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Human Exposure to Asbestos in Central Asian Countries and Health Effects: A Narrative Review. 中亚国家人类接触石棉及其健康影响:述评。
IF 2.4 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-12-19 DOI: 10.23749/mdl.v115i6.15453
Zhyldyz Kurzhunbaeva, Kenesh Dzhusupov, Andrea Spinazzè, Silvia Damiana Visonà, Cholpon Sulaimanova, Omor Kasymov, Elena Belluso, Claudio Colosio

The discovery of the detrimental effects of asbestos on human health came long after its widespread use, with the first scientific evidence of asbestos-related diseases emerging in the late 19th and early 20th centuries. Despite efforts to ban its use, asbestos continues to be mined and used in Central Asia (as well as in Russia, China, and other countries). To gain a deeper understanding of the situation in Central Asia, we have conducted a systematic review of scientific literature on the use of asbestos, exposure assessment, and health consequences of asbestos exposure in this geographic area. This review encompasses studies about exposure assessments, epidemiological data, and biochemical or clinical surveys conducted in Kazakhstan, Uzbekistan, Tajikistan, Turkmenistan, and Kyrgyzstan. A total of 18 articles met the inclusion criteria, and their content is summarised in this review, which represents the first attempt to systematically examine research on asbestos and its impact on the health of workers and the general population in Central Asia countries, including literature published in Russian and English. The findings here highlighted the substantial limitations of the currently available knowledge about the impact of asbestos on health in this geographical area.

石棉对人体健康的有害影响是在其广泛使用很久之后才被发现的,与石棉有关的疾病的第一个科学证据出现在19世纪末和20世纪初。尽管各国努力禁止使用石棉,但在中亚(以及俄罗斯、中国和其他国家),石棉仍在开采和使用。为了更深入地了解中亚的情况,我们对有关该地理区域石棉使用、暴露评估和石棉暴露的健康后果的科学文献进行了系统审查。本综述包括在哈萨克斯坦、乌兹别克斯坦、塔吉克斯坦、土库曼斯坦和吉尔吉斯斯坦进行的暴露评估、流行病学数据和生化或临床调查研究。共有18篇文章符合纳入标准,本文对其内容进行了总结,这是首次尝试系统地审查有关石棉的研究及其对中亚国家工人和一般人群健康的影响,包括以俄文和英文发表的文献。这里的调查结果突出表明,目前关于石棉对该地理区域健康影响的现有知识存在很大局限性。
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引用次数: 0
Reflecting on Success and Looking Towards the Future. 反思成功,展望未来。
IF 2.4 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-12-19 DOI: 10.23749/mdl.v115i6.16629
Antonio Mutti
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引用次数: 0
Immediate Effects of Whole Body Vibration on Proprioception and Upper Extremity Reaction Speed in Young Adult Students. 全身振动对青年学生本体感觉及上肢反应速度的直接影响。
IF 2.4 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-12-19 DOI: 10.23749/mdl.v115i6.16523
Cagtay Maden, Sedat Yiğit, Demet Karabulut, Fatma Betül Kavak, Hatice Yıldırım, Gönül Elpeze, Mehmet Göl

Background: There is limited information on the immediate effects of whole-body vibration (WBV) on the upper limb. This study aims to determine the immediate effects of WBV on reaction speed and proprioception in young adult students' upper extremities.

Methods: In total, 62 students participated in the study. WBV was applied to the participants, and its immediate effects on proprioception and upper extremity reaction speed were examined. Participants' proprioception and perception of joint position at 30-60 degrees of shoulder flexion, shoulder abduction, and elbow flexion angles were measured with absolute error degrees. Reaction rates were evaluated with the Ruler-Drop Test and the mobile application SWAY.

Results: A decrease was observed in the absolute error level of the participants' joint position perception at 30-60 elbow and shoulder position degrees, measured after immediate WBV application (p <0.05). After the RDT application, a decrease in the length of catching the target was observed (p <0.05). The SWAY test determined that they moved the smartphone in a shorter time (p <0.05). Right and left RDT scores showed that the distance to catch the ruler was significantly lower in male individuals before the application. In comparison, the distance to catch the ruler was lower after the application (right/left p<0.05).

Conclusions: The study found that applying WBV improved upper extremity proprioception perception and reaction speed in young adults. This information can guide clinicians in applying WBV to healthy individuals and those with symptoms.

背景:关于全身振动(WBV)对上肢的直接影响的信息有限。本研究旨在探讨白脑对青年学生上肢反应速度和本体感觉的直接影响。方法:共62名学生参与研究。将WBV应用于被试,观察其对本体感觉和上肢反应速度的直接影响。以绝对误差度测量参与者在30-60度肩屈、肩外展和肘关节屈曲角度的本体感觉和关节位置感知。用尺子跌落测试和移动应用程序SWAY评估反应率。结果:立即应用WBV后,观察到参与者在30-60肘部和肩部位置度的关节位置感知的绝对误差水平降低(p)。结论:研究发现,应用WBV改善了年轻人上肢本体感觉知觉和反应速度。这些信息可以指导临床医生对健康个体和有症状的个体应用白细胞计数。
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引用次数: 0
Per- And Poly-Fluoroalkyl Substances (PFAS) Exposure and Risk of Breast, and Female Genital Cancers: A Systematic Review and Meta-Analysis. 全氟和多氟烷基物质(PFAS)暴露与乳腺癌和女性生殖器癌的风险:系统回顾和荟萃分析。
IF 2.4 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-12-19 DOI: 10.23749/mdl.v115i6.16330
Monireh Sadat Seyyedsalehi, Elizabeth Maria Kappil, Sirui Zhang, Tongzhang Zheng, Paolo Boffetta

Background: PFASs, synthetic chemicals, can be encountered by humans through occupational or environmental exposure, and some reports suggest that they can disrupt endocrine and hormonal activities. In this comprehensive review and meta-analysis, we explored the connection between exposure to PFASs and the risks of breast and female genital cancers.

Methods: We systematically reviewed the literature from IARC Monographs, ATSDR documents, and PubMed (as of January 2024) for cohort, case-control, and ecological studies on PFAS exposure and breast or female genital cancers. Four reviewers independently screened studies, and data extraction included study design, patient characteristics, and effect size measures. The quality of studies was assessed using the modified version of the Newcastle-Ottawa Scale (NOS). Forest plots of relative risks (RR) were constructed for breast and female genital cancer. Meta-analyses were conducted using random-effects models, stratified analyses, dose-response assessments, and publication bias evaluation.

Results: The meta-analysis included 24 studies, comprising 10 cohort, 13 case-control, and one ecological study. The summary relative risk (RR) of breast cancer for PFOA exposure was 1.08 (95% CI = 0.97-1.20; n=21), and for PFOS was 1.00 (95% CI = 0.85-1.18; n=12). The RR for ovarian cancer and PFAS was 1.07 (95% CI = 1.04-1.09; n=12). The stratification by quality score, year of publication, and exposure source did not reveal any differences. However, analysis by geographical region (p=0.01) and study design (p=0.03) did show differences, particularly in terms of incidence. Stratified analyses of the dose-response relationship did not reveal a trend in the risk of breast cancer or female genital cancers, and no publication bias was found for either cancer type. No results were available for cervical and endometrial cancers.

Conclusion: In summary, we have found an association between PFAS exposure and ovarian cancer and a possible effect on breast cancer incidence in some specific groups. Although potential bias and confounding prevent conclusions regarding causality, these findings may hold significance for females who encounter such pollutants in their occupational or daily environments.

背景:全氟辛烷磺酸是一种合成化学物质,人类可以通过职业或环境接触接触到它们,一些报告表明它们可以扰乱内分泌和激素活动。在这项综合综述和荟萃分析中,我们探讨了PFASs暴露与乳腺癌和女性生殖器癌风险之间的联系。方法:我们系统地回顾了IARC专著、ATSDR文件和PubMed(截至2024年1月)的文献,包括PFAS暴露与乳腺癌或女性生殖器癌的队列、病例对照和生态学研究。四名审稿人独立筛选研究,数据提取包括研究设计、患者特征和效应量测量。研究质量采用改良版纽卡斯尔-渥太华量表(NOS)进行评估。构建了乳腺癌和女性生殖器癌的相对危险度森林图(RR)。meta分析采用随机效应模型、分层分析、剂量反应评估和发表偏倚评估。结果:meta分析纳入24项研究,包括10项队列研究、13项病例对照研究和1项生态研究。PFOA暴露导致乳腺癌的总相对危险度(RR)为1.08 (95% CI = 0.97-1.20;n=21),全氟辛烷磺酸为1.00 (95% CI = 0.85-1.18;n = 12)。卵巢癌和PFAS的RR为1.07 (95% CI = 1.04-1.09;n = 12)。质量评分、出版年份和暴露源的分层没有发现任何差异。然而,按地理区域(p=0.01)和研究设计(p=0.03)进行的分析确实显示出差异,特别是在发病率方面。剂量-反应关系的分层分析没有揭示乳腺癌或女性生殖器癌风险的趋势,也没有发现两种癌症类型的发表偏倚。子宫癌和子宫内膜癌没有结果。结论:总之,我们已经发现PFAS暴露与卵巢癌之间存在关联,并可能对某些特定人群的乳腺癌发病率产生影响。虽然潜在的偏见和混淆妨碍了对因果关系的结论,但这些发现可能对在职业或日常环境中遇到此类污染物的女性具有重要意义。
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引用次数: 0
Occupational Exposure to Benzene and Risk of Breast Cancer: Systematic Review and Meta-Analysis. 职业暴露于苯与乳腺癌风险:系统回顾与元分析》。
IF 2.4 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-10-24 DOI: 10.23749/mdl.v115i5.16306
Monireh Sadat Seyyedsalehi, Vincent Destefano, Darshi Shah, Veer Shah, Mattia Bonetti, Paolo Boffetta

Introduction: Benzene is a recognized carcinogen; however, its association with breast cancer is not well established. Hence, a meta-analysis of cohort and case-control studies was performed to determine the association between occupational benzene exposure and the risk of breast cancer.

Methods: A systematic literature review identified 7573 publications from which 23 cohort and case-control studies were retained and evaluated using meta-analyses (fixed effects model). PRISMA guidelines were followed. Our protocol was registered in the PROSPERO database (Registration No. CRD42022379720). Study quality was assessed using a modified Newcastle-Ottawa scale (NOS).

Results: The summary relative risk (RR) for ever-benzene exposure was 1.08 (95% CI=1.03-1.14, I2=38.6%, n=23 risk estimates); corresponding RR for cancer incidence and mortality were 1.08 (95% CI=1.02-1.14, I2=56.1%, n=16) and 1.10 (95% CI=0.87-1.37, I2<0.001%, n=10). However, heterogeneity was detected for sex (p-het=0.002), publication year (p-het<0.001), study design (p-het<0.001), study quality (p-het<0.001), and industry of employment (p-het=0.03). The RR for high level of exposure showed positive association with breast cancer 1.35 (95% CI=1.06-1.72, I2 =<0.001%, n=3) and (P-het=0.64). Publication bias was detected (p=0.03).

Conclusions: The results of our meta-analysis indicate a positive association between occupational benzene exposure and an increased risk of breast cancer, particularly when exposed to higher levels of benzene. However, bias and confounding could not be excluded.

简介:苯是一种公认的致癌物质,但其与乳腺癌的关系尚未得到充分证实。因此,我们对队列研究和病例对照研究进行了荟萃分析,以确定职业苯暴露与乳腺癌风险之间的关系:方法:通过系统性文献综述确定了 7573 篇文献,从中保留了 23 项队列研究和病例对照研究,并使用荟萃分析(固定效应模型)对其进行了评估。研究遵循了 PRISMA 指南。我们的研究方案已在 PROSPERO 数据库中注册(注册号:CRD42022379720)。研究质量采用修改后的纽卡斯尔-渥太华量表(NOS)进行评估:曾经接触苯的总相对风险 (RR) 为 1.08(95% CI=1.03-1.14,I2=38.6%,n=23 个风险估计值);癌症发病率和死亡率的相应 RR 分别为 1.08(95% CI=1.02-1.14,I2=56.1%,n=16)和 1.10(95% CI=0.87-1.37,I2C):我们的荟萃分析结果表明,职业性苯暴露与乳腺癌风险增加之间存在正相关,尤其是当暴露于较高水平的苯时。但是,无法排除偏倚和混杂因素。
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引用次数: 0
Occupational Safety and Health of Riders Working for Digital Food Delivery Platforms in the City of Milan, Italy. 意大利米兰市数字送餐平台骑手的职业安全与健康。
IF 2.4 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-10-24 DOI: 10.23749/mdl.v115i5.16278
Luca Boniardi, Laura Campo, Sofia Prudenzi, Luciano Fasano, Paolo Natale, Dario Consonni, Michele Carugno, Angela Cecilia Pesatori, Silvia Fustinoni

Background: The rapid growth of the digital economy has transformed various labor markets, including the food sector. The transient nature and the peculiar work environments of food delivery workers raise concerns about occupational safety and health (OSH). This study aims to better understand these issues by conducting a comprehensive exploratory survey on OSH among food delivery riders in Milan, Italy.

Methods:  The study employed structured interviews based on a validated questionnaire developed through a literature review, expert interviews, and input from riders and health and safety professionals. The survey was performed from July to November 2022 by interviewing riders at their main gathering points.

Results: We interviewed 240 riders, 97% males, 81% less than 35 years old, and 83% with extra-European origin. Delivery was performed mainly by traditional bicycles (40%) and e-bikes (46%), with 44% working seven days per week and 23% working more than 8 hours daily. Road accidents were reported by 39% of riders, influenced by type of vehicle, fatigue, and number of daily deliveries. Physical and verbal assaults (12% and 28%, respectively) were reported, as well as health-related issues, particularly musculoskeletal disorders.

Conclusions: The findings underscore food delivery riders' complex challenges, emphasizing the need for targeted interventions. The study calls for collaborative efforts between policymakers, employers, OSH professionals, and stakeholders to enhance OSH standards and promote decent working conditions, aligning with the 2030 Agenda for Sustainable Development.

背景:数字经济的快速发展改变了包括食品行业在内的各种劳动力市场。送餐员的流动性和特殊的工作环境引起了人们对职业安全与健康(OSH)的关注。本研究旨在通过对意大利米兰食品外卖骑手的职业安全和健康进行全面的探索性调查,更好地了解这些问题: 研究采用了结构化访谈的方法,该方法基于通过文献综述、专家访谈以及骑手和健康与安全专业人士的意见而制定的有效问卷。调查于 2022 年 7 月至 11 月在骑手的主要聚集点进行:我们采访了 240 名骑手,其中 97% 为男性,81% 年龄在 35 岁以下,83% 来自欧洲以外地区。主要使用传统自行车(40%)和电动自行车(46%)送货,44%的人每周工作七天,23%的人每天工作超过 8 小时。39%的骑行者报告了交通事故,影响因素包括车辆类型、疲劳程度和每日送货次数。此外,还报告了人身攻击和语言攻击(分别占 12% 和 28%)以及与健康有关的问题,尤其是肌肉骨骼疾病:研究结果凸显了送餐员面临的复杂挑战,强调了采取有针对性干预措施的必要性。这项研究呼吁决策者、雇主、职业安全和健康专业人员以及利益相关者通力合作,提高职业安全和健康标准,促进体面的工作条件,与《2030 年可持续发展议程》保持一致。
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引用次数: 0
Factor Structure, Psychometric Properties, and Measurement Invariance of the Pandemic Experiences and Perceptions Scale Among Italian Hospital Workers. 意大利医院工作人员大流行病经历和感知量表的因子结构、心理测量特性和测量不变性。
IF 2.4 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-10-24 DOI: 10.23749/mdl.v115i5.16053
Igor Portoghese, Maura Galletta, Michael P Leiter, Ilenia Piras, Luigi Isaia Lecca, Monica Puligheddu, Marcello Campagna

Background: The COVID-19 pandemic represented substantial risks to hospital workers' physical and mental health. The availability of validated measures on the impact of the pandemic on workplaces is crucial for developing data-driven interventions. The primary purpose of our study was to translate it into Italian and assess factor structure, psychometric properties, and measurement invariance of the Pandemic Experiences and Perceptions Scale (PEPS).

Methods: The survey was completed by 766 workers from an Italian hospital. We examined the internal structure of the PEPS using confirmatory factor analyses (CFA) and exploratory structural equation modeling (ESEM) techniques and testing the invariance for clinical vs. nonclinical workers.

Results: The six-factor ESEM solution showed an excellent fit to the data (CFI=0.956, TLI=0.932, RMSEA=0.050), supporting the superiority of the ESEM solution. The factorial invariance of the PEPS across occupational roles (clinical vs. nonclinical hospital workers) was supported, and the ESEM-based McDonald's omega was good for all factors.

Conclusions: The results from this study provided evidence for the factorial validity, reliability, and measurement invariance across occupational roles of the Italian version of the PEPS. Thus, the Italian version of the PEPS is a reliable and valid tool for assessing pandemic experiences and perceptions among Italian workers.

背景:COVID-19 大流行给医院工作人员的身心健康带来了巨大风险。提供有关大流行病对工作场所影响的有效测量方法对于制定数据驱动的干预措施至关重要。我们研究的主要目的是将该量表翻译成意大利文,并评估大流行病经历与感知量表(PEPS)的因子结构、心理测量特性和测量不变性:一家意大利医院的 766 名员工完成了调查。我们使用确证因子分析(CFA)和探索性结构方程建模(ESEM)技术研究了 PEPS 的内部结构,并测试了临床与非临床工作人员的不变性:六因素 ESEM 方案与数据的拟合度非常好(CFI=0.956、TLI=0.932、RMSEA=0.050),证明了 ESEM 方案的优越性。PEPS在不同职业角色(临床与非临床医院工作人员)之间的因子不变性得到了支持,基于ESEM的麦当劳欧米茄对所有因子的拟合效果良好:本研究的结果为意大利版 PEPS 的因子效度、可靠性和不同职业角色的测量不变性提供了证据。因此,意大利语版 PEPS 是评估意大利工人对大流行病的体验和看法的可靠而有效的工具。
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引用次数: 0
Psychometric Evaluation of a Measure of Evidence-Based Practice in Occupational Health. 职业健康循证实践测量的心理计量学评估。
IF 2.4 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-10-24 DOI: 10.23749/mdl.v115i5.16286
Jani Ruotsalainen, Kati Päätalo, Kari-Pekka Martimo, Tuula Oksanen

Background: Occupational Health Services (OHS) are obliged to follow the principles of evidence-based medicine. However, there needs to be tools to measure this. Therefore, we developed and validated a questionnaire for evaluating OHS practitioners' attitudes, competence, and organisational support to perform evidence-based practice (EBP-OHS) following the JBI Model of Evidence-Based Healthcare.

Methods: The questionnaire's content validity was assessed by 12 experts in the field. Then, an opportunity sample of 549 OHS practitioners completed the questionnaire. We examined the questionnaire's psychometric properties using exploratory factor analysis and subjected it to construct validity and reliability testing.

Results: The content validity index of the chosen items was 0.78 or higher. Exploratory factor analysis revealed that the measure's construct validity was adequate (KMO 0.9). Principal component factor analysis supported a three-factor structure (all eigenvalues 1.3 or more), which explained 60.3 % of the total variance. Aligned with these three factors, the EBP-OHS consists of three domains: Organisational support (seven items), OHS practitioners' competence (six items) and OHS practitioners' attitudes (two items). The scale's reliability is good (Cronbach alpha 0.88).

Conclusions: The EBP-OHS is a valid tool for measuring occupational health services' evidence-based practice and enabling the implementation of research into practice. It embodies the phases of evidence transfer and implementation described in the JBI Model of Evidence-Based Healthcare and translates them into concrete measurable activities in the OHS context.

背景:职业健康服务(OHS)有义务遵循循证医学原则。然而,需要有工具来衡量这一点。因此,我们开发并验证了一份问卷,用于评估职业健康服务从业人员的态度、能力和组织支持,以按照 JBI 循证医疗模式开展循证实践(EBP-OHS):方法:12 位该领域的专家对问卷的内容有效性进行了评估。然后,549 名职业健康与安全从业人员完成了问卷调查。我们使用探索性因素分析法检验了问卷的心理测量特性,并对其进行了构建效度和信度测试:结果:所选项目的内容效度指数均在 0.78 或以上。探索性因素分析表明,问卷的结构效度良好(KMO 0.9)。主成分因子分析支持三因子结构(所有特征值均在 1.3 或以上),解释了总方差的 60.3%。根据这三个因子,EBP-OHS 包含三个领域:组织支持(七个项目)、职业健康安全从业人员的能力(六个项目)和职业健康安全从业人员的态度(两个项目)。量表的信度良好(Cronbach alpha 0.88):EBP-OHS 是衡量职业健康服务循证实践的有效工具,有助于将研究成果应用于实践。它体现了 JBI 循证医疗模式中描述的证据转移和实施阶段,并将其转化为职业健康和安全背景下可衡量的具体活动。
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引用次数: 0
We Need to Develop, Not Forget, Our Toxicological Knowledge. 我们需要发展而不是遗忘我们的毒理学知识。
IF 2.4 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-10-24 DOI: 10.23749/mdl.v115i5.16440
Pietro Apostoli
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引用次数: 0
Depression and Anxiety in Voluntarily Unemployed People: A Systematic Review. 自愿失业者的抑郁和焦虑:系统回顾
IF 2.4 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-10-24 DOI: 10.23749/mdl.v115i5.15850
Ivan Borrelli, Paolo Emilio Santoro, Giuseppe Melcore, Antongiulio Perrotta, Maria Francesca Rossi, Maria Rosaria Gualano, Umberto Moscato

Background: Unemployment impacts people's physical and psychological well-being, and gender and age affect mental health among the unemployed. Despite the correlation between unemployment and negative mental health outcomes being largely investigated in scientific literature, research on voluntarily unemployed individuals is scarce. A systematic review was performed on studies evaluating mental health outcomes in voluntarily unemployed adults.

Methods: Following the PRISMA statements, three databases were screened; research articles written in English investigating the relationship between mental health outcomes and employment status were included. The quality of articles was assessed using the Newcastle-Ottawa Scale.

Results: The initial search yielded 727 records; 4 studies were included in this systematic review. One study reported voluntarily unemployed people as less depressed than employed and unemployed people, one as more depressed than employed but less than unemployed people, one reported voluntarily unemployed people as less anxious but more depressed than employed and less anxious and depressed than unemployed people, one study reported voluntarily unemployed men as depressed and anxious more often than employed men. Further research should investigate mental health outcomes in voluntarily unemployed people and strategies to bring back these individuals into the workforce.

背景:失业会影响人们的身心健康,性别和年龄会影响失业者的心理健康。尽管科学文献对失业与负面心理健康结果之间的相关性进行了大量研究,但有关自愿失业者的研究却很少。我们对评估自愿失业成年人心理健康结果的研究进行了系统性回顾:根据 PRISMA 声明,筛选了三个数据库;纳入了调查心理健康结果与就业状况之间关系的英文研究文章。文章质量采用纽卡斯尔-渥太华量表进行评估:初步搜索共获得 727 条记录;4 项研究被纳入本系统综述。一项研究报告称,自愿失业者的抑郁程度低于就业者和失业者;一项研究报告称,自愿失业者的抑郁程度高于就业者,但低于失业者;一项研究报告称,自愿失业者的焦虑程度低于就业者,但抑郁程度高于就业者,焦虑和抑郁程度低于失业者;一项研究报告称,自愿失业男性的抑郁和焦虑程度高于就业男性。进一步的研究应调查自愿失业者的心理健康结果,以及让这些人重返劳动力队伍的策略。
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引用次数: 0
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