International Journal of Occupational and Environmental Medicine最新文献

英文中文

Noise and Occupational Medicine: Common Practice Problems. 噪音与职业医学:常见的实践问题。

Q1 Medicine

International Journal of Occupational and Environmental Medicine

Pub Date : 2019-12-01 DOI: 10.1097/JOM.0000000000001728

Andrew L Phillips, Ryan Cooney, Zachary B Harris, D. Myrtil, M. Hodgson

: Noise-induced hearing loss (NIHL) represents the second most common occupational disease in the US. Although the Occupational Safety and Health Administration (OSHA) has promulgated an occupational noise exposure standard and associated recordkeeping requirements, OSHA inspections increasingly document practices that violate both the noise standard and recordkeeping regulation. This paper describes five deviations from good clinical practices masking the true societal costs of NIHL, leading to missed prevention opportunities, and creating burdens for individuals and society. These include attributing NIHL to non-occupational sources, exculpating the workplace because of audiogram patterns without careful documentation, ignoring symptoms or physical examination findings, and simply denying work-relatedness, leading to employers inappropriately lining-out cases from the OSHA 300 log. The practices identified by OSHA suggest that many individuals are not following widely recognized and accepted practices when administering hearing conservation programs.

噪音性听力损失(NIHL)是美国第二大常见的职业病。尽管职业安全与健康管理局(OSHA)已经颁布了职业噪音暴露标准和相关的记录保存要求，但OSHA检查越来越多地记录了违反噪音标准和记录保存规定的做法。本文描述了五种偏离良好临床实践的情况，掩盖了NIHL的真实社会成本，导致错过预防机会，并给个人和社会带来负担。其中包括将NIHL归因于非职业原因，在没有仔细记录的情况下以听图模式为工作场所开脱，忽视症状或体检结果，以及简单地否认工作相关性，导致雇主不恰当地从OSHA 300日志中列出病例。OSHA确定的做法表明，许多人在管理听力保护计划时没有遵循广泛认可和接受的做法。

引用次数: 5

Associations of Benzo(ghi)perylene and Heptachlorodibenzo-p-dioxin in Serum of Service Personnel Deployed to Balad, Iraq, and Bagram, Afghanistan Correlates With Perturbed Amino Acid Metabolism in Human Lung Fibroblasts. 驻伊拉克巴拉德和阿富汗巴格拉姆服役人员血清中苯并（吉）苝和七氯二苯并-对二恶英的相关性与人肺成纤维细胞氨基酸代谢紊乱相关

Q1 Medicine

International Journal of Occupational and Environmental Medicine

Pub Date : 2019-12-01 DOI: 10.1097/JOM.0000000000001669

Matthew Ryan Smith, Collynn F Woeller, Karan Uppal, Thomas H Thatcher, Douglas I Walker, Philip K Hopke, Patricia Rohrbeck, Timothy M Mallon, Pamela L Krahl, Mark J Utell, Young-Mi Go, Dean P Jones

Objective: A study was conducted to identify metabolic-related effects of benzo(ghi)perylene (BghiP) and 1,2,3,4,6,7,8-heptachlorodibenzo-p-dioxin (HpCDD), on primary human fibroblasts to verify biological associations previously found in occupational health research.

Methods: Human lung fibroblasts were exposed to BghiP or HpCDD and extracts were analyzed with a metabolome-wide association study to test for pathways and metabolites altered relative to controls. Gene expression was measured by quantitative-real time polymerase chain reaction.

Results: Metabolic perturbations in amino-acid, oxidative stress, and fatty-acid pathways were observed for BghiP and HpCDD. HpCDD but not BghiP exposure increased gene expression of the amino acid transporters SLC7A5 and SLC7A11.

Conclusions: Exposure to polycyclic aromatic hydrocarbons (PAH) or dioxins perturbs amino acid pathways at physiologically relevant concentrations with different mechanisms. These findings imply an effect on central homeostatic systems by environmental exposures which could have implications on disease susceptibility.

目的：研究苯并（高）苝（BghiP）和1,2,3,4,6,7,8-七氯二苯并-对二恶英（HpCDD）对原代人成纤维细胞的代谢相关影响，以验证先前在职业卫生研究中发现的生物学关联。方法：将人肺成纤维细胞暴露于bhip或HpCDD中，并通过代谢组相关性研究分析提取物，以检测相对于对照组的通路和代谢物的改变。采用定量实时聚合酶链反应检测基因表达。结果：BghiP和HpCDD在氨基酸、氧化应激和脂肪酸途径中观察到代谢紊乱。HpCDD暴露增加了氨基酸转运体SLC7A5和SLC7A11的基因表达，而bhip暴露没有增加。结论：暴露于多环芳烃（PAH）或二恶英会以不同的机制干扰生理相关浓度的氨基酸通路。这些发现暗示了环境暴露对中枢体内平衡系统的影响，这可能对疾病易感性有影响。

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引用次数: 0

Advances in Comprehensive Exposure Assessment: Opportunities for the US Military. 综合暴露评估进展:美国军方的机会。

Q1 Medicine

International Journal of Occupational and Environmental Medicine

Pub Date : 2019-12-01 DOI: 10.1097/JOM.0000000000001677

Pamela L Krahl, Edward Benchoff, Y. Go, Dean P. Jones, M. Smith, D. Walker, K. Uppal, C. Woeller, T. Thatcher, J. Thakar, R. Phipps, P. Hopke, M. Utell, Timothy M Mallon

OBJECTIVEReview advances in exposure assessment offered by the exposome concept and new -omics and sensor technologies.METHODSNarrative review of advances, including current efforts and potential future applications by the US military.RESULTSExposure assessment methods from both bottom-up and top-down exposomics approaches are advancing at a rapid pace, and the US military is engaged in developing both approaches. Top-down approaches employ various -omics technologies to identify biomarkers of internal exposure and biological effect. Bottom-up approaches use new sensor technology to better measure external dose. Key challenges of both approaches are largely centered around how to integrate, analyze, and interpret large datasets that are multidimensional and disparate.CONCLUSIONSAdvances in -omics and sensor technologies may dramatically enhance exposure assessment and improve our ability to characterize health risks related to occupational and environmental exposures, including for the US military.

目的综述暴露概念、新组学和传感器技术在暴露评估方面的研究进展。方法对研究进展进行述评，包括美国军方目前的努力和潜在的未来应用。结果自下而上和自上而下两种暴露学方法的暴露评估方法都在快速发展，美国军方正在开发这两种方法。自上而下的方法采用各种组学技术来识别内部暴露和生物效应的生物标志物。自下而上的方法使用新的传感器技术来更好地测量外部剂量。这两种方法的主要挑战主要集中在如何集成、分析和解释多维和不同的大型数据集。结论:组学和传感器技术的进步可能会极大地增强暴露评估，并提高我们表征与职业和环境暴露相关的健康风险的能力，包括美国军队。

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引用次数: 7

Predictors of Presenteeism among Hospital Employees: A Cross-Sectional Questionnaire-Based Study in Switzerland. 医院员工出勤的预测因素:瑞士横断面问卷研究。

Q1 Medicine

International Journal of Occupational and Environmental Medicine

Pub Date : 2019-12-01 DOI: 10.1097/JOM.0000000000001721

A. Allemann, Klarissa Siebenhüner, O. Hämmig

OBJECTIVEThe aim of this cross-sectional study was to examine work- and person-related predictors of the largely "invisible" behaviour and phenomenon of presenteeism among employees in a health-care setting in German-speaking Switzerland.METHODSSelf-reported survey data from 1,840 employees of four hospitals and two rehabilitation clinics collected in 2015 and 2016 were utilized and analyzed.RESULTSAll studied work-related factors such as patient contact, job satisfaction, high work load, forced overtime, fear of job-loss, and particularly mental strain turned out to be significant and relevant predictors of presenteeism. Younger employees, female workers and employees with a chronic disease also were more likely to show presenteeism.CONCLUSIONWork stress, work without patients, job dissatisfaction, a chronic disease and/or a younger age or rather less work experience seem to increase the chances of presenteeism among health-care workers.

目的:本横断面研究的目的是检查瑞士德文版医疗机构员工中大部分“隐形”行为和出勤现象的工作和个人相关预测因素。方法利用2015年和2016年收集的4家医院和2家康复诊所1,840名员工的自述调查数据进行分析。结果所有研究的与工作相关的因素，如病人接触、工作满意度、高工作量、强迫加班、害怕失业，特别是精神紧张，都是出勤的显著相关预测因素。年轻员工、女性员工和患有慢性病的员工也更有可能出勤。结论工作压力、无病人工作、工作不满意、慢性疾病和/或年龄较小或工作经验较少似乎增加了卫生保健工作者出勤的机会。

引用次数: 20

A Qualitative Exploration of Return to Work in the First 3-Years After Serious Injury. 重伤后前3年复工的定性探讨。

Q1 Medicine

International Journal of Occupational and Environmental Medicine

Pub Date : 2019-12-01 DOI: 10.1097/JOM.0000000000001719

S. Braaf, A. Collie, S. Ameratunga, J. Harrison, W. Teague, P. Cameron, N. Christie, B. Gabbe

OBJECTIVETo explore how people with serious injuries returned to paid employment in the first 3-years after injury.METHODSFifty-four adult survivors of serious injuries were interviewed at 3-years post-injury, all of whom had returned to work and were currently employed. A framework analysis approach was undertaken.RESULTSParticipant decisions and actions taken to return to work (RTW) were influenced by their resilience, approach to adjusting goals, priorities and plans, and how social connections and relationships were used and maintained. The environment in which these decisions and actions were taken shaped opportunities for work in meaningful, appropriate and sustained employment.CONCLUSIONSOur study of 54 people who RTW indicated the importance of personal adjustments and resources, positive social relations, and advanced planning aligning with responsive employers, insurers and health professionals for successful RTW.

目的探讨严重外伤患者在伤后3年内恢复有薪就业的情况。方法对54例重伤后3年复工在岗的成年幸存者进行访谈。采用了框架分析方法。结果参与者的恢复力、调整目标、优先事项和计划的方法，以及如何使用和维护社会联系和关系，都会影响他们重返工作岗位的决定和行动。作出这些决定和行动的环境形成了有意义、适当和持续就业的工作机会。结论一项对54名复职者的研究表明，复职成功的重要因素是个人调整和资源、积极的社会关系以及与雇主、保险公司和卫生专业人员协调一致的提前计划。

引用次数: 7

Benzo[a]pyrene Perturbs Mitochondrial and Amino Acid Metabolism in Lung Epithelial Cells and Has Similar Correlations With Metabolic Changes in Human Serum. 苯并[a]芘干扰肺上皮细胞线粒体和氨基酸代谢，并与人血清代谢变化具有相似的相关性。

Q1 Medicine

International Journal of Occupational and Environmental Medicine

Pub Date : 2019-12-01 DOI: 10.1097/JOM.0000000000001687

Matthew Ryan Smith, Douglas I Walker, Karan Uppal, Mark J Utell, Philip K Hopke, Timothy M Mallon, Pamela L Krahl, Patricia Rohrbeck, Young-Mi Go, Dean P Jones

Objective: A study was conducted to identifymetabolic-related effects of benzo[a]pyrene (BaP) on human lung epithelial cells and validate these findings using human sera.

Methods: Human lung epithelial cells were treated with BaP, and extracts were analyzed with a global metabolome-wide association study (MWAS) to test for pathways and metabolites altered relative to vehicle controls.

Results: MWAS results showed that BaP metabolites were among the top metabolites differing between BaP-treated cells and controls. Pathway enrichment analysis further confirmed that fatty acid, lipid, and mitochondrial pathways were altered by BaP. Human sera analysis showed that lipids varied with BaP concentration. BaP associations with amino acid metabolism were found in both models.

Conclusions: These findings show that BaP has broad metabolic effects, and suggest that air pollution exacerbates disease processes by altered mitochondrial and amino acid metabolism.

目的：本研究旨在鉴定苯并[A]芘（BaP）对人肺上皮细胞的代谢相关影响，并利用人血清验证这些发现。方法：用BaP处理人肺上皮细胞，并通过全球代谢组关联研究（MWAS）分析提取物，以检测相对于对照物的通路和代谢物的改变。结果：MWAS结果显示，BaP代谢产物是BaP处理细胞与对照组差异最大的代谢产物之一。通路富集分析进一步证实，BaP改变了脂肪酸、脂质和线粒体通路。人血清分析显示脂质随BaP浓度的变化而变化。在两种模型中均发现BaP与氨基酸代谢相关。结论：这些发现表明BaP具有广泛的代谢作用，并表明空气污染通过改变线粒体和氨基酸代谢来加剧疾病进程。

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引用次数: 0

Gender Differences With Regard to Perceived Job Insecurity and Insomnia In A Working Population. 工作人群工作不安全感与失眠症的性别差异

Q1 Medicine

International Journal of Occupational and Environmental Medicine

Pub Date : 2019-12-01 DOI: 10.1097/JOM.0000000000001729

Selin Kim, W. Jeong, Y. Kim, S. Jang, E. Park

OBJECTIVESInsomnia is one of the most prevalent disorders, and it is associated with various factors. Therefore, this study aimed to examine the association between perceived job insecurity and insomnia.METHODSMultiple logistic regression analysis was used to examine the association between three levels of perceived job insecurity and insomnia using the 2017 Korean Working Conditions Survey.RESULTSApproximately 10.2% of the total study population has insomnia. The higher the perception of job insecurity, the greater the chance for insomnia in both men (odds ratio=4.03, 95% confidence interval = 3.18-5.11) and women (odds ratio = 4.44, 95% confidence interval = 3.41-5.77).CONCLUSIONThese findings reveal the gender differences in insomnia, thus suggesting the need to implement different approaches to deal with perceived job insecurity based on gender.

目的:失眠是最常见的疾病之一，与多种因素有关。因此，本研究旨在探讨工作不安全感与失眠之间的关系。方法利用2017年韩国工作条件调查，采用多元logistic回归分析来检验三个层次的工作不安全感与失眠之间的关系。结果约10.2%的研究人群有失眠症。对工作不安全感的感知越高，男性(优势比=4.03,95%可信区间= 3.18-5.11)和女性(优势比= 4.44,95%可信区间= 3.41-5.77)患失眠的几率越大。结论这些发现揭示了失眠的性别差异，提示需要根据性别采取不同的方法来处理工作不安全感。

引用次数: 3

Non Communicable Disease risk factors among a cohort of mine workers in Mongolia. 蒙古一群煤矿工人的非传染性疾病危险因素

Q1 Medicine

International Journal of Occupational and Environmental Medicine

Pub Date : 2019-12-01 DOI: 10.1097/jom.0000000000001755

Andrew Mccarthy, Naransukh Damiran

OBJECTIVEPrevalence of non-communicable diseases (NCD) is growing among workers globally, causing 71% of all premature deaths. We determined baseline prevalence of risk factors among mine workers.METHOD1169 employees were randomly recruited to a cross sectional study. The study focused on key risk factors of hypertension, obesity, alcohol use and smoking status. These factors are known key contributors to NCD risk.RESULTSResults of the study showed prevalence's of hypertension 12.9%, obesity 64.1%, alcohol users 22.1% and smokers 38.8%. The general population prevalence's are 27.5%, 56.8%, 15.5% and 24.8% respectively.CONCLUSIONPrevalence of hypertension for the study cohort was lower than general population which may be the healthy worker effect. Obesity, alcohol use and smoking rates however, were slightly higher in the study cohort. Reducing the prevalence of risk factors will require significant resources.

目的非传染性疾病(NCD)在全球工人中的患病率正在上升，导致71%的过早死亡。我们确定了煤矿工人中危险因素的基线患病率。方法随机抽取1169名员工进行横断面研究。这项研究的重点是高血压、肥胖、饮酒和吸烟状况等关键风险因素。这些因素是已知的非传染性疾病风险的主要因素。结果高血压患病率12.9%，肥胖64.1%，酗酒22.1%，吸烟38.8%。一般人群患病率分别为27.5%、56.8%、15.5%和24.8%。结论研究队列高血压患病率低于一般人群，可能是健康工人效应所致。然而，肥胖、酗酒和吸烟率在研究队列中略高。减少危险因素的流行将需要大量资源。

引用次数: 3

Development of Prediction Model for the Prognosis of Sick Leave Due to Low Back Pain. 腰痛病假预后预测模型的建立。

Q1 Medicine

International Journal of Occupational and Environmental Medicine

Pub Date : 2019-12-01 DOI: 10.1097/JOM.0000000000001749

Lisa C. Bosman, J. Twisk, A. Geraedts, M. Heymans

OBJECTIVEThe aim of this study was to develop a prediction model for the prognosis of sick leave due to low back pain (LBP).METHODSThis is a cohort study with 103 employees sick-listed due to non-specific LBP and spinal disc herniation. A prediction model was developed based on questionnaire data and registered sick leave data with follow up of 180 days.RESULTSAt follow up 31 (30.1%) employees were still sick-listed due to LBP. Forward selection procedure resulted in a model with: catastrophizing, musculoskeletal work load, and disability. The explained variance was 27.3%, calibration was adequate and discrimination was fair with AUC = 0.761 [IQR: 0.755-0.770].CONCLUSIONThe prediction model of this study can adequately predict LBP sick leave after 180 days and could be used for employees sick listed due LBP.

目的:建立下腰背痛(LBP)病假的预后预测模型。方法对103名因非特异性腰痛和椎间盘突出而患病的员工进行队列研究。基于问卷调查数据和180天的挂号病假数据建立预测模型。结果随访中仍有31名员工(30.1%)因腰痛发病。前向选择程序产生了一个具有灾变、肌肉骨骼负荷和残疾的模型。解释方差为27.3%，校正充分，判别公平，AUC = 0.761 [IQR: 0.755-0.770]。结论本研究建立的预测模型能较好地预测180天后腰痛病假，可用于因腰痛而患病的员工。

引用次数: 7

What Can You Achieve in Eight Years? A Case Study on Participation, Effectiveness, and Overall Impact of a Comprehensive Workplace Health Promotion Program. 八年内你能取得什么成就?一个综合工作场所健康促进计划的参与、有效性和整体影响的案例研究。

Q1 Medicine

International Journal of Occupational and Environmental Medicine

Pub Date : 2019-12-01 DOI: 10.1097/JOM.0000000000001699

Antti Äikäs, P. Absetz, M. Hirvensalo, N. Pronk

OBJECTIVETo investigate participation and effectiveness of a multiyear comprehensive workplace health promotion (WHP) program.METHODSParticipation and effectiveness data came from employer and vendor systems. Health data came from health risk assessments (HRA) and biometric screenings. Participation and effectiveness were analyzed using descriptive analyses, T-tests and Mann-Whitney U tests where appropriate. Overall impact was assessed using the PIPE Impact Metric.RESULTS86% of employees completed the HRA and 80% the biometrical screenings. Annual participation rate was 24%, and total reach was 58%. The portion of successful participants was 23% in 2010-2013 and 18% in 2014-2017. PIPE Impact scores were 18% for 2010-2013 and 14% for the 2014-2017 study periods.CONCLUSIONDespite modest annual participation rates, overall eight year reach was considered reasonable. Conservatively, we consider the overall program impact to be moderate.

目的调查多年综合工作场所健康促进(WHP)计划的参与情况和效果。方法参与和有效性数据来自雇主和供应商系统。健康数据来自健康风险评估(HRA)和生物识别筛查。在适当的情况下，使用描述性分析、t检验和Mann-Whitney U检验来分析参与率和有效性。使用PIPE影响指标评估整体影响。结果86%的员工完成了人力资源调查，80%的员工完成了生物特征筛查。年参与率为24%，总覆盖率为58%。2010-2013年成功参与的比例为23%，2014-2017年为18%。2010-2013年的PIPE影响得分为18%，2014-2017年的研究期间为14%。结论:尽管年参与率不高，但总体8年的覆盖率是合理的。保守地说，我们认为整个项目的影响是适度的。

引用次数: 7

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全部化学•材料生命科学医学物理工程技术环境•农林材料科学地球科学法学管理学化学环境科学与生态学计算机科学教育学经济学农林科学人文科学生物学数学物理与天体物理心理学综合性期刊其他工业工程理学历史学农学文学信息工程

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