Occupational and Environmental Medicine最新文献

Objective: To describe cause-specific mortality patterns of banana plantation workers in the French West Indies.

Methods: The study included 11 221 farmers and farm workers who had work in banana cultivation in the French West Indies (Guadeloupe or Martinique) between 1973 and 1993, followed up from January 1981 to December 2017. We calculated standardised mortality ratios (SMRs), causal mortality ratios (CMRs) and relative standardised mortality ratios (rSMRs) using regional reference rates.

Results: SMR analyses showed mortality deficits in the overall mortality and for almost all causes of deaths. In contrast, analyses using CMRs revealed a significant excess in the overall mortality. The CMRs were significantly elevated for all cancers combined and for stomach cancer, colorectal cancer, prostate cancer and haematopoietic malignancies, as well as for several non-cancer causes of death, including diabetes mellitus, Parkinson's disease, Alzheimer's disease, non-ischaemic heart diseases, pneumonia and diseases of the skin and subcutaneous tissue. rSMRs were in general consistent with CMRs with regards to the direction of the association, although rSMRs were lower and in some instances not statistically significant.

Conclusion: The CMR approach showed an elevated mortality for several causes of death, for which work in banana farming and/or exposure to pesticides are plausible explanations.

Objectives: This study examined the association between daily long working hours (LWHs) and diverse health-related outcomes, using objective and subjective measures. It further evaluated the specific durations of daily LWHs that may be considered inappropriate in cases with adverse health effects.

Methods: 98 employees participated in a 10-day observational study. Participants self-reported their daily working hours, subjective states and performed the measurement of blood pressure (BP) and psychomotor vigilance test (PVT) immediately on waking and before bedtime. Objective sleep was recorded nightly using actigraphy. Linear mixed model (LMM) analysis was performed.

Results: LWHs were significantly associated with higher systolic BP (β=0.65), greater fatigue (β=1.79) before bedtime, shorter total sleep time (TST; β=-0.09) and higher systolic BP (β=0.76) on waking (all p<0.05). Reduced TST was significantly linked to slower PVT reciprocal response time (β=0.03), higher lapse (β=-1.10) and greater sleepiness (β=-0.20) after waking (all p<0.05). Categorical LMM analysis revealed that working >12 hours was significantly associated with increased fatigue before bedtime, whereas working >13 hours significantly reduced TST compared to working ≤9 hours. Sleeping <6 hours caused significantly poorer PVT outcomes, and sleeping <5 hours caused significantly stronger sleepiness after waking than sleeping ≥7 hours.

Conclusions: Daily LWHs and consequent reductions in sleep duration were associated with adverse outcomes. These findings underscore the importance of daily management of work hours and adequate sleep duration to prevent excessive workload and promote recovery from occupational demands.

Surgeons face a significant risk of work-related musculoskeletal disorders due to the demands of their profession. However, the effects of physical activity interventions (eg, exercises or active and passive microbreaks) remain unclear. This study aimed to evaluate the effects of physical activity interventions on musculoskeletal health in the surgical population.A systematic literature search was conducted between 15 April 2024 and 30 May 2024, using six databases. We only included experimental studies, and meta-analyses were conducted for active microbreaks, while we narratively synthesised the results for other physical activity interventions due to small number of studies. The level of evidence was evaluated using Grading of Recommendations Assessment, Development and Evaluation.Among 5576 identified articles, a total of 9 articles were included. For active microbreaks, the meta-analyses showed pooled estimates between -0.24 (95% CI -0.36 to -0.11) and -0.62 (95% CI -0.87 to -0.37) for pain in body regions related to the spine, upper extremity and lower extremity. For passive microbreaks, significantly lower levels of musculoskeletal pain and strain were found in the spine, neck, arms and knees at the end of the procedure compared with no intervention. For exercise with and without ergonomic counselling, a significant decrease in pain was found from baseline to 3, 6 and 12 months in most body parts. For all intervention types, the level of evidence ranged from very low to low.We found that physical activity interventions have positive effects on the musculoskeletal health of surgeons. However, the low level of evidence highlights the need for high-quality research.

Trace elements play crucial roles in regulating biological functions and maintaining homeostasis, but toxic metals may exert detrimental effects on the human body even at low doses. Prenatal elements exposure was related to children's anthropometric outcomes at single time points. However, most existing studies ignore the dynamic characteristics of child growth and the evolving trajectories of physical development. This review systematically examines the associations between prenatal trace elements and toxic metals exposure and childhood growth and development, with a particular focus on changes in longitudinal growth trajectories. A comprehensive search was conducted across four electronic databases, and 24 studies were included in the final analysis. Maternal exposure to elevated concentrations of trace elements such as vanadium, chromium and manganese has been linked to physical growth restriction in children. In contrast, prenatal exposure to other trace elements, including zinc, calcium and copper, appears to have positive effects on child growth and development. The effects of lithium exposure during pregnancy have not been fully determined. Moreover, children's growth parameters and trajectories are generally negatively affected by exposure to toxic metals, such as lead, cadmium and mercury. This review provides evidence that prenatal element exposure plays an important role in offspring growth and development, and further research is needed to better elucidate the underlying mechanisms of these effects.

Objectives: Firefighters face a range of hazards, including strenuous tasks in high-temperature environments and exposure to chemicals. These hazards may increase the risk of kidney diseases. However, limited evidence supports this hypothesis within this occupational group. Hence, this study aimed to assess the relationship between firefighting and kidney diseases.

Methods: A cohort comprising 10 094 male Danish firefighters was analysed, including 3455 full-time and 6639 part-time/volunteer firefighters. Diagnoses of kidney disease from 1994 to 2014 were retrieved from the Danish National Patient Registry. Morbidity among firefighters was compared with that of a sample of the male working population, and standardised incidence ratios (SIR) were used to estimate relative risks.

Results: The results indicated a positive association between full-time firefighting and urolithiasis (SIR 1.36; 95% CI 1.13 to 1.63). Shorter employment (<5 years) was associated with a higher risk of glomerulonephritis and chronic kidney disease, whereas longer employment (≥5 years) was linked to lower risks for most outcomes, except for urolithiasis, which remained elevated regardless of employment duration. Full-time specialised smoke divers were indicated to have a higher risk of glomerulonephritis, renal failure and chronic kidney disease. Urolithiasis risk was associated with an elevated risk in both regular and specialised full-time firefighters. Risk estimates for the assessed kidney diseases among part-time/volunteer firefighters generally reflected a lower risk.

Conclusions: This study provides evidence for elevated risks of certain kidney diseases in full-time firefighters, especially urolithiasis. Awareness of sufficient hydration in relation to extreme heat exposures may be particularly important among firefighters.

Objectives: Small airways obstruction (SAO) has been associated with lifetime exposure to several agents in the workplace. Whether this association is modified by genetic variants is unknown.

Methods: Using data from 147 317 adults (33 552 with SAO; 108 762 without SAO) participating in the UK Biobank, we conducted a genome-wide association analysis to identify genetic variants associated with SAO at baseline, defined as the forced expiratory volume in 3 s to 6 s ratio (FEV₃/FEV₆) below the lower limit of normal. We assigned occupational exposures using the ALOHA+ job exposure matrix. Using cross-sectional data from 38 911 participants (8363 with SAO; 30 548 without SAO), who had complete job histories, we assessed whether the identified genetic variants interacted with occupational exposures on SAO using logistic regression models adjusted for confounders. Additionally, we investigated whether gene-occupational exposure signals were associated with gene expression in lung tissue.

Results: We identified 36 genetic variants significantly associated with SAO. Eight of these significantly modified the association of SAO with pesticides, vapour, gases, dusts, fumes and metals, with participants homozygous for the reference allele being at increased risk of SAO when exposed to these agents. Only two of these genetic variants (rs9273529 and rs644045) appeared to affect gene expression in lung tissue. We found no significant interactions with solvents.

Conclusions: Using a large population-based cohort, we identified genetic variants that interact and modify the association between SAO and several common workplace exposures. Further research is needed to confirm these effect modification findings and clarify potential biological mechanisms.

Objectives: There is a lack of knowledge about whether occupational exposures increase the risk of emphysema, especially in never-smokers. Our objective was to determine if occupational exposures are associated with emphysema and impaired diffusing capacity.

Methods: In the Swedish CArdioPulmonary bioImage Study (SCAPIS), persons from the general population aged 50-64 answered a questionnaire and underwent CT of the lung as well as assessment of the diffusing capacity of their lungs for carbon monoxide (DL_CO), presented as DL_CO

Results: In this cross-sectional study (27 370 persons including 13 981 never-smokers), occupational exposure to inorganic dust was associated with emphysema (OR 1.25, 95% CI 1.07 to 1.47), also among never-smokers, (OR 1.46, 95% CI 1.00 to 2.11). There were associations with DL_COCOCO, there was an association with inorganic dust (OR 1.65, 95% CI 1.20 to 2.28), also among never-smokers (OR 3.79, 95% CI 1.35 to 10.63).

Conclusions: Occupational exposures to inorganic dust are associated with emphysema. The association is stronger in those with the combination of emphysema and impaired DL_CO indicating serious exposure effects in the alveoli.

Objectives: Teachers' mental health, an important asset for society, may be impacted by security or health crises alongside more structural changes. Our primary aim was to assess 2012-2022 trends in depressive symptoms among French teachers compared to similar employees. We further examined concomitant trends in job dissatisfaction.

Methods: Within the ongoing French national CONSTANCES cohort, depressive symptoms were regularly assessed (up to four times between 2012 and 2022) using the Center for Epidemiologic Studies-Depression scale (CES-D, score 0-60). We used mixed models adjusted for sociodemographic factors to estimate mean parameters (95% CI) of CES-D variations between 2012 and 2022 among teachers (n=15 022) compared with other intermediate or managerial/professional occupations (n=21 361). We similarly studied changes in job dissatisfaction (score 1-8) from 2018 (first occurrence in questionnaires) to 2022.

Results: In 2012, teachers' CES-D was slightly lower on average compared with that of non-teachers (-0.66 point (-1.19 to -0.12)), but tended to increase more rapidly over the decade, particularly in the years concomitant to the COVID-19 pandemic (+0.14 point/year (0.01 to 0.27)). By 2022, the gap had closed. Job dissatisfaction followed a somewhat different pattern: slightly lower among teachers in 2018, it increased at first more rapidly compared with non-teachers, but then stabilised, in parallel with the waning of the pandemic.

Conclusions: Our study highlights unfavourable long-term trends in the mental well-being of French teachers. Although clinical changes at individual levels would be mostly imperceptible, our findings concern a large population of key professionals, suggesting their growing needs for mental health support in the long run.

Objectives: Evidence regarding the effect of psychosocial working conditions on adverse pregnancy outcomes remains inconclusive. We investigated whether four aspects of psychosocial working conditions were associated with adverse pregnancy outcomes.

Methods: In the Danish National Occupational Cohort with eXposure (DOC*X)-Generation cohort of employed pregnant women, 1977-2018, occupational quantitative demands, influence, emotional demands and physical violence, divided into tertiles, were assessed by job exposure matrices and linked with occupation during pregnancy from the Danish version of the International Standard Classification of Occupations 88. The Danish National Patient Register provided data on miscarriages and the Danish Medical Birth Register data on gestational age and birth weight to estimate preterm birth (PTB) and small for gestational age (SGA) in singleton pregnancies.

Results: The pregnancies in one million women resulted in 13% (~1 921 890 million) miscarriages, 13% (~1 604 96 million) SGA children and 5% (~1 482 493 million) PTB. The risk of miscarriage was higher among women in occupations with high emotional demands (adjusted odds ratio (adjOR)=1.20, 95% CI 1.18 to 1.21) and high physical violence (adjOR=1.24, 95% CI 1.23 to 1.26) compared with those in occupations with low exposure. The combined effect of quantitative demands and influence showed no association or ORs<1 for miscarriage compared with combined low quantitative demands/high influence. The findings on SGA and PTB were inconsistent (adjORs 0.91-1.06).

Conclusions: Our findings suggest that emotional demands and physical violence at work are associated with higher odds of miscarriage, whereas associations between the different exposures and SGA and PTB were inconsistent. Further studies applying individual level measurements of psychosocial working conditions are warranted.

Objectives: The purpose of the current study was to evaluate differences in total sleep time and heart rate variability (HRV) in active-duty firefighters between on-shift and off-shift days.

Methods: 59 structural firefighters (age: 37.3±7.3 years; height: 1.80±0.08 m; weight: 88.9±14.1 kg and body mass index (BMI): 27.5±4.1 kg/m²) participated in this longitudinal observation study. Each morning for 15 weeks, firefighters were asked to sync a smart ring with a smartphone application to download night-time data, which were then extracted to a cloud-based software application for later analysis. The software also computed a readiness score each morning. All day types were coded as on-shift or off-shift.

Results: The average nightly sleep time for all firefighters was 6.95±1.24 hours. When off-shift, firefighters recorded more sleep compared with on-shift nights (off-shift: 6.97±0.50 hours vs on-shift: 6.68±0.52 hours; p<0.0001). HRV (p<0.0001) and readiness scores (p=0.02) were lower off-shift compared with on-shift. For the lagged correlation analysis, total sleep time was moderately positively correlated with the following day's readiness score.

Conclusions: Firefighters recorded more total sleep time when off-shift compared with on-shift; however, HRV and readiness scores were higher on-shift. The lag-time correlations indicate an association between sleep time and HRV or readiness scores, with approximately half of the variability in readiness being attributable to changes in total sleep time, which highlights the complexity of the readiness and HRV signals/systems.