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Ringen K, Dement J, Cloeren M, Almashat S, Hines S, Grier W, Quinn P, Chen A, Haas S. Mortality of older construction and craft workers employed at Department of Energy (DOE) nuclear sites: Follow-up through 2021. Am J Ind Med 2024; 67:261-273. [PMID: 38273456 DOI: 10.1002/ajim.23567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 12/07/2023] [Accepted: 01/11/2024] [Indexed: 01/27/2024]
Abstract
BACKGROUND To determine if construction and trades workers formerly employed at US Department of Energy (DOE) nuclear weapons sites are at significant risk for occupational diseases, we studied the mortality experience of participants in the Building Trades National Medical Screening Program (BTMed). METHODS The cohort included 26,922 participants enrolled between 1998 and 2021 and 8367 deaths. Standardized mortality ratios were calculated based on US death rates. Cox models compared construction workers (n = 22,747; 7487 deaths) to two nonconstruction subpopulations: administrative, scientific and security workers (n = 1894; 330 deaths), and all other nonconstruction workers (n = 2218; 550 deaths). RESULTS Mortality was elevated for all causes, all cancers, cancers of the trachea, bronchus, lung, kidneys, and lymphatic and hematopoietic system, mesothelioma, chronic obstructive pulmonary disease (COPD), asbestosis, transportation injuries, and other injuries, particularly accidental poisonings. There were 167 deaths from coronavirus disease 2019 (COVID-19), which was lower than expected using US death rates. Overall cause-specific mortality was significantly higher among construction workers than for internal comparison groups. CONCLUSIONS Construction workers employed at DOE sites have a significantly increased risk for occupational illnesses. Apart from COVID-19 deaths, this update: (1) found that mortality among construction workers is significantly elevated compared to the US population and significantly higher than in the internal comparison populations, and (2) confirmed excess risk for these workers for first employment after 1990. Cancer mortality risks are similar to the cancers identified for DOE compensation from radiation exposures. The high lung cancer risk supports the value of early lung cancer detection. Continued medical surveillance is important.
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Affiliation(s)
- Knut Ringen
- CPWR - The Center for Construction Research and Training, Seattle, Washington, USA
| | - John Dement
- Division of Occupational and Environmental Medicine, Duke University Medical Center, Durham, North Carolina
| | - Marianne Cloeren
- Division of Occupational and Environmental Medicine, School of Medicine, University of Maryland, College Park, Maryland, USA
| | - Sammy Almashat
- Division of Occupational and Environmental Medicine, School of Medicine, University of Maryland, College Park, Maryland, USA
| | - Stella Hines
- Division of Occupational and Environmental Medicine, School of Medicine, University of Maryland, College Park, Maryland, USA
| | - William Grier
- Division of Pulmonary and Critical Care Medicine, School of Medicine, University of Maryland, College Park, Maryland, USA
| | - Patricia Quinn
- CPWR - The Center for Construction Research and Training, Seattle, Washington, USA
| | - Anna Chen
- Zenith American Solutions, Tampa, Florida, USA
| | - Scott Haas
- Zenith American Solutions, Tampa, Florida, USA
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Ringen K, Dement J, Welch L, Quinn P. How much have adverse occupational health outcomes among construction workers improved over time? Evidence from 25 years of medical screening. Am J Ind Med 2023; 66:18-29. [PMID: 36398410 DOI: 10.1002/ajim.23445] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 11/04/2022] [Accepted: 11/07/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Construction workers have always had a high risk of occupational illnesses. We used 25 years of data from a medical screening program serving older construction workers to determine how much health outcomes have improved over the past 60 years. METHODS We investigated changes in relative risk for chest radiographs consistent with pneumoconiosis, COPD by spirometry, lung cancer mortality, and audiometry-assessed hearing impairment among workers participating in a medical screening program. Results were stratified by decade of first construction employment: before 1960, 1960-1969, 1970-1979, 1980-1989, and after 1990. Poisson and Cox regression analyses assessed relative risk by decade adjusted for age, sex, smoking, and years of construction trade work. RESULTS Subjects were 94% male and, on average, 60 years old with 25 years of construction work. When compared to workers employed before 1960, those first employed after 1990 experienced the following reductions in model-adjusted relative risks: chronic obstructive pulmonary disease, 32%; all pneumoconiosis, 68%; parenchymal abnormalities, 35%; pleural abnormalities, 71%; hearing impairment, 20%; and lung cancer mortality, 48%. Risks started to decline in the 1960s with greatest reductions among workers first employed after 1970. CONCLUSIONS This study demonstrates the positive impact that adoption of occupational health protections have had over the past 60 years. The greatest risk reductions were observed for outcomes with strong regulatory and legal incentives to reduce exposures and associated risks, such as those associated with inhalation hazards (asbestos and silica), while lowest improvement was for hearing impairment, for which little regulatory enforcement and few prevention incentives have been adopted.
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Affiliation(s)
- Knut Ringen
- Energy Employees Department, CPWR-The Center for Construction Research and Training, Silver Spring, Maryland, USA
| | - John Dement
- Division of Occupational and Environmental Medicine, Duke University Medical Center, Durham, North Carolina, USA
| | - Laura Welch
- Energy Employees Department, CPWR-The Center for Construction Research and Training, Silver Spring, Maryland, USA
| | - Patricia Quinn
- Energy Employees Department, CPWR-The Center for Construction Research and Training, Silver Spring, Maryland, USA
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Ringen K, Dement JM, Quinn P, Cloeren M, Chen A, Cranford K, Haas S. Hearing impairment and tinnitus among older construction workers employed at DOE facilities. Am J Ind Med 2022; 65:644-651. [PMID: 35726605 DOI: 10.1002/ajim.23406] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 05/04/2022] [Accepted: 05/27/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Few studies have defined the risk of hearing impairment and tinnitus after retirement. This report measures hearing impairment and tinnitus prevalence among older construction trades workers. METHODS The study cohort included 21,340 participants in a national medical screening program (www.btmed.org). Audiometric hearing impairment was classified according to the Global Burden of Disease Study. Tinnitus was determined by self-report. An internal subcohort of nonconstruction trades workers served as a reference group. Stratified analyses and multivariate analyses were used to measure the prevalence of hearing impairment and tinnitus by age, sex, and job category. RESULTS Prevalence of any hearing impairment was 55.2% (males, 57.7%; females, 26.8%) and increased rapidly with age. Construction trades workers were 40% more likely to have hearing impairment than the reference group. The overall prevalence of tinnitus was 46.52% and followed patterns similar to hearing impairment. Workers with hearing impairment were more likely to also have tinnitus, but tinnitus was frequently reported in the absence of measured hearing impairment. CONCLUSIONS Hearing impairment and tinnitus prevalence were much higher in this study than in previous research. A significant reason for the difference is that BTMed follows participants after they have retired. To draw conclusions about the risk for work-related chronic diseases and disorders it is important to monitor workers through their lifetimes. Also, tinnitus by itself should be given greater significance. These findings reinforce the need to promote noise reduction and hearing conservation in construction.
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Affiliation(s)
- Knut Ringen
- Energy Employees Department, CPWR-The Center for Construction Research and Training, Silver Spring, Maryland, USA
| | - John M Dement
- Division of Occupational and Environmental Medicine, Duke University Medical Center, Durham, North Carolina, USA
| | - Patricia Quinn
- Energy Employees Department, CPWR-The Center for Construction Research and Training, Silver Spring, Maryland, USA
| | - Marianne Cloeren
- Division of Occupational and Environmental Medicine, School of Medicine, University of Maryland, Baltimore, Maryland, USA
| | - Anna Chen
- Government Services Department, Zenith American Solutions, Seattle, Washington, USA
| | - Kim Cranford
- Government Services Department, Zenith American Solutions, Seattle, Washington, USA
| | - Scott Haas
- Government Services Department, Zenith American Solutions, Seattle, Washington, USA
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Movahed N, Ravanshadnia M. Noise Exposure Assessment in Construction Equipment Operators in Tehran, Iran. J UOEH 2022; 44:43-52. [PMID: 35249940 DOI: 10.7888/juoeh.44.43] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Occupational hearing loss is a common complication among construction workers, especially those working with heavy machinery and construction equipment. This research measured the noise that construction operators are exposed to, and proves that most of the construction equipment operators that we studied have a potential risk of hearing impairment. We examined 22 types of construction machinery that are commonly used in various stages of construction projects in Tehran (demolition, excavation, and execution). The noise that construction operators were exposed to was measured with a dosimeter during 8 working hours, and the Time-Weighted Average (TWA) was calculated for each operator according to OSHA standards. Finally, a suitable hearing protection device (HPD) was suggested. The results indicated that the operators of D8N (opened-cab) and CAT D8L SA (closed-cab) bulldozers were exposed to more noise than other operators in this study. Hand-saw, Caterpillar 943, and Komatsu 470 loader operators were also exposed to significant noise levels. Other operators, such as drivers of older Benz and Volvo trucks, the Backhoe HLB95, the Soosan mobile crane, and the Bobcat were also exposed to heavy noise that put them at risk of occupational hearing loss.
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Affiliation(s)
- Nadia Movahed
- Department of Construction Engineering and Management, Islamic Azad University, Science and Research Branch, Tehran, Iran
| | - Mehdi Ravanshadnia
- Department of Construction Engineering and Management, Islamic Azad University, Science and Research Branch, Tehran, Iran
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Pure Tone Audiometry Evaluation Method Effectiveness in Detecting Hearing Changes Due to Workplace Ototoxicant, Continuous Noise, and Impulse Noise Exposures. Ear Hear 2021; 43:1291-1299. [PMID: 34860718 DOI: 10.1097/aud.0000000000001178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The purpose of this retrospective cohort study was to compare the relative risks (RR) of hearing impairment due to co-exposure of continuous noise, impulse noise, metal ototoxicants, and organic solvent ototoxicants using several pure tone audiometry (PTA) evaluation methods. DESIGN Noise and ototoxicant exposure and PTA records were extracted from a DoD longitudinal repository and were analyzed for U.S. Air Force personnel (n = 2372) at a depot-level aircraft maintenance activity at Tinker Air Force Base, Oklahoma using an historical cohort study design. Eight similar exposure groups based on combinations of ototoxicant and noise exposure were created: (1) Continuous noise (reference group); (2) Continuous noise + Impulse noise; (3) Metal exposure + Continuous noise; (4) Metal exposure + Continuous noise + Impulse noise; (5) Solvent exposure + Continuous noise; (6) Solvent exposure + Continuous noise + Impulse noise; (7) Metal exposure + Solvent exposure + Continuous noise; and (8) Metal exposure + Solvent exposure + Continuous noise + Impulse noise. RR of hearing impairment compared to the Continuous noise-exposed reference group was assessed with five PTA evaluation methods including (1) U.S. Department of Defense (DoD) Significant Threshold Shift (STS), (2) Occupational Safety and Health Administration (OSHA) age-adjusted STS, (3) National Institute for Occupational Safety and Health (NIOSH) STS, (4) NIOSH Material Hearing Impairment, and (5) All Frequency Threshold Average. RESULTS Hearing impairment was significantly worse for SEG (2) combined exposure to continuous noise and impulse noise only for the PTA evaluation method (2) OSHA Age Adjusted with an RR of 3.11, [95% confidence interval (CI), 1.16-8.31] and was nearly significantly different using PTA evaluation method (4) NIOSH Material Hearing Impairment with an RR of 3.16 (95% CI, 0.99-10.15). Despite no significant differences for SEGs with an ototoxicant exposure, PTA evaluation method (3) NIOSH STS was most sensitive in detecting hearing changes for SEG (8) Metal exposure + Solvent exposure + Continuous noise + Impulse noise as demonstrated by a RR of 1.12 (95% CI, 0.99-1.27). CONCLUSIONS Results suggest that a single PTA evaluation technique may not be adequate in fully revealing hearing impairment risk due to all stressors and tailoring the PTA evaluation technique to the hazards present in the workplace could better detect hearing impairment. Additionally, results suggest that PTA may not be effective as the sole technique for evaluating hearing impairment due to ototoxicant exposure with continuous noise co-exposure.
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Buqammaz M, Gasana J, Alahmad B, Shebl M, Albloushi D. Occupational Noise-Induced Hearing Loss among Migrant Workers in Kuwait. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105295. [PMID: 34065730 PMCID: PMC8156043 DOI: 10.3390/ijerph18105295] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 05/08/2021] [Accepted: 05/14/2021] [Indexed: 12/20/2022]
Abstract
Although the effect of hearing loss on years lived with disability (YLD) is quite substantial, occupational hearing loss among migrant workers is significantly under-studied. In Kuwait, where nearly two-thirds of the population are migrant workers, the burden of occupational noise-induced hearing loss (ONIHL) is unknown. The objective of the study was to assess the prevalence of ONIHL among migrant workers in Kuwait and explore workplace and individual risk factors that are associated with ONIHL. We obtained data of annual physical exams for the year 2018 conducted by the Shuaiba Industrial Medical Center (SIMC) for all industrial workers in the area. We applied univariate and multivariate logistic regression models to estimate the effects of individual and occupational characteristics on ONIHL. A total of 3474 industrial workers visited the SIMC for an annual exam. The vast majority were men (99%) and non-Kuwaitis (98%) with a median age of 38 years. A total of 710 workers were diagnosed with ONIHL with a prevalence of 20.4%. Age, years of experience, and self-reported exposure to noise were associated with statistically significant higher odds of ONIHL. When adjusted for age, years of experience, and other individual level factors, type of industry was not a statistically significant predictor of ONIHL. The study uncovers the significant burden of hearing loss among the migrant worker subpopulation in Kuwait, an area of occupational health that is often underestimated or unrecognized. Although laws and regulations are in place to prevent and control noise in the workplace, the onus is on local authorities to ensure the necessary training and controls aimed to reduce noise exposure.
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Affiliation(s)
- Mariam Buqammaz
- Department of Environmental & Occupational Health, Faculty of Public Health, Kuwait University, Hawalli 13110, Kuwait; (J.G.); (B.A.)
- Correspondence:
| | - Janvier Gasana
- Department of Environmental & Occupational Health, Faculty of Public Health, Kuwait University, Hawalli 13110, Kuwait; (J.G.); (B.A.)
| | - Barrak Alahmad
- Department of Environmental & Occupational Health, Faculty of Public Health, Kuwait University, Hawalli 13110, Kuwait; (J.G.); (B.A.)
| | - Mohammed Shebl
- Department of Occupational Health, Ministry of Health, Shuwaiba Industrial Medical Center, Ahmadi 60000, Kuwait;
| | - Dalia Albloushi
- Mubarak Al-Kabeer Hospital (MKH), Ministry of Health, Hawalli 47060, Kuwait;
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Rigg KK, Rigg MS. Opioid-Induced Hearing Loss and Neonatal Abstinence Syndrome: Clinical Considerations for Audiologists and Recommendations for Future Research. Am J Audiol 2020; 29:701-709. [PMID: 33115245 DOI: 10.1044/2020_aja-20-00054] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose Over the last two decades, the number of Americans misusing opioids has reached epidemic levels. With such drastic increases in opioid misuse, audiologists are more likely to have patients with opioid-induced hearing loss or neonatal abstinence syndrome (NAS) than in previous years. More attention is needed on how these increases might influence clinical practice and such a discussion could be useful for audiologists. The goal of this article, therefore, is to summarize what is currently known regarding the relationship between opioid misuse and audiology to help guide hearing health care providers (with a particular focus on opioid-induced hearing loss and NAS). This article (a) summarizes the overlap in opioid misuse and hearing loss populations, (b) describes the evidence linking opioid misuse to hearing loss, (c) discusses clinical implications that opioid-induced hearing loss and NAS have for practicing audiologists, and (d) recommends directions for future audiological research on opioid-induced hearing loss and NAS. Conclusions There is considerable overlap between populations at-risk for hearing loss and opioid misuse. Additionally, compelling evidence exists linking opioid misuse to hearing loss, but the specific causal mechanisms remain unclear, indicating a need for additional research. This article attempts to fill a gap in the audiological literature and has the potential to serve as a guide for hearing health care providers to make more informed clinical decisions regarding patients with opioid-induced hearing loss and NAS. Clinicians may wish to consider the concerns raised in this article before intervening with such concerns, especially in the absence of best practice protocols.
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Affiliation(s)
- Khary K. Rigg
- Department of Mental Health Law and Policy, University of South Florida, Tampa
| | - Malika S. Rigg
- Department of Audiology, James A. Haley Veterans' Hospital, Tampa, FL
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Patel S, Wooles N, Martin T. A systematic review of the impact of cigarettes and electronic cigarettes in otology. J Laryngol Otol 2020; 134:1-6. [PMID: 33272335 DOI: 10.1017/s0022215120002315] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The detrimental systemic effects of cigarette smoking are well established. Though less pronounced in the field of otology, they are proposed to contribute to the global burden of unaddressed hearing loss. Recently, in efforts to stop smoking, individuals have used electronic cigarettes of which the long-term safety data are largely unknown. This study aimed to conduct a systematic review of cigarette smoking and electronic cigarette effects in the field of otology. METHOD Relevant articles were identified by a National Institute for Health and Care Excellence healthcare database literature search and by scanning the references of relevant articles and reviews. RESULTS A total of 473 articles were identified, with 43 articles included in the review after trials were excluded. CONCLUSION Cigarette smoking is associated with recurrent otitis media, otitis media with effusion and sensorineural hearing loss in children exposed to second-hand smoke. In adults, it is associated with active and aggressive chronic suppurative otitis media, worse tympanoplasty success rates, increased post-operative complications and sensorineural hearing loss that is more pronounced in the long term and at high frequencies. The effects of e-cigarettes in otology are largely unknown.
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Affiliation(s)
- S Patel
- Department of Otolaryngology and Head and Neck Surgery, Worcestershire Acute Hospitals NHS Trust, Worcester, UK
| | - N Wooles
- Department of Otolaryngology and Head and Neck Surgery, Worcestershire Acute Hospitals NHS Trust, Worcester, UK
| | - T Martin
- Department of Otolaryngology and Head and Neck Surgery, Worcestershire Acute Hospitals NHS Trust, Worcester, UK
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Chen KH, Su SB, Chen KT. An overview of occupational noise-induced hearing loss among workers: epidemiology, pathogenesis, and preventive measures. Environ Health Prev Med 2020; 25:65. [PMID: 33129267 PMCID: PMC7603754 DOI: 10.1186/s12199-020-00906-0] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 10/25/2020] [Indexed: 12/20/2022] Open
Abstract
Occupational noise-induced hearing loss (ONIHL) is the most prevalent occupational disease in the world. The goal of this study was to review the epidemiology, pathogenesis, and preventive measures of ONIHL among workers and provide evidence for the implementation of control measures. Literature studies were identified from the MEDLINE, PubMed, Embase, Web of Science, and Google Scholar using the search terms “noise-induced hearing loss” “prevalence”, “pathogenesis”, and “preventive measures”. The articles reviewed in this report were limited from 2000 to 2020. Articles that were not published in the English language, manuscripts without an abstract, and opinion articles were excluded. After a preliminary screening, all of the articles were reviewed and synthesized to provide an overview of the current status of ONIHL among workers. The mechanism of ONIHL among workers is a complex interaction between environmental and host factors (both genetic and acquired factors). The outcomes of noise exposure are different among individual subjects. Clinical trials are currently underway to evaluate the treatment effect of antioxidants on ONIHL. Noise exposure may contribute to temporary or permanent threshold shifts; however, even temporary threshold shifts may predispose an individual to eventual permanent hearing loss. Noise prevention programs are an important preventive measure in reducing the morbidity of ONIHL among workers.
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Affiliation(s)
- Kou-Huang Chen
- School of Mechanical and Electronic Engineering, Sanming University, Sanming, 365, Fujian Province, China
| | - Shih-Bin Su
- Department of Occupational Medicine, Chi-Mei Medical Center, Tainan, 710, Taiwan
| | - Kow-Tong Chen
- Department of Occupational Medicine, Tainan Municipal Hospital (managed by Show Chwan Medical Care Corporation), No. 670, Chongde Road, East District, Tainan, 701, Taiwan. .,Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, 701, Taiwan.
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Li X, Rong X, Wang Z, Lin A. Association between Smoking and Noise-Induced Hearing Loss: A Meta-Analysis of Observational Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17041201. [PMID: 32069960 PMCID: PMC7068375 DOI: 10.3390/ijerph17041201] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 02/09/2020] [Accepted: 02/10/2020] [Indexed: 12/19/2022]
Abstract
The purpose of this study was to synthesize the results of previously published observational studies through meta-analysis to clarify the association between smoking and noise-induced hearing loss (NIHL). We searched several databases as of October 2019. Based on the results of heterogeneity analysis (Q statistic and I2 statistic), a fixed effect model (for no heterogeneity; Q test P > 0.1 and I2 ≤ 50%) or a random effects model (for heterogeneity) was used to calculate the pooled odds ratios (ORs). We explored the potential dose-response relationship between smoking and NIHL as well. In total, 27 studies involving 30,465 participants were included. Compared with non-smokers, the pooled OR of current smokers was 2.05 (95% Confidence interval (CI): 1.71–2.46), and of former smokers was 1.11 (95% CI: 1.05–1.18). We found a curve linear association between an increasing number of pack-years (packages/day × smoking years) and risk of NIHL. The dose-response meta-analysis suggested that when the number of pack-years was less than fifteen, the risk of NIHL was increasing, and the highest combined OR was 5.25 (95% CI: 2.30–11.96) for pack-years of fifteen. After fifteen pack-years, the pooled OR had a slow decline. Our study indicated that smoking is a risk factor for NIHL. Current smokers have a higher risk than former smokers, and there is a positive dose-response relationship between smoking and NIHL.
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Affiliation(s)
- Xiaowen Li
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Xing Rong
- The Institute of Occupational and Environmental Health, Guangzhou Medical University, 1 Tianqiang St., Huangpu West Ave., Guangzhou 510620, China
| | - Zhi Wang
- The Institute of Occupational and Environmental Health, Guangzhou Medical University, 1 Tianqiang St., Huangpu West Ave., Guangzhou 510620, China
- Correspondence: (Z.W.); (A.L.)
| | - Aihua Lin
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
- Department of Health Service and Management, Xinhua College of Sun Yat-sen University, Guangzhou 510520, China
- Correspondence: (Z.W.); (A.L.)
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Sokas RK, Dong XS, Cain CT. Building a Sustainable Construction Workforce. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16214202. [PMID: 31671567 PMCID: PMC6862229 DOI: 10.3390/ijerph16214202] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 10/24/2019] [Accepted: 10/29/2019] [Indexed: 11/27/2022]
Abstract
The average U.S. construction worker is aged 42.6 years, and will not be eligible for full Social Security retirement benefits until age 67. Delayed retirement is largely driven by economic need, but construction workers face considerable challenges in remaining on the job. This study explores trade-specific age trends within the construction industry, and the experiences of building trade unions with aging membership. A mixed-methods approach used trade-specific age statistics from the Current Population Survey and key informant interviews with labor leaders, in order to identify union experiences and interventions. Mean and median ages for all subgroups in construction increased from 2003 to 2017. Immigrant construction workers were significantly younger than workers who were born in the U.S. (41 vs. 43, p < 0.001). Union workers were older than non-union workers (42 vs. 39 in 2017, p < 0.001); the age differential between self-employed and wage-and-salary workers was wide (49 vs. 40, p < 0.001). Union leaders described barriers, such as age discrimination and the loss of previously available light tasks, as well as current and potential solutions through union contract language requiring the inclusion of older workers, or establishing limits for lifting. Other solutions included career pathways for training and safety, with their attendant limitations; mentoring/pairing opportunities with apprentices; and the potential opportunities and training needs for site management positions.
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Affiliation(s)
- Rosemary K Sokas
- School of Nursing and Health Studies, Georgetown University, Washington, DC 2005, USA.
- CPWR-Center for Construction Research and Training, Silver Spring, MD 20910, USA.
| | - Xiuwen Sue Dong
- CPWR-Center for Construction Research and Training, Silver Spring, MD 20910, USA.
| | - Chris Trahan Cain
- CPWR-Center for Construction Research and Training, Silver Spring, MD 20910, USA.
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12
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Ringen K, Dement J, Hines S, Quinn P, Chen A, Haas S. Mortality of older construction and craft workers employed at department of energy nuclear sites: Follow-up through 2016. Am J Ind Med 2019; 62:742-754. [PMID: 31380577 DOI: 10.1002/ajim.23018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 06/08/2019] [Accepted: 06/14/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND To determine if construction and trades workers employed at U.S. Department of Energy (DOE) nuclear sites facilities are at significant risk for diseases associated with occupational exposures, we compared the mortality experience of participants in the Building Trades National Medical Screening Program (BTMed) to that of the US population. METHODS The cohort includes 24,086 BTMed participants enrolled between 1998 and 2016 and 5203 deaths. Cause-specific standardized mortality ratios were calculated based on US death rates. RESULTS Mortality was elevated for all causes, all cancers, cancers of the trachea, bronchus, and lung and lymphatic and hematopoietic system, mesothelioma, chronic obstructive pulmonary disease, asbestosis, transportation injuries, and other injuries, particularly those caused by accidental poisoning, suggesting a possible effect of the opioid epidemic. CONCLUSIONS Apart from other injuries, mortality patterns were very similar to those reported in the past in this population. Construction workers employed at DOE sites have a significantly increased risk for occupational illnesses. Risks are associated with employment during all time periods covered including possibly after 1990. The cancer risks closely match the cancers identified for DOE compensation from radiation exposures. The high risk of lung cancer supports the value of early lung cancer detection. Continued medical surveillance is important.
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Affiliation(s)
- Knut Ringen
- Energy Workers Department CPWR ‐ The Center for Construction Research and Training Seattle Washington
| | - John Dement
- Division of Occupational and Environmental Medicine Duke University Medical Center Durham North Carolina
| | - Stella Hines
- Division of Occupational and Environmental Medicine, School of Medicine University of Maryland Baltimore Maryland
| | - Patricia Quinn
- Energy Workers Department CPWR ‐ The Center for Construction Research and Training Seattle Washington
| | - Anna Chen
- Government Services Department Zenith American Solutions Seattle Washington
| | - Scott Haas
- Government Services Department Zenith American Solutions Seattle Washington
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