Journal of Occupational Medicine and Toxicology最新文献

Background: Occupational Health Services (OHS) are comprehensive, multidisciplinary services supplied by various trained workers, including occupational physicians (OP), whose specialty is focused on workers' health.

Aims: Our study questions are whether the OP/worker ratio may reflect the scope and availability of OHS.

Methods: This comparative study, conducted on globally different OHS, was based on literature analysis of peer-reviewed articles published in journals covering topics of occupational medicine and public health that addressed parameters on the type and scope of OHS provision.

Results: We described the number of OP/worker ratio, and the correlation to economic parameters (Gross domestic product-GDP, health expenditure, Gini Index-GI) by country. We found that among countries with a GDP per capita higher than US$30,000, only three (US, South Korea and Israel) had a very low OP/worker ratio (about 1:50,000 compared to 1:5,000 in other countries). Looking at all the countries together, there was a statistically significant negative correlation between health expenditure percentage of GDP per capita and OP/worker ratio (rs = -0.54, p = 0.01) and a significant positive correlation between GI and OP/worker ratio (rs = 0.47, p = 0.04).

Conclusions: The lesser the percentage of health expenditure of GDP and the subsequent greater general inequality as reflected by the GI, the lower the OP/worker ratio. The data collected in our comparative study show that the OP/worker ratio is a parameter both easy to define and obtain which best represents the status and disparity of OHS in each country.

Background: So far, previous research suggests positive effects of mental demands at the workplace. However, it may depend on how stressfull these demands are perceived on an individual level.

Objective: The aim was to build on previous research by investigating how mental demands are related to stress, overload, and work discontent and whether this relationship is mediated by individuals resources, such as resilience.

Method: A sub-sample of the LIFE Adult Cohort (n = 480) was asked to answer questions on sociodemographic characteristics, objective stress (using the Trier Inventory of Chronic Stress (TICS)), and perceptions of stress with regard to verbal and executive mental demands at work.

Results: According to generalized linear regression models, higher verbal as well as executive mental demands were associated with higher levels of chronic stress, work overload and discontent. Higher levels of resilience were associated with lower levels of these outcomes. Analyses regarding interaction effects revealed that the interaction between resilience and perceived stress of verbal mental demands was significant only in terms of work overload.

Conclusion: Higher perceived stressfulness of mental demands was associated with higher chronic stress, work overload and work discontent. Therefore, mental demands should be targeted by occupational interventions that aim to improve job conditions and employees' overall well-being. Besides resilience, other potential influencers or personal resources should be focused on in future studies to develop interventions.

Background: Although conventional electrophysiological parameters have been proposed as clinical indicators for monitoring lead neuropathies, their correlations with blood lead level are weak. In this study, we investigated the applicability of nerve excitability tests (NETs) to evaluate lead intoxication.

Methods: Fourteen workers who were exposed to lead with an elevated blood level ranging from 17.8 to 64.9 µg/dL and 20 healthy controls with similar ages and body heights were enrolled. Both workers and controls underwent nerve conduction studies (NCSs), motor evoked potentials (MEPs) with transcranial magnetic stimulation (TMS), and NETs.

Results: NCSs showed prolonged distal latencies and decreased motor nerve conduction velocity of median nerves in the workers but without significant correlation to blood lead level (BLL). Significantly prolonged MEP latency was observed in the workers (+ 6 ms). NETs demonstrated hyperpolarized resting membrane potentials in stimulus-response curves and changes in the property of potassium channels under a hyperpolarized current in threshold electrotonus, implying that lead hyperpolarized nerves by interfering with potassium channels. NETs also showed a better correlation with BLL than conventional electrophysiological parameters.

Conclusions: Axonal hyperpolarization and central conduction delay are more apparently reflecting elevated BLL than NCS. NET may have the potential for early detection of lead neuropathy.

Background: Small and medium-sized enterprises (SMEs) face major financial losses due to mental health issues affecting employees at all levels but seldom apply programs to promote wellbeing and prevent mental health issues among employees. To support the development of a multi-country workplace-based mental health intervention for SMEs (MENTUPP), a multinational consultation study was conducted. The study aimed to examine the experiences and needs of SMEs concerning the promotion of employee wellbeing, and the prevention and management of non-clinical mental health problems in workplaces.

Methods: A survey consisting of open and closed questions was designed to assess key informants' opinion about the acceptability, the use, and the implementation of interventions to promote wellbeing and prevent mental health issues in the workplace. Academic experts and representatives of SME organisations, specific sector organisations, labour or advocacy groups, and occupational health organisations across the nine MENTUPP intervention countries (eight European countries and Australia) were invited to complete the survey. Data were collected via the online platform Qualtrics. Sixty-five of 146 informants responded, representing a 44.5% response rate. Descriptive statistics were used to analyse the quantitative data and qualitative data were analysed through thematic analysis.

Results: Measures to create mentally healthy workplaces were most used in SMEs, while more specific mental health interventions, such as training staff on how to promote wellbeing, were hardly used. Managers lack resources to implement mental health interventions and are concerned about employees spending too much time on these interventions during working hours. Receiving information about the economic benefits of mental health interventions and hearing successful testimonials from other SMEs can persuade managers otherwise. Employees have concerns about confidentiality, discrimination and stigma, and career opportunities when using such interventions.

Conclusions: The study identifies a variety of challenges, needs and possibilities related to implementing mental health interventions in SMEs. Employers need to be convinced that investing in mental health in the workplace is worth their time and money. This requires more studies on the (cost-)effectiveness of mental health interventions. Once employers are engaged, their knowledge and competencies about how to implement such interventions should be increased and privacy concerns of employees to participate in them should be addressed.

Background: Household cleaning products are the second most common cause of unintentional poisoning in children < 6 years old in the United States. The aim of this study is to characterize exposures to household cleaning substances in this age group from data collected from the Nation's Poison Control Centers.

Methods: This cross-sectional study analyzed all household cleaner calls classified as age < 6 years old made to the American Association of Poison Control Centers between January 1st 2000 and December 31th 2015.

Results: Significant clinical effects or injury was low, making up only 2.6% of cases with a known medical outcome. Alkali-based cleaning products accounted for the third highest frequency of overall exposures and the highest number of all exposure outcomes determined to have a significant clinical effect or injury.

Conclusions: This study demonstrated particular danger of adverse outcomes after exposure to alkali-based cleaning products, specifically alkali-based oven and drain cleaners. Both of which are readily accessible in many households. This study may be a good starting point for further study and poison prevention efforts.

Background: Silver nanoparticles (AgNPs) are widely used in medicine owing to their antiseptic activity and inducing cell death. Despite AgNPs' importance in nano-engineering and medical benefits, animal studies have shown silver toxicity can damage multiple organs such as the lungs, liver, kidneys, intestines, and brain. Several investigations revealed the correlation between Ag administration by different methods with impaired cognitive and behavioral abilities. Therefore, this systematic review aimed to conclude on the existing evidence of impairments in learning and memory that were changed in rodents exposed to AgNPs.

Methods: Main searches were retrieved in Google Scholar, Scopus, Web of Science, and PubMed databases from 1979 to 2022. Eligibility Criteria were applied to select and extract 15 articles among 892.

Results: Learning and memory abilities of rats and mice in screened studies were evaluated with MWM, NORT, PAL, T-maze, Y-maze, contextual fear conditioning, Radial Arm Maze and Carousel Maze test. Data have shown various sizes from 10 to 100 nm could affect the results of tests among animals exposed to AgNPs compared with control animals. However, in some treatments, results achieved from tests have not demonstrated significant differences between control and treated groups.

Conclusion: Studies have revealed that treatment with Ag-NPs of different sizes can impair learning and memory skills in rats and mice.

Background: During the first wave of the Covid-19 pandemic in 2020, a total lockdown of universities was implemented by the government in Belgium. University staff was required to work at home. The purpose of the study was to identify factors associated with poor mental health in university staff during mandatory home work.

Methods: Mental well-being of 702 university employees was assessed by need for recovery after work and presence of burnout symptoms. Following factors were considered: personal factors (gender, age), professional status, specific home work environment factors (quiet place to work, taking care of ill or old people, number of children < 12yrs. at home, family member at risk for Covid-19), work-private life balance and worries about long- and short-term work situation. Multivariable logistic regression analyses were used to calculate the odds ratios for the presence a high need for recovery and burnout symptoms.

Results: The presence of a high need for recovery and the presence of burnout symptoms were significantly associated with poor work-private life balance (OR 5.14 and 2.80, respectively), no quiet place to work (OR 3.23 and 2.00, respectively) and being worried about long-term work situation (OR's increasing with increasing degree of worries). Being able to discuss the worries with the supervisor was only significant with a decreased risk of burnout symptoms for the lowest level of discussability with the supervisor. Following factors were not associated with both mental health outcomes: professional status, being worried about short-term work situation, taking care of ill or old people, number of children < 12yrs. at home and having a family member at risk for Covid-19.

Conclusions: When working at home special attention should be paid to work-private life balance and the presence of a quiet place to work. Additionally, in the case of mandatory home work in university personnel, specific worries about long-term work situation should be tackled. Universities and/or governments should provide measures to ensure an extension of research deadlines and, if applicable, job security.

Introduction: Arrhythmias are one of the most common causes of loss of flying privileges for both military and civilian pilots in the Western World, and atrial fibrillation (AF) is one of the most common arrhythmias worldwide. Aircrew, and particularly pilots, are subject to a unique and exacting working environment, especially in high-performance military aircraft. This manuscript analyzes AF cases in German military aircrew from both a clinical and occupational perspective to point out specific characteristics in this comparatively young, highly selected, and closely monitored group, and to discuss AF management with the aim of a return to flying duties.

Methods: The digital information systems of the German Air Force Centre of Aerospace Medicine (GAFCAM) were searched for aircrew (pilot and non-pilot aircrew from German Air Force, Army, and Navy) with the diagnosis of AF. Evaluation results for underlying disease, AF characteristics, important clinical findings, and occupational decisions were analyzed in the light of current clinical guidelines and aeromedical regulations.

Results: In a 34-year period, between March 1989 and January 2023, 42 aircrew with at least one episode of AF were registered, all of them were male. The median age at initial diagnosis was 47 years (min 22 years, max 62 years). The median follow-up period was 5.35 years. 19 of them (45%) were pilots. The breakdown of events and occurrence was found to be: single (23), paroxysmal (16), persistent (2), permanent (1). In 27 aircrew (64%) AF terminated spontaneously. Long-term recurrence prevention was variable with catheter ablations in 8 cases. 36/42 aircrew were returned to flight status with restrictions, while 6/42 were permanently disqualified from flying.

Conclusion: Management of AF in military aircrew requires a comprehensive approach regarding the flight environment as well as clinical guidance. Aeromedical disposition should be case-by-case based on aeromedical regulations, individual clinical findings, and specific occupational requirements in this challenging field of work.

Background: The number of industrially injured workers (IIW) is increasing in Korea. However, little research has been conducted on whether first aid is performed at industrial sites or on the association between first aid for industrial injuries and the prognosis of IIW, including healthcare utilization.

Methods: A total of 3,092 participants (2,562 males and 530 females) were analyzed during the 4-year study period, which contributed to 11,167 observations. Healthcare utilization was evaluated based on the number of outpatient visits, hospitalizations, and duration of hospitalization using a generalized estimating equation Poisson regression. Several time-varying socioeconomic characteristics and information about the injury were adjusted, and transfer time to the medical institutions was also considered.

Results: During 4-year after the termination of medical treatment, participants who had not receive first aid visited outpatient clinics 15.243 times per year, and those who had visited 13.928 times per year, which is 16.16% less (adjusted relative risk [aRR]: 0.838, 95% CI = 0.740-0.950). Participants who had received on-site first aid with less than a 0.5-hour transfer time to the medical institutions visited outpatient clinics 14.87% less per year than those who had not received first aid (aRR: 0.851, 95% CI = 0.750-0.966).

Conclusion: To reduce the long-term outpatient utilization rate for IIW after medical treatment, on-site first aid must be provided in a timely manner. Employee education and first aid training are also necessary.