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  • 11
    Publication Date: 2015-01-10
    Description: Background Six research groups independently conducted prospective studies of carpal tunnel syndrome (CTS) incidence in 54 US workplaces in 10 US States. Physical exposure variables were collected by all research groups at the individual worker level. Data from these research groups were pooled to increase the exposure spectrum and statistical power. Objective This paper provides a detailed description of the characteristics of the pooled physical exposure variables and the source data information from the individual research studies. Methods Physical exposure data were inspected and prepared by each of the individual research studies according to detailed instructions provided by an exposure subcommittee of the research consortium. Descriptive analyses were performed on the pooled physical exposure data set. Correlation analyses were performed among exposure variables estimating similar exposure aspects. Results At baseline, there were a total of 3010 participants in the pooled physical exposure data set. Overall, the pooled data meaningfully increased the spectra of most exposure variables. The increased spectra were due to the wider range in exposure data of different jobs provided by the research studies. The correlations between variables estimating similar exposure aspects showed different patterns among data provided by the research studies. Conclusions The increased spectra of the physical exposure variables among the data pooled likely improved the possibility of detecting potential associations between these physical exposure variables and CTS incidence. It is also recognised that methods need to be developed for general use by all researchers for standardisation of physical exposure variable definition, data collection, processing and reduction.
    Keywords: Musculoskeletal
    Print ISSN: 1351-0711
    Electronic ISSN: 1470-7926
    Topics: Medicine
    Published by BMJ Publishing Group
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  • 12
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    BMJ Publishing Group
    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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  • 13
    Publication Date: 2014-12-17
    Description: Introduction We evaluated associations between three a-cellular measures of the oxidative potential (OP) of particulate matter (PM) and acute health effects. Methods We exposed 31 volunteers for 5 h to ambient air pollution at five locations: an underground train station, two traffic sites, a farm and an urban background site. Each volunteer visited at least three sites. We conducted health measurements before exposure, 2 h after exposure and the next morning. We measured air pollution on site and characterised the OP of PM 2.5 and PM 10 using three a-cellular assays; dithiotreitol (OP DTT ), electron spin resonance (OP ESR ) and ascorbic acid depletion (OP AA ). Results In single-pollutant models, all measures of OP were significantly associated with increases in fractional exhaled nitric oxide and increases in interleukin-6 in nasal lavage 2 h after exposure. These OP associations remained significant after adjustment for co-pollutants when only the four outdoor sites were included, but lost significance when measurements at the underground site were included. Other health end points including lung function and vascular inflammatory and coagulation parameters in blood were not consistently associated with OP. Conclusions We found significant associations between three a-cellular measures of OP of PM and markers of airway and nasal inflammation. However, consistency of these effects in two-pollutant models depended on how measurements at the underground site were considered. Lung function and vascular inflammatory and coagulation parameters in blood were not consistently associated with OP. Our study, therefore, provides limited support for a role of OP in predicting acute health effects of PM in healthy young adults.
    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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  • 14
    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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  • 15
    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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  • 16
    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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  • 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
    Published by BMJ Publishing Group
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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
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    Electronic ISSN: 1470-7926
    Topics: Medicine
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  • 20
    Publication Date: 2014-01-16
    Description: Objectives There is an ongoing debate regarding environmental health risks of exposures to dust and microbial agents from livestock farming in the Netherlands. The aims of the study were (1) to investigate associations between indicators of air pollution from livestock farms and asthma, allergic rhinitis and chronic obstructive pulmonary disease (COPD) among neighbouring residents; and (2) to assess associations between farm exposures and endotoxin levels in participants’ homes. Methods Electronic medical records of all 92 548 patients of 27 general practices in a rural area with a high density of animal farms were analysed, followed up by a case-control component using a subsample of the full population. Distance between livestock farms and home address, presence of livestock within 500 m, and particulate matter (PM)10 emissions from farms within 500 m were computed as proxies for farm exposure. Potential confounding was investigated through a case-control questionnaire study in 269 adult patients with asthma and 546 controls. Endotoxin levels were assessed in 493 homes. Results Modelled PM10 emission was inversely associated with asthma, allergic rhinitis and COPD (p〈0.05). A smaller distance to the nearest farm, and the presence of swine, goat and sheep farms were also inversely related to respiratory morbidity, whereas mink farms showed positive associations with asthma and allergic rhinitis. Adjustment for confounding in the case-control study did not change results. Farm exposures were not associated with endotoxin levels in neighbouring residents’ homes. Conclusions In conclusion, indicators of air pollution from livestock farms were inversely associated with respiratory morbidity among neighbouring residents.
    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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