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  • 1
    Publication Date: 2012-07-14
    Description: Objectives Observational studies suggest that high job strain is a risk factor for retirement on health grounds, but few studies have analysed specific diagnoses. We examined job strain's association with all-cause and cause-specific disability pensions. Methods Survey responses to questions about job strain from 48 598 (response rate, 68%) public sector employees in Finland from 2000 to 2002 were used to determine work unit- and occupation-based scores. These job strain scores were assigned to all the 69 842 employees in the same work units or occupations. All participants were linked to the disability pension register of the Finnish Centre of Pensions with no loss to follow-up. Cox proportional hazard models were used to calculate HRs and their 95% CIs for disability pensions adjusted by demographic, work unit characteristics and baseline health in analyses stratified by sex and socioeconomic position. Results During a mean follow-up of 4.6 years, 2572 participants (4%) were granted a disability pension. A one-unit increase in job strain was associated with a 1.3- to 2.4-fold risk of requiring a disability pension due to musculoskeletal diseases in men, women and manual workers, depending on the measure of job strain (work unit or occupation based). The risk of disability pension due to cardiovascular diseases was increased in men with high job strain but not in women nor in any socioeconomic group. No consistent pattern was found for disability pension due to depression. Conclusion High job strain is a risk factor for disability pension due to musculoskeletal diseases.
    Print ISSN: 1351-0711
    Electronic ISSN: 1470-7926
    Topics: Medicine
    Published by BMJ Publishing Group
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  • 2
    Publication Date: 2012-07-14
    Description: Background Animal data and physical models suggest that the carcinogenicity of asbestos fibres is related to their size and shape. Objectives To investigate the influence of fibre length and diameter on lung cancer risk in workers at asbestos textile mills in North Carolina and South Carolina, USA. Methods Men and women (n=6136) who worked ≥30 days in production and were employed between 1940 and 1973 were enumerated and followed for vital status through 2003. A matrix of fibre size-specific exposure estimates was constructed using determinations of fibre numbers and dimensions through analysis of 160 historical dust samples by transmission electron microscopy. Associations of lung cancer mortality with metrics of fibre exposure were estimated by Poisson regression with adjustment for age, sex, race and calendar year. Results Exposure to fibres throughout the range of length and diameter was significantly associated with increased risk of lung cancer. Models for fibres 〉5 μm long and 〈0.25 μm in diameter provided the best fit to the data, while fibres 5–10 μm long and 〈0.25 μm in diameter were associated most strongly with lung cancer mortality (log rate about 4% per IQR, p〈0.001). When indicators of mean fibre length and diameter were modelled simultaneously, lung cancer risk increased as fibre length increased and diameter decreased. Conclusions The findings support the hypothesis that the occurrence of lung cancer is associated most strongly with exposure to long thin asbestos fibres. The relationship of cancer risk and fibre dimensions should be examined in cohorts exposed to other types of fibres.
    Print ISSN: 1351-0711
    Electronic ISSN: 1470-7926
    Topics: Medicine
    Published by BMJ Publishing Group
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  • 3
    Publication Date: 2012-07-14
    Description: Objectives Mergers and acquisitions (M&A) activities are increasing and may negatively affect workers mental health. However, the impact of M&A on the risk of developing a mental disorder, rather than psychiatric symptoms, has not been investigated. The objectives of this study were to estimate and compare the 12-month incidence of depressive and anxiety disorders in workers who had and who had not experienced M&A in the last year. Methods Employees aged 25 and 64 years old were randomly selected from the community and were followed for 1 year (n=3280). Questions about their experience in M&A in the past 12 months were asked. WHO's Composite International Diagnostic Interview–Auto 2.1 was used to assess depressive and anxiety disorders. The 12-month prevalence and 1-year incidence of mental disorders were estimated and compared in relation to M&A. Results Participants who were exposed to M&A had a significant higher 1-year incidence of generalised anxiety disorder (GAD) (6.7%) than the unexposed (2.4%). They were not different in the incidence of major depressive disorder. The exposed participants were 2.8 times more likely to have had a GAD than others and were about 2.4 times more likely to have developed any anxiety disorders over 1 year. Conclusions M&A may lead to increased risk of GAD, which may, in return, evolve into major depression. Governments, employers and health professionals should be aware of this and work out plans to reduce the negative health outcomes of M&A.
    Print ISSN: 1351-0711
    Electronic ISSN: 1470-7926
    Topics: Medicine
    Published by BMJ Publishing Group
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  • 4
    Publication Date: 2012-07-14
    Description: Objectives Epidemiological studies of air pollution on cardiovascular health show associations of cardiac mortality and admissions with exposure to nitrogen dioxide (NO 2 ) at low concentrations. These associations could be causal or NO 2 could be acting as a surrogate measure for another air pollutant, most likely ultrafine particles. No studies of cardiac susceptibility to acute exposure to NO 2 have been undertaken. Methods Randomised controlled exposures to NO 2 (400 ppb for 1 h) and air in subjects with coronary heart disease and impaired left ventricular systolic function not taking β adrenoceptor blocking drugs. Results There were no significant changes in heart rate, blood pressure, leucocyte coping capacity or any heart rate variability measure following NO 2 exposure compared with air. Conclusion These findings suggest that NO 2 does not affect heart rate variability at these concentrations (which are high for urban background levels) and in the absence of other pollutants. While a synergistic effect has not been ruled out, these data lend support to the idea that the epidemiological data associating cardiac outcomes with NO 2 are more likely due to an associated pollutant rather than NO 2 itself.
    Keywords: Air pollution, air quality, Other exposures
    Print ISSN: 1351-0711
    Electronic ISSN: 1470-7926
    Topics: Medicine
    Published by BMJ Publishing Group
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  • 5
    Publication Date: 2012-07-14
    Description: In a recent editorial, Gerr and Fethke 1 discuss computer work and musculoskeletal outcomes based on self-reported exposure versus objective recordings using computer software. They state that only one small study (n=27) using objective recordings was published before a large study by Ijmker et al , 2 published in the same issue as the editorial. They failed to consider the results of two Neck and Upper extremity Disorders Among Technical Assistants (NUDATA) papers based on more than 2000 study participants, one of them published in the OEM . 3 The results of the study of Ijmker et al and the NUDATA studies consistently indicate that sustained or severe pain outcomes were not related to objective computer work recordings. The editorial argues that the results of the study of Ijmker et al does not invalidate the much larger literature in which self-reported computer use was associated with musculoskeletal symptoms....
    Print ISSN: 1351-0711
    Electronic ISSN: 1470-7926
    Topics: Medicine
    Published by BMJ Publishing Group
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  • 6
    Publication Date: 2012-07-14
    Description: Introduction Fukushima Dai-ichi nuclear power plant (NPP) was heavily damaged by the tsunami that resulted from the 9.0-magnitude earthquake which occurred off the coast of eastern Japan on 11 March 2011. 1 The loss of all alternating current (AC) electrical power, even from emergency generators, disabled cooling functions and the supply of recycled water. Hydrogen explosions destroyed two reactor buildings and there was meltdown of the reactor cores. The nuclear accident was assigned the maximum severity level of 7, which is equal to that of the Chernobyl disaster that occurred in 1986. 2 Efforts were made to achieve stable cooling of the nuclear reactors, and the release of radioactive materials was brought under control. On 16 December 2011, the Japanese government, the Tokyo Electric Power Company (TEPCO) and technical-support companies achieved cold shutdown of all the reactors stricken by the tsunami. During this period, numerous efforts were...
    Keywords: OEM World at work, Unlocked
    Print ISSN: 1351-0711
    Electronic ISSN: 1470-7926
    Topics: Medicine
    Published by BMJ Publishing Group
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  • 7
    Publication Date: 2012-07-14
    Description: I have always found it difficult to consider the occupational class as an indicator of socioeconomic position (SEP) as presented by past researchers. Epidemiological findings are regulated by the concept or definition of variables, and application of the outcome should be considered in the situation of each social system. Although past researchers have quoted references on their occupational class and claimed to have proof of the validity of SEP, I feel that efforts to make their classification simpler are also required to improve the comparability of research outcomes. Ferrario et al investigated the effect of occupational class on the incidence of coronary heart disease by a 12-year follow-up study and concluded that higher HRs of coronary heart disease incidence rates were observed in manual workers, professionals and administrators, and self-employed workers compared with non-manual workers adjusted by age. 1 But the significant increase of HRs in manual workers...
    Print ISSN: 1351-0711
    Electronic ISSN: 1470-7926
    Topics: Medicine
    Published by BMJ Publishing Group
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  • 8
    Publication Date: 2012-07-14
    Description: Objectives Most physicians have received only limited training in occupational medicine (OM) during their studies. Since they rely mainly on one ‘general medical’ journal to keep their medical knowledge up to date, it is worthwhile questioning the importance of OM in these journals. The aim of this study was to measure the relative weight of OM in the major journals of general medicine and to compare the journals. Methods The 14 091 articles published in the Lancet , the NEJM , the JAMA and the BMJ in 1997, 2002 and 2007 were analysed. The relative weight of OM and the other medical specialties was determined by categorisation of all the articles, using a categorisation algorithm, which inferred the medical specialties relevant to each MEDLINE article file from the major medical subject headings (MeSH) terms used by the indexers of the US National Library of Medicine to describe each article. Results The 14 091 articles included in this study were indexed by 22 155 major MeSH terms, which were categorised into 73 different medical specialties. Only 0.48% of the articles had OM as a main topic. OM ranked 44th among the 73 specialties, with limited differences between the four journals studied. There was no clear trend over the 10-year period. Conclusions The importance of OM is very low in the four major journals of general and internal medicine, and we can consider that physicians get a very limited view of the evolution of knowledge in OM.
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    Electronic ISSN: 1470-7926
    Topics: Medicine
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  • 9
    Publication Date: 2013-08-09
    Description: Objectives At the end of the 1990s, as required by European Directive 92/57/EEC, two laws were enacted in Italy which laid down safety and health requirements for construction sites: Decree 494/96 and Decree 528/99. The aim is to evaluate the impact on injury rates due to actions performed by a group of eight regions that planned formalised programmes to enforce the laws around the year 2000. Methods Using the Work History Italian Panel-Salute integrated database, which extends from 1994 to 2005, total and serious injury rates were calculated for the construction sector. An interrupted time series analysis was applied to serious injury rates. Results During the 12 years under observation, at the national level the total and serious injury rates decreased while the number of employees increased. The results of the regression models indicate that in the period after the intervention the injury rates ( x 10 000 weeks worked) decreased by 0.21 per year more than in the period before the intervention (CI –0.41 to –0.01). The difference in pre-post trends is even larger after adjusting for external factors. Conclusions The intervention plans developed to enforce the two Italian decrees had an effect on the reduction in injury rates. The results showed that there was a decrease in injury rates that could not be explained by external factors. These findings highlight the importance of concrete initiatives to have employers and workers comply with regulatory safety standards.
    Keywords: Editor's choice
    Print ISSN: 1351-0711
    Electronic ISSN: 1470-7926
    Topics: Medicine
    Published by BMJ Publishing Group
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  • 10
    Publication Date: 2013-08-09
    Description: Background A number of widely prevalent job stressors have been identified as modifiable risk factors for common mental and physical illnesses such as depression and cardiovascular disease, yet there has been relatively little study of population trends in exposure to job stressors over time. The aims of this paper were to assess: (1) overall time trends in job control and security and (2) whether disparities by sex, age, skill level and employment arrangement were changing over time in the Australian working population. Methods Job control and security were measured in eight annual waves (2000–2008) from the Australian nationally-representative Household Income and Labour Dynamics of Australia panel survey (n=13 188 unique individuals for control and n=13 182 for security). Observed and model-predicted time trends were generated. Models were generated using population-averaged longitudinal linear regression, with year fitted categorically. Changes in disparities over time by sex, age group, skill level and employment arrangement were tested as interactions between each of these stratifying variables and time. Results While significant disparities persisted for disadvantaged compared with advantaged groups, results suggested that inequalities in job control narrowed among young workers compared with older groups and for casual, fixed-term and self-employed compared with permanent workers. A slight narrowing of disparities over time in job security was noted for gender, age, employment arrangement and occupational skill level. Conclusions Despite the favourable findings of small reductions in disparities in job control and security, significant cross-sectional disparities persist. Policy and practice intervention to improve psychosocial working conditions for disadvantaged groups could reduce these persisting disparities and associated illness burdens.
    Print ISSN: 1351-0711
    Electronic ISSN: 1470-7926
    Topics: Medicine
    Published by BMJ Publishing Group
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