Occupational and Environmental Medicine最新文献

The objective of our systematic reviews and meta-analyses were to analyse the associations between high occupational physical activity (HOPA) and cardiovascular (CV) disease (CVD) and CV mortality and the role of leisure-time physical activity (LTPA) and fitness capacity on these associations.Two systematic reviews and related meta-analyses were undertaken using several databases to identify prospective cohort studies. Random-effect models were used to provide ORs and 95% CI, index I² to characterise the associations between the effect of exposure to HOPA on CVD and CV mortality in adjusted and unadjusted models. Stratified analyses according to the level of LTPA were provided. The Newcastle-Ottawa Scale was used to assess the quality of studies.From 25 and 28 prospective studies: compared with workers exposed to low OPA, HOPA increased the risk of CVD non-significantly (+12%), while compared with moderate OPA, a significant excess of risk was found (+24%); HOPA did not significantly increase the risk of CV mortality compared with low and moderate OPA groups. Stratified on the practice of high, moderate and low LTPA, the risks of CVD for the HOPA were ORs: 1.27 (0.86 to 1.88), 1.08 (0.61 to 1.92), 1.28 (1.00 to 1.62) versus low OPA group, respectively. A combination of low physical fitness and high OPA seemed to expose individuals to an elevated risk of CVD.Being exposed to HOPA may have the same effect on CVD as being exposed to low OPA and an excess risk compared with moderate OPA exposure, suggesting a curve effect. The combined effects of leisure and OPA must be considered in future research.

Objectives: We aimed to investigate the impact of ambient carbon particles on hypertensive disorders in pregnancy (HDP) and evaluate whether the associations differed by maternal characteristics.

Methods: A retrospective cohort study was constructed based on data from the Haidian Maternal and Child Health Hospital in Beijing, China. A total of 41 374 participants with last menstrual period dates between 2014 and 2018 were included. Black carbon (BC), ultraviolet light absorbing particulate matter (UVPM), delta carbon (Delta-C) and brown carbon (BrC) were measured at a fixed air monitoring site. Source contributions to BC were analysed using the Aethalometer model. Delta-C has been used as a specific indicator for wood-smoke pollution, and both UVPM and BrC represent a typical cluster of organic fractions. Logistic regression models were used to estimate the association between carbon particle exposure and gestational hypertension or pre-eclampsia risk and identify sensitive windows.

Results: We observed that pre-eclampsia risk was associated with UVPM and Delta-C exposure during the first trimester, with ORs per IQR increase in exposure being 1.27 (95% CI 1.03 to 1.58), and 1.60 (95% CI 1.32 to 1.94), respectively. Pre-eclampsia risk was associated with BC, UVPM, Delta-C and BrC exposure 3 months before conception. No significant associations were found between carbon particles and gestational hypertension. Stronger associations were observed for BC from traffic sources. Subgroup analyses indicated greater risks among participants who were over 30 years old, weighed over 60 kg and were nulliparous.

Conclusions: Our findings suggest that carbon particle exposure may be associated with increased pre-eclampsia risk during early pregnancy, highlighting the importance of anthropogenic emission control for reducing adverse health impacts.

Objective: To evaluate weight loss maintenance among truck drivers following an effective initial intervention and to test a priori hypotheses that social support and stress factors would moderate long-term success.

Methods: Commercial truck drivers enrolled in the Safety & Health Involvement For Truckers cluster-randomised controlled trial (22 terminal clusters; n=452) completed measurements at baseline, postintervention (6 months) and 1 year postintervention (18 months) in the USA in 2012-2015. The mobile health intervention was a group-based competition involving self-monitoring, feedback, incentives, online training and motivational interviewing.

Results: In an intent-to-treat analysis, the difference between groups at 18 months post-baseline in mean body weight was -0.92 kg (p=0.328; intervention=0.00, control=+0.92). Moderation analyses revealed a significant between-group intervention effect on body weight at 18 months for drivers with supervisors who engaged in higher levels of family supportive supervisor behaviours (p=0.033; group difference=-2.74 kg). Intervention effects on several diet and exercise outcomes at 18 months were also significantly moderated by social support and stress factors. Within the intervention group, high initial programme participation was associated with significantly greater 18-month weight loss than lower participation (p<0.001; -3.43 kg vs +2.17 kg).

Conclusions: The intervention produced significant long-term weight loss for truck drivers with a supportive supervisor, providing further evidence for the broad health benefits of this workplace relationship. Additional findings highlight the value of initial programme participation and may inform future replications and extensions of similar health programmes for truck drivers.

Trial registration number: NCT02105571.

Objectives: The manual coding of job descriptions is time-consuming, expensive and requires expert knowledge. Decision support systems (DSS) provide a valuable alternative by offering automated suggestions that support decision-making, improving efficiency while allowing manual corrections to ensure reliability. However, this claim has not been proven with expert coders. This study aims to fill this omission by comparing manual with decision-supported coding, using the new DSS OPERAS.

Methods: Five expert coders proficient in using the French classification systems for occupations PCS2003 and activity sectors NAF2008 each successively coded two subsets of job descriptions from the CONSTANCES cohort manually and using OPERAS. Subsequently, we assessed coding time and inter-coder reliability of assigning occupation and activity sector codes while accounting for individual differences and the perceived usability of OPERAS, measured using the System Usability Scale (SUS; range 0-100).

Results: OPERAS usage substantially outperformed manual coding for all coders on both coding time and inter-coder reliability. The median job description coding time was 38 s using OPERAS versus 60.8 s while manually coding. Inter-coder reliability (in Cohen's kappa) ranged 0.61-0.70 and 0.56-0.61 for the PCS, while ranging 0.38-0.61 and 0.34-0.61 for the NAF for OPERAS and manual coding, respectively. The average SUS score was 75.5, indicating good usability.

Conclusions: Compared with manual coding, using OPERAS as DSS for occupational coding improved coding time and inter-coder reliability. Subsequent comparison studies could use OPERAS' ISCO-88 and ISCO-68 classification models. Consequently, OPERAS facilitates large, harmonised job coding in large-scale occupational health research.

Objectives: Person-related work requires workers to interact with individuals not employed at the workplace, such as clients and patients, and can cause emotional labour and conflict. These stressors may increase workers' risk of type 2 diabetes, but their impact may differ depending on the level of support received from colleagues. We aimed to examine the association between person-related work and the risk of type 2 diabetes, and the effect modification of social support at work.

Methods: The study population consisted of around three million people without type 2 diabetes in Sweden in 2005, who were employed and aged 30-60 years. Three dimensions of person-related work-general contact with people, emotional demands and confrontation-and social support were respectively assessed using job exposure matrices. Patients with type 2 diabetes in 2006-20 were determined based on drug, patient and death registers. Multivariable Cox regression models were used.

Results: High exposures to emotional demands and confrontation were respectively associated with 20% and 15% increased risks of type 2 diabetes in men and 24% and 20% in women. In both men and women, there was statistically significant effect modification by social support-the associations between emotional demands and confrontation and type 2 diabetes were higher among those with low social support than those with high social support.

Conclusions: In both men and women, dimensions of person-related work, including emotional demands and confrontation, are associated with an increased risk of type 2 diabetes, and low social support at work seems to amplify the magnitude of these associations.

Objectives: This analysis aimed at investigating the relationship between death from diseases other than lung cancer and radon exposure in the German uranium miners cohort study with follow-up data from 1946 to 2018.

Methods: The cohort includes 58 975 men who were employed between 1946 and 1990 at the former 'Wismut' uranium mining company in Eastern Germany. Occupational exposure to radon progeny in working level month (WLM) was retrospectively assessed using a comprehensive job-exposure matrix. Based on internal Poisson regression, excess relative rates (ERRs) per 100 WLM were estimated for cumulative lagged exposure to radon for numerous outcomes. Sensitivity analyses examined possible confounding by occupational exposure to silica dust and gamma radiation.

Results: Small but statistically significantly increased excess rates were found for the group of all cancers other than lung cancer (n=6126; ERR/100 WLM=0.014 (95% CI 0.007; 0.022)) and for ischaemic heart diseases (n=6182; 0.010 (95% CI 0.003; 0.016)). The increase in risk was particularly observed at very high exposure levels. No clear association between radon exposure and other causes of death, comprising other subgroups of circulatory system diseases, non-malignant respiratory diseases excluding pneumoconiosis, neurodegenerative diseases and the many considered individual cancer sites was present. Notable were the estimates for myeloid leukaemia (n=114; 0.076 (95% CI -0.011; 0.164)) and pharynx cancer (n=112; 0.070 (95% CI -0.041; 0.182)).

Conclusions: The findings of the Wismut cohort indicate small increased risks for a few selected outcomes. Overall, the study does not provide convincing evidence for an increased risk for other diseases than lung cancer due to radon.

Objectives: In 2014, US Occupational Safety and Health Administration (OSHA) updated a rule requiring employers to directly report all hospitalisations, amputations and eye enucleations to OSHA within 24 hours and within 8 hours for fatalities and multiple injury events. Past studies have shown that employers under-report injuries and illnesses for numerous reasons.

Methods: This study evaluated the completeness of required immediate reporting of severe injuries and illnesses by employers to OSHA by linking cases reported to OSHA with hospital data from 1 January 2017 to 31 December 2023. We evaluated factors associated with failure to report severe injuries or illnesses to OSHA using multivariable logistic regression.

Results: We identified 7578 non-fatal occupational injuries and illnesses and an additional 160 fatalities treated in Illinois hospitals that were not reported to OSHA. The cumulative reporting rate for non-fatal injuries was 39.7%, while non-fatal illnesses (excluding COVID-19 cases) was 25.1%. There was no significant change in reporting rates over the 7-year period for non-fatal injuries and illnesses. Failure to report serious injuries and illnesses was associated with hospitalisations involving acute illnesses (adjusted OR (aOR)=2.60), female workers (aOR=1.29) and incidents occurring on weekends (aOR=2.21) and holidays (aOR=1.98). We also identified factors associated with improperly reporting cases that did not meet the OSHA reporting criteria.

Conclusions: We estimate that failure to report these hospitalisations obscured up to 2122 violations in Illinois workplaces that could have led to remediation to protect other workers from injury. This analysis informs compliance assistance programmes that address reporting practices and record-keeping policy.

Objectives: Occupations vary with respect to workplace factors that influence exposure to COVID-19, such as ventilation, social contacts and protective equipment. Variations between women and men may arise because they have different occupational roles or behavioural responses. We estimated occupational differences in COVID-19 hospital admission and mortality risks by sex.

Methods: We combined (1) individual-level data from 2011 Census with (2) health records and (3) household-level information from residential identifiers, using a Scottish cohort of 1.7 million adults aged 40-64 years between 1 March 2020 and 31 January 2021. We estimated age-standardised COVID-19 hospital admission and mortality rates, stratified by sex and occupation. Cox proportional hazards models were adjusted for pre-pandemic health and occupational exposure factors, including interaction effects between occupation and sex.

Results: Women had lower age-standardised COVID-19 hospital admission and mortality rates than men. Among women, adjusted death risks were lowest for health professionals, and those in associate professional and technical occupations (paramedics and medical technicians), with the latter supported by results from the interaction model. Among men, elevated adjusted admission and death risks were observed for large vehicle and taxi drivers. Additionally, admission risks remained high among men in caring personal services (including home and care workers), while elevated risks were observed among women in customer service occupations (call centre operators) and process, plant and machine operative roles (assemblers and sorters).

Conclusions: Occupational differences in COVID-19 hospital admission and mortality risks between women and men highlight the need to account for sex differences when developing interventions to reduce infections among vulnerable occupational groups.

Objectives: To investigate the effects of overwork on brain structure to better understand its impact on workers' cognitive and emotional health. The goal was to provide evidence for the potential neurological risks associated with prolonged working hours.

Methods: A total of 110 healthcare workers were classified into overworked (≥52 hours/week; n=32) and non-overworked groups (n=78). Brain volume differences were assessed using voxel-based morphometry (VBM) and atlas-based analysis. General linear models adjusted for age, sex and total intracranial volume were applied, and correlation analyses explored relationships between weekly working hours and brain volume in regions with significant differences.

Results: Overworked individuals exhibited significant changes in brain regions associated with executive function and emotional regulation. Atlas-based analysis revealed a 19% increase in left caudal middle frontal gyrus volume in the overworked group compared with the non-overworked group (p=0.006). VBM showed peak increases in 17 regions, including the middle frontal gyrus, insula and superior temporal gyrus (p<0.05). Correlation analyses indicated a positive association between weekly working hours and brain volume changes in the middle frontal gyrus and insula.

Conclusions: This study provides preliminary evidence that overwork is associated with structural brain changes, particularly in regions linked to cognition and emotion. These findings provide novel neurobiological evidence linking prolonged working hours to structural brain changes, emphasising the need for further research to understand the long-term cognitive and emotional implications of overwork.