The aim of this study was to assess the association between occupational biomechanical exposures and the occurrence of surgical treatment for subacromial impingement syndrome (SIS).
A cohort of 220 ...295 male constructions workers who participated in a national occupational health surveillance program (1971-1993) were examined prospectively over a 16-year follow-up period (2001-2016) for surgically treated SIS. Worker job title, smoking status, height, weight, and age were registered on health examination. Job titles were mapped to 21 occupational groups based on tasks and training. A job exposure matrix (JEM) was developed with exposure estimates for each occupational group. Surgical cases were determined through linkage with the Swedish national in- and outpatient registers. Poisson regression was used to assess the relative risks (RR) for each biomechanical exposure.
The total incidence rate of surgically treated SIS over the 16-year observation period was 201.1 cases per 100 000 person-years. Increased risk was evident for workers exposed to upper-extremity loading (push/pull/lift) (RR 1.45-2.30), high hand grip force (RR 1.47-2.23), using handheld tools (RR 1.52-2.09), frequent work with hands above shoulders (RR 1.62-2.11), static work (RR 1.77-2.26), and hand-arm vibration (RR 1.78-2.13). There was an increased risk for SIS surgery for all occupational groups (construction trades) compared with white-collar workers (RR 1.56-2.61).
Occupational upper-extremity load and posture exposures were associated with increased risk for surgical treatment of SIS, which underlines the need for reducing workplace exposures and early symptom detection in highly exposed occupational groups.
In the absence of a standardized work environment, insurance system, occupational safety measures and expanding workload an uptrend of musculoskeletal disorders secondary to occupational hazards is ...observed among a wide range of occupations in developing countries including street sweepers/cleaners. The aim of this study is to determine the burden and potential factors associated with musculoskeletal disorders among street cleaners/solid waste collectors in Gondar town, Ethiopia.
A cross-sectional study design was used to determine the burden and identify potential risk factors of musculoskeletal disorders among street cleaners. Street cleaners (n = 422) working experience of at least one year were randomly selected from the community at their respective work sites (street). A face-to-face interview recorded the participant's response addressing socio-demographic, occupational, job satisfaction, disability related to basic ADL, physical measurements, and self-reported pain using the Nordic-Musculoskeletal questionnaire. The logistic regression model was created to identify potential factors associated with self-reported MSDs.
The sample consists of women street sweepers/cleaners (100%, n = 422, response rate 100%) with at least one-year of work experience with a mean age of 37.03 ± 8.26. About 40% of women sweepers were illiterate and 95% reported no job satisfaction. The overall prevalence of MSDs was 73% (n = 308, 95% CI; 68.5, 77.2), among them nearly 65% reported having experienced disability in performing basic ADL in the past 12 months. Low back pain was the most prevalent region (n = 216, 70.1% case versus MSDs n = 308). In univariate and multivariate logistics analysis, being overweight/obese (AOR of 4.91 (95%, 2.22, 10.87)), age group 35 and above (AOR 2.534 (1.51, 4.26)), not-satisfied with job (AOR 2.66 (1.05, 6.75)), and street cleaning distance of longer than 2 km (AOR 2.82 (1.64, 4.83)) were significantly associated with self-reported musculoskeletal disorder..
This study demonstrated higher self-reported MSDs among street sweepers/cleaners. Modifiable predictors like overweight, lack of job satisfaction, and cleaning longer distance were identified to be associated. Hence, there is a need for ergonomic measures and policy to curb these factors to reduce the burden of MSD among women street sweepers.
This publication is intended to assist the Member States in the application of the ILO List of Occupational Diseases (revised 2010) and in the recognition of the diseases specified in the ILO List at ...the national level as occupational in origin for the purpose of their prevention, recording, notification and, if applicable, compensation.
Aims To examine the association between overtime work and incident coronary heart disease (CHD) among middle-aged employees. Methods and results Six thousand and fourteen British civil servants (4262 ...men and 1752 women), aged 39–61 years who were free from CHD and worked full time at baseline (1991–1994), were followed until 2002–2004, an average of 11 years. The outcome measure was incident fatal CHD, clinically verified incident non-fatal myocardial infarction (MI), or definite angina (a total of 369 events). Cox proportional hazard models adjusted for sociodemographic characteristics showed that 3–4 h overtime work per day was associated with 1.60-fold (95% CI 1.15–2.23) increased risk of incident CHD compared with employees with no overtime work. Adjustment for all 21 cardiovascular risk factors measured made little difference to these estimates (HR 1.56, 95% CI 1.11–2.19). This association was replicated in multivariate analysis with only fatal cardiovascular disease and incident non-fatal MI as the outcome (HR 1.67, 95% CI 1.02–2.76). Conclusion Overtime work is related to increased risk of incident CHD independently of conventional risk factors. These findings suggest that overtime work adversely affects coronary health.
ObjectivesTo investigate further whether inorganic lead is a carcinogen among adults, or associated with increased blood pressure and kidney damage, via a large mortality study.MethodsWe conducted ...internal analyses via Cox regression of mortality in three cohorts of lead-exposed workers with blood lead (BL) data (USA, Finland, UK), including over 88 000 workers and over 14 000 deaths. Our exposure metric was maximum BL. We also conducted external analyses using country-specific background rates.ResultsThe combined cohort had a median BL of 26 µg/dL, a mean first-year BL test of 1990 and was 96% male. Fifty per cent had more than one BL test (mean 7). Significant (p<0.05) positive trends, using the log of each worker’s maximum BL, were found for lung cancer, chronic obstructive pulmonary disease (COPD), stroke and heart disease, while borderline significant trends (0.05≤p≤0.10) were found for bladder cancer, brain cancer and larynx cancer. Most results were consistent across all three cohorts. In external comparisons, we found significantly elevated SMRs for those with BLs>40 µg/dL; for bladder, lung and larynx cancer; and for COPD. In a small subsample of the US cohort (n=115) who were interviewed, we found no association between smoking and BL.ConclusionsWe found strong positive mortality trends, with increasing BL level, for several outcomes in internal analysis. Many of these outcomes are associated with smoking, for which we had no data. A borderline trend was found for brain cancer, not associated with smoking.
Musculoskeletal symptoms account for the majority of work-related illnesses resulting in a significant economic burden on society. Computer users are subject to unique repetitive strains that ...predispose them to musculoskeletal symptoms. In the digitalized field of radiology, radiologists spend long hours interpreting medical images on computers. This study aimed to determine the prevalence of musculoskeletal symptoms among radiologists in Saudi Arabia and their contributing factors.
An online survey was sent to radiologists in all hospitals (academic, public and private) in the major cities of the Eastern Province of Saudi Arabia covering demographic characteristics, workload (e.g. the time spent at a computer workstation), and workstation environments including the number of monitors as well as the adjustability of the height of the workstation and the viewing distance. This survey of 263 radiologists was conducted in April 2019. It included an evaluation of musculoskeletal symptoms using the Nordic Musculoskeletal Questionnaire. The study outcome was the presence of disabling musculoskeletal symptoms in any body region, which restricted the performance of normal activities in the last 12 months. Results were analyzed descriptively using a Chi-square test and logistic regression analysis to estimate the odd ratio of experiencing disabling musculoskeletal symptoms in the last 12 months.
The survey was completed by 198 participants (111 men and 87 women) with a response rate of 75.3%. Most participants (71.2%) were aged below 40 years. A multivariate logistic regression analysis revealed being a female radiologist (OR = 2.7; 95% CI: 1.2-6.5), aged 30-39 years (OR = 4.1; 95% CI: 1.1-15.3), and predominantly reviewing computed tomography (CT) images (OR = 4.1; 95% CI: 1.4-12.3) or ultrasound scans (OR = 5.9; 95% CI: 1.4-25.3) were associated with higher prevalence of disabling musculoskeletal symptoms, compared to those aged below 30 years and those who reviewed various imaging modalities, respectively.
Musculoskeletal symptoms are common among radiologists with lower back and neck pain being the most frequent complaints. Being a female radiologist, aged 30-39 years, and reviewing CT or ultrasound scans were associated with higher rates of disabling musculoskeletal symptoms.
The aim of the present study was to elucidate whether occupational exposure to vapors, gases, dusts, and fumes increases the mortality risk of COPD, especially among never smokers.
The study ...population was a cohort of 354,718 male construction workers; of these, 196,329 were exposed to vapors, gases, dusts, and fumes, and 117,964 were unexposed. Exposure to inorganic dust, wood dust, vapors, fumes, gases, and irritants was based on a job-exposure matrix with a focus on exposure in the mid-1970s. The cohort was followed from 1971 to 2011. Relative risks (RRs) were obtained using Poisson regression models adjusting for age, BMI, and smoking habits.
There were 1,085 deaths from COPD among the exposed workers, including 49 never smokers. Workers with any occupational exposure to vapors, gases, fumes, and dust showed an increased mortality due to COPD (RR, 1.32; 95% CI, 1.18-1.47). When comparing different exposure groups, there was a significantly increased mortality due to COPD among those exposed to fumes (RR, 1.20; 95% CI, 1.07-1.36) and inorganic dust (RR, 1.19; 95% CI ,1.07-1.33). Among never smokers, there was high mortality due to COPD among workers with any occupational airborne exposure (RR, 2.11; 95% CI, 1.17-3.83). The fraction of COPD attributable to occupational exposure was 0.24 among all workers and 0.53 among never-smoking workers.
Occupational exposure to airborne pollution increases the mortality risk for COPD, especially among never smokers.
ObjectiveTo estimate the reported incidence of occupational hypersensitivity pneumonitis (OHP) in the UK and to consider whether the pattern of attributed causation has changed over time.MethodsAll ...cases of OHP reported to the SWORD scheme between January 1996 and December 2015 were classified into 1 of 10 categories of the suspected agent. Cases were grouped into four 5-year time periods to examine any changing pattern in incidence or suspected causation. For each time period, the annual incidence was calculated using the estimated number of reported cases and the working population of the UK.ResultsBetween 1996 and 2015, there were 202 actual cases of OHP reported to SWORD, equating to an estimated 818 cases, when adjusting for the sampling ratio. Over this period, the annual UK incidence was 1.4 per million workers. The mean (SD) age of reported cases was 52 (13) years, and cases were four-times more likely to be men than women. Over the study period, there was a fall in the proportion of cases reported to be due to agricultural exposures (44–12%), and an increase in cases due to metalworking fluids (MWFs, 2–45%).ConclusionsOver the last 20 years, the incidence of OHP in the UK has been ∼1–2 cases per million workers per year. Working with water-based MWFs is now the most commonly suspected causative exposure for OHP cases reported to the SWORD scheme in the UK.
An outbreak of cholangiocarcinoma in a printing company was reported in Japan, and these cases were regarded as an occupational disease (occupational cholangiocarcinoma). This study examined the ...expression status of programmed death‐1 (PD‐1) and programmed death‐ligand 1 (PD‐L1) in occupational cholangiocarcinoma. Immunostaining of PD‐1, PD‐L1, CD3, CD8, and CD163 was performed using tissue sections of occupational cholangiocarcinoma (n = 10), and the results were compared with those of control cases consisting of intrahepatic (n = 23) and extrahepatic (n = 45) cholangiocarcinoma. Carcinoma cells expressed PD‐L1 in all cases of occupational cholangiocarcinoma, whereas the detection of PD‐L1 expression in cholangiocarcinoma cells was limited to a low number of cases (less than 10%) in the control subjects. In cases of occupational cholangiocarcinoma, occasional PD‐L1 expression was also noted in precancerous/preinvasive lesions such as biliary intraepithelial neoplasia and intraductal papillary neoplasm of the bile duct. Additionally, tumor‐associated macrophages and tumor‐infiltrating T cells expressed PD‐L1 and PD‐1, respectively. The number of PD‐L1‐positive mononuclear cells, PD‐1‐positive lymphocytes, and CD8‐positive lymphocytes infiltrating within the tumor was significantly higher in occupational cholangiocarcinoma compared with that in control cases. These results indicate that immune escape via the PD‐1/PD‐L1 axis may be occurring in occupational cholangiocarcinoma.
Abstract
Workers in Coccidioides-endemic areas performing soil-disturbing work or exposed to windy and dusty conditions are at increased risk for coccidioidomycosis. Four occupational ...coccidioidomycosis outbreaks from 2007 to 2014 in California are described, involving construction workers in a number of excavation projects and an outdoor filming event involving cast and crew. These outbreaks highlight the importance of identifying industries and occupations at high risk for coccidioidomycosis, conducting targeted occupational health surveillance to assess the burden of illness, developing and implementing prevention strategies, and setting research priorities.
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