International Archives of Occupational and Environmental Health最新文献

Purpose: Recent studies indicate a potential link between exposure to atmospheric particulate matter 2.5 (PM2.5) and thyroid function, though epidemiological conclusions remain inconsistent. This comprehensive systematic review and meta-analysis aims to clarify the connection between PM2.5 levels and the risks of thyroid function and thyroid cancer.

Methods: Using the medical subject headings "PM2.5" and "thyroid hormones" along with their associated free words, publications from the Web of Science, Embase, Cochrane Library, and PubMed up to April 2024 were searched. The study protocol has been registered on PROSPERO (CRD42024554220).

Results: A total of 1322 articles were collected from databases, of which 27 studies were included in the analysis. The findings indicated that exposure to PM2.5 was a significant risk factor for hypothyroidism, increasing the incidence risk by 0.15 (95% CI 1.08, 1.23, P < 0.001). PM2.5 exposure levels were significantly higher in Asian populations than in European populations; each incremental increase in PM2.5 exposure resulted in a rise in TSH by 0.27 mIU/L (95% CI 0.07, 0.47, P = 0.008) and a decrease in FT4 by 0.21 pmol/L (95% CI - .35, - 0.07, P = 0.004). Additionally, in susceptible pregnant women, each incremental increase in PM2.5 exposure during pregnancy was associated with a rise in TSH levels by 0.08 mIU/L (95% CI - 0.02, 0.17, P < 0.001) and a decrease in FT4 levels by 0.09 pmol/L (95% CI - 0.23, 0.05, P = 0.210).

Conclusion: Our research establishes PM2.5 exposure as a risk factor for diminished thyroid function. In Asian populations, the average level of PM2.5 exposure is high, significantly affecting thyroid hormones (TSH, FT4). Particular attention to PM2.5 exposure levels during pregnancy is essential to reduce the risk of thyroid dysfunction.

Objective: Bone tissue is the chief target for lead (Pb) in chronic exposure. This study aimed to demonstrate the relation between the blood lead levels (BLL) and serum levels of 1,25 dihydroxy cholecalciferol (vitamin D3) and type I collagen cross-linked C-telopeptide (CTX-1) as a biomarker of bone turnover among some Egyptian workers occupationally exposed to Pb in the smelting process. The study also targeted to identify any clinical manifestations indicative of skeletal system affection and their association with the performed investigations.

Methods: A total of 48 smelter workers and 48 administrative controls participated in the study. All subjects underwent comprehensive medical and occupational history taking and detailed clinical examinations, with a particular focus on symptoms indicative of skeletal system involvement. These symptoms included generalized bony aches, low back pain, joint pain, restricted joint movement, a history of fractures from minor trauma, and delayed fracture healing. BLL, as well as serum levels of vitamin D3 and CTX-1, were measured in all participants.

Results: Smelter workers exhibited significantly higher prevalence of bony aches, low back pain, joint pain, and past fractures from minor trauma compared to controls. The BLL and serum CTX-1 levels were significantly elevated in the exposed group, while serum vitamin D3 levels were notably lower. Logistic regression analysis revealed that BLL significantly predicted bony aches and low back pain. Additionally, serum vitamin D3 and CTX-1 levels were significant predictors of low back pain and joint pain, respectively, among exposed workers. The measured parameters were significantly correlated with one another and with the duration of employment in the exposed group.

Conclusion: Significant associations between manifestations of skeletal system affection, BLL, and serum levels of vitamin D3 and CTX-1 were detected among smelter workers with chronic occupational exposure to Pb.

Objectives: Compare home health care (HHC) with self-governing and conventional team structure regarding self-reported low back pain (LBP) and work-related factors.

Methods: A natural experiment was assessed using a cross-sectional design. Primary outcome was LBP intensity; secondary outcomes included LBP duration and work limitations as well as intensity, duration and work limitations of neck/shoulder pain, stress, productivity, influence at work, meaning at work, sickness absence, interpersonal collaboration, and variation in physical behaviour. Home health care (HHC) workers in the self-governing teams were surveyed about their appraisal of the self-governing structure. Data were collected through a questionnaire, except for physical behaviour, which was obtained via accelerometry. Differences between groups were analyzed using t-tests.

Results: From 10 HHC-teams across four municipalities, 125 HHC-workers completed the questionnaire (self-governing n = 60; conventional n = 65). LBP intensity was similar among HHC-workers in the two team structures (self-governing = 4.1; conventional = 4.0, 0-10 scale). Self-governing teams experienced significantly higher levels of (i) meaning at work (5.8 points, 0-100 scale), (ii) improved collaboration with manager (7.5 points, 0-100 scale) and (iii) improved collaboration with needs assessors (11.9 points, 0-100 scale) compared to conventional teams. No significant differences were found in the other outcomes.

Conclusions: The higher scores for self-governing teams in meaning at work, collaboration with manager and collaboration with needs assessors are positive. The lack of a lower report in LBP and neck/shoulder pain calls for more focused efforts to enhance HHC-workers' health in addition to the reorganization into the self-governing structure.

Purpose: The Royal Netherlands Marechaussee, a branch of the Dutch Military, is characterised by a diverse range of mentally and physically demanding occupational tasks. The employability of the personnel depends on the balance between occupational demands and personal resources, which can be measured through the work ability score. Therefore, this study investigates personal and work-related determinants of work ability in a branch of the Dutch Military.

Methods: We gathered cross-sectional data through a survey distributed among all operational Royal Netherlands Marechaussee personnel (n: 7,658). We used binomial logistic regression analysis to estimate the relationship between determinants in four domains (i.e., personal, workload, work characteristics, and work experience) and the dichotomised work ability scores (poor to moderate vs. good to excellent).

Results: The survey had a 20% response rate with 1538 respondents. Our study included a slightly higher percentage of reservists and civilians than the Royal Netherlands Marechaussee's workforce. Forty per cent of participants rated their work ability as poor or moderate. Good or excellent work ability was related to older age (> 50 years compared to < 29 years), lower physical workload, no shift work, less fatigue, more autonomy, task clarity, and social support.

Conclusions: We found that 40% of survey respondents rated their work ability as low or moderate. In the future, factors like shift work, autonomy, task clarity, and social support may be used to improve work ability in this population.

Purpose: This study aimed to evaluate the combined effects of a 12-week ergonomic training and exercise program on musculoskeletal pain and ergonomic risks among supermarket cashiers.

Methods: This study cohort comprised 77 cashiers, aged between 18 and 45, who were experiencing musculoskeletal pain. Of these, 60 participants completed the study after random assignment to either the intervention group, which received ergonomic training and exercise, or the control group, which received only ergonomic training. The study lasted 12 weeks, with assessments conducted at baseline (week 0) and 12 weeks post-intervention. The outcomes included the Visual Analogue Scale, the Extended Nordic Musculoskeletal Questionnaire (NMQ-E), and the Rapid Upper Limb Assessment. The clinical trial registration number is NCT06407440.

Results: Musculoskeletal pain in the upper back, lower back, and hips/thighs decreased significantly after the intervention, while there were no significant changes in the control group, except for a reduction in upper back pain. A significant improvement in activity limitations was observed in the intervention group, particularly in the upper back and lower back. Consultations with health professionals for upper and lower back pain (NMQ-E) decreased significantly in the intervention group. Symptoms in the past 7 days showed a significant decrease in the intervention group, especially for the upper back, lower back, and hips/thighs, with no significant change in the control group.

Conclusion: The integrated approach of ergonomic training and exercise programs has the potential to alleviate musculoskeletal discomfort among supermarket cashiers. These interventions may prove an effective strategy for enhancing the well-being of workers in physically demanding retail environments.

Purpose: World Trade Center (WTC) rescue/recovery workers were exposed to materials hazardous to health. Previous studies found lower than expected mortality among WTC rescue/recovery workers when compared to general populations, possibly due to healthy worker effects, better healthcare access and/or incomparability of the groups. We compared mortality rates in WTC-exposed law enforcement officers (LEOs) with rates in LEOs employed by the Buffalo, NY, Police Department. We also compared both cohorts to the general population.

Methods: Follow-up began at the later of one year after enrollment date or 1/1/2005 and ended at the earlier of death date or 12/31/2018. Analyses were restricted to ages 40-79 years (N = 11,476 WTC LEOs, N = 1668 non-WTC LEOs). We estimated standardized mortality ratios (SMRs) in each cohort using stratum-specific US mortality rates. Relative rates (RRs) and 95% CIs were estimated for the WTC vs. the Buffalo cohort using Poisson regression models adjusted for sex, race, age-group, and calendar-period.

Results: 185 deaths were observed in the WTC cohort and 186 in the Buffalo cohort. All-cause and cause-specific SMRs were significantly lower in the WTC cohort. Similarly, the adjusted all-cause mortality RR for the WTC vs. Buffalo cohorts was 0.30 (95% CI = 0.23-0.40). The cause-specific mortality RRs were all significantly < 1.

Conclusion: We found lower overall and cause-specific mortality rates in WTC LEOs compared with both the general population and Buffalo LEOs. These results suggest that factors other than healthy worker effects, such as access to healthcare via the WTC Health Program, contribute to lower mortality rates in WTC rescue/recovery workers.

Purpose: This study aimed to identify distinct patterns of pesticide poisoning in Brazil through the cluster analysis of epidemiological data from 2011 to 2019.

Methods: A cross-sectional analysis of 49,233 confirmed pesticide poisoning cases was conducted using multiple correspondence analysis and hierarchical clustering. Data from the Brazilian Notifiable Diseases Information System were analyzed by region, demographics, and exposure types.

Results: Three distinct clusters were identified. Cluster 1 was characterized by severe cases, predominantly involving suicide attempts (~90%), required treatment (99.1%) and fatality rates (93.2% of all cases). Exposures were mostly domestic and occurred via ingestion, with a strong prevalence in the Northeast. Cluster 2 consisted mainly of pediatric cases, marked by accidental and acute domestic exposures, and showed minimal representation in the Southeast and South regions. Cluster 3 had a male predominance (80.1%) and was strongly associated with occupational and chronic exposures, involving cutaneous and respiratory routes, and was most prevalent in the Central-West.

Conclusion: The study reveals significant regional and demographic disparities in pesticide poisoning across Brazil. These findings underscore the urgent need for targeted public health interventions and stricter pesticide regulations to address regional vulnerabilities and mitigate pesticide-related harm.

Background: Exposure to occupational noise could lead to detrimental health outcomes by inducing oxidative stress mechanisms. In this study, we sought to investigate the impact of occupational noise exposure on serum and/or plasma levels of oxidative stress markers.

Methods: We performed a thorough search across PubMed, Web of Science, and SCOPUS for articles comparing oxidative stress markers, including malondialdehyde (MDA) and/or superoxide dismutase (SOD) and/or glutathione peroxidase (GPx) and/or total antioxidant capacity (TAC), in individuals occupationally exposed to high noise and unexposed controls. The random-effects model was applied to determine the standardized mean difference (SMD) and the associated 95% confidence interval (CI).

Results: Seven primary studies were included. The analysis encompassed a total of 989 workers, including 537 individuals exposed to occupational noise levels exceeding 85 dB and 452 workers exposed to noise below 85 dB. Meta-analysis indicated that workers with high noise exposure exhibited significantly elevated TAC levels (SMD, 2.74; 95% CI: 1.87 to 3.61; p = 0.00; I² = 88.75%) and SOD levels (SMD, 0.90; 95% CI, 0.47 to 1.33; p = 0.00; I² = 69.32%), while no significant differences were observed among the groups regarding MDA levels (SMD, 1.03; 95% CI, -0.12 to 2.18; p = 0.08; I² = 97.30%) and GPx levels (SMD, 1.35; 95% CI, -0.41 to 3.11; p = 0.13; I² = 98.63%).

Conclusion: Our results suggest that TAC and SOD levels are elevated in workers exposed to high noise, potentially indicating heightened free radical production. However, no significant differences were found in MDA and GPx levels, warranting further investigation. Early detection and intervention may help reduce the harmful health impacts of noise exposure.

Background: The unique characteristics of air pollution in high-altitude regions may significantly influence the transmission and incidence of influenza. However, current research on this phenomenon is limited, and further investigation is urgently needed.

Methods: This study collected influenza outpatient data from Qinghai Province between January 1, 2016, and December 31, 2021. We employed a time-stratified case-crossover design combined with conditional Poisson regression models to quantitatively analyze the relationship between air pollutants (PM_2.5, SO₂, NO₂) and influenza incidence and explored the moderating role of temperature in this relationship. Additionally, stratified analyses were conducted to identify potential vulnerable populations.

Results: The study results indicated that exposure to PM_2.5, SO₂, and NO₂ was positively associated with the risk of influenza incidence. For every 10 µg/m³ increase in the concentration of PM_2.5, SO₂, and NO₂, the percentage change in relative risk (RR) of influenza incidence was 0.35% (95% CI: 0.02%, 0.68%), 2.24% (95% CI: 1.42%, 3.06%), and 1.91% (95% CI: 1.16%, 2.67%), respectively. Under low-temperature conditions, the impact of pollutants other than O₃ on influenza incidence was particularly pronounced. Children, the elderly, and individuals living at altitudes of 3000-3500 m were more sensitive to these pollutants.

Conclusion: This study revealed a close link between air pollution and influenza in high-altitude regions, with greater health risks under low-temperature conditions. The findings underscore the necessity of strengthening air quality monitoring and raising public awareness of environmental health.

Purpose: This study examines the link between high occupational noise exposure and atrial fibrillation (AF), given the limited existing evidence.

Methods: We conducted a cross-sectional study among participants from a large heavy industry enterprise in China. High noise exposure was defined as an equivalent A-weighted sound level (LAeq, 8 h) of ≥ 80 dB(A) during an 8 h workday. Statistical analyses included univariate analysis to assess relationships between high noise exposure, cardiovascular risk factors, and AF. Mediation analysis identified potential mediators between high noise exposure and AF. Propensity score matching (PSM) and multivariable analysis were used to evaluate the independent association between high noise exposure and AF.

Results: A total of 4530 participants were included, with 1526 experiencing high noise exposure, and 167 diagnosed with AF. Adjusted mediation analysis revealed that sleep disorders, hypertension, dyslipidemia, and dietary quality were the primary mediators for AF among those exposed to high noise, accounting for 12.4%, 9.6%, 8.9%, and 6.7% of the effect, respectively. PSM analysis showed a significantly higher proportion of AF in individuals with high noise exposure compared to those with low exposure (5.4% vs. 3.0%, P = 0.003). Multivariable analysis indicated that the risk of AF was doubled in individuals with high noise exposure (OR = 1.99, 95% CI 1.38-2.88, P < 0.001).

Conclusion: High occupational noise exposure increases the risk of AF in the working population, acting both as an independent risk factor and through mediation effects. Sleep disorders, hypertension, dyslipidemia, and dietary quality are the main mediators. These findings highlight the importance of integrating noise control with cardiovascular health management in workplace safety policies to prevent AF among industrial workers.

Trial registration number: ChiCTR2300077951, registered on November 24, 2023, in the Chinese Clinical Trial Registry.