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Childhood lead exposure and sleep problems in adolescents: a longitudinal cohort study 儿童期铅暴露与青少年睡眠问题:一项纵向队列研究
IF 3 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-14 DOI: 10.1007/s00420-024-02099-3
Ying Dai, Olivia M. Halabicky, Xiaopeng Ji, Jianghong Liu

Purpose

Childhood lead exposure is linked to poorer neurobehavioral function in adolescence, but the relationship between lead and adolescent sleep health remains inconsistent. This study aimed to investigate concurrent and longitudinal associations between lead exposure and multiple sleep health domains in adolescents.

Methods

A total of 972 adolescents from China Jintan Child Cohort were included in analyses. The Blood lead levels (BLLs) were assessed in two Waves, at ages 3–5 years (mean 6.50 ± 2.76 μg/dL) and 11–13 years (mean 3.12 ± 1.17 μg/dL). Sleep problems at age 11–13 were parent-reported via the Child Sleep Health Questionnaire (CSHQ) and self-reported by adolescents using the Pittsburgh Sleep Quality Index (PSQI).

Results

Both early and later BLLs were associated positively with parental reported sleep problems, including sleep onset delay, night waking, short duration, parasomnias, and disordered breathing. Sex-stratified analyzes showed that most adjusted associations between two-Wave BLLs and sleep outcomes (CSHQ and PSQI) remained statistically significant in males, with a minor increase in the magnitude of these associations. The association between Wave II BLLs and shorter self-reported sleep duration was only statistically significant in female adolescents. Compared to children with consistently low BLLs at both ages, those with persistently high BLLs at both ages had significantly shorter parental-reported sleep duration and worse sleep onset delay.

Conclusion

Findings suggest that both early and later childhood lead exposures link to more adolescent sleep problems, with recent BLLs showing stronger associations with poor adolescent sleep health reported by their parents.

目的 儿童时期的铅暴露与青春期较差的神经行为功能有关,但铅与青少年睡眠健康之间的关系仍不一致。本研究旨在调查青少年铅暴露与多个睡眠健康领域之间的并发和纵向关系。方法:本研究共纳入中国金坛儿童队列中的 972 名青少年进行分析。血铅水平(BLLs)分两波进行评估,年龄分别为 3-5 岁(平均 6.50 ± 2.76 μg/dL)和 11-13 岁(平均 3.12 ± 1.17 μg/dL)。11-13岁青少年的睡眠问题由家长通过儿童睡眠健康问卷(CSHQ)进行报告,由青少年通过匹兹堡睡眠质量指数(PSQI)进行自我报告。结果早期和晚期的BLL均与家长报告的睡眠问题呈正相关,包括睡眠开始延迟、夜醒、持续时间短、寄生虫病和呼吸紊乱。性别分层分析表明,经调整后,两波 BLLs 与睡眠结果(CSHQ 和 PSQI)之间的大多数关联在男性中仍具有显著的统计学意义,但这些关联的程度略有增加。只有女性青少年的第二波 BLLs 与自我报告的睡眠时间缩短之间的关联具有统计学意义。结论研究结果表明,儿童早期和晚期的铅暴露都会导致青少年出现更多的睡眠问题,而近期的铅中毒水平与家长报告的青少年睡眠健康状况不良之间的关系更为密切。
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引用次数: 0
Bayesian identification and estimation of radon-related increased hazard rates of cancer death in the updated French cohort of uranium miners (1946–2014) 贝叶斯法识别和估算法国铀矿工人最新队列(1946-2014 年)中与氡相关的癌症死亡危险增加率
IF 3 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-13 DOI: 10.1007/s00420-024-02098-4
Julie Fendler, Chantal Guihenneuc, Sophie Ancelet

Objective

A recent update of the French cohort of uranium miners added seven years of follow-up data. We use these new data to look for new possible radon-related increased risks and refine the estimation of the potential association between cumulative radon exposure and four cancer sites: lung cancer, kidney cancer, brain and central nervous system (CNS) cancer and leukemia (excluding chronic lymphocytic leukemia, which is not radiation-induced).

Methods

Several parametric survival models are proposed, fitted and compared under the Bayesian paradigm, to perform new and original exposure-risk analyses. In line with recent UNSCEAR recommendations, we consider time-related effect modifiers and exposure rate as potential effect modifying factors. We use Bayesian model selection criteria to identify radon-related increased hazard rates.

Results

Under the assumption of a linear exposure-risk relationship, we found a substantial evidence for a strictly positive effect of cumulative radon exposure on the hazard rate of death by lung cancer among French uranium miners. Given the current available data under the assumptions of a linear or log-linear exposure-risk relationship, it is not possible to conclude in favour of the absence or the existence of a strictly positive effect of chronic exposure to radon on the hazard rate of death by kidney cancer. Regarding death by brain and CNS cancer, there is a substantial evidence for the absence of radon-related effect. Finally, under the assumption of a log-linear exposure-risk relationship, a small positive radon-related effect appears when looking at the risk of death by leukemia (excluding CLL).

Conclusion

This study investigates the existence of radon-related increased risk of death by lung cancer, kidney cancer, brain and CNS cancer and leukemia under a Bayesian framework and assumptions of linear and log-linear exposure-risk relationships. If there is no doubt in the interpretation of the results for lung cancer and brain and CNS cancer, the conclusion is less clear-cut in the case of kidney cancer and leukemia (excluding CLL). A future update of the French cohort, increasing the follow-up time for miners, may help to reach a clearer conclusion for these two cancer sites.

目的 最近对法国铀矿工人队列进行了更新,增加了七年的随访数据。我们利用这些新数据寻找新的可能与氡相关的增加风险,并改进对累积氡辐照与肺癌、肾癌、脑和中枢神经系统(CNS)癌以及白血病(不包括慢性淋巴细胞白血病,后者不是辐射诱发的)这四种癌症之间潜在关联的估计。方法我们提出了几种参数生存模型,并在贝叶斯范式下进行了拟合和比较,以进行新的和原创的辐照风险分析。根据联合国辐射科委最近的建议,我们将与时间相关的效应修饰因子和暴露率视为潜在的效应修饰因子。我们使用贝叶斯模型选择标准来确定与氡相关的增加危险率。结果在辐照-风险线性关系的假设下,我们发现大量证据表明,累积氡辐照对法国铀矿工人肺癌死亡率的危险率有严格的正效应。根据目前现有的数据,在线性或对数线性辐照风险关系的假设下,无法得出长期辐照氡气对肾癌死亡危险率没有或存在严格正效应的结论。至于脑癌和中枢神经系统癌症导致的死亡,有大量证据表明不存在与氡气有关的影响。结论 本研究在贝叶斯框架以及线性和对数线性暴露风险关系假设下,调查了肺癌、肾癌、脑癌、中枢神经系统癌和白血病的死亡风险是否存在与氡相关的增加。如果说对肺癌、脑癌和中枢神经系统癌的研究结果的解释毫无疑问,那么对肾癌和白血病(不包括 CLL)的研究结论就不那么明确了。今后对法国队列进行更新,增加对矿工的跟踪时间,可能有助于对这两种癌症得出更明确的结论。
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引用次数: 0
Factors of presenteeism and its association with detrimental effects among employees in Switzerland working in different sectors - a cross-sectional study using a multi-item instrument. 在瑞士不同行业工作的雇员中,旷工因素及其与有害影响的关联--一项使用多项目工具的横断面研究。
IF 2.6 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-01 Epub Date: 2024-07-01 DOI: 10.1007/s00420-024-02083-x
Maisa Gerlach, Eva Blozik, André Meichtry, Miriam Hägerbäumer, Gablu Kilcher, Christoph Golz

Purpose: Presenteeism, the phenomenon of employees working despite illness, is a significant issue globally, impacting individual well-being and organizational efficiency. This study examines presenteeism among Swiss employees, exploring its occurrence, primary factors, reasons, and impact on employees' health.

Methods: This study used cross-sectional data from 1,521 employees in different sectors in Switzerland. Descriptive statistics and multiple linear models for influencing factors and detrimental effects, such as burnout symptoms, job satisfaction, general health, and quality of life, were calculated for data analysis. Presenteeism was measured using the Hägerbäumer multi-item scale, ranging from 1 = "Never in case of illness" - 5 = "Very often in case of illness."

Results: The employees reported that in case of illness, they rarely worked in the last 12 months M = 2.04 (SD = 1.00). A positive approach to presenteeism in the team was associated with less presenteeism (β = -0.07) and problematic leadership culture in dealing with presenteeism with increased presenteeism (β = 0.10). In addition to well-known factors, presenteeism was significant for burnout symptoms (β = 1.49), general health status (β = -1.5), and quality of life (β = -0.01).

Conclusion: The study offers insights into the phenomenon of presenteeism among Swiss employees in various sectors by applying a multi-item scale for presenteeism. The findings indicate that a positive team dynamic and organizational culture may significantly reduce presenteeism. Presenteeism behavior is a significant factor of adverse outcomes. This highlights the importance of acknowledging presenteeism in the context of occupational health.

目的:旷工是指员工带病工作的现象,在全球范围内都是一个重要问题,影响着个人福祉和组织效率。本研究对瑞士员工的旷工现象进行了调查,探讨了旷工现象的发生、主要因素、原因以及对员工健康的影响:本研究使用了来自瑞士不同行业 1521 名员工的横截面数据。数据分析采用了描述性统计和多元线性模型,对倦怠症状、工作满意度、总体健康状况和生活质量等影响因素和不利影响进行了计算。缺勤率采用 Hägerbäumer 多项目量表进行测量,量表范围为 1 ="生病时从不缺勤"-5 ="生病时经常缺勤":员工报告称,在过去 12 个月中,如果生病,他们很少工作,M=2.04(SD=1.00)。团队中对待旷工的积极态度与旷工率降低有关(β = -0.07),而领导文化在处理旷工问题上存在问题与旷工率增加有关(β = 0.10)。除众所周知的因素外,旷工对职业倦怠症状(β = 1.49)、总体健康状况(β = -1.5 )和生活质量(β = -0.01)也有显著影响:本研究通过采用多项目旷工量表,对瑞士各行各业员工的旷工现象进行了深入研究。研究结果表明,积极的团队活力和组织文化可以显著减少旷工现象。旷工行为是造成不良后果的一个重要因素。这凸显了在职业健康方面承认旷工的重要性。
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引用次数: 0
The impact of years of training and possible technical, procedural, and individual risk factors for the development of atopic symptoms among bakery and confectionery trainees. 培训年限以及技术、程序和个人风险因素对烘焙和糖果受训者出现特异性症状的影响。
IF 2.6 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-01 Epub Date: 2024-07-01 DOI: 10.1007/s00420-024-02079-7
Gina-Maria Klaut, Stefan Karrasch, Susanne Kutzora, Dennis Nowak, Caroline Quartucci

Purpose: Occupational asthma is commonly observed in bakers and confectioners. Endogenous and exogenous risk factors contribute to bakers' asthma. A heightened awareness of this and early diagnosis can be helpful in terms of prevention. The aim of the study was to identify a temporal relationship between the years of training, as well as possible technical, procedural, and individual risk factors for the development of flour-exposure related atopic symptoms such as rhinitis, cough, and rash in young professionals.

Methods: 127 bakers and confectioner trainees were observed over a one-year period. Two questionnaires served as test instruments. It was investigated whether the rates of atopic symptoms change over the course of a school year and which conditions in the workplace could be responsible for this. Descriptive statistics were used to answer the research questions concerning flour exposure and symptom rates. The Pearson-Chi-Square test was used for testing statistical differences between different groups (e.g. year of training, working conditions).

Results: An increase in rates of self-reported rhinitis, coughing, and rashes throughout the duration of traineeship was shown (e.g. rhinitis of bakers at work: 0% in the first year of training, 20% in the second and 33% in the third year of training). The installation of vapour extraction systems and low-dust transfer of baking agents led to fewer symptoms in the workplace (30% of participants with rhinitis symptoms worked with no installed vapour extraction systems). A medical history of atopy was positively correlated with the occurrence of symptoms.

Conclusion: To prevent the development of asthma in bakers, methods to improve occupational health and safety should be developed. Creating low dust working conditions e.g., due to the use of vapour extraction systems should be considered.

目的:职业性哮喘常见于面包师和糕点师。内源性和外源性风险因素都是导致面包师哮喘的原因。提高认识和早期诊断有助于预防哮喘。本研究的目的是找出年轻专业人员在接受培训的年限以及可能的技术、程序和个人风险因素之间的时间关系,从而发现与接触面粉有关的特应性症状,如鼻炎、咳嗽和皮疹。测试工具为两份问卷。研究调查了特应性症状的发生率在一个学年中是否会发生变化,以及工作场所的哪些条件可能会导致特应性症状的发生。研究使用了描述性统计来回答有关面粉接触和症状发生率的研究问题。使用 Pearson-Chi-Square 检验来测试不同组别(如培训年份、工作条件)之间的统计差异:结果表明,在整个培训期间,自我报告的鼻炎、咳嗽和皮疹发病率均有所上升(例如,面包师在工作中的鼻炎发病率为 0%,培训第一年为 0%,培训第二年为 0%,培训第三年为 0%):培训第一年为 0%,培训第二年为 20%,培训第三年为 33%)。安装蒸汽抽排系统和烘焙剂的低尘转移可减少工作场所的症状(30% 有鼻炎症状的学员在没有安装蒸汽抽排系统的情况下工作)。过敏病史与症状的发生呈正相关:结论:为防止面包师患上哮喘,应制定改善职业健康和安全的方法。结论:为防止面包师患上哮喘,应制定改善职业健康和安全的方法,并考虑创造低粉尘的工作条件,如使用蒸汽抽排系统。
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引用次数: 0
Emergency room visits (ERVs) among occupational groups associated with ambient conditions in Taiwan. 台湾与环境条件相关的职业群体急诊室就诊率(ERVs)。
IF 2.6 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-01 Epub Date: 2024-07-03 DOI: 10.1007/s00420-024-02084-w
Ayushi Sharma, Kang Yajing, Min-Chun Lin, Liwen Deng, Yu-Kai Lin, Lin-Han Chianghsieh, Fung-Chang Sung, Yu-Chun Wang

Objective: This population-based study explored emergency room visits (ERVs) from all-causes, circulatory and respiratory diseases among different occupational groups in Taiwan associated with ambient average temperature.

Method: Daily area-age-sex specific ERVs records were obtained from the Taiwan's Ministry of Health and Welfare from 2009 to 2018. Distributed lag-nonlinear model (DLNM) was used to estimate the exposure-response relationships between daily average temperature and ERVs for all-causes, circulatory and respiratory diseases by occupational groups. Random-effects meta-analysis was used to pool the overall cumulative relative risk (RR) and 95% confidence interval (CI).

Results: The exposure-response curves showed ERVs of all-cause and respiratory diseases increased with rising temperature across all occupational groups. These effects were consistently stronger among younger (20-64 years old) and outdoor workers. In contrast, ERVs risk from circulatory diseases increased significantly during cold snaps, with a substantially higher risk for female workers. Interestingly, female workers, regardless of indoor or outdoor work, consistently showed a higher risk of respiratory ERVs during hot weather compared to males. Younger workers (20-64 years old) exhibited a higher risk of ERVs, likely due to job profiles with greater exposure to extreme temperatures. Notably, the highest risk of all-causes ERVs was observed in outdoor male laborers (union members), followed by farmers and private employees, with the lowest risk among indoor workers. Conversely, female indoor workers and female farmers faced the highest risk of respiratory ERVs. Again, female farmers with consistent outdoor exposure had the highest risk of circulatory ERVs during cold conditions.

Conclusion: Our findings highlighted the complexity of temperature-related health risks associated with different occupational contexts. The population-level insights into vulnerable occupational groups could provide valuable comprehension for policymakers and healthcare practitioners.

目的:这项基于人口的研究探讨了台湾不同职业群体因各种原因、循环系统疾病和呼吸系统疾病导致的急诊就诊率:这项以人口为基础的研究探讨了台湾不同职业群体因各种原因、循环系统疾病和呼吸系统疾病导致的急诊就诊率(ERVs)与环境平均温度的关系:方法:研究人员从台湾卫生福利部获取了 2009 年至 2018 年期间每日特定地区-年龄-性别的急诊室就诊记录。采用分布式滞后非线性模型(DLNM)估算了日平均气温与各职业组别所有原因疾病、循环系统疾病和呼吸系统疾病的ERVs之间的暴露-反应关系。随机效应荟萃分析用于汇总总体累积相对风险(RR)和 95% 置信区间(CI):暴露-反应曲线显示,在所有职业组别中,全因疾病和呼吸系统疾病的ERV随着气温升高而增加。这些效应在年轻(20-64 岁)和户外工作者中持续增强。相比之下,寒流期间循环系统疾病的 ERVs 风险显著增加,女工的风险更高。有趣的是,与男性相比,女性工人(无论在室内还是室外工作)在炎热天气中患呼吸系统 ERV 的风险一直较高。年轻工人(20-64 岁)患急慢性呼吸道病毒的风险较高,这可能是由于其工作性质更容易暴露于极端温度所致。值得注意的是,室外男工(工会成员)患各种原因的 ERV 的风险最高,其次是农民和私人雇员,而室内工人的风险最低。相反,室内女工和女农民患呼吸系统 ERV 的风险最高。同样,在寒冷条件下,长期暴露于室外的女性农民患循环系统 ERV 的风险最高:我们的研究结果凸显了不同职业环境下与温度相关的健康风险的复杂性。从人群层面了解易受影响的职业群体,可为政策制定者和医疗保健从业人员提供有价值的理解。
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引用次数: 0
Longitudinal associations of effort and reward at work with changes in cognitive function: evidence from a national study of U.S. workers. 工作中的努力和回报与认知功能变化的纵向关联:来自美国工人全国性研究的证据。
IF 2.6 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-01 Epub Date: 2024-08-30 DOI: 10.1007/s00420-024-02081-z
Megan Guardiano, Timothy A Matthews, Sunny Liu, Onyebuchi A Arah, Johannes Siegrist, Jian Li

Purpose: This study aimed to examine longitudinal associations of workplace effort and reward with changes in cognitive function among United States workers.

Methods: Data from the national, population-based Midlife in the United States (MIDUS) study with a 9-year follow-up were used. Validated workplace effort and reward scales were measured at baseline, and cognitive outcomes (including composite cognition, episodic memory, and executive functioning) were measured with the Brief Test of Adult Cognition by Telephone (BTACT) at baseline and follow-up. Multivariable linear regression analyses based on generalized estimating equations (GEE) examined the longitudinal associations under study.

Results: Among this worker sample of 1,399, after accounting for demographics, socioeconomics, lifestyle behaviors, health conditions, and job control, high reward at baseline was associated with increased composite cognition (regression coefficient: 0.118 [95% CI: 0.049, 0.187]), episodic memory (0.106 [0.024, 0.188]), and executive functioning (0.123 [0.055, 0.191]) during follow-up. The joint exposure of 'high effort and high reward' was also associated with increased composite cognition (0.130 [0.030, 0.231]), episodic memory (0.131 [0.012, 0.250]), and executive functioning (0.117 [0.017, 0.216]), while the combination of 'low effort and high reward' was associated with increased composite cognition (0.106 [0.009, 0.204]) and executive functioning (0.139 [0.042, 0.235]).

Conclusion: Findings suggest that workplace high reward is related to improved cognitive scores among United States workers. Future research should investigate larger cohorts over longer timespans and expand into disease outcomes such as dementia. If these findings emerge as causal, relevant workplace rewards to promote worker cognitive health should be considered.

目的:本研究旨在探讨工作场所的努力和奖励与美国工人认知功能变化之间的纵向联系:研究采用了美国中年(MIDUS)全国性人口研究的数据,并进行了为期 9 年的跟踪调查。在基线时测量了经过验证的工作场所努力和奖励量表,在基线和随访时使用电话成人认知简测(BTACT)测量了认知结果(包括综合认知、外显记忆和执行功能)。基于广义估计方程(GEE)的多变量线性回归分析检验了研究中的纵向关联:在 1399 名工人样本中,在考虑了人口统计学、社会经济学、生活方式行为、健康状况和工作控制等因素后,基线时的高回报与随访期间综合认知能力(回归系数:0.118 [95% CI:0.049, 0.187])、外显记忆(0.106 [0.024, 0.188])和执行功能(0.123 [0.055, 0.191])的提高有关。高努力和高回报 "的共同暴露也与综合认知(0.130 [0.030, 0.231])、外显记忆(0.131 [0.012, 0.250])和执行功能(0.117 [0.017, 0.216])的增加有关,而 "低努力和高回报 "的组合与综合认知(0.106 [0.009, 0.204])和执行功能(0.139 [0.042, 0.235])的增加有关:研究结果表明,工作场所的高回报与美国工人认知分数的提高有关。未来的研究应在更长的时间跨度内对更大的群体进行调查,并扩展到痴呆症等疾病结果。如果这些研究结果显示出因果关系,则应考虑通过相关的工作场所奖励来促进工人的认知健康。
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引用次数: 0
Sleep duration and quality in permanent night work: an observational field study. 长期夜间工作的睡眠时间和质量:一项实地观察研究。
IF 2.6 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-01 Epub Date: 2024-06-21 DOI: 10.1007/s00420-024-02080-0
Kirsten Nabe-Nielsen, Ann Dyreborg Larsen, Anne Emily Saunte Fiehn Arup, Mette Sallerup, Vivi Schlünssen, Åse Marie Hansen, Anne Helene Garde

Purpose: Permanent night workers conceivably show better adaptation of circadian rhythms to night work than shift workers and therefore better possibilities of obtaining sufficient sleep of good quality after night shifts. We investigated the effect of night shifts including number of consecutive shifts on sleep among self-selected permanent night workers, and studied if the effect of night shifts differed between morning and evening types and compared with 3-shift workers.

Methods: The study population included 90 permanent night workers followed for 14 days (warehouse workers, 1228 observation days, 80% males). For comparison, we included 70 3-shift workers followed for 26 days (police officers, 1774 observation days, 100% men). Total sleep time (TST), primary sleep duration (PSD), and sleep efficiency were assessed by actigraphy. Measures of sleep quality and diurnal type were self-reported.

Results: Among permanent night workers, TST, PSD, difficulties falling asleep, disturbed sleep, and the number of awakenings decreased after night shifts compared with days without night work. Sleep efficiency, difficulties awakening, and non-refreshing sleep increased. More consecutive night shifts were associated with shorter TST and PSD. Sleep outcomes did not differ by diurnal type. Permanent night workers had fewer awakenings after night shifts than 3-shift workers, but no other differences were observed.

Conclusion: This study does not provide evidence that supports recommendation of permanent night work to reduce adverse effects of night shifts on sleep. A limited number of consecutive night shifts is recommended to reduce accumulation of sleep debt.

目的:可以想象,与轮班工人相比,长期夜班工人对夜间工作的昼夜节律有更好的适应性,因此在夜班后更有可能获得充足、高质量的睡眠。我们调查了夜班(包括连续轮班次数)对自我选择的长期夜班工人睡眠的影响,并研究了夜班的影响在早晚班之间以及与三班制工人相比是否存在差异:研究对象包括 90 名长期夜班工人(仓库工人,1228 个观察日,80% 为男性),为期 14 天。作为对比,我们对 70 名三班倒工人进行了为期 26 天的跟踪调查(警察,1774 个观察日,100% 男性)。总睡眠时间(TST)、主要睡眠时间(PSD)和睡眠效率均由动电仪进行评估。睡眠质量和昼夜类型的测量结果均为自我报告:结果:在长期从事夜班工作的人员中,与不从事夜班工作的人员相比,夜班后的睡眠时间(TST)、睡眠持续时间(PSD)、入睡困难、睡眠紊乱和觉醒次数均有所减少。睡眠效率、觉醒困难和非恢复性睡眠则有所增加。连续夜班次数越多,TST 和 PSD 越短。昼夜类型不同,睡眠结果也不同。与三班制工人相比,长期夜班工人在夜班后觉醒的次数较少,但没有观察到其他差异:这项研究没有提供证据支持为减少夜班对睡眠的不利影响而推荐长期夜班的建议。建议进行有限次数的连续夜班,以减少睡眠债务的积累。
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引用次数: 0
Impact of heat waves on human morbidity and hospital admissions in a city of the western mediterranean area. 热浪对西地中海地区某城市人类发病率和入院率的影响。
IF 2.6 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-01 Epub Date: 2024-07-02 DOI: 10.1007/s00420-024-02082-y
Adrián Bujosa Mateu, Luis Alegre Latorre, María Villalonga Comas, Jaume Salom, Mercedes García Gasalla, Lluis Planas Bibiloni, Jaime Orfila Timoner, Javier Murillas Angoiti

Purpose: The effect of heat waves on mortality is well known, but current evidence on morbidity is limited. Establishing the consequences of these events in terms of morbidity is important to ensure communities and health systems can adapt to them.

Methods: We thus collected data on total daily emergency hospital admissions, admissions to critical care units, emergency department admissions, and emergency admissions for specific diagnoses to Hospital Universitario de Son Espases from 1 January 2005 to 31 December 2021. A heat wave was defined as a period of ≥ 2 days with a maximum temperature ≥ 35 °C, including a 7 day lag effect (inclusive). We used a quasi-Poisson generalized linear model to estimate relative risks (RRs; 95%CI) for heat wave-related hospital admissions.

Results: Results showed statistically significant increases in total emergency admissions (RR 1.06; 95%CI 1 - 1.12), emergency department admissions (RR 1.12; 95%CI 1.07 - 1.18), and admissions for ischemic stroke (RR 1.26; 95%CI 1.02 - 1.54), acute kidney injury (RR 1.67; 95%CI 1.16 - 2.35), and heat stroke (RR 18.73, 95%CI 6.48 - 45.83) during heat waves.

Conclusion: Heat waves increase hospitalization risk, primarily for thromboembolic and renal diseases and heat strokes.

目的:热浪对死亡率的影响众所周知,但目前有关发病率的证据却很有限。确定这些事件在发病率方面的后果对于确保社区和卫生系统能够适应这些事件非常重要:因此,我们收集了 2005 年 1 月 1 日至 2021 年 12 月 31 日期间松埃斯帕斯大学医院每日急诊入院总人数、重症监护室入院人数、急诊科入院人数以及因特定诊断而急诊入院人数的数据。热浪的定义是最高气温≥35 °C的时间段≥2天,包括7天的滞后效应(含)。我们采用准泊松广义线性模型来估算与热浪相关的入院人数的相对风险系数(RRs; 95%CI):结果表明,在热浪期间,急诊入院总人数(RR 1.06;95%CI 1 - 1.12)、急诊科入院人数(RR 1.12;95%CI 1.07 - 1.18)以及缺血性中风(RR 1.26;95%CI 1.02 - 1.54)、急性肾损伤(RR 1.67;95%CI 1.16 - 2.35)和中暑(RR 18.73,95%CI 6.48 - 45.83)的入院人数均有统计学意义的增加:结论:热浪会增加住院风险,主要是血栓栓塞性疾病、肾脏疾病和中暑。
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引用次数: 0
Association between urinary polycyclic aromatic hydrocarbons and risk of metabolic associated fatty liver disease. 尿液中多环芳烃与代谢相关性脂肪肝风险之间的关系。
IF 2.6 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-01 Epub Date: 2024-06-17 DOI: 10.1007/s00420-024-02076-w
Minzhen Wang, Shaoyan Tang, Lulu Zhang, Yamin Zhao, Yindi Peng, Shan Zheng, Zanchao Liu

Objective: To investigate the effect of urinary PAHs on MAFLD.

Methods: The study included 3,136 adults from the National Health and Nutrition Examination Survey (NHANES) conducted between 2009 and 2016. Among them, 1,056 participants were diagnosed with MAFLD and were designated as the case group. The analysis of the relationship between monohydroxy metabolites of seven PAHs in urine and MAFLD was carried out using logistic regression and Bayesian kernel regression (BKMR) models.

Results: In single-pollutant models, the concentration of 2-hydroxynaphthalene (2-OHNAP) was positively correlated with MAFLD (OR = 1.47, 95% CI 1.18, 1.84), whereas 3-hydroxyfluorene (3-OHFLU) and 1-hydroxypyrene (1-OHPYR) demonstrated a negative correlation with MAFLD (OR = 0.59, 95% CI 0.48 0.73; OR = 0.70, 95% CI 0.55, 0.89). Conversely, in multi-pollutant models, 2-OHNAP, 2-hydroxyfluorene (2-OHFLU), 2-hydroxyphenanthrene, and 3-hydroxyphenanthrene (2&3-OHPHE) displayed positive correlations with MAFLD (OR = 6.17, 95% CI 3.15, 12.07; OR = 2.59, 95% CI 1.37, 4.89). However, 3-OHFLU and 1-OHPYR continued to exhibit negative correlations with MAFLD (OR = 0.09, 95% CI 0.05, 0.15; OR = 0.62, 95% CI 0.43, 0.88). Notably, the BKMR analysis mixtures approach did not indicate a significant joint effect of multiple PAHs on MAFLD, but identified interactions between 3-OHFLU and 2-OHFLU, 1-OHPYR and 2-OHFLU, and 1-OHPYR and 3-OHFLU.

Conclusion: No significant association was found between mixed PAHs exposure and the risk of MAFLD. However, interactions were observed between 3-OHFLU and 2-OHFLU. Both 2-OHFLU and 2&3-OHPHE exposure are significant risk factors for MAFLD, whereas 3-OHFLU is a key protective factor for the disease.

目的:研究尿液中多环芳烃对 MAFLD 的影响:研究尿液中多环芳烃对 MAFLD 的影响:研究纳入了 2009 年至 2016 年间进行的美国国家健康与营养调查(NHANES)中的 3,136 名成年人。其中,1 056 名参与者被诊断为 MAFLD,被指定为病例组。采用逻辑回归和贝叶斯核回归(BKMR)模型分析了尿液中七种多环芳烃的单羟基代谢物与 MAFLD 之间的关系:在单污染物模型中,2-羟基萘(2-OHNAP)的浓度与 MAFLD 呈正相关(OR = 1.47,95% CI 1.18,1.84),而 3-羟基芴(3-OHFLU)和 1-羟基芘(1-OHPYR)与 MAFLD 呈负相关(OR = 0.59,95% CI 0.48 0.73;OR = 0.70,95% CI 0.55,0.89)。相反,在多污染物模型中,2-OHNAP、2-羟基芴(2-OHFLU)、2-羟基菲和 3-羟基菲(2&3-OHPHE)与 MAFLD 呈正相关(OR = 6.17,95% CI 3.15,12.07;OR = 2.59,95% CI 1.37,4.89)。然而,3-OHFLU 和 1-OHPYR 仍与 MAFLD 呈负相关(OR = 0.09,95% CI 0.05,0.15;OR = 0.62,95% CI 0.43,0.88)。值得注意的是,BKMR分析混合物方法并未显示多种PAHs对MAFLD有显著的联合影响,但发现了3-OHFLU和2-OHFLU、1-OHPYR和2-OHFLU以及1-OHPYR和3-OHFLU之间的相互作用:结论:混合 PAHs 暴露与 MAFLD 风险之间没有发现明显的关联。结论:混合 PAHs 暴露与 MAFLD 风险之间未发现明显关联,但 3-OHFLU 和 2-OHFLU 之间存在相互作用。2-OHFLU和2&3-OHPHE暴露都是MAFLD的重要风险因素,而3-OHFLU则是该疾病的关键保护因素。
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引用次数: 0
Independent and joint associations of multiple metals exposure with vital capacity index: a cross-sectional study in Chinese children and adolescents. 多种金属暴露与生命容量指数的独立和联合关联:一项针对中国儿童和青少年的横断面研究。
IF 2.6 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-01 Epub Date: 2024-07-06 DOI: 10.1007/s00420-024-02085-9
Yuting Xiang, Yuting Wang, Ye Deng, Tianyun Wang, Jiamei Chen, Miao He

Objective: The current study aimed to explore the relationships between urinary metals and vital capacity index (VCI) in 380 children and adolescents in Northeast China using a variety of statistical methods.

Methods: A cross-sectional survey was conducted among 380 children and adolescents in Liaoning Province, China. To assess the relationships between urinary metals and VCI, Elastic-net (ENET) regression, multivariate linear regression, weighted quantile sum (WQS), bayesian kernel machine regression (BKMR) and quantile-based g computation (qgcomp) were adopted.

Results: The ENET model selected magnesium (Mg), vanadium (V), manganese (Mn), arsenic (As), tin (Sn) and lead (Pb) as crucial elements. In multiple linear regression, we observed urinary Pb, Mn was negatively correlated with VCI individually in both total study population and adolescents (all p values < 0.05) in the adjustment model. The WQS indices were negatively related with VCI in total study population (β=-3.19, 95%CI: -6.07, -0.30) and adolescents (β=-3.46, 95%CI: -6.58, -0.35). The highest weight in total study population was Pb (38.80%), in adolescents was Mn (35.10%). In the qgcomp, Pb (31.90%), Mn (27.20%) were the major negative contributors to the association in the total population (β=-3.51, 95%CI: -6.29, -0.74). As (42.50%), Mn (39.90%) were the main negative contributors (β=-3.95, 95% CI: -6.68, -1.22) among adolescents. The results of BKMR were basically consistent with WQS and qgcomp analyses.

Conclusions: Our results indicated that Pb and Mn were priority toxic materials on VCI. The cumulative effect of metals was negatively related to VCI, and this relationship was more pronounced in adolescents.

研究目的本研究旨在采用多种统计方法探讨中国东北地区380名儿童和青少年尿液中金属与生命容量指数(VCI)之间的关系:对中国辽宁省的 380 名儿童和青少年进行了横断面调查。采用弹性网(ENET)回归、多元线性回归、加权量值和(WQS)、贝叶斯核机器回归(BKMR)和基于量值的g计算(qgcomp)来评估尿液中金属与VCI之间的关系:ENET模型选择镁(Mg)、钒(V)、锰(Mn)、砷(As)、锡(Sn)和铅(Pb)作为关键元素。在多元线性回归中,我们观察到尿中的铅、锰分别与研究总人群和青少年的颅内压增高呈负相关(所有 p 值均为结论):我们的研究结果表明,铅和锰是对 VCI 有优先毒性的物质。金属的累积效应与 VCI 呈负相关,这种关系在青少年中更为明显。
{"title":"Independent and joint associations of multiple metals exposure with vital capacity index: a cross-sectional study in Chinese children and adolescents.","authors":"Yuting Xiang, Yuting Wang, Ye Deng, Tianyun Wang, Jiamei Chen, Miao He","doi":"10.1007/s00420-024-02085-9","DOIUrl":"10.1007/s00420-024-02085-9","url":null,"abstract":"<p><strong>Objective: </strong>The current study aimed to explore the relationships between urinary metals and vital capacity index (VCI) in 380 children and adolescents in Northeast China using a variety of statistical methods.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted among 380 children and adolescents in Liaoning Province, China. To assess the relationships between urinary metals and VCI, Elastic-net (ENET) regression, multivariate linear regression, weighted quantile sum (WQS), bayesian kernel machine regression (BKMR) and quantile-based g computation (qgcomp) were adopted.</p><p><strong>Results: </strong>The ENET model selected magnesium (Mg), vanadium (V), manganese (Mn), arsenic (As), tin (Sn) and lead (Pb) as crucial elements. In multiple linear regression, we observed urinary Pb, Mn was negatively correlated with VCI individually in both total study population and adolescents (all p values < 0.05) in the adjustment model. The WQS indices were negatively related with VCI in total study population (β=-3.19, 95%CI: -6.07, -0.30) and adolescents (β=-3.46, 95%CI: -6.58, -0.35). The highest weight in total study population was Pb (38.80%), in adolescents was Mn (35.10%). In the qgcomp, Pb (31.90%), Mn (27.20%) were the major negative contributors to the association in the total population (β=-3.51, 95%CI: -6.29, -0.74). As (42.50%), Mn (39.90%) were the main negative contributors (β=-3.95, 95% CI: -6.68, -1.22) among adolescents. The results of BKMR were basically consistent with WQS and qgcomp analyses.</p><p><strong>Conclusions: </strong>Our results indicated that Pb and Mn were priority toxic materials on VCI. The cumulative effect of metals was negatively related to VCI, and this relationship was more pronounced in adolescents.</p>","PeriodicalId":13761,"journal":{"name":"International Archives of Occupational and Environmental Health","volume":" ","pages":"791-801"},"PeriodicalIF":2.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141537831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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International Archives of Occupational and Environmental Health
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