Occupational and Environmental Medicine最新文献

Objectives: Night work disrupts sleep, which may increase inflammatory processes, pain sensitivity and pain perception. We investigated effects of night shifts on musculoskeletal pain (MSP) and other mental and somatic symptoms using day-to-day measurements in a within-person design. We also disentangled the effect of night work from the effects of shift-related differences in job demands and sleep.

Methods: We included 522 hospital employees with data on ≥1 day shift (n=1926) and ≥1 night shift (n=1422). Participants reported their working hours, MSP, other mental and somatic symptoms, sleep and psychosocial and physical job demands daily for 14 days. We estimated prevalence ratios (PRs) of MSP and symptoms when working night shifts compared with day shifts.

Results: After adjusting for age and job demands, night shifts were associated with pain in the lower extremities (PR 1.12; 95% CI 1.01 to 1.25), gastrointestinal symptoms (PR 2.12; 95% CI 1.26 to 3.53) and other mental and somatic symptoms (PR 2.54; 95% CI 1.31 to 4.91). Adjustment for sleep duration did not alter these findings. However, longer shift duration may explain the higher occurrence of lower extremity pain during night shifts.

Conclusions: We found no evidence of a general effect of night work on MSP. Only an acute effect on lower extremity pain was observed, which may be attributable to longer night shift duration. Employees also more frequently reported other types of symptoms when working night shifts, even after adjusting for job demands and sleep duration. Thus, physiological effects related to circadian misalignment may be a plausible explanation.

Noise-induced hearing loss (NIHL) remains a serious occupational risk in industrial settings with constant high noise exposure. Although Hearing Conservation Programmes (HCPs) are widely implemented, their effectiveness is limited by funding shortages, poor training and low compliance. This systematic review examines factors that facilitate or hinder HCP implementation, variations in program outcomes and the influence of employee attitudes, behavior and regulatory compliance. Methodological quality was assessed using the Effective Public Health Practices Project (EPHPP) tool, and risk of bias in non-randomized studies was evaluated with Risk of Bias in Non-Randomized Studies of Interventions (ROBINS-I).We searched PubMed, Web of Science, Scopus and Cochrane for English-language studies on industrial HCPs published between 2000 and 2024. Eligible designs included randomised or non-randomised trials, observational studies and mixed methods. Data extraction was guided by a standardised form capturing programme components such as training, monitoring, compliance strategies, participant characteristics and outcome indicators, which included hearing protection device usage, NIHL incidence and compliance.Nine studies from various industries met the criteria. Key facilitators included management commitment, worker involvement and tailored interventions that improved compliance and reduced NIHL. Common barriers were inconsistent training, discomfort with protective equipment and gaps between programme goals and workplace conditions. The findings also highlighted that consistent regulatory compliance and a supportive organisational culture play a critical role in the successful implementation of HCPs.Effective HCPs require context-specific designs addressing workplace barriers and enhancing facilitators. Future research should prioritise longitudinal studies to evaluate long-term sustainability and impact.

Objectives: Compared with silicosis, there has been less research on other respiratory diseases in stone benchtop industry workers. Therefore, we explored respiratory symptoms, airflow obstruction and asthma, including associations with workplace dust exposure, in these workers.

Methods: This study included voluntary participants from a stone benchtop industry screening programme conducted in Victoria, Australia, which included chest X-rays, respiratory function tests and a respiratory symptom questionnaire. Asthma status was determined based on self-report, and respiratory function tests were used to measure airflow obstruction. The associations between workplace dust exposure and respiratory symptoms were compared using logistic regression, adjusting for age, smoking status and silicosis.

Results: The prevalence of self-reported asthma in this cohort was 20% (90/450 workers). Workers with histories of high workplace dust exposure, even those without silicosis, were more likely to have self-reported asthma and to report respiratory symptoms. Those with obstruction but no bronchodilator response on respiratory function tests were more likely to report histories of high workplace dust exposure. For over half of workers with wheeze or difficulty breathing, symptoms improved at weekends and/or on holidays.

Conclusions: There was a high prevalence of self-reported asthma in stone benchtop industry workers and an association between workplace dust exposure and airflow obstruction without bronchodilator response, as well as self-reported asthma, independent of silicosis. These findings suggest a potential role of artificial stone dust exposure in the development of obstructive lung disease, in addition to silicosis.

Objectives: To prospectively determine the association between occupational biomechanical exposures and the incidence of surgically treated carpal tunnel syndrome (CTS) in Swedish male construction workers.

Methods: A cohort of 203 866 Swedish male construction workers who participated in a national occupational health surveillance programme between 1971 and 1993 were followed for CTS surgery between 2001 and 2019. Age, height, weight, smoking status and construction trade were obtained from programme records. CTS surgery cases were defined using the diagnostic code for CTS and surgical procedure code for peripheral median nerve decompression in the Swedish National Patient Register. Biomechanical exposure estimates were assigned by trade from a job-exposure matrix. The relative risk (RR) of CTS surgery for each biomechanical exposure was assessed with multivariable negative binomial regression modelling.

Results: The study included 3851 cases and the total incidence rate of CTS surgery was 137.6 cases per 100 000 person-years. Associations were found for upper extremity load (RR 2.6; 95% CI 2.2 to 3.0), repetitive wrist flexion and extension (RR 2.6; 95% CI 2.2 to 3.0), full wrist extension (RR 2.3; 95% CI 1.9 to 2.6), power grip (RR 2.5; 95% CI 2.2 to 2.9), pinch grip (RR 2.0; 95% CI 1.7 to 2.4), handheld tool use (RR 2.3; 95% CI 2.0 to 2.7) and hand-arm vibration exposure (RR 2.3; 95% CI 1.9 to 2.7).

Conclusions: Occupational upper extremity load and postural exposures were associated with increased risk for surgical treatment for CTS in this large construction worker cohort. Preventive actions and consideration of occupation on assessment are warranted.

Objectives: Occupational suicides are an emerging issue in occupational epidemiology. Risk factors like economic sectors, professions and types of contracts are not well-investigated, particularly in Italy.

Methods: A case-control study was carried out using mortality data collected in Italy from 2005 to 2018. We selected as cases those who died by suicide and as controls all other causes of death. The occupational characteristics were retrieved from two administrative archives, considering a working activity within the 3 years preceding the event. We fitted logistic regression models to calculate sex-specific mortality odds ratios (MORs) by employment sector, type of contract, professional qualification and working time. Results were adjusted for age class, education, marital status, professional status and territorial factors.

Results: The study population included 8862 suicides and 177 027 controls. Unemployed workers were found to have twice the risk compared with employed workers in both sexes. Education level and marital status were found to be determinants for suicide. The sectors at higher risk for suicide included the security and investigation in males (MOR=2.34 (1.94-2.83)) and healthcare (MOR=1.79 (1.39-2.30)) and residential social care (MOR=1.55 (1.17-2.06)) in females only. Precarious work was identified as a risk factor compared with permanent jobs (MORs=1.29-2.08). Professions at higher risk are health specialists, qualified professionals in personal health services, farmers and fishing/hunting with different skills, and unqualified operators in fixed machinery, manufacturing, mining and construction. Risks were sex-dependent.

Conclusions: The study highlights a potential role of occupation in the suicide risk and the need to investigate specific sectors and professions.

Objective: Chronic obstructive pulmonary disease (COPD), a progressive lung condition, is a leading cause of disability and death. Cigarette smoking and workplace exposures are important risk factors for COPD. To examine occupations with COPD deaths among decedents with usual lifetime employment in the construction industry.

Method: The 2021-2022 National Vital Statistics System public use multiple cause-of-death data (cross-sectional) were analysed.

Results: Among 6.7 million decedents, 497 031 (10.3%) were employed in the construction industry during most of their life and of those, 11.7% (n=57 937) had COPD listed on the death certificate as the underlying or contributing cause of death. The highest numbers of COPD deaths were among adults 65 years and older (n=44 550), males (n=55 092), non-Hispanic white persons (n=50 903) and persons with ≤high school education (n=46 621). Construction workers had 1.31 (95% CI 1.30 to 1.32) times the odds of COPD deaths as compared with non-construction workers. Within construction occupation groups, roofers (mortality OR (MOR) 2.31, 95% CI 2.10 to 2.55) drywall installers, ceiling tile installers and tapers (MOR 2.29, 95% CI 3.05 to 2.56); painters, paperhangers, pipelayers, plasterers and stucco masons (MOR 2.09; 95% CI 1.92 to 2.28) and insulation workers (MOR 2.00, 95% CI 1.66 to 2.41) COPD mortality risk was significantly increased and the mortality odds were twice or more as compared with the reference group (office and administrative support workers).

Conclusions: Disparities in COPD mortality observed among construction industry workers may be addressed by reducing COPD risk factors, including cigarette smoking and COPD-related workplace exposures, and emphasising the importance of early diagnosis and disease management.

Return-to-work rates among working-age cancer survivors present a complex challenge, varying by cancer type and individual characteristics. This study aimed to identify prognostic factors influencing return to work in cancer survivors. A systematic review was conducted following Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Searches in PubMed, Scopus and Web of Science databases in December 2024 used keywords based on the Population, Prognostic Factors, Outcomes framework to identify relevant studies. Study quality was evaluated using Joanna Briggs Institute tools and the protocol was registered in PROSPERO (CRD42024596102).Twenty studies were selected. Identified factors included sociodemographic: older age, educational level, marital status and sex; clinical: aggressive treatments, comorbidities and physical sequelae; psychological: anxiety, stress, fear of relapse and social support; occupational: flexible work schedules and tasks versus rigid conditions. Multiple factors influence return-to-work outcomes for cancer survivors.Individualised intervention programmes addressing specific patient needs and fostering adapted work environments are essential to promote successful reintegration.

Objectives: To study the effect of a progressively enhanced rest-shade-hydration-hygiene (RSHH) intervention on kidney injury and inflammation biomarkers, and rates of clinical acute kidney injury (AKI) in Nicaraguan sugarcane workers with a very high rate of chronic kidney disease of non-traditional origin (CKDnt).

Methods: We analysed serum creatinine and C-reactive protein (CRP) and leukocyturia from samples obtained before and at the end of four harvest seasons (H1-4). An increase in creatinine≥0.30 mg/dL over the harvest was considered incident kidney injury (IKI). Rates of clinically diagnosed AKI were obtained from medical records. Each season the RSHH intervention included progressively longer and more frequent rest periods with improved access to shade and hydration, implementation monitoring, qualitative interviews and health outcome assessments.

Results: 1044 workers were followed for 1938 person-harvests. Among burned cane cutters, the job group with the highest workload and worst outcomes initially, there were decreasing rates of IKI (21% in H1 to 1% in H4, p<0.01), AKI (20/1000 worker-months to 8/1000 worker-months, p<0.01) and end-harvest leukocyturia (26% to 1%, p<0.01), and less rise in cross-harvest CRP (median 1.75-fold increase in H1 to 1.00 in H4, p<0.01).

Conclusion: Kidney outcomes among outdoor heat-stressed workers at high risk of CKDnt improved as a structured RSHH intervention was implemented and committed to by workplace management. The findings support a causal relationship between occupational heat stress, kidney injury and CKDnt and point to possibilities for prevention.

Objectives: Understanding healthy working life expectancy (HWLE) is critical in ageing societies to promote both extended workforce participation and well-being. This study quantifies WLE and HWLE among middle-aged and older adults in Korea, stratified by gender and education.

Methods: We used data from the Korean Longitudinal Study of Aging (waves 1-9, 2006-2022) to estimate WLE and HWLE at age 50 using a discrete-time 5-state Markov model. Participants were categorised based on health and work status. Education was classified into high (≥high school graduate) and low (

Results: Of the total 72 534 responses across all waves, 69 272 came from living participants, including 29 649 men (42.8%), 39 623 women (57.2%), 28 705 responses with high education (41.4%) and 40 564 responses with low education (58.6%). Men had longer HWLE than women, despite women having higher total life expectancy. At age 50, men with high education had an HWLE of 15.13 years (95% CI 14.70 to 15.56), while those with low education had 14.25 years (95% CI: 13.60 to 14.90). Women with high education had an HWLE of 9.40 years (95% CI 8.85 to 9.95), whereas those with low education had 9.96 years (95% CI 9.43 to 10.49). Not healthy and working life expectancy (NHWLE) was longer for lower-educated individuals (men 2.26 vs 3.16 years; women 1.27 vs 3.00 years).

Conclusions: Our findings show that significant disparities in WLE exist according to gender and education level, with the effect of education differing by gender.