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  • 11
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    Long-term effects of aluminium dust inhalation (2013)
    BMJ Publishing Group
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    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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  • 12
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    Personal and workplace psychosocial risk factors for carpal tunnel syndrome: a pooled study cohort (2013)
    BMJ Publishing Group
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    Publication Date: 2013-07-11
    Description: Background Between 2001 and 2010, six research groups conducted coordinated multiyear, prospective studies of carpal tunnel syndrome (CTS) incidence in US workers from various industries and collected detailed subject-level exposure information with follow-up symptom, physical examination, electrophysiological measures and job changes. Objective This analysis of the pooled cohort examined the incidence of dominant-hand CTS in relation to demographic characteristics and estimated associations with occupational psychosocial factors and years worked, adjusting for confounding by personal risk factors. Methods 3515 participants, without baseline CTS, were followed-up to 7 years. Case criteria included symptoms and an electrodiagnostic study consistent with CTS. Adjusted HRs were estimated in Cox proportional hazard models. Workplace biomechanical factors were collected but not evaluated in this analysis. Results Women were at elevated risk for CTS (HR=1.30; 95% CI 0.98 to 1.72), and the incidence of CTS increased linearly with both age and body mass index (BMI) over most of the observed range. High job strain increased risk (HR=1.86; 95% CI 1.11 to 3.14), and social support was protective (HR=0.54; 95% CI 0.31 to 0.95). There was an inverse relationship with years worked among recent hires with the highest incidence in the first 3.5 years of work (HR=3.08; 95% CI 1.55 to 6.12). Conclusions Personal factors associated with an increased risk of developing CTS were BMI, age and being a woman. Workplace risk factors were high job strain, while social support was protective. The inverse relationship between CTS incidence and years worked among recent hires suggests the presence of a healthy worker survivor effect in the cohort.
    Keywords: Musculoskeletal
    Print ISSN: 1351-0711
    Electronic ISSN: 1470-7926
    Topics: Medicine
    Published by BMJ Publishing Group
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  • 13
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    A prospective study of carpal tunnel syndrome: workplace and individual risk factors (2013)
    BMJ Publishing Group
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    Publication Date: 2013-07-11
    Description: Objectives To quantify the risk for carpal tunnel syndrome (CTS) from workplace physical factors, particularly hand activity level and forceful exertion, while taking into account individual factors including age, gender, body mass index (BMI), and pre-existing medical conditions. Methods Three healthcare and manufacturing workplaces were selected for inclusion on the basis of range of exposure to hand activity level and forceful exertion represented by their jobs. Each study participant's job tasks were observed and evaluated onsite and videotaped for further analysis, including frequency and duration of exertion and postural deviation. Individual health assessment entailed electrodiagnostic testing of median and ulnar nerves, physical examination and questionnaires at baseline with annual follow-up for 2 years. Results The incidence of dominant hand CTS during the study was 5.11 per 100 person-years (29 cases). Adjusted HRs for dominant hand CTS were as follows: working with forceful exertion ≥20% but 〈60% of the time: 2.83 (1.18, 6.79) and ≥60% of the time vs 〈20%: 19.57 (5.96, 64.24), BMI ≥30 kg/m 2 (obesity): 3.19 (1.28, 7.98). The American Conference for Governmental Industrial Hygienists (ACGIH) Threshold Limit Value (TLV) for hand activity level also predicted CTS, HR=1.40 (1.11, 1.78) for each unit increase in the TLV ratio, controlling for obesity and job strain. Conclusions Workplace and individual risk factors both contribute to the risk for CTS. Time spent in forceful exertion can be a greater risk for CTS than obesity if the job exposure is high. Preventive workplace efforts should target forceful exertions.
    Keywords: Musculoskeletal
    Print ISSN: 1351-0711
    Electronic ISSN: 1470-7926
    Topics: Medicine
    Published by BMJ Publishing Group
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  • 14
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    Does transfer of work from a public sector organisation to a commercial enterprise without staff reductions increase risk of long-term sickness absence among the staff? A cohort study of laboratory and radiology employees (2013)
    BMJ Publishing Group
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    Publication Date: 2013-07-11
    Description: Background Privatisations of public sector organisations are not uncommon, and some studies suggest that such organisational changes may adversely affect employee health. In this study, we examined whether transfer of work from public sector hospital units to commercial enterprises, without major staff reductions, was associated with an increased risk of long-term sickness absence among employees. Methods A cohort study of 962 employees from four public hospital laboratory and radiology units in three hospitals which were privatised during the follow-up and 1832 employees from similar units without such organisational changes. Records of new long-term sick leaves (〉90 days) were obtained from national health registers and were linked to the data. Mean follow-up was 9.2 years. Results Age- and sex-adjusted HR for long-term sickness absence after privatisation was 0.83 (95% CI 0.68 to 1.00) among employees whose work unit underwent a change from a public organisation to a commercial enterprise compared with employees in unchanged work units. Further adjustments for occupation, socioeconomic status, type of job contract, size of residence and sick leaves before privatisation had little impact on the observed association. A sensitivity analysis with harmonised occupations across the two groups replicated the finding (multivariable adjusted HR 0.92 (0.70–1.20)). Conclusions In this study, transfer of work from public organisation to commercial enterprise did not increase the risk of long-term sickness absence among employees.
    Keywords: Musculoskeletal
    Print ISSN: 1351-0711
    Electronic ISSN: 1470-7926
    Topics: Medicine
    Published by BMJ Publishing Group
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  • 15
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    Employment and occupational outcomes of workers with musculoskeletal pain in a French region (2013)
    BMJ Publishing Group
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    Publication Date: 2013-02-10
    Description: Objectives To study the employment and occupational outcomes of workers who were diagnosed with upper limb musculoskeletal disorders (UL-MSDs) or had complained of upper limb musculoskeletal pain a few years before compared with workers who had no upper limb pain. Methods In 2002–2005, an epidemiological surveillance system was set up. Occupational physicians examined 3710 randomly selected workers. It focused on six UL-MSDs: rotator cuff syndrome, lateral epicondylitis, flexor-extensor peritendinitis of the hands and fingers, de Quervain's disease, carpal tunnel syndrome and ulnar tunnel syndrome. Three groups were constituted: a ‘UL-MSD’ group (workers with a clinically diagnosed UL-MSD at baseline, 13% of the cohort); a ‘PAIN’ group (workers with pain in the previous 7 days at baseline and without any clinically diagnosed form, 38%); and a ‘HEALTHY’ group (workers with no disorder or upper limb pain in the previous 7 days, 49%). They completed a questionnaire between 2007 and 2009. Results A total of 2332 responded. Fewer subjects were still in work in the ‘UL-MSD’ group (79.3%) than in the ‘PAIN’ (85.9%) and ‘HEALTHY’ (90.4%) groups, the difference remaining significant after adjusting for gender, age, occupational category, type of company and comorbidities. Of the subjects still in work, 24% had changed their work station in the same company in the ‘PAIN’ group compared with 19% in the ‘HEALTHY’ group and 21% in the ‘UL-MSD’ group. Conclusions This study showed the impact of musculoskeletal pain on employment outcome and the difficulty of keeping workers with musculoskeletal problems at work.
    Keywords: Musculoskeletal
    Print ISSN: 1351-0711
    Electronic ISSN: 1470-7926
    Topics: Medicine
    Published by BMJ Publishing Group
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  • 16
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    Pattern and predictors for respiratory illnesses and symptoms and lung function among textile workers in Karachi, Pakistan (2013)
    BMJ Publishing Group
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    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
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