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  • Articles  (34)
  • Other exposures  (23)
  • Editor's choice, Other exposures  (7)
  • Back pain  (4)
  • 2010-2014  (34)
  • 1
    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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  • 2
    Publication Date: 2014-10-09
    Description: Objectives Previous research has indicated that occupational exposure to pesticides and possibly airborne endotoxin may increase the risk of developing Parkinson disease (PD). We studied the associations of PD with occupational exposure to pesticides, specifically to the functional subclasses insecticides, herbicides and fungicides, and to airborne endotoxin. In addition we evaluated specific pesticides (active ingredients) previously associated with PD. Methods We used data from a hospital-based case–control study, including 444 patients with PD and 876 age and sex matched controls. Exposures to pesticides from application and re-entry work were estimated with the ALOHA+job-exposure matrix and with an exposure algorithm based on self-reported information on pesticide use. To assess exposure to specific active ingredients a crop-exposure matrix was developed. Endotoxin exposure was estimated with the DOM job-exposure matrix. Results The results showed almost no significant associations. However, ORs were elevated in the higher exposure categories for pesticides in general, insecticides, herbicides and fungicides, and below unity for endotoxin exposure. The analyses on specific active ingredients showed a significant association of PD risk with the fungicide benomyl. Conclusions This study did not provide evidence for a relation between pesticide exposure and PD. However, the consistently elevated ORs in the higher exposure categories suggest that a positive association may exist. The possible association with the active ingredient benomyl requires follow-up in other studies. This study did not provide support for a possible association between endotoxin exposure and PD.
    Keywords: Other exposures
    Print ISSN: 1351-0711
    Electronic ISSN: 1470-7926
    Topics: Medicine
    Published by BMJ Publishing Group
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  • 3
    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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  • 4
    Publication Date: 2014-09-09
    Description: Objective To investigate the role of occupational exposure to chlorinated solvents in lung cancer aetiology. Methods ICARE (Investigation of occupational and environmental CAuses of REspiratory cancers) is a French, multicentre, population-based, case–control study. Information on the lifelong work history of 2926 cases and 3555 controls was collected using standardised questionnaires. Occupational exposures were assessed using job-exposure matrices for five chlorinated solvents. Solvents were studied separately and in combinations. ORs were computed using unconditional logistic regression models adjusted for classic risk factors, including a history of cigarette smoking and exposure to asbestos. Adjustment for socioeconomic status (SES) was also made. Results After adjustment for exposure to asbestos, we observed a positive, statistically significant association with lung cancer for men and women exposed to a combination of perchloroethylene (PCE), trichloroethylene and dichloromethane (DCM). Further adjustment for SES slightly decreased this association. In contrast, no statistically significant associations were found for other solvent combinations. Conclusions These results suggest that exposure to PCE may constitute a risk factor for lung cancer, especially among women, who seem to have a higher prevalence of exposure than men.
    Keywords: Other exposures
    Print ISSN: 1351-0711
    Electronic ISSN: 1470-7926
    Topics: Medicine
    Published by BMJ Publishing Group
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  • 5
    Publication Date: 2014-09-09
    Description: Objective To develop a job-exposure matrix (JEM) that estimates exposure to eight variables representing different aspects of shiftwork among female workers. Methods Occupational history and shiftwork exposure data were obtained from a population-based breast cancer case–control study. Exposure to light at night, phase shift, sleep disturbances, poor diet, lack of physical activity, lack of vitamin D, and graveyard and early morning shifts, was calculated by occupational code. Three threshold values based on the frequency of exposure were considered (10%, 30% and 50%) for use as cut-offs in determining exposure for each occupational code. JEM-based exposure classification was compared with that from the OccIDEAS application (job-specific questionnaires and assessment by rules) by assessing the effect on the OR for phase shift and breast cancer. Using data from the Australian Workplace Exposure Study, the specificity and sensitivity of the threshold values were calculated for each exposure variable. Results 127 of 413 occupational codes involved exposure to one or more shiftwork variables. Occupations with the highest probability of exposure shiftwork included nurses and midwives. Using the 30% threshold, the OR for the association between phase shift exposure and breast cancer was decreased and no longer statistically significant (OR=1.14, 95% CI 0.92 to 1.42). The 30% cut-off point demonstrated best specificity and sensitivity, although results varied between exposure variables. Conclusions This JEM provides a set of indicators reflecting biologically plausible mechanisms for the potential impact of shiftwork on health and may provide an alternative method of exposure assessment in the absence of detailed job history and exposure data.
    Keywords: Other exposures
    Print ISSN: 1351-0711
    Electronic ISSN: 1470-7926
    Topics: Medicine
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  • 6
    Publication Date: 2014-08-09
    Description: Objective We examined occupational exposures and sperm morphology to establish whether exposures implicated differed from those affecting motile sperm concentration. Methods Computer aided sperm morphometric assessment was undertaken on morphology slides obtained as part of a multi-centre study in 1999–2002 of occupational factors in male infertility. Men attending 14 fertility clinics across the UK were recruited and gave a semen sample. Before results of the semen analysis were known, the men completed detailed questionnaires about their employment and lifestyle. Occupational exposures were assessed by occupational hygienists. Data were analysed using an unmatched case-referent design, allowing for clustering and for confounders. Three case definitions were used: poor morphology (normal morphology 〈4%), low motile sperm count (MSC) (〈4.8 x 10 6 ) and either condition. Results Morphology results were available for 1861/2011 men employed at the time of recruitment. Of these 1861, 296 (15.9%) had poor morphology; of the 2011with sperm count, 453 (22.5%) had low MSC; 654/1981 (33.0%) had either condition. Poor morphology, adjusted for confounding, was related to self-reported lifetime exposure to lead (OR=1.33; 95% CI 1.00 to 1.75). Low MSC was also related to self-reported lead and to hygienist-assessed glycol ether exposure. Self-reported use of paint stripper (OR=1.47; 95% CI 1.07 to 2.03) and lead, but not glycol ether, were significantly related to the combined case definition. Conclusions While this study did not identify any occupational exposure uniquely related to sperm morphology, the capacity of the study to detect risk was increased by including morphology with sperm concentration and motility.
    Keywords: Other exposures
    Print ISSN: 1351-0711
    Electronic ISSN: 1470-7926
    Topics: Medicine
    Published by BMJ Publishing Group
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  • 7
    Publication Date: 2014-08-09
    Description: Globally, neurological disorders account for about 4% of all deaths and about 5% of disability-adjusted life-years from non-communicable disease. 1 Diagnosis of a neurological disease can be devastating, and in most instances there is no cure. A recent editorial in the Lancet 2 commented that neurological diseases remain neglected and ignored: ‘unlike cancer, stroke, and diabetes, which all have strategies and clinical champions, degenerative disorders are heterogeneous and complex’. Neurological disease includes a broad spectrum of conditions, several of which have occupational causes. The motor neurone diseases (MND) are a spectrum of neurodegenerative disorders characterised by progressive muscular paralysis due to degeneration of motor neurones in the primary motor cortex, brainstem and spinal cord. 3 Although the vast majority of cases of (MND) are ‘sporadic’ (ie, non-genetic), most current research into the causes of MND involves primarily or solely genetic factors and few studies of occupational...
    Keywords: Other exposures
    Print ISSN: 1351-0711
    Electronic ISSN: 1470-7926
    Topics: Medicine
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  • 8
    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
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  • 9
    Publication Date: 2014-04-10
    Description: Background People in sedentary occupations are at increased risk of hip fracture. Hip fracture is significantly associated with low bone mineral density (BMD) measured at the hip. Physical activity is important in the development and maintenance of BMD, but the effects of occupational physical activity on bone health are unclear. We investigated the influence of lifetime physical activity on BMD at the hip. Methods This was a cross-sectional epidemiological study of the associations between total hip BMD measured by dual-energy X-ray absorptiometry at retirement age and lifetime exposure to occupational physical workload (standing/walking ≥4 h/day; lifting ≥25 kg; energetic work sufficient to induce sweating and manual work). Results Complete data on occupational exposures were available for 860 adults (488 men and 372 women) who had worked ≥20 years. Their mean age was 65 years, and many reported heavy physical workplace activities over prolonged durations. There were no statistically significant associations between total hip BMD and any of these measures of lifetime occupational physical activity in men or women. Conclusions Lifetime cumulative occupational activity was not associated with hip BMD at retirement age. Our findings suggest that, if sedentary work conveys an increased risk of hip fracture, it is unlikely that the mechanism is through reductions in BMD at the hip and may relate to other physical effects, such as falls risk. Further studies will be needed to test this hypothesis.
    Keywords: Other exposures
    Print ISSN: 1351-0711
    Electronic ISSN: 1470-7926
    Topics: Medicine
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  • 10
    Publication Date: 2014-04-10
    Description: Background Chronic mucus hypersecretion (CMH) is highly prevalent in smokers and associated with an accelerated lung function decline and chronic obstructive pulmonary disease (COPD). Several risk factors contribute to CMH and to COPD. It is, however, unknown if risk factors for CMH are similar in persons with and without COPD. Methods 1479 persons with and 8529 without COPD, participating in the general population-based LifeLines cohort, completed questionnaires and underwent spirometry. Occupational exposure was assessed using the ALOHA+ job exposure matrix. Analyses were performed using multiple logistic regression models. Results In COPD, a significantly higher risk for CMH was associated with higher pack-years smoking (per 10 pack-years) (OR=1.28; 1.12 to 1.46) and environmental tobacco smoke (ETS) (OR=2.06; 1.33 to 3.19). In non-COPD; male gender (OR=1.91; 1.51 to 2.41), higher Body Mass Index (OR=1.04; 1.01 to 1.06), higher pack-years smoking (OR=1.28; 1.14 to 1.44), current smoking (OR=1.50; 1.04 to 2.18), low and high exposure to mineral dust (OR=1.39; 1.04 to 1.87 and OR=1.60; 1.02 to 2.52), high exposure to gases & fumes (OR=2.19; 1.49 to 3.22). Significant interactions were found between COPD and exposure to gases & fumes (p=0.018) and aromatic solvents (p=0.038). Conclusions A higher risk for CMH was associated with higher pack-years smoking regardless of COPD status. However, a higher risk for CMH was associated with high occupational exposure to gases & fumes in individuals without COPD only.
    Keywords: Other exposures
    Print ISSN: 1351-0711
    Electronic ISSN: 1470-7926
    Topics: Medicine
    Published by BMJ Publishing Group
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