In recent years previous declines in cardiovascular disease (CVD) have stalled. There are occupational risk factors for CVD mortality. This study seeks to examine inequalities in CVD mortality for working-age adults in the United States by occupation.
Methods
Death certificate data for CVD deaths were obtained from the National Center for Health Statistics. Occupation data from these death certificates were coded to major occupation groups. Using information about the number of workers employed in these occupations obtained from the American Community Survey, we calculated mortality rates and rate ratios (RRs), adjusted for covariates associated with CVD mortality.
Results
After adjusting for age, sex, race/ethnicity, and educational attainment, workers in 11 occupations had significantly elevated RRs: food preparation and serving; construction and extraction; arts, design, entertainment, sports, and media; life, physical, and social science; farming, fishing, and forestry; legal; protective services; building and grounds cleaning and maintenance; healthcare practitioners and technical; personal care and service; and community and social services.
Conclusions
Occupation appears to be a significant predictor of CVD mortality. Further research is needed to assess how occupational risk factors contribute to changing trends for CVD mortality. Interventions are needed to address workplace risk factors for CVD.
背景：近年来，心血管疾病（CVD）的下降趋势已经停滞。心血管疾病死亡率存在职业风险因素。本研究旨在探讨美国劳动适龄成年人心血管疾病死亡率因职业而存在的不平等现象：方法：从美国国家卫生统计中心获得心血管疾病死亡的死亡证明数据。这些死亡证明中的职业数据被编码为主要职业组。利用从美国社区调查（American Community Survey）中获得的这些职业的就业人数信息，我们计算了死亡率和比率比（RRs），并对与心血管疾病死亡率相关的协变量进行了调整：在对年龄、性别、种族/族裔和教育程度进行调整后，11 个职业的工人的死亡率比明显升高：食品准备和服务；建筑和采掘；艺术、设计、娱乐、体育和媒体；生活、体育和社会科学；农业、渔业和林业；法律；保护服务；建筑和地面清洁与维护；医疗保健从业人员和技术人员；个人护理和服务；社区和社会服务：结论：职业似乎是预测心血管疾病死亡率的一个重要因素。需要进一步开展研究，以评估职业风险因素如何导致心血管疾病死亡率趋势的变化。需要采取干预措施来解决工作场所的心血管疾病风险因素。
{"title":"Occupational inequalities in mortality from cardiovascular disease, 2020–2021","authors":"Devan Hawkins, Karina Thomas, Paul Landsbergis","doi":"10.1002/ajim.23643","DOIUrl":"10.1002/ajim.23643","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In recent years previous declines in cardiovascular disease (CVD) have stalled. There are occupational risk factors for CVD mortality. This study seeks to examine inequalities in CVD mortality for working-age adults in the United States by occupation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Death certificate data for CVD deaths were obtained from the National Center for Health Statistics. Occupation data from these death certificates were coded to major occupation groups. Using information about the number of workers employed in these occupations obtained from the American Community Survey, we calculated mortality rates and rate ratios (RRs), adjusted for covariates associated with CVD mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After adjusting for age, sex, race/ethnicity, and educational attainment, workers in 11 occupations had significantly elevated RRs: food preparation and serving; construction and extraction; arts, design, entertainment, sports, and media; life, physical, and social science; farming, fishing, and forestry; legal; protective services; building and grounds cleaning and maintenance; healthcare practitioners and technical; personal care and service; and community and social services.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Occupation appears to be a significant predictor of CVD mortality. Further research is needed to assess how occupational risk factors contribute to changing trends for CVD mortality. Interventions are needed to address workplace risk factors for CVD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141892665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Occupation is associated with a large part of daily activities, affecting lifestyle and social status. However, limited research exists on the association between longest-held occupation (LHO) and early mortality. We examine if LHO is associated with mortality risk among US adults 51 years of age and older.
Methods
Using Health and Retirement Study data from 1992 to 2020, we followed 26,758 respondents 51 years of age and older for up to 29 years. We used competing-risks analysis methodology to estimate the risk of mortality.
Results
Across the average 20.5 follow-up years, women with LHO in the categories of machine operators (subhazard ratio [SHR]: 1.42), food preparation (SHR: 1.39), handlers and helpers (SHR: 1.35), and sales (SHR: 1.15), were more likely to die earlier than women with the LHO in the professional and technical support occupation, the reference occupation. Men with LHO in the categories of food preparation (SHR: 1.43), machine operators (SHR: 1.36), personal services (SHR: 1.34), handlers and helpers (SHR: 1.32), protective services (SHR: 1.31), clerical (SHR: 1.27), farming and fishing (SHR: 1.26), sales (SHR: 1.23), and precision production (SHR: 1.20) had elevated risks of mortality compared to men whose LHO was in the referent professional and technical support occupation.
Conclusions
Findings from this study provide comprehensive and current evidence that occupation can be one of the risk factors for adverse health outcomes and ultimately for early mortality.
{"title":"Association between longest-held occupation and mortality risk","authors":"Abay Asfaw PhD, Anasua Bhattacharya PhD","doi":"10.1002/ajim.23642","DOIUrl":"10.1002/ajim.23642","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Occupation is associated with a large part of daily activities, affecting lifestyle and social status. However, limited research exists on the association between longest-held occupation (LHO) and early mortality. We examine if LHO is associated with mortality risk among US adults 51 years of age and older.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using Health and Retirement Study data from 1992 to 2020, we followed 26,758 respondents 51 years of age and older for up to 29 years. We used competing-risks analysis methodology to estimate the risk of mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Across the average 20.5 follow-up years, women with LHO in the categories of machine operators (subhazard ratio [SHR]: 1.42), food preparation (SHR: 1.39), handlers and helpers (SHR: 1.35), and sales (SHR: 1.15), were more likely to die earlier than women with the LHO in the professional and technical support occupation, the reference occupation. Men with LHO in the categories of food preparation (SHR: 1.43), machine operators (SHR: 1.36), personal services (SHR: 1.34), handlers and helpers (SHR: 1.32), protective services (SHR: 1.31), clerical (SHR: 1.27), farming and fishing (SHR: 1.26), sales (SHR: 1.23), and precision production (SHR: 1.20) had elevated risks of mortality compared to men whose LHO was in the referent professional and technical support occupation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Findings from this study provide comprehensive and current evidence that occupation can be one of the risk factors for adverse health outcomes and ultimately for early mortality.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141858760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Christopher B. McLeod PhD, Robert A. Macpherson PhD, Ailin He PhD, Benjamin C. Amick III, PhD, Mieke Koehoorn PhD, Emile Tompa PhD
Background
Studies on the impact of workplace safety inspections on work injuries have found mixed effectiveness. Most studies are from the United States, examining Occupational Health and Safety Administration (OSHA) regulatory inspections in manufacturing firms with more than 10 employees. This study examines whether regulatory inspections in Alberta, Canada, result in reductions in workers' compensation claims rates for inspected firms relative to comparable non-inspected firms.
Methods
Firm and claim-level data from the Workers' Compensation Board of Alberta were linked with regulatory enforcement data from the Government of Alberta for construction, manufacturing, and transportation firms with at least one full-time employee for 37 consecutive months. A matched difference-in-differences study design was used to estimate changes in lost-time claim rates for work-related injuries and musculoskeletal diseases of inspected and comparable non-inspected firms between the year pre-inspection and 2 years, post-inspection, controlling for firm-level characteristics.
Results
Inspections were not effective in reducing firm-level claim rates, with the exception of transportation firms with more than one inspection experiencing a 28% decrease in their claim rate in the second year post-inspection, relative to the change in non-inspected firms. In construction, inspected firms experienced a 12% increase in their claim rate in the first year post-inspection. No effect was observed in the manufacturing sector.
Conclusions
Regulatory workplace safety inspections in Alberta generally do not result in greater reductions in firm-level claim rates in the construction, manufacturing, and transportation sectors. Inspections alone may not be sufficient to induce compliance or hazard management changes that lead to reductions in firm-level injuries.
{"title":"The impact of regulatory workplace safety inspections on workers' compensation claim rates","authors":"Christopher B. McLeod PhD, Robert A. Macpherson PhD, Ailin He PhD, Benjamin C. Amick III, PhD, Mieke Koehoorn PhD, Emile Tompa PhD","doi":"10.1002/ajim.23640","DOIUrl":"10.1002/ajim.23640","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Studies on the impact of workplace safety inspections on work injuries have found mixed effectiveness. Most studies are from the United States, examining Occupational Health and Safety Administration (OSHA) regulatory inspections in manufacturing firms with more than 10 employees. This study examines whether regulatory inspections in Alberta, Canada, result in reductions in workers' compensation claims rates for inspected firms relative to comparable non-inspected firms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Firm and claim-level data from the Workers' Compensation Board of Alberta were linked with regulatory enforcement data from the Government of Alberta for construction, manufacturing, and transportation firms with at least one full-time employee for 37 consecutive months. A matched difference-in-differences study design was used to estimate changes in lost-time claim rates for work-related injuries and musculoskeletal diseases of inspected and comparable non-inspected firms between the year pre-inspection and 2 years, post-inspection, controlling for firm-level characteristics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Inspections were not effective in reducing firm-level claim rates, with the exception of transportation firms with more than one inspection experiencing a 28% decrease in their claim rate in the second year post-inspection, relative to the change in non-inspected firms. In construction, inspected firms experienced a 12% increase in their claim rate in the first year post-inspection. No effect was observed in the manufacturing sector.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Regulatory workplace safety inspections in Alberta generally do not result in greater reductions in firm-level claim rates in the construction, manufacturing, and transportation sectors. Inspections alone may not be sufficient to induce compliance or hazard management changes that lead to reductions in firm-level injuries.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajim.23640","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141756688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Risk factors that can result in serious injuries or deaths are frequently not understood or prevented because of the traditional way in which organizations approach safety. This is especially true for falls from heights in the construction sector, which remain a leading safety hazard in construction globally.
Methods: A theoretical framework derived from a thorough review of international evidence provided the foundation for the conduct of 50 structured focus groups with a total of 209 participants representing construction workers and supervisors in two main Chilean construction contractor companies and their subcontractors.
Results: A total of 627 precursors (risk factors), 56 taxonomies (work tasks/activities), and 622 defenses (prevention actions) were identified. These were classified in three macro dimensions and 13 subdimensions in total, providing a comprehensive framework for the origin, manifestation, and neutralization of such precursors.
Discussion: The findings provide a useful framework for understanding of the most critical risks to which workers are exposed and actions to prevent them. This framework should form the basis for the development of practical safety programs and tools such as management and training checklists, and data analysis for early warning signs.
{"title":"Precursors of falls from height in two main contractor companies in the Chilean construction sector and their subcontractors: Shared vision and preventive prioritization.","authors":"Ignacio Andrade Barra, Roberto Morrison Yonge, Francisco Villalonga Regord, Ricardo Patricio Saavedra García-Reyes, Alicia Contador Espinosa","doi":"10.1002/ajim.23638","DOIUrl":"https://doi.org/10.1002/ajim.23638","url":null,"abstract":"<p><strong>Background: </strong>Risk factors that can result in serious injuries or deaths are frequently not understood or prevented because of the traditional way in which organizations approach safety. This is especially true for falls from heights in the construction sector, which remain a leading safety hazard in construction globally.</p><p><strong>Methods: </strong>A theoretical framework derived from a thorough review of international evidence provided the foundation for the conduct of 50 structured focus groups with a total of 209 participants representing construction workers and supervisors in two main Chilean construction contractor companies and their subcontractors.</p><p><strong>Results: </strong>A total of 627 precursors (risk factors), 56 taxonomies (work tasks/activities), and 622 defenses (prevention actions) were identified. These were classified in three macro dimensions and 13 subdimensions in total, providing a comprehensive framework for the origin, manifestation, and neutralization of such precursors.</p><p><strong>Discussion: </strong>The findings provide a useful framework for understanding of the most critical risks to which workers are exposed and actions to prevent them. This framework should form the basis for the development of practical safety programs and tools such as management and training checklists, and data analysis for early warning signs.</p>","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141730982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
William Harris, Amber B Trueblood, Thomas Yohannes, Christopher P Rodman, Rick Rinehart
Background: Construction workers have the second highest suicide death rate; despite this, there is limited literature examining suicides in the industry, which is necessary to identify those at higher risk of death by suicide. The objective of this study was to examine the characteristics of those who died by suicide in construction to address this knowledge gap.
Methods: Data from the National Center for Health Statistics National Vital Statistics System 2021 public use Mortality Multiple Cause-of-Death file were used to identify deaths by suicide, while denominator data for rates come from the 2021 Current Population Survey.
Results: In 2021, construction workers were disproportionately affected by suicide deaths. Almost a fifth (17.9%) of deaths by suicide with a reported industry code were in construction, despite construction workers accounting for only 7.4% of the workforce. Male construction workers accounted for a majority (97.8%) of suicide deaths. The highest percent of deaths by suicide were among individuals who were white, non-Hispanic, completed high school or equivalent, and single, across construction and all industries for males and females.
Discussion and conclusions: Male and female construction workers had the highest rates of suicide across all characteristics when compared to all industries. Our findings support the need for ongoing prevention efforts within the industry. Future research is needed to understand suicide risk among certain characteristics and occupations. In addition, the work environment or other work-related factors should be studied to understand how the unique nature of the construction industry may be associated with higher suicide rates.
{"title":"Suicides among construction workers in the United States, 2021.","authors":"William Harris, Amber B Trueblood, Thomas Yohannes, Christopher P Rodman, Rick Rinehart","doi":"10.1002/ajim.23632","DOIUrl":"https://doi.org/10.1002/ajim.23632","url":null,"abstract":"<p><strong>Background: </strong>Construction workers have the second highest suicide death rate; despite this, there is limited literature examining suicides in the industry, which is necessary to identify those at higher risk of death by suicide. The objective of this study was to examine the characteristics of those who died by suicide in construction to address this knowledge gap.</p><p><strong>Methods: </strong>Data from the National Center for Health Statistics National Vital Statistics System 2021 public use Mortality Multiple Cause-of-Death file were used to identify deaths by suicide, while denominator data for rates come from the 2021 Current Population Survey.</p><p><strong>Results: </strong>In 2021, construction workers were disproportionately affected by suicide deaths. Almost a fifth (17.9%) of deaths by suicide with a reported industry code were in construction, despite construction workers accounting for only 7.4% of the workforce. Male construction workers accounted for a majority (97.8%) of suicide deaths. The highest percent of deaths by suicide were among individuals who were white, non-Hispanic, completed high school or equivalent, and single, across construction and all industries for males and females.</p><p><strong>Discussion and conclusions: </strong>Male and female construction workers had the highest rates of suicide across all characteristics when compared to all industries. Our findings support the need for ongoing prevention efforts within the industry. Future research is needed to understand suicide risk among certain characteristics and occupations. In addition, the work environment or other work-related factors should be studied to understand how the unique nature of the construction industry may be associated with higher suicide rates.</p>","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141578752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Solveig Boeggild Dohrmann PhD, Regina Fromsejer Heiberg MSc, Line Wang Krenzen MSc, Sofie Ronja Petersen MSc, Jordan Thomas Adams MSc, Jane Skov PhD
Background
Seafarers are at an increased risk of developing cardiovascular diseases (CVDs), potentially due to a stressful working environment and behavioral risk factors. To develop better prevention strategies, it is important to elucidate the extent of this risk. Therefore, we conducted a systematic literature review on CVD in seafarers.
Method
We conducted systematic searches in five databases. All studies investigating CVDs among occupational seafarers, published in articles or conference papers, were eligible for inclusion. The identified records were screened and reviewed by two independent researchers, who also evaluated the methodological quality of the included studies.
Results
Three thousand nine hundred and seventeen records qualified for screening, and 55 were eligible for inclusion. Most of the studies were observational, including cohort, frequency, incidence or prevalence studies, and review of case records. Around half were assessed at risk of biased findings. Participants in the studies were primarily from North America or the European continent and work onboard transportation vessels. Many studies investigated CVDs as a cause of death, focusing on conditions such as CVD, ischemic heart disease, and myocardial infarction. Frequency of CVD conditions varied but indicate that seafarers face a greater risk compared to the reference populations or control groups. Environmental factors were mainly investigated as risk factors.
Conclusion
Our results indicate a higher risk of CVDs among seafarers compared to reference or control groups. However, due to the variable quality of the evidence, well-designed studies are needed to establish the causes of cardiovascular mortality and morbidity in seafarers and to investigate behavioral aspects of cardiovascular risk.
{"title":"What is known about cardiovascular diseases among seafarers: A systematic scoping review and quality assessment","authors":"Solveig Boeggild Dohrmann PhD, Regina Fromsejer Heiberg MSc, Line Wang Krenzen MSc, Sofie Ronja Petersen MSc, Jordan Thomas Adams MSc, Jane Skov PhD","doi":"10.1002/ajim.23636","DOIUrl":"10.1002/ajim.23636","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Seafarers are at an increased risk of developing cardiovascular diseases (CVDs), potentially due to a stressful working environment and behavioral risk factors. To develop better prevention strategies, it is important to elucidate the extent of this risk. Therefore, we conducted a systematic literature review on CVD in seafarers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>We conducted systematic searches in five databases. All studies investigating CVDs among occupational seafarers, published in articles or conference papers, were eligible for inclusion. The identified records were screened and reviewed by two independent researchers, who also evaluated the methodological quality of the included studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Three thousand nine hundred and seventeen records qualified for screening, and 55 were eligible for inclusion. Most of the studies were observational, including cohort, frequency, incidence or prevalence studies, and review of case records. Around half were assessed at risk of biased findings. Participants in the studies were primarily from North America or the European continent and work onboard transportation vessels. Many studies investigated CVDs as a cause of death, focusing on conditions such as CVD, ischemic heart disease, and myocardial infarction. Frequency of CVD conditions varied but indicate that seafarers face a greater risk compared to the reference populations or control groups. Environmental factors were mainly investigated as risk factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our results indicate a higher risk of CVDs among seafarers compared to reference or control groups. However, due to the variable quality of the evidence, well-designed studies are needed to establish the causes of cardiovascular mortality and morbidity in seafarers and to investigate behavioral aspects of cardiovascular risk.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajim.23636","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141557791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Louis Everest MPH, Shirui Tan MSc, Tanya Navaneelan MSc, Paul A. Demers PhD, Nathan DeBono PhD, Colin Berriault MSc, Jeavana Sritharan PhD
Objectives
Prior analyses of the Occupational Disease Surveillance System (ODSS) have compared cancer rates using internal referent groups. As an exploratory analysis, we sought to estimate cancer risk using general population reference rates to evaluate the impact that the comparison population has on findings from our surveillance program.
Methods
A cohort of approximately 2.3 million workers in Ontario, Canada with an accepted lost-time workers' compensation claim were followed for all cancer diagnoses between 1983 and 2018. Standardized incidence ratios (SIRs) and 95% confidence intervals were calculated for workers in specific occupational groups using (1) all other workers in the ODSS cohort, and (2) the general population of Ontario.
Results
SIRs using the general population reference group were generally equal to or modestly lower compared to SIRs using the internal reference group. Within occupation groups, SIRs had a discordant direction of association (increased rate in the internal comparison and decreased in the external comparison) for some cancer sites including urinary, prostate, and colorectal.
Conclusions
Findings emphasize the importance of the choice of reference group when evaluating cancer risks in large occupational surveillance cohorts. Importantly, the magnitude of confounding and the healthy worker hire bias may depend on the occupation group and cancer site of interest.
{"title":"Comparison of internal and external reference populations for occupational cancer surveillance in a cohort drawn from a diverse workforce","authors":"Louis Everest MPH, Shirui Tan MSc, Tanya Navaneelan MSc, Paul A. Demers PhD, Nathan DeBono PhD, Colin Berriault MSc, Jeavana Sritharan PhD","doi":"10.1002/ajim.23637","DOIUrl":"10.1002/ajim.23637","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Prior analyses of the Occupational Disease Surveillance System (ODSS) have compared cancer rates using internal referent groups. As an exploratory analysis, we sought to estimate cancer risk using general population reference rates to evaluate the impact that the comparison population has on findings from our surveillance program.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cohort of approximately 2.3 million workers in Ontario, Canada with an accepted lost-time workers' compensation claim were followed for all cancer diagnoses between 1983 and 2018. Standardized incidence ratios (SIRs) and 95% confidence intervals were calculated for workers in specific occupational groups using (1) all other workers in the ODSS cohort, and (2) the general population of Ontario.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>SIRs using the general population reference group were generally equal to or modestly lower compared to SIRs using the internal reference group. Within occupation groups, SIRs had a discordant direction of association (increased rate in the internal comparison and decreased in the external comparison) for some cancer sites including urinary, prostate, and colorectal.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Findings emphasize the importance of the choice of reference group when evaluating cancer risks in large occupational surveillance cohorts. Importantly, the magnitude of confounding and the healthy worker hire bias may depend on the occupation group and cancer site of interest.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajim.23637","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141557790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Julie E. Pedersen PhD, Kajsa U. Petersen PhD, Maria-Helena G. Andersen PhD, Anne T. Saber PhD, Ulla Vogel PhD, Niels E. Ebbehøj PhD, Tina K. Jensen PhD, Regitze S. Wils PhD, Jens P. Bonde PhD, Johnni Hansen PhD
Objectives
To update and extend the examination of cancer incidence in a cohort of Danish firefighters, now adding 7 years of follow-up and 2766 additional firefighters. The primary focus was directed toward cancer sites that recently contributed to the hazard evaluation conducted by the International Agency for Research on Cancer (IARC).
Methods
The updated cohort consisted of 11,827 male Danish firefighters who were followed up for cancer from 1968 to 2021. Cohort cancer morbidity was compared with a working population reference group, and standardized incidence ratios (SIR) were used for estimation of relative risks, along with 95% confidence intervals (95% CI).
Results
Among full-time firefighters, SIR of skin melanoma was 1.30 (95% CI: 1.02–1.66), and SIR = 1.37 (95% CI: 1.02–1.85) for over 5 years of employment. Slightly positive associations were also observed for cancer of the urinary bladder (SIR = 1.16; 95% CI: 0.93–1.45), prostate (SIR = 1.11; 95% CI: 0.97–1.28), and testis (SIR = 1.11; 95% CI: 0.75–1.63).
Conclusions
This updated study provides evidence indicating an elevated risk of skin melanoma in firefighters. Consistent with IARC's evaluation, we also identified positive associations for urinary bladder, prostate, and testis cancer. In contrast, our findings did not suggest an increased risk of colon cancer, non-Hodgkin lymphoma, and mesothelioma. The latter may be due to small numbers in our still relatively young cohort. Continuous follow-up for cancer in firefighters is warranted, including assessment of influence from surveillance bias.
{"title":"Cancer incidence in a cohort of Danish firefighters: An extended long-term follow-up 1968–2021","authors":"Julie E. Pedersen PhD, Kajsa U. Petersen PhD, Maria-Helena G. Andersen PhD, Anne T. Saber PhD, Ulla Vogel PhD, Niels E. Ebbehøj PhD, Tina K. Jensen PhD, Regitze S. Wils PhD, Jens P. Bonde PhD, Johnni Hansen PhD","doi":"10.1002/ajim.23635","DOIUrl":"10.1002/ajim.23635","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To update and extend the examination of cancer incidence in a cohort of Danish firefighters, now adding 7 years of follow-up and 2766 additional firefighters. The primary focus was directed toward cancer sites that recently contributed to the hazard evaluation conducted by the International Agency for Research on Cancer (IARC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The updated cohort consisted of 11,827 male Danish firefighters who were followed up for cancer from 1968 to 2021. Cohort cancer morbidity was compared with a working population reference group, and standardized incidence ratios (SIR) were used for estimation of relative risks, along with 95% confidence intervals (95% CI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among full-time firefighters, SIR of skin melanoma was 1.30 (95% CI: 1.02–1.66), and SIR = 1.37 (95% CI: 1.02–1.85) for over 5 years of employment. Slightly positive associations were also observed for cancer of the urinary bladder (SIR = 1.16; 95% CI: 0.93–1.45), prostate (SIR = 1.11; 95% CI: 0.97–1.28), and testis (SIR = 1.11; 95% CI: 0.75–1.63).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This updated study provides evidence indicating an elevated risk of skin melanoma in firefighters. Consistent with IARC's evaluation, we also identified positive associations for urinary bladder, prostate, and testis cancer. In contrast, our findings did not suggest an increased risk of colon cancer, non-Hodgkin lymphoma, and mesothelioma. The latter may be due to small numbers in our still relatively young cohort. Continuous follow-up for cancer in firefighters is warranted, including assessment of influence from surveillance bias.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141533418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Asthma, a chronic respiratory disease, is associated with high economic burden. This study estimates per-worker medical and incremental medical costs associated with treated asthma by socioeconomic and demographic characteristics, industries, medical events, and sources of payments for workers aged ≥18 years.
Methods
We analyzed Medical Expenditure Panel Survey data from 2018 to 2020 to assess medical costs for treated asthma among workers using the International Classification of Diseases, Tenth Revision, Clinical Modification code for asthma (J45). We used two-part regression models to estimate medical and incremental medical costs controlling for covariates. All results are adjusted for inflation and presented in 2022 US dollar values.
Results
An estimated annual average of 8.2 million workers out of 176 million had at least one medical event associated with treated asthma. The annualized estimated per-worker incremental medical costs for those with treated asthma was $457 and was highest among: those in the age group of 35–44 years ($534), in the western region ($768), of Hispanic ethnicity ($693), employed in the utility and transportation industries ($898), males ($650), and for inpatient admissions ($754). The total annualized medical costs of treated asthma was $21 billion and total of incremental medical costs was $3.8 billion.
Conclusion
Findings of higher incremental medical costs for treated asthma among workers in certain socioeconomic, demographic, and industry groups highlight the economic benefit of prevention and early intervention to reduce morbidity of asthma in working adults. Our results suggest that the per-person incremental medical costs of treated asthma among workers are lower than that for all US adults.
{"title":"Medical costs and incremental medical costs of asthma among workers in the United States","authors":"Anasua Bhattacharya PhD, Girija Syamlal MBBS, MPH, Katelynn E. Dodd MPH","doi":"10.1002/ajim.23633","DOIUrl":"10.1002/ajim.23633","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Asthma, a chronic respiratory disease, is associated with high economic burden. This study estimates per-worker medical and incremental medical costs associated with treated asthma by socioeconomic and demographic characteristics, industries, medical events, and sources of payments for workers aged ≥18 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed Medical Expenditure Panel Survey data from 2018 to 2020 to assess medical costs for treated asthma among workers using the International Classification of Diseases, Tenth Revision, Clinical Modification code for asthma (J45). We used two-part regression models to estimate medical and incremental medical costs controlling for covariates. All results are adjusted for inflation and presented in 2022 US dollar values.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>An estimated annual average of 8.2 million workers out of 176 million had at least one medical event associated with treated asthma. The annualized estimated per-worker incremental medical costs for those with treated asthma was $457 and was highest among: those in the age group of 35–44 years ($534), in the western region ($768), of Hispanic ethnicity ($693), employed in the utility and transportation industries ($898), males ($650), and for inpatient admissions ($754). The total annualized medical costs of treated asthma was $21 billion and total of incremental medical costs was $3.8 billion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Findings of higher incremental medical costs for treated asthma among workers in certain socioeconomic, demographic, and industry groups highlight the economic benefit of prevention and early intervention to reduce morbidity of asthma in working adults. Our results suggest that the per-person incremental medical costs of treated asthma among workers are lower than that for all US adults.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141496894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Matthew M. Coates MPH, Onyebuchi A. Arah PhD, Timothy A. Matthews PhD, Dale P. Sandler PhD, Chandra L. Jackson PhD, Jian Li PhD
Background
Hypertension has been linked to socially patterned stressors, including discrimination. Few studies have quantified the risk of hypertension associated with exposure to perceived job discrimination.
Methods
We used prospective cohort data from the Sister Study (enrollment from 2003–2009) to estimate self-reported incident hypertension associated with perceived job discrimination based on race, gender, age, sexual orientation, or health status. Job discrimination in the prior 5 years was assessed in 2008–2012, and incident doctor-diagnosed hypertension was ascertained in previously hypertension-free participants.
Results
Among the 16,770 eligible participants aged 37–78 years at the start of follow-up, 10.5% reported job discrimination in the past 5 years, and 19.2% (n = 3226) reported incident hypertension during a median follow-up of 9.7 years (interquartile range 8.2–11.0 years). Self-reported poor health or inclusion in minoritized groups based on race/ethnicity or sexual orientation were more frequent among those reporting job discrimination. In a Cox proportional hazards model adjusting for covariates, report of at least one type of job discrimination (compared to none) was associated with a 14% (hazard ratio = 1.14 [95% confidence: 1.02–1.27]) higher hypertension risk. Results from sensitivity analyses reinforced the findings.
Conclusions
Results suggest that interventions addressing job discrimination could have workplace equity and health benefits.
{"title":"Multiple forms of perceived job discrimination and hypertension risk among employed women: Findings from the Sister Study","authors":"Matthew M. Coates MPH, Onyebuchi A. Arah PhD, Timothy A. Matthews PhD, Dale P. Sandler PhD, Chandra L. Jackson PhD, Jian Li PhD","doi":"10.1002/ajim.23634","DOIUrl":"10.1002/ajim.23634","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Hypertension has been linked to socially patterned stressors, including discrimination. Few studies have quantified the risk of hypertension associated with exposure to perceived job discrimination.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used prospective cohort data from the Sister Study (enrollment from 2003–2009) to estimate self-reported incident hypertension associated with perceived job discrimination based on race, gender, age, sexual orientation, or health status. Job discrimination in the prior 5 years was assessed in 2008–2012, and incident doctor-diagnosed hypertension was ascertained in previously hypertension-free participants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the 16,770 eligible participants aged 37–78 years at the start of follow-up, 10.5% reported job discrimination in the past 5 years, and 19.2% (<i>n</i> = 3226) reported incident hypertension during a median follow-up of 9.7 years (interquartile range 8.2–11.0 years). Self-reported poor health or inclusion in minoritized groups based on race/ethnicity or sexual orientation were more frequent among those reporting job discrimination. In a Cox proportional hazards model adjusting for covariates, report of at least one type of job discrimination (compared to none) was associated with a 14% (hazard ratio = 1.14 [95% confidence: 1.02–1.27]) higher hypertension risk. Results from sensitivity analyses reinforced the findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Results suggest that interventions addressing job discrimination could have workplace equity and health benefits.</p>\u0000 </section>\u0000 </div>","PeriodicalId":7873,"journal":{"name":"American journal of industrial medicine","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ajim.23634","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141475707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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