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  • Artikel  (22)
  • Asbestos, Other exposures  (11)
  • Back pain  (8)
  • Editor's choice, Press releases  (3)
  • 11
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    An observational study of shift length, crew familiarity, and occupational injury and illness in emergency medical services workers (2015)
    BMJ Publishing Group
    Details
    Publikationsdatum: 2015-10-16
    Beschreibung: Objectives Emergency medical services (EMS) clinicians are shift workers deployed in two-person teams. Extended shift duration, workplace fatigue, poor sleep and lack of familiarity with teammates are common in the EMS workforce and may contribute to workplace injury. We sought to examine the relationship between shift length and occupational injury while controlling for relevant shift work and teamwork factors. Methods We obtained 3 years of shift schedules and occupational injury and illness reports were from 14 large EMS agencies. We abstracted shift length and additional scheduling and team characteristics from shift schedules. We matched occupational injury and illness reports to shift records and used hierarchical logistic regression models to test the relationship between shift length and occupational injury and illness while controlling for teammate familiarity. Results The cohort contained 966 082 shifts, 4382 employees and 950 outcome reports. Risk of occupational injury and illness was lower for shifts ≤8 h in duration (RR 0.70; 95% CI 0.51 to 0.96) compared with shifts 〉8 and ≤12 h. Relative to shifts 〉8 and ≤12 h, risk of injury was 60% greater (RR 1.60; 95% CI 1.22 to 2.10) for employees that worked shifts 〉16 and ≤24 h. Conclusions Shift length is associated with increased risk of occupational injury and illness in this sample of EMS shift workers.
    Schlagwort(e): Editor's choice, Press releases
    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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    Occupational exposures and lung cancer risk among Minnesota taconite mining workers (2015)
    BMJ Publishing Group
    Details
    Publikationsdatum: 2015-08-15
    Beschreibung: Objective To examine the association between employment duration, elongate mineral particle (EMP) exposure, silica exposure and the risk of lung cancer in the taconite mining industry. Methods We conducted a nested case–control study of lung cancer within a cohort of Minnesota taconite iron mining workers employed by any of the mining companies in operation in 1983. Lung cancer cases were identified by vital records and cancer registry data through 2010. Two age-matched controls were selected from risk sets of cohort members alive and lung cancer free at the time of case diagnosis. Calendar time-specific exposure estimates were made for every job and were used to estimate workers’ cumulative exposures. ORs and 95% CIs were estimated using conditional logistic regression. We evaluated total lung cancer risk and risk of histological subtype by total work duration and by cumulative EMP, and silica exposure by quartile of the exposure distribution. Results A total of 1706 cases and 3381 controls were included in the analysis. After adjusting for work in haematite mining, asbestos exposure and sex, the OR for total duration of employment was 0.99 (95% CI 0.96 to 1.01). The ORs for quartile 4 versus 1 of EMP and silica exposure were 0.82 (95% CI 0.57 to 1.19) and 0.97 (95% CI 0.70 to 1.35), respectively. The risk of each histological subtype of lung cancer did not change with increasing exposure. Conclusions This study suggests that the estimated taconite mining exposures do not increase the risk of developing lung cancer.
    Schlagwort(e): Asbestos, Other exposures
    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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    Certified sickness absence: does the 'fit-note' work? (2015)
    BMJ Publishing Group
    Details
    Publikationsdatum: 2015-06-17
    Beschreibung: Long-term sickness absence is costly for employers, workers and society in general. Besides the economic benefits, enabling timely rehabilitation of employees back to work is also intended to improve their physical well-being and self-esteem. 1 One of the measures recommended in the Black Report to help achieve these aims was the introduction (in the UK) of the ‘fit-note' in 2010. 2 This fit-note was intended to replace, at least in part, stark statements that a worker was too ‘sick’ to work by qualified statements of fitness provided certain reasonable workplace adjustments (such as a graded return to work) were made. The paper by Gabbay et al 3 evaluates the effects of the introduction of the fit-note by examining sickness absence data collected in two separate studies, separated by a decade, and conducted before and after the introduction of the fit-note. The comparison was based on seven...
    Schlagwort(e): Editor's choice, Press releases
    Print ISSN: 1351-0711
    Digitale ISSN: 1470-7926
    Thema: Medizin
    Publiziert von BMJ Publishing Group
    Standort Signatur Einschränkungen Verfügbarkeit
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    PAPER CURRENT
  • 14
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    Extended follow-up of lung cancer and non-malignant respiratory disease mortality among California diatomaceous earth workers (2015)
    BMJ Publishing Group
    Details
    Publikationsdatum: 2015-04-15
    Beschreibung: Objectives Millions of workers worldwide are employed in occupations involving potentiality hazardous exposure to crystalline silica. The diatomaceous earth industry can have particularly high exposures, but there is a lower likelihood of simultaneously occurring confounding exposures. We extended follow-up for diatomaceous earth industry workers previously studied for mortality. Methods The cohort included 2342 white men who were employed for at least 1 year at a diatomaceous earth plant in Lompoc, California beginning in 1942. Workers’ vital status was updated using the National Death Index through 2011, an extension of 19 years from earlier studies. Detailed work history and quantitative air monitoring measurements estimated exposure intensity. Cox proportional hazards modelling estimated HRs and 95% CIs. SMRs were calculated. Results Elevated mortality was observed by quartile of cumulative crystalline silica exposure for lung cancer (HR=2.03, 95% CI 1.07 to 3.85, highest quartile, unlagged) and non-malignant respiratory disease (NMRD) (HR=3.59, 95% CI 1.94 to 6.67, highest quartile, unlagged), although trends were not statistically significant. Associations were attenuated when adjusted for smoking and asbestos exposure. Mortality from NMRD was significantly increased over the entire follow-up compared to the general population (SMR=1.37, 95% CI 1.17 to 1.60). An increase for lung cancer was confined to the earlier follow-up (SMR=1.29, 95% CI 1.01 to 1.61). Conclusions The risk of lung cancer and NMRD mortality remained elevated, although generally non-significant, and exposure-response trends with cumulative crystalline silica persisted on extended follow-up of this cohort. The findings support a generally consistently observed aetiological relation between crystalline silica and lung cancer.
    Schlagwort(e): Asbestos, Other exposures
    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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    Shift work and diabetes mellitus: a meta-analysis of observational studies (2014)
    BMJ Publishing Group
    Details
    Publikationsdatum: 2014-12-17
    Beschreibung: Background Observational studies suggest that shift work may be associated with diabetes mellitus (DM). However, the results are inconsistent. No systematic reviews have applied quantitative techniques to compute summary risk estimates. Objectives To conduct a meta-analysis of observational studies assessing the association between shift work and the risk of DM. Methods Relevant studies were identified by a search of PubMed, Embase, Web of Science and ProQuest Dissertation and Theses databases to April 2014. We also reviewed reference lists from retrieved articles. We included observational studies that reported OR with 95% CIs for the association between shift work and the risk of DM. Two authors independently extracted data and assessed the study quality. Results Twelve studies with 28 independent reports involving 226 652 participants and 14 595 patients with DM were included. A pooled adjusted OR for the association between ever exposure to shift work and DM risk was 1.09 (95% CI 1.05 to 1.12; p=0.014; I 2 =40.9%). Subgroup analyses suggested a stronger association between shift work and DM for men (OR=1.37, 95% CI 1.20 to 1.56) than for women (OR=1.09, 95% CI 1.04 to 1.14) (p for interaction=0.01). All shift work schedules with the exception of mixed shifts and evening shifts were associated with a statistically higher risk of DM than normal daytime schedules, and the difference among those shift work schedules was significant (p for interaction=0.04). Conclusions Shift work is associated with an increased risk of DM. The increase was significantly higher among men and the rotating shift group, which warrants further studies.
    Schlagwort(e): Editor's choice, Press releases
    Print ISSN: 1351-0711
    Digitale ISSN: 1470-7926
    Thema: Medizin
    Publiziert von BMJ Publishing Group
    Standort Signatur Einschränkungen Verfügbarkeit
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    PAPER CURRENT
  • 16
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    Examining the association of lung cancer and highly correlated fibre size-specific asbestos exposures with a hierarchical Bayesian model (2014)
    BMJ Publishing Group
    Details
    Publikationsdatum: 2014-04-10
    Beschreibung: Background Asbestos is a known carcinogen. However, little is known about the differential effects of size-specific asbestos fibres. Previous research has examined the relationship with lung cancer of each fibre group in the absence of others. Attempts to model all fibre groups within a single regression model have failed due to high correlations across fibre size groups. Methods We compare results from frequentist models for individual fibre size groups, and a hierarchical Bayesian model that included all fibre groups to estimate the relationship of size-specific asbestos fibre groups to lung cancer mortality. The hierarchical model assumes partial exchangeability of the effects of size-specific asbestos fibre groups to lung cancer, and is capable of handling the strong correlation of the exposure data. Results When fibre groups are modelled independently with a frequentist model, there appears to be an increase in the dose-response with increasing fibre size. However, when subject to a hierarchical structure, this trend vanishes, and the effects of distinct fibre groups appear largely similar. Conclusions This is the first occasion where distinct asbestos fibre groups have been assessed in a single regression model; however, even the use of a hierarchical modelling structure does not appear to overcome all the statistical fluctuations arising from the high correlations across fibre groups. We believe these results should be compared with other occupational cohorts with similar fibre group information. Finally, results for the smallest fibre group may be suggestive of a carcinogenic potential for nanofibres.
    Schlagwort(e): Asbestos, Other exposures
    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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    A comparison of exposure assessment approaches: lung cancer and occupational asbestos exposure in a population-based case-control study (2014)
    BMJ Publishing Group
    Details
    Publikationsdatum: 2014-03-06
    Beschreibung: Objectives In attempts to overcome the limitations of self-reported data in occupational health research, job-exposure matrices, which assign exposure by occupation, have emerged as an objective approach for assessing occupational exposures. On the basis of a lung cancer case–control study conducted in the Greater Toronto Area, 1997–2002, assessment of occupational exposure to asbestos was compared using self-reports and a general population job-exposure matrix (DOM-JEM). Methods Cases and frequency matched controls provided life-time job histories and self-reported exposures to potential lung carcinogens including asbestos through a detailed questionnaire. Exposure to asbestos was also assigned to each job by linking occupational histories with DOM-JEM. Agreement in classification of exposed and unexposed jobs according to self-reports and DOM-JEM was evaluated using Cohen's . Risks for lung cancer were estimated using unconditional logistic regression for each exposure assessment approach. Results The prevalence of occupational asbestos exposure was greater when based on DOM-JEM than when based on self-reports. Agreement in classifying exposure to jobs between the two assessment approaches was poor. The risk of lung cancer was not elevated among workers who self-reported asbestos exposure, whereas workers considered exposed on the basis of DOM-JEM were almost twice as likely as unexposed workers to be diagnosed with lung cancer (OR 1.9, 95% CI 1.3 to 2.7). Conclusions It is generally assumed by epidemiologists that self-reported exposure assessments result in inflated risk estimates. In this study, self-reports found no association with a well-established risk factor, whereas a high-quality job-exposure matrix revealed relative risk estimates that are more consistent with previous findings.
    Schlagwort(e): Asbestos, Other exposures
    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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    Patterns of work injuries: cases admitted to emergency room treatment compared to cases reported to the Danish Working Environment Authority during 2003-2010 (2014)
    BMJ Publishing Group
    Details
    Publikationsdatum: 2014-01-16
    Beschreibung: Objective To compare work injuries treated in an emergency department (ED) and injuries reported to the Danish Working Environment Authority (DWEA). Methods Work injuries of the ED, Odense University Hospital, and injuries from the geographical catchment area reported to the DWEA between 2003 and 2010 were included. The injuries included in both datasets were identified by merging the ED file and the DWEA file using the civil registry number and injury date information as key. Results Approximately 50 000 work injuries occurred in the catchment area of the ED. The intersection between the two injury registration systems was 16%. A major discordance concerned the type of injuries, as some injuries were seen frequently in the ED but not reported to the DWEA to any significant extent, for example ‘eye injuries’ and ‘superficial lacerations or wounds’. On the other hand, some injuries are rarely seen in the ED, but often reported to the DWEA, for example ‘low back pain’. Additionally, younger workers visit the ED more often than older workers, and injuries in the high risk sectors have the lowest reporting proportion. Conclusions Neither the ED nor DWEA injury files alone give a complete picture of work injuries. But merged, they represent a significant number of injuries, taking into account differences in data sources, for example concerning uneven distribution of age, sex, type of injury and type of industry. Obviously, not all serious work related ED injuries resulting in lost work time are reported to the DWEA.
    Schlagwort(e): Back pain
    Print ISSN: 1351-0711
    Digitale ISSN: 1470-7926
    Thema: Medizin
    Publiziert von BMJ Publishing Group
    Standort Signatur Einschränkungen Verfügbarkeit
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    PAPER CURRENT
  • 19
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    Occupational asbestos exposure is associated with pharyngeal squamous cell carcinoma in men from the greater Boston area (2013)
    BMJ Publishing Group
    Details
    Publikationsdatum: 2013-11-09
    Beschreibung: Objectives Asbestos is the name given to a group of naturally occurring silicate mineral fibres that were widely used in industry during the 20th century due to their desirable physical properties. Although use in the USA has fallen over the last three decades, significant exposure in the developing world continues and the burden of disease is considerable. Asbestos is a known risk factor for several malignant diseases, including lung cancer and mesothelioma, and has more recently been implicated in pharyngeal and laryngeal cancer. However, studies of asbestos and cancers of the larynx or pharynx with adequate sample size that control for major head and neck squamous cell carcinoma (HNSCC) risk factors remain relatively sparse. Methods We report findings from a case–control study of 674 incident male HNSCC cases from the greater Boston region and 857 population-based male controls, matched on age (±3 years), sex, and town or neighbourhood of residence. Multivariable logistic regression was used to assess the association between occupational asbestos exposure and HNSCC by primary tumour site. Results 190 cases (28.2%) and 203 controls (23.7%) reported occupational exposure to asbestos. Occupational asbestos exposure was associated with elevated risk of pharyngeal carcinoma in men (OR 1.41, 95% CI 1.01 to 1.97), adjusted for age, race, smoking, alcohol consumption, education, income and HPV16 serology, with borderline increasing risk for each decade in the exposed occupation (OR 1.10, 95% CI 0.99 to 1.23). Conclusions These observations are consistent with mounting evidence that asbestos is a risk factor for pharyngeal cancer.
    Schlagwort(e): Asbestos, Other exposures
    Print ISSN: 1351-0711
    Digitale ISSN: 1470-7926
    Thema: Medizin
    Publiziert von BMJ Publishing Group
    Standort Signatur Einschränkungen Verfügbarkeit
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    PAPER CURRENT
  • 20
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    Do self-reported psychosocial working conditions predict low back pain after adjustment for both physical work load and depressive symptoms? A prospective study among female eldercare workers (2013)
    BMJ Publishing Group
    Details
    Publikationsdatum: 2013-07-11
    Beschreibung: Objectives To investigate whether psychosocial working conditions predict the development of low back pain (LBP) in female eldercare workers while adjusting for physical workload and depressive symptoms. Methods We investigated risk for developing LBP for between 1 and 30 days in the past year and developing LBP for more than 30 days in the past year at follow-up in 1537 female eldercare workers with no LBP in the year before baseline. Data were analysed using logistic regression analysis adjusted for sociodemographic variables, health behaviours, physical workload and depressive symptoms at baseline. Follow-up ranged from 18 to 22 months. Results High emotional demands, high and medium role conflicts and low influence predicted risk for reporting LBP for between 1 and 30 days in the past year at follow-up after adjustment for sociodemographics, health behaviours and physical workload. All associations became statistically non-significant when adjusted for depressive symptoms. Low and medium influence at work and high emotional demands predicted risk of reporting LBP for more than 30 days in the past year at follow-up, after adjustment for sociodemographics, health behaviours and physical workload. For employees with low (OR 4.16; 95% CI 1.36 to 12.75) and medium (OR 3.93; 95% CI 1.37 to 11.22) influence, this risk remained statistically significant after adjustment for depressive symptoms. Conclusions Most psychosocial working conditions in this study were no longer associated with risk of LBP after adjustment for depressive symptoms. However, low and medium influence at work predicted risk for LBP for more than 30 days after adjustment for both physical workload and depressive symptoms.
    Schlagwort(e): Back pain
    Print ISSN: 1351-0711
    Digitale ISSN: 1470-7926
    Thema: Medizin
    Publiziert von BMJ Publishing Group
    Standort Signatur Einschränkungen Verfügbarkeit
    BibTip Andere fanden auch interessant ...
    PAPER CURRENT
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