Relationship between job, lifestyle, age and occupational injuries

Occupation-based demographic, clinical, and psychological presentation of spine pain: A retrospective analysis of 71,727 patients from urban India

BACKGROUND

Although many studies have investigated the physical and ergonomic risks of spine pain in specific occupation groups, the literature is lacking on occupation-based clinical and psychological presentation in patients with spine pain.

OBJECTIVE

To analyze occupation-based variation in demographic, clinical, and psychological presentation in patients with spine pain.

METHODS

This retrospective study analyzed the clinical data of 71727 patients with spine pain visiting a chain of spine rehabilitation clinics. Demographic and clinical variables such as gender, age, affected site, symptom duration, clinical symptoms and presentation, pain intensity, disability, and STarT Back Screening Tool (SBT) risk were compared between 9 occupational groups.

RESULTS

The service and sales workers (44%) and students (43.5%) groups had the highest percentage of patients who presented with central spine pain; military personnel had the highest percentage of patients who presented with unilateral radicular pain (51.5%); and the retired or unemployed group had the highest percentage of patients who presented with severe myotomal loss (grade≤3) (6%). Homemakers had significantly higher pain intensity and disability (p < 0.001) and had the highest percentage of patients who presented with severe pain (47%), severe and crippled disability (59.5%), and medium to high risk (59%) with SBT when compared to other occupational groups.

CONCLUSION

Patients with spine pain showed variation in demographic, clinical, and psychological presentation based on their occupation. The findings of this study can be the basis for identifying risk factors for spine pain and helping plan preventive and treatment measures based on their occupation.

Structural equation modelling of work related musculoskeletal disorders among dumper operators

The aim of this study is to investigate the impact of personal factors, habitual factors, and work-related factors on work-related musculoskeletal disorders (WRMSDs) among dumper operators. In total, 248 dumper operators working in an iron ore mine were considered for this study. A questionnaire was developed and administered to collect dumper operators' personal, habitual, and work-related data. The reliability of the questionnaire was cross-checked by Cronbach alpha and the test-retest method. The values of Cronbach alpha for all latent variables were above 0.7, and the correlation coefficient of the questionnaire items at Time 1 and Time 2 was above 0.82. After verifying the validity (i.e., convergent and divergent) of the questionnaire data, the relationship between the factors under consideration was examined by structural equation modeling (SEM). The SEM demonstrated a moderate fit, with [Formula: see text] value of 1.386, comparative fit index (CFI) of 0.86, goodness-of-fit index (GFI) of 0.72, adjusted goodness-of-fit index (AGFI) of 0.69, Tucker-Lewis Index (TLI) of 0.83, normed fit index (NFI) of 0.71 and root mean square error of approximation (RMSEA) of 0.051. The SEM analysis revealed a positive relationship between WRMSDs and personal factors (with path coefficient = 0.313 and p < 0.05) as well as work-related factors (with path coefficient = 0.296 and p < 0.05). However, the relationship between WRMSDs and habitual factors was not statistically significant (with path coefficient = 0.142 and p > 0.05). Overall, this study provides valuable insights into the factors that influence the prevalence of WRMSDs among dumper operators. The findings highlight the significance of personal and work-related factors by which one can make a positive decision to prevent and reduce the incidence of WRMSDs among dumper operators.

Household conditions, COVID-19, and equity: Insight from two nationally representative surveys

Background

With people across the United States spending increased time at home since the emergence of COVID-19, housing characteristics may have an even greater impact on health. Therefore, we assessed associations between household conditions and COVID-19 experiences.

Methods

We used data from two nationally representative surveys: the Tufts Equity Study (TES; n = 1449 in 2021; n = 1831 in 2022) and the Household Pulse Survey (HPS; n = 147,380 in 2021; n = 62,826 in 2022). In the TES, housing conditions were characterized by heating/cooling methods; smoking inside the home; visible water damage/mold; age of housing unit; and self-reported concern about various environmental factors. In TES and HPS, household size was assessed. Accounting for sampling weights, we examined associations between each housing exposure and COVID-19 outcomes (diagnosis, vaccination) using separate logistic regression models with covariates selected based on an evidence-based directed acyclic graph.

Results

Having had COVID-19 was more likely among people who reported poor physical housing condition (odds ratio [OR] = 2.32; 95% confidence interval [CI] = 1.17-4.59; 2021), visible water damage or mold/musty smells (OR = 1.50; 95% CI = 1.10-2.03; 2022), and larger household size (5+ versus 1-2 people; OR = 1.53, 95% CI = 1.34-1.75, HPS 2022). COVID-19 vaccination was less likely among participants who reported smoke exposure inside the home (OR = 0.53; 95% CI = 0.31-0.90; 2022), poor water quality (OR = 0.42; 95% CI = 0.21-0.85; 2021), noise from industrial activity/construction (OR = 0.44; 95% CI = 0.19-0.99; 2022), and larger household size (OR = 0.57; 95% CI = 0.46-0.71; HPS 2022). Vaccination was also positively associated with poor indoor air quality (OR = 1.96; 95% CI = 1.02-3.72; 2022) and poor physical housing condition (OR = 2.27; 95% CI = 1.01-5.13; 2022). Certain heating/cooling sources were associated with COVID-19 outcomes.

Conclusions

Our study found poor housing conditions associated with increased COVID-19 burden, which may be driven by systemic disparities in housing, healthcare, and financial access to resources during the COVID-19 pandemic.

Relationship of Healthy Building Determinants With Musculoskeletal Disorders of the Extremities: A Systematic Review

Musculoskeletal disorders (MSDs) are a substantial societal burden and various factors affect their causation, recovery, and prognosis. Management of MSDs is complex and requires multifaceted interventions. Given the challenges of MSDs and their continued burden, it is possible that additional elements could impact these disorders that have not been fully researched, for example, indoor environmental quality. Our previous review provided preliminary evidence that healthy building determinants (HBDs) are associated with the risk of back and neck pain. However, the relationship of HBDs with extremity MSDs and general MSDs (i.e., MSDs involving multiple body regions or in which body regions were unspecified in the original reports) has not been formally studied. The purpose of this review was to conduct a systematic literature review to assess the relationship of HBDs with extremity and general MSDs (PROSPERO ID: CRD42022314832). PubMed, CINAHL, Embase, and PEDRo databases were searched through April 2022. Inclusion criteria for study eligibility were as follows: humans of ages ≥18 years, reported on one or more of eight HBDs (1. air quality and ventilation, 2. dust and pests, 3. lighting and views, 4. moisture, 5. noise, 6. safety and security, 7. thermal health, 8. water quality), and compared these HBDs with extremity MSDs or general MSDs, original research, English. Exclusion criteria were as follows: articles not published in peer-reviewed journals, full-text articles unavailable. Review procedures were conducted and reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. Empirical evidence statements were developed for 33 pairwise comparisons of HBDs with MSDs. The search uncovered 53 eligible studies with 178,532 participants. A total of 74.6% (39/53) of the studies were cross-sectional and 81.1% (43/53) were fair quality. Overall, the majority of uncovered evidence indicates that HBDs are related to risk of extremity and general MSDs. Nineteen comparisons support that as HBDs worsen, the risk of MSDs increases. Six comparisons had conflicting evidence. Three comparisons support that poor HBDs are not related to increased risk of extremity and general MSDs. Five comparisons had no evidence. This systematic review builds upon previous work to provide useful starting points to enhance awareness about the HBD-MSD relationship. These findings can help inform research and public health efforts aimed at addressing suboptimal HBDs through appropriate interventions to improve the lives of those suffering from MSDs.

A Comprehensive Study on Epidemiology Case Studies Using Computational Analysis

Health-related issues and occurrences with regard to a particular population are the subject of an epidemiology study. This paper presents the results of a retrospective epidemiological investigation on 15922 hospitalized hand trauma patients from Central China between 2011 and 2020. Gender, age, onset season, injury mechanism, injury environment, injury location, and clinical characteristics are among the characteristics of the data gathered. The study is using computational analysis to draw inferences from the case studies collected in the databases of the hospitals. The types and characteristics of occupational injuries at home and outdoor are compared and analyzed. The purpose of the study is to present the findings from recent case studies for future reference and to recommend useful roles for the industrial sector in the care of patients with hand trauma in order to lower occupational harm. The injuries of preschool children are also analyzed. The incidence rate of hand injuries in infants has been increasing year by year which is directly related to the inefficient growth of children in rural areas. The data are collected from hospitals, then the data analytical tools are applied to draw conclusions. The suggested model is intelligently learned through the application of computational techniques, which are also used to suggest treatments to trauma victims. According to this study, males are more likely than females to sustain hand trauma; occupational injuries are more common than living injuries; males between the ages of 20 and 50 are at an increased risk of suffering an occupational injury. This study showed that the proportion of hand trauma in preschool children was higher (12.27%), and the 2-3-year-old group was the main injury target of preschool children (45.70%). The accidental injuries of newborns and young children can be reduced by government assistance, social support, and tighter monitoring.

An Examination of Washington State Workers’ Compensation Claims for Home-Based Health Care Workers, 2006 to 2016: Part 1. Description of Claims and Claimants

Home-based health care can be physically and emotionally demanding, resulting in injury or illness. Washington State’s workers’ compensation compensable claims between 2006 and 2016 were analyzed to describe the characteristics of injured home-based health care (HBHC) providers and the burden created by these injuries. Comparisons were made with clinical health care (CHC) providers, as well as between all compensable claims and work-related musculoskeletal disorder (WMSD) claims. Over 90% of claimants for both HBHC and CHC were female. The mean age of all compensable HBHC claimants (45.7 years) was significantly older than for CHC, with the majority (54.5%) between the ages of 40 and 59. However, HBHC claimants with WMSDs were younger, overall. Across health care type and claim type, the majority of injured care providers were overweight or obese (BMI ≥ 25). The highest mean age occurred among claimants injured from falls, either on the same level or to a lower level (HBHC: 48.3-48.6 years, CHC: 46.1-48.1 years). This same group also had the highest BMIs. WMSDs accounted for 47.3% of HBHC compensable claims and 50.3% for CHC. Falls on the same level were the second most common injury event among HBHC claims. For both HBHC and CHC, back injuries were the most common body part for both claim types (all compensable claims: 28.8% HBHC and 23.9% CHC, WMSD claims: 60.8% HBHC and 47.5% CHC). Overexertion was the injury event most attributed to WMSDs (HBHC: 82.6%, CHC: 71.6), overexertion during lifting being the most prevalent overexertion type (HBHC: 27.8%, CHC: 19.6%).

Association of perceived work pace and physical work demands with occupational accidents: a cross-sectional study of ageing male construction workers in Denmark

BACKGROUND

Occupational accidents continue to be a significant public health challenge worldwide. Construction workers in particular are at high risk of occupational accidents, and thus it is of major importance to identify possible predictors of occupational accidents among construction workers. We aimed to investigate the association between self-reported work pace and physical work demands and occupational accidents among ageing male construction workers in Denmark.

METHODS

Data on perceived work pace, physical work demands, and occupational accidents was acquired from questionnaires sent to ageing construction workers in Denmark in 2016 as part of the ALFA project (ALdring og Fysisk Arbejde; Ageing and Physical Work). A sample of 1270 Danish male construction workers above 50 years of age was included in the present study. Multiple logistic regression models were applied, with adjustments for age, smoking, body mass index, musculoskeletal disorders, occupation, work experience, and support at work.

RESULTS

Of 1270 construction workers, 166 (13.1%) reported an occupational accident within the last 12 months. There was no significant association between perceived work pace and occupational accidents, but physical work demands were associated with higher odds for occupational accidents, with an odds ratio of 2.27 (95% confidence interval 1.26-4.10) for medium physical work demands and 2.62 (95% confidence interval 1.50-4.57) for high physical work demands.

CONCLUSIONS

Ageing male construction workers with high physical work demands had statistically significant higher odds of having an occupational accident. By contrast, perceived work pace was not associated with occupational accidents in this large cross-sectional study.

Fraction of acute work-related injuries attributable to hazardous occupational noise across the USA in 2019

INTRODUCTION

The contribution of hazardous noise-a ubiquitous exposure in workplaces-to occupational injury risk is often overlooked. In this ecological study, the fraction of US workplace acute injuries resulting in days away from work in 2019 attributable to hazardous occupational noise exposure was estimated.

METHODS

Using the NoiseJEM, a job exposure matrix of occupational noise, and 2019 Occupational Employment and Wage Statistics data, the proportion of workers experiencing hazardous occupational noise (≥85 dBA) was estimated for every major US Standard Occupational Classification (SOC) group. Population attributable fractions (PAFs) were calculated for each major SOC group using the relative risk (RR) taken from a published 2017 meta-analysis on this relationship.

RESULTS

About 20.3 million workers (13.8%) are exposed to hazardous levels of occupational noise. Nearly 3.4% of acute injuries resulting in days away from work in 2019 (95% CI 2.4% to 4.4%) were attributable to hazardous occupational noise, accounting for roughly 14 794 injuries (95% CI 10 367 to 18 994). The occupations with the highest and the lowest PAFs were production (11.9%) and office and administrative support (0.0%), respectively.

DISCUSSION

Hazardous noise exposure at work is an important and modifiable factor associated with a substantial acute occupational injury burden.

Obesity and Work-Related Injuries Among Farmers in Kentucky, Tennessee, and West Virginia

BACKGROUND

Obesity is a recognized risk factor for work-related injuries (WRI). Despite the inherent safety hazards associated with farm work, research on obesity among farmers is limited giving little guidance to occupational health providers on obesity as a risk factor in farm WRI. This study evaluated the association between obesity and farm WRI.

METHODS

Cross-sectional data were collected from farmers (n = 100) in Kentucky, Tennessee, and West Virginia. Data included a survey (demographic data, farm factors, health indicators, occurrences of work-related injuries consistent with the definition of Occupational Safety and Health Administration [OSHA] recordable injuries) and direct anthropometric measures (height, weight, and waist circumference). Logistic regression was used to model any work-related injury, injuries consistent with the definition of OSHA recordables (herein called OSHA-recordable injuries), and recurrent injuries occurring during farm work performance on body mass index (BMI) and waist circumference.

FINDINGS

Twenty-five percent of the participants reported any injuries, and 18% reported OSHA-recordable injuries. Farmers with a BMI ≥30 kg/m² had 3 times the risk for OSHA-recordable injuries and 5 times the risk for recurrent injuries. No significant relationship was identified between waist circumference and farm WRI.

CONCLUSION

This study provides evidence that increased BMI is a safety risk for farmers. Prospective studies with a larger sample are needed. Occupational health nurses and providers should educate farmers on the potential safety risk of obesity and implement weight management programs addressing obesity in farmers.

Older Workers with Physically Demanding Jobs and their Cognitive Functioning

Although employment can provide older people with both financial and nonfinancial rewards, it is questionable whether those benefits extend to all older workers, particularly those with physically demanding jobs. This study aimed to examine whether the perceived level of physical demands placed on older workers 55 or older is significantly associated with their cognitive function. Using the Health and Retirement Study (HRS) 2010 wave, we analyzed two domains of cognition: verbal episodic memory and reasoning. After controlling for demographics and risk factors for age-related cognitive deterioration, the perceived level of physical demands placed on older workers was still significantly and negatively linked with both memory and reasoning domains of cognition. Older workers with more physically demanding jobs tended to have poorer cognitive function. Further longitudinal studies are needed to confirm this relationship.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12126-020-09404-8.

Pedagogic position of resident physicians as a factor contributing to forming a healthy-oriented lifestyle in patients

The paper describes the features and components of the academic course content and teaching techniques aimed at forming the pedagogic position (a set of pedagogical knowledges, skills, competences, values, and attitudes) of a doctor in young resident physicians. This position contributes to an effective health-oriented lifestyle dissemination and adoption, especially in patients with chronic diseases. It reflects a new perception of physician’s vocational duties, including care for patients’ life and their need for psychological support. Biopsychosocial approach to health and disease was chosen as a conceptual core of the academic course content and methodology design, specially elaborated to unite pedagogical aspects of the physician’s job with the clinical ones. The set of methods aimed at doctor’s pedagogical position formation and development of professional reflection, values and attitudes included lecturing, interviewing, case studies and clinical cases analysis, discussion, questionnaires, brainstorming, trainings and testing. Eighty-six resident physicians were observed within this study. Such components of the pedagogic position as knowledges, skills, attitudes and motivation showed more dynamics, whereas personal traits were seen as a more static and stable component of the pedagogic position in resident physicians. A remarkable divergence of progress was elicited between doctors of various specialties.

Random drug and alcohol testing for preventing injury in workers

BACKGROUND

Drug- and alcohol-related impairment in the workplace has been linked to an increased risk of injury for workers. Randomly testing populations of workers for these substances has become a practice in many jurisdictions, with the intention of reducing the risk of workplace incidents and accidents. Despite the proliferation of random drug and alcohol testing (RDAT), there is currently a lack of consensus about whether it is effective at preventing workplace injury, or improving other non-injury accident outcomes in the work place.

OBJECTIVES

To assess the effectiveness of workplace RDAT to prevent injuries and improve non-injury accident outcomes (unplanned events that result in damage or loss of property) in workers compared with no workplace RDAT.

SEARCH METHODS

We conducted a systematic literature search to identify eligible published and unpublished studies. The date of the last search was 1 November 2020. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, two other databases, Google Scholar, and three trials registers. We also screened the reference lists of relevant publications known to us.

SELECTION CRITERIA

Study designs that were eligible for inclusion in our review included randomised controlled trials (RCTs), cluster-randomised trials (CRTs), interrupted time-series (ITS) studies, and controlled before-after (CBA) studies. Studies needed to evaluate the effectiveness of RDAT in preventing workplace injury or improving other non-injury workplace outcomes. We also considered unpublished data from clinical trial registries. We included employees working in all safety-sensitive occupations, except for commercial drivers, who are the subject of another Cochrane Review.

DATA COLLECTION AND ANALYSIS

Independently, two review authors used a data collection form to extract relevant characteristics from the included study. They then analysed a line graph included in the study of the prevalence rate of alcohol violations per year. Independently, the review authors completed a GRADE assessment, as a means of rating the quality of the evidence.

MAIN RESULTS

Although our searching originally identified 4198 unique hits, only one study was eligible for inclusion in this review. This was an ITS study that measured the effect of random alcohol testing (RAT) on the test positivity rate of employees of major airlines in the USA from 1995 to 2002. The study included data from 511,745 random alcohol tests, and reported no information about testing for other substances. The rate of positive results was the only outcome of interest reported by the study. The average rate of positive results found by RAT increased from 0.07% to 0.11% when the minimum percentage of workers who underwent RAT annually was reduced from 25% to 10%. Our analyses found this change to be a statistically significant increase (estimated change in level, where the level reflects the average percentage points of positive tests = 0.040, 95% confidence interval 0.005 to 0.075; P = 0.031). Our GRADE assessment, for the observed effect of lower minimum testing percentages associating with a higher rate of positive test results, found the quality of the evidence to be 'very low' across the five GRADE domains. The one included study did not address the following outcomes of interest: fatal injuries; non-fatal injuries; non-injury accidents; absenteeism; and adverse effects associated with RDAT.

AUTHORS' CONCLUSIONS

In the aviation industry in the USA, the only setting for which the eligible study reported data, there was a statistically significant increase in the rate of positive RAT results following a reduction in the percentage of workers tested, which we deem to be clinically relevant. This result suggests an inverse relationship between the proportion of positive test results and the rate of testing, which is consistent with a deterrent effect for testing. No data were reported on adverse effects related to RDAT. We could not draw definitive conclusions regarding the effectiveness of RDAT for employees in safety-sensitive occupations (not including commercial driving), or with safety-sensitive job functions. We identified only one eligible study that reflected one industry in one country, was of non-randomised design, and tested only for alcohol, not for drugs or other substances. Our GRADE assessment resulted in a 'very low' rating for the quality of the evidence on the only outcome reported. The paucity of eligible research was a major limitation in our review, and additional studies evaluating the effect of RDAT on safety outcomes are needed.

Profile, risk factors and outcome of occupational injuries reported to the emergency department in a tertiary care hospital in South India

Background:

India is an industrialised country and most work is labour intensive. There is very scarce data on occupation related injuries

Aim:

To evaluate the prevalence, profile, severity and risk factors for occupational injuries presenting to the emergency medicine department of a tertiary care hospital.

Materials and Methods:

A cross-sectional study was done in the emergency department of Christian Medical College, Vellore among the patients who presented with occupational injuries. The risk factors for occupational injuries like age, gender, shift work, work experience and type of work and their severity and outcome were evaluated.

Results:

Older age group, working in shift duty, working longer hours were significant risk factors for occupational injuries.

Conclusion:

Training and use of safety protective measures will decrease occupational injuries.

The Italian National Surveillance System for Occupational Injuries: Conceptual Framework and Fatal Outcomes, 2002-2016

Background: A national database of work-related injuries has been established in Italy since 2002, collecting information on the injured person, his/her work tasks, the workplace and the risk factors contributing to incident dynamics, according to a model called Infor.Mo. Methods: A descriptive study of occupational fatal injuries, excluding work-related fatal traffic injuries, that occurred in Italy from 2002 to 2016 (15 years) was performed. Results: Among 4874 victims involved, all were males, mainly >51 years of age (43.2%), predominantly self-employed (27.8%) or workers with non-standard contracts (25%). About 18.4% and 17.3% of fatal events occurred in micro-enterprises belonging to, respectively, construction and agriculture. A wide range of nationalities (59 countries in addition to Italy) was identified. Overall, 18.9% of work-related fatal injuries were due to some form of hazardous energy—mechanical, thermal, electrical or chemical—that was normally present in the workplace. Workers’ falls from height (33.5%), heavy loads falling on workers from height (16.7%) and vehicles exiting their route and overturning (15.9%) were the events causing the greatest proportion of occupational fatal injuries in the present study (from 2002 to 2016) and in the initial pilot phase, focused on years 2002–2004, with a similar distribution of fatal events between the two time periods. The activity of the injured person made up 43.3% of 9386 risk factors identified in 4874 fatalities. Less common risk factors were related to work equipment (20.2%), work environment (14.9%), third–party activity (9.8%), personal protective equipment/clothing (8.0%) and materials (3.7%). The activity of the injured person remained the most relevant contributing factor even when the incident was caused by two or more risk factors. Discussion: Occupational fatal injuries occurred mainly in small size firms (up to nine employees) in hazardous workplaces. Small companies, which account for 68% (2888/4249) of all firms in the present study, generally have fewer resources to remain current with the continuously evolving health and safety at work regulations; moreover, these firms tend to be less compliant with health and safety at work regulations since they are less likely to be inspected by occupational vigilance services. Perspectives: An approach being introduced in Italy relies on the use of economic incentives to promote safe and healthy workplaces. The comparison of pre-intervention and post-intervention rates of work-related injuries by means of interrupted time series analyses could detect whether the intervention will have an effect significantly greater than the underlying secular trend.

Non-vehicle commuting in Italy: need for ergonomic action for women's lower limbs?

INTRODUCTION

The aim of this paper is to examine gender differences in the occurrence of accidents among workers while walking to or from their workplace (non-vehicle commuting accidents). We have previously found that the lower limb is more often injured at work among women, compared to men, so the paper concentrates on lower limb injuries.

METHODS

Using the records of the National Institute for Insurance against Injuries at Work (INAIL), we focused on the non-vehicle commuting accidents of women and men recognized as work-related for the period 2013-2017. In particular, we examined the gender difference by work sector and type of trauma suffered with particular attention to lower limb injuries.

RESULTS

The rate of non-vehicle commuting accidents (n. 60,936) among women was significantly higher than for men (1.29‰ vs 0.40‰ men, p < 0.001) for the period studied. Lower limb injuries (50.5% for women and 43.7% for men, p < 0.001) constituted the large majority of these injuries. In particular, dislocation of the ankle (78% for women vs 65.5% for men, p < 0.001), bruise of the knee (71.2% for women vs 54.9% for men, p < 0.001) and fracture of the foot (41% for women vs 33.6% for men, p < 0.001) were all significantly higher among women. The work sectors with higher injury rates were: Transport and Warehouse, Public Administration, Health and care services and Wholesale and retail trade. This result may be due to wear and tear from conditions at work. The women injured were on the average, a decade older than men (50-59 vs 40-49 years old).

CONCLUSIONS

Non-vehicle commuting represents an important, albeight neglected, preventable risk for women workers, causing lower limb trauma particularly at the ankle, the foot and the knee. These areas may be particularly injure-prone among women in specific sectors, due to the work environment. Effective prevention of these injuries requires gender-oriented ergonomic actions at work and in the commuting environment.

Fatores associados ao uso de medicamentos ansiolíticos entre bombeiros militares

RESUMO: Introdução: O uso de ansiolíticos é uma opção no tratamento de sintomas psíquicos. Contudo, ainda que o uso seja controlado há riscos de dependência, intoxicação e alterações cognitivas. O uso não controlado entre trabalhadores agrava tais problemas. Objetivos: Identificar a prevalência do uso de ansiolíticos e conhecer os fatores associados ao consumo em bombeiros militares. Método: Pesquisa transversal de base censitária investigou 711 bombeiros de Belo Horizonte, Minas Gerais, por meio de autorrelato. Regressão logística multinomial foi utilizada para verificar associação entre características sociodemográficas, condições de vida, trabalho e saúde e consumo de ansiolíticos de modo controlado ou não. Resultados: A prevalência do uso de ansiolíticos foi 9,9%. Para 7,5% dos bombeiros o consumo ocorreu sem indicação e/ou controle terapêutico especializado. O uso controlado foi associado ao relato compatível com Transtorno Mental Comum (OR = 23,6; IC95% 6,54 - 85,11). O uso não controlado foi associado ao tempo de serviço (OR = 2,57; IC95% 1,03 - 6,40), ao tabagismo (OR = 3,22; IC95% 1,50 - 6,91) e ao Transtorno Mental Comum (OR = 4,02; IC95% 2,17 - 7,45). Conclusão: A alta prevalência de consumo indica alerta para as ações dos programas de saúde ocupacional.

Relating Older Workers' Injuries to the Mismatch Between Physical Ability and Job Demands

OBJECTIVE

We examined the association between job demand and occupational injury among older workers.

METHODS

Participants were workers aged 50+ enrolled in the Health and Retirement Study, 2010 to 2014. Participants reported physical ability within three domains: physical effort, stooping/kneeling/crouching, and lifting. To measure subjective job demand, participants rated their job's demands within domains. We generated objective job demand measures through the Occupational Information Network (ONET). Using Poisson regression, we modeled the association between physical ability, job demand, and self-reported occupational injury. A second model explored interaction between job demand and physical ability.

RESULTS

The injury rate was 22/1000 worker-years. Higher job demand was associated with increased injury risk. Within high job demands, lower physical ability was associated with increased injury risk.

CONCLUSIONS

Older workers whose physical abilities do not meet job demands face increased injury risk.

Factor associated with self-reported work-related musculoskeletal disorders in Brazilian adults

OBJECTIVE

To describe the prevalence of work-related musculoskeletal disorder (WMSD) and analyze the factors associated with this outcome in the Brazilian population.

METHODS

In this cross-sectional, population-based study, we use data from the National Survey on Health (PNS) of 2013. The sample was composed of 60,202 Brazilians aged 18 years or older. The outcome variable was the occurrence of self-reported WMSD. Sociodemographic and occupational characteristics, personal resources, and health conditions were investigated as explanatory variables. Analyses were performed with the software Stata 12.0 and considered the weighting imposed by the sampling design of the study. Then, univariate and multivariate binary logistic models were carried out, considering a significance level of 5%.

RESULTS

The results obtained indicated that the prevalence of WMSD in the Brazilian population was of 2.5%, ranging from 0.2% (Acre) to 4.2% (Santa Catarina). The factors associated with a greater chance of occurrence of WMSD were: female sex (OR = 2.33; 95%CI 1.72–3.15); be temporarily away from work (OR = 2.44; 95%CI 1.41–4.23); be exposed to noise at the workplace (OR = 2.16; 95%CI 1.68–2.77); seniority equal to or greater than 4.5 years at the current job (OR = 1.37; 95%CI 1.09–1.72); participate in volunteer work (OR = 1.65; 95%CI 1.25–2.17); report medical diagnosis of arthritis or rheumatism (OR = 2.40; 95%CI 1.68–3.44); and depression (OR = 2.48; 95%CI 1.86–3.31). On the other hand, factors associated with less chance of WMSD were: not having a partner (OR = 0.73; 95%CI 0.37–0.71) and working in an open environment (OR = 0.51; 95%CI 0.37–0.71).

CONCLUSIONS

The associated factors and the prevalence found indicate regional and gender differences. Special attention to comorbidities and environmental noise monitoring would benefit the health of workers in the Country.

Occupational and non-occupational factors associated with work-related injuries among construction workers in the USA

BACKGROUND

Many factors contribute to occupational injuries. However, these factors have been compartmentalized and isolated in most studies.

OBJECTIVE

To examine the relationship between work-related injuries and multiple occupational and non-occupational factors among construction workers in the USA.

METHODS

Data from the 1988-2000 National Longitudinal Survey of Youth, 1979 cohort (N = 12,686) were analyzed. Job exposures and health behaviors were examined and used as independent variables in four multivariate logistic regression models to identify associations with occupational injuries.

RESULTS

After controlling for demographic variables, occupational injuries were 18% (95% CI: 1.04-1.34) more likely in construction than in non-construction. Blue-collar occupations, job physical efforts, multiple jobs, and long working hours accounted for the escalated risk in construction. Smoking, obesity/overweight, and cocaine use significantly increased the risk of work-related injury when demographics and occupational factors were held constant.

CONCLUSIONS

Workplace injuries are better explained by simultaneously examining occupational and non-occupational characteristics.

Selection bias in follow-up interviews with individuals attending the emergency department for occupational injuries

OBJECTIVE

To examine whether supplementary interview participation was comparable for occupationally injured patients attending two hospital emergency departments and to investigate the magnitude of selection bias in relation to sex, age, severity, job tasks and industry risk level.

METHODS

Workers aged 18-70 years who contacted the two emergency departments for an acute occupational injury in 2013 were eligible and given a short questionnaire. Following written consent, a semi-structured interview concerning health and transient risk factors was conducted by telephone. The two departments were compared for study recruitment by age and sex. Respondents and non-respondents to the interview were compared for age, sex, injury severity, job tasks and industry risk level.

RESULTS

Of 4002 patients attending the two hospitals, 1693 (42%) participated in the interview. One hospital had a markedly higher response rate to the questionnaire, but the proportions of participation in the interview were similar in the two hospitals. Patients aged <30 years were over-represented among non-respondents whereas sex, injury severity, job task and industry risk level were not significantly different between respondents and non-respondents.

CONCLUSIONS

Despite a relatively low interview participation rate among injured individuals attending the emergency department, selection bias was limited. This indicates that results regarding injury risk patterns may be more widely generalisable when examining the causality of occupational injuries. However, the study also showed that young injured workers were less likely to participate in follow-up interviews, which is an important factor when interpreting age-related risk of injury.

Occupational Injuries in Germany: Population-Wide National Survey Data Emphasize the Importance of Work-Related Factors

Unintentional injuries cause much of the global mortality burden, with the workplace being a common accident setting. Even in high-income economies, occupational injury figures remain remarkably high. Because risk factors for occupational injuries are prone to confounding, the present research takes a comprehensive approach. To better understand the occurrence of occupational injuries, sociodemographic factors and work- and health-related factors are tested simultaneously. Thus, the present analysis aims to develop a comprehensive epidemiological model that facilitates the explanation of varying injury rates in the workplace. The representative phone survey German Health Update 2010 provides information on medically treated occupational injuries sustained in the year prior to the interview. Data were collected on sociodemographics, occupation, working conditions, health-related behaviors, and chronic diseases. For the economically active population (18-70 years, n = 14,041), the 12-month prevalence of occupational injuries was calculated with a 95% confidence interval (CI). Blockwise multiple logistic regression was applied to successively include different groups of variables. Overall, 2.8% (95% CI 2.4-3.2) of the gainfully employed population report at least one occupational injury (women: 0.9%; 95% CI 0.7-1.2; men: 4.3%; 95% CI 3.7-5.0). In the fully adjusted model, male gender (OR 3.16) and age 18-29 (OR 1.54), as well as agricultural (OR 5.40), technical (OR 3.41), skilled service (OR 4.24) or manual (OR 5.12), and unskilled service (OR 3.13) or manual (OR 4.97) occupations are associated with higher chances of occupational injuries. The same holds for frequent stressors such as heavy carrying (OR 1.78), working in awkward postures (OR 1.46), environmental stress (OR 1.48), and working under pressure (OR 1.41). Among health-related variables, physical inactivity (OR 1.47) and obesity (OR 1.73) present a significantly higher chance of occupational injuries. While the odds for most work-related factors were as expected, the associations for health-related factors such as smoking, drinking, and chronic diseases were rather weak. In part, this may be due to context-specific factors such as safety and workplace regulations in high-income countries like Germany. This assumption could guide further research, taking a multi-level approach to international comparisons.

Are immigrants in Canada over-represented in riskier jobs relative to Canadian-born labor market participants?

BACKGROUND

This paper uses new data to examine the gap in injury and fatality rates between immigrant men and women and their Canadian-born counterparts.

METHODS

Data from the 2011 National Household Survey and the Association of Workers' Compensation Boards of Canada were used to determine the difference in occupational and industry injury and fatality rates between various arrival cohorts of immigrants and those Canadian born.

RESULTS

For both men and women, there is no significant difference in occupational injury and fatality rates between various arrival cohorts of immigrants and Canadian-born workers. However, industry injury and fatality rates are lower for the most recent arrival cohorts of immigrants relative to Canadian-born workers.

CONCLUSIONS

Although immigrants face many hurdles and challenges in their resettlement process in Canada, given the evidence from the paper, they are not likely to be at higher risk for work-related injuries relative to those Canadian-born.

Associations of Individual-Related and Job-Related Risk Factors with Nonfatal Occupational Injury in the Coal Workers of Shanxi Province: A Cross-Sectional Study

OBJECTIVES

To assess the relationships between the risk factors and the incidence of nonfatal occupational injury of coal mine workers of Shanxi Province.

METHODS

A cross-sectional study was conducted from July 2013 to December 2013, and 4319 workers were recruited from more than 200,000 coal mine employees who are exposed to continuous potential risk of occupational injuries by using a two-stage stratified cluster sampling method. Trained interviewers having necessary medical knowledge conducted face-to-face interviews with the participants. Univariate and multivariable logistic regression models were used to estimate the odds ratio (OR) and the 95% confidence interval (CI).

RESULTS

A total number of 3618 effective respondents were got from 4319 participants (83.77%) and the mean age of the participants was 41.5 years with the standard deviation of 8.65. Significant crude odds ratios were observed for all factors considered except for marital status, education, work duration, BMI, EPQ-RSC(P) scale and EPQ-RSC(L) scale. Results from multivariable logistic regression model showed significant adjusted odds ratios for risk factors including gender (female vs male 0.275, 0.094-0.800), age (≥55 vs ≤25yr 0.169, 0.032-0.900), work type (light physical labor vs heavy physical labor 0.504, 0.328-0.774), workplace (underground auxiliary vs underground front-line 0.595, 0.385-0.919), length of shiftwork experience (0~5yr vs no shift 2.075, 1.287-3.344 and ≥15yr vs no shift 2.076, 1.230-3.504) and EPQ-RSC(E) score (extraversion vs introversion 0.538, 0.334-0.867).

CONCLUSIONS

Several risk factors of nonfatal occupational injury were identified including male, age, heavy physical labor, underground front-line, length of shiftwork experience and introversion. The coal mining enterprises should pay attention to controlling the hazards associated with frontline physical work. Workers' behaviors, life styles and personality traits should also be considered, so that the enterprises could set achievable targets for workers and lessen the exposed period to the risky underground workstation.

Associations of Individual-Related and Job-Related Risk Factors with Nonfatal Occupational Injury in the Coal Workers of Shanxi Province: A Cross-Sectional Study

OBJECTIVES

To assess the relationships between the risk factors and the incidence of nonfatal occupational injury of coal mine workers of Shanxi Province.

METHODS

A cross-sectional study was conducted from July 2013 to December 2013, and 4319 workers were recruited from more than 200,000 coal mine employees who are exposed to continuous potential risk of occupational injuries by using a two-stage stratified cluster sampling method. Trained interviewers having necessary medical knowledge conducted face-to-face interviews with the participants. Univariate and multivariable logistic regression models were used to estimate the odds ratio (OR) and the 95% confidence interval (CI).

RESULTS

A total number of 3618 effective respondents were got from 4319 participants (83.77%) and the mean age of the participants was 41.5 years with the standard deviation of 8.65. Significant crude odds ratios were observed for all factors considered except for marital status, education, work duration, BMI, EPQ-RSC(P) scale and EPQ-RSC(L) scale. Results from multivariable logistic regression model showed significant adjusted odds ratios for risk factors including gender (female vs male 0.275, 0.094-0.800), age (≥55 vs ≤25yr 0.169, 0.032-0.900), work type (light physical labor vs heavy physical labor 0.504, 0.328-0.774), workplace (underground auxiliary vs underground front-line 0.595, 0.385-0.919), length of shiftwork experience (0~5yr vs no shift 2.075, 1.287-3.344 and ≥15yr vs no shift 2.076, 1.230-3.504) and EPQ-RSC(E) score (extraversion vs introversion 0.538, 0.334-0.867).

CONCLUSIONS

Several risk factors of nonfatal occupational injury were identified including male, age, heavy physical labor, underground front-line, length of shiftwork experience and introversion. The coal mining enterprises should pay attention to controlling the hazards associated with frontline physical work. Workers' behaviors, life styles and personality traits should also be considered, so that the enterprises could set achievable targets for workers and lessen the exposed period to the risky underground workstation.

Does tinnitus, hearing asymmetry, or hearing loss predispose to occupational injury risk?

OBJECTIVE

To determine the relative contributions of tinnitus, asymmetrical hearing loss, low frequency hearing loss (pure tone average of 0.5, 1, 2, 3 kHz; PTA.5123), or high frequency hearing loss (pure tone average of 4, 6 kHz; PTA46), to acute injury risk among a cohort of production and maintenance workers at six aluminum manufacturing plants, adjusting for ambient noise exposure and other recognized predictors of injury risk.

DESIGN

Retrospective analysis.

STUDY SAMPLE

The study considered 9920 workers employed during 2003 to 2008. The cohort consisted of 8818 workers (89%) whose complete records were available.

RESULTS

Adjusting for noise exposure and other recognized injury predictors, a 25% increased acute injury risk was observed among workers with a history of tinnitus in conjunction with high-frequency hearing loss (PTA46). Low frequency hearing loss may be associated with minor, yet less serious, injury risk. We did not find evidence that asymmetry contributes to injury risk.

CONCLUSION

These results provide evidence that tinnitus, combined with high-frequency hearing loss, may pose an important safety threat to workers, especially those who work in high-noise exposed environments. These at risk workers may require careful examination of their communication and hearing protection needs.

Occupational injury risk by sex in a manufacturing cohort

OBJECTIVES

This study expands previous research comparing injury risk for women and men in a cohort of 24,000 US aluminium manufacturing workers in 15 facilities from 2001 to 2010.

METHODS

We compared injury rates (all injury, first aid, medical treatment, restricted work and lost work time) by sex and by job and sex. Using a mixed effect modelling approach, we calculated ORs and 95% CIs adjusting for age, job tenure, ethnicity and year as fixed effects and person, job and plant as random effects. Additionally, we modelled the data stratified by plant type to examine potential differences in injury risk between smelter (generally recognised as more hazardous) and fabrication production environments.

RESULTS

Risk of injury was higher for women in four out of the five injury outcomes: all injuries combined (OR: 1.58, CI 1.48 to 1.67), injuries requiring first aid (OR: 1.61, CI 1.54 to 1.70), injuries requiring medical treatment (OR: 1.18, CI 1.03 to 1.36) and injuries requiring restricted work (OR: 1.65, CI 1.46 to 1.87). No difference in the risk of lost time injury by sex was found in this cohort. Analyses stratified by plant type showed similarly elevated injury risk for women, although the risk estimates were higher in smelters than fabrication plants.

CONCLUSIONS

To our knowledge, this is the largest single-firm study examining injury risk by sex with sufficient data to appropriately adjust for job. We show a consistently higher injury risk for women compared with men in the smelting and fabrication environments.

Roles of age, length of service and job in work-related injury: a prospective study of 63,620 person-years in female workers

BACKGROUND

The roles of age, length of service and job in various work-related injury types are unknown and deserve investigations among female workers. This study assessed their roles in the occurrence of injury.

METHODS

Three-year prospective study of all 22,952 permanently employed women at the French national railway company: 63,620 person-years, 756 injuries with working days lost, coded using the company's injury classification derived from that of the French health insurance scheme. We investigated the incidence of four types of injury: fall on same level, fall to lower level, materials/equipment/objects handling, and other injuries. Data were analyzed using negative binomial regression.

RESULTS

Workers aged <25 were subject to a higher risk for all types of injuries. Older workers (45-55 years) were subject to a higher injury risk for fall on same level and fall to lower level. For fall on same level as for fall to lower level the relative risk decreased steadily with increasing length of service with the company, from 1.60 for 1 year to 0.50-0.60 for ≥30 years. For injuries due to materials/equipment/objects handling the relative risk decreased from 1.05 for one year to 0.49 for 5-9 years, and then increased to about 1.50 for 20-29 years and ≥30 years.

CONCLUSIONS

Younger and shorter lengths of service were at risk for various types of injuries. Higher length of service was at risk for injury due to materials/equipment/objects handling. Preventive measures should consider the respective risks associated with age, years of employment and job.

Effect of systematic ergonomic hazard identification and control implementation on musculoskeletal disorder and injury risk

OBJECTIVES

This study aimed to examine the effect of an ergonomic hazard control (HC) initiative, undertaken as part of a company ergonomics standard, on worker injury risk.

METHODS

Using the company's ergonomic hazards database to identify jobs with and without ergonomic HC implementation and linking to individual job and injury histories, injury risk among person-jobs with HC implementation (the HC group) was compared to those without HC (NoHC group) using random coefficient models. Further analysis of the HC group was conducted to determine the effect of additional ergonomic hazards controlled on injury risk.

RESULTS

Among 123 jobs at 17 plant locations, 347 ergonomic hazards were quantitatively identified during the study period. HC were implemented for 204 quantified ergonomic hazards in 84 jobs, impacting 10 385 persons (12 967 person-jobs). No HC were implemented for quantified ergonomic hazards in the remaining 39 jobs affecting 4155 persons (5046 person-jobs). Adjusting for age, sex, plant origin, and year to control for any temporal trend in injury risk, the relative risk (RR) for musculoskeletal disorder (MSD) was 0.85 and the RR for any injury or MSD was 0.92 in the HC compared to NoHC group. Among the HC group, each ergonomic hazard controlled was associated with risk reduction for MSD and acute injury outcomes (RR 0.93).

CONCLUSION

Systematic ergonomic HC through participatory ergonomics, as part of a mandatory company ergonomics standard, is associated with MSD and injury risk reduction among workers in jobs with HC implemented.

Obesity and occupational injury: a prospective cohort study of 69,515 public sector employees

Background

Obesity and overweight are suggested to increase the risk of occupational injury but longitudinal evidence to confirm this is rare. We sought to evaluate obesity and overweight as risk factors for occupational injuries.

Methodology/Principal Findings

A total of 69,515 public sector employees (80% women) responded to a survey in 2000–2002, 2004 or 2008. Body mass index (kg/m²) was derived from self-reported height and weight and was linked to records of subsequent occupational injuries obtained from national registers. Different injury types, locations and events or exposures (the manner in which the injury was produced or inflicted) were analyzed by body mass index category adjusting for baseline socio-demographic characteristics, work characteristics, health-risk behaviors, physical and mental health, insomnia symptoms, and sleep duration. During the mean follow-up of 7.8 years (SD = 3.2), 18% of the employees (N = 12,204) recorded at least one occupational injury. Obesity was associated with a higher overall risk of occupational injury; multivariable adjusted hazard ratio (HR) 1.21 (95% CI 1.14–1.27). A relationship was observed for bone fractures (HR = 1.37; 95% CI: 1.10–1.70), dislocations, sprains and strains (HR = 1.36; 95% CI: 1.25–1.49), concussions and internal injuries (HR = 1.26; 95% CI: 1.11–1.44), injuries to lower extremities (HR = 1.62; 95%: 1.46–1.79) and injuries to whole body or multiple sites (HR = 1.37; 95%: 1.10–1.70). Furthermore, obesity was associated with a higher risk of injuries caused by slipping, tripping, stumbling and falling (HR = 1.55; 95% CI: 1.40–1.73), sudden body movement with or without physical stress (HR = 1.24; 95% CI: 1.10–1.41) and shock, fright, violence, aggression, threat or unexpected presence (HR = 1.33; 95% CI: 1.03–1.72). The magnitude of the associations between overweight and injuries was smaller, but the associations were generally in the same direction as those of obesity.

Conclusions/Significance

Obese employees record more occupational injuries than those with recommended healthy weight.

Examining psychosocial and physical hazards in the Ghanaian mining industry and their implications for employees' safety experience

INTRODUCTION

In addition to hazardous conditions that are prevalent in mines, there are various physical and psychosocial risk factors that can affect mine workers' safety and health. Without due diligence to mine safety, these risk factors can affect workers' safety experience, in terms of near misses, disabling injuries and accidents experienced or witnessed by workers.

METHOD

This study sets out to examine the effects of physical and psychosocial risk factors on workers' safety experience in a sample of Ghanaian miners. 307 participants from five mining companies responded to a cross sectional survey examining physical and psychosocial hazards and their implications for employees' safety experience.

RESULTS

Zero-inflated Poisson regression models indicated that mining conditions, equipment, ambient conditions, support and security, and work demands and control are significant predictors of near misses, disabling injuries, and accidents experienced or witnessed by workers. The type of mine had important implications for workers' safety experience.

Worker populations at risk for work-related injuries across the life course

BACKGROUND

Workplace injuries can have a substantial economic impact. Rates of workplace injuries differ across age groups, yet occupations/industry sectors at highest risk within age groups have not been identified. We examined workplace injury risk across industry sectors for three age groups using nationally representative U.S. data.

METHODS

Data from 1997 to 2009 National Health Interview Survey (NHIS) were pooled for employed adults by age groups: (1) 18-25 (n = 22,261); (2) 26-54 (n = 121,559); and (3) 55+ (n = 24,851). Workplace injury risk comparisons were made using logistic regression, with the Services sector as the referent and adjustment for sample design, gender, education, race/ethnicity, age, and income-to-poverty ratio.

RESULTS

Overall 3-month injury prevalence was 0.88%. Highest risk sectors for workers aged 18-25 included: Agriculture/forestry/fisheries (odds ratio = 4.80; 95% confidence interval 2.23-10.32), Healthcare/social assistance (2.71; 1.50-4.91), Construction (2.66; 1.56-4.53), Manufacturing (2.66; 1.54-4.61); for workers 26-54: Construction (2.30; 1.76-3.0), Agriculture/forestry/fisheries (1.91; 1.16-3.15), and Manufacturing (1.58; 1.28-1.96); for workers 55+: Agriculture/forestry/fisheries (3.01; 1.16-7.81), Transportation/communication/other public utilities (2.55; 1.44-4.49), and Construction (2.25; 1.09-4.67).

CONCLUSIONS

Agriculture/forestry/fisheries and Construction were among the sectors with highest workplace injury risk for workers across all age groups. Differences in highest risk industries were identified between the youngest and oldest industry groups. Our results indicate a need for age-specific interventions in some industries, and a need for more comprehensive measures in others.

HealthWorks: results of a multi-component group-randomized worksite environmental intervention trial for weight gain prevention

Background

U.S. adults are at unprecedented risk of becoming overweight or obese, and most scientists believe the primary cause is an obesogenic environment. Worksites provide an opportunity to shape the environments of adults to reduce obesity risk. The goal of this group-randomized trial was to implement a four-component environmental intervention at the worksite level to positively influence weight gain among employees over a two-year period. Environmental components focused on food availability and price, physical activity promotion, scale access, and media enhancements.

Methods

Six worksites in a U.S. metropolitan area were recruited and randomized in pairs at the worksite level to either a two-year intervention or a no-contact control. Evaluations at baseline and two years included: 1) measured height and weight; 2) online surveys of individual dietary intake and physical activity behaviors; and 3) detailed worksite environment assessment.

Results

Mean participant age was 42.9 years (range 18-75), 62.6% were women, 68.5% were married or cohabiting, 88.6% were white, 2.1% Hispanic. Mean baseline BMI was 28.5 kg/m² (range 16.9-61.2 kg/m²). A majority of intervention components were successfully implemented. However, there were no differences between sites in the key outcome of weight change over the two-year study period (p = .36).

Conclusions

Body mass was not significantly affected by environmental changes implemented for the trial. Results raise questions about whether environmental change at worksites is sufficient for population weight gain prevention.

Trial Registration

ClinicalTrials.gov: NCT00708461

Prevalence of cardiovascular pathologies in elderly population living in an industrialized area, compared to a control population residing in a rural area

The development of cardiovascular pathologies is potentially connected to the surrounding environment, partly due to purely environmental factors, like exposition to pollutions, or anthropological ones, like the type of manual or stressing working activities. The relevant literature has already widely discussed the correlation between the acute and chronic exposition to atmospheric pollutants of different types and the pathogenetic events, such as the atherogenesis, thrombosis, and hypertension, The present study intends to verify this idea on a larger population exposed to different geographical conditions, comparing an agricultural village (Pachino-Siracusa) with an industrialized area (Augusta-Siracusa), both having identical sanitary services of basic importance. On the basis of the specific rates of hospitalizations, we compared the prevalence of cardiovasular pathologies in the resident populations. These studies confirmed the negative influence of the risk factors deriving from the environmental pollutions even on the cardiovascular aging, displaying an increased rate of hospitalization for angina pectoris, myocardial infarction and cardiac arrhytmias in the industrialized population.

Interaction of occupational and personal risk factors in workforce health and safety

Most diseases, injuries, and other health conditions experienced by working people are multifactorial, especially as the workforce ages. Evidence supporting the role of work and personal risk factors in the health of working people is frequently underused in developing interventions. Achieving a longer, healthy working life requires a comprehensive preventive approach. To help develop such an approach, we evaluated the influence of both occupational and personal risk factors on workforce health. We present 32 examples illustrating 4 combinatorial models of occupational hazards and personal risk factors (genetics, age, gender, chronic disease, obesity, smoking, alcohol use, prescription drug use). Models that address occupational and personal risk factors and their interactions can improve our understanding of health hazards and guide research and interventions.

Do sleep complaints contribute to age-related cognitive decline?

The cognitive changes that occur with ageing are usually referred to as 'age-related cognitive decline'. The most pronounced changes may be found in the executive functions that require integrity of the prefrontal cortical circuitry. With age, sleep also changes profoundly, with more sleep fragmentation, earlier awakenings and less slow wave sleep as its main features. Interestingly, experimental sleep deprivation studies in healthy young adults showed a particularly consistent effect on executive functions, suggesting that sleep problems might contribute to the cognitive changes accompanying older age. We here investigate this possibility by reviewing reports on age-related and insomnia-related changes in cognition and brain function and structure, as found in studies investigating subjective complaints, objective functioning in everyday life, neuropsychological assessment, psychometry, structural and functional magnetic resonance imaging, electroencephalography, positron emission tomography and transcranial magnetic stimulation. The chapter focuses on the 'normal' age-related sleep changes that are experienced as insomnia - that is, fragmentation of sleep, more superficial sleep, more wake after sleep onset and earlier awakenings - rather than on specific sleep disturbances as sleep-disordered breathing, restless legs or periodic limb movements during sleep, for all of which the risk increases with age. It turned out that relatively few studies directly addressed the question whether elderly with different degrees of sleep complaints are differentially affected by 'age-related cognitive decline'. Still, several similarities between age-related and insomnia-related cognitive and brain changes are apparent, notably with respect to performance requiring integrity of the prefrontal cortical system. We suggest that at least part of what we regard as age-related changes may, in fact, be due to poor sleep, which is in some cases a treatable condition. Further research directly comparing aged good sleepers versus aged insomniacs will need to elucidate how sleep disturbances are involved in the cognitive, structural and functional changes observed with increasing age. The findings suggest that discrimination of subtypes of poor sleep at high age will aid in understanding the mechanisms by which it affects cognition and brain function.

Fatal occupational injuries in the Arkhangelsk region, Northwest Russia

BACKGROUND

Occupational deaths are used as indicators of occupational safety worldwide. The Arkhangelsk region is among the areas with the highest burden of fatal occupational injuries (FOI) in Russia.

AIMS

To describe the occurrence of FOI in the Arkhangelsk region in 1996-2007.

METHODS

Data on all FOI reported in the Arkhangelsk region in 1996-2007 were obtained from the State Labour Inspection. Data on the number of employees were collected at the Regional Federal State Statistics Service. The incidence of FOI was calculated by gender, age and economic activity per 100,000 employees. Blood alcohol concentration for all victims was available from the autopsy records.

RESULTS

Altogether, there were 734 occupational fatalities during the study period, 94% of them were among men. The incidence of FOI decreased from 18.6 (95% CI 14.6-23.6) in 1996 to 11.7 (95% CI 8.5-16.0) in 2007 among men and from 1.3 (95% CI 0.5-3.2) in 1996 to 0.3 (95% CI 0.1-1.7) in 2006 among women. The agriculture, hunting and forestry sector had the highest incidence of FOI, but they also showed a decrease in FOI from 43.9 (95% CI 32.3-65.3) in 1996 to 20.8 (95% CI 12.0-36.1) in 2007. The highest proportion of FOI occurred on Tuesdays (17%) and Wednesdays (18%). Thirty two of the victims had blood alcohol concentration >0.5 per thousand.

CONCLUSIONS

The incidence of FOI in the Arkhangelsk region decreased from 1996 to 2007, but remains high and varies by gender, age and economic activity over time.