Scandinavian journal of work, environment & health最新文献

Objectives: The association between occupational mechanical exposures and low-back pain (LBP) has been studied in several systematic reviews. However, no systematic review addressing chronic LBP exists. The aim of this systematic review and meta-analysis was to examine the association between occupational mechanical exposures and chronic LBP.

Methods: The study was registered in PROSPERO. We used an existing systematic review to identify articles published before January 2014. For studies published between January 2014 and September 2022, a systematic literature search was conducted in six databases. Two authors independently excluded articles, extracted data, and assessed risk of bias and level of evidence (GRADE). Meta-analyses were conducted using random-effects models comparing highest versus lowest exposure group with sensitivity analyses based on study quality (low/moderate versus high risk of bias), study design (cohort versus case-control), and outcome definition (non-specific LBP versus specific chronic LBP).

Results: Twenty-six articles were included. Highest pooled odd ratios (OR) were found for combined mechanical exposures [OR 2.2, 95% confidence interval (CI) 1.4-3.6], lifting/carrying loads (OR 1.7, 95% CI 1.4-2.2), and non-neutral postures (OR 1.5, 95% CI 1.2-1.9). For the remaining mechanical exposures (ie, whole-body vibrations, standing/walking, and sitting), OR ranged between 1.0 and 1.4. In the sensitivity analyses, generally, higher pooled OR were found in low/moderate risk of bias studies, case-control studies, and studies of specific chronic LBP.

Conclusions: Moderate evidence of an association was found for lifting/carrying loads, non-neutral postures, and combined mechanical exposures. Low or very low evidence was found for whole-body vibrations, standing/walking, and sitting. Studies using standardized exposure definition, metric, and technical measurements are highly warranted.

Objectives: Crystalline silica is found in many construction materials. Although it is one of the oldest known occupational exposures, new exposure contexts have emerged in recent years. In 2021, France classified work involving exposure to respirable crystalline silica (ie, silica dust) generated by a work process as carcinogenic. In order to assess exposure in the French workforce between 1947 and 2020, we developed a silica job-exposure matrix (JEM) for the Matgéné program.

Method: The JEM was linked with occupational data from different population censuses (1982, 1990, 1999, 2007 and 2017). The proportions and numbers of workers exposed to silica dust in France at these various census time points were estimated and described by sex and industry for 2017.

Results: After decreasing between 1982 and 1999, the proportion of workers exposed to silica dust remained stable at 4%, representing 975 000 workers in 2017. Exposed workers were mostly men (93%), and most worked in the construction industry (64%). This was also the industry where the majority of workers were exposed to a level above the French 8-hour time weighted average occupational exposure limit (TWA-OEL).

Conclusion: A large number of workers in France were still exposed (some highly) to silica dust in 2017 so this agent still poses an occupational health concern. The results of this study provide key information about the continued surveillance of the evolution of exposure to silica dust. In a few years, it will be possible to quantify the impact of the 2021 regulation in terms of proportions and number of workers exposed to silica dust.

Objectives: This study investigates the associations between the Danish version of a job exposure matrix for COVID-19 (COVID-19-JEM) and Danish register-based SARS-CoV-2 infection information across three waves of the pandemic. The COVID-19-JEM consists of four dimensions on transmission: two on mitigation measures, and two on precarious work characteristics.

Methods: The study comprised 2 021 309 persons from the Danish working population between 26 February 2020 and 15 December 2021. Logistic regression models were applied to assess the associations between the JEM dimensions and overall score and SARS-CoV-2 infection across three infection waves, with peaks in March-April 2020, December-January 2021, and February-March 2022. Sex, age, household income, country of birth, wave, residential region and during wave 3 vaccination status were accounted for.

Results: Higher risk scores within the transmission and mitigation dimensions and the overall JEM score resulted in higher odds ratios (OR) of a SARS-CoV-2 infection. OR attenuated across the three waves with ranges of 1.08-5.09 in wave 1, 1.06-1.60 in wave 2, and 1.05-1.45 in those not (fully) vaccinated in wave 3. In wave 3, no associations were found for those fully vaccinated. In all waves, the two precarious work dimensions showed weaker or inversed associations.

Conclusions: The COVID-19-JEM is a promising tool for assessing occupational exposure to SARS-CoV-2 and other airborne infectious agents that mainly spread between people who are in close contact with each other. However, its usefulness depends on applied restrictions and the vaccination status in the population of interest.

Objectives: This study aimed to compare the effectiveness of the multifaceted implementation strategy (multifaceted group) versus a discrete implementation strategy (discrete group) for implementing the Swedish Guideline for the Prevention of Mental Ill-health Problems at the Workplace on the primary intervention outcome - exhaustion - and secondary outcomes of stress, health, recovery, psychosocial safety climate, and social and organizational risk factors. Another aim was to examine whether the primary and secondary outcomes differed on the basis of guideline adherence levels, irrespective of the group.

Methods: A cluster-randomized waiting-list controlled trial with 6- and 12-months follow-up was conducted among 19 Swedish public schools. Primary and secondary outcomes as well as guideline adherence were assessed by self-reported questionnaire. Linear mixed modeling was used to compare differences in outcomes between the groups from baseline to 6 and 12 months, and in relation to different adherence levels.

Results: The trial comprised 698 employees (83.1%) participated. There were no differences between groups in the primary and secondary outcomes at 6 months, while at 12 months differences were observed for some outcomes to the advantage of the discrete group. Better guideline adherence was associated with improvements in exhaustion at 12 months and the secondary outcomes of psychosocial safety climate, work organization and job content, interpersonal relations and leadership, and recovery over 6 and 12 months.

Conclusion: The multifaceted implementation strategy was no more effective than the discrete strategy in improving health outcomes or organizational and social work environment. However, higher adherence to the guideline was associated with larger improvements in health outcomes and organizational and social work environment, irrespective of the implementation strategy used.

Objectives: This study aimed to evaluate effects of night and shift work patterns on type 2 diabetes (T2D) and hypertension in a longitudinal study, with detailed information on working hours.

Methods: The cohort comprised about 28 000 nurses and nursing assistants employed for more than one year 2008-2016 in Stockholm, Sweden. The employee register held detailed individual information on daily working hours. Information on diagnoses came from national and regional registers. Hazard ratios (HR) and confidence intervals (CI) were estimated by discrete-time proportional hazard models, adjusting for sex, age, country of birth, and profession.

Results: During follow-up in 2013-2017, we identified 232 cases of T2D and 875 of hypertension. We observed an increased risk of T2D, but not hypertension, among employees who worked only night shifts the previous year (HR 1.59, 95% CI 1.02-2.43) and those with intensive shift work (>120 afternoon and/or night shifts the previous year: HR 1.67, 95% CI 1.11-2.48) compared to only day work. There was a non-significantly increased risk of T2D related to mixed day and afternoon shifts (HR 1.34, 95% CI 0.97-1.88). We observed tendencies in increased risk of T2D related to frequent spells of ≥3 consecutive night shifts and with number of years with exclusive (but not mixed) night work.

Conclusions: Permanent night work and frequent afternoon and/or night shifts were associated with an increased risk of T2D the following year, but not hypertension. The T2D risk was, to some extent, affected by frequent spells of several night shifts in a row and by cumulative years with permanent night work.

Objective: This study aimed to investigate whether workplace factors and occupations are associated with SARS-CoV-2 infection or severe COVID-19 in the later waves of the pandemic.

Methods: We studied 552 562 cases with a positive test for SARS-CoV-2 in the Swedish registry of communicable diseases, and 5985 cases with severe COVID-19 based on hospital admissions from October 2020 to December 2021. Four population controls were assigned the index dates of their corresponding cases. We linked job histories to job-exposure matrices to assess the odds for different transmission dimensions and different occupations. We used adjusted conditional logistic analyses to estimate odds ratios (OR) for severe COVID-19 and SARS-CoV-2 with 95% confidence intervals (CI).

Results: The highest OR for severe COVID-19 were for: regular contact with infected patients, (OR 1.37, 95% CI 1.23-1.54), close physical proximity (OR 1.47, 95% CI 1.34-1.61), and high exposure to diseases or infections (OR 1.72, 95% CI 1.52-1.96). Mostly working outside had lower OR (OR 0.77, 95% CI 0.57-1.06). The odds for SARS-CoV-2 when mostly working outside were similar (OR 0.83, 95% CI 0.80-0.86). The occupation with the highest OR for severe COVID-19 (compared with low-exposure occupations) was certified specialist physician (OR 2.05, 95% CI 1.31-3.21) among women and bus and tram drivers (OR 2.04, 95% CI 1.49-2.79) among men.

Conclusions: Contact with infected patients, close proximity and crowded workplaces increase the risks for severe COVID-19 and SARS-CoV-2 infection. Outdoor work is associated with decreased odds for SARS-CoV-2 infection and severe COVID-19.

Objective: The purpose of this study was to assess cancer risk among agricultural workers compared to the general population.

Methods: The study utilized data from Farmers' Health Insurance (FHI) in Taiwan, which enrolled agricultural workers (N=1 175 149). The enrolled workers were matched to a general population (N=1 175 149) of the same age, gender, township, and enrollment year. The study population was linked to the National Cancer Registry to identify new cancer cases between 2000 and 2018. The Cox proportional hazards model was used to estimate the hazard ratio and 95% confidence interval for outcomes.

Results: During the study period, 136 913 new cancers among agricultural workers were identified. The study found that male farmers had an increased cancer risk, including lymphocytic leukemia, chronic myelogenous leukemia, non-Hodgkin's lymphoma (NHL), oral cancer, lip cancer, esophagus cancer, rectum and rectosigmoid junction cancer, liver and intrahepatic bile duct cancer, lung cancer, trachea and bronchi cancer, and other non-melanoma skin cancer, even when considering the latency period. Female farmers had an elevated risk of multiple myeloma and other non-melanoma skin cancer. Moreover, only lymphoma, NHL, other lymphoid, and multiple myeloma, were both found to occur at different insurance periods.

Conclusions: This study provides farmer cancer patterns and risk, adding to the evidence that farmers are at increased risk of certain types of cancer, especially for hematological cancers. As exposure varies by farm operation type, individual farmer exposure may vary widely. Further understanding of the complex relationship between occupational exposure, environmental factors, and lifestyle factors is needed.

Objectives: This study assessed the short-term associations between in-vehicle ultrafine particles (UFP) and black carbon (BC) concentrations and irritation symptoms and lung parameters of taxi drivers, pre- and post-lockdown.

Methods: As part of PUF-TAXI project, 33 taxi drivers were followed up during two typical working days. In-vehicle UFP and BC were continuously measured by monitoring instruments. Irritation symptoms during the working day were reported via an auto-questionnaire and lung function was assessed by a portable spirometer, pre- and post- work shift. Generalized estimating equations, adjusted for potential confounders, were used to study the association between air pollutants and health outcomes. Effect modification by measurement period (pre- and post-lockdown) was investigated.

Results: UFP and BC concentrations inside taxi vehicles decreased significantly post- compared to pre-lockdown. Incidence of nose irritation was positively associated with in-vehicle UFP and BC levels pre-lockdown, when pollutant levels were higher, whereas no significant association was found post-lockdown. The decrease in the FEF_25-75% (forced expiratory flow at 25-75% of the forced vital capacity) during the working day was significantly associated with in-taxi UFP levels before but not after lockdown. No association was found with BC. By contrast, incidence of eye irritation was significantly inversely associated with in-vehicle humidity, regardless of pollutant concentrations and the measurement period.

Conclusions: Our findings indicate that an upgrade in in-vehicle air quality could improve respiratory health. This study showed that the magnitude of the incidence of nasal irritation and decrease in lung function depends on UFP concentrations the commuters are exposed to.

Objectives: The etiology of testicular germ cell tumors (TGCT) is suspected to be related to prenatal environmental risk factors. Some solvents have potential endocrine disrupting or carcinogenic properties and may disrupt male genital development in utero. The aim of this study was to examine the association between parental occupational exposure to solvents and TGCT risk among their offspring.

Methods: A French nationwide case-control study, TESTIS included 454 TGCT cases and 670 controls frequency-matched on region and 5-year age strata. Participants were interviewed via telephone and provided information on parental occupations at birth. Job-exposure matrices (JEM) developed in the French Matgéné program were used to assign exposure to five petroleum-based solvents, five solvents or groups of oxygenated solvents, and five chlorinated solvents. Odds ratios (OR) for TGCT and 95% confidence intervals (CI) were estimated using conditional logistic regression, adjusting for TGCT risk factors.

Results: Occupational exposure to at least one solvent during the year of their son's birth was 41% among fathers and 21% among mothers. Paternal exposure to at least one solvent showed OR 0.89 (95% CI 0.68-1.15). Exposure to perchloroethylene (OR 1.41, 95% CI 0.55-3.61), methylene chloride (OR 1.13, 95% CI 0.54-2.34) and diesel/kerosene/fuel oil (OR 1.17, 95% CI 0.80-1.73) disclosed OR >1 but with low precision. Our results suggest a possible modest increase in non-seminoma risk for sons whose fathers were highly exposed to trichloroethylene (OR 1.44, 95% CI 0.79-2.63). Maternal exposure to at least one solvent showed OR 0.90 (95% CI 0.65-1.24). When stratifying by birth year, men born in the 1970s experienced an increased TGCT risk following maternal exposure to fuels and petroleum-based solvents (OR 2.74, 95% CI 1.11-6.76).

Conclusion: Overall, no solid association was found between parental occupational exposure to solvents and TGCT risk. The association found with maternal occupational exposure to fuels and petroleum solvents among older men needs further investigation.