Development of a quantitative North and Central European job exposure matrix for wood dust

Wood dust and risk of leukemia: Systematic review and meta-analysis

OBJECTIVES

This study aimed to perform a systematic review and meta-analysis to investigate the relationship between wood dust exposure and leukemia. The objectives included synthesizing available evidence, assessing its quality, identifying potential sources of heterogeneity, and drawing conclusions regarding the association between wood dust and leukemia.

METHODS

A systematic literature search was conducted to identify studies meeting that report on the association between wood dust and leukemia. The Joanna Briggs Institute Critical Appraisal tools were employed to ensure robust quality assessment. Meta-analysis, using random-effects models, synthesized evidence from studies with low risk of bias. Overall odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Subgroup analyses explored potential sources of heterogeneity.

RESULTS

The meta-analysis included a comprehensive review of various study types, encompassing 7 studies that examined the association between wood dust exposure and leukemia risk. The analysis revealed a statistically significant positive association, with an overall odds ratio (OR) of 1.56 (95% CI: 1.15-2.12). This indicates that individuals exposed to wood dust are 1.56 times more likely to develop leukemia compared to those not exposed, with the 95% confidence interval ranging from 1.15 to 2.12, highlighting a substantial risk elevation across different study designs. Quality assessment using The Joanna Briggs Institute Critical Appraisal tools demonstrated a low risk of bias across all included studies, enhancing the credibility of the observed association. Subgroup analyses were conducted to explore potential sources of heterogeneity within the studies. Notably, subgroup analysis based on the year of the study revealed significant differences, as indicated by an I^2 value of 87%. The robustness of these results underscores the importance of addressing wood dust exposure as an occupational hazard, particularly in industries related to woodworking and forestry.

CONCLUSION

This meta-analysis provides robust evidence supporting an increased risk of leukemia associated with wood dust exposure implying proactive measures in people exposed to dust.

Risk of hypersensitivity pneumonitis and other interstitial lung diseases following organic dust exposure

BACKGROUND

Organic dust is associated with hypersensitivity pneumonitis, and associations with other types of interstitial lung disease (ILD) have been suggested. We examined the association between occupational organic dust exposure and hypersensitivity pneumonitis and other ILDs in a cohort study.

METHODS

The study population included all residents of Denmark born in 1956 or later with at least 1 year of gainful employment since 1976. Incident cases of hypersensitivity pneumonitis and other ILDs were identified in the Danish National Patient Register 1994-2015. Job exposure matrices were used to assign individual annual levels of exposure to organic dust, endotoxin and wood dust from 1976 to 2015. We analysed exposure-response relations by different exposure metrics using a discrete-time hazard model.

RESULTS

For organic dust, we observed increasing risk with increasing cumulative exposure with incidence rate ratios (IRR) per 10 unit-years of 1.19 (95% CI 1.12 to 1.27) for hypersensitivity pneumonitis and 1.04 (95% CI 1.02 to 1.06) for other ILDs. We found increasing risk with increasing cumulative endotoxin exposure for hypersensitivity pneumonitis and other ILDs with IRRs per 5000 endotoxin units/m3-years of 1.55 (95% CI 1.38 to 1.73) and 1.09 (95% CI 1.00 to 1.19), respectively. For both exposures, risk also increased with increasing duration of exposure and recent exposure. No increased risks were observed for wood dust exposure.

CONCLUSION

Exposure-response relations were observed between organic dust and endotoxin exposure and hypersensitivity pneumonitis and other ILDs, with lower risk estimates for the latter. The findings indicate that organic dust should be considered a possible cause of any ILD.

TRIAL REGISTRATION NUMBER

j.no.: 1-16-02-196-17.

Health and Safety Executive research on wood dust exposure controls in British manufacturing

To generate new intelligence on occupational exposure to wood dust in woodworking manufacturing activities in Britain, the Health and Safety Executive (HSE) performed 22 occupational hygiene site visits to assess exposure and exposure controls between 2014 and 2017. The work aimed to characterise good practice and therefore sites with a poor health and safety record, as identified from HSE inspection records, were not invited to participate. Sites selected covered furniture production, joinery, saw milling, and boat building and repair. Twenty-three follow-up telephone interviews were also carried out across 15 of the companies with supervisors and managers to explore how they tried to promote good practice among the workforce, and if there are any potential challenges encountered. The aim of the interviews was to gain a better understanding of how to enable organisations to improve the management of wood dust exposure. This study found that 6.0% of all wood dust exposure measurements (15 out of 252) were above 5 mg/m³, and 17.6% of exposures to hardwood dust or mixtures of hardwood and softwood dust (38 out of 216) were above 3 mg/m³ (the then current and future workplace exposure limits). Sanding, cleaning, and maintenance activities were of particular concern. Improvements to exposure controls are required, in particular, improvements to local exhaust ventilation controls for hand-held power tools and hand sanding. The management, selection, and use of respiratory protective equipment were poor. All the managers and supervisors recognised that exposure to wood dust can pose serious health risks, and that controls were crucial to protecting workers' health. The findings from the telephone interviews suggest that supervision and provision of information about the health effects of exposure to wood dust were common approaches that organisations used to raise awareness and promote good practice, in relation to managing wood dust exposure. Worker attitudes towards controls, such as perceptions that they hinder task completion and habitual ways of working, were identified as factors influencing the use of controls. Risk communication approaches that focus on increasing workers' awareness of their susceptibility to ill-health using credible sources, such as peers, can help enhance the uptake of messages on the use of controls. Financial constraints were identified as a challenge to improving the control of wood dust, particularly for small companies.