is endemic. To assess H5N1 seroprevalence and seroconversion among workers at live bird markets (LBMs) in Bangladesh, we followed a cohort of workers from 12 LBMs with existing avian influenza surveillance. Serum samples from workers were tested for H5N1 antibodies at the end of the study or when LBM samples first had H5N1 virus–positive test results. Of 404 workers, 9 (2%) were seropositive at baseline. Of 284 workers who completed the study and were seronegative at baseline, 6 (2%) seroconverted (7 cases/100 poultry worker–years). Workers who frequently fed poultry, cleaned feces from pens, cleaned food/water containers, and did not wash hands after touching sick poultry had a 7.6 times higher risk for infection compared with workers who infrequently performed these behaviors. Despite frequent exposure to H5N1 virus, LBM workers showed evidence of only sporadic infection. PMID:25811942

Radiation-epidemiological Study of Cerebrovascular Diseases in the Cohort of Russian Recovery Operation Workers of the Chernobyl Accident.

PubMed

Kashcheev, V V; Chekin, S Yu; Maksioutov, M A; Tumanov, K A; Menyaylo, A N; Kochergina, E V; Kashcheeva, P V; Gorsky, A I; Shchukina, N V; Karpenko, S V; Ivanov, V K

2016-08-01

The paper presents an analysis of the incidence of cerebrovascular diseases (CeVD) in the cohort of Russian workers involved in recovery tasks after the Chernobyl accident. The studied cohort consists of 53,772 recovery operation workers (liquidators) who arrived in the zone of the Chernobyl accident within the first year after this accident (26 April 1986-26 April 1987). The mean external whole body dose in the cohort was 0.161 Gy, while individual doses varied from 0.0001 Gy to 1.42 Gy. During the follow-up period 1986-2012, a total of 23,264 cases of CeVD were diagnosed as a result of annual health examinations. A Poisson regression model was applied for estimation of radiation risks and for an assessment of other risk factors of CeVD. The following factors were considered as risk factors for CeVD: the dose, duration of the liquidators' work in the Chernobyl zone, and the concomitant diseases (hypertension, ischemic heart disease, atherosclerosis, and diabetes). The baseline incidence of CeVD is statistically significantly (p < 0.001) associated with all studied concomitant diseases. The incidence of CeVD has revealed a statistically significant dose response with the lack of a latent period and with the average ERR/Gy = 0.45, 95% CI: (0.28, 0.62), p < 0.001. Radiation risks of CeVD statistically significantly (p = 0.03) varied with the duration of liquidators' stay in the Chernobyl zone; for those who stayed in the Chernobyl zone less than 6 wk, ERR/Gy = 0.64, 95% CI = (0.38; 0.93), p < 0.001. Among studied concomitant diseases, diabetes mellitus statistically significantly (p = 0.002) increases the radiation risk of CeVD: for liquidators with diagnosed diabetes, ERR/Gy = 1.29.

Pooled exposure-response analyses and risk assessment for lung cancer in 10 cohorts of silica-exposed workers: an IARC multicentre study.

PubMed

Steenland, K; Mannetje, A; Boffetta, P; Stayner, L; Attfield, M; Chen, J; Dosemeci, M; DeKlerk, N; Hnizdo, E; Koskela, R; Checkoway, H

2001-11-01

Silica is one of the most common occupational exposures worldwide. In 1997 the International Agency for Research on Cancer (IARC) classified inhaled crystalline silica as a human carcinogen (group 1), but acknowledged limitations in the epidemiologic data, including inconsistencies across studies and the lack of extensive exposure-response data. We have conducted a pooled exposure-response analysis of 10 silica-exposed cohorts to investigate lung cancer. The pooled cohort included 65,980 workers (44,160 miners, 21,820 nominees), and 1,072 lung cancer deaths (663 miners, 409 nonminers). Follow-up has been extended for five of these cohorts beyond published data. Quantitative exposure estimates by job and calendar time were adopted, modified, or developed to permit common analyses by respirable silica (mg/m3) across cohorts. The log of cumulative exposure, with a 15-year lag, was a strong predictor of lung cancer (p = 0.0001), with consistency across studies (test for heterogeneity, p = 0.34). Results for the log of cumulative exposure were consistent between underground mines and other facilities. Categorical analyses by quintile of cumulative exposure resulted in a monotonic trend with odds ratios of 1.0. 1.0, 1.3, 1.5, 1.6. Analyses using a spline curve also showed a monotonic increase in risk with increasing exposure. The estimated excess lifetime risk (through age 75) of lung cancer for a worker exposed from age 20 to 65 at 0.1 mg/m3 respirable crystalline silica (the permissible level in many countries) was 1.1-1.7%, above background risks of 3-6%. Our results support the decision by the IARC to classify inhaled silica in occupational settings as a carcinogen, and suggest that the current exposure limits in many countries may be inadequate. These data represent the first quantitative exposure-response analysis and risk assessment for silica using data from multiple studies.

Expert ratings of job demand and job control as predictors of injury and musculoskeletal disorder risk in a manufacturing cohort

PubMed Central

Cantley, Linda F; Tessier-Sherman, Baylah; Slade, Martin D; Galusha, Deron; Cullen, Mark R

2016-01-01

Objective To examine associations between workplace injury and musculoskeletal disorder (MSD) risk and expert ratings of job-level psychosocial demand and job control, adjusting for job-level physical demand. Methods Among a cohort of 9260 aluminium manufacturing workers in jobs for which expert ratings of job-level physical and psychological demand and control were obtained during the 2 years following rating obtainment, multivariate mixed effects models were used to estimate relative risk (RR) of minor injury and minor MSD, serious injury and MSD, minor MSD only and serious MSD only by tertile of demand and control, adjusting for physical demand as well as other recognised risk factors. Results Compared with workers in jobs rated as having low psychological demand, workers in jobs with high psychological demand had 49% greater risk of serious injury and serious MSD requiring medical treatment, work restrictions or lost work time (RR=1.49; 95% CI 1.10 to 2.01). Workers in jobs rated as having low control displayed increased risk for minor injury and minor MSD (RR=1.45; 95% CI 1.12 to 1.87) compared with those in jobs rated as having high control. Conclusions Using expert ratings of job-level exposures, this study provides evidence that psychological job demand and job control contribute independently to injury and MSD risk in a blue-collar manufacturing cohort, and emphasises the importance of monitoring psychosocial workplace exposures in addition to physical workplace exposures to promote worker health and safety. PMID:26163544

Ischaemic heart disease incidence and mortality in an extended cohort of Mayak workers first employed in 1948–1982

PubMed Central

Grigoryeva, Evgeniya S; Haylock, Richard G E; Pikulina, Maria V; Moseeva, Maria B

2015-01-01

Objective: Incidence and mortality from ischaemic heart disease (IHD) was studied in an extended cohort of 22,377 workers first employed at the Mayak Production Association during 1948–82 and followed up to the end of 2008. Methods: Relative risks and excess relative risks per unit dose (ERR/Gy) were calculated based on the maximum likelihood using Epicure software (Hirosoft International Corporation, Seattle, WA). Dose estimates used in analyses were provided by an updated “Mayak Worker Dosimetry System—2008”. Results: A significant increasing linear trend in IHD incidence with total dose from external γ-rays was observed after having adjusted for non-radiation factors and dose from internal radiation {ERR/Gy = 0.10 [95% confidence interval (CI): 0.04 to 0.17]}. The pure quadratic model provided a better fit of the data than did the linear one. No significant association of IHD mortality with total dose from external γ-rays after having adjusted for non-radiation factors and dose from internal alpha radiation was observed in the study cohort [ERR/Gy = 0.06 (95% CI: <0 to 0.15)]. A significant increasing linear trend was observed in IHD mortality with total absorbed dose from internal alpha radiation to the liver after having adjusted for non-radiation factors and dose from external γ-rays in both the whole cohort [ERR/Gy = 0.21 (95% CI: 0.01 to 0.58)] and the subcohort of workers exposed at alpha dose <1.00 Gy [ERR/Gy = 1.08 (95% CI: 0.34 to 2.15)]. No association of IHD incidence with total dose from internal alpha radiation to the liver was found in the whole cohort after having adjusted for non-radiation factors and external gamma dose [ERR/Gy = 0.02 (95% CI: not available to 0.10)]. Statistically significant dose effect was revealed in the subcohort of workers exposed to internal alpha radiation at dose to the liver <1.00 Gy [ERR/Gy = 0.44 (95% CI: 0.09 to 0.85)]. Conclusion: This study provides strong evidence of IHD incidence and mortality association with external γ-ray exposure and some evidence of IHD incidence and mortality association with internal alpha-radiation exposure. Advances in knowledge: It is the first time the validity of internal radiation dose estimates has been shown to affect the risk of IHD incidence. PMID:26224431

White fingers, cold environment, and vibration--exposure among Swedish construction workers.

PubMed

Burström, Lage; Järvholm, Bengt; Nilsson, Tohr; Wahlström, Jens

2010-11-01

The aim of this study was to examine the association between white fingers, cold environment, and exposure to hand-arm vibration (HAV). The hypothesis was that working in cold climate increases the risk of white fingers. The occurrence of white fingers was investigated as a cross-sectional study in a cohort of Swedish male construction workers (N=134 757). Exposure to HAV was based on a job-exposure matrix. Living in the north or south of Sweden was, in a subgroup of the cohort, used as an indicator of the exposure to cold environment (ie, living in the north meant a higher exposure to cold climate). The analyses were adjusted for age and use of nicotine products (smoking and snuff). HAV-exposed workers living in a colder climate had a higher risk for white fingers than those living in a warmer climate [odds ratio (OR) 1.71, 95% confidence interval (95% CI) 1.42-2.06]. As expected, we found that HAV-exposed workers had an increased risk compared to controls (OR 2.02, 95% CI 1.75-2.34). The risk for white fingers increased with increased level of exposure to HAV and also age. Cold environment increases the risk for white fingers in workers occupationally exposed to HAV. The results underscore the need to keep exposure to HAV at workplaces as low as possible especially in cold climate.

A prospective cohort study investigating an exposure-response relationship among vibration-exposed male workers with numbness of the hands.

PubMed

Edlund, Maria; Burström, Lage; Gerhardsson, Lars; Lundström, Ronnie; Nilsson, Tohr; Sandén, Helena; Hagberg, Mats

2014-03-01

The aim of this study was to investigate the exposure-response relationship of hand-arm vibration exposure to neurological symptoms (numbness) of the hand in a cohort of vibration-exposed workers. The baseline cohort comprised 241 office and manual workers with and without exposure to hand-arm vibration. Numbness (the symptom or event) in the hand was assessed for all subjects at baseline and follow-ups after 5, 10, and 16 years. The workers were stratified into quartiles with no exposure in the first quartile and increasing intensity of exposure in quartiles 2-4 (groups 1-3). Data analysis was performed using survival analysis (time to event). Information on cumulative exposure and years of exposure to event was collected via questionnaires. Measurements were performed in accordance with the International Organization for Standardization (ISO) 5349-1. The hazard ratio (HR) of risk of event (numbness) differed statistically significantly between the non-exposed group (group 0) and the two higher exposure groups (groups 2 and 3). There was also a significant ratio difference between the lowest exposure group (group 1) and the two higher groups. The ratio for group 1 was 1.77 [95% confidence interval (95% CI) 0.96-3.26] compared with 3.78 (95% CI 2.15-6.62) and 5.31 (95% CI 3.06-9.20) for groups 2 and 3, respectively. The results suggest a dose-response relationship between vibration exposure and numbness of the hands. This underlines the importance of keeping vibration levels low to prevent neurological injury to the hands.

Lung-cancer mortality among Vermont granite workers: factors influencing exposure–response evaluation

PubMed Central

Vacek, Pamela M; Callas, Peter W

2017-01-01

Objective To understand why 2 studies relating crystalline silica exposure to lung-cancer mortality in Vermont granite workers yielded conflicting results. Methods Data used in the 2 studies were linked to identify discrepancies. Mortality data and employment histories from the earlier study were revised based on data obtained in the later study. SMR were computed and Poisson regressions corresponding to those in the earlier study were performed using the original and revised data. Analyses were repeated with the addition of workers omitted from the earlier study. Results After correction of incomplete mortality and employment information in the original data, the overall SMR for the cohort in the earlier study increased from 1.17 (95% CI 1.03 to 1.36) to 1.39 (95% CI 1.22 to 1.59), and was similar to the SMR of 1.37 observed in the later study (95% CI 1.23 to 1.52). The exposure–response relationship was attenuated, particularly when person-years in all exposure categories were included in the analysis. Inclusion of additional workers had a smaller impact on the SMRs but further attenuated the exposure–response relationship. Conclusions Differing results from the 2 studies are partly attributable to incomplete vital status and work history information used in the earlier study, as well as differences in cohort inclusion criteria. However, differences in length of follow-up and other factors likely play a larger role. PMID:27821675

Health and Occupational Outcomes Among Injured, Nonstandard Shift Workers.

PubMed

Wong, Imelda S; Smith, Peter M; Mustard, Cameron A; Gignac, Monique A M

2015-11-01

This study compares health and occupational outcomes following a work-related injury for nonstandard and day-shift workers. National Population Health Survey data were used to explore outcomes 2 years post-work injury. Retrospective-matched cohort analyses examined main effects and interactions of shift schedule and work injury with changes in health, shift schedule, and labor force status. Models were adjusted for respondent characteristics, baseline health status, and occupational strength requirements. Injured nonstandard shift workers reported lower health utility index scores, compared with uninjured and injured daytime workers and uninjured nonstandard-shift workers. No significant interactions between shift and injury were found with schedule change and leaving the labor force. Injured nonstandard-shift workers are as likely to remain employed as other groups, but may be vulnerable in terms of diminished health.

Mortality study among workers producing ferroalloys and stainless steel in France.

PubMed Central

Moulin, J J; Portefaix, P; Wild, P; Mur, J M; Smagghe, G; Mantout, B

1990-01-01

A mortality study was carried out among the workers of a plant that had produced ferrochromium and stainless steel, and was still producing stainless steel, in order to determine whether exposure to chromium compounds, to nickel compounds, and to polycyclic aromatic hydrocarbons (PAH) could result in a risk of lung cancer for the exposed workers. The cohort comprised 2269 men whose vital status were recorded between 1 January 1952 and 31 December 1982. The smoking habits of 67% of the cohort members were known from medical records. The observed numbers of deaths were compared with the expected ones based on national rates with adjustment for age, sex, and calendar time. A low mortality, achieving statistical significance, was found from all causes (observed = 137, standardised mortality ratio (SMR) = 0.82) and from benign respiratory diseases (observed = one, SMR = 0.15). With regard to mortality from lung cancer, a non-significant excess appeared in the whole cohort (observed = 12, SMR = 1.40). Among the exposed workers, however, a significant lung cancer excess was found (observed = 11, SMR = 2.04) that contrasted with a low SMR (0.32) in the non-exposed group. This excess is unlikely to be explained by smoking, as the tobacco consumption of these two groups was similar. No trend was observed for mortality from lung cancer either according to time since first exposure, or according to duration of exposure. A nested case-control study clearly suggested that this excess of deaths from lung cancer was attributable to former PAH exposures in the ferrochromium production workshops rather than to exposures in the stainless steel manufacturing areas. PMID:2393634

Night shift work exposure profile and obesity: Baseline results from a Chinese night shift worker cohort.

PubMed

Sun, Miaomiao; Feng, Wenting; Wang, Feng; Zhang, Liuzhuo; Wu, Zijun; Li, Zhimin; Zhang, Bo; He, Yonghua; Xie, Shaohua; Li, Mengjie; Fok, Joan P C; Tse, Gary; Wong, Martin C S; Tang, Jin-Ling; Wong, Samuel Y S; Vlaanderen, Jelle; Evans, Greg; Vermeulen, Roel; Tse, Lap Ah

2018-01-01

This study aimed to evaluate the associations between types of night shift work and different indices of obesity using the baseline information from a prospective cohort study of night shift workers in China. A total of 3,871 workers from five companies were recruited from the baseline survey. A structured self-administered questionnaire was employed to collect the participants' demographic information, lifetime working history, and lifestyle habits. Participants were grouped into rotating, permanent and irregular night shift work groups. Anthropometric parameters were assessed by healthcare professionals. Multiple logistic regression models were used to evaluate the associations between night shift work and different indices of obesity. Night shift workers had increased risk of overweight and obesity, and odds ratios (ORs) were 1.17 (95% CI, 0.97-1.41) and 1.27 (95% CI, 0.74-2.18), respectively. Abdominal obesity had a significant but marginal association with night shift work (OR = 1.20, 95% CI, 1.01-1.43). A positive gradient between the number of years of night shift work and overweight or abdominal obesity was observed. Permanent night shift work showed the highest odds of being overweight (OR = 3.94, 95% CI, 1.40-11.03) and having increased abdominal obesity (OR = 3.34, 95% CI, 1.19-9.37). Irregular night shift work was also significantly associated with overweight (OR = 1.56, 95% CI, 1.13-2.14), but its association with abdominal obesity was borderline (OR = 1.26, 95% CI, 0.94-1.69). By contrast, the association between rotating night shift work and these parameters was not significant. Permanent and irregular night shift work were more likely to be associated with overweight or abdominal obesity than rotating night shift work. These associations need to be verified in prospective cohort studies.

Exposure assessment for a nested case-control study of lung cancer among European asphalt workers.

PubMed

Agostini, Michela; Ferro, Gilles; Olsson, Ann; Burstyn, Igor; De Vocht, Frank; Hansen, Johnni; Lassen, Christina Funch; Johansen, Christoffer; Kjaerheim, Kristina; Langard, Sverre; Stucker, Isabelle; Ahrens, Wolfgang; Behrens, Thomas; Lindbohm, Marja-Liisa; Heikkilä, Pirjo; Heederik, Dick; Portengen, Lützen; Shaham, Judith; Boffetta, Paolo; Kromhout, Hans

2010-10-01

Development of a method for retrospective assessment of exposure to bitumen fume, bitumen condensate, organic vapour, polycyclic aromatic hydrocarbons, and co-exposures to known or suspected lung carcinogens for a nested case-control study of lung cancer mortality among European asphalt workers. Company questionnaires and structured questionnaires used in interviews and industry-specific job-exposure matrices (JEMs) were elaborated and applied. Three sources of information were eventually used for exposure assessment and assignment: (i) data obtained in cohort phase, (ii) data from living subjects, next-of-kin, and fellow-workers questionnaires, and (iii) JEMs for bitumen exposure by inhalation and via skin and co-exposures to known or suspected lung carcinogens within and outside cohort companies. Inhalation and dermal exposure estimates for bitumen were adjusted for time trends, time spent in a job, and other determinants of exposure (e.g. oil gravel paving). Clothing patterns, personal protective devices, and personal hygiene were taken into consideration while estimating dermal exposure. Occupational exposures could be assessed for 433 cases and 1253 controls for relevant time periods. Only 43% of work histories were spent inside original asphalt and construction companies. A total of 95.8% of job periods in cohort companies could be coded at a more detailed level. Imputation of work time and 'hygienic behaviour' multipliers was needed for <10% of work history years. Overall, downward trends in exposure were present and differences existed between countries and companies. As expected, correlations were strongest (r > 0.7) among bitumen-related agents, while correlations between coal tar, bitumen-related agents, and established lung carcinogens were weaker (r < 0.4). A systematic and detailed approach was developed to estimate inhalation and dermal exposure for a nested case-control study among asphalt workers.

Is prolonged sitting at work associated with the time course of neck–shoulder pain? A prospective study in Danish blue-collar workers

PubMed Central

Gupta, Nidhi; Heiden, Marina; Mathiassen, Svend Erik; Korshøj, Mette; Jørgensen, Marie Birk; Holtermann, Andreas

2016-01-01

Objectives This study aimed to determine the extent to which objectively measured sitting time at work is associated with the course of neck–shoulder pain across 1 year in blue-collar workers. Methods Data were analysed from 625 blue-collar workers in the Danish PHysical ACTivity cohort with Objective measurements (DPHACTO) cohort study (2012–2013). Objective data on sitting time were collected at baseline using accelerometry. Self-reported pain intensity (numeric rating scale 0–10) in the neck–shoulder region was registered for 1 year using repeated text messages (14 in total). Linear mixed models were used to determine the relationship between per cent time in sitting at work and trajectories of neck–shoulder pain, with and without adjustment for demographic, occupational and lifestyle factors, and baseline pain intensity. Results More sitting time at work was associated with a faster decline in pain intensity over 12 months, as indicated by a statistically significant effect of sitting on pain trajectories in the crude (p=0.020) and fully adjusted models (p=0.027). Conclusions In blue-collar workers, more sitting time at work was associated with a favourable development of pain intensity over time. The relationship between sitting at work and pain needs further investigation before explicit recommendations and guidelines on sedentary behaviour among blue-collar workers can be developed. PMID:28186937

Cancer risk in nuclear workers occupationally exposed to uranium-emphasis on internal exposure.

PubMed

Canu, Irina Guseva; Ellis, Elizabeth Dupree; Tirmarche, Margot

2008-01-01

Workers involved in the nuclear fuel cycle have a potential for internal exposure to uranium. The present review of epidemiological studies of these workers aims to elucidate the relationship between occupational internal uranium exposure and cancer risk. Eighteen cohort and 5 nested case-control studies published since 1980 are reviewed. Workers occupationally exposed to uranium appear to be at increased risk of mortality from neoplasms of the lung, larynx, and lymphatic and haematopoietic tissue. Currently available evidence for a positive association between internal exposure to uranium and the risk of cancer is limited. The common weaknesses in reviewed studies include low statistical power and inaccurate assessment of internal exposure to uranium. Further investigations should focus on precise assessment of occupational exposure and address the issue of potential confounders.

Occupational radiation exposure and its health effects on interventional medical workers: study protocol for a prospective cohort study.

PubMed

Ko, Seulki; Chung, Hwan Hoon; Cho, Sung Bum; Jin, Young Woo; Kim, Kwang Pyo; Ha, Mina; Bang, Ye Jin; Ha, Yae Won; Lee, Won Jin

2017-12-15

Although fluoroscopically guided procedures involve a considerably high dose of radiation, few studies have investigated the effects of radiation on medical workers involved in interventional fluoroscopy procedures. Previous research remains in the early stages and has not reached a level comparable with other occupational studies thus far. Furthermore, the study of radiation workers provides an opportunity to estimate health risks at low doses and dose rates of ionising radiation. Therefore, the objectives of this study are (1) to initiate a prospective cohort study by conducting a baseline survey among medical radiation workers who involve interventional fluoroscopy procedures and (2) to assess the effect of occupational radiation exposure and on the overall health status through an in-depth cross-sectional study. Intervention medical workers in Korea will be enrolled by using a self-administered questionnaire survey, and the survey data will be linked with radiation dosimetry data, National Health Insurance claims data, cancer registry and mortality data. After merging these data, the radiation organ dose, lifetime attributable risk due to cancer and the risk per unit dose will be estimated. For the cross-sectional study, approximately 100 intervention radiology department workers will be investigated for blood tests, clinical examinations such as ultrasonography (thyroid and carotid artery scan) and lens opacity, the validation of badge dose and biodosimetry. This study was reviewed and approved by the institutional review board of Korea University (KU-IRB-12-12-A-1). All participants will provide written informed consent prior to enrolment. The findings of the study will be disseminated through peer-reviewed scientific journals, conference presentations, and a report will be submitted to the relevant public health authorities in the Korea Centers for Disease Control and Prevention to help with the development of appropriate research and management policies. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Occupational radiation exposure and its health effects on interventional medical workers: study protocol for a prospective cohort study

PubMed Central

Ko, Seulki; Chung, Hwan Hoon; Cho, Sung Bum; Jin, Young Woo; Kim, Kwang Pyo; Ha, Mina; Bang, Ye Jin; Ha, Yae Won; Lee, Won Jin

2017-01-01

Introduction Although fluoroscopically guided procedures involve a considerably high dose of radiation, few studies have investigated the effects of radiation on medical workers involved in interventional fluoroscopy procedures. Previous research remains in the early stages and has not reached a level comparable with other occupational studies thus far. Furthermore, the study of radiation workers provides an opportunity to estimate health risks at low doses and dose rates of ionising radiation. Therefore, the objectives of this study are (1) to initiate a prospective cohort study by conducting a baseline survey among medical radiation workers who involve interventional fluoroscopy procedures and (2) to assess the effect of occupational radiation exposure and on the overall health status through an in-depth cross-sectional study. Methods and analysis Intervention medical workers in Korea will be enrolled by using a self-administered questionnaire survey, and the survey data will be linked with radiation dosimetry data, National Health Insurance claims data, cancer registry and mortality data. After merging these data, the radiation organ dose, lifetime attributable risk due to cancer and the risk per unit dose will be estimated. For the cross-sectional study, approximately 100 intervention radiology department workers will be investigated for blood tests, clinical examinations such as ultrasonography (thyroid and carotid artery scan) and lens opacity, the validation of badge dose and biodosimetry. Ethics and dissemination This study was reviewed and approved by the institutional review board of Korea University (KU-IRB-12-12-A-1). All participants will provide written informed consent prior to enrolment. The findings of the study will be disseminated through peer-reviewed scientific journals, conference presentations, and a report will be submitted to the relevant public health authorities in the Korea Centers for Disease Control and Prevention to help with the development of appropriate research and management policies. PMID:29248885

A Case–Control Study of Lung Cancer Nested in a Cohort of European Asphalt Workers

PubMed Central

Olsson, Ann; Kromhout, Hans; Agostini, Michela; Hansen, Johnni; Lassen, Christina Funch; Johansen, Christoffer; Kjaerheim, Kristina; Langård, Sverre; Stücker, Isabelle; Ahrens, Wolfgang; Behrens, Thomas; Lindbohm, Marja-Liisa; Heikkilä, Pirjo; Heederik, Dick; Portengen, Lützen; Shaham, Judith; Ferro, Gilles; de Vocht, Frank; Burstyn, Igor; Boffetta, Paolo

2010-01-01

Background We conducted a nested case–control study in a cohort of European asphalt workers in which an increase in lung cancer risk has been reported among workers exposed to airborne bitumen fume, although potential bias and confounding were not fully addressed. Objective We investigated the contribution of exposure to bitumen, other occupational agents, and tobacco smoking to the risk of lung cancer among asphalt workers. Methods Cases were cohort members in Denmark, Finland, France, Germany, the Netherlands, Norway, and Israel who had died of lung cancer between 1980 and the end of follow-up (2002–2005). Controls were individually matched in a 3:1 ratio to cases on year of birth and country. We derived exposure estimates for bitumen fume and condensate, organic vapor, and polycyclic aromatic hydrocarbons, as well as for asbestos, crystalline silica, diesel motor exhaust, and coal tar. Odds ratios (ORs) were calculated for ever-exposure, duration, average exposure, and cumulative exposure after adjusting for tobacco smoking and exposure to coal tar. Results A total of 433 cases and 1,253 controls were included in the analysis. The OR was 1.12 [95% confidence interval (CI), 0.84–1.49] for inhalation exposure to bitumen fume and 1.17 (95% CI, 0.88–1.56) for dermal exposure to bitumen condensate. No significant trend was observed between lung cancer risk and duration, average exposure, or cumulative exposure to bitumen fume or condensate. Conclusions We found no consistent evidence of an association between indicators of either inhalation or dermal exposure to bitumen and lung cancer risk. A sizable proportion of the excess mortality from lung cancer relative to the general population observed in the earlier cohort phase is likely attributable to high tobacco consumption and possibly to coal tar exposure, whereas other occupational agents do not appear to play an important role. PMID:20529766

Cancer occurrence in shipyard workers exposed to asbestos in Hawaii.

PubMed

Kolonel, L N; Yoshizawa, C N; Hirohata, T; Myers, B C

1985-08-01

Because large numbers of persons were employed in United States shipyards during World War II, the long-term risks for cancer associated with asbestos exposure in this setting are of great concern. We report here on the mortality findings after up to 29 years of follow-up on a retrospective cohort of 7971 male Pearl Harbor Naval Shipyard workers, which included more than 3000 men whose employment period spanned the World War II years. Compared with the general population of Hawaii, workers in the shipyard cohort had no increase in total mortality or in total cancer mortality irrespective of the duration of their exposure. However, the risk ratio for lung cancer among workers with at least 15 years of asbestos exposure was 1.4 overall (95% confidence interval, 1.0 to 2.0) and 1.7 for those with a latency interval of 30 or more years (95% confidence interval, 1.0 to 2.5). In addition, seven mesotheliomas occurred between 1977 and 1982 in a subset of the cohort, consisting of 7029 Hawaii residents who are being followed prospectively for cancer incidence. This represented an incidence of 67.3 per million men per year, compared with a rate of 5.8 for the state as a whole. These results suggest that the long-term relative increase in risk for mesothelioma may be even greater than that for bronchogenic carcinoma in this and other cohorts of United States shipyard workers exposed to asbestos.

Occupational Exposure to Magnetic Fields and Breast Cancer Among Women Textile Workers in Shanghai, China

PubMed Central

Li, Wenjin; Ray, Roberta M.; Thomas, David B.; Yost, Michael; Davis, Scott; Breslow, Norman; Gao, Dao Li; Fitzgibbons, E. Dawn; Camp, Janice E.; Wong, Eva; Wernli, Karen J.; Checkoway, Harvey

2013-01-01

Exposure to magnetic fields (MFs) is hypothesized to increase the risk of breast cancer by reducing production of melatonin by the pineal gland. A nested case-cohort study was conducted to investigate the association between occupational exposure to MFs and the risk of breast cancer within a cohort of 267,400 female textile workers in Shanghai, China. The study included 1,687 incident breast cancer cases diagnosed from 1989 to 2000 and 4,702 noncases selected from the cohort. Subjects’ complete work histories were linked to a job–exposure matrix developed specifically for the present study to estimate cumulative MF exposure. Hazard ratios and 95% confidence intervals were calculated using Cox proportional hazards modeling that was adapted for the case-cohort design. Hazard ratios were estimated in relation to cumulative exposure during a woman's entire working years. No association was observed between cumulative exposure to MFs and overall risk of breast cancer. The hazard ratio for the highest compared with the lowest quartile of cumulative exposure was 1.03 (95% confidence interval: 0.87, 1.21). Similar null findings were observed when exposures were lagged and stratified by age at breast cancer diagnosis. The findings do not support the hypothesis that MF exposure increases the risk of breast cancer. PMID:24043439

Long-term health experience of jet engine manufacturing workers: V. Issues with the analysis of non-malignant central nervous system neoplasms.

PubMed

Buchanich, Jeanine M; Youk, Ada O; Marsh, Gary M; Kennedy, Kathleen J; Lacey, Steven E; Hancock, Roger P; Esmen, Nurtan A; Cunningham, Michael A; Leiberman, Frank S; Fleissner, Mary Lou

2011-01-01

We attempted to examine non-malignant central nervous system (CNS) neoplasms incidence rates for workers at 8 jet engine manufacturing facilities in Connecticut. The objective of this manuscript is to describe difficulties encountered regarding these analyses to aid future studies. We traced the cohort for incident cases of CNS neoplasms in states where 95% of deaths in the total cohort occurred. We used external and internal analyses in an attempt to obtain the true risk of non-malignant CNS in the cohort. Because these analyses were limited by data constraints, we conducted sensitivity analyses, including using state driver's license data to adjust person-year stop dates to help minimize underascertainment and more accurately determine cohort risk estimates. We identified 3 unanticipated challenges: case identification, determination of population-based cancer incidence rates, and handling of case underascertainment. These factors precluded an accurate assessment of non-malignant CNS neoplasm incidence risks in this occupational epidemiology study. The relatively recent (2004) mandate of capturing non-malignant CNS tumor data at the state level means that, in time, it may be possible to conduct external analyses of these data. Meanwhile, similar occupational epidemiology studies may be limited to descriptive analysis of the non-malignant CNS case characteristics.

Risk Identification and Prediction of Coal Workers’ Pneumoconiosis in Kailuan Colliery Group in China: A Historical Cohort Study

PubMed Central

Shen, Fuhai; Yuan, Juxiang; Sun, Zhiqian; Hua, Zhengbing; Qin, Tianbang; Yao, Sanqiao; Fan, Xueyun; Chen, Weihong; Liu, Hongbo; Chen, Jie

2013-01-01

Background Prior to 1970, coal mining technology and prevention measures in China were poor. Mechanized coal mining equipment and advanced protection measures were continuously installed in the mines after 1970. All these improvements may have resulted in a change in the incidence of coal workers’ pneumoconiosis (CWP). Therefore, it is important to identify the characteristics of CWP today and trends for the incidence of CWP in the future. Methodology/Principal Findings A total of 17,023 coal workers from the Kailuan Colliery Group were studied. A life-table method was used to calculate the cumulative incidence rate of CWP and predict the number of new CWP patients in the future. The probability of developing CWP was estimated by a multilayer perceptron artificial neural network for each coal worker without CWP. The results showed that the cumulative incidence rates of CWP for tunneling, mining, combining, and helping workers were 31.8%, 27.5%, 24.2%, and 2.6%, respectively, during the same observation period of 40 years. It was estimated that there would be 844 new CWP cases among 16,185 coal workers without CWP within their life expectancy. There would be 273.1, 273.1, 227.6, and 69.9 new CWP patients in the next <10, 10-, 20-, and 30- years respectively in the study cohort within their life expectancy. It was identified that coal workers whose risk probabilities were over 0.2 were at high risk for CWP, and whose risk probabilities were under 0.1 were at low risk. Conclusion/Significance The present and future incidence trends of CWP remain high among coal workers. We suggest that coal workers at high risk of CWP undergo a physical examination for pneumoconiosis every year, and the coal workers at low risk of CWP be examined every 5 years. PMID:24376519

Return-to-work of sick-listed workers without an employment contract – what works?

PubMed Central

Vermeulen, Sylvia J; Tamminga, Sietske J; Schellart, Antonius JM; Ybema, Jan Fekke; Anema, Johannes R

2009-01-01

Background In the past decade flexible labour market arrangements have emerged as a significant change in the European Union labour market. Studies suggest that these new types of labour arrangements may be linked to ill health, an increased risk for work disability, and inadequate vocational rehabilitation. Therefore, the objectives of this study were: 1. to examine demographic characteristics of workers without an employment contract sick-listed for at least 13 weeks, 2. to describe the content and frequency of occupational health care (OHC) interventions for these sick-listed workers, and 3. to examine OHC interventions as possible determinants for return-to-work (RTW) of these workers. Methods A cohort of 1077 sick-listed workers without an employment contract were included at baseline, i.e. 13 weeks after reporting sick. Demographic variables were available at baseline. Measurement of cross-sectional data took place 4–6 months after inclusion. Primary outcome measures were: frequency of OHC interventions and RTW-rates. Measured confounding variables were: gender, age, type of worker (temporary agency worker, unemployed worker, or remaining worker without employment contract), level of education, reason for absenteeism (diagnosis), and perceived health. The association between OHC interventions and RTW was analysed with a logistic multiple regression analysis. Results At 7–9 months after the first day of reporting sick only 19% of the workers had (partially or completely) returned to work, and most workers perceived their health as fairly poor or poor. The most frequently reported (49%) intervention was 'the OHC professional discussed RTW'. However, the intervention 'OHC professional made and discussed a RTW action plan' was reported by only 19% of the respondents. The logistic multiple regression analysis showed a significant positive association between RTW and the interventions: 'OHC professional discussed RTW'; and 'OHC professional made and discussed a RTW action plan'. The intervention 'OHC professional referred sick-listed worker to a vocational rehabilitation agency' was significantly associated with no RTW. Conclusion This is the first time that characteristics of a large cohort of sick-listed workers without an employment contract were examined. An experimental or prospective study is needed to explore the causal nature of the associations found between OHC interventions and RTW. PMID:19602219

Sitting Time, Physical Activity and Sleep by Work Type and Pattern—The Australian Longitudinal Study on Women’s Health

PubMed Central

Clark, Bronwyn K.; Kolbe-Alexander, Tracy L.; Duncan, Mitch J.; Brown, Wendy

2017-01-01

Data from the Australian Longitudinal Study on Women’s Health were used to examine how work was associated with time spent sleeping, sitting and in physical activity (PA), in working women. Young (31–36 years; 2009) and mid-aged (59–64 years; 2010) women reported sleep (categorised as shorter ≤6 h/day and longer ≥8 h/day) and sitting time (work, transport, television, non-work computer, and other; summed for total sitting time) on the most recent work and non-work day; and moderate and vigorous PA (categorised as meeting/not meeting guidelines) in the previous week. Participants reported occupation (manager/professional; clerical/sales; trades/transport/labourer), work hours (part-time; full-time) and work pattern (shift/night; not shift/night). The odds of shorter sleep on work days was higher in both cohorts for women who worked shift or night hours. Longer sitting time on work days, made up primarily of sitting for work, was found for managers/professionals, clerical/sales and full-time workers. In the young cohort, clerical/sales workers and in the mid-aged cohort, full-time workers were less likely to meet PA guidelines. These results suggest multiple behaviour interventions tailored to work patterns and occupational category may be useful to improve the sleep, sitting and activity of working women. PMID:28287446

Sitting Time, Physical Activity and Sleep by Work Type and Pattern-The Australian Longitudinal Study on Women's Health.

PubMed

Clark, Bronwyn K; Kolbe-Alexander, Tracy L; Duncan, Mitch J; Brown, Wendy

2017-03-10

Data from the Australian Longitudinal Study on Women's Health were used to examine how work was associated with time spent sleeping, sitting and in physical activity (PA), in working women. Young (31-36 years; 2009) and mid-aged (59-64 years; 2010) women reported sleep (categorised as shorter ≤6 h/day and longer ≥8 h/day) and sitting time (work, transport, television, non-work computer, and other; summed for total sitting time) on the most recent work and non-work day; and moderate and vigorous PA (categorised as meeting/not meeting guidelines) in the previous week. Participants reported occupation (manager/professional; clerical/sales; trades/transport/labourer), work hours (part-time; full-time) and work pattern (shift/night; not shift/night). The odds of shorter sleep on work days was higher in both cohorts for women who worked shift or night hours. Longer sitting time on work days, made up primarily of sitting for work, was found for managers/professionals, clerical/sales and full-time workers. In the young cohort, clerical/sales workers and in the mid-aged cohort, full-time workers were less likely to meet PA guidelines. These results suggest multiple behaviour interventions tailored to work patterns and occupational category may be useful to improve the sleep, sitting and activity of working women.

Change of exposure response over time and long-term risk of silicosis among a cohort of Chinese pottery workers.

PubMed

Sun, Yi; Bochmann, Frank; Morfeld, Peter; Ulm, Kurt; Liu, Yuewei; Wang, Heijiao; Yang, Lei; Chen, Weihong

2011-07-01

An analysis was conducted on a cohort of Chinese pottery workers to estimate the exposure-response relationship between respirable crystalline silica dust exposure and the incidence of radiographically diagnosed silicosis, and to estimate the long-term risk of developing silicosis until the age of 65. The cohort comprised 3,250 employees with a median follow-up duration of around 37 years. Incident cases of silicosis were identified via silicosis registries (Chinese X-ray stage I, similar to International Labor Organisation classification scheme profusion category 1/1). Individual exposure to respirable crystalline silica dust was estimated based on over 100,000 historical dust measurements. The association between dust exposure, incidence and long-time risk of silicosis was quantified by Poisson regression analysis adjusted for age and smoking. The risk of silicosis depended not only on the cumulative respirable crystalline silica dust exposures, but also on the time-dependent respirable crystalline silica dust exposure pattern (long-term average concentration, highest annual concentration ever experienced and time since first exposure). A long-term "excess" risk of silicosis of approximately 1.5/1,000 was estimated among workers with all annual respirable crystalline silica dust concentration estimates less than 0.1 mg/m(3), using the German measurement strategy. This study indicates the importance of proper consideration of exposure information in risk quantification in epidemiological studies.

Reanalysis of Diesel Engine Exhaust and Lung Cancer Mortality in the Diesel Exhaust in Miners Study Cohort Using Alternative Exposure Estimates and Radon Adjustment.

PubMed

Chang, Ellen T; Lau, Edmund C; Van Landingham, Cynthia; Crump, Kenny S; McClellan, Roger O; Moolgavkar, Suresh H

2018-06-01

The Diesel Exhaust in Miners Study (DEMS) (United States, 1947-1997) reported positive associations between diesel engine exhaust exposure, estimated as respirable elemental carbon (REC), and lung cancer mortality. This reanalysis of the DEMS cohort used an alternative estimate of REC exposure incorporating historical data on diesel equipment, engine horsepower, ventilation rates, and declines in particulate matter emissions per horsepower. Associations with cumulative REC and average REC intensity using the alternative REC estimate and other exposure estimates were generally attenuated compared with original DEMS REC estimates. Most findings were statistically nonsignificant; control for radon exposure substantially weakened associations with the original and alternative REC estimates. No association with original or alternative REC estimates was detected among miners who worked exclusively underground. Positive associations were detected among limestone workers, whereas no association with REC or radon was found among workers in the other 7 mines. The differences in results based on alternative exposure estimates, control for radon, and stratification by worker location or mine type highlight areas of uncertainty in the DEMS data.

Relationships between work-related factors and musculoskeletal health with current and future work ability among male workers.

PubMed

Boschman, J S; Noor, A; Lundström, R; Nilsson, T; Sluiter, J K; Hagberg, M

2017-08-01

The purpose was to increase job-specific knowledge about individual and work-related factors and their relationship with current and future work ability (WA). We studied cross-sectional relationships between mental demands, physical exertion during work, grip strength, musculoskeletal pain in the upper extremities and WA and the relationships between these variables and WA 11 years later. We used a dataset of a prospective cohort study (1997-2008) among employees of an engineering plant (n = 157). The cohort was surveyed by means of tests and written questions on work demands, musculoskeletal health, WA score (WAS; 0-10), and mental and physical WA. Spearman correlation coefficients and logistic regression analysis were used. Among manual workers, we found weak correlations between grip strength and current and future physical WA. We did not find predictors for future poor WA among the manual workers. Among the office workers, we found that musculoskeletal pain was moderately and negatively related to current WAS and physical WA. More handgrip strength related to better future WAS and physical WA. Musculoskeletal pain (OR 1.67 p < 0.01) and lower handgrip strength (OR 0.91 p < 0.05) predicted future poor WA among office workers. Our results showed cross-sectional and longitudinal relationships between musculoskeletal health and work ability depending on occupation. However, the present implies that predicting work ability in the far future based on health surveillance data is rather difficult. Testing the musculoskeletal system (grip strength) and asking workers' about their musculoskeletal health seems relevant when monitoring work ability.

Mortality experience among Minnesota taconite mining industry workers.

PubMed

Allen, Elizabeth M; Alexander, Bruce H; MacLehose, Richard F; Ramachandran, Gurumurthy; Mandel, Jeffrey H

2014-11-01

To evaluate the mortality experience of Minnesota taconite mining industry workers. Mortality was evaluated between 1960 and 2010 in a cohort of Minnesota taconite mining workers employed by any of the seven companies in operation in 1983. Standardised mortality ratios (SMR) were estimated by comparing observed deaths in the cohort with expected frequencies in the Minnesota population. Standardised rate ratios (SRR) were estimated using an internal analysis to compare mortality by employment duration. The cohort included 31,067 workers with at least 1 year of documented employment. Among those, there were 9094 deaths, of which 949 were from lung cancer, and 30 from mesothelioma. Mortality from all causes was greater than expected in the Minnesota population (SMR=1.04, 95% CI 1.02 to 1.04). Mortality from lung cancer and mesothelioma was higher than expected with SMRs of 1.16 for lung cancer (95% CI 1.09 to 1.23) and 2.77 for mesothelioma (95% CI 1.87 to 3.96). Other elevated SMRs included those for cardiovascular disease (SMR=1.10, 95% CI 1.06 to 1.14), specifically for hypertensive heart disease (SMR=1.81, 95% CI 1.39 to 2.33) and ischemic heart disease (SMR=1.11, 95% CI 1.07 to 1.16). Results of the SRR analysis did not show variation in risk by duration of employment. This study provides evidence that taconite workers may be at increased risk for mortality from lung cancer, mesothelioma, and some cardiovascular disease. Occupational exposures during taconite mining operations may be associated with these increased risks, but non-occupational exposures may also be important contributors. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Expert ratings of job demand and job control as predictors of injury and musculoskeletal disorder risk in a manufacturing cohort.

PubMed

Cantley, Linda F; Tessier-Sherman, Baylah; Slade, Martin D; Galusha, Deron; Cullen, Mark R

2016-04-01

To examine associations between workplace injury and musculoskeletal disorder (MSD) risk and expert ratings of job-level psychosocial demand and job control, adjusting for job-level physical demand. Among a cohort of 9260 aluminium manufacturing workers in jobs for which expert ratings of job-level physical and psychological demand and control were obtained during the 2 years following rating obtainment, multivariate mixed effects models were used to estimate relative risk (RR) of minor injury and minor MSD, serious injury and MSD, minor MSD only and serious MSD only by tertile of demand and control, adjusting for physical demand as well as other recognised risk factors. Compared with workers in jobs rated as having low psychological demand, workers in jobs with high psychological demand had 49% greater risk of serious injury and serious MSD requiring medical treatment, work restrictions or lost work time (RR=1.49; 95% CI 1.10 to 2.01). Workers in jobs rated as having low control displayed increased risk for minor injury and minor MSD (RR=1.45; 95% CI 1.12 to 1.87) compared with those in jobs rated as having high control. Using expert ratings of job-level exposures, this study provides evidence that psychological job demand and job control contribute independently to injury and MSD risk in a blue-collar manufacturing cohort, and emphasises the importance of monitoring psychosocial workplace exposures in addition to physical workplace exposures to promote worker health and safety. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Occupational exposure to ionising radiation and mortality among workers of the former Spanish Nuclear Energy Board.

PubMed Central

Rodríguez Artalejo, F; Castaño Lara, S; de Andrés Manzano, B; García Ferruelo, M; Iglesias Martín, L; Calero, J R

1997-01-01

OBJECTIVES: Firstly, to ascertain whether mortality among workers of the former Spanish Nuclear Energy Board (Junta de Energía Nuclear-JEN) was higher than that for the Spanish population overall; and secondly, if this were so, to ascertain whether this difference was associated with exposure to ionising radiation. METHODS: A retrospective follow up of a cohort of 5657 workers was carried out for the period 1954-92. Cohort mortality was compared with that for the Spanish population overall, with standardised mortality ratios (SMRs) adjusted for sex, age, and calendar period. Also, Poisson models were used to analyse mortality from lung cancer in the cohort by level of exposure to ionising radiation. RESULTS: Workers' median and mean cumulative exposures were 4.04 and 11.42 mSv, respectively. Mean annual exposure was 1.33 mSv. Excess mortality due to bone tumours was found for the cohort as a whole (six deaths observed; SMR 2.95; 95% confidence interval (95% CI) 1.08 to 6.43). Among miners, excess mortality was found for non-malignant respiratory diseases (SMR 2.94; 95% CI 2.27 to 3.75), and for lung cancer bordering on statistical significance (SMR 1.50; 95% CI 0.96 to 2.23; P = 0.055). Relative risks of dying of lung cancer from ionising radiation in the dose quartiles 2, 3, and 4 versus the lowest dose quartile, were 1.00, 1.64, and 0.94, respectively. CONCLUSIONS: Excess mortality from lung cancer was found among JEN miners. Nevertheless, no clear relation was found between mortality from lung cancer and level of exposure to ionising radiation in the JEN cohort. Continued follow up of the cohort is required to confirm excess mortality from bone tumours. PMID:9155782

Occupational exposure to ionising radiation and mortality among workers of the former Spanish Nuclear Energy Board.

PubMed

Rodríguez Artalejo, F; Castaño Lara, S; de Andrés Manzano, B; García Ferruelo, M; Iglesias Martín, L; Calero, J R

1997-03-01

Firstly, to ascertain whether mortality among workers of the former Spanish Nuclear Energy Board (Junta de Energía Nuclear-JEN) was higher than that for the Spanish population overall; and secondly, if this were so, to ascertain whether this difference was associated with exposure to ionising radiation. A retrospective follow up of a cohort of 5657 workers was carried out for the period 1954-92. Cohort mortality was compared with that for the Spanish population overall, with standardised mortality ratios (SMRs) adjusted for sex, age, and calendar period. Also, Poisson models were used to analyse mortality from lung cancer in the cohort by level of exposure to ionising radiation. Workers' median and mean cumulative exposures were 4.04 and 11.42 mSv, respectively. Mean annual exposure was 1.33 mSv. Excess mortality due to bone tumours was found for the cohort as a whole (six deaths observed; SMR 2.95; 95% confidence interval (95% CI) 1.08 to 6.43). Among miners, excess mortality was found for non-malignant respiratory diseases (SMR 2.94; 95% CI 2.27 to 3.75), and for lung cancer bordering on statistical significance (SMR 1.50; 95% CI 0.96 to 2.23; P = 0.055). Relative risks of dying of lung cancer from ionising radiation in the dose quartiles 2, 3, and 4 versus the lowest dose quartile, were 1.00, 1.64, and 0.94, respectively. Excess mortality from lung cancer was found among JEN miners. Nevertheless, no clear relation was found between mortality from lung cancer and level of exposure to ionising radiation in the JEN cohort. Continued follow up of the cohort is required to confirm excess mortality from bone tumours.

A study of mortality patterns at a tyre factory 1951-1985: a reference statistic dilemma.

PubMed

Veys, C A

2004-08-01

The general and cancer mortalities of rubber workers at a large tyre factory were studied in an area of marked regional variation in death rates. Three quinquennial intakes of male rubber workers engaged between January 1946 and December 1960 formed a composite cohort of 6454 men to be followed up. Over 99% were successfully traced by December 1985. The cohort analysis used both national and local rates as reference statistics for several causes. Between 1951 and 1985, a national standardized mortality ratio (SMRN) of 101 for all causes (based on 2556 deaths) was noted, whereas the local standardized mortality ratio (SMRL) was only 79. For all cancers, the figures were 115 (SMRN) and 93 (SMRL), for stomach cancer they were 137 (SMRN) and 84 (SMRL), and for lung cancer they were 121 (SMRN) and 94 (SMRL). No outright excesses against the national norm were observed for other cancers except for larynx, brain and central nervous system and thyroid cancer and the leukaemias. Excesses were statistically significant for cancer of the gallbladder and the bile ducts, for silicotuberculosis (SMRN = 1000) and for the pneumoconioses (SMRN = 706). Deaths from cerebrovascular diseases, chronic bronchitis and emphysema showed statistically significant deficits using either norm. These results from a large factory cohort study of rubber workers, followed for over three decades, demonstrate the marked discrepancy that can result from using only one reference statistic in areas of significant variation in mortality patterns.

Cancer mortality in an international cohort of reinforced plastics workers exposed to styrene: a reanalysis.

PubMed

Loomis, Dana; Guha, Neela; Kogevinas, Manolis; Fontana, Vincenzo; Gennaro, Valerio; Kolstad, Henrik A; McElvenny, Damien Martin; Sallmén, Markku; Saracci, Rodolfo

2018-04-17

To investigate the carcinogenicity of styrene by reanalysing data from a previous international cohort study of workers in the reinforced plastics industry. Mortality from cancers of prior interest was analysed with more detailed consideration of exposure-response relations and an updated classification of leukaemias and lymphomas in data from a previous international cohort study of 37 021 reinforced plastics workers exposed to airborne styrene. Increased mortality from non-Hodgkin's lymphoma (NHL) was associated with the mean level of exposure to styrene in air (relative risk (RR) 2.31, 95% CI 1.29 to 4.12 per 100 ppm), but not with cumulative styrene exposure. Similar associations with mean exposure were observed for the oesophagus (RR 2.44, 95% CI 1.11 to 5.36 per 100 ppm) and pancreas (RR 1.89, 95% CI 1.17 to 3.09). Oesophageal cancer mortality was also associated with cumulative styrene exposure lagged 20 years (RR 1.16, 95% CI 1.03 to 1.31). No other cancer, including lung cancer, was associated with any indicator of styrene exposure. This reanalysis does not substantially change the conclusions of the original study with respect to NHL or lung cancer but new evidence concerning cancers of the oesophagus and pancreas merits further investigation. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Pokémon GO and psychological distress, physical complaints, and work performance among adult workers: a retrospective cohort study.

PubMed

Watanabe, Kazuhiro; Kawakami, Norito; Imamura, Kotaro; Inoue, Akiomi; Shimazu, Akihito; Yoshikawa, Toru; Hiro, Hisanori; Asai, Yumi; Odagiri, Yuko; Yoshikawa, Etsuko; Tsutsumi, Akizumi

2017-09-07

The effects of Pokémon GO, a new mobile game application which utilizes augmented reality, on risky behavior and health have already been discussed in anecdotal evidence. However, there have been no studies about its effects on mental health. This study investigated the relationships between Pokémon GO and psychological distress from an existing workers' cohort in Japan. Online surveys were conducted to 3,915 full-time workers, at baseline (Nov 26, 2015-Feb 18, 2016) and at follow-up (Dec 1-4, 2016), using a self-report questionnaire. Pokémon GO players were defined as participants who had played Pokémon GO for one month or longer. Psychological distress was measured using validated scales. Of the completers, 246 (9.7%) had continued to play Pokémon GO. They were significantly younger than non-players. From the results of the general linear modeling, improvement in psychological distress was significantly greater among Pokémon GO players than among non-players (p = 0.025). Cohen's d for the difference in psychological distress was -0.20 (95% CI, -0.33, -0.07). Pokémon GO may be effective for improving psychological distress among workers. Although its effect size is small, the game could have positive effects on the mental health of the adult working population.

[Impact of the Tobacco Law on the workplace: a follow up study of a cohort of workers in Spain 2005-2007].

PubMed

Bauzà-Amengual, M de Lluc; Blasco-González, Manuel; Sánchez-Vazquez, Elena; Pereiró-Berenguer, Inmaculada; Ruiz-Varea, Nidia; Pericás-Beltran, Jordi

2010-06-01

The aim of this study is to describe the changes caused by the Law on Tobacco and its consumption in workers who are active smokers. A post-intervention follow up study of a cohort of users. Health Centres in Valencia and Majorca. Users who attended health centres. The field work consisted of each patient filling in a case report form with the requested information. The variables collected were, sex, place of work, education level, number of workers in the company, number of cigarettes smoked. They were told that on the following day they had to count the cigarettes smoked throughout the day, noting whether they had been smoked during or outside working hours. If they smoked during working hours, they reported whether it was inside or outside the workplace. On the following day they were telephoned to let us know the number of cigarettes smoked. This telephone call was repeated at six months and eighteen months. Smoking prevalence and the number of cigarettes smoked in the workplace has been reduced by 9% per month. The variables associated with compliance with the law were education level, the sex of the worker, and the size of the company. The coming into force of the Tobacco Law has been effective. Copyright 2009 Elsevier España, S.L. All rights reserved.

Sex Work and Motherhood: Social and Structural Barriers to Health and Social Services for Pregnant and Parenting Street and Off-Street Sex Workers

PubMed Central

Duff, Putu; Shoveller, Jean; Chettiar, Jill; Feng, Cindy; Nicoletti, Rachel; Shannon, Kate

2015-01-01

Our study documents the correlates of barriers to pregnancy and mothering among sex workers in Vancouver, Canada. We used baseline data from An Evaluation of Sex Workers’ Health Access (AESHA), a prospective cohort of sex workers. Among the 399 sex workers that had ever been pregnant or had a child, 35% reported ever experiencing a barrier, with lower education, homelessness, and history of injecting drugs significantly correlated with pregnancy and mothering barriers. Our findings highlight a critical need for tailored and non-judgmental services and supports, including improved programs to address intersecting aspects of poverty, health literacy, stigma and substance use. PMID:25513844

The strain index and TLV for HAL: risk of lateral epicondylitis in a prospective cohort.

PubMed

Garg, Arun; Kapellusch, Jay M; Hegmann, Kurt T; Thiese, Matthew S; Merryweather, Andrew S; Wang, Ying-Chih; Malloy, Elizabeth J

2014-03-01

This study's objective was to quantify exposure-response relationships between job physical exposure (JPE) and incidence of lateral epicondylitis (LE). A cohort of 536 workers was enrolled from 10 manufacturing facilities and followed monthly for 6 years to ascertain changes in JPE and health status. JPE was individually measured and quantified using the Strain Index (SI) and TLV for HAL. Worker demographics, medical history, psychosocial factors, and current musculoskeletal disorders were obtained. Fifty-six workers developed LE. In multivariate models JPE, age, family problems, and swimming were associated with increased risk of LE. SI showed an exposure-response relationship with maximum hazard ratio (HR) of 4.5(P = 0.04). TLV for HAL showed a non-statistically significant trend for increased risk of LE (P = 0.19). JPE is associated with increased risk of LE. The SI and TLV for HAL are useful metrics for estimating JPE. © 2013 Wiley Periodicals, Inc.

The Associations between Falls, Fall Injuries and Labor Market Outcomes among U.S. Workers 65 Years and Older.

PubMed

Scott, Kenneth; Fisher, Gwenith G; Barón, Anna E; Tompa, Emile; Stallones, Lorann; DiGuiseppi, Carolyn

2018-06-13

To examine whether falls are associated with the subsequent ability to work among workers 65 years and older. This longitudinal cohort study followed older workers enrolled in the Health and Retirement Study. Outcomes included time to health-related work limitation and to labor force exit. After adjustment multiple falls with or without a medically-treated injury were associated with time to limitation (HR = 1.77, 95% CI: 1.30-2.40; HR = 1.48, 95% CI: 1.26-1.73, respectively). Adjustment mitigated a crude relationship between falls and time to exit. Significant interactions suggest the relationship between falls and labor force exit depends on age, race and job demands. Falls, both non-injurious and injurious, are associated with subsequent health-related work limitation among workers 65 and older. Fall prevention activities would benefit workers who want or need to keep working past age 65.

Mortality in the British printing industry: a historical cohort study of trade union members in Manchester.

PubMed Central

Leon, D A

1994-01-01

A historical cohort study of the printing industry was established after an anecdotal report of a cluster of cases of bladder cancer in a newspaper factory in Manchester. The cohort comprised some 9500 men who were members of one or other of two trade unions (the NGA and NATSOPA) in the Manchester area between 1949 and 1963. During the follow up period (1949-83) 3482 deaths occurred among men born in 1890 or later; follow up was 97% complete. The results of the study do not support the hypothesis of an occupational risk of bladder cancer in the printing industry. The NGA have a standardised mortality ratio (SMR) of 63 (95% confidence interval (95% CI) 31-113) and NATSOPA an SMR of 113 (95% CI 67-178) based on 11 and 18 deaths from bladder cancer, respectively. Men involved in newspaper letterpress printing have a high mortality from lung cancer (SMR = 179, 95% CI 144-218) that is consistent with the findings of previous studies. Increased mortality from cancer of the buccal cavity and pharynx was found for NATSOPA workers in the newspaper industry; editorial workers had an SMR of 1053 (95% CI 128-3803) and clerical workers had an SMR of 638 (95% CI 132-1864). This is consistent with a review of published studies, which strongly suggest that workers in the printing industry have an increased risk of mortality from cancers of the buccal cavity and pharynx. Socioeconomic differences in union composition, rather than occupational factors, may account for the lower mortality in the NGA compared with NATSOPA. The NGA, a craft union, had an all causes SMR of 92 (95% CI 88-97), whereas NATSOPA covered a broader span of occupations and skill levels, and had an all causes SMR of 112 (95% CI 106-117); the NATSOPA and NGA all causes rate ratio was 1.21 (95% CI 1.13-1,29). PMID:8111468

Return-to-work for multiple jobholders with a work-related musculoskeletal disorder: A population-based, matched cohort in British Columbia

PubMed Central

Koehoorn, Mieke; McLeod, Christopher B.

2018-01-01

Introduction Multiple jobholders (MJHs) have a higher risk of injury compared to single jobholders (SJHs), but it is unknown if return-to-work (RTW) after a work injury is affected by multiple jobholding. This study examined the association between multiple versus single jobholding and time to RTW for workers with a work-related musculoskeletal disorder (MSD). Methods We used administrative workers’ compensation data to identify injured workers with an accepted MSD lost-time claim between 2010–2014 in British Columbia, Canada (n = 125,639 SJHs and 9,029 MJHs). The outcome was days until RTW during twelve months after the first day of time-loss. The MJH and SJH cohorts were balanced using coarsened exact matching that yielded a final matched cohort of 8,389 MJHs and 8,389 SJHs. The outcome was estimated with Cox regression, using piecewise models, and the hazard ratios were stratified by type of MSD, a serious injury indicator, gender, weekly workdays preceding MSD, and wage categories. Results MJHs were less likely to RTW compared to SJHs within the first six months after the first time-loss day, with greater and longer lasting effects for males, workers with a serious injury, and a higher wage. No difference between MJHs and SJHs was found for workers who had a six- or seven-day work week preceding MSD, for workers with dislocations, and for workers who were still off work after six months. Conclusions Overall, MJHs with a workweek of maximum five days are disadvantaged compared to SJHs in terms of RTW following a work-related MSD within the first six months after the first time-loss day. This difference might be caused by more precarious job contracts for MJHs that challenges RTW because of lack of support for modified work, higher workload, and reduced likelihood that MJHs file a workers’ compensation claim. Despite adjusting for type of MSD, severity of injury and occupation, the differences persisted for the vast majority of the study sample. PMID:29614128

Non-radiation risk factors for leukemia: A case-control study among chornobyl cleanup workers in Ukraine

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gudzenko, N., E-mail: gudznat@gmail.com; Hatch, M., E-mail: hatchm@mail.nih.gov; Bazyka, D., E-mail: Bazyka@yahoo.com

Background: Occupational and environmental exposure to chemicals such as benzene has been linked to increased risk of leukemia. Cigarette smoking and alcohol consumption have also been found to affect leukemia risk. Previous analyses in a large cohort of Chornobyl clean-up workers in Ukraine found significant radiation-related increased risk for all leukemia types. We investigated the potential for additional effects of occupational and lifestyle factors on leukemia risk in this radiation-exposed cohort. Methods: In a case-control study of chronic lymphocytic and other leukemias among Chornobyl cleanup workers, we collected data on a range of non-radiation exposures. We evaluated these and othermore » potential risk factors in analyses adjusting for estimated bone marrow radiation dose. We calculated Odds Ratios and 95% Confidence Intervals in relation to lifestyle factors and occupational hazards. Results: After adjusting for radiation, we found no clear association of leukemia risk with smoking or alcohol but identified a two-fold elevated risk for non-CLL leukemia with occupational exposure to petroleum (OR=2.28; 95% Confidence Interval 1.13, 6.79). Risks were particularly high for myeloid leukemias. No associations with risk factors other than radiation were found for chronic lymphocytic leukemia. Conclusions: These data – the first from a working population in Ukraine – add to evidence from several previous reports of excess leukemia morbidity in groups exposed environmentally or occupationally to petroleum or its products. - Highlights: • A unique population – a cohort of 110,645 Chernobyl clean-up workers from Ukraine. • Followed 1986–2006 for leukemia, interviewed about non-radiation risk factors. • Petroleum exposure increased risk for non-CLL leukemias, particularly CML. • No risk factor other than radiation was found for CLL.« less

Impact of the Spanish smoking law on exposure to second-hand smoke and respiratory health in hospitality workers: a cohort study.

PubMed

Fernández, Esteve; Fu, Marcela; Pascual, José A; López, María J; Pérez-Ríos, Mónica; Schiaffino, Anna; Martínez-Sánchez, Jose M; Ariza, Carles; Saltó, Esteve; Nebot, Manel

2009-01-01

A smoke-free law came into effect in Spain on 1st January 2006, affecting all enclosed workplaces except hospitality venues, whose proprietors can choose among totally a smoke-free policy, a partial restriction with designated smoking areas, or no restriction on smoking on the premises. We aimed to evaluate the impact of the law among hospitality workers by assessing second-hand smoke (SHS) exposure and the frequency of respiratory symptoms before and one year after the ban. We formed a baseline cohort of 431 hospitality workers in Spain and 45 workers in Portugal and Andorra. Of them, 318 (66.8%) were successfully followed up 12 months after the ban, and 137 nonsmokers were included in this analysis. We obtained self-reported exposure to SHS and the presence of respiratory symptoms, and collected saliva samples for cotinine measurement. Salivary cotinine decreased by 55.6% after the ban among nonsmoker workers in venues where smoking was totally prohibited (from median of 1.6 ng/ml before to 0.5 ng/ml, p<0.01). Cotinine concentration decreased by 27.6% (p = 0.068) among workers in venues with designated smoking areas, and by 10.7% (p = 0.475) among workers in venues where smoking was allowed. In Portugal and Andorra, no differences between cotinine concentration were found before (1.2 ng/ml) and after the ban (1.2 ng/ml). In Spain, reported respiratory symptom declined significantly (by 71.9%; p<0.05) among workers in venues that became smoke-free. After adjustment for potential confounders, salivary cotinine and respiratory symptoms decreased significantly among workers in Spanish hospitality venues where smoking was totally banned. Among nonsmoker hospitality workers in bars and restaurants where smoking was allowed, exposure to SHS after the ban remained similar to pre-law levels. The partial restrictions on smoking in Spanish hospitality venues do not sufficiently protect hospitality workers against SHS or its consequences for respiratory health.

Lung-cancer mortality among Vermont granite workers: factors influencing exposure-response evaluation.

PubMed

Vacek, Pamela M; Callas, Peter W

2017-03-01

To understand why 2 studies relating crystalline silica exposure to lung-cancer mortality in Vermont granite workers yielded conflicting results. Data used in the 2 studies were linked to identify discrepancies. Mortality data and employment histories from the earlier study were revised based on data obtained in the later study. SMR were computed and Poisson regressions corresponding to those in the earlier study were performed using the original and revised data. Analyses were repeated with the addition of workers omitted from the earlier study. After correction of incomplete mortality and employment information in the original data, the overall SMR for the cohort in the earlier study increased from 1.17 (95% CI 1.03 to 1.36) to 1.39 (95% CI 1.22 to 1.59), and was similar to the SMR of 1.37 observed in the later study (95% CI 1.23 to 1.52). The exposure-response relationship was attenuated, particularly when person-years in all exposure categories were included in the analysis. Inclusion of additional workers had a smaller impact on the SMRs but further attenuated the exposure-response relationship. Differing results from the 2 studies are partly attributable to incomplete vital status and work history information used in the earlier study, as well as differences in cohort inclusion criteria. However, differences in length of follow-up and other factors likely play a larger role. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Is prolonged sitting at work associated with the time course of neck-shoulder pain? A prospective study in Danish blue-collar workers.

PubMed

Hallman, David M; Gupta, Nidhi; Heiden, Marina; Mathiassen, Svend Erik; Korshøj, Mette; Jørgensen, Marie Birk; Holtermann, Andreas

2016-11-10

This study aimed to determine the extent to which objectively measured sitting time at work is associated with the course of neck-shoulder pain across 1 year in blue-collar workers. Data were analysed from 625 blue-collar workers in the Danish PHysical ACTivity cohort with Objective measurements (DPHACTO) cohort study (2012-2013). Objective data on sitting time were collected at baseline using accelerometry. Self-reported pain intensity (numeric rating scale 0-10) in the neck-shoulder region was registered for 1 year using repeated text messages (14 in total). Linear mixed models were used to determine the relationship between per cent time in sitting at work and trajectories of neck-shoulder pain, with and without adjustment for demographic, occupational and lifestyle factors, and baseline pain intensity. More sitting time at work was associated with a faster decline in pain intensity over 12 months, as indicated by a statistically significant effect of sitting on pain trajectories in the crude (p=0.020) and fully adjusted models (p=0.027). In blue-collar workers, more sitting time at work was associated with a favourable development of pain intensity over time. The relationship between sitting at work and pain needs further investigation before explicit recommendations and guidelines on sedentary behaviour among blue-collar workers can be developed. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

An effective quarantine measure reduced the total incidence of influenza A H1N1 in the workplace: another way to control the H1N1 flu pandemic.

PubMed

Miyaki, Koichi; Sakurazawa, Hirofumi; Mikurube, Hajime; Nishizaka, Mika; Ando, Hidehiko; Song, Yixuan; Shimbo, Takuro

2011-01-01

To evaluate the effectiveness of a non-vaccine quarantine measure against pandemic influenza A H1N1 in workplaces. Design was quasi-cluster randomized controlled trial in two sibling companies (Cohort 1 n=6,634, Cohort 2 n=8,500). The follow-up period was from July 1st, 2009 to February 19th, 2010 (233 days). Intervention was voluntary waiting at home on full pay if the family became Influenza like Illness (ILI). The incidences of influenza A H1N1 and those of the subgroups whose families got ILI in both cohorts were compared by a Cox regression model and log-rank test. There were 189 and 270 workers who got H1N1 infection during the follow-up period in each cohort. In this period 317 workers in Cohort 1 were asked to wait at home for several days (100% obeyed). The intervention group (Cohort 1) showed a statistically significant lower risk (p for log-rank test=0.033) compared with the control (Cohort 2), and the hazard ratio of the intervention was 0.799 [0.658-0.970] after adjusting for age, sex, BMI and smoking status. The workers who were asked to wait at home showed H1N1 infection more frequently (49 out of 317) compared with the workers whose family got ILI but were not asked to wait and work regularly (77 out of 990, RR=2.17 [1.48-3.18]). The waiting on full pay policy in the workplace reduced the overall risk of influenza A H1N1 by about 20% in one flu season in Japan. This kind of non-vaccine measure will be a promising option in workplaces to control the next flu pandemic.

Chemical exposures and respiratory cancer among Finnish woodworkers.

PubMed Central

Kauppinen, T P; Partanen, T J; Hernberg, S G; Nickels, J I; Luukkonen, R A; Hakulinen, T R; Pukkala, E I

1993-01-01

A case-control study of respiratory cancer, nested within a cohort of male woodworkers, was updated in Finland. The update extended the initial follow up of 3805 workers from 19 plants to 7307 workers from 35 plants. Each case of respiratory cancer (n = 136) diagnosed between 1957 and 1982 within the cohort was matched by year of birth with three controls (n = 408) from the cohort. Chemical exposures were assessed for the cases and the controls by a plant and period specific job exposure matrix. An excess of respiratory cancer was associated with phenol. Concomitant exposures to several other agents occurred as well, however, and no exposure-response relation for phenol was seen. An excess risk and an increasing exposure-response relation were found for engine exhaust from petrol and diesel driven factory trucks. The excess risk associated with pesticides was lower than in our previous study, an indication of qualitative and quantitative differences in exposure between the initial and augmented cohorts. Slightly increased risks were found for terpenes and mould spores, which may be due to chance although the contribution of occupational exposure cannot be ruled out. Exposure to wood dust, mainly from pine, spruce and birch, at a level of about 1 mg/m3, was not associated with lung cancer, upper respiratory cancer, or adenocarcinoma of the lung. PMID:8435346

A cohort mortality and cancer incidence survey of recent entrants (1982-91) to the UK rubber industry: findings for 1983-2004.

PubMed

Dost, Abid; Straughan, Jk; Sorahan, Tom

2007-05-01

To monitor the occurrence of cancer in a recently defined cohort of UK rubber workers. A cohort of 8651 male and female workers from 41 UK rubber factories has been enumerated. All employees had a minimum of 12 months employment and were first employed at one of the participating factories in the period 1982-91. Mortality and cancer incidence data for the period 1983-2004 were compared with expected values based on appropriate national rates. Mortality from lung cancer was close to expectation for males [observed 22, standardized mortality ratio (SMR) 93] and females (observed 2, SMR 70). Mortality from stomach cancer was also unexceptional in males (observed 4, SMR 86) and females (observed 0, SMR 0). Although based on small numbers, significantly elevated mortality was shown for multiple myeloma in males (observed 5, SMR 385) and females (observed 2, SMR 952). All seven of these latter deaths occurred in workers from the general rubber goods (GRG) sector. The findings should be treated with caution as they relate to a relatively early period of follow-up. Nevertheless, they hold out the prospect that the elevated SMRs for stomach and lung cancers reported for historical cohorts of UK rubber workers will not be present in more recent cohorts. The elevated occurrence of multiple myeloma may represent no more than a chance finding. Alternatively, these findings may reflect the presence of an unrecognized occupational cancer hazard in parts of the GRG sector of the UK rubber industry.

Cancer incidence among Finnish ferrochromium and stainless steel production workers in 1967-2011: a cohort study.

PubMed

Huvinen, Markku; Pukkala, Eero

2013-11-19

The aim of the study was to assess the risk of cancer among workers employed in the Finnish ferrochromium and stainless steel industry since the beginning of production in 1967. The study cohort was made up of all persons employed by the Finnish stainless steel production chain from chromite mining to cold rolling of stainless steel during the period 1967-2004, and it was divided into subcohorts by production units with specific exposure patterns of the subcohorts assessed in previous studies. Follow-up for cancer through the files of the Finnish Cancer Registry was performed using the personal identity code as key. Standardised incidence ratios (SIRs) were calculated as the ratios of observed numbers of cancer cases and numbers expected on the basis of incidence rates in the population of the same region. The overall cancer incidence was at the expected level. The lung cancer risk was decreased in the whole cohort (SIR 0.79; 95% CI 0.65 to 1.08). The incidence of prostate cancer was significantly increased (1.31; 1.05 to 1.61) and that for kidney cancer was significantly decreased (0.38; 0.14 to 0.82). None of the department-specific SIRs for lung cancer were significantly different from 1.0. No cancers of the nose and nasal sinuses were observed among workers in the ferrochromium smelter or the stainless steel melting shop. It is not likely that the occupational exposures in the Finnish ferrochromium and stainless steel industry would have increased the risk of cancer.

Social inequalities in teenage fertility outcomes: childbearing and abortion trends of three birth cohorts in Finland.

PubMed

Väisänen, Heini; Murphy, Michael

2014-06-01

Teenagers of low socioeconomic status are more likely to get pregnant, and less likely to choose abortion, than more privileged teenagers. Few studies have used longitudinal data to examine whether these differences persist as overall teenage pregnancy rates decline. Nationally representative register data from 259,242 Finnish women in three birth cohorts (1955-1959, 1965-1969 and 1975-1979) were analyzed using Cox regression to assess socioeconomic differences in teenagers' risks of pregnancy and abortion. Binary logistic regression was used to assess socioeconomic differences in the odds of pregnant teenagers' choosing abortion. Socioeconomic differences in abortion risk did not change substantially across cohorts; however, differences in the risk of childbirth rose between the first two cohorts and then returned to their earlier level. In all cohorts, teenagers from upper-level employee backgrounds, the most privileged group, had the lowest risks of abortion and childbirth (44-53% and 53-69% lower, respectively, than those for manual workers' children). Teenagers whose parents were lower-level employees or farmers also had reduced risks of both outcomes in all cohorts; results for other socioeconomic groups were less consistent. Pregnant teenagers from upper-level employee backgrounds had 2-3 times the odds of abortion of manual workers' children; the largest difference was found in the 1950s cohort. Despite the declining overall teenage pregnancy rate, poorer background continues to be associated with a higher risk of conceiving and of giving birth. Copyright © 2014 by the Guttmacher Institute.

Early predictors of lumbar spine surgery after occupational back injury: results from a prospective study of workers in Washington State.

PubMed

Keeney, Benjamin J; Fulton-Kehoe, Deborah; Turner, Judith A; Wickizer, Thomas M; Chan, Kwun Chuen Gary; Franklin, Gary M

2013-05-15

Prospective population-based cohort study. To identify early predictors of lumbar spine surgery within 3 years after occupational back injury. Back injuries are the most prevalent occupational injury in the United States. Few prospective studies have examined early predictors of spine surgery after work-related back injury. Using Disability Risk Identification Study Cohort (D-RISC) data, we examined the early predictors of lumbar spine surgery within 3 years among Washington State workers, with new workers compensation temporary total disability claims for back injuries. Baseline measures included worker-reported measures obtained approximately 3 weeks after claim submission. We used medical bill data to determine whether participants underwent surgery, covered by the claim, within 3 years. Baseline predictors (P < 0.10) of surgery in bivariate analyses were included in a multivariate logistic regression model predicting lumbar spine surgery. The area under the receiver operating characteristic curve of the model was used to determine the model's ability to identify correctly workers who underwent surgery. In the D-RISC sample of 1885 workers, 174 (9.2%) had a lumbar spine surgery within 3 years. Baseline variables associated with surgery (P < 0.05) in the multivariate model included higher Roland-Morris Disability Questionnaire scores, greater injury severity, and surgeon as first provider seen for the injury. Reduced odds of surgery were observed for those younger than 35 years, females, Hispanics, and those whose first provider was a chiropractor. Approximately 42.7% of workers who first saw a surgeon had surgery, in contrast to only 1.5% of those who saw a chiropractor. The area under the receiver operating characteristic curve of the multivariate model was 0.93 (95% confidence interval, 0.92-0.95), indicating excellent ability to discriminate between workers who would versus would not have surgery. Baseline variables in multiple domains predicted lumbar spine surgery. There was a very strong association between surgery and first provider seen for the injury even after adjustment for other important variables.

Changes in work situation and work ability in young female and male workers. A prospective cohort study.

PubMed

Boström, Maria; Sluiter, Judith K; Hagberg, Mats

2012-08-24

Good work ability is very important in young workers, but knowledge of work situations that influence work ability in this group is poor. The aim of this study was to assess whether changes in self-reported work factors are associated with self-reported work ability among young female and male workers. A sample of 1,311 (718 women and 593 men) was selected from a Swedish cohort of workers aged 21-25 years. At baseline and at 1-year follow-up, participants completed a self-administrated questionnaire including ratings of physical and psychosocial work factors and current work ability. Prevalence ratios were calculated to assess univariate and multivariate associations between changes in work factors and changes in work ability. Decreased job control (PR 1.7, 95% CI 1.49-2.12) and increased negative influence of job demands on private life (PR 1.5, 95% CI 1.25-1.69) were associated with reduced work ability for both female and male workers in the multivariate analyses. Among female workers, an association was found between improved work ability and increased social support at work (PR 2.4, CI 1.43-3.95). For male workers, increased job control (PR 2.3, 95% CI 1.21-4.54) and decreased negative influence of job demands on private life (PR 2.1, 95% CI 1.10-3.87) were associated with improved work ability in the multivariate analyses. Decreased job control and increased negative influence of job demands on private life over time seem to be the most important work factors associated with reduced work ability among young workers of both sexes. Increased social support at work, increased job control, and decreased negative influence of job demands on private life were also found to be the main work factors associated with improved work ability, although with possible gender differences.

Feasibility of cohort studies in Estonia

PubMed Central

Innos, K.; Rahu, M.; Rahu, K.

1999-01-01

OBJECTIVES: To describe the methodology and feasibility of follow up for vital status in retrospective cohort studies in Estonia. METHODS: A cohort of 7412 workers who had been employed at two factories in Tallinn between 1946 and 1988 was followed up for vital status from the date of first employment until death, emigration, or the end of the study, 31 December 1995, whichever occurred first. The cohort was electronically linked with the National Population Registry of Estonia that was created in 1992 and includes personal identification numbers of Estonian citizens and residents, and the Mortality Database that contains information from death certificates issued in 1983-95. A manual search was carried out on several non-computerised population data sources and archives. RESULTS: By 31 December 1995, the vital status of 6780 (91.5%) subjects could be traced (4495 (60.6%) subjects were alive, 1993 (26.9%) had died, and 292 (3.9%) had emigrated). Analysis by calendar period of leaving work showed that the proportion of subjects traced was lowest in the group of workers who had left work between 1946 and 1955 (58.4%), especially those whose age at leaving work was < 30 (53.2%) or > 60 years (42.3%). Among subjects who left work in 1956-65, 1966-75, and 1976-88, the follow up rate was 84.7%, 94.6%, and 98.2%, respectively. CONCLUSIONS: The findings, which are especially important for occupational epidemiology, confirm the feasibility of conducting retrospective cohort studies in Estonia. Most of the issues discussed in the paper apply to other former Soviet countries.   PMID:10472323

[Health risk among workers employed in rubber footwear plant].

PubMed

Szubert, Z; Wilczyńska, U; Sobala, W

2001-01-01

The aim of the study was to assess the health risk of workers performing specific jobs in the process of the rubber footwear production by defining the cause and length of temporary work disability, as well as mortality causes and level. The analysis was carried out in the groups of workers performing the following jobs: mixing, mill operation, pressing and vulcanizing (A); semi-product preparation and calendaring (B); finishing and sorting (C); production of polyvinyl chloride footwear (D); and auxiliary works (E). The sickness absence study covered all workers (208 men and 315 women) employed in a large rubber footwear company and performing all above-listed jobs in 1995. Standardized sick days ratio was used to analyze the risk of temporary work disability. Mortality rate was estimated on the basis of the results of the cohort study performed in the same company among workers who had worked at least three months during the years 1945-1985. The follow-up continued until 31 December 1997. The present study included sub-cohorts composed of 5628 men and 7197 women, performing jobs listed above. The results of both studies indicated the enhanced risk of cardiovascular diseases among workers employed in the basic phases of the production process. The increased risk of the diseases of the digestive system was observed in men and women employed in: finishing, sorting and packing of the products (group C); in men involved in mixing, pressing and vulcanizing (group A); and in women engaged in auxiliary works (group E). In addition, the enhanced risk of sickness absence due to the diseases of the respiratory, digestive, or genitourinary systems was related to the enhanced risk of death from malignant neoplasms in a given site. The analysis showed that the temporary work disability may be regarded as a parameter useful in early assessment of health effects of the work environmental hazards.

Incidence of chronic bronchitis in a cohort of pulp mill workers with repeated gassings to sulphur dioxide and other irritant gases

PubMed Central

2013-01-01

Background Occupational exposure to irritants is associated with chronic bronchitis. The aim of this study was to elucidate whether repeated peak exposures with respiratory symptoms, gassings, to sulphur dioxide (SO2) and other irritant gases could increase the risk of chronic bronchitis. Methods The study population comprised 3,060 Swedish pulp mill workers (84% males) from a cohort study, who completed a comprehensive questionnaire with items on chronic bronchitis symptoms, smoking habit, occupational history, and specific exposures, including gassings. 2,037 have worked in sulphite mills. Incidence rates and hazard ratios (HRs) for the observation period, 1970–2000, in relation to exposure and the frequency of repeated gassings to SO2 and other irritant gases were calculated. Results The incidence rate for chronic bronchitis among workers with repeated gassings was 3.5/1,000 person-years compared with 1.5/1,000 person-years among unexposed workers (HR 2.1, 95% confidence interval (CI) 1.4-3.1). The risk was even higher in the subgroup with frequent gassings (HR 3.2, 95% CI 2.0-5.2), particularly among never-smokers (HR 8.7, 95% CI 3.5-22). Conclusions Repeated gassings to irritant gases increased the incidence of chronic bronchitis in our study population during and after work in pulp mills, supporting the hypothesis that occupational exposures to irritants negatively affect the airways. These results underscore the importance of preventive actions in this work environment. PMID:24354705

Nonwage losses associated with occupational injury among health care workers.

PubMed

Guzman, Jaime; Ibrahimova, Aybaniz; Tompa, Emile; Koehoorn, Mieke; Alamgir, Hasanat

2013-08-01

To examine nonwage losses after occupational injury among health care workers and the factors associated with the magnitude of these losses. Inception cohort of workers filing an occupational injury claim in a Canadian province. Worker self-reports were used to calculate (1) the nonwage economic losses in 2010 Canadian dollars, and (2) the number of quality-adjusted days of life lost on the basis of the EuroQOL Index. Most workers (84%; n = 123) had musculoskeletal injuries (MSIs). Each MSI resulted in nonwage economic losses of Can$3131 (95% confidence interval, Can$3035 to Can$3226), lost wages of Can$5286, and 7.9 quality-adjusted days of life lost within 12 weeks after injury. Losses varied with type of injury, region of the province, and occupation. Non-MSIs were associated with smaller losses. These estimates of nonwage losses should be considered in workers' injury compensation policies and in economic evaluation studies.

Low Prevalence of Chronic Beryllium Disease among Workers at a Nuclear Weapons Research and Development Facility

DOE Office of Scientific and Technical Information (OSTI.GOV)

Arjomandi, M; Seward, J P; Gotway, M B

2010-01-11

To study the prevalence of beryllium sensitization (BeS) and chronic beryllium disease (CBD) in a cohort of workers from a nuclear weapons research and development facility. We evaluated 50 workers with BeS with medical and occupational histories, physical examination, chest imaging with HRCT (N=49), and pulmonary function testing. Forty of these workers also underwent bronchoscopy for bronchoalveolar lavage (BAL) and transbronchial biopsies. The mean duration of employment at the facility was 18 yrs and the mean latency (from first possible exposure) to time of evaluation was 32 yrs. Five of the workers had CBD at the time of evaluation (basedmore » on histology or HRCT); three others had evidence of probable CBD. These workers with BeS, characterized by a long duration of potential Be exposure and a long latency, had a low prevalence of CBD.« less

Low Prevalence of Chronic Beryllium Disease Among Workers at aNuclearWeaponsResearchandDevelopmentFacility

PubMed Central

Arjomandi, Mehrdad; Seward, James; Gotway, Michael B.; Nishimura, Stephen; Fulton, George P.; Thundiyil, Josef; King, Talmadge E.; Harber, Philip; Balmes, John R.

2012-01-01

Objective To study the prevalence of beryllium sensitization (BeS) and chronic beryllium disease (CBD) in a cohort of workers from a nuclear weapons research and development facility. Methods We evaluated 50 workers with BeS with medical and occupational histories, physical examination, chest imaging with high-resolution computed tomography (N = 49), and pulmonary function testing. Forty of these workers also underwent bronchoscopy for bronchoalveolar lavage and transbronchial biopsies. Results The mean duration of employment at the facility was 18 years and the mean latency (from first possible exposure) to time of evaluation was 32 years. Five of the workers had CBD at the time of evaluation (based on histology or high-resolution computed tomography); three others had evidence of probable CBD. Conclusions These workers with BeS, characterized by a long duration of potential Be exposure and a long latency, had a low prevalence of CBD. PMID:20523233

A critical review of the epidemiology of Agent Orange/TCDD and prostate cancer.

PubMed

Chang, Ellen T; Boffetta, Paolo; Adami, Hans-Olov; Cole, Philip; Mandel, Jack S

2014-10-01

To inform risk assessment and regulatory decision-making, the relationship between 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) and prostate cancer requires clarification. This article systematically and critically reviews the epidemiologic evidence on the association between exposure to TCDD or Agent Orange, a TCDD-contaminated herbicide used during the Vietnam War, and prostate cancer risk. Articles evaluated include 11 studies of three cohorts, four case-control or cross-sectional studies, and three case-only studies of military veterans with information on estimated Agent Orange or TCDD exposure; 13 studies of seven cohorts, one case-control study, and eight proportionate morbidity or mortality studies of Vietnam veterans without information on Agent Orange exposure; 11 cohort studies of workers with occupational exposure to TCDD; and two studies of one community cohort with environmental exposure to TCDD. The most informative studies, including those of Vietnam veterans involved in Agent Orange spraying or other handling, herbicide manufacturing or spraying workers with occupational TCDD exposure, and community members exposed to TCDD through an industrial accident, consistently reported no significant increase in prostate cancer incidence or mortality. Only some potentially confounded studies of Vietnam veterans compared with the general population, studies with unreliable estimates of Agent Orange exposure, and analyses of selected subgroups of Vietnam veterans reported positive associations. Overall, epidemiologic research offers no consistent or convincing evidence of a causal relationship between exposure to Agent Orange or TCDD and prostate cancer. More accurate exposure assessment is needed in large epidemiologic studies to rule out a causal association more conclusively.

[Shift Work among Men and Women on the Threshold to Higher Working Age - Working Conditions and Health Status].

PubMed

Leser, C; Tisch, A; Tophoven, S

2016-11-01

Background: The number of older employees in shift and night work has increased significantly in recent years. Furthermore, the proportion of women in shift and night work has increased markedly. This is due to the aging workforce and the expansion of shift work in the tertiary sector. Previous research shows that shift work is often associated with health risks. Against this background, the aim of the present study is to examine the situation of working men and women on the threshold to higher working age with regard to the relationship between shift work and physical health. Methods: We employed data from the study "lidA - leben in der Arbeit" German Cohort Study on Work, Age and Health, a survey of the German baby boom cohorts born in 1959 and 1965 (n=5 637). Linear regression models are used to study the effect of shift work - with and without night work - and of further work exposures on the baby boomers' physical health status. The models control for sleep and health-related behaviour and are stratified by gender. Among women, also the scope of work was taken into account. Results: The results show that male shift workers are burdened by their on average lower occupational status and by physical exposure; female shift workers additionally suffer from high personal effort and low rewards and female part-time shift workers also from overcommitment. Conclusion: Working conditions of shift workers are strongly characterised by work stress. In order to preserve aging shift workers' work ability, some organisational measures seem necessary. In this context, occupational safety and health management as well as opportunities for recovery and encouraging leadership should be considered. © Georg Thieme Verlag KG Stuttgart · New York.

Modelling the effects of exposure to whole-body vibration on low-back pain and its long-term consequences for sickness absence and associated work disability

NASA Astrophysics Data System (ADS)

Burdorf, A.; Hulshof, C. T. J.

2006-12-01

BackgroundExposure to whole-body vibration (WBV) is a well-known risk factor for the occurrence of low-back pain (LBP). Little is known about the long-term course of back pain in workers exposed to WBV and the consequences for (temporary) disability, due to lack of cohort studies with sufficiently long follow-up periods. MethodsA systematic review of the literature was performed to assess associations between exposure to WBV and LBP, sickness absence due to low-back disorders and permanent disability. A meta-analysis was used to estimate the prevalences of LBP and sickness absence due to low-back disorders in occupational populations, depending on relevant exposure characteristics. These prevalences were converted into probabilities for transitions between no complaints, LBP, sickness due to LBP, and disability. A Markov model was applied to evaluate a hypothetical cohort of workers without LBP at the start of the cohort and a follow-up of 40 years (40 cycles of 1 year) to reflect a long-life career with continuous exposure to WBV. ResultsIn this hypothetical cohort it was estimated that among workers with the highest exposure to WBV on average about 47 weeks of their working life were lost due to sick leave because of LBP, which is approximately 2.5% of their working life. When all workers on prolonged sick leave for 52 weeks would remain disabled for the rest of their working life, a maximum of 23.4% of their working life could be lost due to high WBV exposure. Among workers without or low exposure to WBV the corresponding losses were 0.8% and 7.8%, respectively. ConclusionThe approach to assess years of work lost due to an occupational exposure may provide a more adequate description for stakeholders than the traditional measures of relative risk or attributable risk fraction. The concept of work years lost may also facilitate a better appreciation of the potential benefits of preventive measures.

Lung cancer and exposure to diesel exhaust among bus garage workers.

PubMed

Gustavsson, P; Plato, N; Lidström, E B; Hogstedt, C

1990-10-01

Mortality and cancer incidence was investigated among the 695 bus garage workers employed as mechanics, servicemen, or hostlers for at least six months in five bus garages in Stockholm between 1945 and 1970. The exposure to diesel exhaust and asbestos was estimated by industrial hygienists. A small excess of lung cancer mortality was found in the cohort when occupationally active men in Stockholm were used as the reference group. A case-referent study was performed within the cohort, six referents being selected for each of the 20 lung cancer cases. The lung cancer risk increased with increasing cumulative exposure to diesel exhaust, but not with cumulative asbestos exposure. The relative risk for lung cancer among the highly exposed men was 2.4 (95% CI 1.3-4.5) as compared with those with low exposure. The study indicates that exposure to diesel exhaust increases the risk for lung cancer.

Safety of the two-step tuberculin skin test in Indian health care workers.

PubMed

Christopher, Devasahayam J; Shankar, Deepa; Datey, Ashima; Zwerling, Alice; Pai, Madhukar

2014-12-01

Health care workers (HCW) in low and middle income countries are at high risk of nosocomial tuberculosis infection. Periodic screening of health workers for both TB disease and infection can play a critical role in TB infection control. Occupational health programs that implement serial tuberculin skin testing (TST) are advised to use a two-step baseline TST. This helps to ensure that boosting of waned immune response is not mistaken as new TB infection (i.e. conversion). However, there are no data on safety of the two-step TST in the Indian context where HCWs are repeatedly exposed. Nursing students were recruited from 2007 to 2009 at the Christian Medical College and Hospital, Vellore, India. Consenting nursing students were screened with a baseline two-step TST at the time of recruitment. From 2007 to 2008 adverse events were recorded when reported during the TST reading (Cohort A). Nurses recruited in the final study year (2009) answered an investigator administered questionnaire assessing all likely side-effects Cohort B). This information was extracted from the case report forms and analysed. Between 2007 and 09, 800 trainees consented to participate in the annual TB screening study and 779 did not have a past history of TB or recall a positive TST and were selected to administer TST. Of these, 755 returned for reading the result and had complete data and were included for the final analysis - 623 subjects in (cohort A) and 132 in (cohort B). These were included for the final analysis. In cohort A only 1.3% reported adverse events. In cohort B, as per the investigator administered questionnaire; 25% reported minor side effects. Itching and local pain were the most common side effects encountered. There were no major adverse events reported. In particular, the adverse events were similar in the second step of the test and not more severe. Screening of HCWs with two-step TST for LTBI is simple and safe, and hence suitable for wide scale implementation in high-burden settings such as India. Copyright © 2014 Asian-African Society for Mycobacteriology. Published by Elsevier Ltd. All rights reserved.

Occupational Exposure to Vapor-Gas, Dust, and Fumes in a Cohort of Rural Adults in Iowa Compared with a Cohort of Urban Adults.

PubMed

Doney, Brent C; Henneberger, Paul K; Humann, Michael J; Liang, Xiaoming; Kelly, Kevin M; Cox-Ganser, Jean M

2017-11-03

Many rural residents work in the field of agriculture; however, employment in nonagricultural jobs also is common. Because previous studies in rural communities often have focused on agricultural workers, much less is known about the occupational exposures in other types of jobs in rural settings. Characterizing airborne occupational exposures that can contribute to respiratory diseases is important so that differences between rural and urban working populations can be assessed. 1994-2011. This investigation used data from the baseline questionnaire completed by adult rural residents participating in the Keokuk County Rural Health Study (KCRHS). The distribution of jobs and occupational exposures to vapor-gas, dust, and fumes (VGDF) among all participants was analyzed and stratified by farming status (current, former, and never) then compared with a cohort of urban workers from the Multi-Ethnic Study of Atherosclerosis (MESA). Occupational exposure in the last job was assessed with a job-exposure matrix (JEM) developed for chronic obstructive pulmonary disease (COPD). The COPD JEM assesses VGDF exposure at levels of none or low, medium, and high. The 1,699 KCRHS (rural) participants were more likely to have medium or high occupational VGDF exposure (43.2%) at their last job than their urban MESA counterparts (15.0% of 3,667 participants). One fifth (20.8%) of the rural participants currently farmed, 43.1% were former farmers, and approximately one third (36.1%) had never farmed. These three farming groups differed in VGDF exposure at the last job, with the prevalence of medium or high exposure at 80.2% for current farmers, 38.7% for former farmers, and 27.4% for never farmers, and all three percentages were higher than the 15.0% medium or high level of VGDF exposure for urban workers. Rural workers, including those who had never farmed, were more likely to experience occupational VGDF exposure than urban workers. The occupational exposures of rural adults assessed using the COPD JEM will be used to investigate their potential association with obstructive respiratory health problems (e.g., airflow limitation and chronic bronchitis). This assessment might highlight occupations in need of preventive interventions.

Site-specific cancer risk in the Baltic cohort of Chernobyl cleanup workers, 1986–2007

PubMed Central

Rahu, Kaja; Hakulinen, Timo; Smailyte, Giedre; Stengrevics, Aivars; Auvinen, Anssi; Inskip, Peter D.; Boice, John D.; Rahu, Mati

2013-01-01

Objective To assess site-specific cancer risk in the Baltic cohort of Chernobyl cleanup workers 1986–2007. Methods The Baltic cohort includes 17,040 men from Estonia, Latvia and Lithuania who participated in the environmental cleanup after the accident at the Chernobyl Nuclear Power Station in 1986–1991, and who were followed for cancer incidence until the end of 2007. Cancer cases diagnosed in the cohort and in the male population of each country were identified from the respective national cancer registers. The proportional incidence ratio (PIR) with 95% confidence interval (CI) was used to estimate the site-specific cancer risk in the cohort. For comparison and as it was possible, the site-specific standardized incidence ratio (SIR) was calculated for the Estonian sub-cohort, which was not feasible for the other countries. Results Overall, 756 cancer cases were reported during 1986–2007. A higher proportion of thyroid cancers in relation to the male population was found (PIR=2.76; 95%CI 1.63–4.36), especially among those who started their mission shortly after the accident, in April–May 1986 (PIR=6.38; 95% CI 2.34–13.89). Also, an excess of oesophageal cancers was noted (PIR=1.52; 95% CI 1.06–2.11). No increased PIRs for leukaemia or radiation-related cancer sites combined were observed. PIRs and SIRs for the Estonian sub-cohort demonstrated the same site-specific cancer risk pattern. Conclusion Consistent evidence of an increase in radiation-related cancers in the Baltic cohort was not observed with the possible exception of thyroid cancer, where conclusions are hampered by known medical examination including thyroid screening among cleanup workers. PMID:23683549

Site-specific cancer risk in the Baltic cohort of Chernobyl cleanup workers, 1986-2007.

PubMed

Rahu, Kaja; Hakulinen, Timo; Smailyte, Giedre; Stengrevics, Aivars; Auvinen, Anssi; Inskip, Peter D; Boice, John D; Rahu, Mati

2013-09-01

To assess site-specific cancer risk in the Baltic cohort of Chernobyl cleanup workers, 1986-2007. The Baltic cohort includes 17,040 men from Estonia, Latvia and Lithuania who participated in the environmental cleanup after the accident at the Chernobyl Nuclear Power Station in 1986-1991 and who were followed up for cancer incidence until the end of 2007. Cancer cases diagnosed in the cohort and in the male population of each country were identified from the respective national cancer registers. The proportional incidence ratio (PIR) with 95% confidence interval (CI) was used to estimate the site-specific cancer risk in the cohort. For comparison and as it was possible, the site-specific standardised incidence ratio (SIR) was calculated for the Estonian sub-cohort, which was not feasible for the other countries. Overall, 756 cancer cases were reported during 1986-2007. A higher proportion of thyroid cancers in relation to the male population was found (PIR=2.76; 95%CI 1.63-4.36), especially among those who started their mission shortly after the accident, in April-May 1986 (PIR=6.38; 95%CI 2.34-13.89). Also, an excess of oesophageal cancers was noted (PIR=1.52; 95% CI 1.06-2.11). No increased PIRs for leukaemia or radiation-related cancer sites combined were observed. PIRs and SIRs for the Estonian sub-cohort demonstrated the same site-specific cancer risk pattern. Consistent evidence of an increase in radiation-related cancers in the Baltic cohort was not observed with the possible exception of thyroid cancer, where conclusions are hampered by known medical examination including thyroid screening among cleanup workers. Copyright © 2013 Elsevier Ltd. All rights reserved.

A Retrospective Occupational Cohort Study of End-Stage Renal Disease in Aircraft Workers Exposed to Trichloroethylene and Other Hydrocarbons

PubMed Central

Radican, Larry; Wartenberg, Daniel; Rhoads, George G.; Schneider, Dona; Wedeen, Richard; Stewart, Patricia; Blair, Aaron

2006-01-01

Objective Case–control studies suggest hydrocarbons increase end-stage renal disease (ESRD) risk. No cohort studies have been conducted. Methods An occupational database was matched to the U.S. Renal Data System, and the outcome of all-cause ESRD was examined using multivariable Cox regression. Sixteen individual hydrocarbons were studied, although exposures were not mutually exclusive. Results For the 1973–2000 period, there was an approximate twofold increased risk of ESRD among workers exposed to trichloroethylene, 1,1,1-trichloroethane, and JP4 gasoline compared with unexposed subjects (all P < 0.05). Relative risk was greater than unity (P > 0.05) for several other hydrocarbons. Associations attenuated (all P > 0.05) when 2001–2002 data were included in the analyses. Conclusions Certain hydrocarbons may increase all-cause ESRD risk. Uncertainty regarding the mechanism for increased risk and the observed attenuation in risk in 2001–2002, as well as the overlap of exposures, complicates interpretation. Additional research is needed. PMID:16404204

The health and wellbeing of Australian farmers: a longitudinal cohort study.

PubMed

Brew, Bronwyn; Inder, Kerry; Allen, Joanne; Thomas, Matthew; Kelly, Brian

2016-09-15

Isolation, long work days, climate change and globalization are just some of the many pressures that make farming a vulnerable occupation for incurring mental health issues. The objective of this study was to determine whether farming in Australia is associated with poorer wellbeing, physical and mental health, and less health service use. The Australian Rural Mental Health Study, a longitudinal cohort study was analysed over four time points comparing farmers with non-farming workers (n = 1184 at baseline). Participants were recruited from rural NSW, Australia. A number of physical, mental health, wellbeing, service use outcomes were assessed using generalised estimating equations including all waves in each model. Barriers to seeking help were also assessed. Farmers who lived remotely reported worse mental health (β -0.33, 95 % CI -0.53, -0.13) and wellbeing (β -0.21(95 % CI -0.35, -0.06) than remote non-farm workers regardless of financial hardship, rural specific factors eg drought worry, or recent adverse events. All farmers were no different to non-farming workers on physical health aspects except for chronic illnesses, where they reported fewer illnesses (OR 0.66, 95 % CI 0.44, 0.98). All farmers were half as likely to visit a general practitioner (GP) or a mental health professional in the last 12 months as compared to non-farm workers regardless of location (OR 0.59, 95 % CI 0.35, 0.97). Rural workers felt that they preferred to manage themselves rather than access help for physical health needs (50 %) or mental health needs (75 %) and there was little difference between farmers and non-farm workers in reasons for not seeking help. Remoteness is a significant factor in the mental health and wellbeing of farmers, more so than financial stress, rural factors and recent adverse events. Creative programs and policies that improve access for farmers to GPs and mental health professionals should be supported.

Shared Dosimetry Error in Epidemiological Dose-Response Analyses

DOE Office of Scientific and Technical Information (OSTI.GOV)

Stram, Daniel O.; Preston, Dale L.; Sokolnikov, Mikhail

2015-03-23

Radiation dose reconstruction systems for large-scale epidemiological studies are sophisticated both in providing estimates of dose and in representing dosimetry uncertainty. For example, a computer program was used by the Hanford Thyroid Disease Study to provide 100 realizations of possible dose to study participants. The variation in realizations reflected the range of possible dose for each cohort member consistent with the data on dose determinates in the cohort. Another example is the Mayak Worker Dosimetry System 2013 which estimates both external and internal exposures and provides multiple realizations of "possible" dose history to workers given dose determinants. This paper takesmore » up the problem of dealing with complex dosimetry systems that provide multiple realizations of dose in an epidemiologic analysis. In this paper we derive expected scores and the information matrix for a model used widely in radiation epidemiology, namely the linear excess relative risk (ERR) model that allows for a linear dose response (risk in relation to radiation) and distinguishes between modifiers of background rates and of the excess risk due to exposure. We show that treating the mean dose for each individual (calculated by averaging over the realizations) as if it was true dose (ignoring both shared and unshared dosimetry errors) gives asymptotically unbiased estimates (i.e. the score has expectation zero) and valid tests of the null hypothesis that the ERR slope β is zero. Although the score is unbiased the information matrix (and hence the standard errors of the estimate of β) is biased for β≠0 when ignoring errors in dose estimates, and we show how to adjust the information matrix to remove this bias, using the multiple realizations of dose. Use of these methods for several studies, including the Mayak Worker Cohort and the U.S. Atomic Veterans Study, is discussed.« less

Mortality and cancer incidence of aircraft maintenance workers exposed to trichloroethylene and other organic solvents and chemicals: extended follow up

PubMed Central

Blair, A.; Hartge, P.; Stewart, P. A.; McAdams, M.; Lubin, J.

1998-01-01

OBJECTIVES: To extend the follow up of a cohort of 14,457 aircraft maintenance workers to the end of 1990 to evaluate cancer risks from potential exposure to trichloroethylene and other chemicals. METHODS: The cohort comprised civilians employed for at least one year between 1952 and 1956, of whom 5727 had died by 31 December 1990. Analyses compared the mortality of the cohort with the general population of Utah and the mortality and cancer incidence of exposed workers with those unexposed to chemicals, while adjusting for age, sex and calendar time. RESULTS: In the combined follow up period (1952-90), mortality from all causes and all cancer was close to expected (standardised mortality ratios (SMRs) 97 and 96, respectively). Significant excesses occurred for ischaemic heart disease (SMR 108), asthma (SMR 160), and cancer of the bone (SMR 227), whereas significant deficits occurred for cerebrovascular disease (SMR 88), accidents (SMR 70), and cancer of the central nervous system (SMR 64). Workers exposed to trichloroethylene showed non-significant excesses for non-Hodgkin's lymphoma (relative risk (RR) 2.0), and cancers of the oesophagus (RR 5.6), colon (RR 1.4), primary liver (RR 1.7), breast (RR 1.8), cervix (RR 1.8), kidney (RR 1.6), and bone (RR 2.1). None of these cancers showed an exposure- response gradient and RRs among workers exposed to other chemicals but not trichloroethylene often had RRs as large as workers exposed to trichloroethylene. Workers exposed to solvents other than trichloroethylene had slightly increased mortality from asthma, non- Hodgkin's lymphoma, multiple myeloma, and breast cancer. CONCLUSION: These findings do not strongly support a causal link with trichloroethylene because the associations were not significant, not clearly dose-related, and inconsistent between men and women. Because findings from experimental investigations and other epidemiological studies on solvents other than trichloroethylene provide some biological plausibility, the suggested links between these chemicals and non-Hodgkin's lymphoma, multiple myeloma, and breast cancer found here deserve further attention. Although this extended follow up cannot rule out a connection between exposures to solvents and some diseases, it seems clear that these workers have not experienced a major increase in cancer mortality or cancer incidence.   PMID:9624267

A retrospective cohort mortality study of blending and packaging workers of Mobil Corporation.

PubMed

Collingwood, K W; Milcarek, B I; Raabe, G K

1991-01-01

This retrospective cohort mortality study examined 2,467 workers in lubrication products blending and packaging (B&P) operations at two refineries of Mobil Corporation between January 1, 1945 and December 31, 1978. Ninety-seven percent were male. Compared with U.S. males, there were significantly fewer deaths observed among males due to all causes, external causes, and diseases of the circulatory, respiratory, digestive, and genitourinary systems. Deaths observed from all cancer were fewer than expected, although not statistically significant. No statistically significant excess cause-specific mortality occurred at B&P facilities combined or separately. Nonsignificant increases in mortality were observed for cancers of the stomach, large intestine, prostate, the category of "other lymphatic tissue" cancer, and leukemia and aleukemia. Analyses demonstrated a statistically significant pattern of increasing SMR with employment duration for "other lymphatic tissue" cancer. Within the highest cumulative duration of employment category, the excess was confined to workers after 30 or more years since first employment. Although the interpretation of cancer mortality patterns is limited due to small numbers of deaths, the absence of associations with specific B&P departments is evidence against a causal interpretation.

Reanalysis of Diesel Engine Exhaust and Lung Cancer Mortality in the Diesel Exhaust in Miners Study Cohort Using Alternative Exposure Estimates and Radon Adjustment

PubMed Central

Chang, Ellen T; Lau, Edmund C; Van Landingham, Cynthia; Crump, Kenny S; McClellan, Roger O; Moolgavkar, Suresh H

2018-01-01

Abstract The Diesel Exhaust in Miners Study (DEMS) (United States, 1947–1997) reported positive associations between diesel engine exhaust exposure, estimated as respirable elemental carbon (REC), and lung cancer mortality. This reanalysis of the DEMS cohort used an alternative estimate of REC exposure incorporating historical data on diesel equipment, engine horsepower, ventilation rates, and declines in particulate matter emissions per horsepower. Associations with cumulative REC and average REC intensity using the alternative REC estimate and other exposure estimates were generally attenuated compared with original DEMS REC estimates. Most findings were statistically nonsignificant; control for radon exposure substantially weakened associations with the original and alternative REC estimates. No association with original or alternative REC estimates was detected among miners who worked exclusively underground. Positive associations were detected among limestone workers, whereas no association with REC or radon was found among workers in the other 7 mines. The differences in results based on alternative exposure estimates, control for radon, and stratification by worker location or mine type highlight areas of uncertainty in the DEMS data. PMID:29522073

Night shift work exposure profile and obesity: Baseline results from a Chinese night shift worker cohort

PubMed Central

Feng, Wenting; Wang, Feng; Zhang, Liuzhuo; Wu, Zijun; Li, Zhimin; Zhang, Bo; He, Yonghua; Xie, Shaohua; Li, Mengjie; Fok, Joan P. C.; Tse, Gary; Wong, Martin C. S.; Tang, Jin-ling; Wong, Samuel Y. S.; Vlaanderen, Jelle; Evans, Greg; Vermeulen, Roel; Tse, Lap Ah

2018-01-01

Aims This study aimed to evaluate the associations between types of night shift work and different indices of obesity using the baseline information from a prospective cohort study of night shift workers in China. Methods A total of 3,871 workers from five companies were recruited from the baseline survey. A structured self-administered questionnaire was employed to collect the participants’ demographic information, lifetime working history, and lifestyle habits. Participants were grouped into rotating, permanent and irregular night shift work groups. Anthropometric parameters were assessed by healthcare professionals. Multiple logistic regression models were used to evaluate the associations between night shift work and different indices of obesity. Results Night shift workers had increased risk of overweight and obesity, and odds ratios (ORs) were 1.17 (95% CI, 0.97–1.41) and 1.27 (95% CI, 0.74–2.18), respectively. Abdominal obesity had a significant but marginal association with night shift work (OR = 1.20, 95% CI, 1.01–1.43). A positive gradient between the number of years of night shift work and overweight or abdominal obesity was observed. Permanent night shift work showed the highest odds of being overweight (OR = 3.94, 95% CI, 1.40–11.03) and having increased abdominal obesity (OR = 3.34, 95% CI, 1.19–9.37). Irregular night shift work was also significantly associated with overweight (OR = 1.56, 95% CI, 1.13–2.14), but its association with abdominal obesity was borderline (OR = 1.26, 95% CI, 0.94–1.69). By contrast, the association between rotating night shift work and these parameters was not significant. Conclusion Permanent and irregular night shift work were more likely to be associated with overweight or abdominal obesity than rotating night shift work. These associations need to be verified in prospective cohort studies. PMID:29763461

Mortality from Parkinson's disease and other causes among a workforce manufacturing paraquat: a retrospective cohort study

PubMed Central

Campbell, Clive

2011-01-01

Objective To assess the risk of Parkinson's disease (PD) and update information on mortality from major causes of death among a UK workforce who manufactured paraquat (PQ) between 1961 and 1995. There have been no previous studies of the incidence of PD among PQ production workers, although much epidemiological literature exists concerning the relationship between pesticides and PD, and interest has focused on PQ and its users. Methods The cohort included all employees who had ever worked on any of the four plants at Widnes where PQ was manufactured between 1961 and 1995, and 926 male and 42 female workers were followed through 30 June 2009. Mortalities for males were compared with national and local rates, including rates for PD as a mentioned cause of death. Results Overall, 307 workers had died by 30 June 2009. One male death was due to PD, and no other death certificate mentioned PD. At least 3.3 death certificates of male employees would have been expected to have mentioned PD (standardised mortality ratio=31; 95% CI 1 to 171). Personal monitoring results were indicative that the exposure of a PQ production worker on a daily basis was at least comparable with that of a PQ sprayer or mixer/loader. Reduced mortalities compared with local rates were found for major causes of death. Conclusions The study provided no evidence of an increased risk of PD, or increased mortalities from other causes. PMID:22080539

Are immigrants in Canada over-represented in riskier jobs relative to Canadian-born labor market participants?

PubMed

Tiagi, Raaj

2015-09-01

This paper uses new data to examine the gap in injury and fatality rates between immigrant men and women and their Canadian-born counterparts. Data from the 2011 National Household Survey and the Association of Workers' Compensation Boards of Canada were used to determine the difference in occupational and industry injury and fatality rates between various arrival cohorts of immigrants and those Canadian born. For both men and women, there is no significant difference in occupational injury and fatality rates between various arrival cohorts of immigrants and Canadian-born workers. However, industry injury and fatality rates are lower for the most recent arrival cohorts of immigrants relative to Canadian-born workers. Although immigrants face many hurdles and challenges in their resettlement process in Canada, given the evidence from the paper, they are not likely to be at higher risk for work-related injuries relative to those Canadian-born. © 2015 Wiley Periodicals, Inc.

Inpatient hospital admission rates for nonmalignant respiratory disease among workers exposed to metal removal fluids at a U.S. automobile manufacturer.

PubMed

Reeve, Gordon R; Stout, Allen W; Hands, David; Curry, Emmanuel

2003-11-01

This study was undertaken to determine the impact of exposure to metal removal fluids (MRFs) on the respiratory health of exposed workers. The outcome measure selected was the rate of hospital admissions for nonmalignant respiratory disease episodes as determined from healthcare insurance claims data. A cohort of MRF-exposed employees was assembled from 11 manufacturing facilities where MRFs were extensively used in the manufacture of automotive engines, transmissions, and other machined parts. The MRF-exposed cohort included 20,434 employees of such facilities who worked at any time from 1993 through 1997. A non-MRF-exposed cohort was assembled from other employees of the same company during the same time period, but working in warehouse operations and other manufacturing facilities that did not use MRFs or any known respiratory sensitizing agents. The non-exposed cohort included 8681 employees. The crude hospital admission rate for the MRF-exposed cohort was 44 percent higher than that of the non-exposed cohort over the 5-year study period (6.67 vs. 4.62 per 1000 person years at risk, p < 0.05). With age adjustment, the MRF population's rate was still 35 percent higher, and still statistically significant. A nested case-control study was also conducted to determine whether the risk of hospital admission increased with the level of MRF exposure in the population working in MRF plants. The industrial hygiene reconstruction found the levels of exposures of both cases and controls to be very low, with the vast majority of study subjects (more than 90%) having exposures of less than 0.5 mg/m(3). The case-control study did not find any association between increased levels of MRF exposure and risk of hospitalization. The study did document an elevated risk of hospitalization among a sizable population employed in manufacturing operations where MRFs are used.

Risk factors control for primary prevention of cardiovascular disease in men: Evidence from the Aragon Workers Health Study (AWHS).

PubMed

Aguilar-Palacio, Isabel; Malo, Sara; Feja, Cristina; Lallana, MªJesús; León-Latre, Montserrat; Casasnovas, José Antonio; Rabanaque, MªJosé; Guallar, Eliseo

2018-01-01

Benefits of cardiovascular disease (CVD) risk factors control are well known, but goals achievement remains low. The objective of this study is to evaluate the prevalence of CVD risk factors among men ina worker's cohort with no previous CVD, to study control variations across time and the factors associated with poor control. To this end, we conducted a cohort reexamination (2010-2014) within the context of the Aragon Workers Health Study (AWHS). Data from working characteristics, analytical values and pharmacological prescription were included in the analysis. Prevalences of risk factor diagnosis and control were calculated, as well as factors associated with poor control. The prevalence of CVD risk factors was high. In 2014dyslipidaemia was the most prevalent (85.2%) followed by Hypertension (HT) (42.0%). People under treatment increased for the period analysed (p<0.001). The proportion of people treated varied from 72.2% in Diabetes Mellitus to 31.1% in dyslipidaemia in 2014. 46.2% of the workers with HT were controlled, decreasing to 21.9% in Diabetes and 11.0% in dyslipidaemia (2014). Working in a turn different to central shift was associated with poor control, especially for those working at night with HT (Odds Ratio in 2010: 3.6; Confidence Interval 95% 1.8-7.4) and dyslipidaemia (Odds Ratio 2010: 4.7; Confidence Interval 95% 1.3-16.4). We conclude that, although CVD control has increased significantly for the period studied, there are still many people that do not receive any treatment, and control goals are normally not achieved.

Mortality experience of haematite mine workers in China.

PubMed Central

Chen, S Y; Hayes, R B; Liang, S R; Li, Q G; Stewart, P A; Blair, A

1990-01-01

The mortality risk of iron ore (haematite) miners between 1970 and 1982 was investigated in a retrospective cohort study of workers from two mines, Longyan and Taochong, in China. The cohort was limited to men and consisted of 5406 underground miners and 1038 unexposed surface workers. Among the 490 underground miners who died, 205 (42%) died of silicosis and silicotuberculosis and 98 (20%) of cancer, including 29 cases (5.9%) of lung cancer. The study found an excess risk of non-malignant respiratory disease and of lung cancer among haematite miners. The standardised mortality ratio for lung cancer compared with nationwide male population rates was significantly raised (SMR = 3.7), especially for those miners who were first employed underground before mechanical ventilation and wet drilling were introduced (SMR = 4.8); with jobs involving heavy exposure to dust, radon, and radon daughters (SMR = 4.2); with a history of silicosis (SMR = 5.3); and with silicotuberculosis (SMR = 6.6). No excess risk of lung cancer was observed in unexposed workers (SMR = 1.2). Among current smokers, the risk of lung cancer increased with the level of exposure to dust. The mortality from all cancer, stomach, liver, and oesophageal cancer was not raised among underground miners. An excess risk of lung cancer among underground mine workers which could not be attributed solely to tobacco use was associated with working conditions underground, especially with exposure to dust and radon gas and with the presence of non-malignant respiratory disease. Because of an overlap of exposures to dust and radon daughters, the independent effects of these factors could not be evaluated. PMID:2328225

The effect of physical and psychosocial occupational factors on the chronicity of low back pain in the workers of Iranian metal industry: a cohort study.

PubMed

Aghilinejad, Mashallah; Tavakolifard, Negah; Mortazavi, Sayed Aliakbar; Kabir Mokamelkhah, Elahe; Sotudehmanesh, Akbar; Mortazavi, Seyed Alireza

2015-01-01

Low back pain (LBP) is one of the most common problems among the workers of different industries. The role of occupational factors in causing the LBP has been indicated previously. LBP has great socio-economic costs and most of its costs are related to the chronic LBP. The aim of this study was to identify the occupational risk factors that are related to the progression of the LBP from acute to chronic phase. This cohort study has been conducted on 185 workers with acute LBP. Information related to their occupational exposure at baseline has been measured with a valid questionnaire using the self-report approach. Patients follow up was done monthly for three months after the start of the pain. Those workers whose occupational exposure had not changed during the follow up were divided into two groups of chronic LBP (n = 49) and cured (n = 136) according to the duration of the pain period (more or less than 3 months), and their job exposures were compared. Among the physical and psychosocial risk factors, social support (OR= 0.466, CI= 0.231- 0.940) and job satisfaction (OR= 0.455, CI= 0.232-0.891), and lifting weights more than 15kg (OR=2.482, CI= 1.274-4.834) indicated a significant relationship with the chronicity of the LBP. After putting the variables into the regression model, only lifting>15kg remained statistically significant. According to the observed relationship between these occupational risk factors (social support, job satisfaction, lifting>15kg) and the chronicity of the LBP, there is hope that eliminating these factors in the workers with acute LBP will prevent its progression to the chronic phase.

Nail gun injuries among construction workers.

PubMed

Dement, John M; Lipscomb, Hester; Li, Leiming; Epling, Carol; Desai, Tejas

2003-05-01

Pneumatic nail guns greatly increase worker productivity and are extensively used in wood frame building construction, with especially high use in residential construction. One surveillance report of nail gun injuries in Washington State has been published; however, other literature consists largely of case reports and case series in trauma journals. The major objective of the current study was to investigate the occurrence of nail gun-associated injuries among construction workers and to identify preventable work-related factors associated with these injuries. Nail gun-related injuries occurring among a cohort of 13,347 carpenters in Ohio who worked union hours during the time period January 1, 1994, until September 30, 1997, were identified by matching the cohort with workers' compensation claims made to the Ohio Bureau of Workers' Compensation. We also analyzed workers' compensation claims for North Carolina Home Builders Association members for the period July 1996-November 1999 to identify nail gun-related injuries. Analyses included stratified analyses of claims by nature and body part injured, calculation of nail gun injury rates, and analyses of free text descriptions of injuries. Overall, nail gun injuries were responsible for 3.9 percent of workers' compensation claims with 8.3 percent to 25.5 percent of claims involving paid lost work time. The overall rate of nail gun injuries (cases per 200,000 work hours) was 0.33 in North Carolina and 0.26 in Ohio, reflecting the greater concentration of wood frame construction workers in the North Carolina population studied. Higher rates of injury were observed for carpenters in North Carolina and among residential carpenters in Ohio. The predominant body part injured was the hands/fingers, with 80 to 89 percent of injuries being nail punctures. Analyses of free text information for puncture injuries found approximately 70 percent of injuries to occur during the framing/sheathing stage of construction. Our data suggest that approximately 69 percent of puncture injuries may be due to an inadvertent gun discharge or misfire, preventable in large part by the use of sequential triggers. Worker training and education also are important components of nail gun injury prevention.

Who will have Sustainable Employment After a Back Injury? The Development of a Clinical Prediction Model in a Cohort of Injured Workers.

PubMed

Shearer, Heather M; Côté, Pierre; Boyle, Eleanor; Hayden, Jill A; Frank, John; Johnson, William G

2017-09-01

Purpose Our objective was to develop a clinical prediction model to identify workers with sustainable employment following an episode of work-related low back pain (LBP). Methods We used data from a cohort study of injured workers with incident LBP claims in the USA to predict employment patterns 1 and 6 months following a workers' compensation claim. We developed three sequential models to determine the contribution of three domains of variables: (1) basic demographic/clinical variables; (2) health-related variables; and (3) work-related factors. Multivariable logistic regression was used to develop the predictive models. We constructed receiver operator curves and used the c-index to measure predictive accuracy. Results Seventy-nine percent and 77 % of workers had sustainable employment at 1 and 6 months, respectively. Sustainable employment at 1 month was predicted by initial back pain intensity, mental health-related quality of life, claim litigation and employer type (c-index = 0.77). At 6 months, sustainable employment was predicted by physical and mental health-related quality of life, claim litigation and employer type (c-index = 0.77). Adding health-related and work-related variables to models improved predictive accuracy by 8.5 and 10 % at 1 and 6 months respectively. Conclusion We developed clinically-relevant models to predict sustainable employment in injured workers who made a workers' compensation claim for LBP. Inquiring about back pain intensity, physical and mental health-related quality of life, claim litigation and employer type may be beneficial in developing programs of care. Our models need to be validated in other populations.

The risk of lung cancer after cessation of asbestos exposure in construction workers using pleural malignant mesothelioma as a marker of exposure.

PubMed

Järvholm, Bengt; Aström, Evelina

2014-12-01

To study the risk of lung cancer in heavily asbestos-exposed workers after the exposure to asbestos has ended. Lung cancer was studied in a cohort of 189,896 Swedish construction workers through a linkage with the Swedish Cancer Registry. Asbestos exposure was estimated by the incidence of malignant mesothelioma in the occupational group. There were in total 2835 cases of lung cancer. Workers with heavy exposure to asbestos had an increased risk of lung cancer (relative risks = 1.74; 95% confidence interval, 1.25 to 2.41) before exposure ended and a similar risk to those with low exposure 20 years after the exposure had ceased (relative risks = 0.94; 95% confidence interval, 0.77 to 1.15). Workers with heavy exposure to asbestos have a similar risk of lung cancer as persons with low or no exposure 20 years after the exposure has ended.

Early Predictors of Lumbar Spine Surgery after Occupational Back Injury: Results from a Prospective Study of Workers in Washington State

PubMed Central

Keeney, Benjamin J.; Fulton-Kehoe, Deborah; Turner, Judith A.; Wickizer, Thomas M.; Chan, Kwun Chuen Gary; Franklin, Gary M.

2014-01-01

Study Design Prospective population-based cohort study Objective To identify early predictors of lumbar spine surgery within 3 years after occupational back injury Summary of Background Data Back injuries are the most prevalent occupational injury in the United States. Little is known about predictors of lumbar spine surgery following occupational back injury. Methods Using Disability Risk Identification Study Cohort (D-RISC) data, we examined the early predictors of lumbar spine surgery within 3 years among Washington State workers with new worker’s compensation temporary total disability claims for back injuries. Baseline measures included worker-reported measures obtained approximately 3 weeks after claim submission. We used medical bill data to determine whether participants underwent surgery, covered by the claim, within 3 years. Baseline predictors (P < 0.10) of surgery in bivariate analyses were included in a multivariate logistic regression model predicting lumbar spine surgery. The model’s area under the receiver operating characteristic curve (AUC) was used to determine the model’s ability to identify correctly workers who underwent surgery. Results In the D-RISC sample of 1,885 workers, 174 (9.2%) had a lumbar spine surgery within 3 years. Baseline variables associated with surgery (P < 0.05) in the multivariate model included higher Roland Disability Questionnaire scores, greater injury severity, and surgeon as first provider seen for the injury. Reduced odds of surgery were observed for those under age 35, women, Hispanics, and those whose first provider was a chiropractor. 42.7% of workers who first saw a surgeon had surgery, in contrast to only 1.5% of those who saw a chiropractor. The multivariate model’s AUC was 0.93 (95% CI 0.92–0.95), indicating excellent ability to discriminate between workers who would versus would not have surgery. Conclusion Baseline variables in multiple domains predicted lumbar spine surgery. There was a very strong association between surgery and first provider seen for the injury, even after adjustment for other important variables. PMID:23238486

Early predictors of occupational back reinjury: results from a prospective study of workers in Washington State.

PubMed

Keeney, Benjamin J; Turner, Judith A; Fulton-Kehoe, Deborah; Wickizer, Thomas M; Chan, Kwun Chuen Gary; Franklin, Gary M

2013-01-15

Prospective population-based cohort study. To identify early predictors of self-reported occupational back reinjury within 1 year after work-related back injury. Back injuries are the costliest and most prevalent disabling occupational injuries in the United States. A substantial proportion of workers with back injuries have reinjuries after returning to work, yet there are few studies of risk factors for occupational back reinjuries. We aimed to identify the incidence and early (in the claim) predictors of self-reported back reinjury by approximately 1 year after the index injury among Washington State workers with new work disability claims for back injuries. The Washington Workers' Compensation Disability Risk Identification Study Cohort provided a large, population-based sample with information on variables in 7 domains: sociodemographic, employment-related, pain and function, clinical status, health care, health behavior, and psychological. We conducted telephone interviews with workers 3 weeks and 1 year after submission of a time-loss claim for the injury. We first identified predictors (P < 0.10) of self-reported reinjury within 1 year in bivariate analyses. Those variables were then included in a multivariate logistic regression model predicting occupational back reinjury. A total of 290 (25.8%) of 1123 (70.0% response rate) workers who completed the 1-year follow-up interview and had returned to work reported having reinjured their back at work. Baseline variables significantly associated with reinjury (P < 0.05) in the multivariate model included male sex, constant whole-body vibration at work, previous similar injury, 4 or more previous claims of any type, possessing health insurance, and high fear-avoidance scores. Baseline obesity was associated with reduced odds of reinjury. No other employment-related or psychological variables were significant. One-fourth of the workers who received work disability compensation for a back injury self-reported reinjury after returning to work. Baseline variables in multiple domains predicted occupational back reinjury. Increased knowledge of early risk factors for reinjury may help to lead to interventions, such as efforts to reduce fear avoidance and graded activity to promote recovery, effective in lowering the risk of reinjury.

Meta-analysis of benzene exposure and non-Hodgkin lymphoma: biases could mask an important association

PubMed Central

Steinmaus, C; Smith, A H; Jones, R M; Smith, M T

2015-01-01

Objectives Benzene is a widely recognised cause of leukaemia but its association with non-Hodgkin’s lymphoma (NHL) is less well established. The goal of this project is to review the current published literature on this association. Methods We performed a meta-analysis of cohort and case-control studies of benzene exposure and NHL and a meta-analysis of NHL and refinery work, a potential source of benzene exposure. Results In 22 studies of benzene exposure, the summary relative risk for NHL was 1.22 (95% CI 1.02 to 1.47; one-sided p value = 0.01). When studies that likely included unexposed subjects in the “exposed” group were excluded, the summary relative risk increased to 1.49 (95% CI 1.12 to 1.97, n = 13), and when studies based solely on self-reported work history were excluded, the relative risk rose to 2.12 (95% CI 1.11 to 4.02, n = 6). In refinery workers, the summary relative risk for NHL in all 21 studies was 1.21 (95% CI 1.00 to 1.46; p = 0.02). When adjusted for the healthy worker effect, this relative risk estimate increased to 1.42 (95% CI 1.19 to 1.69). Conclusions The finding of elevated relative risks in studies of both benzene exposure and refinery work provides further evidence that benzene exposure causes NHL. In addition, the finding of increased relative risks after removing studies that included unexposed or lesser exposed workers in “exposed” cohorts, and increased relative risk estimates after adjusting for the healthy worker effect, suggest that effects of benzene on NHL might be missed in occupational studies if these biases are not accounted for. PMID:18417556

Sperm mixing in the polyandrous leaf-cutting ant Acromyrmex echinatior

PubMed Central

Stürup, Marlene; Nash, David R; Hughes, William O H; Boomsma, Jacobus J

2014-01-01

The insemination of queens by sperm from multiple males (polyandry) has evolved in a number of eusocial insect lineages despite the likely costs of the behavior. The selective advantages in terms of colony fitness must therefore also be significant and there is now good evidence that polyandry increases genetic variation among workers, thereby improving the efficiency of division of labor, resistance against disease, and diluting the impact of genetically incompatible matings. However, these advantages will only be maximized if the sperm of initially discrete ejaculates are mixed when stored in queen spermathecae and used for egg fertilization in a “fair raffle.” Remarkably, however, very few studies have addressed the level of sperm mixing in social insects. Here we analyzed sperm use over time in the highly polyandrous leaf-cutting ant Acromyrmex echinatior. We genotyped cohorts of workers produced either 2 months apart or up to over a year apart, and batches of eggs laid up to over 2 years apart, and tested whether fluctuations in patriline distributions deviated from random. We show that the representation of father males in both egg and worker cohorts does not change over time, consistent with obligatorily polyandrous queens maximizing their fitness when workers are as genetically diverse as possible. PMID:25478149

Cancer mortality in the asphalt industry: a ten year follow up of an occupational cohort.

PubMed Central

Hansen, E S

1989-01-01

A historical cohort study was conducted to study the possible risk of cancer associated with exposure to asphalt. Altogether 1320 unskilled workers employed in the asphalt industry were followed up over a ten year period and compared with 43,024 unskilled men in terms of cause specific mortality. Both groups were identified from census records and followed up by an automatic record link that had been established previously between the census register, National Register, and Death Certificate Register. The cancer mortality was significantly increased in asphalt workers aged 45 or more, when five years' latency from enrolment into the study was allowed for (SMR for cancer: 159, 95% confidence interval: 106-228). Non-significant increases were seen for respiratory, bladder, and digestive cancers but a significant increase was seen for brain cancer (SMR = 500, 95% CI: 103-1461). Components of asphalt fumes may have been important to the observed association between risk of cancer and employment in the asphalt industry. PMID:2775679

Reduced mortality rates in a cohort of long-term underground iron-ore miners.

PubMed

Björ, Ove; Jonsson, Håkan; Damber, Lena; Wahlström, Jens; Nilsson, Tohr

2013-05-01

Historically, working in iron-ore mines has been associated with an increased risk of lung cancer and silicosis. However, studies on other causes of mortality are inconsistent and in the case of cancer incidence, sparse. The aim of this study was to examine the association between iron-ore mining, mortality and cancer incidence. A 54-year cohort study on iron-ore miners from mines in northern Sweden was carried out comprising 13,000 workers. Standardized rate ratios were calculated comparing the disease frequency, mortality, and cancer incidence with that of the general population of northern Sweden. Poisson regression was used to evaluate the association between the durations of employment and underground work, and outcome. Underground mining was associated with a significant decrease in adjusted mortality rate ratios for cerebrovascular and digestive system diseases, and stroke. For several outcomes, elevated standardized rate ratios were observed among blue-collar workers relative to the reference population. However, only the incidence of lung cancer increased with employment time underground (P < 0.001). Long-term iron-ore mining underground was associated with lower rates regarding several health outcomes. This is possibly explained by factors related to actual job activities, environmental exposure, or the selection of healthier workers for long-term underground employment. Copyright © 2013 Wiley Periodicals, Inc.

Mortality among retired fur workers. Dyers, dressers (tanners) and service workers.

PubMed

Sweeney, M H; Walrath, J; Waxweiler, R J

1985-08-01

A retrospective cohort mortality study was conducted on 807 fur dyers, fur dressers (tanners), and fur service workers who were pensioned between 1952 and 1977 by the Fur, Leather and Machine Workers Union of New York City. Workplace exposures of fur workers varied with job category. Dyers were exposed to oxidative dyes used in commercial hair dyes; dressers and service workers were exposed to tanning chemicals. In a comparison with the New York City population, no significant increases in mortality were observed among the fur dyers. Among fur dressers, mortality from all malignant neoplasms [standardized mortality ratio (SMR) 151] and lung cancer (SMR 232) was significantly elevated, as was mortality from cardiovascular disease (SMR 126) among fur service workers. When examined by ethnic origin, the elevated SMR values and directly age-adjusted rate ratios suggested that foreign-born fur dressers and eastern European-born fur workers experienced the highest risks for lung and colorectal cancers, respectively. These data support previous findings of increased mortality from colorectal cancer in the foreign-born population of the United States and suggest a possible occupational etiology for the observed lung cancer excess.

Effect of a smoking ban on respiratory health in nonsmoking hospitality workers: a prospective cohort study.

PubMed

Rajkumar, Sarah; Stolz, Daiana; Hammer, Jürg; Moeller, Alexander; Bauer, Georg F; Huynh, Cong Khanh; Röösli, Martin

2014-10-01

The aim of this study was to examine the effect of a smoking ban on lung function, fractional exhaled nitric oxide, and respiratory symptoms in nonsmoking hospitality workers. Secondhand smoke exposure at the workplace, spirometry, and fractional exhaled nitric oxide were measured in 92 nonsmoking hospitality workers before as well as twice after a smoking ban. At baseline, secondhand smoke-exposed hospitality workers had lung function values significantly below the population average. After the smoking ban, the covariate-adjusted odds ratio for cough was 0.59 (95% confidence interval, 0.36 to 0.93) and for chronic bronchitis 0.75 (95% confidence interval, 0.55 to 1.02) compared with the preban period. The below-average lung function before the smoking ban indicates chronic damages from long-term exposure. Respiratory symptoms such as cough decreased within 12 months after the ban.

Sociodemographic, clinical, and work characteristics associated with return-to-work outcomes following surgery for work-related knee injury.

PubMed

Fan, Jonathan K; McLeod, Christopher B; Koehoorn, Mieke

2010-06-01

This study examined the association between return-to-work (RTW) outcomes and sociodemographic, clinical, and work characteristics among a cohort of injured workers who underwent knee surgery between 2001-2005 in British Columbia, Canada. Workers' compensation databases were used to identify the retrospective cohort and abstract the study variables. Multinomial logistic regression provided odds ratios (OR) and 95% confidence intervals (95% CI) for the association between RTW (unspecified, partial, full, or non-RTW) and the independent variables. Data was abstracted for 1394 injured workers. Compared to men, women were more likely to have partial RTW (OR 2.55, 95% CI 1.53-4.23) and non-RTW (OR 2.61, 95% CI 1.35-5.03) than full RTW; low income earners were more likely than high income earners to have partial RTW (OR 3.05, 95% CI 1.86-4.99) and non-RTW (OR 4.07, 95% CI 2.19-7.57). Moreover, workers in trade, primary resource, and processing/manufacturing occupations were more likely than those in management occupations to have non-RTW than full RTW by the end of follow-up (OR 2.97, 95% CI 1.32-6.68; OR 9.31, 95% CI 3.41-25.41, and OR 2.71, 95% CI 1.07-6.5, respectively). Surgical and clinical factors were not associated with RTW outcomes. Using population-based data, our study found a link between sociodemographic and work characteristics and the type of RTW outcome following knee surgery for a work-related injury. Women and lower income earners tended not to have full RTW, after controlling for covariates. Workers in physically demanding occupations also tended not to have full RTW, suggesting that factors beyond clinical and surgical characteristics influence disability outcomes. RTW programs need to take into consideration these broader determinants of worker health.

Impact of the Spanish Smoking Law on Exposure to Second-Hand Smoke and Respiratory Health in Hospitality Workers: A Cohort Study

PubMed Central

Fernández, Esteve; Fu, Marcela; Pascual, José A.; López, María J.; Pérez-Ríos, Mónica; Schiaffino, Anna; Martínez-Sánchez, Jose M.; Ariza, Carles; Saltó, Esteve; Nebot, Manel

2009-01-01

Background A smoke-free law came into effect in Spain on 1st January 2006, affecting all enclosed workplaces except hospitality venues, whose proprietors can choose among totally a smoke-free policy, a partial restriction with designated smoking areas, or no restriction on smoking on the premises. We aimed to evaluate the impact of the law among hospitality workers by assessing second-hand smoke (SHS) exposure and the frequency of respiratory symptoms before and one year after the ban. Methods and Finding We formed a baseline cohort of 431 hospitality workers in Spain and 45 workers in Portugal and Andorra. Of them, 318 (66.8%) were successfully followed up 12 months after the ban, and 137 nonsmokers were included in this analysis. We obtained self-reported exposure to SHS and the presence of respiratory symptoms, and collected saliva samples for cotinine measurement. Salivary cotinine decreased by 55.6% after the ban among nonsmoker workers in venues where smoking was totally prohibited (from median of 1.6 ng/ml before to 0.5 ng/ml, p<0.01). Cotinine concentration decreased by 27.6% (p = 0.068) among workers in venues with designated smoking areas, and by 10.7% (p = 0.475) among workers in venues where smoking was allowed. In Portugal and Andorra, no differences between cotinine concentration were found before (1.2 ng/ml) and after the ban (1.2 ng/ml). In Spain, reported respiratory symptom declined significantly (by 71.9%; p<0.05) among workers in venues that became smoke-free. After adjustment for potential confounders, salivary cotinine and respiratory symptoms decreased significantly among workers in Spanish hospitality venues where smoking was totally banned. Conclusions Among nonsmoker hospitality workers in bars and restaurants where smoking was allowed, exposure to SHS after the ban remained similar to pre-law levels. The partial restrictions on smoking in Spanish hospitality venues do not sufficiently protect hospitality workers against SHS or its consequences for respiratory health. PMID:19165321

Physical capacity and risk for long-term sickness absence: a prospective cohort study among 8664 female health care workers.

PubMed

Rasmussen, Charlotte Diana Nørregaard; Andersen, Lars Louis; Clausen, Thomas; Strøyer, Jesper; Jørgensen, Marie Birk; Holtermann, Andreas

2015-05-01

To assess the prospective associations between self-reported physical capacity and risk of long-term sickness absence among female health care workers. Female health care workers answered a questionnaire about physical capacity and were followed in a national register of sickness absence lasting for two or more consecutive weeks during 1-year follow-up. Using Cox regression hazard ratio analyses adjusted for age, smoking, body mass index, physical workload, job seniority, psychosocial work conditions, and previous sickness absence, we modeled risk estimates for sickness absence from low and medium physical capacity. Low and medium aerobic fitness, low muscle strength, low flexibility, and low overall physical capacity significantly increased the risk for sickness absence with 20% to 34% compared with health care workers with high capacity. Low physical capacity increases the risk of long-term sickness absence among female health care workers.

How older workers with coronary heart disease perceive the health effects of work.

PubMed

Dickson, Victoria Vaughan

2013-11-01

More than 3.4 million workers have coronary heart disease (CHD) with significant work limitations and disability. Although the cohort of aging workers with CHD is growing, little is known about how older workers with CHD perceive the relationship between the work environment, including job stress, and their health. The purpose of this qualitative, descriptive study was to explore the perceptions of the health effects of work among older workers with CHD and describe how they cope with work stress. The sample was 47% female and 33% African American. Their mean age was 59.21 (± 5.4) years, and most (55%) worked in professional or managerial jobs. Themes emerged about perceptions of the health effects of work and coping strategies. Because older employees are a vulnerable work group, understanding the perceived health effects of work may guide future workplace program development and policy. Copyright 2013, SLACK Incorporated.

Facility-specific radiation exposure risks and their implications for radiation workers at Department of Energy laboratories

NASA Astrophysics Data System (ADS)

Davis, Adam Christopher

This research develops a new framework for evaluating the occupational risks of exposure to hazardous substances in any setting where As Low As Reasonably Achievable (ALARA) practices are mandated or used. The evaluation is performed by developing a hypothesis-test-based procedure for evaluating the homogeneity of various epidemiological cohorts, and thus the appropriateness of the application of aggregate data-pooling techniques to those cohorts. A statistical methodology is then developed as an alternative to aggregate pooling for situations in which individual cohorts show heterogeneity between them and are thus unsuitable for pooled analysis. These methods are then applied to estimate the all-cancer mortality risks incurred by workers at four Department-of-Energy nuclear weapons laboratories. Both linear, no-threshold and dose-bin averaged risks are calculated and it is further shown that aggregate analysis tends to overestimate the risks with respect to those calculated by the methods developed in this work. The risk estimates developed in Chapter 2 are, in Chapter 3, applied to assess the risks to workers engaged in americium recovery operations at Los Alamos National Laboratory. The work described in Chapter 3 develops a full radiological protection assessment for the new americium recovery project, including development of exposure cases, creation and modification of MCNP5 models, development of a time-and-motion study, and the final synthesis of all data. This work also develops a new risk-based method of determining whether administrative controls, such as staffing increases, are ALARA-optimized. The EPA's estimate of the value of statistical life is applied to these risk estimates to determine a monetary value for risk. The rate of change of this "risk value" (marginal risk) is then compared with the rate of change of workers' compensations as additional workers are added to the project to reduce the dose (and therefore, presumably, risk) to each individual.

Impact of HIV/AIDS on labor productivity in Akaki fiber products factory, Ethiopia.

PubMed

Omer, Endashaw M; Mariam, Damen Haile

2008-04-01

HIV/AIDS has become a full-blown development crisis affecting all sectors of the economy in most developing countries. Its social and economic consequences are felt widely not only in health but in education, industry, agriculture as well as transport. The study attempted to estimate the changes in worker's output and attendance associated with advancing HIV infection, and direct costs incurred by a fiber products factory due to illness and death related to HIV/AIDS. The study is a retrospective cohort with accounting method of cost estimation. The study subjects were factory workers enrolled in a cohort study of HIV incidence and progression in Akaki, Ethiopia since February 1997. The mean incentive earnings were not significantly different between HIV positives and negatives at baseline (in 1997). However, in the following years (1998, 1999 and 2000) the incentive earnings of HIV positives were significantly lower than the incentive earnings of HIV negatives. Trend analysis showed that advancing HIV infection, as measured by drop in CD4 count and increasing viral load, is associated with reduction in productivity and increased sick leave days. The study has shown that there is a direct negative impact of HIV infection on the productivity of factory workers and recommends institution of ART centers and programs in work places to mitigate the socio economic impact of the pandemic.

Transmission of Staphylococcus aureus between health-care workers, the environment, and patients in an intensive care unit: a longitudinal cohort study based on whole-genome sequencing.

PubMed

Price, James R; Cole, Kevin; Bexley, Andrew; Kostiou, Vasiliki; Eyre, David W; Golubchik, Tanya; Wilson, Daniel J; Crook, Derrick W; Walker, A Sarah; Peto, Timothy E A; Llewelyn, Martin J; Paul, John

2017-02-01

Health-care workers have been implicated in nosocomial outbreaks of Staphylococcus aureus, but the dearth of evidence from non-outbreak situations means that routine health-care worker screening and S aureus eradication are controversial. We aimed to determine how often S aureus is transmitted from health-care workers or the environment to patients in an intensive care unit (ICU) and a high-dependency unit (HDU) where standard infection control measures were in place. In this longitudinal cohort study, we systematically sampled health-care workers, the environment, and patients over 14 months at the ICU and HDU of the Royal Sussex County Hospital, Brighton, England. Nasal swabs were taken from health-care workers every 4 weeks, bed spaces were sampled monthly, and screening swabs were obtained from patients at admission to the ICU or HDU, weekly thereafter, and at discharge. Isolates were cultured and their whole genome sequenced, and we used the threshold of 40 single-nucleotide variants (SNVs) or fewer to define subtypes and infer recent transmission. Between Oct 31, 2011, and Dec 23, 2012, we sampled 198 health-care workers, 40 environmental locations, and 1854 patients; 1819 isolates were sequenced. Median nasal carriage rate of S aureus in health-care workers at 4-weekly timepoints was 36·9% (IQR 35·7-37·3), and 115 (58%) health-care workers had S aureus detected at least once during the study. S aureus was identified in 8-50% of environmental samples. 605 genetically distinct subtypes were identified (median SNV difference 273, IQR 162-399) at a rate of 38 (IQR 34-42) per 4-weekly cycle. Only 25 instances of transmission to patients (seven from health-care workers, two from the environment, and 16 from other patients) were detected. In the presence of standard infection control measures, health-care workers were infrequently sources of transmission to patients. S aureus epidemiology in the ICU and HDU is characterised by continuous ingress of distinct subtypes rather than transmission of genetically related strains. UK Medical Research Council, Wellcome Trust, Biotechnology and Biological Sciences Research Council, UK National Institute for Health Research, and Public Health England. Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license. Published by Elsevier Ltd.. All rights reserved.

Disability Pensions due to Skin Diseases: A Cohort Study in Swedish Construction Workers.

PubMed

Meding, Birgitta; Wrangsjö, Karin; Burdorf, Alex; Järvholm, Bengt

2016-02-01

Disability pensions due to skin diseases in Swedish male construction workers were studied by linking data from pension registers and an occupational health service. Incidence rates of disability pensions for cement workers, painters and plumbers were compared with 2 control groups. A total of 623 disability pensions were granted during 4 decades of follow-up. The main diagnoses were eczema (36%) and psoriasis (49%). Pensions were mostly granted in the age range 55-64 years. Among painters, cement workers and plumbers the incidence rates for disability pensions were 33.3, 24.5 and 20.4 cases/100,000 person-years, respectively, compared with 13.7 and 9.2 cases/100,000 person-years in control groups. Relative risks were highest for eczema, and were notable for psoriasis. Attributable fractions for eczema were 90% in cement workers and painters and 75% in plumbers compared with control groups. Attributable fractions for psoriasis in the occupational groups studied were in the range 54-67%. In conclusion, eczema and psoriasis have a high impact on loss of work ability, as reflected by disability pensions.

Risk of bile duct cancer among printing workers exposed to 1,2-dichloropropane and/or dichloromethane.

PubMed

Sobue, Tomotaka; Utada, Mai; Makiuchi, Takeshi; Ohno, Yuko; Uehara, Shinichiro; Hayashi, Tomoshige; Sato, Kyoko Kogawa; Endo, Ginji

2015-01-01

We conducted a retrospective cohort study to examine the risk of bile duct cancer among current and former workers in the offset color proof printing department at a printing company in Osaka, Japan. Standardized incidence ratios (SIRs) between January 1, 1985, and December 31, 2012, were estimated for the cumulative years of exposure to two chemicals, dichloromethane (DCM) and 1,2-dichloropropane (1,2-DCP), using the national incidence level as a reference. In addition, we examined risk patterns by the calendar year in which observation started. Among 106 workers with a total of 1,452.4 person-years of exposure, 17 bile duct cancer cases were observed, resulting in an estimated overall SIR of 1,132.5 (95% confidence interval (CI): 659.7-1,813.2). The SIR was 1,319.9 (95% CI: 658.9-2,361.7) for those who were exposed to both DCM and 1,2-DCP, and it was 1,002.8 (95% CI: 368.0-2,182.8) for those exposed to 1,2-DCP only. SIRs tended to increase according to years of exposure to 1,2-DCP but not DCM when a 5-year lag time was assumed. The SIRs were higher for the cohorts in which observation started in 1993-2000, particularly in cohorts in which it started in 1996-1999, compared with those in which it started before or after 1993-2000. We observed an extraordinarily high risk of bile duct cancer among the offset color proof printing workers. Elevated risk may be related to cumulative exposure to 1,2-DCP, but there remains some possibility that a portion of the risk is due to other unidentified substances.

Effectiveness of N95 respirators versus surgical masks in protecting health care workers from acute respiratory infection: a systematic review and meta-analysis

PubMed Central

Smith, Jeffrey D.; MacDougall, Colin C.; Johnstone, Jennie; Copes, Ray A.; Schwartz, Brian; Garber, Gary E.

2016-01-01

Background: Conflicting recommendations exist related to which facial protection should be used by health care workers to prevent transmission of acute respiratory infections, including pandemic influenza. We performed a systematic review of both clinical and surrogate exposure data comparing N95 respirators and surgical masks for the prevention of transmissible acute respiratory infections. Methods: We searched various electronic databases and the grey literature for relevant studies published from January 1990 to December 2014. Randomized controlled trials (RCTs), cohort studies and case–control studies that included data on health care workers wearing N95 respirators and surgical masks to prevent acute respiratory infections were included in the meta-analysis. Surrogate exposure studies comparing N95 respirators and surgical masks using manikins or adult volunteers under simulated conditions were summarized separately. Outcomes from clinical studies were laboratory-confirmed respiratory infection, influenza-like illness and workplace absenteeism. Outcomes from surrogate exposure studies were filter penetration, face-seal leakage and total inward leakage. Results: We identified 6 clinical studies (3 RCTs, 1 cohort study and 2 case–control studies) and 23 surrogate exposure studies. In the meta-analysis of the clinical studies, we found no significant difference between N95 respirators and surgical masks in associated risk of (a) laboratory-confirmed respiratory infection (RCTs: odds ratio [OR] 0.89, 95% confidence interval [CI] 0.64–1.24; cohort study: OR 0.43, 95% CI 0.03–6.41; case–control studies: OR 0.91, 95% CI 0.25–3.36); (b) influenza-like illness (RCTs: OR 0.51, 95% CI 0.19–1.41); or (c) reported workplace absenteeism (RCT: OR 0.92, 95% CI 0.57–1.50). In the surrogate exposure studies, N95 respirators were associated with less filter penetration, less face-seal leakage and less total inward leakage under laboratory experimental conditions, compared with surgical masks. Interpretation: Although N95 respirators appeared to have a protective advantage over surgical masks in laboratory settings, our meta-analysis showed that there were insufficient data to determine definitively whether N95 respirators are superior to surgical masks in protecting health care workers against transmissible acute respiratory infections in clinical settings. PMID:26952529

Effectiveness of N95 respirators versus surgical masks in protecting health care workers from acute respiratory infection: a systematic review and meta-analysis.

PubMed

Smith, Jeffrey D; MacDougall, Colin C; Johnstone, Jennie; Copes, Ray A; Schwartz, Brian; Garber, Gary E

2016-05-17

Conflicting recommendations exist related to which facial protection should be used by health care workers to prevent transmission of acute respiratory infections, including pandemic influenza. We performed a systematic review of both clinical and surrogate exposure data comparing N95 respirators and surgical masks for the prevention of transmissible acute respiratory infections. We searched various electronic databases and the grey literature for relevant studies published from January 1990 to December 2014. Randomized controlled trials (RCTs), cohort studies and case-control studies that included data on health care workers wearing N95 respirators and surgical masks to prevent acute respiratory infections were included in the meta-analysis. Surrogate exposure studies comparing N95 respirators and surgical masks using manikins or adult volunteers under simulated conditions were summarized separately. Outcomes from clinical studies were laboratory-confirmed respiratory infection, influenza-like illness and workplace absenteeism. Outcomes from surrogate exposure studies were filter penetration, face-seal leakage and total inward leakage. We identified 6 clinical studies (3 RCTs, 1 cohort study and 2 case-control studies) and 23 surrogate exposure studies. In the meta-analysis of the clinical studies, we found no significant difference between N95 respirators and surgical masks in associated risk of (a) laboratory-confirmed respiratory infection (RCTs: odds ratio [OR] 0.89, 95% confidence interval [CI] 0.64-1.24; cohort study: OR 0.43, 95% CI 0.03-6.41; case-control studies: OR 0.91, 95% CI 0.25-3.36); (b) influenza-like illness (RCTs: OR 0.51, 95% CI 0.19-1.41); or (c) reported workplace absenteeism (RCT: OR 0.92, 95% CI 0.57-1.50). In the surrogate exposure studies, N95 respirators were associated with less filter penetration, less face-seal leakage and less total inward leakage under laboratory experimental conditions, compared with surgical masks. Although N95 respirators appeared to have a protective advantage over surgical masks in laboratory settings, our meta-analysis showed that there were insufficient data to determine definitively whether N95 respirators are superior to surgical masks in protecting health care workers against transmissible acute respiratory infections in clinical settings. © 2016 Canadian Medical Association or its licensors.

Uranium Workers Demonstrate Lower Lobe Predominant Irregular Pneumoconiotic Opacities on Chest Radiographs.

PubMed

Kocher, Elizabeth; Rendon, Kristi J; Kesler, Denece; Boyce, Tawny Wilson; Myers, Orrin; Evans, Kandace; Cook, Linda S; Sood, Akshay

2016-01-01

There is a paucity of literature on the chest radiographic findings in uranium workers. To characterize the chest radiographic findings of pneumoconiosis in a New Mexican cohort of uranium workers. The most recent results from chest radiographs were abstracted in this cross-sectional study. Radiographs showed small pneumoconiotic opacities of profusion score of ≥ 1/0 in 155/429 (36.1%) uranium workers. The most common shape/size of the primary and secondary opacities was s (90.3%) and t (83.7%) types, respectively. Lower lung zones were the most affected. American Indians were the population group at greatest odds for having profusion score ≥ 1/0 (O.R. 2.65, 95% C.I. 1.61, 4.36). Uranium workers' pneumoconiosis is associated with predominantly lower lobe, irregular, and small opacities. Clinical providers and policymakers must consider uranium workers' pneumoconiosis in the differential diagnosis for lower lobe-predominant interstitial lung disease, in the appropriate exposure setting.

Methodological lessons from a cohort study of high risk women in Tanzania

PubMed Central

Hoffmann, O; Zaba, B; Wolff, B; Sanga, E; Maboko, L; Mmbando, D; von Sonnenburg, F; Hoelscher, M

2004-01-01

Objectives: To describe the development, characteristics, and follow up of a high risk cohort of women in Tanzania. Differences in social background and sexual behaviour of women working in traditional and modern alcohol selling workplaces are shown. Methods: Data from questionnaires four months before the enrolment of the cohort, at enrolment, and at 32 months were compared. Key informant interviews, social mapping exercises, and focus group discussions were held before the start of the cohort. Results: In the absence of organised prostitution, two different groups of women with high risk exposure were identified during the baseline survey: female workers in modern alcohol selling places such as bars, guesthouses, and restaurants (barmaids) and in traditional places (local brew sellers). Overall, the population had a mean age of 27.7 years with barmaids tending to be younger (24.3 years) than local brew sellers (34.2 years). The main duration of stay in the current workplace was 2.1 years (barmaids 0.9 years; local brew sellers 4.1 years). Barmaids were more likely to have paying casual sex partners than local brew sellers and used condoms more regularly. Local brew sellers tend to be more stable with only 10% lost to follow up after 32 months compared with 24.4% of the bar workers. Conclusions: Preliminary work revealed major differences in characteristics and behaviour between women working in modern and traditional alcohol selling outlets. Thorough preparation of the study, close monitoring of the cohort, and provision of selected benefits resulted in high retention rates over a 32 month project in a highly mobile population. PMID:15572643

The prevalence and incidence of work absenteeism involving neck pain: a cohort of Ontario lost-time claimants.

PubMed

Côté, Pierre; Kristman, Vicki; Vidmar, Marjan; Van Eerd, Dwayne; Hogg-Johnson, Sheilah; Beaton, Dorcas; Smith, Peter M

2008-02-15

Cohort study. To measure the prevalence and incidence of work absenteeism involving neck pain in a cohort of claimants to the Ontario Workplace Safety & Insurance Board (WSIB). According to workers' compensation statistics, neck pain accounts for a small proportion of lost-time claims. However, these statistics may be biased by an underenumeration of claimants with neck disorders. We studied all lost-time claimants to the Ontario WSIB in 1998 and used 2 methods to enumerate neck pain cases. We report the prevalence and incidence of neck pain using 2 denominators: (1) annual number of lost-time claimants and (2) an estimate of the Ontario working population covered by the WSIB. The estimated percentage of lost-time claimants with neck pain ranged from 2.8% (95% CI 2.5-3.3) using only codes specific for neck pain to 11.3% (95% CI 9.5-13.1) using a weighted estimate of codes capturing neck pain cases. The health care sector had the highest percentage of claims with neck pain. The annual incidence of neck pain among the Ontario working population ranged from 6 per 10,000 full-time equivalents (FTE) (95% CI 5-6) to 23 per 10,000 FTE (95% CI 20-27) depending on the codes used to capture neck pain. Male workers between the ages of 20 and 39 years were the most likely to experience an episode of work absenteeism involving neck pain. Neck pain is a common and burdensome problem for Ontario workers. Our study highlights the importance of properly capturing all neck pain cases when describing its prevalence and incidence.

Exposure-response analysis and risk assessment for lung cancer in relationship to silica exposure: a 44-year cohort study of 34,018 workers.

PubMed

Liu, Yuewei; Steenland, Kyle; Rong, Yi; Hnizdo, Eva; Huang, Xiji; Zhang, Hai; Shi, Tingming; Sun, Yi; Wu, Tangchun; Chen, Weihong

2013-11-01

Crystalline silica has been classified as a human carcinogen by the International Agency for Research on Cancer (Lyon, France); however, few previous studies have provided quantitative data on silica exposure, silicosis, and/or smoking. We investigated a cohort in China (in 1960-2003) of 34,018 workers without exposure to carcinogenic confounders. Cumulative silica exposure was estimated by linking a job-exposure matrix to work history. Cox proportional hazards model was used to conduct exposure-response analysis and risk assessment. During a mean 34.5-year follow-up, 546 lung cancer deaths were identified. Categorical analyses by quartiles of cumulative silica exposure (using a 25-year lag) yielded hazard ratios of 1.26, 1.54, 1.68, and 1.70, respectively, compared with the unexposed group. Monotonic exposure-response trends were observed among nonsilicotics (P for trend < 0.001). Analyses using splines showed similar trends. The joint effect of silica and smoking was more than additive and close to multiplicative. For workers exposed from ages 20 to 65 years at 0.1 mg/m(3) of silica exposure, the estimated excess lifetime risk (through age 75 years) was 0.51%. These findings confirm silica as a human carcinogen and suggest that current exposure limits in many countries might be insufficient to protect workers from lung cancer. They also indicate that smoking cessation could help reduce lung cancer risk for silica-exposed individuals.

Post-traumatic Stress Disorder, Bronchodilator Response, and Incident Asthma in World Trade Center Rescue and Recovery Workers

PubMed Central

Jeon, Yunho; Miller, Gregory E.; Wisnivesky, Juan P.

2016-01-01

Rationale: Post-traumatic stress disorder (PTSD) has been associated with asthma in cross-sectional studies. Whether PTSD leads to clinically significant bronchodilator response (BDR) or new-onset asthma is unknown. Objectives: We sought to determine the relationship between probable PTSD and both BDR and incident asthma in a high-risk cohort of World Trade Center workers in New York (NY). Methods: This study was conducted on data from a high-risk cohort of 11,481 World Trade Center workers in New York, including 6,133 never smokers without a previous diagnosis of asthma. Of the 6,133 never smokers without asthma, 3,757 (61.3%) completed a follow-up visit several years later (mean = 4.95 yr, interquartile range = 3.74–5.90 yr). At the baseline visit, probable PTSD was defined as a score 44 points or greater in the PTSD Checklist questionnaire, and BDR was defined as both a change of 12% or greater and an increment of 200 ml or greater in FEV1 after bronchodilator administration. Incident asthma was defined as a self-report of new physician-diagnosed asthma after the baseline visit. Multivariable logistic regression was used for the analysis of probable PTSD and baseline BDR or incident asthma. Measurements and Main and Results: At baseline, probable PTSD was associated with BDR among all participants (adjusted odds ratio = 1.43; 95% confidence interval = 1.19–1.72), with similar results among never smokers without asthma. Among 3,757 never smokers, probable PTSD at baseline was associated with incident asthma, even after adjustment for baseline BDR (odds ratio = 2.41; 95% confidence interval = 1.85–3.13). This association remained significant in a confirmatory analysis after excluding 195 subjects with baseline BDR. Conclusions: In a cohort of adult workers exposed to a severe traumatic event, probable PTSD is significantly associated with BDR at baseline and predicts incident asthma. PMID:27548615

Post-traumatic Stress Disorder, Bronchodilator Response, and Incident Asthma in World Trade Center Rescue and Recovery Workers.

PubMed

de la Hoz, Rafael E; Jeon, Yunho; Miller, Gregory E; Wisnivesky, Juan P; Celedón, Juan C

2016-12-01

Post-traumatic stress disorder (PTSD) has been associated with asthma in cross-sectional studies. Whether PTSD leads to clinically significant bronchodilator response (BDR) or new-onset asthma is unknown. We sought to determine the relationship between probable PTSD and both BDR and incident asthma in a high-risk cohort of World Trade Center workers in New York (NY). This study was conducted on data from a high-risk cohort of 11,481 World Trade Center workers in New York, including 6,133 never smokers without a previous diagnosis of asthma. Of the 6,133 never smokers without asthma, 3,757 (61.3%) completed a follow-up visit several years later (mean = 4.95 yr, interquartile range = 3.74-5.90 yr). At the baseline visit, probable PTSD was defined as a score 44 points or greater in the PTSD Checklist questionnaire, and BDR was defined as both a change of 12% or greater and an increment of 200 ml or greater in FEV 1 after bronchodilator administration. Incident asthma was defined as a self-report of new physician-diagnosed asthma after the baseline visit. Multivariable logistic regression was used for the analysis of probable PTSD and baseline BDR or incident asthma. Measurements and Main and Results: At baseline, probable PTSD was associated with BDR among all participants (adjusted odds ratio = 1.43; 95% confidence interval = 1.19-1.72), with similar results among never smokers without asthma. Among 3,757 never smokers, probable PTSD at baseline was associated with incident asthma, even after adjustment for baseline BDR (odds ratio = 2.41; 95% confidence interval = 1.85-3.13). This association remained significant in a confirmatory analysis after excluding 195 subjects with baseline BDR. In a cohort of adult workers exposed to a severe traumatic event, probable PTSD is significantly associated with BDR at baseline and predicts incident asthma.

Effect of training and lifting equipment for preventing back pain in lifting and handling: systematic review

PubMed Central

2008-01-01

Objectives To determine whether advice and training on working techniques and lifting equipment prevent back pain in jobs that involve heavy lifting. Data sources Medline, Embase, CENTRAL, Cochrane Back Group’s specialised register, CINAHL, Nioshtic, CISdoc, Science Citation Index, and PsychLIT were searched up to September-November 2005. Review methods The primary search focused on randomised controlled trials and the secondary search on cohort studies with a concurrent control group. Interventions aimed to modify techniques for lifting and handling heavy objects or patients and including measurements for back pain, consequent disability, or sick leave as the main outcome were considered for the review. Two authors independently assessed eligibility of the studies and methodological quality of those included. For data synthesis, we summarised the results of studies comparing similar interventions. We used odds ratios and effect sizes to combine the results in a meta-analysis. Finally, we compared the conclusions of the primary and secondary analyses. Results Six randomised trials and five cohort studies met the inclusion criteria. Two randomised trials and all cohort studies were labelled as high quality. Eight studies looked at lifting and moving patients, and three studies were conducted among baggage handlers or postal workers. Those in control groups received no intervention or minimal training, physical exercise, or use of back belts. None of the comparisons in randomised trials (17 720 participants) yielded significant differences. In the secondary analysis, none of the cohort studies (772 participants) had significant results, which supports the results of the randomised trials. Conclusions There is no evidence to support use of advice or training in working techniques with or without lifting equipment for preventing back pain or consequent disability. The findings challenge current widespread practice of advising workers on correct lifting technique. PMID:18244957

[Proposal of an Italian national protocol of health surveillance for former asbestos workers: an ongoing project].

PubMed

Marchiori, Luciano; Marangi, Gianluca; Ballarin, Nicoletta; Valentini, Flavio; D'Anna, Mauro; Barbina, Paolo; Franchi, Alberto; Mastrangelo, Giuseppe

2016-01-01

to define an Italian national protocol of post-occupational health surveillance for asbestos workers according to effectiveness, appropriateness, saving, and social utility. data for 1,071 former asbestos workers from several Italian Regions were collected and analysed. For these workers, a retrospective estimate of asbestos exposure was carried out. A cohort study of 1,588 asbestos workers recruited from 2000 onward during statutory health examinations in Veneto and followed-up for lung cancer mortality until December 2010 was executed. A literature search on methods of follow-up of asbestos workers (imaging, spirometry, and questionnaires) and diagnosis of non-malignant (asbestosis and pleural plaques) and malignant (lung cancer) asbestos disease was done. A consensus, i.e., a process of agreeing on one result among the participants, was made. 19 Italian Regions (North: Veneto, Emilia-Romagna, Lombardia, Piemonte, Valle d'Aosta, Autonomous Province of Trento, Autonomous Province of Bolzano, Friuli Venezia Giulia, Liguria; Centre:Toscana, Umbria; South and Islands: Calabria, Abruzzo, Puglia, Campania, Basilicata,Marche, Sicilia, Sardegna), Department of Occupational Medicine at Italian National Institute for Compensation ofWork-Related Diseases and Accidents (INAIL), and Department of Cardiac, Thoracic, and Vascular Sciences at University of Padova. analysis of current regional experiences on health surveillance; retrospective estimate of asbestos exposure; data collection and analysis of a cohort of asbestos workers; search of the relevant literature; final report with the consensus document. the results obtained in each of the above areas of research, along with the relevant findings of the literature, were presented and discussed among the participants. The several phases of expression and evaluation of the participants' opinions were conducted according to an iterative method of investigation (Delphi method), which allows a progressive converging of different views into one shared result. based on all the above, a consensus has been reached on a proposal for an Italian national protocol of health surveillance for asbestos workers.

Education and Gender Wage Differentials in Portugal: What Can We Learn from an Age Cohort Analysis?

ERIC Educational Resources Information Center

Gonzalez, Pilar; Santos, Luis Delfim; Santos, Maria Clementina

2009-01-01

Important changes characterize the recent evolution of the schooling of workers in Portugal. The purpose of this paper is to investigate the consequences of those changes in the gender wage gap. In particular, we analyze and compare the way that this process has evolved in the groups of young workers and older workers. Our findings suggest that…

The Past Informs the Future: An Overview of the Million Worker Study and the Mallinckrodt Chemical Works Cohort.

PubMed

Boice, John D; Ellis, Elizabeth D; Golden, Ashley P; Girardi, David J; Cohen, Sarah S; Chen, Heidi; Mumma, Michael T; Shore, Roy E; Leggett, Richard W

2018-04-01

The purpose of this paper is to present an overview of ongoing work on the Million Worker Study (MWS), highlighting some of the key methods and progress so far as exemplified by the study of workers at the Mallinckrodt Chemical Works (MCW). The MWS began nearly 25 y ago and continues in a stepwise fashion, evaluating one study cohort at a time. It includes workers from U.S. Department of Energy (DOE) Manhattan Project facilities, U.S. Nuclear Regulatory Commission (NRC) regulated nuclear power plants, industrial radiographers, U.S. Department of Defense (DoD) nuclear weapons test participants, and physicians and technologists working with medical radiation. The purpose is to fill the major gap in radiation protection and science: What is the risk when exposure is received gradually over time rather than briefly as for the atomic bomb survivors? Studies published or planned in 2018 include leukemia (and dosimetry) among atomic veterans, leukemia among nuclear power plant workers, mortality among workers at the MCW, and a comprehensive National Council on Radiation Protection and Measurements (NCRP) Report on dosimetry for the MWS. MCW has a singular place in history: the 40 tons (T) of uranium oxide produced at MCW were used by Enrico Fermi on 2 December 1942 to produce the first manmade sustained and controlled nuclear reaction, and the atomic age was born. Seventy-six years later, the authors followed the over 2,500 MCW workers for mortality and reconstructed dose from six sources of exposure: external gamma rays from the radioactive elements in pitchblende; medical x rays from occupationally required chest examinations; intakes of pitchblende (uranium, radium, and silica) measured by urine samples; radon breath analyses and dust surveys overseen by Robley Evans and Merril Eisenbud; occupational exposures received before and after employment at MCW; and cumulative radon concentrations and lung dose from the decay of radium in the work environment. The unique exposure reconstructions allow for multiple evaluations, including estimates of silica dust. The study results are relevant today. For example, NASA is interested that radium, deposited in the brain, releases high-LET alpha particles - the only human analogue, though limited, for high energy, high-Z particles (galactic cosmic rays) traveling through space that might affect astronauts on Mars missions. Don't discount the past; it's the prologue to the future!

Increased Incidence of Visual Field Abnormalities as Determined by Frequency Doubling Technology Perimetry in High Computer Users Among Japanese Workers: A Retrospective Cohort Study.

PubMed

Nakano, Tadashi; Hayashi, Takeshi; Nakagawa, Toru; Honda, Toru; Owada, Satoshi; Endo, Hitoshi; Tatemichi, Masayuki

2018-04-05

This retrospective cohort study primarily aimed to investigate the possible association of computer use with visual field abnormalities (VFA) among Japanese workers. The study included 2,377 workers (mean age 45.7 [standard deviation, 8.3] years; 2,229 men and 148 women) who initially exhibited no VFA during frequency doubling technology perimetry (FDT) testing. Subjects then underwent annual follow-up FDT testing for 7 years, and VFA were determined using a FDT-test protocol (FDT-VFA). Subjects with FDT-VFA were examined by ophthalmologists. Baseline data about the mean duration of computer use during a 5-year period and refractive errors were obtained via self-administered questionnaire and evaluations for refractive errors (use of eyeglasses or contact lenses), respectively. A Cox proportional hazard analysis demonstrated that heavy computer users (>8 hr/day) had a significantly increased risk of FDT-VFA (hazard ratio [HR] 2.85; 95% confidence interval [CI], 1.26-6.48) relative to light users (<4 hr/day), and this association was strengthened among subjects with refractive errors (HR 4.48; 95% CI, 1.87-10.74). The computer usage history also significantly correlated with FDT-VFA among subject with refractive errors (P < 0.05), and 73.1% of subjects with FDT-VFA and refractive errors were diagnosed with glaucoma or ocular hypertension. The incidence of FDT-VFA appears to be increased among Japanese workers who are heavy computer users, particularly if they have refractive errors. Further investigations of epidemiology and causality are warranted.

External radiation dose and cancer mortality among French nuclear workers: considering potential confounding by internal radiation exposure.

PubMed

Fournier, L; Laurent, O; Samson, E; Caër-Lorho, S; Laroche, P; Le Guen, B; Laurier, D; Leuraud, K

2016-11-01

French nuclear workers have detailed records of their occupational exposure to external radiation that have been used to examine associations with subsequent cancer mortality. However, some workers were also exposed to internal contamination by radionuclides. This study aims to assess the potential for bias due to confounding by internal contamination of estimates of associations between external radiation exposure and cancer mortality. A cohort of 59,004 workers employed for at least 1 year between 1950 and 1994 by CEA (Commissariat à l'Energie Atomique), AREVA NC, or EDF (Electricité de France) and badge-monitored for external radiation exposure were followed through 2004 to assess vital status and cause of death. A flag based on a workstation-exposure matrix defined four levels of potential for internal contamination. Standardized mortality ratios were assessed for each level of the internal contamination indicator. Poisson regression was used to quantify associations between external radiation exposure and cancer mortality, adjusting for potential internal contamination. For solid cancer, the mortality deficit tended to decrease as the levels of potential for internal contamination increased. For solid cancer and leukemia excluding chronic lymphocytic leukemia, adjusting the dose-response analysis on the internal contamination indicator did not markedly change the excess relative risk per Sievert of external radiation dose. This study suggests that in this cohort, neglecting information on internal dosimetry while studying the association between external dose and cancer mortality does not generate a substantial bias. To investigate more specifically the health effects of internal contamination, an effort is underway to estimate organ doses due to internal contamination.

Trends in Loss to Follow-Up among Migrant Workers on Antiretroviral Therapy in a Community Cohort in Lesotho

PubMed Central

Bygrave, Helen; Kranzer, Katharina; Hilderbrand, Katherine; Whittall, Jonathan; Jouquet, Guillaume; Goemaere, Eric; Vlahakis, Nathalie; Triviño, Laura; Makakole, Lipontso; Ford, Nathan

2010-01-01

Background The provision of antiretroviral therapy (ART) to migrant populations raises particular challenges with respect to ensuring adequate treatment support, adherence, and retention in care. We assessed rates of loss to follow-up for migrant workers compared with non-migrant workers in a routine treatment programme in Morjia, Lesotho. Design All adult patients (≥18 years) initiating ART between January 1, 2008, and December 31, 2008, and followed up until the end of 2009, were included in the study. We described rates of loss to follow-up according to migrant status by Kaplan-Meier estimates, and used Poisson regression to model associations between migrant status and loss to follow-up controlling for potential confounders identified a priori. Results Our cohort comprised 1185 people, among whom 12% (148) were migrant workers. Among the migrant workers, median age was 36.1 (29.6–45.9) and the majority (55%) were male. We found no statistically significant differences between baseline characteristics and migrant status. Rates of lost to follow up were similar between migrants and non-migrants in the first 3 months but differences increased thereafter. Between 3 and 6 months after initiating antiretroviral therapy, migrants had a 2.78-fold increased rate of defaulting (95%CI 1.15–6.73); between 6 and 12 months the rate was 2.36 times greater (95%CI 1.18–4.73), whereas after 1 year the rate was 6.69 times greater (95%CI 3.18–14.09). Conclusions Our study highlights the need for programme implementers to take into account the specific challenges that may influence continuity of antiretroviral treatment and care for migrant populations. PMID:20976289

Association Between Occupational Heat Stress and Kidney Disease Among 37 816 Workers in the Thai Cohort Study (TCS)

PubMed Central

Tawatsupa, Benjawan; Lim, Lynette L-Y; Kjellstrom, Tord; Seubsman, Sam-ang; Sleigh, Adrian

2012-01-01

Background We examined the relationship between self-reported occupational heat stress and incidence of self-reported doctor-diagnosed kidney disease in Thai workers. Methods Data were derived from baseline (2005) and follow-up (2009) self-report questionnaires from a large national Thai Cohort Study (TCS). Analysis was restricted to full-time workers (n = 17 402 men and 20 414 women) without known kidney disease at baseline. We used logistic regression models to examine the association of incident kidney disease with heat stress at work, after adjustment for smoking, alcohol drinking, body mass index, and a large number of socioeconomic and demographic characteristics. Results Exposure to heat stress was more common in men than in women (22% vs 15%). A significant association between heat stress and incident kidney disease was observed in men (adjusted odds ratio [OR] = 1.48, 95% CI: 1.01–2.16). The risk of kidney disease was higher among workers reporting workplace heat stress in both 2005 and 2009. Among men exposed to prolonged heat stress, the odds of developing kidney disease was 2.22 times that of men without such exposure (95% CI 1.48–3.35, P-trend <0.001). The incidence of kidney disease was even higher among men aged 35 years or older in a physical job: 2.2% exposed to prolonged heat stress developed kidney disease compared with 0.4% with no heat exposure (adjusted OR = 5.30, 95% CI 1.17–24.13). Conclusions There is an association between self-reported occupational heat stress and self-reported doctor-diagnosed kidney disease in Thailand. The results indicate a need for occupational health interventions for heat stress among workers in tropical climates. PMID:22343327

Association between occupational heat stress and kidney disease among 37,816 workers in the Thai Cohort Study (TCS).

PubMed

Tawatsupa, Benjawan; Lim, Lynette L-Y; Kjellstrom, Tord; Seubsman, Sam-ang; Sleigh, Adrian

2012-01-01

We examined the relationship between self-reported occupational heat stress and incidence of self-reported doctor-diagnosed kidney disease in Thai workers. Data were derived from baseline (2005) and follow-up (2009) self-report questionnaires from a large national Thai Cohort Study (TCS). Analysis was restricted to full-time workers (n = 17 402 men and 20 414 women) without known kidney disease at baseline. We used logistic regression models to examine the association of incident kidney disease with heat stress at work, after adjustment for smoking, alcohol drinking, body mass index, and a large number of socioeconomic and demographic characteristics. Exposure to heat stress was more common in men than in women (22% vs 15%). A significant association between heat stress and incident kidney disease was observed in men (adjusted odds ratio [OR] = 1.48, 95% CI: 1.01-2.16). The risk of kidney disease was higher among workers reporting workplace heat stress in both 2005 and 2009. Among men exposed to prolonged heat stress, the odds of developing kidney disease was 2.22 times that of men without such exposure (95% CI 1.48-3.35, P-trend <0.001). The incidence of kidney disease was even higher among men aged 35 years or older in a physical job: 2.2% exposed to prolonged heat stress developed kidney disease compared with 0.4% with no heat exposure (adjusted OR = 5.30, 95% CI 1.17-24.13). There is an association between self-reported occupational heat stress and self-reported doctor-diagnosed kidney disease in Thailand. The results indicate a need for occupational health interventions for heat stress among workers in tropical climates.

Occupational musculoskeletal and mental disorders as the most frequent associations to worker's sickness absence: a 10-year cohort study.

PubMed

Zechinatti, Antonio Carlos; Belloti, João Carlos; de Moraes, Vinícius Ynoe; Albertoni, Walter Manna

2012-05-11

Sickness absence (SA) is a complex phenomenon influenced by the health of the worker and socio-economic factors. An epidemiological study of SA has never been conducted for Brazilian university workers. This study aimed to determine the main diseases that are associated with SA and find out the average length of SA duration, and its variation among different staff members and between sexes over the 10-year study period. We identified the main diseases responsible for SA in workers at a Brazilian federal university (UNIFESP) from January 1998 to August 2008 and grouped them according to the International Classification of Diseases (ICD10). Independent researchers assessed data collected from expert reports of the university Worker's Health Division. During the period of our study, 1176 workers experienced sickness absence. After evaluating 7579 consultations, ICD10 distribution showed that musculoskeletal and connective tissue disorders ("M" axis) and mental and behavioral diseases ("F" axis) were the most important causes of SA, occurring in 47.3% (IC 95%; 44.15-49.8) of workers aged 46.2 (SD 10.1) years. Female workers represented 78.1% (IC 95%; 76-80.7) of all workers with SA, but men had higher proportional rates (Chi-square; p = 0.044). Longer SA periods were observed for illnesses related to neoplasms and infectious diseases. Musculoskeletal and connective tissue disorders and mental and behavioral diseases were the most frequent cause of sickness absence. Men had an increased frequency of SA, and neoplasms and infectious disorders were associated with longer absences. Mostly, these are occupational disorders. A preventative research-focused agenda is desirable for a more accurate depiction of this population in the scope of policy-making. Our results for SA in Brazilian workers correspond with those of other studies worldwide.

Recent im/migration to Canada linked to unmet health needs among sex workers in Vancouver, Canada: Findings of a longitudinal study.

PubMed

Sou, Julie; Goldenberg, Shira M; Duff, Putu; Nguyen, Paul; Shoveller, Jean; Shannon, Kate

2017-05-01

Despite universal health care in Canada, sex workers (SWs) and im/migrants experience suboptimal health care access. In this analysis, we examined the correlates of unmet health needs among SWs in Metro Vancouver over time. Data from a longitudinal cohort of women SWs (An Evaluation of Sex Workers Health Access [AESHA]) were used. Of 742 SWs, 25.5% reported unmet health needs at least once over the 4-year study period. In multivariable logistic regression using generalized estimating equations, recent im/migration had the strongest impact on unmet health needs; long-term im/migration, policing, and trauma were also important determinants. Legal and social supports to promote im/migrant SWs' access to health care are recommended.

Occupational exposure to asbestos and cardiovascular related diseases: A meta-analysis

PubMed Central

Rong, Yi; Luo, Xin; Zhang, Zhihong; Cui, Xiuqing; Liu, Yuewei; Chen, Weihong

2015-01-01

Asbestos has become one of the leading causes of death among occupational workers in the world. The association between asbestos and cardiovascular disease is less reported. We performed a meta-analysis to quantify the association between asbestos exposure and the mortality of cardiovascular related diseases. We performed a systematic review in the PubMed database before December 2014. All cohort studies citing the standardized mortality ratio (SMR) of cardiovascular related diseases in workers exposed to asbestos were collected. We then calculated the pooled standardized mortality ratios of such diseases. Sixteen studies were included. The combined results from all studies indicated the pooled SMR estimate for cardiovascular related diseases was 1.11 (95% CI, 1.01–1.22). This meta-analysis showed that asbestos exposure significantly increased the risk of cardiovascular related diseases in exposed workers. PMID:26844169

Cohort mortality study of garment industry workers exposed to formaldehyde: update and internal comparisons.

PubMed

Meyers, Alysha R; Pinkerton, Lynne E; Hein, Misty J

2013-09-01

To further evaluate the association between formaldehyde and leukemia, we extended follow-up through 2008 for a cohort mortality study of 11,043 US formaldehyde-exposed garment workers. We computed standardized mortality ratios and standardized rate ratios stratified by year of first exposure, exposure duration, and time since first exposure. Associations between exposure duration and rates of leukemia and myeloid leukemia were further examined using Poisson regression models. Compared to the US population, myeloid leukemia mortality was elevated but overall leukemia mortality was not. In internal analyses, overall leukemia mortality increased with increasing exposure duration and this trend was statistically significant. We continue to see limited evidence of an association between formaldehyde and leukemia. However, the extended follow-up did not strengthen previously observed associations. In addition to continued epidemiologic research, we recommend further research to evaluate the biological plausibility of a causal relation between formaldehyde and leukemia. Copyright © 2013 Wiley Periodicals, Inc.

A cohort study of psychosocial work stressors on work ability among Brazilian hospital workers.

PubMed

Martinez, Maria Carmen; do Rosário Dias de Oliveira Latorre, Maria; Fischer, Frida Marina

2015-07-01

Hospital work is characterized by stressors that can influence work ability. The present study aims to assess the association between psychosocial work stressors and changes in work ability in a group of Brazilian hospital employees. From 1,022 workers included in a 3-year cohort started in 2009, 423 (41.4%) returned the applied questionnaires in 2012. Changes in work ability were considered as the dependent variable and the investigated psychosocial work stressors as independent variables. Logistic regression models adjusted for potential con-founders (demographic, occupational features, social support, overcommitment, and situations liable to cause pain/injury). High levels of exposure to psychosocial work stressors were significantly associated with decreased work ability: job strain (OR = 2.81), effort-reward imbalance (OR = 3.21). Strategies to reduce psychosocial work stressors should be considered to maintain hospital employees' work ability. Such strategies have implications for institutional and social policies and might be included in quality management programs. © 2015 Wiley Periodicals, Inc.

Chernobyl cleanup workers from Estonia: cohort description and related epidemiological research.

PubMed

Rahu, Kaja; Rahu, Mati; Tekkel, Mare; Veidebaum, Toomas; Hakulinen, Timo; Auvinen, Anssi; Bigbee, William L; Hartshorne, Michael F; Inskip, Peter D; Boice, John D

2015-12-01

The Estonian study of Chernobyl cleanup workers was one of the first investigations to evaluate the possible health consequences of working in the Chernobyl area (the 30 km exclusion zone and/or adjacent territories) after the 1986 reactor accident. The cohort consists of 4831 men who were dispatched in 1986-1991 for tasks involving decontamination, construction of buildings, transport, radiation measurement, guard duty or other activities. By 31 December 2012, the follow-up of the cohort yielded 102 158 person-years of observation. Exposure and health data were collected by postal questionnaires, biodosimetry evaluations, thyroid screenings, and record-linkages with cancer, causes of death and health insurance reimbursement registers and databases. These data cover socio-demographic factors, employment history, aspects of health behaviour, medical history, work and living conditions in the Chernobyl area, biomarkers of exposure, cancer and non-cancer disease occurrence and causes of death. Cancer incidence data were obtained for 1986-2008, mortality data for 1986-2011 and non-cancer morbidity data for 2004-2012. Although the cohort is relatively small, it has been extensively examined and benefited from comprehensive nationwide population and health registers. The major finding was an increased risk of suicide. Thyroid examinations did not reveal an association with thyroid nodular disease and radiation dose, but did indicate the importance of accounting for screening when making comparisons with unscreened populations. No risk of leukaemia was observed and risks higher than 2.5-fold could be excluded with 95% confidence. Biodosimetry included GPA analyses and chromosomal translocation analyses and indicated that the Estonian cleanup workers experienced a relatively low mean exposure of the order of 0.1 Gy. One value of the Estonian study is in the methodologic processes brought to bear in addressing possible health effects from the Chernobyl accident. Twenty-five years of research are summarised and opportunities for the future listed.

Journal Article: Localized Pleural Thickening: Smoking and Exposure to Libby Vermiculite

EPA Science Inventory

There is limited research on the combined effects of smoking and asbestos exposure on risk of localized pleural thickening (LPT). This analysis uses data from the Marysville cohort of workers occupationally exposed to Libby amphibole asbestos (LAA). Workers were interviewed to ...

Estimating Counterfactual Risk Under Hypothetical Interventions in the Presence of Competing Events: Crystalline Silica Exposure and Mortality From two Causes of Death.

PubMed

Neophytou, Andreas M; Picciotto, Sally; Brown, Daniel M; Gallagher, Lisa E; Checkoway, Harvey; Eisen, Ellen A; Costello, Sadie

2018-04-03

Exposure to silica has been linked to excess risk of lung cancer and non-malignant respiratory disease mortality. In this study we estimated risk for both these outcomes in relation to occupational silica exposure as well as the reduction in risk that would result from hypothetical interventions on exposure in a cohort of exposed workers. Analyses were carried out in an all-male study population consisting of 2342 California diatomaceous earth workers regularly exposed to crystalline silica, followed between 1942 and 2011. We estimated subdistribution risk for each event under the natural course and interventions of interest using the parametric g-formula to adjust for healthy worker survivor bias. The risk ratio for lung cancer mortality comparing an intervention in which a theoretical maximum exposure limit was set at 0.05 mg/m3 (the current U.S. regulatory limit) to the observed exposure concentrations was 0.86 (95% confidence interval: 0.63, 1.22). The corresponding risk ratio for non-malignant respiratory disease mortality was 0.69 (95% confidence interval: 0.52, 0.93). Our findings suggest that risks from both outcomes would have been considerably lower if historical silica exposures in this cohort had not exceeded current regulatory limits.

Cancer risk in aluminum reduction plant workers (Canada).

PubMed

Spinelli, John J; Demers, Paul A; Le, Nhu D; Friesen, Melissa D; Lorenzi, Maria F; Fang, Raymond; Gallagher, Richard P

2006-09-01

A 14-year update to a previously published historical cohort study of aluminum reduction plant workers was conducted [1]. All men with three or more years at an aluminum reduction plant in British Columbia (BC), Canada between the years 1954 and 1997 were included; a total of 6,423 workers. A total of 662 men were diagnosed with cancer, representing a 400% increase from the original study. Standardized mortality and incidence ratios were used to compare the cancer mortality and incidence of the cohort to that of the BC population. Poisson regression was used to examine risk by cumulative exposure to coal tar pitch volatiles (CTPV) measured as benzene soluble materials (BSM) and benzo(a)pyrene (BaP). The risk for bladder cancer was related to cumulative exposure to CTPV measured as BSM and BaP (p trends <0.001), and the risk for stomach cancer was related to exposure measured by BaP (p trend BaP <0.05). The risks for lung cancer (p trend <0.001), non-Hodgkin lymphoma (p trend <0.001), and kidney cancer (p trend <0.01) also increased with increasing exposure, although the overall rates were similar to that of the general population. Analysis of the joint effect of smoking and CTPV exposure on cancer showed the observed dose-response relationships to be independent of smoking.

Moving from Theory to Practice: Implementing the Kin Keeper[superscript SM] Cancer Prevention Model

ERIC Educational Resources Information Center

Williams, K. P.; Mullan, P. B.; Todem, D.

2009-01-01

This paper presents the rationale and findings of a feasibility and process study of the Kin Keeper[superscript SM] Cancer Prevention Intervention. An observational cohort study design was implemented with African-American women in synergistic female family relationships. Community health workers (CHWs) from two Michigan public health programs…

Older Workers in the 21st Century: Active and Educated, a Case Study.

ERIC Educational Resources Information Center

Besl, John R.; Kale, Balkrishna D.

1996-01-01

A case study of the Wisconsin labor market suggests that in future older adults will have higher educational attainment and labor force participation rates than today's older cohorts. Changes in retirement programs and greater growth in white-collar occupations and women's employment are some of the causal factors. (SK)

Occupational Exposure to Vapor-Gas, Dust, and Fumes in a Cohort of Rural Adults in Iowa Compared with a Cohort of Urban Adults

PubMed Central

Henneberger, Paul K.; Humann, Michael J.; Liang, Xiaoming; Kelly, Kevin M.; Cox-Ganser, Jean M.

2017-01-01

Problem/Condition Many rural residents work in the field of agriculture; however, employment in nonagricultural jobs also is common. Because previous studies in rural communities often have focused on agricultural workers, much less is known about the occupational exposures in other types of jobs in rural settings. Characterizing airborne occupational exposures that can contribute to respiratory diseases is important so that differences between rural and urban working populations can be assessed. Reporting Period 1994–2011. Description of System This investigation used data from the baseline questionnaire completed by adult rural residents participating in the Keokuk County Rural Health Study (KCRHS). The distribution of jobs and occupational exposures to vapor-gas, dust, and fumes (VGDF) among all participants was analyzed and stratified by farming status (current, former, and never) then compared with a cohort of urban workers from the Multi-Ethnic Study of Atherosclerosis (MESA). Occupational exposure in the last job was assessed with a job-exposure matrix (JEM) developed for chronic obstructive pulmonary disease (COPD). The COPD JEM assesses VGDF exposure at levels of none or low, medium, and high. Results The 1,699 KCRHS (rural) participants were more likely to have medium or high occupational VGDF exposure (43.2%) at their last job than their urban MESA counterparts (15.0% of 3,667 participants). One fifth (20.8%) of the rural participants currently farmed, 43.1% were former farmers, and approximately one third (36.1%) had never farmed. These three farming groups differed in VGDF exposure at the last job, with the prevalence of medium or high exposure at 80.2% for current farmers, 38.7% for former farmers, and 27.4% for never farmers, and all three percentages were higher than the 15.0% medium or high level of VGDF exposure for urban workers. Interpretation Rural workers, including those who had never farmed, were more likely to experience occupational VGDF exposure than urban workers. Public Health Action The occupational exposures of rural adults assessed using the COPD JEM will be used to investigate their potential association with obstructive respiratory health problems (e.g., airflow limitation and chronic bronchitis). This assessment might highlight occupations in need of preventive interventions. PMID:29095802

Relationship of night and shift work with weight change and lifestyle behaviors.

PubMed

Bekkers, Marga B M; Koppes, Lando L J; Rodenburg, Wendy; van Steeg, Harry; Proper, Karin I

2015-04-01

To prospectively study the association of night and shift work with weight change and lifestyle behaviors. Workers participating in the Netherlands Working Conditions Cohort Study (2008 and 2009) (N = 5951) reported night and shift work, weight and height. Groups included stable night or shift work, from day work to night or shift work, from night or shift work to day work, and no night or shift work in 2008 and 2009. Regression analyses were used to study association changes in night and shift work with weight change and changes in lifestyle behaviors. A larger weight change was seen in normal-weight workers changing from day to shift work (β = 0.93%; 95% confidence interval, 0.01 to 1.85) compared with stable no shift workers. No further associations of night and shift work with weight change were observed, neither in normal-weight, overweight, and obese workers. Despite the fact that starting night or shift work is associated with some unhealthy lifestyle habits, this study did not confirm a positive association of night and shift work with weight change over 1 year, except for normal-weight workers moving from day to shift work.

Does self-assessed physical capacity predict development of low back pain among health care workers? A 2-year follow-up study.

PubMed

Rasmussen, Charlotte D N; Jørgensen, Marie B; Clausen, Thomas; Andersen, Lars L; Strøyer, Jesper; Holtermann, Andreas

2013-02-01

Prospective cohort study. To determine the prognostic value of self-assessed physical capacity for the development of low back pain (LBP) among female health care workers without LBP. High physical capacities in terms of strength, endurance, flexibility, and balance are assumed to prevent LBP among persons with high physical work demands. However, the few existing studies investigating this relationship show contrasting findings. Female health care workers answered a questionnaire about physical capacity in 2004, and days with LBP in 2005 and 2006. The odds ratios (ORs) for developing nonchronic (1-30 d of the past 12 mo) and persistent (>30 d of the past 12 mo) LBP in 2006 from self-assessed physical capacity were investigated with multiadjusted logistic regressions among female health care workers without LBP in 2005 (n = 1612). Health care workers with low and medium physical capacity had increased risk of developing nonchronic LBP (OR = 1.52 [CI = 1.05-2.20] and OR = 1.37 [CI = 1.01-1.84], respectively), and health care workers with low physical capacity had an increased risk of developing persistent LBP (OR = 2.13 [CI = 1.15-3.96]), referencing those with high physical capacity. Self-assessed low physical capacity is a strong predictor for developing nonchronic and persistent LBP among pain-free female health care workers. Future intervention studies should investigate whether increased physical capacity, for example, through exercise training prevents development of LBP among female health care workers.

Immunotoxicology of arc welding fume: Worker and experimental animal studies

PubMed Central

Zeidler-Erdely, Patti C.; Erdely, Aaron; Antonini, James M.

2015-01-01

Arc welding processes generate complex aerosols composed of potentially hazardous metal fumes and gases. Millions of workers worldwide are exposed to welding aerosols daily. A health effect of welding that is of concern to the occupational health community is the development of immune system dysfunction. Increased severity, frequency, and duration of upper and lower respiratory tract infections have been reported among welders. Specifically, multiple studies have observed an excess mortality from pneumonia in welders and workers exposed to metal fumes. Although several welder cohort and experimental animal studies investigating the adverse effects of welding fume exposure on immune function have been performed, the potential mechanisms responsible for these effects are limited. The objective of this report was to review both human and animal studies that have examined the effect of welding fume pulmonary exposure on local and systemic immune responses. PMID:22734811

Malignant mesothelioma incidence among talc miners and millers in New York State.

PubMed

Finkelstein, Murray M

2012-10-01

There is controversy about the potential for dust from the talc mines and mills of New York State to cause mesothelioma. Honda et al. published a study of mortality among New York talc workers and concluded that it was unlikely that the two deaths from mesothelioma were caused by talc ore dust. However, fibers of tremolite and anthophyllite have been found in the lungs of talc workers and Hull concluded that "New York talc exposure is associated with mesothelioma, and deserves further public health attention." Data concerning additional cases of mesothelioma in the cohort have been posted by NIOSH. I used information from the NIOSH website and the Honda report to analyze the incidence of mesothelioma during the years 1990-2007. There were at least five new cases of mesothelioma in the cohort and mesothelioma incidence rates were at least five (1.6-11.7) times the rate in the general population (P < 0.01). I conclude that: (1) mesothelioma has been diagnosed among members of the cohort at a rate in excess of that in the general population; (2) fibers of tremolite and anthophyllite have been detected in dust and the lungs of talc workers; and (3) these fibers are known causes of mesothelioma. It is prudent, on the balance of probabilities, to conclude that dusts from New York State talc ores are capable of causing mesothelioma in exposed individuals. Copyright © 2012 Wiley Periodicals, Inc.

Prostate cancer mortality risk in relation to working underground in the Wismut cohort study of German uranium miners, 1970-2003.

PubMed

Walsh, Linda; Dufey, Florian; Tschense, Annemarie; Schnelzer, Maria; Sogl, Marion; Kreuzer, Michaela

2012-01-01

A recent study and comprehensive literature review has indicated that mining could be protective against prostate cancer. This indication has been explored further here by analysing prostate cancer mortality in the German 'Wismut' uranium miner cohort, which has detailed information on the number of days worked underground. An historical cohort study of 58 987 male mine workers with retrospective follow-up before 1999 and prospective follow-up since 1999. Uranium mine workers employed during the period 1970-1990 in the regions of Saxony and Thuringia, Germany, contributing 1.42 million person-years of follow-up ending in 2003. Simple standardised mortality ratio (SMR) analyses were applied to assess differences between the national and cohort prostate cancer mortality rates and complemented by refined analyses done entirely within the cohort. The internal comparisons applied Poisson regression excess relative prostate cancer mortality risk model with background stratification by age and calendar year and a whole range of possible explanatory covariables that included days worked underground and years worked at high physical activity with γ radiation treated as a confounder. The analysis is based on miner data for 263 prostate cancer deaths. The overall SMR was 0.85 (95% CI 0.75 to 0.95). A linear excess relative risk model with the number of years worked at high physical activity and the number of days worked underground as explanatory covariables provided a statistically significant fit when compared with the background model (p=0.039). Results (with 95% CIs) for the excess relative risk per day worked underground indicated a statistically significant (p=0.0096) small protective effect of -5.59 (-9.81 to -1.36) ×10(-5). Evidence is provided from the German Wismut cohort in support of a protective effect from working underground on prostate cancer mortality risk.

Recovery and recurrence of mental sickness absence among production and office workers in the industrial sector.

PubMed

Norder, Giny; Bültmann, Ute; Hoedeman, Rob; de Bruin, Johan; van der Klink, Jac J L; Roelen, Corné A M

2015-06-01

Manual workers in the public sector have previously been found to be at risk of mental sickness absence (SA). As the impact of mental illness differs across economic sectors, this study investigated mental SA in the industrial sector, differentiating between office and production workers. Ten-year observational cohort study including 14 369 (8164 production and 6205 office) workers with a total of 101 118 person years. SA data were retrieved from an occupational health register. Mental SA episodes were medically certified as emotional disturbances [10th version of the International Classification of Diseases (ICD-10 R45)] or mental and behavioural disorders (ICD-10 F00-F99). The first mental SA episode since baseline was called index mental SA. Recurrences were defined as any mental SA episode occurring >28 days after recovery from index mental SA. The incidence of mental SA was higher in production workers than in office workers, but office workers needed longer time to recover from mental SA. Mental SA recurred as frequently in production workers as in office workers. The median time to recurrence was 15.9 months and tangibly shorter in office workers (14.9 months) than in production workers (16.7 months). Production and office workers aged >55 years were at increased risk of recurrent mental SA within 12 months of recovery from index mental SA. The incidence of mental SA was higher in production workers than in office workers, whereas recurrence rates did not differ between them. Occupational health providers should pay special attention to older workers as they are at increased risk of recurrent mental SA. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

The Aging of the U.S. Population: Human Resource Implications.

ERIC Educational Resources Information Center

Morrison, Malcolm H.

1983-01-01

This article argues that in the upcoming decades, older workers will be competing against the largest cohort of middle-aged workers in our country's history. In the absence of other options, the elderly may feel increased pressure to retire or work part time. (Author/SSH)

Age-Based Methods to Explore Time-Related Variables in Occupational Epidemiology Studies

DOE Office of Scientific and Technical Information (OSTI.GOV)

Janice P. Watkins, Edward L. Frome, Donna L. Cragle

2005-08-31

Although age is recognized as the strongest predictor of mortality in chronic disease epidemiology, a calendar-based approach is often employed when evaluating time-related variables. An age-based analysis file, created by determining the value of each time-dependent variable for each age that a cohort member is followed, provides a clear definition of age at exposure and allows development of diverse analytic models. To demonstrate methods, the relationship between cancer mortality and external radiation was analyzed with Poisson regression for 14,095 Oak Ridge National Laboratory workers. Based on previous analysis of this cohort, a model with ten-year lagged cumulative radiation doses partitionedmore » by receipt before (dose-young) or after (dose-old) age 45 was examined. Dose-response estimates were similar to calendar-year-based results with elevated risk for dose-old, but not when film badge readings were weekly before 1957. Complementary results showed increasing risk with older hire ages and earlier birth cohorts, since workers hired after age 45 were born before 1915, and dose-young and dose-old were distributed differently by birth cohorts. Risks were generally higher for smokingrelated than non-smoking-related cancers. It was difficult to single out specific variables associated with elevated cancer mortality because of: (1) birth cohort differences in hire age and mortality experience completeness, and (2) time-period differences in working conditions, dose potential, and exposure assessment. This research demonstrated the utility and versatility of the age-based approach.« less

Social and Structural Factors Shaping High Rates of Incarceration among Sex Workers in a Canadian Setting.

PubMed

Socías, M E; Deering, K; Horton, M; Nguyen, P; Montaner, J S; Shannon, K

2015-10-01

In light of the emphasis on enforcement-based approaches towards sex work, and the well-known negative impacts of these approaches on women's health, safety and well-being, we conducted a study to investigate the prevalence and correlates of recent incarceration among a cohort of women sex workers in Vancouver, Canada. Data were obtained from an open prospective community cohort of female and transgender women sex workers, known as An Evaluation of Sex Workers' Health Access (AESHA). Bivariate and multivariable logistic regression analyses, using generalized estimating equations (GEE), were used to model the effect of social and structural factors on the likelihood of incarceration over the 44-month follow-up period (January 2010-August 2013). Among 720 sex workers, 62.5 % (n = 450) reported being incarcerated in their lifetime and 23.9 % (n = 172) being incarcerated at least once during the study period. Of the 172 participants, about one third (36.6 %) reported multiple episodes of incarceration. In multivariable GEE analyses, younger age (adjusted odds ratio [AOR] = 1.04 per year younger, 95 % confidence interval [CI] 1.02-1.06), being of a sexual/gender minority (AOR = 1.62, 95 % CI 1.13-2.34), heavy drinking (AOR = 1.99, 95 % CI 1.20-3.29), being born in Canada (AOR = 3.28, 95 % CI 1.26-8.53), living in unstable housing conditions (AOR = 4.32, 95 % CI 2.17-8.62), servicing clients in public spaces (versus formal sex work establishments) (AOR = 2.33, 95 % CI 1.05-5.17) and experiencing police harassment without arrest (AOR = 1.82, 95 % CI 1.35-2.45) remain independently correlated with incarceration. This prospective study found a very high prevalence and frequency of incarceration among women sex workers in Vancouver, Canada, with the most vulnerable and marginalized women at increased risk of incarceration. Given the well-known social and health harms associated with incarceration, and associations between police harassment and incarceration in this study, our findings further add to growing calls to move away from criminalized and enforcement-based approaches to sex work in Canada and globally.

Assessment of PAH-exposure among coke oven workers.

PubMed

Vähäkangas, K; Pyy, L; Yrjänheikki, E

1992-12-01

Coke oven workers are exposed to high concentrations of polycyclic aromatic hydrocarbons. Only recently have methods been developed to try to assess the individual, biologically significant exposure. The only coke oven plant in Finland started to function in 1987, in Raahe, enabling the implementation of a cohort study among the workers to determine the usefulness of some currently available biomonitoring methods, e.g. methods of measuring PAH-DNA adducts. Urine and blood samples were taken several times from a sample of workers starting from before they worked at the plant. A questionnaire (smoking, diet, former and current occupations) was filled in by the workers at every sampling, and air samples (personal and stationary) were collected at the same time. The mean values of both benzo(a)pyrene diolepoxide (BPDE)-DNA adducts were measured by synchronous fluorescence spectrophotometry (SFS) and the antibodies to these adducts increased somewhat after the work at the plant started. However, all the adduct values were low, and no differences between the smokers and non-smokers at any time point were detected. Battery workers had slightly increased means of BPDE-DNA adducts compared to non-battery workers. Also, coke oven workers had slightly higher adduct values than age, sex and smoking matched controls.

Suicide among agricultural, forestry, and fishery workers.

PubMed

Shiri, Rahman

2018-01-01

In their meta-analysis, Klingelschmidt and her associates (1) found that agricultural, forestry, and fishery workers are at 48% higher risk of suicide than the working-age population. Moreover, they found that the excess risk is even greater among Japanese agricultural workers than workers from other high-income countries. There are several concerns regarding this meta-analysis. It appears that the excess risk has been overestimated for these workers. Furthermore, the excess risk in Japan is not different than other high-income countries. First, in a systematic review, a literature search is comprehensive. A search of a single database is unlikely to identify most of relevant studies, and these types of reviews are not therefore considered as systematic reviews (2). In this review, a specialized database (-PsycINFO) or a European database (EMBASE or -Scopus) was not searched. Second, following the PRISMA guidelines, the critical appraisal of included studies (quality assessment) is a requirement for a systematic review. In a meta-analysis of observational studies, selection bias and confounding should be ruled out. Third, the reviewers did not correctly extract confidence intervals (CI) for the estimates of several studies such as Hassler 2004, Fleming 1999, and Fragar 2011. Moreover, some studies reported both the least- and maximally adjusted risk estimates. The reviewers, however, extracted age- or the least-adjusted risk estimate. A confounder-adjusted estimate is a more appropriate estimate of the true association. In some studies [eg, Kposowa (3) Agerbo (4)], the excess risk dropped by 52-71% after adjustment for confounders. As a sensitivity analysis, the reviewers could limit their meta-analysis to a subgroup of studies controlled for confounders. Fourth, the reviewers did not estimate an overall risk estimate for each study. They included the estimates of 2-6 subgroups for 22 studies in forest and funnel plots. A fixed-effect meta-analysis is a more appropriate model to combine the subgroups of a single study. Moreover, for the assessment of publication bias, it is not appropriate to include several subsamples of a single study in a funnel plot. Using estimates of subgroups can change a large study into several smaller studies. Fifth, some of the included studies compared agricultural, forestry, and fishery workers with a specific occupational group. The reviewers could calculate a risk estimate using all other occupational groups as a comparison group and exclude those studies that did not provide sufficient data for estimating such a risk estimate. In some studies, the excess risk for agricultural, forestry, and fishery workers disappears after comparing with other occupational groups [eg, adjusted risk ratios (RR) for Kposowa (3) = 1.02, 95% CI 0.41-2.54]. This is a main reason for observed higher excess risk in Japanese workers. Wada et al (5) compared Japanese agricultural workers with sales workers and Suzuki et al (6) compared Japanese agricultural, forestry, and fishery workers with production process and related workers. Using all other occupational groups as a reference group, age-adjusted RR dropped from 3.53 (95% CI 2.84-4.38) to 2.61 (95% CI 2.10-3.25) for Wada et al (5) and from 3.24 (CI 2.95-3.57, both sexes combined) to 1.31 (CI 1.27-1.35 age-adjusted OR after excluding unemployed people) for Suzuki et al (6). The pooled estimate of these two register-based studies was 1.33 (95% CI 1.29-1.37) using a fixed model and 1.83 (95% CI 0.93-3.60) using a random model. Sixth, most of the included studies used register data, which had little information on the background characteristics of the participants. A majority of these studies controlled the estimates for age and sex only. Moreover, in this review, prospective cohort studies did not support the observed association. A meta-analysis of 11 case-control and prospective cohort studies shows no significant excess risk of suicide for agricultural, forestry, and fishery workers (pooled estimate = 1.02, 95% CI 0.71-1.47 for 6 cohort studies and 1.13, 95% CI 0.92-1.39, I2 = 91% for 11 case control and cohort studies, combining maximally adjusted risk estimates and comparing agricultural, forestry, and fishery workers with all other occupational groups where possible). The excess risk found in this review (1) can thus largely be due to confounding. References 1. Klingelschmidt J, Milner A, Khireddine-Medouni I, Witt K, Alexopoulos EC, Toivanen S, LaMontagne AD, Chastang JF, Niedhammer I. Suicide among agricultural, forestry, and fishery workers: a systematic literature review and meta-analysis. Scand J Work Environ Health. 2018;44(1):3-15. https://doi.org/10.5271/sjweh.3682.  2. Puljak L. If there is only one author or only one database was searched, a study should not be called a systematic review. J Clin Epidemiol. 2017;91:4-5. https://doi.org/10.1016/j.jclinepi.2017.08.002.  3. Kposowa AJ. Suicide mortality in the United States: differentials by industrial and occupational groups. Am J Ind Med. 1999;36:645-52. https://doi.org/10.1002/(SICI)1097-0274(199912)36:63.0.CO;2-T. 4. Agerbo E, Gunnell D, Bonde JP, Mortensen PB, Nordentoft M. Suicide and occupation: the impact of socio-economic, demographic and psychiatric differences. Psychol Med. 2007;37:1131-40. https://doi.org/10.1017/S0033291707000487.  5. Wada K, Gilmour S. Inequality in mortality by occupation related to economic crisis from 1980 to 2010 among working-age Japanese males. Sci Rep. 2016;6:22255. https://doi.org/10.1038/srep22255. 6. Suzuki E, Kashima S, Kawachi I, Subramanian SV. Social and geographical inequalities in suicide in Japan from 1975 through 2005: a census-based longitudinal analysis. PLoS One. 2013;8:e63443. https://doi.org/10.1371/journal.pone.0063443.

Use and limitations of malaria rapid diagnostic testing by community health workers in war-torn Democratic Republic of Congo.

PubMed

Hawkes, Michael; Katsuva, Jean Paul; Masumbuko, Claude K

2009-12-23

Accurate and practical malaria diagnostics, such as immunochromatographic rapid diagnostic tests (RDTs), have the potential to avert unnecessary treatments and save lives. Volunteer community health workers (CHWs) represent a potentially valuable human resource for expanding this technology to where it is most needed, remote rural communities in sub-Saharan Africa with limited health facilities and personnel. This study reports on a training programme for CHWs to incorporate RDTs into their management strategy for febrile children in the Democratic Republic of Congo, a tropical African setting ravaged by human conflict. Prospective cohort study, satisfaction questionnaire and decision analysis. Twelve CHWs were trained to safely and accurately perform and interpret RDTs, then successfully implemented rapid diagnostic testing in their remote community in a cohort of 357 febrile children. CHWs were uniformly positive in evaluating RDTs for their utility and ease of use. However, high malaria prevalence in this cohort (93% by RDTs, 88% by light microscopy) limited the cost-effectiveness of RDTs compared to presumptive treatment of all febrile children, as evidenced by findings from a simplified decision analysis. CHWs can safely and effectively use RDTs in their management of febrile children; however, cost-effectiveness of RDTs is limited in zones of high malaria prevalence.

Use and limitations of malaria rapid diagnostic testing by community health workers in war-torn Democratic Republic of Congo

PubMed Central

2009-01-01

Background Accurate and practical malaria diagnostics, such as immunochromatographic rapid diagnostic tests (RDTs), have the potential to avert unnecessary treatments and save lives. Volunteer community health workers (CHWs) represent a potentially valuable human resource for expanding this technology to where it is most needed, remote rural communities in sub-Saharan Africa with limited health facilities and personnel. This study reports on a training programme for CHWs to incorporate RDTs into their management strategy for febrile children in the Democratic Republic of Congo, a tropical African setting ravaged by human conflict. Methods Prospective cohort study, satisfaction questionnaire and decision analysis. Results Twelve CHWs were trained to safely and accurately perform and interpret RDTs, then successfully implemented rapid diagnostic testing in their remote community in a cohort of 357 febrile children. CHWs were uniformly positive in evaluating RDTs for their utility and ease of use. However, high malaria prevalence in this cohort (93% by RDTs, 88% by light microscopy) limited the cost-effectiveness of RDTs compared to presumptive treatment of all febrile children, as evidenced by findings from a simplified decision analysis. Conclusions CHWs can safely and effectively use RDTs in their management of febrile children; however, cost-effectiveness of RDTs is limited in zones of high malaria prevalence. PMID:20028563

Mortality and cancer incidence in the perfumery and flavour industry of Geneva.

PubMed Central

Guberan, E; Raymond, L

1985-01-01

An analysis has been made of the mortality and cancer incidence of 1168 workers who entered the three factories of the perfumery industry of the Canton of Geneva from their establishment at the turn of the century to the end of 1964. The workers were followed up from their entry until 31 December 1980, at which date 344 were dead and 28 lost to follow up. Among the whole study population only mortality from tuberculosis was significantly raised; there was no significant increase in the incidence of or mortality from any cancer. Analysis by four exposure categories showed a significant excess of deaths from heart disease among the compounders. In addition, two deaths from aplastic anaemia were recorded in chemical process workers exposed to benzene. Further analysis by cohort of entry and by birth cohort indicated that, among the subgroup of men first employed in 1900-29 and born in 1880-99, the mortality from a wide range of causes was significantly increased below the age of 70. This increase is unlikely to be due to an occupational factor as indicated by the absence of an upward trend of mortality with longer exposure. PMID:3978043

[Accidents with biological material in health care workers in 2 primary health care areas (1990-1999)].

PubMed

Hernández Navarrete, M J; Montes Villameriel, F J; Solano Bernad, V M; Sánchez Matienzo, D; del Val García, J L; Gil Montalbán, E; Arribas Llorente, J L

2001-09-15

To find out the exposures with biological material in health care workers in primary health care, registered in the biological accidents database from Preventive Medicine Service in Miguel Servet Universitary Hospital of Zaragoza. Descriptive study of a retrospective cohort. SITE: Primary health care, Areas II and V of Zaragoza.Participants. Workers in this areas, distributed by: physician, nursing staff, auxiliary, orderly, housekeeping staff, others. Data of: workers, accident, serologic source, worker protection and vaccinal status of hepatitis B. The incidence of accidents was 26 (period 1997-1999). Most proportion of accidents were declared by nursing (78%). The highest occupational incidence was in auxiliary (63 ). In 90,1% of the cases, the accident was needlestick injury. The source was known in 67,7% of cases. The accidents occurred in hands in 96,8% of cases, and only one third of workers carried gloves. Results obtained are similar with previous studies about this event. We must insist on the need to declare these accidents, providing more information and accessibility for the declaration to worker. Moreover, we must insist on the correct application in the health care field of the standard precautions, because almost 50% of accidents are evitable, and to increase hepatitis B vaccination covertures.

Diesel exposure and mortality among railway workers: results of a pilot study.

PubMed Central

Schenker, M B; Smith, T; Muñoz, A; Woskie, S; Speizer, F E

1984-01-01

A pilot study of the mortality of railway workers was undertaken to evaluate the feasibility of studying the association of exposure to diesel exhaust and cause specific mortality. The cohort consisted of 2519 white male subjects aged 45-64 with at least 10 years of railway service by 1967. Subjects were selected on the basis of job classification, and cause specific mortality was ascertained for subjects who died (n = 501) up to 1979. The total follow up period was 28.4 (X 1000) person-years. The standardised mortality ratio (SMR) for the cohort, based on United States national rates, was 87 (95% confidence limits 80, 95), and there were no significant differences from expected number of deaths for any specific neoplasm. The directly standardised rate ratio for respiratory cancer among diesel exposed subjects relative to unexposed subjects was 1.42 +/- 0.50 (means +/- SE). A proportional hazards model was consistent with the findings of the standardised rate ratio, but in neither analysis was the increased risk of respiratory cancer in diesel exposed subjects statistically significant. PMID:6743578

Shared dosimetry error in epidemiological dose-response analyses

DOE PAGES

Stram, Daniel O.; Preston, Dale L.; Sokolnikov, Mikhail; ...

2015-03-23

Radiation dose reconstruction systems for large-scale epidemiological studies are sophisticated both in providing estimates of dose and in representing dosimetry uncertainty. For example, a computer program was used by the Hanford Thyroid Disease Study to provide 100 realizations of possible dose to study participants. The variation in realizations reflected the range of possible dose for each cohort member consistent with the data on dose determinates in the cohort. Another example is the Mayak Worker Dosimetry System 2013 which estimates both external and internal exposures and provides multiple realizations of "possible" dose history to workers given dose determinants. This paper takesmore » up the problem of dealing with complex dosimetry systems that provide multiple realizations of dose in an epidemiologic analysis. In this paper we derive expected scores and the information matrix for a model used widely in radiation epidemiology, namely the linear excess relative risk (ERR) model that allows for a linear dose response (risk in relation to radiation) and distinguishes between modifiers of background rates and of the excess risk due to exposure. We show that treating the mean dose for each individual (calculated by averaging over the realizations) as if it was true dose (ignoring both shared and unshared dosimetry errors) gives asymptotically unbiased estimates (i.e. the score has expectation zero) and valid tests of the null hypothesis that the ERR slope β is zero. Although the score is unbiased the information matrix (and hence the standard errors of the estimate of β) is biased for β≠0 when ignoring errors in dose estimates, and we show how to adjust the information matrix to remove this bias, using the multiple realizations of dose. The use of these methods in the context of several studies including, the Mayak Worker Cohort, and the U.S. Atomic Veterans Study, is discussed.« less

The impact of work-related and personal resources on older workers' fatigue, work enjoyment and retirement intentions over time.

PubMed

Stynen, Dave; Jansen, Nicole W H; Kant, IJmert

2017-12-01

This study aims to examine the impact of work-related and personal resources on older workers' retirement intentions by studying the pathways (fatigue and work enjoyment) from resources to retirement intentions, the buffering role of resources for psychological job demands, in a cross-sectional and longitudinal timeframe. Longitudinal results on a subsample of full-time, older workers (n = 1642) from the Maastricht Cohort Study suggest that over four years of follow-up personal resources like personal mastery and perceived health related to less (prolonged) fatigue and more work enjoyment. Personal mastery also related to later retirement intentions. A work-related resource like decision authority related to less prolonged fatigue. (Prolonged) fatigue related to earlier retirement intentions, suggesting that fatigue may be a pathway to early retirement. Finally, little evidence was found for effect modification by resources. This prospective study indicates that work-related and personal resources may be useful for prolonging working careers. Practitioner Summary: To date, the impact of work-related and personal resources on older workers' retirement intentions is rarely studied. As this prospective study shows that resources may impact older workers' (prolonged) fatigue, work enjoyment and retirement intentions, the monitoring and fostering of resources is of importance for prolonging their working careers.

End-stage renal disease after occupational lead exposure: 20 years of follow-up.

PubMed

Evans, Marie; Discacciati, Andrea; Quershi, Abdul Rashid; Åkesson, Agneta; Elinder, Carl-Gustaf

2017-06-01

Whether low-level exposure to lead may give rise to chronic kidney disease or end-stage renal disease (ESRD) is debated. In this study, we aimed to specifically investigate if low-level occupational exposure to lead was associated with increased incidence of ESRD. The incidence of starting renal replacement therapy as a result of ESRD was examined in a cohort of10 303 lead-workers who had controlled blood lead concentrations due to a compulsory occupational health surveillance programme in Sweden during the time period 1977-1990. The ESRD incidence (obtained through register-linkage) among the lead-exposed workers was compared with the age, sex and calendar period-adjusted expected incidence based on data from the Swedish renal registry. Dose-response association was evaluated in external (general population) and internal (within the occupational cohort) comparisons by highest achieved blood lead level. There were 30 (0.29%) individuals in the cohort who developed ESRD during the median follow-up period of 26.3 years. The standardised incidence ratio (SIR) for ESRD incidence was 0.79 (95% CI 0.54 to 1.13). Among those who achieved the highest blood lead (>41.4 µg/dL), the SIR was 1.01 (0.44 to 1.99). There was no evidence of a dose-response relationship between the maximum achieved blood lead or the cumulative blood lead exposure and ESRD in external or internal comparisons. This study of workers with documented occupational lead exposures followed for 20 years shows no statistically significant association between lead exposure (following the current occupational recommendations for Sweden) and ESRD. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Peptic Ulcer Disease in Healthcare Workers: A Nationwide Population-Based Cohort Study.

PubMed

Lin, Hong-Yue; Weng, Shih-Feng; Lin, Hung-Jung; Hsu, Chien-Chin; Wang, Jhi-Joung; Su, Shih-Bin; Guo, How-Ran; Huang, Chien-Cheng

2015-01-01

Health care workers (HCWs) in Taiwan have heavy, stressful workloads, are on-call, and have rotating nightshifts, all of which might contribute to peptic ulcer disease (PUD). We wanted to evaluate the PUD risk in HCWs, which is not clear. Using Taiwan's National Health Insurance Research Database, we identified 50,226 physicians, 122,357 nurses, 20,677 pharmacists, and 25,059 other HCWs (dieticians, technicians, rehabilitation therapists, and social workers) as the study cohort, and randomly selected an identical number of non-HCW patients (i.e., general population) as the comparison cohort. Conditional logistical regression analysis was used to compare the PUD risk between them. Subgroup analysis for physician specialties was also done. Nurses and other HCWs had a significantly higher PUD risk than did the general population (odds ratio [OR]: 1.477; 95% confidence interval [CI]: 1.433-1.521 and OR: 1.328; 95% CI: 1.245-1.418, respectively); pharmacists had a lower risk (OR: 0.884; 95% CI: 0.828-0.945); physicians had a nonsignificantly different risk (OR: 1.029; 95% CI: 0.987-1.072). In the physician specialty subgroup analysis, internal medicine, surgery, Ob/Gyn, and family medicine specialists had a higher PUD risk than other physicians (OR: 1.579; 95% CI: 1.441-1.731, OR: 1.734; 95% CI: 1.565-1.922, OR: 1.336; 95% CI: 1.151-1.550, and OR: 1.615; 95% CI: 1.425-1.831, respectively). In contrast, emergency physicians had a lower risk (OR: 0.544; 95% CI: 0.359-0.822). Heavy workloads, long working hours, workplace stress, rotating nightshifts, and coping skills may explain our epidemiological findings of higher risks for PUD in some HCWs, which might help us improve our health policies for HCWs.

Depleted and enriched uranium exposure quantified in former factory workers and local residents of NL Industries, Colonie, NY USA

DOE Office of Scientific and Technical Information (OSTI.GOV)

Arnason, John G.

Background: Between 1958 and 1982, NL Industries manufactured components of enriched (EU) and depleted uranium (DU) at a factory in Colonie NY, USA. More than 5 metric tons of DU was deposited as microscopic DU oxide particles on the plant site and surrounding residential community. A prior study involving a small number of individuals (n=23) indicated some residents were exposed to DU and former workers to both DU and EU, most probably through inhalation of aerosol particles. Objectives: Our aim was to measure total uranium [U] and the uranium isotope ratios: {sup 234}U/{sup 238}U; {sup 235}U/{sup 238}U; and {sup 236}U/{supmore » 238}U, in the urine of a cohort of former workers and nearby residents of the NLI factory, to characterize individual exposure to natural uranium (NU), DU, and EU more than 3 decades after production ceased. Methods: We conducted a biomonitoring study in a larger cohort of 32 former workers and 99 residents, who may have been exposed during its period of operation, by measuring Total U, NU, DU, and EU in urine using Sector Field Inductively Coupled Plasma - Mass Spectrometry (SF-ICP-MS). Results: Among workers, 84% were exposed to DU, 9% to EU and DU, and 6% to natural uranium (NU) only. For those exposed to DU, urinary isotopic and [U] compositions result from binary mixing of NU and the DU plant feedstock. Among residents, 8% show evidence of DU exposure, whereas none shows evidence of EU exposure. For residents, the [U] geometric mean is significantly below the value reported for NHANES. There is no significant difference in [U] between exposed and unexposed residents, suggesting that [U] alone is not a reliable indicator of exposure to DU in this group. Conclusions: Ninety four percent of workers tested showed evidence of exposure to DU, EU or both, and were still excreting DU and EU decades after leaving the workforce. The study demonstrates the advantage of measuring multiple isotopic ratios (e.g., {sup 236}U/{sup 238}U and {sup 235}U/{sup 238}U) over a single ratio ({sup 235}U/{sup 238}U) in determining sources of uranium exposure. - Highlights: • Biomonitoring study of residents and former workers exposed to DU in Colonie NY. • Urine (99 residents+32 former workers) analyzed for depleted uranium (DU). • DU detected in 84% of workers and 8% of residents >30 years after plant closed. • Enriched uranium detected in 6% of former workers based on isotope ratios.« less

Cancer risk among workers of a secondary aluminium smelter.

PubMed

Maltseva, A; Serra, C; Kogevinas, M

2016-07-01

Cancer risk in secondary aluminium production is not well described. Workers in this industry are exposed to potentially carcinogenic agents from secondary smelters that reprocess aluminium scrap. To evaluate cancer risk in workers in a secondary aluminium plant in Spain. Retrospective cohort study of male workers employed at an aluminium secondary smelter (1960-92). Exposure histories and vital status through 2011 were obtained through personal interviews and hospital records, respectively. Standardized mortality (SMRs) and incidence ratios (SIRs) were calculated. The study group consisted of 98 workers. We found increased incidence and mortality from bladder cancer [SIR = 2.85, 95% confidence interval (CI) 1.23-5.62; SMR = 5.90, 95% CI 1.58-15.11]. Increased incidence was also observed for prostate cancer and all other cancers but neither were statistically significant. No increased risk was observed for lung cancer. Results of this study suggest that work at secondary aluminium smelters is associated with bladder cancer risk. Identification of occupational carcinogens in this industry is needed. © The Author 2016. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

A nested case-control study of leukemia mortality and ionizing radiation at the Portsmouth Naval Shipyard.

PubMed

Kubale, Travis L; Daniels, Robert D; Yiin, James H; Couch, James; Schubauer-Berigan, Mary K; Kinnes, Gregory M; Silver, Sharon R; Nowlin, Susan J; Chen, Pi-Hsueh

2005-12-01

A nested case-control study using conditional logistic regression was conducted to evaluate the exposure-response relationship between external ionizing radiation exposure and leukemia mortality among civilian workers at the Portsmouth Naval Shipyard (PNS), Kittery, Maine. The PNS civilian workers received occupational radiation exposure while performing construction, overhaul, repair and refueling activities on nuclear-powered submarines. The study age-matched 115 leukemia deaths with 460 controls selected from a cohort of 37,853 civilian workers employed at PNS between 1952 and 1992. In addition to radiation doses received in the workplace, a secondary analysis incorporating doses from work-related medical X rays and other occupational radiation exposures was conducted. A significant positive association was found between leukemia mortality and external radiation exposure, adjusting for gender, radiation worker status, and solvent exposure duration (OR = 1.08 at 10 mSv of exposure; 95% CI = 1.01, 1.16). Solvent exposure (including benzene and carbon tetrachloride) was also significantly associated with leukemia mortality adjusting for radiation dose, radiation worker status, and gender. Incorporating doses from work-related medical X rays did not change the estimated leukemia risk per unit of dose.

Incident Tick-Borne Infections in a Cohort of North Carolina Outdoor Workers.

PubMed

Wallace, John W; Nicholson, William L; Perniciaro, Jamie L; Vaughn, Meagan F; Funkhouser, Sheana; Juliano, Jonathan J; Lee, Sangmi; Kakumanu, Madhavi L; Ponnusamy, Loganathan; Apperson, Charles S; Meshnick, Steven R

2016-05-01

Tick-borne diseases cause substantial morbidity throughout the United States, and North Carolina has a high incidence of spotted fever rickettsioses and ehrlichiosis, with sporadic cases of Lyme disease. The occupational risk of tick-borne infections among outdoor workers is high, particularly those working on publicly managed lands. This study identified incident tick-borne infections and examined seroconversion risk factors among a cohort of North Carolina outdoor workers. Workers from the North Carolina State Divisions of Forestry, Parks and Recreation, and Wildlife (n = 159) were followed for 2 years in a randomized controlled trial evaluating the effectiveness of long-lasting permethrin-impregnated clothing. Antibody titers against Rickettsia parkeri, Rickettsia rickettsii, "Rickettsia amblyommii," and Ehrlichia chaffeensis were measured at baseline (n = 130), after 1 year (n = 82), and after 2 years (n = 73). Titers against Borrelia burgdorferi were measured at baseline and after 2 years (n = 90). Baseline seroprevalence, defined as indirect immunofluorescence antibody titers of 1/128 or greater, was R. parkeri (24%), R. rickettsii (19%), "R. amblyommii" (12%), and E. chaffeensis (4%). Incident infection was defined as a fourfold increase in titer over a 1-year period. There were 40 total seroconversions to at least one pathogen, including R. parkeri (n = 19), "R. amblyommii" (n = 14), R. rickettsii (n = 9), and E. chaffeensis (n = 8). There were no subjects whose sera were reactive to B. burgdorferi C6 antigen. Thirty-eight of the 40 incident infections were subclinical. The overall risk of infection by any pathogen during the study period was 0.26, and the risk among the NC Division of Forest Resources workers was 1.73 times that of workers in other divisions (95% confidence interval [CI]: 1.02, 2.92). The risk of infection was lower in subjects wearing permethrin-impregnated clothing, but not significantly (risk ratio = 0.81; 95% CI: 0.47, 1.39). In summary, outdoor workers in North Carolina are at high risk of incident tick-borne infections, most of which appear to be asymptomatic.

Workplace violence among female sex workers who use drugs in Vancouver, Canada: does client-targeted policing increase safety?

PubMed

Prangnell, Amy; Shannon, Kate; Nosova, Ekaterina; DeBeck, Kora; Milloy, M-J; Kerr, Thomas; Hayashi, Kanna

2018-02-01

Workplace violence, by clients or predators, poses serious negative health consequences for sex workers. In 2013, the Vancouver (British Columbia), Canada Police Department changed their guidelines with the goal of increasing safety for sex workers by focusing law enforcement on clients and third parties, but not sex workers. We sought to examine the trends and correlates of workplace violence among female sex workers (FSW) before and after the guideline change, using data collected from prospective cohorts of persons who use illicit drugs in Vancouver, Canada. Among 259 FSW, 21.0% reported workplace violence at least once during the study period between 2008 and 2014. There was no statistically significant change in rates of workplace violence after the guideline change. In our multivariable analysis, daily heroin use was independently associated with workplace violence. The 2013 policing guideline change did not appear to have resulted in decreased reports of workplace violence. Increased access to opioid agonist therapies may reduce workplace violence among drug-using FSW.

Cohort mortality study of capacitor manufacturing workers, 1944-2000.

PubMed

Mallin, Katherine; McCann, Ken; D'Aloisio, Aimee; Freels, Sally; Piorkowski, Julie; Dimos, John; Persky, Victoria

2004-06-01

A mortality study of workers employed between 1944 and 1977 at an electrical capacitor manufacturing plant where polychlorinated biphenyls (PCBs), chlorinated naphthalenes, and other chemicals were used was undertaken. Age, gender, and calendar year-adjusted standardized mortality ratios (SMRs) were calculated for 2885 white workers. Total mortality and all-cancer mortality were similar to expected in both males and females. Females employed 10 or more years had a significantly elevated SMR of 6.2 for liver/biliary cancer. Intestinal cancer was significantly elevated in females employed 5 or more years after PCBs were introduced (SMR = 2.2). In males, stomach cancer (SMR = 2.2) and thyroid cancer (SMR = 15.2) were significantly elevated. Although individual exposure assessment was limited, PCBs alone or in combination with other chemicals could be associated with increased risks for liver/biliary, stomach, intestinal, and thyroid cancer.

Sick leave before and after the age of 65 years among those in paid work in Sweden in 2000 or 2005: a register-based cohort study.

PubMed

Farrants, Kristin; Kjeldgård, Linnea; Marklund, Staffan; Head, Jenny; Alexanderson, Kristina

2018-02-01

Objective With pressure for older people to remain in work, research is needed on how people aged over 65 years fare in the labour market. However, few studies have focused on sick leave among older workers, especially those over the standard retirement age. This study investigated changes in sick-leave patterns among people aged over 65 years still in work. Methods All individuals in Sweden who turned 65 years old in 2000 or 2005 were followed from 1995 to 2010. The mean number of sick-leave days per year was measured for those who remained in paid work past the age of 65 years. Results Those over 65 years still working had fewer sick-leave days before the age of 65 years than those who retired. They also had fewer sick-leave days after 65 years than before. There were fewer socioeconomic differences after 65 years than before, but these differences were greater for workers over 65 years in the 2005 cohort. Conclusions Although there were more people over 65 years in paid work in 2005, sick-leave days and socioeconomic differences in sick leave were lower in this age group. Sick-leave days and socioeconomic differences in sick leave were greater in the 2005 cohort.

Moving Forward: College and Career Transitions of LAMP Graduates. Findings from the LAMP Longitudinal Study.

ERIC Educational Resources Information Center

MacAllum, Keith; Yoder, Karla; Kim, Scott; Bozick, Robert

A longitudinal study examined the college and career transitions of graduates of the Lansing Area Manufacturing Partnership (LAMP) program, which is a school-to-career (STC) program sponsored by the United Auto Workers, General Motors Corporation, and Michigan's Ingham County Intermediate School District. The progress of three cohorts of LAMP…

Non-malignant disease mortality in meat workers: a model for studying the role of zoonotic transmissible agents in non-malignant chronic diseases in humans.

PubMed

Johnson, E S; Zhou, Y; Sall, M; Faramawi, M El; Shah, N; Christopher, A; Lewis, N

2007-12-01

Current research efforts have mainly concentrated on evaluating the role of substances present in animal food in the aetiology of chronic diseases in humans, with relatively little attention given to evaluating the role of transmissible agents that are also present. Meat workers are exposed to a variety of transmissible agents present in food animals and their products. This study investigates mortality from non-malignant diseases in workers with these exposures. A cohort mortality study was conducted between 1949 and 1989, of 8520 meat workers in a union in Baltimore, Maryland, who worked in manufacturing plants where animals were killed or processed, and who had high exposures to transmissible agents. Mortality in meat workers was compared with that in a control group of 6081 workers in the same union, and also with the US general population. Risk was estimated by proportional mortality and standardised mortality ratios (SMRs) and relative SMR. A clear excess of mortality from septicaemia, subarachnoid haemorrhage, chronic nephritis, acute and subacute endocarditis, functional diseases of the heart, and decreased risk of mortality from pre-cerebral, cerebral artery stenosis were observed in meat workers when compared to the control group or to the US general population. The authors hypothesise that zoonotic transmissible agents present in food animals and their products may be responsible for the occurrence of some cases of circulatory, neurological and other diseases in meat workers, and possibly in the general population exposed to these agents.

Mortality among shipbreaking workers in Taiwan--a retrospective cohort study from 1985 to 2008.

PubMed

Wu, Wei-Te; Lu, Yao-Hua; Lin, Yu-Jen; Yang, Ya-Hui; Shiue, Huei-Sheng; Hsu, Jin-Huei; Li, Chung-Yi; Yang, Chun-Yuh; Liou, Saou-Hsing; Wu, Trong-Neng

2013-06-01

Shipbreaking workers are typically exposed to a wide range of hazardous chemicals. However, long-term follow-up studies of their mortality patterns are lacking. This study examined mortality among shipbreaking workers over a 24-year follow-up period. A total of 4,962 shipbreaking workers were recruited from the database of the Kaohsiung Shipbreaking Workers Union. The data were then linked to the Taiwan National Death Registry from 1985 to 2008. The mortality ratios-standardized for age and calendar years-(SMRs) for various causes of deaths were calculated with reference to the general population of Taiwan. Among men workers, a statistically significant increased SMR was observed for all causes (SMR = 1.28), all cancers (SMR = 1.26; particularly noteworthy for lesions of oral and nasopharyngeal: SMR 2.03, liver: SMR 4.63, and lung: SMR 1.36), cirrhosis of the liver (SMR = 1.32), and accidents (SMR = 1.91). A statistically significant increase in mortality was observed for respiratory system cancer (SMR = 1.87) and lung cancer (SMR = 1.91) among workers with a longer duration of employment (≥7 years). The result also showed that among shipbreaking workers who were still alive, two people had mesothelioma and 10 people have asbestosis. Those employed in shipbreaking industries experienced an increase in mortality from all causes. The increased SMR for lung cancer was probably related to asbestos, metals, and welding fume exposure. Copyright © 2013 Wiley Periodicals, Inc.

Mercury-induced motor and sensory neurotoxicity: systematic review of workers currently exposed to mercury vapor.

PubMed

Fields, Cheryl A; Borak, Jonathan; Louis, Elan D

2017-11-01

The neurotoxicity of elemental mercury (Hg 0 ) is well-recognized, but it is uncertain whether and for how long neurotoxicity persists; among studies that evaluated previously exposed workers, only one examined workers during and also years after exposure ceased. The aim of this review is to document the type, frequency, and dose-relatedness of objective neurological effects in currently exposed mercury workers and thereby provide first approximations of the effects one would have expected in previously exposed workers evaluated during exposure. We systematically reviewed studies of neurotoxicity in currently exposed mercury workers identified by searching MEDLINE (1950-2015), government reports, textbook chapters, and references cited therein; dental cohorts were not included. Outcomes on physical examination (PE), neurobehavioral (NB) tests, and electrophysiological studies were extracted and evaluated for consistency and dose-relatedness. Forty-five eligible studies were identified, comprising over 3000 workers chronically exposed to a range of Hg 0 concentrations (0.002-1.7 mg/m 3 ). Effects that demonstrated consistency across studies and increased frequency across urine mercury levels (<50; 50-99; 100-199; ≥200 μg/L) included tremor, impaired coordination, and abnormal reflexes on PE, and reduced performance on NB tests of tremor, manual dexterity and motor speed. The data suggest response thresholds of U Hg ≈275 μg/L for PE findings and ≈20 μg/L for NB outcomes. These results indicate that PE is of particular value for assessing workers with U Hg >200 μg/L, while NB testing is more appropriate for those with lower U Hg levels. They also provide benchmarks to which findings in workers with historical exposure can be compared.

Employment history indicators and mortality in a nested case-control study from the Spanish WORKing life social security (WORKss) cohort

PubMed Central

2017-01-01

Employment has transitioned from stable to more flexible schemes. Little is known about the effects of dynamic working lives and mortality. We examined the association of employment, unemployment and inactivity on mortality among workers born in 1926–1988, in a nested case-control study of workers from the Spanish WORKss cohort. Cases were all deaths that occurred during 2004–2013 and controls were living persons, matched for sex and age at the time the case occurred. We had information on employment from 1981 to 2013. Logistic regression was used to measure the associations between the 3 employment history indicators separately by sex. There were 53,989 cases and an equal number of controls (n = 107,978). More than 16 years employed showed a protective effect against mortality in women (OR = 0.88, 95%CI: 0.81, 0.94) and men (OR = 0.76, 95%CI: 0.70, 0.79). The number of spells and time in unemployment and inactivity were significantly related to mortality in men, but not women. Sensitivity analyses by labor relationship showed stronger associations of unemployment (OR = 1.42, 95%CI: 1.13, 1.78) and inactivity (OR = 1.34; 95%CI: 1.09, 1.65) for temporary workers. Employment gaps are detrimental to health and have worse effects if the gaps occur without unemployment benefits or after temporary contracts. These results may drive improvement of labor and social policies that protect workers against the potential negative effects of dynamic work lives. PMID:28570614

Occupation, exposure to chemicals, sensitizing agents, and risk of multiple myeloma in Sweden.

PubMed

Lope, Virginia; Pérez-Gómez, Beatriz; Aragonés, Nuria; López-Abente, Gonzalo; Gustavsson, Per; Plato, Nils; Zock, Jan-Paul; Pollán, Marina

2008-11-01

This study sought to identify occupations with high incidence of multiple myeloma and to investigate possible excess risk associated with occupational exposure to chemicals and sensitizing agents in Sweden. A historical cohort of 2,992,166 workers was followed up (1971--1989) through record linkage with the National Cancer and Death Registries. For each job category, age and period standardized incidence ratios and age and period adjusted relative risks of multiple myeloma were calculated using Poisson models. Exposure to chemicals and to sensitizing agents was also assessed using two job-exposure matrices. Men and women were analyzed separately. During follow-up, 3,127 and 1,282 myelomas were diagnosed in men and women, respectively. In men, excess risk was detected among working proprietors, agricultural, horticultural and forestry enterprisers, bakers and pastry cooks, dental technicians, stone cutters/carvers, and prison/reformatory officials. In women, this excess was observed among attendants in psychiatric care, metal workers, bakers and pastry cooks, and paper/paperboard product workers. Workers, particularly bakers and pastry cooks, exposed to high molecular weight sensitizing agents registered an excess risk of over 40% across the sexes. Occasional, although intense, exposure to pesticides was also associated with risk of myeloma in our cohort. Our study supports a possible etiologic role for farming and use of pesticides in myeloma risk. The high incidence found in both female and male bakers and pastry cooks has not been described previously. Further research is required to assess the influence of high molecular weight sensitizing agents on risk of multiple myeloma.

Serum profiles of PCDDs and PCDFs, in individuals near the Escambia Wood Treating Company Superfund site in Pensacola, FL.

PubMed

Karouna-Renier, Natalie K; Rao, K Ranga; Lanza, John J; Davis, Deeya A; Wilson, Patricia A

2007-10-01

The Escambia Wood Treating Company (ETC) Superfund site, Pensacola, FL, is contaminated with polychlorinated dibenzo-p-dioxins and polychlorinated dibenzofurans (PCDD/F), benzo(a)pyrene, lead and arsenic from pentachlorophenol (PCP), creosote, and other compounds used to treat utility poles and foundation pilings. Although ETC's operations ceased in 1982, soils in the areas surrounding the facility continue to exhibit elevated levels of contaminants attributable to ETC operations. In July 2000, individuals who may have been affected by contamination from the ETC site, including current and former residents and former workers and their household members were invited to participate in a study, which included a health and exposure history and routine blood analysis. We also conducted a toxicological health evaluation of a subset of these eligible workers/residents by analyzing serum levels of 17 PCDD/F congeners. Members of the ETC cohort exhibited elevated serum PCDD/F relative to the general population, and congener profiles in members of the cohort reflected patterns commonly observed in persons exposed to PCP. Hypertension prevalence in the cohort was found to correlate with PCDD/F levels, although no other significant relationships were identified with monitored health indices.

Cardiovascular Diseases Risk Factors in oil and gas workers: a ten years observational retrospective cohort.

PubMed

Mannocci, A; Pignalosa, S; Nicosia, V; Saulle, R; Sernia, S; La Torre, G

2016-01-01

The study aim was to examine the trend of major clinical biochemistry factors associated with cardiovascular diseases and dyslipidemia onset over a 10-year period (2000-2010) in Oil and Gas workers. The information extracted from "Computerized management of individual medical services database" regarding 439 Italian workers of an oil and gas company were analysed. A constant and significant increase of the average Body Mass Index and serum cholesterol were found, and in particular in workers < 36 years: BMI was 24.4 (2000) and 25.8 (2010) with p < 0.001, and cholesterol was 188.3 mg/dL (2000) and 206.5 mg/dL (2010) with p < 0.001. Analysed variables are the most important risk factor for cardiovascular, neurological and neoplastic diseases, as well as they reduce life expectancy. Occupational medicine in particular in extreme working environmental conditions, such as for workers in oil and gas companies, monitoring health status and promoting healthy life style, has a strategic role to perform cost-effective strategies to reduce health risks, thus improving the workers lifestyle.

Influence of Manual Labor at Work on Muscular Fitness and Its Relationship With Work Performance.

PubMed

Ryan, Eric D; Thompson, Brennan J; Sobolewski, Eric J

2016-10-01

The present study examined the influence of workplace manual labor on measures of muscular fitness, with a secondary aim to investigate the relationship between muscular fitness and work performance in blue-collar (BC) workers. Leg extension isokinetic strength at slow and fast velocities, hamstring and hip-flexor flexibility, and low back muscular endurance were examined in young and older BC workers and white-collar (WC) controls, while work performance was examined in the BC cohort. There were no differences in muscular fitness variables between BC and WC groups; however, the older men had lower low back muscular endurance (-43.0%) and strength at slow (-9.4%) and fast (-12.7%) velocities. Work performance was associated with strength at fast velocities (r = 0.633) in the older BC workers. Leg strength may influence work performance, with higher velocities becoming more important in older workers.

Psychosocial and organizational work factors and incidence of arterial hypertension among female healthcare workers: results of the Organisation des Soins et Santé des Soignants cohort.

PubMed

Lamy, Sébastien; De Gaudemaris, Régis; Lepage, Benoit; Sobaszek, Annie; Caroly, Sandrine; Kelly-Irving, Michelle; Lang, Thierry

2014-06-01

Many studies have supported the role of organizational work factors (OWFs) on the risk of cardiovascular diseases (CVDs) and CVD risk factors, including arterial hypertension. However, a little information is available concerning the role of collective stressors deriving from work organization on nurse's risk of hypertension. This study aimed to test the independent longitudinal relationships linking the 2-year incidence of arterial hypertension to collective stressors at the work unit level, among baseline normotensive female hospital registered nurses and nursing assistants, after adjusting for known individual predictors of CVDs and for occupational stress. Arterial hypertension was defined as the intake of antihypertensive drug or as blood pressure (BP) measures higher than 140  mmHg (SBP) or 90  mmHg (DBP) at both the clinical visit and 1 month later. We analyzed the effect of OWFs at the work unit level, constraints related to the physical work environment and the individual perception of the work environment in 2006 on the risk of arterial hypertension in 2008 among 1882 initially normotensive female healthcare workers followed in the French Organisation des soins et santé des soignants (ORSOSA) cohort. We showed that OWFs at the work unit level may influence the 2-year risk of arterial hypertension independently of work factors at the worker level, baseline BP, age and BMI. In this study, OWFs affected 2-year risk of arterial hypertension only through direct effects. Our results pointed out the possibility of a primary prevention of arterial hypertension through interventions based at the work unit level among healthcare workers.

Occupation and mesothelioma in Sweden: updated incidence in men and women in the 27 years after the asbestos ban

PubMed Central

Hillerdal, Gunnar

2016-01-01

OBJECTIVES We updated the Swedish component of the Nordic Occupational Cancer (NOCCA) Study through 2009 in order to investigate the incidence of mesothelioma of the peritoneum and pleura in both genders, and explored occupational exposures that may be associated with mesothelioma. METHODS The Swedish component of the NOCCA Study includes 6.78 million individuals. Data from this cohort were linked to the population-based Swedish Cancer Registry and Swedish Total Population Registry for three periods between 1961 and 2009, and then further linked to the Swedish NOCCA job-exposure matrix, which includes 25 carcinogenic substances and the corresponding exposure levels for 280 occupations. Multivariate analysis was used to calculate standardized incidence ratios (SIRs) for mesothelioma of the peritoneum and pleura by gender, occupational category, carcinogenic substance, and for multiple occupational exposures simultaneously. RESULTS A total of 3,716 incident mesotheliomas were recorded (21.1% in women). We found a significantly increased risk of mesothelioma in 24 occupations, as well as clear differences between the genders. Among men, increased risks of mesothelioma of the pleura were observed in male-dominated occupations, with the greatest elevation of risk among plumbers (SIR, 4.99; 95% confidence interval, 4.20 to 5.90). Among women, increased risks were observed in sewing workers, canning workers, packers, cleaners, and postal workers. In multivariate analysis controlling for multiple occupational exposures, significant associations were only observed between asbestos exposure and mesothelioma. CONCLUSIONS Asbestos exposure was associated with mesothelioma incidence in our study. The asbestos ban of 1982 has yet to show any clear effect on the occurrence of mesothelioma in this cohort. Among women, the occupations of canning workers and cleaners showed increased risks of mesothelioma of the pleura without evidence of asbestos exposure. PMID:27866405

[Shiftwork and health--experience from a chemical company].

PubMed

Oberlinner, C; Lang, S; Nasterlack, M; Yong, M

2013-03-01

Shiftwork is an essential part of our society. At the same time scientific evaluations demonstrate possible negative effects of shiftwork on the health status of the employees. Against this background we performed different studies to evaluate these effects within the specific shift system in a large chemical site in Germany. METHODS AND STUDY GROUP: To evaluate the impact of the different working times on job-related stress perception and work-life-balance we performed a cross-sectional study with 1494 blue collar workers (825 shift- and 669 day workers). Employees working in the rotating shift system reported lower frequencies of perceived time pressure (p = 0.008), and lower stress levels (p = 0.01), compared to the day workers. No significant difference was found with regard to work-life-balance and other aspects of job-related stress perception within both groups. Against the general opinion and study-results in the past we did not find a negative effect of our shift-system on self-reported stress. These results are in accordance with results of other cohort-studies on the specific shift system within the company demonstrating no difference in the health status of our shift workers compared to day workers. © Georg Thieme Verlag KG Stuttgart · New York.

Estimates of Radiation Effects on Cancer Risks in the Mayak Worker, Techa River and Atomic Bomb Survivor Studies.

PubMed

Preston, Dale L; Sokolnikov, Mikhail E; Krestinina, Lyudmila Yu; Stram, Daniel O

2017-04-01

For almost 50 y, the Life Span Study cohort of atomic bomb survivor studies has been the primary source of the quantitative estimates of cancer and non-cancer risks that form the basis of international radiation protection standards. However, the long-term follow-up and extensive individual dose reconstruction for the Russian Mayak worker cohort (MWC) and Techa River cohort (TRC) are providing quantitative information about radiation effects on cancer risks that complement the atomic bomb survivor-based risk estimates. The MWC, which includes ~26 000 men and women who began working at Mayak between 1948 and 1982, is the primary source for estimates of the effects of plutonium on cancer risks and also provides information on the effects of low-dose rate external gamma exposures. The TRC consists of ~30 000 men and women of all ages who received low-dose-rate, low-dose exposures as a consequence of Mayak's release of radioactive material into the Techa River. The TRC data are of interest because the exposures are broadly similar to those experienced by populations exposed as a consequence of nuclear accidents such as Chernobyl. In this presentation, it is described the strengths and limitations of these three cohorts, outline and compare recent solid cancer and leukemia risk estimates and discussed why information from the Mayak and Techa River studies might play a role in the development and refinement of the radiation risk estimates that form the basis for radiation protection standards. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Prevalence of Symptoms of Depression, Anxiety, and Posttraumatic Stress Disorder in Workers With Upper Extremity Complaints.

PubMed

Degen, Ryan M; MacDermid, Joy C; Grewal, Ruby; Drosdowech, Darren S; Faber, Kenneth J; Athwal, George S

2016-07-01

Study Design Cross-sectional cohort study. Background Symptoms of depression, panic disorder (PD), and posttraumatic stress disorder (PTSD) have been associated with musculoskeletal complaints and could represent barriers to recovery in injured workers. Objectives To determine the prevalence of symptoms of depression, PD, and PTSD utilizing the Patient Health Questionnaire (PHQ) in a cohort of patients presenting to an upper extremity injured-worker clinic; secondarily, to identify any relationships between patients screening positive and patient-reported outcome measures. Methods In 2010, 418 patients completed the PHQ during their initial evaluation. Patients with PHQ scores exceeding threshold values for symptoms of depression, PD, or PTSD were compared based on patient-reported outcome scores, including the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH) and Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). The prevalence of symptoms, and their relationship with presenting complaints and patient-reported outcomes, were calculated. Results Thirty-one percent of patients scored above thresholds for symptoms of at least 1 mental health disorder. Of those who screened positive, 67% screened positive for depression, 44% for PTSD, and 50% for PD, with 43% of patients positive for multiple symptoms. Patients experiencing neck pain had significantly higher screening rates of depressive symptoms (62.5% versus 20.1%, P = .004) and PD (37.5% versus 12.9%, P = .044) compared with other presenting complaints. Similarly, patients with chronic pain had higher rates of depression (54.5% versus 20.1%, P = .006), PD (63.6% versus 12%, P<.001), and PTSD (36.4% versus 14.8%, P = .05) compared with other presenting complaints. Patients endorsing depressive symptoms had significantly lower SF-36 mental component summary scores (26.3 ± 10.7 versus 37.6 ± 9.9, P<.001) and higher shortened-version DASH (72.3 ± 16.7 versus 61.5 ± 11.1, P = .003) and DASH work scores (86.5 ± 19.2 versus 82.1 ± 20.1, P = .007) compared to patients endorsing other items on the PHQ. Conclusion In this prospective cohort study of injured workers, we identified a relatively high prevalence of symptoms of psychological disorders utilizing the PHQ, with one third of injured workers screening positive for symptoms of depression, PD, or PTSD. Further longitudinal follow-up is necessary to determine the impact on treatment outcomes. Level of Evidence Symptom prevalence, level 1b. J Orthop Sports Phys Ther 2016;46(7):590-595. Epub 12 May 2016. doi:10.2519/jospt.2016.6265.

Depleted and enriched uranium exposure quantified in former factory workers and local residents of NL Industries, Colonie, NY USA.

PubMed

Arnason, John G; Pellegri, Christine N; Moore, June L; Lewis-Michl, Elizabeth L; Parsons, Patrick J

2016-10-01

Between 1958 and 1982, NL Industries manufactured components of enriched (EU) and depleted uranium (DU) at a factory in Colonie NY, USA. More than 5 metric tons of DU was deposited as microscopic DU oxide particles on the plant site and surrounding residential community. A prior study involving a small number of individuals (n=23) indicated some residents were exposed to DU and former workers to both DU and EU, most probably through inhalation of aerosol particles. Our aim was to measure total uranium [U] and the uranium isotope ratios: (234)U/(238)U; (235)U/(238)U; and (236)U/(238)U, in the urine of a cohort of former workers and nearby residents of the NLI factory, to characterize individual exposure to natural uranium (NU), DU, and EU more than 3 decades after production ceased. We conducted a biomonitoring study in a larger cohort of 32 former workers and 99 residents, who may have been exposed during its period of operation, by measuring Total U, NU, DU, and EU in urine using Sector Field Inductively Coupled Plasma - Mass Spectrometry (SF-ICP-MS). Among workers, 84% were exposed to DU, 9% to EU and DU, and 6% to natural uranium (NU) only. For those exposed to DU, urinary isotopic and [U] compositions result from binary mixing of NU and the DU plant feedstock. Among residents, 8% show evidence of DU exposure, whereas none shows evidence of EU exposure. For residents, the [U] geometric mean is significantly below the value reported for NHANES. There is no significant difference in [U] between exposed and unexposed residents, suggesting that [U] alone is not a reliable indicator of exposure to DU in this group. Ninety four percent of workers tested showed evidence of exposure to DU, EU or both, and were still excreting DU and EU decades after leaving the workforce. The study demonstrates the advantage of measuring multiple isotopic ratios (e.g., (236)U/(238)U and (235)U/(238)U) over a single ratio ((235)U/(238)U) in determining sources of uranium exposure. Copyright © 2016 Elsevier Inc. All rights reserved.

Experiences of work ability in young workers: an exploratory interview study.

PubMed

Boström, Maria; Holmgren, Kristina; Sluiter, Judith K; Hagberg, Mats; Grimby-Ekman, Anna

2016-05-01

The aim of this study was to explore the experiences of and influences on work ability in young workers related to their work and life situation. In a qualitative study of a strategic sample of 12 young female and 12 young male workers, aged 25-30 years, in work or recently left work, recruited from the 5-year follow-up of a Swedish cohort, semi-structured interviews were performed to explore the experiences of work ability in these young workers. Systematic text condensation inspired by phenomenology was used in the analysis. Work ability was experienced as complex, consisting of four themes, each with three subthemes. To be alert and have energy, to possess sufficient education, skills and working life experience and experience meaningfulness and engagement in work, were perceived to be fundamental for work ability and were seen as the worker's own responsibility. Moreover, work ability can be improved or reduced by the psychosocial work climate, the work organization and the private life. Optimal work ability was experienced when all themes integrated in a positive way. Work ability was experienced as the worker's own responsibility that could be influenced by work circumstances and private life. To promote good work ability among young workers, work ability has to be understood in its specific context. Whether the understanding of work ability found in this study is explicit for the group of young adults needs to be explored in a more general population in further research.

Hepatitis E, Helicobacter pylori, and gastrointestinal symptoms in workers exposed to waste water

PubMed Central

Jeggli, S; Steiner, D; Joller, H; Tschopp, A; Steffen, R; Hotz, P

2004-01-01

Background: Workers exposed to sewage may have an increased risk of infection by Helicobacter pylori and hepatitis E virus (HEV). Aims: To assess the prevalence of clinical hepatitis E (HE) and peptic ulcer disease as well as the seroprevalence of antibodies to H pylori and HEV in workers with and without sewage exposure and to look for symptoms due to exposure to endotoxin. Methods: In the first year of a prospective cohort study 349 sewage exposed workers and 429 municipal manual workers (participation: 61%) underwent a complete medical examination. Travelling to endemic areas, socioeconomic level, age, country in which childhood was spent, and number of siblings were considered as the main confounding factors. Results: Peptic ulcer disease and clinical HE did not occur more often in workers exposed to sewage. Prevalence of antibodies to HEV was 3.3% and overall prevalence of IgG antibodies to H pylori was 42% with large differences between subgroups. Logistic regression did not show an increased risk of seropositivity or antibodies to parietal cells in sewage exposed workers, but disentangling the effect of exposure from that of confounders was extremely difficult. No increase of symptoms due to exposure to endotoxin was found in sewage workers, with the exception of diarrhoea. Conclusions: No clear increased risk of infection by H pylori or by HEV in workers exposed to sewage was found in this cross-sectional study, but these results need to be confirmed by follow up. PMID:15208379

Letter in reference to: "Short-term effects of night shift work on breast cancer risk: a cohort study of payroll data".

PubMed

Stevens, Richard G

2017-01-01

There are major flaws with the analyses in the Vistisen et al (1) cohort study examining if night shift work is a short-term risk factor for breast cancer. The crucial problem is the potential for exposure misclassification, which is very high. The authors' definition of day shift is "≥3 hours of work between 06:00-20:00 hours". This means that a worker on an 8-hour shift that begins at 03:00 hours would be classified as a day rather than night shift worker because he/she worked only two hours between 24:00-05:00 hours. Similarly, a second shifter might start work at 17:00 but not get off until 01:00 and yet still be classified as a "day shift" worker. This does not make sense as a baseline comparison group "unexposed" to work during the night hours. A sensible classification system would be to define "day shift" as any shift that begins after 07:00 and ends before 18:00 hours. This is straightforward and avoids all of the ambiguities inherent in the definition used by the authors. In addition, the authors claim that the "inception population" is less likely to have had past prior non-day work hours. However, this group has an average age of >35 years. It is inconceivable that all of these women were new graduates who started a public health sector job for the first time. Rather, the majority must surely have worked elsewhere for many years but then started in the regions covered only after 2006. This topic is too important, and this cohort too valuable, not to carefully define the baseline comparison group of "day workers" in a sensible manner. All the inferences rely crucially on this definition. The authors have the data to define the day-working baseline group in a way that avoids these obvious biases. That is why it is so frustrating that the authors chose to conduct the analyses as they did, with a highly flawed definition of "day work", when they could have done so much better. A highly flawed epidemiological report is worse than no report at all because it misleads the scientific community and the public. Reference 1. Vistisen HT, Garde AH, Frydenberg M, Christiansen P, Hansen ÅM, Hansen J, Bonde JPE, Kolstad HA. Short-term effects of night shift work on breast cancer risk: a cohort study of payroll data. Scand J Work Environ Health - online first. http://dx.doi.org/10.5271/sjweh.3603.

Mortality of a cohort of workers in the styrene-butadiene polymer manufacturing industry (1943-1982).

PubMed Central

Matanoski, G M; Santos-Burgoa, C; Schwartz, L

1990-01-01

A cohort of 12,110 male workers employed 1 or more years in eight styrene-butadiene polymer (SBR) manufacturing plants in the United States and Canada has been followed for mortality over a 40-year period, 1943 to 1982. The all-cause mortality of these workers was low [standardized mortality ratio (SMR) = 0.81] compared to that of the general population. However, some specific sites of cancers had SMRs that exceeded 1.00. These sites were then examined by major work divisions. The sites of interest included leukemia and non-Hodgkin's lymphoma in whites. The SMRs for cancers of the digestive tract were higher than expected, especially esophageal cancer in whites and stomach cancer in blacks. The SMR for arteriosclerotic heart disease in black workers was significantly higher than would be expected based on general population rates. Employees were assigned to a work area based on job longest held. The SMRs for specific diseases differed by work area. Production workers showed increased SMRs for hematologic neoplasms and maintenance workers, for digestive cancers. A significant excess SMR for arteriosclerotic heart disease occurred only in black maintenance workers, although excess mortality from this disease occurred in blacks regardless of where they worked the longest. A significant excess SMR for rheumatic heart disease was associated with work in the combined, all-other work areas. For many causes of death, there were significant deficits in the SMRs. PMID:2401250

How many work-related injuries requiring hospitalization in British Columbia are claimed for workers' compensation?

PubMed

Alamgir, Hasanat; Koehoorn, Mieke; Ostry, Aleck; Tompa, Emile; Demers, Paul A

2006-06-01

Workplace compensation claims datasets represent an important source of information on work-related injuries. This study investigated the concordance between hospital discharge records and workers' compensation records for work-related serious injuries among a cohort of sawmill workers in British Columbia (BC), Canada. It also examined the extent to which workers' compensation capturing patterns varied by cause, severity of injuries, and demographic characteristics of workers. Work-related injuries were identified in hospitalization records between April 1989 and December 1998, and were matched by dates and description of injury to compensation records. The agreement between the hospital records and compensation records was good (kappa = 0.84, P < 0.01). A lower claim reporting rate for work-related hospitalization was observed for older and non-white workers. More serious injuries defined by longer length of stay and emergency admissions were more likely to be reported. Falls, struck against, and overexertion injuries had lower reporting rates; whereas, machinery-related, cutting/piercing, and caught in/between injuries had higher reporting rates. When compared with hospital discharge records, the compensation agency underreported incidents of serious work-related injuries by 10-15% among the sawmill workers.

Structural Barriers to Antiretroviral Therapy Among Sex Workers Living with HIV: Findings of a Longitudinal Study in Vancouver, Canada

PubMed Central

Goldenberg, Shira M.; Montaner, Julio; Duff, Putu; Nguyen, Paul; Dobrer, Sabina; Guillemi, Silvia; Shannon, Kate

2015-01-01

In light of limited data on structural determinants of access and retention in antiretroviral therapy (ART) among sex workers, we examined structural correlates of ART use among sex workers living with HIV over time. Longitudinal data were drawn from a cohort of 646 female sex workers in Vancouver, Canada (2010–2012) and linked pharmacy records on ART dispensation. We used logistic regression with generalized estimating equations (GEE) to examine correlates of gaps in ART use (i.e., treatment interruptions or delayed ART initiation), among sex workers living with HIV (n=74). Over a 2.5-year period, 37.8% of participants experienced gaps in ART use (i.e., no ART dispensed in a six-month period). In a multivariable GEE model, younger age, migration/mobility, incarceration, and non-injection drug use independently correlated with gaps in ART use. In spite of successes scaling-up ART in British Columbia, younger, mobile, or incarcerated sex workers face persistent gaps in access and retention irrespective of drug use. Community-based, tailored interventions to scale-up entry and retention in ART for sex workers should be further explored in this setting. PMID:26148850

Injuries in a modern dance company effect of comprehensive management on injury incidence and cost.

PubMed

Ojofeitimi, Sheyi; Bronner, Shaw

2011-09-01

Injury costs strain the finances of many dance companies. The objectives of this study were to analyze the effect of comprehensive management on injury patterns, incidence, and time loss and examine its financial impact on workers compensation premiums in a modern dance company. In this retrospective-prospective cohort study, injury was defined as any physical insult that required financial outlay (workers compensation or self insurance) or caused a dancer to cease dancing beyond the day of injury (time-loss injury). Injury data and insurance premiums were analyzed over an eight-year period. Injuries were compared using a mixed linear model with phase and gender as fixed effects. It was found that comprehensive management resulted in 34% decline in total injury incidence, 66% decrease in workers compensation claims, and 56% decrease in lost days. These outcomes achieved substantial savings in workers compensation premiums. Thus, this study demonstrates the effectiveness of an injury prevention program in reducing injury-related costs and promoting dancers' health and wellness in a modern dance company.

What is different about workers' compensation patients? Socioeconomic predictors of baseline disability status among patients with lumbar radiculopathy.

PubMed

Atlas, Steven J; Tosteson, Tor D; Hanscom, Brett; Blood, Emily A; Pransky, Glenn S; Abdu, William A; Andersson, Gunnar B; Weinstein, James N

2007-08-15

Combined analysis of 2 prospective clinical studies. To identify socioeconomic characteristics associated with workers' compensation in patients with an intervertebral disc herniation (IDH) or spinal stenosis (SpS). Few studies have compared socioeconomic differences between those receiving or not receiving workers' compensation with the same underlying clinical conditions. Patients were identified from the Spine Patient Outcomes Research Trial (SPORT) and the National Spine Network (NSN) practice-based outcomes study. Patients with IDH and SpS within NSN were identified satisfying SPORT eligibility criteria. Information on disability and work status at baseline evaluation was used to categorize patients into 3 groups: workers' compensation, other disability compensation, or work-eligible controls. Enrollment rates of patients with disability in a clinical efficacy trial (SPORT) and practice-based network (NSN) were compared. Independent socioeconomic predictors of baseline workers' compensation status were identified in multivariate logistic regression models controlling for clinical condition, study cohort, and initial treatment designation. Among 3759 eligible patients (1480 in SPORT and 2279 in NSN), 564 (15%) were receiving workers' compensation, 317 (8%) were receiving other disability compensation, and 2878 (77%) were controls. Patients receiving workers' compensation were less common in SPORT than NSN (9.2% vs. 18.8%, P < 0.001), but patients receiving other disability compensation were similarly represented (8.9% vs. 7.7%, P = 0.19). In univariate analyses, many socioeconomic characteristics significantly differed according to baseline workers' compensation status. In multiple logistic regression analyses, gender, educational level, work characteristics, legal action, and expectations about ability to work without surgery were independently associated with receiving workers' compensation. Clinical trials involving conditions commonly seen in patients with workers' compensation may need special efforts to ensure adequate representation. Socioeconomic characteristics markedly differed between patients receiving and not receiving workers' compensation. Identifying the independent effects of workers' compensation on outcomes will require controlling for these baseline characteristics and other clinical features associated with disability status.

Cancer incidence and mortality in workers employed at a transformer manufacturing plant: update to a cohort study.

PubMed

Yassi, Annalee; Tate, Robert B; Routledge, Michael

2003-07-01

This study is an extension of a previously published analysis of cancer mortality in a transformer manufacturing plant where there had been extensive use of mineral oil transformer fluid. The objectives of the present study were to update the mortality analysis and include deaths for the past 6 years as well as to do an analysis of cancer incidence of the cohort. A cohort of 2,222 males working at a transformer manufacturing plant between 1946 and 1975 was constructed. Using a classical historical cohort study design, cancer incidence and mortality were determined through record linkage with Canadian provincial and national registries. The rates of cancer incidence and mortality experienced by this cohort were compared to that of the Canadian male population. A statistically significant increased risk of developing and dying of pancreatic cancer was found but not an increase in overall cancer mortality. This was consistent with the previous report from this group. Interestingly, the cohort demonstrated a statistically significant risk of overall cancer incidence and specific increased incidence of gallbladder cancer. This study contributes further evidence to the growing body of literature indicating the carcinogenic properties of mineral oils used in occupational settings, in particular those used prior to 1970s. Copyright 2003 Wiley-Liss, Inc.

A 2-year cohort study on the impact of an Employee Assistance Programme (EAP) on depression and suicidal thoughts in male Japanese workers.

PubMed

Nakao, Mutsuhiro; Nishikitani, Mariko; Shima, Satoru; Yano, Eiji

2007-11-01

Depression and suicide-related behaviours are important issues for workers, and the number of Japanese companies contracting with the Employee Assistance Programme (EAP) to promote employees' mental health has recently increased. However, no longitudinal studies have reported that the EAP maintains or improves the overall level of depression among employees qualitatively. Thus, we attempted to assess the impact of the EAP on depression and suicide-related behaviours in the workplace. A cohort study was conducted on 283 male Japanese employees aged 22-38 years at a Japanese information-technology company introducing the EAP. Because the privacy policy of the EAP service made it difficult to perform a randomised design in the workplace, 22 men working at an affiliated company without the EAP were used as a reference group. All the subjects completed the 17-item Hamilton Depression Scale (HAM-D) and Job Content Questionnaire (JCQ) consisting of job demands, control, and social support before the EAP was introduced to establish a baseline and after 2 years. In the EAP group, the total HAM-D scores significantly decreased after the 2-year study period (P=0.0011); the changes in the scores of the five HAM-D items (i.e., suicidal thoughts, agitation, psychomotor retardation, guilt, and depressed mood) were significant. Specifically, 19 (86%) of the 22 workers with a positive response to the suicidal thoughts item (i.e., score >or= 1) at baseline reported that they no longer had suicidal thoughts (i.e., score=0) after the 2 year study period. No significant changes were observed in the reference group. The three JCQ scores were not significantly different between the baseline and after the 2 year study period in both groups. Although further studies are needed, EAPs may be a promising strategy for maintaining the good mental health of workers.

Incidence of surgically treated osteoarthritis in the hip and knee in male construction workers.

PubMed

Järvholm, B; From, C; Lewold, S; Malchau, H; Vingård, E

2008-04-01

Occupational workload has been associated with an increased risk of osteoarthritis. The objective was to further examine the association between workload and occurrence of osteoarthritis and in particular to study whether heavy workload has similar importance as a causative factor for osteoarthritis of the hip and knee. In a cohort study, the authors investigated the incidence of surgically treated osteoarthritis in the hip and knee among men employed in the Swedish construction industry (n = 204 741). Incident cases were found by linkage with the Swedish hospital discharge register between 1987 and 1998. Incidence rates adjusted for age and BMI were compared between different occupational groups. The incidence rates for osteoarthritis in hip and knee were positively correlated (r = 0.62; p = 0.01). There was a significantly increased risk of surgically treated osteoarthritis in the knee among floor layers, asphalt workers, sheet-metal workers, rock workers, plumbers, brick layers, wood workers and concrete workers. Even if there was a trend towards increased relative risks for osteoarthritis in the hip in floor layers, asphalt workers, wood workers and concrete workers they were not statistically significant. The relative risk for surgically treated osteoarthritis of the knee was 4.7 (95% CI 1.8 to 12.3) among floor layers, indicating an attributable fraction for work factors of 79%. This study shows that some work-related factors seem to be risk factors for osteoarthritis both in the knee and hip. However, the risk factors seem to be of greater importance for osteoarthritis in the knee compared with the hip. This study indicates that at least 50% of the cases of severe osteoarthritis of the knee can be prevented through decreasing occupational risk factors in some occupational groups.

Cancer mortality in a northern Italian cohort of rubber workers.

PubMed

Negri, E; Piolatto, G; Pira, E; Decarli, A; Kaldor, J; La Vecchia, C

1989-09-01

An analysis of the mortality of a cohort of 6629 workers employed from 1906 to 1981 in a rubber tyre factory in northern Italy (978 deaths and over 133,000 man-years at risk) showed that the all cause mortality ratio was slightly lower than expected (0.91). Overall cancer mortality was close to expected (275 v 259.4) but there were significant excess rates for two cancer sites: pleura (9 observed v 0.8 expected, which may be due to the use of fibre containing talc) and bladder (16 observed v 8.8 expected). Death rates were not raised for other sites previously associated with employment in the rubber industry, such as cancers of the lung and brain, leukaemias, or lymphomas. The substantially reduced relative risk of pleural cancer among workers first employed after 1940 (RR = 0.05 compared with before 1940) probably reflected improvements in working conditions over more recent periods. For cancer of the bladder, the relative risk was also lower for workers first engaged after 1940. Thus no appreciable risk for any disease was apparent for workers employed over the past four decades. Analysis for each of the 27 job categories showed a substantial excess for cancer of the pleura in the mechanical maintenance workers (4 observed v 0.17 expected); an excess of cancer of the lung (21 v 13.48) was also present in this job category.

Cancer mortality in a northern Italian cohort of rubber workers.

PubMed Central

Negri, E; Piolatto, G; Pira, E; Decarli, A; Kaldor, J; La Vecchia, C

1989-01-01

An analysis of the mortality of a cohort of 6629 workers employed from 1906 to 1981 in a rubber tyre factory in northern Italy (978 deaths and over 133,000 man-years at risk) showed that the all cause mortality ratio was slightly lower than expected (0.91). Overall cancer mortality was close to expected (275 v 259.4) but there were significant excess rates for two cancer sites: pleura (9 observed v 0.8 expected, which may be due to the use of fibre containing talc) and bladder (16 observed v 8.8 expected). Death rates were not raised for other sites previously associated with employment in the rubber industry, such as cancers of the lung and brain, leukaemias, or lymphomas. The substantially reduced relative risk of pleural cancer among workers first employed after 1940 (RR = 0.05 compared with before 1940) probably reflected improvements in working conditions over more recent periods. For cancer of the bladder, the relative risk was also lower for workers first engaged after 1940. Thus no appreciable risk for any disease was apparent for workers employed over the past four decades. Analysis for each of the 27 job categories showed a substantial excess for cancer of the pleura in the mechanical maintenance workers (4 observed v 0.17 expected); an excess of cancer of the lung (21 v 13.48) was also present in this job category. PMID:2789965

[Occupational injury incidence due to biological material in a tertiary referral public hospital in Santa Fe province].

PubMed

Huanca, Romina; Perretta, Luis; Lebensohn, Natalia; Di Paolo, Oscar; Pires, Miryam; Quaglia, Nora Beatriz

2016-01-01

Occupational accidents due to biological materials cause significant harm to workers and institutions. To estimate the risk of accidents in doctors and nurses at the Hospital Provincial del Centenario (HPC) and particularly in Emergency Medical Service (EMS) between 2009 and 2013. retrospective cohort study from the survey information of injuries by accidents with biohazard in doctors and nurses workers from HPC. medical workers reported 45.7% (95% CI 37.2 to 54.3%) of accidents and nurses 38.4% (from 30.3 to 47.1%). The incidence rate ratio (IRR) (doctors / nurses) (2009-2013) = 0.953 (0.661-1.373). EMS workers ages and seniority were significantly lower than those of other care areas taken together. Reports of accidents from the EMS were 34.1% (95% CI: 26.2 to 42.6%) of the total. EMS workers had age and seniority average significantly less than workers in other services. In EMS, the IRR (doctors / nurses) (2009-2013) = 6.337 (2.264 -17.733). SGM medical workers ages and seniority were significantly lower than those of nurses working in this service. The EMS was particularly vulnerable to occupational injuries, medical workers have a higher risk of accidents compared to nursing workers. The younger age and lower seniority of medical workers could be related at least partly to these findings.

Can lung cancer risk among nickel refinery workers be explained by occupational exposures other than nickel?

PubMed

Grimsrud, Tom K; Berge, Steinar R; Haldorsen, Tor; Andersen, Aage

2005-03-01

Exposures in nickel refineries represent complex chemical mixtures, but only the effect of nickel has been evaluated quantitatively in epidemiologic studies of nickel workers. For a Norwegian refinery, time- and department-specific exposure estimates were developed for arsenic, sulfuric acid mists, and cobalt in air on the basis of personal measurements and chemical data on raw materials and process intermediates. Exposure to asbestos, as well as employment in high-risk occupations outside the refinery, were assessed. We conducted a case-control study nested in a cohort of refinery workers, with 213 cases (diagnosed 1952-1995) and 525 age-matched controls. We analyzed lung cancer risk, adjusted for smoking, by cumulative exposure and duration of work. There was a substantial association between cumulative exposure to water-soluble nickel and lung cancer risk. Weaker effects were suggested for exposure to arsenic at the refinery and for occupational exposures outside the refinery for 15 years or more. No detectable excess risk was found for refinery exposure to asbestos or sulfuric acid mists, and no dose-related increase in risk was seen from cobalt. Exposure to water-soluble nickel remained the most likely explanation for the excess lung cancer risk in the cohort. Other occupational exposures did not confound the strong dose-related effect of nickel to any appreciable degree.

Quantitative cancer risk assessment for ethylene oxide inhalation in occupational settings.

PubMed

Valdez-Flores, Ciriaco; Sielken, Robert L; Teta, M Jane

2011-10-01

The estimated occupational ethylene oxide (EO) exposure concentrations corresponding to specified extra risks are calculated for lymphoid mortality as the most appropriate endpoint, despite the lack of a statistically significant exposure-response relationship. These estimated concentrations are for occupational exposures--40 years of occupational inhalation exposure to EO from age 20 to age 60 years. The estimated occupational inhalation exposure concentrations (ppm) corresponding to specified extra risks of lymphoid mortality to age 70 years in a population of male and female EO workers are based on Cox proportional hazards models of the most recent updated epidemiology cohort mortality studies of EO workers and a standard life-table calculation. An occupational exposure at an inhalation concentration of 2.77 ppm EO is estimated to result in an extra risk of lymphoid mortality of 4 in 10,000 (0.0004) in the combined worker population of men and women from the two studies. The corresponding estimated concentration decreases slightly to 2.27 ppm when based on only the men in the updated cohorts combined. The difference in these estimates reflects the difference between combining all of the available data or focusing on only the men and excluding the women who did not show an increase in lymphoid mortality with EO inhalation exposure. The results of sensitivity analyses using other mortality endpoints (all lymphohematopoietic tissue cancers, leukemia) support the choice of lymphoid tumor mortality for estimation of extra risk.

The reciprocal relationship between sickness presenteeism and psychological distress in response to job stressors: evidence from a three-wave cohort study.

PubMed

Oshio, Takashi; Tsutsumi, Akizumi; Inoue, Akiomi; Suzuki, Tomoko; Miyaki, Koichi

2017-11-25

Sickness presenteeism (SP) is postulated as workers' response to their general state of health; hence, SP is expected to affect workers' future health. In the present study, we examined the reciprocal relationship between SP and health in response to job stressors, with specific reference to psychological distress (PD) as workers' state of health. We conducted mediation analysis, using data from a three-wave cohort occupational survey conducted at 1-year intervals in Japan; it involved 1,853 employees (1,661 men and 192 women) of a manufacturing firm. We measured SP and PD, using the World Health Organization Health and Work Performance Questionnaire and Kessler 6 score, respectively. For job stressors, we considered job demands and control, effort and reward, and procedural and interactional justice. PD mediated 11.5%-36.2% of the impact of job control, reward, and procedural and interactional justice on SP, whereas SP mediated their impact on PD, albeit to a much lesser extent in the range of 3.4%-11.3%. Unlike in the cases of these job stressors related to job resources, neither SP nor PD mediated the impact of job demands or effort. Our results confirmed the reciprocal relationship between SP and PD in response to selected types of job stressors, emphasizing the need for more in-depth analysis of the dynamics of these associations.

Short-term effects of night shift work on breast cancer risk: a cohort study of payroll data.

PubMed

Vistisen, Helene Tilma; Garde, Anne Helene; Frydenberg, Morten; Christiansen, Peer; Hansen, Åse Marie; Andersen, Johnni; Bonde, Jens Peter E; Kolstad, Henrik A

2017-01-01

Objectives The objective was to examine if night shift work is a short-term risk factor for breast cancer, including combined estrogen receptor (ER) and human epidermal growth factor 2 (HER2) breast cancer subtypes. Methods The cohort comprised 155 540 public sector female workers in Denmark who were followed from 2007-2012. Day-to-day work-hour information was available from payroll registers and 1245 incident cases of breast cancer were identified in national cancer registries together with receptor subtype information. Results A rate ratio (RR) of 0.90 [95% confidence interval (95% CI) 0.80-1.01] was observed for workers ever working night shifts during the follow-up period compared with workers only working day shifts after adjustment for age, age at first child, parity, family history of breast or ovarian cancer, sex hormones, medications related to alcoholism, family educational level, mammography screening, and other potential confounders. Comparable results were seen for the inception population of employees with first recorded employment after 2007. Modestly increased RR were suggested for breast cancer subtypes characterized by a positive HER2 status irrespective of ER status. Conclusions These findings do not support an overall short-term effect of night shift work on breast cancer risk. Future studies should explore further the impact of HER2 status.

DNA-damage response associated with occupational exposure, age and chronic inflammation in workers in the automotive industry.

PubMed

Savina, Natalya V; Smal, Marharyta P; Kuzhir, Tatyana D; Ershova-Pavlova, Alla A; Goncharova, Roza I

2012-10-09

The evaluation of genome integrity in populations occupationally exposed to combine industrial factors is of medical importance. In the present study, the DNA-damage response was estimated by means of the alkaline comet assay in a sizeable cohort of volunteers recruited among workers in the automotive industry. For this purpose, freshly collected lymphocytes were treated with hydrogen peroxide (100μM, 1min, 4°C) in vitro, and the levels of basal and H(2)O(2)-induced DNA damage, and the kinetics and efficiency of DNA repair were measured during a 180-min interval after exposure. The parameters studied in the total cohort of workers were in a range of values prescribed for healthy adult residents of Belarus. Based on the 95th percentiles, individuals possessing enhanced cellular sensitivity to DNA damage were present in different groups, but the frequency was significantly higher among elderly persons and among individuals with chronic inflammatory diseases. The results indicate that the inter-individual variations in DNA-damage response should be taken into account to estimate adequately the environmental genotoxic effects and to identify individuals with an enhanced DNA-damage response due to the influence of some external factors or intrinsic properties of the organism. Underling mechanisms need to be further explored. © 2012 Elsevier B.V. All rights reserved.

Cancer in printing workers in Denmark.

PubMed Central

Lynge, E; Rix, B A; Villadsen, E; Andersen, I; Hink, M; Olsen, E; Møller, U L; Silfverberg, E

1995-01-01

OBJECTIVES--To study the cancer incidence in printing workers in Denmark. METHODS--The cohort of 15,534 men and 3593 women working in the printing industry in 1970 were followed up for death, emigrations, and incident cancer cases until the end of 1987. Their cancer incidence was compared with that of all economically active people in Denmark. The smoking and drinking habits reported by members of the printing trade unions at a survey in 1972 were compared with habits reported by members of other trade unions. RESULTS--Lung, bladder, renal pelvis, and primary liver cancers were in excess among the printing workers. The excess risks of lung cancer among the factory workers in newspaper and magazine production, of bladder cancer in typographers in printing establishments, of renal pelvis cancer in typographers and lithographers, and of primary liver cancer among lithographers and bookbinders exceeded those expected based on the reported smoking and drinking habits. CONCLUSION--Our results indicate, in line with a previous study from Manchester, that work with rotary letterpress printing was associated with an increased risk of lung cancer. The inconsistent results from studies on bladder cancer in printing workers may point to a risk confined to a certain subgroup. The sixfold risk of primary liver cancer in Danish lithographers warrants studies in other countries. PMID:8535493

Estimating exposures in the asphalt industry for an international epidemiological cohort study of cancer risk.

PubMed

Burstyn, Igor; Boffetta, Paolo; Kauppinen, Timo; Heikkilä, Pirjo; Svane, Ole; Partanen, Timo; Stücker, Isabelle; Frentzel-Beyme, Rainer; Ahrens, Wolfgang; Merzenich, Hiltrud; Heederik, Dick; Hooiveld, Mariëtte; Langård, Sverre; Randem, Britt G; Järvholm, Bengt; Bergdahl, Ingvar; Shaham, Judith; Ribak, Joseph; Kromhout, Hans

2003-01-01

An exposure matrix (EM) for known and suspected carcinogens was required for a multicenter international cohort study of cancer risk and bitumen among asphalt workers. Production characteristics in companies enrolled in the study were ascertained through use of a company questionnaire (CQ). Exposures to coal tar, bitumen fume, organic vapor, polycyclic aromatic hydrocarbons, diesel fume, silica, and asbestos were assessed semi-quantitatively using information from CQs, expert judgment, and statistical models. Exposures of road paving workers to bitumen fume, organic vapor, and benzo(a)pyrene were estimated quantitatively by applying regression models, based on monitoring data, to exposure scenarios identified by the CQs. Exposures estimates were derived for 217 companies enrolled in the cohort, plus the Swedish asphalt paving industry in general. Most companies were engaged in road paving and asphalt mixing, but some also participated in general construction and roofing. Coal tar use was most common in Denmark and The Netherlands, but the practice is now obsolete. Quantitative estimates of exposure to bitumen fume, organic vapor, and benzo(a)pyrene for pavers, and semi-quantitative estimates of exposure to these agents among all subjects were strongly correlated. Semi-quantitative estimates of exposure to bitumen fume and coal tar exposures were only moderately correlated. EM assessed non-monotonic historical decrease in exposures to all agents assessed except silica and diesel exhaust. We produced a data-driven EM using methodology that can be adapted for other multicenter studies. Copyright 2003 Wiley-Liss, Inc.

A Developmental Study of Parenting Attitudes in England and the USA: A Cross National Study.

ERIC Educational Resources Information Center

Wynn, Ruth L.

Investigated as a function of adults' birth cohort--a group of adults born during a specific time period--were beliefs influencing current attitudes toward parenting that prevail in England and the United States. Particular attention was given to the value attached to parental role in relation to the specific roles of spouse and worker. The total…

Early Predictors of Occupational Back Re-Injury: Results from a Prospective Study of Workers in Washington State

PubMed Central

Keeney, Benjamin J.; Turner, Judith A.; Fulton-Kehoe, Deborah; Wickizer, Thomas M.; Chan, Kwun Chuen Gary; Franklin, Gary M.

2014-01-01

Study Design Prospective population-based cohort study Objective To identify early predictors of self-reported occupational back re-injury within 1 year after work-related back injury Summary of Background Data Back injuries are the costliest and most prevalent disabling occupational injuries in the United States. A substantial proportion of workers with back injuries have re-injuries after returning to work, yet there are few studies of risk factors for occupational back re-injuries. Methods We aimed to identify the incidence and early (in the claim) predictors of self-reported back re-injury by approximately 1 year after the index injury among Washington State workers with new work disability claims for back injuries. The Washington Workers’ Compensation Disability Risk Identification Study Cohort (D-RISC) provided a large, population-based sample with information on variables in seven domains: sociodemographic, employment-related, pain and function, clinical status, health care, health behavior, and psychological. We conducted telephone interviews with workers 3 weeks and 1 year after submission of a time-loss claim for the injury. We first identified predictors (p-values < 0.10) of self-reported re-injury within 1 year in bivariate analyses. Those variables were then included in a multivariate logistic regression model predicting occupational back re-injury. Results 290 (25.8%) of 1,123 (70.0% response rate) workers who completed the one-year follow-up interview and had returned to work reported having re-injured their back at work. Baseline variables significantly associated with re-injury (p-value < 0.05) in the multivariate model included male gender, constant whole body vibration at work, a history of previous similar injury, 4 or more previous claims of any type, possessing health insurance, and high fear-avoidance scores. Baseline obesity was associated with reduced odds of re-injury. No other employment-related or psychological variables were significant. Conclusion One-fourth of workers who received work disability compensation for a back injury self-reported re-injury after returning to work. Baseline variables in multiple domains predicted occupational back re-injury. Increased knowledge of early risk factors for re-injury may help lead to interventions, such as efforts to reduce fear-avoidance and graded activity to promote recovery, effective in lowering the risk of re-injury. PMID:22772568

Site-specific cancer mortality inequalities by employment and occupational groups: a cohort study among Belgian adults, 2001-2011.

PubMed

Vanthomme, Katrien; Van den Borre, Laura; Vandenheede, Hadewijch; Hagedoorn, Paulien; Gadeyne, Sylvie

2017-11-12

This study probes into site-specific cancer mortality inequalities by employment and occupational group among Belgians, adjusted for other indicators of socioeconomic (SE) position. This cohort study is based on record linkage between the Belgian censuses of 1991 and 2001 and register data on emigration and mortality for 01/10/2001 to 31/12/2011. Belgium. The study population contains all Belgians within the economically active age (25-65 years) at the census of 1991. Both absolute and relative measures were calculated. First, age-standardised mortality rates have been calculated, directly standardised to the Belgian population. Second, mortality rate ratios were calculated using Poisson's regression, adjusted for education, housing conditions, attained age, region and migrant background. This study highlights inequalities in site-specific cancer mortality, both related to being employed or not and to the occupational group of the employed population. Unemployed men and women show consistently higher overall and site-specific cancer mortality compared with the employed group. Also within the employed group, inequalities are observed by occupational group. Generally manual workers and service and sales workers have higher site-specific cancer mortality rates compared with white-collar workers and agricultural and fishery workers. These inequalities are manifest for almost all preventable cancer sites, especially those cancer sites related to alcohol and smoking such as cancers of the lung, oesophagus and head and neck. Overall, occupational inequalities were less pronounced among women compared with men. Important SE inequalities in site-specific cancer mortality were observed by employment and occupational group. Ensuring financial security for the unemployed is a key issue in this regard. Future studies could also take a look at other working regimes, for instance temporary employment or part-time employment and their relation to health. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Mortality among workers in a nickel refinery and alloy manufacturing plant in West Virginia.

PubMed

Enterline, P E; Marsh, G M

1982-06-01

Workers from a nickel refinery at Huntington, W. Va., which received a nickel matte from smelters in Ontario, Canada, during 1922-47 were studied for excesses in sinonasal and lung cancers. Other workers who were in a nickel alloy production plant operated in conjunction with the refinery but who did not work in the refinery were also studied. Evidence is presented on the existence of a nasal cancer hazard and possibly a lung cancer hazard among workers employed in the nickel refinery. Two of these workers developed a sinonasal cancer. Evidence of a respiratory cancer hazard in other parts of the plant before or after 1947 is weak, and the observed results could be due to chance variations from the mortality experience of the standard reference populations. Among nonrefinery workers hired while the nickel refinery was in operation, 2 employees had a probable sinonasal cancer. The first employee worked in a high-temperature conversion process where nickel carbonate was decomposed to nickel oxide, and the second employee is believed to have done maintenance work in the plant where this process was used. For both cohorts combined there were slight overall excesses in lung, stomach, and prostate cancers with some evidence of a dose-response relationship for these cancers.

Occupational factors associated with the potential years of working life lost due to a non-work related permanent disability.

PubMed

Duran, Xavier; Martínez, José Miguel; Benavides, Fernando G

2013-01-01

To analyze the association between occupational factors (number of contracts and occupational category) and potential years of working life lost (PYWLL) due to non-work related permanent disability (PD). The study design was a retrospective cohort of 11,812 workers affiliated with the Social Security System in Spain that began a non-work related PD between 2004 and 2009. The PYWLL was defined as the time in years between the age at which a worker initiates a PD and age 65 or the age of reinstatement to a job. The PYWLL was analyzed by calculating the quartiles and using an approach based on a median regression. The difference in medians of PYWLL between men and women was 2.49 years (95% CI: 2.01-2.97); between skilled non-manual and unskilled manual workers was 1.88 years (95% CI: 1.08-2.69); between workers with three or more contracts and workers with a single contract in the period was 3.78 years (95% CI: 3.28-4.29). Women, non-skilled workers and employees that have had more contracts within the period of study are those with greatest loss of PYWLL. This suggests that individuals with poorer working and employment conditions could have more PYWLL.

A 12 year prospective study of circulatory disease among Danish shift workers.

PubMed

Tüchsen, F; Hannerz, H; Burr, H

2006-07-01

Previous studies of the risk of heart disease after shift work reached different estimates and review authors disagree about the validity of some of the studies. A cross sectional study showed that shift workers had a higher prevalence of nearly every unfavourable work environment factor investigated. Conflicts at work and low decision latitude were more frequent among shift workers, and all-day walking or standing work and part-time jobs were more often found among female shift workers. To estimate the risk of circulatory disease in a prospective follow up of a representative sample of gainfully employed Danes, considering known or suspected confounding factors. A cohort of 5517 people who were gainfully employed in 1990 were followed up for all hospital treatments due to circulatory diseases (390-458, ICD-8; I00-I99, ICD-10) from 1991 to 2002 inclusive. A log linear Poisson regression model was applied to control confounding factors and calculate the relative risk for 927 men and women working nights, evenings, or other non-day shifts compared to 4579 day workers. Non-day workers compared to day workers had a relative risk (RR) for all circulatory diseases of 1.31 (95% CI 1.06-1.63). Without control for BMI and smoking, the RR estimate was 1.33 (95% CI 1.07-1.65). For a subgroup of workers with at least three years' seniority, the RR was 1.40 (95% CI 1.09-1.81). The population based aetiological fraction of shift work was estimated to 5%. This study adds to a growing body of evidence suggesting that shift work carries an excess risk of circulatory diseases.

Importance of nasal clipping in screening investigations of flow volume curve.

PubMed

Yanev, I

1992-01-01

Comparative analysis of some basic lung indices obtained from a screening investigation of the flow volume curve by using two techniques, with a nose clip and without a nose clip, was made on a cohort of 86 workers in a factory shop for the production of bearings. We found no statistically significant differences between the indices obtained by the two techniques. Our study showed that the FVC and FEV1 obtained in workers without using nose clips were equal to or better than those obtained using nose clips in 60% of the workers. The reproducibility of the two methods was similar. The analysis of the data has shown that the flow volume curve investigation gives better results when performed without a nose clip, especially in industrial conditions.

Effect of the National Stress Check Program on mental health among workers in Japan: A 1-year retrospective cohort study.

PubMed

Imamura, Kotaro; Asai, Yumi; Watanabe, Kazuhiro; Tsutsumi, Akizumi; Shimazu, Akihito; Inoue, Akiomi; Hiro, Hisanori; Odagiri, Yuko; Yoshikawa, Toru; Yoshikawa, Etsuko; Kawakami, Norito

2018-04-18

This retrospective cohort study evaluated the impact of the Stress Check Program, a recently introduced national policy and program aimed at reducing psychological distress among Japanese workers. A baseline survey was conducted from November 2015 to February 2016, the period when Japan began enforcing the Stress Check Program. A one-year follow-up survey was conducted in December 2016. In the follow-up survey, two exposure variables were collected: having taken the annual stress survey, and experiencing an improvement in the psychosocial work environment. Psychological distress was assessed using the Brief Job Stress Questionnaire (BJSQ) at baseline and 1-year follow-up. The two exposure variables were used to define four groups: "Neither", "Stress survey (SS) only", "Psychosocial work environment improvement (WI) only", and "Both". BJSQ results were analyzed using repeated measures general linear modeling (GLM). The study included 2,492 participants: 1,342 in the "Neither" group, 1,009 in the "SS only" group, 76 in the "WI only" group, and 65 in the "Both" group. Overall time-group interaction effects were not significant. The "Both" group showed significantly greater improvements in psychological distress than the "Neither" group (p = 0.02) at the 1-year follow-up, although the effect size was small (d = -0.14). Combination of the annual stress survey and improvement in psychosocial work environment may have been effective in reducing psychological distress in workers, although the effect size was small.

THE UKRAINIAN-AMERICAN STUDY OF LEUKEMIA AND RELATED DISORDERS AMONG CHORNOBYL CLEANUP WORKERS FROM UKRAINE: III. RADIATION RISKS

PubMed Central

Romanenko, A.Ye.; Finch, S.; Hatch, M.; Lubin, J.; Bebeshko, V.G.; Bazyka, D.A.; Gudzenko, N.; Dyagil, I.S.; Reiss, R.; Bouville, A.; Chumak, V.V.; Trotsiuk, N.K.; Babkina, N.G.; Belayev, Y.; Masnyk; Ron, E.; Howe, G.R.; Zablotska, L.B.

2010-01-01

Leukemia is one of the cancers most susceptible to induction by ionizing radiation, but the effects of lower doses delivered over time have not been adequately quantified. Following the Chornobyl (Chernobyl) accident in Ukraine in April 1986, several hundred thousand workers who were involved in cleaning up the site and its surroundings received fractionated exposure, primarily from external gamma radiation. To increase our understanding of the role of protracted low-dose radiation exposure in the etiology of leukemia, we conducted a nested case-control study of leukemia in a cohort of cleanup workers identified from the Chornobyl State Registry of Ukraine. The analysis is based on 71 cases of histologically confirmed leukemia diagnosed in 1986–2000 and 501 age- and residence-matched controls selected from the same cohort. Study subjects or their proxies were interviewed about their cleanup activities and other relevant factors. Individual bone marrow radiation doses were estimated by the RADRUE dose reconstruction method (mean dose=76.4 (SD=213.4) milligray (mGy)). We used conditional logistic regression to estimate leukemia risks. The excess relative risk of total leukemia was 3.44 per Gy (95% confidence interval 0.47–9.78, p<0.01). The dose-response was linear and did not significantly differ by calendar period of first work in the 30-km Chornobyl zone, duration or type of work. We found a similar dose-response relationship for chronic and non-chronic lymphocytic leukemia. PMID:19138038

Mortality patterns and trends among 49,705 U.S.-based women in a petroleum company: update 1979-2000.

PubMed

Huebner, Wendy W; Wojcik, Nancy C; Jorgensen, Gail; Marcella, Susan P; Nicolich, Mark J

2010-01-01

To examine mortality patterns and trends in a cohort of women employed in U.S. operating segments of a petroleum company. Based on human resources databases, we defined a cohort of 49,705 U.S.-based women with at least one day of company employment during 1979 to 2000. These data sources provided demographic and most work history information. Standardized mortality ratios and 95% confidence intervals were calculated for 95 causes of death for the total cohort and with separate analyses by job type and operating segment when numbers allowed. Cohort women have a 25% lower overall death rate than the general U.S. female population comparison. This lower rate is expected in light of the "healthy worker effect" that influences employee studies. Circulatory diseases have a deficit of 40%, and external causes of death and cancer have deficits of 13% and 9%, respectively. For analyses by job type, office/clerical workers have an elevation in ovarian cancer (standardized mortality ratio = 1.40, 95% confidence interval = 1.02 to 1.87), based on 46 deaths, with no work-related patterns. White-collar groups have generally large overall deficits for noncancer causes of death. In contrast, and based on smaller numbers, operators and laborers have elevations of motor vehicle accidents and other external causes of death, and laborers also have elevations of cerebrovascular disease and chronic obstructive pulmonary disease. These variations by job type are probably associated with differences in lifestyle factors. This large mortality surveillance study of women in the petroleum industry provides an opportunity for meaningful analysis of many causes of death. The study found an overall favorable mortality profile and, for a small number of elevations, helped identify possible subgroups for health and safety prevention programs and interventions.

[Risk factors for absenteeism due to sick leave in the petroleum industry].

PubMed

Oenning, Nágila Soares Xavier; Carvalho, Fernando Martins; Lima, Veronica Maria Cadena

2014-02-01

To identify risk factors for absenteeism among workers with sick leave in an oil company. A case-control study (120 cases and 656 controls) nested in a retrospective cohort study following up all employees of an oil company in the North-Northeast of Brazil from 2007 to 2009. The response variable used to represent absenteeism with sick leave was the average incidence of sick leave, defined as the ratio between total sick days and potential working days in the period. Logistic regression techniques were used to investigate the association between average incidence of sick leave > 5.0% over the period and the variables sex, position, age, time at work, shift work, smoking, arterial hypertension, body mass index, physical activity, coronary risk, sleep, glycemia, non-managed diabetes, cardiovascular, digestive, musculoskeletal, neurological and neoplastic diseases, straining body positioning during work, satisfaction at work, relationship with management, and concentrated attention at work. Average incidence of sick leave higher than 5.0% in the cohort period was 15.5%. The logistic model revealed that workers with average incidence of sick leave higher than 5.0% were 2.6 times more likely to be female; 2.0 time more likely to be smokers; 1.8 time more likely to be former smokers; 2.2 times more likely to report abnormal sleep and 10.5 times more likely to report dissatisfaction with their than workers with average incidence of sick leave ≤ 5.0% in the period. In this population, female gender, being a smoker or a former smoker, reporting dissatisfaction with the job and reporting abnormal sleep are good predictors of occupational absenteeism with sick leave. To identify risk factors for absenteeism among workers with sick leave in an oil company. A case-control study (120 cases and 656 controls) nested in a retrospective cohort study following up all employees of an oil company in the North-Northeast of Brazil from 2007 to 2009. The response variable used to represent absenteeism with sick leave was the average incidence of sick leave, defined as the ratio between total sick days and potential working days in the period. Logistic regression techniques were used to investigate the association between average incidence of sick leave > 5.0% over the period and the variables sex, position, age, time at work, shift work, smoking, arterial hypertension, body mass index, physical activity, coronary risk, sleep, glycemia, non-managed diabetes, cardiovascular, digestive, musculoskeletal, neurological and neoplastic diseases, straining body positioning during work, satisfaction at work, relationship with management, and concentrated attention at work. Average incidence of sick leave higher than 5.0% in the cohort period was 15.5%. The logistic model revealed that workers with average incidence of sick leave higher than 5.0% were 2.6 times more likely to be female; 2.0 time more likely to be smokers; 1.8 time more likely to be former smokers; 2.2 times more likely to report abnormal sleep and 10.5 times more likely to report dissatisfaction with their than workers with average incidence of sick leave ≤ 5.0% in the period. In this population, female gender, being a smoker or a former smoker, reporting dissatisfaction with the job and reporting abnormal sleep are good predictors of occupational absenteeism with sick leave.

The impact of depression and diabetes mellitus on older workers' functioning.

PubMed

Stynen, D; Jansen, N W H; Kant, I J

2015-12-01

Using the International Classification of Functioning, Disability and Health as a framework, this study investigates the impact of depression and diabetes mellitus on older workers' functioning (problems with concentration, physical functioning, need for recovery and work and social participation restrictions). The study focuses on how these chronic conditions, in their interaction with the work context, affect older workers' functioning, which may be an important precursor of early retirement. Older workers (≥ 45years) with depression (n=127) or diabetes mellitus (n=107) enrolled in the prospective Maastricht Cohort Study (MCS) were followed between October 2008 and October 2012. Linear, logistic and Cox regression analyses were performed to investigate the effect of these health conditions on workers' functioning compared to a reference group of older workers without a chronic condition (n=1612). The interaction with participants' working conditions (psychological job demands, decision latitude and strenuous work) was also analysed. Compared to the reference group, depression and diabetes mellitus were (over time) positively related with need for recovery caseness and restrictions in social participation but not with restrictions in work participation. Depression was positively related with concentration problems and need for recovery, whereas diabetes mellitus was negatively related with physical functioning. Finally, the relationship between functioning and depression and diabetes mellitus depends on working conditions. Older workers with depression or diabetes mellitus are vulnerable to losses in specific domains of functioning. The impact on functioning varies across working conditions, providing insight for disease-tailored preventive measures. Copyright © 2015 Elsevier Inc. All rights reserved.

Smoking intensity among male factory workers in Kunming, China.

PubMed

Cheng, Kai-Wen; Tsoh, Janice Y; Cui, Wenlong; Li, Xiaoliang; Kohrman, Matthew

2015-03-01

This study investigated the intensity of cigarette consumption and its correlates in China among urban male factory workers, a cohort especially vulnerable to tobacco exposure, one that appears to have benefitted little from recent public health efforts to reduce smoking rates. Data were collected from men working in factories of Kunming city, Yunnan, China, who are current daily smokers (N = 490). A multinomial logistic regression was conducted to examine the factors in association with smoking intensity in light, moderate, and heavy levels. Light smoking correlated with social smoking, smoking the first cigarette later in the day, self-reported health condition, and quit intention. Heavy smoking was associated with purchase of lower priced cigarettes, difficulty refraining from smoking, and prehypertensive blood pressure. Even in regions where smoking is highly prevalent, even among cohorts who smoke heavily, variation exists in how cigarettes are consumed. Analyses of this consumption, with special consideration given to smoking intensity and its correlates, can help guide tobacco-control strategists in developing more effective interventions. © 2013 APJPH.

Dose-response relationships between internally-deposited uranium and select health outcomes in gaseous diffusion plant workers, 1948-2011.

PubMed

Yiin, James H; Anderson, Jeri L; Bertke, Stephen J; Tollerud, David J

2018-05-09

To examine dose-response relationships between internal uranium exposures and select outcomes among a cohort of uranium enrichment workers. Cox regression was conducted to examine associations between selected health outcomes and cumulative internal uranium with consideration for external ionizing radiation, work-related medical X-rays and contaminant radionuclides technetium ( 99 Tc) and plutonium ( 239 Pu) as potential confounders. Elevated and monotonically increasing mortality risks were observed for kidney cancer, chronic renal diseases, and multiple myeloma, and the association with internal uranium absorbed organ dose was statistically significant for multiple myeloma. Adjustment for potential confounders had minimal impact on the risk estimates. Kidney cancer, chronic renal disease, and multiple myeloma mortality risks were elevated with increasing internal uranium absorbed organ dose. The findings add to evidence of an association between internal exposure to uranium and cancer. Future investigation includes a study of cancer incidence in this cohort. © 2018 Wiley Periodicals, Inc.

Increased Standardised Incidence Ratio of Malignant Pleural Mesothelioma in Taiwanese Asbestos Workers: A 29-Year Retrospective Cohort Study

PubMed Central

Lin, Cheng-Kuan; Chang, Yu-Ying; Wang, Jung-Der

2015-01-01

Objective. This paper aimed to determine the standardised incidence ratio (SIR) of malignant pleural mesothelioma (MPM) in workers exposed to asbestos in Taiwan. Methods. All workers employed in asbestos-related factories and registered by the Bureau of Labour Insurance between 1 March, 1950, and 31 December, 1989, were included in the study and were followed from 1 January, 1980, through 31 December, 2009. Incident cases of all cancers, including MPM (ICD-9 code: 163), were obtained from the Taiwan Cancer Registry. SIRs were calculated based on comparison with the incidence rate of the general population of Taiwan and adjusted for age, calendar period, sex, and duration of employment. Results. The highest SIR of MPM was found for male workers first employed before 1979, with a time since first employment more than 30 years (SIR 4.52, 95% CI: 2.25–8.09). After consideration of duration of employment, the SIR for male MPM was 5.78 (95% CI: 1.19–16.89) for the workers employed for more than 20 years in asbestos-related factories. Conclusions. This study corroborates the association between occupational asbestos exposure and MPM. The highest risk of MPM was found among male asbestos workers employed before 1979 and working for more than 20 years in asbestos-related factories. PMID:26290869

Temporarily Disabled Workers Account For A Disproportionate Share Of Health Care Payments.

PubMed

Gifford, Brian

2017-02-01

About one in four employees in a cohort of 408,000 US workers took a temporary leave of absence from work because of illness or injury in the period 2008-12. They accounted for nearly 60 percent (about $6.5 billion) of total worker health care and disability payments. This finding underscores the importance of workplace care management, lifestyle management, and health and safety efforts to prevent disability leaves. Project HOPE—The People-to-People Health Foundation, Inc.

Non-malignant disease mortality in meat workers: a model for studying the role of zoonotic transmissible agents in non-malignant chronic diseases in humans

PubMed Central

Johnson, E S; Zhou, Y; Sall, M; Faramawi, M El; Shah, N; Christopher, A; Lewis, N

2007-01-01

Background Current research efforts have mainly concentrated on evaluating the role of substances present in animal food in the aetiology of chronic diseases in humans, with relatively little attention given to evaluating the role of transmissible agents that are also present. Meat workers are exposed to a variety of transmissible agents present in food animals and their products. This study investigates mortality from non-malignant diseases in workers with these exposures. Methods A cohort mortality study was conducted between 1949 and 1989, of 8520 meat workers in a union in Baltimore, Maryland, who worked in manufacturing plants where animals were killed or processed, and who had high exposures to transmissible agents. Mortality in meat workers was compared with that in a control group of 6081 workers in the same union, and also with the US general population. Risk was estimated by proportional mortality and standardised mortality ratios (SMRs) and relative SMR. Results A clear excess of mortality from septicaemia, subarachnoid haemorrhage, chronic nephritis, acute and subacute endocarditis, functional diseases of the heart, and decreased risk of mortality from pre-cerebral, cerebral artery stenosis were observed in meat workers when compared to the control group or to the US general population. Conclusions The authors hypothesise that zoonotic transmissible agents present in food animals and their products may be responsible for the occurrence of some cases of circulatory, neurological and other diseases in meat workers, and possibly in the general population exposed to these agents. PMID:17604337

Mortality in a cohort of asbestos-exposed workers undergoing health surveillance.

PubMed

Barbiero, Fabiano; Zanin, Tina; Pisa, Federica Edith; Casetta, Anica; Rosolen, Valentina; Giangreco, Manuela; Negro, Corrado; Bovenzi, Massimo; Barbone, Fabio

2018-02-06

The coastal area of Friuli Venezia Giulia (FVG) region, north-eastern Italy, was characterized by work activities in which asbestos was used until the early 1990s, particularly in shipbuilding. A public health surveillance program (PHSP) for asbestos-exposed workers was established, although limited evidence exists about the efficacy of such programs in reducing disease occurrence and mortality. To compare mortality in a cohort of 2,488 men occupationally exposed to asbestos, enrolled in a PHSP in FVG between the early 1990s and 2008, with that of the general population of FVG and Italy. Standardized Mortality Ratios (SMR), with 95% Confidence Interval (95% CI), for all causes, all cancers, lung (LC) and pleural cancer (PC) were estimated in the cohort and in subgroups of workers with the first hire in shipbuilding that caused asbestos exposure (<1974, 1974-1984, 1985-1994). A strong excess in mortality for PC with reference to FVG (SMR=6.87, 95% CI 4.45-10.17) and Italian population (SMR=13.95, 95% CI 9.02-20.64) was observed. For LC, the FVG-based SMR was 1.49 (95% CI 1.17-1.89) and the Italy-based 1.43 (95% CI 1.12-1.81). Mortality among workers with the first hire in shipbuilding before 1974 was high for PC (FVG-based SMR=8.98, 95% CI 5.56-13.75; Italy-based SMR=18.41, 95% CI 11.40-28.17) and for LC (FVG-based SMR =1.60, 95% CI 1.18-2.11; Italy-based SMR=1.54, 95% CI 1.14-2.03). Further, for LC between 1974 and 1984, the FVG-based SMR was 2.45 (95% CI 1.06-4.82), and the Italy-based SMR was 2.33 (95% CI 1.01-4.60). This cohort experienced an excess mortality for pleural and lung cancer, compared with regional and national populations. For lung cancer, the excess was stronger in workers with the first hire in shipbuilding before 1985, suggesting a key role of asbestos exposure.

Haematopoietic cancer mortality among vehicle mechanics.

PubMed Central

Hunting, K L; Longbottom, H; Kalavar, S S; Stern, F; Schwartz, E; Welch, L S

1995-01-01

OBJECTIVE AND METHODS--This historical cohort study investigated causes of death among car and mobile equipment mechanics in the District of Columbia's Department of Public Works. Men who were employed for at least one year between 1977 and 1989 were eligible for inclusion in the cohort; follow up was up to the end of 1991. Three cases of leukaemia (index cases) had been reported among these workers before the inception of this study. This research was undertaken to estimate the relative risk of haematological cancer among mechanics working for the District of Columbia. RESULTS--Among the 335 male fleet maintenance workers, the all cause standardised mortality ratio (SMR) was 0.50 (33 observed deaths, 95% confidence interval (95% CI) 0.35-0.70), and the all cancer SMR was 0.55 (nine deaths, 95% CI 0.25-1.05). Three deaths from lymphatic and haematopoietic cancer were observed; the SMR was 3.63 (95% CI 0.75-10.63). In the subgroup with highest potential for exposure to fuels and solvents, the SMR for leukaemia and aleukaemia was 9.26 (two deaths, 95% CI 1.12-33.43), and the SMR for other lymphatic and haematopoietic neoplasms was 2.57 (one death from malignant lymphoma, 95% CI 0.06-14.27). All three lymphatic and haematopoietic cancer deaths were among car and mobile equipment mechanics (one was an index case). The two additional index cases were a fourth mechanic who died of leukaemia in 1992, after mortality follow up ended, and a fifth mechanic who was diagnosed with leukaemia in 1988 and is still alive. CONCLUSION--Many garage mechanics in this cohort regularly used petrol to clean parts and to wash their hands; some workers would occasionally siphon petrol by mouth. Benzene, a recognised cause of haematological cancer, is a component of petrol. Previous research indicates that garage mechanics may be at risk of leukaemia and other haematological cancers, presumably due to exposure to petrol; this study supports those findings. PMID:7489058

Mortality of nitrate fertiliser workers.

PubMed Central

Al-Dabbagh, S; Forman, D; Bryson, D; Stratton, I; Doll, R

1986-01-01

An epidemiological cohort study was conducted to investigate the mortality patterns among a group of workers engaged in the production of nitrate based fertilisers. This study was designed to test the hypothesis that individuals exposed to high concentrations of nitrates might be at increased risk of developing cancers, particularly gastric cancer. A total of 1327 male workers who had been employed in the production of fertilisers between 1946 and 1981 and who had been occupationally exposed to nitrates for at least one year were followed up until 1 March 1981. In total, 304 deaths were observed in this group and these were compared with expected numbers calculated from mortality rates in the northern region of England, where the factory was located. Analysis was also carried out separately for a subgroup of the cohort who had been heavily exposed to nitrates--that is, working in an environment likely to contain more than 10 mg nitrate/m3 for a year or longer. In neither the entire cohort nor the subgroup was any significant excess observed for all causes of mortality or for mortality from any of five broad categories of cause or from four specific types of cancer. A small excess of lung cancer was noted more than 20 years after first exposure in men heavily exposed for more than 10 years. That men were exposed to high concentrations of nitrate was confirmed by comparing concentrations of nitrates in the saliva of a sample of currently employed men with control men, employed at the same factory but not in fertiliser production. The men exposed to nitrate had substantially raised concentrations of nitrate in their saliva compared with both controls within the industry and with men in the general population and resident nearby. The results of this study therefore weight against the idea that exposure to nitrates in the environment leads to the formation in vivo of material amounts of carcinogens. PMID:3015194

Haematopoietic cancer mortality among vehicle mechanics.

PubMed

Hunting, K L; Longbottom, H; Kalavar, S S; Stern, F; Schwartz, E; Welch, L S

1995-10-01

This historical cohort study investigated causes of death among car and mobile equipment mechanics in the District of Columbia's Department of Public Works. Men who were employed for at least one year between 1977 and 1989 were eligible for inclusion in the cohort; follow up was up to the end of 1991. Three cases of leukaemia (index cases) had been reported among these workers before the inception of this study. This research was undertaken to estimate the relative risk of haematological cancer among mechanics working for the District of Columbia. Among the 335 male fleet maintenance workers, the all cause standardised mortality ratio (SMR) was 0.50 (33 observed deaths, 95% confidence interval (95% CI) 0.35-0.70), and the all cancer SMR was 0.55 (nine deaths, 95% CI 0.25-1.05). Three deaths from lymphatic and haematopoietic cancer were observed; the SMR was 3.63 (95% CI 0.75-10.63). In the subgroup with highest potential for exposure to fuels and solvents, the SMR for leukaemia and aleukaemia was 9.26 (two deaths, 95% CI 1.12-33.43), and the SMR for other lymphatic and haematopoietic neoplasms was 2.57 (one death from malignant lymphoma, 95% CI 0.06-14.27). All three lymphatic and haematopoietic cancer deaths were among car and mobile equipment mechanics (one was an index case). The two additional index cases were a fourth mechanic who died of leukaemia in 1992, after mortality follow up ended, and a fifth mechanic who was diagnosed with leukaemia in 1988 and is still alive. Many garage mechanics in this cohort regularly used petrol to clean parts and to wash their hands; some workers would occasionally siphon petrol by mouth. Benzene, a recognised cause of haematological cancer, is a component of petrol. Previous research indicates that garage mechanics may be at risk of leukaemia and other haematological cancers, presumably due to exposure to petrol; this study supports those findings.

Meeting the Challenge of Preparing Social Workers for Integrated Health Practice: Evidence from Two MSW Cohorts

ERIC Educational Resources Information Center

Rishel, Carrie W.; Hartnett, Helen P.

2017-01-01

Changes in health care policy have led to an expansion of integrated care models that rely on collaboration among interprofessional health teams. Recent federal funding has encouraged the development of innovative training models to prepare social workers for integrated health practice. This article presents evidence from the first two MSW cohorts…

Mortality in an extended follow-up of British coal workers

NASA Astrophysics Data System (ADS)

MacCalman; L; Miller; G, B.

2009-02-01

The Pneumoconiosis Field Research (PFR) programme was established in the 1950s, to evaluate effects of coal mining exposures on the health and mortality of British coal workers. Surveys of working miners were carried out at 5-yearly intervals, initially in 24 collieries but later concentrating on 10, collecting detailed work histories and health information for each recruit. Here we report on cause-specific mortality in a cohort of almost 18,000 men from 10 British collieries, followed up for periods up to 47 years, yielding over 516,000 life-years of follow-up. External analyses compared cause-specific death rates in the cohort to those of the population of the regions in which the collieries were situated, using Standardised Mortality Ratios (SMRs). The causes investigated included lung cancer, stomach cancer, non-malignant respiratory disorders and cardiovascular disorders. SMRs showed evidence of an initial healthy worker effect diminishing over time. Several causes, including non-malignant respiratory disease and lung cancer, showed a significant deficit of mortality at the start of the study period with an excess in the latter part of the follow-up period. In these results, effects of working conditions are likely to be confounded with smoking habits. Overall, we believe our results may be generalised to the British coal industry since nationalisation.

Baby boomers in the United States: Factors associated with working longer and delaying retirement.

PubMed

Dong, Xiuwen Sue; Wang, Xuanwen; Ringen, Knut; Sokas, Rosemary

2017-04-01

This study estimated the self-reported probability of working full-time past age 62 (P62) or age 65 (P65) among four cohorts of Americans born between 1931 and 1959. Data from the Health and Retirement Study (HRS) were analyzed. Respondents in four age cohorts were selected for comparison. Multivariable linear regression models were used to assess cohort differences in P62 and P65 while adjusting for covariates. P62 and P65 increased among boomers despite worsened self-rated health compared to the two preceding cohorts, with 37% and 80% increases among mid-boomers in construction trades. Cohort differences in P62 and P65 remained after controlling for covariates. Changes in pensions, income inequity, and education were significantly associated with work expectations, but SSA policy was not. Baby boomers expect to work longer than their predecessors. Efforts to improve work quality and availability for older workers are urgently needed, particularly in physically demanding occupations. Am. J. Ind. Med. 60:315-328, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

A large, nationwide, longitudinal study of central nervous system diseases among Korean workers exposed to manganese.

PubMed

Yoon, Jin-Ha; Ahn, Yeon-Soon

2015-03-01

In occupational epidemiologic studies, the low incidence and chronic process of central nervous system (CNS) diseases has complicated the determination of the relationship between increased morbidity and manganese (Mn) exposure. Therefore, through this large cohort study, we evaluated CNS disease morbidity among Korean workers exposed to Mn Data were collected from Mn-associated specialized medical check-up 2000 and 2004 in Korea. The number of workers admitted to hospital because of clinically diagnosed CNS disease was analyzed in male workers exposed to Mn (n = 104,544). As a control reference population, 2% of Korean men were randomly selected and their hospital admission data were analyzed. For Mn-exposed workers, Standardized admission ratios (SARs) for CNS disease, as determined by ICD-10 classifications, were estimated in reference to the control population During follow up, 64 workers admitted because of CNS diseases. Chronic exposure to Mn (≥ 10 years) was significantly associated with the SAR (95% CI) of extrapyramidal and movement disorders (SAR: 2.03, 95% CI: 1.05-3.55), in particular, other extrapyramidal and movement disorders (SAR: 4.81, 95% CI: 1.29-12.32). Also borderline association (SAR = 4.88, 90% CI: 1.05-7.04) was noted for secondary Parkinsonism among workers with chronic Mn exposure. SARs (95% CI) for other degenerative nervous system diseases were significantly higher in Mn-exposed workers compared with the control population (SAR: 3.60, 95% CI: 1.16-8.40) CONCLUSION: In conclusion, Mn-exposed workers exhibited significantly elevated SARs for degenerative nervous system diseases and extrapyramidal and movement disorders, compared to the age-matched reference population, suggesting a relatedness with Mn exposure. Copyright © 2014 Elsevier Ltd. All rights reserved.

Is fatigue after work a barrier for leisure-time physical activity? Cross-sectional study among 10,000 adults from the general working population.

PubMed

Bláfoss, Rúni; Micheletti, Jéssica K; Sundstrup, Emil; Jakobsen, Markus D; Bay, Hans; Andersen, Lars L

2018-04-01

In spite of the many health-related benefits of regular physical activity, fatiguing work may be a barrier to performing leisure-time physical activity. This study investigates the association between work-related fatigue and the duration of low- and high-intensity leisure-time physical activity in workers with sedentary and physically demanding jobs. From the 2010 round of the Danish Work Environment Cohort Study, currently employed wage earners from the general working population ( N=10,427) replied to questions about work-related fatigue (predictor) and duration of low- and high-intensity leisure-time physical activity (outcome). Associations were modelled using general linear models controlling for various confounders. Among workers with physically demanding jobs, higher levels of work-related fatigue were associated with gradually lower levels of leisure-time physical activity - for low, moderate and high levels of work-related fatigue the duration of high-intensity leisure-time physical activity was 133 (95% confidence interval (CI) 127-178), 134 (95% CI 109-160) and 113 (95% CI 86-140) min per week, respectively (trend test p<0.001). The duration of high-intensity leisure-time physical activity was lower among older workers (≥50 years) compared to younger workers (<50 years) (132 ± 126 vs 168 ± 150 min per week) ( p<0.0001). The duration of high-intensity leisure-time physical activity gradually decreases with increased work-related fatigue in workers with physically demanding jobs. Older workers perform less high-intensity physical activity than younger workers. Workplaces should consider initiatives to allow workers with physically demanding jobs and older workers to perform physical exercise during working hours and thereby increase physical capacity to meet the job demands.

Loss of permanent employment and its association with suicidal ideation: a cohort study in South Korea.

PubMed

Yoon, Seohyun; Kim, Ja Young; Park, Jooyoung; Kim, Seung-Sup

2017-09-01

Objective Precarious employment is associated with worse mental health, but it is unclear whether changes in employment status are related to suicidal behaviors. This study examined the association between change in employment status and suicidal ideation among workers in South Korea. Methods To maximize power of the analysis, we combined data from the ongoing Korean Welfare Panel Study. We analyzed 3793 participants who were permanent workers at baseline (2011-2014) and who either: (i) maintained permanent employment; (ii) became a full-time precarious worker; (iii) became a part-time precarious worker; or (iv) became unemployed in the following year (2012-2015). Suicidal ideation was assessed annually by asking participants, "Have you ever seriously thought about dying by suicide in the past year?" Logistic regression was applied to examine associations between change in employment status and suicidal ideation, adjusting for potential confounders such as lifetime suicidal ideation and depressive symptoms at baseline. Results Participants who became part-time precarious workers were more likely to have suicidal ideation [odd ratio (OR) 2.37, 95% confidence interval (95% CI) 1.07-5.25, P=0.033] compared to those who remained permanent workers. In analysis restricted to workers who never previously thought about dying by suicide, suicidal ideation was more common among those who became either full-time (OR 2.33, 95% CI 1.09-4.99, P=0.029) or part-time (OR 3.94, 95% CI 1.46-10.64, P=0.007) precarious workers. Conclusions Our findings suggest that change in employment status from permanent to precarious employment may increase suicidal ideation among workers in South Korea.

Mortality of workers at a nickel carbonyl refinery, 1958-2000.

PubMed

Sorahan, T; Williams, S P

2005-02-01

Excess risks of respiratory cancer have been shown in some groups of nickel exposed workers. It is clear, however, that not all forms of nickel exposure are implicated in these excess risks. To determine whether occupational exposures received in a modern nickel carbonyl refinery lead to increased risks of cancer, in particular nasal cancer and lung cancer. The mortality experienced by a cohort of 812 workers employed at a nickel refinery was investigated. Study subjects were all male workforce employees first employed in the period 1953-92 who had at least five years' employment with the company. Observed numbers of cause specific deaths were compared with expectations based on national mortality rates; SMRs were also calculated by period from commencing employment, year of commencing employment, and type of work. Overall, standardised mortality ratios (SMRs) were close to 100 for all causes (Obs 191, SMR 96, 95% CI 83 to 111), all neoplasms (Obs 63, SMR 104, 95% CI 80 to 133), non-malignant diseases of the respiratory system (Obs 18, SMR 97, 95% CI 57 to 153), and diseases of the circulatory system (Obs 85, SMR 94, 95% CI 75 to 116). There were no significantly increased SMRs for any site of cancer. There was a non-significant excess for lung cancer (Obs 28, Exp 20.17, SMR 139, 95% CI 92 to 201), and in subgroup analyses a significantly increased SMR of 231 (Obs 9) was found for those 142 workers with at least five years' employment in the feed handling and nickel extraction departments. In the total cohort there was a single death from nasal cancer (Exp 0.10). The non-significant excess of lung cancer deaths may well be a chance finding, but in light of previous studies some role for nickel exposures cannot be excluded.

Age at exposure to ionising radiation and cancer mortality among Hanford workers: follow up through 1994

PubMed Central

Wing, S; Richardson, D

2005-01-01

Background: Studies of workers at the plutonium production factory in Hanford, WA have led to conflicting conclusions about the role of age at exposure as a modifier of associations between ionising radiation and cancer. Aims: To evaluate the influence of age at exposure on radiation risk estimates in an updated follow up of Hanford workers. Methods: A cohort of 26 389 workers hired between 1944 and 1978 was followed through 1994 to ascertain vital status and causes of death. External radiation dose estimates were derived from personal dosimeters. Poisson regression was used to estimate associations between mortality and cumulative external radiation dose at all ages, and in specific age ranges. Results: A total of 8153 deaths were identified, 2265 of which included cancer as an underlying or contributory cause. Estimates of the excess relative risk per Sievert (ERR/Sv) for cumulative radiation doses at all ages combined were negative for all cause and leukaemia and positive for all cancer and lung cancer. Cumulative doses accrued at ages below 35, 35–44, and 45–54 showed little association with mortality. For cumulative dose accrued at ages 55 and above (10 year lag), the estimated ERR/Sv for all cancers was 3.24 (90% CI: 0.80 to 6.17), primarily due to an association with lung cancer (ERR/Sv: 9.05, 90% CI: 2.96 to 17.92). Conclusions: Associations between radiation and cancer mortality in this cohort are primarily a function of doses at older ages and deaths from lung cancer. The association of older age radiation exposures and cancer mortality is similar to observations from several other occupational studies. PMID:15961623

Is there an occupational status gradient in the development of periodontal disease in Japanese workers? A 5-year prospective cohort study.

PubMed

Irie, Koichiro; Yamazaki, Toru; Yoshii, Saori; Takeyama, Hideo; Shimazaki, Yoshihiro

2017-02-01

Development of periodontal disease (PD) may be affected by socioeconomic status. This study examined the relationship between occupational status and PD in a 5-year prospective cohort of Japanese workers. In total, 19,633 participants had initial examinations at the Aichi Health Promotion Foundation, of whom 8210 participants aged 20 years or older did not have PD. Follow-up examinations were conducted for 3757 participants, accounting for 45.8% of baseline participants. Ultimately, 3390 participants were analyzed according to the criterion of job classification at baseline, which was based on the International Standard Classification of Occupations, 1987. Oral examinations were performed using the Community Periodontal Index (CPI). The CPI scores were coded as follows: healthy (score of 0); bleeding after probing (1); dental calculus (2); shallow pockets (3); and deep pockets (4). Participants with one or more sextants with a score >2 were diagnosed with PD. Poisson regression analysis was performed to adjust for age and other potential confounders. Overall, 31.6% of men and 23.8% of women had developed PD (CPI scores of 3 or 4). The adjusted relative risk (RR) for PD (CPI scores of 3 or 4) in men was not significant. On the other hand, the adjusted RRs for PD (CPI score of 4) in men were 2.52-, 2.39-, and 2.74-fold higher for skilled workers, sales persons, and drivers, respectively, than for professionals. In contrast, we found no gradient in women. We found a gradient related to the risk of developing PD according to occupational status among men in a Japanese worker population. Copyright © 2016 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

Is outdoor work associated with elevated rates of cerebrovascular disease mortality? A cohort study based on iron-ore mining.

PubMed

Björ, Ove; Jonsson, Håkan; Damber, Lena; Burström, Lage; Nilsson, Tohr

2016-01-01

A cohort study that examined iron ore mining found negative associations between cumulative working time employed underground and several outcomes, including mortality of cerebrovascular diseases. In this cohort study, and using the same group of miners, we examined whether work in an outdoor environment could explain elevated cerebrovascular disease rates. This study was based on a Swedish iron ore mining cohort consisting of 13,000 workers. Poisson regression models were used to generate smoothed estimates of standardized mortality ratios and adjusted rate ratios, both models by cumulative exposure time in outdoor work. The adjusted rate ratio between employment classified as outdoor work ≥25 years and outdoor work 0-4 years was 1.62 (95 % CI 1.07-2.42). The subgroup underground work ≥15 years deviated most in occurrence of cerebrovascular disease mortality compared with the external reference population: SMR (0.70 (95 % CI 0.56-0.85)). Employment in outdoor environments was associated with elevated rates of cerebrovascular disease mortality. In contrast, work in tempered underground employment was associated with a protecting effect.

Radiographic abnormalities and the risk of lung cancer among workers exposed to silica dust in Ontario.

PubMed Central

Finkelstein, M M

1995-01-01

OBJECTIVE: To determine whether workers in Ontario who had been exposed to silica dust and who have radiographic abnormalities are at increased risk of lung cancer. DESIGN: Cohort and case-control studies of rates of death from lung cancer and cancer incidence rates; data were obtained from the Ontario Silicosis Surveillance Registry. Follow-up was through linkage to the Ontario mortality and cancer registries. SETTING: Ontario. PARTICIPANTS: A total of 523 workers with radiographic abnormalities and 1568 control subjects with normal radiographic findings who had been exposed to silica dust. Matching criteria were year of birth and the requirement that the control subject have a normal radiographic finding either later than or in the same year that the radiographic abnormality was identified in the silicosis subject. OUTCOME MEASURES: Standardized mortality ratios (SMRs), standardized incidence ratios (SIRs) and odds ratios for lung cancer. RESULTS: In the cohort analysis, with the Ontario population rates as reference, the all-cause SMR was 0.96 among the workers with radiographic abnormalities and 0.51 among the control subjects. The corresponding SIRs for lung cancer were 2.49 and 0.87 (p < 0.001). In the case-control analysis the workers with silicosis were more likely than the control subjects to have been smokers, but this difference likely accounted for only a small part of the difference in the incidence of lung cancer. The relative risk of lung cancer was elevated among the workers with silicosis from the foundry, mining and nonmetallic-minerals industries; however, the number of subjects was too small for a significant difference to be detected. Among the miners exposure to radon daughters did not affect the risk of lung cancer attributable to radiographic abnormalities. CONCLUSIONS: Radiographic abnormalities suggestive of exposure to silica dust are markers for increased risk of lung cancer. Physicians might thus wish to warn their patients with silica-associated radiographic abnormalities about the increased risk and to counsel those who smoke to stop. PMID:7804920

Do ambient noise exposure levels predict hearing loss in a modern industrial cohort?

PubMed Central

Rabinowitz, P M; Galusha, D; Dixon‐Ernst, C; Slade, M D; Cullen, M R

2007-01-01

Background Much of what is known about the exposure–response relationship between occupational noise exposures and hearing loss comes from cross‐sectional studies conducted before the widespread implementation of workplace hearing conservation programmes. Little is known about the current relationship of ambient noise exposure measurements to hearing loss risk. Aim To examine the relationship between rates of high frequency hearing loss and measured levels of noise exposure in a modern industrial workforce. Methods Ten‐year hearing loss rates were determined for 6217 employees of an aluminium manufacturing company. Industrial hygiene and human resources records allowed for reconstruction of individual noise exposures. Hearing loss rates were compared to ANSI 3.44 predictions based on age and noise exposure. Associations between hearing loss, noise exposure, and covariate risk factors were assessed using multivariate regression. Results Workers in higher ambient noise jobs tended to experience less high frequency hearing loss than co‐workers exposed at lower noise levels. This trend was also seen in stratified analyses of white males and non‐hunters. At higher noise exposure levels, the magnitude of hearing loss was less than predicted by ANSI 3.44 formulae. There was no indication that a healthy worker effect could explain these findings. The majority of 10 dB standard threshold shifts (STS) occurred in workers whose calculated ambient noise exposures were less than or equal to 85 dBA. Conclusions In this modern industrial cohort, hearing conservation efforts appear to be reducing hearing loss rates, especially at higher ambient noise levels. This could be related to differential use of hearing protection. The greatest burden of preventable occupational hearing loss was found in workers whose noise exposure averaged 85 dBA or less. To further reduce rates of occupational hearing loss, hearing conservation programmes may require innovative approaches targeting workers with noise exposures close to 85 dBA. PMID:16973736

Determinants of workplace injury among Thai Cohort Study participants

PubMed Central

Berecki-Gisolf, Janneke; Tawatsupa, Benjawan; McClure, Roderick; Seubsman, Sam-ang; Sleigh, Adrian

2013-01-01

Objectives To explore individual determinants of workplace injury among Thai workers. Design Cross-sectional analysis of a large national cohort. Setting Thailand. Participants Thai Cohort Study participants who responded to the 2009 follow-up survey were included if they reported doing paid work or being self-employed (n=51 751). Outcome measures Self-reported injury incidence over the past 12 months was calculated. Multivariate logistic regression models were used to test associations between individual determinants and self-reported workplace injury. Results Workplace injuries were reported by 1317 study participants (2.5%); the incidence was 34 (95% CI 32 to 36)/1000 worker-years for men, and 18 (17–20) for women. Among men working ≥41 h and earning <10 000 Baht, the injury rate was four times higher compared with men working <11 h and earning ≥20 001 Baht; differences in injury rates were less pronounced in women. Multivariate modelling showed that working ≥49 h/week (23%) and working for ≤10 000 Bath/month (37%) were associated with workplace injury. The increase in injury risk with increased working hours did not exceed the risk expected from increased exposure. Conclusions Reductions in occupational injury rates could be achieved by limiting working hours to 48/week. Particularly for Thai low wage earners and those with longer workdays, there is a need for effective injury preventive programmes. PMID:23869104

DOE Office of Scientific and Technical Information (OSTI.GOV)

Saccomanno, G.

''Early Lung Cancer Detection in Uranium Miners with Abnormal Sputum Cytology'' was funded by the Department of Energy to monitor the health effects of radon exposure and/or cigarette smoke on uranium workers from the Colorado Plateau. The resulting Saccomanno Uranium Workers Archive and data base has been used as a source of information to prove eligibility for compensation under the Radiation Exposure Compensation Act and as the source of primary data tissue for a subcontract and other collaborations with outside investigators. The latter includes a study of radon exposure and lung cancer risk in a non-smoking cohort of uranium minersmore » (subcontract); a study of genetic markers for lung cancer susceptibility; and a study of {sup 210}Pb accumulation in the skull as a biomarker of radon exposure.« less

COPD and occupation: a retrospective cohort study of industrial workers.

PubMed

Mazitova, Nailya N; Saveliev, Anatoly A; Berheeva, Zuhra M; Amirov, Nail Kh

2012-09-01

The aim of this paper was to ascertain chronic obstructive pulmonary disease (COPD) prevalence among industrial workers in the Russian Federation and determine relative contribution of smoking and occupational factors to COPD. We recruited 1,375 workers aged 30 or over. Six hundred and twenty-four of them were occupationally exposed to vapours, gases, dust, and fumes (VGDF). Physical examination and baseline spirometry were performed for all the participants of the study. Those with airfl ow limitation of FEV1/FVC<0.70 were considered having COPD and those with presence of cough and sputum production for at least three months in each of two consecutive years were considered having chronic bronchitis (CB), with no overlapping between these 2 groups. Data on occupational history and VGDF levels in the working area were collected from all participants. In total, 105 cases of COPD and 170 cases of CB were diagnosed in the cohort of examined workers. Occupational exposure to VGDF was twice as often present among COPD patients than among both patients with CB and the control group of healthy workers (p<0.05). More than 40 % of COPD patients were occupationally exposed to VGDF above the value of 3.0 of the occupational exposure limit (OEL) and more than 20 % to 6.0 OEL and higher. Overall odds ratio for COPD development due to occupational VGDF exposure was 5.9 (95 % CI=3.6 to 9.8, p=0.0001). Both smoking and VGDF seem to be important for the development of COPD. Analysis of the combined effect of tobacco smoking and occupational noxious particles and gases on COPD development has shown the following order of risk factors based on the strength of their infl uence: VGDF levels, smoking index, age, and heating microclimate. There is a statistically signifi cant level of relationship and "dose-effect" dependence between occupational exposures to VGDF and the development of COPD. The effect of VGDF composition on the probability of COPD development was not found in the study. Results of this study were used to substantiate the inclusion of COPD into the National List of Occupational Diseases of the Russian Federation.

Solid cancer mortality associated with chronic external radiation exposure at the French atomic energy commission and nuclear fuel company.

PubMed

Metz-Flamant, C; Samson, E; Caër-Lorho, S; Acker, A; Laurier, D

2011-07-01

Studies of nuclear workers make it possible to directly quantify the risks associated with ionizing radiation exposure at low doses and low dose rates. Studies of the CEA (Commissariat à l'Energie Atomique) and AREVA Nuclear Cycle (AREVA NC) cohort, currently the most informative such group in France, describe the long-term risk to nuclear workers associated with external exposure. Our aim is to assess the risk of mortality from solid cancers among CEA and AREVA NC nuclear workers and its association with external radiation exposure. Standardized mortality ratios (SMRs) were calculated and internal Poisson regressions were conducted, controlling for the main confounding factors [sex, attained age, calendar period, company and socioeconomic status (SES)]. During the period 1968-2004, there were 2,035 solid cancers among the 36,769 CEA-AREVA NC workers. Cumulative external radiation exposure was assessed for the period 1950-2004, and the mean cumulative dose was 12.1 mSv. Mortality rates for all causes and all solid cancers were both significantly lower in this cohort than in the general population. A significant excess of deaths from pleural cancer, not associated with cumulative external dose, was observed, probably due to past asbestos exposure. We observed a significant excess of melanoma, also unassociated with dose. Although cumulative external dose was not associated with mortality from all solid cancers, the central estimated excess relative risk (ERR) per Sv of 0.46 for solid cancer mortality was higher than the 0.26 calculated for male Hiroshima and Nagasaki A-bomb survivors 50 years or older and exposed at the age of 30 years or older. The modification of our results after stratification for SES demonstrates the importance of this characteristic in occupational studies, because it makes it possible to take class-based lifestyle differences into account, at least partly. These results show the great potential of a further joint international study of nuclear workers, which should improve knowledge about the risks associated with chronic low doses and provide useful risk estimates for radiation protection.

The hospital costs of treating work-related sawmill injuries in British Columbia.

PubMed

Alamgir, Hasanat; Tompa, Emile; Koehoorn, Mieke; Ostry, Aleck; Demers, Paul A

2007-05-01

This study estimates the hospital costs of treating work-related injury among a cohort of sawmill workers in British Columbia. Hospital discharge records were extracted from 1989 to 1998 for a cohort of 5,876 actively employed sawmill workers. Injury cases were identified as work-related from these records using ICD-9 external cause of injury codes that indicate place of occurrence and the responsibility of payment schedule that identifies workers' compensation as being responsible for payment. The hospitals in British Columbia have a standard ward rate chart prepared annually by the provincial Ministry of Health to bill and collect payment from agency like workers' compensation agency. Costs were calculated from the hospital perspective using this billing chart. All costs were expressed in 1995 Canadian dollars. The workers' compensation claim records for this study population were extracted and matched with the hospitalised work-related injury records. Costs were also calculated for work-related hospitalisations that the hospital did not appear to be reimbursed for by the workers' compensation system. There were 173 injuries requiring hospitalisation during the 10-year followup period. The median stay in hospitals was 3 days and the median hospital costs were $847. The most costly cause of injury categories were fire, flame, natural and environmental and struck against with median costs of $10,575 and $1,206, respectively, while the least costly category was cutting and piercing with median costs of $296. The most costly nature of injury categories were burns and fracture of lower limb with median costs of $10,575 and $1,800, respectively, while the least costly category was dislocation, sprains and strains with median costs of $437. The total hospital costs for all the work-related injuries were $434,990. Out of a total hospital cost of $434,990 for the 173 work-related injuries, the provincial compensation agency apparently did not compensate $50,663 (12%). Prevention of work-related injuries can save significant amount of health care resources. Substantial costs remain uncompensated by the provincial compensation agency and are thus transferred to the provincial health care system annually.

Source-specific workplace social support and high-sensitivity C-reactive protein levels among Japanese workers: A 1-year prospective cohort study.

PubMed

Eguchi, Hisashi; Shimazu, Akihito; Kawakami, Norito; Inoue, Akiomi; Tsutsumi, Akizumi

2016-08-01

This study investigated the prospective association between source-specific workplace social support and high-sensitivity C-reactive protein (hs-CRP) levels in workers in Japan. We conducted a 1-year prospective cohort study with 1,487 men and 533 women aged 18-65 years. Participants worked at two manufacturing worksites in Japan and were free of major illness. We used multivariable linear regression analyses to evaluate the prospective association between supervisor and coworker support at baseline, and hs-CRP levels at follow-up. We conducted the analyses separately for men and women. For women, high supervisor support at baseline was significantly associated with lower hs-CRP levels at follow-up (β = -0.109, P < 0.01), whereas coworker support at baseline was not significantly associated with hs-CRP levels at follow-up. Associations between supervisor and coworker support and hs-CRP levels were not significant for men. Supervisor support may have beneficial effects on inflammatory markers in working women. Am. J. Ind. Med. 59:676-684, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Paying for retirement: sex differences in inclusion in employer-provided retirement plans.

PubMed

Wright, Rosemary

2012-04-01

This study examines sex differences among Baby Boom workers in the likelihood of coverage by an employer-provided retirement plan. This study used a sample of Baby Boom workers drawn from the 2009 Current Population Survey. Independent variables were selected to replicate as closely as possible those in two 1995 studies of retired workers and pension plans. Three new variables were added to reflect major social and economic shifts since 1995. Logistic regression was performed to analyze the effect of the independent variables on the likelihood of retirement plan coverage. In this cohort, the proportions of men and women included in employer-provided retirement plans were almost the same. The overall odds of women being included in a plan were only slightly less than even and in certain cases were significantly higher than the odds for men. Predictors of inclusion that were most important for both women and men were minority status, employment in a core industry or in a government position, educational level, and marital status. Although a much larger group of workers is included in retirement plans than in previous studies, and Baby Boom women are less disadvantaged in this regard than women in earlier studies, minority and immigrant workers continue to be disadvantaged, and the security of government retirement plans may be weakening with current economic difficulties.

The radiologic technologists' health study in South Korea: study design and baseline results.

PubMed

Lee, Won Jin; Ha, Mina; Hwang, Seung-sik; Lee, Kyoung-Mu; Jin, Young-Woo; Jeong, Meeseon; Jun, Jae Kwan; Cha, Eun Shil; Ko, Yousun; Choi, Kyung-Hwa; Lee, Jung-Eun

2015-08-01

To describe the study design, methods, and baseline results of a prospective cohort of radiologic technologists which we have initiated in South Korea. The cohort participants were enrolled through a self-administered questionnaire survey administered from April 2012 to May 2013. Survey data were linked with radiation dosimetry, a cancer registry, and health insurance data by personal identification numbers. A nationwide representative survey was also conducted using a stratified random sampling design with face-to-face interviews. A total of 12,387 radiologic technologists were enrolled, which accounted for approximately 63% of all diagnostic radiologic technologists working in South Korea. For nationwide survey, 585 workers were interviewed using the detailed questionnaire, and buccal cells were also collected by scraping the inside of the cheek. The majority of study subjects were under 50-year-old and male workers. The average annual effective dose of radiation declined both men (from 2.75 to 1.43 mSv) and women (from 1.34 to 0.95 mSv) over the period of 1996-2011. A total of 99 cancers (66 cancers in men and 33 in women) were reported from 1992 to 2010. The standardized incidence ratio of all cancer combined was significantly lower in men (SIR = 0.75, 95% CI 0.58-0.96) than general population, but the ratios for thyroid cancer were significantly higher than expected among both men and women. This cohort provides comprehensive information on work activities and health status of diagnostic radiologic technologists. In addition, the nationwide representative sample provides unique opportunities compared with previous radiologic technologist studies.

Structural Barriers to Antiretroviral Therapy Among Sex Workers Living with HIV: Findings of a Longitudinal Study in Vancouver, Canada.

PubMed

Goldenberg, Shira M; Montaner, Julio; Duff, Putu; Nguyen, Paul; Dobrer, Sabina; Guillemi, Silvia; Shannon, Kate

2016-05-01

In light of limited data on structural determinants of access and retention in antiretroviral therapy (ART) among sex workers, we examined structural correlates of ART use among sex workers living with HIV over time. Longitudinal data were drawn from a cohort of 646 female sex workers in Vancouver, Canada (2010-2012) and linked pharmacy records on ART dispensation. We used logistic regression with generalized estimating equations (GEE) to examine correlates of gaps in ART use (i.e., treatment interruptions or delayed ART initiation), among HIV seropositive participants (n = 74). Over a 2.5-year period, 37.8 % of participants experienced gaps in ART use (i.e., no ART dispensed in a 6-month period). In a multivariable GEE model, younger age, migration/mobility, incarceration, and non-injection drug use independently correlated with gaps in ART use. In spite of successes scaling-up ART in British Columbia, younger, mobile, or incarcerated sex workers face persistent gaps in access and retention irrespective of drug use. Community-based, tailored interventions to scale-up entry and retention in ART for sex workers should be further explored in this setting.

Half-century archives of occupational medical data on French nuclear workers: a dusty warehouse or gold mine for epidemiological research?

PubMed

Garsi, Jerome-Philippe; Samson, Eric; Chablais, Laetitia; Zhivin, Sergey; Niogret, Christine; Laurier, Dominique; Guseva Canu, Irina

2014-12-01

This article discusses the availability and completeness of medical data on workers from the AREVA NC Pierrelatte nuclear plant and their possible use in epidemiological research on cardiovascular and metabolic disorders related to internal exposure to uranium. We created a computer database from files on 394 eligible workers included in an ongoing nested case-control study from a larger cohort of 2897 French nuclear workers. For each worker, we collected records of previous employment, job positions, job descriptions, medical visits, and blood test results from medical history. The dataset counts 9,471 medical examinations and 12,735 blood test results. For almost all of the parameters relevant for research on cardiovascular risk, data completeness and availability is over 90%, but it varies with time and improves in the latest time period. In the absence of biobanks, collecting and computerising available good-quality occupational medicine archive data constitutes a valuable alternative for epidemiological and aetiological research in occupational health. Biobanks rarely contain biological samples over an entire worker's carrier and medical data from nuclear industry archives might make up for unavailable biomarkers that could provide information on cardiovascular and metabolic diseases.

Chronic obstructive pulmonary disease mortality in railroad workers.

PubMed

Hart, J E; Laden, F; Eisen, E A; Smith, T J; Garshick, E

2009-04-01

There is little information describing the risk of non-malignant respiratory disease and occupational exposure to diesel exhaust. US railroad workers have been exposed to diesel exhaust since diesel locomotives were introduced after World War II. In a retrospective cohort study we examined the association of chronic obstructive pulmonary disease (COPD) mortality with years of work in diesel-exposed jobs. To examine the possible confounding effects of smoking, multiple imputation was used to model smoking history. A Cox proportional hazards model was used to estimate an incidence rate ratio, adjusted for age, calendar year, and length of follow-up after leaving work (to reduce bias due to a healthy worker survivor effect). Workers in jobs with diesel exhaust exposure had an increased risk of COPD mortality relative to those in unexposed jobs. Workers hired after the introduction of diesel locomotives had a 2.5% increase in COPD mortality risk for each additional year of work in a diesel-exposed job. This risk was only slightly attenuated after adjustment for imputed smoking history. These results support an association between occupational exposure to diesel exhaust and COPD mortality.

Mortality among three refinery/petrochemical plant cohorts. II. Retirees.

PubMed

Gamble, J F; Lewis, R J; Jorgensen, G

2000-07-01

This study updates mortality data for 6238 retirees from three refinery/petrochemical plants. Almost 90% of the cohort was deceased. Deaths from all causes (standardized mortality ratio, 104; 95% confidence interval, 102 to 107) and all cancers (standardized mortality ratio, 109; 95% confidence interval, 102 to 116) were elevated. Increased deaths due to kidney cancer, mesothelioma, and the category of other lymphohemopoietic cancers also were observed. The rate of leukemia was not increased. There was little internal or external consistency to support an occupational relationship for kidney cancer, but findings for mesothelioma and other lymphohemopoietic cancers are consistent with reports for other petroleum cohorts. Analyses by age indicated significantly higher all-cause mortality rates among persons retiring before age 65. The results suggest that continued surveillance of mesothelioma and lymphohemopoietic cancer malignancies in younger workers with more contemporary exposures may be warranted. Furthermore, age at retirement should be considered when analyzing occupational cohorts.

Updated mortality study of a cohort of asbestos textile workers.

PubMed

Pira, Enrico; Romano, Canzio; Violante, Francesco S; Farioli, Andrea; Spatari, Giovanna; La Vecchia, Carlo; Boffetta, Paolo

2016-09-01

Limited information is available on risk of peritoneal mesothelioma after asbestos exposure, and in general on the risk of cancer after cessation of asbestos exposure. We updated to 2013 the follow-up of a cohort of 1083 female and 894 male textile workers with heavy asbestos exposure (up to 100 fb/mL), often for short periods. A total of 1019 deaths were observed, corresponding to a standardized mortality ratio (SMR) of 1.68 (95% confidence interval [CI]: 1.57-1.78). SMRs were 29.1 (95% CI: 21.5-38.6) for peritoneal cancer, 2.96 (95% CI: 2.50-3.49) for lung cancer, 33.7 (95% CI: 25.7-43.4) for pleural cancer, and 3.03 (95% CI: 1.69-4.99) for ovarian cancer. For pleural and peritoneal cancer, there was no consistent pattern of risk in relation to time since last exposure, whereas for lung cancer there was an indication of a decline in risk after 25 years since last exposure. The findings of this unique cohort provide novel data for peritoneal cancer, indicating that - as for pleural cancer - the excess risk does not decline up to several decades after cessation of exposure. © 2016 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

The Porto Alegre Early Life Nutrition and Health Study.

PubMed

Chaffee, Benjamin Wilk; Vítolo, Márcia Regina; Feldens, Carlos Alberto

2014-12-01

Early childhood caries is a persistent worldwide problem. The etiologic contribution of feeding practices has been less frequently investigated in prospective studies of young children. The Porto Alegre Early Life Nutrition and Health Study has followed a birth cohort of 715 mother-child pairs, recruited from municipal health centers, originally involved in a cluster-randomized controlled trial of healthcare worker training. The birth cohort links prospectively collected socio-demographic, infant feeding, and general and oral health information. To date, oral health data, including caries status and oral health-related quality of life, have been collected for 458 children at the age of 2-3 years. Studies are underway to investigate possible determinants and consequences of oral health among these children.

The Voices of Their Childhood: Families and Early Years' Practitioners Developing Emancipatory Methodologies through a Tracer Study

ERIC Educational Resources Information Center

Whalley, Margy; Arnold, Cath; Lawrence, Penny; Peerless, Sally

2012-01-01

The Pen Green Tracer Study questions the difference we may or may not have made to children's lives. An initial cohort of young people, now aged between 11-20, revisited their nursery in 2010. Their stories prompted discussion on parental involvement and advocacy within the education system, key worker attachment, and children's sense of self. Our…

A Virtual Learning Environment for Part-Time MASW Students: An Evaluation of the WebCT

ERIC Educational Resources Information Center

Chan, Charles C.; Tsui, Ming-sum; Chan, Mandy Y. C.; Hong, Joe H.

2008-01-01

This study aims to evaluate the perception of a cohort of social workers studying for a part-time master's program in social work in using the popular Web-based learning platform--World Wide Web Course Tools (WebCT) as a complimentary method of teaching and learning. It was noted that social work profession began incorporating computer technology…

Diagnostic strategies using physical examination are minimally useful in defining carpal tunnel syndrome in population-based research studies.

PubMed

Descatha, A; Dale, A-M; Franzblau, A; Coomes, J; Evanoff, B

2010-02-01

We evaluated the utility of physical examination manoeuvres in the prediction of carpal tunnel syndrome (CTS) in a population-based research study. We studied a cohort of 1108 newly employed workers in several industries. Each worker completed a symptom questionnaire, a structured physical examination and nerve conduction study. For each hand, our CTS case definition required both median nerve conduction abnormality and symptoms classified as "classic" or "probable" on a hand diagram. We calculated the positive predictive values and likelihood ratios for physical examination manoeuvres in subjects with and without symptoms. The prevalence of CTS in our cohort was 1.2% for the right hand and 1.0% for the left hand. The likelihood ratios of a positive test for physical provocative tests ranged from 2.0 to 3.3, and those of a negative test from 0.3 to 0.9. The post-test probability of positive testing was <50% for all strategies tested. Our study found that physical examination, alone or in combination with symptoms, was not predictive of CTS in a working population. We suggest using specific symptoms as a first-level screening tool, and nerve conduction study as a confirmatory test, as a case definition strategy in research settings.

Health behaviours and outcomes associated with fly-in fly-out and shift workers in Western Australia.

PubMed

Joyce, S J; Tomlin, S M; Somerford, P J; Weeramanthri, T S

2013-04-01

To examine the association of health behaviours and outcomes with employment type in the West Australian adult population. Cross-sectional study of employed adults aged 16 years and over using self-reported information collected in the WA Health and Wellbeing Surveillance System between 2008 and 2010. A total of 380 fly-in fly-out (FIFO) workers, 913 shift workers and 10 613 workers of other employment types were identified. FIFO workers exhibited similar health behaviours to shift workers but had a different sociodemographic profile. Compared with other employment types, FIFO workers were significantly more likely to be current smokers, drink alcohol at risky levels, and be overweight or obese, after adjusting for age, sex and survey sampling strategies. They were less likely to report current mental health problems. Self-reported health behaviours of FIFO workers differ from other employment types. FIFO workers are expected to increase in number over the next decade, as the mining and resources sector expands in Australia. Our findings suggest that health interventions, whether in the workplace or clinical settings, need to be informed by the demographic mix of the cohort of workers on entry as they are not a homogenous group, and targeted towards specific employment patterns (length of shifts and type of employment) to improve their current and future well-being. © 2012 The Authors; Internal Medicine Journal © 2012 Royal Australasian College of Physicians.

Two-Year Community: The Impact of the Clinical Social Worker in a Community College Biotech Program: A Cohort Study

ERIC Educational Resources Information Center

Tanski, Anne E.; Bobick, Sandra; Mosley-Turner, Katherine; Garofalo, Giovanni

2016-01-01

Given biotechnology's emergence as a major competitor in the Pittsburgh region, critically linking education to industry through the Community College of Allegheny County's Biotechnology Workforce Collaborative (BWC) provided a well-trained workforce. The collaborative also sought to increase the number of women in the sciences, specifically…

Racial Differences in the Association Between Night Shift Work and Melatonin Levels Among Women

PubMed Central

Bhatti, Parveen; Mirick, Dana K.; Davis, Scott

2013-01-01

Reduced suppression of melatonin in response to working the night shift among people of Asian ancestry has been suggested as a possible explanation for the null results observed in a recent analysis of shift work and breast cancer risk in a Chinese cohort. The authors analyzed the impact of Asian versus white race on previously reported differences in urinary 6-sulfatoxymelatonin levels in a 2003–2008 study in Seattle, Washington, of female health-care workers that exclusively worked night or day shifts. A total of 225 white and 51 Asian participants were included in the analysis. Although 6-sulfatoxymelatonin levels were affected by night shift work in both racial groups, Asian night shift workers consistently showed 6-sulfatoxymelatonin levels that were closer to levels in day shift workers than did white night shift workers. Furthermore, differences in 6-sulfatoxymelatonin levels between white and Asian night shift workers relative to day shift workers were statistically significant in every instance (P < 0.05). These results suggest that Asians may be better able to maintain a “normal” circadian pattern of melatonin production compared with whites and suggest a biological mechanism by which Asian night shift workers may be at a reduced risk of cancer. PMID:23380044

Apparently-Different Clearance Rates from Cohort Studies of Mycoplasma genitalium Are Consistent after Accounting for Incidence of Infection, Recurrent Infection, and Study Design.

PubMed

Smieszek, Timo; White, Peter J

2016-01-01

Mycoplasma genitalium is a potentially major cause of urethritis, cervicitis, pelvic inflammatory disease, infertility, and increased HIV risk. A better understanding of its natural history is crucial to informing control policy. Two extensive cohort studies (students in London, UK; Ugandan sex workers) suggest very different clearance rates; we aimed to understand the reasons and obtain improved estimates by making maximal use of the data from the studies. As M. genitalium is a sexually-transmitted infectious disease, we developed a model for time-to-event analysis that incorporates the processes of (re)infection and clearance, and fitted to data from the two cohort studies to estimate incidence and clearance rates under different scenarios of sexual partnership dynamics and study design (including sample handling and associated test sensitivity). In the London students, the estimated clearance rate is 0.80 p.a. (mean duration 15 months), with incidence 1.31%-3.93% p.a. Without adjusting for study design, corresponding estimates from the Ugandan data are 3.44 p.a. (mean duration 3.5 months) and 58% p.a. Apparent differences in clearance rates are probably mostly due to lower testing sensitivity in the Uganda study due to differences in sample handling, with 'true' clearance rates being similar, and adjusted incidence in Uganda being 28% p.a. Some differences are perhaps due to the sex workers having more-frequent antibiotic treatment, whilst reinfection within ongoing sexual partnerships might have caused some of the apparently-persistent infection in the London students. More information on partnership dynamics would inform more accurate estimates of natural-history parameters. Detailed studies in men are also required.

Shift workers have similar leisure-time physical activity levels as day workers but are more sedentary at work.

PubMed

Hulsegge, Gerben; Gupta, Nidhi; Holtermann, Andreas; Jørgensen, Marie Birk; Proper, Karin I; van der Beek, Allard J

2017-03-01

Objective Physical inactivity has been hypothesized as an underlying factor for the association between shift work and adverse health outcomes. We compared leisure-time and occupational physical activity and sedentary behavior between day, night, and non-night shift workers. Methods We identified 612 day workers, 139 night shift workers and 61 non-night shift workers aged 18-65 years (54% men) in two Danish studies: the New method for Objective Measurements of physical Activity in Daily living (NOMAD) and the Danish Physical ACTivity cohort with Objective measurements (DPhacto) between 2011-2013. Sedentary behavior, light, and moderate-to-vigorous physical activity were measured using an accelerometer. Physical activity was expressed as percentage of leisure and work time spent in each activity. Linear regression analyses were used to test differences in physical activity and sedentary behavior between day, night, and non-night shift workers. Results No differences in leisure-time sedentary behavior and physical activity were observed between day and shift workers (P>0.05). Non-night shift workers spent 7.2% [95% confidence interval (95% CI) 2.3-12.1) more time in occupational sedentary behavior than day workers and 5.9% (95% CI -10.1- -1.7) and 1.9% (95% CI -3.7- -0.2) less time in occupational light and moderate-to-vigorous physical activity, respectively. Compared to day workers, night shift workers spent 4.3% (95% CI 2.4-6.1) more time at work in uninterrupted sedentary periods of ≥30 minutes. Conclusions Shift workers had similar leisure-time physical activity patterns as day workers, but were more sedentary at work. Future research should elucidate whether occupational physical inactivity and sedentary behavior contributes to shift work-related adverse health effects.

Past occupational dust exposure, depressive symptoms and anxiety in retired Chinese factory workers: the Guangzhou Biobank Cohort Study.

PubMed

Lin, Qiu-Hong; Jiang, Chao-Qiang; Lam, Tai-Hing; Xu, Lin; Jin, Ya-Li; Cheng, Kar-Keung

2014-01-01

Few studies have systematically investigated the impact of past occupational dust exposure on mental health. We examined whether retired factory workers exposed to any of the 4 dusts of silica, cement, coal and asbestos had more depressive symptoms and anxiety in southern China, which has experienced rapid economic development. We used data from the Guangzhou Biobank Cohort Study phase 3. Exposures, lifestyle, symptoms and medical history of the participants were assessed with a structured interview. Self-reported intensity and duration of past occupational dust exposure were used to derive cumulative exposure. Outcome measures were assessed by the 15-item Chinese version of the Geriatric Depression Scale (score ≥5) and the single-item on anxiety. The results revealed that 359 workers were exposed to at least one of the 4 dusts and that 1,253 were unexposed (controls). After adjustment of multiple confounders, greater risks of depressive symptoms were associated with high exposure to silica (odds ratio (OR) of 3.12, 95% CI of 1.17-8.31) and asbestos (OR of 6.90; CI of 1.29-36.75). Risks of anxiety were higher in those with low or high exposures to dust (OR of 2.01 and CI of 1.04-3.87 and OR of 2.29 and CI of 1.30-4.03, respectively) and cement (OR of 3.20 and CI of 1.27-8.07 and OR of 2.30 and CI of 1.09-4.87, respectively), and those with high exposure to silica (OR of 5.29, CI of 1.76-15.92). Past occupational exposures to silica, cement, coal and asbestos dusts were associated with adverse mental health outcomes in retired factory workers. The mechanism underlying the relationship between occupational exposures and psychological symptoms in later life needs to be further studied.

Lung disease and coal mining: what pulmonologists need to know.

PubMed

Go, Leonard H T; Krefft, Silpa D; Cohen, Robert A; Rose, Cecile S

2016-03-01

Coal mine workers are at risk for a range of chronic respiratory diseases including coal workers' pneumoconiosis, diffuse dust-related fibrosis, and chronic obstructive pulmonary disease. The purpose of this review is to describe coal mining processes and associated exposures to inform the diagnostic evaluation of miners with respiratory symptoms. Although rates of coal workers' pneumoconiosis declined after regulations were enacted in the 1970s, more recent data shows a reversal in this downward trend. Rapidly progressive pneumoconiosis with progressive massive fibrosis (complicated coal workers' pneumoconiosis) is being observed with increased frequency in United States coal miners, with histologic findings of silicosis and mixed-dust pneumoconiosis. There is increasing evidence of decline in lung function in individuals with pneumoconiosis. Multiple recent cohort studies suggest increased risk of lung cancer in coal miners. A detailed understanding of coal mining methods and processes allows clinicians to better evaluate and confirm chronic lung diseases caused by inhalational hazards in the mine atmosphere.

Investigation of a Q fever outbreak in a Scottish co-located slaughterhouse and cutting plant.

PubMed

Wilson, L E; Couper, S; Prempeh, H; Young, D; Pollock, K G J; Stewart, W C; Browning, L M; Donaghy, M

2010-12-01

Outbreaks of Q fever are rare in the UK. In 2006, the largest outbreak of Q fever in Scotland occurred at a co-located slaughterhouse and cutting plant with 110 cases. Preliminary investigations pointed to the sheep lairage being the potential source of exposure to the infective agent. A retrospective cohort study was carried out among workers along with environmental sampling to guide public health interventions. A total of 179 individuals were interviewed of whom 66 (37%) were migrant workers. Seventy-five (41.9%) were serologically confirmed cases. Passing through a walkway situated next to the sheep lairage, a nearby stores area, and being male were independently associated with being serologically positive for Q fever. The large proportion of migrant workers infected presented a significant logistical problem during outbreak investigation and follow up. The topic of vaccination against Q fever for slaughterhouse workers is contentious out with Australasia, but this outbreak highlights important occupational health issues. © 2009 Blackwell Verlag GmbH.

The association between weekly work hours, crew familiarity, and occupational injury and illness in emergency medical services workers.

PubMed

Weaver, Matthew D; Patterson, P Daniel; Fabio, Anthony; Moore, Charity G; Freiberg, Matthew S; Songer, Thomas J

2015-12-01

Emergency Medical Services (EMS) workers are shift workers in a high-risk, uncontrolled occupational environment. EMS-worker fatigue has been associated with self-reported injury, but the influence of extended weekly work hours is unknown. A retrospective cohort study was designed using historical shift schedules and occupational injury and illness reports. Using multilevel models, we examined the association between weekly work hours, crew familiarity, and injury or illness. In total, 966,082 shifts and 950 reports across 14 EMS agencies were obtained over a 1-3 year period. Weekly work hours were not associated with occupational injury or illness. Schedule characteristics that yield decreased exposure to occupational hazards, such as part-time work and night work, conferred reduced risk of injury or illness. Extended weekly work hours were not associated with occupational injury or illness. Future work should focus on transient exposures and agency-level characteristics that may contribute to adverse work events. © 2015 Wiley Periodicals, Inc.

The Changing Epidemiology of Human T-Cell Lymphotropic Virus Type 1 Infection in Peruvian Female Sex Workers, 1993–2010

PubMed Central

Stewart, Jenell; Heitzinger, Kristen; Pollett, Simon; Calderón, Martha; Alarcón, Jorge; Ton, Thanh G. N.; Zunt, Joseph R.

2017-01-01

Human T-cell lymphotropic virus type 1 (HTLV-1) was the first human retrovirus to be reported and is associated with neoplastic, neurological, autoimmune, and infectious complications. HTLV-1 is endemic in Peru, with the highest prevalence reported among commercial sex workers. Seroprevalence data collected from Peruvian female sex workers (FSWs) working in Callao over three study periods between 1993 and 2010 were used to examine the secular trend in HTLV-1 prevalence. Between 1993 and 2010, the prevalence of HTLV-1 decreased significantly from 14.5% to 3.1% (P < 0.01). The prevalence of HTLV-1 seropositivity differed significantly by birth cohort (1922–1959, 1960–1969, 1970–1979, and 1980–1992), and for each of the four birth cohorts, the prevalence did not significantly decrease by screening year (P > 0.07). There were no cases of HTLV-1 detected among FSW born after 1979 (N = 224). Participant characteristics associated with HTLV-1 seropositivity were birth in the Andes Mountains region, age, increased time in sex work, younger age of starting sex work, and human immunodeficiency virus (HIV) seropositivity. The secular trend in declining prevalence persisted after adjustment for age, time in sex work, place of birth, and HIV serostatus, with the odds of HTLV-1 infection decreasing approximately 16% per year (adjusted odds ratio = 0.84, 95% confidence interval = 0.78, 0.90). The increasing use of condoms by later birth cohorts noted in our analysis, as well as the increasing availability of free condoms provided by the Peruvian government—which started in the late 1980s before this study— may have been responsible for declining HTLV seroprevalence. PMID:27879458

Longitudinal associations between stressors and work ability in hospital workers.

PubMed

Carmen Martinez, Maria; da Silva Alexandre, Tiago; Dias de Oliveira Latorre, Maria do Rosario; Marina Fischer, Frida

This study sought to assess associations between work stressors and work ability in a cohort (2009-2012) of 498 hospital workers. Time-dependent variables associated with the Work Ability Index (WAI) were evaluated using general linear mixed models. Analyses included effects of individual and work characteristics. Except for work demands, the work stressors (job control, social support, effort-reward imbalance, overcommitment and work-related activities that cause pain/injury) were associated with WAI (p < 0.050) at intercept and in the time interaction. Daytime work and morning shift work were associated with decreased WAI (p < 0.010). Work stressors negatively affected work ability over time independently of other variables.

Cancer morbidity among workers in the telecommunications industry.

PubMed Central

Vågerö, D; Ahlbom, A; Olin, R; Sahlsten, S

1985-01-01

A retrospective cohort study of 2918 workers in the telecommunications industry in Sweden recorded the cancer morbidity for the period 1958-79. Cases of cancer were collected from the Swedish Cancer Registry for this period and information on work characteristics was collected for the entire period of employment. The total cancer morbidity was as expected. There was no excess risk of lung cancer but an excess risk of malignant melanoma of the skin was detected (SMR = 2.6, 12 cases). This excess risk was particularly associated with work environments where soldering was practised. Estimates of the SMR became larger with the assumption of a longer induction/latency period. PMID:3970885

Antiretroviral treatment and the health workforce in South Africa: how have ART workers been affected by scaling up?

PubMed

Tobi, Patrick; George, Gavin; Schmidt, Elena; Renton, Adrian

2008-12-01

To investigate the effect of scaling up antiretroviral treatment (ART) on the working environment and motivation of health workers in South Africa; and to suggest strategies to minimize negative effects and maximise positive effects. Exploratory interviews with health managers and senior clinical staff were used to identify locally relevant work environment indicators. A self-reported Likert scale questionnaire was administered to a randomly selected cohort of 269 health professionals at health facilities in KwaZulu Natal and Western Cape provinces of South Africa that included ART delivery sites. The cohort was disaggregated into ART and non-ART groups and differences between the two compared with Fisher's exact test and the non-parametric Mann-Whitney U-test. The ART sub-cohort reported: (i) a lighter workload (P = 0.013), (ii) higher level of staffing (P = 0.010), (iii) lower sickness absence (P = 0.032), (iv) higher overall job satisfaction (P = 0.010), (v) poorer physical state of their work premises (P = 0.003), and (vi) higher staff turnover (P = 0.036). Conclusion Scale-up affects the work environment in ways that influence workers' motivation both positively and negatively. A net negative balance is likely to drive staff out-migration, undermine the quality of care and compromise the capacity of the programme to achieve significant scale. As health workers are the most important element of the health system, a comprehensive and systematic understanding of scale-up impacts on their working conditions and motivation needs to be an integral part of any delivery strategy.

Problematic interpersonal relationships at work and depression: a Swedish prospective cohort study.

PubMed

Stoetzer, Ulrich; Ahlberg, Gunnel; Johansson, Gun; Bergman, Peter; Hallsten, Lennart; Forsell, Yvonne; Lundberg, Ingvar

2009-01-01

Studies have shown that interpersonal relations at work are important for several health related outcomes. The aim of the present study was to investigate whether low social support, serious conflict, exclusion by superiors or by co-workers at work may be determinants of depression. In a representative Swedish cohort study data were obtained in two waves three years apart. 4,040 women and men who did not change their jobs between the waves were chosen for the study. Exposure and confounders were obtained at Time 1 and outcome, depression according to Bech's MDI at Time 2. Previous depression was controlled for by adjusting for depression at Time 1. Data were analyzed using multiple logistic regression analyses. Odds-ratios adjusted for possible confounders and depression at base-line showed significant effects for all four exposures on depression (adjusted OR, low social support 1.5 CI 95% 1.1-2.0, serious conflict 1.4 CI 95% 1.1-1.9, exclusion by superiors 1.6 CI 95% 1.2-2.1 and exclusion by co-workers 1.7 CI 95% 1.2-2.3). The present results support the conclusion that problematic interpersonal relationships at work can be determinants of depression. These prospective findings may be of relevance for prevention and when rehabilitating depressed patients.

Longitudinal decline in pulmonary diffusing capacity among nitrate fertilizer workers.

PubMed

Hovland, K H; Skogstad, M; Bakke, B; Skare, Ø; Skyberg, K

2014-04-01

This study is part of a 3-year follow-up of lung function among nitrate fertilizer production workers. To study the possible adverse effects of occupational exposure to aerosols and gases on pulmonary diffusing capacity. A longitudinal study of a cohort of fertilizer workers who performed single-breath carbon monoxide diffusing capacity (DLco) tests and spirometry in 2007 and 2010. The workers completed a questionnaire on respiratory symptoms and smoking habits. Exposure to mineral dust, acid aerosols and inorganic gases was measured. The overall median inhalable and thoracic aerosol mass concentrations were 1.1mg/m(3) (min-max: <0.93-45) and 0.21mg/m(3) (min-max: <0.085-11), respectively. There were 308 participants in 2007 with 168 returning subjects in 2010. Overall, we found a statistically significant decline in the DLco of 0.068 mmol/min/kPa/year, adjusted for gender, age, height, weight, smoking status and doctor-diagnosed asthma during the 3-year follow-up (P < 0.01). The change in DLco did not vary significantly between the various job groups. Subjects with respiratory symptoms did not show a larger decline in DLco than those without symptoms. This study indicates a larger than expected decline in the DLco of fertilizer workers during a 3-year follow-up. However, the decline was not related to specific exposures at work, or to possible covariates of exposure.

Human visual function in the North Carolina clinical study on possible estuary-associated syndrome.

PubMed

Hudnell, H K; House, D; Schmid, J; Koltai, D; Stopford, W; Wilkins, J; Savitz, D A; Swinker, M; Music, S

2001-04-20

The U.S. Environmental Protection Agency assisted the North Carolina Department of Health and Human Services in conducting a study to investigate the potential for an association between fish kills in the North Carolina estuary system and the risk for persistent health effects. Impetus for the study was recent evidence suggesting that estuarine dinoflagellates, including members of the toxic Pfiesteria complex (TPC), P. piscicida and P. schumwayae, may release a toxin(s) that kills fish and adversely affects human health. This report describes one component of the study in which visual system function was assessed. Participants working primarily in estuaries inhabited by TPC or in off-shore waters thought not to contain TPC were studied. The potentially exposed estuary (n = 22) and unexposed offshore (n = 20) workers were matched for age, gender, and education. Visual acuity did not differ significantly between the cohorts, but visual contrast sensitivity (VCS), an indicator of visual pattern-detection ability for stimuli of various sizes, was significantly reduced by about 30% in the estuary relative to the offshore cohort. A further analysis that excluded participants having a history possibly predictive of neuropsychological impairment showed a similar VCS reduction. Additional analyses indicated that differences between the cohorts in age, education, smoking, alcohol consumption, and total time spent on any water did not account for the difference in VCS. Exploratory analyses suggested a possible association between the magnitude of VCS reduction and hours spent in contact with a fish kill. The profile of VCS deficit across stimulus sizes resembled that seen in organic solvent-exposed workers, but an assessment of occupational solvent, and other neurotoxicant, exposures did not indicate differences between the cohorts. These results suggest that factor(s) associated with the North Carolina estuaries, including the possibility of exposure to TPC toxin(s), may impair visual system function.

Non-Radiation Risk Factors for Leukemia: A case-control study among Chornobyl Cleanup Workers in Ukraine

PubMed Central

Gudzenko, Nataliya; Hatch, Maureen; Bazyka, Dimitry; Dyagil, Irina; Reiss, Robert F; Brenner, Alina; Chumak, Vadim; Babkina, Natalie; Zablotska, Lydia B; Mabuchi, Kiyohiko

2015-01-01

Background Occupational and environmental exposure to chemicals such as benzene has been linked to increased risk of leukemia. Cigarette smoking and alcohol consumption have also been found to affect leukemia risk. Previous analyses in a large cohort of Chornobyl clean-up workers in Ukraine found significant radiation-related increased risk for all leukemia types. We investigated the potential for additional effects of occupational and lifestyle factors on leukemia risk in this radiation-exposed cohort. Methods In a case-control study of chronic lymphocytic and other leukemias among Chornobyl cleanup workers, we collected data on a range of non-radiation exposures. We evaluated these other potential risk factors in analyses adjusting for estimated bone marrow radiation dose. We calculated Odds Ratios and 95% Confidence Intervals in relation to lifestyle factors and occupational hazards. Results After adjusting for radiation, we found no clear association of leukemia risk with smoking or alcohol but identified a two-fold elevated risk for non-CLL leukemia with occupational exposure to petroleum (OR=2.28; 95% Confidence Interval 1.13, 6.79). Risks were particularly high for myeloid leukemias. No associations with risk factors other than radiation were found for chronic lymphocytic leukemia. Conclusions These data – the first from a working population in Ukraine – add to evidence from several previous reports of excess leukemia morbidity in groups exposed environmentally or occupationally to petroleum or its products. PMID:26117815

Non-radiation risk factors for leukemia: A case-control study among chornobyl cleanup workers in Ukraine.

PubMed

Gudzenko, N; Hatch, M; Bazyka, D; Dyagil, I; Reiss, R F; Brenner, A; Chumak, V; Babkina, N; Zablotska, L B; Mabuchi, K

2015-10-01

Occupational and environmental exposure to chemicals such as benzene has been linked to increased risk of leukemia. Cigarette smoking and alcohol consumption have also been found to affect leukemia risk. Previous analyses in a large cohort of Chornobyl clean-up workers in Ukraine found significant radiation-related increased risk for all leukemia types. We investigated the potential for additional effects of occupational and lifestyle factors on leukemia risk in this radiation-exposed cohort. In a case-control study of chronic lymphocytic and other leukemias among Chornobyl cleanup workers, we collected data on a range of non-radiation exposures. We evaluated these and other potential risk factors in analyses adjusting for estimated bone marrow radiation dose. We calculated Odds Ratios and 95% Confidence Intervals in relation to lifestyle factors and occupational hazards. After adjusting for radiation, we found no clear association of leukemia risk with smoking or alcohol but identified a two-fold elevated risk for non-CLL leukemia with occupational exposure to petroleum (OR=2.28; 95% Confidence Interval 1.13, 6.79). Risks were particularly high for myeloid leukemias. No associations with risk factors other than radiation were found for chronic lymphocytic leukemia. These data - the first from a working population in Ukraine - add to evidence from several previous reports of excess leukemia morbidity in groups exposed environmentally or occupationally to petroleum or its products. Copyright © 2015 Elsevier Inc. All rights reserved.

The reciprocal relationship between sickness presenteeism and psychological distress in response to job stressors: evidence from a three-wave cohort study

PubMed Central

Oshio, Takashi; Tsutsumi, Akizumi; Inoue, Akiomi; Suzuki, Tomoko; Miyaki, Koichi

2017-01-01

Objectives: Sickness presenteeism (SP) is postulated as workers' response to their general state of health; hence, SP is expected to affect workers' future health. In the present study, we examined the reciprocal relationship between SP and health in response to job stressors, with specific reference to psychological distress (PD) as workers' state of health. Methods: We conducted mediation analysis, using data from a three-wave cohort occupational survey conducted at 1-year intervals in Japan; it involved 1,853 employees (1,661 men and 192 women) of a manufacturing firm. We measured SP and PD, using the World Health Organization Health and Work Performance Questionnaire and Kessler 6 score, respectively. For job stressors, we considered job demands and control, effort and reward, and procedural and interactional justice. Results: PD mediated 11.5%-36.2% of the impact of job control, reward, and procedural and interactional justice on SP, whereas SP mediated their impact on PD, albeit to a much lesser extent in the range of 3.4%-11.3%. Unlike in the cases of these job stressors related to job resources, neither SP nor PD mediated the impact of job demands or effort. Conclusions: Our results confirmed the reciprocal relationship between SP and PD in response to selected types of job stressors, emphasizing the need for more in-depth analysis of the dynamics of these associations. PMID:28993575

Occupational exposure to herbs containing aristolochic acids increases the risk of urothelial carcinoma in Chinese herbalists.

PubMed

Yang, Hsiao-Yu; Wang, Jung-Der; Lo, Tsai-Chang; Chen, Pau-Chung

2013-01-01

Aristolochic acid can cause urothelial carcinoma. Herbal remedies containing aristolochic acids were previously categorized as proven group 1 human carcinogens by the WHO cancer agency, the International Agency for Research on Cancer. However, the health effect on workers exposed to aristolochic acid is unclear. Fangchi, a representative herb containing aristolochic acid, is commonly used in the Chinese herbal medicine industry. We determined whether workers exposed to fangchi are at increased risk for urothelial carcinoma. We designed a case-control study based in a national representative cohort of Chinese herbalists. This study analyzed 6,564 Chinese herbalists employed between 1985 and 1998. All incident cases of urothelial carcinoma that occurred between 1988 and 2001 were defined as the case group. Controls were selected from the baseline cohort in a randomized manner. A total of 24 cases and 140 controls were included in analysis. Information about fangchi exposure was obtained in a questionnaire survey administered in 2002. Processing, selling or dispensing herbs containing fangchi significantly increased the risk of urothelial carcinoma (HR 2.4, 95% CI 1.1-5.3, p = 0.03). This relationship was independent of cigarette smoking or potential arsenic exposure from drinking water from deep wells. Exposure to the Chinese herbal drug fangchi increases the risk of urothelial carcinoma in herbalists. Appropriate medical monitoring is warranted for workers who have similar exposure. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Further follow up of mortality in a United Kingdom oil distribution centre cohort.

PubMed Central

Rushton, L

1993-01-01

Results of an extension of follow up (1976 to 1989) of a cohort of workers employed for at least one year between 1 January 1950 and 31 December 1975 at oil distribution centres in Britain are presented. Over 99% of the workers were successfully traced to determine their vital status at 31 December 1989. The mortality observed was compared with that expected from the death rates of all the male population of England and Wales. The mortality from all causes of death for the total study population was less than that of the comparison population, and reduced mortality was also found for many of the major non-malignant causes of death. No healthy worker effect was found for ischaemic heart disease, and raised mortality from this disease was found in particular for one company and in several job groups. Raised mortality was also found for aortic aneurysm. Mortality from all neoplasms was lower than expected overall, largely due to a deficit of deaths from malignant neoplasm of the lung. Raised mortality patterns from all neoplasms, malignant neoplasm of the lung, and several non-malignant disease groups were found for general manual workers although the mortality from many of these diseases for all men in this social class in the national population is also high. There was increased mortality from malignant neoplasms of the larynx and prostate but these tended to be in isolated subgroups. Mortality from malignant neoplasm of the kidney was raised overall and in drivers in particular. Mortality from leukaemia was high at one company and in drivers overall. PMID:8329322

Twenty years of work-related injury and illness among union carpenters in Washington State.

PubMed

McCoy, Amanda J; Kucera, Kristen L; Schoenfisch, Ashley L; Silverstein, Barbara A; Lipscomb, Hester J

2013-04-01

Individuals who work in the construction industry are at high risk of occupational injury. Robust surveillance systems are needed to monitor the experiences of these workers over time. We updated important surveillance data for a unique occupational cohort of union construction workers to provide information on long-term trends in their reported work-related injuries and conditions. Combining administrative data sources, we identified a dynamic cohort of union carpenters who worked in Washington State from 1989 through 2008, their hours worked by month, and their workers' compensation claims. Incidence rates of reported work-related injuries and illnesses were examined. Poisson regression was used to assess risk by categories of age, gender, time in the union, and calendar time contrasting medical only and paid lost time claims. Over the 20-year study period, 24,830 carpenters worked 192.4 million work hours. Work-related injuries resulting in medical care or paid lost time (PLT) from work occurred at a rate of 24.3 per 200,000 hr worked (95% CI: 23.5-25.0). Medical only claims declined 62% and PLT claims declined 77%; more substantive declines were seen for injuries resulting from being struck and falls to a lower level than from overexertion with lifting. Differences in risk based on union tenure and age diminished over time as well. Significant declines in rates of reported work-related injuries and illnesses were observed over the 20-year period among these union carpenters. Greater declines were observed among workers with less union tenure and for claims resulting in PLT. Copyright © 2012 Wiley Periodicals, Inc.

Impact of social inequalities at birth on the longevity of children born 1914-1916: A cohort study.

PubMed

Todd, Nicolas; Le Fur, Sophie; Bougnères, Pierre; Valleron, Alain-Jacques

2017-01-01

Testing whether familial socioeconomic status (SES) in childhood is a predictor of mortality has rarely been done on historical cohorts. The birth certificates of 4,805 individuals born 1914-1916 in 16 districts of the Paris region were retrieved. The handwritten information provided the occupation of parents, the legitimacy status, life events (e.g. marriage, divorce), and the precise date of death when after 1945 (i.e. age 31 years (y) in the cohort). We used the median age at death (MAD) as a global measure of mortality, then studied separately survival to and after 31 y. Multivariate Imputation by Chained Equations (MICE), Generalized Additive Models (GAMs) and mixed effect Cox models were used. MAD showed large variations according to paternal occupation. The lowest MAD in both sexes was that of workers' children: it was 56.3 y (95% CI: [48.6-62.7]) in men and 67.4 y (95% CI: [60.8-72.7]) in women, respectively (95% CI: 13.4 y [5.7-21.3]) and 12.3 y (95% CI: [4.0-19.2]) below the highest MAD attained. MAD experienced by illegitimate children was 18.9 y (95% CI: [13.3-32.3]) shorter than of legitimate children. The multivariate analysis revealed that in both sexes survival to age 31 y was predicted independently by legitimacy and paternal occupation. Paternal occupation was found significantly associated with mortality after age 31 y in females only: accordingly difference in life expectancy at age 31 y was 4.4 y (95% CI: [1.2-7.6]) between upper class and workers' daughters. Paternal occupation and legitimacy status were strong predictors of offspring longevity in this one-century historical cohort born during World War One.

Radiation Risk of Cardiovascular Diseases in the Cohort of Russian Emergency Workers of the Chernobyl Accident.

PubMed

Kashcheev, V V; Chekin, S Yu; Karpenko, S V; Maksioutov, M A; Menyaylo, A N; Tumanov, K A; Kochergina, E V; Kashcheeva, P V; Gorsky, A I; Shchukina, N V; Lovachev, S S; Vlasov, O K; Ivanov, V K

2017-07-01

This paper continues a series of publications that analyze the impact of radiation on incidence of circulatory system diseases in the cohort of Russian recovery operation workers (liquidators) and presents the results of the analysis of cardiovascular disease (CVD) incidence. The studied cohort consists of 53,772 liquidators who arrived in the Chernobyl accident zone within the first year after the accident (26 April 1986 to 26 April 1987). The individual doses varied from 0.0001 Gy to 1.42 Gy, and the mean external whole body dose in the cohort was 0.161 Gy. A total of 27,456 cases of CVD were diagnosed during the follow-up period 1986-2012 as a result of annual health examinations. A Poisson regression model was applied to estimate radiation risks and other risk factors associated with CVD. The following factors were identified as risk factors for CVD: the dose, duration of the liquidators' work in the Chernobyl zone, and concomitant diseases (diabetes mellitus, hypertension, overweight, and alcohol dependence). The baseline incidence of CVD is statistically significantly (p < 0.001) associated with all studied concomitant diseases. The incidence of CVD has revealed a statistically significant dose response with the lack of a latent period and with the average ERR Gy = 0.47, 95% CI = 0.31, 0.63, p < 0.001. Radiation risks of CVD statistically significantly (p = 0.01) varied with the duration of liquidators' stay in the Chernobyl zone; for those who stayed in the Chernobyl zone less than 6 wk, ERR/Gy = 0.80, 95% CI = 0.53; 1.08, p < 0.001.

SHIFT WORK AND BREAST CANCER AMONG WOMEN TEXTILE WORKERS IN SHANGHAI, CHINA

PubMed Central

Li, Wenjin; Ray, Roberta M.; Thomas, David B.; Davis, Scott; Yost, Michael; Breslow, Norman; Gao, Dao Li; Fitzgibbons, E. Dawn; Camp, Janice E.; Wong, Eva; Wernli, Karen J.; Checkoway, Harvey

2014-01-01

PURPOSE Although night shift work has been associated with elevated risk of breast cancer in numerous epidemiologic studies, evidence is not consistent. We conducted a nested case-cohort study to investigate a possible association between shift work including a night shift and risk of breast cancer within a large cohort of women textile workers in Shanghai, China. METHODS The study included 1709 incident breast cancer cases and 4780 non-cases. Data on historical shift-work schedules were collected by categorized jobs from the factories where the study subjects had worked, and then were linked to the complete work histories of each subject. No jobs in the factories involved exclusively night shift work. Therefore, night shift was evaluated as part of a rotating shift work pattern. Hazard ratios and 95% confidence intervals were calculated using Cox proportional hazards modeling adapted for the case-cohort design for years of night-shift work and the total number of nights worked. Additionally, analyses were repeated with exposures lagged by 10 and 20 years. RESULTS We observed no associations with either years of night-shift work, or number of nights worked during the entire employment period, irrespective of lag intervals. Findings from the age-stratified analyses were very similar to those observed for the entire study population. CONCLUSIONS The findings from this study provide no evidence to support the hypothesis that shift work increases breast cancer risk. The positive association between shift work and breast cancer observed in Western populations, but not observed in this and other studies of the Chinese population, suggest that the effect of shift work on breast cancer risk may be different in Asian and Caucasian women. PMID:25421377

Shift work and breast cancer among women textile workers in Shanghai, China.

PubMed

Li, Wenjin; Ray, Roberta M; Thomas, David B; Davis, Scott; Yost, Michael; Breslow, Norman; Gao, Dao Li; Fitzgibbons, E Dawn; Camp, Janice E; Wong, Eva; Wernli, Karen J; Checkoway, Harvey

2015-01-01

Although night-shift work has been associated with elevated risk of breast cancer in numerous epidemiologic studies, evidence is not consistent. We conducted a nested case-cohort study to investigate a possible association between shift work including a night shift and risk of breast cancer within a large cohort of women textile workers in Shanghai, China. The study included 1,709 incident breast cancer cases and 4,780 non-cases. Data on historical shift work schedules were collected by categorized jobs from the factories, where the study subjects had worked, and then were linked to the complete work histories of each subject. No jobs in the factories involved exclusively night-shift work. Therefore, night shift was evaluated as part of a rotating shift work pattern. Hazard ratios and 95 % confidence intervals were calculated using Cox proportional hazards modeling adapted for the case-cohort design for years of night-shift work and the total number of nights worked. Additionally, analyses were repeated with exposures lagged by 10 and 20 years. We observed no associations with either years of night-shift work or number of nights worked during the entire employment period, irrespective of lag intervals. Findings from the age-stratified analyses were very similar to those observed for the entire study population. The findings from this study provide no evidence to support the hypothesis that shift work increases breast cancer risk. The positive association between shift work and breast cancer observed in Western populations, but not observed in this and other studies of the Chinese population, suggests that the effect of shift work on breast cancer risk may be different in Asian and Caucasian women.

Lung cancer mortality and occupational exposure to asbestos among telephone linemen: a historical cohort study in France.

PubMed

Meguellati-Hakkas, Djamila; Cyr, Diane; Stücker, Isabelle; Févotte, Joëlle; Pilorget, Corinne; Luce, Danièle; Guénel, Pascal

2006-11-01

The authors studied the mortality by lung cancer in telephone linemen exposed to asbestos at low levels during installation of telephone cables. Three hundred eight lung cancers deaths were identified in the cohort. Exposure to asbestos and to other occupational carcinogens was assessed using a job-exposure matrix. The relative risk for lung cancer death associated with an estimated exposure of approximately 2 f/cc-years was 2.1 (95% confidence interval = 1.1-4.0) as compared with workers exposed to less than 0.5 f/cc-years. Mean annual exposure or exposure duration were not clearly related to lung cancer. Adjustment for other occupational lung carcinogens did not change this finding. The observed mortality by lung cancer associated with asbestos exposure at low levels is higher than the prediction based on linear downward extrapolations from highly exposed occupational cohorts.

Benzene exposure and risk of lymphohaematopoietic cancers in 25 000 offshore oil industry workers

PubMed Central

Stenehjem, J S; Kjærheim, K; Bråtveit, M; Samuelsen, S O; Barone-Adesi, F; Rothman, N; Lan, Q; Grimsrud, T K

2015-01-01

Background: The aim of this work was to examine the risk of lymphohaematopoietic (LH) cancer according to benzene exposure among offshore workers. Methods: Cancer registry data were used to identify 112 cancer cases diagnosed during 1999–2011 in a cohort of 24 917 Norwegian men reporting offshore work between 1965 and 1999. Analyses were conducted according to a stratified case–cohort design with a reference subcohort of 1661 workers. Cox regression was used to estimate hazard ratios with 95% confidence intervals, adjusted for other benzene exposure and smoking. Results: Most workers were exposed to benzene for <15 years. The upper range values of average intensity and cumulative exposure were estimated to 0.040 p.p.m. and 0.948 p.p.m.-years, respectively. Risks were consistently elevated among exposed workers for all LH cancers combined and for most subgroups, although case numbers were small and yielded imprecise risk estimates. There was evidence of dose-related risk patterns according to cumulative exposure for acute myeloid leukaemia (AML), multiple myeloma (MM) (P trends 0.052 and 0.024, respectively), and suggestively so for chronic lymphocytic leukaemia (CLL) according to average intensity (P trend 0.094). Conclusions: Our results support an association between cumulative and intensity metrics of low-level benzene exposure and risk for AML, MM, and suggestively for CLL. PMID:25867262

Health Of Americans Who Must Work Longer To Reach Social Security Retirement Age.

PubMed

Choi, HwaJung; Schoeni, Robert F

2017-10-01

To receive full Social Security benefits, Americans born after 1937 must claim those benefits at an older age than earlier birth cohorts. Additionally, proposals to improve the fiscal position of Social Security typically include increasing the age at which workers can receive full benefits. Birth cohorts required to work longer are in worse health at ages 49-60, based on multiple measures of morbidity, than cohorts who could retire earlier. Project HOPE—The People-to-People Health Foundation, Inc.

Workplace risk factors for cancer in the German rubber industry: Part 1. Mortality from respiratory cancers

PubMed Central

Weiland, S. K.; Straif, K.; Chambless, L.; Werner, B.; Mundt, K. A.; Bucher, A.; Birk, T.; Keil, U.

1998-01-01

OBJECTIVES: To determine the cancer specific mortality by work area among active and retired male workers in the German rubber industry. METHODS: A cohort of 11,663 male German workers was followed up for mortality from 1 January 1981 to 31 December 1991. Cohort members were classified as active (n = 7536) or retired (n = 4127) as of 1 January 1981 and had been employed for at least one year in one of five study plants producing tyres or technical rubber goods. Work histories were reconstructed with routinely documented "cost centre codes" which were classified into six categories: I preparation of materials; II production of technical rubber goods; III production of tyres; IV storage and dispatch; V maintenance; and VI others. Standardised mortality ratios (SMRs) adjusted for age and calendar year and 95% confidence intervals (95% CIs), stratified by work area (employment in respective work area for at least one year) and time related variables (year of hire, lagged years of employment in work area), were calculated from national reference rates. RESULTS: SMRs for laryngeal cancer were highest in work area I (SMR 253; 95% CI 93 to 551) and were significant among workers who were employed for > 10 years in this work area (SMR 330; 95% CI 107 to 779). Increased mortality rates from lung cancer were identified in work areas I (SMR 162; 95% CI 129 to 202), II (SMR 134; 95% CI 109 to 163), and V (SMR 131; 95% CI 102 to 167). Mortality from pleural cancer was increased in all six work areas, and significant excesses were found in work areas I (SMR 448; 95% CI 122 to 1146), II (SMR 505; 95% CI 202 to 1040), and V (SMR 554; 95% CI 179 to 1290). CONCLUSION: A causal relation between the excess of pleural cancer and exposure to asbestos among rubber workers is plausible and likely. In this study, the pattern of excess of lung cancer parallels the pattern of excess of pleural cancer. This points to asbestos as one risk factor for the excess deaths from lung cancer among rubber workers. The study provides further evidence for an increased mortality from laryngeal cancer among workers in the rubber industry, particularly in work area I.   PMID:9764109

Urine cytology screening of French workers exposed to occupational urinary tract carcinogens: a prospective cohort study over a 20-year period

PubMed Central

Rouanet, Lucile; Mulliez, Aurélien; Naughton, Geraldine; Fontana, Luc; Druet-Cabanac, Michel; Moustafa, Farès; Chamoux, Alain

2017-01-01

Objectives To demonstrate that urine cytology screening can provide relevant epidemiological data for earlier detection of urothelial cancer caused by occupational exposure. Design Prospective cohort study. Setting Industries using urothelial carcinogens in France. Urine samples were collected on site, after a work week and were analysed at the University Hospital of Clermont-Ferrand, France. Participants Participants were workers exposed to urothelial carcinogens. Women and current smokers at time of study recruitment were exclusion criteria. Outcomes Urine cells atypia were ranged into three classes: negative/normal, atypical/suspicious/dysplasia or positive/malignant. Results We included 2020 workers over a period of 20 years from 1993 to 2013: 606 worked in rubber manufacturing, 692 from metal processing, 245 in chemical industry and 477 in roadwork and building industry. Workers had a mean exposure of 15.2±10.4 years before their first urine cytology screening. There was a mean of 3.4±4.3 urine cytology screenings per worker between 1993 and 2013. 6478 cytology were normal, 462 suspicious and 13 malignant. Suspicious and malignant cytology occurred in 4.8% of workers exposed for 1–10 years, 6.2% for 11–20 years of exposure, 7.6% for 21–30 years and 8.6% for >30 years (p<0.001). Using exposure for 1–10 years as reference, the adjusted OR of receiving a suspicious or malignant diagnosis increased with duration of exposure: OR=1.50 (95% CI 1.10 to 2.05, p=0.01) for 21–30 years and OR=1.78 (95% CI 1.23 to 2.56, p=0.002) for >30 years of exposure. Using metal processing as reference, the risk of pathological urine cytology results increased for rubber manufacturing (OR=1.32, 95% CI 1.05 to 1.65, p=0.02), with a trend for roadwork and building industry (OR=1.39, 95% CI 0.98 to 1.97, p=0.07) and for chemical industry (OR=1.34, 95% CI 0.94 to 1.93, p=0.11). Conclusions Urine cytology is a useful tool in occupational medicine. We promote new guidelines with an early screening of urothelial cancer by cytology, starting with beginning of exposure. PMID:28939575

Reduced serum club cell protein as a pulmonary damage marker for chronic fine particulate matter exposure in Chinese population.

PubMed

Wang, Yanhua; Duan, Huawei; Meng, Tao; Shen, Meili; Ji, Qianpeng; Xing, Jie; Wang, Qingrong; Wang, Ting; Niu, Yong; Yu, Tao; Liu, Zhong; Jia, Hongbing; Zhan, Yuliang; Chen, Wen; Zhang, Zhihu; Su, Wenge; Dai, Yufei; Zhang, Xuchun; Zheng, Yuxin

2018-03-01

Exposure to fine particulate matter (PM 2.5 ) pollution is associated with increased morbidity and mortality from respiratory diseases. However, few population-based studies have been conducted to assess the alterations in circulating pulmonary proteins due to long-term PM 2.5 exposure. We designed a two-stage study. In the first stage (training set), we assessed the associations between PM 2.5 exposure and levels of pulmonary damage markers (CC16, SP-A and SP-D) and lung function in a coke oven emission (COE) cohort with 558 coke plant workers and 210 controls. In the second stage (validation set), significant initial findings were validated by an independent diesel engine exhaust (DEE) cohort with 50 DEE exposed workers and 50 controls. Serum CC16 levels decreased in a dose response manner in association with both external and internal PM 2.5 exposures in the two cohorts. In the training set, serum CC16 levels decreased with increasing duration of occupational PM 2.5 exposure history. An interquartile range (IQR) (122.0μg/m 3 ) increase in PM 2.5 was associated with a 5.76% decrease in serum CC16 levels, whereas an IQR (1.06μmol/mol creatinine) increase in urinary 1-hydroxypyrene (1-OHP) concentration was associated with a 5.36% decrease in serum CC16 levels in the COE cohort. In the validation set, the concentration of serum CC16 in the PM 2.5 exposed group was 22.42% lower than that of the controls and an IQR (1.24μmol/mol creatinine) increase in urinary 1-OHP concentration was associated with a 12.24% decrease in serum CC16 levels in the DEE cohort. Serum CC16 levels may be a sensitive marker for pulmonary damage in populations with high PM 2.5 exposure. Copyright © 2017 Elsevier Ltd. All rights reserved.

Influenza vaccination in healthcare workers; comparison of side effects and preferred route of administration of intradermal versus intramuscular administration.

PubMed

Meijer, W J; Wensing, A M J; Bos, A A; Kuiphuis, J C F; Hagelen, E M M; Wilschut, J C; de Vries, M J T; Riezebos-Brilman, A

2017-03-13

To explore the nature and severity of side effects and future preference of intradermal versus intramuscular influenza vaccination in healthcare workers. Prospective cohort study. Two University Medical Centers in The Netherlands. Healthcare workers receiving an influenza vaccination. Healthcare workers that were vaccinated during the influenza vaccination season of 2012-2013 were approached for participation in a questionnaire study. The questionnaire was divided into two parts. The first part had to be answered directly after vaccination and the second part two weeks after vaccination. The motivation for vaccine uptake, whether or not the HCWs had direct contact with patients and the prevalence and severity of local and systemic side effects of influenza vaccination were explored. In addition, it was assessed how participants experienced the vaccination and which type of administration they preferred for future vaccination. Side effects of vaccination were more prevalent in the intradermal group versus the intramuscular group (56% versus 26%, p<0.001). Local side effects were perceived as more severe in healthcare workers receiving the intradermal vaccine. Directly after vaccination, healthcare workers preferred the intradermal vaccination. Two weeks after vaccination both types of vaccine were equally appreciated. This study shows that there are significant differences in the nature and severity of side effects upon intramuscular and intradermal influenza vaccination. This difference did not result in a preference among the vaccinated subjects for one type of vaccine. Copyright © 2017 Elsevier Ltd. All rights reserved.

Ionising radiation and risk of death from leukaemia and lymphoma in radiation-monitored workers (INWORKS): an international cohort study.

PubMed

Leuraud, Klervi; Richardson, David B; Cardis, Elisabeth; Daniels, Robert D; Gillies, Michael; O'Hagan, Jacqueline A; Hamra, Ghassan B; Haylock, Richard; Laurier, Dominique; Moissonnier, Monika; Schubauer-Berigan, Mary K; Thierry-Chef, Isabelle; Kesminiene, Ausrele

2015-07-01

There is much uncertainty about the risks of leukaemia and lymphoma after repeated or protracted low-dose radiation exposure typical of occupational, environmental, and diagnostic medical settings. We quantified associations between protracted low-dose radiation exposures and leukaemia, lymphoma, and multiple myeloma mortality among radiation-monitored adults employed in France, the UK, and the USA. We assembled a cohort of 308,297 radiation-monitored workers employed for at least 1 year by the Atomic Energy Commission, AREVA Nuclear Cycle, or the National Electricity Company in France, the Departments of Energy and Defence in the USA, and nuclear industry employers included in the National Registry for Radiation Workers in the UK. The cohort was followed up for a total of 8.22 million person-years. We ascertained deaths caused by leukaemia, lymphoma, and multiple myeloma. We used Poisson regression to quantify associations between estimated red bone marrow absorbed dose and leukaemia and lymphoma mortality. Doses were accrued at very low rates (mean 1.1 mGy per year, SD 2.6). The excess relative risk of leukaemia mortality (excluding chronic lymphocytic leukaemia) was 2.96 per Gy (90% CI 1.17-5.21; lagged 2 years), most notably because of an association between radiation dose and mortality from chronic myeloid leukaemia (excess relative risk per Gy 10.45, 90% CI 4.48-19.65). This study provides strong evidence of positive associations between protracted low-dose radiation exposure and leukaemia. Centers for Disease Control and Prevention, Ministry of Health, Labour and Welfare of Japan, Institut de Radioprotection et de Sûreté Nucléaire, AREVA, Electricité de France, National Institute for Occupational Safety and Health, US Department of Energy, US Department of Health and Human Services, University of North Carolina, Public Health England. Copyright © 2015 Elsevier Ltd. All rights reserved.

Peptic Ulcer Disease in Healthcare Workers: A Nationwide Population-Based Cohort Study

PubMed Central

Lin, Hong-Yue; Weng, Shih-Feng; Lin, Hung-Jung; Hsu, Chien-Chin; Wang, Jhi-Joung; Su, Shih-Bin; Guo, How-Ran; Huang, Chien-Cheng

2015-01-01

Health care workers (HCWs) in Taiwan have heavy, stressful workloads, are on-call, and have rotating nightshifts, all of which might contribute to peptic ulcer disease (PUD). We wanted to evaluate the PUD risk in HCWs, which is not clear. Using Taiwan’s National Health Insurance Research Database, we identified 50,226 physicians, 122,357 nurses, 20,677 pharmacists, and 25,059 other HCWs (dieticians, technicians, rehabilitation therapists, and social workers) as the study cohort, and randomly selected an identical number of non-HCW patients (i.e., general population) as the comparison cohort. Conditional logistical regression analysis was used to compare the PUD risk between them. Subgroup analysis for physician specialties was also done. Nurses and other HCWs had a significantly higher PUD risk than did the general population (odds ratio [OR]: 1.477; 95% confidence interval [CI]: 1.433–1.521 and OR: 1.328; 95% CI: 1.245–1.418, respectively); pharmacists had a lower risk (OR: 0.884; 95% CI: 0.828–0.945); physicians had a nonsignificantly different risk (OR: 1.029; 95% CI: 0.987–1.072). In the physician specialty subgroup analysis, internal medicine, surgery, Ob/Gyn, and family medicine specialists had a higher PUD risk than other physicians (OR: 1.579; 95% CI: 1.441–1.731, OR: 1.734; 95% CI: 1.565–1.922, OR: 1.336; 95% CI: 1.151–1.550, and OR: 1.615; 95% CI: 1.425–1.831, respectively). In contrast, emergency physicians had a lower risk (OR: 0.544; 95% CI: 0.359–0.822). Heavy workloads, long working hours, workplace stress, rotating nightshifts, and coping skills may explain our epidemiological findings of higher risks for PUD in some HCWs, which might help us improve our health policies for HCWs. PMID:26301861

Recent im/migration to Canada linked to unmet health needs among sex workers in Vancouver, Canada: Findings of a longitudinal study

PubMed Central

Sou, Julie; Goldenberg, Shira M.; Duff, Putu; Nguyen, Paul; Shoveller, Jean; Shannon, Kate

2017-01-01

Despite universal health care in Canada, sex workers (SW) and im/migrants experience suboptimal health care access. In this analysis, we examined the correlates of unmet health needs among SWs in Metro Vancouver over time. Data from a longitudinal cohort of women SWs (AESHA) was used. Of 742 SWs, 25.5% reported unmet health needs at least once over the 4-year study period. In multivariable logistic regression using generalized estimating equations, recent im/migration had the strongest impact on unmet health needs; long-term im/migration, policing, and trauma were also important determinants. Legal and social supports to promote im/migrant SWs’ access to health care are recommended. PMID:28300492

[Shift work and night work: what effect on blood pressure?].

PubMed

Cassat, M; Wuerzner, G; Burnier, M

2015-09-09

Shift work has become more and more common for the last thirty years. By definition, shift work disturbs the circadian rhythm and the internal clock. Even if the pathophysiological mechanisms are not well understood, a greater cardiovascular risk has been attributed to shift work. Cross-sectional and cohort studies have identified an association between shift work and an elevated blood pressure. Shift workers also present a higher incidence of hypertension and progression than day workers. Unfortunately, the heterogeneity of the studies, the multiple confounding factors, as well as the complexity to achieve a suitable comparison group make it impossible to draw firm clinical evidence. Nevertheless, this population needs a medical follow-up focused on the cardiovascular risks and blood pressure.

Healthy Worker Effect Phenomenon: Revisited with Emphasis on Statistical Methods – A Review

PubMed Central

Chowdhury, Ritam; Shah, Divyang; Payal, Abhishek R.

2017-01-01

Known since 1885 but studied systematically only in the past four decades, the healthy worker effect (HWE) is a special form of selection bias common to occupational cohort studies. The phenomenon has been under debate for many years with respect to its impact, conceptual approach (confounding, selection bias, or both), and ways to resolve or account for its effect. The effect is not uniform across age groups, gender, race, and types of occupations and nor is it constant over time. Hence, assessing HWE and accounting for it in statistical analyses is complicated and requires sophisticated methods. Here, we review the HWE, factors affecting it, and methods developed so far to deal with it. PMID:29391741

Estimation of Future Cancer Burden Among Rescue and Recovery Workers Exposed to the World Trade Center Disaster.

PubMed

Singh, Ankura; Zeig-Owens, Rachel; Moir, William; Hall, Charles B; Schwartz, Theresa; Vossbrinck, Madeline; Jaber, Nadia; Webber, Mayris P; Kelly, Kerry J; Ortiz, Viola; Koffler, Ellen; Prezant, David J

2018-06-01

Elevated rates of cancer have been reported in individuals exposed to the World Trade Center (WTC) disaster, including Fire Department of the City of New York (FDNY) rescue and recovery workers. To project the future burden of cancer in WTC-exposed FDNY rescue and recovery workers by estimating the 20-year cancer incidence. A total of 14 474 WTC-exposed FDNY employees who were cancer-free on January 1, 2012; subgroup analyses were conducted of the cohort's white male population (n = 12 374). In this closed-cohort study, we projected cancer incidence for the January 1, 2012, to December 31, 2031, period. Simulations were run using demographic-specific New York City (NYC) cancer and national mortality rates for each individual, summed for the whole cohort, and performed 1000 times to produce mean estimates. Additional analyses in the subgroup of white men compared case counts produced by using 2007-2011 FDNY WTC Health Program (FDNY-WTCHP) cancer rates vs NYC rates. Average and 20-year aggregate costs of first-year cancer care were estimated using claims data. World Trade Center disaster exposure defined as rescue and recovery work at the WTC site at any time from September 11, 2001, to July 25, 2002. (1) Projected number of incident cancers in the full cohort, based on NYC cancer rates; (2) cancer incidence estimates in the subgroup projected using FDNY-WTCHP vs NYC rates; and (3) estimated first-year treatment costs of incident cancers. On January 1, 2012, the cohort was 96.8% male, 87.1% white, and had a mean (SD) age of 50.2 (9.2) years. The projected number of incident cancer cases was 2960 (95% CI, 2883-3037). In our subgroup analyses using FDNY-WTCHP vs NYC cancer rates, the projected number of new cases in white men was elevated (2714 [95% CI, 2638-2786] vs 2596 [95% CI, 2524-2668]). Accordingly, we expect more prostate (1437 [95% CI, 1383-1495] vs 863 [95% CI, 816-910]), thyroid (73 [95% CI, 60-86] vs 57 [95% CI, 44-69]), and melanoma cases (201 [95% CI, 179-223] vs 131 [95% CI, 112-150), but fewer lung (237 [95% CI, 212-262] vs 373 [95% CI, 343-405]), colorectal (172 [95% CI, 152-191] vs 267 [95% CI, 241-292]), and kidney cancers (66 [95% CI, 54-80] vs 132 [95% CI, 114-152]) (P < .001 for all comparisons). The estimated 20-year cost of first-year treatment was $235 835 412 (95% CI, $187 582 227-$284 088 597). We project that the FDNY-WTCHP cohort will experience a greater cancer burden than would be expected from a demographically similar population. This underscores the importance of cancer prevention efforts and routine screening in WTC-exposed rescue and recovery workers.

Outbreak of Severe Histoplasmosis Among Tunnel Workers-Dominican Republic, 2015.

PubMed

Armstrong, Paige A; Beard, John D; Bonilla, Luis; Arboleda, Nelson; Lindsley, Mark D; Chae, Sae-Rom; Castillo, Delia; Nuñez, Ramona; Chiller, Tom; de Perio, Marie A; Pimentel, Raquel; Vallabhaneni, Snigdha

2018-05-02

Histoplasmosis is a fungal infection associated with exposure to bat guano. An outbreak of an unknown severe febrile illness occurred among tunnel workers in the Dominican Republic, and resulted in several deaths. We conducted an investigation to confirm etiology and recommend control measures. A case was defined as fever and ≥2 symptoms consistent with histoplasmosis in a tunnel worker, July-September 2015. We interviewed workers and family members, reviewed medical records, tested serum and urine for Histoplasma antigen/antibody, and conducted a cohort study to identify risk factors for histoplasmosis and severe infection (intensive care). A crew of 36 male workers removed large amounts of bat guano from tunnels without respiratory protection for a median of 24 days per worker (range, 1-25 days). Median age was 32 years (range, 18-62 years); none were immunocompromised. Thirty (83%) workers had illness that met the case definition, of whom 28 (93%) were hospitalized, 9 (30%) required intensive care, 6 (20%) required intubation, and 3 (10%) died. The median time from symptom onset to antifungal treatment was 6 days (range, 1-11 days). Twenty-two of 34 (65%) workers had laboratory evidence of infection. Severe illnesses and death likely resulted from exposure to large inocula of Histoplasma capsulatum spores in an enclosed space, lack of respiratory protection, and delay in recognition and treatment. Clinician education about histoplasmosis, improved laboratory capacity to diagnose fungal infections, and occupational health guidance to protect workers against endemic fungi are recommended in the Dominican Republic.

Cancer mortality in poultry slaughtering/processing plant workers belonging to a union pension fund.

PubMed

Johnson, Eric S; Ndetan, Harrison; Lo, Ka-Ming

2010-08-01

The role of zoonotic biological agents in human cancer occurrence has been little studied. Humans are commonly exposed to viruses that naturally infect and cause cancer in food animals such as poultry that constitute part of the biological environment. It is not known if these viruses cause cancer in humans. To study cancer mortality in the largest cohort to date, of 20,132 workers in poultry slaughtering and processing plants, a group with the highest human exposures to these viruses. Mortality in poultry workers was compared with that in the US general population through the estimation of standardized mortality ratios. Significantly increased risks were observed in the cohort as a whole or in subgroups, for several cancer sites, viz: cancers of the buccal cavity and pharynx; pancreas; trachea/bronchus/lung; brain; cervix; lymphoid leukemia; monocytic leukemia; and tumors of the hemopoietic and lymphatic systems. Elevated SMRs that were not statistically significant were observed for cancers of the liver, nasopharynx, myelofibrosis, and myeloma. New sites observed to be significantly in excess in this study were cancers of the cervix and penis. This large study provides evidence that a human group with high exposure to poultry oncogenic viruses has increased risk of dying from several cancers. Other occupational carcinogenic exposures could be of importance in explaining some of the findings, such as fumes from wrapping machines. These findings may have implications for public health amongst persons in the general population who may also be exposed to these viruses. What is needed now are epidemiologic studies that can demonstrate whether the excess of specific cancers can be attributed to specific occupational exposures while adequately controlling for other potential occupational and non-occupational carcinogenic exposures. Copyright 2010 Elsevier Inc. All rights reserved.

A Point System for Predicting 10-Year Risk of Developing Type 2 Diabetes Mellitus in Japanese Men: Aichi Workers' Cohort Study.

PubMed

Yatsuya, Hiroshi; Li, Yuanying; Hirakawa, Yoshihisa; Ota, Atsuhiko; Matsunaga, Masaaki; Haregot, Hilawe Esayas; Chiang, Chifa; Zhang, Yan; Tamakoshi, Koji; Toyoshima, Hideaki; Aoyama, Atsuko

2018-03-17

Relatively little evidence exists for type 2 diabetes mellitus (T2DM) prediction models from long-term follow-up studies in East Asians. This study aims to develop a point-based prediction model for 10-year risk of developing T2DM in middle-aged Japanese men. We followed 3,540 male participants of Aichi Workers' Cohort Study, who were aged 35-64 years and were free of diabetes in 2002, until March 31, 2015. Baseline age, body mass index (BMI), smoking status, alcohol consumption, regular exercise, medication for dyslipidemia, diabetes family history, and blood levels of triglycerides (TG), high density lipoprotein cholesterol (HDLC) and fasting blood glucose (FBG) were examined using Cox proportional hazard model. Variables significantly associated with T2DM in univariable models were simultaneously entered in a multivariable model for determination of the final model using backward variable selection. Performance of an existing T2DM model when applied to the current dataset was compared to that obtained in the present study's model. During the median follow-up of 12.2 years, 342 incident T2DM cases were documented. The prediction system using points assigned to age, BMI, smoking status, diabetes family history, and TG and FBG showed reasonable discrimination (c-index: 0.77) and goodness-of-fit (Hosmer-Lemeshow test, P = 0.22). The present model outperformed the previous one in the present subjects. The point system, once validated in the other populations, could be applied to middle-aged Japanese male workers to identify those at high risk of developing T2DM. In addition, further investigation is also required to examine whether the use of this system will reduce incidence.

State-of-the-science review: Does manganese exposure during welding pose a neurological risk?

PubMed

Santamaria, Annette B; Cushing, Colleen A; Antonini, James M; Finley, Brent L; Mowat, Fionna S

2007-01-01

Recent studies report that exposure to manganese (Mn), an essential component of welding electrodes and some steels, results in neurotoxicity and/or Parkinson's disease (PD) in welders. This "state-of-the-science" review presents a critical analysis of the published studies that were conducted on a variety of Mn-exposed occupational cohorts during the last 100 yr, as well as the regulatory history of Mn and welding fumes. Welders often perform a variety of different tasks with varying degrees of duration and ventilation, and hence, to accurately assess Mn exposures that occurred in occupational settings, some specific information on the historical work patterns of welders is desirable. This review includes a discussion of the types of exposures that occur during the welding process--for which limited information relating airborne Mn levels with specific welding activities exists--and the human health studies evaluating neurological effects in welders and other Mn-exposed cohorts, including miners, millers, and battery workers. Findings and implications of studies specifically conducted to evaluate neurobehavioral effects and the prevalence of PD in welders are also discussed. Existing exposure data indicate that, in general, Mn exposures in welders are less than those associated with the reports of clinical neurotoxicity (e.g., "manganism") in miners and smelter workers. It was also found that although manganism was observed in highly exposed workers, the scant exposure-response data available for welders do not support a conclusion that welding is associated with clinical neurotoxicity. The available data might support the development of reasonable "worst-case" exposure estimates for most welding activities, and suggest that exposure simulation studies would significantly refine such estimates. Our review ends with a discussion of the data gaps and areas for future research.

Reckoning HIV/AIDS care: A longitudinal study of community home-based caregivers and clients in Swaziland.

PubMed

Root, Robin; Van Wyngaard, Arnau; Whiteside, Alan

2015-01-01

The article is a descriptive case study of a community home-based care (CHBC) organisation in Swaziland that depicts the convergence of CHBC expansion with substantially improved health outcomes. Comprised of 993 care supporters who tend to 3 839 clients in 37 communities across southern Swaziland, Shiselweni Home-based Care (SHBC) is illustrative of many resource-limited communities throughout Africa that have mobilised, at varying degrees of formality, to address the individual and household suffering associated with HIV/AIDS. To better understand the potential significance of global and national health policy/programming reliance on community health workers (task shifting), we analysed longitudinal data on both care supporter and client cohorts from 2008 to 2013. Most CHBC studies report data from only one cohort. Foremost, our analysis demonstrated a dramatic decline (71.4%) among SHBC clients in overall mortality from 32.2% to 9.2% between 2008 and 2013. Although the study was not designed to establish statistical significance or causality between SHBC expansion and health impact, our findings detail a compelling convergence among CHBC, improved HIV health practices, and declines in client mortality. Our analysis indicated (1) the potential contributions of community health workers to individual and community wellbeing, (2) the challenges of task-shifting agendas, above all comprehensive support of community health workers/care supporters, and (3) the importance of data collection to monitor and strengthen the critical health services assigned to CHBC. Detailed study of CHBC operations and practices is helpful also for advancing government and donor HIV/AIDS strategies, especially with respect to health services decentralisation, in Swaziland and similarly profiled settings.

Mental health training for health workers in Africa: a systematic review.

PubMed

Liu, Germaine; Jack, Helen; Piette, Angharad; Mangezi, Walter; Machando, Debra; Rwafa, Chido; Goldenberg, Matthew; Abas, Melanie

2016-01-01

Commitment to building mental health treatment capacity in Africa is increasing but little agreement exists on strategies to train health workers on mental health or evaluation of training efforts. We systematically reviewed published literature on interventions to train health-care workers in Africa on mental health. 37 studies met our inclusion criteria. Training outcomes focused on changes in knowledge and attitude, with few studies evaluating skill and practice and only two studies measuring clinical outcomes. Quality of study methodology was generally not high, with scarce follow-up data and use of control cohorts. Existing studies provide examples of many training and evaluation strategies, but evidence to draw conclusions about the efficacy of different training techniques is inadequate. Key knowledge gaps include development and testing of innovative educational strategies; development of standardised, competency-based learning objectives and outcome measures; and training that facilitates implementation of integrated mental health systems. African institutions need to be empowered to do research in these areas to encourage the development of best practices for the continent. Copyright © 2016 Elsevier Ltd. All rights reserved.

Psychosocial work characteristics and long-term sickness absence due to mental disorders.

PubMed

van Hoffen, Marieke F A; Roelen, Corné A M; van Rhenen, Willem; Schaufeli, Wilmar B; Heymans, Martijn W; Twisk, Jos W R

2018-02-09

Psychosocial work characteristics are associated with all-cause long-term sickness absence (LTSA). This study investigated whether psychosocial work characteristics such as higher workload, faster pace of work, less variety in work, lack of performance feedback, and lack of supervisor support are prospectively associated with higher LTSA due to mental disorders. Cohort study including 4877 workers employed in the distribution and transport sector in The Netherlands. Psychosocial work characteristics were included in a logistic regression model estimating the odds ratios (OR) and 95% confidence intervals (CI) of mental LTSA during 2-year follow-up. The ability of the regression model to discriminate between workers with and without mental LTSA was investigated with the area under the receiver operating characteristic curve (AUC). Tow thousand seven hundred and eighty-two (57%) workers were included in the analysis; 73 (3%) had mental LTSA. Feedback about one's performance (OR = 0.82; 95% CI 0.70-0.96) was associated with mental LTSA. A prediction model including psychosocial work characteristics poorly discriminated (AUC = 0.65; 95% CI 0.56-0.74) between workers with and without mental LTSA. Feedback about one's performance is associated with lower rates of mental LTSA, but it is not useful to measure psychosocial work characteristics to identify workers at risk of mental LTSA.

Development of a total hydrocarbon ordinal job-exposure matrix for workers responding to the Deepwater Horizon disaster: The GuLF STUDY.

PubMed

Stewart, Patricia A; Stenzel, Mark R; Ramachandran, Gurumurthy; Banerjee, Sudipto; Huynh, Tran B; Groth, Caroline P; Kwok, Richard K; Blair, Aaron; Engel, Lawrence S; Sandler, Dale P

2018-05-01

The GuLF STUDY is a cohort study investigating the health of workers who responded to the Deepwater Horizon oil spill in the Gulf of Mexico in 2010. The objective of this effort was to develop an ordinal job-exposure matrix (JEM) of airborne total hydrocarbons (THC), dispersants, and particulates to estimate study participants' exposures. Information was collected on participants' spill-related tasks. A JEM of exposure groups (EGs) was developed from tasks and THC air measurements taken during and after the spill using relevant exposure determinants. THC arithmetic means were developed for the EGs, assigned ordinal values, and linked to the participants using determinants from the questionnaire. Different approaches were taken for combining exposures across EGs. EGs for dispersants and particulates were based on questionnaire responses. Considerable differences in THC exposure levels were found among EGs. Based on the maximum THC level participants experienced across any job held, ∼14% of the subjects were identified in the highest exposure category. Approximately 10% of the cohort was exposed to dispersants or particulates. Considerable exposure differences were found across the various EGs, facilitating investigation of exposure-response relationships. The JEM is flexible to allow for different assumptions about several possibly relevant exposure metrics.

Decrease in seroprevalence of hepatitis A after the implementation of nationwide disposable tableware use in Taiwan.

PubMed

Su, Shih-Bin; Lin, Ching-Yih; Sheu, Ming-Jen; Kan, Wei-Chih; Wang, Hsien-Yi; Guo, How-Ran

2010-11-23

Taiwan is an endemic area of viral hepatitis, including hepatitis A, which is transmitted mainly from the fecal-oral route. In order to reduce the transmission through food intake, the government implemented a policy of nationwide disposal tableware use in public eating places in 1982. We conducted a study to estimate the seroprevalence of Hepatitis A in a group of workers in Taiwan in 2005, determine the risk factors, and compare seroprevalence to published estimates in Taiwan to evaluate changes in the seroprevalence after the implementation of the nationwide disposal tableware use. We recruited workers of an industrial park during their annual health examinations in 2005 and measured their anti-hepatitis A virus IgG titer using microparticle enzyme immunoassay. We compared the seroprevalence across different birth cohorts within the study population and also analyzed data from previous studies. The overall sero-positive rate was 22.0% in the 11,777 participants. The rate was much lower among those who were covered by the program since birth (born after 1982) in comparison with those who were not (2.7% vs. 25.3%, p < 0.001). From the analyses of data from previous studies, we found the age-specific rates were similar in cohorts born in or after 1982 across studies conducted in different time periods but decreased with the calendar year in cohorts born before 1982. In particular, the age-specific seroprevalence dropped to less than one third in a three-year period among those who were born around 1982. Data from both the current and previous studies in different time periods supported the effectiveness of disposal tableware in preventing the transmission of hepatitis A.

Decrease in seroprevalence of Hepatitis A after the implementation of nationwide disposable tableware use in Taiwan

PubMed Central

2010-01-01

Background Taiwan is an endemic area of viral hepatitis, including hepatitis A, which is transmitted mainly from the fecal-oral route. In order to reduce the transmission through food intake, the government implemented a policy of nationwide disposal tableware use in public eating places in 1982. We conducted a study to estimate the seroprevalence of Hepatitis A in a group of workers in Taiwan in 2005, determine the risk factors, and compare seroprevalence to published estimates in Taiwan to evaluate changes in the seroprevalence after the implementation of the nationwide disposal tableware use. Methods We recruited workers of an industrial park during their annual health examinations in 2005 and measured their anti-hepatitis A virus IgG titer using microparticle enzyme immunoassay. We compared the seroprevalence across different birth cohorts within the study population and also analyzed data from previous studies. Results The overall sero-positive rate was 22.0% in the 11,777 participants. The rate was much lower among those who were covered by the program since birth (born after 1982) in comparison with those who were not (2.7% vs. 25.3%, p < 0.001). From the analyses of data from pervious studies, we found the age-specific rates were similar in cohorts born in or after 1982 across studies conducted in different time periods but decreased with the calendar year in cohorts born before 1982. In particular, the age-specific seroprevalence dropped to less than one third in a three-year period among those who were born around 1982. Conclusions Data from both the current and previous studies in different time periods supported the effectiveness of disposal tableware in preventing the transmission of hepatitis A. PMID:21092247

Long-term health experience of jet engine manufacturing workers: VII: occupational exposures.

PubMed

Kennedy, Kathleen J; Esmen, Nurtan A; Hancock, Roger P; Lacey, Steven E; Marsh, Gary M; Buchanich, Jeanine M; Youk, Ada O

2013-06-01

To reconstruct agent-specific occupational exposures for a cohort of jet engine manufacturing workers for use in an epidemiological mortality study. Potential chemical and physical exposures at eight jet engine manufacturing and overhaul/repair plants were evaluated for the period 1952 to 2001. Eleven agents were selected for detailed examination, and a job-exposure matrix was constructed. Quantitative exposure estimates were generated for metalworking fluids, nickel, cobalt, chromium, solvents, and incomplete combustion aerosol from metalworking fluids. Qualitative exposure estimates were assigned for ionizing radiation, electromagnetic fields, polychlorinated biphenyls, and lead-cadmium. All exposures showed decreasing trends over the study period. The quantitative exposure levels generated in this study were lower than early contemporaneous professional practice recommendations and were similar to or lower than published data from other industries.

Where Do Highly Educated Russians Work, and What Do They Do for a Living?

ERIC Educational Resources Information Center

Varshavskaya, E. Ya.

2016-01-01

During the postreform period, the educational structure of the Russian workforce has seen a sharp increase in the proportion of workers who possess a higher education. Thus, between 2001 and 2014 the share of workers with a university degree rose from 23.8 percent to 32.2 percent. These shifts are even more pronounced in youth cohorts. In 2014, a…

Delayed repair of distal biceps tendon ruptures is successful: a case-control study.

PubMed

Haverstock, John; Grewal, Ruby; King, Graham J W; Athwal, George S

2017-06-01

The literature has shown an increased complication rate with a delay to surgical repair of acute distal biceps tendon ruptures; however, little has been documented regarding the outcome of delayed repairs. This case-control study compared a study cohort of delayed (>21 days) distal biceps tendon repairs with a control cohort repaired acutely (<21 days). Sixteen delayed repair cases were reviewed and matched with acute controls (1:3) based on repair technique, age, and workers' compensation status. The delayed cohort was reviewed and completed isometric strength testing and the Disabilities of the Arm, Shoulder and Hand questionnaire; Patient-Rated Elbow Evaluation; and American Shoulder and Elbow Surgeons elbow questionnaire. The time to surgery averaged 37 ± 12 days in the delayed cohort versus 10 ± 6 days in the acute cohort. Complications occurred in 63% of patients in the delayed cohort versus 29% in the acute cohort (P = .04); however, 90% of the delayed cohort's complications consisted of transient paresthesias. Follow-up scores on the Patient-Rated Elbow Evaluation, Disabilities of the Arm, Shoulder and Hand questionnaire, and American Shoulder and Elbow Surgeons elbow questionnaire were not statistically different between cohorts (P > .37, P > .22, and P > .46, respectively). Despite a high rate of initial complications, patients treated with distal biceps tendon repair after a delay (>21 days) can expect similar functional outcomes to those treated acutely. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Meta-Analysis of Cardiac Mortality in Three Cohorts of Carbon Black Production Workers

PubMed Central

Morfeld, Peter; Mundt, Kenneth A.; Dell, Linda D.; Sorahan, Tom; McCunney, Robert J.

2016-01-01

Epidemiological studies have demonstrated associations between airborne environmental particle exposure and cardiac disease and mortality; however, few have examined such effects from poorly soluble particles of low toxicity such as manufactured carbon black (CB) particles in the work place. We combined standardised mortality ratio (SMR) and Cox proportional hazards results from cohort studies of US, UK and German CB production workers. Under a common protocol, we analysed mortality from all causes, heart disease (HD), ischemic heart disease (IHD) and acute myocardial infarction (AMI). Fixed and random effects (RE) meta-regression models were fit for employment duration, and for overall cumulative and lugged quantitative CB exposure estimates. Full cohort meta-SMRs (RE) were 1.01 (95% confidence interval (CI) 0.79–1.29) for HD; 1.02 (95% CI 0.80–1.30) for IHD, and 1.08 (95% CI 0.74–1.59) for AMI mortality. For all three outcomes, meta-SMRs were heterogeneous, increased with time since first and time since last exposure, and peaked after 25–29 or 10–14 years, respectively. Meta-Cox coefficients showed no association with lugged duration of exposure. A small but imprecise increased AMI mortality risk was suggested for cumulative exposure (RE-hazards ratio (HR) = 1.10 per 100 mg/m3-years; 95% CI 0.92–1.31), but not for lugged exposures. Our results do not demonstrate that airborne CB exposure increases all-cause or cardiac disease mortality. PMID:27005647

The Strain Index (SI) and Threshold Limit Value (TLV) for Hand Activity Level (HAL): risk of carpal tunnel syndrome (CTS) in a prospective cohort.

PubMed

Garg, A; Kapellusch, J; Hegmann, K; Wertsch, J; Merryweather, A; Deckow-Schaefer, G; Malloy, E J

2012-01-01

A cohort of 536 workers was enrolled from 10 diverse manufacturing facilities and was followed monthly for six years. Job physical exposures were individually measured. Worker demographics, medical history, psychosocial factors, current musculoskeletal disorders (MSDs) and nerve conduction studies (NCS) were obtained. Point and lifetime prevalence of carpal tunnel syndrome (CTS) at baseline (symptoms + abnormal NCS) were 10.3% and 19.8%. During follow-up, there were 35 new CTS cases (left, right or both hands). Factors predicting development of CTS included: job physical exposure (American conference of governmental industrial hygienists Threshold Limit Value (ACGIH TLV) for Hand Activity Level (HAL) and the Strain Index (SI)), age, BMI, other MSDs, inflammatory arthritis, gardening outside of work and feelings of depression. In the adjusted models, the TLV for HAL and the SI were both significant per unit increase in exposure with hazard ratios (HR) increasing up to a maximum of 5.4 (p = 0.05) and 5.3 (p = 0.03), respectively; however, similar to other reports, both suggested lower risk at higher exposures. Data suggest that the TLV for HAL and the SI are useful metrics for estimating exposure to biomechanical stressors. This study was conducted to determine how well the TLV for HAL and the SI predict risk of CTS using a prospective cohort design with survival analysis. Both the TLV for HAL and the SI were found to predict risk of CTS when adjusted for relevant covariates.

Physical activity and calorie intake mediate the relationship from depression to body fat mass among female Mexican health workers.

PubMed

Quezada, Amado D; Macías-Waldman, Nayeli; Salmerón, Jorge; Swigart, Tessa; Gallegos-Carrillo, Katia

2017-11-17

Depression is a foremost cause of morbidity throughout the world and the prevalence of depression in women is about twice as high as men. Additionally, overweight and obesity are major global health concerns. We explored the relationship between depression and body fat, and the role of physical activity and diet as mediators of this relationship in a sample of 456 adult female Mexican health workers. Longitudinal and cross-sectional analyses using data from adult women of the Health Workers Cohort Study (HWCS) Measures of body fat mass (kg from DEXA), dietary intake (kcal from FFQ), leisure time activity (METs/wk) and depression (CES-D) were determined in two waves (2004-2006 and 2010-2011). We explored the interrelation between body fat, diet, leisure time, physical activity, and depression using a cross-lagged effects model fitted to longitudinal data. We also fitted a structural equations model to cross-sectional data with body fat as the main outcome, and dietary intake and physical activity from leisure time as mediators between depression and body fat. Baseline depression was significantly related to higher depression, higher calorie intake, and lower leisure time physical activity at follow-up. From our cross-sectional model, each standard deviation increase in the depression score was associated with an average increase of 751 ± 259 g (± standard error) in body fat through the mediating effects of calorie intake and physical activity. The results of this study show how depression may influence energy imbalance between calories consumed and calories expended, resulting in higher body fat among those with a greater depression score. Evaluating the role of mental conditions like depression in dietary and physical activity behaviors should be positioned as a key research goal for better designed and targeted public health interventions. The HealthWorkers Cohort Study (HWCS) has been approved by the Institutional IRB. Number: 2005-785-012.

A prospective cohort study of exposure-response relationship for vibration-induced white finger.

PubMed

Bovenzi, M

2010-01-01

To investigate prospectively the relation between vibration-induced white finger (VWF) and measures of cumulative (lifetime) exposure to hand-transmitted vibration (HTV). Two hundred and forty-nine HTV workers and 138 control men of the same companies participated in a 3-year follow-up study. The diagnosis of VWF (Raynaud's phenomenon in the controls) was based on the medical history, the administration of colour charts and the results of a cold test. Tool vibration magnitudes were expressed as root-mean-square (r.m.s.) acceleration, frequency-weighted according to international standard ISO 5349-1 and also unweighted over the frequency range 6.3-1250 Hz. From the vibration magnitudes and exposure durations, alternative measures of cumulative vibration dose were calculated for each HTV worker, according to the expression: dose = Sigmaa(i)(m)t(i), where a(i) is the acceleration magnitude on tool i, t(i) is the lifetime exposure duration (hours) for tool i, and m = 0, 1, 2 or 4. The incidence of VWF varied from 5 to 6% in the HTV workers versus 0 to 1.5% for Raynaud's phenomenon in the controls. After adjusting for potential confounders, measures of cumulative vibration dose derived from total operating hours and high powers of unweighted acceleration (ie, , with m>1) gave better predictions of the occurrence of VWF than dose measures calculated from frequency-weighted acceleration (ie, ). These findings were observed in the entire sample of HTV workers, in those with no VWF at the initial investigation, and in those with normal cold test results at baseline. This prospective cohort study suggests that measures of cumulative vibration doses constructed from unweighted r.m.s. acceleration perform better for the prediction of VWF than dose measures calculated according to the recommendations of current standards. These findings should contribute to the improvement of the ISO frequency weighting for evaluating the severity of hand-transmitted vibration.

A retrospective cohort study of shift work and risk of cancer-specific mortality in German male chemical workers.

PubMed

Yong, Mei; Nasterlack, Michael; Messerer, Peter; Oberlinner, Christoph; Lang, Stefan

2014-02-01

Human evidence of carcinogenicity concerning shift work is inconsistent. In a previous study, we observed no elevated risk of total mortality in shift workers followed up until the end of 2006. The present study aimed to investigate cancer-specific mortality, relative to shift work. The cohort consisted of male production workers (14,038 shift work and 17,105 day work), employed at BASF Ludwigshafen for at least 1 year between 1995 and 2005. Vital status was followed from 2000 to 2009. Cause-specific mortality was obtained from death certificates. Exposure to shift work was measured both as a dichotomous and continuous variable. While lifetime job history was not available, job duration in the company was derived from personal data, which was then categorized at the quartiles. Cox proportional hazard model was used to adjust for potential confounders, in which job duration was treated as a time-dependent covariate. Between 2000 and 2009, there were 513 and 549 deaths among rotating shift and day work employees, respectively. Risks of total and cancer-specific mortalities were marginally lower among shift workers when taking age at entry and job level into consideration and were statistically significantly lower when cigarette smoking, alcohol intake, job duration, and chronic disease prevalence at entry to follow-up were included as explanatory factors. With respect to mortality risks in relation to exposure duration, no increased risks were found in any of the exposure groups after full adjustment and there was no apparent trend suggesting an exposure-response relation with duration of shift work. The present analysis extends and confirms our previous finding of no excess risk of mortality associated with work in the shift system employed at BASF Ludwigshafen. More specifically, there is also no indication of an increased risk of mortality due to cancer.

Health and carcinogenic risk evaluation for cohorts exposed to PAHs in petrochemical workplaces in Rawalpindi city (Pakistan).

PubMed

Kamal, Atif; Cincinelli, Alessandra; Martellini, Tania; Palchetti, Ilaria; Bettazzi, Francesca; Malik, Riffat Naseem

2016-01-01

This study presents the analyses of urinary biomarkers (1-OHPyr, α- and β-naphthols) of polycyclic aromatic hydrocarbons (PAHs) exposure and biomarkers of effect (i.e. blood parameters) in petroleum-refinery workers (RFs) and auto-repair workers (MCs). Exposed subjects had higher concentrations of white blood cell (WBC) count than control subjects (CN) subjects (5.31 × 10(3) μL(-1) in exposed vs. 5.15 × 10(3) μL(-1) in CN subjects), while the biomarker of oxidative DNA damage (8-OHdG) was significantly higher in MCs. The exposure among these two cohorts could be influenced by the ambience of the workplaces; in fact, MCs' shops are relatively damp and enclosed workplaces in comparison with the indoor environment of refineries. PAHs in the dust samples from mechanical workshops probably originated from mixed sources (traffic exhaust and petroleum spills), while the incremental lifetime cancer risk (ILCR) for MCs showed moderate-to-low cancer risk from exposure to dust-bound PAHs. The study shows that increasing PAH exposure can be traced in MC workstations and needs to be investigated for the safety of public health.

The Healthy Worker Effect and Nuclear Industry Workers

PubMed Central

Fornalski, Krzysztof W.; Dobrzyński, Ludwik

2010-01-01

The linear no-threshold (LNT) dose-effect relationship has been consistently used by most radiation epidemiologists to estimate cancer mortality risk. The large scattering of data by International Agency for Research on Cancer, IARC (Vrijheid et al. 2007; Therry-Chef et al. 2007; Cardis et al. 2007), interpreted in accordance with LNT, has been previously demonstrated (Fornalski and Dobrzyński 2009). Using conventional and Bayesian methods the present paper demonstrates that the standard mortality ratios (SMRs), lower in the IARC cohort of exposed nuclear workers than in the non exposed group, should be considered as a hormetic effect, rather than a healthy worker effect (HWE) as claimed by the IARC group. PMID:20585442

Temporal Patterns of Exposure to Asbestos and Risk of Asbestosis: An Analysis of a Cohort of Asbestos Textile Workers.

PubMed

Farioli, Andrea; Violante, Francesco S; La Vecchia, Carlo; Negri, Eva; Pelucchi, Claudio; Spatari, Giovanna; Boffetta, Paolo; Pira, Enrico

2018-01-12

The aim of the study was to assess the risk of asbestosis death based on the temporal pattern of exposure to asbestos. We followed up a cohort of asbestos textile workers, employed in 1946 to 1984, until November 2013. We measured the duration of the employment, the time since last employment (TSLE), the age, and the year of first employment. Hazard ratios (HR) were estimated through multivariable Cox regression models. We observed 51 asbestosis deaths among 1823 workers. The HR of asbestosis death increased with exposure duration (HR 2.4 for ≥15 years compared with <5 years, P trend = 0.014) and declined with TSLE (HR 0.3 for ≥25 compared with <5 years, P = 0.004). The risk of asbestosis mortality strongly declined for exposure starting after 1968. The risk of asbestosis death strongly declines in the decades after cessation of the exposure.This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0.

Exposure reconstruction for the TCDD-exposed NIOSH cohort using a concentration- and age-dependent model of elimination.

PubMed

Aylward, Lesa L; Brunet, Robert C; Starr, Thomas B; Carrier, Gaétan; Delzell, Elizabeth; Cheng, Hong; Beall, Colleen

2005-08-01

Recent studies demonstrating a concentration dependence of elimination of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) suggest that previous estimates of exposure for occupationally exposed cohorts may have underestimated actual exposure, resulting in a potential overestimate of the carcinogenic potency of TCDD in humans based on the mortality data for these cohorts. Using a database on U.S. chemical manufacturing workers potentially exposed to TCDD compiled by the National Institute for Occupational Safety and Health (NIOSH), we evaluated the impact of using a concentration- and age-dependent elimination model (CADM) (Aylward et al., 2005) on estimates of serum lipid area under the curve (AUC) for the NIOSH cohort. These data were used previously by Steenland et al. (2001) in combination with a first-order elimination model with an 8.7-year half-life to estimate cumulative serum lipid concentration (equivalent to AUC) for these workers for use in cancer dose-response assessment. Serum lipid TCDD measurements taken in 1988 for a subset of the cohort were combined with the NIOSH job exposure matrix and work histories to estimate dose rates per unit of exposure score. We evaluated the effect of choices in regression model (regression on untransformed vs. ln-transformed data and inclusion of a nonzero regression intercept) as well as the impact of choices of elimination models and parameters on estimated AUCs for the cohort. Central estimates for dose rate parameters derived from the serum-sampled subcohort were applied with the elimination models to time-specific exposure scores for the entire cohort to generate AUC estimates for all cohort members. Use of the CADM resulted in improved model fits to the serum sampling data compared to the first-order models. Dose rates varied by a factor of 50 among different combinations of elimination model, parameter sets, and regression models. Use of a CADM results in increases of up to five-fold in AUC estimates for the more highly exposed members of the cohort compared to estimates obtained using the first-order model with 8.7-year half-life. This degree of variation in the AUC estimates for this cohort would affect substantially the cancer potency estimates derived from the mortality data from this cohort. Such variability and uncertainty in the reconstructed serum lipid AUC estimates for this cohort, depending on elimination model, parameter set, and regression model, have not been described previously and are critical components in evaluating the dose-response data from the occupationally exposed populations.

Mortality of older construction and craft workers employed at Department of Energy (DOE) nuclear sites.

PubMed

Dement, John M; Ringen, Knut; Welch, Laura S; Bingham, Eula; Quinn, Patricia

2009-09-01

The U.S. Department of Energy (DOE) established medical screening programs at the Hanford Nuclear Reservation, Oak Ridge Reservation, the Savannah River Site, and the Amchitka site starting in 1996. Workers participating in these programs have been followed to determine their vital status and mortality experience through December 31, 2004. A cohort of 8,976 former construction workers from Hanford, Savannah River, Oak Ridge, and Amchitka was followed using the National Death Index through December 31, 2004, to ascertain vital status and causes of death. Cause-specific standardized mortality ratios (SMRs) were calculated based on US death rates. Six hundred and seventy-four deaths occurred in this cohort and overall mortality was slightly less than expected (SMR = 0.93, 95% CI = 0.86-1.01), indicating a "healthy worker effect." However, significantly excess mortality was observed for all cancers (SMR = 1.28, 95% CI = 1.13-1.45), lung cancer (SMR = 1.54, 95% CI = 1.24-1.87), mesothelioma (SMR = 5.93, 95% CI = 2.56-11.68), and asbestosis (SMR = 33.89, 95% CI = 18.03-57.95). Non-Hodgkin's lymphoma was in excess at Oak Ridge and multiple myeloma was in excess at Hanford. Chronic obstructive pulmonary disease (COPD) was significantly elevated among workers at the Savannah River Site (SMR = 1.92, 95% CI = 1.02-3.29). DOE construction workers at these four sites were found to have significantly excess risk for combined cancer sites included in the Department of Labor' Energy Employees Occupational Illness Compensation Program (EEOCIPA). Asbestos-related cancers were significantly elevated. (c) 2009 Wiley-Liss, Inc.

Work Ability Index as tool to identify workers at risk of premature work exit.

PubMed

Roelen, Corné A M; Heymans, Martijn W; Twisk, Jos W R; van der Klink, Jac J L; Groothoff, Johan W; van Rhenen, Willem

2014-12-01

To investigate the Work Ability Index (WAI) as tool for identifying workers at risk of premature work exit in terms of disability pension, unemployment, or early retirement. Prospective cohort study of 11,537 male construction workers (mean age 45.5 years), who completed the WAI at baseline and reported their work status (employed, unemployed, disability pension, or retired) after mean 2.3 years of follow-up. Associations between WAI scores and work status were investigated by multinomial logistic regression analysis. The ability of the WAI to discriminate between workers at high and low risk of premature work exit was analyzed by the area (AUC) under the receiver operating characteristic curve. 9,530 (83 %) construction workers had complete data for analysis. At follow-up, 336 (4 %) workers reported disability pension, 125 (1 %) unemployment, and 255 (3 %) retirement. WAI scores were prospectively associated with the risk of disability pension at follow-up, but not with the risk of unemployment and early retirement. The WAI showed fair discrimination to identify workers at risk of disability pension [AUC = 0.74; 95 % confidence interval (CI) 0.70-0.77]. The discriminative ability decreased with age from AUC = 0.78 in workers aged 30-39 years to AUC = 0.69 in workers ≥50 years of age. Discrimination failed for unemployment (AUC = 0.51; 95 % CI 0.47-0.55) and early retirement (AUC = 0.58; 95 % CI 0.53-0.61). The WAI can be used to identify construction workers <50 years of age at increased risk of disability pension and invite them for preventive interventions.

Food Insecurity Increases HIV Risk Among Young Sex Workers in Metro Vancouver, Canada.

PubMed

Barreto, Daniella; Shannon, Kate; Taylor, Chrissy; Dobrer, Sabina; Jean, Jessica St; Goldenberg, Shira M; Duff, Putu; Deering, Kathleen N

2017-03-01

This research aimed to determine the effect of food insecurity on sexual HIV risk with clients among youth sex workers (YSWs) <30 years in Metro Vancouver, Canada. Data were drawn from a prospective community cohort of sex workers (2010-2013). We examined the independent relationship between YSWs' food insecurity and being pressured into sex without a condom by clients ("client condom refusal"). Of 220 YSWs, 34.5 % (n = 76) reported client condom refusal over the 3.5-year study period and 76.4 % (n = 168) reported any food insecurity. Adjusting for other HIV risk pathways, food insecurity retained an independent effect on client condom refusal (AOR 2.08, 95 % CI 1.23-3.51), suggesting that food insecurity is significantly associated with HIV risk among YSWs. This study indicates a critical relationship between food insecurity and HIV risk, and demonstrates YSWs' particular vulnerability. Public policies for food assistance as a harm reduction measure may be key to addressing this disparity.

FOOD INSECURITY INCREASES HIV RISK AMONG YOUNG SEX WORKERS IN METRO VANCOUVER, CANADA

PubMed Central

Barreto, Daniella; Shannon, Kate; Taylor, Chrissy; Dobrer, Sabina; St. Jean, Jessica; Goldenberg, Shira M.; Duff, Putu; Deering, Kathleen N.

2017-01-01

This research aimed to determine the effect of food insecurity on sexual HIV risk with clients among youth sex workers (YSWs) <30 years in Metro Vancouver, Canada. Data were drawn from a prospective community cohort of sex workers (2010–2013). We examined the independent relationship between YSWs food insecurity and being pressured into sex without a condom by clients (“client condom refusal”). Of 220 YSWs, 34.5 % (n = 76) reported client condom refusal over the 3.5-year study period and 76.4 % (n = 168) reported any food insecurity. Adjusting for other HIV risk pathways, food insecurity retained an independent effect on client condom refusal (AOR 2.08, 95 % CI 1.23–3.51), suggesting that food insecurity is significantly associated with HIV risk among YSWs. This study indicates a critical relationship between food insecurity and HIV risk, and demonstrates YSWs particular vulnerability. Public policies for food assistance as a harm reduction measure may be key to addressing this disparity. PMID:27752869

Social security status and mortality in Belgian and Spanish male workers.

PubMed

Duran, Xavier; Vanroelen, Christophe; Deboosere, Patrick; Benavides, Fernando G

2016-01-01

To assess differences in mortality rates between social security statuses in two independent samples of Belgian and Spanish male workers. Study of two retrospective cohorts (Belgium, n=23,607; Spain, n=44,385) of 50-60 year old male employees with 4 years of follow-up. Mortality rate ratios (MRR) were estimated using Poisson regression models. Mortality for subjects with permanent disability was higher than for the employed, for both Belgium [MRR=4.56 (95% CI: 2.88-7.21)] and Spain [MRR=7.15 (95% CI: 5.37-9.51)]. For the unemployed/early retirees, mortality was higher in Spain [MRR=1.64 (95% CI: 1.24-2.17)] than in Belgium [MRR=0.88 (95% CI: 0.46-1.71)]. MRR differences between Belgium and Spain for unemployed workers could be partly explained because of differences between the two social security systems. Future studies should further explore mortality differences between countries with different social security systems. Copyright © 2016 SESPAS. Published by Elsevier Espana. All rights reserved.

[Determinants of partner violence in health workers of IMSS, Morelos].

PubMed

Ortega-Ceballos, Paola Adanari; Mudgal, Jyoti; Flores, Yvonne; Rivera-Rivera, Leonor; Díaz-Montiel, Juan Carlos; Salmerón, Jorge

2007-01-01

To study the prevalence of partner violence, and to identify the associated risk factors in a sample of female workers of IMSS (Mexican Social Security Institute), Morelos State. Cross-sectional data from 1 173 women participating in the cohort study of IMSS workers are utilized to study these associations. The study provides information on frequency of psychological, physical or sexual violence and perception of severity during the 12 months prior to the time of data collection. It was carried out in Morelos between October 1998 and March 2000. Polytomous logistic regression models were used to obtain odds ratios for different degrees of partner violence. A high prevalence of partner violence is observed in the sample. Main factors associated with higher severity of violence are state of the relationship and alcohol intake, emotional status of the couple at home, work burden of the woman, and a history of violence in childhood. All these factors are potentially modifiable through interventions aimed at stress reduction. These results should be considered when developing preventive programs against partner violence in Mexico.

Prevalence of undiagnosed cardiovascular risk factors and 10-year CVD risk in male steel industry workers.

PubMed

Gray, Benjamin J; Bracken, Richard M; Turner, Daniel; Morgan, Kerry; Mellalieu, Stephen D; Thomas, Michael; Williams, Sally P; Williams, Meurig; Rice, Sam; Stephens, Jeffrey W

2014-05-01

To assess the prevalence of undiagnosed cardiovascular disease (CVD) in a cohort of male steelworkers in South Wales, UK. Male steel industry workers (n = 221) with no prior diagnosis of CVD or diabetes accepted a CVD risk assessment within the work environment. Demographic, anthropometric, family, and medical histories were all recorded and capillary blood samples obtained. The 10-year CVD risk was predicted using the QRISK2-2012 algorithm. Up to 81.5% of workers were either overweight or obese. More than 20% of workers were found to have diastolic hypertension, high total cholesterol, and/or a total cholesterol/high-density lipoprotein ratio of six or more. Over one quarter of workers assessed had an increased 10-year CVD risk. Despite a physically demanding occupation, risk assessment in the workplace uncovered significant occult factors in CVD risk in a sample of male heavy industry workers.

The incidence and impact of recurrent workplace injury and disease: a cohort study of WorkSafe Victoria, Australia compensation claims

PubMed Central

Ruseckaite, Rasa; Collie, Alex

2013-01-01

Objective To determine the incidence and impact of recurrent workplace injury and disease over the period 1995–2008. Design Population-based cohort study using data from the state workers’ compensation system database. Setting State of Victoria, Australia. Participants A total of 448 868 workers with an accepted workers’ compensation claim between 1 January 1995 and 31 December 2008 were included into this study. Of them, 135 349 had at least one subsequent claim accepted for a recurrent injury or disease during this period. Main outcome measures Incidence of initial and recurrent injury and disease claims and time lost from work for initial and recurrent injury and disease. Results Over the study period, 448 868 workers lodged 972 281 claims for discrete occurrences of work-related injury or disease. 53.4% of these claims were for recurrent injury or disease. On average, the rates of initial claims dropped by 5.6%, 95% CI (−5.8% to −5.7%) per annum, while the rates of recurrent injuries decreased by 4.1%, 95% CI (−4.2% to −0.4%). In total, workplace injury and disease resulted in 188 978 years of loss in full-time work, with 104 556 of them being for the recurrent injury. Conclusions Recurrent work-related injury and disease is associated with a substantial social and economic impact. There is an opportunity to reduce the social, health and economic burden of workplace injury by enacting secondary prevention programmes targeted at workers who have incurred an initial occupational injury or disease. PMID:23457329

[Changes in hospitality workers' expectations and attitudes after the implementation of the Spanish smoking law].

PubMed

Martínez-Sánchez, Jose M; Fenández, Esteve; Fu, Marcela; Pérez-Ríos, Mónica; Schiaffino, Anna; López, María J; Alonso, Begoña; Saltó, Esteve; Nebot, Manel; Borràs, Josep M

2010-01-01

To assess changes in hospitality workers' expectations and attitudes towards the Spanish smoking law before and 2 years after the smoking ban. We performed a longitudinal study of a cohort (n=431) of hospitality workers in five regions in Spain before the law came into effect and 24 months later. Expectations and attitudes towards the ban and knowledge about the effect of second-hand smoke on health were compared before and after the ban. We recruited 431 hospitality workers in the baseline survey and 219 were followed-up 24 months later (overall follow-up rate of 50.8%). The percentage of hospitality workers who knew the law was 79.0% before it was passed and was 94.1% 24 months later (p<0.05). We observed an increase in support to the smoke-free ban in all public places, including bars and restaurants (54.1% to 65.8%; p<0.05). The percentages of support for the current ban, perception of compliance with the ban by employees and customers, and knowledge of the effect of second-hand smoke on health also increased. Knowledge and support to the Spanish smoking law among hospitality workers increased 2 years after the implementation of the ban. Copyright 2009 SESPAS. Published by Elsevier Espana. All rights reserved.

Cancer mortality in a synthetic spinning plant in Besançon, France

PubMed Central

Hours, M; Févotte, J; Lafont, S; Bergeret, A

2007-01-01

Objectives To assess the mortality of a cohort of workers in a synthetic textile spinning plant and to evaluate the relationship between mortality from lung, liver and bladder cancer and the processes or the products used. Methods The study population consisted of male workers present for at least 6 months in the plant from 1968 to 1984. The cohort was followed until 1999. Vital status and the causes of death were determined by consulting national registries. The population of the Franche‐Comté region was used for comparison. In total, 17 groups of exposure were assessed by the industrial hygienist, based on the consensus of an expert group that determined the exposure levels of each job to selected occupational hazards. Each worker was assigned to one or several groups, according to his occupational history. Confounding factors could not be assessed. Standardised mortality ratios (SMR) and 95% bilateral confidence intervals were calculated based on an assumed Poisson distribution of the number of cases to compare the plant mortality and the population mortality. Internal analyses were performed with Cox models in order to assess the risks of death related to the various exposures. Results In the whole cohort, mortality from all malignant neoplasms was lower than expected, but this was not significant. All the estimated SMRs were lower than or close to 1. The “hot ‐line fitters” (RR = 2.13; n = 9; 1.06 to 4.29) and the “fibre‐drawing workers” (RR = 1.83; n = 20;1.09 to 3.07) experienced a statistically significant excess in mortality from lung cancer. A slightly elevated but not significant risk of death related to lung cancer (RR = 1.5; n = 41; 0.8 to 2.7) was observed in the groups with the highest exposure to mineral fibres. A statistically significant increase in cancer deaths was observed for workers with high exposure to dust (higher intensity: RR = 1.42; n = 79; 1.06 to 1.89). Conclusion Some findings, mainly of lung cancer, justify further exploration in other plants in this industry, PMID:17227838

Is beryllium-induced lung cancer caused only by soluble forms and high exposure levels?

PubMed

Schubauer-Berigan, Mary K; Couch, James R; Deddens, James A

2017-08-01

The US Occupational Safety and Health Administration (OSHA) recently proposed a permissible exposure limit of 0.2 µg/m 3 for beryllium, based partly on extrapolated estimates of lung cancer risk from a pooled occupational cohort. The purpose of the present analysis was to evaluate whether cohort members exposed at lower levels to mainly insoluble forms of beryllium exhibit increased risk of lung cancer. We conducted Cox proportional hazards regression analyses among 75 lung cancer cases in age-based risk sets within two lower exposure plants in the pooled cohort followed from 1940 to 2005. We used categorical and power models to evaluate exposure-response patterns for mean and cumulative beryllium exposures in the two-plant cohort, comparing findings with the full pooled cohort. We also evaluated the distribution of exposure-years in each cohort by solubility class (soluble, insoluble and mixed). 98% of workers in the two-plant cohort were hired between 1955 and 1969. The mean beryllium exposure averaged 1.3 µg/m 3 and the predominant form was insoluble. Adjusting for confounders, we observed a monotonic increase in lung cancer mortality across exposure categories in the two-plant cohort. The exposure-response coefficients (per unit ln exposure) were 0.270 (p=0.061) for mean exposure and 0.170 (p=0.033) for cumulative exposure, compared with 0.155 and 0.094 (respectively) in the full cohort. The low-exposure levels at these two plants and the predominance of insoluble beryllium suggest that the overall pooled cohort findings on which OSHA's lung cancer risk assessment is based are relevant for current workers exposed to any form of beryllium. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Central nervous system diseases of organic solvents exposed workers based on nationwide medical surveillance-data in Korea.

PubMed

Min, Young-Sun; Ahn, Yeon-Soon

2016-05-01

New light is being shed on the relationship between chronic neurotoxicity of the central nervous system (CNS) and exposure to low-level organic solvents (OS). However, there are few longitudinal studies with a large sample size. A cohort of OS-exposed male workers was selected who had undergone an OS-associated specialized medical check-up at least once between 2000 and 2004 in Korea. The standardized admission ratios (SAR) for CNS diseases were calculated with reference to the Korean adult male population. Adjusted relative risks (ARR) were also estimated in comparison to noise-exposed male workers. There were 238,574 OS-exposed workers, yielding 954,772 person-years of exposure. OS-exposed workers were at elevated risk of "other extrapyramidal and movement disorders" (G25) with a SAR = 2.95 (95% CI: 1.41-5.42) and "systemic atrophies primarily affecting the CNS" (G10-G13) SAR = 2.08 (95% CI: 1.03-3.74). There were no significant differences between the OS-exposed workers and noise-exposed workers. A limited number of CNS diseases identified through hospital admissions data and short observation periods reduced statistical power to determine effect size. OS exposure was positively associated with "other extrapyramidal and movement disorder and systemic atrophies primarily affecting the CNS. © 2016 Wiley Periodicals, Inc.

Bladder cancer incidence among workers exposed to o-toluidine, aniline and nitrobenzene at a rubber chemical manufacturing plant

PubMed Central

Carreón, Tania; Hein, Misty J; Hanley, Kevin W; Viet, Susan M; Ruder, Avima M

2015-01-01

Background An earlier investigation found increased bladder cancer incidence among workers at a rubber chemical manufacturing plant that used o-toluidine, aniline and nitrobenzene. The cohort was expanded to include additional workers (n=1875) and updated through 2007 to assess bladder cancer with improved exposure characterisation. Methods Work histories were updated and exposure categories and ranks were developed for o-toluidine, aniline and nitrobenzene combined. Incident cancers were identified by linkage to six state cancer registries. Residency in time-dependent cancer registry catchment areas was determined. SIR and standardised rate ratios for bladder cancer were calculated by exposure category and cumulative rank quartiles for different lag periods. Cox regression was used to model bladder cancer incidence with estimated cumulative rank, adjusting for confounders. Indirect methods were used to control for smoking. Results Excess bladder cancer was observed compared to the New York State population (SIR=2.87, 95% CI 2.02 to 3.96), with higher elevations among workers definitely exposed (moderate/high) (SIR=3.90, 95% CI 2.57 to 5.68), and in the highest cumulative rank quartile (SIR=6.13, 95% CI 2.80 to 11.6, 10-year lag). Bladder cancer rates increased significantly with estimated cumulative rank (10-year lag). Smoking only accounted for an estimated 8% elevation in bladder cancer incidence. Conclusions Bladder cancer incidence remains elevated in this cohort and significantly associated with estimated cumulative exposure. Results are consistent with earlier findings in this and other cohorts. Despite other concurrent chemical exposures, we consider o-toluidine most likely responsible for the bladder cancer incidence elevation and recommend a re-examination of occupational exposure limits. PMID:24368697

Socioeconomic disparities in work performance following mild stroke.

PubMed

Brey, Joseph K; Wolf, Timothy J

2015-01-01

The purpose of this study was to investigate the relationships among the factors that influence return to work for young individuals with mild stroke from different socioeconomic backgrounds. Prospective cohort study of working adults with mild stroke (N = 21). Participants completed an assessment battery of cognitive, work environment and work performance measures at approximately 3 weeks and 7 months post mild stroke. Individuals were placed in "skilled" and "unskilled" worker categories based on the Hollingshead Index. Unskilled workers had significantly poorer scores on the majority of the cognitive assessments. Unskilled workers also perceived less social support (p = 0.017) and autonomy (p = 0.049) in work responsibilities than individuals in the skilled worker group and also reported significantly poorer work productivity due to stroke than those in the skilled group (p = 0.015). Individuals from low socioeconomic backgrounds have more difficulty returning to work following mild stroke than individuals from higher socioeconomic backgrounds. Future work is needed to identify factors that can increase long-term work success and quality of work performance following a mild stroke that specifically targets the needs of individuals who have a lower socioeconomic status.