American journal of industrial medicine最新文献_第6页

Platform-Mediated Gig Work and Health: A Scoping Review 平台中介的零工工作与健康：范围审查。

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

American journal of industrial medicine

Pub Date : 2025-07-15 DOI: 10.1002/ajim.70007

Claire E. Margerison, Grace E. Joachim, Tim R. Michling, Candice Y. Johnson

Background

We sought to assess the size, depth, and rigor of empirical literature on platform-mediated gig work and health.

Methods

We conducted a scoping review of peer-reviewed studies from January 1, 2000, through May 29, 2024, that examined platform-mediated gig work and any measure of physical or mental health. We abstracted country, study design, population, sample size, exposure measure, and health outcome. We assessed whether the study addressed any of three potential mechanisms connecting gig work and health: occupational hazards, social determinants, or the specific nature of digital platforms.

Results

We identified 45 total studies examining transportation safety (n = 12), work-related injuries (n = 4), other physical health outcomes (n = 5), COVID-19 vulnerabilities (n = 10), mental health (n = 10), mental well-being (n = 18), and safety (n = 12). These categories were not mutually exclusive. Cross-sectional and qualitative studies identified physical and mental health problems among gig workers, but the literature lacks study population-representative designs, prospective data, comparisons of gig workers to other similar non-gig workers (i.e., external comparison groups), and validated measures of physical health.

Conclusions

Platform-mediated gig work may have unique impacts on health, but causal evidence is lacking. Future research should examine how the nature of digital platforms—specifically, algorithmic control, ratings, and surveillance—impacts health of workers.

背景：我们试图评估关于平台中介的零工工作和健康的实证文献的规模、深度和严谨性。方法：我们对2000年1月1日至2024年5月29日期间的同行评议研究进行了范围审查，这些研究检查了平台中介的零工工作和任何身体或心理健康指标。我们对国家、研究设计、人口、样本量、暴露测量和健康结果进行了抽象。我们评估了该研究是否解决了将零工工作与健康联系起来的三种潜在机制中的任何一种：职业危害、社会决定因素或数字平台的特定性质。结果：我们共确定了45项研究，涉及交通安全（n = 12）、工伤（n = 4）、其他身体健康结果（n = 5）、COVID-19脆弱性（n = 10）、心理健康（n = 10）、心理健康（n = 18）和安全（n = 12）。这些类别并非相互排斥。横断面和定性研究确定了零工工人的身心健康问题，但文献缺乏研究人口代表性设计、前瞻性数据、零工工人与其他类似的非零工工人（即外部对照组）的比较，以及有效的身体健康措施。结论：以平台为媒介的零工工作可能对健康有独特的影响，但缺乏因果证据。未来的研究应该考察数字平台的本质——特别是算法控制、评级和监控——如何影响员工的健康。

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引用次数: 0

Impact of Extreme Bushfires on Occupational Injury and Disease Claims in the Nonemergency Response Labor Force 极端森林大火对非紧急响应劳动力职业伤害和疾病索赔的影响

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

American journal of industrial medicine

Pub Date : 2025-07-09 DOI: 10.1002/ajim.70004

Win Wah, Janneke Berecki-Gisolf, Alex Collie, Karen Walker-Bone

Background

Extreme bushfires pose significant occupational health risks; however, research has primarily focused on emergency responders without investigating the effects on the broader labor force. This study examined the association between extreme bushfire periods and workers' compensation claims in the nonemergency response workforce.

Methods

Workers' compensation claims from the labor force (excluding first responders) were obtained from WorkSafe Victoria for the period January 2005 through April 2023. Claims for injury or disease with recorded onset dates that occurred during extreme bushfires in Victoria, Australia (Black Saturday 2009; Black Summer 2019–2020) were compared with claims in other periods using logistic regression, adjusting for sociodemographic, injury/disease, occupational, and seasonality variables.

Results

Of 78,057 claims, 1646 (2.1%) had injury/disease onset dates within extreme bushfire periods. Extreme bushfire period claims were associated with workers aged 25–34 years (odds ratio [OR] = 1.21, 95% confidence interval [CI] = 1.04–1.42) and ≥ 55 years (OR = 1.30, 95% CI = 1.12–1.51) compared to those aged 35–44 years. Claims for respiratory conditions (OR = 3.81, 95% CI = 2.58–5.62) and fractures (OR = 1.31, 95% CI = 1.09–1.56) were associated with extreme bushfire periods. Claims from workers in construction (OR = 1.25, 95% CI = 1.03–1.51), accommodation and food services (OR = 1.53, 95% CI = 1.18–1.99), education and training (OR = 1.34, 95% CI = 1.07–1.67), and financial services (OR = 2.01, 95% CI = 1.35–3.00) industries, relative to manufacturing industry claims, were associated with extreme bushfire periods.

Conclusion

During extreme bushfire events, patterns of workers' compensation claims changed somewhat among the nonemergency response labor force. Although these were relatively small numbers of events, this study provided some evidence to suggest that events like bushfires, predicted to become more common, could have wider occupational consequences, highlighting the need for prevention and mitigation strategies.

背景：极端森林火灾造成重大职业健康风险；然而，研究主要集中在紧急救援人员身上，而没有调查对更广泛的劳动力的影响。本研究考察了极端森林大火时期与非应急响应劳动力中工人赔偿索赔之间的关系。方法：从2005年1月至2023年4月，从维多利亚工作安全中心获得劳动力（不包括第一响应者）的工人赔偿要求。澳大利亚维多利亚州极端森林火灾期间发生的有发病日期记录的伤害或疾病索赔(2009年黑色星期六；黑色夏季（2019-2020）与其他时期的索赔进行了比较，使用逻辑回归，调整了社会人口统计学、伤害/疾病、职业和季节性变量。结果：在78057例索赔中，1646例（2.1%）的伤害/疾病发病日期在极端森林火灾期间。与35-44岁的工人相比，极端森林火灾期间索赔与25-34岁（比值比[OR] = 1.21, 95%可信区间[CI] = 1.04-1.42）和≥55岁（OR = 1.30, 95% CI = 1.12-1.51）的工人相关。呼吸系统疾病（OR = 3.81, 95% CI = 2.58-5.62）和骨折（OR = 1.31, 95% CI = 1.09-1.56）的索赔与极端森林大火时期相关。与制造业索赔相比，建筑行业（OR = 1.25, 95% CI = 1.03-1.51）、住宿和食品服务行业（OR = 1.53, 95% CI = 1.18-1.99）、教育和培训行业（OR = 1.34, 95% CI = 1.07-1.67）和金融服务行业（OR = 2.01, 95% CI = 1.35-3.00）工人的索赔与极端森林大火时期有关。结论：在极端山火事件中，非应急劳动力的工伤索赔模式发生了一定的变化。虽然这些事件的数量相对较少，但本研究提供的一些证据表明，预计将变得更加常见的森林火灾等事件可能产生更广泛的职业后果，突出表明需要制定预防和缓解战略。

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引用次数: 0

Incidence of Cancer Due to Exposure to Ionizing Radiation: A Cohort of Nuclear Sector Workers in the City of São Paulo 暴露于电离辐射的癌症发病率：<s:1>圣保罗市核部门工作人员队列。

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

American journal of industrial medicine

Pub Date : 2025-07-08 DOI: 10.1002/ajim.70003

Glacy Sabra Vieira, Maria Carmen Martinez

Objective

To compare cancer incidence between workers exposed to ionizing radiation in an organization based in São Paulo and the general population of the city, as well as between monitored and unmonitored subgroups for gamma- and X-irradiation within this worker population.

Methods

A retrospective open cohort study based on data from workers employed from 08/31/1956 to 12/31/2016, collected from the organization and official institutions. Standardized incidence ratios (SIRs) were calculated, stratified by sex, age, and calendar period, for cancer groupings by type, risk factor, organ system, and morphological aspect. Two analyses were performed: the external analysis, which compared the cancer incidence of the study population with that of the general population of São Paulo, and the internal analysis, which compared the cancer incidence of the monitored subgroup with the unmonitored subgroup for gamma and X-irradiation.

Results

The external incidence analysis showed an SIR = 0.590 (95% CI 0.537; 0.647, p < 0.001), and the internal incidence analysis showed an SIR = 1.066 (95% CI 0.950; 1.192, p = 0.277).

Conclusion

This study showed that cancer incidence was lower among all workers compared to the general population, and there was no increase in cancer incidence among those monitored for gamma and X-irradiation compared to the unmonitored subgroup. An increased incidence of thyroid cancer was observed among monitored workers and among male monitored workers.

目的：比较圣保罗某组织中暴露于电离辐射的工人与该市一般人群之间的癌症发病率，以及该工人群体中伽马和x射线辐照监测组与未监测组之间的癌症发病率。方法：采用回顾性开放队列研究，收集1956年8月31日至2016年12月31日在组织和官方机构工作的工人数据。计算标准化发病率（SIRs），按性别、年龄和日历期间分层，并按类型、危险因素、器官系统和形态方面进行癌症分组。进行了两项分析：外部分析，将研究人群的癌症发病率与圣保罗市一般人群的癌症发病率进行比较；内部分析，将监测亚组的癌症发病率与未监测亚组的癌症发病率进行比较。结果：外部发生率分析显示SIR = 0.590 (95% CI 0.537；结论：该研究表明，与一般人群相比，所有工人的癌症发病率较低，并且与未受监测的亚组相比，受伽马和x射线照射监测的工人的癌症发病率没有增加。在受监测工人和男性受监测工人中观察到甲状腺癌发病率增加。

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引用次数: 0

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