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  • 11
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    Response to: Artificial stone-associated silicosis in the UK' by Barber et al (2018)
    BMJ Publishing Group
    Details
    Publikationsdatum: 2018-06-15
    Beschreibung: We thank Barber and colleagues 1 for their interest in our paper. 2 It is excellent that the Surveillance of Work-related Occupational Respiratory Disease (SWORD)  database could be interrogated; in Australia we have no such centralised resource. We were concerned that two-thirds of their cases of silicosis were diagnosed in men of working age; we agree that in the absence of specific information about occupational exposures within the category of ‘stonemason’, it is difficult to be entirely sure that none of these were related to artificial stone processing. The letter highlights the challenge of differentiating silicosis from sarcoidosis in young workers with progressive lung opacities. Compared with chronic and acute silicosis, the histopathological features of accelerated silicosis are yet to be clearly defined. 3 This is partly due to the modest number of reported cases, but also the fact that this is a condition that produces progressive...
    Print ISSN: 1351-0711
    Digitale ISSN: 1470-7926
    Thema: Medizin
    Publiziert von BMJ Publishing Group
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 12
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    Update of an occupational asthma-specific job exposure matrix to assess exposure to 30 specific agents (2018)
    BMJ Publishing Group
    Details
    Publikationsdatum: 2018-06-15
    Beschreibung: Objectives We aimed to update an asthmagen job exposure matrix (JEM) developed in the late 1990s. Main reasons were: the number of suspected and recognised asthmagens has since tripled; understanding of the aetiological role of irritants in asthma and methodological insights in application of JEMs have emerged in the period. Methods For each agent of the new occupational asthma-specific JEM (OAsJEM), a working group of three experts out of eight evaluated exposure for each International Standard Classification of Occupations, 1988 (ISCO-88) job code into three categories: ‘high’ (high probability of exposure and moderate-to-high intensity), ‘medium’ (low-to-moderate probability or low intensity) and ‘unexposed’. Within a working group, experts evaluated exposures independently from each other. If expert assessments were inconsistent the final decision was taken by consensus. Specificity was favoured over sensitivity, that is, jobs were classified with high exposure only if the probability of exposure was high and the intensity moderate-to-high. In the final review, all experts checked assigned exposures and proposed/improved recommendations for expert re-evaluation after default application of the JEM. Results The OAsJEM covers exposures to 30 sensitisers/irritants, including 12 newly recognised, classified into seven broad groups. Initial agreement between the three experts was mostly fair to moderate ( values 0.2–0.5). Out of 506 ISCO-88 codes, the majority was classified as unexposed (from 82.6% (organic solvents) to 99.8% (persulfates)) and a minority as ‘high-exposed’ (0.2% (persulfates) to 2.6% (organic solvents)). Conclusions The OAsJEM developed to improve occupational exposure assessment may improve evaluations of associations with asthma in epidemiological studies and contribute to assessment of the burden of work-related asthma.
    Print ISSN: 1351-0711
    Digitale ISSN: 1470-7926
    Thema: Medizin
    Publiziert von BMJ Publishing Group
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 13
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    Gender and health in occupational epidemiology (2018)
    BMJ Publishing Group
    Details
    Publikationsdatum: 2018-05-18
    Beschreibung: There has been limited attention to gender as a wider structural influence on either working conditions or health outcomes in occupational epidemiology. 1 2 From an analytic perspective, gender is often treated as an individual characteristic that may either confound or modify an exposure–outcome relationship. 3 This is despite the awareness in epidemiology that expressions of gender relations, such as gendered segregation of the workforce and gender discrimination in wages, are important public health issues. 4 The article by Buscariolli and colleagues 5 uses a national data set to interrogate the influence of both the gendered working environment and gender on antidepressant use in Finland. As the authors point out in the rationale for the study, there has been a lack of longitudinal research on this topic. The current study is based on a 19-year follow-up of over 752 683 women and men working in...
    Print ISSN: 1351-0711
    Digitale ISSN: 1470-7926
    Thema: Medizin
    Publiziert von BMJ Publishing Group
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 14
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    Sinonasal adenocarcinoma following styrene exposure in the reinforced plastics industry (2018)
    BMJ Publishing Group
    Details
    Publikationsdatum: 2018-05-18
    Beschreibung: Background Sinonasal adenocarcinoma is a rare disease expected to have rare causes and potential for strong risk factors as reflected by the strong association with occupational wood dust exposure. High level styrene exposure is a rare and suspected carcinogen, and this study examines the exposure–response relation between occupational styrene exposure, sinonasal adenocarcinoma and other subtypes. Methods We followed 73 092 styrene-exposed workers from 1968 to 2011 and identified sinonasal cancers in the Danish Cancer Registry. We modelled cumulative styrene exposure and estimated incidence rates and age, sex and wood-industry adjusted ORs. Results During 1 585 772 person-years, we observed nine cases of adenocarcinoma, corresponding to a fivefold non-significantly increased OR for estimates of high versus low cumulative styrene exposure (OR 5.11, 95% CI 0.58 to 45.12). The increased risk was confined to exposure received during the recent 15 years. The other histological subtypes showed no increased risk. Conclusion This study suggests increased risk of sinonasal adenocarcinoma following styrene exposure. The observations are, however, few, confounding from wood dust exposure cannot be ruled out, and additional studies are needed before firm conclusions can be drawn.
    Schlagwort(e): Open access, Epidemiology
    Print ISSN: 1351-0711
    Digitale ISSN: 1470-7926
    Thema: Medizin
    Publiziert von BMJ Publishing Group
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 15
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    Human service work, gender and antidepressant use: a nationwide register-based 19-year follow-up of 752 683 women and men (2018)
    BMJ Publishing Group
    Details
    Publikationsdatum: 2018-05-18
    Beschreibung: Objectives To examine antidepressant use among male and female human service professionals. Methods A random sample of individuals between 25 years and 54 years of age (n=752 683; 49.2% women; mean age 39.5 years). Information about each individual’s filled antidepressant prescriptions from 1995 to 2014 was provided by the Social Insurance Institution. First, antidepressant use in five broad human service categories was compared with that in all other occupations grouped together, separately for men and women. Then, each of the 15 human service professions were compared with all other occupations from the same skill/education level (excluding other human services professions). Cox models were applied and the results are presented as HRs for antidepressant use with 95% CIs. Results The hazard of antidepressant use was higher among men working in human service versus all other occupations with the same skill/occupational level (1.22, 95% CI 1.18 to 1.27), but this was not the case for women (0.99, 95% CI 0.98 to 1.01). The risks differed between professions: male health and social care professionals (including medical doctors, nurses, practical nurses and home care assistants), social workers, childcare workers, teachers and psychologists had a higher risk of antidepressant use than men in non-human service occupations, whereas customer clerks had a lower risk. Conclusions Male human service professionals had a higher risk of antidepressant use than men working in non-human service occupations. Gendered sociocultural norms and values related to specific occupations as well as occupational selection may be the cause of the elevated risk.
    Schlagwort(e): Editor's choice, Epidemiology
    Print ISSN: 1351-0711
    Digitale ISSN: 1470-7926
    Thema: Medizin
    Publiziert von BMJ Publishing Group
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 16
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    Case-control investigation of occupational exposure to chlorinated solvents and non-Hodgkins lymphoma (2018)
    BMJ Publishing Group
    Details
    Publikationsdatum: 2018-05-18
    Beschreibung: Objectives Although many studies have investigated the association between trichloroethylene (TCE) exposure and non-Hodgkin’s lymphoma (NHL), less is known about other chlorinated solvents. We extended our previous analysis of occupational TCE exposure in a multicentre population-based case-control study of NHL to investigate associations with five additional chlorinated solvents: 1,1,1,-trichloroethane, carbon tetrachloride, chloroform, methylene chloride and perchloroethylene. Methods Cases (n=1189) and controls (n=982) provided detailed information on their occupational histories and workplace exposure to chlorinated solvents for selected occupations using job-specific interview modules. An industrial hygienist used this information and a review of the literature to assess occupational exposure to chlorinated solvents. We computed ORs and 95% CIs for different exposure metrics, with the unexposed group as the referent. We also computed ORs by NHL subtype. Results High cumulative hours exposed to carbon tetrachloride was associated with NHL (〉520 hours: OR 1.9; 95% CI 1.0 to 3.6; P trend =0.04). This association remained after restricting to jobs with high-intensity exposure (OR 2.0; 95% CI 1.1 to 3.8; P=0.03) and ≥90% exposure probability (OR 2.1; 95% CI 1.0 to 4.3; P=0.03), adjusting for TCE (OR 2.1; 95% CI 1.0– to 4.1; P=0.04) and incorporating a 15-year lag (OR 1.9; 95% CI 1.0 to 3.6; P=0.06). The other evaluated chlorinated solvents were not associated with NHL. Conclusions This is the first study using high-quality quantitative exposure assessment methods to identify a statistically significant elevated association between occupational exposure to carbon tetrachloride and NHL. Our findings, although limited by a small number of exposed cases, offer evidence that carbon tetrachloride may be a lymphomagen.
    Schlagwort(e): Epidemiology
    Print ISSN: 1351-0711
    Digitale ISSN: 1470-7926
    Thema: Medizin
    Publiziert von BMJ Publishing Group
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 17
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    Are changes in objective working hour characteristics associated with changes in work-life conflict among hospital employees working shifts? A 7-year follow-up (2018)
    BMJ Publishing Group
    Details
    Publikationsdatum: 2018-05-18
    Beschreibung: Objective To investigate whether changes in objective working hour characteristics are associated with parallel changes in work-life conflict (WLC) among hospital employees. Methods Survey responses from three waves of the Finnish Public Sector study (2008, 2012 and 2015) were combined with payroll data from 91 days preceding the surveys (n=2 482, 93% women). Time-dependent fixed effects regression models adjusted for marital status, number of children and stressfulness of the life situation were used to investigate whether changes in working hour characteristics were associated with parallel change in WLC. The working hour characteristics were dichotomised with cut-points in less than or greater than 10% or less than or greater than25% occurrence) and WLC to frequent versus seldom/none. Results Change in proportion of evening and night shifts and weekend work was significantly associated with parallel change in WLC (adjusted OR 2.19, 95% CI 1.62 to 2.96; OR 1.71, 95% CI 1.21 to 2.44; OR 1.63, 95% CI 1.194 to 2.22, respectively). Similarly, increase or decrease in proportion of quick returns (adjusted OR 1.45, 95% CI 1.10 to 1.89) and long work weeks (adjusted OR 1.26, 95% CI 1.04 to 1.52) was associated with parallel increase or decrease in WLC. Single days off and very long work weeks showed no association with WLC. Conclusions Changes in unsocial working hour characteristics, especially in connection with evening shifts, are consistently associated with parallel changes in WLC.
    Schlagwort(e): Open access
    Print ISSN: 1351-0711
    Digitale ISSN: 1470-7926
    Thema: Medizin
    Publiziert von BMJ Publishing Group
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 18
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    Physical work exposure, chronic musculoskeletal pain and risk of insomnia: longitudinal data from the HUNT study, Norway (2018)
    BMJ Publishing Group
    Details
    Publikationsdatum: 2018-05-18
    Beschreibung: Objectives To prospectively investigate (i) the association of physical work demands and work-related physical fatigue with risk of insomnia symptoms and (ii) if these associations are influenced by chronic musculoskeletal pain. Methods Prospective study on a working population of 8563 women and 7598 men participating in the Nord-Trøndelag Health Study (Norway) who reported no insomnia at baseline in 1995–1997. Occurrence of insomnia symptoms was assessed at follow-up in 2006–2008. A Poisson regression model was used to calculate adjusted risk ratios (RRs) for insomnia symptoms with 95% CI. Results Compared with workers without work-related physical fatigue, women and men who reported that they were always fatigued had RRs of insomnia of 2.34 (95% CI 1.72 to 3.18) and 2.47 (95% CI 1.59 to 3.83), respectively. Overall, physical work demands was not associated with risk of insomnia, although men who reported heavy physical work had an RR of 0.67 (95% CI 0.47 to 0.97) compared with men with mostly sedentary work. Compared with the reference group of workers without work-related physical fatigue and no chronic pain, analyses of joint effects showed that women with excessive work-related fatigue had an RR of 4.20 (95% CI 2.95 to 5.98) if they reported chronic pain and an RR of 1.67 (95% CI 0.87 to 3.18) if they did not. Corresponding RRs in men were 3.55 (95% CI 2.11 to 5.98) and 2.13 (95% CI 1.07 to 4.25). Conclusion These findings suggest that there is an interplay between work-related physical fatigue and musculoskeletal pain that should receive particular attention in the prevention of insomnia in working populations.
    Print ISSN: 1351-0711
    Digitale ISSN: 1470-7926
    Thema: Medizin
    Publiziert von BMJ Publishing Group
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 19
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    Urinary excretion of platinum from South African precious metals refinery workers (2018)
    BMJ Publishing Group
    Details
    Publikationsdatum: 2018-05-18
    Beschreibung: Background Urinary platinum (Pt) excretion is a reliable biomarker for occupational Pt exposure and has been previously reported for precious metals refinery workers in Europe but not for South Africa, the world’s largest producer of Pt. Objective This study aimed to quantify the urinary Pt excretion of South African precious metals refinery workers. Methods Spot urine samples were collected from 40 workers (directly and indirectly exposed to Pt) at two South African precious metals refineries on three consecutive mornings prior to their shifts. Urine samples were analysed for Pt using inductively coupled plasma-mass spectrometry and were corrected for creatinine content. Results The urinary Pt excretion of workers did not differ significantly between sampling days. Urinary Pt excretions ranged from 〈0.1 to 3.0 µg Pt/g creatinine with a geometric mean of 0.21 µg Pt/g creatinine (95% CI 0.17 to 0.26 µg Pt/g creatinine). The work area (P=0.0006; 2 =0.567) and the number of years workers were employed at the refineries (P=0.003; 2 =0.261) influenced their urinary Pt excretion according to effect size analyses. Directly exposed workers had significantly higher urinary Pt excretion compared with indirectly exposed workers (P=0.007). Conclusion The urinary Pt excretion of South African precious metals refinery workers reported in this study is comparable with that of seven other studies conducted in precious metals refineries and automotive catalyst plants in Europe. The Pt body burden of workers is predominantly determined by their work area, years of employment in the refineries and whether they are directly or indirectly exposed to Pt.
    Print ISSN: 1351-0711
    Digitale ISSN: 1470-7926
    Thema: Medizin
    Publiziert von BMJ Publishing Group
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 20
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    Meta-analyses in environmental and occupational health (2018)
    BMJ Publishing Group
    Details
    Publikationsdatum: 2018-05-18
    Beschreibung: Objectives Meta-analyses are considered generally as the highest level of evidence, but concerns have been voiced about their massive, low-quality production. This paper aimed to evaluate the landscape of meta-analyses in the field of occupational and environmental health and medicine. Methods Using relevant search terms, all meta-analyses were searched for, but those published in 2015 were assessed for their origin, whether they included randomised trials and individual-level data and whether they had authors from the industry or consultancy firms. Results PubMed searches (last update February 2017) identified 1251 eligible meta-analyses in this field. There was a rapid increase over time (n=16 published in 1995 vs n=163 published in 2015). Of the 163 eligible meta-analyses published in 2015, 49 were from China, followed at a distance by the USA (n=19). Only 16 considered randomised (intervention) trials and 13 included individual-level data. Only 1 of the 150 meta-analyses had industry authors and none had consultancy firm authors. As an example of conflicting findings, 12 overlapping meta-analyses addressed mobile phones and brain cancer risk and they differed substantially in number of studies included, eligibility criteria and conclusions. Conclusions There has been a major increase in the publication of meta-analyses in occupational and environmental health over time, with the majority of these studies focusing on observational data, while a commendable fraction used individual-level data. Authorship is still limited largely to academic and non-profit authors. With massive production of meta-analyses, redundancy needs to be anticipated and efforts should be made to safeguard quality and protect from bias.
    Print ISSN: 1351-0711
    Digitale ISSN: 1470-7926
    Thema: Medizin
    Publiziert von BMJ Publishing Group
    Standort Signatur Einschränkungen Verfügbarkeit
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