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  • Articles  (38)
  • Air pollution, air quality, Other exposures  (29)
  • Editor's choice, Other exposures  (9)
  • 11
    Publication Date: 2014-11-07
    Description: Background Human parvovirus B19 (B19V) infection during early pregnancy increases the risk of miscarriage. Studies have inconsistently shown an elevated risk of infection among women with occupational contacts with children. Methodological differences, particularly in defining occupational exposure and in the type of reference group, may explain the conflicting findings. Methods This cohort study compared B19V infections in pregnant day-care employees and healthcare professionals during a B19V epidemic in Finland. Women were identified from the files of nationwide trade unions and the National Supervisory Authority for Welfare and Health. Early-pregnancy maternal B19V IgG was analysed in 3710 women, and infections were defined as seroconversions after analysing in parallel the available umbilical cord blood samples of the 847 seronegative mothers. Independently of the serological status, the actual employment during pregnancy was assessed using registered information on employment history. Results B19V infections were more common among day-care employees (22/331, 6.6%), than among those working in healthcare (12/326, 3.7%). The adjusted HRs of B19V infection, using proportional hazard regression, was 2.63 (95% CI 1.27 to 5.46) among all women and 5.59 (95% CI 1.40 to 22.4) among nulliparous women. Conclusions Day-care employees are at an increased risk of B19V infection, which warrants preventive measures.
    Keywords: Editor's choice, Other exposures
    Print ISSN: 1351-0711
    Electronic ISSN: 1470-7926
    Topics: Medicine
    Published by BMJ Publishing Group
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  • 12
    Publication Date: 2014-10-09
    Description: The 2014 International Epidemiology in Occupational Health (EPICOH) meeting in Chicago, USA, focused on the theme: ‘Challenges for Occupational Epidemiology in the 21st Century’. These are exciting times and with them come no end to challenges faced by occupational epidemiology. And participants eagerly engaged in vigorous discussion on a number of current concerns with both wisdom and wit. Ultimately each individual must decide what challenges are most important and how best to address those selected for first order attention. Nonetheless, some overview of challenges could prove worthwhile and so six general areas are provided as a focus for consideration. Concentrating on important problems Acting on what we find Advancing occupational disease and injury surveillance Relying on worker self-reports Looking at data Addressing health disparities Concentrating on the important problems We always run the risk of studying what we know how to study...
    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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  • 13
    Publication Date: 2014-10-09
    Description: Objectives The primary aim was to examine exposure–response relationships between cumulative occupational shoulder exposures and surgery for subacromial impingement syndrome (SIS), and to compare sex-specific exposure–response relationships. The secondary aim was to examine the time window of relevant exposures. Methods We conducted a nationwide register study of all persons born in Denmark (1933–1977), who had at least 5 years of full-time employment. In the follow-up period (2003–2008), we identified first-time events of surgery for SIS. Cumulative exposure estimates for a 10-year exposure time window with a 1-year lag time were obtained by linking occupational codes with a job exposure matrix. The exposure estimates were expressed as, for example, arm-elevation-years in accordance with the pack-year concept of tobacco consumption. We used a multivariable logistic regression technique equivalent to discrete survival analysis. Results The adjusted OR (OR adj ) increased to a maximum of 2.1 for arm-elevation-years, repetition-years and force-years, and to 1.5 for hand-arm-vibration-years. Sex-specific exposure–response relationships were similar for men and women, when assessed using a relative risk scale. The OR adj increased gradually with the number of years contributing to the cumulative exposure estimates. The excess fraction was 24%. Conclusions Cumulative occupational shoulder exposures carried an increase in risk of surgery for SIS with similar exposure–response curves for men and women. The risk of surgery for SIS increased gradually, when the period of exposure assessment was extended. In the general working population, a substantial fraction of all first-time operations for SIS could be related to occupational exposures.
    Keywords: Editor's choice, Other exposures
    Print ISSN: 1351-0711
    Electronic ISSN: 1470-7926
    Topics: Medicine
    Published by BMJ Publishing Group
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  • 14
    Publication Date: 2014-09-09
    Description: The fetus and infant are especially vulnerable to the effects of environmental agents that disrupt developmental processes because their organs are rapidly growing and developing, their metabolism is immature and their intakes can be greater relative to their body weight. In utero and early postnatal stressors, including environmental contaminant exposures, can permanently change the body's structure, physiology and metabolism, predisposing individuals to the development of serious chronic pathologies later in life (eg, cardiovascular, respiratory and neurodegenerative disease), a hypothesis grounded in the Developmental Origins of Health and Disease (DOHaD) paradigm for which there is a growing evidential basis. Up to relatively recently, good epidemiological evidence for early-life developmental effects was available only for a few pollutants, mostly at high-level exposure, such as lead, mercury and polychlorinated biphenyls (PCBs). 1 The past decade has seen rapid increase in the study of effects of environmental agents at lower doses on...
    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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  • 15
    Publication Date: 2014-07-11
    Description: Objectives To investigate the association between preeclampsia and maternal exposure to ambient particulate matter (PM) with aerodynamic diameter less than 10 μm (PM 10 ) and 2.5 μm (PM 2.5 ) mass and sources. Methods Our analysis was based on a hospital cohort of pregnant women (N=3182) residing in Barcelona, Spain, during 2003–2005. Positive matrix factorisation source apportionment (PMF2) was used to identify sources of PM 10 and PM 2.5 samples obtained by an urban background monitor, resulting in detection of eight sources. We further combined traffic-related sources (brake dust, vehicle exhaust and secondary nitrate/organics) to generate an indicator of combined traffic sources. Logistic regression models were developed to estimate the association between preeclampsia and exposure to each PM source and mass separately during the entire pregnancy and trimester one, adjusted for relevant covariates. Results For the exposure during the entire pregnancy, we found a 44% (95% CI 7% to 94%) and a 80% (95% CI 4% to 211%) increase in the risk of preeclampsia associated with one IQR increase in exposure to PM 10 brake dust and combined traffic-related sources, respectively. These findings remained consistent after an alternative source apportionment method (Multilinear Engine (ME2)) was used. The results for PM 2.5 mass and sources and also exposure during trimester one were inconclusive. Conclusions: Risk of preeclampsia was associated with exposure to PM 10 brake dust and combined traffic-related sources.
    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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  • 16
    Publication Date: 2014-07-11
    Description: Objectives To better understand respiratory symptoms and lung function in flavouring manufacturing workers. Methods We offered a questionnaire and lung function testing to the current workforce of a flavouring manufacturing facility that had transitioned away from diacetyl and towards substitutes in recent years. We examined symptoms, spirometric parameters and diffusing capacity measurements by exposure variables, including facility tenure and time spent daily in production areas. We used linear and logistic regression to develop final models adjusted for age and smoking status. Results A total of 367 (93%) current workers participated. Shortness of breath was twice as common in those with tenure ≥7 years (OR 2.0, 95% CI 1.1 to 3.6). Other chest symptoms were associated with time spent daily in production. Participants who spent ≥1 h daily in production areas had twice the odds of any spirometric abnormality (OR 2.3; 95% CI 1.1 to 5.3) and three times the odds of low diffusing capacity (OR 2.8; 95% CI 0.9 to 9.4) than other participants. Mean spirometric parameters were significantly lower in those with tenure ≥7 years and those who spent ≥1 h daily in production. Mean diffusing capacity parameters were significantly lower in those with tenure ≥7 years. Differences in symptoms and lung function could not be explained by age, smoking status or employment at another flavouring plant. Conclusions Symptoms and lung function findings were consistent with undiagnosed or subclinical obliterative bronchiolitis and associated with workplace exposures. Further efforts to lower exposures to flavouring chemicals, including diacetyl substitutes, are warranted.
    Keywords: Editor's choice, Other exposures
    Print ISSN: 1351-0711
    Electronic ISSN: 1470-7926
    Topics: Medicine
    Published by BMJ Publishing Group
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  • 17
    Publication Date: 2014-06-10
    Description: Objectives To assess the effects of long-term variations in ambient air pollutants on longitudinal changes in exhaled nitric oxide (FeNO), a potentially useful biomarker of eosinophilic airway inflammation, based on data from the southern California Children's Health Study. Methods Based on a cohort of 1211 schoolchildren from eight Southern California communities with FeNO measurements in 2006–2007 and 2007–2008, regression models adjusted for short-term effects of air pollution were fitted to assess the association between changes in annual long-term exposures and changes in FeNO. Results Increases in annual average concentrations of 24-h average NO 2 and PM 2.5 (scaled to the IQR of 1.8 ppb and 2.4 μg/m 3 , respectively) were associated with a 2.29 ppb (CI 0.36 to 4.21; p=0.02) and a 4.94 ppb (CI 1.44 to 8.47; p=0.005) increase in FeNO, respectively, after adjustments for short-term effects of the respective pollutants. In contrast, changes in annual averages of PM 10 and O 3 were not significantly associated with changes in FeNO. These findings did not differ significantly by asthma status. Conclusions Changes in annual average exposure to current levels of ambient air pollutants are significantly associated with changes in FeNO levels in children, independent of short-term exposures and asthma status. Use of this biomarker in population-based epidemiological research has great potential for assessing the impact of changing real world mixtures of ambient air pollutants on children's respiratory health.
    Keywords: Air pollution, air quality, Other exposures
    Print ISSN: 1351-0711
    Electronic ISSN: 1470-7926
    Topics: Medicine
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  • 18
    Publication Date: 2014-03-06
    Description: Objectives We evaluated interactions between SERPINA1 PiMZ genotype, associated with intermediate α1-antitrysin deficiency, with outdoor particulate matter ≤10 µm (PM 10 ), and occupational exposure to vapours, dusts, gases and fumes (VGDF), and their effects on annual change in lung function. Methods Pre-bronchodilator spirometry was performed in 3739 adults of the Swiss Cohort Study on Air Pollution and Lung Disease in Adults (SAPALDIA) for whom SERPINA1 genotypes were available. At baseline in 1991, participants were aged 18–62 years; follow-up measurements were conducted from 2001 to 2003. In linear mixed regression models of annual change in lung function, multiplicative interactions were evaluated between PiMZ genotype (PiMM as reference) and change in PM 10 (μg/m 3 ), and VGDF exposure (high-level, low-level or no exposure as reference) during follow-up. Results Annual declines in forced expiratory flow at 25–75% of forced vital capacity (FEF 25–75% ) (–82 mL/s, 95% CI –125 to –39) and forced expiratory volume in 1 s over forced vital capacity (FEV 1 /FVC) (–0.3%, 95% CI –0.6% to 0.0%) in association with VGDF exposure were observed only in PiMZ carriers (P interaction 〈0.0001 and P interaction =0.03, respectively). A three-way interaction between PiMZ genotype, smoking and VGDF exposure was identified such that VGDF-associated FEF 25–75% decline was observed only in ever smoking PiMZ carriers (P interaction =0.01). No interactions were identified between PiMZ genotype and outdoor PM 10 . Conclusions SERPINA1 PiMZ genotype, in combination with smoking, modified the association between occupational VGDF exposure and longitudinal change in lung function, suggesting that interactions between these factors are relevant for lung function decline. These novel findings warrant replication in larger studies.
    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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  • 19
    Publication Date: 2014-02-07
    Description: Objectives Ambient air pollution has been associated with sudden deaths, some of which are likely due to ventricular arrhythmias. Defibrillator discharge studies have examined the association of air pollution with arrhythmias in sensitive populations. No studies have assessed this association using residence-specific estimates of air pollution exposure. Methods In the Normative Aging Study, we investigated the association between temporally resolved and spatially resolved black carbon (BC) and PM 2.5 and arrhythmia episodes (bigeminy, trigeminy or couplets episodes) measured as ventricular ectopy (VE) by 4 min ECG monitoring in repeated measures of 701 subjects, during the years 2000–2010. We used a binomial distribution (having or not a VE episode) in a mixed effect model with a random intercept for subject, controlling for seasonality, temperature, day of the week, medication use, smoking, having diabetes, body mass index and age. We also examined whether these associations were modified by genotype or phenotype. Results We found significant increases in VE with both pollutants and lags; for the estimated concentration averaged over the 3 days prior to the health assessment, we found increases in the odds of having VE with an OR of 1.52 (95% CI 1.19 to 1.94) for an IQR (0.30 μg/m 3 ) increase in BC and an OR of 1.39 (95% CI 1.12 to 1.71) for an IQR (5.63 μg/m 3 ) increase in PM 2.5 . We also found higher effects in subjects with the glutathione S-transferase theta-1 and glutathione S-transferase mu-1 variants and in obese (p〈0.05). Conclusions Increased levels of short-term traffic-related pollutants may increase the risk of ventricular arrhythmia in elderly subjects.
    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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  • 20
    Publication Date: 2014-01-16
    Description: Objectives Occupational exposures are important and possibly modifiable contributors to the global burden of chronic obstructive pulmonary disease (COPD). Exposure to vapours, gases, dusts and fumes (VGDF) has been associated with a two- to threefold higher COPD risk. Less is known about effects of occupational exposure to pesticides and solvents. In the current study, we assessed if VGDF, pesticides and solvents are associated with the level of lung function and the prevalence of airway obstruction in the general population. Methods We included 11 851 subjects aged 18–89 years from the LifeLines cohort study. Regression models assessing associations between occupational exposures (no/low/high), level of lung function (prebronchodilator FEV 1 , FEV 1 /FVC) and mild and moderate/severe airway obstruction were adjusted for sex, age, height, weight, current/ex-smoking and packyears. Additionally, we stratified by smoking status and gender and tested for interaction. A second general population cohort (n=2364) was used to verify our initial findings. Results Occupational exposure to VGDF and pesticides was associated with a lower level of FEV 1 and FEV 1 /FVC and with a higher prevalence of mild and moderate/severe airway obstruction in the two general populations investigated. There were no associations with exposure to solvents. Conclusions Occupational exposure to both VGDF and pesticides is associated with airway obstruction in the general population.
    Keywords: Editor's choice, Other exposures
    Print ISSN: 1351-0711
    Electronic ISSN: 1470-7926
    Topics: Medicine
    Published by BMJ Publishing Group
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