Journal of occupational and environmental medicine最新文献

Objective: To provide clinicians an occupational framework to assess climate-related health conditions, determine at-risk workers, and devise solutions.

Methods: An interactive workshop was presented at the 2022 American Occupational Health Conference (AOHC). Six climactic events related to occupational health were chosen with corresponding cases from National Institute of Environmental Health Sciences. Participants answered and discussed scripted questions. A 5-point Likert® Scale utilized by AOHC evaluated the workshop's quality and utility, and the audience's ability to apply the knowledge.

Results: Sixty-one (N = 66) participants ranked the workshop highly (4.4-4.6/5). Most participants (90%) reported incorporation of practical knowledge gained, increased advocacy capacity and ability to teach about the issue.

Conclusions: Successful integration of engaging interactive sessions in clinician education on climate change and health is critical as climactic conditions can increase patient vulnerability in their role as workers.

Structured abstract: Objective: We investigated factors associated with acute injury among U.S. Coast Guard responders to the Deepwater Horizon oil spill.Methods: Self-reported data across five domains (demographic, operational, military, environmental, and comorbidities) were evaluated as potential risk factors for self-reported injuries experienced while deployed (slips, trips, and falls [STFs] and penetrating injuries [PIs]). Adjusted prevalence ratios (PRs) and 95% confidence intervals (CIs) were calculated.Results: Factors associated with STFs included increasing age, Hispanic ethnicity, Unknown race/ethnicity, service in the Selected Reserve, junior enlisted rank, operational response duties for longer duration, self-reported crude oil exposure, use of heat-susceptible personal protective equipment, musculoskeletal symptoms, reduced sleep, and high overall exposure based on a latent class variable. Factors associated with PIs were similar, though also included time outdoors and fatigue.Conclusions: The environment defined by the Deepwater Horizon oil spill was associated with increased acute injury prevalence in oil spill responders.

Abstract: Objective: The aim of this study was to investigate whether the mortality risk from infectious pneumonia was associated with the severity of airflow limitation among subjects in the cohort of pneumoconiosis.Methods: Proportional mortality study was designed as a case-control study with 347 cases and 328 controls. Mortality odds ratios (OR) were evaluated according to the severity of airflow limitation.Results: The odds of mortality from pneumonia among the severe and very severe airflow limitation groups who performed spirometry at the time less than 1 year ago before death were 2.34 (OR 2.34; 95% CI 1.04 to 5.28) and 8.77 times (OR 8.77; 95% CI 1.69 to 45.68) greater compared to the non-airflow limitation group.Conclusions: Severe airflow limitation in pneumoconiosis increases mortality from infectious pneumonia, presenting a dose-response relationship.

Abstract: Objective: To develop and evaluate "eTóraxLaboral," an intelligent platform for detecting signs of pneumoconiosis in chest radiographs, and to assess its predictive capacity. Methods: A retrospective analysis of 2300 randomly selected chest radiographs was performed. Sensitivity, specificity, false positive/negative rates, predictive values, likelihood ratios, efficiency, error rate, and area under the receiver operating characteristic curve (AUC) were evaluated. A Fagan nomogram and ROC curve analysis were included. Results: "eTóraxLaboral" demonstrated high sensitivity to signs of pneumoconiosis (LR+ 23, LR- 0.2). A slight tendency toward a higher number of false positives was observed, possibly due to the superposition of anatomical elements and increased lung markings. False negatives were less common, often misinterpreting pneumoconiotic opacities as consolidation-type findings. Conclusions: "eTóraxLaboral" facilitates early pneumoconiosis detection, providing crucial diagnostic support for healthcare workers in Chile and other developed or developing nations.

Abstract: Objective: This abbreviated version of the American College of Occupational and Environmental Medicine's (ACOEM) Work Disability Prevention and Management Guideline reviews the available evidence and provides recommendations to clinicians regarding interventions to help patients remain at or return to work.Methods: Systematic literature reviews were conducted. Studies were graded and evidence tables were created, with involvement of a multidisciplinary expert panel that evaluated the evidence and finalized recommendations for all clinical questions. Extensive peer review was performed. Consensus recommendations were formulated when evidence was lacking.Results: Evidence-based recommendations have been developed to guide work disability prevention and management.Conclusion: Clinicians should utilize quality evidence in determining treatment methods to prevent and alleviate work disability for workers.

Objective: This study aimed to share the process of epidemiologic survey and demonstrate the decisive factors for evaluating work-related Idiopathic interstitial pneumonias (IIPs) in Korea.

Methods: Data and reports of epidemiologic surveys were investigated and completed during 2010-2022.

Results: A total of 228 idiopathic pulmonary fibrosis (IPF) cases requested for an epidemiologic survey, of which 153 (67.1%) were work-related. The level of exposure intensity was more than intermediate and the exposure duration was more than 10 years in the work-related IPF, so the decisive factors for work-related IPF were exposure substances, intensity and duration.The main factors for work-related acute interstitial pneumonia or cryptogenic organising pneumonia were exposure latency and exposure intensity.

Conclusions: The results of this study indicated the process of the epidemiologic survey and important factors for evaluating work-related IIPs.

Objective: This study aimed to compare physiological changes when wearing a N95 and surgical mask at rest.

Methods: 42 subjects aged 18-55 (19 males; age 22.98 ± 3.83) were recruited. Respiratory and metabolic data were collected using indirect calorimetry under a hood. VO2, VCO2, and RER were measured. RR, MV, and HR were recorded using Hexoskin Smart Shirt apparatus. Testing consisted of 3 15-minute trials: no mask, surgical mask, and a N95 respirator. RPE was assessed. Results were analyzed using separate repeated measures ANOVAs.

Results: RER, MV, and RPE were significantly higher in both conditions. Highest RPE reported while wearing the N95 mask.

Conclusion: The use of a surgical or N95 face mask can cause small metabolic, respiratory, and RPE changes. Minor physiological changes were observed but remained within normally expected physiological parameters at rest.