Journal of occupational and environmental medicine最新文献

Objective: Examine the effects of transitioning from a 24/48 to a 48/96 shift schedule on health and performance in firefighters assigned to a single, suburban station.

Methods: A longitudinal analysis was conducted over 3 time points in 11 male firefighters. Measures included VO 2peak , peak power, blood pressure, resting heart rate, lipid profiles, and psychological assessments. Linear mixed-effects models analyzed changes across time points.

Results: Transitioning to the 48/96 schedule was associated with improvements in peak power (+27.1 W, P = 0.042), resting blood pressure (SBP -5.5 mm Hg, P = 0.05, DBP -5.8 mm Hg, P = 0.04), heart rate (-13.2 bpm, P = 0.03), sleep quality (ISI -2.6, P = 0.03), and alcohol use (AUDIT -1.8, P = 0.02); VO 2peak did not reveal a significant time effect ( P > 0.05).

Conclusions: Extended intershift recovery in a 48/96 schedule may promote cardiovascular recovery and readiness without negative health effects in similar departments.

Abstract: This guideline provides an overview of principal findings and foundational principles for the optimal evaluation and management of workers. Selecting appropriate judicious tests and implementing optimal treatments with quality evidence of efficacy enhance patient recovery. It is important to emphasize functional recovery and provide the best treatment options starting with the first appointment to enhance the speed of recovery and prevent long-term disability that impairs quality of life. Key principles of recovery include avoiding or reducing substantially aggravating exposures, returning to work promptly and safely, encouraging active over passive treatments and exercise regimens, and patient education and active involvement. The reader is referred to ACOEM's other disorder-specific guidelines for more specific guidance.

Objective: Poor sleep and obstructive sleep apnea (OSA) are prevalent among transportation workers.

Methods: Forty-five transportation workers from worksites in the Northeast US completed surveys assessing (1) sleepiness, (2) OSA, and (3) OSA stage of change and then participated in focus groups or interviews.

Results: Participants were 93.2% male, and 90.1% were White non-Hispanic. Furthermore, 77.8% scored high risk for OSA, whereas 11.1% of those at risk reported an OSA diagnosis. Only 31.4% of high-risk participants reported having contemplated OSA evaluation or treatment. Qualitative themes pertained to difficulty unwinding, uncertain work hours, fears about and barriers to OSA treatment, and misinformation about OSA.

Conclusions: Results reveal a high prevalence of OSA risk and a low rate of diagnosis and OSA readiness to change. We identify themes for future interventions to improve awareness about OSA among transportation workers.

Objective: We evaluated risk factors of thyroid abnormalities detected on low-dose computed tomography (LDCT) among nuclear weapons workers in a lung cancer screening program.

Methods: We conducted a matched case-control study of participants with (647 cases) and without (1941 controls) incidental thyroid abnormalities on LDCT, matching on LDCT year and age between August 2006 and June 2023. Multivariable conditional logistic regression analysis adjusted for demographic, smoking, and occupational attributes yielded matched adjusted odds ratio (MAOR) with 95% confidence intervals.

Results: Estimated occupational radiation exposure (medium exposure MAOR: 1.58 [1.07, 2.33] and high exposure MAOR: 1.52 [0.99, 2.33]), female (MAOR: 2.67 [2.03, 3.50]), African American (MAOR: 2.49 [1.79, 3.45]), and obesity (BMI: 30-39.9 kg/m 2 MAOR: 1.53 [1.14, 2.06], ≥40 kg/m 2 MAOR: 2.43 [1.55, 3.82]) were significantly associated with thyroid abnormalities.

Conclusion: Further studies of occupationally exposed populations are warranted.

Objectives: This study investigates the association between workaholism and work engagement on the incidence of long-term sickness absence due to all diseases and mental disorders.

Methods: This retrospective cohort study included 7013 Japanese employees from four companies. Participants were categorized into four groups based on median splits of workaholism and work engagement. Long-term sickness absence (≥30 days) was tracked for 3 years using company records. Hazard ratios (HRs) were calculated using Cox proportional hazards models.

Results: Compared with high workaholism and low engagement, low workaholism and high engagement were associated with a significantly reduced incidence of long-term sickness absence due to both all diseases and mental disorders. High workaholism and high engagement showed a lower incidence for mental disorders only.

Conclusions: Work engagement reduces the impact of workaholism on long-term sickness absence, particularly for mental health outcomes.

Objective: The aim of this study was to evaluate associations between deployment to Karshi-Khanabad (K2) and adverse health outcomes.

Methods: This is a retrospective cohort study comparing K2 veterans (2001 to 2005) with two matched groups: veterans deployed to Southwest Asia (Operation Enduring Freedom [OEF]-deployed) and non-deployed veterans (OEF-era). Morbidity (through 2022) was identified via Veterans Affairs (VA)/Department of Defense health care databases, and prevalence ratios were estimated using generalized linear models. Mortality (through 2021) was assessed via VA/DoD Mortality Data Repository using standardized mortality ratios and Cox proportional hazards models.

Results: Only 2 of the 60 outcomes had elevated prevalence but did not show a pattern suggesting association with K2 deployment. Mortality (hazard ratio: 1.03; 95% confidence interval: 0.88 to 1.22) was not elevated among K2 veterans.

Conclusions: Deployment to K2 does not appear to be associated with increased morbidity or mortality at this time. Continued surveillance of this cohort is planned over the next decade.

Objective: To estimate the association between occupational exposures to extremely low-frequency magnetic fields (ELF-MF) and postmenopausal breast cancer.

Methods: Lifetime job histories from a population-based case-control study (2008 to 2011) of histologically confirmed breast cancer in Montréal, Canada, were linked to a job-exposure matrix to assign geometric mean ELF-MF exposure/workday. Logistic regression estimated odds ratios and 95% confidence intervals for cumulative, average, maximum, and duration of maximum exposure to ELF-MFs (per interquartile range increase), adjusting for individual-level and ecological covariables.

Results: Data from 663 cases and 592 controls revealed no association between occupational ELF-MF exposure and postmenopausal breast cancer, though restricting exposures to 0 to 10 years before interview and to those during breast development, some positive associations was observed, particularly for ER+/PR+ tumors.

Conclusions: Our findings suggest no association between occupational ELF-MF exposure and postmenopausal breast cancer risk.

Objective: This study investigates whether transit operators' risk perceptions of workplace exposure to drug use incidents, occupational stress, and job satisfaction were associated with intent to leave their job.

Methods: A cross-sectional survey of operators from union locals (WA, OR) assessed perceived risk of drug exposures, occupational stress, job satisfaction, and intent to leave (N = 273). Ordinal logistic regression models were developed for intent to leave.

Results: Most operators were bus drivers. Higher perceived risk was significantly positively associated with greater intent to leave; stress and job satisfaction attenuated this relationship. Higher stress and lower job satisfaction were significantly associated with greater intent to leave across models.

Conclusions: Operator turnover can potentially be reduced by increasing supports targeting risk perceptions of drugs, such as training, or by providing supports (eg, mental health resources) that reduce stress and improve job satisfaction.

Objective: This study aimed to examine the association between sedentary behavior at work and mental health among workers.

Methods: A cross-sectional study was conducted among 344 workers at a pharmaceutical manufacturing industry in Japan. Mental health conditions were assessed using the Kessler Psychological Distress Scale. Participants were classified into the two groups based on the frequency of breaking up prolonged sitting: high-frequency (standing at least once every 60 minutes) and low-frequency (intervals between standing exceeding 60 minutes or prolonged sitting) groups. Prevalence ratios and 95% confidence intervals for mental health were estimated using Poisson regression with robust variance.

Results: The low-frequency group had higher prevalence ratios for stress (1.82), anxiety (2.68), and depression (3.64) than the high-frequency group.

Conclusions: Prolonged sitting at the workplace may be associated with worse mental health among Japanese workers.

Objective: The aim of the study was to analyze the clinical efficacy of a multimodal physical therapy program combined with pain neuroscience education (PNE) in elderly care workers with nonspecific chronic neck pain (NSCNP).

Methods: A sample of 50 elderly care workers was randomly assigned to an intervention group (IG; n = 25), which received a multimodal physiotherapy program combined with PNE, and a control group (IG; n = 25). Self-reported pain intensity (visual analog scale), pressure pain threshold, cervical disability, active cervical range of motion, and health-related quality of life were analyzed.

Results: Significant results were observed for IG in the variables analyzed P < 0.001. Improvements were maintained with large effect sizes (d ≥ 0.9) after a 4-week follow up.

Conclusions: Five weeks of workplace-based physiotherapy combined with PNE reduced self-reported pain intensity and increase pressure pain threshold and cervical range of motion in caregivers with NSCNP.