American journal of industrial medicine最新文献_第5页

Influence of Sex on Whole-Body Heat Exchange Following Cold Beverage Ingestion During Work–Rest Cycles in the Heat 性对高温下工作-休息周期饮用冷饮后全身热交换的影响

IF 3.1 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

American journal of industrial medicine

Pub Date : 2025-07-06 DOI: 10.1002/ajim.70002

Brodie J. Richards, Fergus K. O'Connor, Nicholas J. Koetje, Kristina-Marie T. Janetos, Gregory W. McGarr, Glen P. Kenny

Background

Consuming cold beverages during work in the heat can reduce sweat output in males. However, responses in females may differ given sex-related differences in whole-body heat exchange during work in the heat. We therefore assessed whether sex influences whole-body heat exchange following cold beverage ingestion during intermittent work in hot conditions.

Methods

Twenty young adults (ten females, mean ± SD: 23 ± 3 years) performed four 15-min bouts of moderate-intensity cycling at a fixed rate of metabolic heat production (200 W·m⁻²), each interspersed by 15-min rest periods in dry heat (40°C, ~12% relative humidity). On separate days, participants ingested either ice-slurry (~0°C), standardized to provide a heat transfer capacity of 75 kJ·m⁻², or an identical mass of warm fluid (37.5°C) prior to the first and third exercise bouts. Dry and evaporative heat exchange (direct calorimetry), as well as metabolic heat production (indirect calorimetry), were measured continuously and used to determine cumulative heat storage (summation of heat loss and heat gain) over the entire protocol.

Results

Dry and evaporative heat exchange were unaffected by beverage condition or sex (all p > 0.05). Relative to warm fluid, ice-slurry ingestion reduced cumulative heat storage in females (86 ± 120 vs. 167 ± 103 kJ, p = 0.01) and males (69 ± 181 vs. 216 ± 94 kJ) but responses did not differ between sexes (p = 0.70).

Conclusion

Whole-body heat exchange was unaffected by beverage temperature, albeit the heat transfer to the ingested ice-slurry reduced cumulative heat storage in both sexes during intermittent work in dry heat.

背景：在高温下工作时饮用冷饮可以减少男性的排汗量。然而，由于在高温下工作时全身热交换的性别差异，女性的反应可能会有所不同。因此，我们评估了在炎热条件下间歇性工作时，性行为是否会影响冷饮摄入后的全身热交换。方法20只青壮年（10只雌性，平均±SD: 23±3岁）在固定的代谢产热率（200 W·m−2）下进行4次15分钟的中等强度循环，每组在干热条件下（40°C， ~12%相对湿度）休息15分钟。在不同的天，参与者摄取冰浆（~0°C），标准化以提供75 kJ·m - 2的传热能力，或相同质量的热流体（37.5°C）在第一次和第三次锻炼之前。干热交换和蒸发热交换（直接量热法）以及代谢产热（间接量热法）被连续测量，并用于确定整个方案中的累积蓄热（热损失和热增益的总和）。结果干热交换和蒸发热交换不受饮料条件和性别的影响（p > 0.05）。相对于温暖的液体，冰浆摄入减少了雌性（86±120比167±103 kJ， p = 0.01）和雄性（69±181比216±94 kJ）的累积热量储存，但性别之间的反应没有差异（p = 0.70）。结论饮料温度对全身热交换没有影响，但向摄入的冰浆的热量传递减少了干热间歇工作时两性的累积热量储存。

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引用次数: 0

Mortality and Cancer Incidence After Exposure to Blue Asbestos in Childhood: A Further 10 Years of Follow-Up 儿童接触蓝色石棉后的死亡率和癌症发病率：进一步的10年随访。

IF 3.1 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

American journal of industrial medicine

Pub Date : 2025-07-06 DOI: 10.1002/ajim.70001

Renee N. Carey, Alison Reid, Nicholas de Klerk, Peter Cinquini, Nola Olsen, Fraser Brims, Peter Franklin

Objectives

The impact of early-life exposure to asbestos on disease risk remains uncertain. Childhood exposure to blue asbestos at Wittenoom has previously been linked to the development of malignant mesothelioma and various cancers in adulthood, as well as to a greater risk of all-cause mortality compared with the general population. This study aims to provide an update on mortality and cancer incidence rates after this exposure.

Methods

The cohort of all those who lived in the asbestos mining town of Wittenoom as children (less than 15 years of age; 1279 males and 1185 females) was linked to state and national cancer and death registries. We calculated standardized incidence ratios (SIRs) for a range of cancers, and standardized mortality ratios (SMRs) for all-cause and cause-specific mortality for the cohort compared with the general Western Australian population.

Results

Compared with the Western Australian population, males from the cohort had an increased risk of all cancers and mesothelioma, as well as melanoma and cancers of the lip and mouth, liver, and brain. Females had a significantly elevated risk of all cancers, mesothelioma, and cancers of the ovary and brain. Higher rates of mesothelioma were observed among those with a longer duration of exposure and higher cumulative exposure, consistent with a known exposure–response relationship. Former Wittenoom children also had a greater risk of all-cause mortality and mortality from cancer, mesothelioma, and ill-defined symptoms.

Conclusions

This update confirms earlier studies and shows that exposure to asbestos in childhood is associated with several cancer and mortality outcomes in adulthood.

目的：生命早期接触石棉对疾病风险的影响仍不确定。在Wittenoom，儿童时期接触蓝色石棉与成年后恶性间皮瘤和各种癌症的发展有关，而且与一般人群相比，全因死亡率的风险更高。这项研究的目的是提供这种暴露后死亡率和癌症发病率的最新情况。方法：选取居住在石棉开采小镇Wittenoom的所有儿童(小于15岁；1279名男性和1185名女性)与州和国家癌症和死亡登记处有联系。我们计算了一系列癌症的标准化发病率（SIRs），以及该队列与西澳大利亚普通人群相比的全因和病因特异性死亡率的标准化死亡率（SMRs）。结果：与西澳大利亚人口相比，队列中的男性患所有癌症和间皮瘤，以及黑色素瘤和唇部、口腔、肝脏和脑部癌症的风险增加。女性患所有癌症、间皮瘤、卵巢癌和脑癌的风险都明显升高。间皮瘤的发病率在暴露时间较长和累积暴露程度较高的人群中较高，这与已知的暴露-反应关系一致。前Wittenoom儿童的全因死亡率以及癌症、间皮瘤和症状不明确导致的死亡率风险也更高。结论：这一更新证实了早期的研究，并表明儿童期接触石棉与成年期的几种癌症和死亡率有关。

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引用次数: 0

Stress, Health, and Injury Among Illinois Farmers 伊利诺斯州农民的压力、健康和伤害。

IF 3.1 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

American journal of industrial medicine

Pub Date : 2025-07-02 DOI: 10.1002/ajim.70000

Josie M. Rudolphi, Salah Issa, Courtney Cuthbertson, Kaleigh Barnett

Objectives

The goal of this cross-sectional study was to characterize stress, injury, and chronic health conditions among agricultural producers in Illinois. The objectives were to: (1) describe the prevalence and nature of work-related injuries; (2) describe chronic health conditions, stress, and symptoms of mental health conditions; and (3) explore relationships between work-related injuries and stress, mental health, and health conditions.

Methods

A cross-sectional survey was conducted using a modified Dillman approach. Agricultural producers received mailed questionnaires assessing demographics, farm characteristics, chronic health conditions, stress (using the PSS questionnaire), anxiety (GAD-7), depression (PHQ-9), and work-related injuries. Descriptive statistics describe the population, farm characteristics, injuries, symptoms of mental health, and chronic health conditions. Chi-squared tests describe associations between variables.

Results

Agricultural injuries were reported by 8.01% of respondents, and were primarily minor or moderate. Nearly half (49.07%) reported moderate to high stress, and 10.83% had symptoms of moderate to severe anxiety. No significant associations were found between injury and stress, anxiety, or depression.

Conclusions

These findings highlight the complex interplay between health, stress, and safety in agricultural workers. Longitudinal and qualitative approaches are needed to better understand how stress and chronic conditions may relate to agricultural injuries.

目的：本横断面研究的目的是表征伊利诺伊州农业生产者的压力、伤害和慢性健康状况。目标是：(1)描述工伤的发生率和性质；(2)描述慢性健康状况、压力和精神健康状况的症状；(3)探讨工伤与应激、心理健康、健康状况之间的关系。方法：采用改良的Dillman方法进行横断面调查。农业生产者收到邮寄的问卷，评估人口统计、农场特征、慢性健康状况、压力（使用PSS问卷）、焦虑（GAD-7）、抑郁（PHQ-9）和工伤。描述性统计描述了人口、农场特征、伤害、精神健康症状和慢性健康状况。卡方检验描述了变量之间的关联。结果：农业伤害发生率为8.01%，以轻、中度伤害为主。近一半（49.07%）的人报告有中度到高度的压力，10.83%的人有中度到重度焦虑的症状。没有发现损伤与压力、焦虑或抑郁之间有显著关联。结论：这些发现强调了农业工人健康、压力和安全之间复杂的相互作用。需要纵向和定性方法来更好地了解压力和慢性疾病如何与农业伤害相关。

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引用次数: 0

COVID-19 Vaccine Hesitancy and Uptake Among California Workers in 2020–2022 2020-2022年加州工人对COVID-19疫苗的犹豫和吸收

IF 3.1 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

American journal of industrial medicine

Pub Date : 2025-06-18 DOI: 10.1002/ajim.23743

Kathleen Garvey, Ximena Vergara

Background

Workplace interactions provide an opportunity for COVID-19 transmission, contributing to severe morbidity and mortality. While vaccines offer a key mitigation measure, hesitancy among certain populations may reduce the achievement of widespread immunity. This analysis characterizes COVID-19 vaccine hesitancy and uptake among California workers to inform interventions aimed at increasing vaccine confidence.

Methods

We analyzed data from the 2020–2022 adult California Health Interview Surveys (CHIS). We estimated survey-weighted COVID-19 vaccine hesitancy (2020) and unvaccinated frequencies (2021, 2022) with 95% confidence intervals (CI) among employed Californians by demographics and major occupational group. Multivariable logistic regression models examined vaccine intention and uptake by occupation, controlling for potential confounders.

Results

In 2020, 24.1% (CI: 23.1%–25.1%) of California workers were considered “vaccine hesitant,” and in 2021 and 2022, 43.1% (CI: 42.2%–44.1%) and 9.3% (CI: 8.5%–10.2%) of California workers were unvaccinated, respectively. Hesitancy was highest among Black and Hispanic workers, and vaccine uptake was lowest among these groups in both years. Workers in the Installation, Maintenance, and Repair and the Construction and Extraction occupations had the lowest odds of vaccine intention and uptake each year.

Conclusion

The aforementioned workers faced the highest burden of COVID-19 fatalities in 2020 and may be at higher risk of SARS-CoV-2 exposure, COVID-19 infection, and subsequent long-term health consequences. These trends should be considered when planning intervention programs to increase worker vaccine confidence and uptake. Further exploration of the reasons for low vaccine uptake and ways to minimize these gaps is paramount for both COVID-19 and impending pandemic threats.

背景：工作场所的互动为COVID-19的传播提供了机会，导致严重的发病率和死亡率。虽然疫苗是一项关键的缓解措施，但某些人群的犹豫不决可能会降低实现广泛免疫的难度。该分析描述了加州工人对COVID-19疫苗的犹豫和接受情况，为旨在提高疫苗信心的干预措施提供信息。方法：我们分析了2020-2022年加州成人健康访谈调查（CHIS）的数据。我们按人口统计学和主要职业群体估计了加州就业人口中调查加权的COVID-19疫苗犹豫（2020年）和未接种疫苗频率（2021年、2022年），置信区间（CI）为95%。多变量逻辑回归模型检查了疫苗意向和职业摄取情况，控制了潜在的混杂因素。结果：2020年，24.1% （CI: 23.1%-25.1%）的加州工人被认为是“疫苗犹豫”，2021年和2022年，分别有43.1% （CI: 42.2%-44.1%）和9.3% （CI: 8.5%-10.2%）的加州工人未接种疫苗。在这两年中，黑人和西班牙裔工人的犹豫率最高，而这些群体的疫苗接种率最低。安装、维护和维修以及建筑和提取职业的工人每年接种疫苗的意愿和接种几率最低。结论：上述工人在2020年面临着最高的COVID-19死亡负担，并且可能面临更高的SARS-CoV-2暴露、COVID-19感染以及随后的长期健康后果的风险。在规划干预方案以提高工人对疫苗的信心和接受度时，应考虑到这些趋势。对于COVID-19和即将到来的大流行威胁而言，进一步探索疫苗接种率低的原因和最小化这些差距的方法至关重要。

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引用次数: 0

Expanding Perspectives on Long COVID: Multisystem Outcomes, Socioeconomic Factors, and Occupational Implications 扩展长期COVID的视角：多系统结果、社会经济因素和职业影响。

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

American journal of industrial medicine

Pub Date : 2025-06-10 DOI: 10.1002/ajim.23744

Chien-Liang Lai, Lien-Chung Wei, Hsien-Jane Chiu

引用次数: 0

A Work Systems Hierarchy of Controls: Analysis of Risk Controls Developed by Paramedics 工作系统控制层次：护理人员开发的风险控制分析。

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

American journal of industrial medicine

Pub Date : 2025-06-10 DOI: 10.1002/ajim.23741

Karen Davies, Victoria Weale, Jodi Oakman

Background

The hierarchy of control (HOC) is a fundamental construct in work health and safety practice and central for employers to manage risk to the health and safety of workers in Australia, to fulfil their legal obligations. The current HOC has been identified as more effective for developing risk controls for physical hazards than for psychosocial hazards.

Methods

To address this limitation, this study involved development and testing of a more comprehensive hierarchy of risk control. The work systems hierarchy of control (WS-HOC) includes three hierarchical levels; elimination, re-design of systems and individual actions. Non-hierarchical categories within levels were developed to distinguish different risk control options, suitable for both physical and psychosocial hazards. Using the WS-HOC, risk controls developed by paramedics to address physical and psychosocial hazards associated with work-related musculoskeletal disorders were analyzed. These risk controls were developed using the APHIRM (A Participative Hazard Identification and Risk Management) toolkit in an ambulance service.

Results

The WS-HOC provided a single, contemporary, nuanced approach to evaluating the risk controls for paramedics and their likely effectiveness, regardless of the type of hazard.

Conclusions

This novel approach provides an alternative to previous attempts at supplementing the HOC to improve its application to psychosocial hazards. Further evaluation is required by both practitioners and researchers to examine its utility for other, different occupations.

背景：控制等级制度（HOC）是工作健康和安全实践的基本结构，是澳大利亚雇主管理工人健康和安全风险、履行其法律义务的核心。目前的HOC已被确定为对身体危害的风险控制比对社会心理危害的风险控制更有效。方法：为了解决这一限制，本研究涉及开发和测试一个更全面的风险控制层次。工作系统控制层次（WS-HOC）包括三个层次；消除，重新设计系统和个人行动。在各个级别内制定了非等级分类，以区分适合于身体和心理危害的不同风险控制方案。使用WS-HOC，分析了由护理人员开发的风险控制，以解决与工作相关的肌肉骨骼疾病相关的身体和社会心理危害。这些风险控制是在救护车服务中使用apirm（一种参与式危害识别和风险管理）工具包开发的。结果：WS-HOC提供了一种单一的、现代的、细致入微的方法来评估护理人员的风险控制及其可能的有效性，而不考虑危害的类型。结论：这种新颖的方法提供了一种替代以往尝试补充HOC，以提高其在社会心理危害中的应用。从业者和研究人员都需要进一步的评估，以检验其对其他不同职业的效用。

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引用次数: 0

Risk of Mortality From Esophageal Cancer Among US Poultry Workers, 1950−2019 1950-2019年美国家禽工人食道癌死亡风险

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

American journal of industrial medicine

Pub Date : 2025-06-10 DOI: 10.1002/ajim.23742

Leanna Delhey, Christina Joshua, Jaimi L. Allen, Robert Delongchamp, Benjamin C. Amick, Wendy Nembhard

Background

While research suggests poultry industry workers have an increased risk of cancer mortality, little is known about their risk of esophageal cancer mortality. We investigated the association between working with poultry and esophageal cancer mortality while concurrently investigating other occupational and nonoccupational risk factors amongst poultry industry workers.

Methods

We conducted a case-cohort analysis from a cohort of unionized workers in the United States (N = 46,816) and conducted follow-up for mortality from 1950 to 2019 with the National Death Index. Cases were those who died of esophageal cancer and a sub-cohort was randomly selected (N = 2666) for further analysis. We interviewed participants and relatives about their work and personal life. We used multivariable Cox proportional hazards regression to estimate the hazard of esophageal cancer mortality due to working with poultry among the full cohort and weighted regression for the sub-cohort and those interviewed. We conducted exploratory analyses to estimate hazard ratios (HR) and 95% confidence intervals (CI) for each interview question, adjusted for confounders, and computed a false discovery rate (FDR).

Results

In the full and sub-cohort, working in a poultry plant was associated with an increased hazard of esophageal cancer mortality (HR = 1.62, 95% CI = 1.05, 2.50; and HR = 1.65, 95% CI = 1.03, 2.65, respectively). Among survey respondents, working in a poultry plant appeared to decrease the risk of esophageal cancer mortality (HR = 0.67; 95% CI = 0.34, 1.35).

Conclusions

Working in poultry plants may increase the risk of death from esophageal cancer, but further research is needed to validate these findings and explore potential mechanisms.

背景：虽然研究表明家禽业工人患癌症死亡的风险增加，但对他们患食道癌死亡的风险知之甚少。我们调查了与家禽工作与食管癌死亡率之间的关系，同时调查了家禽业工人中其他职业和非职业风险因素。方法：我们对美国工会工人队列（N = 46,816）进行了病例队列分析，并使用国家死亡指数对1950年至2019年的死亡率进行了随访。病例为死于食管癌的患者，随机选择一个亚队列（N = 2666）进行进一步分析。我们采访了参与者及其亲属，了解他们的工作和个人生活。我们使用多变量Cox比例风险回归来估计全队列中与家禽一起工作的食管癌死亡率的风险，并对亚队列和受访者进行加权回归。我们进行了探索性分析，以估计每个面试问题的风险比（HR）和95%置信区间（CI），调整了混杂因素，并计算了错误发现率（FDR）。结果：在全队列和亚队列中，在家禽厂工作与食管癌死亡率增加相关(HR = 1.62, 95% CI = 1.05, 2.50；HR = 1.65, 95% CI = 1.03, 2.65)。在调查对象中，在家禽加工厂工作似乎降低了食管癌死亡的风险(HR = 0.67；95% ci = 0.34, 1.35)。结论：在家禽工厂工作可能会增加食管癌死亡的风险，但需要进一步的研究来验证这些发现并探索潜在的机制。

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引用次数: 0

Social and Labor Policies or Programs as Structural Determinants of Occupational Heat Vulnerability 社会和劳动政策或计划作为职业热脆弱性的结构性决定因素。

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

American journal of industrial medicine

Pub Date : 2025-06-06 DOI: 10.1002/ajim.23739

Leah H. Schinasi, Claire Moore, Augusta Williams, Alina Schnake-Mahl

Ambient heat poses a critical threat to population health. Heat exposures are associated with a variety of adverse health or well-being outcomes, including dehydration, acute cardiovascular respiratory events, injury, adverse pregnancy outcomes, and death. These risks are not borne equally; laborers working in industries that require hazardous heat exposures and high metabolic output—construction, agriculture, or manufacturing, among others—are particularly vulnerable. Identifying modifiable interventions to protect heat-vulnerable workers is critical. The objective of this paper is to describe the ways by which social and labor policies or programs, including healthcare access, home weatherization and energy assistance programs, neighborhood greening, workplace heat safety policies, paid leave, pregnancy accommodation laws, minimum wage laws, and collective bargaining, are important upstream determinants of worker heat vulnerability. Informed by the social ecological model and the Intergovernmental Panel on Climate Change's definition of climate vulnerability as being determined by exposure intensity, sensitivity, and adaptive capacity, we synthesized literature on heat vulnerability, workplace heat safety policies, social and labor policies or programs and links to the determinants of heat vulnerability. Without broad access to social and labor policies and programs, both inside and outside the workplace, socioeconomic and racialized inequities in worker heat vulnerability will widen. Insights from this paper can inform an equity-focused research, policy and organizing agenda aimed at safeguarding workers against hot temperatures.

环境热对人口健康构成严重威胁。热暴露与各种不良健康或福祉结果相关，包括脱水、急性心血管呼吸事件、损伤、不良妊娠结局和死亡。这些风险并不是平等承担的；在建筑、农业或制造业等需要接触危险热量和高代谢输出的行业工作的劳动者尤其容易受到伤害。确定可修改的干预措施来保护易受热伤害的工人是至关重要的。本文的目的是描述社会和劳工政策或计划的方式，包括医疗保健服务、家庭天气和能源援助计划、社区绿化、工作场所热安全政策、带薪休假、怀孕住宿法、最低工资法和集体谈判，这些都是工人热脆弱性的重要上游决定因素。根据社会生态模型和政府间气候变化专门委员会对气候脆弱性的定义，即由暴露强度、敏感性和适应能力决定，我们综合了热脆弱性、工作场所热安全政策、社会和劳动政策或计划以及与热脆弱性决定因素的联系方面的文献。在工作场所内外，如果没有广泛的社会和劳工政策和计划，工人热脆弱性方面的社会经济和种族不平等将会扩大。本文的见解可以为旨在保护工人免受高温影响的以公平为重点的研究、政策和组织议程提供信息。

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引用次数: 0

Occupational Benzene Exposure and Risk of Male Genital Cancers: A Systematic Review and Meta-Analysis 职业性苯暴露与男性生殖器癌风险：系统回顾和荟萃分析。

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

American journal of industrial medicine

Pub Date : 2025-05-27 DOI: 10.1002/ajim.23740

Alessandro Godono, Andrea Quattrocolo, Roberta Caradonna, Maria Vittoria Picciaiola, Paolo Boffetta, Monireh Sadat Seyyedsalehi

Background

Benzene is an established Group 1 carcinogen due to its leukemogenic properties. Recent studies suggest that occupational benzene exposure may be associated with solid cancers. However, little is known about its association with male genital cancers. We aimed to summarize the scientific evidence on occupational benzene exposure and the risk of male genital cancers.

Methods

We searched for relevant articles in three electronic databases. Methodological quality and the certainty of evidence were evaluated using a modified version of the Newcastle-Ottawa Scale (NOS) and Grading of Recommendations Assessment, Development and Evaluation (GRADE) assessment tool. We performed pooled and stratified meta-analyses, as well as meta-regressions to explore potential sources of heterogeneity.

Results

Thirty-one publications were included. Pooled results of incidence and mortality for prostate and testis cancer did not indicate a significant association with occupational benzene exposure. A borderline association was found for the incidence of prostate cancer (standardized incidence ratio (SIR): 1.07, 95% CI 0.97–1.19). Subgroup analyses stratified by study design and study quality revealed significant heterogeneity, with case-control (relative risk (RR): 1.19, 95% CI 1.04–1.36) and high-quality studies (RR: 1.22, 95% CI 1.14–1.31) showing an increased risk. Both NOS and GRADE assessments yielded mostly low to very low-quality results.

Conclusions

This review provides no clear evidence of an association between occupational exposure to benzene and the risk of male genital cancers. Subgroup analysis suggests an increased risk of prostate cancer in high-quality studies. Nevertheless, it is important to acknowledge the methodological limitations of the available studies. Further analyses including methodologically sound studies are needed to corroborate these findings.

背景：苯因其致白血病的特性是公认的一类致癌物。最近的研究表明，职业性苯暴露可能与实体癌有关。然而，人们对它与男性生殖器癌的关系知之甚少。我们旨在总结职业苯暴露与男性生殖器癌风险的科学证据。方法：在3个电子数据库中检索相关文献。使用改良版的纽卡斯尔-渥太华量表（NOS）和建议评估、发展和评估分级（GRADE）评估工具评估方法学质量和证据的确定性。我们进行了汇总和分层荟萃分析，以及荟萃回归来探索异质性的潜在来源。结果：共纳入31篇文献。前列腺癌和睾丸癌的发病率和死亡率汇总结果没有显示与职业性苯暴露有显著关联。前列腺癌的发病率呈临界相关性（标准化发病率比（SIR）： 1.07, 95% CI 0.97-1.19）。按研究设计和研究质量分层的亚组分析显示显著的异质性，病例对照（相对风险（RR）： 1.19, 95% CI 1.04-1.36）和高质量研究（RR: 1.22, 95% CI 1.14-1.31）显示风险增加。NOS和GRADE评估的结果大多是低质量到非常低质量的。结论：本综述没有提供明确的证据表明职业接触苯与男性生殖器癌风险之间存在关联。亚组分析表明高质量研究中前列腺癌的风险增加。然而，重要的是要承认现有研究方法的局限性。需要进一步的分析，包括方法学上合理的研究来证实这些发现。

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引用次数: 0

Medical Surveillance of Occupational Lead Exposure Using the EPA's Toxics Release Inventory and Adult Blood Lead Epidemiology and Surveillance Program: Illinois, 2016–2023 使用EPA有毒物质释放清单和成人血铅流行病学和监测计划的职业铅暴露医学监测：伊利诺伊州，2016-2023。

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

American journal of industrial medicine

Pub Date : 2025-05-23 DOI: 10.1002/ajim.23738

Chibuzor Abasilim, Brett Shannon, Dana Madigan, Lee S. Friedman

Background

Despite existing regulations mandating exposure control, training, and monitoring, many worksites continue to inadequately protect workers from lead exposure. The Environmental Protection Agency (EPA) requires facilities to report lead emissions to the Toxics Release Inventory (TRI), presenting a potential tool for identifying at-risk worksites. Research has demonstrated that facilities responsible for high levels of environmental pollution often have poor occupational hygiene controls.

Methods

We linked EPA's TRI, the Illinois Adult Blood Lead Registry and business employer data. Using generalized estimating equation (GEE) models, we evaluated the relationship between lead emissions and blood lead testing to estimate the number of potentially exposed workers at sites without medical surveillance of lead exposures between 2016 and 2023.

Results

Of 477 Illinois facilities reporting lead emissions, 8.2% (n = 39) were above-threshold polluters. Only 3.98% (n = 19) reported blood lead testing for 2 or more workers between 2016 and 2023. Average annual on-site emissions were 86 pounds for below-threshold polluters, 2601 pounds for facilities providing medical surveillance, and 16,917 pounds among above-threshold polluters without medical surveillance. Among the 39 above-threshold worksites without medical surveillance, the GEE model estimates that (range low-to-high) 7 to 684 workers annually had positive blood lead levels, and 10 to 256 workers had levels ≥ 25 μg/dL. The models indicate that the majority of estimated exposed workers would be employed at 15 worksites.

Conclusions

Among facilities reporting above-threshold lead releases, workers rarely received blood lead testing. EPA's TRI data can identify facilities where compliance with the OSHA lead standards is inadequate and can help prioritize worksites for outreach.

背景：尽管现有法规要求进行暴露控制、培训和监测，但许多工作场所仍然不能充分保护工人免受铅暴露。环境保护署（EPA）要求工厂向有毒物质释放清单（TRI）报告铅排放情况，这是识别有风险的工作场所的潜在工具。研究表明，造成严重环境污染的设施往往缺乏职业卫生控制。方法：我们将EPA的TRI，伊利诺伊州成人血铅登记和商业雇主数据联系起来。利用广义估计方程（GEE）模型，我们评估了铅排放与血铅检测之间的关系，以估计2016年至2023年间在没有铅暴露医疗监测的地点潜在暴露的工人人数。结果：在伊利诺伊州报告铅排放的477家设施中，8.2% （n = 39）是超过阈值的污染者。在2016年至2023年期间，只有3.98% （n = 19）报告了2名或更多工人的血铅检测。低于阈值的污染者的平均年现场排放量为86磅，提供医疗监测的设施为2601磅，而没有医疗监测的高于阈值的污染者为16,917磅。在39个没有医疗监测的超过阈值的工作场所中，GEE模型估计（从低到高）每年有7至684名工人的血铅水平呈阳性，10至256名工人的血铅水平≥25 μg/dL。这些模型表明，大多数估计受辐射的工人将在15个工作地点工作。结论：在报告铅释放超过阈值的设施中，工人很少接受血铅检测。EPA的TRI数据可以识别不符合OSHA铅标准的设施，并可以帮助确定优先推广的工作场所。

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