bluuebunny/crossref_metadata_2025 huggingface dataset:
P.1.32 Comparisons of the results from ergonomic tools between rapid entire body assessment and quick exposure check in a steel factory
Authors: Pinyowiwat Khongrit , Supapong Soontorn , Rattananupong Thanapoom
Published: May 2020

Conducting ergonomic risk assessment is important as it helps employers identify the significant risks in their workplace and will resulting in adequate preventive measures. Simpler observational techniques is one of the types of ergonomic evaluation tools which is commonly used. It is practical, user-friendly and gathering information from both employees and practitioners. This paper presents comparisons between two observational ergonomics tools for determining ergonomics risk factors for work-related musculoskeletal disorders. The Rapid Entire Body Assessment (REBA) and Quick Exposure Check (QEC) were used to assess 296 employees participating in the study from all 12 sections which involved different work tasks in a steel factory. The results are compared using three risk categories (low, moderate, high). Standardised Nordic questionnaires was also used for evaluating the musculoskeletal disorders and effects on working. Data were gathered using questionnaires and evaluations taken at workstation. The findings show the results analyzed using weighted kappa statistic and prevalence of musculoskeletal disorders among workers.
P.2.09 Health risks of worker who work with the infectious and health care waste transportation from hospital by private transport sector
Authors: Hansakul Anong
Published: May 2020

Infectious and health care waste dramatically increasing due to the varieties of health care activities. This aims to identify problems and the health risk of worker who work with the infectious and health care waste transportation from hospital by private transport sector (PTS). The cross-sectional study was applied to the factors effecting with the outcome. 13 PTSs and 127 workers were employed in this study. The results found that: total of 127 workers from 13 PTSs in Thailand , among this 86.6% of workers were male, mean age of 31 years old, and the mean of working with infection and health care waste of 5.03 years. The main job specification was health care waste collector of 57.5%, drivers of 26%, both driver and collector of 16.5%. Only 38.6% was trained (control, precaution and protection) by the Ministry of Public Health (MoPH). A part one year later, the worker had an accident or injury (punch with needle or other sharp) from infectious and health care waste during working 42.5%, 37.8% have had contaminated or touch with the infectious fluid, 18.9% had traffic accident (car turnover, clash, offside cone) and 8.3%had the infectious and health care waste or leachates flood pour out from vehicle or container. The factors associated with risk of the health of the infectious and health care waste worker taken into account of affect of other factors, it were found that prevention and precaution training, job position, age and yearly health check were statistical significant with the health risk, respectively (OR=4.61, 95%CI=0.26 to 1.44, p=0.01) job position (OR=3.68, 95%CI=1.09 to 12.35, p=0.05), Age (OR=2.97, 95% CI=0.16 to 48.49, p=0.01) and yearly health check (OR=0.96, 95% CI=0.34 to 2.72, p=0.01).
O1D.3 Fumigant and chemical residue 8-hour exposures in workers handling cargo from shipping containers and export logs in new zealand
Authors: Hinz Ruth , Mannetje Andrea’t , Glass Bill , McLean Dave , Pearce Neil , Douwes Jeroen
Published: May 2020

Background

Previous studies found elevated concentrations of fumigants and other chemicals in the air of unopened shipping containers, which led to the assumption that workers were likely to be highly exposed. This study assessed personal 8 hour exposures in workers handling cargo from shipping containers or export logs, which were fumigated prior to loading.

Methods

193 personal 8 hour air samples were collected and analysed for 1,2-dibromoethane, chloropicrin, ethylene oxide, hydrogen cyanide, hydrogen phosphide and methyl bromide, 1,2-dichloroethane, C2-alkylbenzenes, acetaldehyde, ammonia, benzene, formaldehyde, methanol, styrene and toluene. Additive Mixture Values were calculated using the Work Exposure (WES) standard set by Worksafe NZ and the Threshold Limit Values (TLV) set by the ACGIH. Linear regression was conducted to assess associations between time spent inside shipping containers and exposure (n=98).

Results

Chemical exposures as indicated by median and geometric mean values were low (e.g. 2.5 and 4.4 ppb respectively for methyl bromide) and none exceeded the NZ WES, although formaldehyde exceeded the TLV in 48 (26.2%) samples. The AMV-TLV threshold of 1 was exceeded in 54 (29.5%) samples. Major differences between the occupational groups (container, log and retail workers and fumigators) were not found. Time spent inside the container was significantly and positively associated with ethylene oxide, C2-alkylbenzenes and acetaldehyde, but this was based on a small number of detectable observations (non-detects 52.0%–95.9%) and for one chemical (methyl bromide, n=94) we found inverse associations.

Conclusion

This study has shown that personal exposures measured over an 8 hour working day were low, with the exception of formaldehyde, and do not confirm earlier suggestions (based on measurements inside closed containers) that they regularly exceed exposure limits. Association with time spent unloading containers was weak suggesting that exposures may result from short peak exposures rather than continuous low level exposure.
P.2.17 Case report: three occupational diseases in a nail technician
Authors: Moshe Shlomo , Krakov Ayala
Published: May 2020

Introduction

In cosmetics, acrylic glues are used to apply nail and eyelash extensions. Acrylates are highly irritant materials and may cause local irritation (Contact Dermatitis – CD), respiratory irritation (Asthma) and systemic irritation (Urticaria). This case report describes these three occupational diseases.

Clinical presentation

A 48-year-old female, normally healthy, has been working in the nail beauty field for 11 years. Lately, following an increase of work, she started coughing every morning and feeling shortness of breath which was worsen at the start of work, and improved on vacations. In addition, the patient suffered from skin tenderness in her fingers. An examination of the hands showed a typical picture of CD in left hand fingers 4–5.

Methods and results

Specific Patch Tests showed sensitivity to Hydroxyethyl Methacrylate and Hydroxypropyl Methacrylate. A methacholine challenge test showed a 22% decrease in FEV1 at 3.94μmol methacholine (i.e. positive test). The patient performed a Peak Expiratory Flow test (PEF). After a week in the nail salon her respiratory and dermatological status worsened greatly, including development of contact urticaria. She was instructed to stop immediately the exposure and start taking p/o steroids. Due to her 3 occupational diseases she was removed from work and latter was recognized as having 3 occupational disease by the Israeli National Insurance which supported her vocational rehabilitation.

Discussion

Acrylic glues are hazardous agents which can cause several occupational diseases and require occupational environment monitoring yearly according to Israeli regulations. The TLV-TWA is 2ppm. Small private businesses like the patients‘ place don’t perform environmental monitoring or use personal or environmental protective equipment which endanger its workers (usually low social class women) who are not aware of the dangers in this industry. More public attention should be given to the risk in this industry.
P.2.18 The curriculum implementation of occupational medicine in israel
Authors: Moshe Shlomo
Published: May 2020

Background

At the early 1990s occupational medicine (OM) was recognized as a specialty in Israel. Fifteen years later after gathering problems and shortcomings of the first curriculum, the Israeli Association of occupational medicine (IAOM) defined the framework for a new curriculum in order to have a modern and better curriculum.

Methods

In the early 2000 an expert committee apointed by the IAOM suggested a new sylabous, based on the scientific literature. The recommendations were sent to all experts in OM in Israel, and other proffesional members like industrial hygienist. We got several responses. Most people suggested additional standards.

Results

The curiculun includes 54 months of training programme. The characteristics of the new curriculum are: interaction between theory and practice; fields of knowledge, learning process; competencies which are needed; and multidisciplinarity. We added an obligatory walkthroug list of industries. Three of the walkthroug reports consists a part of the final oral examinations.

Conclusions

The aim of the curriculum was to produce a comprhensive aproach in OM competencies. The curiculum was adopted by the Israeli Medical Association and Ministery of Health since 2010.
P.2.29 Does a change in working conditions influence labour force participation among workers with a chronic disease?
Authors: Schram Jolinda , Robroek Suzan , Ots Patricia , Zon Sander van , Brouwer Sandra , Burdorf Alex , Hengel Karen Oude
Published: May 2020

Objective

This study investigated the association between changing working conditions and exit from paid employment during the following year among older workers with a chronic disease in the Netherlands.

Method

Four annual waves from the Study on Transitions in Employment, Ability and Motivation (STREAM; 2010–2013) provided information on working conditions and demographics for 2838 older workers with a chronic disease, aged 45–64 years. The analytical sample consisted of 5491 responses from 2838 workers. Five types of working conditions were investigated; physical workload, psychological job demands, job autonomy, emotional job demands and social support. Discrete-time survival models were used to estimate the associations of change in working conditions in a particular year on the probability of exiting paid work for persons with a chronic disease in the following year.

Results

Of the 2838 workers, a small majority was male (52%), most workers had an intermediate level of education (39.7%), and the mean age was 53.7 years (SD 5.50). Results showed that working conditions substantially changed (i.e. difference of one standard deviation) between two waves. Social support and emotional job demands had the highest amounts of substantial changes (17% and 19%), while physical demands remained relatively stable (6% substantial change). After the first two waves, about 12% of workers with a chronic illness left paid employment. Results of discrete-time survival models are expected to be available in 2019 (by the time of the EPICOH conference).

Conclusion

Ensuring that working conditions can be adapted to the needs of older workers who have a chronic disease may help to extend working life.
P.2.36 Assessment of serum and urinary biomarkers for pneumoconiosis in a cohort of stone workers exposed to asbestos-contaminated minerals
Authors: Yang Hsiao-Yu , Chen Pau-Chung
Published: May 2020

Background

Pneumoconiosis is still a problem in workers process non-asbestiform asbestos minerals and serpentinite rocks, such as nephrite, antigorite or talc that may contaminate with paragenetic asbestos minerals. An effective screening method is still lacking. The objective of this study was to assess the diagnostic accuracy using the serum and urinary biomarkers for pneumoconiosis in workers exposed to asbestos-contaminated minerals.

Methods

Prediction models of pneumoconiosis were constructed from 140 stone workers (48 cases of pneumoconiosis and 118 controls) exposed to asbestos-contaminated minerals. We measured serum soluble mesothelin-related peptide (SMRP), fibulin-3, carcinoembryonic antigen, and urinary 8-Oxo-2’-deoxyguanosine (8-OHdG)/creatinine levels. Using the ILO international classification of radiographs of pneumoconiosis profusion subcategory ≥1/0 as the reference standard, we established a prediction model by machine learning algorithm. We assessed the accuracy by the area under the receiver operating characteristic curve (AUROC).

Results

The SMRP level increased in workers exposed to nephrite. A dose-response relationship was found between the SMRP level and the severity of pneumoconiosis in workers exposed to asbestos-contaminated minerals. Machine learning algorithm composed of sex, age, and 4 serum and urinary biomarkers is able to predict pneumoconiosis with high accuracy (AUROC ranged from 0.76 to 1.00).

Conclusion

Our finding highlight the use of serum and urinary biomarkers can be developed as a screening tool for pneumoconiosis in workers exposed to potential asbestos contaminated minerals.
P.2.38 Occupational exposure and incidence of asthma based on prescription of drugs
Authors: Bælum Jesper , Skadhauge Lars Rauff , Thilsing Trine , Davidsen Jesper Rønhild , Omland Øjvind , Schlünssen Vivi
Published: May 2020

Prescription of drugs for obstructive lung diseases (ATC code R03) has previously been shown to be an indicator of actual asthma. In this cohort study, we have combined occupational information with data from redeemed prescriptions between 2000 and 2013 extracted from the National Danish Prescription register.

In 2003 a total of 7255 persons aged 20 and 44 years fulfilled a questionnaire, which among other things, included information on their longest held job. The jobs of 6470 were coded according to ISCO-88 and an asthma Job Exposure Matrix (JEM) was applied. Prevalent asthma was defined as at least two redeemed prescriptions of a R03 drug within 2 years. Incident asthma between 2003 and 2013 was defined as not having redeemed a R03 prescription in the previous years. Data was analyzed separately for each gender using multivariate logistic regression and presented as odds ratios (OR) with 95% confidence intervals (CI).

Among those having a job 327 (5.1%) were identified as incident cases and 467 (7.2%) as prevalent cases. In females increased incidences were seen in exposures to reactive low molecular weight (LMW) substances (OR1.47 (95% CI 1.04–2.07)), cleaning agents (OR 1.52 (1.05–2.18)), metals (OR 3.31 (1.63–6.64)), while increased prevalence was seen with mite exposure (OR 4.41 (1.74–11.2)) and irritant gases (OR 1.76 (1.16–2.69)). In males no increased incidences were seen and only an increased prevalence with mixed environments (OR 2.24 (1.13–4.43)).In jobs increased prevalence and incidence were seen in female cleaners and drivers. Increased prevalence was seen in male printing workers.

Meaningful associations with well-known asthmagenic exposures in young adults with asthma can be identified in administrative register data, and implementing the analyses of register data from larger populations will have the power to detect potential increased risks due to rare exposures or changes in risk over time.
P.3.11 Implementation of community-based occupational health programs for informal workers in indonesia
Authors: Ferdiana Astri , Baiquni Fahmi , Rahman Dhiya Ur , Febriana Awalia , Solikhah Siti , Nervilia Ajeng Viska , Kusumaningrum Fitrina , Supriyati Supriyati , Sari Tetra Dewi Fatwa
Published: May 2020

Informal workers account for 60% of workforce in Indonesia. Most do not have access to occupational health and safety (OHS) services. The study aims to explore the implementation of community-based OHS program consisting of OHS post and cadres (referred to as UKK program) among informal workers in rural areas in Indonesia. This study was an implementation research using focus group discussion (FGDs) and key informant interviews (KIIs) to workers, primary health care (PHC) staff, and provincial and district program managers. Thematic analysis was used to identify barriers and enablers of UKK implementation at intrapersonal, interpersonal, community, organizational and policy level.

A total of 10 FGDs with informal workers from different areas of occupation, two FGDs with PHC staff and 6 KIIs with program managers were conducted. Informal workers faced various occupational risks yet personal protective equipment were rarely available or used. OHS was perceived as important, however, participation in UKK was low because of lack of time and information. There was lack of workers empowerment, resulting in top-down planning of activities by PHC. Informal workers expected PHC health workers to provide OHS services rather than UKK cadres. Not all PHCs have implemented UKK. Few programmers were trained on OHS. The program was assigned low priority and resource allocation by PHC and District Health Office. The absence of OHS regulation for informal workers offered little incentive for government departments to implement OHS programs and services for informal workers.

Informal workers had unmet needs of OHS. Substantial efforts are needed to implement UKK, especially investment in financial and human resources. UKK establishment should be focused at workplace with the highest occupational risks. Technical capacity of programmers responsible for health promotion and OHS should be improved. Local policy on social protection and OHS services for informal workers should be developed.
O2A.1 Pesticides and work-related asthma: how this relates to self-reported exposures
Authors: Fishwick David , Harding Anne-Helen , Fox David , Chen Yiqun , Pearce Neil , Frost Gillian
Published: May 2020

Pesticide exposure has been linked to a number of potentially adverse health outcomes, including asthma. We were interested to explore the relationship between asthma and pesticide use, particularly from the perspective of self-reported work-related asthma.

Using the existing UK PIPAH (Prospective Investigation of Pesticide Applicators’ Health) study population, we administered a respiratory questionnaire to 4814 current and past pesticide users. Participants were asked about doctor-diagnosed and self-reported asthma symptoms, and, if present, their views about the cause of work-related asthma (asthma reported to be worse at work).

Of the 2562 respondents (53% response) with a median age of 60.2 years, 97.4% were male and 34.1% ever smoked. The prevalence of ever being doctor diagnosed asthma was 11.4% (n=292), and 123 of these (42.1% of those with asthma) reported that their asthma was caused, or made worse, by their work. 17.8% reported wheeze in the last 12 months.

Grouping relevant exposures, 117 of the 123 participants reported in decreasing order of proportion, the following agents as being responsible for worsening of their asthma; organic dusts (n=73, 59%), unspecified dust (n=12, 10%), mixed exposures (n=12, 10%), any mention of chemical (n=9, 7%), physical work environment, e.g. temperature, exercise (n=7, 6%), other, e.g. irritant, fumes (n=4, 3%).

This large study of pesticide applicators has confirmed a prevalence of 11.4% for doctor-diagnosed asthma. Self-reported exposures thought by workers to aggravate their asthma were predominantly organic in nature, although a smaller proportion identified chemicals as aggravants. Workplace based preventative strategies in this sector should address all potential inhaled hazards and their associated risks to respiratory health.
O2C.3 What predicts a secondary absence following return to work among workers’ compensation claimants in victoria? Results from a longitudinal cohort
Authors: Smith Peter
Published: May 2020

Time taken to first return to work (RTW) is often a primary endpoint for studies among injured workers. However, studies using administrative workers’ compensation claims data have documented that a substantial proportion (approximately one half) of claimants will incur a subsequent period of wage replacement. Unfortunately, workers’ compensation data is limited in the information collected to better understand which claimants are more likely to have a subsequent absence from work. The objective of this study is to address this gap using a cohort of workers’ compensation claimants in the Australian state of Victoria.

The sample for this study is drawn from a longitudinal cohort of workers’ compensation claimants (n=869). For the purpose of this analysis we focused on those claimants who had returned to work (self-reported) at the baseline interview, which was conducted approximately 4 months after the injury had occurred (n=372). Independent variables examined included if the respondent was working on full or partial duties, currently receiving health care for their injury, type of injury (musculoskeletal versus psychological), co-worker responses when they returned to work (measured using nine questions), and work limitations, measured using an abbreviated form of the work limitations questionnaire.

A total of 205 respondents (55% of the sample) reported a subsequent absence from work when interviewed 6 months later. All independent variables, with the exception of injury type, were associated with subsequent absences from work. In a multivariable model, only working modified duties and greater limitations remained statistically significant.

The results of the current study help inform our understanding of trajectories in RTW and factors, measured after the first RTW, which may be associated with a subsequent absence from work. These findings can be integrated into RTW programs to help more workers achieve sustainable RTW following a work injury.
O2D.1 A follow-up study of occupational styrene exposure and risk of systemic sclerosis, rheumatoid arthritis, and other systemic autoimmune rheumatological diseases
Authors: Boudigaard Signe Hjuler , Stokholm Zara Ann , Vestergaard Jesper Medom , Mohr Mette Skovgaard , Søndergaard Klaus , Schlünssen Vivi , Kolstad Henrik Albert
Published: May 2020

Background

Increased risk of systemic sclerosis, systemic lupus erythematosus, rheumatoid arthritis, primary systemic vasculitis, and systemic Sjogren’s syndrome has been suggested following occupational solvent exposure. The evidence for specific solvents is, however, limited and little is known about exposure and risk patterns.

Aim

Our aim is to examine the exposure response relation for systemic sclerosis, rheumatoid arthritis, systemic lupus erythematosus, primary systemic vasculitis, and systemic Sjogren’s syndrome following occupational styrene exposure.

Methods

We followed 72 467 styrene exposed workers of the Danish reinforced plastics industry from 1977–2012. We modelled styrene exposure from employment history, survey data and historical styrene exposure measurements. We identified cases in a national patient register, and investigated gender specific exposure response relations by cumulative styrene exposure for different exposure time windows adjusting for age, decade, educational level and a proxy for tobacco smoking.

Results

During 1,553,577 person-years, we identified 223 women and 453 men diagnosed with a systemic autoimmune rheumatological disease, of which three out of four were rheumatoid arthritis. When adjusting for potential confounders and comparing the highest with the lowest styrene exposure tertile, we observed a statistically non- significantly increased risk of systemic sclerosis among men (IRR=1.79; 95% CI 0.48–6.87) and women (IRR=2.58; 95% CI 0.51–12.94), based on 20 and 9 cases respectively. However, for women with systemic sclerosis, we saw a significantly increasing trend of 1.19 (1.01–1.40) pr. 100 mg/m3-years. Increased risks were also suggested for primary systemic vasculitis (IRR=2.32; 95% CI 0.63–8.52) and rheumatoid arthritis (IRR=1.26; 95% CI 0.95–1.67) among men. Analyses of exposure time windows suggest a latency period for rheumatoid arthritis of about 15 years.

Conclusion

This study might indicate that styrene exposure is associated with the occurrence of systemic sclerosis among men and women, and primary systemic vasculitis and rheumatoid arthritis among men.
O2D.2 Occupational exposure to oxygenated, petroleum-based and chlorinated solvents of women in childbearing age in france in 2013
Authors: Lagarrigue Robin , Houot Marie , workgroup Matgéné , Yamani Mounia El , Pilorget Corinne
Published: May 2020

Objective

Occupational exposure to chemical agents including solvents is sparsely described among women although they constitute a vulnerable population at certain points in life and particularly during the procreative period. The aim of this study is to document the occupational exposure to oxygenated, petroleum-based and chlorinated solvents in women of childbearing age (WCA).

Methods

We linked 17 job-exposure matrices describing exposure to oxygenated, petroleum-based and chlorinated solvents from the MATGÉNÉ programme to the 2013 French census. The occupational exposure prevalence was estimated in women aged from 15 to 44 years. The occupational exposure prevalence was described by 5 year age group, occupation and worker status (salaried or self-employed).

Results

The most frequently used solvents in French workplace in 2013 by WCA are oxygenated solvents (15% of WCA at work, n=1,112,000), then petroleum-based solvents (1%, n=73,000) and chlorinated solvents (0.1%, n=9,000). The younger WCA (15–29 years) are more exposed to oxygenated solvents than their elders (19.9% vs 14.9%). On the contrary, the elderly (35–44 years) are more exposed to petroleum-based and chlorinated solvents. Three quarters of the WCA exposed to at least one oxygenated solvent are civil and public servants (41%), health and social workers (21%) or direct personal services staff (19%). Half of WCA exposed to at least one petroleum-based solvent are drivers (20%) and skilled workers of industrial and artisanal fields (13% respectively). For WCA exposed to at least one chlorinated solvent, nearly half worked as non-skilled workers of industrial and artisanal type (17% respectively) and health and social workers (15%).

Conclusions

This study is the first describing occupational exposure to three major solvents’ families for the entire working WCA in France regardless of working status or occupation. These information will help in the surveillance of this occupational risk and to prioritize prevention actions.
O2D.5 Risk of parkinson disease in solvent exposed workers in finland
Authors: Sallmén Markku , Uuksulainen Sanni , Hublin Christer , Koskinen Aki , Sainio Markku
Published: May 2020

Epidemiologic studies indicate that occupational exposure to solvents may increase risk of Parkinson disease (PD).

We constructed a population-based case-control study of incident PD using a register of Reimbursement of medicine costs of the Social Insurance Institution of Finland, along with the Population Information System, including census records for all Finnish residents. PD cases were diagnosed between 1995–2014. Controls were randomly selected from the population while matching on diagnosis year, birth year (1930–1950), and sex. A total of 11,757 PD cases and 23 236 controls had data from the occupational census in 1990, ensuring ≥4 years exposure lagging and 21 years of occupational history data (5 censuses from 1970–1990). We used the Finnish Job Exposure Matrix to assess cumulative exposure (CE) to four groups of solvents (aliphatic/alicyclic hydrocarbon, aromatic hydrocarbon, chlorinated hydrocarbon, other). We estimated PD-solvent odds ratios (ORs) and 95% confidence intervals (CIs) using unconditional logistic regression, while adjusting for age, sex, socioeconomic status and smoking (a_OR), or additionally for CE to chromium and one of the other solvent groups (ab_OR).

In total, 3758 cases (30.4%) and 7445 controls (32.0%) were potentially exposed to solvents (a_OR 0.99; CI: 0.94–1.05). Exposure to chlorinated hydrocarbons was associated with PD (a_OR 1.20; CI: 1.05–1.36; ab_OR 1.21 CI: 1.04–1.40) at the highest CE group (20–145 ppm-years, n=409 cases and 728 controls) but not at lower CE levels. Overall, CE to chlorinated hydrocarbons (n=1840 cases and 3693 controls) was associated with increased risk of PD (p-for-trend=0.01). There was no evidence of a positive association for any of the other solvent groups.

We observed a positive association between occupational exposure to chlorinated hydrocarbons and risk of PD. This was especially true for greatest duration and/or level of exposure.
O2E.1 Why the quality of exposure assessment matters in human observational studies and consequent hazard and risk assessment
Authors: Kromhout Hans
Published: May 2020

Occupational exposures can vary dramatically and therefore their assessment and assignment in epidemiological studies often come with considerable error. In prior eras of occupational epidemiology, exposure was treated as static; often in a binary (yes/no) or ordinal (no/low/medium/high) manner. In modern times the need for better quality exposure assessment and assignment is clear, particularly in situations where occupational exposures and outcomes are less convincingly associated. High quality exposure assessment is imperative for informative human observational studies that permit better hazard classifications and quantification of exposure response relationships.

A wide range of exposure assessment methods exist and have been applied; varying from self-reports general and specific job-exposure matrices, and case-by-case expert-based assessments to elaborate quantitative algorithms using the collective information of thousands of workplace measurements. The selection of method largely depends on the type of epidemiological study performed (retrospective versus prospective; case-control versus cohort; general population versus worker-based), the agent under consideration, and the extent of access to experts and measurement data. In addition, each method has its own specific limitations and possibilities, and will not be feasible for use in every study.

Formal methods to evaluate exposure assessment quality in epidemiological studies are largely non-existent, but recent work within the IARC Monographs Programme and elsewhere have provided a direction for a more systematic approach. Several systematic literature reviews of human observational studies have shown that incorporating the quality of exposure assessment can produce a more convincing and informative evaluation when reviewing a body of evidence.

As part of a mini-symposium on the importance of exposure assessment in epidemiology for hazard identification and risk characterization, this presentation will provide a brief introduction to exposure assessment and assignment for human observational studies, as well as directions for a more formal approach to their evaluation.
O2E.6 Defining shift work exposure in epidemiological studies of cancer: where have we been, and what comes next?
Authors: Hall Amy
Published: May 2020

In the epidemiological context, ‘exposure’ to shift work encompasses a variety of social, workplace, and individual characteristics. This complexity lends itself to coarse exposure assessment and assignment, which increases misclassification error and often reduces contrast between comparison groups. In early epidemiological studies of shift work, broad exposure assignment, such as ‘day’ versus ‘night’ worker, was commonly used; a technique that ignored various characteristics (e.g., shift intensity, timing, and work history) with potential impacts on long-term health risks.

In 2007, The International Agency for Research on Cancer classified ‘shift work that involves circadian disruption’ as a probable human carcinogen (Group 2A), on the basis of limited human evidence and sufficient evidence in experimental animals. In this evaluation, a major limitation of the epidemiological studies reviewed was the definition of shift work. A subsequent workshop convened by IARC considered how shift work should be assessed and quantified to improve the validity of future shift work and cancer studies. Since the publication of this working group’s recommendations in 2011, the role of strong exposure assessment as a vital component of informative epidemiological studies of shift work has increasingly been recognized.

As part of a proposed symposium on the importance of exposure assessment in epidemiology for hazard identification and risk characterization, this presentation will summarize progress to date in the adoption of stronger exposure assessment methodologies in epidemiological studies of shift work, and offer ideas for next steps. A particular focus will be placed on the refinement of measurement techniques to assess long-term exposure to shift work (e.g., roster-based assessment and validity studies), and on quantitative considerations of important co-exposures (e.g., light-at-night).
O3B.3 Estimating the impact of changes to occupational standards for silica exposure on lung cancer mortality
Authors: Keil Alex , Richardson David , Westreich Daniel , Steenland Kyle
Published: May 2020

Background

Respiratory exposure to silica is associated with the risk of death due to malignant and non-malignant disease. 2.3 million U.S. workers are exposed to silica. Occupational exposure limits for silica are derived from a number of lines of evidence, including observational studies. Observational studies may be subject to healthy worker survivor bias, which could result in underestimates of silica’s impact on worker mortality and, in turn, bias risk estimates for occupational exposure limits.

Methods

Using data on 65 999 workers pooled across multiple industries, we estimate the impacts of several hypothetical occupational exposure limits on silica exposure on lung cancer and all-cause mortality. We use the parametric g-formula, which can account for healthy worker survivor bias.

Results

Assuming we could eliminate occupational exposure, we estimate that there would be 20.7 fewer deaths per 1000 workers in our pooled study by age 80 (95% confidence interval: 14.5, 26.8), including 3.91 fewer deaths due to lung cancer (95% CI: 1.53, 6.30). Less restrictive interventions demonstrated smaller, but still substantial risk reductions.

Conclusions

Our results suggest that occupational exposure limits for silica can be further strengthened to reduce silica-associated mortality and illustrate how current risk analysis for occupational limits can be improved.
O3D.2 45 years of follow-up for cancer for jobs and occupational exposures in 15 millions in five nordic countries – NOCCA
Authors: Hansen Johnni , Martinsen Jan Ivar , Weiderpass Elisabete , Kjærheim Kristina , Sparén Pär , Tryggvadottir Laufey , Lynge Elsebeth , Pukkala Eero
Published: May 2020

Introduction

A majority of established human carcinogens have been discovered in the occupational setting. For most cancers, including even frequent cancers like colorectal, prostate and breast, however, only a minor fraction of the overall causes has been identified so far. Therefore, it is obvious than even more carcinogens can be discovered through studies of occupation and cancer. This can be facilitated by the use of big high quality data.

Methods

Our study covers 15 million working-aged persons who participated in population censuses between 1960 and 1990 in Denmark, Finland, Iceland, Norway and Sweden. These persons have been followed-up for cancer and divided into 70 cancer categories. Further, country and calendar time specific job exposure matrices (JEM) are developed for 30 documented and potential carcinogens, including e.g. asbestos, formaldehyde, wood dust, quartz and several specific metals and organic solvents.

Results

In total 2.8 million incident cancer cases are diagnosed in these people during the follow-up. Even for all cancers combined, there is a wide statistically significant variation among men from a relative risk (RR) of 0.79 in domestic assistants to 1.48 in waiters. The occupations with the highest RR also includes workers producing beverage and tobacco, seamen and chimney sweeps. Among women, the overall RR varied from 0.58 in seafarers to 1.27 in tobacco workers. Low RRs were found for farmers, gardeners and forestry workers in both genders. We have also estimated RRs after exposure to e.g. various metals, solvents, formaldehyde and wood dust. Additional examples from the over 50 papers published so far based on this comprehensive on-going cohort will be presented.

Conclusions

The present study shows that the risk of cancer is highly dependent on occupation and specific occupational exposures.
O3D.3 Medication as proxy of work-related health problems
Authors: Godderis Lode , Vandersmissen Lieve , Schouteden Martijn
Published: May 2020

Introduction

In order to investigate the impact of work on health, we hypothesize that medication consumption registered in medical files of workers could serve as a proxy for work-related health problems. In this study, we describe variations in prevalence of specific medication groups between sectors, adjusting for age and gender. In addition, we investigated whether a change in job/sector can have an impact on medication use.

Method

Logistic regression analysis is being performed to investigate the effect of occupational sector on the prevalence of specific medication groups, adjusted for year, age and gender. For this, an occupational surveillance dataset of 6 86 434 workers collected between 2011 and 2017 was used. Additionally, regarding the impact on job changes on medication use, analyses are currently being performed by comparing prevalence of specific medication groups in 2011 with 2017 for those employees who changed job during this time period.

Results and discussion

In 2011 30,6% male and 49,8% female workers used medication. These figures roze to 43,1% and 67,3% respectively in 2017. The use of medication increased with age: in 2017 38,2% for workers<25 year, 43,6% for 25–34 year old employees, 48,7% between 35–44 year, 61,6% between 45–54 year and 74,1% for older workers>=55 year. Big differences were observed between sectors. Medication use was highest in health care (67,1% in 2017), government and education. These differences remained after adjustment for age and gender. 9,8% and 9,1% of the workers were treated for respectively pain and neuropsychological disorders in 2017.

Conclusion

Significant differences in workers’ medical consumption were observed between sectors. This information is now being used for the implementation of a sector-oriented health surveillance program.
O3D.6 Inventory of occupational, industrial and population cohorts in switzerland
Authors: Bovio Nicolas , Vienneau Danielle , Canu Irina Guseva
Published: May 2020

Context

Given the importance of harmonization in occupational epidemiology (OE) research, an European network, OMEGA-NET, is developing an inventory of occupational, industrial and population cohorts in Europe. We inventorized existing cohorts in Switzerland and assessed their relevance for OE.

Methods

We identified cohorts based on the review of data repositories and publications of the leading occupational and public health institutions in Switzerland. Cohorts were considered relevant for OE if data on occupation were available. The quality of these data was assessed critically.

Results

In Switzerland, we found no industrial cohort, one retrospective occupational cohort exposed to magnetic fields [20,141 Swiss Federal Railway workers, cancer morbidity follow-up=1972–2002] and four population-based cohorts relevant for OE: the census-based Swiss National Cohort (SNC) [5.8 million adult residents in Switzerland, mortality by cause follow-up=1990–2014], the Study on Air Pollution And Lung Disease In Adults (SAPALDIA) [n=9,561, lung function and morbidity follow-up=1991-present], CoLaus|PsyCoLaus [6,700 35–75 year-old residents of Lausanne, cardiovascular and mental morbidity follow-up=2003-present], the Swiss Kidney Project on Genes in Hypertension (SKIPOGH) [1134 residents of Lausanne, Geneva and Berne, kidney and metabolic morbidity follow-up=2009-present].

Occupation was coded using the International Standard Classification of Occupations (ISCO) only in the SNC (ISCO-68 and ISCO-88) and SAPALDIA (ISCO-88). In SKIPOGH, the Belgian Classification of occupations was used. In CoLaus|PsyCoLaus, occupation remains uncoded. Noteworthy, the percentage of missing occupations is 43%, non-reported, 65% and 61%, respectively.

Conclusion

Having detailed high-quality data on multiple health outcomes, the identified Swiss cohorts may represent a valuable contribution to OE research. However, in absence of standardisation in collecting and coding of occupational data in these cohorts, their use in OE is still challenging. Planned harmonization efforts in frame of OMEGA-NET will be beneficial for improving the quality of these data and OE research in Switzerland and abroad.
O3E.5 Military veterans pathways to mental health support: the need for new solutions
Authors: Rafferty Laura , Stevelink Sharon , Greenberg Neil
Published: May 2020

Military service can place personnel at a greater risk of developing mental health issues yet both serving personnel and military veterans are reluctant to seek help for mental health issues. Delay in seeking support for mental health distress can result in reduced quality of life as well as a worse treatment prognosis. This research aims to explore the barriers and facilitators to care for the UK veteran population, identifying the relationship between these factors and help seeking behaviour.

Sixty- two in-depth qualitative interviews were conducted with male UK military veterans who had left the Armed Forces in the last five years and screened positive for a degree of mental health distress on self-report questionnaires covering common mental disorders (anxiety or depression), post-traumatic stress disorder or alcohol misuse. Thematic analysis was utilised to identify core themes which were developed into an illustrative journey to mental health support, outlining the key stages through which a veteran may travel on their journey to engaging in effective mental health treatment.

Veterans’ decision to seek care was mainly concentrated on the perceived need for treatment. Those not in mental health treatment failed to identify problems they were having as being indicative of a ‘mental health disorder’ as they had not yet reached a crisis point where they could no longer cope. Those veterans who were in mental health treatment typically had reached a point where the severity of their condition meant that their need for treatment was highlighted regardless of their intention, either due to a crisis event or to another’s intervention.

Interventions are needed to target early identification and management of mental health distress and encourage veterans to seek support before reaching a crisis event. The implications for this research to other high stress, masculine occupations will be explored within the talk.
O4B.1 The impact of manual patient handling on work ability: a cross-sectional study
Authors: Dias Adriano , Bernardes João Marcos
Published: May 2020

This cross-sectional study investigated the level of work ability (WA) and its association with manual patient handling (MPH) in healthcare workers (HCW). Participants were HCWs working at the University Hospital of Botucatu Medical School, who were willing to participate and provided written informed consent. Of the 488 HCWs who were invited, 320 participated for a response rate of 65.6%. Sixteen participants (5%) were subsequently excluded from data analysis due to missing data. Data were collected using a self-administered anonymous paper questionnaire containing seven parts: manual patient handling, low back pain, demographic characteristics, occupational variables, psychosocial work conditions, lifestyle variables and work ability. Work ability was measured by the Brazilian version of the Work Ability Index (WAI). The association between WA and LBP was analyzed using a Poisson regression model. Initially, simple Poisson regression models with robust variance were conducted for each covariate. Those variables with a p value ≤ 0.25 were selected for inclusion in a multiple Poisson regression model with robust variance, and those with p<0.05 were considered statistically significant. Most respondents were female (83.6%), the mean age was 40.35 years (SD 9.74, range 22-66) and the average duration of employment was 10.67 years (SD 9.36, range 1-40). The WAI mean score was 38.03 points (SD 6.15, 95% CI 37.33-38.72), and the prevalence of adequate WA (equal to or above 37 points) was 56.58%. In the multiple Poisson regression model, MPH (PR 1.375, 95% CI 1.038-1.821) was significantly associated with WA, even when adjusted for the covariates. Thus, hospital managers should plan and implement interventions to maintain healthcare workers’ work ability, and these interventions should include the limitation of manual patient handling activities.
O4B.4 Predictors of return to work with readaptation in public workers
Authors: Dias Adriano , Marcos Bernardes Bernardes João , Augusto Servilha Coquemala Sandro , Gómez-Salgado Juan , Ruiz-Frutos Carlos
Published: May 2020

Objectives

To identify factors associated with work readaptation after sick leaves in a group of public workers in Brazil.

Methods

Case-control study of sick leaves in a university campus from 2010 to 2015. Logistic regression models were adjusted for two different response variables: readaptation and readaptation with limitations. A digital database was created and completed with data from manual sources.

Results

Age at the beginning of the process, number of sick leaves, those of more than 16 days, average duration (total time of sick leaves/number of medical records), and mid-level healthcare positions were associated with work readaptation. In the model of readaptation with limitations, the age of hiring by the university, the number of sick leaves, those of more than 16 days, and mid-level healthcare positions, both rural work and operational positions were associated to the response variable.

Discussion

A computerized database has been created, based on manual records, which has allowed us to identify labour and non-labour factors associated with the return to work after a sick leave and the possible functional readaptation, with or without limitation, in public workers. This has allowed proposing more efficient management of health measures to this population.
O4C.2 Impact of precarious work on the wellbeing of women and migrants in australia
Authors: Reid Alison , Daly Alison , Schenker Marc
Published: May 2020

Introduction

Women and migrants are more likely to be in precarious work than men and native-born workers. Precarious work impacts adversely on work-related injuries, fatalities and health but little is known about how it affects the wellbeing of women and migrant workers. The aims of this study are; (1) to examine whether precarious work differs by migration status and sex and 2) to determine whether the impact of precarious work on the wellbeing of women and migrants differs to that of males and native-born workers.

Methods

In 2016/17 a national telephone survey examined psychosocial workplace hazards among 1630 migrant and 1051 Australian-born workers. Precarious work (vulnerability and job insecurity) and wellbeing were collected with sociodemographic and employment variables. Higher scores indicate greater vulnerability/insecurity/less wellbeing. Univariate statistics examined the association between precarious work and wellbeing by sex and country of birth. Stratified linear regression modelled the relationship between precarious work and wellbeing by sex.

Results

Independent of country of birth, females had higher vulnerability (µ=6.5, σ=3.4) than males (µ=5.5, σ=3.6), in contrast to job insecurity (Women µ=8.2, σ=4.0; Men µ=8.2, σ=3.9). Workers born in the Philippines had higher vulnerability compared with other migrant workers (µ=6.6, σ=3.4 vs µ=5.9, σ=3.6) whereas workers born in India had higher employment insecurity compared with other migrant workers (µ=8.8, σ=4.1 vs µ=8.1, σ=3.9). Increasing vulnerability and insecurity adversely impacted wellbeing most in Australian workers. Compared with men, vulnerability had a greater adverse impact on the wellbeing of women.

Discussion

Two dimensions of precarious work impact the wellbeing of men and women differently. Vulnerability impacts women most whereas work insecurity impacts men. For Australian born, the impact of either dimension on wellbeing is greater than for migrant workers.