bluuebunny/crossref_metadata_2025 huggingface dataset:
P.1.25 The effect of variations air pollution concentration on ischemic stroke
Authors: Lin Gwan-Ling , Wu Wei-Te , Liou Saou-Hsing , Wu Trong-Neng
Published: May 2020

Background

Stroke is the third most common cause of death in Taiwan. However, the reasonable range in time scale of air pollution concentration for inducing ischemic stroke has not been clear. Therefore, the purpose of the study was to examine the effect of time scale air pollution concentration and stroke risk.

Methods

We recruited 256 ischemic stroke patients in emergency department and 98 healthy controls from a Taiwan Medical Center between 2012 and 2013. The subjects were interviewed in person and completed the demographic, disease history questionnaires. Each participant provided blood samples for metal and oxidative stress measurements. We used the geographic information system (GIS) and the Inverse distance weighting (IDW) model to estimate the concentrations of air pollutants (PM2.5, PM10, SO2, NO2, CO, O3) at home address from 75 monitoring stations in Taiwan at different time scales (1 day, 2 days, 3 days, 7 days, 14 days, 1 month, 7 months, 1 year) before blood drawing. Logistic regression models were performed to estimate the odds ratio (OR) for stroke risk.

Results

The interquartile range (IQR) PM2.5 concentrations were 17.5, 16.3, 14.5, 14.4, 12.0, 9.2, 6.6, and 1.9 µg/m3 respectively, for different time scales within 1 day, 2 days, 3 days, 7 days, 14 days, 1 month, 7 months, 1 year period before stroke onset. We found that the 7 days, 14 days, 1 month PM2.5 concentrations were significantly increased risk of stroke, after adjustment for smoking, environmental tobacco smoke, ever stroke, family history of stroke, hypertension, hyperlipidemia, type 2 diabetes, heart disease history, temperature, and relative humidity. The results also showed that elevated stroke risks with 2 days, 3 days, 7 days, 14 days, 1 month PM10, and with 7 days, 14 days, and 1 month O3.
P.2.07 Times of sick leave due to temporary disability related to a non-work-related illness and re-adaptation to work
Authors: Dias Adriano , Bernardes João Marcos , Gomez-Salgado Juan , Ruiz-Frutos Carlos
Published: May 2020

Objective

To evaluate if the times of sick leave due to temporary disability related to a non-work-related illness (NWRI) depends on whether or not the workers have required a vocational rehabilitation.

Method

Historical cohort study of university workers in São Paulo, Brazil, between 2010 and 2015. Data were obtained from work institutional databases that recorded personal, occupation, physician’s examination and vocational rehabilitation data. The Charlson Comorbidity Index was obtained from medical history according to the most prevalent diagnoses in each physician’s assessment report and respective sick leave episode duration. Associations between variables were analyzed by simple and multiple Cox regression models.

Results

Depressive disorders, convalescences and back pain were responsible for 70% of all sick leaves due to non-work-related conditions that caused temporary disability. Follow-up time was decreased when the number of NWRI per worker increases, follow-up times until readaptation between 4 and 320 days and great variability within the same disease. The CCI weight was of 0 in 96.2% of sick leaves. In the Cox model, the number of physician’s examinations (HR=0.96), non-insulin-dependent diabetes mellitus (HR=0.40) and primary essential hypertension (HR=0.29) were found to be significant protective factor for sick leave duration until vocational rehabilitation. Recurrent depressive disorders (HR=1.5), conjunctivitis (HR=2.78), acute sinusitis (HR=4.99), skin conditions (HR=3, 80), back pain (HR=1.62), kidney and ureter calculus (HR=2.31), pelvic abdominal pain (HR=2.33) and falls at the same level (HR=3.71) were risk factors to longer sick leave duration until vocational rehabilitation.

Conclusion

When there was more medical assessment during the period of sick leave the times were reduced and some diseases such as upper airways, eyes and skin, pain and depression require longer times until vocational rehabilitation.
P.2.15 Exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin and mortality at a trichlorophenol plant in new zealand
Authors: Mcbride David , Collins James , Bender Thomas , Bodner Kenneth , Aylward Lesa
Published: May 2020

Objectives

To describe how 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) exposure influenced mortality in a cohort of workers exposed more recently, and at lower levels, than other cohorts of trichlorophenol process workers.

Methods

A cohort study of 1599 men and women working between January 1, 1969 and November 1, 1988 at a plant producing the herbicide 2,4,5-trichlorophenoxyacetic acid (2,4,5 T) with TCDD as a contaminant.

A toxicokinetic model developed in a previous follow up was updated to estimate cumulative TCDD exposure for each individual in the study. Calculation of cause-specific standardized mortality ratios (SMRs) and 95% confidence intervals (95%CIs) compared those never and ever exposed to TCDD. Dose-response trends were assessed firstly through SMRs stratified in quartiles of cumulative TCCD exposure, and secondly with a proportional hazards model.

Results

The toxicokinetic model intercept of 5.1 parts per trillion (ppt) of TCDD was consistent with background New Zealand TCDD concentrations among older members of the population. Exposed workers had non-significant increases in all cancer deaths SMR=1.08, 95% CI 0.86–1.34, deaths from soft tissue sarcoma, SMR=2.38, 95% CI: 0.06–13.26, non-Hodgkin lymphoma, SMR=1.57, 95% CI: 0.32–4.59, diabetes, SMR=1.27, 95% CI: 0.55–2.50 and ischaemic heart disease, SMR=1.21, 95% CI: 0.96–1.50. Lung cancer deaths SMR=0.95, 95% CI: 0.56–1.53, were fewer than expected. Neither the stratified SMR nor proportional hazard analysis showed a dose response relationship.

Conclusion

We found neither an excess of all cancers, or any specific cancer, nor a trend with TCDD exposure. This argues against the carcinogenicity of TCDD at lower levels of exposure.
P.2.16 Health and productivity: a five year study (2010–14) in a large automobile industry in india
Authors: Sukumar Gautham , Kupatira Kowshik , Banandur Pradeep , Gururaj G
Published: May 2020

Introduction

This ‘Health and productivity’ project was implemented to identify priority health problems and health related productivity loss in a large automobile industry in India. It hopes to re-emphasize that ‘OH department’ is a partner in productivity.

Objectives

To estimate prevalence, incidence rates , trends and risk for health problems among employees (year 2010–14)

To identify leading causes of hospitalization and out–patient care among employees (year 2010–14).

To quantify loss in productive work time attributed to health related absence in year 2014 and forecast to year 2025

Methods

A five year records analysis (2010–14) was conducted in a leading automobile industry in year 2015–16. Data was pooled from clinic visit records, annual medical examination , insurance claims and leave records, systematically using employee ID. Trends and incidence rates of leading health risks were computed per 1000 person-months of employment. Leading causes and trends in out-patient and in-patient care of employees were determined. Total work time (man-hours) was computed and health related loss in work-time was derived. Cox-regression was used to assess risk between work department and morbidity. ARIMA method was used to forecast productivity loss till year 2025.

Results

Between 2010–14, overweight and hypertension were identified as leading health risks. Respiratory, musculoskeletal and digestive disorders were leading causes for clinic visits. Infectious diseases are leading cause for hospitalization. Health related absence accounted for 1.87% of total productive time. Forecasting indicates an increase to 9.31% by year 2025.

Conclusion

Health related absence contributes to significant loss in productive work-time. There is scope to reduce these losses by improvement in health situation. Our study provided key information and trends for planning evidence based health promotion programmes in the industry.
P.2.32 Change in employment status in survivors with occupational cancers
Authors: Wang Chung-ching , Chen Wei-liang , Wu Wei-Te , Saou-Hsing LIOU
Published: May 2020

Background

The aim of this study is to investigate the socio-demographic information and employment status for 2 years after diagnosis with occupational cancers.

Method

In the Labor Registry Cohort of Taiwan during the period 2004–2015, 86 workers diagnosed with occupational cancers were identified. The cancer group included all kind of cancer diagnosed during this period. The cancer diagnoses were recorded according to the International Classification of Diseases for Oncology. Sex, age, industrial classifications, and occupational status were registered for the year 2004. The person’s annual wage and salary income was registered in New Taiwan Dollar (NTD) and divided into tertiles of 16500–22800, 24000–40100, and 42000–43 900.

Results

There were 86 eligible workers with occupational cancers in our cohort study. All eligible participants were categorized into 2 groups based on their work status. There were 61 unemployed survivors with mean age of 53.05±8.3 and 25 employed survivors with mean age of 46.2±9.2 (table 1). Employed survivors had younger age and lower salary income than unemployed survivors. At 2 year of follow-up (figure 1), there was substantial declined trend for employment percentage (from 100% to 29%). For change of salary income, increased percentage of salary income change was observed. In different age groups (figure 2), young group aged 28–45 years had significantly higher employment percentages than older groups aged 46–55 years and 56–71 years. Notably, there were elevated percentage of salary income change in older group aged 56–71 years.

Conclusion

Our study highlighted that the workers with occupational cancers had apparent dilemmas in the workplace 2 years after diagnosis.
P.3.03 Low back pain and manual patient handling among healthcare workers: a cross-sectional study
Authors: Dias Adriano , Bernardes João Marcos
Published: May 2020

This cross-sectional study investigated the prevalence of low back pain and analyzed whether manual patient handling activities (MPH) were related to low back pain (LBP) 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%. 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 history of low back pain. The association between MPH 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 (83.8%), the mean age was 39.93 years (range 21 - 66, SD 9.78). Of those participating in the study, the majority were nursing technicians (71.3%), 19.4% were nurses, 5.3% were nurse assistants, 2.2% were physical therapists and 1.9% were radiography technicians. The 3-month period prevalence of LBP was 57.8% (95% CI 52.3%-63.2%). In the multiple Poisson regression model, MPH (PR 1.444, 95% CI 1.169-1.783) was significantly associated with LBP, even when adjusted for other known predictive factors. Thus, preventive initiatives for low back pain among healthcare workers must focus on limiting manual patient handling and include the use of proper mechanical patient handling equipment and training on the use of these equipment.
P.3.07 Prognosis and quality of life in workers with occupational upper limb injury
Authors: Chu Po-Ching , Hsieh Ching-Lin , Guo Yue Leon
Published: May 2020

Objectives

Because literatures about health impact of occupational upper limb injury in injured workers are rare, the study aimed to investigate effects of the injury on workers’ prognosis and health-related quality of life.

Methods

This was a cross-sectional study of 206 workers with occupational upper limb injury recruited from two teaching hospitals. Their sociodemographic factors, work-related factors, disease severity, return to work status, psychological symptoms, and quality of life were assessed by questionnaire interview at 2 years after injury.

Results

The study found that the majority of injured workers were middle-aged (44.0±12.2 years) and men (58.3%). There were 36.3% workers did not return to work at 2 year post-injury. The average EQ-5D was 0.81(ranged from 0 to 1), and the psychological symptoms using 5-item Brief Symptom Rating Scale was 4.19(ranged from 0 to 20). The multivariable linear regression showed that high educated injured workers had poorer quality of life (β=−0.218, p=0.003) and more psychological symptoms (β=6.35, p=0.001) than those with low education. In addition, workers with longer duration (months) of return to work had better quality of life (β=0.0013, p=0.029) and lesser psychological symptoms (β=−0.05, p=0.002), and the workers’ compensation scheme may explain the inconsistent with previous studies, and further exploration for other reasons was warranted.

Conclusions

The health impact of occupational upper limb injury are multiple aspects, including psychological, return to work, and quality of life. Further studies with longitudinal follow-up are needed to further elucidate their associated risk factors in different stages post-injury, which could be useful for prevention of workers’ long-term disability.
P.3.16 The associations between psychosocial work conditions and work sustainability: findings from a national survey of working people in taiwan
Authors: Li Yi-Jing , Liu Hsi-Chen , Cheng Yawen
Published: May 2020

Background

One of the aspects of work sustainability concerns workers’ intention to stay at the current job until retirement age. While psychosocial work conditions are expected to influence workers’ intention to stay, its distributions across occupations and the associations with psychosocial work factors have not been well understood.

Methods

We analyzed data from a national survey conducted in 2010, consisting of 11 209 male and 8189 female workers aged between 25 to 55 years old. Intention to stay at the current job was assessed by a single question: ‘Thinking of your health status, would you expect yourself to stay at the current job at age of 60 years old?’. Responses were coded as ‘probably yes’, ‘probably not’, ‘not sure’ and ‘not willing’. We regrouped ‘probably not’ and ‘not willing’ as ‘no intention’. Information concerning age, educational attainment, occupation type and psychosocial work factors were also assessed by the questionnaire.

Results

Descriptive analyses showed that 14.2% and 17.1% of male and female workers did not intend to stay the current job at the age of 60 years old. Lack of intention was more prevalent in younger workers, workers with lower employment grade and workers in certain industrial sectors including electronics manufacturing industries for both genders and health care industry for female workers. Workers in these industries were also significantly younger than those in other industries. Findings from multivariate logistic regression models indicated that lack of intention to stay was associated with nonstandard work shift, higher psychosocial demands, physically demanding work, lower job control and higher job insecurity.

Conclusion

A substantial proportion of workers lack of intention to stay at the current job until old age. We suggest that improving work conditions may help to keep workers in employment until old age, especially among workers in socioeconomic lower positions.
P.3.18 Association between nightshift schedule and mental health symptoms among factory workers: a cross-sectional study
Authors: Lu Sophia Francesca
Published: May 2020

Introduction

Nightshift is one of the major issues in work-time schedule. The association between working at night and the occurrence of mental health symptoms has been a subject of considerable debate. This study aimed to look at the association between working at night and mental health symptoms, and mediating factors to this association.

Methods

This study looked at a database of 500 factory workers that originally investigated hazard exposures and occupational health of workers in export processing zones in the Philippines. Associations between shift schedule and probable confounders with frequency of occurrence of mental health symptoms were studied using chi-square test of association. Multiple logistic regression was used to analyze the overall association.

Results

The study showed that work schedule, work load and occurrence of mental health symptoms are associated with night schedule. The crude odds ratio for the association between shift schedule and frequency of occurrence of mental health symptoms is 2.13 (0.77–5.81). This means that without adjusting for confounders, those who work in the evening are 2.13 times more likely to have frequent occurrence of mental health symptoms as compared to those who work in the morning. Specifically, among females, those who work at night are 2.97 times more likely to have frequent occurrences of mental health symptoms compared to those who work in the morning. Controlling for age, sex, educational attainment, tenure, work load, and exposure to occupational hazards, those who are working at night are 2.13 (0.79–5.71) times more likely to have frequent episodes of mental health symptoms compared to those who work in the morning. Those who are frequently exposed to occupational hazards are 5.78 (1.17–28.71) times more likely to have frequent mental health symptoms.

Conclusion

The study has shown that among Filipino factory workers, nightshift work is associated with mental health symptoms.
P.3.30 Understanding the impact of psychiatric morbidity on employment and benefit changes: a data linkage project
Authors: Stevelink Sharon , Fear Nicola , Hotopf Matthew
Published: May 2020

In the UK the largest cause of long term occupational disability is mental disorders. Closing the disability employment gap has become a focus for recent UK government social policy initiatives, as those being disabled are 32% less likely to be in employment compared to non-disabled people. Long-term sickness absence is associated with social exclusion, poorer health outcomes and increased mortality. Despite the extensive costs to society and the large number of people adversely affected by this issue, surprisingly little is known about the underlying health reasons for the receipt of benefits and the effectiveness of interventions to support people’s return to work. We will describe a novel study that will accelerate our understanding about the dynamics between welfare, benefits and occupational needs of patients presenting with a mental health disorder. This will be done by linking and analysing the Department for Work and Pension data with the South London Maudsley mental health electronic data resulting in the largest clinical cohort of adults (n=380,000) referred to psychiatric services in the UK. The challenges and opportunities accompanying a data linkage project on such a substantial scale will be explored, a description of the linked data will be given and an overview of work currently being conducted.
O1E.3 Evaluation of the norwegian agreement on a more inclusive working life: sickness absence in individuals with musculoskeletal and psychological diagnoses
Authors: Hasting Rachel L , Hanvold Therese N , Merkus Suzanne L , Kristensen Petter , Mehlum Ingrid S
Published: May 2020

Objectives

The Norwegian Agreement on a More Inclusive Working Life (the IW Agreement) was introduced in 2001 amid efforts to reduce sickness absence (SA) and increase work participation. Little research has been done on the effects of this agreement. The study’s aim was to compare SA before and after introduction of the IW Agreement.

Methods

Data from several national registries involving 115,119 individuals born in Norway 1967–1976 was used. Individuals were classified using ICPC-2 codes into musculoskeletal (code L) and mental health (code P) diagnosis groups. A difference-in-differences method using logistic regression was used to compare the difference in one year risk of SA lasting >16 days in individuals working in IW companies relative to non-IW companies in 2000 and 2005. Analyses were adjusted for age, gender, and industry. Standard errors were clustered at the individual level and average marginal effects were calculated with 95% confidence intervals. Gender and industry specific models were also estimated.

Results

There was no significant association between the IW Agreement and risk of SA in the overall musculoskeletal diagnosis group (-0.4 percentage points (PP), CI -0.9,0.1), but women had significantly lower risk of SA (-0.8 PP, CI -1.5,-0.1). There was no association between the IW Agreement and risk of SA in the mental health diagnosis group (overall: 0.0 PP, CI -0.3,0.3). Significant associations were found in the electricity (males: 5.2 PP, CI 0.4,10.0) and wholesale/retail sectors (females: -4.9 PP, CI -8.9,-1.0) for musculoskeletal diagnoses, and in the financial/real estate sector (overall: 1.6 PP, CI 0.2,2.9, females: 3.1 PP, CI 0.2,5.9) for mental health diagnoses.

Conclusions

Women in companies with an IW Agreement had a significant reduction in one year risk of SA for musculoskeletal diagnoses. Gender and industry may modify the association between the IW Agreement and SA in musculoskeletal and mental health diagnoses.
K-03 A global disease but a local phenomenom
Authors: Benschop Jackie
Published: May 2020

Leptospirosis is a globally important multi-host, multi-pathogen zoonosis with over 1 million cases and 60,000 deaths annually. Humans are infected through contact with urine from infected mammals including wildlife, rodents, farmed species and pets. Despite extensive nationwide intervention measures, leptospirosis remains an unacceptable burden on New Zealanders particularly those living in rural communities and on Māori. Famers and meat-workers remain most at risk and key intervention strategies for these occupations are the use of personal protective equipment (PPE) and animal vaccination. I will present our work on leptospirosis at the human-animal interface with focus on meat-workers who are required to use PPE yet have no say in the vaccination status of animals they are exposed to.
O1E.5 Short-term disability leave and employment termination: using marginal structural models to estimate counterfactual risks
Authors: Picciotto Sally , Neophytou Andreas , Cullen Mark , Eisen Ellen
Published: May 2020

Introduction

Short-term disability leave can be considered as a measure of not being well enough to work. The American Manufacturing Cohort, followed 1996–2013, consists of employees of a light-metal company that provided short-term disability insurance to all employees: coverage to replace wages for up to 6 months of work absence due to medical issues. We hypothesized that since brief short-term disability leave allows workers time to recover from illness or injury without losing their jobs, it should be protective against employment termination.

Methods

We analyzed 18 386 (83% male, 80% white) hourly employees. We censored workers once their accumulated disability leave exceeded 6 weeks because longer time spent on short-term disability leave suggests more serious illness or injury that may prevent return to work. To analyze the effect of short-term disability leave on employment termination, we applied a marginal structural pooled logistic model that allowed for a time-varying hazard function. We adjusted for time-varying confounding by occupational exposures and health-related variables using inverse probability weighting. Using the estimated coefficients, we compared the predicted probabilities (by person-month) of terminating employment with the corresponding counterfactual probabilities if the worker had never taken disability leave. These probabilities yielded estimated survival curves under the two scenarios.

Results

The average worker was followed for 5.5 years. Approximately 42% of the workers took at least one day of disability leave, and 48% terminated employment during follow-up. We estimated that 1058 (29%) more workers would have terminated employment within 5 years from cohort entry if the company had had no disability leave benefit than were predicted under the natural course.

Conclusion

Short-term disability leave is a potentially relevant health variable for occupational epidemiologists. This analysis suggests that short-term disability leave can help employees retain their jobs when a temporary health issue prevents them from working.
O2C.6 The economic burden of occupational injuries and diseases in five european union countries
Authors: Tompa Emile , Mofidi Amirabbas , Jung Young , Bree Thijmen van , Heuvel Swenneke van den , Michaelsen Frithjof , Porsch Lucas , Emmerik Martijn van
Published: May 2020

The objective of this study was to estimate the economic burden of occupational injuries and diseases in five European Union countries for the reference year 2015.

We used a ‘bottom up’ approach to estimate the economic burden from a societal perspective for Finland, Germany, Italy, The Netherlands, and Poland. Three broad cost categories were considered—direct health care, indirect productivity, and intangible health-related quality of life costs. The methods started with data on newly diagnosed occupational injuries and diseases from calendar year 2015. We considered lifetime costs for cases across all cost categories. Sensitivity analysis was undertaken to assess the impact of key parameters.

Indirect costs represent the largest proportion of total costs (with the exception is Poland), ranging from 66% for The Netherland to 43% for Poland. Intangible costs are the second highest, ranging from 49% for Poland to 21% for Finland and The Netherlands. Direct costs range from 16% for Finland to 8% for Poland.

Average per case costing is highest for The Netherlands (€75,342), followed by Italy (€58,411), German (€44,919), Finland (€43,069) and lastly Poland (€38,918). Total costs as a percentage of GDP are highest for Poland (10.4%), followed by Italy (6.7%), The Netherlands (3.6%), Germany (3.3%) and lastly Finland (2.7%). In terms of costs per working population, the value is highest for Italy (€4,956), followed by The Netherland (€2,930), Poland (€2,793), Germany (€2,527) and lastly Finland (€2,331).

The economic burden of occupational injuries and diseases in the countries considered are substantial, despite efforts to reduce adverse workplace exposures. Our case costs and total economic burden estimates provide a basis for undertaking economic evaluations of prevention efforts and can serve as a template for monitoring and evaluation at the country level. We advance the methods on several fronts.
O2D.3 Protective effects of PPE use and good workplace hygiene practices against symptoms of neurotoxicity in collision repair workers
Authors: Keer Samuel , McLean Dave , Glass Bill , Taptiklis Phoebe , McGlothlin James , Douwes Jeroen
Published: May 2020

Objectives

We have recently shown that solvent-exposed collision repair workers (spray painters and panel beaters) in New Zealand are at an increased risk of both self-reported and objectively assessed neurobehavioural effects, indicating a need for more effective exposure controls. This study assessed the association between personal protective equipment (PPE) use and workplace hygiene and symptoms of neurotoxicity in vehicle spray painters.

Methods

Exposure controls including PPE-use and workplace hygiene practices and symptoms of neurotoxicity were assessed in 267 vehicle repair spray painters. Symptoms were assessed using the EUROQUEST questionnaire.

Results

Frequent respirator and glove use was inversely associated with symptoms of neurotoxicity in a dose-dependent manner (p<0.05 for trend). The strongest protective effect was found for consistent glove use (OR 0.1and 0.2, p<0.01, for reporting ≥10 and≥5 symptoms, respectively). A dose-response trend (p<0.05) was also observed when combining frequency of respirator and glove use, with an overall reduction in risk of 90% (OR 0.1 for reporting ≥10 and≥5 symptoms, p<0.01) for those who consistently used both. Protective effects were most pronounced for psychosomatic (p<0.05 for trend, for combined PPE use), mood (p<0.05) and memory and concentration symptoms combined (p<0.05), with reductions in risk of >80%. Poor hygiene workplace practices, e.g. solvent exposure to multiple body parts were associated with an increased risk of symptoms, but this was not statistically significant. When using a general workplace hygiene score derived from a combination of PPE-use and (good) workplace hygiene an inverse dose-response trend was observed for reporting ≥5 (p<0.01) and ≥10 symptoms (p<0.01).

Conclusions

This study has shown that PPE-use and good workplace hygiene are associated with a strongly reduced risk of symptoms of neurotoxicity in solvent-exposed vehicle spray painters. Glove use was most protective, suggesting dermal exposures may be of particular importance in the development of symptoms.
O2E.4 Evaluation of exposure assessment methods in epidemiological studies: the welding example
Authors: Peters Susan , Lavoue Jerome , Baker Marissa , Kromhout Hans
Published: May 2020

Exposure assessment quality is a fundamental consideration in the design and evaluation of observational studies. High quality exposure assessment is particularly relevant for outcomes with long latency, such as cancer, where detailed information on past exposures are often missing and must therefore be estimated.

For the IARC Monograph on welding, the exposure group provided an overview of assessment methods used in the key epidemiological studies. Strengths and weaknesses of each study were assessed, along with their potential effects on interpretation of risk estimates.

For the association between lung cancer and welding fume exposure, 9 cohort and 10 case-control studies were reviewed. For ocular melanoma and ultraviolet radiation (UVR) from welding, 7 case-control studies were reviewed. Quality criteria were: full occupational histories, and standardized, blinded and quantitative exposure assessment. Additional criteria for lung cancer: specifically assessing welding fumes and using information on welding tasks. For ocular melanoma: assessing artificial and solar radiation separately, taking into account eye burns, eye protection and welding type.

Exposure assessment of welding fumes by applying a ‘welding-exposure matrix’ (n=2) or welding-specific questionnaires (n=3) were considered highest quality, followed by case-by-case expert assessment (n=5) or general job-exposure matrices (JEMs, n=4). Job title alone was considered less informative (n=5). For exposure to UVR, JEMs were most informative (n=2), followed by self-reported eye burns and self-reported exposure from specific welding types (n=2), although caution is advised regarding recall bias. Assessing welding fume exposure or ever exposure to welding arcs as proxy for UVR was considered less informative. For both exposures, ever versus never welder, or assessments based on data collected from proxies, were considered least informative.

The overall evaluation was that there is sufficient evidence in humans for the carcinogenicity of welding fumes and ultraviolet radiation from welding.
O3B.6 The economic burden of work-related asbestos exposure
Authors: Tompa Emile , Kalcevich Christina , McLeod Christopher , Lebeau Martin , Song Chaojie , Kim Joanne , Demers Paul
Published: May 2020

The objective of this study was to estimate the economic burden of lung cancer and mesothelioma due to occupational and paraoccupational asbestos exposure in Canada.

We estimated the lifetime cost of newly diagnosed lung cancer and mesothelioma cases associated with occupational and para-occupational asbestos exposure for calendar year 2011 based on the societal perspective. The key cost components considered were healthcare costs, productivity and output costs, and quality of life costs.

There were 427 cases of newly diagnosed mesothelioma cases and 1904 lung cancer cases attributable to asbestos exposure in our reference year—calendar year 2011—for a total of 2331 cases. Our estimate of the economic burden is $C831 million in direct and indirect costs for newly identified cases of mesothelioma and lung cancer and $C1.5 billion in quality of life costs based on a value of $C100,000 per quality-adjusted life year. This amounts to $C356,429 and $C652,369 per case, respectively.

The economic burden of lung cancer and mesothelioma associated with occupational and para-occupational asbestos exposure is substantial. The estimate identified is for 2331 newly diagnosed, occupational and para-occupational exposure cases in 2011, so it is only a portion of the burden of existing cases in that year. Our findings provide important information for policy decision makers for priority setting, in particular the merits of banning the mining of asbestos and use of products containing asbestos in countries where they are still allowed and also the merits of asbestos removal in older buildings with asbestos insulation.
O1A.2 Exposure to benzimidazole fungicides in agriculture and non-hodgkin lymphomas, overall and by subtypes, in the AGRIculture and CANcer (AGRICAN) cohort
Authors: Busson Amandine , Tual Séverine , Boulanger Mathilde , Renier Marine , Pons Romain , Piel Clément , Pouchieu Camille , Lecluse Yannick , Perrier Stéphanie , Levêque-Morlais Noémie , AGRICAN- GROUP , Guizard Anne-Valérie , Monnereau Alain , Baldi Isabelle , Lebailly Pierre
Published: May 2020

Purpose

Increased risks of Non-Hodgkin’s Lymphomas (NHLs) have been reported among farmers in several meta-analyses, with exposure to pesticides as the main explanation. Few studies investigated associations by NHL subtypes and considering specific pesticides. From the French agricultural cohort AGRICAN, we assessed the role of benzimidazole fungicides use on NHL risk, overall and for multiple myeloma (MM), Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma (CLL-SLL) and Diffuse Large B-cell Lymphoma (DLBCL).

Methods

Nearly 1 82 000 participants affiliated in a health assurance system reported in the enrollment questionnaire (2005–2007) lifetime pesticide use with start and end year on 13 crops and were followed until 2013. Using the crop-exposure matrix PESTIMAT, associations between NHLs and benzimidazole fungicides exposure (overall and for benomyl, carbendazim, fenzaflore, thiabendazole and thiophanate methyl) were estimated using Cox models.

Results

After exclusion of prevalent cases, individuals with incomplete agricultural profession history data or a zero tracking period, 1,133 NHL incident cases were identified from cancer registries (269 MM, 244 CLL-SLL, 190 DLBCL). Nearly 20% of participants were considered exposed (median duration from 7 to 20 years according to active ingredient). Increased NHL risk was observed with exposure to benzimidazole, overall, on any crops (NHL: HR=1.13, 95%CI=0.94–1.37, 150 cases, no duration relationship). Moreover, borderline positive associations were reported on specific crops: wheat/barley (NHL: HR=1.23, CLL-SLL: HR=1.42), beets (DLBCL, HR=2.19) and rape (DLBCL, 2.32). Significant increased risks were reported with MM for use of thiophanate-methyl on wheat/barley (HR=3.46, 23 exposed cases, no duration relationship) and with DLBCL for all 4 benzimidazole used on beets (HR from 2.34 to 2.57 and for the 2 used on rape (HR=2.39 and 2.46), although based on respectively 7 and 6 cases.

Conclusion

These findings suggest positive associations between incidence of specific NHL subtypes, and exposure to benzimidazole as a chemical family or specific ingredients in this family.
O3D.1 Omega-net inventory of occupational cohorts
Authors: Turner Michelle C , Schlünssen Vivi , Castano-Vinyals Gemma , Godderis Lode , Sim Malcolm , Mehlum Ingrid Sivesind , Kogevinas Manolis
Published: May 2020

Europe currently has some of the most valuable occupational, industrial, and population cohorts worldwide. However, in recent years there has been limited coordination and promotion of European health research on occupation and employment. OMEGA-NET is a COST Action (2017–2021) funded by the EU, currently involving researchers from 29 European countries and an increasing number of near neighbour and international partner countries. The overarching concept is to create a network to advance i) collaboration of existing cohorts, ii) coordination and harmonisation of exposure assessment, and iii) facilitation of an integrated research strategy for occupational health in Europe. As part of this work, OMEGA-NET is currently building an online searchable ‘Inventory of Occupational Cohorts’. We will inventory epidemiological, occupational, population, and registry-based cohorts with data on occupational exposures and health effects. The inventory will include cohorts with data that is potentially accessible; that have collected information on occupation and/or industry or at least one occupational exposure; and have at least one follow-up point with health outcomes. Cohorts will be identified through systematic searches and personal records. An initial search identified more than sixty cohorts including more than 40 million persons with information on occupation. Researchers responsible for the cohorts will be contacted and asked to complete a web-based questionnaire. An online searchable ‘Inventory of Occupational Cohorts’ database will be developed to make the information publicly accessible and to facilitate researcher and policy-maker access to information from past and ongoing cohort studies. Users will be able to search for specific exposures and outcomes and extract basic information on the methodology of the cohorts. The OMEGA-NET Inventory of Occupational Cohorts will be the most comprehensive inventory of occupational cohorts worldwide and is expected to enhance scientific output from individual studies, and facilitate pooled studies, data sharing, and more efficient use of existing cohorts.
O3D.4 Innovative approaches to data acquisition, standardization, pooling and analyses of occupational health information
Authors: Vermeulen Roel
Published: May 2020

Occupation and employment is a major determinant of health and healthy aging. Despite the temporal increase in time spent in employment and profound changes in working life, there is limited coordinated research on occupation and health.

We recently estimated that in Europe alone there is information available on more than 30 million individuals that could be used to study the association between working life and health. However, lack of standardization, inability to code large numbers of job-entries and inabilities to share data have hindered progress. In order to unlock the vault of occupational-health information novel ways of data acquisition, standardization, pooling and analyses have to be developed and implemented. The ability of pooling studies would greatly improve occupational health studies by increasing sample size for robust inference, and would allow risk stratification, identification of new risks, exploration of interactions with work and non-work-related factors and detailed analyses on the shapes of the exposure-response curves.

In recent years we have seen progress in several different methodological aspects. Currently, new tools are available to collect information on work and work exposures. These include amongst others the use of sensors and mobile phone applications. Standardization of occupational information is essential for comparison of results between studies and for pooling of studies. This could be achieved by using common occupational coding schemes, use of automatic coding instruments and common exposure assessment tools. Virtual pooling of data has become possible by using data-shields which instead of bringing the data to the analyses bring the analyses to the data allowing federated analyses.

As part of the OMEGA-NET symposium we will discuss the need for new tools and avenues of how to bring occupational health information together. We will present our inventory of novel tools to aid this process, and will discuss future needs.
O3D.7 Constances: a population-based cohort for occupational epidemiology
Authors: Goldberg Marcel , Descatha Alexis , Leclerc Annette , Roquelaure Yves , Siemiatycki Jack , Zins Marie
Published: May 2020

The CONSTANCES general-purpose population-based cohort is intended to serve as an epidemiological research infrastructure accessible to the epidemiologic research community. CONSTANCES also provides useful public health information to the public health authorities. CONSTANCES was designed as a randomly selected sample of French adults aged 18–69 years at inception; 2 00 000 subjects will be included over a six-year period. At inclusion, the selected subjects are invited to complete questionnaires, including a lifetime job history, and to attend a Health Screening Centre (HSC) for a comprehensive health examination. A biobank is being set up. The follow-up includes a yearly self-administered questionnaire, and a periodic visit to an HSC. Social and health data are collected from the French national administrative databases. Data collected for participants include social and demographic characteristics, socioeconomic status, life events, and behaviours. Regarding occupational factors, a full job history and a wealth of data on employment and organizational, chemical, biological, biomechanical and psychosocial lifelong exposure are collected at inception and during the follow-up. The health data cover a wide spectrum: self-reported health scales, reported prevalent and incident diseases, long-term chronic diseases and hospitalizations, sick-leaves, handicaps, limitations, disabilities and injuries, healthcare utilization and services provided, and causes of death. To consider non-participation at inclusion and attrition throughout the longitudinal follow-up, a cohort of non-participants was set up and will be followed through the same national databases as participants.

Inclusion began in 2012 and more than 1 80 000 participants were enrolled by July 2018. Several projects on occupational risks are already in progress, and an Occupational Health Users Club was established. This platform and its potential contributions will be described, as well as the means for international investigators to access it.
O3D.9 Psychosocial context, somatic complaints, work ability, and job satisfaction in anaesthesia health professionals. setting up a prospective cohort study
Authors: Mijakoski Dragan , Minov Jordan , Karadzinska-Bislimovska Jovanka , Stoleski Sasho , Atanasovska Aneta , Bislimovska Dragana
Published: May 2020

Background

Psychosocial context, characterized by the levels of job demands, shift/night work, burnout, and teamwork, as well as presence of certain somatic complaints (chronic respiratory, skin, and musculoskeletal symptoms) and health disorders could affect the work ability and job satisfaction of health professionals (HPs).

The aim of this prospective cohort study will be to assess changes in self-reported psychosocial factors, work ability, and job satisfaction, as well as to evaluate the incidence of somatic complaints and health disorders in anaesthesia HPs. Additional objective of the study will be to evaluate associations between analysed variables.

Cohort participants

HPs working in a health institution for anaesthesia, reanimation and intensive care from Skopje will be included in the first phase of the study with a possibility to enrol other health institutions during the next phases of the research. The first phase will involve about 120 anaesthesia HPs (about 50 physicians and 70 nurses).

Data collection phases

At enrolment point, the participants will be invited to complete questionnaires and to attend a preventive medical examination by a specialist in occupational medicine (OM). The follow-up will include an annually self-administered questionnaire as well as periodic visits to an OM specialist.

Main types of data collected

Data collected for participants will include demographic and job characteristics; physical, organisational, emotional, and cognitive job demands; characteristics of shift/night work; burnout dimensions; teamwork; presence of chronic respiratory, skin, and musculoskeletal symptoms; work ability index; and job satisfaction factors (planning issues, general attitudes, performance issues, management issues, supervisory issues, training and salary issues, and benefits issues). Regarding medical examination by an OM specialist, a plenty of data on health status as well as work ability, will be collected at enrolment phase, and during follow-up.
O3E.3 Changes in job security and mental health: an analysis of 14 annual waves of an australian working population panel survey
Authors: LaMontagne Anthony , Too Lan Say , Punnett Laura , Milner Allison
Published: May 2020

Background

There is increasing recognition of job insecurity as an emerging issue in public health. We sought to examine whether job security improvements were associated with improvements in mental health in a large, working population-representative repeated-measures panel study.

Methods

We used both within-person fixed effects (FE) and random effects (RE) regression to analyse data from 14 annual waves of a national Australian survey (19 169 persons, 1 06 942 observations). Mental Health Inventory-5 scores (outcome) were modeled in relation to self-reported job security (categorical, quintiles), adjusting for age, year, education, and job change in the past year.

Results

Both FE and RE models showed stepwise improvements in MHI-5 scores with improving job security, with stronger exposure-outcome relationships in the RE models, and for men compared to women. All models showed roughly monotonic improvements in MHI-5 score by quintile of improvement in job security. The strongest relationship was observed in the RE model for males: for a one-quintile improvement in job security, beta=2.06 [1.67, 2.46], and the following for two- (3.94 [3.54, 4.34]), three- (5.82 [5.40, 6.24]), and four- (7.18 [6.71, 7.64]) quintile improvements. The FE model for males produced slightly smaller coefficients, reaching a maximum of 5.55 [5.06, 6.05] for a four-quintile improvement.

Conclusions

This Australian national panel study showed a strong dose-response relationship between job security and depression and anxiety symptoms. Stronger causal inference over previous observational research is supported by the dose-response finding and the relative consistency of the FE and RE results. Policy and practice intervention to improve job security could benefit population health.