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Khodadadi F, Bagheri SR, Ahmadi S, Rahmatinezhad M, Arjmandnia F, Abdi A, Alimohammadi E. The association between menopausal status and clinical outcomes of female patients with carpal tunnel release: a retrospective observational study. Int J Neurosci 2024; 134:318-322. [PMID: 35815446 DOI: 10.1080/00207454.2022.2100783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/07/2022] [Accepted: 06/23/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND The relationship between menopausal status and clinical outcomes of female patients with carpal tunnel release (CTR) has been not clearly investigated. This study aimed to evaluate the clinical outcomes of CTR among women with different menopausal statuses. METHODS Two hundred-eighteen consecutive female patients with carpal tunnel syndrome (CTS) who underwent surgery at our hospital between May 2016 and May 2020 were included in this study. Based on whether subjects had undergone menopause before surgery, they were divided into three groups: the premenopausal group, the early postmenopausal group (less than 10 years since menopause) and the late postmenopausal group (more than 10 years since menopause). The clinical outcome was assessed before surgery and at six-month postoperative visits using the Boston Carpal Tunnel Questionnaire (BCTQ). RESULTS There were 86 patients in the premenopausal group, 70 patients in the early postmenopausal group and 62 patients in the late postmenopausal group. All the groups showed significant improvements in their Symptom Severity Scale (SSS) and Functional Status Scale (FSS) compared with preoperative scores. Although, there was a significant difference between the groups based and post-surgical SSS and FSS (p < 0.05). Patients in the postmenopausal group had less improvement in SSS and FSS in comparison with those in the other groups (p < 0.05). CONCLUSIONS Our results showed that all the groups had significant improvement in their SSS and FSS. However, the clinical outcomes were poorer in late postmenopausal patients than in premenopausal or early postmenopausal patients. These findings can be used in pre-operative counseling and interpretation of outcomes in women with CTR.
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Affiliation(s)
- Foziyeh Khodadadi
- Department of anesthesiology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Seyed Reza Bagheri
- Department of neurosurgery, Kermanshah University of Medical Sciences, Imam Reza hospital, Kermanshah, Iran
| | - Samane Ahmadi
- Imam Reza hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Maryam Rahmatinezhad
- Department of anesthesiology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Alireza Abdi
- Imam Reza hospital, Nursing and midwifery school, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ehsan Alimohammadi
- Department of neurosurgery, Kermanshah University of Medical Sciences, Imam Reza hospital, Kermanshah, Iran
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Mohammadi A, Torres-Cuenca T, Mirza-Aghazadeh-Attari M, Faeghi F, Acharya UR, Abbasian Ardakani A. Deep Radiomics Features of Median Nerves for Automated Diagnosis of Carpal Tunnel Syndrome With Ultrasound Images: A Multi-Center Study. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2023; 42:2257-2268. [PMID: 37159483 DOI: 10.1002/jum.16244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 03/18/2023] [Accepted: 04/16/2023] [Indexed: 05/11/2023]
Abstract
OBJECTIVES Ultrasound is widely used in diagnosing carpal tunnel syndrome (CTS). However, the limitations of ultrasound in CTS detection are the lack of objective measures in the detection of nerve abnormality and the operator-dependent nature of ultrasound imaging. Therefore, in this study, we developed and proposed externally validated artificial intelligence (AI) models based on deep-radiomics features. METHODS We have used 416 median nerves from 2 countries (Iran and Colombia) for the development (112 entrapped and 112 normal nerves from Iran) and validation (26 entrapped and 26 normal nerves from Iran, and 70 entrapped and 70 normal nerves from Columbia) of our models. Ultrasound images were fed to the SqueezNet architecture to extract deep-radiomics features. Then a ReliefF method was used to select the clinically significant features. The selected deep-radiomics features were fed to 9 common machine-learning algorithms to choose the best-performing classifier. The 2 best-performing AI models were then externally validated. RESULTS Our developed model achieved an area under the receiver operating characteristic (ROC) curve (AUC) of 0.910 (88.46% sensitivity, 88.46% specificity) and 0.908 (84.62% sensitivity, 88.46% specificity) with support vector machine and stochastic gradient descent (SGD), respectively using the internal validation dataset. Furthermore, both models consistently performed well in the external validation dataset, and achieved an AUC of 0.890 (85.71% sensitivity, 82.86% specificity) and 0.890 (84.29% sensitivity and 82.86% specificity), with SVM and SGD models, respectively. CONCLUSION Our proposed AI models fed with deep-radiomics features performed consistently with internal and external datasets. This justifies that our proposed system can be employed for clinical use in hospitals and polyclinics.
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Affiliation(s)
- Afshin Mohammadi
- Department of Radiology, Faculty of Medicine, Urmia University of Medical Science, Urmia, Iran
| | - Thomas Torres-Cuenca
- Department of Physical Medicine and Rehabilitation, National University of Colombia, Bogotá, Colombia
| | - Mohammad Mirza-Aghazadeh-Attari
- Russell H. Morgan Department of Radiology and Radiological Sciences, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Fariborz Faeghi
- Department of Radiology Technology, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - U Rajendra Acharya
- School of Mathematics, Physics and Computing, University of Southern Queensland, Springfield, Queensland, Australia
- Department of Biomedical Engineering, School of Science and Technology, SUSS University, Singapore
- Department of Biomedical Informatics and Medical Engineering, Asia University, Taichung, Taiwan
| | - Ali Abbasian Ardakani
- Department of Radiology Technology, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Waiting time from identification to recognition an occupational disease in Spain. GACETA SANITARIA 2022; 36:257-259. [PMID: 35477508 DOI: 10.1016/j.gaceta.2022.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 01/17/2022] [Accepted: 01/18/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To estimate the waiting time since a suspected an occupational disease (OD) is identified, notified and recognized in Spain. METHOD A series of 34 patients attended at Occupational Diseases Unit (ODU) of Hospital del Mar in Barcelona were follow up since their identification until final resolution by the National Institute of Social Security (INSS). Median, and 25 and 75 percentiles (interquartile range [IQR]) were calculated in weeks by total time (n=27), ODU time (n=34), patient time (n=31) and INSS time (n=27). RESULTS Total time was 51 weeks (IQR: 33.6 and 122.6), of which 42 weeks (17.6-99.5) corresponded to the waiting period at the INSS. CONCLUSIONS The disproportionately long waiting time since INSS receives a case could impact on the under-recognition of OD. Urgent improvement of the administrative process is needed to reduce the patient waiting time for the recognition of OD.
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Otgonnasan A, Damdinbazar O, Damiran N, Erdenebayar E, Yundendorj G. Diseases-attributable disability-adjusted life years in copper and molybdenum ore workers in Mongolia: 1999-2019. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2022:1-9. [PMID: 35220850 DOI: 10.1080/09603123.2022.2044457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 02/14/2022] [Indexed: 06/14/2023]
Abstract
Most illnesses and deaths in industry workers are associated with occupational diseases (ODs). In recent years, mining has grown rapidly into a major driver of the Mongolian economy. In this study, the organization-based registry data on OD incidence and mortality from the archival data of the 'Erdenet' Copper and Molybdenum Concentrator Plant in Mongolia were used. We estimated the ODs burden in disability-adjusted life years (DALYs) loss between 1999 and 2019. A total of 72,802 DALYs were lost over 20 years, of which 97.5% were due to years lived with disability and 2.5% for years of life lost. The disease burden was high in men, accounting for 76.8% of total DALY. In terms of age groups, among people aged 46-55, DALY accounted for the largest percentage of losses. We found that workplace dust, noise, ergonomics, and vibration were the main factors attributed to the DALYs during the past two decades.
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Affiliation(s)
- Altansukh Otgonnasan
- School of Public Health, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Otgonbayar Damdinbazar
- Division for Science and Technology, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | | | - Erdenechimeg Erdenebayar
- Department of Environmental Health, School of Public Health, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Gantugs Yundendorj
- Department of Health Policy, School of Public Health, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
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Lee KH, Benke G, Mckenzie D. The efficacy of earplugs at a major hazard facility. Phys Eng Sci Med 2022; 45:107-114. [PMID: 35023076 DOI: 10.1007/s13246-021-01087-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 11/26/2021] [Indexed: 10/19/2022]
Abstract
At a major hazard facility, cases of occupational noise-induced hearing loss have occurred despite the use of hearing protection devices. Preliminary measurements of personal attenuation ratings (PAR) suggested that earplugs may not achieve the attenuation implied by their Australian SLC80 Class designation in field-use conditions. We examined the relationship between PAR and the SLC80 classification for earplugs, as a good understanding of the attenuation provided by earplugs under normal field-use conditions, rather than in laboratory settings, is vital to their effective use as a control measure for noise exposure. A cross-sectional study was performed with 65 volunteers. Participants were recruited from Operations and Maintenance Technicians at the major hazard facility. The participants had their PARs checked with different earplug types using the 3 M™ E-A-Rfit™ system. We examined the PARs measured and also assigned a 'pass' or 'fail' rating depending on whether the earplug achieved 22 dB attenuation. 22 dB attenuation for 80% of users is the minimum to meet the definition for Australian SLC80 Class 4 hearing protection. None of the earplug types achieved 22 dB attenuation for 80% of users when tested in field-use conditions. There were statistically significant differences in the frequency of achieving a 'Pass', and in PAR, depending on earplug type. Roll-down foam earplugs may provide superior attenuation compared to pre-moulded earplugs. Earplugs are unlikely to achieve the attenuation found in laboratory conditions during field-use. Personalised selection of hearing protection devices based on fit-testing results should be encouraged.
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Affiliation(s)
- Kah Heng Lee
- School of Public Health and Preventive Medicine, Faculty of Medicine Nursing and Health Sciences, Monash University, Clayton, VIC, Australia. .,Fellow of the Australasian Faculty of Occupational and Environmental Medicine - Royal Australasian College of Physicians, Monash University, Clayton, Australia.
| | - Geza Benke
- Department of Epidemiology and Preventive Medicine, Monash University, Clayton, VIC, Australia
| | - Dean Mckenzie
- Department of Epidemiology and Preventive Medicine, Monash University, Clayton, VIC, Australia.,Epworth HealthCare, Richmond, VIC, Australia
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Pankova VB, Vilk MF, Fedina IN, Bukhtiyarov IV, Daikhes NA, Tavartkiladze GA, Volokhov LL. [New criteria for professional selection and professional suitability by hearing to work in conditions of exposure to industrial hazards]. Vestn Otorinolaringol 2022; 87:57-62. [PMID: 35818947 DOI: 10.17116/otorino20228703157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
New regulations of professional selection and professional suitability for the state of auditory function for persons entering for the first time and already working under the influence of harmful and (or) hazardous production factors are discussed.
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Affiliation(s)
- V B Pankova
- All-Russian Research Institute of Transport Hygiene of the Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Moscow, Russia
- National Medical Research Center of Otorhinolaryngology of the Federal Medical and Biological Agency, Moscow, Russia
- Russian Medical Academy for Continuous Professional Education, Moscow, Russia
- Russian Scientific and Clinical Center of Audiology and Hearing Prosthetics of the Federal Medical and Biological Agency, Moscow, Russia
| | - M F Vilk
- All-Russian Research Institute of Transport Hygiene of the Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Moscow, Russia
| | - I N Fedina
- National Medical Research Center of Otorhinolaryngology of the Federal Medical and Biological Agency, Moscow, Russia
- Izmerov Research Institute of Occupational Health, Moscow, Russia
| | - I V Bukhtiyarov
- Izmerov Research Institute of Occupational Health, Moscow, Russia
- Sechenov First Moscow State Medical University, Moscow, Russia
| | - N A Daikhes
- National Medical Research Center of Otorhinolaryngology of the Federal Medical and Biological Agency, Moscow, Russia
| | - G A Tavartkiladze
- Russian Medical Academy for Continuous Professional Education, Moscow, Russia
- Russian Scientific and Clinical Center of Audiology and Hearing Prosthetics of the Federal Medical and Biological Agency, Moscow, Russia
| | - L L Volokhov
- National Medical Research Center of Otorhinolaryngology of the Federal Medical and Biological Agency, Moscow, Russia
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OUP accepted manuscript. Occup Med (Lond) 2022; 72:264-272. [DOI: 10.1093/occmed/kqac012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Hand Dermatitis in the Time of COVID-19: A Review of Occupational Irritant Contact Dermatitis. Dermatitis 2021; 32:86-93. [PMID: 33606414 DOI: 10.1097/der.0000000000000721] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Occupational contact dermatitis accounts for 95% of all cases of occupational skin disease with irritant contact dermatitis (ICD) constituting 80% to 90% of these cases. Health care workers, hairdressers, and food service workers are typically most affected by occupational ICD of the hands as these occupations require frequent hand hygiene and/or prolonged exposure to water, also known as "wet work." In the context of the current COVID-19 pandemic, frequent hand hygiene has become a global recommendation for all individuals, and new workplace guidelines for hand sanitization and surface sterilization are affecting occupations not previously considered at risk of excessive wet work including grocery or retail workers, postal workers, sanitization workers, and others. In this review, we discuss the etiology and pathogenesis of occupational ICD with additional focus on treatment and interventions that can be made at an institutional and even national level for education and prevention of ICD resulting from frequent hand hygiene.
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van Dijk F, Caraballo-Arias Y. Where to Find Evidence-Based Information on Occupational Safety and Health? Ann Glob Health 2021; 87:6. [PMID: 33505865 PMCID: PMC7792450 DOI: 10.5334/aogh.3131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background Occupational Safety and Health (OSH) professionals must base their advice and interventions on evidence from science, in balance with their expertise, and with workers' and other stakeholders' values and preferences. Evidence-based professional practice is one of the remedies against misinformation creating confusion and distrust in the society. Objectives To present, for OSH professionals, an overview and critical considerations about concepts, strategies, and tools needed for an accurate search for evidence-based information. Methods Information sources have been collected and discussed as a base for a documented vision on knowledge questions, online information sources, search engines, databases, and tools. Results Every search should start with a carefully phrased question. To help finding a reliable answer, potential evidence-based online sources are presented. Systematic reviews and original scientific articles are regarded as primary sources. Secondary and tertiary sources are discussed, such as practice guidelines, point-of-care summaries, advisory reports, quality websites or apps, Wikipedia, quality videos, and e-lessons. To find sources, adequate use of search engines and databases is required. Examples are discussed briefly, such as PubMed/MEDLINE, Virtual Health Library, NICE, Cochrane Library, Cochrane Work, Google (Scholar), and YouTube. Conclusions Evidence-based practice in OSH must be stimulated, relying mainly on trusted online sources. The breadth of appropriate information sources is wider than described in most publications. Search engines facilitate the finding of quality reports, videos, e-courses, and websites. Such sources can be explored by well-trained professionals to complement the use of scientific articles, reviews, point-of-care summaries, and guidelines. Adequate use of online information sources requires awareness, motivation, and skills in professionals and educators. To date, the quality of skills in searching is low, thus a more adequate education is crucial. The quality of sources, search engines, and databases will be considered more thoroughly in another study. International collaboration is profitable and needs new drivers.
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Affiliation(s)
- Frank van Dijk
- Occupational Physician. Learning and Developing Occupational Health (LDOH) Foundation; emeritus professor in Occupational Health (The Netherlands). Leiden, Netherlands
| | - Yohama Caraballo-Arias
- Occupational Physician. International Commission on Occupational Health (ICOH) Venezuelan National Secretary; Council of Scientific Advisors American College of Occupational & Environmental Medicine (ACOEM); Learning and Developing Occupational Health (LDOH) Foundation. Caracas, Venezuela
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Chen KH, Su SB, Chen KT. An overview of occupational noise-induced hearing loss among workers: epidemiology, pathogenesis, and preventive measures. Environ Health Prev Med 2020; 25:65. [PMID: 33129267 PMCID: PMC7603754 DOI: 10.1186/s12199-020-00906-0] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 10/25/2020] [Indexed: 12/20/2022] Open
Abstract
Occupational noise-induced hearing loss (ONIHL) is the most prevalent occupational disease in the world. The goal of this study was to review the epidemiology, pathogenesis, and preventive measures of ONIHL among workers and provide evidence for the implementation of control measures. Literature studies were identified from the MEDLINE, PubMed, Embase, Web of Science, and Google Scholar using the search terms “noise-induced hearing loss” “prevalence”, “pathogenesis”, and “preventive measures”. The articles reviewed in this report were limited from 2000 to 2020. Articles that were not published in the English language, manuscripts without an abstract, and opinion articles were excluded. After a preliminary screening, all of the articles were reviewed and synthesized to provide an overview of the current status of ONIHL among workers. The mechanism of ONIHL among workers is a complex interaction between environmental and host factors (both genetic and acquired factors). The outcomes of noise exposure are different among individual subjects. Clinical trials are currently underway to evaluate the treatment effect of antioxidants on ONIHL. Noise exposure may contribute to temporary or permanent threshold shifts; however, even temporary threshold shifts may predispose an individual to eventual permanent hearing loss. Noise prevention programs are an important preventive measure in reducing the morbidity of ONIHL among workers.
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Affiliation(s)
- Kou-Huang Chen
- School of Mechanical and Electronic Engineering, Sanming University, Sanming, 365, Fujian Province, China
| | - Shih-Bin Su
- Department of Occupational Medicine, Chi-Mei Medical Center, Tainan, 710, Taiwan
| | - Kow-Tong Chen
- Department of Occupational Medicine, Tainan Municipal Hospital (managed by Show Chwan Medical Care Corporation), No. 670, Chongde Road, East District, Tainan, 701, Taiwan. .,Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, 701, Taiwan.
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Madan I, Parsons V, Ntani G, Wright A, English J, Coggon D, McCrone P, Smedley J, Rushton L, Murphy C, Cookson B, Lavender T, Williams H. A behaviour change package to prevent hand dermatitis in nurses working in health care: the SCIN cluster RCT. Health Technol Assess 2020; 23:1-92. [PMID: 31635689 DOI: 10.3310/hta23580] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Although strategies have been developed to minimise the risk of occupational hand dermatitis in nurses, their clinical effectiveness and cost-effectiveness remain unclear. OBJECTIVES The Skin Care Intervention in Nurses trial tested the hypothesis that a behaviour change package intervention, coupled with provision of hand moisturisers, could reduce the point prevalence of hand dermatitis when compared with standard care among nurses working in the NHS. The secondary aim was to assess the impact of the intervention on participants' beliefs and behaviour regarding hand care, and the cost-effectiveness of the intervention in comparison with normal care. DESIGN Cluster randomised controlled trial. SETTING Thirty-five NHS hospital trusts/health boards/universities. PARTICIPANTS First-year student nurses with a history of atopic tendency, and full-time intensive care unit nurses. INTERVENTION Sites were randomly allocated to be 'intervention plus' or 'intervention light'. Participants at 'intervention plus' sites received access to a bespoke online behaviour change package intervention, coupled with personal supplies of moisturising cream (student nurses) and optimal availability of moisturising cream (intensive care unit nurses). Nurses at 'intervention light' sites received usual care, including a dermatitis prevention leaflet. MAIN OUTCOME MEASURE The difference between intervention plus and intervention light sites in the change of point prevalence of visible hand dermatitis was measured from images taken at baseline and at follow-up. RANDOMISATION Fourteen sites were randomised to the intervention plus arm, and 21 sites were randomised to the intervention light arm. BLINDING The participants, trial statistician, methodologist and the dermatologists interpreting the hand photographs were blinded to intervention assignment. NUMBERS ANALYSED An intention-to-treat analysis was conducted on data from 845 student nurses and 1111 intensive care unit nurses. RESULTS The intention-to-treat analysis showed no evidence that the risk of developing dermatitis was greater in the intervention light group than in the intervention plus group (student nurses: odds ratio 1.25, 95% confidence interval 0.59 to 2.69; intensive care unit nurses: odds ratio 1.41, 95% confidence interval 0.81 to 2.44). Both groups had high levels of baseline beliefs about the benefits of using hand moisturisers before, during and after work. The frequency of use of hand moisturisers before, during and after shifts was significantly higher in the intensive care unit nurses in the intervention plus arm at follow-up than in the comparator group nurses. For student nurses, the intervention plus group mean costs were £2 lower than those for the comparator and 0.00002 more quality-adjusted life-years were gained. For intensive care unit nurses, costs were £4 higher and 0.0016 fewer quality-adjusted life-years were gained. HARMS No adverse events were reported. LIMITATIONS Only 44.5% of participants in the intervention plus arm accessed the behaviour change package. CONCLUSION The intervention did not result in a statistically significant decrease in the prevalence of hand dermatitis in the intervention plus group. FUTURE WORK Participants had a high level of baseline beliefs about the importance of using hand moisturisers before, during and after work. Future research should focus on how workplace culture can be changed in order for that knowledge to be actioned. TRIAL REGISTRATION Current Controlled Trials ISRCTN53303171. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 23, No. 58. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Ira Madan
- Occupational Health Service, Guy's and St Thomas' NHS Foundation Trust, London, UK.,King's College London, London, UK
| | - Vaughan Parsons
- Occupational Health Service, Guy's and St Thomas' NHS Foundation Trust, London, UK.,King's College London, London, UK
| | - Georgia Ntani
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Alison Wright
- Centre for Behaviour Change, Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - John English
- Dermatology, Circle Nottingham NHS Treatment Centre, Nottingham, UK
| | - David Coggon
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Paul McCrone
- Centre for the Economics of Mental and Physical Health, King's College London, London, UK
| | - Julia Smedley
- Occupational Health Service, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Lesley Rushton
- Epidemiology and Biostatistics, Imperial College London, London, UK
| | - Caroline Murphy
- King's Clinical Trial Unit, King's College London, London, UK
| | - Barry Cookson
- Medical Microbiology, University College London, London, UK
| | - Tina Lavender
- School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK
| | - Hywel Williams
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
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Mekonnen TH, Yenealem DG, Geberu DM. Physical environmental and occupational factors inducing work-related neck and shoulder pains among self-employed tailors of informal sectors in Ethiopia, 2019: results from a community based cross-sectional study. BMC Public Health 2020; 20:1265. [PMID: 32819334 PMCID: PMC7439718 DOI: 10.1186/s12889-020-09351-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 08/04/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Musculoskeletal disorders (MSD) caused by occupational-related factors continue to place huge burdens on global workforces. Significant numbers of workers report potential adverse health outcomes related to the condition, such as physical injury, disability, and decline in quality of life. Occupational-related MSD also poses additional burdens to healthcare services and diminishes productivity at work. The condition usually worsens in informal sectors where the work environments are often poorly designed. This paper explored occupational and physical environmental factors that induce work-related neck and/or shoulder pains among self-employed tailors in Gondar city, Northwest Ethiopia. METHODS We conducted across-sectional survey from April to May 2019 on 422 tailors selected with systematic random sampling technique. Nordic Musculoskeletal questionnaire was used to measure pains in neck and/or shoulder, and the questionnaire was pretested and administered by interviewers. Work-related factors such as working posture, rest break, training in safety and health, and the availability of adjustable chairs at workplaces were assessed. The significance of associations was set at a < 0.05 p-value and adjusted odds ratios (AOR) with a confidence interval (CI) of 95% were used to determine strength of associations. RESULTS A total of 419 tailors participated with a response rate of 99.3%. The mean age and mean years of experience were 29.23 (SD ± 7.03) and 1.48 (SD ± 0.50) years, respectively. The study found that the prevalence of pain in either neck or shoulder or both sites in the last 12 months was 66.6% (N = 279) [95% CI (62.1, 71.1)]. Pains in shoulder and neck were observed in 72.1% (N = 302)[95% CI (67.8, 76.4)] and 68.3% (N = 286) [95% CI (64.0, 72.6)] of the interviewees, respectively. The majority, 78.1% (n = 218) of those with pains indicated they were prevented from doing normal daily activities. Work experience (AOR = 1.81), rest break (AOR = 2.13), awkward working posture (AOR = 2.60), prolonged sitting (AOR = 2.00) and inadequate light (AOR = 5.02) were significantly associated factors of neck and/ or shoulder pains. CONCLUSION Work-related neck and/or shoulder pain induced by physical factors of the work environment among self-employed tailors is pervasive in Ethiopia. Efforts to curb the condition, therefore, need to impalement diverse approaches addressing the physical environment and occupational factors. We also promote the integration of schemes for the effective use of rest breaks into health and safety programs in the workplace.
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Affiliation(s)
- Tesfaye Hambisa Mekonnen
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia.
| | - Dawit Getachew Yenealem
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia
| | - Demiss Mulatu Geberu
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia
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Keefe AR, Demers PA, Neis B, Arrandale VH, Davies HW, Gao Z, Hedges K, Holness DL, Koehoorn M, Stock SR, Bornstein S. A scoping review to identify strategies that work to prevent four important occupational diseases. Am J Ind Med 2020; 63:490-516. [PMID: 32227359 DOI: 10.1002/ajim.23107] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 02/27/2020] [Accepted: 02/28/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND Despite being largely preventable, many occupational diseases continue to be highly prevalent and extremely costly. Effective strategies are required to reduce their human, economic, and social impacts. METHODS To better understand which approaches are most likely to lead to progress in preventing noise-related hearing loss, occupational contact dermatitis, occupational cancers, and occupational asthma, we undertook a scoping review and consulted with a number of key informants. RESULTS We examined a total of 404 articles and found that various types of interventions are reported to contribute to occupational disease prevention but each has its limitations and each is often insufficient on its own. Our principal findings included: legislation and regulations can be an effective means of primary prevention, but their impact depends on both the nature of the regulations and the degree of enforcement; measures across the hierarchy of controls can reduce the risk of some of these diseases and reduce exposures; monitoring, surveillance, and screening are effective prevention tools and for evaluating the impact of legislative/policy change; the effect of education and training is context-dependent and influenced by the manner of delivery; and, multifaceted interventions are often more effective than ones consisting of a single activity. CONCLUSIONS This scoping review identifies occupational disease prevention strategies worthy of further exploration by decisionmakers and stakeholders and of future systematic evaluation by researchers. It also identified important gaps, including a lack of studies of precarious workers and the need for more studies that rigorously evaluate the effectiveness of interventions.
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Affiliation(s)
- Anya R. Keefe
- SafetyNet Centre for Occupational Health and Safety Research, Memorial University St. John's Newfoundland Canada
| | - Paul A. Demers
- Occupational Cancer Research Centre, Cancer Care Ontario Toronto Ontario Canada
| | - Barbara Neis
- SafetyNet Centre for Occupational Health and Safety Research, Memorial University St. John's Newfoundland Canada
| | | | - Hugh W. Davies
- Occupational and Environmental Health, School of Population and Public HealthUniversity of British Columbia Vancouver British Columbia Canada
| | - Zhiwei Gao
- Department of Clinical Epidemiology, Faculty of MedicineMemorial University St. John's Newfoundland Canada
| | - Kevin Hedges
- Occupational Health Clinics for Ontario Workers Ottawa Ontario Canada
| | - D. Linn Holness
- Department of Medicine and Public Health SciencesSt. Michael's Hospital/University of Toronto, Toronto, Ontario, Canada
| | - Mieke Koehoorn
- Occupational and Environmental Health, School of Population and Public HealthUniversity of British Columbia Vancouver British Columbia Canada
| | - Susan R. Stock
- Division of Biological Risks and Occupational HealthInstitut national de santé publique du Québec (Quebec Institute of Public Health) Montreal Quebec Canada
- Department of Social and Preventive MedicineSchool of Public Health, Université de Montreal Montreal Quebec Canada
| | - Stephen Bornstein
- SafetyNet Centre for Occupational Health and Safety Research, Memorial University St. John's Newfoundland Canada
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Laditka JN, Laditka SB, Arif AA, Hoyle JN. Work-related asthma in the USA: nationally representative estimates with extended follow-up. Occup Environ Med 2020; 77:617-622. [PMID: 32404531 DOI: 10.1136/oemed-2019-106121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 04/10/2020] [Accepted: 04/25/2020] [Indexed: 11/03/2022]
Abstract
OBJECTIVE We studied the associations of working in occupations with high asthma trigger exposures with the prevalence and incidence of asthma, and with ever reporting an asthma diagnosis throughout working life. METHODS We used the nationally representative Panel Study of Income Dynamics (1968-2015; n=13 957; 205 498 person-years), with annual reports of occupation and asthma diagnoses across 48 years. We compared asthma outcomes in occupations likely to have asthma trigger exposures with those in occupations with limited trigger exposures. We estimated the prevalence ratios and the incidence risk ratios using log-binomial regression adjusted for age, sex, race/ethnicity, education, and current and past atopy and smoking, and accounting for the survey design and sampling weights. We calculated the attributable risk fractions and population attributable risks, and used multinomial logistic Markov models and microsimulation to estimate the percentage of people ever diagnosed with asthma during working life. RESULTS The adjusted prevalence ratio comparing high-risk occupations with low-risk was 4.1 (95% CI 3.5 to 4.8); the adjusted risk ratio was 2.6 (CI 1.8 to 3.9). The attributable risk was 16.7% (CI 8.5 to 23.6); the population attributable risk was 11.3% (CI 5.0 to 17.2). In microsimulations, 14.9% (CI 13.4 to 16.3) with low trigger exposure risk reported asthma at least once, ages 18-65, compared with 23.9% (CI 22.3 to 26.0) with high exposure risk. CONCLUSION Adults were more than twice as likely to report a new asthma diagnosis if their occupation involved asthma triggers. Work exposures to asthma triggers may cause or aggravate about 11% of all adult asthma and increase the risk of work-life asthma by 60%.
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Affiliation(s)
- James N Laditka
- Public Health Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina, USA
| | - Sarah B Laditka
- Public Health Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina, USA
| | - Ahmed A Arif
- Public Health Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina, USA
| | - Jessica N Hoyle
- Public Health Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina, USA
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15
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Santarossa M, Mauro M, Belloni Fortina A, Corradin MT, Larese Filon F. Occupational contact dermatitis in Triveneto: Analysis of patch test data of the North Eastern Italian Database from 1996 to 2016. Contact Dermatitis 2020; 82:370-379. [DOI: 10.1111/cod.13512] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 03/02/2020] [Accepted: 03/05/2020] [Indexed: 12/24/2022]
Affiliation(s)
- Monica Santarossa
- Department of Medical Sciences, Clinical Unit of Occupational MedicineUniversity of Trieste Trieste Italy
| | - Marcella Mauro
- Department of Medical Sciences, Clinical Unit of Occupational MedicineUniversity of Trieste Trieste Italy
| | - Anna Belloni Fortina
- Padua Hospital Internal Medicine Department – DIMED, Paediatric Dermatology UnitUniversity of Padua Padua Italy
| | - Maria T. Corradin
- Pordenone Hospital – Internal and Specialistic DepartmentOspedale Santa Maria degli Angeli Pordenone Italy
| | - Francesca Larese Filon
- Department of Medical Sciences, Clinical Unit of Occupational MedicineUniversity of Trieste Trieste Italy
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16
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Global and regional burden of disease and injury in 2016 arising from occupational exposures: a systematic analysis for the Global Burden of Disease Study 2016. Occup Environ Med 2020; 77:133-141. [PMID: 32054817 PMCID: PMC7035694 DOI: 10.1136/oemed-2019-106008] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 10/18/2019] [Accepted: 11/30/2019] [Indexed: 02/07/2023]
Abstract
OBJECTIVES This study provides an overview of the influence of occupational risk factors on the global burden of disease as estimated by the occupational component of the Global Burden of Disease (GBD) 2016 study. METHODS The GBD 2016 study estimated the burden in terms of deaths and disability-adjusted life years (DALYs) arising from the effects of occupational risk factors (carcinogens; asthmagens; particulate matter, gases and fumes (PMGF); secondhand smoke (SHS); noise; ergonomic risk factors for low back pain; risk factors for injury). A population attributable fraction (PAF) approach was used for most risk factors. RESULTS In 2016, globally, an estimated 1.53 (95% uncertainty interval 1.39-1.68) million deaths and 76.1 (66.3-86.3) million DALYs were attributable to the included occupational risk factors, accounting for 2.8% of deaths and 3.2% of DALYs from all causes. Most deaths were attributable to PMGF, carcinogens (particularly asbestos), injury risk factors and SHS. Most DALYs were attributable to injury risk factors and ergonomic exposures. Men and persons 55 years or older were most affected. PAFs ranged from 26.8% for low back pain from ergonomic risk factors and 19.6% for hearing loss from noise to 3.4% for carcinogens. DALYs per capita were highest in Oceania, Southeast Asia and Central sub-Saharan Africa. On a per capita basis, between 1990 and 2016 there was an overall decrease of about 31% in deaths and 25% in DALYs. CONCLUSIONS Occupational exposures continue to cause an important health burden worldwide, justifying the need for ongoing prevention and control initiatives.
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van der Molen HF, Marsili C, Vitali A, Colosio C. Trends in occupational diseases in the Italian agricultural sector, 2004-2017. Occup Environ Med 2020; 77:340-343. [PMID: 31996472 PMCID: PMC7231438 DOI: 10.1136/oemed-2019-106168] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 01/06/2020] [Accepted: 01/14/2020] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To estimate the incidence of, trends in and effect of change in reporting rules on occupational diseases (ODs) in the Italian agricultural sector. METHODS Over a 14-year period (2004-2017), ODs among Italian agricultural workers were diagnosed by physicians and reported to the National Institute for Insurance against Workplace Accidents and Occupational Diseases. OD was defined as a disease with a specific clinical diagnosis (International Classification of Diseases) and was predominantly caused by work-related factors. Trends in incidence and effects of changed eligibility criteria for reporting occupational musculoskeletal disorders (MSDs) and noise-induced hearing loss (NIHL) were estimated using a Poisson regression model. RESULTS In 2017, the incidence of all ODs was 1295 per 100 000 agricultural workers. MSDs (961 per 100 000 workers) were the most frequently occurring ODs. MSDs and NIHL showed statistically significant increasing time trends, 26% and 7% annual increase, respectively, during the 2004-2017 period. There was no statistically significant change in the incidence of occupational respiratory, skin and cancer diseases during the 14-year period. After changes in reporting rules, the incidence of MSDs showed an immediate increased effect, with an incidence rate ratio (IRR) of 2.9 (95% CI 2.65 to 3.14) and a significant annual decreasing trend of -9% (95% CI -6% to -12%) over the years after the changed reporting rules (from 2008 to 2017), and an immediate effect on NIHL with an IRR of 1.3 (95% CI 1.13 to 1.53). CONCLUSION In total, 1.3% of the Italian agricultural workers were diagnosed in 2017 as having an OD. Over a 14-year period, the annual incidence of ODs showed a considerable increasing trend consistent with changed eligibility reporting criteria for occupational MSDs and to a lesser extent for NIHL.
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Affiliation(s)
- Henk F van der Molen
- Amsterdam UMC, University of Amsterdam, Department: Coronel Institute of Occupational Health, Netherlands Center for Occupational Diseases, Amsterdam Public Health research institute, Amsterdam, The Netherlands
| | - Chiara Marsili
- Occupational Health Unit and International Centre for Rural Health, ASST of the Saints Paolo and Carlo, Milano, Italy
| | - Andrea Vitali
- University of Milan, Department of Health Sciences, Occupational Health Unit and International Centre for Rural Health, ASST of the Saints Paolo and Carlo, Milano, Italy
| | - Claudio Colosio
- Occupational Health Unit and International Centre for Rural Health, ASST of the Saints Paolo and Carlo, Milano, Italy.,University of Milan, Department of Health Sciences, Occupational Health Unit and International Centre for Rural Health, ASST of the Saints Paolo and Carlo, Milano, Italy
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18
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Jarolímek J, Legáth Ľ, Urban P. Occupational diseases in the automotive industry from medical and geographic viewpoints - comparison between the Czech Republic and the Slovak Republic. Cent Eur J Public Health 2020; 27:296-304. [PMID: 31951689 DOI: 10.21101/cejph.a5848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 09/01/2019] [Accepted: 09/01/2019] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The aim of the study was to compare the occurrence of occupational diseases (ODs) in the automotive industry in the Czech Republic and the Slovak Republic and to analyze their determinants. METHODS The aggregated and anonymized data on ODs from the period 2001-2017 were used. A questionnaire survey was conducted in the Czech Republic (response rate 70.6%) and in the Slovak Republic (response rate 57%). The occurrence of ODs according to socioeconomic factors, the size of enterprises and their position in the global production networks was evaluated. The quality and scope of the occupational health services were also taken into consideration. RESULTS Workers older than 40 years were at a significantly higher risk of ODs than the younger ones. In the Czech Republic, it corresponded to OR 2.77 (95% CI 2.41-3.19), in the Slovak Republic to OR 2.01 (95% CI 1.34-3.01). The risk of ODs in women was significantly higher than in men - in the Czech Republic it corresponded to OR 3.20 (95% CI 2.79-3.67), in the Slovak Republic to OR 2.43 (95% CI 2.05-2.87). The difference between the two states did not reach statistical significance in any of the studied factors. In both states, no ODs were reported from the microenterprises. CONCLUSION Given the results of the study, it can be recommended to focus on the ergonomics of assembly work in the automotive industry. Special attention should be given to the provision of occupational health services, especially in microenterprises.
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Affiliation(s)
- Jan Jarolímek
- Department of Social Geography and Regional Development, Faculty of Science, Charles University in Prague, Czech Republic.,Public Health Authority of the City of Prague, Prague, Czech Republic
| | - Ľubomír Legáth
- Faculty of Medicine, Pavol Jozef Safarik Univerzity in Kosice, Kosice, Slovak Republic
| | - Pavel Urban
- National Institute of Public Health, Prague, Czech Republic.,Department of Occupational Medicine, First Faculty of Medicine, Charles University, Prague, Czech Republic
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Benavides FG, Ramada JM, Ubalde-López M, Delclos GL, Serra C. A hospital occupational diseases unit: an experience to increase the recognition of occupational disease. LA MEDICINA DEL LAVORO 2019; 110:278-284. [PMID: 31475689 PMCID: PMC7809997 DOI: 10.23749/mdl.v110i4.8138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 07/18/2019] [Indexed: 11/25/2022]
Abstract
Background: Under-reporting and recognition of occupational diseases is a problem in countries with workers’ compensation schemes. Objective: To describe the role of a public hospital Occupational Disease Unit (ODU) in Barcelona that resulted in improved reporting and official recognition of occupational diseases from 2010 to 2017. Methods: Hospital physicians referred possible cases of work-related disease to the ODU, where in-depth medical evaluations were then performed, and a detailed report addressing causation was generated. Patients with confirmed cases of occupational disease were counselled and followed while pursuing official recognition and benefits claims by the Spanish Social Security System. Results: Between 2010 and 2017, 149 cases were referred to the ODU for evaluation. Of these, 80 (53.7%) were confirmed to have an occupational disease, 54 (67.5%) patients pursued official recognition, and to date 26 (48.1%) have been recognized by the Social Security System. The recognition rate varied by diagnosis group (p=0.003), and was highest for skin diseases (71.4%) and cancer (66.7%), and lowest for hearing loss (29.4%) and musculoskeletal disorders (16.7%). Conclusions: A hospital ODU can improve reporting and official recognition of occupational diseases that otherwise might not have been recognized. Expanding this experience to other Spanish and European hospitals could improve the efficiency of workers’ compensation schemes and better support preventive policies.
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20
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Oksa P, Sauni R, Talola N, Virtanen S, Nevalainen J, Saalo A, Uitti J. Trends in occupational diseases in Finland, 1975-2013: a register study. BMJ Open 2019; 9:e024040. [PMID: 31015267 PMCID: PMC6500243 DOI: 10.1136/bmjopen-2018-024040] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES The objective was to investigate trends in the incidence of recognized and suspected cases of occupational diseases in Finland from 1975 to 2013, including variations by industry - and describe and recognize factors affecting variations in incidence. DESIGN A register study. SETTING The data consisted of recognized and suspected cases of occupational diseases recorded in the Finnish Registry of Occupational Diseases (FROD) in 1975-2013. PARTICIPANTS Altogether 240 000 cases of suspected and recognized ODs were analysed. PRIMARY AND SECONDARY OUTCOME MEASURES From the annual workforce statistics and FROD data, we calculated the incidence of ODs and suspected ODs per 10 000 employees. For time trends by industrial sector, we used a 5-year moving average and a Poisson regression analysis. RESULTS Annual average rates of ODs have varied from year to year. The total number was 25.0/10 000 employees in 1975 and 20.1/10 000 employees in 2013. Screening campaigns and legislative changes have caused temporary increases. When the financial sector was the reference (1.0), the highest incidence rates according to industrial sector were in mining and quarrying (9.87; 95% CI 8.65 to 11.30), construction (9.11; 95% CI 9.98 to 10.43), manufacturing (9.04; 95% CI 7.93 to 10.36) and agriculture (8.78; 95% CI 7.69 to 10.06). There is a distinct decreasing trend from 2005 onwards: the average annual change in incidence was, for example, -9.2% in agriculture, -10.3% in transportation and -4.7% in construction. The average annual decline was greatest in upper limb strain injuries (-11.1%). CONCLUSION This study provides a useful overview of the status of ODs in Finland over several decades. These data are a valuable resource for determining which occupations are at an increased risk and where preventive actions should be targeted. It is important to study long-term trends in the statistics of ODs to see beyond the year-to-year fluctuations.
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Affiliation(s)
- Panu Oksa
- Department of Occupational Health Services, Finnish Institute of Occupational Health, Tampere, Finland
| | - Riitta Sauni
- Department for Work and Gender Equality, Ministry of Social Affairs and Health, Tampere, Finland
| | - Nina Talola
- Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Simo Virtanen
- Department of Operations and Project Support, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Jaakko Nevalainen
- Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Anja Saalo
- Department of Operations and Project Support, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Jukka Uitti
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Clinic of Occupational Medicine, Tampere University Hospital, Tampere, Finland
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21
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Seed MJ, Carder M, Gittins M, Sen D, Money A, Fishwick D, Barber CM, van Tongeren M. Emerging trends in the UK incidence of occupational asthma: should we be worried? Occup Environ Med 2019; 76:396-397. [PMID: 30936407 DOI: 10.1136/oemed-2018-105414] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 01/03/2019] [Accepted: 01/20/2019] [Indexed: 11/03/2022]
Abstract
While 15% of adult-onset asthma is estimated to have an occupational cause, there has been evidence of a downward trend in occupational asthma incidence in several European countries since the start of this millennium. However, recent data from The Health and Occupation Reporting network in the UK have suggested a possible reversal of this downward trend since 2014. We present these data and discuss possible explanations for this observed change in incidence trend. A high index of suspicion of occupational causation in new-onset asthma cases continues to be important, whether or not the recently observed increase in occupational asthma incidence in the UK is real or artefactual.
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Affiliation(s)
- Martin J Seed
- The University of Manchester, Centre for Occupational and Environmental Health, Manchester, UK
| | - Melanie Carder
- The University of Manchester, Centre for Occupational and Environmental Health, Manchester, UK
| | - Matthew Gittins
- The University of Manchester, Centre for Occupational and Environmental Health, Manchester, UK
| | - Dil Sen
- The University of Manchester, Centre for Occupational and Environmental Health, Manchester, UK
| | - Annemarie Money
- The University of Manchester, Centre for Occupational and Environmental Health, Manchester, UK
| | - David Fishwick
- Health and Safety Laboratory, Centre for Workplace Health, Harpur Hill, Buxton, UK
| | - Chris M Barber
- Health and Safety Laboratory, Centre for Workplace Health, Harpur Hill, Buxton, UK
| | - Martie van Tongeren
- The University of Manchester, Centre for Occupational and Environmental Health, Manchester, UK
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22
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Li M, Fan X, Ji L, Fan Y, Xu L. Exacerbating effects of trimellitic anhydride in ovalbumin-induced asthmatic mice and the gene and protein expressions of TRPA1, TRPV1, TRPV2 in lung tissue. Int Immunopharmacol 2019; 69:159-168. [PMID: 30716586 DOI: 10.1016/j.intimp.2019.01.038] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 01/11/2019] [Accepted: 01/27/2019] [Indexed: 12/27/2022]
Abstract
With the increasing morbidity and mortality of asthma, asthma aggravated by environmental pollution has drawn more attention. This study investigated the exacerbating effects of trimellitic anhydride (TMA), a typical pollutant, in ovalbumin (OVA)-induced asthmatic mice and the gene and protein expressions of TRPA1, V1, V2 in lung tissue. Female BALB/c mice were respectively administered for 42 days as follow: sensitized and challenged with OVA, sensitized and challenged with TMA, sensitized with OVA and challenged with OVA plus TMA, as well as sensitized and challenged with OVA plus TMA. 24 h after the last challenge, the changes in airway resistance (RI) and lung dynamic compliance (Cdyn) were tested. The levels of the inflammatory cells in blood and bronchoalveolar lavage fluid (BALF) were determined. The gene and protein expressions of TRPA1, V1, V2 in lung tissue were examined, and levels of interleukin (IL)-4, -13, substance P (SP), prostaglandin D2 (PGD2), nerve growth factor (NGF) in BALF and the supernatant of lung homogenate were measured. The results indicated that OVA plus TMA significantly increased the amount of inflammatory cells in blood and BALF, enhanced RI while decreased Cdyn, and aggravated lung injury. Increased gene and protein expressions of TRPA1, V1, V2 in lung tissue, level of IL-4 in the supernatant of lung homogenate, levels of IL-13, SP, PGD2, NGF in BALF and the supernatant of lung homogenate were observed. It was suggested that exacerbating effects of TMA in OVA-induced asthma might be related to the regulation of TRPA1, V1, V2 and relevant neurokines.
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Affiliation(s)
- Mengwen Li
- School of Basic Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Xinsheng Fan
- School of Basic Medicine, Nanjing University of Chinese Medicine, Nanjing, China.
| | - Leilei Ji
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, China
| | - Yuhao Fan
- School of Basic Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Li Xu
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, China
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23
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LaSee CR, Reeb-Whitaker CK. Work-related asthma surveillance in Washington State: time trends, industry rates, and workers' compensation costs, 2002-2016. J Asthma 2019; 57:421-430. [PMID: 30701998 DOI: 10.1080/02770903.2019.1571084] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objective: Washington State's work-related asthma (WRA) surveillance program utilizes workers' compensation (WC) data as its primary data source and has spanned a 15-year time period. This study analyses trends for WRA claim incidence rates compared to all WC claim incidence rates. WRA claim incidence rates and WC costs are analyzed by industry. Methods: Potential WRA cases were identified through the WC system and through direct provider report and classified by industry, age, and year of illness onset. WRA claim rates by industry and year were calculated using total work hours reported by employers covered by the WC system. Claim costs for accepted claims were compared by industry and year. Results: WRA claim incidence rates decreased 8.9% (95% CI: -10.6, -7.2) annually for the time period 2002-2016. The decline in WRA claim incidence rate is slightly faster than the incidence rate for all WC claims which had its steepest decrease from 2007 to 2010 at an estimated annual 8.4% decrease (95% CI: -11.8, -5.0). WRA claim rates were highest for workers in Public Administration, Manufacturing, and the Agricultural, Forestry, Fishing and Hunting industries. Median claim costs for WRA did not change significantly by year (p = 0.2, range $595-$1442) and the distribution of WRA WC claim costs by industry were highest in Manufacturing (21.3%) and Construction (16.4%) industries. Conclusion: WRA claim incidence rates are declining in Washington State. The cause for the decline is unclear. Workers across all industries in Washington remain at risk for WRA.
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Affiliation(s)
- Claire R LaSee
- Washington State Department of Labor and Industries, Safety and Health Assessment and Research for Prevention (SHARP), Olympia, Washington, USA
| | - Carolyn K Reeb-Whitaker
- Washington State Department of Labor and Industries, Safety and Health Assessment and Research for Prevention (SHARP), Olympia, Washington, USA
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Occupational Diseases among Workers in Lower and Higher Socioeconomic Positions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15122849. [PMID: 30551643 PMCID: PMC6313496 DOI: 10.3390/ijerph15122849] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 12/10/2018] [Accepted: 12/12/2018] [Indexed: 01/06/2023]
Abstract
Background: To determine differences between workers in lower and higher socioeconomic positions (SEP) in incidences of occupational disease (OD) and incapacity for work due to ODs. Methods: From a Dutch dynamic prospective cohort of occupational physicians (OPs), ODs assessed by OPs were retrieved for lower and higher SEP groups. Results: Among the lower SEP, musculoskeletal disorders, and noise-induced hearing loss (NIHL) comprised two-thirds of the OD diagnoses. Among the higher SEP, stress/burnout comprised 60% of the OD diagnoses. Temporary and permanent incapacity for work due to work-related lower back disorders and repetitive strain injuries differed significantly between workers in lower compared to higher SEP. Conclusions: Occupational diseases occur at a 2.7 higher incidence rate for workers in lower SEP compared with higher SEP. Incapacity for work varies between the type of OD and the level of SEP.
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25
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Al-Rousan T, Sparks JA, Pettinger M, Chlebowski R, Manson JE, Kauntiz AM, Wallace R. Menopausal hormone therapy and the incidence of carpal tunnel syndrome in postmenopausal women: Findings from the Women's Health Initiative. PLoS One 2018; 13:e0207509. [PMID: 30513095 PMCID: PMC6279038 DOI: 10.1371/journal.pone.0207509] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 11/10/2018] [Indexed: 01/08/2023] Open
Abstract
Importance Carpal tunnel syndrome (CTS) is a common and debilitating condition that commonly affects postmenopausal women. Objective To determine the effect of menopausal hormone therapy (HT) in healthy postmenopausal women on CTS risk. Design We conducted a secondary analysis of the Women’s Health Initiative’s (WHI) HT trials linked to Medicare claims data. Separate intention-to-treat analyses were performed for the two trials; the conjugated equine estrogens alone (CEE alone) and the trial of CEE plus medroxyprogesterone acetate (MPA) trial. (ClinicalTrials.gov, NCT number): NCT00000611. Setting Two randomized, double-blind, placebo-controlled trials conducted at 40 US clinical centers. Participants The sample size included in the analysis was 16,053 community-dwelling women aged ≥65 years at study entry or those who later aged into Medicare eligibility, and who were enrolled in Medicare (including Part A and/or Part B coverage). Intervention Women with hysterectomy were randomized to 0.625 mg/d of conjugated equine estrogens (CEE) or placebo (n = 8376). Women without hysterectomy were randomized to estrogen plus progestin (E+P), given as CEE plus 2.5 mg/d of medroxyprogesterone acetate (n = 14203). Main outcome(s) The primary outcome was incident CTS and the secondary outcome was therapeutic CTS procedure occurring during the intervention phases of the trials. Results A total of 16,053 women were randomized in both trials. During mean follow up of 4.5 ± 2.8 years in the CEE trial (n = 6,833), there were 203 incident CTS cases in the intervention and 262 incident CTS cases in the placebo group (HR, 0.78; 95% CI, 0.65–0.94; P = 0.009). The CEE+MPA trial (n = 9,220) followed participants for a mean of 3.7 ± 2.3 years. There were 173 incident CTS cases in the intervention compared to 203 cases in the placebo group (HR, 0.80, 95% CI, 0.65–0.97; P = 0.027). Conclusions These findings suggest a protective effect of menopausal HT on the incidence of CTS among postmenopausal women. A potential therapeutic role for other forms of estrogen therapy in the management of CTS warrants future research.
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Affiliation(s)
- Tala Al-Rousan
- Department of Global Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, United States of America
- * E-mail:
| | - Jeffrey A. Sparks
- Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
| | - Mary Pettinger
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America
| | - Rowan Chlebowski
- Department of Medical Oncology and Therapeutics Research, City of Hope National Medical Center, Duarte, California, United States of America
| | - JoAnn E. Manson
- Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Andrew M. Kauntiz
- Department of Obstetrics and Gynecology, University of Florida College of Medicine, Jacksonville, Florida, United States of America
| | - Robert Wallace
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa, United States of America
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Uter W, Bauer A, Bensefa-Colas L, Brans R, Crépy MN, Giménez-Arnau A, Larese Filon F, Ljubojević Hadžavdić S, Pesonen M, Schuttelaar ML, Wilkinson M. Pilot study on a new concept of documenting the clinical relevance of patch test results in contact dermatitis patients. Contact Dermatitis 2018; 79:370-377. [DOI: 10.1111/cod.13097] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 07/04/2018] [Accepted: 07/16/2018] [Indexed: 12/01/2022]
Affiliation(s)
- Wolfgang Uter
- Department of Medical Informatics, Biometry and Epidemiology; University of Erlangen/Nürnberg; Erlangen Germany
| | - Andrea Bauer
- Department of Dermatology, University Hospital Carl Gustav Carus; University Allergy Centre, Technical University of Dresden; Dresden Germany
| | - Lynda Bensefa-Colas
- Department of Occupational and Environmental Diseases; University Hospital of Centre of Paris, Hotel-Dieu Hospital, AP-HP; Paris France
- Laboratoire Santé Publique et Environnement, EA 4064; Descartes University, Sorbonne Paris Cité; Paris France
| | - Richard Brans
- Department of Dermatology, Environmental Medicine and Health Theory; University of Osnabrück; Osnabrück Germany
| | - Marie-Noëlle Crépy
- Department of Occupational and Environmental Diseases; University Hospital of Centre of Paris, Hotel-Dieu Hospital, AP-HP; Paris France
| | - Ana Giménez-Arnau
- Department of Dermatology, Hospital del Mar; Institut Mar d'Investigacions Mediques, Universitat Autónoma; Barcelona Spain
| | - Francesca Larese Filon
- Department of Medical Sciences; Unit of Occupational Medicine, University of Trieste; Trieste Italy
| | | | - Maria Pesonen
- Occupational Medicine, Finnish Institute of Occupational Health (FIOH), Työterveyslaitos; Helsinki Finland
| | - Marie L.A. Schuttelaar
- Department of Dermatology, University Medical Centre Groningen; University of Groningen; Groningen The Netherlands
| | - Mark Wilkinson
- Department of Dermatology, Chapel Allerton Hospital; Leeds UK
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Benavides FG, Delclós J, Serra C. [Welfare State and public health: the role of occupational health]. GACETA SANITARIA 2018; 32:377-380. [PMID: 28941662 DOI: 10.1016/j.gaceta.2017.07.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 07/11/2017] [Accepted: 07/11/2017] [Indexed: 11/25/2022]
Abstract
In the context of the current crisis of the Welfare State, occupational health can contribute significantly to its sustainability by facilitating decent and healthy employment throughout the working life. To this end, occupational health must take on the challenge of promoting health, preventing and managing injuries, illnesses and disability, based on better coordination of prevention services, mutual insurance companies, and health services, as well as by empowering the leadership in prevention of companies and the active participation of those who work.
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Affiliation(s)
- Fernando G Benavides
- Centro de Investigación en Salud Laboral, Universitat Pompeu Fabra, Barcelona, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España; IMIM-Parc Salut Mar, Barcelona, España.
| | - Jordi Delclós
- Centro de Investigación en Salud Laboral, Universitat Pompeu Fabra, Barcelona, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España; IMIM-Parc Salut Mar, Barcelona, España; Escuela de Salud Pública, Universidad de Texas, Houston, Estados Unidos
| | - Consol Serra
- Centro de Investigación en Salud Laboral, Universitat Pompeu Fabra, Barcelona, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España; IMIM-Parc Salut Mar, Barcelona, España
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28
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Lesage FX, Dutheil F, Godderis L, Divies A, Choron G. Incidence of ill-health related job loss and related social and occupational factors. The "unfit for the job" study: a one-year follow-up study of 51,132 workers. PeerJ 2018; 6:e5073. [PMID: 29942704 PMCID: PMC6014311 DOI: 10.7717/peerj.5073] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 06/04/2018] [Indexed: 11/26/2022] Open
Abstract
Objective The analysis of ill-health related job loss may be a relevant indicator for the prioritization of actions in the workplace or in the field of public health, as well as a target for health promotion. The aim of this study was to analyze the medical causes, the incidence, and the characteristics of employees medically unfit to do their job. Methods This one-year prospective study included all workers followed by occupational physicians in an occupational health service in the south of France. The incidence of unfitness for work have been grouped according to the main medical causes and analyzed. We performed a multivariate analysis in order to adjust the observed risk of job loss based on the age groups, sex, occupation and the activity sectors. Results A total of 17 occupational physicians followed up 51,132 workers. The all-cause incidence of being unfit to return to one’s job was 7.8‰ (n = 398). The two main causes of being unfit for one’s job were musculoskeletal disorders (47.2%, n = 188) and mental ill-health (38.4%, n = 153). Being over 50 years old (Odds ratio (OR) 2.63, confidence interval 95% CI [2.13–3.25]) and being a woman (OR 1.52, 95% CI [1.21–1.91]) were associated with the all-cause unfitness, independent of occupation and activity sector. Conclusions Identification of occupational and demographic determinants independently associated with ill-health related job loss may provide significant and cost-effective arguments for health promotion and job loss prevention.
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Affiliation(s)
| | - Frederic Dutheil
- CNRS, LaPSCo, Physiological and Psychosocial Stress, University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Preventive and Occupational Medicine, WittyFit, Université Clermont Auvergne, Clermont-Ferrand, France.,Faculty of Health, School of Exercise Science, Australian Catholic University, Melbourne, VIC, Australia
| | - Lode Godderis
- Department of Public Health and Primary Care, Environment and Health, Katholieke Universiteit Leuven, Leuven, Belgium
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Macpherson RA, Lane TJ, Collie A, McLeod CB. Age, sex, and the changing disability burden of compensated work-related musculoskeletal disorders in Canada and Australia. BMC Public Health 2018; 18:758. [PMID: 29914425 PMCID: PMC6007009 DOI: 10.1186/s12889-018-5590-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 05/23/2018] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND The objectives of this study were (1) to identify age and sex trends in the disability burden of compensated work-related musculoskeletal disorders (MSDs) in Canada and Australia; and (2) to demonstrate a means of comparing workers' compensation data internationally. METHODS All non-fatal, work-related MSD claims with at least one day of compensated time-loss were extracted for workers aged 15-80 during a 10-year period (2004-2013) using workers' compensation data from five Canadian and eight Australian jurisdictions. Disability burden was calculated for both countries by sex, age group, and injury classification, using cumulative compensated time-loss payments of up to two years post-injury. RESULTS A total of 1.2 million MSD claims were compensated for time-loss in the Canadian and Australian jurisdictions during 2004-2013. This resulted in time-loss equivalent to 239,345 years in the Canadian jurisdictions and 321,488 years in the Australian jurisdictions. The number of time-loss years declined overall among male and female workers, but greater declines were observed for males and younger workers. The proportion of the disability burden grew among older workers (aged 55+), particularly males in the Canadian jurisdictions (Annual Percent Change [APC]: 7.2, 95% CI 6.7 to 7.7%) and females in the Australian jurisdictions (APC: 7.5, 95% CI 6.2 to 8.9%). CONCLUSIONS The compensated disability burden of work-related MSDs is shifting towards older workers and particularly older females in Australia and older males in Canada. Employers and workers' compensation boards should consider the specific needs of older workers to reduce injuries and time off work. Comparative research made possible through research-stakeholder partnerships offers a unique opportunity to use existing administrative data to identify long-term trends in disability burden. Future research can apply similar approaches for estimating long-term trends in occupational health.
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Affiliation(s)
- Robert A. Macpherson
- Partnership for Work, Health and Safety, School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC V6T 1Z3 Canada
| | - Tyler J. Lane
- Insurance, Work and Health Group, Faculty of Medicine Nursing and Health Sciences, Monash University, Melbourne, VIC Australia
| | - Alex Collie
- Insurance, Work and Health Group, Faculty of Medicine Nursing and Health Sciences, Monash University, Melbourne, VIC Australia
| | - Christopher B. McLeod
- Partnership for Work, Health and Safety, School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC V6T 1Z3 Canada
- Institute for Work & Health, Toronto, ON Canada
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30
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Turner MC, Mehlum IS. Greater coordination and harmonisation of European occupational cohorts is needed. Occup Environ Med 2018; 75:475-476. [PMID: 29735748 PMCID: PMC6035485 DOI: 10.1136/oemed-2017-104955] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 03/17/2018] [Accepted: 04/23/2018] [Indexed: 12/15/2022]
Affiliation(s)
- Michelle C Turner
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,McLaughlin Centre for Population Health Risk Assessment, University of Ottawa, Ottawa, Ontario, Canada
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31
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De Matteis S, Heederik D, Burdorf A, Colosio C, Cullinan P, Henneberger PK, Olsson A, Raynal A, Rooijackers J, Santonen T, Sastre J, Schlünssen V, van Tongeren M, Sigsgaard T. Current and new challenges in occupational lung diseases. Eur Respir Rev 2017; 26:170080. [PMID: 29141963 PMCID: PMC6033059 DOI: 10.1183/16000617.0080-2017] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 09/02/2017] [Indexed: 01/13/2023] Open
Abstract
Occupational lung diseases are an important public health issue and are avoidable through preventive interventions in the workplace. Up-to-date knowledge about changes in exposure to occupational hazards as a result of technological and industrial developments is essential to the design and implementation of efficient and effective workplace preventive measures. New occupational agents with unknown respiratory health effects are constantly introduced to the market and require periodic health surveillance among exposed workers to detect early signs of adverse respiratory effects. In addition, the ageing workforce, many of whom have pre-existing respiratory conditions, poses new challenges in terms of the diagnosis and management of occupational lung diseases. Primary preventive interventions aimed to reduce exposure levels in the workplace remain pivotal for elimination of the occupational lung disease burden. To achieve this goal there is still a clear need for setting standard occupational exposure limits based on transparent evidence-based methodology, in particular for carcinogens and sensitising agents that expose large working populations to risk. The present overview, focused on the occupational lung disease burden in Europe, proposes directions for all parties involved in the prevention of occupational lung disease, from researchers and occupational and respiratory health professionals to workers and employers.
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Affiliation(s)
- Sara De Matteis
- Respiratory Epidemiology, Occupational Medicine and Public Health, Imperial College London, London, UK
| | - Dick Heederik
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Alex Burdorf
- Dept of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Claudio Colosio
- Dept of Health Sciences of the University of Milan and International Centre for Rural Health of the S. Paolo Hospital, Milan, Italy
| | - Paul Cullinan
- Respiratory Epidemiology, Occupational Medicine and Public Health, Imperial College London, London, UK
| | - Paul K Henneberger
- Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - Ann Olsson
- International Agency for Research on Cancer, Lyon, France
| | - Anne Raynal
- Occupational Medicine Division, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Jos Rooijackers
- Netherlands Expertise Center for Occupational Respiratory Disorders, Utrecht, The Netherlands
| | - Tiina Santonen
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Joaquin Sastre
- Allergy Service, Fundacion Jimenez Diaz, Faculty of Medicine Universidad Autonoma de Madrid, CIBER of Respiratory Diseases, Ministry of Economy, Madrid, Spain
| | - Vivi Schlünssen
- Dept of Public Health, Section of Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
- National Research Center for the Working Environment, Copenhagen, Denmark
| | - Martie van Tongeren
- Centre for Occupational and Environmental Health; Centre for Epidemiology; Division of Population Health, Health Services Research and Primary Care; School of Health Sciences; Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Torben Sigsgaard
- Dept of Public Health, Section of Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
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32
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Montgomery RL, Agius R, Wilkinson SM, Carder M. UK trends of allergic occupational skin disease attributed to fragrances 1996-2015. Contact Dermatitis 2017; 78:33-40. [DOI: 10.1111/cod.12902] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 08/21/2017] [Accepted: 09/03/2017] [Indexed: 12/01/2022]
Affiliation(s)
- Rachel L. Montgomery
- Leeds Teaching Hospitals NHS Trust - Centre for Dermatology; Chapel Allerton Hospital; Leeds LS7 4SA UK
| | - Raymond Agius
- Centre for Occupational and Environmental Health; University of Manchester; Manchester M13 9PL UK
| | - Stephen M. Wilkinson
- Leeds Teaching Hospitals NHS Trust - Centre for Dermatology; Chapel Allerton Hospital; Leeds LS7 4SA UK
| | - Melanie Carder
- Centre for Occupational and Environmental Health; University of Manchester; Manchester M13 9PL UK
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33
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Mustard CA. Work disability prevention: should we focus on high body weights or heavy physical workload? Occup Environ Med 2017; 74:619-620. [PMID: 28483972 DOI: 10.1136/oemed-2017-104394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 01/02/2017] [Accepted: 04/17/2017] [Indexed: 11/03/2022]
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34
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Stieb DM, Boot CR, Turner MC. Promise and pitfalls in the application of big data to occupational and environmental health. BMC Public Health 2017; 17:372. [PMID: 28482822 PMCID: PMC5422881 DOI: 10.1186/s12889-017-4286-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 04/22/2017] [Indexed: 11/26/2022] Open
Affiliation(s)
- David M Stieb
- Population Studies Division, Environmental Health Science and Research Bureau, Health Canada, 420-757 West Hastings St. - Federal Tower, Vancouver, BC, V6C 1A1, Canada. .,School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Canada.
| | - Cécile R Boot
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Center Amsterdam, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - Michelle C Turner
- Barcelona Institute for Global Health (ISGlobal), 4c/ Rosselló, 132, 5th 2nd, 08036, Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,McLaughlin Centre for Population Health Risk Assessment, University of Ottawa, Ottawa, ON, Canada
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35
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The Health and Occupation Research Network: An Evolving Surveillance System. Saf Health Work 2017; 8:231-236. [PMID: 28951798 PMCID: PMC5605884 DOI: 10.1016/j.shaw.2016.12.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Revised: 12/06/2016] [Accepted: 12/12/2016] [Indexed: 11/23/2022] Open
Abstract
Vital to the prevention of work-related ill-health (WRIH) is the availability of good quality data regarding WRIH burden and risks. Physician-based surveillance systems such as The Health and Occupation Research (THOR) network in the UK are often established in response to limitations of statutory, compensation-based systems for addressing certain epidemiological aspects of disease surveillance. However, to fulfil their purpose, THOR and others need to have methodologic rigor in capturing and ascertaining cases. This article describes how data collected by THOR and analogous systems can inform WRIH incidence, trends, and other determinants. An overview of the different strands of THOR research is provided, including methodologic advancements facilitated by increased data quantity/quality over time and the value of the research outputs for informing Government and other policy makers. In doing so, the utility of data collected by systems such as THOR to address a wide range of research questions, both in relation to WRIH and to wider issues of public and social health, is demonstrated.
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Gittins M, McNamee R, Holland F, Carter LA. Accounting for reporting fatigue is required to accurately estimate incidence in voluntary reporting health schemes. J Clin Epidemiol 2017; 81:77-85. [DOI: 10.1016/j.jclinepi.2016.09.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 09/05/2016] [Accepted: 09/12/2016] [Indexed: 10/21/2022]
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37
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Sim MR. Reflections on OEM in 2016. Occup Environ Med 2016; 74:1. [PMID: 27974630 DOI: 10.1136/oemed-2016-104224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2016] [Indexed: 11/04/2022]
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38
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Stocks SJ, Bensefa-Colas L, Berk SF. Worldwide trends in incidence in occupational allergy and asthma. Curr Opin Allergy Clin Immunol 2016; 16:113-9. [PMID: 26844753 DOI: 10.1097/aci.0000000000000249] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Recent improvements in the methods for analyzing trends in occupational health surveillance and the prospect of future improvements in the collecting and sharing of electronic data alongside increasing availability of linked datasets make this a good time to review the existing literature on trends in occupational allergy and asthma (OAA). RECENT FINDINGS There is a notable lack of reports of recent trends in OAA in the academic literature and much of the published work comes from European countries. The incidence of OAA appears to be declining based on physician-reporting or recognized compensation claims for the countries with published data. However, we need to be cautious in interpreting this as a decline in the 'true' incidence of OAA. Few of the studies adjusted appropriately for changes in the population at risk and one of the most robust study designs showed no change in the incidence of allergic contact dermatitis in contrast to the other studies. SUMMARY Many existing datasets have the potential to be used to examine trends, and studies from Canada show the potential of using linked databases for surveillance. We hope that this review will encourage improvements in the analysis, and more dissemination, of trends.
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Affiliation(s)
- Susan J Stocks
- aNIHR Greater Manchester Primary Care Patient Safety Translational Research Centre, Centre for Primary Care, Institute of Population Health, University of Manchester, Manchester, UK bOccupational Diseases Department, University Hospital of Centre of Paris HOTEL-DIEU, AP-HP cParis Descartes University, Sorbonne Paris Cité, Laboratoire Santé, Publique et Environnement, Paris, France dCollege of Engineering, Mathematics and Physical Sciences, University of Exeter, Exeter, UK
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39
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Barber CM, Wiggans RE, Carder M, Agius R. Epidemiology of occupational hypersensitivity pneumonitis; reports from the SWORD scheme in the UK from 1996 to 2015. Occup Environ Med 2016; 74:528-530. [PMID: 27919062 PMCID: PMC5520266 DOI: 10.1136/oemed-2016-103838] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 07/13/2016] [Accepted: 08/02/2016] [Indexed: 11/05/2022]
Abstract
Objective To estimate the reported incidence of occupational hypersensitivity pneumonitis (OHP) in the UK and to consider whether the pattern of attributed causation has changed over time. Methods All cases of OHP reported to the SWORD scheme between January 1996 and December 2015 were classified into 1 of 10 categories of the suspected agent. Cases were grouped into four 5-year time periods to examine any changing pattern in incidence or suspected causation. For each time period, the annual incidence was calculated using the estimated number of reported cases and the working population of the UK. Results Between 1996 and 2015, there were 202 actual cases of OHP reported to SWORD, equating to an estimated 818 cases, when adjusting for the sampling ratio. Over this period, the annual UK incidence was 1.4 per million workers. The mean (SD) age of reported cases was 52 (13) years, and cases were four-times more likely to be men than women. Over the study period, there was a fall in the proportion of cases reported to be due to agricultural exposures (44–12%), and an increase in cases due to metalworking fluids (MWFs, 2–45%). Conclusions Over the last 20 years, the incidence of OHP in the UK has been ∼1–2 cases per million workers per year. Working with water-based MWFs is now the most commonly suspected causative exposure for OHP cases reported to the SWORD scheme in the UK.
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Affiliation(s)
- C M Barber
- Health and Safety Laboratory, Centre for Workplace Health, Health and Safety Executive, Buxton, UK
| | - R E Wiggans
- Health and Safety Laboratory, Centre for Workplace Health, Health and Safety Executive, Buxton, UK
| | - M Carder
- Centre for Occupational and Environmental Health, The University of Manchester, Manchester, UK
| | - R Agius
- Centre for Occupational and Environmental Health, The University of Manchester, Manchester, UK
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40
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Radon K, Nowak D, Vogelberg C, Ruëff F. Career Advice for Young Allergy Patients. DEUTSCHES ARZTEBLATT INTERNATIONAL 2016; 113:519-24. [PMID: 27581504 PMCID: PMC5012160 DOI: 10.3238/arztebl.2016.0519] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Revised: 04/14/2016] [Accepted: 04/14/2016] [Indexed: 02/06/2023]
Abstract
BACKGROUND One-third of all young persons entering the work force have a history of atopic disease. Occupationally induced allergy and asthma generally arise in the first few months on the job, while pre-existing symptoms tend to worsen. Young persons with a history of an atopic disease should receive evidence-based advice before choosing a career. METHODS We systematically searched PubMed for cohort studies investigating the new onset of asthma, rhinitis, or hand eczema among job trainees from before the start of training and onward into the first few years on the job. The search revealed 514 articles; we read their abstracts and selected 85 full-text articles for further analysis. 24 of these met the inclusion criteria. RESULTS According to present evidence, atopy and a history of allergic disease (allergic rhinitis, atopic dermatitis) are the main risk factors for occupationally induced disease. The predictive value of a personal history of allergic diseases for the later development of an occupationally induced disease varies from 9% to 64% in the studies we analyzed. It follows that only young people with severe asthma or severe atopic eczema should be advised against choosing a job that is associated with a high risk of allergy, e.g., hairdressing or working with laboratory animals. Young people with a history of other atopic diseases should be counseled about their individual risk profile. CONCLUSION In view of the relatively poor predictive value of pre-existing atopic disease, secondary prevention is particularly important. This includes frequent medical follow-up of the course of symptoms over the first few years on the job. If sensitization or allergic symptoms arise, it should be carefully considered whether exposure reduction will enable the apprentice to stay on the job.
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Affiliation(s)
- Katja Radon
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, AllergieZENTRUM, Klinikum der Universität München
- Comprehensive Pneumology Center, DZL, Deutsches Zentrum für Lungenforschung, München
| | - Dennis Nowak
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, AllergieZENTRUM, Klinikum der Universität München
- Comprehensive Pneumology Center, DZL, Deutsches Zentrum für Lungenforschung, München
| | | | - Franziska Ruëff
- Department of Dermatology and Allergology, AllergieZENTRUM, Klinikum der Universität München
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Abstract
INTRODUCTION The diagnoses of workers being unfit to work may be a relevant health indicator. Therefore, the aim of this study was to analyze the one-year incidence of an unfit to work diagnosis. METHOD This one-year prospective study included all workers undergoing annual work medical examination from occupational health services in Troyes, France. RESULTS Twenty-one occupational physicians followed 54,026 employees. The all-cause incidence of being unfit to return to work was 0.772%. The two main causes of being unfit to work were musculoskeletal disorders (61%) and psychopathologies (24%). The relative risk (RR) of being unfit to work, independent of the cause, was higher when employees were aged over 50 years (RR = 2.51), and female (RR = 1.51). CONCLUSIONS Prospective results from occupational physicians' medical records may provide significant and cost-effective directions to prioritize actions and target health promotion in the workplace.
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van der Molen HF, de Vries SC, Stocks SJ, Warning J, Frings-Dresen MHW. Incidence rates of occupational diseases in the Dutch construction sector, 2010-2014. Occup Environ Med 2016; 73:350-2. [PMID: 26940576 DOI: 10.1136/oemed-2015-103429] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2015] [Accepted: 01/20/2016] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To estimate incidence and trends in incidence of occupational diseases (ODs) in the Dutch construction sector. METHODS In a dynamic prospective cohort over a 5-year period (2010-2014), ODs assessed by occupational physicians (OPs) participating in a voluntary construction workers health surveillance (WHS) were reported to the Netherlands Centre for Occupational Diseases (NCOD). ODs were defined as a disease with a specific clinical diagnosis (International Classification of Diseases) that was predominantly caused by work-related factors as assessed by an OP. Annual incidences were determined for the total number of ODs and six frequently occurring OD groups. Trends in incidence were estimated using a multilevel negative binominal regression model. RESULTS In 2014 the incidence of all OD was 12 964 per 100 000 workers and there was no significant change in incidence between 2010 and 2014 (3%; 95% CI -2% to +9%). Hearing loss (8125 per 100 000 workers) and musculoskeletal disorders (2081 per 100 000 workers) were the most frequently occurring ODs. Noise-induced hearing loss (+7%; 95% CI 1% to 13%) and contact dermatitis (+19%; 95% CI 6% to 33%) showed increasing trends. There was no statistically significant change in the incidence of low back pain, arthrosis, repetitive strain injuries, distress/burnout and chronic obstructive pulmonary disease/asthma. CONCLUSIONS In total, 13% of workers participating in WHS in the Dutch construction industry during 2014 had an OD diagnosed and reported by an OP. Over a 5-year period the annual incidence of reported ODs showed a statistically non-significant increase. Incidences in noise-induced hearing loss and contact dermatitis showed statistically significant increasing trends, 7% and 19%, respectively.
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Affiliation(s)
- Henk F van der Molen
- Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Netherlands Center for Occupational Diseases, Amsterdam, The Netherlands
| | - Sanne C de Vries
- Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Netherlands Center for Occupational Diseases, Amsterdam, The Netherlands
| | - S Jill Stocks
- NIHR Greater Manchester Primary Care Patient Safety Translational Research Centre, Centre for Primary Care, Institute of Population Health, University of Manchester, Manchester, UK
| | | | - Monique H W Frings-Dresen
- Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, Netherlands Center for Occupational Diseases, Amsterdam, The Netherlands
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Agius R, Lenderink A, Colosio C. Finding ‘new’ occupational diseases and trends in ‘old’ ones. Occup Med (Lond) 2015; 65:607-9. [DOI: 10.1093/occmed/kqv110] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Campo G, Papale A, Baldasseroni A, Di Leone G, Magna B, Martini B, Mattioli S. The surveillance of occupational diseases in Italy: the MALPROF system. Occup Med (Lond) 2015; 65:632-7. [DOI: 10.1093/occmed/kqv167] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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45
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Wiszniewska M, Walusiak-Skorupa J. Recent Trends in Occupational Contact Dermatitis. Curr Allergy Asthma Rep 2015; 15:43. [PMID: 26143395 DOI: 10.1007/s11882-015-0543-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Occupational contact dermatitis (OCD) remains prevalent among workers and impacts quality of life and workability. The purpose of this review is to summarize the recent advances in occupational contact dermatitis as well as potential hazardous agents in the workplaces causing OCD. The review covers new developments in the epidemiology, etiology, diagnosis, and management of occupational contact dermatitis. This article also provides updated information on the prevalence of work-related skin symptoms and on new contact allergens among working population. It is emphasized that in the context of prevention of OCD, special attention should be focused on the identified high-risk occupational groups, especially healthcare workers and hairdressers starting with the apprentices. Current approaches include working out the standards and guidelines to improve the education, knowledge, diagnosis, and management of OCD based on a multidisciplinary team of medical specialists and an employer.
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Affiliation(s)
- Marta Wiszniewska
- Department of Occupational Diseases and Clinical Toxicology, Nofer Institute of Occupational Medicine, 8 Teresy St., 91-348, Lodz, Poland,
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Carder M, Bensefa-Colas L, Mattioli S, Noone P, Stikova E, Valenty M, Telle-Lamberton M. A review of occupational disease surveillance systems in Modernet countries. Occup Med (Lond) 2015; 65:615-25. [DOI: 10.1093/occmed/kqv081] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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van der Molen HF, Stocks SJ, Frings-Dresen MHW. Exploring Study Designs for Evaluation of Interventions Aimed to Reduce Occupational Diseases and Injuries. Saf Health Work 2015; 7:83-5. [PMID: 27014496 PMCID: PMC4792913 DOI: 10.1016/j.shaw.2015.09.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Revised: 08/18/2015] [Accepted: 09/03/2015] [Indexed: 01/17/2023] Open
Abstract
Effective interventions to reduce work-related exposures are available for many types of work-related diseases or injuries. However, knowledge of the impact of these interventions on injury or disease outcomes is scarce due to practical and methodological reasons. Study designs are considered for the evaluation of occupational health interventions on occupational disease or injury. Latency and frequency of occurrence of the health outcomes are two important features when designing an evaluation study with occupational disease or occupational injury as an outcome measure. Controlled evaluation studies—giving strong indications for an intervention effect—seem more suitable for more frequently occurring injuries or diseases. Uncontrolled evaluation time or case series studies are an option for evaluating less frequently occurring injuries or diseases. Interrupted time series offer alternatives to experimental randomized controlled trials to give an insight into the effectiveness of preventive actions in the work setting to decision and policy makers.
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Affiliation(s)
- Henk F van der Molen
- Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, The Netherlands
| | - Susan J Stocks
- Center for Occupational and Environmental Health, University of Manchester, Manchester, UK
| | - Monique H W Frings-Dresen
- Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam, The Netherlands
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Gallus S, Lugo A, Garavello W, Bosetti C, Santoro E, Colombo P, Perin P, La Vecchia C, Langguth B. Prevalence and Determinants of Tinnitus in the Italian Adult Population. Neuroepidemiology 2015; 45:12-9. [DOI: 10.1159/000431376] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2015] [Accepted: 05/10/2015] [Indexed: 11/19/2022] Open
Abstract
Background: Limited, outdated, and poor quality data are available on the prevalence of tinnitus, particularly in Italy. Methods: A face-to-face survey was conducted in 2014 on 2,952 individuals, who represented the Italian population aged 18 or more (50.6 million). Any tinnitus was defined as the presence of ringing or buzzing in the ears lasting for at least 5 min in the previous 12 months. Results: Any tinnitus was reported by 6.2% of Italian adults, chronic tinnitus (i.e. for more than 3 months) by 4.8%, and severe tinnitus (i.e. which constitutes a big or very big problem) by 1.2%. The corresponding estimates for the population aged ≥45 years were 8.7, 7.4 and 2.0%, respectively. Multivariable analysis on population aged ≥45 years revealed that old age (odds ratio (OR) = 4.49 for ≥75 vs. 45-54 years) and obesity (OR = 2.14 compared to normal weight) were directly related to any tinnitus, and high monthly family income (OR = 0.50) and moderate alcohol consumption (OR = 0.59 for <7 drinks/week vs. non-drinking) were inversely related. Conclusions: This is the first study on tinnitus prevalence among the general Italian adult population. It indicates that in Italy tinnitus affects more than 3 million adults and is felt as a major problem by more than 600,000 Italians, mostly aged 45 years or more.
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Tarlo SM. Trends in incidence of occupational asthma. Occup Environ Med 2015; 72:688-9. [PMID: 25896329 DOI: 10.1136/oemed-2015-102852] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Accepted: 03/25/2015] [Indexed: 11/04/2022]
Affiliation(s)
- Susan M Tarlo
- Department of Medicine, University of Toronto, Toronto Western Hospital, Toronto, Ontario, Canada
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