Occupational Medicine-Oxford最新文献

Background: Understanding of hazardous alcohol drinking and insomnia among Australian ambulance personnel is limited. Australian ambulance organizations have strengthened their organizational human resource management (HRM) to promote their employees' healthy lifestyles, health and well-being.

Aims: To describe the prevalence of hazardous alcohol consumption and insomnia among Australian ambulance personnel and to explore their associations with the organizational HRM strength.

Methods: This cross-sectional study was conducted on 492 ambulance personnel randomly selected from three Australian states. The Alcohol Use Disorders tool, The Insomnia Severity Index and the Perceived HRM System Strength instrument measured alcohol consumption, insomnia and HRM strength. Descriptive analyses, bivariate association analyses and general linear models were used for data analysis.

Results: Twenty per cent of Australian ambulance personnel consumed alcohol at a hazardous level and 68% experienced clinically significant insomnia. There was no significant association between organizational HRM strength and ambulance personnel's hazardous alcohol consumption. There was a significant association between organizational HRM strength (consensus) and ambulance personnel's insomnia experience.

Conclusions: Hazardous alcohol consumption and insomnia were concerns among Australian ambulance personnel. Even though strengthening the HRM system might reduce their experience of insomnia, simply strengthening the HRM system could not reduce their hazardous alcohol consumption.

Background: Sleep of inadequate quality, duration or regularity has potential negative physical and mental health outcomes. The impacts of poor sleep within the paramedic occupation are not well understood.

Aims: This review aimed to determine the prevalence of insomnia, excessive daytime sleepiness and poor sleep quality amongst paramedics, and to identify any relationships between insomnia, excessive daytime sleepiness, poor sleep quality and other health-related outcomes.

Methods: A systematic search identified studies that measured excessive sleepiness, insomnia or poor sleep quality using validated measures. The population was limited to paramedics in Australia, New Zealand or the UK owing to the similar nature of the workload, education standards, shift patterns and scope of practice.

Results: Four studies were included. All used the Pittsburgh Sleep Quality Index, two used the Epworth Sleepiness Scale and one used the Insomnia Severity Index. Sample sizes ranged between 60 and 342. The weighted mean prevalence of excessive daytime sleepiness was 30 %, and poor sleep quality reported as 71%. Only one study measured the association between sleep and other health-related outcomes; this study reported an association between sleep quality and multiple measures of mental health.

Conclusions: The findings of this review suggest that paramedics experience both poor-quality sleep and excessive daytime sleepiness, and further suggest that there may be an association between poor sleep quality and mental health. Given sleep impacts a variety of health outcomes, as well as impacts work performance, research on the specific components of sleep is important.

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.

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.

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.