bluuebunny/crossref_metadata_2025 huggingface dataset:
Crystalline silica and risk of lung cancer in the potteries.
Authors: Cherry N M , Burgess G L , Turner S , McDonald J C
Published: January 2009

OBJECTIVE: To evaluate crystalline silica as a human carcinogen. METHODS: A cohort of 5115 men, born 1916-45 and employed in the pottery, refractory, and sandstone industries of Stoke-on-Trent was identified from occupations subject to health surveillance by the local Silicosis Medical Board (now the Department of Social Security). Detailed occupational and smoking histories, and records of small parenchymal opacities on periodic radiographs were extracted from medical records. An exposure matrix was derived from some 1400 personal or static dust samples and tested against the presence of small parenchymal opacities in a subcohort of 1080 men employed for at least 10 years, who had started working in the industry before 1960. RESULTS: Standardised mortality ratios (SMRs) calculated against mortalities for Stoke-on-Trent, with 95% confidence intervals (95% CIs), were raised for all causes (1.15 (1.05 to 1.26)), lung cancer (1.28 (0.99 to 1.62)) and non-malignant respiratory disease (2.04 (1.55 to 2.65)). Average concentration and duration of exposure to silica were, taken together, significantly related to the presence of small opacities (> or = 1/0). In a nested case-referent analysis of 52 cases of lung cancer and 197 matched referents, conditional logistic regression gave a significantly increased odds ratio (OR) for average silica concentration (micrograms/m3.100), after adjustment for smoking, of 1.66 (1.14 to 2.41) but not for duration of exposure nor, in consequence, for cumulative exposure. CONCLUSION: The association between risk of lung cancer and quantitative estimates of silica exposure supports the SMR analysis and implies that crystalline silica may well be a human carcinogen.
Asthma-like symptoms, atopy, and bronchial responsiveness in furniture workers.
Authors: Talini D , Monteverdi A , Benvenuti A , Petrozzino M , Di Pede F , Lemmi M , Carletti A , Macchioni P , Serretti N , Viegi G , Paggiaro P
Published: January 2009

OBJECTIVES: To study the role of individual and occupational risk factors for asthma in furniture workers. METHODS: 296 workers were examined (258 men, 38 women) with a questionnaire of respiratory symptoms and diseases, baseline spirometry, bronchial provocative test with methacholine, and skin prick tests. Non-specific bronchial hyperreactivity was defined as when a provocative dose with a fall of 20% in forced expiratory volume in 1 second (PD20FEV1) was < 0.8 mg and atopy in the presence of at least one positive response to skin prick tests. Workers were subdivided into spray painters (exposed to low concentrations of diisocyanates and solvents), woodworkers (exposed to wood dusts), and assemblers (control group). RESULTS: The prevalences of attacks of shortness of breath with wheezing and dyspnoea were higher in spray painters (13.5% and 11.5% respectively) than in woodworkers (7.7% and 6.3%) or in assemblers (1.6% and 1.6%); prevalences of chronic cough, asthma, and rhinitis were also slightly but not significantly higher in spray painters and in woodworkers than in assemblers. The difference in the prevalence of respiratory symptoms among the job titles was due to the atopic subjects, who showed a higher prevalence of chronic cough, wheeze, shortness of breath with wheeze, dyspnoea, and asthma in spray painters than in the other groups. The prevalence of non-specific bronchial hyperreactivity in subjects who performed bronchial provocative tests was 17.7%, with no significant difference among groups. Asthma symptoms were significantly associated with non-specific bronchial hyperreactivity. Asthma-like symptoms plus non-specific bronchial hyperreactivity was found in 4% of assemblers, 10% of woodworkers, and 13.3% of spray painters (chi 2 = 2.6, NS). Multiple logistic analysis taking into account individual (smoke, atopy, age) and occupational (job titles) risk factors confirmed that spray painters had higher prevalence of chronic cough than assemblers, and a trend in increasing the prevalence of shortness of breath with wheeze, dyspnoea, and asthma. CONCLUSIONS: Painters in the furniture industry, particularly atopic subjects, are at higher risk of asthma-like symptoms than other job titles. In these workers asthma-like symptoms are more sensitive than non-specific bronchial hyperreactivity in detecting a negative effect of the occupational exposure.
Does the US Navy attract young women who smoke?
Authors: Weaver K B , Woodruff S I , Conway T L , Edwards C C , Zhu S H , Elder J P
Published: January 2009

OBJECTIVE: To assess whether the United States Navy is disproportionately attracting and recruiting female smokers from the civilian sector. METHODS: Standardised comparisons of cigarette use among Navy women recruits and civilian women were conducted with data from a 1996-97 Department of Defense study and the 1994 National Health Interview Survey. RESULTS: Young Navy women recruits (18-22 years) had significantly higher rates of current and heavy smoking than their civilian counterparts after adjusting for differences in sociodemographic characteristics. Smoking rates among older recruits and civilian women (23-30 years) were not significantly different. CONCLUSIONS: It seems that the Navy attracts young civilian women who already smoke, many of whom smoke heavily.
Proposal for the assessment of quantitative dermal exposure limits in occupational environments: Part 1. Development of a concept to derive a quantitative dermal occupational exposure limit.
Authors: Bos P M , Brouwer D H , Stevenson H , Boogaard P J , de Kort W L , van Hemmen J J
Published: January 2009

Dermal uptake of chemicals at the workplace may contribute considerably to the total internal exposure and so needs to be regulated. At present only qualitative warning signs--the "skin notations"--are available as instruments. An attempt was made to develop a quantitative dermal occupational exposure limit (DOEL) complementary to respiratory occupational exposure limits (OELs). The DOEL refers to the total dose deposited on the skin during a working shift. Based on available data and experience a theoretical procedure for the assessment of a DOEL was developed. A DOEL was derived for cyclophosphamide and 4,4-methylene dianiline (MDA) according to this procedure. The DOEL for MDA was tested for applicability in an actual occupational exposure scenario. An integrated approach is recommended for situations in which both dermal and respiratory exposures contribute considerably to the internal exposure of the worker. The starting point should be an internal health based occupational exposure limit--that is, the maximum dose to be absorbed without leading to adverse systemic effects. The proposed assessment of an external DOEL is then either based on absorption rate or absorption percentage. The estimation of skin penetration seems to be of crucial importance in this concept. If for a specific substance a maximal absorption rate can be estimated a maximal skin surface area to be exposed can be assessed which may then serve the purpose of a DOEL. As long as the actual skin surface exposed is smaller than this maximal skin surface area the internal OEL will not be exceeded, and therefore, no systemic health problems would be expected, independent of the dermal dose/unit area. If not, the DOEL may be interpreted as the product of dermal dose/unit area (mg/cm2) and exposed skin surface area (cm2). The proposed concept for a DOEL is relevant and can be made applicable for health surveillance in the occupational situation where dermal exposure contributes notably to the systemic exposure. Further research should show whether this concept is more generally applicable.
Proposal for the assessment to quantitative dermal exposure limits in occupational environments: Part 2. Feasibility study for application in an exposure scenario for MDA by two different dermal exposure sampling methods.
Authors: Brouwer D H , Hoogendoorn L , Bos P M , Boogaard P J , van Hemmen J J
Published: January 2009

OBJECTIVE: To evaluate two different techniques for assessing dermal exposure to 4,4'-methylene dianiline (MDA) in a field study. The results were used to test the applicability of a recently proposed quantitative dermal occupational exposure limit (DOEL) for MDA in a workplace scenario. METHODS: For two consecutive weeks six workers were monitored for exposure to MDA in a factory that made glass fibre reinforced resin pipes. Dermal exposure of the hands and forearms was assessed during week 1 by a surrogate skin technique (cotton monitoring gloves) and during week 2 by a removal technique (hand wash). As well as the dermal exposure sampling, biological monitoring, measurement of MDA excretion in urine over 24 hours, occurred during week 2. Surface contamination of the workplace and equipment was monitored qualitatively by colorimetric wipe samples. RESULTS AND CONCLUSIONS: Geometric means of daily exposure ranged from 81-1762 micrograms MDA for glove monitoring and from 84-1783 micrograms MDA for hand washes. No significant differences, except for one worker, were found between exposure of the hands in weeks 1 and 2. Significant differences between the mean daily exposure of the hands (for both weeks and sampling methods) were found for all workers. The results of the colorimetric wipe samples indicated a general contamination of the workplace and equipment. Excretion of MDA in 24 hour urine samples ranged from 8 to 249 micrograms MDA, whereas cumulative MDA excretion over a week ranged from 82 to 717 micrograms MDA. Cumulative hand wash and MDA excretion results over a week showed a high correlation (R2 = 0.94). The highest actual daily dermal exposure found seemed to be about 4 mg (hand wash worker A on day 4), about 25% of the external DOEL. Testing of compliance by means of a biological limit value (BLV) led to similar results for the same worker. It is concluded that both dermal exposure monitoring methods were applicable and showed a compatible performance in the present exposure scenario, where the exposure relevant to dermal absorption is considered mainly restricted to hands. The concept for a DOEL seemed to be relevant and applicable for compliance testing and health surveillance in the situation under investigation.
Does living near a constellation of petrochemical, steel, and other industries impair health?
Authors: Bhopal R S , Moffatt S , Pless-Mulloli T , Phillimore P R , Foy C , Dunn C E , Tate J A
Published: January 2009

OBJECTIVES: To investigate concern that local industrial air pollution in Teesside, England, was causing poor health, several areas there were compared with parts of the City of Sunderland. METHODS: Populations in similar social and economic circumstances but varying in their proximity to major industries were compared. Study populations lived in 27 housing estates in Teesside and Sunderland, north east England, with some data from subsets of estates. The estates were aggregated into zones (designated as A, B, and C in Teesside where A is closest to and C furthest from industry, and S in Sunderland). Zone S provided a reference area. The hypothesis was that a health gradient both within Teesside (A > B > C) and between Teesside and Sunderland (ABC > S) would indicate a possible health effect of local industrial air pollution. Data presented were: mortality (1981-91) from 27 housing estates; population self completion questionnaire survey data (1993, 9115 subjects) from 15 housing estates; and general practitioner (GP) consultation data (1989-94) from 2201 subjects in 12 Teesside estates. RESULTS: The populations in the four zones were comparable for indicators including smoking habits, residential histories, and unemployment. All cause and cause specific mortalities were high compared with England and Wales. Mortality in all Teesside zones (ABC) combined was mostly higher than in zone S. In people aged 0-64, lung cancer and respiratory disease showed gradients with highest mortality in areas closest to industry (A > B > C and ABC > S). The association was clearest for lung cancer in women (0-64 years old, trend across zones ABC, p = 0.07, directly standardised rate ratio relative to zone S was 169 (95% confidence interval (95% CI) 116-122)). There were no important, consistent gradients in the hypothesised direction between zones in consultation rates in general practice, and self reported respiratory and nonrespiratory health including asthma. CONCLUSIONS: There was no clear evidence that living close to industry was associated with morbidity, including asthma, or for most measures of mortality. For lung cancer in women the gradients indicated a health effect of local industrial air pollution. In the age group 0-64 observed gradients in lung cancer in men and mortality from respiratory disease in men and women were consistent with the study hypothesis, although not significant. The reasons for the different patterns at different ages, and between men and women, remain a puzzle.
Smoking and musculoskeletal disorders in the metal industry: a prospective study.
Authors: Leino-Arjas P
Published: January 2009

OBJECTIVES: To obtain longitudinal information of the relation between smoking and musculoskeletal disorders in an industrial setting. METHODS: The associations of lifetime tobacco exposure (pack-years), current smoking status, and stopping smoking with back and limb disorders were studied in a cohort of white collar and blue collar employees in a metal industry. Measurements were made three times at 5 year intervals. Two thirds of an initial sample of 902 took part in both re-examinations. Musculoskeletal morbidity was measured as the abundance of symptoms during the past year and as clinical findings assessed by a physiotherapist (upper decile score/score difference = index category). Logistic regression and a generalised estimating equation were used, allowing for sociodemographic variables, physical workload, body mass index, exercise activity, and mental distress. RESULTS: By comparison with never smokers, exposure of 10-< 20 pack-years, the odds ratio (OR) (95% confidence interval (95% CI) of the 10 year change in neck-shoulder symptoms was 3.1 (1.4 to 6.8), in low back symptoms 2.4 (1.1 to 5.1), in upper limb symptoms 1.9 (NS), and in lower limb symptoms 3.4 (1.5 to 7.8). The highest exposure category of > or = 20 pack-years was associated with the change in upper limb findings 2.9 (1.4 to 6.2) and lower limb findings 2.9 (1.2 to 7.2). Those who continued to smoke through the follow up period had a higher increase in clinical findings 2.5 (1.1 to 5.9) than never smokers. There was a dose-response in the association of smoking intensity with future musculoskeletal symptoms. Also, those who stopped smoking during the follow up had a higher increase in symptoms 4.4 (2.0 to 9.9) and findings 3.5 (1.4 to 8.8) than never smokers. CONCLUSION: Smoking seems to predict the development in the occurrence of musculoskeletal symptoms and signs. Stopping smoking is associated with high morbidity.
Respiratory health of cigar factory workers.
Authors: Uitti J , Nordman H , Huuskonen M S , Roto P , Husman K , Reiman M
Published: January 2009

OBJECTIVES: To determine whether occupational exposure to raw tobacco causes respiratory or allergic diseases, an excess of respiratory symptoms, a decrease in lung function, or parenchymal changes in chest radiography among Finnish cigar workers. METHODS: This cross sectional study included all Finnish cigar workers (n = 106) exposed to raw tobacco and also a group of unexposed matched referents. Data were collected with a self administered questionnaire, flow volume spirometry, measurements of diffusing capacity of the lung for carbon monoxide, chest radiography and skin prick tests. A questionnaire was also sent to former workers of the factory. RESULTS: There were no significant differences between the groups in the prevalence of respiratory symptoms and chest radiography findings. Nine of 102 tobacco workers had pulmonary fibrosis of at least 1/0 (according to the International Labour Organisation (ILO) 1980 classification) and the corresponding figure was five for the referents. The tobacco workers tended to have a low forced vital capacity (FVC), and they had impaired forced expiratory volume in 1 second and lower means of the maximal expiratory flow at 25% of the FVC significantly more often than the referents. Diffusing capacity tended to be lower among the referents. The referents more often had atopy and earlier atopic diseases than the exposed workers. These results indicate the possibility of selection among the exposed workers. CONCLUSIONS: No excess of prevalence of respiratory symptoms in the tobacco workers was found. According to the questionnaire episodes of allergic alveolitis may have occurred in the cigar factory workers. However, in the absence of impairments in lung function and radiological changes it was not possible to distinguish humidifier fever and allergic alveolitis. In exposure conditions that include humidification of the air humidifier, fever and allergic alveolitis constitute a risk for tobacco workers. No effects were shown of exposure to tobacco dust on lung function.
Asbestos lung burden and asbestosis after occupational and environmental exposure in an asbestos cement manufacturing area: a necropsy study.
Authors: Magnani C , Mollo F , Paoletti L , Bellis D , Bernardi P , Betta P , Botta M , Falchi M , Ivaldi C , Pavesi M
Published: January 2009

OBJECTIVE: The largest Italian asbestos cement factory had been active in Casale Monferrato until 1986: in previous studies a substantial increase in the incidence of pleural mesothelioma was found among residents without occupational exposure to asbestos. To estimate exposure to asbestos in the population, this study evaluated the presence of histological asbestosis and the lung burden of asbestos fibres (AFs) and asbestos bodies (ABs). METHODS: The study comprises the consecutive series of necropsies performed at the Hospital of Casale Monferrato between 1985 and 1988. A sample of lung parenchima was collected and stored for 48 out of 55 necropsies. The AF concentration was measured with a TEM electron microscope with x ray mineralogical analysis. The ABs were counted and fibrosis evaluated by optical microscopy. The nearest relative of each subject was interviewed on occupational and residential history. Mineralogical and histological analyses and interviews were conducted in 1993-4. RESULTS: Statistical analyses included 41 subjects with AF, AB count, and interview. Subjects without occupational exposure who ever lived in Casale Monferrato had an average concentration of 1500 AB/g dried weight (gdw); Seven of 18 presented with asbestosis or small airway lung disease (SAL). G2 asbestosis was diagnosed in two women with no occupational asbestos exposure. One of them had been teaching at a school close to the factory for 12 years. Ten subjects had experienced occupational asbestos exposure, seven in asbestos cement production: mean concentrations were 1.032 x 10(6) AF/gdw and 96,280 AB/gdw. Eight of the 10 had asbestosis or SAL. CONCLUSION: The high concentration of ABs and the new finding of environmental asbestosis confirm that high asbestos concentration was common in the proximity of the factory. Subjects not occupationally exposed and ever living in Casale Monferrato tended to have higher AB concentration than subjects never living in the town (difference not significant). The concentrations of ABs and AFs were higher than those found in other studies on nonoccupationally exposed subjects.
Adult myeloid leukaemia, geology, and domestic exposure to radon and gamma radiation: a case control study in central Italy.
Authors: Forastiere F , Sperati A , Cherubini G , Miceli M , Biggeri A , Axelson O
Published: January 2009

OBJECTIVES: To investigate whether indoor randon or gamma radiation might play a part in myeloid leukaemia as suggested by studies based on crude geographical or geological data for exposure assessment. METHODS: For six months randon and gamma radiation was measured with solid state nuclear track detectors and thermoluminescent dosimeters in dwellings of 44 adult male cases of acute myeloid leukaemia and 211 controls (all subjects deceased). Conditional logistic regression ORs (ORs) and 95% confidence intervals (95% CIs) were estimated for quartiles of radon and gamma radiation and for municipality and dwelling characteristics. RESULTS: The risk of leukaemia was associated with an increasing urbanisation index (p value for trend = 0.008). An increased OR was found among those living in more modern houses (OR 3.0, 95% CI 1.4 to 6.6). Confirming the findings of a previous study in the same area, geological features bore a positive association with myeloid leukemia, even by adjusting for level of urbanisation. Contrary to expectations from the previous study, however, no association appeared between myeloid leukaemia and radon and gamma radiation; for the highest quartiles of exposure, ORs were 0.56 (95% CI 0.2 to 1.4) and 0.52 (95% CI 0.2 to 1.4), respectively. Considering only subjects who had lived > or = 20 years in the monitored home and adjusting for urbanisation, there was still no effect of exposure to radiation. CONCLUSIONS: In view of the limited numbers, the results do not in general refute a possible risk of myeloid leukaemia from exposure to indoor radon or gamma radiation, but decrease the credibility of such a relation in the area studied and also of other studies suggesting an effect without monitoring indoor radiation. Some other fairly strong determinants have appeared--that is, level of urbanisation and living in modern houses--that might need further consideration.
Increased risk of lung cancer among different types of professional drivers in Denmark.
Authors: Hansen J , Raaschou-Nielsen O , Olsen J H
Published: January 2009

OBJECTIVES: To study risk of lung cancer among groups of professional drivers probably exposed to different levels of traffic exhaust fumes. METHODS: A nationwide case-control study (1970-89) based on employees comprising 28,744 men with primary lung cancer and incidence density sampled matched controls (1:1). Employment histories were reconstructed back to 1964 for each study subject from the records of a nationwide pension scheme with compulsory membership. Socioeconomic status was derived from the individual job title taken from the national population registry. Information on tobacco smoking habits was available from historical surveys. Relative risks were estimated by odds ratios (ORs) based on conditional logistic regression analyses. RESULTS: In total 2251 of the male lung cancer cases had been employed as bus, lorry, taxi, or unspecified drivers. No significant difference in tobacco smoking habits was found among professional male Danish drivers and the total employed population. The OR for lung cancer adjusted for socioeconomic status was 1.6 (95% confidence interval (95% CI) 1.2 to 2.2) among taxi drivers, who were considered to be exposed to the highest concentrations of vehicle exhaust fumes, and 1.3 (1.2 to 1.5) for bus and lorry drivers. The OR was 1.4 (1.3 to 1.5) for unspecified drivers. The adjusted risk of lung cancer increased significantly with increasing duration of employment as a driver, and the risk was highest for long term taxi drivers with 10 years of lag time (OR 3.0; 1.2 to 6.8). CONCLUSION: Occupational factors, probably exposure to vehicle exhaust, seems to play an important part in the development of lung cancer among drivers.
Dioxin exposure and non-malignant health effects: a mortality study.
Authors: Pesatori A C , Zocchetti C , Guercilena S , Consonni D , Turrini D , Bertazzi P A
Published: January 2009

OBJECTIVE: To investigate, in a population heavily exposed to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), the possible unusual occurrence of diseases other than cancer. METHODS: Five year extension of the follow up of the cohort involved in the Seveso accident. Soil measurements identified three exposure zones: (A) highest contamination, (B) substantial, and (R) low but higher than background contamination. Blood TCDD measurements, although limited in number, confirmed zone exposure ranking. The 15 year mortality in the exposed cohort was compared with that of a large population in the surrounding non-contaminated territory. Relative risks (RRs) and 95% confidence intervals (95% CIs) were estimated with Poisson regression techniques. RESULTS: The already noted increased occurrence of cardiovascular deaths was confirmed, in particular in zone A, among males for chronic ischaemic heart disease (five deaths, RR 3.0, 95% CI 1.2 to 7.3), and among females for hypertensive disease (three deaths, RR 3.6, 95% CI 1.2 to 11.4) and chronic rheumatic heart disease. Novel findings were the increase of chronic obstructive pulmonary disease, most notably among males in zone A (four deaths, RR 3.7, 95% CI 1.4 to 9.9) and females in zone B (seven deaths, RR 2.4, 95% CI 1.1 to 5.1); and from diabetes, which was significantly increased in females in zone B (13 deaths, RR 1.9, 95% CI 1.1 to 3.2). In zone R, chronic ischaemic heart disease (males and females), hypertension (females), and diabetes (females) showed less pronounced, although significant excesses. CONCLUSIONS: As well as high TCDD exposure, the accident caused a severe burden of strain in the population. Both these factors might have contributed to the noted increased risks (in particular, circulatory and respiratory). The cardiovascular and immune toxicity of TCDD, as well as its complex interaction with the endocrine system, might be relevant to the explanations of these findings. These results, although not conclusive, concur with previous data in suggesting cardiopulmonary and endocrine effects in humans highly exposed to TCDD.
Urinary excretion of platinum from platinum industry workers.
Authors: Schierl R , Fries H G , van de Weyer C , Fruhmann G
Published: January 2009

OBJECTIVES: Assessment of level of exposure to platinum and platinum concentration in urine from platinum industry workers to evaluate internal exposures and excretion kinetics. METHODS: Platinum concentrations in urine samples from 34 workers were measured by adsorptive voltammetry after UV-photolysis. Morning and evening samples were taken two to six times during six months. Individual exposures were assessed by personal air sampling. Also, two male volunteers were exposed to platinum dust for four hours at a typical platinum refinery workplace. RESULTS: Urinary platinum excretion after a shift in platinum industry workers was found to be up to 6270 ng/g creatinine--that is, 1000 times above the median value of unexposed people. Urinary excretion reached the maximum nearly 10 hours after inhalative exposure to dust containing platinum. Elimination corresponded to a first half life of about 50 (95% confidence interval (95% CI) 36 to 66) hours, but there were indications that a part of the incorporated platinum is stored longer. The amount of urinary platinum excretion showed a close correlation with the exposure level monitored by personal air sampling. CONCLUSIONS: A newly developed analytical method enabled the detection of even natural background concentrations of platinum. Thus, increased urinary platinum concentrations could be detected early, which is important to avoid damaging health of exposed workers.
Diver's hand: a skin disorder common in occupational saturation diving.
Authors: Ahlén C , Iversen O J , Risberg J , Volden G , Aarset H
Published: January 2009

Saturation divers regularly inspect North Sea installations, working at depth for periods of 12-16 days. Diver's hand is a particular problem in saturation diving, and there is no effective protection or treatment available. This paper presents the occurrence of diver's hand and describes the disease in clinical and epidemiological terms. Three studies of diver's hand have been carried out, in 1990, 1994, and 1995. Most long term saturation divers have had diver's hand at some time in their professional career. Diver's hand seems able to occur without any previous skin symptoms, and divers without diver's hand can have several other skin symptoms during a saturation period. It is likely that diver's hand is a specific phenomenon associated with saturation diving.
Dutch monitor on stress and physical load: risk factors, consequences, and preventive action.
Authors: Houtman I L , Goudswaard A , Dhondt S , van der Grinten M P , Hildebrandt V H , van der Poel E G
Published: January 2009

OBJECTIVES: Due to recent changes in legislation on occupational health and safety, a national monitor on stress and physical load was developed in The Netherlands to monitor (a) risks and consequences of stress and physical load at work, (b) preventive actions in companies to reduce these risks, and (c) organisational and environmental variables that facilitate preventive actions. METHODS: Information was gathered from employers, employees, and employees' representatives. The monitor was used with a nationally representative sample of companies in industry, wholesale trade, and banking and finance, 782 companies in total. RESULTS AND CONCLUSIONS: The information from the employees, aggregated at the company level, was not found to be correlated with that from the employer from the same companies. Although many employers do recognise risk factors for both physical load and stress as a problem they often seem to underestimate the problem when compared with employees or their representatives. This is particularly the case for psychosocial risk factors. Also, the perception of outcome measures, especially employers who consider emotional exhaustion to be work related, were fewer than the employees' representatives of the same organisation. Preventive measures on physical load are much more popular than measures against stress. It is the responsibility of the employer to take more preventive action of all kinds. They need to recognise risk factors as problems and health outcomes to be related to work. Employees of larger companies should participate with employers to consider effective measures, and more use should be made of support at branch level. For specific preventive measures, specific predictors emerged. Except for measures to prevent work stress, information from employees did not sufficiently contribute to the initiation of preventive measures in the workplace.
Are long working hours and shiftwork risk factors for subfecundity? A study among couples from southern Thailand.
Authors: Tuntiseranee P , Olsen J , Geater A , Kor-anantakul O
Published: January 2009

OBJECTIVE: To estimate the effect of long working hours and shift work on time to pregnancy. METHODS: Cross sectional samples with retrospective data collection from two 700 bed hospitals at secondary to tertiary care level in Hatyai district, Songkhla Province, Thailand. The study was conducted from March 1995 to November 1995 among 1496 pregnant women attending the antenatal clinics. Subfecundity was defined as time to pregnancy longer than 7.8, 9.5, or 12 months (time to pregnancy was calculated from the date at which the couples started having sexual relations without any contraception until last menstrual date). RESULTS: The descriptive analyses were restricted to 1201 planned pregnancies and the analytical part to 907 working women. Separate analyses on primigravid women were also done. Logistic regressions adjusted for age, education, body mass index, menstrual regularity, obstetric and medical history, coital frequency, and potential exposure to reproductive toxic agents, showed an odds ratio (OR) associated with female exposure to long working hours of 2.3 (95% confidence interval (95% CI) 1.0 to 5.1) in primigravid and 1.6 (1.0 to 2.7) in all pregnant women. Male exposure to long working hours and shiftwork showed no association with subfecundity. The OR of subfecundity was highest when both partners worked > 70 hours a week irrespective of the cut off point used (OR 4.1 (95% CI 1.3 to 13.4) in primigravid women; OR 2.0 (95% CI 1.1 to 3.8) in all pregnant women). CONCLUSIONS: Long working hours is a risk factor for subfecundity especially for women. Shiftwork was not associated with subfecundity in this study.
Chronic bronchitis, work related respiratory symptoms, and pulmonary function in welders in New Zealand.
Authors: Bradshaw L M , Fishwick D , Slater T , Pearce N
Published: January 2009

OBJECTIVES: A cross sectional study of respiratory symptoms and lung function in welders was performed at eight New Zealand welding sites: 62 current welders and 75 non-welders participated. METHODS: A questionnaire was administered to record demographic data, smoking habit, and current respiratory symptoms. Current and previous welding exposures were recorded to calculate a total lifetime welding fume exposure index. Forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and peak expiratory flow (PEF) were measured before the start of the shift. RESULTS: There were no significant differences in ethnicity, smoking habits, or years of work experience between welders and non-welders. Symptoms of chronic bronchitis were more common in current welders (11.3%) than in non-welders (5.0%). Of those workers with a cumulative exposure index to welding fume > or = 10 years, 16.7% reported symptoms of chronic bronchitis compared with 4.7% of those with a cumulative exposure index < 4 years (odds ratio (OR) 4.1, 95% confidence interval (95% CI) 0.90 to 17.6). Workers with chronic bronchitis had significantly lower measures of baseline PEF (p = 0.008) and FEV/FVC ratio (p = 0.001) than workers without chronic bronchitis. Multivariate analysis showed that current smoking (OR 9.3, 1.0 to 86.9) and total exposure index to welding fumes > 10 years (OR 9.5, 1.3 to 71.9) were independent risk factors for chronic bronchitis. The report of any work related respiratory symptom was more prevalent in welders (30.7%) than non-welders (15.0%) and workers with these symptoms had significantly lower FEV, (p = 0.004) and FVC (p = 0.04) values. Multivariate analysis identified a high proportion of time spent welding in confined spaces as the main risk factor for reporting these symptoms (OR 2.8, 1.0 to 8.3). CONCLUSION: This study has documented a high prevalence of symptoms of chronic bronchitis and other work related respiratory symptoms in current welders. Also, workers with chronic bronchitis had reduced PEF and FEV/FVC compared with those without chronic bronchitis. These symptoms related both to cigarette smoking and a measure of lifetime exposure to welding fume.
Tyler asbestos workers: mortality experience in a cohort exposed to amosite.
Authors: Levin J L , McLarty J W , Hurst G A , Smith A N , Frank A L
Published: January 2009

OBJECTIVES: To examine the causes of death among 1130 former workers of a plant in Tyler, Texas dedicated to the manufacture of asbestos pipe insulation materials. This cohort is important and unusual because it used amosite as the only asbestiform mineral in the production process. High level exposure of such a specific type was documented through industrial hygiene surveys in the plant. METHODS: Deaths were ascertained through various sources including data tapes from the Texas Department of Health and the national death index files. As many death certificates as possible were secured (304/315) and cause of death assigned. After select exclusions, 222 death certificates were used in the analysis. Causes of death were compared with age, race, and sex specific mortalities for the United States population with a commercial software package (OCMAP Version 2.0). RESULTS: There was an excess of deaths from respiratory cancer including the bronchus, trachea, and lung (standardised mortality ratio (SMR) 277 with 95% confidence interval (95% CI) 193 to 385). Four pleural mesotheliomas and two peritoneal mesotheliomas were identified. The analysis also showed an increasing risk of respiratory malignancy with increased duration of exposure including a significant excess of total deaths from respiratory cancer with less than six months of work at the plant (SMR 268 with 95% CI 172 to 399). CONCLUSIONS: The importance of the cohort lies with the pure amosite exposure which took place in the plant and the extended period of latency which has followed. The death certificate analysis indicates the pathogenicity of amosite, the predominant commercial amphibole used in the United States. These data confirm a link between amosite asbestos and respiratory malignancy as well as mesothelioma.
Epidemiology of sick building syndrome and its associated risk factors in Singapore.
Authors: Ooi P L , Goh K T , Phoon M H , Foo S C , Yap H M
Published: January 2009

OBJECTIVES: To investigate the occurrence of sick building syndrome in a tropical city, and its relation to indoor air quality and other factors. METHODS: 2856 office workers in 56 randomly selected public and private sector buildings were surveyed. The study consisted of a self administered questionnaire assessing symptoms and perception of the physical and psychosocial environment, inspection of the building plans and premises, and measurement of temperature, relative humidity, respirable particles, chemicals, bioaerosols, and other variables. RESULTS: Symptoms typical of the sick building syndrome were reported in 19.6% of the respondents. Multivariate modelling substantiated contributions associated with low thermal comfort, high work related stress, too much noise, a history of allergy or other medical conditions, poor lighting, young employees, and female sex. Measurements of indoor air quality or ventilation were not found to be reliable predictors of the symptoms. CONCLUSION: The survey confirmed the presence of sick building syndrome and its risk factors in the tropics. A biopsychosocial approach to the problem involving symptomatic treatment, environmental control, good ergonomic design, and stress management is recommended.
Use of a crop and job specific exposure matrix for retrospective assessment of long-term exposure in studies of chronic neurotoxic effects of agrichemicals.
Authors: London L , Myers J E
Published: January 2009

RATIONALE: Job exposure matrices (JEMs) are widely used in occupational epidemiology, particularly when biological or environmental monitoring data are scanty. However, as with most exposure estimates, JEMs may be vulnerable to misclassification. OBJECTIVES: To estimate the long term exposure of farm workers based on a JEM developed for use in a study of the neurotoxic effects of organophosphates and to evaluate the repeatability and validity of the JEM. METHODS: A JEM was constructed with secondary data from industry and expert opinion of the estimate of agrichemical exposure within every possible job activity in the JEM to weight job days for exposure to organophosphates. Cumulative lifetime and average intensity exposure of organophosphate exposure were calculated for 163 pesticide applicators and 84 controls. Repeat questionnaires were given to 29 participants three months later to test repeatability of measurements. The ability of JEM based exposure to predict a known marker of organophosphate exposure was used to validate the JEM. RESULTS: Cumulative lifetime exposure as measured in kg organophosphate exposure, was significantly associated with erythrocyte cholinesterase concentrations (partial r2 = 5%; p < 0.01), controlled for a range of confounders. Repeatability in a subsample of 29 workers of the estimates of cumulative (Pearson's r = 0.67; 95% confidence interval (95% CI) 0.41 to 0.83), and average lifetime intensity of exposure (Pearson's r = 0.60 95% CI 0.31 to 0.79) was adequate. CONCLUSION: The JEM seems promising for farming settings, particularly in developing countries where data on chemical application and biological monitoring are unavailable.
Role of human neurobehavioural tests in regulatory activity on chemicals.
Authors: Stephens R , Barker P
Published: January 2009

Psychological performance tests have been used since the mid-1960s in occupational and environmental health toxicology. The interpretation of significantly different test scores in neurobehavioural studies is not straightforward in the regulation of chemicals. This paper sets out some issues which emerged from discussions at an international workshop, organised by the United Kingdom Health and Safety Executive (HSE), to discuss differences in interpretation of human neurobehavioural test data in regulatory risk assessments. The difficulties encountered by regulators confronted with neurobehavioural studies seem to be twofold; some studies lack scientific rigor; other studies, although scientifically sound, are problematic because it is not clear what interpretation to place on the results. Issues relating to each of these points are discussed. Next, scenarios within which to consider the outcomes of neurobehavioural studies are presented. Finally, conclusions and recommendations for further work are put forward.
Work shift duration: a review comparing eight hour and 12 hour shift systems.
Authors: Smith L , Folkard S , Tucker P , Macdonald I
Published: January 2009

OBJECTIVES: Shiftwork is now a major feature of working life across a broad range of industries. The features of the shift systems operated can impact on the wellbeing, performance, and sleep of shiftworkers. This paper reviews the current state of knowledge on one major characteristic of shift rotas-namely, shift duration. Evidence comparing the relative effects of eight hour and 12 hour shifts on fatigue and job performance, safety, sleep, and physical and psychological health are considered. At the organisational level, factors such as the mode of system implementation, attitudes towards shift rotas, sickness absence and turnover, overtime, and moonlighting are discussed. METHODS: Manual and electronic searches of the shiftwork research literature were conducted to obtain information on comparisons between eight hour and 12 hour shifts. RESULTS: The research findings are largely equivocal. The bulk of the evidence suggests few differences between eight and 12 hour shifts in the way they affect people. There may even be advantages to 12 hour shifts in terms of lower stress levels, better physical and psychological wellbeing, improved durations and quality of off duty sleep as well as improvements in family relations. On the negative side, the main concerns are fatigue and safety. It is noted that a 12 hour shift does not equate with being active for only 12 hours. CONCLUSIONS: There can be considerable extension of the person's time awake either side of the shift. However, the effects of longer term exposure to extended work days have been relatively uncharted in any systematic way. Longitudinal comparative research into the chronic impact of the compressed working week is needed.
Mortality from cancer and other causes of death among synthetic rubber workers.
Authors: Sathiakumar N , Delzell E , Hovinga M , Macaluso M , Julian J A , Larson R , Cole P , Muir D C
Published: January 2009

OBJECTIVES: This study evaluated the mortality experience of workers from the styrene-butadiene rubber industry. Concerns about a possible association of 1,3-butadiene and styrene with lymphohaematopoietic, gastrointestinal, and lung cancers prompted the investigation. METHODS: A retrospective follow up study was conducted of 15,649 men employed for at least one year at any of eight North American styrene-butadiene rubber plants. Analyses used standardised mortality ratios (SMRs) to compare styrene-butadiene rubber workers' cause specific mortalities (1943-91) with those of the United States and Ontario general populations. RESULTS: On average, there were 25 years of follow up per subject. The standardised mortality ratio (SMR) was 87 (95% confidence interval (95% CI) 85 to 90) for all causes of death combined and was 93 (95% CI 87 to 99) for all cancers. There was an excess of leukaemia (SMR 131, 95% CI 97 to 174), restricted to hourly workers (SMR 143, 95% CI 104 to 191). For causes of death other than leukaemia, SMRs were close to or below the null value of 100. Results by work area (process group) were unremarkable for non-Hodgkin's lymphoma, multiple myeloma, and stomach cancer. Maintenance workers had a slight increase in deaths from lung cancer, and certain subgroups of workers had more than expected deaths from cancer of the large intestine and the larynx. CONCLUSION: This study found an excess of leukaemia that is likely to be due to exposure to butadiene or to butadiene plus other chemicals. Deaths from non-Hodgkin's lymphoma, multiple myeloma, and stomach cancer did not seem to be related to occupational exposure. The excess deaths from lung cancer among maintenance workers may be due in part to confounding by smoking, which was not controlled for, and in part to an unidentified occupational exposure other than butadiene or styrene. Increases in cancer of the large intestine and larynx were based on small numbers, did not seem to be due to exposure to butadiene or styrene, and may be chance observations.
Silica, compensated silicosis, and lung cancer in Western Australian goldminers.
Authors: de Klerk N H , Musk A W
Published: January 2009

OBJECTIVES: Silica has recently been reclassified as carcinogenic to humans based largely on the observed increase in rates of lung cancer in subjects with silicosis. Other recent reviews have arrived at different conclusions as to whether silicosis or silica itself is carcinogenic. This study aims to examine exposure-response relations between exposure to silica and subsequent silicosis and lung cancer in a cohort of goldminers. METHODS: 2,297 goldminers from Kalgoorlie in Western Australia were examined in 1961, 1974, and 1975. Data were collected on respiratory symptoms, smoking habits, and employment history. Subjects were followed up to the end of 1993. Survival analyses for lung cancer mortality and incidence of compensated silicosis were performed with age and year matched conditional logistic regression analyses. RESULTS: 89% of the cohort were traced to the end of 1993. 84% of the men had smoked at some time and 66% were current smokers. 1386 deaths occurred during the follow up period, 138 from lung cancer, and 631 subjects were compensated for silicosis. A strong effect of smoking on mortality from lung cancer, and a smaller effect on the incidence of compensated silicosis was found. There was a strong effect of duration and intensity of exposure on the incidence of silicosis. The risk of mortality from lung cancer increased after compensation for silicosis. Of all direct measures of exposure to silica, only log cumulative exposure was significantly related to incidence of lung cancer, but this effect disappeared once the onset of silicosis was taken into account. CONCLUSIONS: The incidence of silicosis was clearly related to exposure to silica and the onset of silicosis conferred a significant increase in risk for subsequent lung cancer, but there was no evidence that exposure to silica caused lung cancer in the absence of silicosis.