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A cross-sectional study on occupational hygiene in biowaste plants. 生物废料厂职业卫生横断面研究。
IF 1.8 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-11-25 DOI: 10.1093/annweh/wxae074
Anne Mette Madsen, Pil Uthaug Rasmussen, Mohammad Seeiar Delsuz, Margit W Frederiksen

Recycling demands are increasing and new biowaste plants are established. The aim of this study is to obtain knowledge about occupational hygiene in biowaste pretreatment plants. At 6 plants, bioaerosol exposure, hand hygiene, and bioaerosol concentrations in work areas were investigated repeatedly. The total inflammatory potential (TIP) of exposures was measured using the human HL-60 cell line. Exposure to airborne bacteria, bacteria able to grow anaerobic, fungi(37°C), endotoxin, and TIP differed between plants and was lowest in a plant transporting waste in closed pipes compared to plants where waste was delivered on the receiving hall floor. Conversely, high exposures were measured in a plant that also processes compost. All microbial components had an impact on TIP of workers' exposure with main effects of fungi and endotoxin. Seasonality was found for several exposures and TIP, and they were lowest in the winter. Concentrations of bacteria and fungi on workers' hands at the end of the workday were 15 times higher for production than for nonproduction workers. In work areas, the concentrations of airborne fungi were highest in the waste-receiving area. Bacteria (3.2 µm) and anaerobic bacteria (4.0 µm) were present as larger airborne particles than fungi (2.8 µm), and bacteria were largest in the waste-receiving area. The microbial community compositions of exposures and work areas differed between plants and work areas. In conclusion, measures to reduce exposure should focus on the waste-receiving area and on the production workers. Differences in exposures and community compositions were found between seasons, work areas, work groups, and plants.

回收需求不断增加,新的生物垃圾处理厂也随之建立。本研究旨在了解生物垃圾预处理厂的职业卫生情况。对 6 家工厂的生物气溶胶暴露、手部卫生和工作区的生物气溶胶浓度进行了反复调查。使用人类 HL-60 细胞系测量了暴露的总炎症潜能(TIP)。不同工厂暴露于空气中的细菌、能厌氧生长的细菌、真菌(37°C)、内毒素和 TIP 的情况各不相同,与在接收大厅地板上运送废物的工厂相比,在封闭管道中运送废物的工厂暴露量最低。相反,在一家同时处理堆肥的工厂中测得的暴露量较高。所有微生物成分都会对工人的接触量产生影响,其中主要是真菌和内毒素。几种暴露和 TIP 都有季节性,冬季最低。工作日结束时,生产工人手上的细菌和真菌浓度是非生产工人的 15 倍。在工作区,废物接收区的空气传播真菌浓度最高。与真菌(2.8 微米)相比,细菌(3.2 微米)和厌氧细菌(4.0 微米)在空气中的颗粒更大,而细菌在废物接收区的数量最多。不同工厂和工作区的暴露和工作区的微生物群落组成各不相同。总之,减少接触的措施应侧重于废物接收区和生产工人。不同季节、不同工作区、不同工作小组和不同工厂之间的接触和群落组成存在差异。
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引用次数: 0
Managing SARS-CoV-2 transmission risk in workplace COVID-19 outbreaks. 在工作场所爆发 COVID-19 时管理 SARS-CoV-2 传播风险。
IF 1.8 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-11-25 DOI: 10.1093/annweh/wxae070
Vince Sandys, Andrew Simpson, Chris Keen, Yiqun Chen

Objectives: A Coronavirus disease 2019 (COVID-19) workplace outbreak is a risk to the health of workers and business continuity. To minimise this risk, companies have implemented risk management measures (RMMs) designed to mitigate SARS-CoV-2 transmission within the workforce. The objective of this work was to gather insights into the application of RMMs in non-healthcare workplaces and to improve understanding of the practical barriers to their implementation.

Methods: Data were collected using a pre-designed framework from 12 volunteer workplaces through discussions with staff responsible for site safety and during site visits to observe the RMMs and work processes. To evaluate ventilation effectiveness, measurements for carbon dioxide (CO2) were taken during the site visit and logged over an extended period in selected occupied areas.

Results: RMMs that were implemented well included working at home for office and other non-production staff, provision, and use of face coverings, provision for hand hygiene, and as methods became commonly available, carrying out testing for infected people. However, maintaining adequate physical distancing in many production areas proved difficult because established factory layouts cannot be easily changed and there is often a need for workers to be close to each other to communicate. A major shortcoming identified was the understanding and application of measures to improve workplace ventilation. Rapidly installing and/or upgrading mechanical ventilation systems during a pandemic may not be practical and ideally should be considered in building design. Measuring CO2 in occupied workspaces proved to be a useful tool for identifying areas with potentially inadequate ventilation.

Conclusions: Preventing workplace attendance by identifying infected individuals is challenging, making effective RMMs crucial to mitigating virus transmission. The effectiveness of individual RMMs can be uncertain; therefore, it is necessary to adopt multilayered RMMs. Successful implementation relies on measures that are specific to individual workplaces, identified by accurate risk assessment, regularly reviewed for effectiveness, and worker compliance. Establishing suitable risk mitigation policies and providing staff supervision are vital to ensure the sustained and effective implementation of RMMs. For RMMs that require technical understanding, such as workplace ventilation systems, specialist support may be necessary to ensure effective implementation.

目标:2019 年冠状病毒病(COVID-19)在工作场所的爆发是对工人健康和业务连续性的一种威胁。为了最大限度地降低这种风险,公司实施了风险管理措施 (RMM),旨在减少 SARS-CoV-2 在员工中的传播。这项工作的目的是收集有关在非医疗保健工作场所应用风险管理措施的见解,并进一步了解实施这些措施的实际障碍:方法:采用预先设计的框架,通过与负责现场安全的工作人员讨论以及实地考察 RMM 和工作流程,从 12 个志愿工作场所收集数据。为了评估通风效果,在实地考察期间测量了二氧化碳(CO2)含量,并在选定的占用区域进行了长时间记录:实施效果良好的 RMM 包括办公室和其他非生产人员在家工作、提供和使用面部遮盖物、提供手部卫生设施,以及随着方法的普及,对感染者进行检测。然而,在许多生产区保持足够的物理距离证明是困难的,因为既定的工厂布局不容易改变,而且工人之间往往需要靠近才能进行交流。已发现的一个主要缺陷是对改善工作场所通风措施的理解和应用。在大流行期间迅速安装和/或升级机械通风系统可能不切实际,理想情况下应在建筑设计中加以考虑。事实证明,测量占用工作空间的二氧化碳是确定通风可能不足区域的有用工具:通过识别受感染的个人来防止工作场所的人员进入是一项挑战,因此有效的 RMM 对减少病毒传播至关重要。单个 RMM 的有效性可能不确定;因此,有必要采用多层次的 RMM。成功的实施有赖于针对具体工作场所的措施,这些措施通过准确的风险评估来确定,并定期审查其有效性和工人的遵守情况。制定适当的风险缓解政策并对员工进行监督,对确保持续有效地实施风险监 管措施至关重要。对于工作场所通风系统等需要技术知识的风险监测机制,可能需要专家支持,以确保有效实施。
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引用次数: 0
"Why should care workers be any different from prison workers?" A qualitative study of second-hand smoke exposure during home-care visits and potential measures to eliminate exposure. "为什么护理人员与监狱工作人员有什么不同?关于家庭护理探访期间二手烟暴露的定性研究以及消除暴露的潜在措施。
IF 1.8 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-11-25 DOI: 10.1093/annweh/wxae069
Rachel O'Donnell, Ruaraidh Dobson, Sean Semple

Introduction: Despite world-leading measures in place to protect employees from second-hand smoke exposure in workplaces in the United Kingdom, workers who deliver health and social care in private homes remain unprotected legally in this setting from second-hand smoke exposure (SHS).

Methods: Fourteen individuals took part in either an in-depth telephone interview (n = 11) or an online focus group discussion (n = 3), including home-care workers (n = 5) and managers (n = 5) based in Lanarkshire (Scotland) and local/national policy makers (n = 4). Participants were asked about the extent to which exposure to SHS is an issue during home visits and possible additional measures that could be put in place to eliminate exposure.

Results: Participants highlighted the difficulties in balancing the provision of care in a person's own home with the right of workers to be able to breathe clean air and be protected from SHS. Current strategies to reduce staff exposure to SHS during home visits were often reported as inadequate with SHS not a hazard considered by managers beyond protecting pregnant staff or those with pre-existing respiratory conditions such as asthma. Simple respiratory protective equipment (as used during the COVID-19 pandemic) was rightly identified as being ineffective. Methods such as nicotine replacement therapy and e-cigarettes were identified as potential ways to help people who smoke achieve temporary asbstinence prior to a home visit.

Conclusion: Implementing appropriate and proportionate measures to protect home-care workers from the harms posed by SHS should be a priority to help protect the health of this often overlooked occupational group.

简介:尽管英国采取了世界领先的措施来保护员工免受工作场所二手烟的危害,但在私人住宅中提供医疗和社会护理服务的工作人员在这种环境下仍然不受二手烟暴露(SHS)的法律保护:14人参加了电话深度访谈(11人)或在线焦点小组讨论(3人),其中包括拉纳克郡(苏格兰)的家庭护理工作者(5人)和管理人员(5人)以及地方/国家政策制定者(4人)。参与者被问及家访期间接触可吸入有害气体的程度,以及为消除接触可采取的额外措施:结果:与会者强调了在个人家中提供护理与工作人员呼吸清洁空气和免受 SHS 影响的权利之间取得平衡的困难。据报告,目前减少员工在家访过程中接触 SHS 的策略往往不够充分,除了保护怀孕员工或患有哮喘等呼吸系统疾病的员工外,SHS 并未被管理者视为一种危害。简单的呼吸防护设备(如在 COVID-19 大流行期间使用的设备)被正确地认为是无效的。尼古丁替代疗法和电子烟等方法被认为是帮助吸烟者在家访前实现暂时戒烟的潜在方法:实施适当、适度的措施来保护家庭护理人员免受可吸入有害物质的危害,应成为帮助保护这一经常被忽视的职业群体健康的优先事项。
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引用次数: 0
Occupational exposure to chrysotile in an asbestos cement factory in Kyrgyzstan. 吉尔吉斯斯坦一家石棉水泥厂的温石棉职业暴露。
IF 1.8 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-11-25 DOI: 10.1093/annweh/wxae059
Zhyldyz Kurzhunbaeva, Andrea Spinazzè, Davide Campagnolo, Sabrina Rovelli, Giacomo Fanti, Omor Kasymov, Andrea Cattaneo, Claudio Colosio, Domenico M Cavallo

Objectives: An increasing number of countries are banning the production and use of asbestos, in compliance with the ratification of the C162 Asbestos Convention and the Basel Convention, and in response to the call for its elimination in the ILO resolution and WHO reports on the health risks associated with asbestos. Nevertheless, several countries, including Kyrgyzstan, are still miners and/or manufacturers of asbestos. The main objective of the study is to assess the occupational exposure to chrysotile of workers engaged in a production facility of asbestos-cement products in Kyrgyzstan.

Methods: Monitored workers (n = 16, for a total of n = 18 samples) were divided into 3 "Similar Exposure Groups" (SEGs; SEG-1: asbestos loading; SEG-2; asbestos-cement mixing; SEG-3: cutting of asbestos-cement sheets) according to EN 689 standard. Samples were collected through personal sampling and subsequently examined by means of scanning electron microscope equipped with an energy-dispersive spectrometer for the compositional analysis of each fibre. The numerical concentration of airborne asbestos fibres was henceforward determined by dividing the number of fibres and the volume of sampled air (expressed in the number of fibres per millilitre of air: ff/ml).

Results: Investigated workers resulted to be exposed to chrysotile fibres. Results (GM ± GSD) outlined extremely high exposure levels for SEG-1 (2.2 ± 2.1 ff/ml) and SEG-3 (4.7 ± 1.6 ff/ml) workers and lower-but still relevant-exposure values for SEG-2 (0.91 ± 2.6 ff/ml) workers.

Conclusions: The results obtained in this case study can help to document potentially critical situations of occupational exposure to asbestos that can still occur nowadays in low and middle-income countries where asbestos is still mined and processed.

目标:越来越多的国家正在禁止生产和使用石棉,以遵守 C162 号《石棉公约》和《巴塞 尔公约》的批准,并响应国际劳工组织决议和世界卫生组织关于石棉对健康危害的报 告中提出的消除石棉的呼吁。然而,包括吉尔吉斯斯坦在内的一些国家仍然是石棉的开采国和/或生产国。本研究的主要目的是评估吉尔吉斯斯坦一家石棉水泥制品生产厂的工人接触温石棉的职业情况:根据 EN 689 标准,受监测的工人(n = 16,共 n = 18 个样本)被分为 3 个 "类似接触组"(SEGs;SEG-1:石棉装载;SEG-2:石棉-水泥混合;SEG-3:石棉-水泥板切割)。通过个人取样收集样本,然后用配备能量色散光谱仪的扫描电子显微镜对每种纤维进行成分分析。空气中石棉纤维的数值浓度是用纤维数量除以采样空气的体积(以每毫升空气中的纤维数量表示:ff/ml)得出的:结果:接受调查的工人暴露于温石棉纤维。结果(GM ± GSD)显示,SEG-1(2.2 ± 2.1 ff/ml)和 SEG-3(4.7 ± 1.6 ff/ml)工人的接触水平极高,SEG-2(0.91 ± 2.6 ff/ml)工人的接触值较低,但仍具有相关性:本案例研究获得的结果有助于记录中低收入国家目前仍在开采和加工石棉时可能出现的石棉职业暴露危急情况。
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引用次数: 0
Comparison of a radiofrequency electric and magnetic field source-based job-exposure matrix with personal radiofrequency exposure measurements. 基于射频电场和磁场源的工作暴露矩阵与个人射频暴露测量结果的比较。
IF 1.8 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-11-25 DOI: 10.1093/annweh/wxae072
Maxime Turuban, Hans Kromhout, Javier Vila, Frank de Vocht, Miquel Vallbona-Vistós, Isabelle Baldi, Elisabeth Cardis, Michelle C Turner

Objectives: Assessing occupational exposure to radiofrequency electromagnetic fields (RF-EMF) presents significant challenges due to the considerable variability in exposure levels within and between occupations. This spatial and temporal variability complicates the reliable evaluation of potential health risks associated with RF-EMF exposure in the workplace. Accurate assessment methods are crucial to understand the extent of exposure and to evaluate potential health risks, especially given the potential for higher exposures in occupational settings compared to the general population. This study compares the historical RF-EMF exposure estimates in the INTEROCC RF-EMF job-exposure matrix (RF-JEM) with recent personal measurement data collected in 2 countries as part of the OccRF-Health study, to assess the broader applicability of the RF-JEM.

Methods: Weighted kappa (kw) coefficients and Spearman rank correlation tests were performed to assess the alignment between RF-JEM estimates and measurements for 8 h time-weighted average exposure intensity and prevalence estimates across various occupations. The comparisons were mainly based on 22 jobs having ≥5 measured workers in the OccRF-Health study.

Results: Poor agreement was found for both exposure prevalence and intensity between both methods (kw < 0.1). RF-JEM values likely overestimated exposure levels for both electric (E) and magnetic (H) fields (mean percentage difference >194%) compared to current personal measurements.

Conclusions: Findings suggest that the INTEROCC-JEM likely overestimates current exposure intensity levels in the measured jobs. Adopting a semiquantitative JEM could also mitigate misclassification errors due to exposure variability, improving accuracy in exposure assessment. These findings indicate the need for more targeted personal measurements, including among highly exposed workers, and for potentially considering new exposure metrics to more accurately assess occupational RF-EMF exposures in occupational epidemiological research.

目标:由于职业内部和职业之间的暴露水平存在很大差异,因此评估职业暴露于射频电磁场(RF-EMF)是一项重大挑战。这种空间和时间上的可变性使可靠评估工作场所射频电磁场暴露的潜在健康风险变得更加复杂。准确的评估方法对于了解暴露程度和评估潜在健康风险至关重要,特别是考虑到与普通人群相比,职业环境中的暴露量可能更高。本研究将 INTEROCC 射频-电磁场工作暴露矩阵(RF-JEM)中的历史射频-电磁场暴露估计值与 OccRF-Health 研究中在两个国家收集的最新个人测量数据进行比较,以评估 RF-JEM 的广泛适用性:方法:采用加权卡帕(k w)系数和斯皮尔曼等级相关性检验来评估 RF-JEM 估计值与不同职业 8 小时时间加权平均暴露强度和流行率估计值的测量值之间的一致性。比较主要基于 OccRF-Health 研究中测量人数≥5 人的 22 种工作:结果发现,两种方法在暴露流行率和强度方面的一致性较差(k w < 0.1)。与目前的个人测量值相比,RF-JEM 值可能高估了电场(E)和磁场(H)的暴露水平(平均百分比差异大于 194%):研究结果表明,INTEROCC-JEM 很可能高估了当前测量工作中的暴露强度水平。采用半定量的 JEM 还可以减少由于暴露变异造成的错误分类,提高暴露评估的准确性。这些研究结果表明,在职业流行病学研究中,需要进行更有针对性的个人测量,包括对高暴露工人进行测量,并考虑采用新的暴露指标,以更准确地评估职业射频-电磁场暴露。
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引用次数: 0
Occupational mechanical exposures as risk factor for shoulder osteoarthritis: a systematic review. 作为肩关节骨关节炎风险因素的职业机械接触:系统综述。
IF 1.8 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-11-25 DOI: 10.1093/annweh/wxae063
Ea Helene Korsgaard Thorsen, Annett Dalbøge, Nicholas Hovgaard, Johan Hviid Andersen, Alexander Jahn

Objectives: The aim of this systematic review was to study the association between occupational mechanical exposures and shoulder osteoarthritis (OA).

Methods: A protocol was registered in PROSPERO. Four databases were systematically searched based on PECOS criteria. Outcome was defined as shoulder OA (acromioclavicular (AC) and/or glenohumeral OA) and exposure as occupational mechanical exposures (vibration, upper arm elevation, force, lifting, repetition, and combined mechanical exposures). We included epidemiological studies estimating the prevalence of shoulder OA or the association between occupational mechanical exposures and shoulder OA. Two researchers independently screened articles, performed data extraction, and assessed the risk of bias and level of evidence using GRADE.

Results: A total of 1642 articles were screened, of which 7 met the inclusion criteria. Four studies were assessed as having a high risk of bias, 1 with a moderate risk, and 2 with a low risk. Based on job titles, higher prevalence estimates (2.9% to 61.8%) were found in exposed job groups. For all occupational mechanical exposures, exposure-response relations were found in relation to AC OA. For vibration, the odds ratio (OR) ranged between 1.7 and 3.1 in the highest exposure groups, while the ORs for upper arm-elevation, force, lifting, repetition, and combined mechanical exposures ranged between 0.5 to 2.2, 1.3 to 1.8, 7.3 to 10.3, 2.4, and 2.2 to 2.9. Low or very low level of evidence was found for all exposures.

Conclusions: This systematic review found an indication of an association between occupational mechanical exposures and shoulder OA, especially AC OA. However, the level of evidence varied between low and very low. High-quality studies assessing the association and differentiating between the specific shoulder joints are highly warranted.

目的:本系统综述旨在研究职业性机械接触与肩关节骨关节炎(OA)之间的关系:本系统综述旨在研究职业性机械接触与肩关节骨性关节炎(OA)之间的关系:方法: 在 PROSPERO 上注册了一项研究方案。根据 PECOS 标准对四个数据库进行了系统检索。结果定义为肩关节 OA(肩锁关节和/或盂肱关节 OA),暴露定义为职业机械暴露(振动、上臂抬高、用力、提举、重复和综合机械暴露)。我们纳入了估计肩部 OA 患病率或职业机械接触与肩部 OA 之间关系的流行病学研究。两名研究人员独立筛选文章,进行数据提取,并使用 GRADE 评估偏倚风险和证据等级:共筛选出 1642 篇文章,其中 7 篇符合纳入标准。经评估,4 项研究存在高偏倚风险,1 项存在中度风险,2 项存在低风险。根据职称,暴露职业组的患病率估计值较高(2.9% 至 61.8%)。在所有职业性机械接触中,都发现了与交流性踝关节损伤有关的接触-反应关系。对于振动,最高暴露组的几率比(OR)介于 1.7 和 3.1 之间,而上臂抬高、用力、提升、重复和综合机械暴露的几率比介于 0.5 和 2.2 之间、1.3 和 1.8 之间、7.3 和 10.3 之间、2.4 和 2.2 和 2.9 之间。所有暴露的证据水平都较低或很低:本系统综述发现,有迹象表明职业性机械接触与肩部 OA(尤其是 AC OA)之间存在关联。然而,证据水平介于较低和极低之间。我们非常有必要开展高质量的研究,评估两者之间的关联,并对特定的肩关节进行区分。
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引用次数: 0
Healthcare workers' experiences protecting themselves and their families during the COVID-19 pandemic in 2020-2021. 医护人员在 2020-2021 年 COVID-19 大流行期间保护自己和家人的经验。
IF 1.8 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-11-25 DOI: 10.1093/annweh/wxae064
Diana M Ceballos, Diana Vasquez, Lina M Ceballos, Julia E Noguchi, Jonathan I Levy, Jennifer Greif Green, William E Baker, Elissa M Schechter-Perkins, Jessica H Leibler

We characterized experiences and strategies used by frontline healthcare workers to prevent severe-acute-respiratory-syndrome-related coronavirus transmission at work and to household members during the coronavirus disease pandemic. Alongside an online questionnaire (n = 234), remote semi-structured interviews (n = 23: 15 clinicians, 8 non-clinicians) were conducted in 2021. Mitigation challenges and facilitators were identified from data to represent experiences as a process considering the before, during, and after work shifts. Journey mapping was utilized to visually describe how healthcare workers experienced the stages of the work environment, leaving work, commuting home, and the home environment, and strategies implemented to stay safe. Major facilitators included the uptake of coronavirus disease vaccines and testing, information regarding virus transmission, and adequate personal protective equipment. The most critical challenges identified included a lack of designated areas for end-of-day disinfection, changing rooms, showers, and lockers in the leaving work stage. Psychosocial and environmental factors must be considered in future hospital pandemic preparations.

我们描述了一线医护人员在冠状病毒疾病大流行期间在工作场所和家庭成员中预防与重症急性呼吸综合征相关的冠状病毒传播的经验和策略。除了在线问卷调查(n = 234),2021 年还进行了远程半结构化访谈(n = 23:15 名临床医生,8 名非临床医生)。从数据中确定了缓解挑战和促进因素,将工作前、工作中和工作后的经历作为一个过程来体现。利用旅程图直观地描述了医护人员如何经历工作环境、下班、通勤回家和家庭环境等阶段,以及为保持安全而实施的策略。主要的促进因素包括冠状病毒疾病疫苗的接种和检测、有关病毒传播的信息以及充足的个人防护设备。所发现的最严峻挑战包括缺乏下班消毒的指定区域、更衣室、淋浴室和离岗阶段的储物柜。在未来的医院大流行准备工作中,必须考虑社会心理和环境因素。
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引用次数: 0
Effort-reward imbalance at work assessed at midlife and prediabetes prevalence assessed 18 years later in a prospective cohort of white-collar workers. 在一个白领前瞻性队列中,评估中年时的工作努力回报失衡与 18 年后的糖尿病患病率。
IF 1.8 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-11-25 DOI: 10.1093/annweh/wxae071
Camille Riopel, Xavier Trudel, Alain Milot, Danielle Laurin, Mahée Gilbert-Ouimet, Chantal Brisson

Objectives: Evidence suggests that workers exposed to psychosocial stressors at work from the effort-reward imbalance (ERI) model are at increased risk for type 2 diabetes mellitus (T2DM). However, evidence about the effect of ERI on prediabetes is scarce. This study aimed to examine the association between effort-reward imbalance at work, glycated hemoglobin level and the prevalence of prediabetes in women and men from a prospective cohort study.

Methods: This study was conducted among 1354 white-collar workers followed for an average of 18 years. Effort-reward imbalance at work was measured in 1999 to 2001 using a validated instrument. Glycated hemoglobin was assessed at follow-up (2015 to 2018). Differences in mean glycated hemoglobin levels were estimated with linear models. Prediabetes prevalence ratios (PRs) were computed using robust Poisson regression models.

Results: In women, those exposed to effort-reward imbalance at work at baseline had a higher prevalence of prediabetes (PR = 1.60, 95% confidence interval: 1.02-2.49) at follow-up following adjustment for sociodemographic, lifestyle-related, clinical, and other occupational risk factors. There was no difference in mean glycated hemoglobin levels.

Conclusion: Among women, effort-reward imbalance at work at midlife was associated with the prevalence of prediabetes, at older age. Preventive workplace interventions aiming to reduce the prevalence of effort-reward imbalance at work may be effective to reduce the prevalence of prediabetes among women.

目的:有证据表明,在工作中受到努力-回报不平衡(ERI)模式的社会心理压力的工人患 2 型糖尿病(T2DM)的风险会增加。然而,有关 ERI 对糖尿病前期影响的证据却很少。本研究旨在通过一项前瞻性队列研究,探讨工作中努力-回报失衡、糖化血红蛋白水平与女性和男性糖尿病前期患病率之间的关联:这项研究对 1354 名白领进行了平均 18 年的跟踪调查。在 1999 年至 2001 年期间,使用一种经过验证的工具测量了工作中的付出与回报不平衡。在随访(2015 年至 2018 年)时对糖化血红蛋白进行了评估。平均糖化血红蛋白水平的差异通过线性模型进行估算。使用稳健的泊松回归模型计算糖尿病前期患病率(PR):结果:在对社会人口学、生活方式相关、临床和其他职业风险因素进行调整后,基线工作时暴露于努力-回报不平衡的女性在随访时的糖尿病前期患病率更高(PR = 1.60,95% 置信区间:1.02-2.49)。平均糖化血红蛋白水平没有差异:结论:在中年女性中,工作中的付出与回报不平衡与老年糖尿病前期的发病率有关。旨在减少工作中付出与回报失衡的预防性工作场所干预措施可能会有效降低女性糖尿病前期的发病率。
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引用次数: 0
A field investigation of 3 masks proposed as respiratory protection for wildland firefighters: a randomized controlled trial in British Columbia, Canada. 对建议用作野外消防员呼吸保护的 3 种面具的实地调查:在加拿大不列颠哥伦比亚省进行的随机对照试验。
IF 1.8 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-11-25 DOI: 10.1093/annweh/wxae073
Natasha Broznitsky, Mona Shum, David Kinniburgh, Drew Lichty, Sylvia Tiu, Taryn Toic, Tanis Zadunayski, Nicola Cherry
<p><strong>Introduction: </strong>Wildland firefighters are exposed through the lungs and skin to particulate matter, fumes, and vapors containing polycyclic aromatic hydrocarbons (PAH). Wearing respiratory protection should reduce pulmonary exposure, but there is uncertainty about the most effective and acceptable type of mask.</p><p><strong>Methods: </strong>Firefighters from 6 unit crews working with the British Columbia Wildfire Service were approached and those consenting were randomly allocated within each crew to a "no mask" control group or to use 1 of 3 types of masks: X, half-face respirator with P100/multi gas cartridge; Y, cloth with alpaca filter; Z mesh fabric with a carbon filter. Crews were followed for 3 consecutive firefighting days. The mask allocated was constant for each firefighter throughout. All participants completed a brief questionnaire at the start and end of each day, giving information on mask use, respiratory symptoms, and assessment of mask qualities. Spot urine samples were collected pre and post shift to assess 1-hydroxypyrene (1-HP) concentration as an indicator of total PAH absorption. Skin wipe samples from the hands and throat were collected pre and post shift and analyzed for PAH concentration. On each day monitored, 4 participants carried sampling pumps to measure total particulates and PAHs on particles and in vapor phase. The primary outcome was the concentration of urinary 1-HP at the end of the fire day. Secondary outcomes were changes in respiratory and eye symptoms during the course of the shift, reported mask use, and perception of mask qualities. The analysis used a 3-level random intercept regression model that clustered observations within individuals and crews. We aimed to detect any relation of allocated mask type to the 4 outcomes, having allowed for estimated exposure.</p><p><strong>Results: </strong>Information was collected from 89 firefighters, including 14 women: 49% (37/75) of male firefighters were bearded. Nineteen fire days were monitored for a total of 263 firefighter × days, 64 to 68 for each intervention group. The end of shift 1-HP was higher than the start of the shift. Urinary 1-HP was more strongly related to PAHs on the skin than in the breathing zone. Men with beards had higher end-of-shift urinary log 1-HP/creat (ng/g) than other firefighters. None of the groups allocated a mask had lower 1-HP than the no-mask group, either in the study group overall or when stratified by beard-wearing. Among those without either beards or a failed fit-test, Mask Z reduced at the end of shift 1-HP where airborne PAH concentration was high. End-of-shift symptoms were related to particle mass in the breathing zone but was not mitigated by any of the masks. Hours electing not to wear a mask increased from the first to third shift for all mask types. Mask Z was rated as more comfortable than other types. Mask X was rated highest on fit and perceived protection. Mask Y gained the lowest ratings on
简介:野地消防员会通过肺部和皮肤接触到含有多环芳烃 (PAH) 的颗粒物质、烟雾和蒸汽。佩戴呼吸保护装置可减少肺部暴露,但最有效、最可接受的面罩类型尚不确定:我们联系了在不列颠哥伦比亚省野外消防局工作的 6 支消防队的消防员,并将同意的消防员随机分配到 "无面具 "对照组或使用 3 种面具中的 1 种:X,带 P100/多种气体滤芯的半面式呼吸器;Y,带羊驼毛过滤器的布;Z,带碳过滤器的网状织物。连续 3 个消防日对消防员进行跟踪。每名消防员分配的面罩始终保持不变。所有参与者在每天开始和结束时都要填写一份简短的问卷,提供有关面罩使用、呼吸道症状和面罩质量评估的信息。在班前和班后收集点滴尿样,以评估 1- 羟基芘 (1-HP) 的浓度,作为多环芳烃总吸收量的指标。在班前和班后收集手部和喉咙的皮肤擦拭样本,并分析多环芳烃的浓度。在监测的每一天,4 名参与者携带采样泵测量颗粒物和气相中的总颗粒物和多环芳烃。主要结果是火灾日结束时尿中 1-HP 的浓度。次要结果是当班期间呼吸道和眼睛症状的变化、报告的口罩使用情况以及对口罩质量的感知。分析采用了 3 级随机截距回归模型,将观察结果聚类到个人和机组中。我们的目标是在考虑到估计暴露量的情况下,检测分配的面具类型与 4 种结果之间的关系:我们收集了 89 名消防员的信息,其中包括 14 名女性:49%(37/75)的男性消防员留有胡须。对 19 个消防日进行了监测,共计 263 个消防员 × 天,每个干预组为 64 到 68 天。轮班结束时的 1-HP 比轮班开始时高。尿液中的 1-HP 与皮肤上的多环芳烃的关系比与呼吸区的多环芳烃的关系更为密切。与其他消防员相比,留胡子的男性在班末尿液中的 1-HP/creat 对数(纳克/克)更高。无论是在整个研究小组中,还是在按留胡子情况进行分层时,戴面罩组的 1-HP 均低于不戴面罩组。在既未留胡子也未通过佩戴面具测试的消防员中,在空气中多环芳烃浓度较高的情况下,佩戴面具 Z 会降低下班时的 1-HP 值。班末症状与呼吸区的颗粒质量有关,但任何口罩都无法减轻。从第一班到第三班,所有类型的口罩都增加了不戴口罩的小时数。Z 型口罩被评为比其他类型口罩更舒适。X 型口罩在佩戴舒适度和防护感方面得分最高。Y 型口罩在佩戴舒适度和防护感方面的评分最低:结论:分配的口罩总体上不能提供保护,但结果突出表明,有必要更广泛地了解在哪些情况下佩戴有效的保护装置是明智之举。
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引用次数: 0
Determination of ultrafine particle number emission factors from building materials in standardized conditions. 在标准化条件下测定建筑材料的超细粒子数排放系数。
IF 1.8 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-11-09 DOI: 10.1093/annweh/wxae083
Nicolas Concha-Lozano, Yan Muller, Philippe Favreau, Guillaume Suarez

When comparing the particle emissivity for different materials and/or mechanical activities, a serious methodological issue emerges due to the dynamic nature of solid aerosols. Particle size distribution and concentration depend on initial particle emission that constantly evolves due to aerodynamic collisions. In this context, we propose a methodological approach and an experimental setup that enables to assess the release of fine/ultra-fine particles maintaining a steady-state inhalable mass concentration, here chosen at the Swiss occupational exposure level value for biopersistent granular particles (OEL: 10 mg/m3) in a controlled ventilation chamber. As a case study, this methodological protocol was tested in the occupational exposure scenario in which a series of insulating materials based on silica aerogel and conventional mortar and concrete were subjected to handling or sawing. Once the OEL was reached, the particle size distribution and morphology of the aerosols were characterized using direct reading instruments (scanning mobility sizer, aerosol photometer) and electron microscopy (SEM and TEM) analyses. As a main result, the presence of silica aerogel in the mortar did not modify the emission profile for submicronic particles during sawing in comparison to the bulk mortar. Emission factors for ultra-fine particles were found to be 88 × 106 and 81 × 106 particles/µg of inhalable dust for the aerogel mortar and bulk mortar, respectively. For concrete sawing, the number concentration of submicronic particles at the OEL is one order of magnitude greater. The aerogel-glass-wool handling generated similar particle number concentration at the OEL with ultra-fine particle emission factors of 647 × 106 particles/µg of inhalable dust, in comparison to 758 × 106 particles/µg of inhalable dust during dry concrete sawing. In conclusion, the methodology introduced in this work provides standardized particle emission factors for comparing materials and activities, while establishing a link between particle number emissions and occupational exposure limits.

在比较不同材料和/或机械活动的粒子发射率时,由于固体气溶胶的动态性质,出现了一个严重的方法问题。颗粒大小分布和浓度取决于初始颗粒发射,而初始颗粒发射会因空气动力碰撞而不断变化。在这种情况下,我们提出了一种方法和一种实验装置,可以评估细颗粒/超细颗粒在可吸入质量浓度保持稳定的情况下的释放情况,这里选择的是瑞士生物持久性颗粒的职业接触水平值(OEL:10 毫克/立方米)。作为一项案例研究,该方法方案在职业接触情景中进行了测试,在该情景中,一系列基于硅气凝胶和传统砂浆及混凝土的绝缘材料被搬运或锯开。达到 OEL 值后,使用直读仪器(扫描流动性测定仪、气溶胶光度计)和电子显微镜(扫描电镜和 TEM)分析气溶胶的粒度分布和形态特征。主要结果是,与散装砂浆相比,砂浆中二氧化硅气凝胶的存在不会改变锯切过程中亚微米粒子的排放曲线。研究发现,气凝胶砂浆和大体积砂浆的超细粒子排放系数分别为 88 × 106 和 81 × 106 粒子/微克可吸入粉尘。在混凝土锯切过程中,亚微米粒子的数量浓度比 OEL 值高一个数量级。在气凝胶-玻璃-羊毛处理过程中,可吸入粉尘 OEL 值处的颗粒数量浓度相似,超细颗粒排放系数为 647 × 106 个颗粒/微克可吸入粉尘,而在干混凝土锯切过程中,可吸入粉尘 OEL 值处的颗粒数量浓度为 758 × 106 个颗粒/微克可吸入粉尘。总之,这项工作中引入的方法为比较材料和活动提供了标准化的微粒排放系数,同时在微粒数排放和职业接触限值之间建立了联系。
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引用次数: 0
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Annals Of Work Exposures and Health
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