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Associations between effort-reward imbalance and risk of burnout among Swedish physicians. 瑞典医生的努力-回报失衡与职业倦怠风险之间的关系。
IF 2.4 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-29 DOI: 10.1093/occmed/kqae039
F Christiansen, B E Gynning, A Lashari, G Johansson, E Brulin

Background: The high prevalence of burnout among Swedish physicians may have several possible effects on individuals and society. However, further investigations of work-related factors associated with the risk of burnout among Swedish physicians are needed.

Aims: We aimed to study the associations between psychosocial work factors, based on the effort-reward imbalance (ERI) model, and the risk of burnout among Swedish physicians.

Methods: A representative sample of 7200 Swedish physicians was invited in 2021. Data were gathered through questionnaires, with a response rate of 41%. Logistic regression models were used to study the associations between exposure to ERI and the risk of burnout.

Results: Approximately 62% of Swedish physicians were exposed to a high ERI. Exposure to a high ERI was associated with 11 times increased risk (95% confidence interval 6.5-20.0) of burnout in adjusted models. Large variations in the prevalence of ERI and risk of burnout across sociodemographic and occupational factors were identified, particularly across different clinical specialties.

Conclusions: A majority of Swedish physicians were exposed to high levels of work-related stress, strongly associated with an increased risk of burnout. This population-based cross-sectional study underlines the need to further study variations of work-related stress across clinical specialties and to monitor occupational health among physicians longitudinally.

背景:瑞典医生的职业倦怠发生率很高,可能会对个人和社会产生多种影响。目的:我们旨在研究基于努力-回报不平衡(ERI)模型的社会心理工作因素与瑞典医生职业倦怠风险之间的关联:方法:邀请 2021 年的 7200 名瑞典医生作为代表性样本。通过问卷调查收集数据,回复率为 41%。采用逻辑回归模型研究ERI暴露与职业倦怠风险之间的关联:结果:约 62% 的瑞典医生暴露于高 ERI 环境中。在调整模型中,暴露于高ERI与职业倦怠风险增加11倍(95%置信区间为6.5-20.0)有关。不同社会人口和职业因素导致的ERI发生率和职业倦怠风险差异很大,尤其是在不同临床专科之间:结论:大多数瑞典医生都面临着很大的工作压力,这与职业倦怠风险的增加密切相关。这项以人群为基础的横断面研究强调,有必要进一步研究不同临床专科中工作相关压力的变化,并对医生的职业健康状况进行纵向监测。
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引用次数: 0
Risks of occupational mental disorders in Korean civil servants (2009-18). 韩国公务员的职业精神障碍风险(2009-18 年)。
IF 2.4 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-29 DOI: 10.1093/occmed/kqae041
B-Y Choi, K-B Min, S-W Ryoo, J-Y Min

Background: Previous studies have suggested that firefighters, police officers and civil servants in the education sector, particularly in Western countries, are vulnerable to mental stress and disorders; however, evidence for this association in South Korea is lacking.

Aims: This study aimed to identify whether firefighters, police officers and teachers are at a higher risk for occupational mental health disorders.

Methods: We used workers' compensation claims from civil servants (2009-18). Our target population comprised 46 209 civil servants (9009 civil servants in administrative and technical positions, 23 107 police officers, 4417 firefighters and 8676 civil servants in the educational sector). Occupational and environmental medicine physicians and medical doctors defined and confirmed mental disorders. We conducted Cox proportional hazards regression analyses to evaluate civil servants' risk of occupational mental health disorders.

Results: Compared with the civil servants in administrative and technical positions, civil servants in the education sector (hazard ratio [HR] = 2.16; 95% confidence interval [CI]:1.65-2.84) showed a statistically significant increased risk of mental disorders; conversely, firefighters did not (HR = 0.80; 95% CI 0.51-1.27). Police officers had a significantly decreased mental disorder risk compared with civil servants in administrative and technical positions (HR = 0.17; 95% CI 0.11-0.25).

Conclusions: The risk of occupational mental health disorders was higher in civil servants in the education sector but lower in police officers and firefighters than civil servants in administrative and technical positions. Further studies on civil servants' mental health awareness are required to confirm our results.

背景:以前的研究表明,消防员、警察和教育部门的公务员容易受到精神压力和精神障碍的影响,尤其是在西方国家:以前的研究表明,消防员、警察和教育部门的公务员,尤其是西方国家的公务员,容易受到精神压力和精神障碍的影响;然而,在韩国却缺乏这方面的证据:我们使用了公务员的工伤索赔(2009-18 年)。我们的目标人群包括 46 209 名公务员(9009 名行政和技术岗位公务员、23 107 名警官、4417 名消防员和 8676 名教育部门公务员)。职业与环境医学医生和内科医生对精神障碍进行了定义和确认。我们进行了考克斯比例危险回归分析,以评估公务员患职业性精神疾病的风险:与担任行政和技术职务的公务员相比,教育部门的公务员(危险比 [HR] = 2.16;95% 置信区间 [CI]:1.65-2.84)患精神障碍的风险在统计学上显著增加;相反,消防员患精神障碍的风险没有增加(危险比 = 0.80;95% 置信区间 0.51-1.27)。与行政和技术岗位的公务员相比,警察患精神障碍的风险明显降低(HR = 0.17; 95% CI 0.11-0.25):结论:与行政和技术岗位的公务员相比,教育部门的公务员患职业性精神障碍的风险较高,但警察和消防员患职业性精神障碍的风险较低。需要对公务员的心理健康意识进行进一步研究,以证实我们的结果。
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引用次数: 0
The risk of complaints against occupational physicians to the medical regulatory body in Ireland. 向爱尔兰医疗监管机构投诉职业医师的风险。
IF 2.4 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-29 DOI: 10.1093/occmed/kqad136
Deirdre Gleeson
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引用次数: 0
Accuracy of chest x-ray screening of silica-exposed miners for tuberculosis. 对暴露于二氧化硅的矿工进行胸部 X 射线肺结核筛查的准确性。
IF 2.4 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-29 DOI: 10.1093/occmed/kqae043
B Maboso, R I Ehrlich

Background: The World Health Organization recommends systematic chest X-ray (CXR) screening for tuberculosis (TB) in silica-exposed workers. However, evidence on the accuracy of CXR screening in such populations is lacking.

Aims: To measure the accuracy of CXR screening for active TB in silica-exposed miners, in a population with a high prevalence of silicosis, post-TB lung disease and HIV.

Methods: A secondary analysis of data from a miner screening programme in Lesotho was undertaken. We measured the performance of CXR (in participants with and without cough) for 'abnormalities suggestive of TB' against Xpert MTB/RIF (Xpert). The sample size was 2572 and positive Xpert prevalence was 3%.

Results: CXR alone had high sensitivity (0.93, 95% confidence interval [CI] 0.87-0.99), but low specificity (0.41, 95% CI 0.39-0.42). Requiring cough and a positive CXR increased specificity (0.79, 95% CI 0.77-0.81), resulting in reduced sensitivity (0.41, 95% CI 0.30-0.52). There was no difference in CXR accuracy by HIV status. However, specificity was markedly reduced in the presence of silicosis (from 0.70, 95% CI 0.68-0.72, to 0.03, 95% CI 0.02-0.04) or past TB history (from 0.59, 95% CI 0.56-0.62 to 0.27, 95% CI 0.25-0.29). Throughout, positive predictive value remained very low (5%) and negative predictive value very high (99%).

Conclusions: CXR screening accurately identifies TB-negative CXRs in this population, but post-TB lung disease and silicosis would result in a high proportion of Xpert-negative referrals and an increased risk of unneeded empirical treatment. Adapted screening algorithms, practitioner training and digital access to previous mining CXRs are needed.

背景:世界卫生组织建议对接触二氧化硅的工人进行系统的胸部 X 光(CXR)肺结核(TB)筛查。目的:在矽肺病、结核病后肺部疾病和 HIV 感染率较高的人群中,对暴露于二氧化硅的矿工进行活动性肺结核胸部 X 光筛查的准确性进行测量:对莱索托矿工筛查计划的数据进行了二次分析。我们对照 Xpert MTB/RIF (Xpert),测量了 CXR(有咳嗽和无咳嗽的参与者)对 "提示肺结核的异常情况 "的检测结果。样本量为 2572 份,Xpert 阳性率为 3%:结果:仅做 CXR 的灵敏度较高(0.93,95% 置信区间 [CI] 0.87-0.99),但特异性较低(0.41,95% 置信区间 0.39-0.42)。要求咳嗽和 CXR 阳性会增加特异性(0.79,95% CI 0.77-0.81),但会降低敏感性(0.41,95% CI 0.30-0.52)。艾滋病毒感染状况对 CXR 的准确性没有影响。但是,如果存在矽肺(从 0.70,95% CI 0.68-0.72 降至 0.03,95% CI 0.02-0.04)或既往结核病史(从 0.59,95% CI 0.56-0.62 降至 0.27,95% CI 0.25-0.29),特异性则明显降低。在整个筛查过程中,阳性预测值仍然很低(5%),阴性预测值很高(99%):结论:胸片筛查能准确识别肺结核阴性胸片,但肺结核后肺部疾病和矽肺会导致高比例的 Xpert 阴性转诊,增加不需要的经验性治疗的风险。因此需要对筛查算法进行调整,对从业人员进行培训,并通过数字化手段获取以往的采矿CXR。
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引用次数: 0
Mental health and employment outcomes in working-age US adults, 2010-2019. 2010-2019 年美国劳动适龄成年人的心理健康和就业结果。
IF 2.4 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-26 DOI: 10.1093/occmed/kqae054
J Jou, A Hicks, P J Johnson

Background: Individuals with severe mental illness experience greater unemployment and barriers to workforce re-entry. However, less is known about additional indicators of employment stability for individuals across mental illness severity.

Aims: This study aims to examine associations between mental illness severity, use and adequacy of mental health treatment, and indicators of employment stability.

Methods: In this repeated cross-sectional study, 2010-2019 data from the U.S. National Survey of Drug Use and Health were used to construct multivariate logistic regression models predicting the odds of part-time employment, past-year work interruption, number of past-year employers, and past-month health-related work absence by mental illness severity and adequacy of mental health treatment.

Results: Compared to individuals with no mental illness, those with any and severe mental illness had significantly higher odds of part-time employment (adjusted odds ratios [AORs] = 1.51 and 2.16, 95% confidence intervals [CIs] 1.4-1.6 and 2.0-2.3), multiple past-year employers (AORs = 1.78 and 2.34, CIs 1.7-1.9 and 2.1-2.6), past-year work interruption (AORs = 1.69 and 2.20, CIs 1.6-1.8 and 2.1-2.4), and >7 days of past-month work absence (AORs = 2.51 and 3.82, CIs 2.3-2.8 and 3.3-4.5). Among respondents with mental illness, perceived inadequacy of mental treatment predicted higher odds of all adverse employment outcomes.

Conclusions: Compared to those with no mental illness, individuals with mental illness of any severity have higher odds of employment instability. Policy and programmatic support aimed at addressing the needs of individuals with mental illness, including access to adequate mental health treatment, are needed to facilitate continued, competitive employment.

背景:患有严重精神疾病的人失业率更高,重新就业的障碍也更大。目的:本研究旨在探讨精神疾病严重程度、精神健康治疗的使用和充分性与就业稳定性指标之间的关联:在这项重复性横断面研究中,我们使用了 2010-2019 年美国全国药物使用与健康调查的数据,构建了多变量逻辑回归模型,根据精神疾病严重程度和精神健康治疗的充分性预测兼职就业、过去一年工作中断、过去一年雇主数量以及过去一个月与健康相关的缺勤几率:与无精神疾病的人相比,患有任何精神疾病和严重精神疾病的人从事兼职工作的几率明显更高(调整后的几率比 [AORs] = 1.51 和 2.16,95% 置信区间 [CIs] 1.4-1.6 和 2.0-2.3)。3)、过去一年有多个雇主(AORs = 1.78 和 2.34,CIs 1.7-1.9 和 2.1-2.6)、过去一年工作中断(AORs = 1.69 和 2.20,CIs 1.6-1.8 和 2.1-2.4)以及过去一个月缺勤超过 7 天(AORs = 2.51 和 3.82,CIs 2.3-2.8 和 3.3-4.5)。在患有精神疾病的受访者中,认为精神治疗不充分预示着出现所有不良就业结果的几率更高:结论:与没有精神疾病的人相比,患有任何严重程度精神疾病的人都有更高的就业不稳定性。我们需要政策和项目支持来满足精神病患者的需求,包括获得适当的心理健康治疗,以促进持续的、有竞争力的就业。
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引用次数: 0
Sleep quality according to chronotype in nurses working 8-hour shifts. 8 小时轮班护士的睡眠质量与时间类型有关。
IF 5.1 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-06-11 DOI: 10.1093/occmed/kqae029
H Yang, S Kim, S-H Yoo, Y Mun, M L Choi, J A Lee, E Song

Background: To date, studies have been focused on sleep disturbances of nurses working during night shifts. There is a lack of understanding regarding the sleep quality of nurses working in the rapid rotation system for each type of shift work.

Aims: To determine the relationship between chronotype and sleep quality according to shift type (i.e. day, evening and night shifts) in nurses working 8-hour rotating shifts.

Methods: A cross-sectional, descriptive study was conducted from two tertiary hospitals in South Korea from December 2021 to September 2022, including nurses working 8-hour rotating shifts (N = 74). They completed questionnaires to measure general, occupational and sleep-related characteristics, chronotype, insomnia severity and daytime sleepiness. Additionally, sleep parameters were collected from actigraphy and sleep diaries for 7 days.

Results: A total of 64% of nurses had an evening chronotype and 37% of nurses had an intermediate chronotype. Nurses had significantly less total sleep time and worsened sleep latency and efficiency during the day shift compared to other shift types. Compared to nurses with an intermediate chronotype, those with an evening chronotype had poorer sleep quality during day shift work.

Conclusions: Strategies to enhance nurses' sleep quality during day shifts should consider a two-level approach: individual approaches, such as improving sleep hygiene, and administrative approaches, such as establishing a chronotype-based shift system for scheduling.

背景:迄今为止,研究主要集中于夜班护士的睡眠障碍。目的:根据轮班类型(即白班、晚班和夜班)确定 8 小时轮班护士的时型与睡眠质量之间的关系:方法:2021 年 12 月至 2022 年 9 月,在韩国两家三级医院开展了一项横断面描述性研究,研究对象包括 8 小时轮班工作的护士(N = 74)。他们填写了调查问卷,以测量一般、职业和睡眠相关特征、慢性型、失眠严重程度和白天嗜睡情况。此外,还从动电仪和睡眠日记中收集了 7 天的睡眠参数:结果:共有 64% 的护士属于晚间时型,37% 的护士属于中间时型。与其他班次相比,白班护士的总睡眠时间明显减少,睡眠潜伏期和睡眠效率也有所下降。与中间时型的护士相比,晚间时型的护士在白班工作期间的睡眠质量更差:提高护士白班睡眠质量的策略应考虑两个层面:个人方法(如改善睡眠卫生)和管理方法(如建立基于时型的排班系统)。
{"title":"Sleep quality according to chronotype in nurses working 8-hour shifts.","authors":"H Yang, S Kim, S-H Yoo, Y Mun, M L Choi, J A Lee, E Song","doi":"10.1093/occmed/kqae029","DOIUrl":"10.1093/occmed/kqae029","url":null,"abstract":"<p><strong>Background: </strong>To date, studies have been focused on sleep disturbances of nurses working during night shifts. There is a lack of understanding regarding the sleep quality of nurses working in the rapid rotation system for each type of shift work.</p><p><strong>Aims: </strong>To determine the relationship between chronotype and sleep quality according to shift type (i.e. day, evening and night shifts) in nurses working 8-hour rotating shifts.</p><p><strong>Methods: </strong>A cross-sectional, descriptive study was conducted from two tertiary hospitals in South Korea from December 2021 to September 2022, including nurses working 8-hour rotating shifts (N = 74). They completed questionnaires to measure general, occupational and sleep-related characteristics, chronotype, insomnia severity and daytime sleepiness. Additionally, sleep parameters were collected from actigraphy and sleep diaries for 7 days.</p><p><strong>Results: </strong>A total of 64% of nurses had an evening chronotype and 37% of nurses had an intermediate chronotype. Nurses had significantly less total sleep time and worsened sleep latency and efficiency during the day shift compared to other shift types. Compared to nurses with an intermediate chronotype, those with an evening chronotype had poorer sleep quality during day shift work.</p><p><strong>Conclusions: </strong>Strategies to enhance nurses' sleep quality during day shifts should consider a two-level approach: individual approaches, such as improving sleep hygiene, and administrative approaches, such as establishing a chronotype-based shift system for scheduling.</p>","PeriodicalId":54696,"journal":{"name":"Occupational Medicine-Oxford","volume":" ","pages":"290-296"},"PeriodicalIF":5.1,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140877954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Work and Retirement Among Women: The Health and Employment After Fifty Study. 妇女的工作与退休:五十岁后健康与就业研究》。
IF 5.1 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-06-11 DOI: 10.1093/occmed/kqae035
G Palermo, S D'Angelo, G Ntani, G Bevilacqua, K Walker-Bone

Background: Women increasingly work beyond age 50+ but their occupational health is under-researched.

Aims: To investigate what jobs older contemporary women do, when they exit their jobs and what factors predict job exit.

Methods: Data came from the Health and Employment After Fifty cohort, which recruited women aged 50-64 at baseline in 2013-14 and has followed them up annually collecting: demographic, lifestyle and work information. Exits from employment were mapped longitudinally over five follow-ups. Time-to-first event Cox regression analyses were used to identify risk factors for job exit.

Results: At baseline, 4436 women participated, 64% of whom were working. The proportions of women working at 50-54, 55-60 and over 60 years were 86%, 79% and 38%, respectively. Amongst all women, after adjustment for age, managing comfortably financially and not coping with the mental demands of the job were associated with exit. Risk factors for job exit differed in the age bands: 50-54; 55-59 and >60 years, reflecting socio-economic status, markers of health (musculoskeletal pain and poor self-rated health) and work factors (under-appreciation, job dissatisfaction, temporary/permanent contracts, coping with work's physical demands).

Conclusions: Factors contributing to exit from work among older women differ by age group, after controlling for perceived financial position, age and mental demands of the job. A number of work characteristics predict job exit and suggest that employers can play an important role in supporting women to continue working until older ages. Identification and treatment of musculoskeletal pain could also enable work amongst older women.

背景:50 岁以上的女性越来越多地参加工作,但对她们的职业健康研究不足:目的:调查当代老年妇女从事哪些工作、何时离职以及哪些因素会影响她们的离职:数据来自 "五十岁后的健康与就业 "队列,该队列于 2013-14 年招募了 50-64 岁的基线女性,并每年对她们进行跟踪调查,收集人口、生活方式和工作信息。在五次随访中对离职情况进行了纵向调查。采用时间-首次事件考克斯回归分析来确定离职的风险因素:基线调查共有 4436 名妇女参加,其中 64% 的妇女有工作。50-54岁、55-60岁和60岁以上女性的工作比例分别为86%、79%和38%。在所有妇女中,在对年龄进行调整后,经济状况良好和无法应对工作的精神需求与离职有关。不同年龄段的离职风险因素有所不同:50-54岁、55-59岁和60岁以上年龄段的离职风险因素各不相同,反映了社会经济地位、健康指标(肌肉骨骼疼痛和自评健康不佳)和工作因素(不受重视、对工作不满意、临时/长期合同、应付工作的生理需求):结论:在控制了经济状况、年龄和工作的精神要求之后,导致老年妇女离职的因素因年龄组而异。一些工作特征可以预测离职情况,这表明雇主在支持妇女继续工作到老年方面可以发挥重要作用。识别和治疗肌肉骨骼疼痛也可以使老年妇女能够继续工作。
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引用次数: 0
Cardiovascular and lifestyle risk factors of mild cognitive impairment in UK veterans and non-veterans. 英国退伍军人和非退伍军人轻度认知障碍的心血管和生活方式风险因素。
IF 5.1 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-06-11 DOI: 10.1093/occmed/kqae027
R Akhanemhe, S A M Stevelink, A Corbett, C Ballard, H Brooker, B Creese, Dag Aarsland, Adam Hampshire, Neil Greenberg

Background: The link between poor cardiovascular health (CVH), lifestyle and mild cognitive impairment (MCI) has been well established in the general population. However, there is limited research exploring these associations in ageing UK veterans.

Aims: This study explored the risk of MCI and its association with nine CVH and lifestyle risk factors (including diabetes, heart disease, high cholesterol, high blood pressure, obesity, stroke, physical inactivity, the frequency of alcohol consumption and smoking) in UK veterans and non-veterans.

Methods: This prospective cohort study comprised data from the PROTECT study between 2014 and 2022. Participants comprised of UK military veterans and non-veterans aged ≥50 years at baseline. Veteran status was defined using the Military Service History Questionnaire. CVH and lifestyle risk factors were defined using a combination of self-report measures, medication history or physical measurements. MCI was defined as the presence of subjective and objective cognitive impairment.

Results: Based on a sample of 9378 veterans (n = 488) and non-veterans (n = 8890), the findings showed the risk of MCI significantly reduced in veterans with obesity, those who frequently consumed alcohol and were physically inactive compared to non-veterans. The risk of MCI significantly increased in veterans with diabetes (hazards ratio [HR] = 2.22, 95% confidence interval [CI] 1.04-4.75, P ≤ 0.05) or high cholesterol (HR = 3.11, 95% CI 1.64-5.87, P ≤ 0.05) compared to veterans without.

Conclusions: This study identified CVH and lifestyle factors of MCI in UK veterans and non-veterans. Further work is needed to understand these associations and the underpinning mechanisms which could determine intervention strategies to reduce the risk of MCI.

背景:在普通人群中,不良心血管健康状况(CVH)、生活方式与轻度认知障碍(MCI)之间的联系已被充分证实。目的:本研究探讨了英国退伍军人和非退伍军人患 MCI 的风险及其与九种心血管健康和生活方式风险因素(包括糖尿病、心脏病、高胆固醇、高血压、肥胖、中风、缺乏运动、饮酒频率和吸烟)之间的关系:这项前瞻性队列研究包括 PROTECT 研究在 2014 年至 2022 年间的数据。参与者包括基线年龄≥50 岁的英国退伍军人和非退伍军人。退伍军人身份通过兵役史问卷进行定义。心血管疾病和生活方式风险因素通过自我报告、用药史或身体测量相结合的方式进行定义。MCI的定义是存在主观和客观认知障碍:基于 9378 名退伍军人(n = 488)和非退伍军人(n = 8890)的样本,研究结果显示,与非退伍军人相比,肥胖、经常饮酒和缺乏运动的退伍军人患 MCI 的风险明显降低。与没有糖尿病的退伍军人相比,患有糖尿病(危险比 [HR] = 2.22,95% 置信区间 [CI] 1.04-4.75,P ≤ 0.05)或高胆固醇(HR = 3.11,95% CI 1.64-5.87,P ≤ 0.05)的退伍军人患 MCI 的风险明显增加:本研究确定了英国退伍军人和非退伍军人中导致 MCI 的心血管健康和生活方式因素。需要进一步开展工作,以了解这些关联及其基础机制,从而确定降低 MCI 风险的干预策略。
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引用次数: 0
Sinonasal cancer incidence in Lombardy, Italy, 2008-20. 2008-20 年意大利伦巴第大区的鼻窦癌发病率。
IF 5.1 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-06-11 DOI: 10.1093/occmed/kqae034
D Consonni, G Stoppa, A Binazzi, B Dallari, S Stella, S Rugarli, C Trobbiani, A Biggeri, D Catelan, C Mensi

Background: Epithelial sinonasal cancers (SNC) are rare tumours with recognized associations with known/suspected occupational carcinogens (wood/leather dust, nickel/chromium compounds and formaldehyde). In Italy, a national SNC registry organized as a network of regional registries was established by law in 2008.

Aims: To describe SNC time trends, occupational exposures and geographical distribution in Lombardy, North-West Italy, based on population registry data (2008-20).

Methods: The Lombardy SNC Registry records epithelial SNCs using various sources. Interviews to collect occupational history are performed using a standardized questionnaire. Using several standard populations, we calculated yearly crude and age-standardized rates (ASRs per 100,000 person-years). Standardized incidence ratios (SIR) at municipality level were calculated, and Bayesian models were fitted to produce smoothed SIR maps.

Results: We recorded 827 cases (553 men, 274 women). Crude (world standardized) ASRs were 0.9 (0.4) in men and 0.4 (0.2) in women, with no time trends. Interviews were obtained for 485 (88%) men and 223 (81%) women. Among men, 217 (45%) had been exposed to occupational carcinogens (wood/leather dust: 150/65 cases, 31%/13%), while only 36 women (16%) were exposed. Among 201 men with adenocarcinoma, exposure to wood/leather dust occurred in 103/50 cases (75%/50%). Areas with elevated SIRs associated with leather dust were found in the Western areas. Exposure to wood dust was more widespread.

Conclusions: This study found a high frequency of occupational exposures (wood and leather dust), particularly in men with SNC. Employment in shoe industries clustered in the Western part, while work in furniture industries was less spatially structured.

背景:鼻窦上皮癌(SNC)是一种罕见肿瘤,公认与已知/疑似职业致癌物(木材/皮革粉尘、镍/铬化合物和甲醛)有关。目的:根据人口登记数据(2008-20 年),描述意大利西北部伦巴第大区 SNC 的时间趋势、职业暴露和地理分布:伦巴第SNC登记处通过各种渠道记录上皮性SNC。采用标准化问卷进行访谈,收集职业史。我们利用几个标准人群,计算出每年的粗发病率和年龄标准化发病率(ASRs/100,000 人-年)。我们还计算了城市一级的标准化发病率(SIR),并通过贝叶斯模型拟合出平滑的 SIR 地图:我们记录了 827 个病例(553 名男性,274 名女性)。男性的粗略(世界标准化)ASR 为 0.9 (0.4),女性为 0.4 (0.2),没有时间趋势。对 485 名男性(88%)和 223 名女性(81%)进行了访谈。其中,217 名男性(45%)接触过职业致癌物(木屑/皮革粉尘:150/65 例,31%/13%),而只有 36 名女性(16%)接触过职业致癌物。在 201 例男性腺癌患者中,103/50 例(75%/50%)接触过木材/皮革粉尘。与皮革粉尘相关的 SIR 值升高的地区位于西部地区。接触木屑的情况更为普遍:这项研究发现,职业暴露(木屑和皮革粉尘)的频率很高,尤其是在患有 SNC 的男性中。在制鞋业工作的人主要集中在西部地区,而在家具业工作的人在空间上的分布则较少。
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引用次数: 0
Healthcare worker burnout during a persistent crisis: a case-control study. 持续危机期间医护人员的职业倦怠:一项病例对照研究。
IF 2.4 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-06-11 DOI: 10.1093/occmed/kqae032
S Appelbom, A Nordström, A Finnes, R K Wicksell, A Bujacz

Background: During the immediate outbreak of the COVID-19 pandemic, burnout symptoms increased among healthcare workers. Knowledge is needed on how early symptoms developed during the persistent crisis that followed the first pandemic wave.

Aims: To investigate if high levels of burnout symptoms during the first pandemic wave led to high burnout and depressive symptoms up to a year later, and if participation in psychological support was related to lower levels of symptoms.

Methods: A longitudinal case-control study followed 581 healthcare workers from two Swedish hospitals. Survey data were collected with a baseline in May 2020 and three follow-up assessments until September 2021. The case group was participants reporting high burnout symptoms at baseline. Logistic regression analyses were performed separately at three follow-ups with case-control group assignment as the main predictor and burnout and depression symptoms as outcomes, controlling for frontline work, changes in work tasks and psychological support participation.

Results: One out of five healthcare workers reported high burnout symptoms at baseline. The case group was more likely to have high burnout and depressive symptoms at all follow-ups. Participation in psychological support was unrelated to decreased burnout and depressive symptoms at any of the follow-ups.

Conclusions: During a persistent crisis, healthcare organizations should be mindful of psychological reactions among staff and who they place in frontline work early in the crisis. To better prepare for future healthcare crises, preventive measures on burnout are needed, both at workplaces and as part of the curricula in medical and nursing education.

背景:在 COVID-19 大流行刚刚爆发时,医护人员的职业倦怠症状有所增加。目的:调查在第一波大流行期间,高水平的职业倦怠症状是否会导致一年后出现高水平的职业倦怠和抑郁症状,以及参与心理支持是否与降低症状水平有关:一项纵向病例对照研究对瑞典两家医院的 581 名医护人员进行了跟踪调查。收集的调查数据包括 2020 年 5 月的基线调查和 2021 年 9 月之前的三次随访评估。病例组为基线时报告高职业倦怠症状的参与者。在三次随访中分别进行了逻辑回归分析,以病例对照组分配为主要预测因素,以职业倦怠和抑郁症状为结果,并对一线工作、工作任务变化和心理支持参与情况进行了控制:结果:每五名医护人员中就有一人在基线时报告了严重的职业倦怠症状。在所有随访中,病例组更有可能出现高度职业倦怠和抑郁症状。参与心理支持与倦怠和抑郁症状的减少无关:在危机持续期间,医疗机构应注意员工的心理反应,以及在危机早期安排哪些人从事一线工作。为了更好地应对未来的医疗危机,需要在工作场所和医学与护理教育课程中采取预防职业倦怠的措施。
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Occupational Medicine-Oxford
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