bluuebunny/crossref_metadata_2025 huggingface dataset:
O6E.6 Occupational exposures and ALS: international collaborations and new ways to identify risk factors
Authors: Peters Susan , Berg Leonard van den , Veldink Jan , Vermeulen Roel
Published: May 2020

Background

Associations between occupational exposures and amyotrophic lateral sclerosis (ALS) have been suggested, but results are inconsistent. Case-control studies are best suited for inclusion of clinically confirmed incident cases, but prone to recall bias. Cohort studies are free from recall bias and may have pre-symptomatic blood stored, to inform about exposures (e.g. lead) well before disease onset.

Methods

An ongoing nation-wide ALS case-control study has been conducted in the Netherlands since 2006 (currently over 3000 cases and 4500 controls) to study risk factors and possible gene-environment interactions. Part of this study has been pooled with case-control studies from Ireland and Italy (Euro-MOTOR), where the same questionnaire was administered.

Results

Within the Euro-MOTOR study, ∼1300 cases and ∼2600 controls had full job histories available. Occupational exposures to a range of agents were assessed using job-exposure matrices. Analyses were adjusted for age, sex, centre, education, smoking and alcohol. We found significant associations between ALS and exposure to silica (OR 1.73, 95% CI 1.28–2.33), extremely low-frequency magnetic fields (OR 1.16, 95% CI 1.01–1.33) and electric shocks (OR 1.23, 95% CI 1.05–1.43), independent of the other occupational exposures studied.

Future perspectives

A nested ALS case-control study was conducted within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. 219 people who died from ALS have been identified, and pre-symptomatic blood samples from 168 of these cases are available for analyses. Three controls per case were selected by incidence density sampling matched by age at recruitment, sex and study centre. Metal concentrations will be analysed in the erythrocytes. This would be the first prospective study on the association between exposure to metals and ALS.

Conclusion

Each study design has its strengths and weaknesses, and ALS should be investigated in a range of (occupational) studies to gain better understanding of its aetiology.
O7A.2 Gender, immigration status, and work disability for acute injuries
Authors: Saffari Niloufar , Koehoorn Mieke , McGrail Kimberlyn , McLeod Christopher B
Published: May 2020

Background

The nature of work is changing rapidly with precarious work emerging as an occupational health issue. Both immigration status and gender are associated with precarious work and health inequalities. This paper investigated the modifying effect of gender on the relationship between immigration status and work disability duration for acute injuries in the Canadian context.

Methods

Workers in the Canadian jurisdiction of British Columbia with a workers’ compensation claim from 1995 to 2012 were linked to immigration data (n=8 83 830 claims), and categorized as recent (<10 years, 6.7%) or established immigrants (10+years, 4.0%), versus Canadian-born (89.3%). Work disability days one-year post-injury were modeled using quantile regression, adjusted for confounders and stratified by gender (29.6% women). The analyses was restricted to fractures (n=55 324 claims, 19.4% women), a ‘visible’ injury with a prescribed treatment trajectory within a public health care system.

Results

Disability duration for a work-related fracture was significantly longer for immigrant workers compared to Canadian–born workers regardless of immigration timing or gender, across the disability distribution: 7 to 10 days longer at the 25th percentile [e.g. recent immigrant women 10.4 [95% CI 5.6, 15.2] and men 8.9 days [6.8, 10.9]]; 12 to 15 days longer at the 50th percentile [e.g. recent immigrant women 15.3 [8.0, 22.7] and men 15.6 [12.5, 18.8]]; and 22 to 26 days longer at the 75th percentile [e.g. established immigrant women 22.5 [9.4, 35.8] and men 21.9 [13.4–30.3]].

Discussion

Longer disabilities durations for fractures suggest that health inequalities and work vulnerabilities for immigrant workers are not readily explained by subjective injury characteristics or variability in clinical treatment guidelines. The current findings informed two research initiatives to investigate precarious employment on worker health, and to identity policy levers to mitigate inequalities.
O7B.1 Modelling mortality by suicide among women at work in the swiss national cohort
Authors: Wild Pascal , Bovio Nicolas , Canu Irina Guseva
Published: May 2020

Context

The aim of this study was to describe the factors associated with mortality by suicide among women at work with a particular focus on work-related factors.

Population and methods

The study population was based on the data of the Swiss National Cohort (SNC) consisting in all Swiss residents recorded in the 1990 and/or the 2000 compulsory national censuses linked to emigration and mortality registers. Within the SNC we selected all working women aged between 18 and 65 at the official census dates.

Following work-related variables were available in both censuses: Socio-economic status, weekly hours of work, the sector of activity according to the Swiss NOGA scheme and the job title coded according to ISCO. The date of beginning of follow-up was the date of the relevant census. The date of end of follow-up was the earliest of the 65th anniversary, dec 31 st 2014 (the end of mortality follow-up), the date of loss of follow-up or dec 4th 2010 if no declared work in the 2000 census. The risk of suicide was modelled using negative binomial regression incorporating the number of person-years as offset.

Results

The cohort comprised 1,843,619 women and 2524 deaths by suicide corresponding to 24.9 million person-years. The most significant non-occupational predictors of suicide were age, civil status, period, nationality and geographical regions. Part-time work and long working hours were associated with increased suicide rates. Health and social activities had the highest suicide risks and education the lowest. Overall the job title according to ISCO-1d was not significant. However the rank of suicide risk among women followed approximately the skill levels associated with these codes. Of interest is however the high RR among professionals.

Conclusion

After accounting for the main non-occupational factors, the suicide risk varied significantly with some work-related factors that were specific for women.
O7B.2 Pilot project for identifying psychosocial risk factors among senior physicians in the pediatric medical center of a university hospital center
Authors: Denis Marie-Agnès , Dumetier Fabienne , Poyard-Berger Ghislaine , Mantha-Belisle Marie-Michèle , Vézina Michel
Published: May 2020

Context

After several warning signals coming from senior physicians working in a Department of pediatrics at a large university hospital, the Department of occupational health decided to assess objectively the psychosocial risks to which this personnel was exposed.

Methods

A research team from the scientific unit of the Institut National de Santé Publique du Québec has developed an identification grid with markers that help understanding and limiting physical and psychological risks at work. This grid includes characteristics of the workplace environment and various aspects of management practices. It is based on theoretical models such as ‘Demand-Latitude-Support’ (Karasek & Theorell, 1990), ‘effort-reward imbalance’ (Siegrist, 1996), ‘organizational justice’ (Adams, 2000), and ‘prevention’ (Kristensen, 1999). The assessment involved an interview guide with a scoring system of data collected from credible persons familiar with the working environment.

After adequate training in the use of the interview guide, an occupational physician and an occupational psychologist interviewed jointly each of 34 pediatricians and 3 managers and scored the 12 items of the guide according to specific recommendations. The data collected from the interviews were submitted to a thematic analysis.

Results

The analysis showed that the working environment of the Department was not favorable to the return to work or work-life balance. Regarding management, the warning signals pointed to heavy workloads, lack of recognition, and communication problems. There were some protecting factors such as support from colleagues, some decision latitude (but limited possibilities of knowledge development) and, unevenly between wards, support from the hierarchy. The most negative indicators were reported by junior doctors and, as expected, by temporary personnel.

Discussion

According to these results, group involving the assessment team, pediatricians, and ward managers will be formed to suggest improvements in the fields of human-resource management, communication, recognition, workloads, and occupational health.
O7B.3 A cohort study of sleep on health psychology among professional drivers
Authors: Lin Yu Jen , Guo Yue Liang , Liou Saou-Hsing
Published: May 2020

Background

Long-term effects of sleep-related factors on risk of psychiatric disorders among professional drivers have not been conclusive. A cohort study was used to evaluate the effectiveness of subjective and objective sleep assessment tools to assess for both the 7 year risk of psychiatric disorders events. Methods: Taiwan Bus Driver Cohort Study (TBDCS) recruited 1650 professional drivers from a large bus company in Taiwan in 2005. The subjects were interviewed in person, completed the sleep assessment questionnaires (Pittsburg sleeping quality score (PSQI), Epworth daytime sleepiness score (ESS), Snore Outcomes Survey score(SOS)), and had an overnight pulse oximeter survey. Psychiatric diseases as diagnosed in the National Health Research Database were the outcomes of this study, including substance abuse, anxiety, mood, and sleep disorders. Cox proportional hazards model was performed to estimate the hazard ratio for psychiatric disorders. Results: Between 2006 and 2012, 102 bus drivers were diagnosed as having psychiatric disorders. Psychiatric disorders were related to higher PSQI score, SOS score, ODI4 levels, and ODI3 levels. The relation between PSQI and psychiatric disorders remains robust after adjusting for age, education, drinking, smoking, refreshing drinks, exercise, bus driving experience, and shift modes. Conclusion: This study showed increased psychiatric disorders in the 7 year follow-up after self-reported poor sleeping quality. Further research is warranted to develop strategies for preventing sleep-related psychiatric disorders among professional drivers.
O7B.4 Are psychosocial working conditions associated with suicide and intentional self-harm? a register-based study of 420,895 norwegians
Authors: Mehlum Ingrid Sivesind , Hanvold Therese N , Mehlum Lars , Hasting Rachel L , Merkus Suzanne L , Kristensen emerit Petter
Published: May 2020

Objectives

Poor psychosocial working conditions are associated with increased risk of mental health disorders. Some studies suggest that work factors may also increase the risk of suicidal behaviour. However, these studies mostly measured suicidal ideation, rarely completed suicides, and hardly ever used longitudinal data. We aimed to examine the relationship between selected psychosocial work factors and death by suicide, as well as hospital treatment for intentional self-harm and similar diagnoses.

Methods

Data on all persons born in Norway 1967–1976, employed in 2007 (n=420,895), were retrieved from national registers. Binary psychosocial work exposures were obtained from a job-exposure matrix for job demands, job control and leader support. Based on these, we constructed job strain (high demands, low control), and isostrain (high demands, low control, low support) exposure variables. These were linked to occupation in 2007 (ISCO88 four-digit codes). We estimated associations (Risk Ratios, RRs) between the psychosocial work factors and four-year risk of intentional self-harm and suicide in binomial regression models, adjusted for year of birth, education level, marital history and current family pattern.

Results

During 2008–2011, 884 had diagnoses of intentional self-harm (annual rate 53 per 100,000; women 56, men 49), while 164 suicided (annual rate 9.7; women 4.5, men 14.5). Intentional self-harm was associated with all work factors, except job demands and leader support among men. Associations were strongest for high isostrain, adjusted RR 1.5 (95% confidence interval 1.2–1.7) and high job strain RR 1.3 (1.2–1.5), similar in women and men. Associations with suicide were positive only among men, with strongest associations for high job strain, RR 1.5 (1.0–2.1).

Conclusions

Psychosocial work factors were associated with intentional self-harm in both sexes, but only in men for suicide. High isostrain and high job strain showed the strongest associations. Reasons other than a causal relationship cannot be excluded, particularly health selection.
O7B.6 Mortality by suicide in the swiss national cohort (1990–2014): analysis according to occupation and economic activity
Authors: Canu Irina Guseva , Bovio Nicolas , Mediouni Zakia , Bochud Murielle , Wild Pascal
Published: May 2020

Objective

Given the known importance of work in our everyday lives, and growing economic and psychosocial pressure related to rapid changes in current working conditions, the link between occupation and suicide regains both academic and practical interest. Sex-specific mortality from suicide in Swiss working-age (18–65) population was investigated.

Methods

The study sample comprised 5’834’618 participants of the Swiss National Cohort (SNC) (94’918’456 person-years). For every occupation and economic activity/industry (coded using international standard classifications) we computed directly age-standardized mortality rates (DSRs) using the age structure of the European population (2010) and standardized mortality ratios (SMRs) for suicide using Swiss population cause-specific mortality rates.

Results

The highest DSRs were observed among unemployed/job seeking group (52.94 per 1 00 000 person-years based on 568 suicides), in agricultural, fishery and related male workers, and in health and social activities female workers. A consistent reduction in DSRs across three calendar periods, 1990–1998, 1999–2006, and 2007–2014 was observed in men. In female corporate managers, DSRs increased over the 2007–2014 period compared with 1999–2006. Unemployed/job seeking people, manufacturing labourers, personal care and related workers, and motor vehicle drivers of both sexes were identified at risk of suicide (SMR >1) compared to general working-age population. Moreover, an excess of suicide was observed among male material recording and transport clerks; nursing and midwife associated professionals; and agricultural workers as well as among female writers and performing artists.

Conclusions

This study showed a distinctive pattern of suicide mortality between the two sexes and identified occupation groups at high and low risk of suicide among men and women. Sex-specific results need further investigation. In-depth analyses, taking into account the individual, social, and organizational characteristics of this population are necessary to understand the differences between and within protective and harmful occupations and to design targeted interventions aiming at suicide prevention among high-risk workers.
O7C.2 Developing a measuring strategy for monitoring and evaluation of a national occupational health intervention programme in great britain (GB)
Authors: Chen Yiqun , Curran Andrew
Published: May 2020

The Health and Safety Executive (HSE) is the GB regulator for health and safety at work. The HSE Health and Work (H&W) program designs and carries out a wide range of interventions; including inspection, enforcement and other regulatory activities as well as prevention; targeting priority health conditions in high-risk sectors. It is anticipated that long-term, sustainable and coordinated actions developed as part of the program will over time improve awareness, behaviors, control of exposures, and, as a result, prevent work-related ill health in GB workforce.

An HSE Measuring Strategy, together with measurement framework and principles, has been developed. The measurement framework draws together data systems, covering Attitudes (A), Behaviors (B), Control of exposures (C), and Disease and work-related ill health reduction (D), based on a simple model to provide evidence required for evaluating the short, medium and long term impacts of the large scale and complex H&W program on the GB health and safety system. The Strategy gives a new focus on measuring behavioral changes and risk reductions; and emphasizes longitudinal measurement designs to assess progress over time.

For developing the Strategy, workshops were organized to bring stakeholders across HSE to review existing systems for conducting population surveys, collecting exposure intelligence and occupational health surveillance, which have contributed to forming a long-term vision of fit-for-purpose measurement systems.

We will present the development of the Strategy and the plans to implement it with the H&W program, which requires close collaborations between epidemiologists and social researchers, policy makers, and other multidisciplinary regulatory specialists. The lessons learnt will help HSE towards building the right evidence base for monitoring and evaluation of a range of national level intervention programs for work-related ill health prevention.

©British Crown copyright (2019)
O7C.6 Effectiveness of an audit-based occupational health and safety management system certification on firm injury rates in alberta, canada
Authors: McLeod Chris , Macpherson Robert , Aderounmu Adebayo , Quirke Willianm , Koehoorn Mieke
Published: May 2020

Objectives

To determine if achieving an audit-based occupational health and safety management system certification (OHSMS) is associated with lower firm-level lost-time injury rates.

Methods

Firm-level workers’ compensation claims and OHSMS audit data were extracted from eligible industry sectors for the years 2000 to 2015. OHSMS and non-OHSMS firms were matched on observable baseline characteristics using coarsened exact matching methods. A difference-in-difference observational research design using population-averaged negative binomial regression models estimated the effect (incidence rate ratios (IRR) with 95% confidence intervals) of OHSMS certification on firm lost-time injury rates, adjusting for confounders. Models were stratified by industry sector and type of OHSMS (certification for small versus large firms).

Results

The cohort included 14,377 OHSMS firms matched to 11 338 non-OHSMS firms. Overall, OHSMS certification reduced lost time injuries (IRR: 0.86, 95% CI: 0.83–0.88), with a greater effect in 2011–15 (IRR: 0.79, 95% CI: 0.75–0.82). OHSMS certification was most effective in reducing injuries in the manufacturing (IRR: 0.75, 95% CI: 0.70–0.80), trade (IRR: 0.79, 95% CI: 0.73–0.86), and transportation (IRR: 0.80, 95% CI: 0.72–0.89) sectors. No effect was found in oil and gas (IRR: 1.05, 95% CI 0.91–1.20), business (IRR: 0.89, 95% CI: 0.89–1.10) and forestry (IRR: 1.05, 95% CI: 0.83–1.33) sectors. OHSMS certification for small firms was not associated with a reduction in injuries (IRR: 0.98, 95% CI: 0.91–1.06.) in contrast to OHSMS certification for large firms (IRR: 0.84, 95% CI: 0.82–0.87).

Conclusions

OHSMS certification is effective in reducing firm injury rates. Effectiveness varied by sector, time period, and small or large firm certification. Sectoral differences in OHSMS effectiveness suggest that the ability to prevent hazards targeted by certification may vary by work environment. Further, small firm OHSMS certification may not be identifying safer firms.
O7D.1 Investigating the difference of work-related harms in new zealand by ethnicity
Authors: Khieu Trang , Poland Michelle , Lovelock Kirsten
Published: May 2020

In New Zealand about 10% of workers are harmed every year, with approximately 2 00 000 claims made to Accident Compensation Corporation (ACC) to cover the cost of injury and illness. Work-related injury and illness outcomes differ between ethnic groups. M&_x0101;ori (indigenous population) workplace fatality rates are 19% higher by industry and 10% higher by occupation than for non-M&_x0101;ori. According to Statistics New Zealand from 2002–2017, M&_x0101;ori were more likely to have higher rates of work-related claims than non-M&_x0101;ori. This study currently underway has used the Integrated Data Infrastructure (IDI) to look at different injury types and explore injury distribution between M&_x0101;ori and non- M&_x0101;ori in terms of age, sex, industry and occupation. WorkSafe applied to Statistics New Zealand (Stats NZ) for access to microdata in the IDI in July 2018 and was granted access in September 2018. In this study, data for people with accepted work-related ACC claims has been linked to 2013 Census to identify the industry that ACC claimants have worked in and their occupations. This data has then been linked to data on sex, age and ethnicity as recorded for the IDI population. Confidentiality of data in this study has followed Stats NZ’s output rules including random rounding to base 3, suppression and aggregation.
O7D.5 Subjective cognitive decline among us workers aged ≥45 years by occupation, BRFSS, 2015–2016
Authors: Kaur Harpriya , Grosch James
Published: May 2020

Background

Subjective cognitive decline (SCD) is one of the earliest noticeable symptom of dementia, including Alzheimer’s disease. Some studies have shown that half of older adults with subjective memory complaints go on to develop more severe cognitive decline within 7–18 years. The objective of this study was to examine the prevalence of SCD among US workers and to identify occupations with a high prevalence of SCD, even after adjustment for common risk factors.

Methods

Data from the 2015–2016 Behavioral Risk Factor Surveillance System were used to examine the prevalence of SCD among US workers aged ≥45 years who were currently employed or were employed at some point in the past 12 months. SCD is defined as frequent confusion or memory loss within the previous 12 months. Only states (n=28) that collected data on both industry/occupation and cognitive decline were included in this study.

Results

The overall prevalence of SCD among US workers aged ≥45 years was 6.2%, and was higher for workers 65 years and older. The prevalence was significantly higher among Veterans (8.3%) compared to non-veterans (5.9%). 29.2% of those with SCD reported that they need assistance with day-to day activities and 35.1% had discussed confusion/memory loss with a healthcare professional. The prevalence of SCD was significantly lower among workers in management, business and financial operations, Healthcare practitioners and technical, and office and administrative support occupations. While workers in building and ground cleaning and maintenance, and personal care and service occupations had elevated prevalence of SCD.

Conclusion

Cognitive decline is an important public health issue affecting older workers and their ability to work. SCD prevalence is much higher among occupations that are less mentally challenging which indicates that interventions to improve or maintain cognitive functioning may help older workers to remain productive and in the workforce.
O7E.4 Estimating economic impact of heat on china’s labor productivity: new evidence from a CGE model
Authors: Cai Wenjia , Zhao Mengzhen , Chen Yidan , Wang Can
Published: May 2020

High heat exposure and heat-related health impacts is a well-known occupational health hazard. Though recent studies have quantified high heat impacts on labor productivity in occupational group, little is known about the scale of economic impacts of labor productivity losses, resulting in inadequate policy response. Besides, sectors that suffer most from heat, such as agriculture, service and construction, have extensive inter-dependent relationship with other sectors in the economy. Therefore, it is also important to include these indirect impacts, to avoid the underestimation of the economy-wide impacts.

Computable general equilibrium (CGE) model can capture direct and indirect economic impact of heat on labor productivity and do the comprehensive analysis. In this study, we used WBGT to estimate future labor productivity changes. Meanwhile we employed a China dynamic CGE model (CHEER) with 2012 as base year in the paper to investigate the economic impacts of heat on labor productivity and to find out the specific sectors’ losses and the whole-economy losses in China. Taking temperature projections (daily maximum temperature, daily minimum temperature, and daily average temperature) under RCP scenario, population projections (demographic age structure and employment structure) under SSP scenario in China as input and dividing China’s economic sector into 22 sectors in our model, we analyzed 22 sectors’ economic impacts in the long term.

Based on these scenarios, our study quantifies the full scope of economic impact of heat on labor productivity and analyze the changes of GDP, specific sectors output and industrial structure in the future. Our study could contribute to the understanding of social cost of carbon in China. A range of measures for different economic sectors were also suggested to reduce future economic loss from heat in China. Future research needs were discussed at the end of the paper.
O7E.5 New initiatives in international collaboration for describing the occupational heat hazards via epidemiological studies and modelling
Authors: Lee Jason
Published: May 2020

The negative effects of heat stress on work tolerance are well known. In order to optimise exercise tolerance in the heat, various physiological strategies can be employed to alter heat strain such as optimising work-rest cycles, maximising aerobic fitness, heat acclimatisation, pre-exercise cooling and fluid ingestion. In order to optimise workers’ health and productivity in the heat, there is an urgent need for collaborative efforts across various disciplines. A holistic heat management programme requires accurate quantification of the impact due to heat stress before formulating and evaluating the eventual heat mitigation strategies. The International Commission on Occupational Health Scientific Committee on Thermal Factors can serve as an effective platform for dedicated scientists to network and for active research and analysis specific to protection of working people from excessive heat and cold exposures in current and future work environments, including analysis of climate change impact and mitigation analysis. This platform will enable members of Scientific Committee of Thermal Factors to become co-authors on reports in major scientific journals, to collaborate across country boundaries, to get recognition for their own research work, and to be part of future funded global activities.
O8A.1 Estimating the burden of lung cancer due to occupational exposure to radon gas
Authors: Peters Cheryl , Kim Joanne , Song Chaojie , Ge Calvin , Demers Paul
Published: May 2020

Background

Radon is a well-known cause of lung cancer. Our goal was to estimate the prevalence and level of occupational exposure to radon, and to estimate the current lung cancer burden caused by radon exposure in Canadian workplaces.

Methods

Highly exposed (i.e. underground) workers were assigned exposure proportions at the national level using CAREX methodology. Exposure for the indoor working population was estimated using province-specific radon measurements from the Canadian federal building survey (n=12 870 samples). The proportion of workers exposed to specific ranges of radon (50–100, 100–150, 150–200, 200–400, 400–800,>800 Bq/m3) were calculated and we assigned the midpoint of the range as the average radon concentration for each exposure group. For the >800 Bq/m3category, the province-specific mean of measurements>800 Bq/m3was assigned. The above exposure assessment was applied to a population model of the historical Canadian labour force and exposures between 1961 and 2001 (the risk exposure period) were considered as contributing to cancer cases in 2011. The BEIR VI exposure-age-concentration model was used to assign relative risks by exposure category. The population attributable fraction was calculated using Levin’s equation.

Results

There were an estimated 4.4 million indoor workers and 26 000 highly exposed workers exposed to radon during the risk exposure period. Nearly 80% of these workers were exposed below 50 Bq/m3 (half the WHO reference level). Combining the indoor and highly exposed workers, we calculated that 0.80% of lung cancers are attributable to occupational radon exposure; this equates to 188 lung cancer cases per year.

Conclusions

Ours was the first study to use a data-driven approach to estimate radon exposure and lung cancer burden for indoor workers. Some of the attributable cases can be prevented by reducing workers’ exposure at workplace.
O8A.3 Mining exposures and lung cancer in contemporary western australian miners
Authors: Sodhi-Berry Nita , Klerk Nicholas de , Franklin Peter , Reid Alison , Fritschi Lin , Musk Bill , Vermeulen Roel , Peters Susan
Published: May 2020

Objectives

Mining is associated with exposures to various lung carcinogens such as diesel engine exhaust (DEE) and respirable crystalline silica (RCS). We aimed to determine if lung cancer incidence was higher in Western Australian (WA) miners than the general population and if risk varied within the cohort according to exposures and work or job types.

Methods

Exposure data for 1 72 398 miners living and working in WA between 1996 and 2013 was combined with administrative WA cancer and death data until June-2017. Causal Incidence Ratios (CIRs) were calculated for general population comparisons. Hazard Ratios (HRs) were derived from multivariable Cox regression models including sex, only-underground work, ore-type (gold, iron-ore, other metal, non-metal, unknown or multi-ore mines) and quantitative estimates of DEE (measured as elemental carbon) and RCS, after adjusting for ever-smoker status and entry-age. Additional analyses were done after lagging exposures by 15 years.

Results

Mean DEE and RCS cumulative exposures were estimated as 0.15 mg/m3-years (std:0.37) and 0.09 mg/m3-years (std:0.18), respectively. Miners had lower lung cancer incidence than the general population (observed=382; expected=538.11; CIR:0.71, 95% CI:0.64–0.78). Within the mining cohort, higher lung cancer risks were observed for: females vs. males (HR:1.44, 95% CI:0.97–2.03); ever-smokers vs. never-smokers (HR:10.1, 95% CI:6.37–16.1); only-underground vs. only-surface miners (HR:1.72, 95% CI:1.02–2.90); only gold vs. multi-ore miners (HR:1.44, 95% CI:1.01–2.05); and only iron ore vs. multi-ore miners (HR:1.47, 95% CI:1.07–2.04). Neither DEE (HR:1.01, 95% CI:0.89–1.14) nor RCS (HR:0.89, 95% CI:0.61–1.3) was significantly associated with incidence. There was no significant difference in estimates after lagging exposures.

Conclusion

Miners had lower risk of lung cancer than the general population. Workers mining exclusively in underground, iron ore or gold mines had higher lung cancer risks than their peers, as did ever-smokers and females. Low levels of DEE and RCS exposures in WA mines may explain the lack of association between these exposures and lung cancer.
O8B.1 Risk of heat related illness in latino agricultural workers: environmental temperature and activity levels
Authors: Schenker Marc , Mitchell Diane , Armitage Tracey , Tancredi Daniel
Published: May 2020

Introduction

Farmworkers are at risk of heat related illness (HRI). The main contributors are thought to be environmental temperatures and activity levels, but the association has not been objectively assessed.

Methods

California farmworkers were monitored for one work-shift each in the summers of 2014 and 2015. Interviewers recorded personal and demographic information. Wet bulb globe temperature (WBGT) was collected in minute intervals over the shift as were accelerometer activity data from each participant. This data was grouped into physiologically meaningful 15 min increments, with the average used for analysis. Data from the previous 15 min were used to predict current activity. Generalized Additive Modeling was used to determine the form of the association between WBGT and activity level. This information was used to build an appropriate repeated measures model including demographics and work-related attributes.

Results

Final analyses included 318 Latina/o farmworkers. Only 70 subjects (22%) were a healthy BMI, and 115 subjects (36%) were considered obese (BMI ≥30). None were underweight. The majority of participants were paid hourly (n=233, 73%) as opposed to piece-rate (n=85, 27%). Activity counts averaged 452, or a low intensity activity level. In the final repeat measures model, work activity was inversely associated with WBGT, for every oC increase in WBGT activity decreased by 4.5 counts (95% CI 1.2–7.6) P 0.01. Other independent negative associations with activity were found with age and male gender. An interaction was found between piece-rate workers and gender. Male piece rate workers did not decrease activity levels with WBGT, but females and hourly paid workers did.

Conclusion

In general, farmworkers decrease their work activity with increasing environmental heat. Men, especially piece-rate workers are less likely to decrease their activity levels putting them at increased risk of HRI.
O8B.2 Epidemiological descriptions of occupational health effects of climate change
Authors: Lemke Bruno , Kjellstrom Tord
Published: May 2020

There have been many laboratory studies of the effect of heat on the health of individuals in sport, at work or in the military. However, epidemiological studies are needed to develop impact assessment of climate change. In this presentation we outline the development and use of population-exposure risk functions for different heat effects.

The first risk function is for heat discomfort based on the predicted mean vote with 10% population feeling discomfort at WBGT=21C and with 90% affected at 29C.

The second population risk function is for heat exhaustion which we derive by using epidemiological data from the US military. 10% of the population is affected by heat exhaustion at WBGT=31C increasing up to 90% of the population affected at a WBGT=38C.

The most severe population risk is heat stroke for which we use hospital data to calculate 10% of the population affected by heat stroke at WBGT=41C and 90% of the population at WBGT=44C.

These health effects of heat create different durations of ill health, with serious heat stroke causing prolonged periods of dis-ability. Based on climate modelling and our risk functions the number of people affected globally can be calculated. For heat stroke, few persons working in the shade at 300W metabolic rate, will currently suffer from heat levels that can cause heat stroke. By 2085 half a million workers (at 300W) will be exposed to heat levels that cause heat stroke. As for becoming totally exhausted (and unable to work) while working at 300W in the sun, currently that stands at about 124 million worldwide, but in 2085 that number will jump to 835 million.

Additional epidemiological studies are utilised to validate these risk estimates at local and national level.
O8B.5 Occupational heat exposure and cardiovascular health risks related to climate change in pacific countries
Authors: Akerman Ashley , Cotter Jim , Kjellstrom Tord
Published: May 2020

Recent global analysis of current and future ambient heat conditions has shown that occupational heat exposure in Pacific countries, measured or projected as WBGT, is among the most extreme in the world. Many Pacific countries face a serious and unprecedented collision of adverse environmental, sociocultural/demographic and chronic health factors. Environmentally, high temperatures and humidity exist several months each year, reducing physical work capacity. Conservative assessments reveal annual loss of healthy work hours for a person working at 400 W metabolic rate in countries like Papua New Guinea, Kiribati, Nauru and Guam increasing from 2%–3% to 9%–18% by 2100, based on the RCP6.0 pathway for climate change. Socio-culturally, such countries have low average income levels and high reliance on primary industries, so occupational and domestic exposure to ambient heat is chronic and somewhat intractable. Health wise, such countries have among the highest burden of chronic cardiometabolic disease in the world. Diabetes is already prevalent (20%–35%), as is hypertension. Casual links between heat exposure and cardiovascular health problems is strengthening and these health problems are becoming a major threat to health in Pacific countries. A diet that is increasingly more divergent from traditional foods is one key factor, but increasing heat conditions will contribute, particularly for people working in physically intensive occupations. Obesity is also prevalent, which is relevant because it adds to heat production while concurrently reducing heat loss, thereby impairing work capacity and tolerance of humid heat. Collectively these factors compromise thermal tolerance, reduce functional capacity and contribute to cardiometabolic disease. This paper will analyse the physiological base for the heat effects on cardiovascular disease with particular reference to occupational heat exposure, and estimate the impacts of climate change in the Pacific countries as well as identify solutions to reduce the future impacts.
O8C.4 Effective group education for healthy dietary habit using results of a dietary questionnaire in occupational field: an intervention study
Authors: Katagiri Ryoko , Muto Go , Sasaki Satoshi
Published: May 2020

Introduction

In Japan, a health promotion education in occupational field is often performed in groups because of the limited number of occupational health workers. When using individual result obtained from a dietary questionnaire, even in a group education, it may be possible to educate individually and may lead to behavioral change of employees effectively.

Method

A non-randomized intervention study was conducted in 2016. Group education using the results of ‘Brief-type self-administered diet history questionnaire (BDHQ)’ from which information for nutrient intake, food intake and dietary habits can be obtained, were compared with usual group education among selected companies. The dietary questionnaire was used in 3 companies with 269 employees (intervention group) and 2 companies with 111 employees were educated normally (control group). Alteration in stages of behavior change in each person were compared between two groups.

Result

Among employees who had originally thought that their dietary habits are healthy, significantly more people in the intervention group had willingness to change behavior than people in the usual education group (p=0.008), while no significant difference could be found in employees who had originally thought that their dietary habits are unhealthy (p=0.44). Nevertheless, among individuals who originally recognized their diet as unhealthy and had willingness to change behavior, the number of employees who selected ‘could understand the issue of your own dietary habits’ as the reason for changing behavior in intervention group were significantly more than that of control group (33% vs 15%. p=0.02).

Conclusion

Despite in a group education, BDHQ could show the points to change in dietary habits individually. Although how to motivate employees who are entirely uninterested warrant further investigation, using a dietary questionnaire in health education can be an effective way in occupational field.
O8C.6 Tobacco control and oral cancer screening among public transport bus drivers, conductors and other staff in mumbai, india
Authors: Mishra Gauravi Ashish , Pimple Sharmila , Singal Anil , Kulkarni Vasundhara , Shaikh Heena , Majmudar Parishi
Published: May 2020

Introduction

Tobacco is the single most preventable cause of deaths globally. India is the second largest consumer and third largest producer of tobacco. A plethora of tobacco products are consumed. India has highest number of oral cancer cases globally and bears one fourth of the global burden.

With the smoke free public places legislation being implemented since 2nd October 2008, smoking is prohibited on public transport bus premises in India. Tobacco addiction is common among the commuters, drivers, conductors and other staff of the public transport department.

The present study was conducted to understand the knowledge, attitude and practices (KAP) regarding harmful effects of tobacco among the public transport bus staff, to educate them regarding the importance of smoke free legislation and health hazards associated with tobacco use, to support them in tobacco cessation, to conduct oral cancer screening and to assist in the further management.

Materials and methods

Around 4000 public transport bus employees in Mumbai were enrolled after explaining the programme and obtaining informed consent. They were interviewed and their KAP regarding tobacco was recorded. The employees were then given detailed health education. They were screened for oral cancers and counseled for tobacco cessation. The screened positive employees were referred for diagnostic evaluation and management.

Results

4000 public transport bus employees were enrolled. Amongst them 1691 (42.28%) were tobacco users. Smokeless form of tobacco use was dominant, 1561 (92.31%). All 4000 employees participated in oral cancer screening and were enrolled for tobacco cessation counselling. 743 employees were screened positive, 592 complied to referral for diagnostic evaluation and 534 employees were clinically diagnosed with oral pre-cancers

Conclusions

Tobacco use and oral pre-cancers are high among the public transport bus employees in Mumbai. Hence, awareness, oral cavity screening and tobacco cessation counseling should be incorporated within their annual health check-up.
O8D.2 Occupational complexity in relation to late life physical functioning in sweden
Authors: Kåreholt Ingemar , Mattsson Alexander Darin
Published: May 2020

Background

Occupational complexity is a measure of intellectual stimulation at work. Higher occupational complexity has consistently been associated with less cognitive decline, decreased risk of dementia, less psychological distress, and lower mortality. We build on this research by investigating the association between occupational complexity and physical functioning in late life.

Methods

Two linked Swedish nationally representative surveys were used. Midlife health, education, social class, income, and occupational complexity from current/latest occupation was assessed in 1991. Data from 1991 also include retrospective questions about life-time occupations. From this data we created an aggregated score (based on occupational complexity at ages 25, 30, 35, 40, 45, and 50 in addition to the first occupation). Trajectories of change in complexity scores were measured using random slope and intercept models. Physical functioning was assessed in 2014 by self-reported mobility limitations and limitations in activities of daily living (ADL).

Results

The results show an association between latest and aggregated higher occupational complexity and fewer mobility and ADL limitations. Adjusting for midlife health only moderately affected the associations. The associations were reduced to non-significant when adjusted for education, social class, and income. Trajectories of occupational complexity were only marginally, or not at all, associated with physical functioning in late life.

Discussion

Occupational complexity was associated with physical functioning; however, the association could be entirely attributed to socioeconomic position. The initially observed associations between occupational complexity and physical functioning in late life appear to be explained by the same pathways as socioeconomic position. The combined associations between occupational complexity and socioeconomic position on one hand and physical functioning on the other hand need to be further analyzed.
O8D.3 The effectiveness of vocational rehabilitation on work participation: a propensity score matched analysis using nationwide register data
Authors: Leinonen Taina , Viikari-Juntura Eira , Husgafvel-Pursiainen Kirsti , Juvonen-Posti Pirjo , Laaksonen Mikko , Solovieva Svetlana
Published: May 2020

Introduction

Research on the effectiveness of vocational rehabilitation has often focused on small and selected groups of rehabilitees, lacked proper controls, or not captured dynamic changes in work participation. Using rich nationwide data on vocational rehabilitees and their matched controls, we examined long-term changes in work participation before and after vocational rehabilitation to assess its effectiveness.

Methods

We used representative Finnish register data to examine 2692 recently employed individuals with histories of musculoskeletal- and mental-related work disability who started vocational rehabilitation in 2008–2010 at age 30–55 (intervention group), and 2692 propensity score matched non-rehabilitees who otherwise met the same criteria (control group). Matching was performed based on sociodemographic and work-related factors, work disability diagnosis, and three-year labour market history. We used generalised estimation equations to examine differences in the proportion of time spent at work between periods of three years before and three years after rehabilitation among the intervention and control group and the difference in these differences (DID).

Results

Among those with 105+days of work disability in the preceding three-year period, vocational rehabilitation resulted in significant percentage point gains in work participation, with the total DID across the disease groups and genders being 9.2 (95% confidence interval 7.3–11.1). The gains tended to actualise immediately after rehabilitation. No gains were observed among those with shorter preceding work disability.

Conclusions

Vocational rehabilitation after musculoskeletal- and mental-related work disability showed only shorter-term effectiveness on work participation and only among those with longer work disability histories. The effectiveness of alternative and complementary interventions to vocational rehabilitation should be investigated.