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BACKGROUND: Flight attendants face various risk factors in their working environments, particularly occupational exposure to cosmic radiation. This study aimed to assess cancer risk among air transportation industry workers, including flight attendants, in Korea by constructing a cohort using national health registry-based data and analyzing cancer incidence risk. METHODS: We used the Korea National Health Insurance Service database from 2002 to 2021 to construct a cohort of 37,011 workers in the air transportation industry. Cancer incidence was defined using the tenth version of the International Classification of Diseases. We calculated the age- and sex-specific standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) by applying the cancer incidence rate of the general population between 2002 and 2019. RESULTS: Approximately 5% of the cohort developed cancer. Overall, the cancer incidence in the cohort was similar to or lower than that of the general population, with the SIRs for all cancers being lower. However, significantly higher SIRs were observed for nasopharyngeal cancer (SIR, 3.21; 95% CI, 1.71-5.48) and non-Hodgkin lymphoma (SIR, 1.57; 95% CI, 1.02-2.32) in male workers and breast and genital cancer (SIR, 1.51; 95% CI, 1.34-1.70) and thyroid cancer (SIR, 1.25; 95% CI, 1.05-1.47) in female workers. CONCLUSIONS: The lower overall cancer incidence among air transportation industry workers observed in this study could indicate the "healthy worker effect"; however, the incidences of certain cancers were higher than those in the general population. Given that these workers are exposed to multiple occupational and lifestyle-related risk factors, including cosmic radiation, further studies are necessary to determine radiation-induced cancer risk while considering potential confounding factors.
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Neoplasias , Exposición Profesional , Sistema de Registros , Humanos , Masculino , República de Corea/epidemiología , Femenino , Exposición Profesional/efectos adversos , Exposición Profesional/estadística & datos numéricos , Adulto , Neoplasias/epidemiología , Persona de Mediana Edad , Incidencia , Enfermedades Profesionales/epidemiología , Factores de Riesgo , Estudios de Cohortes , Adulto Joven , Medición de Riesgo , AncianoRESUMEN
BACKGROUND: Despite increasing awareness, silica dust-induced silicosis still contributes to the huge disease burden in China. Worryingly, recent silica dust exposure levels and silicosis risk in Chinese noncoal mines remain unclear. OBJECTIVE: We aimed to determine recent silica dust exposure levels and assess the risk of silicosis in Chinese noncoal mines. METHODS: Between May and December 2020, we conducted a retrospective cohort study on 3 noncoal mines and 1 public hospital to establish, using multivariable Cox regression analyses, prediction formulas of the silicosis cumulative hazard ratio (H) and incidence (I) and a cross-sectional study on 155 noncoal mines in 10 Chinese provinces to determine the prevalence of silica dust exposure (PDE), free silica content, and total dust and respirable dust concentrations. The qualitative risk of silicosis was assessed using the International Mining and Metals Commission's risk-rating table and the occupational hazard risk index; the quantitative risk was assessed using prediction formulas. RESULTS: Kaplan-Meier survival analysis revealed significant differences in the silicosis probability between silica dust-exposed male and female miners (log-rank test χ21=7.52, P=.01). A total of 126 noncoal mines, with 29,835 miners and 4623 dust samples, were included; 13,037 (43.7%) miners were exposed to silica dust, of which 12,952 (99.3%) were male. The median PDE, free silica content, total dust concentration, and respirable dust concentration were 61.6%, 27.6%, 1.30 mg/m3, and 0.58 mg/m3, respectively, indicating that miners in nonmetal, nonferrous metal, small, and open-pit mines suffer high-level exposure to silica dust. Comprehensive qualitative risk assessment showed noncoal miners had a medium risk of silicosis, and the risks caused by total silica dust and respirable silica dust exposure were high and medium, respectively. When predicting H and I over the next 10, 20, and 30 years, we assumed that the miner gender was male. Under exposure to current total silica dust concentrations, median I10, I20, and I30 would be 6.8%, 25.1%, and 49.9%, respectively. Under exposure to current respirable silica dust concentrations, median I10, I20, and I30 would be 6.8%, 27.7%, and 57.4%, respectively. These findings showed that miners in nonmetal, nonferrous metal, small, and open-pit mines have a higher I and higher qualitative silicosis risk. CONCLUSIONS: Chinese noncoal miners, especially those in nonmetal, nonferrous metal, small, and open-pit mines, still suffer high-level exposure to silica dust and a medium-level risk of silicosis. Data of both total silica dust and respirable silica dust are vital for occupational health risk assessment in order to devise effective control measures to reduce noncoal mine silica dust levels, improve miners' working environment, and reduce the risk of silicosis.
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Polvo , Minería , Exposición Profesional , Dióxido de Silicio , Silicosis , Humanos , Silicosis/epidemiología , Silicosis/etiología , Exposición Profesional/efectos adversos , Exposición Profesional/análisis , Exposición Profesional/estadística & datos numéricos , Dióxido de Silicio/análisis , Dióxido de Silicio/efectos adversos , Polvo/análisis , Masculino , China/epidemiología , Femenino , Medición de Riesgo/métodos , Estudios Retrospectivos , Minería/estadística & datos numéricos , Adulto , Persona de Mediana Edad , Estudios Transversales , Estudios de CohortesRESUMEN
Through the report of 4 cases of occupational heatstroke among sanitation workers working in high-temperature weather, this study analyzes the risk of occupational heatstroke among workers in the environmental sanitation industry working in high-temperature weather, and provides scientific suggestions for standardizing occupational health management, safeguarding the health rights and interests of workers, and preventing the occurrence of occupational heatstroke in summer. Through case analysis, we aim to raise high awareness of the occupational health of sanitation workers in the whole society, in order to provide a scientific and healthy working environment for sanitation workers and promote their physical and mental health.
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Golpe de Calor , Calor , Enfermedades Profesionales , Humanos , Golpe de Calor/etiología , Adulto , Calor/efectos adversos , Masculino , Exposición Profesional/efectos adversos , Salud Laboral , Femenino , Persona de Mediana Edad , SaneamientoRESUMEN
This paper analyzes the pathogenesis, clinical characteristics, treatment measures and prognosis of a case of methemoglobin and hemolytic anemia caused by acute nitrogen trifluoride poisoning. The patient with occupational exposure to nitrogen trifluoride was treated immediately after the onset of illness, methemoglobin was monitored and a comprehensive examination was conducted. After comprehensive analysis, it was considered that acute nitrogen trifluoride poisoning could cause methemoglobinemia, hemolytic anemia and liver injury. The patient was disengaged and given symptomatic treatment such as oxygen therapy, methylene blue, low-dose methylpredrone, vitamin C and reduced glutathione. The prognosis of the patient is good, which provides a reference for the clinical treatment and occupational health examination of nitrogen trifluoride poisoning.
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Anemia Hemolítica , Metahemoglobinemia , Humanos , Metahemoglobinemia/inducido químicamente , Masculino , Anemia Hemolítica/inducido químicamente , Anemia Hemolítica/terapia , Adulto , Exposición Profesional/efectos adversos , Persona de Mediana EdadRESUMEN
Chronic chloropropene poisoning is a disease mainly caused by peripheral nerve damage due to close contact with chloropropene in industrial production, its clinical manifestations include varying degrees of sensory, motor, or tendon reflex disorders in the distal limbs, and neuromyography can show neurogenic damage. This article analyzed and summarized the clinical characteristics, diagnosis and treatment methods of three patients with occupational chronic chloropropene poisoning, in order to enhance the clinical understanding of occupational chronic chloropropene poisoning and provide reference for clinical diagnosis and treatment.
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Exposición Profesional , Humanos , Masculino , Adulto , Exposición Profesional/efectos adversos , Enfermedades Profesionales/inducido químicamente , Persona de Mediana Edad , Propano/envenenamiento , Propano/análogos & derivados , Hidrocarburos Clorados/envenenamiento , Femenino , Enfermedad CrónicaRESUMEN
Objective: To ascertain the prevalence of asthma attacks among archivists and identify the associated occupational factors in this understudied professional population. Methods: We conducted a cross-sectional, questionnaire-based study among 1,002 archival workers. A multiple logistic regression was conducted to identify the association between asthma attacks and occupational exposures. The Strobe Protocol was applied. Results: 999 workers were included in the final analysis with the asthma prevalence of 33.3%. Main factors associated with asthma attacks (OR [95% CI]) were the presence of chemically irritating odors (2.152 [1.532-3.024]), mold odors (1.747 [1.148-2.658]), and insects (1.409[1.041-1.907]). A significant synergistic effect was observed between chemical irritants and mold, the odds ratio was 7.098 (95% CI, 4.752-10.603). Conclusion: There was a high prevalence of asthma attacks among archival workers, an under-studied population. Chemical irritants, molds and insects were associated with their asthma attacks. Notably, this study's data analysis has revealed a strong synergy (OR = 7.098) between chemical odors and molds in the workplace. While the existing international literature on this specific interaction remains somewhat limited, previous studies have already demonstrated the potential for chemical irritants, such as sulfur dioxide and ozone, to synergistically interact with inhalable allergens, including fungi, molds and dust mites. Consequently, this interaction seems to exacerbate asthma symptoms and perpetuate untreated exposure. Furthermore, in damp and damaged buildings, the presence of microbial components, such as cellular debris or spores released during fungal growth can trigger an inflammatory response, potentially served as a shared pathway for the development of asthma among individuals exposed to these hazardous factors.
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Asma , Hongos , Exposición Profesional , Humanos , Estudios Transversales , Masculino , Adulto , Femenino , Asma/epidemiología , Asma/etiología , Exposición Profesional/efectos adversos , Exposición Profesional/estadística & datos numéricos , Prevalencia , Encuestas y Cuestionarios , Persona de Mediana Edad , Hongos/aislamiento & purificación , Factores de Riesgo , Salud Pública , Odorantes , Irritantes/efectos adversosRESUMEN
The association between self-assessed cold threshold (CT) and thermal insulation of clothing (Icl) was analysed in 283 poultry workers in Thailand. The mean CT was 13.5 °C (range - 28-29) and the mean Icl was 1.23 clo (range 0.35-2.21). The adjusted CT remained unchanged at low Icls (0.35 through 1.25 clo) but was estimated to increase by 14.8 °C at high Icls (1.25 through 2.21 clo). Overall, CT was higher by 2.4 °C (95% confidence interval [CI] 0.3-3.8) at high (≥ 1.25 clo) than that at low (< 1.25 clo) Icl, but this difference was modified by personal and work-related factors. The difference was 2.6 °C (CI 0.5-4.6) for older (30-57 y) compared to younger (18-29 y) participants, with an excess of 7.3 °C (CI 5.6-9.0) for low vs high educated participants, 2.6 °C (CI 0.5-4.8) for those doing heavy vs light work, 7.4 °C (CI 3.7-11.0) for alcohol consumers vs others, and 3.4 °C (CI 0.6-6.3) for smokers vs non-smokers. The differences were independent of personal characteristics and worksite physical conditions and were interpreted as increased cold sensitivity among subgroups with lesser stamina and poorer health. Sensitive worker subgroups should be identified, and their need for cold protection should be reviewed.
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Frío , Aves de Corral , Humanos , Adulto , Animales , Masculino , Persona de Mediana Edad , Femenino , Tailandia , Adulto Joven , Adolescente , Exposición Profesional/efectos adversos , Autoevaluación (Psicología) , Vestuario , Ropa de ProtecciónRESUMEN
OBJECTIVES: This study aimed to estimate the incidence of asthma and assess the association between job exposure matrix (N-JEM) assigned occupational exposure, self-reported occupational exposure to vapour, gas, dust and fumes (VGDF), mould, damages from moisture and cold, and new-onset asthma. We also aimed to assess the corresponding population attributable fraction (PAF) for ever exposure to VGDF. DESIGN: Longitudinal population-based respiratory health study. SETTING: Responders from the baseline Telemark Study in south-eastern Norway were followed up from 2013 to 2018. PARTICIPANTS: 7120 participants, aged 16-55, were followed during a 5-year period. MAIN OUTCOME MEASURES: New-onset asthma and its association with self-reported occupational exposure to VGDF, data from the N-JEM and self-reported workplace conditions were assessed using logistic regression adjusted for gender, age, smoking and body mass index. The PAF was calculated using the PUNAF command in STATA. RESULTS: There were 266 (3.7%) cases of new-onset asthma and an incidence density of 7.5 cases per 1000 person-years. A statistically significant association was found for ever exposed to VGDF with an OR of 1.49 (95% CI 1.15 to 1.94), weekly OR 2.00 (95% CI 1.29 to 3.11) and daily OR 2.46 (95% CI 1.39 to 4.35) exposure to VGDF. The corresponding PAF for ever exposed to VGDF was 17% (95% CI 5.4% to 27.8%) and the risk of asthma onset increased with frequent VGDF exposure, indicating a possible exposure-response relationship (p=0.002 for trend). The N-JEM exposure group, accidental peak exposure to irritants had an increased risk of new-onset asthma, OR 2.43 (95% CI 1.21 to 4.90). A significant association was also found for self-reported exposure to visible damages due to moisture 1.51 (95% CI 1.08 to 2.11), visible and smell of mould 1.88 (95% CI 1.32 to 2.68), 1.55 (95% CI 1.12 to 2.16) and cold environment 1.41 (95% CI 1.07 to 1.86). CONCLUSION: Participants had elevated ORs for asthma associated with self-reported and N-JEM-assigned exposures. A PAF of 17% indicates that work-related asthma is still common. The possible exposure-response relationship suggests that reducing occupational VGDF exposure frequency could prevent the onset of asthma.
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Asma , Exposición Profesional , Humanos , Masculino , Adulto , Exposición Profesional/efectos adversos , Exposición Profesional/estadística & datos numéricos , Femenino , Noruega/epidemiología , Persona de Mediana Edad , Asma/epidemiología , Asma/etiología , Adolescente , Estudios de Seguimiento , Incidencia , Adulto Joven , Estudios Longitudinales , Autoinforme , Enfermedades Profesionales/epidemiología , Enfermedades Profesionales/etiología , Factores de Riesgo , Modelos Logísticos , PolvoRESUMEN
Workers who use handheld vibrating machines such as grinders, hammers and chainsaws expose themselves to hand-arm vibration (HAV). Exposure to HAV may cause injuries to both the neurological and the vascular system. The occupational health services (OHS) in Sweden use a formal guideline for secondary prevention focusing on early detection of vibration-related injuries. The guide includes several screening tools, such as a screening questionnaire, clinical examinations, and laboratory tests. There are no studies, to our knowledge, on the diagnostic value of the separate items on symptoms in the screening questionnaire in relation to the laboratory tests or the clinical examinations performed during a medical examination among patients exposed to HAV. Furthermore, the recently presented ISO standard for HAV measurements (ISO/TR 18,750) has only been tested for vascular injuries and not neurological injuries. This research roadmap aims to evaluate separate items in a screening questionnaire on neurological symptoms in relation to laboratory and clinical tests among HAV exposed workers in the Arctic region of Northern Sweden. It also covers a comparison of the dose-response of the current ISO 5349-1 measurement standard and the new suggested standard ISO/TR 18,750 with the neurosensory outcomes. This manuscript describes the study rationale, design, methods, and significance.
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Síndrome por Vibración de la Mano y el Brazo , Exposición Profesional , Vibración , Humanos , Suecia , Exposición Profesional/efectos adversos , Síndrome por Vibración de la Mano y el Brazo/diagnóstico , Vibración/efectos adversos , Encuestas y Cuestionarios , Masculino , Regiones Árticas , Adulto , Femenino , Persona de Mediana EdadRESUMEN
PURPOSE: A growing body of research indicates a correlation between occupational exposure, particularly among individuals in driving-related occupations, and the incidence of low back pain (LBP). METHODS: Databases were systematically searched, including PubMed, Embase, Web of Science, Cochrane Library, and SinoMed, from their inception through December 2023 for relevant studies of the prevalence and risk factors of LBP among professional drivers. Subsequent meta-analyses were performed utilizing Stata 17.0 and RevMan 5.4 software, while risk factor indicators were assessed using the Grading of Recommendations, Assessment, Development and Evaluation evidence quality grading system. RESULTS: A systematic review and meta-analysis comprising 19 studies involving 7,723 patients indicated that the incidence of LBP among drivers was 39% (95% confidence interval [CI] 0.20-0.57) in the past 7 days and 53% (95% CI 0.43-0.63) in the past 12 months. A subgroup analysis revealed a prevalence of 48% (95% CI 0.33-0.64) in 2005-2015 and 56% (95% CI 0.42-0.70) in 2016-2023. Among the identified factors, robust evidence highlighted age ≥ 41 years (odds ratio [OR] = 2.10; 95% CI 1.36-3.24; P = 0.0008), alcohol consumption (OR = 1.75; 95% CI 1.31-2.34; P = 0.0001), sleeping < 6 h/night (OR = 1.60; 95% CI 1.13-2.24; P = 0.007), uncomfortable seating (OR = 1.71; 95% CI 1.23-2.36; P = 0.001), improper driving posture (OR = 2.37; 95% CI 1.91-2.94; P < 0.00001), and manual handling (OR = 2.23; 95% CI 1.72-2.88; P < 0.00001) as significant risk factors for LBP. There was moderate evidence of a lack of exercise (OR = 1.78; 95% CI 1.37-2.31; P < 0.0001), working > 10 h/day (OR = 2.49; 95% CI 1.89-3.28; P < 0.00001), > 5 years' driving experience (OR = 2.12; 95% CI 1.66-2.69; P < 0.00001), a lack of back support (OR = 1.81; 95% CI 1.25-2.62; P = 0.002), high work-related pressure (OR = 2.04; 95% CI 1.59-2.61; P < 0.00001), and job dissatisfaction (OR = 1.57; 95% CI 1.23-2.01; P = 0.0003) as moderate risk factors. There was no evidence of body mass index or smoking as risk factors for LBP among professional drivers. CONCLUSION: The current evidence indicates an increasing annual trend in the prevalence of LBP among professional drivers. Factors including age ≥ 41 years, alcohol consumption, and sleeping < 6 h/night were among the 12 influential factors contributing to LBP in professional drivers. Enhancing awareness of these factors and formulating targeted preventive strategies may be beneficial.
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Conducción de Automóvil , Dolor de la Región Lumbar , Enfermedades Profesionales , Humanos , Dolor de la Región Lumbar/epidemiología , Dolor de la Región Lumbar/etiología , Factores de Riesgo , Prevalencia , Enfermedades Profesionales/epidemiología , Enfermedades Profesionales/etiología , Masculino , Adulto , Consumo de Bebidas Alcohólicas/efectos adversos , Consumo de Bebidas Alcohólicas/epidemiología , Incidencia , Femenino , Exposición Profesional/efectos adversosRESUMEN
Green jobs are to be understood as those jobs directly associated with specific sustainability issues and activities related to the efficiency, quality and innovation of goods and services offered, from an eco-sustainability perspective. The objective of the research was to fill knowledge gaps of new and emerging environmental and occupational risks related to sustainable activities and to understand the impact these might have on workers' psychological and physical well-being. A selection of several scientific articles and a critical analysis of the selected articles was carried out from the perspective of defining the concept of "emerging occupational risks in green jobs," using different keywords in the title or abstract as search criteria. Emerging occupational risks, most prevalent in the green sector are those determined by the rapid introduction of new technologies, new materials, new processes and work organizations. In order to be able to improve prevention and protection at work, it is necessary to act on a more careful and adequate risk assessment, the definition of new professional figures expert in green issues, the expansion of research and development of scientific knowledge, and the improvement of ergonomic aspects. Int J Occup Med Environ Health. 2024;37(3):244-56.
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Exposición Profesional , Humanos , Exposición Profesional/efectos adversos , Exposición Profesional/prevención & control , Salud Laboral , Medición de Riesgo , Ocupaciones , Ergonomía , Conservación de los Recursos NaturalesRESUMEN
Silico-Tuberculosis (silico-TB) is a severe combination of tuberculosis and silicosis, caused by occupational exposure to fine crystalline silica dust, which has become a global health concern. This comprehensive review compiles the updated knowledge regarding pathophysiology, clinical manifestations, important diagnostic techniques, treatment aspects, and challenges in understanding silico-TB. The review compiles the disease's history and epidemiology, highlighting a lack of data owing to poor monitoring and healthcare particularly in low- and middle-income countries like India. Further weak safety regulations, lack of preventative measures, and inadequate education increase the rates of silico-TB. The pathophysiology shows how silica particles impair the immune system and stimulate Th2 cells and M2 macrophages, which exacerbate TB, while inhibiting Th1 cells and M1 macrophages, which fight against the disease. Subsequently, it can be difficult to distinguish current TB from pre-existing silicosis. In cases where sputum and X-ray results are negative, chest CT scans may be helpful since radiographic screening identifies TB earlier than sputum assessment. Isoniazid, rifampicin, or both minimize the risk of active tuberculosis in people with silicosis. Consistent anti-tuberculosis drug therapy is recommended for 8-9 months to stop recurrence. The assessment recommends integrating silicosis and TB control initiatives to fight this combined health issue.
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Silicosis , Humanos , Silicosis/diagnóstico , Antituberculosos/uso terapéutico , Antituberculosos/efectos adversos , Exposición Profesional/efectos adversos , India/epidemiología , Silicotuberculosis/diagnósticoRESUMEN
BACKGROUND: Previous studies reported that lead (Pb) exposure induced adverse health effects at high exposure concentrations, however, there have been limited data on sensitivity comparisons among different health outcomes at low blood Pb levels. OBJECTIVES: To compare sensitivity between blood parameters and a genotoxic biomarker among workers exposed to low blood Pb levels (< 20⯵g/dl), and to estimate a benchmark dose (BMD). METHODS: Pb-exposed workers were recruited from a lead-acid storage battery plant. Their blood lead levels (BLLs) were measured. Blood parameters and micronuclei (MN) frequencies were determined. Multivariate linear or Poisson regression was used to analyze relationships between blood parameters or MN frequencies with BLLs. Two BMD software were used to calculate BMD and its 95â¯% lower confidence limit (BMDL) for BLLs. RESULTS: The median BLL for 611 workers was 10.44⯵g/dl with the 25th and 75th percentile being 7.37 and 14.62⯵g/dl among all participants. There were significantly negative correlations between blood parameters and BLLs. However, MN frequencies correlated positively with BLLs (all P<0.05). Results from the two BMD software revealed that the dichotomous model was superior to the continuous model, and the BMDL for BLL derived from red blood cell (RBC) was 15.11⯵g/dl, from hemoglobin (HGB) was 8.50⯵g/dl, from mean corpuscular hemoglobin (MCH) was 7.87⯵g/dl, from mean corpuscular hemoglobin concentration (MCHC) was 3.98⯵g/dl, from mean corpuscular volume (MCV) was 11.44⯵g/dl, and from hematocrit (HCT) was 6.65⯵g/dl. The conservative BMDL obtained from the MN data was 7.52⯵g/dl. CONCLUSION: Our study shows that low dose Pb exposure caused decrease of blood parameters and increase of MN frequencies. The genotoxic biomarker was more sensitive than most blood parameters. BMDLs for BLL derived from MN frequencies and the red blood cell indicators should be considered as new occupational exposure limits. Our results suggest that MN assay can be considered as a part of occupational health examination items.
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Biomarcadores , Plomo , Pruebas de Micronúcleos , Exposición Profesional , Humanos , Plomo/sangre , Plomo/toxicidad , Exposición Profesional/efectos adversos , Masculino , Adulto , Biomarcadores/sangre , Femenino , Persona de Mediana Edad , Adulto Joven , Hemoglobinas/análisisRESUMEN
BACKGROUND: Occupational diseases are one of the most important health problems related to employment However, in Malaysia, there are few epidemiological studies discussing these issues, especially among workers in the industry. For that, this study aimed to screen workers from high-risk industrial sectors, identify hazards in the workplace and recommend improvement measures in the workplace to prevent occupational diseases. METHODS AND ANALYSIS: This is a 3-year project in which a survey of 100 000 workers from all 13 states in Malaysia will be conducted using a web-based screening tool that is comprised of two parts: occupational disease screening tool and hazard identification, risk assessment and risk control method. Data will be collected using a multistage stratified sampling method from 500 companies, including seven critical industrial sectors. The independent variables will be sociodemographic characteristics, comorbidities, previous medical history, high-risk behaviour and workplace profile. The dependent variable will be the types of occupational diseases (noise-induced hearing loss, respiratory, musculoskeletal, neurotoxic, skin and mental disorders). Subsequently, suggestions of referral for medium and high-risk workers to occupational health clinics will be attained. The approved occupational health service clinics/providers will make a confirmatory diagnosis of each case as deemed necessary. Subsequently, a walk-through survey to identify workplace hazards and recommend workplace improvement measures to prevent these occupational diseases will be achieved. Both descriptive and inferential statistics will be used in this study. Simple and adjusted binary regression will be used to find the determinants of occupational diseases. ETHICS AND DISSEMINATION: This study has been approved by the MARA University of Technology Research Ethics Board. Informed, written consent will be obtained from all study participants. Findings will be disseminated to the Department of Occupational Health and Safety, involved industries, and through peer-reviewed publications.
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Enfermedades Profesionales , Lugar de Trabajo , Humanos , Estudios Transversales , Malasia/epidemiología , Medición de Riesgo/métodos , Enfermedades Profesionales/epidemiología , Enfermedades Profesionales/diagnóstico , Enfermedades Profesionales/prevención & control , Tamizaje Masivo/métodos , Masculino , Salud Laboral , Femenino , Encuestas y Cuestionarios , Proyectos de Investigación , Exposición Profesional/efectos adversos , Exposición Profesional/prevención & control , AdultoRESUMEN
Although a significant body of evidence has attributed certain occupational exposures with leukemia, such as benzene, formaldehyde, 1,3-butadiene and ionizing radiation, more research is needed to identify work environments at increased risk for this disease. Our study aimed to identify occupational and industry groups associated with an elevated incidence of leukemia using a diverse cohort of workers' compensation claimants from Ontario, Canada. A total of 2,363,818 workers in the Occupational Disease Surveillance System (ODSS) cohort, with claims between 1983-2019, were followed for malignant leukemia diagnoses up to 31 December 2019. We used a Cox proportional-hazards model to estimate the relative incidence of leukemia in specific occupation and industry groups. After adjusting for age and birth year, males in protective services (HR = 1.17, 95% CI = 1.02-1.35), metal machining (HR = 1.23, 95% CI = 1.07-1.41), transport (HR = 1.15, 95% CI = 1.06-1.25), and mining occupations (HR = 1.28, 95% CI = 1.02-1.60) had elevated risks of leukemia compared to other workers in the ODSS, with comparable findings by industry. Among female workers, slight risk elevations were observed among product fabricating, assembling, and repairing occupations, with other increased risks seen in furniture and fixture manufacturing, storage, and retail industries. These findings underscore the need for exposure-based studies to better understand occupational hazards in these settings.
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Industrias , Leucemia , Enfermedades Profesionales , Exposición Profesional , Ocupaciones , Humanos , Ontario/epidemiología , Masculino , Femenino , Incidencia , Adulto , Persona de Mediana Edad , Exposición Profesional/estadística & datos numéricos , Exposición Profesional/efectos adversos , Estudios de Cohortes , Enfermedades Profesionales/epidemiología , Ocupaciones/estadística & datos numéricos , Leucemia/epidemiología , Leucemia/inducido químicamente , Industrias/estadística & datos numéricos , Adulto Joven , Anciano , Modelos de Riesgos ProporcionalesRESUMEN
The mission of the Force Health Protection (FHP) program of the U.S. Air Force (USAF), sustaining the readiness of warfighters, relies on determinations of acceptable levels of exposure to a wide array of substances that USAF personnel may encounter. In many cases, exposure details are limited or authoritative toxicity reference values (TRVs) are unavailable. To address some of the TRV gaps, we are integrating several approaches to generate health protective exposure guidelines. Descriptions are provided for identification of chemicals of interest for USAF FHP (467 to date), synthesis of multiple TRVs to derive Operational Exposure Limits (OpELs), and strategies for identifying and developing candidate values for provisional OpELs when authoritative TRVs are lacking. Rodent bioassay-derived long-term Derived No Effect Levels (DNELs) for workers were available only for a minority of the substances with occupational TRV gaps (19 of 84). Additional occupational TRV estimation approaches were found to be straightforward to implement: Tier 1 Occupational Exposure Bands, cheminformatics approaches (multiple linear regression and novel nearest-neighbor approaches), and empirical adjustment of short term TRVs. Risk assessors working in similar contexts may benefit from application of the resources referenced and developed in this work.
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Personal Militar , Exposición Profesional , Humanos , Exposición Profesional/normas , Exposición Profesional/prevención & control , Exposición Profesional/efectos adversos , Valores de Referencia , Animales , Medición de Riesgo , Estados Unidos , Nivel sin Efectos Adversos Observados , Pruebas de Toxicidad/normas , Pruebas de Toxicidad/métodos , Sustancias Peligrosas/toxicidadRESUMEN
Force Health Protection programs in the U.S. Air Force endeavor to sustain the operational readiness of the warfighters. We have previously identified hundreds of chemical substances of interest and toxicity reference value (TRV) knowledge gaps that constrain risk based-decision-making for potential exposures. Multiple approaches to occupational TRV estimation were used to generate possible guideline values for 84 compounds (18% of the substances of interest). These candidate TRVs included values from international databases, chemical similarity (nearest neighbor) approaches, empirical adjustments to account for duration differences, quantitative activity relationships, and thresholds of toxicological concern. This present work describes derivation of provisional TRVs from these candidate values. Rodent bioassay-derived long-term worker Derived No-Effect Levels (DNELs) were deemed presumptively the most reliable, but only 19 such DNELs were available for the 84 substances with TRV gaps. In the absence of DNELs, the quality of the approaches and consistency among candidate values were key elements of the weight of evidence used to select the most suitable guideline values. The use of novel nearest-neighbor approaches, empirical adjustment of short term TRVs, and occupational exposure bands were found to be options that would allow occupational TRV estimation with reasonable confidence for nearly all substances evaluated.
Asunto(s)
Nivel sin Efectos Adversos Observados , Exposición Profesional , Exposición Profesional/normas , Exposición Profesional/prevención & control , Exposición Profesional/efectos adversos , Humanos , Animales , Valores de Referencia , Guías como Asunto , Medición de Riesgo , Personal Militar , Sustancias Peligrosas/toxicidad , Estados Unidos , Salud Laboral/normas , Pruebas de Toxicidad/normasRESUMEN
OBJECTIVES: Autoimmune disorders are multifactorial but occupational exposures have long been implicated, including respirable crystalline silica (RCS). A modern epidemic of silicosis is emerging internationally, associated with dry processing of engineered stone with high (>90%) RCS content. We aimed to investigate the prevalence of clinical autoimmune disease and common autoantibodies in exposed workers. METHODS: Stone benchtop industry workers in Victoria, Australia were offered free screening for silicosis and related disorders. Symptoms or diagnoses of autoimmune disease were evaluated by questionnaire and blood tests taken for rheumatoid factor (RF), antinuclear antibodies (ANAs) and extractable nuclear antigens (ENAs). RESULTS: Among 1238 workers (93.3% male) screened from 2019 to 2021, 0.9% were confirmed with autoimmune disease. Among those without clinical disease, 24.6% had detectable ANAs (93.5% male), 4.6% detectable ENAs and 2.6% were positive for RF. Silicosis was diagnosed in 253 workers (24.3% of those with diagnostic information available). Of those with ANA readings, 54 (6.6%) had ANA titre >1:320. The likelihood of positive autoantibodies increased with age; smoking; higher exposure to RCS and silicosis diagnosis. CONCLUSION: The proportion of workers with detectable ANAs or ENAs was considerably higher than the 5%-9% expected in the general population. Some of the antibodies detected (eg, Scl-70, CENPB) have high sensitivity and specificity for systemic sclerosis. Long-term follow-up will be needed to estimate incidence. Rheumatologists should explore occupational history in new cases of autoimmune disease. Screening for autoimmune disease is indicated in workers exposed to RCS as these individuals need specialised management and may be entitled to compensation.
Asunto(s)
Autoanticuerpos , Enfermedades Autoinmunes , Exposición Profesional , Dióxido de Silicio , Silicosis , Humanos , Silicosis/epidemiología , Silicosis/inmunología , Silicosis/sangre , Silicosis/etiología , Masculino , Femenino , Persona de Mediana Edad , Exposición Profesional/efectos adversos , Adulto , Enfermedades Autoinmunes/epidemiología , Enfermedades Autoinmunes/inmunología , Autoanticuerpos/sangre , Dióxido de Silicio/efectos adversos , Victoria/epidemiología , Estudios de Cohortes , Anticuerpos Antinucleares/sangre , Enfermedades Profesionales/epidemiología , Enfermedades Profesionales/inmunología , Enfermedades Profesionales/sangre , Enfermedades Profesionales/etiología , Prevalencia , Anciano , Factor Reumatoide/sangre , Factor Reumatoide/inmunologíaRESUMEN
OBJECTIVES: Exposure to bioaerosols in salmon processing workers is associated with occupational asthma. IgE-mediated allergy and other disease mechanisms may be involved in airway inflammation and obstruction. Knowledge about disease burden, mechanisms, phenotypes and occupational exposure is limited. METHODS: Salmon processing workers referred to our occupational medicine clinic from 2019 to 2024 were included in a patient register. They were investigated in line with current guidelines for the management of occupational asthma, categorised according to diagnostic certainty and characterised with a focus on symptoms, work tasks and clinical findings. RESULTS: A total of 36 patients were included, among whom 27 had typical symptoms of work-related asthma, and 21 were diagnosed with occupational asthma. Among those with occupational asthma, all worked in the filleting or slaughtering area at the time of symptom onset. Median latency from the start of exposure to symptom onset was 4 years. 14 (67%) of the patients with occupational asthma were sensitised to salmon. Three patients were sensitised to salmon skin but not salmon meat. CONCLUSIONS: Occupational asthma among salmon processing workers displays a heterogeneous clinical picture. IgE-mediated inhalation allergy towards various parts of the salmon seems to represent an important pathophysiological mechanism. However, some have occupational asthma with negative allergy tests. A comprehensive workup strategy including early initiation of serial peak expiratory flow and skin prick tests with various parts of the salmon should be considered. Although the incidence remains unknown, the substantial number of cases presented warrant increased efforts to reduce harmful exposure in the salmon processing industry.
Asunto(s)
Asma Ocupacional , Industria de Procesamiento de Alimentos , Exposición Profesional , Salmón , Humanos , Asma Ocupacional/etiología , Adulto , Masculino , Femenino , Persona de Mediana Edad , Animales , Exposición Profesional/efectos adversos , Inmunoglobulina E/sangre , Pruebas Cutáneas/métodos , Enfermedades Profesionales/etiologíaRESUMEN
Long-term aluminum (Al) exposure increases the risk of mild cognitive impairment (MCI). The aim of the present study was to investigate the neural mechanisms of Al-induced MCI. In our study, a total of 52 individuals with occupational Al exposure >10â years were enrolled and divided into two groups: MCI (Al-MCI) and healthy controls (Al-HC). Plasma Al concentrations and Montreal Cognitive Assessment (MoCA) score were collected for all participants. And diffusion tensor imaging and resting-state functional magnetic resonance imaging were used to examine changes of white matter (WM) and functional connectivity (FC). There was a negative correlation between MoCA score and plasma Al concentration. Compared with the Al-HC, fractional anisotropy value for the right fornix (cres)/stria terminalis (FX/ST) was higher in the Al-MCI. Furthermore, there was a difference in FC between participants with and without MCI under Al exposure. We defined the regions with differing FC as a "pathway," specifically the connectivity from the right temporal pole to the right FX/ST, then to the right sagittal stratum, and further to the right anterior cingulate and paracingulate gyri and right inferior frontal gyrus, orbital part. In summary, we believe that the observed differences in WM integrity and FC in the right FX/ST between participants with and without MCI under long-term Al exposure may represent the neural mechanisms underlying MCI induced by Al exposure.