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Occupational exposure to pesticides and neurobehavioral outcomes. Impact of different original and recalled exposure measures on the associations. 农药职业暴露与神经行为结果。不同的原始和回忆暴露测量方法对相关性的影响。
IF 1.8 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-08 DOI: 10.1093/annweh/wxae025
Samuel Fuhrimann, William Mueller, Aggrey Atuhaire, Ruth Mubeezi, Johan Ohlander, Andrew Povey, Ioannis Basinas, Martie van Tongeren, Kate Jones, Karen S Galea, Hans Kromhout

Background: Several measures of occupational exposure to pesticides have been used to study associations between exposure to pesticides and neurobehavioral outcomes. This study assessed the impact of different exposure measures for glyphosate and mancozeb on the association with neurobehavioral outcomes based on original and recalled self-reported data with 246 smallholder farmers in Uganda.

Methods: The association between the 6 exposure measures and 6 selected neurobehavioral test scores was investigated using linear multivariable regression models. Exposure measures included original exposure measures for the previous year in 2017: (i) application status (yes/no), (ii) number of application days, (iii) average exposure-intensity scores (EIS) of an application and (iv) number of EIS-weighted application days. Two additional measures were collected in 2019: (v) recalled application status and (vi) recalled EIS for the respective periods in 2017.

Results: Recalled applicator status and EIS were between 1.2 and 1.4 times more frequent and higher for both pesticides than the original application status and EIS. Adverse associations between the different original measures of exposure to glyphosate and 4 neurobehavioral tests were observed. Glyphosate exposure based on recalled information and all mancozeb exposure measures were not associated with the neurobehavioral outcomes.

Conclusions: The relation between the different original self-reported glyphosate exposure measures and neurobehavioral test scores appeared to be robust. When based on recalled exposure measures, associations observed with the original exposure measures were no longer present. Therefore, future epidemiological studies on self-reported exposure should critically evaluate the potential bias towards the null in observed exposure-response associations.

背景:研究农药职业暴露与神经行为结果之间的关系时,使用了多种农药职业暴露测量方法。本研究根据乌干达 246 名小农户的原始数据和回忆性自我报告数据,评估了草甘膦和代森锰锌不同暴露测量方法对神经行为结果相关性的影响:采用线性多变量回归模型研究了 6 种暴露测量与 6 种选定的神经行为测试得分之间的关系。暴露测量包括 2017 年上一年的原始暴露测量:(i) 施用状态(是/否),(ii) 施用天数,(iii) 施用的平均暴露强度分数(EIS),(iv) EIS 加权施用天数。2019 年还收集了两项额外的测量数据:(v) 2017 年相应时期的召回施药状态和 (vi) 召回的 EIS:与原始施药状态和 EIS 相比,两种农药的召回施药状态和 EIS 的频率和数量均高出 1.2 至 1.4 倍。观察到草甘膦不同原始暴露量与 4 项神经行为测试之间存在不利关联。根据回忆信息得出的草甘膦暴露量和所有曼耕灵暴露量与神经行为结果无关:不同的原始自我报告草甘膦暴露量与神经行为测试得分之间的关系似乎是稳健的。当基于回顾性暴露测量时,与原始暴露测量之间的关系不再存在。因此,今后关于自我报告接触情况的流行病学研究应严格评估观察到的接触-反应关联中可能存在的偏差。
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引用次数: 0
Response to: Letter to the Editor-Productivity as an efficacy measure in rest-shade-hydration interventions: the need for a more complete dissemination and implementation science approach by Dally M and Newman LS. 回应Dally M 和 Newman LS 撰写的致编辑的信--将生产率作为休息-遮阳-补水干预措施的疗效衡量标准:需要更全面的传播和实施科学方法。
IF 1.8 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-08 DOI: 10.1093/annweh/wxae046
Erik Hansson, Kristina Jakobsson, Jason R Glaser, Catharina Wesseling, Denis Chavarria, Rebekah A I Lucas, Heath Prince, David H Wegman
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引用次数: 0
The role of European chemical manufacturing companies in promoting effective communication of conditions of safe use by workers. 欧洲化学品制造公司在促进有效宣传工人安全使用条件方面的作用。
IF 1.8 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-08 DOI: 10.1093/annweh/wxae042
Jan Urbanus, Evelyn Tjoe Nij, Cornelia Tietz

In 2006, the revised chemicals management legislation mandated that manufacturers of hazardous chemical substances conduct risk assessments for the entire substance life cycle. Additionally, they must communicate use-specific safe handling advice (exposure scenarios) to their customer, as annex to the Safety Data Sheet (SDS). Despite significant efforts to develop workable solutions for chemical mixtures, this goal has not yet been fully achieved. Therefore, a Cefic research project (LRI B23) was commissioned on how to ensure meaningful health risk communication for workers across supply chains. The research project determined that risk-based safe use advice generated by manufacturers, often does not reach the intended end-user and was seen as not tailored to specific user needs. Recipients of the advice are also not prepared to act based on information developed by suppliers. From an industry perspective, the complexity of supply chains and substance life cycles are considered major barriers for effective safe use communication. Exposure scenarios for substance use in industrial work environments are often perceived as adding little value compared to existing safe use arrangements required by other health, safety, and environmental legislation applicable to employers and duty-holders. To attain meaningful use-specific safe handling advice for workers, including those at non-industrial premises who may benefit most from such advice, knowledge transfer and close collaboration between manufacturers and formulators remain key elements, supported by enhanced regulatory appreciation.

2006 年,修订后的化学品管理法规定,危险化学物质制造商必须对物质的整个生命周期进行风险评估。此外,他们还必须向客户传达特定用途的安全处理建议(暴露情景),作为安全数据表(SDS)的附件。尽管为化学混合物开发可行的解决方案付出了巨大努力,但这一目标尚未完全实现。因此,Cefic 委托开展了一个研究项目(LRI B23),研究如何确保在整个供应链中对工人进行有意义的健康风险交流。该研究项目发现,制造商提出的基于风险的安全使用建议往往无法送达预期的最终用户,而且被认为不符合特定用户的需求。建议的接受者也不准备根据供应商提供的信息采取行动。从行业角度来看,供应链和物质生命周期的复杂性被认为是有效安全使用沟通的主要障碍。与适用于雇主和责任人的其他健康、安全和环境法规所要求的现有安全使用安排相比,工业工作环境中的物质使用暴露情景通常被认为没有什么附加价值。为了向工人(包括那些可能从此类建议中获益最多的非工业场所工人)提供有意义的特定用途安全处理建议,知识转让以及制造商和配方设计师之间的密切合作仍然是关键因素,同时还要加强监管力度。
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引用次数: 0
Productivity as an efficacy measure in rest-shade-hydration interventions: the need for a more complete dissemination and implementation science approach. 将生产率作为休息-遮阳-补水干预措施的疗效衡量标准:需要更全面的传播和实施科学方法。
IF 1.8 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-08 DOI: 10.1093/annweh/wxae044
Miranda Dally, Lee S Newman
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引用次数: 0
Prospective associations of occupational and leisure-time physical activity with risk of diabetes: a cohort study from the United States. 职业和业余时间体育锻炼与糖尿病风险的前瞻性关联:美国的一项队列研究。
IF 1.8 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-08 DOI: 10.1093/annweh/wxae034
Timothy A Matthews, Xinyue Liu, Liwei Chen, Jian Li

Objectives: Leisure-time physical activity (LTPA) can reduce the risk of incident diabetes, whereas the role of occupational physical activity (OPA) in developing diabetes is still unclear due to conflicting evidence. Moreover, the joint associations of OPA and LTPA with incident diabetes among US workers have not yet been systematically examined. The objective of this study was to assess the independent and joint associations of OPA and LTPA with incident diabetes.

Methods: This prospective cohort study included 1406 workers free from diabetes at baseline (2004-2006) from the national, population-based Mid-life in the United States (MIDUS) study. Associations of OPA and LTPA at baseline with incident diabetes during 9 years of follow-up were examined using Poisson regression models. High OPA was defined based on engagement in physical demands at work, and high LTPA was defined as participation in moderate or vigorous LTPA at least once per week.

Results: High OPA was associated with an increased risk of diabetes compared to low OPA (adjusted risk ratios and 95% confidence interval = 1.52 [1.04, 2.22]), while high LTPA was associated with a decreased risk of diabetes compared to low LTPA (0.66 [0.44, 0.97]). Diabetes risk was the highest among workers with high OPA and low LTPA (2.30 [1.30, 4.07]).

Conclusions: In a national, population-based prospective cohort study of US workers, high OPA was associated with an elevated risk of diabetes, while high LTPA was associated with a decreased diabetes risk. The combination of high OPA and low LTPA exhibited the greatest risk of diabetes.

目的:业余体力活动(LTPA)可以降低糖尿病的发病风险,而职业体力活动(OPA)在糖尿病发病中的作用因证据不一而尚不明确。此外,在美国工人中,职业体力活动(OPA)和休闲时间体力活动(LTPA)与糖尿病发病的共同关系尚未得到系统研究。本研究的目的是评估 OPA 和 LTPA 与糖尿病发病的独立和联合关系:这项前瞻性队列研究纳入了 1406 名基线时(2004-2006 年)未患糖尿病的工人,他们来自以人口为基础的全国性美国中年(MIDUS)研究。研究人员使用泊松回归模型检验了基线OPA和LTPA与9年随访期间糖尿病发病率的关系。高OPA的定义基于工作中的体力需求,高LTPA的定义是每周至少参加一次中等强度或高强度的LTPA:与低 OPA 相比,高 OPA 与糖尿病风险增加有关(调整风险比和 95% 置信区间 = 1.52 [1.04, 2.22]),而与低 LTPA 相比,高 LTPA 与糖尿病风险降低有关(0.66 [0.44, 0.97])。高OPA和低LTPA工人患糖尿病的风险最高(2.30 [1.30,4.07]):在一项对美国工人进行的全国性、基于人群的前瞻性队列研究中,高OPA与糖尿病风险升高有关,而高LTPA与糖尿病风险降低有关。高 OPA 和低 LTPA 的组合表现出最大的糖尿病风险。
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引用次数: 0
Effects of the combined exposure to chemicals and unusual working hours. 接触化学品和不正常工作时间的综合影响。
IF 1.8 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-08 DOI: 10.1093/annweh/wxae033
Jenny-Anne S Lie, Shan Zienolddiny-Narui, Magne Bråtveit

Objective: Both exposure to occupational chemicals and to unusual working hours have well documented effects on health. Determination of occupational exposure limits is, however, usually based on chemical-only exposure and assumes an 8-h workday, 5 days/week and a 40-h work week. A significant proportion of the workforce is exposed to chemicals while working in other work schedules. This review thus aimed to synthesize and evaluate the scientific support for a combined effect of unusual working hours and chemical exposure and, if possible, give recommendations for OEL adjustments to account for unusual working hours.

Methods: The search for articles was made as part of the preparation of a report for the Nordic Expert Group for Criteria Documentation of Health Risks from Chemicals. In this report, unusual working hours were categorized as shift work or extended (>8 h) working hours. Inclusion criteria were observational studies in the English language published up to November 2021 in peer-reviewed journals, with explicit metrics of exposure (chemicals and unusual working hours) and of health outcome, and which explicitly tested the association between exposure and outcome. Search engines of seven databases were used.

Results: Of the initially 15 400 identified papers, 9 studies published between 1985 and 2021 met the inclusion criteria, 7 of which showed significant associations. Results from a few of the studies, i.e. regarding effects of dust and endotoxin on lung function, effects of acetone on sleep quality and tiredness, effects of carbon disulphide on coronary artery disease and effects of chemicals on spontaneous abortion, suggested more pronounced effects during night shifts compared to during day shifts.

Discussion: The reviewed data is considered insufficient to conclude on recommendations for OEL adjustment for shift work. Suggested areas of future studies are mentioned.

Conclusion: Further studies about the effects of the combined exposure to unusual working hours and chemical exposure are essential for risk assessment, and for recommendation of potential OEL adjustments. What is important about this paper? Effects of chemical agents at the workplace may depend not only on exposure level and duration but also on the time of exposure in relation to the circadian rhythm. This study reviewed the scientific support for a combined effect of unusual working hours and chemical exposure and revealed an obvious need for additional studies regarding the complex interplay of the two different exposures with respect to adverse health effects.

目的:接触职业化学品和非正常工作时间对健康的影响都有充分的记录。然而,职业接触限值的确定通常以仅接触化学品为基础,并假定每天工作 8 小时,每周工作 5 天,每周工作 40 小时。很大一部分劳动力是在其他工作时间段接触化学品的。因此,本综述旨在综合并评估不寻常工作时间和化学品暴露的综合影响的科学依据,并在可能的情况下,针对不寻常工作时间提出调整 OEL 的建议:文章搜索是为北欧化学品健康风险标准文件专家组编写报告的一部分。在该报告中,非正常工作时间被归类为轮班工作或延长(>8 小时)工作时间。纳入标准为截至 2021 年 11 月在同行评审期刊上发表的英文观察性研究,这些研究对暴露(化学品和非正常工作时间)和健康结果有明确的衡量标准,并对暴露和结果之间的关联进行了明确的测试。研究使用了七个数据库的搜索引擎:在最初确定的 15 400 篇论文中,1985 年至 2021 年间发表的 9 项研究符合纳入标准,其中 7 项显示出显著的关联性。少数研究的结果表明,与白班相比,夜班的影响更为明显,这些研究涉及粉尘和内毒素对肺功能的影响、丙酮对睡眠质量和疲劳的影响、二硫化碳对冠状动脉疾病的影响以及化学品对自然流产的影响:讨论:所审查的数据被认为不足以就调整轮班工作的 OEL 得出结论。结论:结论:对于风险评估和可能的 OEL 调整建议而言,进一步研究非正常工作时间和化学品接触的综合影响至关重要。本文的重要意义何在?工作场所化学制剂的影响可能不仅取决于接触水平和持续时间,还取决于与昼夜节律相关的接触时间。本研究回顾了不寻常的工作时间和化学物质接触的综合影响的科学依据,并揭示了就两种不同接触对健康的不良影响的复杂相互作用开展更多研究的明显必要性。
{"title":"Effects of the combined exposure to chemicals and unusual working hours.","authors":"Jenny-Anne S Lie, Shan Zienolddiny-Narui, Magne Bråtveit","doi":"10.1093/annweh/wxae033","DOIUrl":"10.1093/annweh/wxae033","url":null,"abstract":"<p><strong>Objective: </strong>Both exposure to occupational chemicals and to unusual working hours have well documented effects on health. Determination of occupational exposure limits is, however, usually based on chemical-only exposure and assumes an 8-h workday, 5 days/week and a 40-h work week. A significant proportion of the workforce is exposed to chemicals while working in other work schedules. This review thus aimed to synthesize and evaluate the scientific support for a combined effect of unusual working hours and chemical exposure and, if possible, give recommendations for OEL adjustments to account for unusual working hours.</p><p><strong>Methods: </strong>The search for articles was made as part of the preparation of a report for the Nordic Expert Group for Criteria Documentation of Health Risks from Chemicals. In this report, unusual working hours were categorized as shift work or extended (>8 h) working hours. Inclusion criteria were observational studies in the English language published up to November 2021 in peer-reviewed journals, with explicit metrics of exposure (chemicals and unusual working hours) and of health outcome, and which explicitly tested the association between exposure and outcome. Search engines of seven databases were used.</p><p><strong>Results: </strong>Of the initially 15 400 identified papers, 9 studies published between 1985 and 2021 met the inclusion criteria, 7 of which showed significant associations. Results from a few of the studies, i.e. regarding effects of dust and endotoxin on lung function, effects of acetone on sleep quality and tiredness, effects of carbon disulphide on coronary artery disease and effects of chemicals on spontaneous abortion, suggested more pronounced effects during night shifts compared to during day shifts.</p><p><strong>Discussion: </strong>The reviewed data is considered insufficient to conclude on recommendations for OEL adjustment for shift work. Suggested areas of future studies are mentioned.</p><p><strong>Conclusion: </strong>Further studies about the effects of the combined exposure to unusual working hours and chemical exposure are essential for risk assessment, and for recommendation of potential OEL adjustments. What is important about this paper? Effects of chemical agents at the workplace may depend not only on exposure level and duration but also on the time of exposure in relation to the circadian rhythm. This study reviewed the scientific support for a combined effect of unusual working hours and chemical exposure and revealed an obvious need for additional studies regarding the complex interplay of the two different exposures with respect to adverse health effects.</p>","PeriodicalId":8362,"journal":{"name":"Annals Of Work Exposures and Health","volume":" ","pages":"647-656"},"PeriodicalIF":1.8,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11229379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140847697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Assessing the impact of authorisation process as a regulatory tool in the European REACH regulation: A study on improving occupational safety for applying companies. 评估授权程序作为欧洲 REACH 法规中一种监管工具的影响:关于改善申请公司职业安全的研究。
IF 1.8 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-08 DOI: 10.1093/annweh/wxae032
Holger-Lars Deubner, Gudrun Walendzik, Andreas Lüdeke, Urs Schlüter

This study looks into the effectiveness of the authorisation procedure as a regulatory instrument within the framework of the European REACH regulation. It highlights its impact on enhancing occupational safety and health for both applicants and companies utilising the substances. This procedure encompasses manufacturers, importers, and downstream users of substances, as well as representatives of foreign manufacturers who are also eligible to seek authorisation. When applying for authorisation, the ECHA Risk Assessment Committee (RAC) assesses the risks associated with the intended uses of the substance, including the appropriateness and effectiveness of the Occupational Conditions (OCs) and Risk Management Measures (RMMs) described in the application and the risks posed by potential alternatives. If the RAC determines that the OCs/RMMs are inadequate for managing or controlling the risk, or if the measures to protect workers are deemed insufficient, it may recommend additional measures to enhance occupational safety and health or environmental protection. The 398 processed Applications for Authorisation (AfA) that have been submitted to date were examined to determine these recommended measures, categorised as Conditions for use, Monitoring arrangements, and Recommendations for Review Reports. Overall, a significant improvement concerning occupational safety and health seems necessary, as indicated by the large number of measures recommended by the ECHA Committee for Risk Assessment (RAC) and ECHA Committee for Socio-economic Analysis (SEAC) or supplemented by the European Commission. In addition to the proposed measures, a short assessment provided by the committees as to whether the operational conditions and risk management measures are adequate in controlling the risks is also included in the study.

本研究探讨了授权程序作为欧洲 REACH 法规框架内的一种监管手段的有效性。它强调了授权程序对提高申请者和使用这些物质的公司的职业安全和健康的影响。该程序包括物质的制造商、进口商和下游用户,以及也有资格申请授权的外国制造商的代表。在申请授权时,欧洲化学品管理局风险评估委员会(RAC)会评估与物质预期用途相关的风险,包括申请中描述的职业条件(OCs)和风险管理措施(RMMs)的适当性和有效性,以及潜在替代品带来的风险。如果 RAC 认定 OCs/RMMs 不足以管理或控制风险,或保护工人的措施被认为不充分,它可以建议采取额外措施,以加强职业安全和健康或环境保护。对迄今已提交的 398 份经过处理的授权申请(AfA)进行了审查,以确定这些建议措施,并将其归类为使用条件、监测安排和审查报告建议。总体而言,欧洲化学品管理局风险评估委员会(RAC)和欧洲化学品管理局社会经济分析委员会(SEAC)建议或欧盟委员会补充的大量措施表明,似乎有必要在职业安全和健康方面做出重大改进。除了建议的措施外,研究报告中还包括了这两个委员会对操作条件和风险管理措施是否足以控制风险的简短评估。
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引用次数: 0
Outdoor workers' perceptions of skin cancer prevention: a qualitative study. 户外工作者对皮肤癌预防的看法:一项定性研究。
IF 1.8 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-08 DOI: 10.1093/annweh/wxae039
Jeanne Ward, Frances Hardin-Fanning, Andrew Scott LaJoie, Lesley Harris, Anna Simpson

Objectives: Outdoor workers are at increased risk for skin cancer and melanoma. This qualitative study aimed to explore outdoor workers' perspectives and experiences of primary (i.e. sun protection) and secondary prevention, i.e. skin self-examination (SSE) of skin cancer.

Methods: Purposive, snowball, and theoretical sampling was used to recruit outdoor workers in Kentucky and Indiana. Semi-structured interviews via telephone or videoconference of approximately 45 min were conducted with interviewer probes and questions about perceptions of cancer risk, prevention, and screening techniques conducted, perceived barriers and facilitators, and preferences for health dissemination venues. The recordings were transcribed verbatim and de-identified. Analysis involved constructivist grounded theory coding strategies. Using peer debriefing and consensus building around themes, the researcher established a codebook for all interviews to utilize within Dedoose software for systematizing and organizing data.

Results: Eighteen interviews were conducted. Interviewees (N = 18) ranged in age from 35 to 78 yr, with 3 females. Outdoor industries included agriculture, maintenance, and grounds maintenance. Themes derived from the data showed the underlying factors and perceptions that influence outdoor workers to conduct primary and secondary cancer prevention activities. The level of alarm attributed to disease and the level of trust in information contribute to intentions to conduct activities. The intentions and trust toward healthcare institutions and providers drive the primary or secondary prevention behaviors. Cultural and contextual factors included masculinity and self-sufficiency, familial and occupational priorities, and community ties.

Conclusions: These data provide a basis for developing future communications and interventions to decrease skin cancer incidence in outdoor workers. They indicate that secondary prevention and building self-efficacy in conducting SSE should be emphasized in tandem or over primary skin cancer prevention methods in this population. Trusted local healthcare providers should primarily provide prevention information, and materials should utilize testimonials from the local community to best influence this population. Communications and training interventions are needed in this population to induce a proactive level of alarm about cancer and result in the performance of SSE.

目的:户外工作者罹患皮肤癌和黑色素瘤的风险较高。这项定性研究旨在探讨户外工作者对皮肤癌一级预防(即防晒)和二级预防(即皮肤自我检查)的观点和经验:方法:在肯塔基州和印第安纳州采用有目的抽样、滚雪球抽样和理论抽样等方法招募户外工作者。通过电话或视频会议进行了约 45 分钟的半结构化访谈,访谈者就癌症风险、预防和筛查技术的看法、感知到的障碍和促进因素以及对健康传播场所的偏好进行了探究和提问。录音被逐字转录并去标识。分析采用建构主义基础理论编码策略。通过同行汇报和围绕主题达成共识,研究人员为所有访谈建立了一个编码手册,以便在 Dedoose 软件中系统化和组织数据:共进行了 18 次访谈。受访者(N = 18)的年龄从 35 岁到 78 岁不等,其中女性 3 人。户外行业包括农业、维修和场地维护。从数据中得出的主题显示了影响户外工作者开展一级和二级癌症预防活动的潜在因素和观念。对疾病的警觉程度和对信息的信任程度会影响开展活动的意愿。对医疗机构和医疗服务提供者的意向和信任则是一级或二级预防行为的驱动因素。文化和环境因素包括男性气质和自立能力、家庭和职业优先顺序以及社区联系:这些数据为今后制定减少户外工作者皮肤癌发病率的沟通和干预措施提供了依据。这些数据表明,在这一人群中,二级预防和培养进行自我防护的自我效能应与一级皮肤癌预防方法同时强调,或重于一级皮肤癌预防方法。值得信赖的当地医疗保健提供者应主要提供预防信息,材料应利用当地社区的推荐信,以对这一人群产生最佳影响。需要对这一人群进行沟通和培训干预,以引起他们对癌症的主动警觉,从而进行皮肤癌自我检测。
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引用次数: 0
Sources of noise exposure across Australian workplaces: cross-sectional analysis and modelling the impact of a targeted noise-source reduction initiative. 澳大利亚工作场所的噪声暴露源:横截面分析和有针对性的噪声源减少倡议的影响建模。
IF 1.8 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-07-08 DOI: 10.1093/annweh/wxae029
Kate Lewkowski, Jane S Heyworth, Kahlia McCausland, Warwick Williams, Lin Fritschi

Context: Workplace noise regulations and guidance follow the hierarchy of control model that prioritizes eliminating or reducing noise at its source.

Objectives: To determine the main sources of workplace noise exposure in the Australian working population and estimate the reduction of workers exposed over the noise limit (LAeq,8h > 85 dB) if noise levels of specific tools or equipment were reduced by 10 dB.

Methods: Information on the tools used and tasks performed during each participant's last working shift was collected from 4,977 workers via telephone survey. Using a predetermined database of task-based noise levels, partial noise exposures (Pa2h) were determined for each noisy activity performed by the workers and their daily noise exposure level (LAeq,8h) was estimated. Partial exposures were categorized into 15 tool/task groups and the tally, average, and sum (Pa2h) for each group were calculated. The impacts of 5 different scenarios that simulated a reduction of 10 dB in noise emissions for specific tool groups were modelled.

Results: Powered tools and equipment were responsible for 59.3% of all noise exposure (Pa2h); vehicles for 10.6%; mining, refineries, and plant equipment for 5.1%; and manufacturing and food processing for 4.2%. Modelling demonstrated that a 10 dBA noise-level reduction of all powered tools and equipment would lead to a 26.4% (95% confidence interval: 22.7% to 30.3%) reduction of workers with an LAeq,8h > 85 dB. This could represent over 350,000 Australian workers no longer exposed above the workplace limit daily.

Conclusions: A universal reduction of 10 dB to power tools and equipment would substantially reduce the future burden of hearing loss, tinnitus, workplace injuries, and other health effects. Initiatives to reduce the noise emissions of specific powered tool groups are warranted.

背景:工作场所噪声法规和指南遵循优先从源头消除或降低噪声的分级控制模式:确定澳大利亚工作人群暴露于工作场所噪声的主要来源,并估算如果将特定工具或设备的噪声水平降低 10 分贝,可减少多少工人暴露于超过噪声限值(LAeq,8h > 85 分贝)的噪声:方法:通过电话调查从 4,977 名工人中收集了每位参与者在最后一个工作班次中使用的工具和执行的任务的信息。利用预先确定的基于任务的噪声级数据库,确定了工人所从事的每项高噪声活动的部分噪声暴露量(Pa2h),并估算了他们的日噪声暴露量(LAeq,8h)。部分暴露量被分为 15 个工具/任务组,并计算出每组的总暴露量、平均暴露量和总暴露量(Pa2h)。模拟了 5 种不同方案的影响,这些方案模拟将特定工具组的噪声排放降低 10 分贝:结果:电动工具和设备占所有噪声暴露(Pa2h)的 59.3%;车辆占 10.6%;采矿、炼油和工厂设备占 5.1%;制造和食品加工占 4.2%。建模表明,如果所有电动工具和设备的噪音水平降低 10 分贝,那么 LAeq,8h > 85 分贝的工人将减少 26.4%(95% 置信区间:22.7% 至 30.3%)。这意味着超过 350,000 名澳大利亚工人每天不再暴露在超过工作场所限值的环境中:结论:将电动工具和设备的噪音普遍降低 10 分贝,将大大减轻未来听力损失、耳鸣、工伤和其他健康影响的负担。有必要采取措施减少特定电动工具组的噪声排放。
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引用次数: 0
128 Assessing potential health risks from multi-exposure to chemicals in U.S. workplaces: findings from the OSHA database 128 评估美国工作场所多次接触化学品的潜在健康风险:来自 OSHA 数据库的发现
IF 2.6 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-06-27 DOI: 10.1093/annweh/wxae035.060
Philippe Sarazin, Jean-François Sauvé, France Labrèche, Vikki Ho, Maude Pomerleau, Delphine Bosson-Rieutort, Jérôme Lavoué
Introduction The combined effects of occupational exposure to multiple chemicals on health can be substantial. However, the most prevalent multi-exposure situations and their toxic effects remain understudied. We assessed the health risks from multi-exposure to chemicals in U.S. workplaces using the Occupational Safety and Health Administration’s (OSHA) measurement database. Methods We analysed personal air measurements for the period 1971-2021 summarized by workplace situation (WS), corresponding to measurements taken for the same job title, within a company, within a year. We calculated hazard quotients (HQ) by dividing the agents’ concentrations by their ACGIH® threshold limit value. We calculated the mixtures’ hazard indices (HI) by summing the HQs of agents by combination of WS and toxicological class (n=24) using the MiXie tool, which identifies classes of toxic effects for &gt;700 chemicals. Results We extracted 609,233 measurements of 206 chemicals from 162,473 WSs. Workers in 58,252 WSs were exposed to ≥2 agents, of which 21,563 had an HI&gt;1, indicating overexposure for at least one toxicological class. Toxicological classes with the highest HIs among multi-exposed WSs were lower airway damage (median 0.41; interquartile interval 0.05-1.9; percentage of overexposed WSs 35%), ototoxicity (0.28; 0.04-1.1; 26%) and central nervous system (CNS) damage (0.26; 0.02-1.2; 28%). For these three classes respectively, the most frequent multi-exposures leading to high values of HI were manganese-iron oxides, toluene-xylene and manganese-lead. Conclusions Although the OSHA database does not necessarily represent a random sample of U.S. workplaces, our approach provides insights into the health risks of occupational exposures to prevalent chemical mixtures.
导言 职业暴露于多种化学品对健康的综合影响可能是巨大的。然而,对最常见的多重接触情况及其毒性影响的研究仍然不足。我们利用职业安全与健康管理局(OSHA)的测量数据库评估了美国工作场所多重接触化学品对健康造成的风险。方法 我们分析了 1971-2021 年期间按工作场所情况 (WS) 汇总的个人空气测量结果,工作场所情况与一年内对同一公司同一职位的测量结果相对应。我们通过将制剂浓度除以 ACGIH® 临界限值来计算危害商数 (HQ)。我们使用 MiXie 工具计算混合物的危害指数 (HI),方法是按 WS 和毒理学类别(n=24)组合计算药剂的 HQ,该工具可识别 700 种化学品的毒性效应类别。结果 我们从 162,473 个 WS 中提取了 206 种化学品的 609,233 个测量值。58,252个WS中的工人暴露于≥2种制剂,其中21,563人的HI&gt;为1,表明至少有一种毒物类别暴露过度。在多重暴露的 WSs 中,HIs 最高的毒理学类别是下呼吸道损伤(中位数 0.41;四分位间 0.05-1.9;占过度暴露 WSs 的 35%)、耳毒性(0.28;0.04-1.1;26%)和中枢神经系统(CNS)损伤(0.26;0.02-1.2;28%)。在这三个类别中,最常导致高 HI 值的多重暴露分别是锰-氧化铁、甲苯-二甲苯和锰-铅。结论 虽然职业安全与健康管理局数据库并不一定代表美国工作场所的随机样本,但我们的方法提供了有关职业暴露于普遍化学混合物的健康风险的见解。
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Annals Of Work Exposures and Health
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