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What it takes to reduce sitting at work: a pilot study on the effectiveness and correlates of a multicomponent intervention. 减少久坐工作需要什么:一项关于多成分干预的有效性和相关性的试点研究。
IF 3 3区 医学 Q1 Medicine Pub Date : 2024-01-01 Epub Date: 2023-11-10 DOI: 10.1007/s00420-023-02020-4
Jannik Porath, Laura I Schmidt, Juliane Möckel, Chiara Dold, Lisa Hennerkes, Alexander Haussmann

Objective: This study aimed to assess the feasibility and effects of a simple-to-implement multicomponent intervention to reduce sedentary time of office workers.

Methods: Six groups of eight to ten office workers took part in the two-week Leicht Bewegt intervention. Participants completed questionnaires at baseline (T0, n = 52), after 2 weeks (T1, n = 46), and after 5 weeks (T2, n = 38), including subjective sedentary measures and social-cognitive variables based on the health action process approach (HAPA). Objective sedentary measures were obtained using activPAL trackers.

Results: The intention to reduce sedentary behavior during work increased significantly from T0 to T1. Participants' objective and subjective sitting time decreased significantly from T0 to T1, corresponding to an average decrease per 8-h-workday of 55 min (d = - .66) or 74 min (d = - 1.14), respectively. This reduction persisted (for subjective sitting time) at T2 (d = - 1.08). Participants indicated a high satisfaction with the intervention.

Conclusions: The Leicht Bewegt intervention offers a feasible and effective opportunity to reduce sedentary behavior at work. Randomized controlled trials including longer follow-up time periods are needed to validate its benefits in different workplaces.

目的:本研究旨在评估一种简单易行的多组分干预措施的可行性和效果,以减少上班族的久坐时间。方法:六组八至十名上班族参加为期两周的Leicht-Bewegt干预。参与者在基线(T0,n = 52),2周后(T1,n = 46),并且在5周后(T2,n = 38),包括基于健康行动过程方法(HAPA)的主观久坐测量和社会认知变量。使用activPAL跟踪器获得了客观的久坐测量。结果:从T0到T1,减少工作中久坐行为的意愿显著增加。参与者的客观和主观坐着时间从T0到T1显著减少,对应于每8小时工作日平均减少55分钟(d = -.66)或74分钟(d = -1.14)。这种减少在T2(d)持续存在(对于主观坐着时间) = -1.08)。参与者对干预表示高度满意。结论:Leicht-Bewegt干预为减少工作中的久坐行为提供了一个可行而有效的机会。需要进行随机对照试验,包括更长的随访时间,以验证其在不同工作场所的益处。
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引用次数: 0
The combined effect of air pollution and non-optimal temperature on mortality in Shandong Province, China: establishment of air health index 中国山东省空气污染和非最佳气温对死亡率的综合影响:建立空气健康指数
IF 3 3区 医学 Q1 Medicine Pub Date : 2023-12-29 DOI: 10.1007/s00420-023-02036-w
Shuyue Niu, Junli Tang, Kejia Hu, Xiaohui Xu, Jing Dong, Jie Chu, Xiaolei Guo, Haitao Wang, Yanwen Cao, Qi Zhao, Lovel Fornah, Zilong Lu, Wei Ma

Purpose

The air health index (AHI) captures the combined effects of air pollution and non-optimal temperatures and helps assess the atmospheric environment’s overall health risk. Shandong Province is a crucial industrial base in China, and the health effects of air pollution and non-optimal temperature cannot be ignored. To construct an AHI for Shandong Province and assess the district-level mortality burden due to AHI in the study area.

Methods

Daily district-specific mortality, meteorological, and air pollution data over 2013–2018 were collected in Shandong Province, China. The AHI construction eventually incorporated PM2.5 and NO2, O3, and non-optimal temperatures. Attributable fraction (AF) and attributable number (AN) were used to estimate the district-specific mortality burden attributable to AHI.

Results

The average AHI value observed in Shandong Province was 6. Our research revealed a positive association between the total AHI and total mortality, with an overall trend of a slow increase followed by a rapid increase. The exposure–response curves, when stratified by gender, age, and cause of death, were approximately consistent with the overall trend. The provincial attributable fraction (AF) was 5.31% (95% CI 4.58%, 5.91%), and the attributable number (AN) was 188,246 (95% CI 162,396, 209,533). Overall, higher ANs mainly appeared in the southwestern area, while higher values of AF were observed in the central-eastern and central-northern areas.

Conclusions

The air health index performs well in predicting death burden and can convey health risks related to exposure to the ambient environment to the public.

目的 空气健康指数(AHI)反映了空气污染和非最佳温度的综合影响,有助于评估大气环境的整体健康风险。山东省是中国重要的工业基地,空气污染和非最佳温度对健康的影响不容忽视。方法在中国山东省收集了 2013-2018 年期间各地区的死亡率、气象和空气污染数据。AHI 的构建最终纳入了 PM2.5、二氧化氮(NO2)、臭氧(O3)和非最佳温度。我们的研究发现,总 AHI 与总死亡率之间存在正相关,总体趋势是先缓慢上升后快速上升。按性别、年龄和死因分层后,暴露-反应曲线与总体趋势基本一致。该省的可归因比例(AF)为 5.31%(95% CI 4.58%,5.91%),可归因人数(AN)为 188,246 人(95% CI 162,396 人,209,533 人)。总体而言,较高的AN值主要出现在西南地区,而较高的AF值则出现在中东部和中北部地区。
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引用次数: 0
Occupational-related exposure to diesel exhaust and risk of leukemia: systematic review and meta-analysis of cohort studies 与职业相关的柴油废气暴露和白血病风险:队列研究的系统回顾和荟萃分析
IF 3 3区 医学 Q1 Medicine Pub Date : 2023-12-24 DOI: 10.1007/s00420-023-02034-y
Darshi Shah, Vincent DeStefano, Giulia Collatuzzo, Federica Teglia, Paolo Boffetta

Purpose

Diesel exhaust (DE) is an established lung carcinogen. The association with leukemia is not well established. We conducted a systematic review and meta-analysis of cohort studies to determine the association between occupational DE exposure and risk of leukemia.

Methods

A systematic literature review was performed to identify all cohort studies on occupational exposure to DE and associated risk of leukemia. STROBE guidelines and PECOS criteria were followed. Meta-analyses with fixed effects (and random-effects model in cases of high heterogeneity) were performed to calculate summary relative risks (RR) and 95% confidence intervals (CI), including subgroup analyses by outcome (mortality or incidence), sex, geographic region, industry type, and study quality. Study quality was assessed using the the Joanna Briggs Institute (JBI) critical appraisal checklist for cohort studies.

Results

Of the 30 studies retained, 20 (8 from North America, 12 from Europe) reported a total of 33 estimates of the risk of leukemia. Overall, the relative risk (RR) of leukemia was 1.01 (95% CI = 0.97–1.05, I2 = 21.2%, n = 33); corresponding results for leukemia incidence and mortality were RR = 1.02 (95% CI = 0.98–1.06, I2 = 27.9%, n = 19) and RR = 0.91 (95% CI = 0.81–1.02, I2 = 0.0%, n = 15), respectively. The main results were confirmed in analyses by sex and geographic area. A statistically significant association was detected for miners (RR = 1.58, 95% CI = 1.15–2.15, I2 = 77.0%, n = 2) but not for other occupational groups. Publication bias was not detected (p = 0.7).

Conclusion

Our results did not indicate an association between occupational DE exposure and leukemia, with the possible exception of miners. Residual confounding cannot be excluded.

目的柴油废气(DE)是一种公认的肺致癌物。但其与白血病的关系尚未得到充分证实。我们对队列研究进行了系统性回顾和荟萃分析,以确定职业性柴油废气暴露与白血病风险之间的关联。方法我们进行了系统性文献回顾,以确定所有有关职业性柴油废气暴露和相关白血病风险的队列研究。研究遵循了 STROBE 指南和 PECOS 标准。采用固定效应进行 Meta 分析(异质性较高时采用随机效应模型),以计算汇总相对风险 (RR) 和 95% 置信区间 (CI),包括按结果(死亡率或发病率)、性别、地理区域、行业类型和研究质量进行亚组分析。研究质量采用乔安娜-布里格斯研究所 (Joanna Briggs Institute, JBI) 的队列研究关键评估清单进行评估。总体而言,白血病的相对风险 (RR) 为 1.01 (95% CI = 0.97-1.05, I2 = 21.2%, n = 33);白血病发病率和死亡率的相应结果分别为 RR = 1.02 (95% CI = 0.98-1.06, I2 = 27.9%, n = 19) 和 RR = 0.91 (95% CI = 0.81-1.02, I2 = 0.0%, n = 15)。按性别和地理区域进行的分析证实了主要结果。矿工(RR = 1.58,95% CI = 1.15-2.15,I2 = 77.0%,n = 2)与此有统计学意义,而其他职业群体则没有。结论我们的研究结果并未表明职业性 DE 暴露与白血病之间存在关联,但矿工可能是个例外。不能排除残余混杂因素。
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引用次数: 0
Occupational exposure to vapors, gasses, dusts, and fumes in relation to causes of death during 24 years in Helsinki, Finland 芬兰赫尔辛基 24 年间与蒸汽、气体、粉尘和烟雾的职业接触与死亡原因的关系
IF 3 3区 医学 Q1 Medicine Pub Date : 2023-12-19 DOI: 10.1007/s00420-023-02031-1
Juuso Jalasto, Ritva Luukkonen, Ari Lindqvist, Arnulf Langhammer, Hannu Kankaanranta, Helena Backman, Eva Rönmark, Anssi Sovijärvi, Päivi Piirilä, Paula Kauppi

Purpose

Environmental particulate matter (PM) exposure has been shown to cause excess all-cause and disease-specific mortality. Our aim was to compare disease-specific mortality by estimated occupational exposure to vapors, gasses, dusts, and fumes (VGDF).

Methods

The data source is the Helsinki part of the population-based FinEsS study on chronic obstructive pulmonary diseases including information on age, education level, main occupation, sex, and tobacco smoking combined with death registry information. We compared estimated VGDF exposure to mortality using adjusted competing-risks regression for disease-specific survival analysis for a 24-year follow-up.

Results

Compared to the no-exposure group, the high occupational VGDF exposure group had sub-hazard ratios (sHR) of 1.7 (95% CI 1.3–2.2) for all cardiovascular-related and sHR 2.1 (1.5–3.9) for just coronary artery-related mortality. It also had sHR 1.7 (1.0–2.8) for Alzheimer’s or vascular dementia-related mortality and sHR 1.7(1.2–2.4) for all respiratory disease-related mortality.

Conclusion

Long-term occupational exposure to VGDF increased the hazard of mortality- to cardiovascular-, respiratory-, and dementia-related causes. This emphasizes the need for minimizing occupational long-term respiratory exposure to dust, gasses, and fumes.

目的环境颗粒物(PM)暴露已被证明会导致超常的全因死亡率和特定疾病死亡率。我们的目的是根据蒸汽、气体、粉尘和烟雾(VGDF)的估计职业暴露量来比较疾病特异性死亡率。方法数据来源于基于人群的慢性阻塞性肺病 FinEsS 研究的赫尔辛基部分,包括年龄、教育水平、主要职业、性别和吸烟等信息以及死亡登记信息。结果与未暴露组相比,高职业 VGDF 暴露组所有心血管相关死亡率的次危险比 (sHR) 为 1.7 (95% CI 1.3-2.2),仅冠状动脉相关死亡率的次危险比 (sHR) 为 2.1 (1.5-3.9)。结论 长期职业暴露于 VGDF 会增加心血管、呼吸系统和痴呆相关原因的死亡率。这强调了尽量减少职业性长期呼吸接触粉尘、气体和烟雾的必要性。
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引用次数: 0
Club cell protein (CC16) in serum as an effect marker for small airway epithelial damage caused by diesel exhaust and blasting fumes in potash mining 血清中的俱乐部细胞蛋白(CC16)是钾盐开采中柴油废气和爆破烟尘造成小气道上皮损伤的效应标志物
IF 3 3区 医学 Q1 Medicine Pub Date : 2023-12-18 DOI: 10.1007/s00420-023-02035-x

Abstract

Objective

The effect marker club cell protein (CC16) is secreted by the epithelium of the small respiratory tract into its lumen and passes into the blood. Increased amounts of CC16 in serum are observed during acute epithelial lung injury due to air pollutants. CC16 in serum was determined as part of this cross-sectional study in underground potash miners on acute and chronic health effects from exposures to diesel exhaust and blasting fumes.

Methods

Nitrogen oxides, carbon monoxide, and diesel particulate matter were measured in 672 workers at a German potash mining site on a person-by-person basis over an early shift or midday shift, together with CC16 serum concentrations before and after the respective shift. CC16 concentrations and CC16 shift-differences were evaluated with respect to personal exposure measurements and other quantitative variables by Spearman rank correlation coefficients. CC16 shift-differences were modeled using multiple linear regression. Above-ground workers as reference group were compared to the exposed underground workers.

Results

Serum concentrations of CC16 were influenced by personal characteristics such as age, smoking status, and renal function. Moreover, they showed a circadian rhythm. While no statistically significant effects of work-related exposure on CC16 concentrations were seen in never smokers, such effects were evident in current smokers.

Conclusion

The small airways of current smokers appeared to be vulnerable to the combination of measured work-related exposures and individual exposure to smoking. Therefore, as health protection of smokers exposed to diesel exhaust and blasting fumes, smoking cessation is strongly recommended.

摘要 目的 小呼吸道上皮细胞向腔内分泌效应标志物俱乐部细胞蛋白(CC16)并进入血液。在空气污染物导致急性肺上皮损伤时,可观察到血清中的 CC16 含量增加。作为这项横断面研究的一部分,对地下钾盐矿工进行了血清中 CC16 的测定,以了解接触柴油废气和爆破烟雾对健康造成的急性和慢性影响。 方法 在德国的一个钾盐采矿场,对早班或中班的 672 名工人逐人测量了氮氧化物、一氧化碳和柴油微粒物质,并测量了各班前后的 CC16 血清浓度。通过斯皮尔曼等级相关系数评估了 CC16 浓度和 CC16 班次差异与个人暴露测量值和其他定量变量之间的关系。CC16 班次差异采用多元线性回归建模。作为参照组的地面工人与暴露在地下的工人进行了比较。 结果 血清中的 CC16 浓度受年龄、吸烟状况和肾功能等个人特征的影响。此外,它们还呈现出昼夜节律。虽然从未吸烟者的工作相关暴露对 CC16 浓度没有明显的统计学影响,但当前吸烟者的工作相关暴露对 CC16 浓度有明显影响。 结论 当前吸烟者的小气道似乎很容易受到工作相关暴露和个人吸烟暴露的共同影响。因此,为了保护暴露在柴油机废气和爆破烟雾中的吸烟者的健康,强烈建议戒烟。
{"title":"Club cell protein (CC16) in serum as an effect marker for small airway epithelial damage caused by diesel exhaust and blasting fumes in potash mining","authors":"","doi":"10.1007/s00420-023-02035-x","DOIUrl":"https://doi.org/10.1007/s00420-023-02035-x","url":null,"abstract":"<h3>Abstract</h3> <span> <h3>Objective</h3> <p>The effect marker club cell protein (CC16) is secreted by the epithelium of the small respiratory tract into its lumen and passes into the blood. Increased amounts of CC16 in serum are observed during acute epithelial lung injury due to air pollutants. CC16 in serum was determined as part of this cross-sectional study in underground potash miners on acute and chronic health effects from exposures to diesel exhaust and blasting fumes.</p> </span> <span> <h3>Methods</h3> <p>Nitrogen oxides, carbon monoxide, and diesel particulate matter were measured in 672 workers at a German potash mining site on a person-by-person basis over an early shift or midday shift, together with CC16 serum concentrations before and after the respective shift. CC16 concentrations and CC16 shift-differences were evaluated with respect to personal exposure measurements and other quantitative variables by Spearman rank correlation coefficients. CC16 shift-differences were modeled using multiple linear regression. Above-ground workers as reference group were compared to the exposed underground workers.</p> </span> <span> <h3>Results</h3> <p>Serum concentrations of CC16 were influenced by personal characteristics such as age, smoking status, and renal function. Moreover, they showed a circadian rhythm. While no statistically significant effects of work-related exposure on CC16 concentrations were seen in never smokers, such effects were evident in current smokers.</p> </span> <span> <h3>Conclusion</h3> <p>The small airways of current smokers appeared to be vulnerable to the combination of measured work-related exposures and individual exposure to smoking. Therefore, as health protection of smokers exposed to diesel exhaust and blasting fumes, smoking cessation is strongly recommended.</p> </span>","PeriodicalId":13761,"journal":{"name":"International Archives of Occupational and Environmental Health","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138742673","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
Impact of welding occupation on serum aluminium level and its association with physical health, cognitive function, and quality of life: a cross-sectional study 焊接职业对血清铝水平的影响及其与身体健康、认知功能和生活质量的关系:一项横断面研究
IF 3 3区 医学 Q1 Medicine Pub Date : 2023-12-18 DOI: 10.1007/s00420-023-02038-8
Ogochukwu Kelechi Onyeso, Arinze Kingsley Ugwu, Henrietha Chibuzor Adandom, Suha Damag, Kelechi Mirabel Onyeso, James Okechukwu Abugu, Okwukweka Emmanuela Aruma, Adesola Christiana Odole, Oluwaghohunmi A. Awosoga, Charles Ikechukwu Ezema

Objective

There is an occupational health concern about welders’ inhalation of toxic aluminium fumes. We investigated whether serum aluminium level (SAL) and demographic variables can significantly predict physical health parameters, cognition, and quality of life (QoL) among welders.

Methods

The cross-sectional study involved 100 age- and location-matched men (50 welders and 50 non-welders). SAL obtained using a graphite furnace atomic absorption spectrometer, and data collected using blood pressure and body mass index (BMI) apparatuses, biodata form, pain rating scale, General Practitioner Assessment of Cognition, WHOQoL-BREF, and Nordic musculoskeletal symptoms (MSS) questionnaire were analysed using independent samples t test, chi-square, Pearson’s correlation, and hierarchical linear regression.

Results

Welders had significantly higher SAL (mean difference [MD] = 1.77 µg/L, p < 0.001), lower QoL (MD = 3.92, p = 0.039), and higher prevalence of MSS on the neck (χ2 = 10.187, p = 0.001), shoulder (χ2 = 9.007, p = 0.003), upper back (χ2 = 6.832, p = 0.009), and knee (χ2 = 12.190, p < 0.001) than non-welders. There was a significant bivariate association between SAL, systolic blood pressure (β = 0.313, p = 0.002), and BMI (β = 0.279, p = 0.005), but not pain intensity, cognition, or QoL. SAL remained a significant predictor of systolic blood pressure after adjustment for physical health and QoL parameters (β = 0.191, p = 0.044). The association between SAL and social QoL became significant after adjustment for physical health and other QoL domains (β = − 0.210, p = 0.032) and demographic variables (β = − 0.233, p = 0.046).

Conclusion

Welders had significantly higher SAL, musculoskeletal symptoms, blood pressure, and lower QoL than non-welders. SAL was associated with adverse physical health parameters and social-related QoL, not cognition. We recommend routine aluminium bioavailability and physical health checks among welders.

目的人们对电焊工吸入有毒铝烟雾的职业健康问题十分关注。我们研究了血清铝水平(SAL)和人口统计学变量是否能显著预测电焊工的身体健康参数、认知能力和生活质量(QoL)。方法这项横断面研究涉及 100 名年龄和地点匹配的男性(50 名电焊工和 50 名非电焊工)。使用石墨炉原子吸收光谱仪获得 SAL 值,并使用血压和体重指数 (BMI) 仪器、生物数据表、疼痛评分量表、全科医生认知评估、WHOQoL-BREF 和北欧肌肉骨骼症状 (MSS) 问卷收集数据,然后使用独立样本 t 检验、卡方检验、皮尔逊相关性和分层线性回归进行分析。结果 焊工的 SAL 值明显更高(平均差 [MD] = 1.77 µg/L,p = 0.001),QoL 值更低(MD = 3.92,p = 0.039),颈部 MSS 患病率更高(χ2 = 10.187,p = 0.001)、肩部(χ2 = 9.007,p = 0.003)、上背部(χ2 = 6.832,p = 0.009)和膝部(χ2 = 12.190,p <0.001)的 MSS 患病率高于非焊接工。SAL、收缩压(β = 0.313,p = 0.002)和体重指数(BMI)(β = 0.279,p = 0.005)之间有明显的双变量关联,但疼痛强度、认知能力或 QoL 之间没有关联。在对身体健康和 QoL 参数进行调整后,SAL 仍是收缩压的重要预测因素(β = 0.191,p = 0.044)。在对身体健康和其他 QoL 领域(β = - 0.210,p = 0.032)以及人口统计学变量(β = - 0.233,p = 0.046)进行调整后,SAL 与社会 QoL 之间的关系变得显著。SAL 与不利的身体健康参数和与社会相关的 QoL 相关,而与认知能力无关。我们建议对电焊工进行常规铝生物利用率和身体健康检查。
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引用次数: 0
Occupational physical activity, all-cause mortality and incidence of cardiovascular diseases: results from three Italian cohorts 职业体力活动、全因死亡率和心血管疾病发病率:意大利三个队列的结果
IF 3 3区 医学 Q1 Medicine Pub Date : 2023-12-15 DOI: 10.1007/s00420-023-02028-w
Dario Fontana, Raffaele Ceron, Angelo d’Errico

Purpose

To examine the association of exposure to Occupational Physical Activity (OPA) with all-cause mortality and incidence of cardiovascular diseases (CVD).

Methods

The study population was composed of three Italian cohorts: a national cohort of employees participating in the National Health Survey 2005, followed-up until 2014 (ILS 2005), and two urban cohorts of employees resident in Turin at 2001 and 2011 censuses (TLS 2001 and TLS 2011, respectively), both followed-up until 2018. Follow-up was conducted through individual record-linkage with death registries and hospital admissions archives. Exposure to OPA was assigned through an Italian job-exposure matrix (JEM). Relative Risks of both CVD incidence and overall mortality associated with OPA quartiles (IRR) were estimated using Poisson regression models adjusted for socio-demographics and health, and in the national cohort, also for leisure time physical activity, BMI, smoking, diabetes, and hypertension.

Results

Compared to the lowest quartile, the highest OPA quartile was associated in both genders with significantly increased mortality in TLS 2001 (IRR = 1.11 among men, IRR = 1.20 among women) and in TLS 2011 (IRR = 1.27 among men and IRR = 1.73 among women), whereas in the ILS 2005 cohort no association was found. Among women, high OPA was also associated with CVD risk in TLS 2001 and 2011 (IRR = 1.39 and IRR = 1.16 for the highest quartile, respectively), while in the ILS cohort in both genders only the third quartile showed a significantly higher risk.

Conclusion

Our results indicate that OPA does not have a beneficial effect on CVD and mortality, but rather suggest that it may produce deleterious health effects.

目的 研究暴露于职业体力活动(OPA)与全因死亡率和心血管疾病(CVD)发病率之间的关系。方法 研究对象由三个意大利队列组成:一个是参加 2005 年全国健康调查的全国雇员队列,随访至 2014 年(ILS 2005);另一个是 2001 年和 2011 年人口普查时居住在都灵的两个城市雇员队列(分别为 TLS 2001 和 TLS 2011),均随访至 2018 年。跟踪调查是通过与死亡登记处和入院档案的个人记录链接进行的。OPA暴露是通过意大利工作暴露矩阵(JEM)分配的。使用泊松回归模型估算了与OPA四分位数相关的心血管疾病发病率和总死亡率的相对风险(IRR),并对社会人口统计学和健康状况进行了调整,在全国队列中还对闲暇时间体育活动、体重指数、吸烟、糖尿病和高血压进行了调整。结果与最低四分位数相比,在TLS 2001(男性IRR=1.11,女性IRR=1.20)和TLS 2011(男性IRR=1.27,女性IRR=1.73)中,OPA最高四分位数与男女死亡率的显著增加有关,而在ILS 2005队列中则没有发现这种关联。结论我们的研究结果表明,OPA 对心血管疾病和死亡率并无益处,反而可能对健康产生有害影响。
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引用次数: 0
Risk of obstructive sleep apnea among health workers: results of a screening in a large Italian University Hospital 医务工作者患阻塞性睡眠呼吸暂停的风险:意大利一所大型大学医院的筛查结果
IF 3 3区 医学 Q1 Medicine Pub Date : 2023-12-12 DOI: 10.1007/s00420-023-02029-9
Gianluca Spiteri, Maria Grazia Lourdes Monaco, Angela Carta, Francesco Taus, Lorena Torroni, Giuseppe Verlato, Stefano Porru

Purpose

Obstructive sleep apnea (OSA) is a common respiratory sleep disorder, related to increased mortality, poor quality of life, and higher risk of work accidents and injuries. Studies on the risk of OSA (rOSA) among health workers (HW) are scant. The aims of this study were to investigate this issue in a large University Hospital and to assess the effectiveness of a screening program.

Methods

The STOP-BANG questionnaire (SBQ) was sent via e-mail to the 5031 HW employed at the University Hospital of Verona. HW who completed the SBQ were classified at low, moderate, and high rOSA. HW at high rOSA were invited to undergo nocturnal polygraphy. The determinants of rOSA were studied by non-parametric Kruskal–Wallis test, Pearson's chi-squared, and multinomial logistic model.

Results

Of 5031 HW, 1564 (31.1%) completed the online questionnaire. Responders with low, moderate, and high rOSA were 72.7%, 13.7%, and 13.6%. Male gender, older age, and higher body mass index (BMI) were significant predictors of high rOSA, as expected. Physicians had the lowest probability of being in the high-risk category. Polygraphy was performed in 64 subjects. The positive predictive value of the self-administered SBQ was 68.8% (95%C.I. 55.9–79.8%) but raised to 96.9% (95%C.I. 89.2–99.6%) when re-administered by medical staff.

Conclusion

SBQ showed its effectiveness as a screening tool in detecting undiagnosed OSA in HW. Systematic screening for OSA in work settings could allow early diagnosis and treatment, reducing short- and long-term health effects of OSA.

目的阻塞性睡眠呼吸暂停(OSA)是一种常见的呼吸性睡眠障碍,与死亡率增加、生活质量下降以及工作事故和伤害风险增加有关。关于卫生工作者(HW)中阻塞性睡眠呼吸暂停(rOSA)风险的研究很少。本研究的目的是在一家大型大学医院调查这一问题,并评估筛查计划的有效性。方法采用电子邮件方式对维罗纳大学医院5031名住院医生进行STOP-BANG问卷调查。完成SBQ的志愿者被分为低、中、高三个等级。高蔷薇的HW被邀请进行夜间测谎。采用非参数Kruskal-Wallis检验、Pearson卡方检验和多项logistic模型研究rOSA的影响因素。结果5031名在校生中,有1564名(31.1%)完成了在线问卷调查。低、中、高rOSA应答者分别为72.7%、13.7%和13.6%。正如预期的那样,男性、年龄较大和较高的身体质量指数(BMI)是高rOSA的显著预测因素。医生成为高危人群的可能性最低。对64名受试者进行了测谎。自我给药SBQ阳性预测值为68.8% (95% c.i.)。55.9-79.8%),但上升至96.9% (95% ci。89.2-99.6%),由医务人员重新管理。结论sbq可作为一种有效的筛查工具,用于检测HW患者未确诊的OSA。在工作环境中对阻塞性睡眠呼吸暂停进行系统筛查可以实现早期诊断和治疗,减少阻塞性睡眠呼吸暂停对健康的短期和长期影响。
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引用次数: 0
Relationship between exposure to metalworking fluids and nonalcoholic fatty liver disease 接触金属加工液与非酒精性脂肪肝之间的关系
IF 3 3区 医学 Q1 Medicine Pub Date : 2023-12-09 DOI: 10.1007/s00420-023-02025-z
Weiling Chan, Geyang Li, Li Zhou, Jin Wang, Lin Song, Lejia Zhu, Lan Lin, Beining Wu, Jing Xiao, Yulong Lian

Objective

The relationship between metalworking fluids (MWFs) and nonalcoholic fatty liver disease (NAFLD) has not been previously explored. We aim to investigate the relationship between occupational exposure to MWFs and the prevalence of NAFLD and to determine the cumulative exposure threshold per day.

Methods

In 2020, 2079 employees were selected randomly from one computer numerical control machining factory in Wuxi for a questionnaire survey, and occupational health examinations were conducted at the affiliated branch of Wuxi Eighth People's Hospital. MWF samples were collected within the factory using the National Institute for Occupational Safety and Health (NIOSH) 5524 method. NAFLD was defined as having a hepatic steatosis index (HSI) ≥ 36 without significant alcohol consumption. The relationship between NAFLD and MWFs was analyzed using logistic regression, and the daily exposure threshold was calculated using R software.

Results

MWF exposure was found to be a risk factor for NAFLD in exposed workers compared to the non-exposed group. The OR for NAFLD in workers exposed to MWFs compared to controls was 1.42 (95% CI: 1.04–1.95). An increased risk of NAFLD was shown to be associated with an increasing dose. The daily exposure dose threshold to MWFs was found to be 6.54 mg/m3 (OR = 2.09, 95% CI: 1.24–3.52).

Conclusion

An association between occupational exposure to MWFs and NAFLD was found. As the concentration of exposure rose, the prevalence of NAFLD was also escalated.

目的 以前从未探讨过金属加工液(MWF)与非酒精性脂肪肝(NAFLD)之间的关系。方法 2020年,我们从无锡一家计算机数控加工厂随机抽取了2079名员工进行问卷调查,并在无锡市第八人民医院附属分院进行了职业健康检查。采用美国国家职业安全与健康研究所(NIOSH)的 5524 方法在工厂内采集 MWF 样本。非酒精性脂肪肝的定义是肝脏脂肪变性指数(HSI)≥36,且无明显饮酒。采用逻辑回归分析了非酒精性脂肪肝与 MWF 之间的关系,并使用 R 软件计算了每日暴露阈值。与对照组相比,暴露于MWF的工人患非酒精性脂肪肝的OR值为1.42(95% CI:1.04-1.95)。非酒精性脂肪肝风险的增加与剂量的增加有关。MWFs的日暴露剂量阈值为6.54毫克/立方米(OR = 2.09,95% CI:1.24-3.52)。随着接触浓度的升高,非酒精性脂肪肝的发病率也随之升高。
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引用次数: 0
Effects of ambient air pollution on the hospitalization risk and economic burden of mental disorders in Qingdao, China 环境空气污染对中国青岛精神障碍住院风险和经济负担的影响
IF 3 3区 医学 Q1 Medicine Pub Date : 2023-12-07 DOI: 10.1007/s00420-023-02030-2
Yuanyuan Cheng, Yujie Meng, Xiao Li, Junbo Yin

Objective

The aim of this study was to examine the impacts of short-term exposure to air pollutants on hospitalizations for mental disorders (MDs) in Qingdao, a Chinese coastal city, and to assess the corresponding hospitalization risk and economic cost.

Methods

Daily data on MD hospitalizations and environmental variables were collected from January 1, 2015, to December 31, 2019. An overdispersed generalized additive model was used to estimate the association between air pollution and MD hospitalizations. The cost of illness method was applied to calculate the corresponding economic burden.

Results

With each 10 μg/m3 increase in the concentration of fine particulate matter (PM2.5) at lag05, inhalable particulate matter (PM10) at lag0, sulfur dioxide (SO2) at lag06 and ozone (O3) at lag0, the corresponding relative risks (RRs) and 95% confidence intervals (CIs) were 1.0182 (1.0035–1.0332), 1.0063 (1.0001–1.0126), 1.0997 (1.0200–1.1885) and 1.0099 (1.0005–1.0194), respectively. However, no significant effects of nitrogen dioxide (NO2) or carbon monoxide (CO) were found. Stratified analysis showed that males were susceptible to SO2 and O3, while females were susceptible to PM2.5. Older individuals (≥ 45 years) were more vulnerable to air pollutants (PM2.5, PM10, SO2 and O3) than younger individuals (< 45 years). Taking the Global Air Quality Guidelines 2021 as a reference, 8.71% (2,168 cases) of MD hospitalizations were attributable to air pollutant exposure, with a total economic burden of 154.36 million RMB.

Conclusion

Short-term exposure to air pollution was associated with an increased risk of hospitalization for MDs. The economic advantages of further reducing air pollution are enormous.

目的 本研究旨在探讨中国沿海城市青岛的空气污染物短期暴露对精神障碍(MD)住院率的影响,并评估相应的住院风险和经济成本。方法 收集了2015年1月1日至2019年12月31日期间MD住院率和环境变量的日常数据。采用过度分散广义相加模型估算空气污染与急性呼吸系统疾病住院率之间的关系。结果细颗粒物(PM2.结果细颗粒物(PM2.5)、可吸入颗粒物(PM10)、二氧化硫(SO2)和臭氧(O3)的浓度每增加 10 微克/立方米(滞后 05 天),相应的相对风险(RRs)和 95% 置信区间(CIs)分别为 1.0182(1.0035-1.0332)、1.0063(1.0001-1.0126)、1.0997(1.0200-1.1885)和 1.0099(1.0005-1.0194)。然而,二氧化氮(NO2)和一氧化碳(CO)没有明显的影响。分层分析表明,男性易受二氧化硫和臭氧的影响,而女性易受 PM2.5 的影响。老年人(≥ 45 岁)比年轻人(< 45 岁)更容易受到空气污染物(PM2.5、PM10、SO2 和 O3)的影响。以《2021 年全球空气质量指南》为参考,8.71%(2 168 例)的 MD 住院病例可归因于空气污染物暴露,总经济负担为 1.5436 亿元人民币。进一步减少空气污染将带来巨大的经济效益。
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引用次数: 0
期刊
International Archives of Occupational and Environmental Health
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