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  • 21
    Publication Date: 2018-05-18
    Description: Objectives Many residents in Beijing use disposable face masks in an attempt to protect their health from high particulate matter (PM) concentrations. Retail masks may be certified to local or international standards, but their real-life performance may not confer the exposure reduction potential that is marketed. This study aimed to evaluate the effectiveness of a range of face masks that are commercially available in China. Methods Nine masks claiming protection against fine PM (PM 2.5 ) were purchased from consumer outlets in Beijing. The masks’ filtration efficiency was tested by drawing airborne diesel exhaust through a section of the material and measuring the PM 2.5 and black carbon (BC) concentrations upstream and downstream of the filtering medium. Four masks were selected for testing on volunteers. Volunteers were exposed to diesel exhaust inside an experimental chamber while performing sedentary tasks and active tasks. BC concentrations were continuously monitored inside and outside the mask. Results The mean per cent penetration for each mask material ranged from 0.26% to 29%, depending on the flow rate and mask material. In the volunteer tests, the average total inward leakage (TIL) of BC ranged from 3% to 68% in the sedentary tests and from 7% to 66% in the active tests. Only one mask type tested showed an average TIL of less than 10%, under both test conditions. Conclusions Many commercially available face masks may not provide adequate protection, primarily due to poor facial fit. Our results indicate that further attention should be given to mask design and providing evidence-based guidance to consumers.
    Keywords: Open access
    Print ISSN: 1351-0711
    Electronic ISSN: 1470-7926
    Topics: Medicine
    Published by BMJ Publishing Group
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  • 22
    Publication Date: 2018-05-18
    Description: Objectives Occupational pesticide exposure is associated with a wide range of diseases, including lung diseases, but it is largely unknown how pesticides influence airway disease pathogenesis. A potential mechanism might be through epigenetic mechanisms, like DNA methylation. Therefore, we assessed associations between occupational exposure to pesticides and genome-wide DNA methylation sites. Methods 1561 subjects of LifeLines were included with either no (n=1392), low (n=108) or high (n=61) exposure to any type of pesticides (estimated based on current or last held job). Blood DNA methylation levels were measured using Illumina 450K arrays. Associations between pesticide exposure and 420 938 methylation sites (CpGs) were assessed using robust linear regression adjusted for appropriate confounders. In addition, we performed genome-wide stratified and interaction analyses by gender, smoking and airway obstruction status, and assessed associations between gene expression and methylation for genome-wide significant CpGs (n=2802). Results In total for all analyses, high pesticide exposure was genome-wide significantly (false discovery rate P〈0.05) associated with differential DNA methylation of 31 CpGs annotated to 29 genes. Twenty of these CpGs were found in subjects with airway obstruction. Several of the identified genes, for example, RYR1 , ALLC , PTPRN2 , LRRC3B , PAX2 and VTRNA2-1 , are genes previously linked to either pesticide exposure or lung-related diseases. Seven out of 31 CpGs were associated with gene expression levels. Conclusions We show for the first time that occupational exposure to pesticides is genome-wide associated with differential DNA methylation. Further research should reveal whether this differential methylation plays a role in the airway disease pathogenesis induced by pesticides.
    Keywords: Open access
    Print ISSN: 1351-0711
    Electronic ISSN: 1470-7926
    Topics: Medicine
    Published by BMJ Publishing Group
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  • 23
    Publication Date: 2018-05-18
    Description: Objectives Exposure to farm environments during childhood and adult life seems to reduce the risk of atopic sensitisation. Most studies have been conducted among farmers, but people living in rural areas may have similar protective effects for atopy. This study aims to investigate the association between residential proximity to livestock farms and atopy among non-farming adults living in a rural area in the Netherlands. Methods We conducted a cross-sectional study among 2443 adults (20–72 years). Atopy was defined as specific IgE to common allergens and/or total IgE ≥100 IU/mL. Residential proximity to livestock farms was assessed as 1) distance to the nearest pig, poultry, cattle or any farm, 2) number of farms within 500 m and 1000 m, and 3) modelled annual average fine dust emissions from farms within 500 m and 1000 m. Data were analysed with multiple logistic regression and generalised additive models. Results The prevalence of atopy was 29.8%. Subjects living at short distances from farms (〈327 m, first tertile) had a lower odds for atopy compared with subjects living further away (〉527 m, third tertile) (OR 0.79, 95% CI 0.63 to 0.98). Significant associations in the same direction were found with distance to the nearest pig or cattle farm. The associations between atopy and livestock farm exposure were somewhat stronger in subjects who grew up on a farm. Conclusions Living in close proximity to livestock farms seems to protect against atopy. This study provides evidence that protective effects of early-life and adult farm exposures may extend beyond farming populations.
    Print ISSN: 1351-0711
    Electronic ISSN: 1470-7926
    Topics: Medicine
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  • 24
    Publication Date: 2018-05-18
    Description: Barone Gibbs B, Hergenroeder AL, Perdomo SJ , et al . Reducing sedentary behaviour to decrease chronic low back pain: the stand back randomised trial.  Occup Environ Med 2018;75:321–7. There is an error in the clinical trials registration number listed in this article. The correct number is: NCT02624687.
    Print ISSN: 1351-0711
    Electronic ISSN: 1470-7926
    Topics: Medicine
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  • 25
    Publication Date: 2018-05-18
    Description: Marsh and colleagues 1 have published a review and meta-analysis of non-occupational exposure to asbestos and the risk of pleural mesothelioma. They confirmed that non-occupational exposures to asbestos fibres are associated with a large increased risk of pleural mesothelioma and reported a fibre-type potency difference for non-occupational exposures. A major problem with assessing fibre-type differences is the very few studies in which fibre type can be unambiguously identified. Given the paucity of studies, it is important to have data from the most recent studies with the largest number of cases. Marsh used PubMed to locate relevant studies. Of the four chrysotile studies they identified, there were one each from Egypt 2 and France 3 and two from Canada. 4   5 The 1998 Canadian publication of Camus  et al 4 reported seven neighbourhood cases of mesothelioma. The Public Health Institute of Quebec published an updated report of...
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    Electronic ISSN: 1470-7926
    Topics: Medicine
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  • 26
    Publication Date: 2018-05-18
    Description: We reviewed the letter submitted by Finkelstein 1 regarding our paper evaluating the risk of pleural mesothelioma from non-occupational asbestos exposure. 2 Finkelstein indicated that, in addition to two Canadian studies in our analysis, 3 4 a third unpublished report was produced in 2004 by Quebec Public Health. 5 It is unclear if Finkelstein is suggesting that the Quebec report is an update to both Camus 3 and McDonald, 4 but it should be noted that although the study populations were similar, case ascertainment was different. Finkelstein 1 cited that the historical progression of case ascertainment for pleural mesothelioma among women with neighbourhood exposure in the Quebec mining regions was 0 cases in 1980, 4 7 cases in 1998 3 and 17 cases in 2004. 5 However, in 2004, Quebec Public Health only reported a total of...
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    Electronic ISSN: 1470-7926
    Topics: Medicine
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  • 27
    Publication Date: 2018-05-18
    Description: Chetty-Mhlanga S, Basera W, Aqiel Dalvie M, et al . A study of school-going children on neurobehavior and currently used agricultural pesticide exposure in the rural western cape, South Africa. Occup Environ Med 2018;75(Suppl 1):A11.2. doi: 10.1136/oemed-2018-ISEEabstracts.27 The following changes are required to abstract number A11.2 of the ‘ISEE Young 2018, Early Career Researchers Conference on Environmental Epidemiology – Together for a Healthy Environment’ supplement. (1) The first author should be listed as Shala Chetty-Mhlanga; (2) the third author should be listed as Mohamed Aqiel Dalvie; (3) Martin Röösli should be the last author (not Nicole Probst).
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    Topics: Medicine
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  • 28
    Publication Date: 2018-05-18
    Description: Managers are in an influential position to make decisions that can impact on the mental health and well-being of their employees. As a result, there is an increasing trend for organisations to provide managers with training in how to reduce work-based mental health risk factors for their employees. A systematic search of the literature was conducted to identify workplace interventions for managers with an emphasis on the mental health of employees reporting directing to them. A meta-analysis was performed to calculate pooled effect sizes using the random effects model for both manager and employee outcomes. Ten controlled trials were identified as relevant for this review. Outcomes evaluating managers’ mental health knowledge (standardised mean difference (SMD)=0.73; 95% CI 0.43 to 1.03; p〈0.001), non-stigmatising attitudes towards mental health (SMD=0.36; 95% CI 0.18 to 0.53; p〈0.001) and improving behaviour in supporting employees experiencing mental health problems (SMD=0.59; 95% CI 0.14 to 1.03; p=0.01) were found to have significant pooled effect sizes favouring the intervention. A significant pooled effect was not found for the small number of studies evaluating psychological symptoms in employees (p=0.28). Our meta-analysis indicates that training managers in workplace mental health can improve their knowledge, attitudes and self-reported behaviour in supporting employees experiencing mental health problems. At present, any findings regarding the impact of manager training on levels of psychological distress among employees remain preliminary as only a very limited amount of research evaluating employee outcomes is available. Our review suggests that in order to understand the effectiveness of manager training on employees, an increase in collection of employee level data is required.
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    Topics: Medicine
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  • 29
    Publication Date: 2018-04-13
    Description: Objective Women in veterinary occupations are routinely exposed to potential reproductive hazards, yet research into their birth outcomes is limited. We conducted a population-based retrospective cohort study of the association between maternal veterinary occupation and adverse birth outcomes. Methods Using Washington State birth certificate, fetal death certificate and hospital discharge data from 1992 to 2014, we compared birth outcomes of mothers in veterinary professions (n=2662) with those in mothers in dental professions (n=10 653) and other employed mothers (n=8082). Relative risks (RRs) and 95% CIs were estimated using log binomial regression. Outcomes studied were premature birth (〈37 weeks), small for gestational age (SGA), malformations and fetal death (death at ≥20 weeks gestation). Subgroup analyses evaluated risk of these outcomes among veterinarians and veterinary support staff separately. Results While no statistically significant associations were found, we noted a trend for SGA births in all veterinary mothers compared with dental mothers (RR=1.16, 95% CI 0.99 to 1.36) and in veterinarians compared with other employed mothers (RR=1.37, 95% CI 0.96 to 1.96). Positive but non-significant association was found for malformations among children of veterinary support staff. Conclusions These results support the need for further study of the association between veterinary occupation and adverse birth outcomes.
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    Topics: Medicine
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  • 30
    Publication Date: 2018-04-13
    Description: Objectives Past studies have identified socioeconomic inequalities in the timing and route of labour market exit at older ages. However, few studies have compared these trends cross-nationally and existing evidence focuses on specific institutional outcomes (such as disability pension and sickness absence) in Nordic countries. We examined differences by education level and occupational grade in the risks of work exit and health-related work exit. Methods Prospective longitudinal data were drawn from seven studies (n=99 164). Participants were in paid work at least once around age 50. Labour market exit was derived based on reductions in working hours, changes in self-reported employment status or from administrative records. Health-related exit was ascertained by receipt of health-related benefit or pension or from the reported reason for stopping work. Cox regression models were estimated for each study, adjusted for baseline self-rated health and birth cohort. Results There were 50 003 work exits during follow-up, of which an average of 14% (range 2–32%) were health related. Low level education and low occupational grade were associated with increased risks of health-related exit in most studies. Low level education and occupational grade were also associated with an increased risk of any exit from work, although with less consistency across studies. Conclusions Workers with low socioeconomic position have an increased risk of health-related exit from employment. Policies that extend working life may disadvantage such workers disproportionally, especially where institutional support for those exiting due to poor health is minimal.
    Keywords: Open access
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    Topics: Medicine
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