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Berrington de González A, Masten SA, Bhatti P, Fortner RT, Peters S, Santonen T, Yakubovskaya MG, Barouki R, Barros SBM, Barupal D, Beane Freeman LE, Calaf GM, Dillner J, El Rhazi K, Fritschi L, Fukushima S, Godderis L, Kogevinas M, Lachenmeier DW, Mandrioli D, Muchengeti MM, Niemeier RT, Pappas JJ, Pi J, Purdue MP, Riboli E, Rodríguez T, Schlünssen V, Benbrahim-Tallaa L, de Conti A, Facchin C, Pasqual E, Wedekind R, Ahmadi A, Chittiboyina S, Herceg Z, Kulasingam S, Lauby-Secretan B, MacLehose R, Sanaa M, Schüz J, Suonio E, Zavadil J, Mattock H, Madia F, Schubauer-Berigan MK. Advisory Group recommendations on priorities for the IARC Monographs. Lancet Oncol 2024; 25:546-548. [PMID: 38621402 DOI: 10.1016/s1470-2045(24)00208-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Affiliation(s)
| | - Scott A Masten
- International Agency for Research on Cancer, Lyon, France
| | - Parveen Bhatti
- International Agency for Research on Cancer, Lyon, France
| | | | - Susan Peters
- International Agency for Research on Cancer, Lyon, France
| | - Tiina Santonen
- International Agency for Research on Cancer, Lyon, France
| | | | - Robert Barouki
- International Agency for Research on Cancer, Lyon, France
| | | | - Dinesh Barupal
- International Agency for Research on Cancer, Lyon, France
| | | | - Gloria M Calaf
- International Agency for Research on Cancer, Lyon, France
| | - Joakim Dillner
- International Agency for Research on Cancer, Lyon, France
| | | | - Lin Fritschi
- International Agency for Research on Cancer, Lyon, France
| | | | - Lode Godderis
- International Agency for Research on Cancer, Lyon, France
| | | | | | | | | | | | - Jane J Pappas
- International Agency for Research on Cancer, Lyon, France
| | - Jingbo Pi
- International Agency for Research on Cancer, Lyon, France
| | - Mark P Purdue
- International Agency for Research on Cancer, Lyon, France
| | - Elio Riboli
- International Agency for Research on Cancer, Lyon, France
| | | | | | | | - Aline de Conti
- International Agency for Research on Cancer, Lyon, France
| | | | - Elisa Pasqual
- International Agency for Research on Cancer, Lyon, France
| | | | - Ayat Ahmadi
- International Agency for Research on Cancer, Lyon, France
| | | | - Zdenko Herceg
- International Agency for Research on Cancer, Lyon, France
| | | | | | | | - Moez Sanaa
- International Agency for Research on Cancer, Lyon, France
| | - Joachim Schüz
- International Agency for Research on Cancer, Lyon, France
| | - Eero Suonio
- International Agency for Research on Cancer, Lyon, France
| | - Jiri Zavadil
- International Agency for Research on Cancer, Lyon, France
| | - Heidi Mattock
- International Agency for Research on Cancer, Lyon, France
| | - Federica Madia
- International Agency for Research on Cancer, Lyon, France
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Biering K, Kinnerup M, Cramer C, Dalbøge A, Toft Würtz E, Lund Würtz AM, Kolstad HA, Schlünssen V, Meulengracht Flachs E, Nielsen KJ. Use, failure, and non-compliance of respiratory personal protective equipment and risk of upper respiratory tract infections-A longitudinal repeated measurement study during the COVID-19 pandemic among healthcare workers in Denmark. Ann Work Expo Health 2024; 68:376-386. [PMID: 38373246 DOI: 10.1093/annweh/wxae008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 01/31/2024] [Indexed: 02/21/2024] Open
Abstract
INTRODUCTION Upper respiratory tract infections (URTI) are common and a common cause of sick-leave for healthcare workers, and furthermore pose a threat especially for patients susceptible to other diseases. Sufficient use of respiratory protective equipment (RPE) may protect both the workers and the patients. The COVID-19 pandemic provided a unique opportunity to study the association between use of RPE and URTI in a real-life setting. The aim of this study was to examine if failure of RPE or non-compliance with RPE guidelines increases the risk of non-COVID-19 URTI symptoms among healthcare workers. METHODS In a longitudinal cohort study, we collected self-reported data daily on work tasks, use of RPE, and URTI symptoms among healthcare workers with patient contact in 2 Danish Regions in 2 time periods during the COVID-19 pandemic. The association between failure of RPE or non-compliance with RPE guidelines and URTI symptoms was analyzed separately by generalized linear models. Persons tested positive for severe acute respiratory syndrome coronavirus 2 were censored from the analyses. The 2 waves of data collection were analyzed separately, as there were differences in recommendations of RPE during the 2 waves. RESULTS We found that for healthcare workers performing work tasks with a risk of transmission of viruses or bacteria, failure of RPE was associated with an increased risk of URTI symptoms, RR: 1.65[0.53-5.14] in wave 1 and RR: 1.30[0.56-3.03] in wave 2. Also non-compliance with RPE guidelines was associated with an increased risk of URTI symptoms compared to the use of RPE in wave 1, RR: 1.28[0.87-1.87] and wave 2, RR: 1.39[1.01-1.91]. Stratifying on high- versus low-risk tasks showed that the risk related to failure and non-compliance was primarily associated with high-risk tasks, although not statistically significant. DISCUSSION The study was conducted during the COVID-19 pandemic and thus may be affected by other preventive measures in society. However, this gave the opportunity to study the use of RPE in a real-life setting, also in departments that did not previously use RPE. The circumstances in the 2 time periods of data collection differed and were analyzed separately and thus the sample size was limited and affected the precision of the estimates. CONCLUSION Failures of RPE and non-compliance with RPE guidelines may increase the risk of URTI, compared to those who reported use of RPE as recommended. The implications of these findings are that the use of RPE to prevent URTI could be considered, especially while performing high-risk tasks where other prevention strategies are not achievable.
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Affiliation(s)
- Karin Biering
- Department of Occupational Medicine, University Research Clinic, Danish Ramazzini Centre, Goedstrup Hospital, 7400 Herning, Denmark
| | - Martin Kinnerup
- Department of Occupational Medicine, University Research Clinic, Danish Ramazzini Centre, Goedstrup Hospital, 7400 Herning, Denmark
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | - Christine Cramer
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, 8200 Aarhus N, Denmark
- Department of Public Health, Research Unit for Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, 8000 Aarhus C, Denmark
| | - Annett Dalbøge
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | - Else Toft Würtz
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, 8200 Aarhus N, Denmark
- Department of Occupational and Environmental Medicine, Danish Ramazzini Centre, Aalborg University Hospital, 9000 Aalborg, Denmark
| | - Anne Mette Lund Würtz
- Department of Public Health, Research Unit for Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, 8000 Aarhus C, Denmark
| | - Henrik Albert Kolstad
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | - Vivi Schlünssen
- Department of Public Health, Research Unit for Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, 8000 Aarhus C, Denmark
| | - Esben Meulengracht Flachs
- Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, 2400 Copenhagen NV, Denmark
| | - Kent J Nielsen
- Department of Occupational Medicine, University Research Clinic, Danish Ramazzini Centre, Goedstrup Hospital, 7400 Herning, Denmark
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Iversen IB, Vestergaard JM, Ohlander J, Peters S, Bendstrup E, Bonde JPE, Schlünssen V, Bønløkke JH, Rasmussen F, Stokholm ZA, Andersen MB, Kromhout H, Kolstad HA. The asbestos-asbestosis exposure-response relationship: a cohort study of the general working population. Scand J Work Environ Health 2024:4153. [PMID: 38577971 DOI: 10.5271/sjweh.4153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024] Open
Abstract
OBJECTIVES The association between asbestos exposure and asbestosis in high-exposed industrial cohorts is well-known, but there is a lack of knowledge about the exposure-response relationship for asbestosis in a general working population setting. We examined the exposure-response relationship between occupational asbestos exposure and asbestosis in asbestos-exposed workers of the Danish general working population. METHODS We followed all asbestos-exposed workers from 1979 to 2015 and identified incident cases of asbestosis using the Danish National Patient Register. Individual asbestos exposure was estimated with a quantitative job exposure matrix (SYN-JEM) from 1976 onwards and back-extrapolated to age 16 for those exposed in 1976. Exposure-response relations for cumulative exposure and other exposure metrics were analyzed using a discrete time hazard model and adjusted for potential confounders. RESULTS The range of cumulative exposure in the population was 0.001 to 18 fibers per milliliter-year (f/ml-year). We found increasing incidence rate ratios (IRR) of asbestosis with increasing cumulative asbestos exposure with a fully adjusted IRR per 1 f/ml-years of 1.18 [95% confidence interval (CI) 1.15- -1.22]. The IRR was 1.94 (95% CI 1.53-2.47) in the highest compared to the lowest exposure tertile. We similarly observed increasing risk with increasing cumulative exposure in the inception population. CONCLUSIONS This study found exposure-response relations between cumulative asbestos exposure and incident asbestosis in the Danish general working population with mainly low-level exposed occupations, but there is some uncertainty regarding the exposure levels.
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Affiliation(s)
- Inge Brosbøl Iversen
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark.
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Rokkedrejer SI, Schlünssen V, Kinnerup MB, Vestergaard JM, Kolstad HA, Cramer C. Risk of myocardial infarction among pigeon breeders: A follow-up study. Arch Environ Occup Health 2024; 78:507-511. [PMID: 38240700 DOI: 10.1080/19338244.2024.2302113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 01/01/2024] [Indexed: 02/08/2024]
Abstract
Pigeon breeders are exposed to high levels of fine particulate organic matter in the pigeon lofts. A total of 6,704 pigeon breeders and their 1:30 sex and age-matched referents from the general Danish population were followed from 1980 or first year of membership in the Danish Racing Pigeon Association, until first event of myocardial infarction, emigration, death, or end of study, on December 31, 2013. Information on outcomes and covariates was obtained by record linkage with national registers. Stratified Cox regression models estimated the hazard ratio of myocardial infarction, adjusted for occupation and residence at the start of follow-up. Compared with referents, pigeon breeders had an adjusted hazard ratio of 1.14 (95% CI: 1.05-1.22) for myocardial infarction. Exposure to pigeon-derived organic dust may increase the risk of myocardial infarction, but this finding needs to be corroborated.
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Affiliation(s)
- Sandra Ileby Rokkedrejer
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark
| | - Vivi Schlünssen
- Department of Public Health, Unit for Work, Environment and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - Martin Byskov Kinnerup
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark
| | - Jesper Medom Vestergaard
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark
| | - Henrik Albert Kolstad
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark
| | - Christine Cramer
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark
- Department of Public Health, Unit for Work, Environment and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
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Viken AF, Siiak SP, Schlünssen V, Thorarinsdottir EH, Skulstad SM, Gyawali S, Bertelsen RJ, Real FG. Muscle Strength and Male Sexual Function. J Clin Med 2024; 13:426. [PMID: 38256560 PMCID: PMC10816204 DOI: 10.3390/jcm13020426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 01/03/2024] [Accepted: 01/08/2024] [Indexed: 01/24/2024] Open
Abstract
Sexual dysfunction, in particular erectile dysfunction, is a common complaint among aging men. Obesity, diabetes, hypertension, and smoking are shown to be independent risk factors for erectile dysfunction, while cardiorespiratory fitness is shown to be protective. Less is known about the role of muscle strength in male sexual function. Our objective was to study the association between male sexual function and typical cardiovascular risk factors, together with exercise and muscle strength. We included data from the fourth wave of the RHINE study. Data on anthropometrics, exercise habits, diseases, muscle strength, and sexual function were collected using questionnaires, including the Aging Males' Symptoms (AMS) scale. We used multivariable logistic regression analysis to measure the association between sexual function and body mass index (BMI), age, smoking, diabetes, hypertension, exercise and muscle strength status. We included 2116 men aged 48-75 from four Nordic-Baltic countries. BMI, age, smoking, diabetes, and hypertension were found to be associated with higher odds of reporting decreased sexual function, while reporting intact muscle strength was associated with lower odds. In a large Nordic-Baltic male study population, we show that known cardiovascular risk factors are associated with decreased sexual function, while reporting intact muscle strength is associated with lower odds of reporting decreased sexual function.
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Affiliation(s)
- Anders Flataker Viken
- Department of Clinical Science, University of Bergen, 5021 Bergen, Norway; (R.J.B.); (F.G.R.)
| | | | - Vivi Schlünssen
- Research Unit for Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, 8000 Aarhus, Denmark;
- Department of Public Health, Aarhus University, 8000 Aarhus, Denmark
| | | | - Svein Magne Skulstad
- Department of Occupational Medicine, Haukeland University Hospital, 5021 Bergen, Norway (S.G.)
| | - Sanjay Gyawali
- Department of Occupational Medicine, Haukeland University Hospital, 5021 Bergen, Norway (S.G.)
| | | | - Francisco Gómez Real
- Department of Clinical Science, University of Bergen, 5021 Bergen, Norway; (R.J.B.); (F.G.R.)
- Department of Gynecology and Obstetrics, Haukeland University Hospital, 5021 Bergen, Norway
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Christiansen AG, Kinnerup MB, Carstensen O, Sommerlund M, Clausen PA, Bønløkke JH, Schlünssen V, Isaksson M, Schmidt SAJ, Kolstad HA. Occupational exposure to epoxy components and risk of dermatitis: A registry-based follow-up study of the wind turbine industry. Contact Dermatitis 2024; 90:32-40. [PMID: 37795841 DOI: 10.1111/cod.14431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 09/06/2023] [Accepted: 09/15/2023] [Indexed: 10/06/2023]
Abstract
BACKGROUND Allergic contact allergy and dermatitis are frequently reported among epoxy-exposed workers. OBJECTIVES To determine the risk of dermatitis associated with epoxy exposure. METHODS We followed 825 epoxy-exposed and 1091 non-exposed blue-collar workers, and 493 white-collar workers of a Danish wind turbine blade factory during 2017-2022 with linked data from national health registers on diagnoses, patch testing, or fillings of prescriptions for topical corticosteroids. Incidence rate ratios of dermatitis or a first-time topical corticosteroid prescription were estimated with Poisson regression using non-exposed blue-collar workers as reference. We similarly estimated incidence rate ratios for the duration of epoxy exposure and current epoxy exposure. RESULTS Epoxy-exposed blue-collar workers showed a dermatitis incidence rate of 2.1 per 100 000 person days, a two-fold increased risk of dermatitis and a 20% increased risk of filling a prescription for topical corticosteroids. Incidence rate ratios were higher during early exposure and declined with further exposure for both outcomes. White-collar workers had generally lower risks. CONCLUSION We observed an increased risk of dermatitis following epoxy exposure confirming previous case reports and cross-sectional studies emphasizing the need for intensified focus on preventive efforts for this group of workers.
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Affiliation(s)
| | - Martin Byskov Kinnerup
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark
- Department of Occupational Medicine, Danish Ramazzini Centre, The Regional Hospital Goedstrup, University Research Clinic, Herning, Denmark
| | - Ole Carstensen
- Department of Occupational Medicine, Danish Ramazzini Centre, The Regional Hospital Goedstrup, University Research Clinic, Herning, Denmark
| | - Mette Sommerlund
- Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark
| | - Per Axel Clausen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Jakob Hjort Bønløkke
- Department of Occupational and Environmental Medicine, Danish Ramazzini Centre, Aalborg University Hospital, Aalborg, Denmark
| | - Vivi Schlünssen
- Department of Public Health, Research Unit for Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - Marléne Isaksson
- Department of Occupational and Environmental Dermatology, Skane University Hospital Malmö, Lund University, Malmö, Sweden
| | - Sigrun Alba Johannesdottir Schmidt
- Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Henrik Albert Kolstad
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark
- Institute of Clinical Medicine, Aarhus University, Aarhus, Denmark
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Verscheure E, Stierum R, Schlünssen V, Lund Würtz AM, Vanneste D, Kogevinas M, Harding BN, Broberg K, Zienolddiny-Narui S, Erdem JS, Das MK, Makris KC, Konstantinou C, Andrianou X, Dekkers S, Morris L, Pronk A, Godderis L, Ghosh M. Characterization of the internal working-life exposome using minimally and non-invasive sampling methods - a narrative review. Environ Res 2023; 238:117001. [PMID: 37683788 DOI: 10.1016/j.envres.2023.117001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 08/24/2023] [Accepted: 08/25/2023] [Indexed: 09/10/2023]
Abstract
During recent years, we are moving away from the 'one exposure, one disease'-approach in occupational settings and towards a more comprehensive approach, taking into account the totality of exposures during a life course by using an exposome approach. Taking an exposome approach however is accompanied by many challenges, one of which, for example, relates to the collection of biological samples. Methods used for sample collection in occupational exposome studies should ideally be minimally invasive, while at the same time sensitive, and enable meaningful repeated sampling in a large population and over a longer time period. This might be hampered in specific situations e.g., people working in remote areas, during pandemics or with flexible work hours. In these situations, using self-sampling techniques might offer a solution. Therefore, our aim was to identify existing self-sampling techniques and to evaluate the applicability of these techniques in an occupational exposome context by conducting a literature review. We here present an overview of current self-sampling methodologies used to characterize the internal exposome. In addition, the use of different biological matrices was evaluated and subdivided based on their level of invasiveness and applicability in an occupational exposome context. In conclusion, this review and the overview of self-sampling techniques presented herein can serve as a guide in the design of future (occupational) exposome studies while circumventing sample collection challenges associated with exposome studies.
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Affiliation(s)
- Eline Verscheure
- Department of Public Health and Primary Care, Centre for Environment and Health, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Rob Stierum
- Netherlands Organisation for Applied Scientific Research TNO, Risk Analysis for Products in Development, Utrecht, the Netherlands
| | - Vivi Schlünssen
- Department of Public Health, Research unit for Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - Anne Mette Lund Würtz
- Department of Public Health, Research unit for Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - Dorian Vanneste
- Department of Public Health and Primary Care, Centre for Environment and Health, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Manolis Kogevinas
- Environment and Health over the Lifecourse Program, ISGlobal, Barcelona, Spain
| | - Barbara N Harding
- Environment and Health over the Lifecourse Program, ISGlobal, Barcelona, Spain
| | - Karin Broberg
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | | | - Mrinal K Das
- National Institute of Occupational Health, Oslo, Norway
| | - Konstantinos C Makris
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus
| | - Corina Konstantinou
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus
| | - Xanthi Andrianou
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus
| | - Susan Dekkers
- Netherlands Organisation for Applied Scientific Research TNO, Risk Analysis for Products in Development, Utrecht, the Netherlands
| | | | - Anjoeka Pronk
- Netherlands Organisation for Applied Scientific Research TNO, Risk Analysis for Products in Development, Utrecht, the Netherlands
| | - Lode Godderis
- Department of Public Health and Primary Care, Centre for Environment and Health, Katholieke Universiteit Leuven, Leuven, Belgium; Idewe, External Service for Prevention and Protection at work, Heverlee, Belgium.
| | - Manosij Ghosh
- Department of Public Health and Primary Care, Centre for Environment and Health, Katholieke Universiteit Leuven, Leuven, Belgium.
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Hammel SC, Hansen KK, Madsen AM, Kolstad HA, Schlünssen V, Frederiksen M. Organophosphate ester (OPE) exposure among waste recycling and administrative workers in Denmark using silicone wristbands. Chemosphere 2023; 345:140449. [PMID: 37839747 DOI: 10.1016/j.chemosphere.2023.140449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 09/10/2023] [Accepted: 10/12/2023] [Indexed: 10/17/2023]
Abstract
In a recent estimate, 96 million tons of hazardous waste were produced in the European Union, most of which were handled among the member states. Organophosphate esters (OPEs) are applied as flame retardants and plasticizers and are present in many products, e.g., electronics, which end up in the hazardous waste stream upon disposal. Given the growing body of information suggesting potential adverse health effects of OPEs, waste recycling workers who handle hazardous waste could potentially be at risk of elevated exposure to these chemicals. Using silicone wristbands, we evaluated OPE exposure among waste recycling workers who handled hazardous waste and compared their exposure to that of administrative workers from the same waste companies. Wristbands were extracted and analyzed for six OPEs, which were all detected in >75% of wristbands. Overall, the sum of tris(2-chloroisopropyl) phosphate (∑TCIPP) isomers was the most abundant OPE across all wristbands collected within the study. In general, the sum of tri(methyl phenyl) phosphate isomers (∑TMPP) was elevated for all waste workers (10β = 7.9), whereas tri-n-butyl phosphate (TnBP), tris(1,3-dichloroisopropyl) phosphate (TDCIPP), and ∑TMPP were 3-12 times higher among those specifically handling electronic and hazardous waste compared to the administrative workers (p < 0.05). Repeated wristband measurements from the same worker had fair to good consistency in OPE concentrations (intraclass correlation coefficients = 0.54-0.77), except for the two most volatile chlorinated OPEs. Taken together, our results suggest that waste recycling workers who handle electronic and hazardous waste have significantly elevated exposure to OPEs, and efforts to reduce these exposures should be considered.
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Affiliation(s)
- Stephanie C Hammel
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen Ø, Denmark.
| | - Karoline K Hansen
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, 8200, Aarhus, Denmark.
| | - Anne Mette Madsen
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen Ø, Denmark.
| | - Henrik A Kolstad
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, 8200, Aarhus, Denmark.
| | - Vivi Schlünssen
- Department of Public Health, Research Unit for Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, 8000, Aarhus, Denmark.
| | - Marie Frederiksen
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen Ø, Denmark.
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Schlünssen V, Jones RM. Gender aspects in occupational exposure and health studies. Ann Work Expo Health 2023; 67:1023-1026. [PMID: 37812681 DOI: 10.1093/annweh/wxad063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 09/27/2023] [Indexed: 10/11/2023] Open
Abstract
While sex is a biological attribute associated with physical and physiological features, gender refers to socially constructed roles, behaviors, expressions, and identities. On the biological side, males and females differ concerning hormonal and anatomical differences, and It is therefore plausible occupational exposure may act differently on males and females. In contrast, gender may influence the work organization, work environment conditions and exposures, and employment conditions, leading people of different genders to perform different jobs or job tasks, be exposed to different stressors, and work under different employment terms. Traditionally, occupational exposures have been assessed without considering how exposures may differ by sex or gender. Early research focused on occupations that primarily employed men. However, women have entered occupations historically dominated by men, leading to emerging exploration of gender differences in exposure. Some women-dominated occupations have become the focus of intensive research activity. In the Annals, the number of articles including sex and gender issues has increased dramatically over time, with only two published prior to 1980, and 70 in the 2010s, and with a special issue dedicated to Gender, Work, and Health in 2018 where the editors highlighted a need to improve assessment of gender and sex identities to allow for more nuanced knowledge to elucidate the role of work organization and contextual factors about gender, work exposures, and health. Females, on average, have different body dimensions than males, which affects how well workplaces and personal protective equipment (PPE) fit females, and there remains a need for further improvements to ensure that females are protected equally well. On the other hand, females tend to comply more frequently with PPE requirements than men highlighting the need for gender-specific initiatives in order to increase PPE performance and compliance. In conclusion, there is still work to do in order to fill in the existing knowledge gap with regard to sex, gender, and work, but there are promising initiatives and the field is progressing.
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Affiliation(s)
- Vivi Schlünssen
- Department of Public Health, Research Unit for Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, Bartholins Allé 2, bg 1260, 8000 Aarhus C, Denmark
| | - Rachael M Jones
- Department of Environmental Health Science, Fielding School of Public Health, University of California Los Angeles, 650 Charles E. Young Drive S, 56-070 CHS, Los Angeles, CA 90095, United States
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Xu S, Marcon A, Bertelsen RJ, Benediktsdottir B, Brandt J, Engemann K, Frohn LM, Geels C, Gislason T, Heinrich J, Holm M, Janson C, Markevych I, Modig L, Orru H, Schlünssen V, Sigsgaard T, Johannessen A. Long-term exposure to low-level air pollution and greenness and mortality in Northern Europe. The Life-GAP project. Environ Int 2023; 181:108257. [PMID: 37857189 DOI: 10.1016/j.envint.2023.108257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 09/28/2023] [Accepted: 10/09/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND Air pollution has been linked to mortality, but there are few studies examining the association with different exposure time windows spanning across several decades. The evidence for the effects of green space and mortality is contradictory. OBJECTIVE We investigated all-cause mortality in relation to exposure to particulate matter (PM2.5 and PM10), black carbon (BC), nitrogen dioxide (NO2), ozone (O3) and greenness (normalized difference vegetation index - NDVI) across different exposure time windows. METHODS The exposure assessment was based on a combination of the Danish Eulerian Hemispheric Model and the Urban Background Model for the years 1990, 2000 and 2010. The analysis included a complete case dataset with 9,135 participants from the third Respiratory Health in Northern Europe study (RHINE III), aged 40-65 years in 2010, with mortality follow-up to 2021. We performed Cox proportional hazard models, adjusting for potential confounders. RESULTS Altogether, 327 (3.6 %) persons died in the period 2010-2021. Increased exposures in 1990 of PM2.5, PM10, BC and NO2 were associated with increased all-cause mortality hazard ratios of 1.40 (95 % CI1.04-1.87 per 5 μg/m3), 1.33 (95 % CI: 1.02-1.74 per 10 μg/m3), 1.16 (95 % CI: 0.98-1.38 per 0.4 μg/m3) and 1.17 (95 % CI: 0.92-1.50 per 10 μg/m3), respectively. No statistically significant associations were observed between air pollution and mortality in other time windows. O3 showed an inverse association with mortality, while no association was observed between greenness and mortality. Adjusting for NDVI increased the hazard ratios for PM2.5, PM10, BC and NO2 exposures in 1990. We did not find significant interactions between greenness and air pollution metrics. CONCLUSION Long term exposure to even low levels of air pollution is associated with mortality. Opening up for a long latency period, our findings indicate that air pollution exposures over time may be even more harmful than anticipated.
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Affiliation(s)
- Shanshan Xu
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
| | - Alessandro Marcon
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | | | - Bryndis Benediktsdottir
- Department of Respiratory Medicine and Sleep, Landspitali - the National University Hospital of Iceland, Reykjavik, Iceland
| | - Jørgen Brandt
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Kristine Engemann
- Section for Ecoinformatics & Biodiversity, Department of Bioscience, Aarhus University, Aarhus C, Denmark
| | - Lise Marie Frohn
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Camilla Geels
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Thorarinn Gislason
- Department of Respiratory Medicine and Sleep, Landspitali - the National University Hospital of Iceland, Reykjavik, Iceland
| | - Joachim Heinrich
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany; Allergy and Lung Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Mathias Holm
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Christer Janson
- Department of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Iana Markevych
- Institute of Psychology, Jagiellonian University, Krakow, Poland
| | - Lars Modig
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Sweden
| | - Hans Orru
- Department of Public Health, Institute of Family Medicine and Public Health, Faculty of Medicine, University of Tartu, Tartu, Estonia
| | - Vivi Schlünssen
- Department of Public Health, Research Unit for Environment Occupation and Health, Danish Ramazzini Center, Aarhus University, Aarhus, Denmark
| | - Torben Sigsgaard
- Department of Public Health, Research Unit for Environment Occupation and Health, Danish Ramazzini Center, Aarhus University, Aarhus, Denmark
| | - Ane Johannessen
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
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11
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Silva V, Gai L, Harkes P, Tan G, Ritsema CJ, Alcon F, Contreras J, Abrantes N, Campos I, Baldi I, Bureau M, Christ F, Mandrioli D, Sgargi D, Pasković I, Polić Pasković M, Glavan M, Hofman J, Huerta Lwanga E, Norgaard T, Bílková Z, Osman R, Khurshid C, Navarro I, de la Torre A, Sanz P, Ángeles Martínez M, Dias J, Mol H, Gort G, Martins Figueiredo D, Scheepers PTJ, Schlünssen V, Vested A, Alaoui A, Geissen V. Pesticide residues with hazard classifications relevant to non-target species including humans are omnipresent in the environment and farmer residences. Environ Int 2023; 181:108280. [PMID: 37924602 DOI: 10.1016/j.envint.2023.108280] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 10/16/2023] [Accepted: 10/19/2023] [Indexed: 11/06/2023]
Abstract
Intensive and widespread use of pesticides raises serious environmental and human health concerns. The presence and levels of 209 pesticide residues (active substances and transformation products) in 625 environmental samples (201 soil, 193 crop, 20 outdoor air, 115 indoor dust, 58 surface water, and 38 sediment samples) have been studied. The samples were collected during the 2021 growing season, across 10 study sites, covering the main European crops, and conventional and organic farming systems. We profiled the pesticide residues found in the different matrices using existing hazard classifications towards non-target organisms and humans. Combining monitoring data and hazard information, we developed an indicator for the prioritization of pesticides, which can support policy decisions and sustainable pesticide use transitions. Eighty-six percent of the samples had at least one residue above the respective limit of detection. One hundred residues were found in soil, 112 in water, 99 in sediments, 78 in crops, 76 in outdoor air, and 197 in indoor dust. The number, levels, and profile of residues varied between farming systems. Our results show that non-approved compounds still represent a significant part of environmental cocktails and should be accounted for in monitoring programs and risk assessments. The hazard profiles analysis confirms the dominance of compounds of low-moderate hazard and underscores the high hazard of some approved compounds and recurring "no data available" situations. Overall, our results support the idea that risk should be assessed in a mixture context, taking environmentally relevant mixtures into consideration. We have uncovered uncertainties and data gaps that should be addressed, as well as the policy implications at the EU approval status level. Our newly introduced indicator can help identify research priority areas, and act as a reference for targeted scenarios set forth in the Farm to Fork pesticide reduction goals.
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Affiliation(s)
- Vera Silva
- Soil Physics and Land Management Group, Wageningen University & Research, Netherlands
| | - Lingtong Gai
- Soil Physics and Land Management Group, Wageningen University & Research, Netherlands.
| | - Paula Harkes
- Soil Physics and Land Management Group, Wageningen University & Research, Netherlands
| | - Gaowei Tan
- Soil Physics and Land Management Group, Wageningen University & Research, Netherlands
| | - Coen J Ritsema
- Soil Physics and Land Management Group, Wageningen University & Research, Netherlands
| | - Francisco Alcon
- Agricultural Engineering School, Universidad Politécnica de Cartagena, Spain
| | - Josefa Contreras
- Agricultural Engineering School, Universidad Politécnica de Cartagena, Spain
| | - Nelson Abrantes
- CESAM and Department of Biology, University of Aveiro, Portugal
| | - Isabel Campos
- CESAM and Department of Biology, University of Aveiro, Portugal
| | - Isabelle Baldi
- Univ. Bordeaux, INSERM, BPH, U1219, F-33000 Bordeaux, France
| | - Mathilde Bureau
- Univ. Bordeaux, INSERM, BPH, U1219, F-33000 Bordeaux, France
| | - Florian Christ
- Institute of Geography, University of Bern, Hallerstrasse 12, 3012 Bern, Switzerland
| | | | - Daria Sgargi
- Cesare Maltoni Cancer Research Center, Ramazzini Institute, Italy
| | - Igor Pasković
- Department of Agriculture and Nutrition, Institute of Agriculture and Tourism, K. Huguesa 8, 52440 Poreč, Croatia
| | - Marija Polić Pasković
- Department of Agriculture and Nutrition, Institute of Agriculture and Tourism, K. Huguesa 8, 52440 Poreč, Croatia
| | - Matjaž Glavan
- Agronomy Department, Biotechnical Faculty, University of Ljubljana, Jamnikarjeva 101, 1000 Ljubljana, Slovenia
| | - Jakub Hofman
- RECETOX, Faculty of Science, Masaryk University, Brno, The Czech Republic
| | | | - Trine Norgaard
- Department of Agroecology, Aarhus University, Blichers Allé 20, 8830 Tjele, Denmark
| | - Zuzana Bílková
- RECETOX, Faculty of Science, Masaryk University, Brno, The Czech Republic
| | - Rima Osman
- Soil Physics and Land Management Group, Wageningen University & Research, Netherlands
| | - Chrow Khurshid
- Soil Physics and Land Management Group, Wageningen University & Research, Netherlands
| | - Irene Navarro
- Unit of POPs and Emerging Pollutants in Environment, Department of Environment, CIEMAT, Madrid, Spain
| | - Adrián de la Torre
- Unit of POPs and Emerging Pollutants in Environment, Department of Environment, CIEMAT, Madrid, Spain
| | - Paloma Sanz
- Unit of POPs and Emerging Pollutants in Environment, Department of Environment, CIEMAT, Madrid, Spain
| | - María Ángeles Martínez
- Unit of POPs and Emerging Pollutants in Environment, Department of Environment, CIEMAT, Madrid, Spain
| | - Jonatan Dias
- Wageningen Food Safety Research (WFSR), part of Wageningen University & Research, Wageningen, The Netherlands
| | - Hans Mol
- Wageningen Food Safety Research (WFSR), part of Wageningen University & Research, Wageningen, The Netherlands
| | - Gerrit Gort
- Biometris, Wageningen University, The Netherlands
| | | | - Paul T J Scheepers
- Radboud Institute for Biological and Environmental Sciences, Radboud University, Nijmegen, the Netherlands
| | - Vivi Schlünssen
- Department of Public Health, Research Unit for Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - Anne Vested
- Department of Public Health, Research Unit for Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - Abdallah Alaoui
- Institute of Geography, University of Bern, Hallerstrasse 12, 3012 Bern, Switzerland
| | - Violette Geissen
- Soil Physics and Land Management Group, Wageningen University & Research, Netherlands
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12
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Struijs F, Hooijmans CR, Buijs M, Dahan A, Hoffmann S, Kiffen R, Mandrioli D, Menon J, Ritskes-Hoitinga M, Roeleveld N, de Ruijter A, Scheffer GJ, Schlünssen V, Scheepers PTJ. Establishing a health-based recommended occupational exposure limit for isoflurane using experimental animal data: a systematic review protocol. Syst Rev 2023; 12:166. [PMID: 37710304 PMCID: PMC10503167 DOI: 10.1186/s13643-023-02331-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 08/18/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUND Isoflurane is used as an inhalation anesthetic in medical, paramedical, and veterinary practice. Epidemiological studies suggest an increased risk of miscarriages and malformations at birth related to maternal exposure to isoflurane and other inhalation anesthetics. However, these studies cannot be used to derive an occupational exposure level (OEL), because exposure was not determined quantitatively and other risk factors such as co-exposures to other inhalation anesthetics and other work-related factors may also have contributed to the observed adverse outcomes. The aim of this systematic review project is to assess all available evidence on the effects of isoflurane in studies of controlled exposures in laboratory animals to derive a health-based recommended OEL. METHODS A comprehensive search strategy was developed to retrieve all animal studies addressing isoflurane exposure from PubMed, EMBASE, and Web of Science. Title-abstract screening will be performed by machine learning, and full-text screening by one reviewer. Discrepancies will be resolved by discussion. We will include primary research in healthy, sexually mature (non human) vertebrates of single exposure to isoflurane. Studies describing combined exposure and treatments with > = 1 vol% isoflurane will be excluded. Subsequently, details regarding study identification, study design, animal model, and intervention will be summarized. All relevant exposure characteristics and outcomes will be extracted. The risk of bias will be assessed by two independent reviewers using an adapted version of the SYRCLE's risk of bias tool and an addition of the OHAT tool. For all outcomes for which dose-response curves can be derived, the benchmark dose (BMD) approach will be used to establish a point of departure for deriving a recommended health-based recommended OEL for 8 h (workshift exposure) and for 15 min (short-term exposure). DISCUSSION Included studies should be sufficiently sensitive to detect the adverse health outcomes of interest. Uncertainties in the extrapolation from animals to humans will be addressed using assessment factor. These factors are justified in accordance with current practice in chemical risk assessment. A panel of experts will be involved to reach consensus decisions regarding significant steps in this project, such as determination of the critical effects and how to extrapolate from animals to humans. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42022308978.
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Affiliation(s)
- Fréderique Struijs
- Radboud Institute for Biological and Environmental Sciences, Radboud University, Nijmegen, The Netherlands
| | - Carlijn R Hooijmans
- Department of Anaesthesiology, Pain and Palliative Care, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marije Buijs
- Radboud Institute for Biological and Environmental Sciences, Radboud University, Nijmegen, The Netherlands
| | - Albert Dahan
- Leiden University Medical Center, Leiden, The Netherlands
| | - Sebastian Hoffmann
- The Evidence-Based Toxicology Collaboration (EBTC), Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Romy Kiffen
- Radboud Institute for Biological and Environmental Sciences, Radboud University, Nijmegen, The Netherlands
| | - Daniele Mandrioli
- Cesare Maltoni Cancer Research Center, Ramazzini Institute, Bologna, Italy
| | - Julia Menon
- Netherlands Heart Institute, Utrecht, The Netherlands
| | | | - Nel Roeleveld
- Department for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Anne de Ruijter
- Radboud Institute for Biological and Environmental Sciences, Radboud University, Nijmegen, The Netherlands
| | - Gert Jan Scheffer
- Department of Anaesthesiology, Pain and Palliative Care, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Vivi Schlünssen
- Department of Public Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
- National Research Center for the Working Environment, Copenhagen, Denmark
| | - Paul T J Scheepers
- Radboud Institute for Biological and Environmental Sciences, Radboud University, Nijmegen, The Netherlands.
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13
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van der Feltz S, Schlünssen V, Basinas I, Begtrup LM, Burdorf A, Bonde JPE, Flachs EM, Peters S, Pronk A, Stokholm ZA, van Tongeren M, van Veldhoven K, Oude Hengel KM, Kolstad HA. Associations between an international COVID-19 job exposure matrix and SARS-CoV-2 infection among 2 million workers in Denmark. Scand J Work Environ Health 2023; 49:375-385. [PMID: 37167299 PMCID: PMC10790132 DOI: 10.5271/sjweh.4099] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Indexed: 05/13/2023] Open
Abstract
OBJECTIVES This study investigates the associations between the Danish version of a job exposure matrix for COVID-19 (COVID-19-JEM) and Danish register-based SARS-CoV-2 infection information across three waves of the pandemic. The COVID-19-JEM consists of four dimensions on transmission: two on mitigation measures, and two on precarious work characteristics. METHODS The study comprised 2 021 309 persons from the Danish working population between 26 February 2020 and 15 December 2021. Logistic regression models were applied to assess the associations between the JEM dimensions and overall score and SARS-CoV-2 infection across three infection waves, with peaks in March-April 2020, December-January 2021, and February-March 2022. Sex, age, household income, country of birth, wave, residential region and during wave 3 vaccination status were accounted for. RESULTS Higher risk scores within the transmission and mitigation dimensions and the overall JEM score resulted in higher odds ratios (OR) of a SARS-CoV-2 infection. OR attenuated across the three waves with ranges of 1.08-5.09 in wave 1, 1.06-1.60 in wave 2, and 1.05-1.45 in those not (fully) vaccinated in wave 3. In wave 3, no associations were found for those fully vaccinated. In all waves, the two precarious work dimensions showed weaker or inversed associations. CONCLUSIONS The COVID-19-JEM is a promising tool for assessing occupational exposure to SARS-CoV-2 and other airborne infectious agents that mainly spread between people who are in close contact with each other. However, its usefulness depends on applied restrictions and the vaccination status in the population of interest.
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Affiliation(s)
- Sophie van der Feltz
- Department of Occupational Medicine, Danish Ramazzini Center, Aarhus University Hospital, Palle Juul-Jensens Boulevard 35, 8200 Aarhus N, Denmark.
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14
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Schlünssen V, Ádám B, Momen NC, Nemery B, Pega F. Response to Letter to the Editor regarding "The prevalences and levels of occupational exposure to dusts and/or fibres (silica, asbestos and coal): A systematic review and meta-analysis from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury". Environ Int 2023; 179:108165. [PMID: 37669593 DOI: 10.1016/j.envint.2023.108165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 08/21/2023] [Indexed: 09/07/2023]
Affiliation(s)
- Vivi Schlünssen
- Department of Public Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark.
| | - Balázs Ádám
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, United Arab Emirates
| | - Natalie C Momen
- Department of Environment, Climate Change and Health, World Health Organization, Geneva, Switzerland
| | - Ben Nemery
- Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Frank Pega
- Department of Environment, Climate Change and Health, World Health Organization, Geneva, Switzerland.
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15
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Kitaba NT, Knudsen GTM, Johannessen A, Rezwan FI, Malinovschi A, Oudin A, Benediktsdottir B, Martino D, González FJC, Gómez LP, Holm M, Jõgi NO, Dharmage SC, Skulstad SM, Watkins SH, Suderman M, Gómez-Real F, Schlünssen V, Svanes C, Holloway JW. Fathers' preconception smoking and offspring DNA methylation. Clin Epigenetics 2023; 15:131. [PMID: 37649101 PMCID: PMC10469907 DOI: 10.1186/s13148-023-01540-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 07/24/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND Experimental studies suggest that exposures may impact respiratory health across generations via epigenetic changes transmitted specifically through male germ cells. Studies in humans are, however, limited. We aim to identify epigenetic marks in offspring associated with father's preconception smoking. METHODS We conducted epigenome-wide association studies (EWAS) in the RHINESSA cohort (7-50 years) on father's any preconception smoking (n = 875 offspring) and father's pubertal onset smoking < 15 years (n = 304), using Infinium MethylationEPIC Beadchip arrays, adjusting for offspring age, own smoking and maternal smoking. EWAS of maternal and offspring personal smoking were performed for comparison. Father's smoking-associated dmCpGs were checked in subpopulations of offspring who reported no personal smoking and no maternal smoking exposure. RESULTS Father's smoking commencing preconception was associated with methylation of blood DNA in offspring at two cytosine-phosphate-guanine sites (CpGs) (false discovery rate (FDR) < 0.05) in PRR5 and CENPP. Father's pubertal onset smoking was associated with 19 CpGs (FDR < 0.05) mapped to 14 genes (TLR9, DNTT, FAM53B, NCAPG2, PSTPIP2, MBIP, C2orf39, NTRK2, DNAJC14, CDO1, PRAP1, TPCN1, IRS1 and CSF1R). These differentially methylated sites were hypermethylated and associated with promoter regions capable of gene silencing. Some of these sites were associated with offspring outcomes in this cohort including ever-asthma (NTRK2), ever-wheezing (DNAJC14, TPCN1), weight (FAM53B, NTRK2) and BMI (FAM53B, NTRK2) (p < 0.05). Pathway analysis showed enrichment for gene ontology pathways including regulation of gene expression, inflammation and innate immune responses. Father's smoking-associated sites did not overlap with dmCpGs identified in EWAS of personal and maternal smoking (FDR < 0.05), and all sites remained significant (p < 0.05) in analyses of offspring with no personal smoking and no maternal smoking exposure. CONCLUSION Father's preconception smoking, particularly in puberty, is associated with offspring DNA methylation, providing evidence that epigenetic mechanisms may underlie epidemiological observations that pubertal paternal smoking increases risk of offspring asthma, low lung function and obesity.
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Affiliation(s)
- Negusse Tadesse Kitaba
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, SO16 6YD, UK
| | - Gerd Toril Mørkve Knudsen
- Department of Clinical Sciences, University of Bergen, Bergen, Norway
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
| | - Ane Johannessen
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Faisal I Rezwan
- Department of Computer Science, Aberystwyth University, Aberystwyth, UK
| | - Andrei Malinovschi
- Department of Medical Sciences: Clinical Physiology, Uppsala University, Uppsala, Sweden
| | - Anna Oudin
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Bryndis Benediktsdottir
- Department of Allergy, Respiratory Medicine and Sleep, Landspitali University Hospital, Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - David Martino
- Wal-Yan Respiratory Research Centre, Telethon Kids Institute, University of Western Australia, Perth, Australia
| | | | | | - Mathias Holm
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Nils Oskar Jõgi
- Department of Clinical Sciences, University of Bergen, Bergen, Norway
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
| | - Shyamali C Dharmage
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Svein Magne Skulstad
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
| | - Sarah H Watkins
- University of Bristol, MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, Bristol, UK
| | - Matthew Suderman
- University of Bristol, MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, Bristol, UK
| | - Francisco Gómez-Real
- Department of Clinical Sciences, University of Bergen, Bergen, Norway
- Department of Gynaecology and Obstetrics, Haukeland University Hospital, Bergen, Norway
| | - Vivi Schlünssen
- Department of Public Health, Work, Environment and Health, Danish Ramazzini Centre, Aarhus University Denmark, Aarhus, Denmark
- National Research Center for the Working Environment, Copenhagen, Denmark
| | - Cecilie Svanes
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - John W Holloway
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, SO16 6YD, UK.
- NIHR Southampton Biomedical Research Center, University Hospitals Southampton, Southampton, UK.
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16
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Amin H, Šantl-Temkiv T, Cramer C, Finster K, Real FG, Gislason T, Holm M, Janson C, Jögi NO, Jogi R, Malinovschi A, Marshall IPG, Modig L, Norbäck D, Shigdel R, Sigsgaard T, Svanes C, Thorarinsdottir H, Wouters IM, Schlünssen V, Bertelsen RJ. Indoor Airborne Microbiome and Endotoxin: Meteorological Events and Occupant Characteristics Are Important Determinants. Environ Sci Technol 2023; 57:11750-11766. [PMID: 37523308 PMCID: PMC10433529 DOI: 10.1021/acs.est.3c01616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 07/13/2023] [Accepted: 07/13/2023] [Indexed: 08/02/2023]
Abstract
Airborne bacteria and endotoxin may affect asthma and allergies. However, there is limited understanding of the environmental determinants that influence them. This study investigated the airborne microbiomes in the homes of 1038 participants from five cities in Northern Europe: Aarhus, Bergen, Reykjavik, Tartu, and Uppsala. Airborne dust particles were sampled with electrostatic dust fall collectors (EDCs) from the participants' bedrooms. The dust washed from the EDCs' clothes was used to extract DNA and endotoxin. The DNA extracts were used for quantitative polymerase chain (qPCR) measurement and 16S rRNA gene sequencing, while endotoxin was measured using the kinetic chromogenic limulus amoebocyte lysate (LAL) assay. The results showed that households in Tartu and Aarhus had a higher bacterial load and diversity than those in Bergen and Reykjavik, possibly due to elevated concentrations of outdoor bacterial taxa associated with low precipitation and high wind speeds. Bergen-Tartu had the highest difference (ANOSIM R = 0.203) in β diversity. Multivariate regression models showed that α diversity indices and bacterial and endotoxin loads were positively associated with the occupants' age, number of occupants, cleaning frequency, presence of dogs, and age of the house. Further studies are needed to understand how meteorological factors influence the indoor bacterial community in light of climate change.
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Affiliation(s)
- Hesham Amin
- Department
of Clinical Science, University of Bergen, 5021 Bergen, Norway
| | - Tina Šantl-Temkiv
- Section
for Microbiology, Department of Biology, Aarhus University, 8000 Aarhus, Denmark
| | - Christine Cramer
- Department
of Public Health, Environment, Work and Health, Danish Ramazzini Center, Aarhus University, 8000 Aarhus, Denmark
- Department
of Occupational Medicine, Danish Ramazzini Center, Aarhus University Hospital, 8200 Aarhus, Denmark
| | - Kai Finster
- Section
for Microbiology, Department of Biology, Aarhus University, 8000 Aarhus, Denmark
| | | | | | - Mathias Holm
- Department
of Occupational and Environmental Medicine, University of Gothenburg, 405 30 Gothenburg, Sweden
| | - Christer Janson
- Department
of Medical Sciences: Respiratory, Allergy, Sleep Research, Uppsala University, 751 85 Uppsala, Sweden
- Department
of Medical Sciences: Clinical Physiology, Uppsala University, 751
85 Uppsala, Sweden
| | - Nils Oskar Jögi
- Department
of Clinical Science, University of Bergen, 5021 Bergen, Norway
| | - Rain Jogi
- Tartu
University Hospital, Lung Clinic, 50406 Tartu, Estonia
| | - Andrei Malinovschi
- Department
of Medical Sciences: Clinical Physiology, Uppsala University, 751
85 Uppsala, Sweden
| | - Ian P. G. Marshall
- Section
for Microbiology, Department of Biology, Aarhus University, 8000 Aarhus, Denmark
| | - Lars Modig
- Division
of Occupational and Environmental Medicine, Department of Public Health
and Clinical Medicine, Umeå University, 901 87 Umeå, Sweden
| | - Dan Norbäck
- Department of Medical
Sciences, Occupational and Environmental Medicine, Uppsala University, 751
85 Uppsala, Sweden
| | - Rajesh Shigdel
- Department
of Clinical Science, University of Bergen, 5021 Bergen, Norway
| | - Torben Sigsgaard
- Department
of Public Health, Environment, Work and Health, Danish Ramazzini Center, Aarhus University, 8000 Aarhus, Denmark
| | - Cecilie Svanes
- Department of Occupational Medicine, Haukeland
University Hospital, 5053 Bergen, Norway
- Centre for International Health, University
of Bergen Department of Global Public Health and Primary Care, 5009 Bergen, Norway
| | - Hulda Thorarinsdottir
- Department of Anesthesia
and Intensive Care, Landspitali University
Hospital, 101 Reykjavik, Iceland
| | - Inge M. Wouters
- Institute for Risk Assessment Sciences, Faculty of Veterinary Medicine, Utrecht University, 3584 CS Utrecht, The Netherlands
| | - Vivi Schlünssen
- Department
of Public Health, Environment, Work and Health, Danish Ramazzini Center, Aarhus University, 8000 Aarhus, Denmark
| | - Randi J. Bertelsen
- Department
of Clinical Science, University of Bergen, 5021 Bergen, Norway
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17
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Hansen KK, Schlünssen V, Broberg K, Østergaard K, Frederiksen MW, Madsen AM, Kolstad HA. Exposure levels of dust, endotoxin, and microorganisms in the Danish recycling industry. Ann Work Expo Health 2023; 67:816-830. [PMID: 37191914 PMCID: PMC10410489 DOI: 10.1093/annweh/wxad025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 04/17/2023] [Accepted: 04/25/2023] [Indexed: 05/17/2023] Open
Abstract
INTRODUCTION Recycling of domestic waste and a number of employees in the recycling industry is expected to increase. This study aims to quantify current exposure levels of inhalable dust, endotoxin, and microorganisms and to identify determinants of exposure among recycling workers. METHODS This cross-sectional study included 170 full-shift measurements from 88 production workers and 14 administrative workers from 12 recycling companies in Denmark. The companies recycle domestic waste (sorting, shredding, and extracting materials from waste). We collected inhalable dust with personal samplers that were analysed for endotoxin (n = 170) and microorganisms (n = 101). Exposure levels of inhalable dust, endotoxin, and microorganisms and potential determinants of exposure were explored by mixed-effects models. RESULTS The production workers were 7-fold or higher exposed to inhalable dust, endotoxin, bacteria, and fungi than the administrative workers. Among production workers recycling domestic waste, the geometric mean exposure level was 0.6 mg/m3 for inhalable dust, 10.7 endotoxin unit (EU)/m3 for endotoxin, 1.6 × 104 colony forming units (CFU)/m³ of bacteria, 4.4 × 104 CFU/m³ of fungi (25 °C), and 1.0 × 103 CFU/m³ of fungi (37 °C). Workers handling paper or cardboard had higher exposure levels than workers handling other waste fractions. The temperature did not affect exposure levels, although there was a tendency toward increased exposure to bacteria and fungi with higher temperatures. For inhalable dust and endotoxin, exposure levels during outdoor work were low compared to indoor work. For bacteria and fungi, indoor ventilation decreased exposure. The work task, waste fraction, temperature, location, mechanical ventilation, and the company size explained around half of the variance of levels of inhalable dust, endotoxin, bacteria, and fungi. CONCLUSION The production workers of the Danish recycling industry participating in this study had higher exposure levels of inhalable dust, endotoxin, bacteria, and fungi than the administrative workers. Exposure levels of inhalable dust and endotoxin among recycling workers in Denmark were generally below established or suggested occupational exposure limits (OEL). However, 43% to 58% of the individual measurements of bacteria and fungi were above the suggested OEL. The waste fraction was the most influential determinant for exposure, and the highest exposure levels were seen during handling paper or cardboard. Future studies should examine the relationship between exposure levels and health effects among workers recycling domestic waste.
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Affiliation(s)
- Karoline Kærgaard Hansen
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, DK-8200 Aarhus N, Denmark
| | - Vivi Schlünssen
- Department of Public Health, Research Unit for Environment Occupation and Health, Danish Ramazzini Centre, Aarhus University, DK-8000 Aarhus C, Denmark
| | - Karin Broberg
- Division of Occupational and Environmental Medicine, Lund University, SE-221 85 Lund, Sweden
- Institute of Environmental Medicine, Karolinska Institutet, SE-17177 Stockholm, Sweden
| | - Kirsten Østergaard
- Department of Public Health, Research Unit for Environment Occupation and Health, Danish Ramazzini Centre, Aarhus University, DK-8000 Aarhus C, Denmark
| | - Margit W Frederiksen
- National Research Centre of the Working Environment, DK-2100 Copenhagen Ø, Denmark
| | - Anne Mette Madsen
- National Research Centre of the Working Environment, DK-2100 Copenhagen Ø, Denmark
| | - Henrik Albert Kolstad
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, DK-8200 Aarhus N, Denmark
- Institute of Clinical Medicine, Occupational Medicine, Aarhus University, DK-8200 Aarhus N, Denmark
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18
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Schlünssen V, Mandrioli D, Pega F, Momen NC, Ádám B, Chen W, Cohen RA, Godderis L, Göen T, Hadkhale K, Kunpuek W, Lou J, Mandic-Rajcevic S, Masci F, Nemery B, Popa M, Rajatanavin N, Sgargi D, Siriruttanapruk S, Sun X, Suphanchaimat R, Thammawijaya P, Ujita Y, van der Mierden S, Vangelova K, Ye M, Zungu M, Scheepers PTJ. The prevalences and levels of occupational exposure to dusts and/or fibres (silica, asbestos and coal): A systematic review and meta-analysis from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury. Environ Int 2023; 178:107980. [PMID: 37487377 DOI: 10.1016/j.envint.2023.107980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 05/03/2023] [Accepted: 05/12/2023] [Indexed: 07/26/2023]
Abstract
BACKGROUND The World Health Organization (WHO) and the International Labour Organization (ILO) are developing joint estimates of the work-related burden of disease and injury (WHO/ILO Joint Estimates), with contributions from a large number of individual experts. Evidence from human, animal and mechanistic data suggests that occupational exposure to dusts and/or fibres (silica, asbestos and coal dust) causes pneumoconiosis. In this paper, we present a systematic review and meta-analysis of the prevalences and levels of occupational exposure to silica, asbestos and coal dust. These estimates of prevalences and levels will serve as input data for estimating (if feasible) the number of deaths and disability-adjusted life years that are attributable to occupational exposure to silica, asbestos and coal dust, for the development of the WHO/ILO Joint Estimates. OBJECTIVES We aimed to systematically review and meta-analyse estimates of the prevalences and levels of occupational exposure to silica, asbestos and coal dust among working-age (≥ 15 years) workers. DATA SOURCES We searched electronic academic databases for potentially relevant records from published and unpublished studies, including Ovid Medline, PubMed, EMBASE, and CISDOC. We also searched electronic grey literature databases, Internet search engines and organizational websites; hand-searched reference lists of previous systematic reviews and included study records; and consulted additional experts. STUDY ELIGIBILITY AND CRITERIA We included working-age (≥ 15 years) workers in the formal and informal economy in any WHO and/or ILO Member State but excluded children (< 15 years) and unpaid domestic workers. We included all study types with objective dust or fibre measurements, published between 1960 and 2018, that directly or indirectly reported an estimate of the prevalence and/or level of occupational exposure to silica, asbestos and/or coal dust. STUDY APPRAISAL AND SYNTHESIS METHODS At least two review authors independently screened titles and abstracts against the eligibility criteria at a first stage and full texts of potentially eligible records at a second stage, then data were extracted from qualifying studies. We combined prevalence estimates by industrial sector (ISIC-4 2-digit level with additional merging within Mining, Manufacturing and Construction) using random-effects meta-analysis. Two or more review authors assessed the risk of bias and all available authors assessed the quality of evidence, using the ROB-SPEO tool and QoE-SPEO approach developed specifically for the WHO/ILO Joint Estimates. RESULTS Eighty-eight studies (82 cross-sectional studies and 6 longitudinal studies) met the inclusion criteria, comprising > 2.4 million measurements covering 23 countries from all WHO regions (Africa, Americas, Eastern Mediterranean, South-East Asia, Europe, and Western Pacific). The target population in all 88 included studies was from major ISCO groups 3 (Technicians and Associate Professionals), 6 (Skilled Agricultural, Forestry and Fishery Workers), 7 (Craft and Related Trades Workers), 8 (Plant and Machine Operators and Assemblers), and 9 (Elementary Occupations), hereafter called manual workers. Most studies were performed in Construction, Manufacturing and Mining. For occupational exposure to silica, 65 studies (61 cross-sectional studies and 4 longitudinal studies) were included with > 2.3 million measurements collected in 22 countries in all six WHO regions. For occupational exposure to asbestos, 18 studies (17 cross-sectional studies and 1 longitudinal) were included with > 20,000 measurements collected in eight countries in five WHO regions (no data for Africa). For occupational exposure to coal dust, eight studies (all cross-sectional) were included comprising > 100,000 samples in six countries in five WHO regions (no data for Eastern Mediterranean). Occupational exposure to silica, asbestos and coal dust was assessed with personal or stationary active filter sampling; for silica and asbestos, gravimetric assessment was followed by technical analysis. Risk of bias profiles varied between the bodies of evidence looking at asbestos, silica and coal dust, as well as between industrial sectors. However, risk of bias was generally highest for the domain of selection of participants into the studies. The largest bodies of evidence for silica related to the industrial sectors of Construction (ISIC 41-43), Manufacturing (ISIC 20, 23-25, 27, 31-32) and Mining (ISIC 05, 07, 08). For Construction, the pooled prevalence estimate was 0.89 (95% CI 0.84 to 0.93, 17 studies, I2 91%, moderate quality of evidence) and the level estimate was rated as of very low quality of evidence. For Manufacturing, the pooled prevalence estimate was 0.85 (95% CI 0.78 to 0.91, 24 studies, I2 100%, moderate quality of evidence) and the pooled level estimate was rated as of very low quality of evidence. The pooled prevalence estimate for Mining was 0.75 (95% CI 0.68 to 0.82, 20 studies, I2 100%, moderate quality of evidence) and the pooled level estimate was 0.04 mg/m3 (95% CI 0.03 to 0.05, 17 studies, I2 100%, low quality of evidence). Smaller bodies of evidence were identified for Crop and animal production (ISIC 01; very low quality of evidence for both prevalence and level); Professional, scientific and technical activities (ISIC 71, 74; very low quality of evidence for both prevalence and level); and Electricity, gas, steam and air conditioning supply (ISIC 35; very low quality of evidence for both prevalence and level). For asbestos, the pooled prevalence estimate for Construction (ISIC 41, 43, 45,) was 0.77 (95% CI 0.65 to 0.87, six studies, I2 99%, low quality of evidence) and the level estimate was rated as of very low quality of evidence. For Manufacturing (ISIC 13, 23-24, 29-30), the pooled prevalence and level estimates were rated as being of very low quality of evidence. Smaller bodies of evidence were identified for Other mining and quarrying (ISIC 08; very low quality of evidence for both prevalence and level); Electricity, gas, steam and air conditioning supply (ISIC 35; very low quality of evidence for both prevalence and level); and Water supply, sewerage, waste management and remediation (ISIC 37; very low quality of evidence for levels). For coal dust, the pooled prevalence estimate for Mining of coal and lignite (ISIC 05), was 1.00 (95% CI 1.00 to 1.00, six studies, I2 16%, moderate quality of evidence) and the pooled level estimate was 0.77 mg/m3 (95% CI 0.68 to 0.86, three studies, I2 100%, low quality of evidence). A small body of evidence was identified for Electricity, gas, steam and air conditioning supply (ISIC 35); with very low quality of evidence for prevalence, and the pooled level estimate being 0.60 mg/m3 (95% CI -6.95 to 8.14, one study, low quality of evidence). CONCLUSIONS Overall, we judged the bodies of evidence for occupational exposure to silica to vary by industrial sector between very low and moderate quality of evidence for prevalence, and very low and low for level. For occupational exposure to asbestos, the bodies of evidence varied by industrial sector between very low and low quality of evidence for prevalence and were of very low quality of evidence for level. For occupational exposure to coal dust, the bodies of evidence were of very low or moderate quality of evidence for prevalence, and low for level. None of the included studies were population-based studies (i.e., covered the entire workers' population in the industrial sector), which we judged to present serious concern for indirectness, except for occupational exposure to coal dust within the industrial sector of mining of coal and lignite. Selected estimates of the prevalences and levels of occupational exposure to silica by industrial sector are considered suitable as input data for the WHO/ILO Joint Estimates, and selected estimates of the prevalences and levels of occupational exposure to asbestos and coal dust may perhaps also be suitable for estimation purposes. Protocol identifier: https://doi.org/10.1016/j.envint.2018.06.005. PROSPERO registration number: CRD42018084131.
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Affiliation(s)
- Vivi Schlünssen
- Department of Public Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark; National Research Center for the Working Environment, Copenhagen, Denmark.
| | - Daniele Mandrioli
- Cesare Maltoni Cancer Research Center, Ramazzini Institute, Bologna, Italy
| | - Frank Pega
- Department of Environment, Climate Change and Health, World Health Organization, Geneva, Switzerland.
| | - Natalie C Momen
- Department of Environment, Climate Change and Health, World Health Organization, Geneva, Switzerland
| | - Balázs Ádám
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, United Arab Emirates
| | - Weihong Chen
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Robert A Cohen
- Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Lode Godderis
- Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Thomas Göen
- University of Erlangen-Nuremberg, Erlangen, Germany
| | | | - Watinee Kunpuek
- International Health Policy Program, Ministry of Public Health, Nonthaburi, Thailand
| | - Jianlin Lou
- Institute of Occupational Diseases, Hangzhou Medical College, Zhejiang Academy of Medical Sciences, Hangzhou, People's Republic of China
| | - Stefan Mandic-Rajcevic
- Department of Health Sciences, University of Milano, Milan, Italy; International Centre for Rural Health, San Paolo Hospital, Milan, Italy
| | - Federica Masci
- Department of Health Sciences, University of Milano, Milan, Italy; International Centre for Rural Health, San Paolo Hospital, Milan, Italy
| | - Ben Nemery
- Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Madalina Popa
- Center for Diabetes Research, Université Libre de Bruxelles, Brussels, Belgium
| | | | - Daria Sgargi
- Cesare Maltoni Cancer Research Center, Ramazzini Institute, Bologna, Italy
| | - Somkiat Siriruttanapruk
- Division of Epidemiology, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand
| | - Xin Sun
- National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
| | - Repeepong Suphanchaimat
- International Health Policy Program, Ministry of Public Health, Nonthaburi, Thailand; Division of Epidemiology, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand
| | - Panithee Thammawijaya
- Division of Epidemiology, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand
| | - Yuka Ujita
- Labour Administration, Labour Inspection and Occupational Safety and Health Branch, International Labour Organization, Geneva, Switzerland; Decent Work Technical Support Team for East and South-East Asia and the Pacific, International Labour Organization, Thailand
| | - Stevie van der Mierden
- Cesare Maltoni Cancer Research Center, Ramazzini Institute, Bologna, Italy; Institute for Laboratory Animal Science, Hannover Medical School, Hannover, Germany
| | - Katya Vangelova
- National Center of Public Health and Analyses, Ministry of Health, Sofia, Bulgaria
| | - Meng Ye
- National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
| | - Muzimkhulu Zungu
- National Institute for Occupational Health, South Africa, Johannesburg, Gauteng Province, South Africa
| | - Paul T J Scheepers
- Radboud Institute for Health Sciences, Radboudumc, Nijmegen, The Netherlands; Radboud Institute for Biological and Environmental Sciences, Radboud University, Nijmegen, The Netherlands
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19
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Basinas I, Liukkonen T, Sigsgaard T, Andersen NT, Vestergaard JM, Galea KS, van Tongeren M, Wiggans R, Savary B, Eduard W, Kolstad HA, Vested A, Kromhout H, Schlünssen V. Development of a quantitative North and Central European job exposure matrix for wood dust. Ann Work Expo Health 2023; 67:758-771. [PMID: 37167588 PMCID: PMC10795000 DOI: 10.1093/annweh/wxad021] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 04/12/2023] [Indexed: 05/13/2023] Open
Abstract
Wood dust is an established carcinogen also linked to several non malignant respiratory disorders. A major limitation in research on wood dust and its health effects is the lack of (historical) quantitative estimates of occupational exposure for use in general population-based case-control or cohort studies. The present study aimed to develop a multinational quantitative Job Exposure Matrix (JEM) for wood dust exposure using exposure data from several Northern and Central European countries. For this, an occupational exposure database containing 12653 personal wood dust measurements collected between 1978 and 2007 in Denmark, Finland, France, The Netherlands, Norway, and the United Kingdom (UK) was established. Measurement data were adjusted for differences in inhalable dust sampling efficiency resulting from the use of different dust samplers and analysed using linear mixed effect regression with job codes (ISCO-88) and country treated as random effects. Fixed effects were the year of measurement, the expert assessment of exposure intensity (no, low, and high exposure) for every ISCO-88 job code from an existing wood dust JEM and sampling duration. The results of the models suggest that wood dust exposure has declined annually by approximately 8%. Substantial differences in exposure levels between countries were observed with the highest levels in the United Kingdom and the lowest in Denmark and Norway, albeit with similar job rankings across countries. The jobs with the highest predicted exposure are floor layers and tile setters, wood-products machine operators, and building construction labourers with geometric mean levels for the year 1997 between 1.7 and 1.9 mg/m3. The predicted exposure estimates by the model are compared with the results of wood dust measurement data reported in the literature. The model predicted estimates for full-shift exposures were used to develop a time-dependent quantitative JEM for exposure to wood dust that can be used to estimate exposure for participants of general population studies in Northern European countries on the health effects from occupational exposure to wood dust.
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Affiliation(s)
- Ioannis Basinas
- Centre for Occupational and Environmental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom
- Institute of Occupational Medicine, Edinburgh, United Kingdom
- Department of Public Health, Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | | | - Torben Sigsgaard
- Department of Public Health, Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - Nils T Andersen
- Department of Public Health, Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - Jesper M Vestergaard
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark
| | - Karen S Galea
- Institute of Occupational Medicine, Edinburgh, United Kingdom
| | - Martie van Tongeren
- Centre for Occupational and Environmental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Ruth Wiggans
- Centre for Occupational and Environmental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | | | - Wijnand Eduard
- Department of Chemical and Biological Work Environment, National Institute of Occupational Health, Oslo, Norway
| | - Henrik A Kolstad
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark
| | - Anne Vested
- Department of Public Health, Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark
| | - Hans Kromhout
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Vivi Schlünssen
- Department of Public Health, Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
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20
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Veber T, Pyko A, Carlsen HK, Holm M, Gislason T, Janson C, Johannessen A, Sommar JN, Modig L, Lindberg E, Schlünssen V, Toompere K, Orru H. Traffic noise in the bedroom in association with markers of obesity: a cross-sectional study and mediation analysis of the respiratory health in Northern Europe cohort. BMC Public Health 2023; 23:1246. [PMID: 37370100 DOI: 10.1186/s12889-023-16128-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 06/15/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Previous research suggests an association between road traffic noise and obesity, but current evidence is inconclusive. The aim of this study was to assess the association between nocturnal noise exposure and markers of obesity and to assess whether sleep disturbance might be a mediator in this association. METHODS We applied data from the Respiratory Health in Northern Europe (RHINE) cohort. We used self-measured waist circumference (WC) and body mass index (BMI) as outcome values. Noise exposure was assessed as perceived traffic noise in the bedroom and/or the bedroom window's location towards the street. We applied adjusted linear, and logistic regression models, evaluated effect modifications and conducted mediation analysis. RESULTS Based on fully adjusted models we found that women, who reported very high traffic noise levels in bedroom, had 1.30 (95% CI 0.24-2.37) kg/m2 higher BMI and 3.30 (95% CI 0.39-6.20) cm higher WC compared to women, who reported no traffic noise in the bedroom. Women who reported higher exposure to road traffic noise had statistically significant higher odds of being overweight and have abdominal obesity with OR varying from 1.15 to 1.26 compared to women, who reported no traffic noise in the bedroom. For men, the associations were rather opposite, although mostly statistically insignificant. Furthermore, men, who reported much or very much traffic noise in the bedroom, had a statistically significantly lower risk of abdominal obesity. Sleep disturbance fully or partially mediated the association between noise in bedroom and obesity markers among women. CONCLUSION Our results suggest that self-reported traffic noise in the bedroom may be associated to being overweight or obese trough sleep disturbance among women, but associations were inconclusive among men.
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Affiliation(s)
- Triin Veber
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Andrei Pyko
- Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Hanne Krage Carlsen
- Department of Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Mathias Holm
- Department of Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | - Christer Janson
- Department of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Ane Johannessen
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Johan Nilsson Sommar
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Lars Modig
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Eva Lindberg
- Department of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Vivi Schlünssen
- Research Unit for Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - Karolin Toompere
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Hans Orru
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia.
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
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Gyawali S, López-Cervantes JP, Johannessen A, Gislason T, Holm M, Janson C, Jögi R, Modig L, Schlünssen V, Mustafa T, Svanes C. Maternal and paternal tuberculosis is associated with increased asthma and respiratory symptoms in their offspring: a study from Northern Europe. Front Allergy 2023; 4:1193141. [PMID: 37361110 PMCID: PMC10286510 DOI: 10.3389/falgy.2023.1193141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 05/24/2023] [Indexed: 06/28/2023] Open
Abstract
Background Given the profound impact of tuberculosis (TB) on immunity and given murine studies suggesting that infections may influence immunity across generations, we hypothesize that parental TB might impact health and disease in future offspring. Objective This study investigated the impact of maternal and paternal TB on offspring asthma and respiratory symptoms. Methods We included data from the third follow-up of the Respiratory Health in Northern Europe study (RHINE). Information on own asthma status, asthma-like symptoms and other respiratory symptoms, as well as information about parental TB and asthma, were collected using standardized questionnaires. The associations between parental TB and RHINE participants' asthma and respiratory symptoms were analyzed using multiple logistic regression, with adjustment for parental education, smoking habits and asthma. Results Of 8,323 study participants, 227 (2.7%) reported only paternal TB, 282 (3.4%) only maternal TB, and 33 (0.4%) reported that both parents had TB. We found a higher risk of asthma (aOR: 1.29, 95% CI: 1.05-1.57) in offspring with a history of parental TB as compared to offspring without parental TB., Parental TB was significantly associated with allergic asthma in offspring (aOR: 1.58, 95% CI: 1.29-2.05), while no significant association between parental TB and asthma without allergy (aOR: 1.00, 95% CI: 0.76-1.32) in offspring was observed. Conclusion Results from this study indicate that parental TB might be a risk factor for offspring's asthma and respiratory symptoms. We raise the hypothesis that the immunological impact of infections might be transmitted to influence offspring phenotype in humans.
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Affiliation(s)
- Sanjay Gyawali
- Department of Global Public Health and Primary Care, Centre for International Health, University of Bergen, Bergen, Norway
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
| | - Juan Pablo López-Cervantes
- Department of Global Public Health and Primary Care, Centre for International Health, University of Bergen, Bergen, Norway
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
| | - Ane Johannessen
- Department of Global Public Health and Primary Care, Centre for International Health, University of Bergen, Bergen, Norway
| | - Thorarinn Gislason
- Faculty of Medical, University of Iceland, Reykjavik, Iceland
- Department of Sleep, Landspitali University Hospital, Reykjavik, Iceland
| | - Mathias Holm
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Christer Janson
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Rain Jögi
- Lung Clinic, Tartu University Hospital, Tartu, Estonia
| | - Lars Modig
- Department of Public Health and Clinical Medicine, Sustainable Health, Umeå University, Umeå, Sweden
| | - Vivi Schlünssen
- Department of Public Health, Research Unit for Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - Tehmina Mustafa
- Department of Global Public Health and Primary Care, Centre for International Health, University of Bergen, Bergen, Norway
- Department of Thoracic Medicine, Haukeland University Hospital, Bergen, Norway
| | - Cecilie Svanes
- Department of Global Public Health and Primary Care, Centre for International Health, University of Bergen, Bergen, Norway
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
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22
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Klausen FB, Amidi A, Kjærgaard SK, Schlünssen V, Ravn P, Østergaard K, Gutzke VH, Glasius M, Grønborg TK, Hansen SN, Zachariae R, Wargocki P, Sigsgaard T. The effect of air quality on sleep and cognitive performance in school children aged 10-12 years: a double-blinded, placebo-controlled, crossover trial. Int J Occup Med Environ Health 2023; 36:177-191. [PMID: 36861764 PMCID: PMC10464806 DOI: 10.13075/ijomeh.1896.02032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 11/09/2022] [Indexed: 02/18/2023] Open
Abstract
OBJECTIVES To investigate the effect of CO2 during sleep on next-morning cognitive performance in young schoolchildren, the authors performed a double-blind fully balanced crossover placebo-controlled study. MATERIAL AND METHODS The authors included 36 children aged 10-12 years in the climate chamber. The children slept at 21°C in 6 groups each at 3 different conditions separated by 7 days in a random order. Conditions were as follows: high ventilation with CO2 at 700 ppm, high ventilation with added pure CO2 at 2000-3000 ppm, and reduced ventilation with CO2 at 2-3000 ppm and bioeffluents. Children were subjected to a digital cognitive test battery (CANTAB) in the evening prior to sleep and on the next morning after breakfast. Sleep quality was monitored with wrist actigraphs. RESULTS There were no significant exposure effects on cognitive performance. Sleep efficiency was significantly lower at high ventilation with CO2 at 700 ppm which is considered to be a chance effect. No other effects were seen, and no relation between air quality during sleep and next-morning cognitive performance was observed in the children emitting an estimated 10 lCO2/h per child. CONCLUSIONS No effect of CO2 during sleep was found on next day cognition. The children were awakened in the morning, and spent from 45-70 min in well-ventilated rooms before they were tested. Hence, it cannot be precluded that the children have benefitted from the good indoor air quality conditions before and during the testing period. The slightly better sleep efficiency during high CO2 concentrations might be a chance finding. Hence, replication is needed in actual bedrooms controlling for other external factors before any generalizations can be made. Int J Occup Med Environ Health. 2023;36(2):177-91.
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Affiliation(s)
- Frida Bejder Klausen
- Aarhus University, Department of Public Health, Section for Environment, Occupation and Health, Aarhus, Denmark
| | - Ali Amidi
- Aarhus University, Department of Psychology and Behavioural Sciences, Aarhus, Denmark
| | - Søren K. Kjærgaard
- Aarhus University, Department of Public Health, Section for Environment, Occupation and Health, Aarhus, Denmark
| | - Vivi Schlünssen
- Aarhus University, Department of Public Health, Section for Environment, Occupation and Health, Aarhus, Denmark
| | - Peter Ravn
- Aarhus University, Department of Public Health, Section for Environment, Occupation and Health, Aarhus, Denmark
| | - Kirsten Østergaard
- Aarhus University, Department of Public Health, Section for Environment, Occupation and Health, Aarhus, Denmark
| | - Vibeke Heitmann Gutzke
- Aarhus University, Department of Public Health, Section for Environment, Occupation and Health, Aarhus, Denmark
| | | | - Therese Koops Grønborg
- Aarhus University, Department of Public Health, Research Section of Biostatistics, Aarhus, Denmark
| | - Stefan Nygaard Hansen
- Aarhus University, Department of Public Health, Research Section of Biostatistics, Aarhus, Denmark
| | - Robert Zachariae
- Aarhus University, Department of Psychology and Behavioural Sciences, Aarhus, Denmark
| | - Pawel Wargocki
- Technical University of Denmark, Department of Environmental and Resource Engineering, Lyngby, Denmark
| | - Torben Sigsgaard
- Aarhus University, Department of Public Health, Section for Environment, Occupation and Health, Aarhus, Denmark
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23
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Rhodes S, Beale S, Wilkinson J, van Veldhoven K, Basinas I, Mueller W, Oude Hengel KM, Burdorf A, Peters S, Stokholm ZA, Schlünssen V, Kolstad H, Pronk A, Pearce N, Hayward A, van Tongeren M. Exploring the relationship between job characteristics and infection: Application of a COVID-19 job exposure matrix to SARS-CoV-2 infection data in the United Kingdom. Scand J Work Environ Health 2023; 49:171-181. [PMID: 36537299 PMCID: PMC10621898 DOI: 10.5271/sjweh.4076] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE This study aimed to assess whether workplace exposures as estimated via a COVID-19 job exposure matrix (JEM) are associated with SARS-CoV-2 in the UK. METHODS Data on 244 470 participants were available from the Office for National Statistics Coronavirus Infection Survey (CIS) and 16 801 participants from the Virus Watch Cohort, restricted to workers aged 20-64 years. Analysis used logistic regression models with SARS-CoV-2 as the dependent variable for eight individual JEM domains (number of workers, nature of contacts, contact via surfaces, indoor or outdoor location, ability to social distance, use of face covering, job insecurity, and migrant workers) with adjustment for age, sex, ethnicity, index of multiple deprivation (IMD), region, household size, urban versus rural area, and health conditions. Analyses were repeated for three time periods (i) February 2020 (Virus Watch)/April 2020 (CIS) to May 2021), (ii) June 2021 to November 2021, and (iii) December 2021 to January 2022. RESULTS Overall, higher risk classifications for the first six domains tended to be associated with an increased risk of infection, with little evidence of a relationship for domains relating to proportion of workers with job insecurity or migrant workers. By time there was a clear exposure-response relationship for these domains in the first period only. Results were largely consistent across the two UK cohorts. CONCLUSIONS An exposure-response relationship exists in the early phase of the COVID-19 pandemic for number of contacts, nature of contacts, contacts via surfaces, indoor or outdoor location, ability to social distance and use of face coverings. These associations appear to have diminished over time.
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Affiliation(s)
- Sarah Rhodes
- Division of Population Health, Health Services Research & Primary Care, University of Manchester, Manchester, UK.
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24
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Tabatabaeifar S, Vestergaard JM, Würtz ET, Hansen KK, Nielsen KJ, Schlünssen V, Kolstad HA. Systemic reactogenicity following homologues and heterologous prime-boost AZD1222 and BNT162b2 COVID-19 vaccination of 2862 healthcare workers compared with an unvaccinated population. Vaccine X 2023; 13:100280. [PMID: 36945661 PMCID: PMC10010832 DOI: 10.1016/j.jvacx.2023.100280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 02/13/2023] [Accepted: 03/06/2023] [Indexed: 03/16/2023] Open
Abstract
During spring 2021, AZD1222 and BNT162b2 were used as prime and BNT162b2 as booster COVID-19 vaccines in Denmark. We obtained self-reported information on systemic reactogenicity day-by-day during two weeks for 2862 healthcare workers vaccinated with heterologous AZD1222 + BNT162b2 or homologous BNT162b2 + BNT162b2 regimens and compared prevalences of symptoms with unvaccinated healthcare workers. We found comparable systemic reactogenicity during the first week in the two vaccine regimens and no reactogenicity during the second week. Most of the symptoms returned to a level equal to the control population four days after booster vaccination.
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Affiliation(s)
- Sorosh Tabatabaeifar
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark
| | - Jesper M Vestergaard
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark
| | - Else T Würtz
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark
| | - Karoline K Hansen
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark
| | - Kent J Nielsen
- Department of Occupational Medicine, Danish Ramazzini Centre, Goedstrup Hospital, Herning, Denmark
| | - Vivi Schlünssen
- Department of Public Health, Environment, Work and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - Henrik A Kolstad
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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25
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Bonde JPE, Begtrup LM, Jensen JH, Flachs EM, Schlünssen V, Kolstad HA, Jakobsson K, Nielsen C, Nilsson K, Rylander L, Vilhelmsson A, Petersen KKU, Soegaard Toettenborg S. Occupational risk of SARS-CoV-2 infection: a nationwide register-based study of the Danish workforce during the COVID-19 pandemic, 2020-2021. Occup Environ Med 2023; 80:202-208. [PMID: 36813540 PMCID: PMC10086477 DOI: 10.1136/oemed-2022-108713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 02/05/2023] [Indexed: 02/24/2023]
Abstract
OBJECTIVE Most earlier studies on occupational risk of COVID-19 covering the entire workforce are based on relatively rare outcomes such as hospital admission and mortality. This study examines the incidence of SARS-CoV-2 infection by occupational group based on real-time PCR (RT-PCR) tests. METHODS The cohort includes 2.4 million Danish employees, 20-69 years of age. All data were retrieved from public registries. The incidence rate ratios (IRRs) of first-occurring positive RT-PCR test from week 8 of 2020 to week 50 of 2021 were computed by Poisson regression for each four-digit Danish Version of the International Standard Classification of Occupations job code with more than 100 male and 100 female employees (n=205). Occupational groups with low risk of workplace infection according to a job exposure matrix constituted the reference group. Risk estimates were adjusted by demographic, social and health characteristics including household size, completed COVID-19 vaccination, pandemic wave and occupation-specific frequency of testing. RESULTS IRRs of SARS-CoV-2 infection were elevated in seven healthcare occupations and 42 occupations in other sectors, mainly social work activities, residential care, education, defence and security, accommodation and transportation. No IRRs exceeded 2.0. The relative risk in healthcare, residential care and defence/security declined across pandemic waves. Decreased IRRs were observed in 12 occupations. DISCUSSION We observed a modestly increased risk of SARS-CoV-2 infection among employees in numerous occupations, indicating a large potential for preventive actions. Cautious interpretation of observed risk in specific occupations is needed because of methodological issues inherent in analyses of RT-PCR test results and because of multiple statistical tests.
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Affiliation(s)
- Jens Peter Ellekilde Bonde
- Department of Occupational and Environmental Medicine, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark .,Department of Occupational and Environmental Medicine, Bispebjerg and Frederikberg Hospital, Copenhagen, Denmark
| | - Luise Moelenberg Begtrup
- Department of Occupational and Environmental Medicine, Bispebjerg and Frederikberg Hospital, Copenhagen, Denmark
| | - Johan Høy Jensen
- Department of Occupational and Environmental Medicine, Bispebjerg and Frederikberg Hospital, Copenhagen, Denmark
| | - Esben Meulengracht Flachs
- Department of Occupational and Environmental Medicine, Bispebjerg and Frederikberg Hospital, Copenhagen, Denmark
| | - Vivi Schlünssen
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark
| | - Henrik A Kolstad
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark
| | - Kristina Jakobsson
- Sahlgrenska Academy, University of Gothenburg, School of Public Health and Community Medicine, Gothenburg, Sweden
| | - Christel Nielsen
- Laboratory Medicine, Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Kerstin Nilsson
- Laboratory Medicine, Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Lars Rylander
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Andreas Vilhelmsson
- Laboratory Medicine, Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | | | - Sandra Soegaard Toettenborg
- Department of Occupational and Environmental Medicine, Bispebjerg and Frederikberg Hospital, Copenhagen, Denmark
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26
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Dalbøge A, Albert Kolstad H, Ulrik CS, Sherson DL, Meyer HW, Ebbehøj N, Sigsgaard T, Zock JP, Baur X, Schlünssen V. The Relationship Between Potential Occupational Sensitizing Exposures and Asthma: An Overview of Systematic Reviews. Ann Work Expo Health 2023; 67:163-181. [PMID: 36472234 DOI: 10.1093/annweh/wxac074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 10/05/2022] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES The aim was to identify, appraise, and synthesize the scientific evidence of the relationship between potential occupational sensitizing exposures and the development of asthma based on systematic reviews. METHODS The study was conducted as an overview of systematic reviews. A systematic literature search was conducted for systematic reviews published up to 9 February 2020. Eligibility study criteria included persons in or above the working age, potential occupational sensitizing exposures, and outcomes defined as asthma. Potential occupational sensitizing exposures were divided into 23 main groups comprising both subgroups and specific exposures. Two reviewers independently selected studies, extracted study data, assessed study quality, and evaluated confidence in study results and level of evidence of the relationship between potential occupational sensitizing exposures and asthma. RESULTS Twenty-seven systematic reviews were included covering 1242 studies and 486 potential occupational sensitizing exposures. Overall confidence in study results was rated high in three systematic reviews, moderate in seven reviews, and low in 17 reviews. Strong evidence for the main group of wood dusts and moderate evidence for main groups of mites and fish was found. For subgroups/specific exposures, strong evidence was found for toluene diisocyanates, Aspergillus, Cladosporium, Penicillium, and work tasks involving exposure to laboratory animals, whereas moderate evidence was found for 52 subgroups/specific exposures. CONCLUSIONS This overview identified hundreds of potential occupational sensitizing exposures suspected to cause asthma and evaluated the level of evidence for each exposure. Strong evidence was found for wood dust in general and for toluene diisocyanates, Aspergillus, Cladosporium, Penicillium, and work tasks involving exposure to laboratory animals.
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Affiliation(s)
- Annett Dalbøge
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, 8200 Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, 8200 Aarhus, Denmark
| | - Henrik Albert Kolstad
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, 8200 Aarhus, Denmark
| | - Charlotte Suppli Ulrik
- Department of Respiratory Medicine, Hvidovre University Hospital, 2650 Hvidovre, Denmark
| | - David Lee Sherson
- Department of Occupational and Environmental Medicine, Odense University Hospital, 5000 Odense, Denmark.,Department of Pulmonary Medicine, Odense University Hospital, 5000 Odense, Denmark
| | - Harald William Meyer
- Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital, 2400 Copenhagen, Denmark
| | - Niels Ebbehøj
- Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital, 2400 Copenhagen, Denmark
| | - Torben Sigsgaard
- Department of Public Health, Environment, Occupation, and Health, Danish Ramazzini Centre, Aarhus University, 8000 Aarhus, Denmark
| | - Jan-Paul Zock
- National Institute for Public Health and the Environment (RIVM), Bilthoven, 3721 MA, The Netherlands
| | - Xaver Baur
- Institut für Arbeitsmedizin, Charité Universitätsmedizin Berlin, 10117 Berlin, Germany
| | - Vivi Schlünssen
- National Research Centre for the Working Environment, 2100 Copenhagen, Denmark.,Department of Public Health, Environment, Occupation, and Health, Danish Ramazzini Centre, Aarhus University, 8000 Aarhus, Denmark
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27
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Amin H, Marshall IPG, Bertelsen RJ, Wouters IM, Schlünssen V, Sigsgaard T, Šantl-Temkiv T. Optimization of bacterial DNA and endotoxin extraction from settled airborne dust. Sci Total Environ 2023; 857:159455. [PMID: 36252657 DOI: 10.1016/j.scitotenv.2022.159455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 10/03/2022] [Accepted: 10/11/2022] [Indexed: 06/16/2023]
Abstract
Collecting and obtaining sufficient amount of airborne particles for multiple microbial component assessments can be challenging. A passive dust sampling device, the electrostatic dust fall collector (EDC) has been established for assessing airborne exposures including endotoxin and glucans. Recently, with advances in next-generation sequencing techniques, EDCs were used to collect microbial cells for DNA sequencing analysis to promote the study of airborne bacterial and fungal communities. However, low DNA yields have been problematic when employing passive sampling with EDC. To address this challenge, we attempted to increase the efficiency of extraction. We compared DNA extraction efficiency of bacterial components from EDCs captured on filters through filtration using five extraction techniques. By measuring the abundance, diversity and structure of bacterial communities using qPCR and amplicon sequencing targeting 16S rRNA genes, we found that two techniques outperformed the rest. Furthermore, we developed protocols to simultaneously extract both DNA and endotoxin from a single EDC cloth. Our technique promotes a high quality to price ratio and may be employed in large epidemiological studies addressing airborne bacterial exposure where a large number of samples is needed.
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Affiliation(s)
- Hesham Amin
- Department of Clinical Science, University of Bergen, Bergen, Norway.
| | - Ian P G Marshall
- Section for Microbiology, Department of Biology, Aarhus University, Aarhus, Denmark
| | - Randi J Bertelsen
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Inge M Wouters
- Institute for Risk Assessment Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands
| | - Vivi Schlünssen
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Torben Sigsgaard
- Department of Public Health, Environment, Work and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - Tina Šantl-Temkiv
- Section for Microbiology, Department of Biology, Aarhus University, Aarhus, Denmark
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28
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Kolstad HA, Frydenberg M, Nielsen KJ, Schlünssen V, Biering K, Kjærsgaard M, Vestergaard JM, Würtz ET, Pugdahl K, Würtz AML, Hansen KK, Jespersen S, Kragh Thomsen M, Sørensen MM, Ellermann-Eriksen S, Dvinge Redder J, Storgaard M. SARS-CoV-2 Infection Rates Following Use of Regular Compared With Defective Respirators When Caring for COVID-19 Patients: A Retrospective Follow-up Study. Ann Work Expo Health 2023; 67:141-146. [PMID: 35488370 DOI: 10.1093/annweh/wxac031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 03/22/2022] [Accepted: 04/19/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND There is strong observational evidence that respirators are highly effective in protecting the users from being infected with Middle East respiratory syndrome and severe acute respiratory syndrome coronavirus (SARS-CoV), but the evidence for SARS-CoV-2 during daily work is limited. This study utilized a subset of healthcare workers' temporary use of a new brand respirator with frequent defects when caring for coronavirus disease 2019 (COVID-19) patients to assess the protective effect of regular respirators against SARS-CoV-2 infection. METHODS We retrospectively followed 463 participants wearing a regular respirator and 168 wearing the new brand respirator day-by-day when caring for COVID-19 patients until testing polymerase chain reaction positive for SARS-CoV-2 between 27th December 2020 and 14th January 2021. RESULTS We observed seven and eight incident SARS-CoV-2-infected cases. This corresponded with daily infection rates of 0.2 and 0.5%, an incidence rate ratio of 0.4 [95% confidence interval (CI) 0.1; 1.0], and an incidence rate difference of 0.3% (95% CI -0.1; 0.8) when comparing a regular with the new brand respirator. DISCUSSION We regard the new brand respirator a sham intervention, and this study thus provides further evidence for the protective effect of respirators when exposed to SARS-CoV-2 virus.
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Affiliation(s)
- Henrik A Kolstad
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, DK-8200 Aarhus N, Denmark.,Institute of Clinical Medicine, Aarhus University, DK-8200 Aarhus N, Denmark
| | - Morten Frydenberg
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, DK-8200 Aarhus N, Denmark
| | - Kent Jacob Nielsen
- Department of Occupational Medicine, Danish Ramazzini Centre, Goedstrup Hospital, DK-7400 Herning, Denmark
| | - Vivi Schlünssen
- Department of Public Health, Work, Environment and Health, Danish Ramazzini Centre, Aarhus University, DK-8000 Aarhus C, Denmark
| | - Karin Biering
- Department of Occupational Medicine, Danish Ramazzini Centre, Goedstrup Hospital, DK-7400 Herning, Denmark
| | - Mona Kjærsgaard
- Department of Clinical Microbiology, Aarhus University Hospital, DK-8200 Aarhus N, Denmark
| | - Jesper Medom Vestergaard
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, DK-8200 Aarhus N, Denmark
| | - Else Toft Würtz
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, DK-8200 Aarhus N, Denmark
| | - Kirsten Pugdahl
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, DK-8200 Aarhus N, Denmark
| | - Anne Mette Lund Würtz
- Department of Public Health, Work, Environment and Health, Danish Ramazzini Centre, Aarhus University, DK-8000 Aarhus C, Denmark
| | - Karoline Kærgaard Hansen
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, DK-8200 Aarhus N, Denmark
| | - Sanne Jespersen
- Department of Infectious Diseases, Aarhus University Hospital, DK-8200 Aarhus N, Denmark
| | - Marianne Kragh Thomsen
- Department of Clinical Microbiology, Aarhus University Hospital, DK-8200 Aarhus N, Denmark
| | - Mette Marie Sørensen
- Department of Infectious Diseases, Aarhus University Hospital, DK-8200 Aarhus N, Denmark
| | | | | | - Merete Storgaard
- Department of Infectious Diseases, Aarhus University Hospital, DK-8200 Aarhus N, Denmark
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29
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Bonde JPE, Sell L, Flachs EM, Coggon D, Albin M, Oude Hengel KM, Kolstad H, Mehlum IS, Schlünssen V, Solovieva S, Torén K, Jakobsson K, Nielsen C, Nilsson K, Rylander L, Petersen KU, Tøttenborg SS. Occupational risk of COVID-19 related hospital admission in Denmark 2020-2021: a follow-up study. Scand J Work Environ Health 2023; 49:84-94. [PMID: 36228167 PMCID: PMC10549918 DOI: 10.5271/sjweh.4063] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Indexed: 01/31/2023] Open
Abstract
OBJECTIVE Mounting evidence indicates increased risk of COVID-19 among healthcare personnel, but the evidence on risks in other occupations is limited. In this study, we quantify the occupational risk of COVID-19-related hospital admission in Denmark during 2020-2021. METHODS The source population included 2.4 million employees age 20-69 years. All information was retrieved from public registers. The risk of COVID-19 related hospital admission was examined in 155 occupations with at least 2000 employees (at-risk, N=1 620 231) referenced to a group of mainly office workers defined by a COVID-19 job exposure matrix (N=369 341). Incidence rate ratios (IRR) were computed by Poisson regression. RESULTS During 186 million person-weeks of follow-up, we observed 2944 COVID-19 related hospital admissions in at-risk occupations and 559 in referents. Adjusted risk of such admission was elevated in several occupations within healthcare (including health care assistants, nurses, medical practitioners and laboratory technicians but not physiotherapists or midwives), social care (daycare assistants for children aged 4-7, and nursing aides in institutions and private homes, but not family daycare workers) and transportation (bus drivers, but not lorry drivers). Most IRR in these at-risk occupations were in the range of 1.5-3. Employees in education, retail sales and various service occupations seemed not to be at risk. CONCLUSION Employees in several occupations within and outside healthcare are at substantially increased risk of COVID-19. There is a need to revisit safety measures and precautions to mitigate viral transmission in the workplace during the current and forthcoming pandemics.
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Affiliation(s)
- Jens Peter Ellekilde Bonde
- Department of Occupational and Environmental Medicine, Bispebjerg Frederiksberg Hospitals, Bispebjerg Bakke 23, DK-Copenhagen 2400 NV, Denmark.
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Lea Sell
- Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg University Hospital, Copenhagen, Denmark
| | - Esben Meulengracht Flachs
- Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg University Hospital, Copenhagen, Denmark
| | - David Coggon
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
| | - Maria Albin
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Centre for occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Karen Marieke Oude Hengel
- Netherlands Organization for Applied Scientific Research TNO, Department of Work Health Technology, Leiden, The Netherlands
| | - Henrik Kolstad
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Århus, Denmark
| | - Ingrid Sivesind Mehlum
- National Institute of Occupational Health (STAMI), Oslo, Norway
- Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Vivi Schlünssen
- Department of Public Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
- National Research Center for the Working Environment, Copenhagen, Denmark
| | | | - Kjell Torén
- Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
- Discipline of Occupational and Environmental Health, University of KwaZulu-Natal, Durban, South Africa
| | - Kristina Jakobsson
- Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
- School of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Christel Nielsen
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Kerstin Nilsson
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
- Division of Public Health, Kristianstad University, Kristianstad, Sweden
| | - Lars Rylander
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Kajsa Ugelvig Petersen
- Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg University Hospital, Copenhagen, Denmark
| | - Sandra Søgaard Tøttenborg
- Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg University Hospital, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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30
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Wang J, Janson C, Malinovschi A, Holm M, Franklin KA, Modig L, Johannessen A, Schlünssen V, Gislason T, Jogi NO, Norbäck D. Asthma, allergic rhinitis and atopic dermatitis in association with home environment - The RHINE study. Sci Total Environ 2022; 853:158609. [PMID: 36089044 DOI: 10.1016/j.scitotenv.2022.158609] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 09/02/2022] [Accepted: 09/04/2022] [Indexed: 06/15/2023]
Abstract
We studied home environment exposures in relation to asthma, allergic rhinitis and atopic dermatitis among offspring of participants (parents) in the Respiratory Health in Northern Europe (RHINE) study (age ≤ 30 y). Totally 17,881 offspring from Iceland, Norway, Sweden, Denmark and Estonia were included. Home environment exposures, including dampness and mold, type of dwelling, construction year and indoor painting were registered through a questionnaire answered by parents in the first follow up (RHINE II). The parents reported ten years later with in the frame of RHINE III offspring's birth year and offspring's asthma, allergic rhinitis, atopic dermatitis. They also reported dampness and mold at home from RHINE II to RHINE III. The prevalence of offspring's asthma before 10 y, asthma after 10 y, allergic rhinitis at any age and atopic dermatitis at any age were 9.7 %, 4.3 %, 15.6 % and 17.3 %, respectively. Asthma before 10 y was related to any indoor painting at RHINE II (OR = 1.14, 95%CI (1.02, 1.29)). Asthma after 10 y was associated with dampness/mold at home (OR = 1.33-1.62) and living in the newest buildings (constructed in 1986-2001) (OR = 1.30, 95%CI (1.02, 1.66)). Allergic rhinitis was associated with living in newer buildings (constructed in 1961-2001) (OR = 1.16-1.24). Atopic dermatitis was associated with visible mold (OR = 1.35, 95%CI(1.12, 1.62)), dampness/mold at home (OR = 1.18-1.38), living in apartments (OR = 1.22, 95%CI(1.10, 1.35)) and living in newer buildings (constructed in 1961-2001) (OR = 1.14-1.25). There were dose-response effects of dampness and mold on offspring's asthma after 10 y and atopic dermatitis (20 years exposure vs. 10 years exposure). Older offspring had increased risk of developing asthma after 10 y and atopic dermatitis. In conclusion, home dampness and mold, living in apartments, living in newer buildings and indoor painting were associated with offspring's asthma or allergic diseases. Stronger health effects were found among offspring with prolonged exposure of dampness/mold.
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Affiliation(s)
- Juan Wang
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden.
| | - Christer Janson
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Andrei Malinovschi
- Department of Medical Sciences, Clinical Physiology, Uppsala University, Uppsala, Sweden
| | - Mathias Holm
- Occupational and Environmental Medicine, Gothenburg University, Gothenburg, Sweden
| | - Karl A Franklin
- Department of Surgical and Preoperative Sciences, Surgery, Umeå University, SE-901 85 Umeå, Sweden
| | - Lars Modig
- Department of Public Health and Clinical Medicine, Sustainable Health, Umeå University, Umeå, Sweden
| | - Ane Johannessen
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Vivi Schlünssen
- Department of Public Health, Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - Thorarinn Gislason
- Department of Sleep, Landspitali University Hospital, Reykjavik, Iceland; Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Nils Oskar Jogi
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway; Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Dan Norbäck
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden
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Christiansen AG, Carstensen O, Sommerlund M, Clausen PA, Bønløkke JH, Schlünssen V, Isaksson M, Schmidt SAJ, Kolstad HA. Prevalence of skin sensitization and dermatitis among epoxy-exposed workers in the wind turbine industry. Br J Dermatol 2022; 187:988-996. [PMID: 35972390 PMCID: PMC10087335 DOI: 10.1111/bjd.21830] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 08/12/2022] [Accepted: 08/14/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND A high prevalence of skin sensitization and dermatitis has been reported among workers exposed to epoxy components. OBJECTIVES To estimate the risk of skin sensitization and dermatitis among workers exposed to epoxy components during production of wind turbine blades while using comprehensive safety measures. METHODS A cross-sectional study of 180 highly epoxy-exposed production workers and 41 nonexposed office workers was conducted at two wind turbine blade factories in Denmark. Participants underwent a skin examination, were tested with a tailored patch test panel including epoxy-containing products used at the factories, and answered a questionnaire. RESULTS Sixteen production workers (8·9%) were sensitized to an epoxy component compared with none of the office workers. Skin sensitization was more frequent within the first year of exposed employment. Strong selection bias by atopic status was indicated. Among nonatopic workers, the prevalence of dermatitis was higher among production workers (16·4%) than among office workers [6·5%, odds ratio (OR) 2·3, 95% confidence interval (CI) 0·6-9·1] and higher among the sensitized workers (43·8%) than the nonsensitized workers (14·6%, OR 4·5, 95% CI 1·6-12·7). Resins based on diglycidyl ether of bisphenol A and F were the most frequent sensitizers. One of the four workers sensitized to epoxy components used at the factories did not react to the epoxy resin of the TRUE test® panel. CONCLUSIONS Despite comprehensive skin protection, sensitization and dermatitis are prevalent among highly epoxy-exposed workers in the wind turbine industry in Denmark. Our findings document the need for intensified preventive efforts and emphasize the importance of tailored patch testing. What is already known about this topic? Epoxy components are well-known sensitizers of the skin. A high prevalence of skin sensitization and dermatitis has been reported among workers exposed to epoxy components. Comprehensive protective equipment is recommended when working with epoxy components. What does this study add? Despite comprehensive skin protection, skin sensitization and dermatitis are prevalent among epoxy-exposed workers. We found that 40% of workers sensitized to epoxy products had dermatitis. Only 75% of the sensitized workers were detected by the epoxy resin of the TRUE test® , which emphasizes the importance of tailored testing.
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Affiliation(s)
- Alexandra G Christiansen
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark
| | - Ole Carstensen
- Department of Occupational Medicine, The Regional Hospital Goedstrup, University Research Clinic, Herning, Denmark
| | - Mette Sommerlund
- Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark
| | - Per A Clausen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Jakob H Bønløkke
- Department of Occupational and Environmental Medicine, Danish Ramazzini Centre, Aalborg University Hospital, Aalborg, Denmark
| | - Vivi Schlünssen
- National Research Centre for the Working Environment, Copenhagen, Denmark.,Department of Public Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - Marléne Isaksson
- Department of Occupational and Environmental Dermatology, Lund University, Skane University Hospital Malmö, Malmö, Sweden
| | - Sigrun A J Schmidt
- Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Henrik A Kolstad
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark.,Institute of Clinical Medicine, Aarhus University, Aarhus, Denmark
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Barański K, Schlünssen V. The Accuracy of a Screening Tool in Epidemiological Studies-An Example of Exhaled Nitric Oxide in Paediatric Asthma. Int J Environ Res Public Health 2022; 19:14746. [PMID: 36429465 PMCID: PMC9690257 DOI: 10.3390/ijerph192214746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/12/2022] [Accepted: 11/08/2022] [Indexed: 06/16/2023]
Abstract
UNLABELLED Diagnostic tests are widely used in medicine, especially in the clinical setting. The doctor's decision regarding the treatment process is mostly based on the result of the diagnostic test. The value of the test is expressed by its accuracy. It is easier to verify the accuracy of a diagnostic test in a clinical setting in comparison to an epidemiological setting. Moreover, a very good test may not work in epidemiological settings in the same effective way as in a clinical setting, especially because the accuracy is affected by the prevalence of the disease. The aim of the study is to assess the accuracy of FeNO measurement in different respiratory disorders or symptoms, including their prevalence, in a childhood population. The secondary aim is to suggest the optimal FeNO cut-off for epidemiological screening for respiratory diseases and symptoms. METHODS The cross-sectional study included 447 children (50.8% boys and 49.2% girls) aged 6-9 years. An adapted version of the ISAAC questionnaire was used for the assessment of the respiratory status. FeNO was measured with an electrochemical device (Niox Mino) according to ERS/ATS recommendations. For interpretation, the FeNO cut-off values of 20 parts per billion (ppb), 25 ppb and 35 ppb were applied taking the real-life prevalence of the disease or symptoms into consideration and also for simulated prevalences of 20%, 30%, 40%, 50% for the interpretation of the accuracy of the test. The accuracy was calculated according to the following formula: Accuracy = (Prevalence) (Sensitivity) + (1- Prevalence) (Specificity). The area under the curve was calculated based on logistic regression. RESULTS For all respiratory outcomes, FeNO accuracy decreased with increasing prevalence, and in general the area under the curve (AUC) was low. The highest FeNO accuracy was found for any asthma diagnosis (with possible coexisting diseases/symptoms), i.e., 78.6%, 92.8% and 88.5% for FeNO cut-offs >19 ppb, >24 ppb and >34 ppb, respectively. The AUC was 0.628. For the same FeNO cut-offs, the accuracy of an asthma diagnosis without any coexisting diseases and symptoms was 81.2%, 87.5%, 92.9%, respectively, with an AUC of 0.757. CONCLUSION FeNO accuracy decreases with increasing prevalence of the respiratory disease and symptoms. The best accuracy for the FeNO cut-off in the screening of asthma for epidemiological purposes is 35 ppb. For isolated asthma, the best accuracy for FeNO was 92.9%.
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Affiliation(s)
- Kamil Barański
- Department of Epidemiology, Medical University of Silesia, 40-055 Katowice, Poland
| | - Vivi Schlünssen
- Research Unit for Environment, Occupation and Health, Department of Public Health, Danish Ramazzini Centre, Aarhus University, 8000 Aarhus, Denmark
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Heldin J, Malinovschi A, Johannessen A, Alving K, Holm M, Franklin KA, Forsberg B, Schlünssen V, Jögi R, Gislason T, Benediktsdottir B, Svanes C, Janson C. Clinical Remission of Asthma and Allergic Rhinitis - in a Longitudinal Population Study. J Asthma Allergy 2022; 15:1569-1578. [PMID: 36387839 PMCID: PMC9643071 DOI: 10.2147/jaa.s378584] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 10/14/2022] [Indexed: 10/01/2023] Open
Abstract
BACKGROUND Although asthma and allergic rhinitis are chronic diseases, some patients experience periods of remission. Information on prognostic factors associated with the remission of asthma and allergic rhinitis is valuable in resource prioritization. This study investigated factors associated with the clinical remission of asthma and allergic rhinitis. METHODS In the Respiratory Health In Northern Europe (RHINE) study, data was collected with questionnaires in stage one (RHINE I, 1989-1992) and two follow-ups (RHINE II, 1999-2001 and RHINE III, 2010-2012) from Sweden, Norway, Denmark, Iceland and Estonia. Clinical remission was defined as having reported asthma or allergic rhinitis in RHINE I or RHINE II but not in RHINE III. RESULTS Of 13,052 participants, 975 (7.5%) reported asthma in RHINE I or RHINE II, and 3379 (25.9%) allergic rhinitis. Clinical remission of asthma and allergic rhinitis was found in 46.4% and 31.8%, respectively. Living in Estonia (OR (95% CI) 2.44 (1.22-4.85)) and living in an apartment (1.45 (1.06-1.98)) were related to remission of asthma, while subjects reporting allergic rhinitis (0.68 (0.51-0.90)), asthma onset ≤ 12 years of age (0.49 (0.35-0.68)), receiving treatment with antibiotics for respiratory illness (0.64 (0.47-0.87)) were less likely to have asthma remission. Factors related to a higher likelihood of remission of allergic rhinitis were no asthma at baseline, age ≥ 58 years in RHINE III, allergic rhinitis onset after 12 years of age, living in rural areas as a child, having only a primary school education and not being pregnant. CONCLUSION Clinical remission was found in almost one-half of those with asthma and one-third of persons with allergic rhinitis. Coexisting allergic symptoms were associated with less clinical asthma remission. Age, asthma symptoms and environmental factors in childhood, such as living in a rural area, were found to influence the clinical remission of allergic rhinitis.
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Affiliation(s)
- Johanna Heldin
- Department of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Andrei Malinovschi
- Department of Medical Sciences: Clinical Physiology, Uppsala University, Uppsala, Sweden
| | - Ane Johannessen
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Kjell Alving
- Department of Women’s and Children’s Health, Paediatric Research, Uppsala University, Uppsala, Sweden
| | - Mathias Holm
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Karl A Franklin
- Department of Surgical and Perioperative Sciences, Surgery, Umeå University, Umeå, Sweden
| | - Bertil Forsberg
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden
| | - Vivi Schlünssen
- Department of Public Health, Unit for Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
- National Research Center for the Working Environment, Copenhagen, Denmark
| | - Rain Jögi
- Tartu University Hospital, Lung Clinic, Tartu, Estonia
| | - Thorarinn Gislason
- The Medical Faculty, University of Iceland, Reykjavik, Iceland
- Department of Sleep, Landspitali University Hospital Reykjavik, Reykjavik, Iceland
| | - Bryndis Benediktsdottir
- The Medical Faculty, University of Iceland, Reykjavik, Iceland
- Department of Sleep, Landspitali University Hospital Reykjavik, Reykjavik, Iceland
| | - Cecilie Svanes
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
| | - Christer Janson
- Department of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
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34
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Würtz AM, Kinnerup MB, Pugdahl K, Schlünssen V, Vestergaard JM, Nielsen K, Cramer C, Bonde JP, Biering K, Carstensen O, Hansen KK, Dalbøge A, Flachs EM, Hansen ML, Thulstrup AM, Würtz ET, Kjærsgaard M, Christensen MW, Kolstad HA. Healthcare workers' SARS-CoV-2 infection rates during the second wave of the pandemic: follow-up study. Scand J Work Environ Health 2022; 48:530-539. [PMID: 35780381 PMCID: PMC10539104 DOI: 10.5271/sjweh.4049] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES This study aimed to assess if, during the second wave of the COVID-19 pandemic, healthcare workers had increased severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection rates, following close contact with patients, co-workers and persons outside work with COVID-19. METHODS A follow-up study of 5985 healthcare workers from Denmark was conducted between November 2020 and April 2021 and provided day-to-day information on COVID-19 contacts. SARS-CoV-2 infection was defined by the first positive polymerase chain reaction (PCR) test ever. Data was analyzed in multivariable Poisson regression models. RESULTS The SARS-CoV-2 infection rates following close contact 3-7 days earlier with patients, co-workers and persons outside work with COVID-19 were 153.7, 240.8, and 728.1 per 100 000 person-days, respectively. This corresponded with age, sex, month, number of PCR tests and mutually adjusted incidence rate ratios of 3.17 [40 cases, 95% confidence interval (CI) 2.15-4.66], 2.54 (10 cases, 95% CI 1.30-4.96) and 17.79 (35 cases, 95% CI 12.05-26.28). The risk of SARS-CoV-2 infection was thus lower, but the absolute numbers affected was higher following COVID-19 contact at work than COVID-19 contact off work. CONCLUSIONS Despite strong focus on preventive measures during the second wave of the pandemic, healthcare workers were still at increased risk of SARS-CoV-2 infection when in close contact with patients or co-workers with COVID-19. There is a need for increased focus on infection control measures in order to secure healthcare workers' health and reduce transmission into the community during ongoing and future waves of SARS-CoV-2 and other infections.
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Affiliation(s)
- Anne Mette Würtz
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark.
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35
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Cramer C, Hansen KK, Kinnerup MB, Flachs EM, Vestergaard JM, Biering K, Nielsen K, Würtz AM, Dalbøge A, Würtz ET, Kjærsgaard M, Kolstad HA, Schlünssen V. Use of Personal Protective Equipment Among Healthcare Workers During the First and the Second Wave of the COVID-19 Pandemic. Ann Work Expo Health 2022; 67:59-75. [PMID: 36039576 PMCID: PMC9452181 DOI: 10.1093/annweh/wxac054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 06/17/2022] [Accepted: 07/26/2022] [Indexed: 01/14/2023] Open
Abstract
INTRODUCTION To treat and properly care for COVID-19 patients it is vital to have healthy healthcare workers to ensure the continued function of the healthcare system and to prevent transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to patients, co-workers, and the community. Personal protective equipment (PPE) can prevent healthcare workers from being infected with and transmitting SARS-CoV-2. Experience and training are pivotal to ensure optimal protection. This study aims to examine the use and failure of PPE and compliance with PPE guidelines during the first and the second wave of the COVID-19 pandemic among Danish healthcare workers. METHODS Healthcare workers from the Central Denmark Region and the Capital Region of Denmark were invited to participate April-June 2020 during the first wave and November 2020-April 2021 during the second wave. Day-by-day, participants reported work procedures, use and failure of PPE, and compliance with PPE guidelines. Register-based information on sex, age, department, and profession was available for all participants. RESULTS In total, 21 684 and 10 097 healthcare workers participated during the first and the second wave, respectively. During the first wave, 1.7% used filtering face piece-2 or -3 (FFP2 or FFP3) respirators and 8.2% used face masks [fluid resistant (type IIR) masks, masks with visor (typically type IIR), and other unspecified face masks] during physical contact with patients. During the second wave, the corresponding figures increased to 17.8% and 80.7%. During respiratory procedures, the use of FFP2 or FFP3 respirators increased from 5.6 to 24.3%, and the use of face masks from 14.7 to 77.8%. The no PPE use decreased from 21.3% during the first wave to 0.4% in the second wave, during respiratory procedures. Total PPE failures decreased from 0.7 to 0.4% from the first to second wave. The proportion not complying with PPE guidelines declined from 3.6 to 2.2% during physical contact with patients and from 6.5 to 4.6% during respiratory procedures. PPE failure and non-compliance varied by age, sex and type of department. Frequent reasons for non-compliance were forgetfulness and lack of time, and during the first but not during the second wave, limited availability of PPE. CONCLUSION We found a substantial increase in the use of PPE and a substantial decrease in PPE failures from the first to the second wave of COVID-19 in Denmark. However, there is still a need for continuous focus on compliance in use of PPE among healthcare workers.
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Affiliation(s)
- Christine Cramer
- Author to whom correspondence should be addressed. Tel.: +4578450900; e-mail:
| | | | - Martin Byskov Kinnerup
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, DK-8200 Aarhus N, Denmark,Department of Occupational Medicine, Danish Ramazzini Centre, Goedstrup Hospital, DK-7400 Herning, Denmark
| | - Esben Meulengracht Flachs
- Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, DK-2400 Copenhagen, Denmark
| | - Jesper Medom Vestergaard
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, DK-8200 Aarhus N, Denmark,Department of Occupational Medicine, Danish Ramazzini Centre, Goedstrup Hospital, DK-7400 Herning, Denmark
| | - Karin Biering
- Department of Occupational Medicine, Danish Ramazzini Centre, Goedstrup Hospital, DK-7400 Herning, Denmark
| | - Kent Nielsen
- Department of Occupational Medicine, Danish Ramazzini Centre, Goedstrup Hospital, DK-7400 Herning, Denmark
| | - Anne Mette Würtz
- Department of Public Health, Work, Environment and Health, Danish Ramazzini Centre, Aarhus University, DK-8000 Aarhus C, Denmark
| | - Annett Dalbøge
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, DK-8200 Aarhus N, Denmark
| | - Else Toft Würtz
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, DK-8200 Aarhus N, Denmark
| | - Mona Kjærsgaard
- Department of Clinical Microbiology, Aarhus University Hospital, DK-8200 Aarhus N, Denmark
| | - Henrik Albert Kolstad
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, DK-8200 Aarhus N, Denmark
| | - Vivi Schlünssen
- Department of Public Health, Work, Environment and Health, Danish Ramazzini Centre, Aarhus University, DK-8000 Aarhus C, Denmark,National Research Center for the Working Environment, DK-2100 Copenhagen, Denmark
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Oțelea MR, Fell AKM, Handra CM, Holm M, Filon FL, Mijakovski D, Minov J, Mutu A, Stephanou E, Stokholm ZA, Stoleski S, Schlünssen V. The value of fractional exhaled nitric oxide in occupational diseases - a systematic review. J Occup Med Toxicol 2022; 17:14. [PMID: 35879723 PMCID: PMC9317127 DOI: 10.1186/s12995-022-00355-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 07/04/2022] [Indexed: 12/04/2022] Open
Abstract
Fractional exhaled nitric oxide (FeNO) is a non-invasive biomarker of respiratory tract inflammation, originally designated to identify eosinophilic airway inflammation and to predict steroid response. The main field of application of this biomarker is asthma, but FeNO has also been used for other allergic and non-allergic pulmonary disorders such as chronic obstructive pulmonary disease, hypersensitivity pneumonitis and interstitial lung disease. A substantial part of respiratory diseases are related to work, and FeNO, a safe and easy measure to conduct, is a potential valid examination in an occupational setting. This systematic review assesses the value of measuring FeNO related to three types of airborne exposures: allergens, irritants, and respiratory particles inhaled during occupational activities. The review covers results from longitudinal and observational clinical studies, and highlights the added value of this biomarker in monitoring effects of exposure and in the diagnostic criteria of occupational diseases. This review also covers the possible significance of FeNO as an indicator of the efficacy of interventions to prevent work-related respiratory diseases. Initially, 246 articles were identified in PUBMED and SCOPUS. Duplicates and articles which covered results from the general population, symptoms (not disease) related to work, non-occupational diseases, and case reports were excluded. Finally, 39 articles contributed to this review, which led to the following conclusions: a) For occupational asthma there is no consensus on the significant value of FeNO for diagnosis, or on the magnitude of change needed after specific inhalation test or occupational exposure at the workplace. There is some consensus for the optimal time to measure FeNO after exposure, mainly after 24 h, and FeNO proved to be more sensitive than spirometry in measuring the result of an intervention. b) For other occupational obstructive respiratory diseases, current data suggests performing the measurement after the work shift. c) For interstitial lung disease, the evaluation of the alveolar component of NO is probably the most suitable.
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Affiliation(s)
| | - Anne Kristin M Fell
- Occupational and Environmental Medicine, Telemark Hospital, Skien, Norway.,Department of Global Health and Community Medicine, Institute of Health and Community, University of Oslo, Oslo, Norway
| | - Claudia Mariana Handra
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.,Colentina Clinical Hospital, Clinic for Occupational Medicine, Bucharest, Romania
| | - Mathias Holm
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Francesca Larese Filon
- Unit of Occupational Medicine, Department of Medical Sciences, University of Trieste, Trieste, Italy
| | - Dragan Mijakovski
- Institute of Occupational Health of RN Macedonia, Skopje, North Macedonia.,Faculty of Medicine, Ss. Cyril and Methodius, University in Skopje, Skopje, North Macedonia
| | - Jordan Minov
- Institute of Occupational Health of RN Macedonia, Skopje, North Macedonia.,Faculty of Medicine, Ss. Cyril and Methodius, University in Skopje, Skopje, North Macedonia
| | - Andreea Mutu
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.,Central Military University Emergency Hospital "Carol Davila", Bucharest, Romania
| | | | - Zara Ann Stokholm
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark
| | - Sasho Stoleski
- Institute of Occupational Health of RN Macedonia, Skopje, North Macedonia.,Faculty of Medicine, Ss. Cyril and Methodius, University in Skopje, Skopje, North Macedonia
| | - Vivi Schlünssen
- Department of Public Health, Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
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Schlünssen V, du Prel JB, van Tongeren M, Godderis L, Turner MC, McElvenny D. Development of Harmonized COVID-19 Occupational Questionnaires. Ann Work Expo Health 2022; 67:4-8. [PMID: 35810354 PMCID: PMC9278210 DOI: 10.1093/annweh/wxac044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 04/27/2022] [Accepted: 06/06/2022] [Indexed: 01/14/2023] Open
Abstract
Harmonized tools and approaches for data collection can help to detect similarities and differences within and between countries and support the development, implementation, and assessment of effective and consistent preventive strategies. We developed open source occupational questionnaires on COVID-19 within COVID-19 working groups in the OMEGA-NET COST action (Network on the Coordination and Harmonisation of European Occupational Cohorts, omeganetcohorts.eu), and the EU funded EPHOR project (Exposome project for health and occupational research, ephor-project.eu). We defined domains to be included in order to cover key working life aspects of the COVID-19 pandemic. Where possible, we selected questionnaire items and instruments from existing questionnaire resources. Both a general occupational COVID-19 questionnaire and a specific occupational COVID-19 questionnaire are available. The general occupational COVID-19 questionnaire covers key working life aspects of the COVID-19 pandemic, including the domains: COVID-19 diagnosis and prevention, Health and demographics, Use of personal protective equipment and face covering, Health effects, Work-related effects (e.g. change in work schedule and work-life balance), Financial effects, Work-based risk factors (e.g. physical distancing, contact with COVID-19-infected persons), Psychosocial risk factors, Lifestyle risk factors, and Personal evaluation of the impact of COVID-19. For each domain, additional questions are available. The specific occupational COVID-19 questionnaire focusses on occupational risk factors and mitigating factors for SARS-CoV2 infection and COVID-19 disease and includes questions about the type of job, amount of home working, social distancing, human contact (colleagues, patients, and members of the public), commuting, and use of personal protective equipment and face coverings. The strength of this initiative is the broad working life approach to various important issues related to SARS-CoV-2 infection, COVID-19 disease, and potentially future pandemics. It requires further work to validate the questionnaires, and we welcome collaboration with researchers willing to do this. A limitation is the moderate number of questions for each of the domains in the general questionnaire. Only few questions on general core information like ethnicity, demographics, lifestyle factors, and general health status are included, but the OMEGA-NET questionnaires can be integrated in existing questionnaires about sociodemographic and health-related aspects. The questionnaires are freely accessible from the OMEGA-NET and the EPHOR homepages.
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Affiliation(s)
- Vivi Schlünssen
- Author to whom correspondence should be addressed. Tel: +45-28992499; e-mail:
| | - Jean Baptist du Prel
- Department of Occupational Health Science, University of Wuppertal, Wuppertal, Germany
| | - Martie van Tongeren
- Centre for Occupational and Environmental Health, School or Health Sciences, University of Manchester, Manchester, UK
| | - Lode Godderis
- Centre for Environment and Health, KU Leuven, Leuven, Belgium,IDEWE, External Service for Prevention and Protection at Work, Heverlee, Belgium
| | - 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
| | - Damien McElvenny
- Centre for Occupational and Environmental Health, School or Health Sciences, University of Manchester, Manchester, UK,Research Group, Institute of Occupational Medicine, Edinburgh, UK
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Amin H, Šantl-Temkiv T, Cramer C, Vestergaard DV, Holst GJ, Elholm G, Finster K, Bertelsen RJ, Schlünssen V, Sigsgaard T, Marshall IPG. Cow Farmers’ Homes Host More Diverse Airborne Bacterial Communities Than Pig Farmers’ Homes and Suburban Homes. Front Microbiol 2022; 13:883991. [PMID: 35847077 PMCID: PMC9278274 DOI: 10.3389/fmicb.2022.883991] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 05/05/2022] [Indexed: 01/04/2023] Open
Abstract
Living on a farm has been linked to a lower risk of immunoregulatory disorders, such as asthma, allergy, and inflammatory bowel disease. It is hypothesized that a decrease in the diversity and composition of indoor microbial communities is a sensible explanation for the upsurge in immunoregulatory diseases, with airborne bacteria contributing to this protective effect. However, the composition of this potentially beneficial microbial community in various farm and suburban indoor environments is still to be characterized. We collected settled airborne dust from stables and the associated farmers’ homes and from suburban homes using electrostatic dust collectors (EDCs) over a period of 14 days. Then, quantitative PCR (qPCR) was used to assess bacterial abundance. The V3–V4 region of the bacterial 16S rRNA gene was amplified and sequenced using Ilumina MiSeq in order to assess microbial diversity. The Divisive Amplicon Denoising Algorithm (DADA2) algorithm was used for the inference of amplicon sequence variants from amplicon data. Airborne bacteria were significantly more abundant in farmers’ indoor environments than in suburban homes (p < 0.001). Cow farmers’ homes had significantly higher bacterial diversity than pig farmers’ and suburban homes (p < 0.001). Bacterial taxa, such as Firmicutes, Prevotellaceae, Lachnospiraceae, and Lactobacillus were significantly more abundant in farmers’ homes than suburban homes, and the same was true for beneficial intestinal bacterial species, such as Lactobacillus amylovorus, Eubacterium hallii, and Faecalibacterium prausnitzii. Furthermore, we found a higher similarity between bacterial communities in individual farmers’ homes and their associated cow stables than for pig stables. Our findings contribute with important knowledge on bacterial composition, abundance, and diversity in different environments, which is highly valuable in the discussion on how microbial exposure may contribute to the development of immune-mediated diseases in both children and adults.
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Affiliation(s)
- Hesham Amin
- Department of Clinical Science, University of Bergen, Bergen, Norway
- *Correspondence: Hesham Amin,
| | - Tina Šantl-Temkiv
- Section for Microbiology, Department of Biology, Aarhus University, Aarhus, Denmark
| | - Christine Cramer
- Department of Public Health, Environment, Work, and Health, Danish Ramazzini Center, Aarhus University, Aarhus, Denmark
- Department of Occupational Medicine, Danish Ramazzini Center, Aarhus University Hospital, Aarhus, Denmark
| | - Ditte V. Vestergaard
- Section for Microbiology, Department of Biology, Aarhus University, Aarhus, Denmark
- Department of Public Health, Environment, Work, and Health, Danish Ramazzini Center, Aarhus University, Aarhus, Denmark
| | - Gitte J. Holst
- Department of Public Health, Environment, Work, and Health, Danish Ramazzini Center, Aarhus University, Aarhus, Denmark
| | - Grethe Elholm
- Department of Public Health, Environment, Work, and Health, Danish Ramazzini Center, Aarhus University, Aarhus, Denmark
| | - Kai Finster
- Section for Microbiology, Department of Biology, Aarhus University, Aarhus, Denmark
| | | | - Vivi Schlünssen
- Department of Public Health, Environment, Work, and Health, Danish Ramazzini Center, Aarhus University, Aarhus, Denmark
- The National Research Center for the Working Environment, Copenhagen, Denmark
| | - Torben Sigsgaard
- Department of Public Health, Environment, Work, and Health, Danish Ramazzini Center, Aarhus University, Aarhus, Denmark
| | - Ian P. G. Marshall
- Section for Microbiology, Department of Biology, Aarhus University, Aarhus, Denmark
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Svanes C, Johannessen A, Bertelsen RJ, Dharmage S, Benediktsdottir B, Bråbäck L, Gislason T, Holm M, Jõgi O, Lodge CJ, Malinovschi A, Martinez-Moratalla J, Oudin A, Sánchez-Ramos JL, Timm S, Janson C, Real FG, Schlünssen V. Cohort profile: the multigeneration Respiratory Health in Northern Europe, Spain and Australia (RHINESSA) cohort. BMJ Open 2022; 12:e059434. [PMID: 35654464 PMCID: PMC9163543 DOI: 10.1136/bmjopen-2021-059434] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 03/07/2022] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The Respiratory Health in Northern Europe, Spain and Australia (RHINESSA) cohort was established to (1) investigate how exposures before conception and in previous generations influence health and disease, particularly allergies and respiratory health, (2) identify susceptible time windows and (3) explore underlying mechanisms. The ultimate aim is to facilitate efficient intervention strategies targeting multiple generations. PARTICIPANTS RHINESSA includes study participants of multiple generations from ten study centres in Norway (1), Denmark (1), Sweden (3), Iceland (1), Estonia (1), Spain (2) and Australia (1). The RHINESSA core cohort, adult offspring generation 3 (G3), was first investigated in 2014-17 in a questionnaire study (N=8818, age 18-53 years) and a clinical study (subsample, n=1405). Their G2 parents participated in the population-based cohorts, European Community Respiratory Heath Survey and Respiratory Health In Northern Europe, followed since the early 1990s when they were 20-44 years old, at 8-10 years intervals. Study protocols are harmonised across generations. FINDINGS TO DATE Collected data include spirometry, skin prick tests, exhaled nitric oxide, anthropometrics, bioimpedance, blood pressure; questionnaire/interview data on respiratory/general/reproductive health, indoor/outdoor environment, smoking, occupation, general characteristics and lifestyle; biobanked blood, urine, gingival fluid, skin swabs; measured specific and total IgE, DNA methylation, sex hormones and oral microbiome. Research results suggest that parental environment years before conception, in particular, father's exposures such as smoking and overweight, may be of key importance for asthma and lung function, and that there is an important susceptibility window in male prepuberty. Statistical analyses developed to approach causal inference suggest that these associations may be causal. DNA methylation studies suggest a mechanism for transfer of father's exposures to offspring health and disease through impact on offspring DNA methylation. FUTURE PLANS Follow-up is planned at 5-8 years intervals, first in 2021-2023. Linkage with health registries contributes to follow-up of the cohort.
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Affiliation(s)
- Cecilie Svanes
- Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
- Centre for International Health, University of Bergen Department of Global Public Health and Primary Care, Bergen, Norway
| | - Ane Johannessen
- Centre for International Health, University of Bergen Department of Global Public Health and Primary Care, Bergen, Norway
| | - Randi Jacobsen Bertelsen
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Oral Helath Centre of Expertise Western Norway, Bergen, Norway
| | - Shyamali Dharmage
- Allergy and Health Unit, School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Bryndis Benediktsdottir
- Medical Faculty, University of Iceland, Reykjavik, Iceland
- Department of Sleep, Landspitali University Hospital Reykjavík, Reykjavik, Iceland
| | - Lennart Bråbäck
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå Universitet, Umeå, Sweden
| | - Thorarinn Gislason
- Department of Sleep, Landspitali University Hospital Reykjavík, Reykjavik, Iceland
| | - Mathias Holm
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Goteborg, Sweden
| | - Oskar Jõgi
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Lung Clinic, Tartu University Hospital, Tartu, Estonia
| | - Caroline J Lodge
- Allergy and Lung Health Unit, School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Andrei Malinovschi
- Department of Medical Sciences: Clinical Physiology, Uppsala University, Uppsala, Sweden
| | - Jesus Martinez-Moratalla
- Servicio de Neumología, Complejo Hospitalario Universitario de Albacete, Albacete, Spain
- Facultad de Medicina, Universidad de Castilla-La Mancha - Campus de Albacete, Albacete, Spain
| | - Anna Oudin
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå Universitet, Umeå, Sweden
| | | | - Signe Timm
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Research Unit, Kolding Hospital, University Hospital of Southern Denmark, Kolding, Denmark
| | - Christer Janson
- Department of Medical Sciences: Clinical Physiology, Uppsala University, Uppsala, Sweden
- Department of Medical Sciences: Respiratory, Allergy, Sleep Research, Uppsala University, Uppsala, Sweden
| | - Francisco Gomez Real
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway
| | - Vivi Schlünssen
- Department of Public Health - Work, Environment and Health, Danish Ramazzini Centre, Aarhus Universitet, Aarhus, Denmark
- National Research Centre for the Working Environment, Kobenhavn, Denmark
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Vogt EC, Real FG, Husebye ES, Björnsdottir S, Benediktsdottir B, Bertelsen RJ, Demoly P, Franklin KA, de Aja Gallastegui LS, González FJC, Heinrich J, Holm M, Jogi NO, Leynaert B, Lindberg E, Malinovschi A, Martínez-Moratalla J, Mayoral RG, Oudin A, Pereira-Vega A, Semjen CR, Schlünssen V, Triebner K, Øksnes M. Premature menopause and autoimmune primary ovarian insufficiency in two international multi-center cohorts. Endocr Connect 2022; 11:e220024. [PMID: 35521804 PMCID: PMC9175594 DOI: 10.1530/ec-22-0024] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 04/22/2022] [Indexed: 11/08/2022]
Abstract
Objective To investigate markers of premature menopause (<40 years) and specifically the prevalence of autoimmune primary ovarian insufficiency (POI) in European women. Design Postmenopausal women were categorized according to age at menopause and self-reported reason for menopause in a cross-sectional analysis of 6870 women. Methods Variables associated with the timing of menopause and hormone measurements of 17β-estradiol and follicle-stimulating hormone were explored using multivariable logistic regression analysis. Specific immunoprecipitating assays of steroidogenic autoantibodies against 21-hydroxylase (21-OH), side-chain cleavage enzyme (anti-SCC) and 17alpha-hydroxylase (17 OH), as well as NACHT leucine-rich-repeat protein 5 were used to identify women with likely autoimmune POI. Results Premature menopause was identified in 2.8% of women, and these women had higher frequencies of nulliparity (37.4% vs 19.7%), obesity (28.7% vs 21.4%), osteoporosis (17.1% vs 11.6%), hormone replacement therapy (59.1% vs 36.9%) and never smokers (60.1% vs 50.9%) (P < 0.05), compared to women with menopause ≥40 years. Iatrogenic causes were found in 91 (47%) and non-ovarian causes in 27 (14%) women, while 77 (39%) women were classified as POI of unknown cause, resulting in a 1.1% prevalence of idiopathic POI. After adjustments nulliparity was the only variable significantly associated with POI (odds ratio 2.46; 95% CI 1.63-3.42). Based on the presence of autoantibodies against 21 OH and SCC, 4.5% of POI cases were of likely autoimmune origin. Conclusion Idiopathic POI affects 1.1% of all women and almost half of the women with premature menopause. Autoimmunity explains 4.5% of these cases judged by positive steroidogenic autoantibodies.
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Affiliation(s)
- Elinor Chelsom Vogt
- Department of Clinical Science, University of Bergen, Bergen, Norway
- K.G. Jebsen Center for Autoimmune Disorders, University of Bergen, Bergen, Norway
- Department of Medicine, Haukeland University Hospital, Bergen, Norway
| | - Francisco Gómez Real
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Gynecology and Obstetrics, Haukeland University Hospital, Bergen, Norway
| | - Eystein Sverre Husebye
- Department of Clinical Science, University of Bergen, Bergen, Norway
- K.G. Jebsen Center for Autoimmune Disorders, University of Bergen, Bergen, Norway
- Department of Medicine, Haukeland University Hospital, Bergen, Norway
| | - Sigridur Björnsdottir
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Department of Endocrinology, Metabolism and Diabetes, Karolinska University Hospital, Stockholm, Sweden
| | - Bryndis Benediktsdottir
- Medical Faculty, University of Iceland, Reykjavik, Iceland
- Department of Sleep, Landspitali University Hospital Reykjavík, Reykjavik, Iceland
| | | | - Pascal Demoly
- University Hospital of Montpellier, IDESP, Univ Montpellier-Inserm, Montpellier, France
| | - Karl Anders Franklin
- Department of Surgical and Perioperative Sciences, Surgery, Umeå University, Umeå, Sweden
| | | | | | - Joachim Heinrich
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany
- Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Mathias Holm
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Nils Oscar Jogi
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Benedicte Leynaert
- Université Paris-Saclay, Inserm U1018, Center for Epidemiology and Population Health, Integrative Respiratory Epidemiology Team, Villejuif, France
| | - Eva Lindberg
- Department of Medical Sciences, Respiratory, Allergy and Sleep Medicine, Uppsala University, Uppsala, Sweden
| | - Andrei Malinovschi
- Department of Medical Sciences, Clinical Physiology, Uppsala University, Uppsala, Sweden
| | - Jesús Martínez-Moratalla
- Pneumology Service of the General University Hospital of Albacete, Albacete, Spain
- Albacete Faculty of Medicine, Castilla-La Mancha University, Albacete, Spain
| | - Raúl Godoy Mayoral
- Department of Respiratory Medicine, Albacete University Hospital, Albacete, Spain
| | - Anna Oudin
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | | | | | - Vivi Schlünssen
- Department of Public Health, Environment, Work and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
- The National Research Center for the Working Environment, Copenhagen, Denmark
| | - Kai Triebner
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Marianne Øksnes
- Department of Clinical Science, University of Bergen, Bergen, Norway
- K.G. Jebsen Center for Autoimmune Disorders, University of Bergen, Bergen, Norway
- Department of Medicine, Haukeland University Hospital, Bergen, Norway
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van der Feltz S, Peters S, Pronk A, Schlünssen V, Stokholm ZA, Kolstad HA, van Veldhoven K, Basinas I, van Tongeren M, Burdorf A, Oude Hengel KM. Validation of a COVID-19 Job Exposure Matrix (COVID-19-JEM) for Occupational Risk of a SARS-CoV-2 Infection at Work: Using Data of Dutch Workers. Ann Work Expo Health 2022; 67:9-20. [PMID: 35583140 PMCID: PMC9129190 DOI: 10.1093/annweh/wxac032] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 04/11/2022] [Accepted: 04/19/2022] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVES A COVID-19 Job Exposure Matrix (COVID-19-JEM) has been developed, consisting of four dimensions on transmission, two on mitigation measures, and two on precarious work. This study aims to validate the COVID-19-JEM by (i) comparing risk scores assigned by the COVID-19-JEM with self-reported data, and (ii) estimating the associations between the COVID-19-JEM risk scores and self-reported COVID-19. METHODS Data from measurements 2 (July 2020, n = 7690) and 4 (March 2021, n = 6794) of the Netherlands Working Conditions Survey-COVID-19 (NWCS-COVID-19) cohort study were used. Responses to questions related to the transmission risks and mitigation measures of Measurement 2 were used to calculate self-reported risk scores. These scores were compared with the COVID-19-JEM attributed risk scores, by assessing the percentage agreement and weighted kappa (κ). Based on Measurement 4, logistic regression analyses were conducted to estimate the associations between all COVID-19-JEM risk scores and self-reported COVID-19 (infection in general and infected at work). RESULTS The agreement between the COVID-19-JEM and questionnaire-based risk scores was good (κ ≥ 0.70) for most dimensions, except work location (κ = 0.56), and face covering (κ = 0.41). Apart from the precarious work dimensions, higher COVID-19-JEM assigned risk scores had higher odds ratios (ORs; ranging between 1.28 and 1.80) on having had COVID-19. Associations were stronger when the infection were thought to have happened at work (ORs between 2.33 and 11.62). CONCLUSIONS Generally, the COVID-19-JEM showed a good agreement with self-reported infection risks and infection rates at work. The next step is to validate the COVID-19-JEM with objective data in the Netherlands and beyond.
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Affiliation(s)
- Sophie van der Feltz
- Netherlands Organisation for Applied Scientific Research TNO, Department of Work Health Technology, Unit Healthy Living, Schipholweg 79-86, 2316 ZL Leiden, The Netherlands
| | - Susan Peters
- Department Population Health Sciences, Institute for Risk Assessment Sciences, Utrecht University, Yalelaan 2, 3584 CM Utrecht, The Netherlands
| | - Anjoeka Pronk
- Netherlands Organisation for Applied Scientific Research TNO, Department of Work Health Technology, Unit Healthy Living, Schipholweg 79-86, 2316 ZL Leiden, The Netherlands,Netherlands Organisation for Applied Scientific Research TNO, Department pf Risk Analysis for Products in Development, Princetonlaan 6 3584 CB Utrecht, The Netherlands
| | - Vivi Schlünssen
- Department of Public Health, Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, Bartholins Allé 2, 8000 Aarhus C, Denmark,National Research Centre for the Working Environment, Lersø Parkallé 105, 2100 Copenhagen Ø, Denmark
| | - Zara A Stokholm
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark
| | - Henrik A Kolstad
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark
| | - Karin van Veldhoven
- London School of Hygiene & Tropical Medicine, Faculty of Epidemiology and Public Health, Department of Non-Communicable Disease Epidemiology, Keppel Street, London WC1E 7HT, UK
| | - Ioannis Basinas
- 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
| | - 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
| | - Alex Burdorf
- Erasmus Medical Center Rotterdam, Department of Public Health, Wytemaweg 80, 3015 CN Rotterdam, The Netherlands
| | - Karen M Oude Hengel
- Author to whom correspondence should be addressed. Tel: +31-6-468-47-269; e-mail:
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Lønnebotn M, Calciano L, Johannessen A, Jarvis DL, Abramson MJ, Benediktsdóttir B, Bråbäck L, Franklin KA, Godoy R, Holm M, Janson C, Jõgi NO, Kirkeleit J, Malinovschi A, Pereira-Vega A, Schlünssen V, Dharmage SC, Accordini S, Gómez Real F, Svanes C. Parental Prepuberty Overweight and Offspring Lung Function. Nutrients 2022; 14:nu14071506. [PMID: 35406119 PMCID: PMC9002985 DOI: 10.3390/nu14071506] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 03/28/2022] [Accepted: 04/01/2022] [Indexed: 01/27/2023] Open
Abstract
In a recent study we found that fathers' but not mothers' onset of overweight in puberty was associated with asthma in adult offspring. The potential impact on offspring's adult lung function, a key marker of general and respiratory health, has not been studied. We investigated the potential causal effects of parents' overweight on adult offspring's lung function within the paternal and maternal lines. We included 929 offspring (aged 18-54, 54% daughters) of 308 fathers and 388 mothers (aged 40-66). Counterfactual-based multi-group mediation analyses by offspring's sex (potential moderator) were used, with offspring's prepubertal overweight and/or adult height as potential mediators. Unknown confounding was addressed by simulation analyses. Fathers' overweight before puberty had a negative indirect effect, mediated through sons' height, on sons' forced expiratory volume in one second (FEV1) (beta (95% CI): -144 (-272, -23) mL) and forced vital capacity (FVC) (beta (95% CI): -210 (-380, -34) mL), and a negative direct effect on sons' FVC (beta (95% CI): -262 (-501, -9) mL); statistically significant effects on FEV1/FVC were not observed. Mothers' overweight before puberty had neither direct nor indirect effects on offspring's lung function. Fathers' overweight starting before puberty appears to cause lower FEV1 and FVC in their future sons. The effects were partly mediated through sons' adult height but not through sons' prepubertal overweight.
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Affiliation(s)
- Marianne Lønnebotn
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, 5020 Bergen, Norway; (A.J.); (J.K.); (C.S.)
- Department of Occupational Medicine, Haukeland University Hospital, 5021 Bergen, Norway
- Correspondence: ; Tel.: +47-9596-8484
| | - Lucia Calciano
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy; (L.C.); (S.A.)
| | - Ane Johannessen
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, 5020 Bergen, Norway; (A.J.); (J.K.); (C.S.)
| | - Deborah L. Jarvis
- Faculty of Medicine, National Heart & Lung Institute, Imperial College, London SW7 2AZ, UK;
- MRC-PHE Centre for Environment and Health, Imperial College, London W2 1PG, UK
| | - Michael J. Abramson
- School of Public Health & Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia;
| | | | - Lennart Bråbäck
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, 901 87 Umeå, Sweden;
| | - Karl A. Franklin
- The Department of Surgical and Perioperative Sciences, Surgery, Umeå University, 901 87 Umeaa, Sweden;
| | - Raúl Godoy
- Department of Pulmonary Medicine, University Hospital Complex of Albacete, University of Castilla La Mancha, 02008 Albacete, Spain;
| | - Mathias Holm
- Occupational and Environmental Medicine, Institute of Medicine, School of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden;
| | - Christer Janson
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, 751 85 Uppsala, Sweden;
| | - Nils O. Jõgi
- Department of Clinical Science, University of Bergen, 5021 Bergen, Norway; (N.O.J.); (F.G.R.)
| | - Jorunn Kirkeleit
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, 5020 Bergen, Norway; (A.J.); (J.K.); (C.S.)
- Department of Occupational Medicine, Haukeland University Hospital, 5021 Bergen, Norway
| | - Andrei Malinovschi
- Department of Medical Sciences, Clinical Physiology, Uppsala University, 751 85 Uppsala, Sweden;
| | - Antonio Pereira-Vega
- Pneumology Service, Juan Ramón Jiménez University Hospital in Huelva, 21005 Huelva, Spain;
| | - Vivi Schlünssen
- Department of Public Health, Environment, Work and Health, Danish Ramazzini Centre, Aarhus University, 8000 Aarhus, Denmark;
- National Research Center for the Working Environment, 2100 Copenhagen, Denmark
| | - Shyamali C. Dharmage
- Allergy and Lung Health Unit, School of Population and Global Health, University of Melbourne, Melbourne, VIC 3010, Australia;
| | - Simone Accordini
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy; (L.C.); (S.A.)
| | - Francisco Gómez Real
- Department of Clinical Science, University of Bergen, 5021 Bergen, Norway; (N.O.J.); (F.G.R.)
- Department of Obstetrics and Gynecology, Haukeland University Hospital, 5053 Bergen, Norway
| | - Cecilie Svanes
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, 5020 Bergen, Norway; (A.J.); (J.K.); (C.S.)
- Department of Occupational Medicine, Haukeland University Hospital, 5021 Bergen, Norway
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Andrianjafimasy MV, Febrissy M, Zerimech F, Dananché B, Kromhout H, Matran R, Nadif M, Oberson-Geneste D, Quinot C, Schlünssen V, Siroux V, Zock JP, Le Moual N, Nadif R, Dumas O. Response to: Correspondence on “Association between occupational exposure to irritant agents and a distinct asthma endotype in adults” by Andrianjafimasy et al. Occup Environ Med 2022; 79:359-360. [DOI: 10.1136/oemed-2021-108117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 12/18/2021] [Indexed: 11/03/2022]
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44
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Bowatte G, Bui DS, Priyankara S, Lowe AJ, Perret JL, Lodge CJ, Hamilton GS, Erbas B, Thomas P, Thompson B, Schlünssen V, Martino D, Holloway JW, Svanes C, Abramson MJ, Walters EH, Dharmage SC. Parental preconception BMI trajectories from childhood to adolescence and asthma in the future offspring. J Allergy Clin Immunol 2022; 150:67-74.e30. [PMID: 35007625 DOI: 10.1016/j.jaci.2021.11.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 10/12/2021] [Accepted: 11/24/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Recent evidence suggests that parental exposures before conception can increase the risk of asthma in offspring. OBJECTIVE We investigated the association between parental preconception Body Mass Index (BMI) trajectories from childhood to adolescence and subsequent risk of asthma in their offspring. METHODS Using group-based trajectory modeling from the Tasmanian Longitudinal Health Study (TAHS), we identified BMI trajectories for index participants (parents) when aged 4 to 15 years. Multinomial regression models adjusted for potential confounders were utilized to estimate the association between these early-life parental BMI trajectories and asthma phenotypes in their subsequent offspring. RESULTS The main analysis included 1822 parents and 4208 offspring. Four BMI trajectories from age 4 to 15 years were identified as the best fitting model: "low" (8.8%); "normal" (44.1%); "above normal" (40.2%); and "high" (7.0%). Associations were observed between father's "high" BMI trajectory and risk of asthma in offspring before the age of 10 years (RRR=1.70, 95%CI 0.98, 2.93) and also asthma ever (RRR=1.72, 95%CI 1.00, 2.97), especially allergic asthma ever (RRR=2.05, 95%CI 1.12, 3.72). These associations were not mediated by offspring birth weight. No associations were observed for maternal BMI trajectories and offspring asthma phenotypes. CONCLUSION This cohort study over six decades of life and across two generations suggests that the "high BMI" trajectory in fathers, well before conception, increased the risk of asthma in their offspring.
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Affiliation(s)
- Gayan Bowatte
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia; Department of Basic Sciences, Faculty of Allied Health Sciences, University of Peradeniya, Peradeniya, Sri Lanka
| | - Dinh S Bui
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Sajith Priyankara
- Department of Basic Sciences, Faculty of Allied Health Sciences, University of Peradeniya, Peradeniya, Sri Lanka; Department of Mathematics & Statistics, Texas Tech University, Lubbock, Tex
| | - Adrian J Lowe
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Jennifer L Perret
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Caroline J Lodge
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Garun S Hamilton
- Monash Lung, Sleep, Allergy and Immunology, Monash Health, Clayton, Australia; School of Clinical Sciences, Monash University, Melbourne, Australia
| | - Bircan Erbas
- School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Paul Thomas
- Prince of Wales' Clinical School, Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Bruce Thompson
- School of Health Sciences, Swinburne University of Technology, Melbourne, Australia
| | - Vivi Schlünssen
- Department of Public Health, Danish Ramazzini Center, Aarhus University and the National Research Center for the Working Environment, Copenhagen, Denmark
| | - David Martino
- Wal-yan Respiratory Research Centre, Telethon Kids Institute, The University of Western Australia, Perth, Australia
| | - John W Holloway
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Cecilie Svanes
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway; Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
| | - Michael J Abramson
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - E Haydn Walters
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia; School of Medicine, University of Tasmania, Hobart, Australia
| | - Shyamali C Dharmage
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia.
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Hansen PW, Schlünssen V, Fonager K, Bønløkke JH, Hansen CD, Bøggild H. Association of perceived work pace and physical work demands with occupational accidents: a cross-sectional study of ageing male construction workers in Denmark. BMC Public Health 2022; 22:18. [PMID: 34991530 PMCID: PMC8740362 DOI: 10.1186/s12889-021-12461-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 12/16/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Occupational accidents continue to be a significant public health challenge worldwide. Construction workers in particular are at high risk of occupational accidents, and thus it is of major importance to identify possible predictors of occupational accidents among construction workers. We aimed to investigate the association between self-reported work pace and physical work demands and occupational accidents among ageing male construction workers in Denmark. METHODS Data on perceived work pace, physical work demands, and occupational accidents was acquired from questionnaires sent to ageing construction workers in Denmark in 2016 as part of the ALFA project (ALdring og Fysisk Arbejde; Ageing and Physical Work). A sample of 1270 Danish male construction workers above 50 years of age was included in the present study. Multiple logistic regression models were applied, with adjustments for age, smoking, body mass index, musculoskeletal disorders, occupation, work experience, and support at work. RESULTS Of 1270 construction workers, 166 (13.1%) reported an occupational accident within the last 12 months. There was no significant association between perceived work pace and occupational accidents, but physical work demands were associated with higher odds for occupational accidents, with an odds ratio of 2.27 (95% confidence interval 1.26-4.10) for medium physical work demands and 2.62 (95% confidence interval 1.50-4.57) for high physical work demands. CONCLUSIONS Ageing male construction workers with high physical work demands had statistically significant higher odds of having an occupational accident. By contrast, perceived work pace was not associated with occupational accidents in this large cross-sectional study.
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Affiliation(s)
- Pernille Weber Hansen
- Department of Public Health, Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, Bartholins Allé 2, 8000, Aarhus C, Denmark.,Department of Clinical Medicine, Aalborg University, Sdr. Skovvej 15, 9000, Aalborg, Denmark
| | - Vivi Schlünssen
- Department of Public Health, Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, Bartholins Allé 2, 8000, Aarhus C, Denmark.,National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen Ø, Denmark
| | - Kirsten Fonager
- Department of Clinical Medicine, Aalborg University, Sdr. Skovvej 15, 9000, Aalborg, Denmark.,Department of Social Medicine, Aalborg University Hospital, Havrevangen 1, 9000, Aalborg, Denmark
| | - Jakob Hjort Bønløkke
- Department of Occupational and Environmental Medicine, Danish Ramazzini Centre, Aalborg University Hospital, Havrevangen 1, 9000, Aalborg, Denmark
| | - Claus D Hansen
- Department of Sociology and Social Work, Aalborg University, Fibigerstræde 13, 9220, Aalborg Ø, Denmark
| | - Henrik Bøggild
- Department of Health Science and Technology, Public Health and Epidemiology Group, Aalborg University, Niels Jernes Vej 14, 9220, Aalborg, Denmark.
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46
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Rui F, Otelea MR, Fell AKM, Stoleski S, Mijakoski D, Holm M, Schlünssen V, Larese Filon F. Occupational Asthma: The Knowledge Needs for a Better Management. Ann Work Expo Health 2022; 66:287-290. [PMID: 34984434 PMCID: PMC9006971 DOI: 10.1093/annweh/wxab113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 11/03/2021] [Accepted: 11/22/2021] [Indexed: 11/12/2022] Open
Abstract
The management of occupational asthma (OA) may be influenced by several factors and removal from exposure is the main tertiary prevention approach, but it is not always feasible without personal and socioeconomic consequences. Reducing the delay between the onset of suggestive symptoms of OA and the diagnosis of OA is associated with a better prognosis. Workers' education to increase awareness to trigger agents and a medical surveillance program directed especially at at-risk workers could be helpful in reducing this latency time. An early identification of workers who develop rhinitis and conjunctivitis which often precede the onset of asthma symptoms could be important for an early identification of OA. This is particularly important for cases of asthma caused by high-molecular-weight sensitizers and in the early years of employment. The availability of financial support and compensation measures for workers with OA may influence the latency time before diagnosis and, consequently, may influence the OA outcomes. In conclusion, there is a need for high-quality cohort studies that will increase knowledge about risk factor that may influence the timing of diagnosis of OA. This knowledge will be useful for implementation of future surveillance and screening programs in workplaces.
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Affiliation(s)
- Francesca Rui
- Unit of Occupational Medicine, Department of Medical Sciences, University of Trieste, Trieste, Italy
| | - Marina Ruxandra Otelea
- University of Medicine and Pharmacy Carol Davila, Bucharest, Clinical Department 5, Dionisie Lupu St, 37, Bucharest, Romania
| | - Anne Kristin Møller Fell
- Department of Occupational and Environmental Medicine, Telemark hospital, Skien, Norway.,Department of Global Health and Community Medicine, Institute of Health and Community, University of Oslo, Oslo, Norway
| | - Sasho Stoleski
- Department of Occupational Diseases, Institute of Occupational Health of R.N. Macedonia, WHO CC, GA2LEN CC, II Makedonska Brigada 43, Skopje, R.N. Macedonia.,Department of Occupational Medicine, Faculty of Medicine, Ss. Cyril and Methodius, University in Skopje, 50 Divizija 6, Skopje, R.N. Macedonia
| | - Dragan Mijakoski
- Department of Occupational Diseases, Institute of Occupational Health of R.N. Macedonia, WHO CC, GA2LEN CC, II Makedonska Brigada 43, Skopje, R.N. Macedonia.,Department of Occupational Medicine, Faculty of Medicine, Ss. Cyril and Methodius, University in Skopje, 50 Divizija 6, Skopje, R.N. Macedonia
| | - Mathias Holm
- Department of Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Box 414, SE 40530 Gothenburg, Sweden
| | - Vivi Schlünssen
- Department of Public Health, Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, Barholins Allé 2, bg 1260, 8000 Aarhus, Denmark.,National Research Center for Working Environment, Lersø Parallé 105, 2100 Copenhagen, Denmark
| | - Francesca Larese Filon
- Unit of Occupational Medicine, Department of Medical Sciences, University of Trieste, Trieste, Italy
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Mehlum IS, Albin M, Bugge MD, Burdorf A, Castaño G, Kogevinas M, Kolstad H, Lucas R, McElvenny D, Pearce N, Peters S, Schlünssen V, Vermeulen R, Turner MC. Network on the Coordination and Harmonisation of European Occupational Cohorts (OMEGA-NET): Achievements after 4 years of networking, collaboration and training. Saf Health Work 2022. [DOI: 10.1016/j.shaw.2021.12.1141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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48
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Momen NC, Streicher KN, da Silva DTC, Descatha A, Frings-Dresen MHW, Gagliardi D, Godderis L, Loney T, Mandrioli D, Modenese A, Morgan RL, Pachito D, Scheepers PTJ, Sgargi D, Paulo MS, Schlünssen V, Sembajwe G, Sørensen K, Teixeira LR, Tenkate T, Pega F. Assessor burden, inter-rater agreement and user experience of the RoB-SPEO tool for assessing risk of bias in studies estimating prevalence of exposure to occupational risk factors: An analysis from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury. Environ Int 2022; 158:107005. [PMID: 34991265 PMCID: PMC8685606 DOI: 10.1016/j.envint.2021.107005] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 11/19/2021] [Accepted: 11/23/2021] [Indexed: 05/08/2023]
Abstract
BACKGROUND As part of the development of the World Health Organization (WHO)/International Labour Organization (ILO) Joint Estimates of the Work-related Burden of Disease and Injury, WHO and ILO carried out several systematic reviews to determine the prevalence of exposure to selected occupational risk factors. Risk of bias assessment for individual studies is a critical step of a systematic review. No tool existed for assessing the risk of bias in prevalence studies of exposure to occupational risk factors, so WHO and ILO developed and pilot tested the RoB-SPEO tool for this purpose. Here, we investigate the assessor burden, inter-rater agreement, and user experience of this new instrument, based on the abovementioned WHO/ILO systematic reviews. METHODS Twenty-seven individual experts applied RoB-SPEO to assess risk of bias. Four systematic reviews provided a total of 283 individual assessments, carried out for 137 studies. For each study, two or more assessors independently assessed risk of bias across the eight RoB-SPEO domains selecting one of RoB-SPEO's six ratings (i.e., "low", "probably low", "probably high", "high", "unclear" or "cannot be determined"). Assessors were asked to report time taken (i.e. indicator of assessor burden) to complete each assessment and describe their user experience. To gauge assessor burden, we calculated the median and inter-quartile range of times taken per individual risk of bias assessment. To assess inter-rater reliability, we calculated a raw measure of inter-rater agreement (Pi) for each RoB-SPEO domain, between Pi = 0.00, indicating no agreement and Pi = 1.00, indicating perfect agreement. As subgroup analyses, Pi was also disaggregated by systematic review, assessor experience with RoB-SPEO (≤10 assessments versus > 10 assessments), and assessment time (tertiles: ≤25 min versus 26-66 min versus ≥ 67 min). To describe user experience, we synthesised the assessors' comments and recommendations. RESULTS Assessors reported a median of 40 min to complete one assessment (interquartile range 21-120 min). For all domains, raw inter-rater agreement ranged from 0.54 to 0.82. Agreement varied by systematic review and assessor experience with RoB-SPEO between domains, and increased with increasing assessment time. A small number of users recommended further development of instructions for selected RoB-SPEO domains, especially bias in selection of participants into the study (domain 1) and bias due to differences in numerator and denominator (domain 7). DISCUSSION Overall, our results indicated good agreement across the eight domains of the RoB-SPEO tool. The median assessment time was comparable to that of other risk of bias tools, indicating comparable assessor burden. However, there was considerable variation in time taken to complete assessments. Additional time spent on assessments may improve inter-rater agreement. Further development of the RoB-SPEO tool could focus on refining instructions for selected RoB-SPEO domains and additional testing to assess agreement for different topic areas and with a wider range of assessors from different research backgrounds.
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Affiliation(s)
- Natalie C Momen
- Department of Environment, Climate Change and Health, World Health Organization, Geneva, Switzerland.
| | - Kai N Streicher
- Department of Environment, Climate Change and Health, World Health Organization, Geneva, Switzerland.
| | - Denise T C da Silva
- Workers' Health and Human Ecology Research Center, National School of Public Health Sergio Arouca, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil
| | - Alexis Descatha
- UNIV Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, Angers, France; AP-HP (Paris Hospital), Occupational Health Unit, Poincaré University Hospital, Garches, France; Versailles St-Quentin Univ-Paris Saclay Univ (UVSQ), UMS 011, UMR-S 1168, France; Inserm, U1168 UMS 011, Villejuif, France.
| | - Monique H W Frings-Dresen
- Amsterdam UMC, University of Amsterdam, Department Public and Occupational Health/Coronel Institute of Occupational Health, Amsterdam Research Institute, Amsterdam, the Netherlands.
| | - Diana Gagliardi
- Inail, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Rome, Italy.
| | - Lode Godderis
- Centre for Environment and Health, KU Leuven, Leuven, Belgium; KIR Department (Knowledge, Information & Research), IDEWE, External Service for Prevention and Protection at Work, Leuven, Belgium.
| | - Tom Loney
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates.
| | - Daniele Mandrioli
- Cesare Maltoni Cancer Research Center, Ramazzini Institute, Bologna, Italy.
| | - Alberto Modenese
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.
| | - Rebecca L Morgan
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
| | - Daniela Pachito
- Núcleo de Avaliação de Tecnologias em Saúde, Hospital Sírio-Libanês, Bela Vista, São Paulo, SP, Brazil; Fundação Getúlio Vargas, Bela Vista, São Paulo, SP, Brazil.
| | - Paul T J Scheepers
- Radboud Institute for Health Sciences, Radboudumc, Nijmegen, the Netherlands.
| | - Daria Sgargi
- Cesare Maltoni Cancer Research Center, Ramazzini Institute, Bologna, Italy
| | - Marília Silva Paulo
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.
| | - Vivi Schlünssen
- Aarhus University, Aarhus, Denmark; National Research Center for the Working Environment, Copenhagen, Denmark.
| | - Grace Sembajwe
- Department of Environmental, Occupational, and Geospatial Health Sciences, CUNY Graduate School of Public Health and Health Policy, CUNY Institute for Implementation Science in Population Health, New York, NY, United States.
| | - Kathrine Sørensen
- National Research Center for the Working Environment, Copenhagen, Denmark.
| | - Liliane R Teixeira
- Workers' Health and Human Ecology Research Center, National School of Public Health Sergio Arouca, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil.
| | - Thomas Tenkate
- School of Occupational and Public Health, Ryerson University, Toronto, ON, Canada.
| | - Frank Pega
- Department of Environment, Climate Change and Health, World Health Organization, Geneva, Switzerland.
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Boudigaard SH, Hansen KK, Kolstad H, Kromhout H, Schlünssen V. Determinants of Respirable Quartz Exposure Concentrations Across Occupations in Denmark, 2018. Ann Work Expo Health 2021; 66:472-480. [PMID: 34931218 PMCID: PMC9030110 DOI: 10.1093/annweh/wxab116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 11/19/2021] [Accepted: 12/05/2021] [Indexed: 11/13/2022] Open
Abstract
Background High concentrations of respirable quartz have been reported from workers in construction, foundries, and quarries. Current exposure concentrations in prevalent but presumably lower exposed occupations have been less examined. We aimed to quantify current exposure concentrations of respirable dust and quartz across prevalent occupations and to identify determinants of respirable quartz exposure across these occupations. Methods One hundred and eighty-nine full-shift personal samples of respirable dust of workers within 11 occupations in Denmark were sampled during 2018. Respirable dust was determined gravimetrically and analysed for quartz content with infrared spectrometry. Determinants for respirable quartz exposure, i.e. use of power tools, outdoor or indoor location, and percentage of quartz in respirable dust, were analysed in linear mixed effect models. Results The overall geometric means (geometric standard deviations) for respirable dust and quartz were 216 µg m−3 (4.42) and 16 µg m−3 (4.07), respectively. The highest quartz concentrations were observed among stone cutters and carvers [93 µg m−3 (3.47)], and metal melters and casters [61 µg m−3 (1.71)]. Use of power tools increased exposure concentrations of quartz by a factor of 3.5. Occupations explained 27%, companies within occupations 28%, and differences between workers within companies within occupations 14% of the variability in quartz concentrations. Thirty percent was due to day-to-day variability in exposure concentrations. In total, 19% of the variation in quartz concentration could be explained by type of tool, indoor/outdoor location, and percentage of quartz in respirable dust. Conclusion Current exposure concentrations are generally low, but some occupations in this study had average exposure concentrations to respirable quartz above the ACGIH threshold limit value of 25 µg m−3. Preventive measures to lower excess risk of quartz-related diseases among these workers are still needed. In terms of preventive strategies, use of power tools and quartz content of used materials were identified as main determinants of exposure. Lowering of exposures will be most efficient when focussed on these major determinants, e.g. tool dust control with water, dust extraction, and use of low quartz content materials.
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Affiliation(s)
- Signe Hjuler Boudigaard
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Palle Juul Jensens Boulevard 99, 8200 Aarhus N, Denmark
| | - Karoline Kærgaard Hansen
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Palle Juul Jensens Boulevard 99, 8200 Aarhus N, Denmark
| | - Henrik Kolstad
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Palle Juul Jensens Boulevard 99, 8200 Aarhus N, Denmark.,Institute of Clinical Medicine, Aarhus University Hospital, Palle Juul Jensens Boulevard 99, 8200 Aarhus N, Denmark
| | - Hans Kromhout
- Department of Population Health Sciences, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Yalelaan 2, 3584 CM Utrecht, The Netherlands
| | - Vivi Schlünssen
- Department of Public Health, Environment, Work and Health, Danish Ramazzini Centre, Aarhus University, Bartholins Alle 2, bg. 1260, 8000 Aarhus C, Denmark.,National Research Center for the Working Environment, Lersø Parkallé 125, 2100 Copenhagen, Denmark
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50
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Amdisen L, Daugaard S, Vestergaard JM, Vested A, Bonde JP, Vistisen HT, Christoffersen J, Garde AH, Hansen ÅM, Markvart J, Schlünssen V, Kolstad HA. A longitudinal study of morning, evening, and night light intensities and nocturnal sleep quality in a working population. Chronobiol Int 2021; 39:579-589. [PMID: 34903140 DOI: 10.1080/07420528.2021.2010741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
We aimed to investigate whether higher light intensity in the morning is associated with better nocturnal sleep quality and whether higher light intensities in the evening or night have the opposite effect. Light intensity was recorded for 7 consecutive days across the year among 317 indoor and outdoor daytime workers in Denmark (55-56° N) equipped with a personal light recorder. Participants reported sleep quality after each nocturnal sleep. Sleep quality was measured using three parameters; disturbed sleep index, awakening index, and sleep onset latency. Associations between increasing light intensities and sleep quality were analyzed using mixed effects models with participant identity as a random effect. Overall, neither white nor blue light intensities during morning, evening, or night were associated with sleep quality, awakening, or sleep onset latency of the subsequent nocturnal sleep. However, secondary analyses suggested that artificial light during the morning and day contrary to solar light may increase vulnerability to evening light exposure. Altogether, we were not able to confirm that higher morning light intensity significantly improves self-reported sleep quality or that higher evening or night light intensities impair self-reported sleep quality at exposure levels encountered during daily life in a working population in Denmark. This suggests that light intensities alone are not important for sleep quality to a degree that it is distinguishable from other important parameters in daily life settings.
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Affiliation(s)
- Lau Amdisen
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark
| | - Stine Daugaard
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark
| | - Jesper Medom Vestergaard
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark.,Department of Occupational Medicine, Danish Ramazzini Centre, University Research Clinic, Herning, Denmark
| | - Anne Vested
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark
| | - Jens Peter Bonde
- Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark.,Department of Public Health, Section of Social Medicine, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Helene Tilma Vistisen
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark
| | - Jens Christoffersen
- Knowledge Centre for Daylight, Energy and Indoor Climate, Velux A/s, Velux Group, Hørsholm, Denmark
| | - Anne Helene Garde
- Danish Ministry of Employment, National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Åse Marie Hansen
- Department of Public Health, Section of Social Medicine, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark.,Danish Ministry of Employment, National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Jakob Markvart
- Department of the Built Environment, Division of Energy Efficiency, Indoor Climate and Sustainability of Buildings, Aalborg University, Copenhagen, Denmark
| | - Vivi Schlünssen
- Department of Public Health, Environment, Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - Henrik Albert Kolstad
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark
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