International Archives of Occupational and Environmental Health最新文献

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.

Purpose: Little is known about the relationship between conflict at work and incident chronic low back pain (CLBP). Thus, this retrospective cohort study analyzed the association between conflict at work and the five-year incidence of CLBP in adults living in Germany.

Methods: This study included individuals aged 18-65 years reporting conflict at work for the first time in one of 1,293 general practices in Germany between 2005 and 2022 (index date). Patients not reporting conflict at work were matched (5:1) to those reporting conflict at work using a propensity score based on multiple demographic and clinical variables. In people not reporting conflict at work, the index date was a randomly selected consultation in 2005-2022. CLBP corresponded to two diagnoses of LBP at least three months apart. The relationship between conflict at work and incident CLBP was studied using Cox regression models.

Results: There were 16,925 patients reporting (mean [SD] age 39.5 [13.0] years; 63% women) and 84,625 patients not reporting conflict at work (mean [SD] age 39.6 [12.9] years; 64% women). Conflict at work was not associated with incident CLBP in the overall population (HR = 1.07, 95% CI = 0.99-1.14). However, there was a positive and significant association for CLBP without sciatica, individuals aged 18-30 years, and those with no history of low back pain before the index date.

Conclusion: Conflict at work may be a predisposing factor for CLBP without sciatica, highlighting the need to prevent conflict in the workplace. Further research is warranted to corroborate these results in other countries.

Background: Mitochondrial DNA copy number (mtDNAcn) is an effective biomarker to evaluate the effects of cationic metals on mtDNA integrity and function. In this study, we explored the relationships between individual and combined urinary metal concentrations and mtDNAcn among workers.

Methods: Blood mtDNAcn and urinary metal concentrations were quantified in a cohort of 328 participants. Restricted cubic spline (RCS) models were applied to explore potential non-linear association, while generalized linear models (GLMs) were utilized to assess the associations between urinary metal levels and blood mtDNAcn. We further explored the combined effects of multiple metals on mtDNAcn through quantile g-computation (GQC) and Bayesian kernel machine regression (BKMR).

Results: The dose-response relationship between nickel (Ni) and mtDNAcn exhibited an inverted U-shaped pattern. Notably, GLMs revealed significant reductions in mtDNAcn associated with Ni and silver (Ag) in the second quartile. An overall inverse association between urinary metal mixture and mtDNAcn was observed in the BKMR model when urine dilutions were SG-adjusted. Cre-adjusted lead (Pb) was identified as the primary contributor to decreased mtDNAcn, while SG-adjusted lithium (Li) was indicated as the most substantial contribution to mtDNAcn.

Conclusions: Urinary metal concentrations were associated with decreased mtDNAcn following SG adjustment. Future research should investigate these associations in a larger population with improved calibration techniques.

Objective: The association between high-dose ionizing radiation and the incidence of hypertension is well-established, whereas the impact of low-dose ionizing radiation (<20 mSv) on hypertension remains uncertain. The aim of this study is to assess the risk of hypertension among petroleum workers workers following long-term exposure to low-dose ionizing radiation (<20 mSv).

Methods: The study began in July 2013 and was followed up to December 2019. The subjects were petroleum and petrochemical workers in Karamay, Xinjiang (n = 2658). The radiation type is ionizing radiation (X-rays, γ-rays), with a dose range of 0-110.84 mSv. This study identifies hypertension cases based on the "Chinese Guidelines for the Prevention and Treatment of Hypertension". logistic regression is the primary statistical methods employed in this study.

Results: Compared with the unexposed group, long-term low-dose ionizing radiation exposure is a risk factor for the incidence of hypertension (RR = 2.09, 95% CI = 1.40-3.06). middle (5.17-20.00 mSv) (RR = 2.70, 95% CI = 1.39-4.99), cutoff (20.00-48.33 mSv) (RR = 3.02, 95% CI = 1.38-6.13) and high cumulative exposure dose (48.33-110.84 mSv) (RR = 3.05, 95% CI = 1.46-5.96) are all associated with the incidence of hypertension, and the risk of hypertension increases with the increase of exposure dose. Low (>0-5.17 mSv), middle (5.17-20.00 mSv), cutoff (20.00-48.33 mSv)and high cumulative exposure dose (48.33-110.84 mSv) systolic and diastolic blood pressure increase with the increase of cumulative exposure dose (P < 0.05).

Conclusions: This study found that low-dose ionizing radiation (<20 mSv) is associated with the incidence of hypertension among petroleum workers. The cumulative exposure dose is related to the risk of hypertension in petroleum workers, as well as to their systolic and diastolic blood pressure.

Purpose: The rising prevalence of ASD has prompted extensive research into potential environmental risk factors, with air pollution particularly emerging as a major concern. A systematic review and meta-analysis on the effect of air pollutants and time of exposure (particularly, PM_2.5, PM₁₀, NO₂, and O₃) and the risk of ASD was therefore performed.

Methods: Following PRISMA guidelines and PROSPERO registration (Ref: CRD42023464592), a thorough literature search was conducted across multiple databases, including Scopus, PubMed/MEDLINE, Embase, PsycINFO, Web of Science, and Cochrane Library. The analysis included 27 studies encompassing 369,460 participants, 47,973 of whom were diagnosed with ASD.

Results: Preconception exposure to air pollutants showed a protective trend for PM_2.5, PM₁₀, and O₃ with a 10%, 5%, and 19% reduced risk of ASD, whereas NO₂ had a 28% higher likelihood of ASD. During gestation, PM_2.5 exposure increased ASD risk by 15%, with 13% and 9%, 25% and 7%, and 25% and 10% increases in ASD risk with PM_2.5 and NO₂ for the first, second, and third trimesters, respectively. In the first year of life, 20%, 8%, 33%, and 14% increases in risk were found for PM_2.5, PM₁₀, NO₂, and O₃, respectively, while such risk estimates increased to 179%, 60%, 12%, and 179% for the second year of life.

Conclusions: In this meta-analysis, the relationships between air pollutants and ASD risk revealed significant associations, particularly for PM_2.5 and NO₂. Exposure during preconception exhibited a protective trend, while postnatal exposure, particularly during the second year of life uncovered substantially higher ASD risk.

Background: In an effort to combat burnout, a study investigates Mindfulness-Based Stress Reduction (MBSR) training for nurses. The goal is to reduce stress and improve job satisfaction, ultimately enhancing patient care. These findings may inspire the development of mindfulness-based support systems for healthcare professionals to promote overall well-being in the workplace.

Materials and methods: A single-blinded, randomized controlled trial with 60 emergency medical center nurses was conducted to assess the effectiveness of an eight-session MBSR program in reducing stress and burnout. The randomization process, utilizing sealed envelopes, ensured unbiased allocation to intervention or control groups. The training program included group sessions focused on meditation, yoga, and discussions, with participants receiving educational materials and CDs for home practice. Collected data included demographics, Maslach Burnout Inventory, and Occupational Stress Questionnaire results. Statistical analysis, utilizing SPSS version 21, featured Kolmogorov-Smirnov, Mann-Whitney U, and Wilcoxon tests to evaluate outcomes.

Results: Following MBSR Training, the intervention group displayed statistically significant differences in all occupational stress subscales compared to the control group (P < 0.05). Post-intervention, the intervention group also exhibited significant differences in burnout subscale scores (P < 0.001) compared to the control group.

Conclusion: MBSR can boost resilience and job satisfaction, enhancing patient care. Healthcare organizations should integrate MBSR programs for nursing staff well-being and combat stress and burnout. Research should probe long-term impacts and effective delivery methods for sustained stress relief in nursing.

Trial registration: This study has registered in Iranian Registry of Clinical Trials by the number of IRCT20131112015390N5 on Jun 2022.