Occupational Medicine-Oxford最新文献

Background: Shift work has become popular along with adverse effects such as disrupted biological rhythms, metabolic changes, sleep disorders and myocardial infarction. Studies have shown a link between myocardial infarction and shift work, but evidence is still lacking.

Aims: We aim to explore the association between present and past shift work and risk of myocardial infarction in a large population of European workers.

Methods: We analysed data from the UK Biobank with >500 000 participants and an average 12-year follow-up duration. Cox proportional hazard models were employed to analyse the relationship between present shift work (n = 265 064), lifetime duration or frequency of shift work (n = 71 428) and the risk of myocardial infarction, as well as the association between rest day during shift work and myocardial infarction incidents in night shift workers (n = 14 588).

Results: Night shift workers had a higher risk of myocardial infarction compared to day workers, including 'shift but never/rarely night shifts' (hazard ratio [HR] = 1.09, 95% confidence interval [CI] 1.00-1.20), 'some night shifts' (HR = 1.13, 95% CI 1.01-1.27) and 'usual/permanent night shifts' (HR = 1.21, 95% CI 1.07-1.37), respectively. Similarly, higher frequency and longer duration of night shift work were associated with the increased risk of myocardial infarction (<10 years: HR = 1.20, 95% CI 1.01-1.42; ≥10 years: HR = 1.51, 95% CI 1.28-1.77; or an average of more than eight nights per month: HR = 1.45, 95% CI 1.23-1.71). However, longer rest days couldn't decrease myocardial infarction risk compared to those who rest 1 day.

Conclusions: Present and lifetime exposure to night shifts were associated with a risk of myocardial infarction and did not benefit from longer rest days.

Background: Occupational short-latency respiratory disease (SLRD; predominantly asthma, rhinitis, hypersensitivity pneumonitis, and occupational infections) prevalence is difficult to determine but certain occupations may be associated with increased susceptibility.

Aims: This study aimed to examine which occupations and industries are currently at high risk for SLRD and determine their respective suspected causal agents.

Methods: SLRD cases reported to the SWORD scheme between 1999 and 2019 were analysed to determine directly standardized rate ratios (SRR) by occupation against the average rate for all other occupations combined.

Results: 'Bakers and flour confectioners' and 'vehicle spray painters' showed significantly raised SRR for SLRD in general, mostly due to occupational rhinitis (234.4; 95% CI 200.5-274.0) and asthma (63.5; 95% CI 51.5-78.3), respectively. Laboratory technicians also showed significantly raised SRR for occupational rhinitis (18.7; 95% CI 15.1-23.1), primarily caused by laboratory animals and insects. Metal machining setters and setter-operators showed increased SRR for occupational hypersensitivity pneumonitis (42.0; 95% CI 29.3-60.3), largely due to cutting/soluble oils. The occupation mostly affected by infectious disease was welding trades (12.9; 95% CI 5.7-29.3), mainly attributable to microbial pathogenicity.

Conclusions: This study identified the occupational groups at increased risk of developing an SLRD based on data recorded over a recent two-decade period in the UK. Occupational asthma and rhinitis were identified as the prevailing conditions and hypersensitivity pneumonitis as a potentially rising respiratory problem in the metalworking industry.

Background: In many workplaces, the coronavirus disease 2019 pandemic changed work arrangements, but there is scarce longitudinal evidence on whether psychosocial work environment and employee well-being were affected.

Aims: To examine the psychosocial work environment and employee well-being before, during and after the pandemic in relation to pandemic-induced changes (working from home, change to other tasks and team reorganization).

Methods: Survey data from a cohort of 20 944 public sector employees in Finland were collected before (2016-2018), during (2020) and after the pandemic (2022). Multilevel linear and logistic regression was used to examine group differences between the before-during and during-after periods of the pandemic.

Results: Working from home was associated with a small but favourable change in worktime control, organizational justice and social capital (scale 1-5) during the pandemic and after the pandemic (marginal mean difference ranging from 0.02 to 0.09 with 95% confidence intervals [CIs] from 0.01 to 0.10). There was a post-pandemic increase in work time control, even among participants with a transfer into other tasks (0.11, 95% CI 0.07, 0.14) or team reorganization (0.06, 95% CI 0.02, 0.10). The decline in self-rated work ability (scale 0-10) before and during the pandemic was greater in those transferred into other tasks (-0.10, 95% CI -0.13, -0.06) than in those not (-0.05, 95% CI -0.06, -0.04).

Conclusions: Working from home during the pandemic was accompanied by small favourable changes in the psychosocial work environment during the pandemic, whereas transition to different tasks was associated with a decline in self-rated work ability.

Background: Fatigue is commonly reported in population surveys and has been identified in patients with health conditions as a key co-morbidity which makes remaining in work challenging. Such patients, however, rarely have access to programmes to help them manage their fatigue.

Aims: To quantify the relationship between fatigue, work impairment and health-related job loss.

Methods: We use data from the Health and Employment After Fifty study, a longitudinal study of people aged 50-64 years when recruited through general practices in England in 2013-14. During follow-up, fatigue was measured using the Fatigue Assessment Scale, work impairment was assessed using the Work Productivity and Activity Impairment scale, and changes in employment status were recorded.

Results: A total of 2743 participants were eligible for the current analysis; 23% satisfied criteria for being fatigued. People who were fatigued were less likely to have a partner, university degree, be physically active and were more likely to be obese. Their job was more likely to involve shifts, be perceived as insecure, have reported difficulties coping with job demands, and be unsatisfying. After adjustment for socio-economic, lifestyle and work-related factors, they were almost twice as likely to report both work impairment (relative risk 1.8; 95% confidence interval [CI] 1.6, 2.1) and future health-related job loss, although the latter effect was only in those with other morbidities (incidence rate ratio 1.96; 95% CI 1.03-3.72).

Conclusions: Providing evidence-based support for workers with health conditions who experience fatigue may have an important impact at a population level in terms of extending working lives.

Background: Employee mental health and well-being (MH&WB) is critical to the productivity and success of organizations. Training line managers (LMs) in mental health plays an important role in protecting and enhancing employee well-being, but its relationship with other MH&WB practices is under-researched.

Aims: To determine whether organizations offering LM training in mental health differ in the adoption of workplace- (i.e. primary/prevention-focused) and worker-directed (including both secondary/resiliency-focused and tertiary/remedial-focused) interventions to those organizations not offering LM training and to explore changes in the proportions of activities offered over time.

Methods: Secondary analysis of enterprise data from computer-assisted telephone interview surveys. The analysis included data from organizations in England across 4 years (2020: n = 1900; 2021: n = 1551; 2022: n = 1904; 2023: n = 1902).

Results: Offering LM training in mental health was associated with organizations' uptake of primary-, secondary-, and tertiary-level MH&WB activities across all 4 years. The proportion of organizations offering primary-, secondary- and tertiary-level interventions increased over time. On average, tertiary-level activities were most adopted (2020: 80%; 2021: 81%; 2022: 84%; 2023: 84%), followed by primary-level activities (2020: 66%; 2021: 72%; 2022: 72%; 2023: 73%) and secondary-level activities (2020: 62%; 2021: 60%; 2022: 61%; 2023: 67%).

Conclusions: Offering LM training in mental health is associated with the adoption of other MH&WB practices by organizations. Suggesting that organizations that are committed to the mental health agenda are more likely to take a holistic approach (including both worker and workplace strategies) to promoting workforce mental health, rather than providing LM training in isolation.

Background: Ethical climate in the workplace has been highlighted to have an important impact on workers' mental health; the evaluation of workplace ethics and its impact on workers' health should be considered an occupational health issue.

Aims: The present study aims to investigate ethical climate as perceived by workers, and its correlation with mental health outcomes, in particular, symptoms of depression, anxiety and stress.

Methods: A cross-sectional study was performed by administering an online survey, investigating socio-demographic variables, workplace ethics (through the Italian short version of the Corporate Ethical Virtues questionnaire) and mental health outcomes (using the short version of the Depression, Anxiety and Stress Scale). Descriptive analyses, analyses of variance and regression models were performed; P-values were considered significant for values ≤0.05.

Results: The sample included 176 workers; the mean age of participants was 46.22 years and 44% were males. The most represented job sector was health care (37%), and 42% of participants had college-level education. Ethical climate was significantly correlated with all mental health outcomes investigated in the study: anxiety (P ≤ 0.001), depression (P ≤ 0.05) and stress (P ≤ 0.05).

Conclusions: Results from this study highlighted a significant correlation between workplace ethical climate and depression, anxiety and stress. This study underlines the importance of evaluating and improving ethical climate to prevent the onset of psychological distress in workers. Furthermore, results from this study should be a starting point for future research investigating the role of ethics and mental health in employees' turnover intention and job satisfaction.

The current global outbreak of artificial stone silicosis is a recrudescence of a major occupational disease in the context of a novel exposure source. Respirable crystalline silica exposure, even without frank pneumoconiosis, is associated with an increased risk of respiratory infection. Empyema is a well-recognized complication of bacterial pneumonia; pneumonia among working-age adults, in turn, has been epidemiologically linked to occupational exposure to fumes and dust, including silica. A connection between empyema and silica dust inhalation has not been reported, however, whether through antecedent pneumonia or another mechanism. We describe a case of silicosis initially presenting with empyema in a 31-year-old Computerized Numerical Control stone-cutting machine operator who had heavy exposure to artificial stone and other rock dust.

Background: Diesel exhaust exposure and cancer other than the lungs have been limitedly investigated.

Aims: To conduct a systematic review and meta-analysis on the association between occupational exposure to diesel exhaust and gastrointestinal cancers.

Methods: Two researchers performed a systematic literature review to identify all cohort studies on occupational exposure to diesel exhaust and risk of cancers other than lung. Of the 30 retained studies, 10 reported risk estimates for oesophageal, 18 on gastric, 15 on colon and 14 on rectal cancer. We performed random-effects meta-analyses to calculate summary relative risks (RRs) and 95% confidence intervals (CIs) for ever-exposure to diesel exhaust.

Results: We calculated summary RR = 1.08 (95% CI 0.97-1.21, P heterogeneity = 0.06) for oesophageal, 1.06 (95% CI 0.99-1.14, P < 0.001) for gastric, 0.98 (95% CI 0.96-1.00, P = 0.453) for colon, and RR = 1.04 (95% CI 0.97-1.11, P = 0.013) for rectal cancer. Drivers showed an association with oesophageal (RR = 1.26, 95% CI 0.99-1.62), gastric (RR = 1.20, 95% CI 0.91-1.59) and rectal cancer (RR = 1.41, 95% CI 1.13-1.75); machine operators with oesophageal (RR = 1.09, 95% CI 1.00-1.20) and gastric (RR = 1.15, 95% CI 1.10-1.20) and handlers with oesophageal cancer (RR = 1.95, 95% CI 1.23-3.09). Studies from Europe revealed an association with gastric cancer while those from North America did not (P < 0.05). No difference was found by quality score except for gastric cancer, where high-quality studies but not low-quality ones showed increased risk (P heterogeneity = 0.04). There was no evidence of publication bias.

Conclusions: An increased but insignificant risk of oesophageal, gastric and rectal, but not colon cancer, was suggested in workers exposed to diesel exhaust. Residual confounding cannot be excluded.