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  • 1
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    A new look for OEM in 2015 (2014)
    BMJ Publishing Group
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    Publication Date: 2014-12-17
    Description: In this first edition of Occupational and Environmental Medicine for 2015 we have introduced a new front cover. We have decided to retire the ‘word cloud’, which has adorned the front cover since May 2012. This word cloud was based on the frequency of words contained in articles published in OEM prior to that date and after more than two and a half years it was becoming increasingly out of date. Our new front cover retains the blue colour scheme and continues the tradition of OEM being known as the ‘blue journal‘ amongst occupational health journals. The central feature of the new cover is a globe which signifies the wide reach of OEM around the world. For this first edition, we have selected a group of pictures which illustrate a range of hazardous working environments, as well as motor vehicle exhausts, an increasingly recognised contributor to a wide...
    Keywords: Musculoskeletal
    Print ISSN: 1351-0711
    Electronic ISSN: 1470-7926
    Topics: Medicine
    Published by BMJ Publishing Group
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  • 2
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    CAREX Canada: an enhanced model for assessing occupational carcinogen exposure (2014)
    BMJ Publishing Group
    Details
    Publication Date: 2014-12-17
    Description: Objectives To estimate the numbers of workers exposed to known and suspected occupational carcinogens in Canada, building on the methods of CARcinogen EXposure (CAREX) projects in the European Union (EU). Methods CAREX Canada consists of estimates of the prevalence and level of exposure to occupational carcinogens. CAREX Canada includes occupational agents evaluated by the International Agency for Research on Cancer as known, probable or possible human carcinogens that were present and feasible to assess in Canadian workplaces. A Canadian Workplace Exposure Database was established to identify the potential for exposure in particular industries and occupations, and to create exposure level estimates among priority agents, where possible. CAREX EU data were reviewed for relevance to the Canadian context and the proportion of workers likely to be exposed by industry and occupation in Canada was assigned using expert assessment and agreement by a minimum of two occupational hygienists. These proportions were used to generate prevalence estimates by linkage with the Census of Population for 2006, and these estimates are available by industry, occupation, sex and province. Results CAREX Canada estimated the number of workers exposed to 44 known, probable and suspected carcinogens. Estimates of levels of exposure were further developed for 18 priority agents. Common exposures included night shift work (1.9 million exposed), solar ultraviolet radiation exposure (1.5 million exposed) and diesel engine exhaust (781 000 exposed). Conclusions A substantial proportion of Canadian workers are exposed to known and suspected carcinogens at work.
    Keywords: Open access, Other exposures
    Print ISSN: 1351-0711
    Electronic ISSN: 1470-7926
    Topics: Medicine
    Published by BMJ Publishing Group
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  • 3
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    Dupuytren's contracture and occupational exposure to hand-transmitted vibration (2014)
    BMJ Publishing Group
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    Publication Date: 2014-03-06
    Description: Aims The relation between Dupuytren's contracture and occupational exposure to hand-transmitted vibration (HTV) has frequently been debated. We explored associations in a representative national sample of workers with well-characterised exposure to HTV. Methods We mailed a questionnaire to 21 201 subjects aged 16–64 years, selected at random from the age-sex registers of 34 general practices in Great Britain and to 993 subjects chosen randomly from military pay records, asking about occupational exposure to 39 sources of HTV and about fixed flexion contracture of the little or ring finger. Analysis was restricted to men at work in the previous week. Estimates were made of average daily vibration dose ( A (8) root mean squared velocity (rms)) over that week. Associations with Dupuytren's contracture were estimated by Poisson regression, for lifetime exposure to HTV and for exposures in the past week 〉 A (8) of 2.8 ms –2 rms. Estimates of relative risk (prevalence ratio (PR)) were adjusted for age, smoking status, social class and certain manual activities at work. Results In all 4969 eligible male respondents supplied full information on the study variables. These included 72 men with Dupuytren's contracture, 2287 with occupational exposure to HTV and 409 with A (8)〉2.8 ms –2 in the past week. PRs for occupational exposure to HTV were elevated 1.5-fold. For men with an A (8)〉2.8 ms –2 in the past week, the adjusted PR was 2.85 (95% CI 1.37 to 5.97). Conclusions Our findings suggest that risk of Dupuytren's contracture is more than doubled in men with high levels of weekly exposure to HTV.
    Keywords: Open access, Other exposures
    Print ISSN: 1351-0711
    Electronic ISSN: 1470-7926
    Topics: Medicine
    Published by BMJ Publishing Group
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  • 4
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    Personal and workplace psychosocial risk factors for carpal tunnel syndrome: a pooled study cohort (2013)
    BMJ Publishing Group
    Details
    Publication Date: 2013-07-11
    Description: Background Between 2001 and 2010, six research groups conducted coordinated multiyear, prospective studies of carpal tunnel syndrome (CTS) incidence in US workers from various industries and collected detailed subject-level exposure information with follow-up symptom, physical examination, electrophysiological measures and job changes. Objective This analysis of the pooled cohort examined the incidence of dominant-hand CTS in relation to demographic characteristics and estimated associations with occupational psychosocial factors and years worked, adjusting for confounding by personal risk factors. Methods 3515 participants, without baseline CTS, were followed-up to 7 years. Case criteria included symptoms and an electrodiagnostic study consistent with CTS. Adjusted HRs were estimated in Cox proportional hazard models. Workplace biomechanical factors were collected but not evaluated in this analysis. Results Women were at elevated risk for CTS (HR=1.30; 95% CI 0.98 to 1.72), and the incidence of CTS increased linearly with both age and body mass index (BMI) over most of the observed range. High job strain increased risk (HR=1.86; 95% CI 1.11 to 3.14), and social support was protective (HR=0.54; 95% CI 0.31 to 0.95). There was an inverse relationship with years worked among recent hires with the highest incidence in the first 3.5 years of work (HR=3.08; 95% CI 1.55 to 6.12). Conclusions Personal factors associated with an increased risk of developing CTS were BMI, age and being a woman. Workplace risk factors were high job strain, while social support was protective. The inverse relationship between CTS incidence and years worked among recent hires suggests the presence of a healthy worker survivor effect in the cohort.
    Keywords: Musculoskeletal
    Print ISSN: 1351-0711
    Electronic ISSN: 1470-7926
    Topics: Medicine
    Published by BMJ Publishing Group
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  • 5
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    A prospective study of carpal tunnel syndrome: workplace and individual risk factors (2013)
    BMJ Publishing Group
    Details
    Publication Date: 2013-07-11
    Description: Objectives To quantify the risk for carpal tunnel syndrome (CTS) from workplace physical factors, particularly hand activity level and forceful exertion, while taking into account individual factors including age, gender, body mass index (BMI), and pre-existing medical conditions. Methods Three healthcare and manufacturing workplaces were selected for inclusion on the basis of range of exposure to hand activity level and forceful exertion represented by their jobs. Each study participant's job tasks were observed and evaluated onsite and videotaped for further analysis, including frequency and duration of exertion and postural deviation. Individual health assessment entailed electrodiagnostic testing of median and ulnar nerves, physical examination and questionnaires at baseline with annual follow-up for 2 years. Results The incidence of dominant hand CTS during the study was 5.11 per 100 person-years (29 cases). Adjusted HRs for dominant hand CTS were as follows: working with forceful exertion ≥20% but 〈60% of the time: 2.83 (1.18, 6.79) and ≥60% of the time vs 〈20%: 19.57 (5.96, 64.24), BMI ≥30 kg/m 2 (obesity): 3.19 (1.28, 7.98). The American Conference for Governmental Industrial Hygienists (ACGIH) Threshold Limit Value (TLV) for hand activity level also predicted CTS, HR=1.40 (1.11, 1.78) for each unit increase in the TLV ratio, controlling for obesity and job strain. Conclusions Workplace and individual risk factors both contribute to the risk for CTS. Time spent in forceful exertion can be a greater risk for CTS than obesity if the job exposure is high. Preventive workplace efforts should target forceful exertions.
    Keywords: Musculoskeletal
    Print ISSN: 1351-0711
    Electronic ISSN: 1470-7926
    Topics: Medicine
    Published by BMJ Publishing Group
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  • 6
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    Does transfer of work from a public sector organisation to a commercial enterprise without staff reductions increase risk of long-term sickness absence among the staff? A cohort study of laboratory and radiology employees (2013)
    BMJ Publishing Group
    Details
    Publication Date: 2013-07-11
    Description: Background Privatisations of public sector organisations are not uncommon, and some studies suggest that such organisational changes may adversely affect employee health. In this study, we examined whether transfer of work from public sector hospital units to commercial enterprises, without major staff reductions, was associated with an increased risk of long-term sickness absence among employees. Methods A cohort study of 962 employees from four public hospital laboratory and radiology units in three hospitals which were privatised during the follow-up and 1832 employees from similar units without such organisational changes. Records of new long-term sick leaves (〉90 days) were obtained from national health registers and were linked to the data. Mean follow-up was 9.2 years. Results Age- and sex-adjusted HR for long-term sickness absence after privatisation was 0.83 (95% CI 0.68 to 1.00) among employees whose work unit underwent a change from a public organisation to a commercial enterprise compared with employees in unchanged work units. Further adjustments for occupation, socioeconomic status, type of job contract, size of residence and sick leaves before privatisation had little impact on the observed association. A sensitivity analysis with harmonised occupations across the two groups replicated the finding (multivariable adjusted HR 0.92 (0.70–1.20)). Conclusions In this study, transfer of work from public organisation to commercial enterprise did not increase the risk of long-term sickness absence among employees.
    Keywords: Musculoskeletal
    Print ISSN: 1351-0711
    Electronic ISSN: 1470-7926
    Topics: Medicine
    Published by BMJ Publishing Group
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  • 7
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    Employment and occupational outcomes of workers with musculoskeletal pain in a French region (2013)
    BMJ Publishing Group
    Details
    Publication Date: 2013-02-10
    Description: Objectives To study the employment and occupational outcomes of workers who were diagnosed with upper limb musculoskeletal disorders (UL-MSDs) or had complained of upper limb musculoskeletal pain a few years before compared with workers who had no upper limb pain. Methods In 2002–2005, an epidemiological surveillance system was set up. Occupational physicians examined 3710 randomly selected workers. It focused on six UL-MSDs: rotator cuff syndrome, lateral epicondylitis, flexor-extensor peritendinitis of the hands and fingers, de Quervain's disease, carpal tunnel syndrome and ulnar tunnel syndrome. Three groups were constituted: a ‘UL-MSD’ group (workers with a clinically diagnosed UL-MSD at baseline, 13% of the cohort); a ‘PAIN’ group (workers with pain in the previous 7 days at baseline and without any clinically diagnosed form, 38%); and a ‘HEALTHY’ group (workers with no disorder or upper limb pain in the previous 7 days, 49%). They completed a questionnaire between 2007 and 2009. Results A total of 2332 responded. Fewer subjects were still in work in the ‘UL-MSD’ group (79.3%) than in the ‘PAIN’ (85.9%) and ‘HEALTHY’ (90.4%) groups, the difference remaining significant after adjusting for gender, age, occupational category, type of company and comorbidities. Of the subjects still in work, 24% had changed their work station in the same company in the ‘PAIN’ group compared with 19% in the ‘HEALTHY’ group and 21% in the ‘UL-MSD’ group. Conclusions This study showed the impact of musculoskeletal pain on employment outcome and the difficulty of keeping workers with musculoskeletal problems at work.
    Keywords: Musculoskeletal
    Print ISSN: 1351-0711
    Electronic ISSN: 1470-7926
    Topics: Medicine
    Published by BMJ Publishing Group
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