Work-attributed symptom clusters (darkroom disease) among radiographers versus physiotherapists: associations between self-reported exposures and psychosocial stressors

Effects of Occupational Radiation Exposure on Job Stress and Job Burnout of Medical Staff in Xinjiang, China: A Cross-Sectional Study

BACKGROUND Although the potential effects of long-term and low-dose radiation exposure on physical health have attracted considerable attention, few systematic evaluations have been reported regarding the mental health of occupational groups. This study sought to investigate the effects of occupational radiation exposure on job stress and job burnout of medical radiation staff. MATERIAL AND METHODS Using cluster random sampling, a total of 1573 medical radiation workers were initially selected from 10 hospitals in Xinjiang, China, and 1396 valid questionnaires were finally collected. Job stress and job burnout were assessed using the Effort-Reward Imbalance (ERI) questionnaire and the Chinese Maslach Burnout Inventory (CMBI), respectively. RESULTS The percentages of medical radiation staff experiencing job stress and job burnout were 53.08% and 63.32%, respectively. A statistically significant difference in job stress was observed in association with age, ethnicity, professional title, marital status, radiation work type, radiation working years, family history, hypertension, obesity, smoking, and drinking (P<0.05). A statistically significant difference in job burnout was observed in association with age, sex, ethnicity, professional title, educational level, marital status, job post, radiation work type, radiation working years, family history, hypertension, diabetes, and obesity (P<0.05). Female (odds ratio [OR]=0.75, 95% confidence interval [CI]: 0.58-0.98), senior professional title (OR=0.64, 95% CI: 0.43-0.96), and radiation work types of nuclear medicine (OR=0.15, 95% CI: 0.07-0.33) and radiotherapy (OR=0.54, 95% CI: 0.36-0.79) were protective factors, and job stress (OR=4.57, 95% CI: 3.55-5.91) was the risk factor for job burnout of medical radiation staff. CONCLUSIONS Medical radiation staff experience high levels of job stress and job burnout. The interventions of occupational physical examination, personal dose monitoring, occupational health education, and management optimization are recommended to relieve job stress and job burnout and enhance occupational health of medical radiation staff.

Evaluation of Darkroom disease's symptoms among radiographers in the West Bank hospitals: a cross-sectional study in Palestine

Background

Radiographers report many unexplained work related symptoms attributed to “darkroom disease symptoms” such as headache, skin rash, mouth sores, blurred vision, palpitation, and chemical taste. The aim of the present study was to assess the prevalence of occupationally-related darkroom disease symptoms among male radiographers in the West Bank hospitals.

Methods

A cross sectional study was conducted on a non-random purposive sample of male radiographers (study group) and nurses (control group) using a previously validated and standardized questionnaire.

Results

We were able to recruit 330 radiographers and 242 nurses. Data analysis showed that the majority of both groups aged between (36–43) years. Furthermore, the differences in the reported prevalence of symptoms among radiographers showed a statistically significant higher percentage for each reported symptom compared to nurses (P-values <0.001). In multivariate linear regression, staying more than 30 minutes in the darkroom per shift was associated with a significant increase in the mean number of reported symptoms (P-value < 0.001). However, the availability of a ventilating machine in the darkroom showed a strong negative association with the mean number of reported symptoms (P-value < 0.001).

Conclusions

Our findings could help overcome the limitations usually encountered in such complex occupational exposure. However, trying to interpret our finding directly to chemicals exposure in the radiographers’ occupational setting should be done with caution due to the absence of active or passive monitoring for the suspected chemicals.

Symptoms after mould exposure including Stachybotrys chartarum, and comparison with darkroom disease

BACKGROUND

Mould-attributed symptoms have included features which overlap with unexplained syndromes such as sick building syndrome.

OBJECTIVES

We describe questionnaire and chart review findings in patients following exposure to moulds which include Stachybotrys and compare responses with two control groups.

METHODS

Thirty-two patients presented with symptoms attributed to mould exposures. Exposure identification for 25 patients had reported S tachybotrys chartarum as well as other mould (Aspergillus, Penicillium), 88% at work. The remaining seven had professionally visualized or self-reported/photographic exposure evidence only. A chart review was performed and a follow-up with a questionnaire, including questions on current health status, and nonspecific symptoms.

RESULTS

Cough, shortness of breath and chest tightness (at presentation) were reported in 79%, 70% and 64%, respectively, and persisted >6 weeks in 91%. Skin test(s) were positive to fungal extract(s) in 30%. Seventeen returned questionnaires were obtained 3.1 (SD 0.5) years after the initial clinic assessment. Among this subgroup, persisting asthma-like symptoms and symptoms suggestive of sick building syndrome were frequent, and similar to a group previously assessed for darkroom disease among medical radiation technologists. The mould-exposed group more commonly reported they were bothered when walking in a room with carpets, complained of a chemical or metallic taste in their mouth, and had problems in concentration when compared with a control physiotherapist group (P < 0.005).

CONCLUSIONS

Although only a minority with health concerns from indoor mould exposure had demonstrable mould-allergy, a significant proportion had asthma-like symptoms. Other symptoms were also common and persistent after the initial implicated exposure.

Effects of glutaraldehyde exposure on human health

Glutaraldehyde (GA) is widely used in the industrial, scientific and biomedical fields. Many adverse health effects on humans have been reported in association with biomedical uses of GA, with 2-3.5% aqueous GA solution generally used for cold sterilization and GA exposure ranges of 0.001 to 2.6 ppm for this type of use. GA is metabolized extensively to CO(2), but urinary excretion of it is low. Sensory irritant effects, sensitization of skin and respiratory organs and other symptoms have been reported among endoscopy nurses and medical radiation technologists. The prevalence of chronic bronchitis and nasal symptoms in humans is significantly correlated with peak concentrations of GA exposure. The extent of primary skin irritation depends on the duration and site of contact, and the severity of symptoms is dose-related. Chronic inhalation affects the nose and respiratory tract, and lesions become severe with prolonged duration of exposure. Increases in neither mortality nor tumor incidence have been found in workers with less than 0.2 ppm GA exposure, no evidence of carcinogenic activity has been obtained in experimental animal studies. There has been no clear evidence of genetic toxicity of GA in either in vitro or in vivo studies, and neither developmental nor reproductive toxicity has been found in humans or animals. To prevent hazards from GA exposure, use of closed-system, fully automated washing machines is recommended, since numerous symptoms have been found in individuals with less than 0.05 ppm GA exposure, the recommended peak exposure limit in many countries.

Cough: occupational and environmental considerations: ACCP evidence-based clinical practice guidelines

OBJECTIVES

This section of the guideline aims to review the role of occupational and environmental factors in causing and contributing to cough. It also aims to indicate when such causes should be considered in a clinical setting, and a general approach to assessment and management.

METHODS

A review was performed of published data between 1985 and 2004 using PubMed. The search terms used included "air pollution," "sick building syndrome," "occupational asthma," "occupational lung disease," "hypersensitivity pneumonitis" (HP), "cigarette smoke," and "asthma." Selected articles were chosen when meeting the objectives, but the extent of articles available and the limited space for this section does not permit a fully comprehensive review of all of these areas, for which the reader is referred to other sections of this clinical practice guideline, the published literature, textbooks of occupational lung disease, or more specific review articles.

RESULTS/CONCLUSIONS

Almost any patient presenting with cough may have an occupational or environmental cause of or contribution to their cough. The importance of this is that recognition and intervention may result in full or partial improvement of the cough, may limit the need for medication/symptomatic treatment, and may improve the long-term prognosis. Nonoccupational environmental contributing factors for upper and lower airway causes of cough include indoor irritant and allergenic agents such as cigarette smoke, cooking fumes, animals, dust mites, fungi, and cockroaches. Causes of HP indoors include birds and fungal antigens. Outdoor pollutants and allergens also contribute to upper and lower airway causes of cough. Occupational exposures can cause hypersensitivity responses leading to rhinitis and upper airway cough syndrome, previously referred to as postnasal drip syndrome, as well as asthma, HP, chronic beryllium disease, and hard metal disease, as well as irritant or toxic responses. The diagnosis is only reached by initially considering possible occupational and environmental factors, and by obtaining an appropriate medical history to determine relevant exposures, followed by objective investigations. This may require referral to a center of expertise.