Occupational Medicine-Oxford最新文献

Background: The association between occupational titles and lung function has mostly been examined through cross-sectional studies. Preventive measures are expected to mitigate adverse effects; hence, updated estimates are necessary.

Aims: To study change in lung function measured by spirometry across occupations.

Methods: This population-based prospective cohort study comprised 5618 working adult participants of the Trøndelag Health Study (HUNT3, 2005-07), Norway. Among these, 3800 individuals (43% men, mean age 42 years, range 20-55) also attended HUNT4 (2017-19). We analysed longitudinal decline in forced expiratory volume in 1 second (FEV1) z-score during the 11-year follow-up by occupation (white-collar workers as reference category), in mixed models, adjusting for age, sex and smoking. We assessed the prevalence of self-reported respiratory symptoms and disease in the working population in HUNT4 (n = 32 124) and HUNT3 (n = 32 070).

Results: Compared with white-collar workers, agricultural workers and 'drivers and mobile plant operators', had larger declines in FEV1z-score during follow-up. In sex-stratified analyses, men defined as agricultural workers and 'drivers and mobile plant operators' had larger declines than white-collar workers. Among women, who were underrepresented in many blue-collar jobs, workers classified as 'machine operators and assemblers' experienced greater declines. In the working population in HUNT4, the prevalence of respiratory symptoms in connection with work was 8%, and lower among white-collar workers (6%) than blue-collar workers (14%).

Conclusions: Although certain workers in Norway remain at risk for occupational lung function decline, there were modest differences between occupations. The findings encourage continuous efforts to implement preventive measures in high-risk jobs.

Background: Occupational exposure to solar ultraviolet (UV) is known to cause malignant melanoma (MM) and non-melanoma skin cancer (NMSC). However, knowledge of the causal associations has developed erratically.

Aims: This review aims to identify when it was accepted that workplace solar UV exposure could cause skin cancer and when it was recognized that there was a risk for outdoor workers in Britain, identifying the steps employers should have taken to protect their workers.

Methods: Informative reviews, published since 1974, were located through a systematic literature search. These were used to chart changes in summative knowledge of the role of occupational solar UV exposure in causing skin cancer. An assessment was made of the identified hazards of skin cancer and the recognition of risks for outdoor workers in Britain.

Results: From at least 1975, it has been accepted that occupational solar UV exposure could cause squamous cell carcinoma, and from around 2011 for MM and basal cell carcinoma. From 2004, repeated sunburn at work was identified as a likely cause of MM. From 1999, it was accepted that occupational solar UV exposure causes NMSC amongst British workers, and from 2012 there was limited evidence for an MM risk for outdoor workers in northern European countries.

Conclusions: Skin cancer risks for British outdoor workers should be actively managed and they should have health surveillance. Outdoor workers who have skin cancer should be eligible for compensation.

Dental professionals who handle dental amalgam are at risk of mercury exposure, though the prevalence and severity of elevated mercury levels from non-occupational sources are not well characterized. We report two dental workers who had elevated urinary mercury levels (37 and 25.6 mcg/L) during routine health screenings. Their previous mercury tests were normal, and no symptoms or abnormal findings were identified on clinical examination. Mercury exposure in these two workers occurred both occupationally through amalgam contact and non-occupationally via unregulated facial creams and seafood consumption. Their urine mercury levels normalized within 2 months after transitioning to amalgam-free roles and discontinuing the use of the facial products. No chelation or medication was administered in these cases. The identified primary source was inorganic mercury from unregistered facial creams, with levels measuring 18 302.17 and 6221.53 mcg/g surpassing the Thai regulation's maximum limit of zero.

Background: Exposure to strong inorganic acid mists (SIAMs) in the workplace has been linked to respiratory tract cancers.

Aims: We conducted a meta-analysis of cohort and case-control studies examining the association between occupational SIAMs and respiratory tract cancers other than laryngeal cancer, which is already established.

Methods: Studies mentioned in the 1992 IARC Monograph on carcinogenicity of SIAMs were combined with later studies identified from a systematic search of Scopus, PubMed and Embase. Forest plots of relative risks (RR) and odds ratios were constructed for the 34 identified studies. A random-effects model was used to address heterogeneity.

Results: An association between the roles associated with occupational SIAMs exposure and risk of lung (RR = 1.17; 95% confidence interval [CI] = 1.05-1.32), and nasal cancers (RR = 3.30, 95% CI = 1.16-9.41) was found. The risk of oral and pharyngeal cancer was also associated with SIAMs exposure-related roles (RR = 1.59, 95% CI = 0.98-2.57). Results did not differ by study design, gender or outcome for all three cancers. A positive association for lung cancer was found with chemical (RR = 1.25, 95% CI = 1.13-1.38), and metal and steel industries (RR = 1.19, 95% CI = 1.04-1.37), as well as for oral and pharyngeal cancer with chemical industry (RR = 1.72, 95% CI = 1.57-1.89). We checked publication bias for lung (p = 0.35), oral and pharyngeal (p = 0.02) and nasal cancer (p = 0.40).

Conclusions: Our study showed an association between occupational SIAM exposure and risk of lung, nasal, and possibly oral and pharyngeal cancers. However, weaknesses in the recording of confounding and exposure data in the currently available literature were found.

Background: Shift work is associated with an increased risk of liver injury. However, whether and how shift work alters liver function remains unclear.

Aims: This study aimed to investigate the associations between shift work and the liver function parameters, and further explore the mediating roles of thyroid function indicators.

Methods: We conducted a cross-sectional study involving a convenience sample of 724 subway workers. Multivariate linear regression models were adopted to approximate the effect values for the associations of shift work with liver function parameters and thyroid function indicators. Mediation analyses were used to explore the roles of thyroid function indicators in the association between shift work and liver function parameters.

Results: Shift work was associated with increased levels of alkaline phosphatase (ALP), total triiodothyronine (TT3) and free thyroxine (FT4) (β = 6.309, 95% confidence interval [CI] 2.739-9.879, β = 0.328, 95% CI 0.242-0.415 and β = 2.913, 95% CI 1.502-2.884, respectively). In stratification analysis, the positive association between shift work and TT3, FT3 and FT4 was more pronounced among people >30 years old. The increase in shift worker FT3 and aspartate transaminase levels was stronger among alcohol users. Mediation analysis showed that TT3 and FT4 mediated 39% and 29% of the associations between shift work and the increased level of ALP, respectively (all P < 0.05).

Conclusions: The results suggest that shift work is associated with increased ALP levels of subway workers, which is partly mediated by the increase of TT3 and FT4 levels.