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Occupational and environmental medicine
BMJ Pub. Group
Occupational and environmental medicine

BMJ Pub. Group

1351-0711

Occupational and environmental medicine/Journal Occupational and environmental medicineAHCISCIISTP
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    Occupation and COVID-19 mortality in England: a national linked data study of 14.3 million adults

    Nafilyan, VahePawelek, PiotrAyoubkhani, DanielRhodes, Sarah...
    9页
    查看更多>>摘要：Objectives To estimate occupational differences in COVID-19 mortality and test whether these are confounded by factors such as regional differences， ethnicity and education or due to non-workplace factors， such as deprivation or prepandemic health。 Methods Using a cohort study of over 14 million people aged 40-64 years living in England， we analysed occupational differences in death involving COVID-19， assessed between 24 January 2020 and 28 December 2020。 We estimated age-standardised mortality rates (ASMRs) per 100 000 person-years at risk stratified by sex and occupation。 We estimated the effect of occupation on COVID-19 mortality using Cox proportional hazard models adjusted for confounding factors。 We further adjusted for non-workplace factors and interpreted the residual effects of occupation as being due to workplace exposures to SARS-CoV-2。 Results In men， the ASMRs were highest among those working as taxi and cab drivers or chauffeurs at 119。7 deaths per 100 000 (95% CI 98。0 to 141。4)， followed by other elementary occupations at 106。5 (84。5 to 132。4) and care workers and home carers at 99。2 (74。5 to 129。4)。 Adjusting for confounding factors strongly attenuated the HRs for many occupations， but many remained at elevated risk。 Adjusting for living conditions reduced further the HRs， and many occupations were no longer at excess risk。 For most occupations， confounding factors and mediators other than workplace exposure to SARS-CoV-2 explained 70%-80% of the excess age-adjusted occupational differences。 Conclusions Working conditions play a role in COVID-19 mortality， particularly in occupations involving contact with patients or the public。 However， there is also a substantial contribution from non-workplace factors。
      原文链接:
    • NSTL
    • Bmj Publishing Group

    Occupational risk factors for work disability following carpal tunnel syndrome: a pooled prospective study

    Harris-Adamson, CarisaEisen, Ellen A.Kapellusch, JayHegmann, Kurt T....
    10页
    查看更多>>摘要：Background Although recent studies have identified important risk factors associated with incident carpal tunnel syndrome (CTS)， risk factors associated with its severity have not been well explored。 Objective To examine the associations between personal， workplace psychosocial and biomechanical factors and incident work disability among workers with CTS。 Methods Between 2001 and 2010 five research groups conducted coordinated prospective studies of CTS and related work disability among US workers from various industries。 Workers with prevalent or incident CTS (N=372) were followed for up to 6。4 years。 Incident work disability was measured as: (1) change in work pace or work quality， (2) lost time or (3) job change following the development of CTS。 Psychosocial factors were assessed by questionnaire。 Biomechanical exposures were assessed by observation and measurements and included force， repetition， duty cycle and posture。 HRs were estimated using Cox models。 Results Disability incidence rates per 100 person-years were 33。2 for changes in work pace or quality， 16。3 for lost time and 20。0 for job change。 There was a near doubling of risk for job change among those in the upper tertile of the Hand Activity Level Scale (HR 2。17; 95% CI 1。17 to 4。01)， total repetition rate (HR 1。75; 95% CI 1。02 to 3。02)， % time spent in all hand exertions (HR 2。20; 95% CI 1。21 to 4。01) and a sixfold increase for high job strain。 Sensitivity analyses indicated attenuation due to inclusion of the prevalent CTS cases。 Conclusion Personal， biomechanical and psychosocial job factors predicted CTS-related disability。 Results suggest that prevention of severe disability requires a reduction of both biomechanical and organisational work stressors。
      原文链接:
    • NSTL
    • Bmj Publishing Group

    Night shift work and lymphoma: results from an Italian multicentre case-control study

    Gambelunghe, AngelaMuzi, GiacomoFerri, Giovanni MariaVimercati, Luigi...
    8页
    查看更多>>摘要：Background Night shift work can disrupt circadian rhythm and cause chronic sleep deprivation， which might increase the risk of lymphoma through immunosuppression and oxidative stress。 Material and methods We investigated the association between night shift work and risk of lymphoma subtypes in 867 incident cases and 774 controls， who participated in a multicentre Italian study between 2011 and 2017。 Based on questionnaire information， occupational experts assessed the lifetime probability of night shift work， the total number of night shifts and years of night shift work among study participants。 OR and 95% CI for lymphoma and its major subtypes associated with night shift work was calculated with logistic regression， adjusting by age， gender， education， study area， marital status and family history of haemolymphatic cancer。 Results Ever working night shifts was associated with an increase in the risk of chronic lymphocytic leukaemia (CLL) (OR 1。9， 95% CI 1。14 to 3。32)， which was highest after a 15-34 years latency。 However， there was not a linear increase in risk by probability of exposure， years of night shift work， nor lifetime number of night shifts whether under rotating or permanent work schedules。 Risk of lymphoma overall， B cell lymphoma (BCL)， its major subtypes other than CLL， and other less prevalent BCL subtypes combined did not show an association。 Conclusions We found conflicting evidence of an association between night shift work and the risk of CLL。 We did not observe an association with other lymphoma subtypes。
      原文链接:
    • NSTL
    • Bmj Publishing Group

    Randomised control trial of a proactive intervention supporting recovery in relation to stress and irregular work hours: effects on sleep, burn-out, fatigue and somatic symptoms

    Tucker, PhilipEpstein, MajkenGustavsson, PetterDahlgren, Anna...
    9页
    查看更多>>摘要：Objectives To examine if a proactive recovery intervention for newly graduated registered nurses (RNs) could prevent the development of sleep problems， burnout， fatigue or somatic symptoms。 Methods The study was a randomised control trial with parallel design。 Newly graduated RNs with less than 12 months' work experience were eligible to participate。 461 RNs from 8 hospitals in Sweden were invited， of which 207 signed up。 These were randomised to either intervention or control groups。 After adjustments， 99 RNs were included in the intervention group (mean age 27。5 years， 84。7% women) and 108 in the control group (mean age 27。0 years， 90。7% women)。 82 RNs in the intervention group attended a group-administered recovery programme， involving three group sessions with 2 weeks between each session， focusing on proactive strategies for sleep and recovery in relation to work stress and shift work。 Effects on sleep， burn-out， fatigue and somatic symptoms were measured by questionnaires at baseline， postintervention and at 6 months follow-up。 Results Preventive effect was seen on somatic symptoms for the intervention group。 Also， the intervention group showed less burn-out and fatigue symptoms at postintervention。 However， these latter effects did not persist at follow-up。 Participants used many of the strategies from the programme。 Conclusions A proactive， group-administered recovery programme could be helpful in strengthening recovery and preventing negative health consequences for newly graduated RNs。
      原文链接:
    • NSTL
    • Bmj Publishing Group

    Environmental exposures contribute to respiratory and allergic symptoms among women living in the banana growing regions of Costa Rica

    Alhanti, Brookede Joode, Berna van WendelMartinez, Manuel SotoMora, Ana M....
    8页
    查看更多>>摘要：Objectives This research evaluates whether environmental exposures (pesticides and smoke) influence respiratory and allergic outcomes in women living in a tropical， agricultural environment。 Methods We used data from 266 mothers from the Infants' Environmental Health cohort study in Costa Rica。 We evaluated environmental exposures in women by measuring seven pesticide and two polycyclic aromatic hydrocarbons metabolites in urine samples。 We defined 'high exposure' as having a metabolite value in the top 75th percentile。 We collected survey data on respiratory and allergic outcomes in mothers as well as on pesticides and other environmental exposures。 Using logistic regression models adjusted for obesity， we assessed the associations of pesticide exposure with multiple outcomes (wheeze， doctor-diagnosed asthma， high (>= 2) asthma score based on symptoms， rhinitis， eczema and itchy rash)。 Results Current pesticide use in the home was positively associated with diagnosed asthma (OR=1。99 (95% CI=1。05 to 3。87))。 High urinary levels of 5-hydroxythiabendazole (thiabendazole metabolite) and living in a neighbourhood with frequent smoke from waste burning were associated with a high asthma score (OR=1。84 (95%CI=1。05 to 3。25) and OR=2。31 (95%CI=1。11 to 5。16)， respectively)。 Women who worked in agriculture had a significantly lower prevalence of rhinitis (0。19 (0。01 to 0。93))， but were more likely to report eczema (OR=2。54 (95%CI=1。33 to 4。89)) and an itchy rash (OR=3。17 (95%CI=1。24 to 7。73))。 Conclusions While limited by sample size， these findings suggest that environmental exposure to both pesticides and smoke may impact respiratory and skin-related allergic outcomes in women。
      原文链接:
    • NSTL
    • Bmj Publishing Group

    Effectiveness of interventions on the stress management of schoolteachers: a systematic review and meta-analysis

    Paudel, Netra RajAdhikari, Bidhya AcharyaPrakash, K. C.Kyronlahti, Saila...
    9页
    查看更多>>摘要：Background This systematic review aimed to analyse the effectiveness of interventions on the stress management of schoolteachers。 Methods We searched the Medline， PsycINFO， CINAHL and Education Research Complete until 30 November 2021， to identify relevant studies using relevant key words。 Job or occupational stress was used as the outcome measure。 Stress was defined as Perceived Stress Scale， Teacher Stress Inventory， Maslach Burnout Inventory， Teacher's Distress， Brief Symptoms Inventory or Global Severity Index。 Study selection， data extraction， risk of bias assessment was performed by two independent reviewers。 The pooled estimate of the effect by the type of outcome measurement tool and by type of interventions used was calculated using random effects meta-analysis。 We used Grades of Recommendations， Assessment， Development and Evaluation to assess the overall quality of the evidence。 Results We reviewed 26 studies， of which 24 were randomised trials and 2 pre-test/post-test studies。 Based on meta-analysis， a positive effect of intervention (pooled estimate -1。13， 95% CI -1。52 to -0。73) with high heterogeneity among studies (chi(2)=426。88， p<0。001， I-2=94%) was found by type of interventions used。 Cognitive-behavioural therapy had the strongest positive effect， followed by meditation among the types of interventions studied。 We identified evidence of a moderate quality for interventions aiming to manage the stress level of schoolteachers。 Conclusions The meta-analysis showed a positive effect of interventions， suggesting that interventions might reduce the stress level among teachers。 The quality of the evidence was moderate。 PROSPERO registration number CRD42021225098
      原文链接:
    • NSTL
    • Bmj Publishing Group

    Feasibility and sustainability of working in different types of jobs after total hip arthroplasty: analysis of longitudinal data from two cohorts

    Zaballa, ElenaNtani, GeorgiaHarris, E. ClareLubbeke, Anne...
    8页
    查看更多>>摘要：Objectives To investigate the rates of return to work and workability among working-age people following total hip arthroplasty (THA)。 Methods Participants from the Geneva Arthroplasty Registry and the Clinical Outcomes for Arthroplasty Study aged 18-64 years when they had primary THA and with at least 5 years' follow-up were mailed a questionnaire 2017-2019。 Information was collected about preoperative and post-THA employment along with exposure to physically demanding activities at work or in leisure。 Patterns of change of job were explored。 Survival analyses using Cox proportional hazard models were created to explore risk factors for having to stop work because of difficulties with the replaced hip。 Results In total， 825 returned a questionnaire (response 58%)， 392 (48%) men， mean age 58 years， median follow-up 7。5 years post-THA。 The majority (93%) of those who worked preoperatively returned to work， mostly in the same sector but higher rates of non-return (36%-41%) were seen among process， plant and machine operatives and workers in elementary occupations。 7% reported subsequently leaving work because of their replaced hip and the risk of this was strongly associated with: standing >4 hours/day (HR 3。81， 95% CI 1。62 to 8。96); kneeling/squatting (HR 3。32， 95% CI 1。46 to 7。55) and/or carrying/lifting >= 10 kg (HR 5。43， 95% CI 2。29 to 12。88)。 Conclusions It may be more difficult to return to some (particularly physically demanding) jobs post-THA than others。 Rehabilitation may need to be targeted to these types of workers or it may be that redeployment or job change counselling are required。
      原文链接:
    • NSTL
    • Bmj Publishing Group

    Unemployment due to the SARS-CoV-2-pandemic among people with and without severe disabilities: a difference-in-differences analysis

    Booke, FrederikeFauser, DavidReims, NancyBethge, Matthias...
    3页
    查看更多>>摘要：Objectives Unemployment reduces health and impairs participation in important areas of life， especially for people with severe disabilities， who tend to have a longer duration of unemployment and are less likely to find new employment than their counterparts without such constraints。 Our analysis examines the increase in unemployment due to the SARS-CoV-2 pandemic among people with and without severe disabilities in Germany。 Methods Monthly cross-sectional data on unemployment for 2019 and 2020 were provided by the Federal Employment Agency。 We used a difference-in-differences model to estimate the increase in unemployment attributable to the pandemic。 The months April to December 2020 represented the months of exposure to the pandemic。 Incidence rate ratios (IRRs) are reported。 Results The increase in unemployment among people with severe disabilities due to the pandemic is 11。2% (IRR 1。112; 95% CI 1。107 to 1。117)。 People with severe disabilities receiving unemployment benefits due to unemployment lasting less than a year (Social Code III: short-term unemployment) and women have been most affected。 Among people without severe disabilities， unemployment has increased by 24。8% due to the pandemic (IRR 1。248; 95% CI 1。246 to 1。249)， while people receiving unemployment benefits according to social code III and men have been most affected。 Both groups show a varying increase in unemployment depending on the region of residency。 Conclusions The findings show a particularly significant increase in unemployment among people without severe disabilities。 People with severe disabilities might be less impacted due to the special legal protection against their dismissal。 The clear regional differences in the increase in unemployment suggest a strong influence of regional economics。
      原文链接:
    • NSTL
    • Bmj Publishing Group

    Large difference but high correlation between creatinine and cystatin C estimated glomerular filtration rate in Mesoamerican sugarcane cutters

    Xu, YiyiJakobsson, KristinaAndersson, AxelHansson, Erik...
    6页
    查看更多>>摘要：Objectives To explore the relationship between creatinine and cystatin C based estimated glomerular filtration rate (eGFR) in actively working sugarcane cutters。 Methods This cohort study included 458 sugarcane cutters from Nicaragua and El Salvador。 Serum samples were taken before and at end of harvest seasons and analysed for creatinine and cystatin C。 Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formulas were used to calculate eGFRs based on creatinine (eGFR(cr))， cystatin C (eGFR(cys)) and both creatinine and cystatin C (eGFR(crcys)) at each time point。 Bland-Altman plots and paired t-tests were used to compare the difference between eGFR(cr) and eGFR(cys)， and the difference in eGFRs between before and at end of the harvest seasons。 Results The mean eGFR(cr) was higher than eGFR(cys) in both cohorts; absolute difference 22 mL/min/1。73 m(2) (95% CI 21 to 23) in Nicaragua and 13 mL/min/1。73 m(2) (95% CI 11 to 15) in El Salvador。 Correlations between eGFR(cr) and eGFR(cys) were high， with r=0。69， 0。77 and 0。67 in Nicaragua at pre-harvest， end-harvest and cross-harvest， and r=0。89， 0。89 and 0。49 in El Salvador。 Conclusions Creatinine increases among heat-stressed workers reflect reduced glomerular filtration as estimated using eGFR(cys)， a marker independent of muscle mass and metabolism。 The discrepancy between eGFR(cr) and eGFR(cys) may indicate reduced glomerular filtration of larger molecules and/or systemic bias in CKD-EPI performance in this population。
      原文链接:
    • NSTL
    • Bmj Publishing Group

    Health burdens of uranium miners will extend beyond the radiation exposure compensation act deadline

    Kelly-Reif, KaitlinBertke, Stephen J.Samet, JonathanSood, Akshay...
    2页
      原文链接:
    • NSTL
    • Bmj Publishing Group