Sex and Gender Differences in Occupational Hazard Exposures: a Scoping Review of the Recent Literature

Sex and gender differences in the molecular etiology of Parkinson's disease: considerations for study design and data analysis

Parkinson's disease (PD) is more prevalent in men than women, and presents with different clinical features in each sex. Despite widespread recognition of these differences, females are under-represented in clinical and experimental studies of PD, and much remains to be elucidated regarding the biological underpinnings of sex differences in PD. In this review, we summarize known contributors to sex differences in PD etiology across the life course, with a focus on neurological development and gene regulation. Sex differences that are established at conception and heightened during adolescence and midlife may partially embed future PD risk, due to the complex interactions between gonadal hormones, gene regulation, lifestyle factors, and aging. While the neuroprotective properties of estrogen are strongly implicated in reduced prevalence of PD in women, interactions with genotype and gender-biased lifestyle factors are incompletely understood. Consideration of sex and gender-related factors in study design, data analysis, and interpretation have the power to expedite our knowledge of the etiology of PD in men and in women, and to inform prevention and therapeutic strategies tailored to each sex.

New job, new habits? A multilevel interrupted time series analysis of changes in diet, physical activity and sleep among young adults starting work for the first time

BACKGROUND

The workplace is an important determinant of health that people are exposed to for the first-time during adolescence or early adulthood. This study investigates how diet, physical activity, and sleep change as people aged 16-30 years transition into work and whether this varies for different individuals and job types.

METHODS

Multilevel linear regression models assessed changes in fruit and vegetable intake, sleep duration, and physical activity among 3,302 UK Household Longitudinal Study (UKHLS) participants aged 16-30 years, who started work for the first time between 2015 and 2023. In line with interrupted time series analysis, models assessed behavioural trends in the period before starting work, the immediate effect of starting work, and changes in behaviour over time after employment. Stratified analyses examined differences by selected individual and job characteristics, adjusted for covariates. All analyses were conducted in R v.4.3.2.

RESULTS

Sleep duration was stable over the years before and after starting work, but starting work was associated with an immediate reduction in sleep duration (β[Formula: see text]-9.74 [95% CI:-17.32 to -2.17 min/night). Physical activity, measured in Metabolic Equivalent Tasks (METs), increased immediately after starting work (β = 113.3, [95% CI: 80.49 to 146.11] MET-min/day), but subsequently decreased over time after starting work (β= -26.7, [95% CI: -40.75 to -12.66] MET-min/day/year). The increase in physical activity was greater among males, among those with no degree and among those starting lower socioeconomic classification jobs. Starting a "work from home" job had an immediate negative effect on physical activity (β= -126.42 [95% CI: -264.45 to 11.61] MET-min/day), whereas those who worked at their employer's premises showed an initial increase (β = 128.81 [95% CI: 89.46 to 168.16] MET-min/day). Starting work had little influence on fruit and vegetable consumption.

CONCLUSIONS

This is the first study to examine how diet, physical activity, and sleep in young adults change as they start employment in the UK. Starting work is associated with decreased sleep time and increased physical activity, with differences based on sociodemographic and job characteristics. Future research should consider these potential influences of the work environment when developing interventions to promote healthy behaviour in the workplace.

Occupation and 11-year lung function decline in the HUNT Study

BACKGROUND

The association between occupational titles and lung function has mostly been examined through cross-sectional studies. Preventive measures are expected to mitigate adverse effects; hence, updated estimates are necessary.

AIMS

To study change in lung function measured by spirometry across occupations.

METHODS

This population-based prospective cohort study comprised 5618 working adult participants of the Trøndelag Health Study (HUNT3, 2005-07), Norway. Among these, 3800 individuals (43% men, mean age 42 years, range 20-55) also attended HUNT4 (2017-19). We analysed longitudinal decline in forced expiratory volume in 1 second (FEV1) z-score during the 11-year follow-up by occupation (white-collar workers as reference category), in mixed models, adjusting for age, sex and smoking. We assessed the prevalence of self-reported respiratory symptoms and disease in the working population in HUNT4 (n = 32 124) and HUNT3 (n = 32 070).

RESULTS

Compared with white-collar workers, agricultural workers and 'drivers and mobile plant operators', had larger declines in FEV1z-score during follow-up. In sex-stratified analyses, men defined as agricultural workers and 'drivers and mobile plant operators' had larger declines than white-collar workers. Among women, who were underrepresented in many blue-collar jobs, workers classified as 'machine operators and assemblers' experienced greater declines. In the working population in HUNT4, the prevalence of respiratory symptoms in connection with work was 8%, and lower among white-collar workers (6%) than blue-collar workers (14%).

CONCLUSIONS

Although certain workers in Norway remain at risk for occupational lung function decline, there were modest differences between occupations. The findings encourage continuous efforts to implement preventive measures in high-risk jobs.

Leveraging Administrative Health Databases to Address Health Challenges in Farming Populations: Scoping Review and Bibliometric Analysis (1975-2024)

BACKGROUND

Although agricultural health has gained importance, to date, much of the existing research relies on traditional epidemiological approaches that often face limitations related to sample size, geographic scope, temporal coverage, and the range of health events examined. To address these challenges, a complementary approach involves leveraging and reusing data beyond its original purpose. Administrative health databases (AHDs) are increasingly reused in population-based research and digital public health, especially for populations such as farmers, who face distinct environmental risks.

OBJECTIVE

We aimed to explore the reuse of AHDs in addressing health issues within farming populations by summarizing the current landscape of AHD-based research and identifying key areas of interest, research gaps, and unmet needs.

METHODS

We conducted a scoping review and bibliometric analysis using PubMed and Web of Science. Building upon previous reviews of AHD-based public health research, we conducted a comprehensive literature search using 72 terms related to the farming population and AHDs. To identify research hot spots, directions, and gaps, we used keyword frequency, co-occurrence, and thematic mapping. We also explored the bibliometric profile of the farming exposome by mapping keyword co-occurrences between environmental factors and health outcomes.

RESULTS

Between 1975 and April 2024, 296 publications across 118 journals, predominantly from high-income countries, were identified. Nearly one-third of these publications were associated with well-established cohorts, such as Agriculture and Cancer and Agricultural Health Study. The most frequently used AHDs included disease registers (158/296, 53.4%), electronic health records (124/296, 41.9%), insurance claims (106/296, 35.8%), population registers (95/296, 32.1%), and hospital discharge databases (41/296, 13.9%). Fifty (16.9%) of 296 studies involved >1 million participants. Although a broad range of exposure proxies were used, most studies (254/296, 85.8%) relied on broad proxies, which failed to capture the specifics of farming tasks. Research on the farming exposome remains underexplored, with a predominant focus on the specific external exposome, particularly pesticide exposure. A limited range of health events have been examined, primarily cancer, mortality, and injuries.

CONCLUSIONS

The increasing use of AHDs holds major potential to advance public health research within farming populations. However, substantial research gaps persist, particularly in low-income regions and among underrepresented farming subgroups, such as women, children, and contingent workers. Emerging issues, including exposure to per- and polyfluoroalkyl substances, biological agents, microbiome, microplastics, and climate change, warrant further research. Major gaps also persist in understanding various health conditions, including cardiovascular, reproductive, ocular, sleep-related, age-related, and autoimmune diseases. Addressing these overlooked areas is essential for comprehending the health risks faced by farming communities and guiding public health policies. Within this context, promoting AHD-based research, in conjunction with other digital data sources (eg, mobile health, social health data, and wearables) and artificial intelligence approaches, represents a promising avenue for future exploration.

Demographics, Prognostic Factors, and Survival Outcomes in Hepatic Angiosarcoma: A Retrospective Analysis

BACKGROUND

Hepatic angiosarcoma (HA) is a rare malignant vascular neoplasm. Currently, there are no standardized protocols for treating HA. This study aims to understand clinicopathologic analysis, prognostic factors, and treatment outcomes comprehensively.

METHODS

The data retrieved from the SEER database was reviewed for hepatic angiosarcoma cases between 2000 and 2021.

RESULTS

A total of 389 patients with hepatic angiosarcoma were identified with a mean age of 63.9 years (SD ± 16). Most patients were male (64%), and per US census data, non-Hispanic Asians or Pacific Islanders were the most common race (17%). In known cases of tumor stage (61%), the most common tumor stage was distant (22%), and most were grade III (18%) tumors. Overall, the 3-year survival rate was 6.7% with a 95% confidence interval (95% CI 0.044-0.100), disease-specific survival at a 1-year survival rate was 4.43% (95% CI 0.023-0.083), and no patients survived by 3 years. The best overall survival rate was the 1-year rate for surgical resection, 18.20% (95% CI 0.075-0.441). Chemotherapy had a 1-year survival rate of 11% (95% CI 0.057-0.211), and radiation therapy had no survival significance (p = 0.2). Multivariate analysis shows age above 70 years (H.R. 1.67 (95% CI 1.181-2.381), p < 0.05), no surgical intervention (H.R. 2.29 (95% CI 1.585-3.336) p < 0.001), and distant stage (H.R. 2.54 (95% CI 1.696-3.805) p < 0.001) are negative prognostic factors, whereas female sex (H.R. 0.68 (95% CI 0.536-0.875) p < 0.05) is a positive prognostic factor.

CONCLUSION

Increasing age (> 70 years), male sex, and distant stage were found to be strong predictors of poor survival outcomes. Patients had better outcomes when surgical resection and chemotherapy were included in their treatment. These results can provide continued evidence in the future management of patients with hepatic angiosarcoma.

Gender-specific perception of job stressors and resources: a structural equation model-based secondary analysis

Objective

Stress is an extensive issue in modern society, affecting men and women differently. A better understanding of these patterns is required within the work context. Therefore, this study aimed to identify gender differences in the effects of stressors (quantitative demands, qualitative demands, working time) and resources (job control, quality of leadership, co-worker support) on subjective perceived stress across occupational groups.

Methods

This study was conducted as a secondary data analysis based on the 'German Study on Mental Health at Work' data. The national representative cross-sectional sample included 4,118 employees. The data were analyzed using structural equation modeling.

Results

Correlations between quantitative demands, working time, co-worker support, quality of leadership, job control, and subjective perceived stress were first confirmed for a total sample of employees. Gender differences in these interactions were then analyzed using multi-group equation modeling and a gender-stratified sample. Men and women showed an increase in subjective perceived stress for high quantitative demands. This increase was more prominent for men. Women further showed an increase in subjective perceived stress in response to long working time. High co-worker support, quality of leadership, and job control had stress-reducing effects but did not result in significant gender differences. No association was found between qualitative demands and subjective perceived stress.

Conclusion

The results underline that not all working conditions significantly impact stress for both genders and gender differences exist only within the stressors. Hence, gendered strategies may only be required in some constellations. However, specific contexts require integrating gendered approaches in research and operational practice.

How to prevent 3 million deaths worldwide: a systematic review of occupational accident research-a factor- and cost-based approach

Occupational accidents have emerged as a global concern, necessitating a comprehensive examination of their determinants and associated costs. This review aims to summarize, synthesize, and organize the factors and cost drivers of occupational accidents, exploring whether there is a gender perspective. Adhering to PRISMA guidelines, we performed a narrative synthesis to systematically review relevant literature. A systematic search was conducted in the electronic databases PubMed, Web of Science, and Scopus. Two researchers screened all records to eliminate any duplicates, and they selected the articles for full review. A third researcher was consulted to resolve discrepancies and reach a consensus. The analysis of 15 studies revealed diverse perspectives; in terms of determinants, studies on organizational aspects and the theory of human error were grouped together, while in cost drivers, the human capital model and willingness to pay were the most frequently used. Gender, meanwhile, is identified as a determinant variable for accident rate. Additionally, limitations such as data underestimation were noted in the existing literature. The review highlights the need for empirical studies capable of addressing both determinants and cost drivers. It also provides guidelines for researchers to design studies that are more comparable across different contexts, including the gender debate.

Mind the glass ceiling: The gender gap in how depressive symptoms after age 55 relate to earlier career mobility in CONSTANCES

A substantial body of research has shown an association between career mobility and mental health in later life through health selection and causal processes, with favourable health outcomes associated with upward mobility. However, gender differences in these associations have been largely overlooked, despite evidence of gender inequalities in career opportunities. We use data on individuals aged 55-69 from the CONSTANCES cohort. We examine their current mental health and career trajectories between ages 20-55, reconstructed through a retrospective questionnaire. Using sequence analysis, we identify 11 types of past occupational mobility (upward, downward, stagnant) across a gradient from unskilled to high-skilled occupations. We use nested logistic regression to assess their association with depressive symptoms (CES-D) in men and women separately, controlling for socio-demographic variables and occupational hazards. For both men and women, depressive symptoms are strongly associated with careers involving unskilled jobs, with no difference between directions of mobility. For men, upward mobility into skilled or high-skilled jobs is associated with fewer depressive symptoms compared to a stagnant career. This is not the case for women, for whom upward career mobility to high-skilled jobs is associated with more depressive symptoms compared to stagnation at origin. Our findings show a gendered relationship between mental health in later life and past career mobility and highlight the mental health issues faced by women who break through the glass ceiling. They call for further research into the circumstances of women's careers that challenge their mental health in later life.

Global trends and projections of occupational trichloroethylene (TCE) exposure-associated kidney cancer: Insights of the Global Burden of Disease (GBD) Study 2021 from 1990 to 2021 and prediction to 2050

BACKGROUND

Exposure to trichloroethylene (TCE) in occupations is associated with an increased risk of kidney cancer (KC). However, there is a lack of comprehensive study on the global burden of occupational exposure to TCE-related KC.

METHODS

Epidemiological data on occupational TCE exposure-associated KC from 1990 to 2021 were obtained from Global Burden of Disease (GBD) 2021 study, including death counts and disability-adjusted life years (DALYs). Global burden of this disease was stratified by genders, age, socio-demographic index (SDI) quintiles, GBD subcontinental regions, and countries. The estimated annual percentage change (EAPC) was calculated to illustrate trends over the last 32 years, and forecasts were conducted to predict the disease burden until 2050.

RESULTS

In 2021, the global age-standardized death rate (ASDR) of occupational TCE exposure-related KC was 0.0009 (95 %UI: 0.0002-0.0016) per 100,000 persons, and the age-standardized DALY rate (ASDAR) was 0.0284 (95 %UI: 0.0062-0.0522) per 100,000 individuals. The disease showed significant heterogeneity by sex and age, with males bearing a notably higher burden, and the burden being concentrated in the 50-79 year-old group. Major burdens were focused in middle to high-middle SDI regions, especially in Southern Latin America (Uruguay, Argentina, and Chile). Over 32 years, the burden of occupational TCE exposure-associated KC has gradually increased, with projections indicating continued growth to 2050, particularly among males and individuals aged 50-79. Regions like high-middle SDI areas, North America, High-income North America, Southern Sub-Saharan Africa, saw the most significant increases. Correlation analyses indicated a positive association between ASDR and ASDAR with SDI, while EAPC showed a notable negative correlation with SDI. Decomposition analyses reveals three global population determinants that positively contributed to the increase in deaths, but negatively impacted DALYs.

CONCLUSION

This study highlights a significant rising trend of occupational TCE exposure-associated KC from 1990 to 2021 and projected to 2050, with an emphasis on the disease burden in men, elderly population, and middle to high-middle SDI regions, underscoring the impact of occupational TCE exposure on KC.

Incorporating sex and gender considerations in research on psychosocial work exposures and cardiovascular diseases: A systematic review of 55 prospective studies

Cardiovascular diseases (CVDs) are a leading cause of morbidity and mortality, with disparities observed between males and females. Psychosocial work exposures (PWE), including workload, job control, reward and long working hours, are associated with CVD development. Despite higher prevalence among females, the association with CVD is consistently observed in males, with limited explanations for these differences. This study aimed to examine the consideration of sex and gender in prospective studies within systematic reviews on PWE - specifically, the demand-control model, the effort-reward imbalance model, and long working hours - and CVD. Conducting a systematic review, we assessed sex and gender considerations using criteria from the Sex and Gender Equity in Research (SAGER) guidelines. While most studies recognized potential sex and gender differences in the associations between PWE and CVD, only about half of the 28 studies that included both sexes (15 studies) analyzed females and males separately. Moreover, few studies included criteria for sex- and gender-based analyses. Less than half of the studies (23 studies) incorporated a sex and/or gender perspective to discuss observed differences and similarities between men and women. Although there is a rising trend in integrating sex and gender considerations, significant gaps persist in methodologies and reporting, highlighting the need for comprehensive incorporation of sex and gender considerations to bolster CVD prevention strategies and policies.

Farming Activities and Risk of Inflammatory Bowel Disease: A French Nationwide Population-based Cohort Study

BACKGROUND AND AIMS

Epidemiological data regarding inflammatory bowel disease [IBD] are lacking, in particular for occupationally exposed populations. We investigated whether, among the entire French farm manager [FM] workforce, certain agricultural activities are more strongly associated with IBD than others.

METHODS

Nationwide, population-based, insurance claims and electronic health records from all FMs who worked at least once over the period 2002-2016 were used [n = 1 088 561, 69% males]. The outcome measure was the association between 26 farming activities and the risk of IBD, Crohn's disease [CD], and ulcerative colitis [UC], measured as hazard ratios [HRs], after adjusting for age, sex, pre-existing medical comorbidities, and farm location. The time to first chronic disease declaration was used as the underlying time scale. A model was generated for every activity and disease, using a reference group comprising all FMs who abstained from the specified activity from 2002 to 2016.

RESULTS

There were 1752 IBD cases, with 704 CD [40.2%] and 1048 UC [59.8%] cases, respectively. Elevated HRs were observed for fruit arboriculture [HR from 1.17 to 1.52] and dairy farming [HR from 1.22 to 1.46] for all IBD, in crop farming for CD only (HR = 1.26, 95% confidence interval [CI]: 1.06-1.49), and in shellfish farming [HR from 2.12 to 2.51] for both CD and IBD.

CONCLUSIONS

Further research regarding specific farming activities and exposures likely to modify the microbiota [eg, pesticides, pathogens] is required to identify potential occupational risk factors [agricultural exposome] for IBD. Exposure to Mycobacterium avium subspecies paratuberculosis, Cryptosporidium, environmental toxins, micro/nanoplastics, and pesticides represents promising research avenues.

Comparison Between Musculoskeletal Pain and Gender-Specific, Non-gendered Job-Exposure Matrix and Self-reported Exposures in CONSTANCES

PURPOSE

Musculoskeletal disorders (MSDs) are common worldwide and gender differences exist in terms of prevalence and disability. MSDs are a leading cause of sick leave and physical work exposures. To assess the association between physical exposures assessed by the gender-specific CONSTANCES Job-Exposure Matrix (JEM) and musculoskeletal pain in six areas: neck pain, shoulder pain, elbow/arm pain, hand/wrist pain, low back pain, knee/leg pain; and to compare the results with those obtained using the non-gendered CONSTANCES JEM and with individual self-report exposures.

METHODS

We included 48,736 male and 63,326 female workers from the CONSTANCES cohort (France). The association between 27 physical exposures and musculoskeletal self-reported pain in six body areas was assessed using logistic regression. We conducted the analysis with three types of exposures: (1) individual self-reported exposures; (2) gender-specific CONSTANCES JEM; (3) non-gendered CONSTANCES JEM, and adjusted for age and Body Mass Index (BMI). Analyses were stratified by gender.

RESULTS

The associations to the gender-specific and non-gendered JEM were similar. The odds ratios using individual self-reported exposures were comparable to the JEM-based associations, with the exceptions of the exposures 'change tasks', 'rest eyes' and 'reach behind'. In some comparisons, there were differences in the direction and/or significance of effects between genders (regardless of whether the JEM used was gender-specific or not).

CONCLUSION

The gender-specific and non-gendered JEMs gave similar results, hence, developing physical work exposures JEMs that are gender-specific may not be essential. However, when predicting musculoskeletal pain, it seems relevant to stratify the analysis by gender.

Gender and sex differences in occupation-specific infectious diseases: a systematic review

Occupational infectious disease risks between men and women have often been attributed to the gendered distribution of the labour force, with limited comparative research on occupation-specific infectious disease risks. The objective of this study was to compare infectious disease risks within the same occupations by gender. A systematic review of peer-reviewed studies published between 2016 and 2021 was undertaken. To be included, studies were required to report infectious disease risks for men, women or non-binary people within the same occupation. The included studies were appraised for methodological quality. A post hoc power calculation was also conducted. 63 studies were included in the systematic review. Among high-quality studies with statistical power (9/63), there was evidence of a higher hepatitis risk for men than for women among patient-facing healthcare workers (HCWs) and a higher parasitic infection risk for men than for women among farmers (one study each). The rest of the high-quality studies (7/63) reported no difference between men and women, including for COVID-19 risk among patient-facing HCWs and physicians, hepatitis risk among swine workers, influenza risk among poultry workers, tuberculosis risk among livestock workers and toxoplasmosis risk among abattoir workers. The findings suggest that occupational infectious disease risks are similarly experienced for men and women within the same occupation with a few exceptions showing a higher risk for men. Future studies examining gender/sex differences in occupational infectious diseases need to ensure adequate sampling by gender.

Association between multiple jobs and physical and psychological symptoms among the Korean working population

Background

The prevalence of multiple job-holding (MJH) is expected to show an upward trend among Korean workers, yet its potential impact on workers' health remains poorly discussed. This study aimed to explore the association between MJH and experience of physical and psychological symptoms in various aspects among active Korean workers and to identify its differences depending on workers' gender.

Methods

We conducted a population-based cross-sectional study among South Korean workers aged 15-59 using data from the 6th Korean Working Conditions Survey. The final study sample comprised 34,175 participants. MJH status and symptoms, such as musculoskeletal pain, headache or eyestrain, fatigue, insomnia, and anxiety, were measured by self-reported data. Logistic regression analyses were performed on the total sample and gender-stratified groups, with adjustments for the sociodemographic and occupational characteristics of the participants.

Results

One hundred thirty-five men and 103 women were defined as multiple job-holders (MJHers) among the study sample. When adjusted for sociodemographic and occupational characteristics, MJHers suffered more events of headache or eyestrain (odds ratio [OR]: 1.85, 95% confidence interval [CI]: 1.23-2.78) and anxiety (OR: 1.99, 95% CI: 1.05-3.79). Gender-stratified analyses with adjustment showed that among women workers, MJH was associated with musculoskeletal pain (OR: 1.85, 95% CI: 1.02-3.34), headache or eyestrain (OR: 2.53, 95% CI: 1.37-4.67), fatigue (OR: 2.38, 95% CI: 1.29-4.40), insomnia (OR: 1.92, 95% CI: 1.04-3.57), and anxiety (OR: 2.83, 95% CI: 1.11-7.20).

Conclusions

We found a significant association between MJH and various symptoms. Women MJHers were revealed to be a more vulnerable population than their men counterparts. Further research should account for the social context of MJH, and appropriate monitoring and intervention for maintaining the well-being of MJHers are needed.

An analysis of exogenous harmful substance exposure as risk factors for COPD and hypertension co-morbidity using PSM

Background

Some occupational and environmental exposures could increase the risk of chronic obstructive pulmonary disease (COPD) and hypertension in various work and living environments. However, the effect of exposure to multiple exogenous harmful substances on COPD and hypertension co-morbidities remains unclear.

Methods

Participants were selected from eight hospitals in five provinces in China using a multistage cluster sampling procedure. Participants' demographic, exposure, and disease information were collected through questionnaires, spirometry, and blood pressure examinations. Demographic data were used as matching factors, and 1:1 matching between the exposed and non-exposed groups was performed by employing propensity score matching (PSM) to minimize the influence on the results. A one-way chi-squared analysis and multifactorial logistic regression were used to analyze the association between the exposure to exogenous harmful substances (metals and their compound dust, inorganic mineral dust, organic chemicals, and livestock by-products) and the co-morbidity of COPD and hypertension.

Results

There were 6,610 eligible participants in the final analysis, of whom 2,045 (30.9%) were exposed to exogenous harmful substances. The prevalence of co-morbidities of COPD and hypertension (6.0%) in the exposure group was higher than their prevalence in the total population (4.6%). After PSM, exogenous harmful substance exposure was found to be a risk factor for the co-morbidity of COPD and hypertension [odds ratio (OR) = 1.347, 95% confidence interval (CI): 1.011-1.794], which was not statistically significant before PSM (OR = 1.094, 95% CI: 0.852-1.405). Meanwhile, the results of different outcomes showed that the association between hypertension and exogenous harmful substance exposure was not statistically significant (OR = 0.965, 95% CI: 0.846-1.101). Smoking (OR = 4.702, 95% CI: 3.321-6.656), history of a respiratory disease during childhood (OR = 2.830, 95% CI: 1.600-5.006), and history of respiratory symptoms (OR = 1.897, 95% CI: 1.331-2.704) were also identified as risk factors for the co-morbidity of COPD and hypertension.

Conclusion

The distribution of exogenous harmful substance exposure varies in the population, and the prevalence of co-morbidities is generally higher in susceptible populations. Exposure to exogenous harmful substances was found to be a key risk factor after adjusting for demographic confounders.

Risk of hand and forearm conditions due to vibrating hand-held tools exposure: a retrospective cohort study from Sweden

OBJECTIVES

The occurrence of hand and forearm disorders related to vibration exposure, adjusted for relevant background factors, is scarcely reported. We analysed the prevalence of such conditions in a large population cohort, stratified by sex, and associations with exposure to vibrating hand-held tools.

DESIGN

This is a retrospective cohort study.

SETTING

Individuals in the Malmö Diet and Cancer Study cohort (MDCS; inclusion 1991-1996; followed until 2018) were asked, 'does your work involve working with vibrating hand-held tools?' (response: 'not at all', 'some' and 'much'). Data were cross-linked with national registers to identify treatment for carpal tunnel syndrome (CTS), ulnar nerve entrapment (UNE), Dupuytren's disease, trigger finger or first carpometacarpal joint (CMC-1) osteoarthritis (OA). Cox regression models, unadjusted and adjusted (age, sex, prevalent diabetes, smoking, hypertension and alcohol consumption), were performed to analyse the effects of reported vibration exposure.

PARTICIPANTS

Individuals in the MDCS who had answered the questionnaire on vibration exposure (14 342 out of the originally 30 446 individuals in MDCS) were included in the study.

RESULTS

In total, 12 220/14 342 individuals (76%) reported 'no' exposure, 1392/14 342 (9%) 'some' and 730/14 342 (5%) 'much' exposure to vibrating hand-held tools. In men, 'much' exposure was independently associated with CTS (HR 1.71 (95% CI 1.11 to 2.62)) and UNE (HR 2.42 (95% CI 1.15 to 5.07)). 'Some' exposure was independently associated with UNE in men (HR 2.10 (95% CI 1.12 to 3.95)). 'Much' exposure was independently associated with trigger finger in women (HR 2.73 (95% CI 1.49 to 4.99)). We found no effect of vibration exposure on Dupuytren's disease or CMC-1 OA. 'Much' vibration exposure predicted any hand and forearm diagnosis in men (HR 1.44 (95% CI 1.08 to 1.80)), but not in women.

CONCLUSIONS

Vibration exposure by hand-held tools increases the risk of developing CTS and UNE and any common hand and forearm conditions in men, whereas women only risk trigger finger and CMC-1 OA. Adjustment for relevant confounders in vibration exposure is crucial.

Physical working conditions over time: a repeated cross-sectional study in German employees

BACKGROUND

This study aimed to examine time trends in physical working conditions across and within occupational groups in Germany between 2006 and 2018.

METHODS

Logistic regression analyses were conducted using data from the BIBB/BAuA Employment Surveys in 2006, 2012, and 2018, with a total sample size of 59,006 participants. The study investigated changes in various self-reported occupational exposure measures over time, along with demographic shifts in the workforce.

RESULTS

The results showed overall improvements in most occupational exposure measures during the study period, alongside an aging and upskilling workforce. However, exposure to awkward postures, microorganisms, and, to a lesser extent, noise increased. Substantial variation was observed between occupational groups, with more favourable trends among white-collar high-skilled and blue-collar low-skilled workers, and less favourable trends among white-collar low-skilled and blue-collar high-skilled workers.

CONCLUSIONS

While trends in physical working conditions in Germany are partly promising, some exposures are worsening, and substantial inequalities between occupations persist. As occupational exposures remain common, there is still a need for targeted interventions to improve working conditions, particularly in higher-risk occupations.

Occupational asbestos exposure and risk of esophageal cancer: A systematic review and meta-analysis

Esophageal cancer (EC), which includes squamous cell carcinoma (ESCC) and adenocarcinoma (EAC), is an important cancer with poor prognosis and high mortality rate. Several occupational exposures have been associated with EC. We aim to investigate the association between occupational asbestos exposure and EC risk, considering types of asbestos and histology of the disease. We included studies mentioned in the list of references in previous reviews and pooled analyses, and we conducted an independent search in PubMed and Scopus. Forest plots of relative risks (RR) were constructed based on the association between occupational asbestos and EC risk. Random-effects models were used to address heterogeneity between 48 independent cohort and case-control studies. We found an association between occupational asbestos exposure and EC (meta-relative risk [RR] = 1.20, 95% confidence interval [CI] = 1.09-1.32; I2 = 58.8%, p-heterogeneity [het] <.001). The results of stratification by job (p-het = .20) indicate an increased RR among asbestos product workers (RR = 1.39, 95% CI = 1.07-1.81), asbestos applicators (RR = 1.41, 95% CI = 1.20-1.67), and construction workers (RR = 1.12, 95% CI = 1.02-1.24). There was no heterogeneity in meta-RR according to outcome (p = .29), geographic region (p = .69), year of publication (p = .59), quality score (p = .73), asbestos type (p = .93), study design (p = .87), and gender (p = .88), control for potential confounders (p = .20), year of first employment (p = .94) and exposure level (p = .43). The stratification analysis by histology type found an increased RR for both ESCC 1.33(1.03-1.71) and EAC 1.45(1.03-2.04) (p-het = .68). We didn't find evidence of publication bias (p = .07). The results of our study suggest that occupational asbestos exposure is associated with an increased risk of EC in both histology types.

Risk stratification and survival time of patients with gram-negative bacillary pneumonia in the intensive care unit

Introduction

Pneumonia is a common infection in the intensive care unit (ICU), and gram-negative bacilli are the most common bacterial cause. The purpose of the study was to investigate the risk factors for 30-day mortality in patients with gram-negative bacillary pneumonia in the ICU, construct a predictive model, and stratify patients based on risk to assess their short-term survival.

Methods

Patients admitted to the ICU with gram-negative bacillary pneumonia at Fujian Medical University Affiliated First Hospital between January 2018 and September 2020 were selected. Patients were divided into deceased and survivor groups based on whether death occurred within 30 days. Multifactorial logistic regression analysis was used to identify independent risk factors for 30-day mortality in these patients, and a predictive nomogram model was constructed based on these factors. Patients were categorized into low-, medium-, and high-risk groups according to the model's predicted probability, and Kaplan-Meier survival curves were plotted to assess short-term survival.

Results

The study included 305 patients. Lactic acid (odds ratio [OR], 1.524, 95% CI: 1.057-2.197), tracheal intubation (OR: 4.202, 95% CI: 1.092-16.169), and acute kidney injury (OR:4.776, 95% CI: 1.632-13.978) were identified as independent risk factors for 30-day mortality. A nomogram prediction model was established based on these three factors. Internal validation of the model showed a Hosmer-Lemeshow test result of X2=5.770, P=0.834, and an area under the ROC curve of 0.791 (95% CI: 0.688-0.893). Bootstrap resampling of the original data 1000 times yielded a C-index of 0.791, and a decision curve analysis indicated a high net benefit when the threshold probability was between 15%-90%. The survival time for low-, medium-, and high-risk patients was 30 (30, 30), 30 (16.5, 30), and 17 (11, 27) days, respectively, which were significantly different.

Conclusion

Lactic acid, tracheal intubation, and acute kidney injury were independent risk factors for 30-day mortality in patients in the ICU with gram-negative bacillary pneumonia. The predictive model constructed based on these factors showed good predictive performance and helped assess short-term survival, facilitating early intervention and treatment.

Demographic disparity in diurnal surface urban Heat Island exposure across local climate zones: A case study of Chongqing, China

Surface urban heat island (SUHI) exposure significantly harms human health during rapid urbanization. Identifying the areas and demographic groups under high SUHI exposure is critical for mitigating heat-related hazards. However, despite broad concern in US-European countries, rare studies discuss the diurnal SUHI exposure of demographic subgroups across Local Climate Zones (LCZs) in Chinese cities. Therefore, taking Chongqing as the case study, we measured the diurnal SUHI exposure of demographic subgroups (e.g., gender, age, and income) across different LCZs (compact, open, and sparsely-built zones) by coupling the ECOSTRESS data and mobile phone signaling data. The results indicated that Chongqing's compact high/middle-rise zones suffered a higher SUHI exposure due to high land surface temperature (LST) and a larger size of population than open zones. Despite a relatively low population density, extremely high LST in compact low-rise zones (e.g., industrial parks) contributes to considerable accumulated SUHI exposure. The SUHI exposure risk exhibited the differences between daytime and nighttime, resulting from SUHI variation and population flow. The demographic analysis showed that Chongqing's demographic subgroups are exposed disproportionately to SUHI. Elderly groups suffered relatively high exposure in compact high-rise zones. Low-incomers witnessed a high exposure in open zones. These findings call for alleviating SUHI exposure risk by targeting vulnerable groups and high-intensity exposure areas.

Risk of chronic obstructive pulmonary disease in a large cohort of Ontario, Canada workers

Although several occupational exposures have been linked to the risk of COPD; limited data exists on sex-specific differences. This study aimed to identify at-risk occupations and sex differences for COPD risk. Cases were identified in a large surveillance system established through the linkage of former compensation claimants' data (non-COPD claims) to physician visits, ambulatory care data, and hospital inpatient data (1983-2020). Cox proportional hazard models were used to estimate hazard ratios (HRs) and corresponding 95% confidence intervals (CI) for occupation groups (occupation at time of claim), stratified by sex. HRs were indirectly adjusted for cigarette smoking using another population dataset. A total of 29,445 male and 14,693 female incident cases of COPD were identified. Increased risks were observed in both sexes for construction (HRmale 1.15, 95% CI 1.12-1.19; HRfemale 1.54, 95% CI 1.29-1.83) transport/equipment operating (HRmale 1.32, 95% CI 1.28-1.37; HRfemale 1.53, 95% CI 1.40-1.68) farming (HRmale 1.23, 95% CI 1.15-1.32; HRfemale 1.19, 95% CI 1.04-1.37) and janitors/cleaners (HRmale 1.31, 95% CI 1.24-1.37; HRfemale 1.40, 95% CI 1.31-1.49). Increased risks were observed for females employed as chefs and cooks (HR 1.44, 95% CI 1.31-1.58), bartenders (HR 1.38, 95% CI 1.05-1.81), and those working in food/beverage preparation (HR 1.34, 95% CI 1.24-1.45) among other occupations. This study demonstrates elevated risk of COPD among both male and female workers potentially exposed to vapours, gases, dusts, and fumes, highlighting the need for occupational surveillance of COPD.

Occupational hazard in urolithiasis patients in Qatar: A single-center cross-sectional study

BACKGROUND

Urolithiasis is one of the most prevalent urological diseases and is associated with a substantial economic burden. Its prevalence varies according to geographical location. Qatar is a Middle Eastern country located in the Afro-Asian Stone Belt. It has a dry and hot climate, which may predispose individuals working in these environments to form kidney stones (KSs).

METHODS

A population sample of 4204 patients was categorized into five occupational classes. The frequencies and correlations of these occupations with KS formation were calculated.

RESULTS

Among the total cases, 2000 presented with KSs, with the majority being of Asian descent (49%), followed by individuals of Middle Eastern descent (35.1%). Technicians accounted for 35.15% of KS cases followed by clerks (29.2%) and executives (14.6%). Among KS cases, 44% had a single stone, 30% had multiple stones, and 26% had two stones. In comparing both KS and non-KS groups, age, gender, occupation, and race were significantly associated with KS formation (p<0.05), while BMI did not show any significant correlation (p>0.05). Asian males aged 31-40, working as technicians, were significantly more prone to urolithiasis. In comparing age, BMI, and gender with stone characteristics, only age was found significantly associated with stone size (p<0.05). Occupation showed an impact on all studied stone characteristics. Clerks and technicians presented more frequently with stones within the 11-15 mm range, while executives more frequently presented with smaller stones (p<0.001). Stone density was more frequently <500 HU in workers, technicians and housewives and >500 HU in executives and clerks (p<0.001).

CONCLUSIONS

Our findings revealed an elevated risk of urolithiasis among certain occupational groups, particularly technicians, who frequently work outdoors in high-temperature environments. Alternatively, the sedentary nature of clerical and executive positions can also contribute to the risk of urolithiasis.

PTSD prevalence and factors in intern nursing students after COVID-19 full liberalization in China: a cross-sectional study

Objective

This study aimed to assess the prevalence of post-traumatic stress disorder (PTSD) and its influencing factors among intern nursing students after the full liberalization of the COVID-19 prevention and control policy in China.

Methods

Participants completed the online survey from January 14 to January 19, 2023. A demographic questionnaire, COVID-19 and internship-related questionnaire, the Fear of COVID-19 scale, the Primary Care PTSD Screen, and the Connor-Davidson Resilience Scale were used to conduct the online survey.

Results

Of 438 participants, 88.4% tested positive for COVID-19 in the last 6 months. The prevalence of fear, resilience, and PTSD was 16.9, 15.5, and 11.2%, respectively. Direct care of COVID patients in hospital (OR = 2.084, 95%CI 1.034 ~ 4.202), the experience of occupational exposure (OR = 2.856, 95%CI 1.436 ~ 5.681), working with an experienced team (OR = 2.120, 95%CI 1.070 ~ 4.198), and fear COVID-19 (OR = 8.269, 95%CI 4.150 ~ 16.479) were significantly and positively associated with PTSD in nursing internship students.

Conclusion

After COVID-19 full liberalization in China, intern nursing students still experienced pandemic-related mental distress, which can bring PTSD. Adequate support and counseling should be provided, as needed, to intern nursing students who are about to enter the workforce and have experienced severe PTSD symptoms related to COVID-19. Our findings indicated that should understand the importance of screening, formulate intervention strategies and preventive measures to address psychosocial problems, and provide coping skills training to intern nursing students.

Impact of physical activity on disability-free and disabled life expectancies in middle-aged and older adults: Data from the healthy aging longitudinal study in Taiwan

AIM

Leisure-time physical activity (LTPA) promotes healthy aging; however, data on work-related physical activity (WPA) are inconsistent. This study was conducted to examine the disability-free life expectancy (DFLE) and disabled life expectancy (DLE) across physical activity levels, with a focus on WPA, in middle-aged and older adults.

METHODS

Data from 5663 community-dwelling participants aged ≥55 years and enrolled in the Healthy Aging Longitudinal Study in Taiwan were evaluated. Energy expenditures from LTPA and WPA were calculated from baseline questionnaires and categorized into sex-specific cutoffs. Disability was based on repeat measures of participants' activities of daily living and instrumental activities of daily living. Mortality was confirmed via data linkage with the Death Certificate database. DFLE and DLE were estimated from discrete-time multistate life-table models.

RESULTS

At age 65, women with low WPA had a DLE of 2.88 years (95% confidence interval [CI], 1.67-4.08), which was shorter than that of women without WPA (DLE, 5.24 years; 95% CI, 4.65-5.83) and with high WPA (DLE, 4.01 years; 95% CI, 2.69-5.34). DFLE and DLE were similar across WPA levels in men. DFLE tended to increase as the LTPA increased in men and women.

CONCLUSION

Women with low WPA had shorter DLE than did those with no or high WPA. To reduce the risks of disability associated with physical activity, public policy should advocate for older people to watch the type, amount, and intensity of their activities as these may go ignored during WPA. Geriatr Gerontol Int 2024; 24: 229-239.

Whether occupational injuries of the industrial workers can be prevented: an analysis from the slums of West Bengal-India?

A lack of research exists concerning the heterogeneity of the occupational injuries of slum dwellers across industries which has a close link with health expenditure and hence livelihood. It necessitates analysing their occupational injuries and associated out-of-pocket health expenditures. Multi-stage random sampling is used to collect the primary data and the logit model is used for data analyses. Permanent non-fatal injuries in the civil-mechanical industries and temporary non-fatal injuries in textile industries are common. The share of health expenditure of the injured workers seeking medical consultations remains 59% of their average monthly income. Average monthly income, parental occupation, types of industry, job security, risk intensity, and salary basis are significant estimates of occupational injuries. The differences in the nature and extent of the occupational injuries of the workers across industries in the light of the socio-demographic and working environment context provide significant insight into the policy implications.

Gender Differences among Nurses in Managing Arterial Puncture-Related Pain: A Multicenter Cross-Sectional Study

There is evidence that healthcare can be executed differentially depending on the gender of patients, researchers, and clinicians. The aim was to analyze the possible existence of nursing gender differences in pain management produced by arterial puncture for blood gas analysis. A cross-sectional, multicenter study designed was conducted in Castilla-la Mancha (Spain). Variables of interest were collected from nurses in the public health system of a European region through a questionnaire. Data were collected for four months; the primary outcome was the use of any intervention to reduce pain and the explanatory variable was the nurse's gender. Bivariate analysis was carried out to assess associations between gender and pain-reducing interventions and a multivariate model was created with those factors that were relevant using logistic regression. A significantly higher proportion of men reported using some form of intervention (45% vs. 30%) and had more specific training (45.9% vs. 32.4%). The adjusted probability of using pain-reducing interventions by men was 71% higher than women. Thus, we found gender differences in the management of pain caused by arterial punctures performed by nurses as the main healthcare providers.

Perceived challenges and barriers for females working in the heat

Given rising temperatures, globally, heat exposures and catastrophic heat illnesses are a major concern in laborer and industrial sectors. The purpose of this study was to evaluate the perceptions of females laboring in the heat regarding challenges and barriers encountered in their respective industries while working in the heat. A consensual qualitative research (CQR) design was employed to gain information related to participant occupational and job characteristics, feelings while working in the heat, adjustments made by employers when they work in the heat, and their experience working in the heat specific to their identified sex. Females were eligible to participate if they were currently employed in an environment that required them to work in the heat. Twelve females participated in a single, 45-60 min one-on-one semi-structured interview. Participants reported working in the manufacturing, agriculture, tourism, and railroad industries. Upon completion of data analysis, one primary theme was identified: heat stress mitigation strategies, which were further broken down into two subthemes of formal strategies provided by the employer and informal strategies driven by the employees. Participants indicated there was a lack of heat stress prevention strategies implemented by their employers, which resulted in employees creating their own strategies to protect themselves and their coworkers from heat stress. Results indicated there are limited heat stress prevention strategies that are provided in industries that include females working in the heat. Unique considerations should be made to protect this population from the dangers of heat stress and must go beyond workers protecting themselves.

Sex disparities in physical activity domains and hypertension prevalence

BACKGROUND

This study aimed to examine the associations of leisure time physical activity (LTPA) and occupational physical activity (OPA) with the prevalence of hypertension, while exploring the sex disparities in these associations.

METHODS

A cross-sectional study was conducted using data from the Korea National Health and Nutrition Examination Survey between 2014 and 2019 (n = 26,534). Hypertension was defined as the use of antihypertensive drugs or systolic and diastolic blood pressure ≥ 140/90 mm Hg. Self-reported physical activity (PA), assessed by the global PA questionnaire, was categorized into three domains: total PA, LTPA and OPA. Each PA domain was classified based on METs-min/wk and intensity.

RESULTS

In a multivariable adjusted model, the odds ratio (OR) with 95% confidence intervals (CIs) for the prevalence of hypertension in the active versus inactive group, based on METs, was 0.92 (95% CI 0.85-0.99) for total PA, 0.90 (95% CI 0.83-0.98) for LTPA and 1.21 (95% CI 1.05-1.38) for OPA. Compared to the inactive group, moderate to vigorous intensity was associated with a lower odds of hypertension for total PA and LTPA (total PA: OR 0.95, 95% CI 0.89-1.00 and LTPA: OR 0.92, 95% CI 0.86-0.98), but a higher odd for OPA (OR 1.17, 95% CI 1.05-1.30). Subgroup analyses showed significant evidence of effect modification by sex on the associations of total PA and LTPA (METs and intensity) with hypertension prevalence (p-values for interaction < 0.01); the associations were generally stronger for women. OPA was associated with a higher prevalence of hypertension in women, but not in men (p-value for interaction > 0.05).

CONCLUSIONS

Higher levels of total PA and LTPA were associated with lower prevalence of hypertension in both men and women, with slightly stronger associations for women. However, higher OPA was associated with a higher prevalence of hypertension in women. These findings support the PA health paradox hypothesis and highlight the sex disparities in the association between OPA and hypertension prevalence.

Potential Work-related Exposure to SARS-CoV-2 by Standard Occupational Grouping Based on Pre-lockdown Working Conditions in France

This study aims to ascertain occupations potentially at greatest risk of exposure to SARS-CoV-2 based on pre-lockdown working conditions in France. We combined two French population-based surveys documenting workplace exposures to infectious agents, face-to-face contact with the public, and working with colleagues just before the pandemic. Then, for each 87-level standard French occupational grouping, we estimated the number and percentage of the French working population reporting these occupational exposure factors, by gender, using survey weights. As much as 40% (11 million) of all workers reported at least two exposure factors. Most of the workers concerned were in the healthcare sector. However, army/police officers, firefighters, hairdressers, teachers, cultural/sports professionals, and some manual workers were also exposed. Women were overrepresented in certain occupations with potentially higher risks of exposure such as home caregivers, childminders, and hairdressers. Our gender-stratified matrix can be used to assign prelockdown work-related exposures to cohorts implemented during the pandemic.

Global burden of tracheal, bronchus, and lung cancer attributable to occupational carcinogens in 204 countries and territories, from 1990 to 2019: results from the global burden of disease study 2019

BACKGROUND

Occupational-related cancers are a substantial global health issue. The largest proportion of occupational-related cancers is tracheal, bronchus, and lung (TBL) cancer. This study aimed to explore the geographical and temporal trends in occupational carcinogens related to TBL cancer.

METHODS

Data on TBL cancer attributable to occupational carcinogens were collected from the Global Burden of Disease Study 2019. Numbers and age-standardized rates (ASRs) of deaths, disability-adjusted life years (DALYs), and corresponding average annual percentage change (AAPC) were evaluated and stratified by geographic location, socio-demographic index (SDI) quintiles, age, and sex.

RESULTS

Globally, ASRs of deaths and DALYs in TBL cancer attributable to occupational carcinogens showed a downward trend (AAPC = - 0.69%, - 1.01%) while increases were observed in the low, low-middle, and middle SDI quintiles. Although males accounted for 82.4% and 81.5% of deaths and DALYs in 2019, respectively, it showed an upward trend of ASRs in females (AAPC = 0.33%, 0.02%). Occupational exposure to asbestos, silica and diesel engine exhaust were the top three causes of age-standardized TBL cancer deaths and DALYs. Over the past three decades, the percentage of age-standardized TBL cancer deaths and DALYs attributable to occupational asbestos and silica exposure decreased by 18.24, 6.71 and 20.52%, 4.00% globally, but increased significantly in lower SDI regions, while the burden attributable to occupational diesel engine exhaust exposure increased by 32.76, 37.23% worldwide.

CONCLUSIONS

Occupational exposure remains an important risk factor for TBL cancer. The burden of TBL cancer attributable to occupational carcinogens showed obvious heterogeneity which decreased in higher SDI but increased in lower SDI regions. The burden of males was significantly higher than females, but the females showed an increasing trend. Occupational exposure to asbestos was the main causes of the burden. Therefore, effective prevention and control measures tailored to local conditions are necessary.

Visualization and bibliometric analysis of occupational exposure among nurses in Asia

Background

Occupational exposure is of increasing concern, posing a serious threat to nurses, especially in the event of a public health emergency. Bibliometrics sheds novel light on the current state of research and factors influencing nurses' occupational exposures, illuminating hot topics and trends in the literature. Bibliometrics is essential to analyze the potential harm to nurses in Asia.

Methods

Data were extracted from the Web of Science Core Collection on August 6, 2022 with the following search terms: TS= (nurses) AND (TS= (occupational exposure OR occupational health)). CiteSpace and VOSviewer were used to analyze national and institutional collaborations, reference clustering, citations and co-citations of journals and keyword bursts, and HistCite was used to analyze the citation historiography map. To analyze the data and generate statistical charts, Origin and Microsoft Excel were utilized.

Results

A total of 1448 studies on nurses' occupational exposure in Asia were identified. China Medical University had the most publications among Asian institutions, and China had the largest share among Asian countries. Most articles on nurses' occupational exposure in Asia were in the Journal of Occupational Health, and the journal with the highest impact factor was the Journal of Nursing Management. The COVID-19 outbreak caused a substantial shift in the direction of studies on nurses' occupational exposure in Asia. Mental health is a current hot topic, while sharps injuries and bodily fluid exposure are long-term priorities for attention.

Conclusions

The hotspots of research on nurses' occupational exposure in Asia focus on mental health, burnout, blood exposure, infection, and sharps injury. Due to the COVID-19 pandemic, recent research has concentrated on personalized mental health care and the development of protective equipment, and cross-disciplinary collaboration may be a new trend in the future.

Development and evaluation of the gender-specific CONSTANCES job exposure matrix for physical risk factors in France

OBJECTIVES

This study aimed to construct and evaluate a gender-specific job exposure matrix (JEM) for 27 physical work exposures, based on self-report.

METHODS

We constructed a JEM using questionnaire data on current physical exposures from 29 381 male and 35 900 female asymptomatic workers aged 18-69 years in the French CONSTANCES cohort study. We excluded workers with musculoskeletal pain to reduce potential reporting bias. We grouped 27 self-reported physical exposures using the French national job codes and stratified by gender. We compared individual and group-based exposures using the performance indicators Cohen's kappa (κ), sensitivity, specificity, and area under the receiver operating curve (AUC).

RESULTS

JEM validation showed fair-to-moderate agreement (κ 0.21-0.60) for most physical exposures for both genders except for 'reach behind' (poor), 'bend neck' (poor), 'finger pinch' (poor), standing' (good), 'use computer screen' (good), and 'use keyboard or scanner' (good). We found the highest AUC for 'standing' (men 0.85/ women 0.87), 'kneel/squat' (men 0.80/women 0.81), 'use computer screen' (men/women 0.81), and 'use keyboard or scanner' (men 0.82/ women 0.84). The AUC was <0.60 for only three exposures: 'bend neck' (men 0.58/women 0.57), 'finger pinch' (men 0.56/ women 0.55), and 'reach behind' (men 0.54/ women 0.51).

CONCLUSION

The constructed JEM validation measures were comparable for men and women for all exposures. Further research will examine the predictive ability of this gender-specific JEM for musculoskeletal disorders and the relevance of gender-stratification in this process, knowing accuracy of each exposure.

Underreporting of work-related low back pain among registered nurses: A mixed method study

BACKGROUND

Identifying and addressing work-related health problems early is crucial, but workers often perceive barriers in reporting these to management. This study aimed to investigate the factors associated with nurses' reporting of work-related low back pain to their managers and explored the reasons why nurses with patient handling injuries did not report them.

METHODS

This study is a concurrent mixed-method analysis of data from two statewide cross-sectional surveys of California registered nurses conducted in 2013 and 2016. The reporting of work-related low back pain to management (n = 288) was examined for associations with individual, occupational, and organizational factors. For qualitative analysis, the reasons for not reporting patient handling injuries were explored using open-ended responses (n = 42).

RESULTS

Reporting was associated with BIPOC (Black, Indigenous, and People of Color) men (adjusted odds ratio [AOR]: 1.31, 95% confidence interval [CI]: 1.07-1.59) compared to non-Hispanic White women; being a non-US educated nurse (AOR: 0.90, 95% CI: 0.80-1.01); experiencing greater low back pain (AOR: 1.07, 95% CI: 1.02-1.12); missing work (AOR: 1.38, 95% CI: 1.21-2.62); perceiving high physical workload (AOR: 0.89, 95% CI: 0.81-0.98); perceiving high people-oriented culture (AOR: 1.14, 95% CI: 1.04-1.25); and perceiving high ergonomic practices (AOR: 0.89, 95% CI: 0.81-0.98). Identified themes on the reasons for not reporting injuries included organizational-culture attitudes toward work-related injuries and injury characteristics of musculoskeletal disorders.

CONCLUSIONS

The findings indicate a need for management to remove structural barriers and improve organizational practices, and for a culture that promotes trust and open communication between workers and management.

Long working hours and self-rated health in the national Brazilian working population: gender and employment status differences, 2019

BACKGROUND

The regulation of working hours is governed by legal standards in formal employment. While the association between long working hours and various health outcomes has been extensively studied, there is limited evidence regarding Brazil. The objective of this study was to investigate the association among working hours, employment status, and self-rated health (SRH), taking into account differences between men and women in a national representative sample of the working population in Brazil.

METHODS

A cross-sectional study was conducted among a representative sample of 33,713 workers in Brazil to assess self-rated health (SRH). We examined the associations between working hours and employment status, categorizing working hours as standard (40-44 h per week) or long (> 44 h per week), and employment status as formal or informal. Logistic regression models were employed, adjusting for sociodemographic, occupational characteristics, and health behaviors. Probabilities of negative SRH were calculated for men and women in different exposure profiles. Results were stratified by gender, and 95% confidence intervals (CIs) were applied to the findings.

RESULTS

The prevalence of long working hours was higher among informal workers for both men and women. Adjusted odds ratio (AOR) results revealed that informal employment (AORwomen = 1.53; 95% CI: 1.13-2.07 and AORmen = 1.55; 95% CI: 1.22-1.96) and long working hours (AORwomen = 1.23; 95% CI: 1.06-1.43 and AORmen = 1.14; 95% CI: 1.00-1.30) were independently associated with negative SRH. Significant interactions between long working hours and informal employment were observed. Among individuals with the same exposure profile, women who engaged in long working hours had a higher probability of reporting negative SRH compared to men.

CONCLUSIONS

The results of this study are in line with the literature, as differences between men and women in the likelihood of negative self-rated health were observed. The adverse health effects underscore the importance of implementing intersectoral actions to inform the revision of regulations concerning weekly working hours and the expansion of informal employment in low- and middle-income countries.

Concentrated disadvantage and functional disability: a longitudinal neighbourhood analysis in 100 US cities

BACKGROUND

Socioeconomic disadvantage related to poverty, unemployment and social disinvestment contributes to significant disparities in community health in the USA. Yet, there remains limited ecological research on the relationship between neighbourhood disadvantage and functional disability. Much of the work in this area has focused on elderly populations without attention to variation across age and sex groups.

METHODS

Using a longitudinal dataset of almost 16 000 neighbourhoods, we examine the relationship between neighbourhood disadvantage and functional disability. Leveraging a series of cross-lagged panel models, we account for reciprocal dynamics and a range of pertinent covariates while assessing differences across age- and sex-specific groups.

RESULTS

Accounting for reciprocal effects, we found that the association between concentrated disadvantage and functional disability varies across age and sex groups. Concentrated disadvantage is most consistently associated with increased functional disability among boys (5-17 years), young men (18-34 years) and middle-aged men (35-64 years). Similar associations are found among girls (5-17 years) and middle-aged women (35-64 years).

CONCLUSION

Local neighbourhood economic conditions are significantly associated with functional disability among relatively young populations of males and females. Exposure to neighbourhood disadvantage and deprivation may accelerate disablement processes and shift the age curve of disability risk.

Global burden of neoplasms attributable to specific occupational carcinogens over 30 years: a population-based study

OBJECTIVES

The study aimed to analyze the global burden of occupational neoplasms from various epidemiological perspectives.

STUDY DESIGN

In this cross-sectional study, secondary analyses were conducted to assess the burden of neoplasms attributable to occupational carcinogens and their distribution characteristics using data from GBD 2019 and the World Bank database.

METHODS

Based on the GBD 2019 and the World Bank database, we analyzed the global burden of occupational neoplasms including the age-period-cohort model, decomposition analysis, health inequality analysis, and panel model. All analyses were conducted in R (version 4.0.3) and Joinpoint (version 4.9.1).

RESULTS

The absolute number of neoplasms burden attributable to occupational carcinogens has continued to rise over 30 years. In 2019, occupational neoplasms caused 333,867 [95% uncertainty interval (UI): 263,491 to 404,641] mortalities and 6,964,775 (95% UI: 5,467,884 to 8,580,431) disability-adjusted life years (DALYs) globally. Greenland, Monaco, the Netherlands, and Andorra suffered the highest burden. The burden was higher in countries with a higher sociodemographic index. The age effect was prominent in the elderly, and the 1925 birth cohort had the highest cohort effect. Population growth was the most significant driver of the mortalities (89%) and DALYs (111%) change. Moreover, the proportion of urban population was significantly positively associated with the disease burden, while GDP per capita was negatively correlated with the disease burden.

CONCLUSIONS

The burden of occupational neoplasms was unevenly distributed across locations and populations. The need for rational allocation of healthcare resources was urgent.

Comparing physical work exposures between men and women: findings from 65 281 workers in France

OBJECTIVES

Musculoskeletal disorders (MSDs) are a leading cause of disability and sick leave among workers. Although MSDs are associated with physical exposures, there are gender differences in the prevalence and related disability. This study aimed to compare self-reported physical work exposures by gender for people within the same occupational group.

METHODS

We used cross-sectional data from 65 281 asymptomatic workers aged 18-69 years from the CONSTANCES cohort study (France). We compared 27 physical exposures between men and women in the same occupational groups ('Profession et Categorie Sociale' group) using Mann-Whitney U tests.

RESULTS

Men and women performing the same job often reported different levels of exposure. 38 of 365 occupational groups had a gender difference in reported exposure for 10 or more of 27 physical exposures, with men reporting higher exposures in 79% of these jobs. Women reported higher exposures in nursing and other healthcare professions. The probability that a random man had an exposure value higher than a random woman varied widely, from 8% to 92%, and was highly dependent on occupational groups and the specific exposure.

CONCLUSIONS

Men and women working in the same jobs reported different physical exposures for some jobs and some exposures. Further research should further define and explore these reported differences to improve prevention and research.

Acute myocardial infarctions identified in the Manitoba Occupational Disease Surveillance System: A linkage of worker's compensation and provincial health data

INTRODUCTION

The purpose of this study was to identify jobs and industries that may be associated with increased or decreased risk of myocardial infarction.

METHODS

We linked provincial health care data with Workers Compensation Board (WCB) of Manitoba claims data to create the Manitoba Occupational Disease Surveillance System (MODSS). Workers were eligible for inclusion in this study if their WCB claim listed an occupation, their claim could be linked to health data, they had an accepted non-acute myocardial infarction (AMI) compensation time loss claim and were free of a recent (<1 year) AMI diagnosis at the start of disease follow-up. AMI cases were identified as the most-responsible diagnosis in the hospitalization file (ICD-9 410 or ICD-10 I20). Cases were included if they occurred after the WCB record injury date until end of coverage, either through moving out of province, reaching age 65, death, or the end of the study period (March 1, 2020).

RESULTS

We identified 1880 incident AMIs amongst 150,022 claims recorded in the MODSS (1.25%). A number of industries and occupations were found to have higher and lower AMI rates. Care providers and educational, legal, and public protection support occupations had a lower hazard ratio (HR; 0.64; 95% confidence interval [CI]: 0.44-0.92) compared to the overall cohort. Female chefs and cooks, and male butchers and bakers had elevated AMI HRs. Both male and female transport and heavy equipment operators and related maintenance occupations had increased HRs (1.48; 95% CI: 1.30-1.67). Often male and female workers employed in the same occupations had congruent AMI risks, but this was not always the case.

CONCLUSIONS

The linkage of a WCB data set with provincial health claims data led to the identification of a number of occupations with elevated risks of AMI in Manitoba. This was most notable in the transportation industry. Identifying work areas with increased risk of AMIs could lead to targeted educational efforts and potential workplace modifications to lower this risk.

Association between Occupational Noise Exposure and Insomnia among Night-Shift Production Workers: A 4-Year Follow-up Study

Objectives

This study aimed to investigate whether occupational noise exposure is a risk factor for insomnia among male night-shift production workers.

Methods

This study followed 623 male night-shift production workers at a tire manufacturing factory without insomnia for 4 years. Insomnia was evaluated based on the insomnia severity index at baseline and at 4-year follow-up. A score of ≥15 was defined as insomnia. The higher occupational noise exposure group was defined as those individuals exposed to 8-hour time-weighted-average noise above 80 dB (A).

Results

Participants' mean age was 46.3 ± 5.6 years. Of the 623 participants, 362 (58.1%) were in the higher occupational noise exposure group. At 4-year follow-up, insomnia occurred in 3.2% (n = 20) of the participants. In a multiple logistic regression analysis, the odds ratio of insomnia was 3.36 (95% confidence interval 1.083-10.405, P = 0.036) in the higher occupational noise exposure group when compared with the lower noise exposure group after adjusting for confounders.

Conclusion

Our findings suggested that occupational noise exposure affected insomnia in male night-shift production workers. To prevent insomnia, efforts are required to reduce workplace noise exposure levels. Alternatively, moving to a less noisy work environment should be considered for workers with severe insomnia.

Occupational inhalable agents constitute major risk factors for rheumatoid arthritis, particularly in the context of genetic predisposition and smoking

OBJECTIVES

To assess the effects of occupational inhalable exposures on rheumatoid arthritis (RA) development and their interactions with smoking and RA-risk genes, stratifying by presence of anticitrullinated protein antibodies (ACPA).

METHODS

Data came from the Swedish Epidemiological Investigation of RA, consisting of 4033 incident RA cases and 6485 matched controls. Occupational histories were retrieved, combining with a Swedish national job-exposure matrix, to estimate exposure to 32 inhalable agents. Genetic data were used to define Genetic Risk Score (GRS) or carrying any copy of human leucocyte antigen class II shared epitope (HLA-SE) alleles. Associations were identified with unconditional logistical regression models. Attributable proportion due to interaction was estimated to evaluate presence of interaction.

RESULTS

Exposure to any occupational inhalable agents was associated with increased risk for ACPA-positive RA (OR 1.25, 95% CI 1.12 to 1.38). The risk increased as number of exposed agents increased (P_trend<0.001) or duration of exposure elongated (P_trend<0.001). When jointly considering exposure to any occupational inhalable agents, smoking and high GRS, a markedly elevated risk for ACPA-positive RA was observed among the triple-exposed group compared with those not exposed to any (OR 18.22, 95% CI 11.77 to 28.19). Significant interactions were found between occupational inhalable agents and smoking/genetic factors (high GRS or HLA-SE) in ACPA-positive RA.

CONCLUSIONS

Occupational inhalable agents could act as important environmental triggers in RA development and interact with smoking and RA-risk genes leading to excessive risk for ACPA-positive RA. Future studies are warranted to assess preventive strategies aimed at reducing occupational hazards and smoking, especially among those who are genetically vulnerable.

Association between antinuclear antibody positivity and chemical exposure among pregnant Japanese women: A cross-sectional study based on the Japan environment and Children's study

Antinuclear antibodies (ANAs) are detected in healthy individuals, they are more prevalent in women than in men. Pregnant women are immunologically unique, but epidemiological data on ANA positivity in them remain limited. The exposure received from the mother during the fetal period impacts the future health of the fetus and has thus received increased attention in recent years. Thus, we investigated the association between ANA positivity and chemical exposure among pregnant Japanese women, registered in the Japan Environment and Children's Study (JECS). ANA titers were assessed by indirect immunofluorescence with HEp-2 cells at a cutoff dilution of 1:40. Sociodemographic and other data were obtained in the JECS from a self-administered questionnaire. We analyzed 1,235 Japanese women in their first trimester of pregnancy. The ANA prevalence was 17.2%. Among ANA-positive women, a speckled pattern was the most common (95.3%), followed by a homogeneous pattern (72.3%). Exposure to chemicals more than once a week significantly increased the probability of ANA positivity (kerosene, petroleum, benzene, or gasoline: adjusted odds ratio [AOR], 2.11; 95% confidence interval [95% CI], 1.03-4.34; chlorine bleach or germicide: AOR, 1.97; 95% CI, 1.10-3.54; organic solvents: AOR, 5.34; 95% CI, 1.40-20.36; and photocopying machines or laser printers: AOR, 1.73; 95% CI, 1.17-2.54). ANA positivity was associated with exposure to several chemicals in Japanese women. Our exploratory results suggested that ANAs as potential markers of chemical exposure warrant further research.

Performance-Based Pay System and Job Stress Related to Depression/Anxiety in Korea: Analysis of Korea Working Condition Survey

The adoption rate of performance-based pay systems has increased in recent years, and the adverse effects of systems have been emphasized. However, no study has analyzed the increase in the risk of depression/anxiety symptoms caused by the pay system in Korea. This study aimed to reveal the association between performance-based pay systems and symptoms of depression/anxiety, using data from the fifth Korean Working Conditions Survey. Depressive/anxiety symptoms were assessed using "yes" or "no" questions regarding medical problems related to depression/anxiety. The performance-based pay system and job stress were estimated using self-response answers. Logistic regression analyses were conducted to determine the association between performance-based pay systems, job stress, and symptoms of depression/anxiety using data from 27,793 participants. The performance-based pay system significantly increased the risk of the symptoms. Additionally, risk increments were calculated after grouping by pay system and job stress. Workers with two risk factors had the highest risk of symptoms of depression/anxiety for both sexes (male: OR 3.05; 95% CI 1.70-5.45; female: OR 2.15; 95% CI 1.32-3.50), implying synergistic effect of performance-based pay system and job stress on depression/anxiety symptoms. Based on these findings, policies should be established for early detection and protection against the risk of depression/anxiety.

The effect of weather and temporal factors on emergency hand trauma consultations

INTRODUCTION

Fluctuations in the numbers of patient consultations in hand trauma emergency units are challenging in terms of both scheduling and the provision of sufficient resources. Trauma consultations in general are affected by both temporal and meteorological variables. As the genesis and epidemiology of hand trauma have their own characteristics, this study aimed to identify the influence of temporal and meteorological factors on hand trauma consultations.

MATERIALS AND METHODS

All patients treated for hand trauma in our level one trauma center in 2019 were included in the study population and the data were analyzed in retrospect. The daily weather data, including temperature, sunshine duration, precipitation, humidity and wind speed, as well as temporal factors such as time of day, weekday and public holidays were considered and correlated with patient consultations. Gender differences were studied as well.

RESULTS

We included 4787 hand trauma patients (66.4% male, mean age 38.4 ± 19.3 years, 31.7% occupational injuries). Significantly more consultations occurred on Saturdays as compared to weekdays (14.8 ± 0.6, n = 52 vs. 13.0 ± 0.2, n = 261; p = 0.028), and fewer occurred on official holidays (11.8 ± 0.5, n = 63 vs. 13.4 ± 0.2, n = 302; p = 0.0047). We found a significant positive correlation between daily consultations, sunshine duration (r = 0.14, p = 0.0056) and the mean temperature (r = 0.20, p < 0.0001); in contrast, a significant negative correlation between daily consultations and humidity (r = - 0.17, p = 0.001) was observed. Furthermore, fewer consultations were seen on days with precipitation (12.7 ± 0.3, n = 219 vs. 13.8 ± 0.3, n = 146; p = 0.009). The variation was considerably stronger in men.

CONCLUSIONS

Hand trauma consultations increased with increasing temperatures, duration of sunshine, and decreasing humidity. Peak admissions were seen on Fridays and Saturdays. These findings can assist in predicting days with peak admissions to allocate resources appropriately.

Risk of adverse pregnancy outcomes by maternal occupational status: A national population-based study in South Korea

OBJECTIVE

This study examined the association between maternal occupational status and adverse pregnancy outcomes in the general South Korean population.

METHODS

We analyzed 1 825 845 employed and non-employed women with a diagnostic code for pregnancy in the National Health Insurance Service (NHIS) database (2010-2019) of South Korea. Based on their employment status and type of occupation, we calculated risk ratios for three adverse outcomes: early abortive outcomes (miscarriage, ectopic pregnancy, and molar pregnancy), stillbirth, and no live birth (diagnosis of pregnancy with no record of live birth thereafter, which include early abortive outcomes and stillbirth) with adjusting for covariates.

RESULTS

Overall, 18.0%, 0.7%, and 39.8% ended in early abortive outcomes, stillbirths, and no live births, respectively. The risk of early abortive outcomes and stillbirths was higher in non-employed women than in employed women, while no live births were more frequent in employed women. Those in the health and social work industry showed the highest risk of no live births. Manufacturing jobs (1.030, 95% CI: 1.013, 1.047) and health/social work (1.029, 95% CI: 1.012, 1.046) were associated with an increased risk of early abortive outcomes compared with financial and insurance jobs. Consistently higher risks of no live births were observed in the manufacturing, wholesale/retail trade, education, health/social work, and public/social/personal service occupation.

CONCLUSION

Employment during pregnancy and several occupation types were associated with a higher risk of pregnancy loss. Additional research using detailed job activity data is needed to determine specific occupational causes of adverse pregnancy outcomes.

How Can Quantitative Analysis Be Used to Improve Occupational Health without Reinforcing Social Inequalities? An Examination of Statistical Methods

Taking account of sex and gender in occupational health studies poses statistical challenges. Other sociodemographic variables, such as racialization, class, and age, also affect the relations between workplace exposures and health and interact with sex and gender. Our objective was to perform a critical review of conventional and emerging statistical tools, examining whether each analysis takes account of sociodemographic variables (1) in a way that contributes to identification of critical occupational determinants of health (2) while taking account of relevant population characteristics to reflect intersectional approaches to health and (3) using sample sizes and population characteristics available to researchers. A two-step search was conducted: (1) a scientific watch concerning the statistical tools most commonly used in occupational health over the past 20 years; (2) a screening of the 1980-2022 literature with a focus on emerging tools. Our examination shows that regressions with adjustment for confounders and stratification fail to reveal the sociodemographic mechanisms that interact with occupational health problems, endangering the identification of occupational risks. Multilevel (notably MAIHDA) analyses, decision tree, cluster, and latent analyses are useful methods to consider when seeking to orientate prevention. Researchers should consider methods that adequately reveal the mechanisms connecting sociodemographic variables and occupational health outcomes.

Co-exposures to physical and psychosocial work factors increase the occurrence of workplace injuries among French care workers

Objective

The aim of this study was to analyze the effect of co-exposures to physical and psychosocial factors (PSF) regarding the incidence of workplace injuries (WI) among care workers. Additional objective was to identify the work factors associated with the co-exposure combinations leading to the highest rates of WI.

Methods

The study sample consisted of 4,418 care workers participating to the French Working Conditions Survey both in 2013 and 2016. WI were assessed during the 4-year follow-up by matching the databases of the National Health Insurance Funds' compensation system. We assessed exposure for physical factors and PSF using factorial analyses and hierarchical clustering. We implemented a Poisson regression model with the WI incidence as the outcome and the clusters as independent variables of interest. Logistic regression model allowed identifying the work factors that predicted co-exposure combinations with a WI rate > 40%.

Results

WI were highly related to both physical and psychosocial exposures. With low exposure to one or the other, there was no increased risk of WI. Physical factors and PSF potentiated each other and their co-exposure significantly increased the risk of WI, with model predicted rates per 1,000 persons-year for those most exposed to physical risk of 14.6 [4.5-24.8] with low PSF and 38.0 [29.8-46.3] with high PSF. Work factors that predicted co-exposure combinations with a rate > 40 WI% were: working as nursing assistant or hospital services officer, lack of predictability and flexibility of schedules, overtime, controlled schedules, work-family imbalance and insufficient preventive measures.

Conclusions

Our findings highlight the need to take into account psychosocial factors in addition of only considering physical factors when analyzing WI occurrence, as usually done. Prevention actions must be taken to reduce both physical and psychosocial exposure. These results provide keys points for the prevention of WI among care workers.

Occupational exposure to respirable crystalline silica and acute myocardial infarction among men and women in Sweden

OBJECTIVES

Occupational exposure to respirable crystalline silica (RCS) is common. The study aimed to assess the risk for acute myocardial infarction (AMI) after long-term exposure to RCS and to explore differences in risk between men and women.

METHODS

The cohort included all manual workers identified from the Swedish National Census in 1980 using data on job titles and demography altogether from five censuses from 1960 to 1990, in total 605 246 men and 480 607 women. Information on AMI was obtained from nationwide registers from 1992 to 2006. Exposure to RCS was assessed with a job-exposure matrix. HRs and 95% CIs were estimated by Cox regression, adjusted for age, socioeconomic status and urbanisation index.

RESULTS

Among manual workers ever exposed to RCS, the adjusted risk of AMI was HR 1.29 (95% CI 1.15 to 1.46) in women, and HR 1.02 (95% CI 1.00 to 1.04) in men. In the highest quartile of cumulative exposure, the risk of AMI was HR 1.66 (95% CI 1.27 to 2.18) for women, and HR 1.06 (95% CI 1.03 to 1.10) for men, respectively. The risk of AMI increased with cumulative exposure to RCS both in women (p=0.001) and in men (p=0.016). An interaction analysis showed that the relative risk from exposure to RCS was statistically significantly lower in men than in women at similar exposure levels.

CONCLUSIONS

Occupational exposure to RCS was related to the risk of AMI. Women were more sensitive to exposure to RCS than men.

Association of psychological symptoms with job burnout and occupational stress among coal miners in Xinjiang, China: A cross-sectional study

Objective

The study aimed to investigate the influencing factors of psychological symptoms in relation to job burnout and occupational stress among coal miners in Xinjiang, so as to provide data support for enterprises in an effort to help them identify internal psychological risk factors and improve the mental health of coal miners.

Methods

A cross-sectional study was carried out. A total of 12 coal mines were selected using the stratified cluster random sampling method and 4,109 coal miners were investigated by means of online electronic questionnaires. The Symptoms Check List-90 (SCL-90), Chinese Maslach Burnout Inventory (CMBI), and Job Demand-Control (JDC) model were respectively used to measure the status of psychological symptoms, job burnout, and occupational stress among coal miners. The mediation analysis was performed through structural equation modeling (SEM) by using Analysis of Moment Structure (AMOS).

Results

The prevalence of psychological symptoms was higher in the occupational stress group than in the non-occupational stress group, and increased with job burnout (P < 0.05). The multivariate logistic regression analysis results showed that mild (OR = 1.401, 95% CL: 1.165, 1.685), moderate (OR = 2.190, 95% CL: 1.795, 2.672), or severe levels of burnout (OR = 6.102, 95% CL: 3.481, 10.694) and occupational stress (OR = 1.462, 95% CL: 1.272, 1.679) were risk factors for psychological symptoms in coal miners. The results of structural equation modeling indicated that occupational stress (β = 0.11, P = 0.002) and job burnout (β = 0.46, P = 0.002) had significant positive direct effects on psychological symptoms, and job burnout was an intermediate variable between occupational stress and psychological symptoms.

Conclusion

High levels of job burnout and occupational stress were risk factors for psychological symptoms. Both occupational stress and job burnout had direct effects on psychological symptoms, and occupational stress could also have an indirect effect on coal miners' psychological symptoms through the intermediate variable of job burnout.

Workplace Violence Against Female Health Managers in the Male-Dominated Construction Industry

OBJECTIVES

The purpose of this study is to investigate health managers' exposure to workplace violence (WPV) at construction sites and to review the statistical characteristics of experts in the safety and health fields using a gender-based analysis.

METHODS

A preliminary survey of health managers at construction sites was conducted from March to April 2020 via the Health Managers Council in Construction Industry online community (https://band.us/band/62438722). Available national statistical data of safety and health personnel were reviewed.

RESULTS

A total of 85 health managers (13 men, 72 women) responded to a preliminary survey. Health managers reported little physical violence (5.9%), while inappropriate work orders (83.5%) and sexual harassment (52.9%) were high, and health managers' experience of sexual harassment was significantly higher among women than men (P < 0.01). The professional safety and health field in Korea have a large gender gap, with few women. In particular, the proportion of women in the safety field was lower than in the health field.

CONCLUSIONS

Young female health managers in the male-dominated construction industry are more vulnerable to WPV, including sexual harassment. To reduce the risk of WPV exposure and gender discrimination among female health managers, it is necessary to increase regular employment and provide more practical WPV prevention education for all construction employees.