American journal of industrial medicine最新文献_第3页

Job strain and adverse pregnancy outcomes: A scoping review and meta-analysis 工作压力与不良妊娠结局：范围综述和荟萃分析。

IF 2.7 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

American journal of industrial medicine

Pub Date : 2024-09-05 DOI: 10.1002/ajim.23655

Kota Nakayama, Etsuji Suzuki MD, PhD, Natalie Slopen ScD, Ichiro Kawachi MD, PhD

Background

Previous studies have shown that job strain is associated with low birthweight (LBW), preterm birth (PTB), and small for gestational age (SGA). We conducted a scoping review and meta-analysis to assess the association between job strain and adverse pregnancy outcomes.

Methods

A literature search was performed on PubMed. We included English-language studies that examined the association between job strain (based on the Karasek demand-control model) and pregnancy outcomes. We excluded letters, posters, reviews, and qualitative studies. Random effects meta-analysis was performed. Heterogeneity was assessed using τ² and I² statistics. Potential bias was assessed using standard funnel plots. Asymmetry was evaluated by Egger's test. Leave-one-out analysis was performed for sensitivity analyses.

Results

Three eligible studies were found for LBW, seven for PTB, and four for SGA. The number of subjects ranged from 135 to 4889, and the prevalence of high job strain ranged from 6.64% to 33.9%. The pooled odds ratio and 95% confidence interval (CI) for LBW, PTB, and SGA were 1.23 (95% CI: 0.97, 1.56), 1.10 (95% CI: 1.00, 1.22), and 1.16 (95% CI: 0.97, 1.39) respectively, indicating modest associations. Heterogeneity for LBW and PTB may not be important but may be moderate for SGA. No publication bias was detected for LBW and PTB, but possible publication bias exists for SGA.

Conclusion

We found a modest association between job strain and PTB. Since job strain is only one of the many aspects of an unhealthy work environment, interventions that improve working conditions more broadly are needed.

背景：以往的研究表明，工作压力与低出生体重（LBW）、早产（PTB）和小胎龄（SGA）有关。我们进行了一项范围综述和荟萃分析，以评估工作压力与不良妊娠结局之间的关联：我们在 PubMed 上进行了文献检索。我们纳入了研究工作压力（基于卡拉塞克需求控制模型）与妊娠结局之间关系的英文研究。我们排除了信件、海报、综述和定性研究。进行了随机效应荟萃分析。使用τ2和I2统计量评估异质性。使用标准漏斗图评估潜在偏倚。通过 Egger 检验评估不对称情况。对敏感性分析进行了剔除分析：符合条件的研究有 3 项针对低体重儿，7 项针对小儿麻痹症，4 项针对 SGA。受试者人数从 135 人到 4889 人不等，高工作负荷率从 6.64% 到 33.9% 不等。LBW、PTB 和 SGA 的合计几率比和 95% 置信区间（CI）分别为 1.23（95% CI：0.97, 1.56）、1.10（95% CI：1.00, 1.22）和 1.16（95% CI：0.97, 1.39），表明相关性不大。低体重儿和初产妇的异质性可能并不重要，但 SGA 的异质性可能适中。未发现LBW和PTB存在发表偏倚，但SGA可能存在发表偏倚：我们发现工作压力与婴儿肥胖之间存在一定的联系。由于工作压力只是不健康工作环境的诸多方面之一，因此需要更广泛地采取干预措施来改善工作条件。

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引用次数: 0

Emergency department visits for heat-related illness among workers: Occupational health surveillance using Washington syndromic surveillance data 工人因热病而到急诊室就诊：利用华盛顿州症候群监测数据进行职业健康监测。

IF 2.7 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

American journal of industrial medicine

Pub Date : 2024-09-02 DOI: 10.1002/ajim.23650

Sara Wuellner PhD, MPH, Kali Turner MPH, June T. Spector MD, MPH

Background

Information on worker occupation and industry is critical to understanding the occupational risks of heat-related illness (HRI), yet few syndromic surveillance systems capture these key data elements. This study evaluates the work data reported through Washington syndromic surveillance for its utility in characterizing HRI ED visits by industry and occupation.

Methods

Standard industry and occupation codes were assigned to employer name and occupation descriptions reported in Washington ED visit records maintained within the state's syndromic surveillance system, for visits involving HRI in 2020–2022. HRI ED visits involving workplace heat exposure were identified based on discharge diagnoses or on keywords in the triage note or chief complaint fields. HRI ED visits were summarized by patient characteristics, and visit rates were calculated by industry and occupation.

Results

Employer name or occupation descriptions were reported in 21.5% of HRI ED records among patients age 16 and older, and in 41.2% of records with mention of heat exposure at work. Twice as many records were classified for industry as for occupation. Agriculture, forestry, fishing, and hunting and transportation and warehousing had the highest rates of HRI ED visits. Specific industries with the highest rates included support activities for agriculture and forestry, the postal service, and fruit and vegetable preserving and specialty food manufacturing.

Conclusion

Syndromic surveillance data are a valuable source of occupational health surveillance information when work characteristics are reported, enhancing our understanding of the occupational risks of injuries and illnesses.

背景：工人职业和行业信息对于了解热相关疾病（HRI）的职业风险至关重要，但很少有综合征监测系统能捕捉到这些关键数据元素。本研究评估了华盛顿州综合症监测系统报告的工作数据，以确定其在按行业和职业划分热相关疾病急诊就诊人数方面的实用性：方法：针对 2020-2022 年期间涉及 HRI 的就诊情况，为华盛顿州综合症监测系统中保存的急诊室就诊记录中报告的雇主名称和职业描述分配了标准行业和职业代码。根据出院诊断或分诊记录或主诉字段中的关键字确定涉及工作场所热暴露的 HRI 急诊就诊。根据患者特征对急诊室 HRI 就诊情况进行汇总，并按行业和职业计算就诊率：在 16 岁及以上患者的 HRI 急诊记录中，21.5% 的记录报告了雇主名称或职业描述，41.2% 的记录提到了工作中的热暴露。行业分类记录是职业分类记录的两倍。农业、林业、渔业和狩猎业以及运输和仓储业的 HRI 急诊就诊率最高。发病率最高的特定行业包括农业和林业的辅助活动、邮政服务、果蔬保鲜和特色食品制造：当报告工作特征时，综合监测数据是职业健康监测信息的一个宝贵来源，可增强我们对伤病职业风险的了解。

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引用次数: 0

Managing workplace AI risks and the future of work 管理工作场所的人工智能风险和工作的未来。

IF 2.7 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

American journal of industrial medicine

Pub Date : 2024-09-02 DOI: 10.1002/ajim.23653

John Howard MD, Paul Schulte PhD

Artificial intelligence (AI)—the field of computer science that designs machines to perform tasks that typically require human intelligence—has seen rapid advances in the development of foundation systems such as large language models. In the workplace, the adoption of AI technologies can result in a broad range of hazards and risks to workers, as illustrated by the recent growth in industrial robotics and algorithmic management. Sources of risk from deployment of AI technologies across society and in the workplace have led to numerous government and private sector guidelines that propose principles governing the design and use of trustworthy and ethical AI. As AI capabilities become integrated in devices, machines, and systems across industry sectors, employers, workers, and occupational safety and health practitioners will be challenged to manage AI risks to worker health, safety, and well-being. Five risk management options are presented as ways to assure that only trustworthy and ethical AI enables workplace devices, machinery, and processes. AI technologies will play a significant role in the future of work. The occupational safety and health practice and research communities need to ensure that the promise of these new AI technologies results in benefit, not harm, to workers.

人工智能（AI）是计算机科学领域的一门学科，它设计机器来完成通常需要人类智慧才能完成的任务，在大型语言模型等基础系统的开发方面取得了突飞猛进的进展。在工作场所，采用人工智能技术会给工人带来广泛的危害和风险，最近工业机器人和算法管理的发展就说明了这一点。在全社会和工作场所部署人工智能技术的风险来源，促使政府和私营部门制定了许多指导方针，提出了设计和使用可信和合乎道德的人工智能的原则。随着人工智能功能被整合到各行业领域的设备、机器和系统中，雇主、工人和职业安全与健康从业人员将面临管理人工智能对工人健康、安全和福祉的风险的挑战。本文提出了五种风险管理方案，以确保只有值得信赖、符合道德规范的人工智能才能为工作场所的设备、机器和流程提供支持。人工智能技术将在未来的工作中发挥重要作用。职业安全与健康实践和研究界需要确保这些新的人工智能技术能给工人带来益处而不是伤害。

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引用次数: 0

SARS-CoV-2 infection among Colorado adults working outside the home: Occupation, race and ethnicity and mask use 科罗拉多州外出工作的成年人感染 SARS-CoV-2：职业、种族和民族以及口罩使用情况。

IF 2.7 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

American journal of industrial medicine

Pub Date : 2024-09-02 DOI: 10.1002/ajim.23639

Michelle R. Torok PhD, Alice E. White MS, Rachel H. Jervis MPH, Amanda D. Tran MPH, Bernadette A. Albanese MD, Elaine J. Scallan Walter PhD

Objectives

The workplace is an important setting for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exposure and transmission. Using data from a large case–control study in Colorado during 2021 and 2022, we aimed to evaluate working outside the home and SARS-CoV-2 infection, the racial and ethnic distribution of workers in occupations associated with infection, and workplace face mask use.

Methods

Cases were Colorado adults with a positive SARS-CoV-2 test by reverse transcription-polymerase chain reaction (RT-PCR) reported to Colorado's COVID-19 surveillance system selected from surveillance data ≤12 days after their specimen collection date. Control participants were randomly selected adult Coloradans with a RT-PCR-confirmed negative SARS-CoV-2 test result reported to the same surveillance system.

Results

Working outside the home was associated with infection (odds ratio [OR] = 1.46, 95% confidence interval [CI]: 1.39–1.54). Among participants working outside the home, “Food Preparation and Serving Related” (aOR = 2.35, 95% CI: 1.80–3.06), “Transportation and Material Moving” (aOR = 2.09, 95% CI: 1.62–2.69), “Construction and Extraction” (aOR = 1.88, 95% CI: 1.36–2.59), “Protective Service” (aOR = 1.60, 95% CI: 1.15–2.24), and “Sales and Related” (aOR = 1.44, 95% CI: 1.22–1.69) were occupational categories most strongly associated with infection. American Indian/Alaskan Native, Black, and Hispanic/Latino participants were more likely than others to work in occupational categories with the highest odds of infection (p < 0.05). Cases were less likely than controls to report always wearing a mask (31.9% vs. 41.5%) and wearing a KN95/N95/KF94 mask (16.8% vs. 27.2%) at work.

Conclusions

These findings emphasize the importance of occupation and workplace mask use in the COVID-19 pandemic and its disproportionate racial/ethnic impact on workers.

目的：工作场所是严重急性呼吸系统综合征冠状病毒 2（SARS-CoV-2）暴露和传播的重要场所。利用 2021 年和 2022 年在科罗拉多州进行的一项大型病例对照研究的数据，我们旨在评估外出工作与 SARS-CoV-2 感染、与感染相关的职业工人的种族和民族分布以及工作场所口罩的使用情况：病例为通过反转录聚合酶链反应（RT-PCR）对科罗拉多州 COVID-19 监测系统报告的 SARS-CoV-2 检测呈阳性的科罗拉多州成人，从标本采集日期后 12 天内的监测数据中选出。对照组参与者是随机抽取的科罗拉多州成年人，他们在同一监测系统中的SARS-CoV-2检测结果经RT-PCR证实为阴性：结果：外出工作与感染有关（几率比 [OR] = 1.46，95% 置信区间 [CI]：1.39-1.54）。在外出工作的参与者中，"食品准备和服务相关"（aOR = 2.35，95% CI：1.80-3.06）、"运输和材料搬运"（aOR = 2.09，95% CI：1.62-2.69）、"建筑和采掘"（aOR = 1.88，95% CI：1.36-2.59）、"保护性服务"（aOR = 1.60，95% CI：1.15-2.24）和 "销售及相关"（aOR = 1.44，95% CI：1.22-1.69）是与感染关系最密切的职业类别。美国印第安人/阿拉斯加原住民、黑人和西班牙裔/拉丁裔参与者比其他人更有可能在感染几率最高的职业类别中工作（p 结论：美国印第安人/阿拉斯加原住民、黑人和西班牙裔/拉丁裔参与者比其他人更有可能在感染几率最高的职业类别中工作：这些发现强调了在 COVID-19 大流行中职业和工作场所口罩使用的重要性，以及其对工人造成的不成比例的种族/族裔影响。

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引用次数: 0

Characterization of health and safety hazards of deconstruction activities. 确定解构活动对健康和安全的危害。

IF 2.7 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

American journal of industrial medicine

Pub Date : 2024-08-27 DOI: 10.1002/ajim.23652

Kaushik Bhattacharjee, Shamita Chaudhary, Avni Vishnoi, D A Patel, Nikhil Bugalia

Background: Manual deconstruction-an alternative to mechanical demolition-is a crucial technique in the building industry that facilitates a circular economy for the built environment and achieves sustainable development goals (SDGs). However, the current body of literature lacks a thorough grasp of the OHS (occupational health and safety) hazards related to the deconstruction process. The current work closes this scholarly gap by outlining the deconstruction process as phases and sets of activities and highlighting potential health and safety hazards throughout different activities and phases.

Methods: The study uses numerous case studies and applies a descriptive case study technique to gather and analyze primary data from hundreds of photos and notes from over 40 field visits. The primary data are first used to prepare a comprehensive process map of deconstruction. Six construction safety experts and four industrial hygiene experts were then interviewed to identify and characterize health and safety hazards in images representative of the deconstruction activities.

Results: A taxonomy of OHS hazards for deconstruction was developed based on identifying 35 unique safety and 51 unique health hazards. Significant safety hazards in deconstruction activities include "struck-by," "trip, slip, and fall" hazards, and "lack of personal protective equipment." Major health hazards include ergonomic concerns, respiratory diseases, and eye strain.

Discussion: The study highlights the occupational health and safety issues faced by the deconstruction trade with a granularity rarely covered in existing literature. The assessments can be helpful for OHS practitioners to identify potential health and safety improvements across various deconstruction phases.

背景：人工解构--机械拆除的替代方法--是建筑行业的一项重要技术，可促进建筑环境的循环经济并实现可持续发展目标（SDGs）。然而，目前的文献缺乏对与解构过程相关的职业健康安全（OHS）危害的全面了解。目前的研究通过将解构过程概述为不同阶段和一系列活动，并强调不同活动和阶段中潜在的健康和安全危害，填补了这一学术空白：本研究使用了大量案例研究，并采用描述性案例研究技术，从 40 多次实地考察的数百张照片和笔记中收集和分析原始数据。首先利用原始数据绘制了一份全面的解构过程图。然后对六位建筑安全专家和四位工业卫生专家进行访谈，以识别和描述具有代表性的解构活动图片中的健康和安全危害：结果：在确定了 35 种独特的安全隐患和 51 种独特的健康隐患的基础上，编制了一份有关解构活动的职业健康安全隐患分类法。施工活动中的重大安全隐患包括 "被撞"、"绊倒、滑倒和跌倒 "以及 "缺乏个人防护设备"。主要的健康危害包括人体工程学问题、呼吸系统疾病和眼睛疲劳：讨论：本研究以现有文献极少涉及的细化程度，强调了解构行业面临的职业健康和安全问题。这些评估有助于职业健康和安全从业人员在不同的解构阶段确定潜在的健康和安全改进措施。

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引用次数: 0

Ex votos dedicated to eyes: A historical perspective on worker injuries and devotional practices Ex votos献给眼睛：从历史角度看工人受伤和虔诚的做法。

IF 2.7 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

American journal of industrial medicine

Pub Date : 2024-08-26 DOI: 10.1002/ajim.23654

Michele Augusto Riva MD, PhD, Michael Belingheri MD, Maria Emilia Paladino MD

引用次数: 0

Validity of an expert-based job exposure matrix of hand-wrist physical exposures and their prospective associations with carpal tunnel syndrome 以专家为基础的工作暴露矩阵的有效性及其与腕管综合征的前瞻性关联。

IF 2.7 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

American journal of industrial medicine

Pub Date : 2024-08-26 DOI: 10.1002/ajim.23651

Jonathan Aavang Petersen PhD, MD, Christina Bach Lund PhD, MD, Esben Meulengracht Flachs PhD, MSc, Rolf Petersen PhD, MD, Sigurd Mikkelsen MD, DrMedSci, Jane Frølund Thomsen PhD, MD

Background

Epidemiological studies of occupational risk factors for rare disorders require large study populations with adequate exposure estimates. Job exposure matrices (JEMs) linked to national information on standardized job titles may enable such large studies. We aimed to establish and validate a JEM for occupational hand-wrist exposures that could be linked to Danish national register data on job titles and hand-wrist disorders.

Methods

We developed a JEM for hand-wrist repetition, force, vibration, and computer work in 96 job groups covering 91% of the 2227 occupational titles in the Danish version of the International Standard Classification of Occupation-88, and examined inter-rater reliability of five expert ratings. Poisson regression models were used to estimate incidence rate ratios for the association of carpal tunnel syndrome (CTS) with the level of repetitive movements, force, vibration, and hours of computer work described by the JEM, adjusted for relevant confounders.

Results

The JEM based on expert ratings had fair to good interrater reliability. The incidence of CTS increased with increasing levels of force, hand-wrist repetition, and vibration, Exposure-response patterns for repetition and vibration became less consistent after adjustment for force. The interaction between repetition and force was complex and did not support an overall positive interaction. Computer work was negatively associated with incident CTS.

Conclusion

The JEM was able to identify known risk factors for CTS consistent with current evidence, and provided further associations on exposure-response patterns, mutual exposure adjustment, and interaction effects between repetition and force. The reliability of expert assessments of hand-wrist physical exposures was fair to good.

背景：对罕见疾病的职业风险因素进行流行病学研究需要大量的研究人群和足够的暴露估计值。与全国标准化职称信息相关联的职业暴露矩阵（JEM）可以促成此类大型研究。我们的目标是建立并验证一种可与丹麦全国职称和手-腕疾病登记数据相连接的职业手-腕暴露矩阵：方法：我们针对丹麦版《国际标准职业分类-88》中 2227 个职业名称中 91% 的 96 个职业组别中的手-腕重复、力量、振动和计算机工作制定了 JEM，并检查了五位专家评分的评分者之间的可靠性。使用泊松回归模型估算了腕管综合征（CTS）的发病率与 JEM 所描述的重复性动作、力量、振动水平和计算机工作时间的关系，并对相关混杂因素进行了调整：以专家评分为基础的 JEM 交互可靠性一般到良好。CTS的发病率随着力量、手腕部重复动作和振动程度的增加而增加，在对力量进行调整后，重复动作和振动的暴露-反应模式变得不那么一致。重复和力量之间的相互作用很复杂，不支持总体上的正相互作用。计算机工作与 CTS 事故呈负相关：JEM能够识别CTS的已知风险因素，与目前的证据一致，并提供了关于暴露-反应模式、相互暴露调整以及重复和力量之间相互作用效应的进一步关联。专家对手腕暴露的评估结果的可靠性从一般到良好。

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引用次数: 0

Incidence of cardiovascular disease in a cohort of mine workers exposed to ultrafine aluminum powder in Ontario, Canada 加拿大安大略省接触超细铝粉的矿工群组中心血管疾病的发病率。

IF 2.7 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

American journal of industrial medicine

Pub Date : 2024-08-23 DOI: 10.1002/ajim.23646

Andrew Zarnke PhD, Sarah Rhodes PhD, Nathan DeBono PhD, Colin Berriault MA, Sandra C. Dorman PhD

Background

A retrospective cohort study was conducted to estimate associations between an ultrafine aluminum powder, McIntyre Powder (MP), and cardiovascular disease incidence in a cohort of mine workers from Ontario, Canada. Disease outcomes included ischemic heart disease (IHD), acute myocardial infarction (AMI), congestive heart failure (CHF), and strokes and transient ischemic attacks (STIA).

Methods

Using work history records from the Ontario Mining Master File (MMF) mine workers were followed for disease incidence in administrative health records. The analysis included 25,813 mine workers who were exposed to MP between 1943 and 1979 and followed for cardiovascular disease (CVD) diagnoses between 2006 and 2018. Cardiovascular disease cases were ascertained using physician, hospital, and ambulatory care records. Poisson regression models were used to estimate age and birth-year adjusted incidence rate ratios (RR) and 95% confidence intervals (CI) for associations between MP exposure and CVD outcomes.

Results

Ever-exposure to MP was positively associated with modest increases in the incidence rate of IHD, AMI, and CHF, but not STIA, using both assessment approaches. Duration of self-reported MP exposure was positively associated with monotonically increasing rates of IHD and AMI compared to never-exposed miners, with the greatest association observed among miners with >20 years of exposure (for IHD: RR 1.24, 95% CI: 0.91–1.68; and for AMI: RR 1.52, 95% CI 1.01–2.28).

Conclusion

Mine workers ever-exposed to MP had modestly elevated rates of CVD. The rate of CVD diagnoses appeared to increase with longer duration of exposure when assessed by both self-reported exposure and through historical records.

背景：我们开展了一项回顾性队列研究，以估算加拿大安大略省矿工队列中超细铝粉麦金塔粉（MP）与心血管疾病发病率之间的关系。疾病结果包括缺血性心脏病（IHD）、急性心肌梗塞（AMI）、充血性心力衰竭（CHF）、中风和短暂性脑缺血发作（STIA）：方法：利用安大略省采矿主档案（MMF）中的工作历史记录，对矿工的行政健康记录中的疾病发病率进行跟踪调查。分析对象包括 25813 名矿工，他们在 1943 年至 1979 年期间接触过 MP，并在 2006 年至 2018 年期间接受了心血管疾病（CVD）诊断跟踪。心血管疾病病例是通过医生、医院和非卧床护理记录确定的。采用泊松回归模型估算了经年龄和出生年份调整的发病率比（RR）以及MP暴露与心血管疾病结果之间关系的95%置信区间（CI）：结果：采用两种评估方法得出的结果表明，曾经接触过 MP 与 IHD、AMI 和 CHF 发病率的适度增加呈正相关，但与 STIA 无关。与从未接触过MP的矿工相比，自我报告接触MP的时间长短与IHD和AMI发病率的单调递增呈正相关，在接触MP超过20年的矿工中观察到的相关性最大（IHD：RR 1.24，95% CI：0.91-1.68；AMI：RR 1.52，95% CI 1.01-2.28）：结论：曾经接触过《蒙特利尔议定书》的矿工的心血管疾病发病率略有升高。根据自我报告的接触情况和历史记录评估，心血管疾病的诊断率似乎随着接触时间的延长而增加。

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引用次数: 0

Authors' response to “Resting diffusing capacity and severity of radiographic disease predict gas exchange abnormalities with exercise in former US coal miners” 科恩等人回应。

IF 2.7 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

American journal of industrial medicine

Pub Date : 2024-08-22 DOI: 10.1002/ajim.23649

Robert A. Cohen, Leonard H. T. Go, Lee Friedman, Lauren M. Zell-Baran, Cecile S. Rose, Kirsten S. Almberg

引用次数: 0

Re: Cohen et al. Resting diffusing capacity and severity of radiographic disease predict gas exchange abnormalities with exercise in former US coal miners Re：Cohen等人.静态弥散能力和放射病的严重程度可预测前美国煤矿工人运动时的气体交换异常。

IF 2.7 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

American journal of industrial medicine

Pub Date : 2024-08-22 DOI: 10.1002/ajim.23648

Albert Miller MD

引用次数: 0