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  • Articles  (6)
  • Respiratory  (4)
  • Open access, Editor's choice  (1)
  • Respiratory, Other exposures
  • 2010-2014  (6)
  • 2013  (6)
  • 1
    Publication Date: 2013-12-07
    Description: Objectives To evaluate respiratory related mortality among underground coal miners after 37 years of follow-up. Methods Underlying cause of death for 9033 underground coal miners from 31 US mines enrolled between 1969 and 1971 was evaluated with life table analysis. Cox proportional hazards models were fitted to evaluate the exposure-response relationships between cumulative exposure to coal mine dust and respirable silica and mortality from pneumoconiosis, chronic obstructive pulmonary disease (COPD) and lung cancer. Results Excess mortality was observed for pneumoconiosis (SMR=79.70, 95% CI 72.1 to 87.67), COPD (SMR=1.11, 95% CI 0.99 to 1.24) and lung cancer (SMR=1.08; 95% CI 1.00 to 1.18). Coal mine dust exposure increased risk for mortality from pneumoconiosis and COPD. Mortality from COPD was significantly elevated among ever smokers and former smokers (HR=1.84, 95% CI 1.05 to 3.22; HR K =1.52, 95% CI 0.98 to 2.34, respectively) but not current smokers (HR=0.99, 95% CI 0.76 to 1.28). Respirable silica was positively associated with mortality from pneumoconiosis (HR=1.33, 95% CI 0.94 to 1.33) and COPD (HR=1.04, 95% CI 0.96 to 1.52) in models controlling for coal mine dust. We saw a significant relationship between coal mine dust exposure and lung cancer mortality (HR=1.70; 95% CI 1.02 to 2.83) but not with respirable silica (HR=1.05; 95% CI 0.90 to 1.23). In the most recent follow-up period (2000–2007) both exposures were positively associated with lung cancer mortality, coal mine dust significantly so. Conclusions Our findings support previous studies showing that exposure to coal mine dust and respirable silica leads to increased mortality from malignant and non-malignant respiratory diseases even in the absence of smoking.
    Keywords: Respiratory
    Print ISSN: 1351-0711
    Electronic ISSN: 1470-7926
    Topics: Medicine
    Published by BMJ Publishing Group
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  • 2
    Publication Date: 2013-11-09
    Description: Objective To quantify the relationship between death from non-malignant respiratory diseases (NMRD) and exposure to silica dust or radon in a cohort of 58 690 former German uranium miners. Methods In the follow-up period from 1946 to 2008, a total of 2336 underlying deaths from NMRDs occurred, including 715 deaths from chronic obstructive pulmonary diseases (COPD) and 975 deaths from silicosis or other pneumoconiosis. Exposure to respirable crystalline silica and radon was individually assessed by means of a comprehensive job-exposure matrix. Risk analyses were based on a linear Poisson regression model with the baseline stratified by age, calendar year and duration of employment. Results There was no increase in risk of death from COPDs or any other NMRDs in relation to cumulative exposure to silica (mean=5.9, max=56 mg/m 3 -years), except in the group of deaths from silicosis or other pneumoconiosis. Here, a strong non-linear increase in risk was observed. Cumulative radon exposure (mean=280; max=3224 Working Level Months) was not related to death from COPDs or any other NMRDs. Conclusions The present findings do not indicate a relationship between mortality from COPD with silica dust or radon. However, validity of cause of death and lack of control for smoking remain potential sources of bias.
    Keywords: Respiratory
    Print ISSN: 1351-0711
    Electronic ISSN: 1470-7926
    Topics: Medicine
    Published by BMJ Publishing Group
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  • 3
    Publication Date: 2013-11-09
    Description: Objectives During the 1950s and 1960s, aluminium dust inhalation was used as a potential prophylaxis against silicosis in underground miners, including in Australia. We investigated the association between aluminium dust inhalation and cardiovascular, cerebrovascular and Alzheimer's diseases in a cohort of Australian male underground gold miners. We additionally looked at pneumoconiosis mortality to estimate the effect of the aluminium therapy. Methods SMRs and 95% CI were calculated to compare mortality of the cohort members with that of the Western Australian male population (1961–2009). Internal comparisons on duration of aluminium dust inhalation were examined using Cox regression. Results Aluminium dust inhalation was reported for 647 out of 1894 underground gold miners. During 42 780 person-years of follow-up, 1577 deaths were observed. An indication of increased mortality of Alzheimer's disease among miners ever exposed to aluminium dust was found (SMR=1.38), although it was not statistically significant (95% CI 0.69 to 2.75). Rates for cardiovascular and cerebrovascular death were above population levels, but were similar for subjects with or without a history of aluminium dust inhalation. HRs suggested an increasing risk of cardiovascular disease with duration of aluminium dust inhalation (HR=1.02, 95% CI 1.00 to 1.04, per year of exposure). No difference in the association between duration of work underground and pneumoconiosis was observed between the groups with or without aluminium dust exposure. Conclusions No protective effect against silicosis was observed from aluminium dust inhalation. Conversely, exposure to aluminium dust may possibly increase the risk of cardiovascular disease and dementia of the Alzheimer's type.
    Keywords: Respiratory
    Print ISSN: 1351-0711
    Electronic ISSN: 1470-7926
    Topics: Medicine
    Published by BMJ Publishing Group
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  • 4
    Publication Date: 2013-07-11
    Description: Objectives To quantify the variation in rates of absence due to musculoskeletal pain across 47 occupational groups (mostly nurses and office workers) from 18 countries, and to explore personal and group-level risk factors that might explain observed differences. Methods A standardised questionnaire was used to obtain information about musculoskeletal pain, sickness absence and possible risk factors in a cross-sectional survey of 12 416 workers (92–1017 per occupational group). Additionally, group-level data on socioeconomic variables, such as sick pay and unemployment rates, were assembled by members of the study team in each country. Associations of sickness absence with risk factors were examined by Poisson regression. Results Overall, there were more than 30-fold differences between occupational groups in the 12-month prevalence of prolonged musculoskeletal sickness absence, and even among office workers carrying out similar occupational tasks, the variation was more than tenfold. Personal risk factors included older age, lower educational level, tendency to somatise, physical loading at work and prolonged absence for non-musculoskeletal illness. However, these explained little of the variation between occupational groups. After adjustment for individual characteristics, prolonged musculoskeletal sickness absence was more frequent in groups with greater time pressure at work, lower job control and more adverse beliefs about the work-relatedness of musculoskeletal disorders. Conclusions Musculoskeletal sickness absence might be reduced by eliminating excessive time pressures in work, maximising employees’ responsibility and control and providing flexibility of duties for those with disabling symptoms. Care should be taken not to overstate work as a cause of musculoskeletal injury.
    Keywords: Open access, Editor's choice
    Print ISSN: 1351-0711
    Electronic ISSN: 1470-7926
    Topics: Medicine
    Published by BMJ Publishing Group
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  • 5
    Publication Date: 2013-06-11
    Description: Objective The 2004 amendment to the Control of Substances Hazardous to Health 2002 regulations (COSHH 2004) introducing workplace exposure limits (WELs) was enacted in the UK in 2005. This study aimed to determine whether introducing this legislation coincided with a reduction in the incidence of work-related short latency respiratory disease (SLRD) attributed to the agents with a WEL. The second objective was to determine whether changes in legislation, WELs and market forces coincided with a reduction in the incidence of SLRD attributed to glutaraldehyde and latex. Method Reports of SLRD made to the Surveillance of Work-related and Occupational Respiratory Disease scheme were used to estimate the change in incidence within reporters between two time periods (interrupted time series design) using a longitudinal, negative binomial regression model with β distributed random effects. A statistical interaction term was included in the model to make comparisons between the groups defined by suspected causal agent and/or occupation, essentially comparing two interrupted time series. Time periods were defined prospectively representing the changes in legislation or market forces. Results The introduction of the COSHH 2004 legislation in the UK coincided with a significant reduction in reports of SLRD attributed to agents with a WEL relative to those without a WEL (ratio of incidence rate ratios: 0.70; 95% CI 0.52 to 0.93) and a significant reduction in SLRD attributed to glutaraldehyde in healthcare workers (0.20; 0.07 to 0.57) and latex in all workers (0.37; 0.16 to 0.85). Conclusions These data are consistent with a beneficial effect of legislation aiming to reduce workplace exposures.
    Keywords: Respiratory, Other exposures
    Print ISSN: 1351-0711
    Electronic ISSN: 1470-7926
    Topics: Medicine
    Published by BMJ Publishing Group
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  • 6
    Publication Date: 2013-01-19
    Description: Objectives To determine pattern and predictors for respiratory illnesses and symptoms and lung function among textile workers in Karachi, Pakistan. Methods This was a cross-sectional survey of 372 adult male textile workers from the spinning and weaving sections of 15 textile mills from Karachi. Data were collected from November to December 2009 through a structured, pretested questionnaire and spirometry. Results Prevalence of byssinosis was 10.5%, chronic cough 7.5%, chronic phlegm 12.9%, wheeze with shortness of breath 22.3%, shortness of breath (grade 2) 21%, chest tightness ever 33.3%; whereas, a low prevalence of asthma (4%) was identified in this population. Eight per cent had obstructive, 8% restrictive and 2% mixed pattern of lung function abnormality. After controlling for potential confounders, work in the spinning section predicts frequent wheeze (AOR=2.0; 95% CI 1.1 to 3.5), wheeze with shortness of breath (AOR=1.8; 95% CI 1.0 to 3.4), and obstructive pattern on spirometry (AOR=2.5; 95% CI 1.0 to 6.2). Prolonged duration of work predicts breathlessness grade 1 (AOR=1.8; 95% CI 1.0 to 3.1) and grade 2 (AOR=2.7; 95% CI 1.3 to 5.4), as well as decrements in Forced Expiratory Volume in the first second (FEV 1 ) and FEV 1 /Forced Vital Capacity ratio. Lack of education predicts frequent wheeze (AOR=2.0; 95% CI 1.2 to 3.3), and Sindhi ethnicity predicts chest tightness apart from during cold (AOR=2.7; 95% CI 1.1 to 6.6). Conclusions This study highlights the burden of respiratory illnesses and symptoms, and a low prevalence of asthma among textile workers in Karachi. Work in the spinning section, lack of education, prolonged duration of work and Sindhi ethnicity, were identified as important risk factors.
    Keywords: Respiratory
    Print ISSN: 1351-0711
    Electronic ISSN: 1470-7926
    Topics: Medicine
    Published by BMJ Publishing Group
    Location Call Number Limitation Availability
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