Exposure to nickel aerosol in the nickel production is associated with greater occupational risk, yet little is known how many workers will develop an occupational disease and claim compensation. The ...aim of this analysis was to prospectively observe a cohort of nickel electrolysis workers and quantitatively assess confirmed occupational disease claims. We observed a cohort of nickel electrolysis workers (N = 1397, median age 39, 68% males) from 2008 till 2020 in one of the largest nickel producers in the Russian High North. Cumulative incidence of confirmed occupational disease claims in seven occupational groups, including electrolysis operators, hydrometallurgists, crane operators, final product cleaners, metalworkers, electricians and 'other' was analyzed and supplemented with Cox proportional hazards regression, yielding hazard ratios (HR) with their 95% confidence intervals (CI) of occupational disease claims for each group. N patients with occupational disease claims varied from 1 in 2016 to 22 in 2009, and in total 87 patients developed one or more occupational diseases (cumulative incidence 6.2%, p < 0.001 between seven groups). Accounting for 35,527 person-years of observation in total, cleaners exhibited the greatest risk (HR 2.58 (95% CI 1.43-4.64)), also adjusted for smoking, number of non-occupational diseases and group 2 (hydrometallurgists). Smoking was independently associated with having an occupational disease claim in all groups (p < 0.001), as was the number of non-work-related diseases in six groups of seven. Despite consistent improvement in the exposure control measures in nickel production, occupational morbidity persists. More effort is needed to reduce exposure in final product cleaners.
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Abstract
Very little is known about the factors of healthy worker survival effect at high-altitude mines. We conducted this cohort observation of the new hires for a high-altitude gold mine in ...Kyrgyzstan with the aim to ascertain predictors of survival at work. All new hires in 2009 through 2012 for a high-altitude gold mine (3600–4500 m above sea level) were followed up to January 2022. We tested the association of demographic, physiological predictors and diagnoses at the pre-employment screening with non-survival at work in Cox proportional hazards yielding hazard ratios (HR) with their 95% confidence intervals (CI). The cumulative observation time was 5190 person-years. Blood pressure at pre-employment, lung function, the diagnoses of essential hypertension, chronic obstructive pulmonary disease (COPD) or any other analyzed physiological variables were not associated with non-survival at work. However, smoking (HR 1.55; 95% CI 1.10; 2.17) increased the likelihood of non-survival at work, independent of any diagnosis or lowland residence (HR 1.95; 95% CI 1.31; 2.90). Adjusted for covariates and all diagnoses, having chronic rheumatic fever (HR 10.95; 95% CI 2.92; 33.92), hemorrhoids (HR 1.32; 95% CI 1.01; 3.75), adhesive otitis (HR 1.74; 95% CI 1.05; 2.89) or obesity (HR 1.71; 95% CI 1.01; 2.88) were associated with non-survival at work with time. This prospective observation of new hires for a high-altitude mining operation demonstrated that selected diagnoses, smoking and lowland residence elevated the risk of early exit in prospective workers.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Workplace inhalational hazards remain common worldwide, even though they are ameliorable. Previous American Thoracic Society documents have assessed the contribution of workplace exposures to asthma ...and chronic obstructive pulmonary disease on a population level, but not to other chronic respiratory diseases. The goal of this document is to report an in-depth literature review and data synthesis of the occupational contribution to the burden of the major nonmalignant respiratory diseases, including airway diseases; interstitial fibrosis; hypersensitivity pneumonitis; other noninfectious granulomatous lung diseases, including sarcoidosis; and selected respiratory infections.
Relevant literature was identified for each respiratory condition. The occupational population attributable fraction (PAF) was estimated for those conditions for which there were sufficient population-based studies to allow pooled estimates. For the other conditions, the occupational burden of disease was estimated on the basis of attribution in case series, incidence rate ratios, or attributable fraction within an exposed group.
Workplace exposures contribute substantially to the burden of multiple chronic respiratory diseases, including asthma (PAF, 16%); chronic obstructive pulmonary disease (PAF, 14%); chronic bronchitis (PAF, 13%); idiopathic pulmonary fibrosis (PAF, 26%); hypersensitivity pneumonitis (occupational burden, 19%); other granulomatous diseases, including sarcoidosis (occupational burden, 30%); pulmonary alveolar proteinosis (occupational burden, 29%); tuberculosis (occupational burden, 2.3% in silica-exposed workers and 1% in healthcare workers); and community-acquired pneumonia in working-age adults (PAF, 10%).
Workplace exposures contribute to the burden of disease across a range of nonmalignant lung conditions in adults (in addition to the 100% burden for the classic occupational pneumoconioses). This burden has important clinical, research, and policy implications. There is a pressing need to improve clinical recognition and public health awareness of the contribution of occupational factors across a range of nonmalignant respiratory diseases.
Outdoor security non-smoking guards (N = 12) wore TSI DustTrack AM520 aerosol monitors with a 10-μm impactor for 8 hours of outdoor shift. Ten samples (k = 10) from each worker were obtained for the ...cold season (November-March) from various locations across Almaty. Total sampling time was 57600 minutes. We compared normalized time-weighted average (TWA) concentrations for 8-hour shifts within and between workers using analysis of variance (ANOVA) and assessed compliance with environmental exposure limit (EEL) (0.060 mg/m3) via exceedance (γ) and probability of overexposure (θ).
PM10 TWA ranged from 0.050 to 2.075 mg/m3 with the geometric mean 0.366 and median 0.352 mg/m3. PM10 TWA distribution was left-skewed with large variation. The fold-range of within-person variability, containing 95% of the exposure concentration (wR0.95) was 13, whereas between-person fold-range (bR0.95) was 3. However, between-person variance exceeded the one within with F-ratio 2.797 (p = 0.003) with statistical power 97% at α = 0.05. Only two of 120 samples had TWA below EEL, yielding γ = 0.995 and θ = 1.
Outdoor workers in polluted cities like Almaty are exposed to very high levels of PM10 during the cold season. Urgent action should be taken to regulate such occupational exposure and to raise awareness of workers and employers on hazards associated with it.
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The purpose of the study was to obtain new data on the causes, development, prevalence and nature of occupational multimorbidity in the nickel industry workers. We extracted data from the register of ...occupational disease and intoxication cases in the population of the Murmansk region and the Krasnoyarsk Territory in 2007-2021. In 2007-2021, 24.6% of nickel industry workers with newly diagnosed occupational diseases developed a multimorbid pathology. Its prevalence rose from 0% in 2007 to 83.3% in 2021, and the number of occupational diseases increased by 3.17 times. Two diagnoses were found in 66 (14.9%), three in 22 (5.0%), four in fifteen (3.4%), five in eleven (2.5%), and six in three (0.7%) employees. Respiratory and musculoskeletal diseases were the most prevalent disorders, accounting for 31.5% and 23.0% of cases, respectively. Occupational multimorbidity resulted from the increased combined exposure to occupational hazards, outdated technological processes, and the working conditions in the finished product cleaners and crane operators. Multimorbid diseases can be better prevented with improvement in working conditions and better quality of periodic medical examinations.
Abstract
Background
Reinforced concrete production is widespread, but little is known about the occupational exposure to fine particulate matter (PM) in such workplaces, including from metalworking ...and concrete processing. Therefore, the aim was to characterize exposure to fine PM in the typical workplaces of the whole production cycle and to quantify the risk of respiratory symptoms and lung function in a cohort of reinforced concrete parts production industry.
Methods
At a reinforced concrete parts producing facility in Almaty, we collected 50 personal PM
2.5
samples from the main exposure sites and the measured mass concentrations using gravimetric method. Workers also completed questionnaires on a detailed working history, respiratory symptoms (chronic obstructive pulmonary disease (COPD) Assessment Tool (CAT)), followed by spirometry. The association of cumulative dose with CAT score and forced expiratory volume in one second (FEV
1
)/forced vital capacity (FVC) was tested with multiple regression.
Results
The highest PM
2.5
concentrations were found in the concrete-mixing unit (median 1180 µg/m
3
), followed by metalworking (510 µg/m
3
), armature workshop (375 µg/m
3
) and molding site (245 µg/m
3
), different from the concentrations in the office (29.5 µg/m
3
), Kruskall-Wallis
p
< 0.001. Cumulative PM
2.5
dose, mg/m
3
-year (beta 0.10 (95% confidence interval (CI) 0.05; 0.15)) was strongly associated with CAT score, whereas production with FEV
1
/FVC (beta -4.96 (-8.31; -1.61)), independent of smoking and chronic bronchitis and sex.
Conclusions
Mixing concrete and metalworks pose the greatest risk for worker’s health in the reinforced concrete production from the inhalational exposure to aerosol, adversely affecting respiratory health.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Abstract
Background
Pyrometallurgical nickel production exposes workers to a wide range of occupational risk factors, including nickel aerosol, occupational noise and heat, but occupational ...(compensation) claims do not get enough attention in the literature. We, therefore, aimed to identify and analyze new occupational disease predictors in order to tailor prevention measures in the nickel pyrometallurgical production workers.
Methods
In a prospective observational study, a cohort of workers grouped in 16 occupations (N = 1424, 88% males, median age 39 (interquartile range (IQR) 31–47 years)), was fixed in 2007 at a large nickel production plant in the Russian High North. We then followed the cohort until 2021 and analyzed the association of selected predictors, including exposure to nickel and occupational group, with the risk of an occupational (compensation) claim in a Cox regression analysis.
Results
With 18,843 person-years of observation, occupational disease claims were confirmed in 129 workers (9% of the initial cohort, N = 108 men (84%)). Top three diagnoses were chronic bronchitis (3.81 cases/1000 workers/year), sensorineural deafness (2.36 cases/1000 workers /year) and musculoskeletal disorders (1.90 cases/1000 workers/year). Smoking was significantly associated with each diagnosis (adjusted hazard ratio (HR) ranged from 2.56 (95% confidence interval (CI) 1.17–5.57) for bronchitis to 6.69 (95% CI 1.46–30.64) for chronic obstructive pulmonary disease (COPD)). High nickel exposure was associated with occupational bronchitis and occupational asthma, whereas associations of occupational groups were also identified for COPD, asthma and musculoskeletal disorders.
Conclusion
Smoking, high exposure to nickel and specific exposure in the occupational groups increase the risk of occupational disease claims and should be prioritized directions for targeted intervention.
Abstract
Background
Health-related quality of life (HRQL) in the general population of Kazakhstan has never been characterized. We constructed this population-based study of the largest city in ...Kazakhstan, Almaty with the aim to quantitatively assess HRQL and ascertain whether occupation and lifestyle are associated with HRQL in this population.
Methods
In a random sample (N = 1500) of general population in Almaty (median age 49 (interquartile range 28) years, 50% women), we collected data on demographics, socioeconomic status, lifestyle, lifetime occupational history and general HRQL using SF-8 instrument. The association of demographic and occupational predictors with HRQL was tested in multiple regression models.
Results
No occupational associations were found for physical component score in the models adjusted for age, sex, income, cigarette and waterpipe smoking, electronic cigarette use, physical activity, alcohol and exposure to secondhand smoke. Ever being a manager (β − 1.63 (95% confidence interval (CI) − 2.92; − 0.34)), a welder (β − 5.11 (95% CI − 8.77; − 1.46)) and a secretary (β − 5.06 (95% CI − 8.56; − 1.56)) for one year or more was associated with poorer mental component score in the models adjusted for age, sex, income, cigarette smoking, physical activity and each other. Age, income and physical activity were independent predictors of both physical and mental components.
Conclusions
Occupational history is associated with HRQL in the general population in Almaty, Kazakhstan, but the mechanism explaining this association should be further elucidated.
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Purpose
Secondary metalworking carries exposure to relatively heavy levels of respirable particulate. We investigated the extent to which metalworking is associated with increased exhaled nitric ...oxide (FeNO), an established inflammatory biomarker.
Methods
We studied 80 metalworking factory employees in Kazakhstan. Informed by industrial hygiene data, we categorized them into three groups: (1) machine operators (41%); (2) welders or assemblers (33%); and (3) all others, including administrative and ancillary staff (26%). Participants completed questionnaires covering occupational history, smoking, home particulate sources, respiratory symptoms, and comorbidities. We measured exhaled carbon monoxide (CO), exhaled fractional nitric oxide (FeNO), and spirometric function. We used mixed-effects modeling to test the associations of occupational group with FeNO, adjusted for covariates.
Results
The median age was 51.5 (interquartile range 20.5) years; 7% were women. Occupational group (
p
< 0.01), daily current cigarette smoking intensity (
p
< 0.05), and age (
p
< 0.05), each was statistically associated with FeNO. Welders, or assemblers (Group 2), who had intermediate particulate exposure, manifested significantly higher exhaled FeNO compared to machinists (Group 1, with the highest particulate exposure) and all others (Groups 3, the lowest particulate): adjusted Group 2 mean 44.8 ppb (95% confidence interval (CI) 33.8–55.9) vs. Group 1 24.6 ppb (95% 20.5–28.7) and Group 3, 24.3 ppb (95% CI 17.7–30.9). Secondhand smoking and height were not associated with FeNO.
Conclusion
In a metalworking industrial cohort, welders/assemblers manifested significantly higher levels of FeNO. This may reflect respiratory tract inflammation associated with airborne exposures specific to this group.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Almaty is the largest city of Kazakhstan with extreme air pollution, mostly in the cold season, but little is known whether staying indoors could lessen the exposure. The aim was to quantitatively ...characterize indoor fine PM levels and to verify the contribution of ambient pollution to it in a polluted city like Almaty.
We collected forty-six 24-hour 15-min average samples of the ambient air and a similar number of paired indoor samples (total 92 samples). Predictors of both ambient and indoor PM2.5 mass concentrations in mg/m3, including ambient concentration, precipitation, minimal daily temperature and humidity, along with the indoor/outdoor (I/O) ratio were tested in the adjusted regression models at eight 15-min lags.
Ambient air PM2.5 15-min average mass concentrations were highly variable and ranged from 0.001 to 0.694 mg/m3 (geometric mean (GM) 0.090, geometric standard deviation (GSD) 2.285). Snowing was the strongest predictor of lower ambient PM2.5 24-hour mass concentrations (median 0.053 vs 0.135 mg/m3 (p<0.001)). Indoor mean 15-min PM2.5 concentrations ranged from 0.002 to 0.228 mg/m3 (GM 0.034, GSD 2.254). In adjusted models, outdoor PM2.5 concentration explained 0.58 of all variability of the indoor concentration with a 75-min delay (R2 0.67 at lag8 on snowing days). Median I/O ranged from 0.386 (IQR 0.264 to 0.532) at lag0 to 0.442 (IQR 0.339 to 0.584) at lag8.
During the cold season when fossil fuel is burnt for heating, the population in Almaty is exposed to very high fine PM levels even indoors. Urgent public health action is needed.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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