bluuebunny/crossref_metadata_2025 huggingface dataset:
Geographic disparities in bladder cancer incidence among men in the department of Bouches-du-Rhône
Authors: Mantey K , Cortaredona S , Grisoni V , De Fromont M , Albert P , Karsenty G , Pascal L
Published: November 2019

Bladder cancer incidence is investigated in the department of Bouches-du-Rhône to provide answers to the population reporting an excess of cancer cases in industrial areas. The study aimed to describe the geographical variations of bladder cancer incidence among men and detect potential spatial clusters without point source specification.

Incident cases diagnosed between 2013 and 2016 were extracted from the departmental observatory of cancers REVELA13. Age-standardized incidence ratios (SIRs) were calculated for each commune and bayesian smoothed risk estimate based on the Besag, York and Mollie model were computed for incidence mapping. Morans’I, Potthoff-Whittinghill and Tango statistic tests were used to investigate global clustering and the spatial scan statistic of Kulldorf (SaTScan) was used to investigate local clustering. Analyses were adjusted on a French deprivation index, access to health-care services and population density.

During the study period, 1 735 cases of bladder cancers were diagnosed among men. The study found a spatial heterogeneity (p < 0.01) and aggregation (p < 0.01) but no spatial autocorrelation (p = 0.09). Bayesian smoothed SIRs were not related to the confounding factors studied. An over-incidence was observed in the communes located in the South East of the department including Marseille, the biggest city of the study area. SaTScan algorithms detected two significant high-risk clusters in the same area (RR = 1.50 and 1.38). Introduction of each confounding factors in spatial scan detection, changed slightly the shape of clusters and/or the value of the relative risk but not the location. None high-risk cluster was detected in the communes of the industrial area.

Spatial analysis provides a first answer to the population concerning an excess of risk of bladder cancer at commune level. However, more analysis should be led to identify etiological factors or common environmental exposure.

Key messages

Geographic disparities exist in bladder cancer incidence among men at a commune level in the department of Bouches-du-Rhône. Spatial analysis show excess of risk of bladder cancer in the south-east of the department including the urban area of Marseille.
Health Literacy Profile and educational intervention as a prevention action for Type2 Diabetes
Authors: Dowlut S D , Balcou Debussche M B D , Debussche X D
Published: November 2019

Diabetes Type 2 is being categorized as a health crisis in Mauritius where 22.8% of the population suffers from it coupled with a 19.5% who are pre-diabetic. Government is already spending a huge proportion of the national budget in care of diabetic patients. Since one of the known means to better control diabetes is structured diabetes education, we tested the “learning nests” as a prevention measure for Type2 Diabetes. The “learning nests” is a structured health education programme which takes into account both biomedical and psychosocial dimensions which has already proved its effectiveness in other countries and it is theoretically based on socio-constructivism, social contextualization, empowerment and action planning.

Health literacy refers to the capacity to access, understand and use health related information to make appropriate health decisions. A concept which is highly correlated to the health outcomes of a population since it addresses necessary competencies to maintain oneself in good health.

The objectives of the educational sessions were to educate people on the risk factors of diabetes and at the same time these people can disseminate the knowledge acquired in their social environment. Six educational sessions were organized for 30 participants whereby the main eligibility criteria was age > =18 years. A qualitative study was conducted with the participants to analyse the learning process as well as their health literacy competencies in terms of access, comprehension and evaluation of health information. The study was conducted before and after three structured educational sessions based on cardiovascular risks, Physical Activities and managing fat intake.

The findings show that these learning situations when contextualized can prove to be promising, in terms of health actions being undertaken by participants and improvement in health literacy competences in a middle-income country like Mauritius.

Key messages

Improvement of Health Literacy level can decrease the prevalence of Diabetes. Structured Health Education can help in improving health literacy.
Prognostic value of the Diverticular Inflammation and Complication Assessment (DICA) classification
Authors: Nasi G , Mastromatteo A M , Cambiè G , Di Mario F , Elisei W , Franceschi M , Nouvenne A , Tursi A , Violi A , Brandimarte G
Published: November 2019

Colonic Diverticulosis is one of the most common anatomic alterations found in the clinical practice. This condition has 60% incidence in the population over 60 years old. About 20% of patients with this condition will develop Diverticular Disease, and 5% of them will evolve into Diverticulitis. The aim of the study is to analyse the validation of the classification considering the distribution of the severity DICA score between the patients with diagnosis of colonic Diverticulosis.

We analysed and classified with DICA 5635 colonoscopies in the period between January 2012 and April 2018 and we obtained the Hospital Discharge Form from all the patients that had been admitted to the hospital in the same time period. The results showed that 69.9% of the patients were assigned to the score DICA1, 21% to DICA2 and 9.1% to DICA3. Ageing increased both the diagnosis of Diverticular Disease and the severity score. The severity was higher in female patients (DICA1=44.6%,DICA2=50.8%,DICA3=57.8%). The occurrence of complications overall was 5.4% and specifically: not complicated Diverticular Disease (DICA1=1%, DICA2=1.8%, DICA3=3.5%); not complicated Diverticulitis (DICA1=2.1%, DICA2=4.7%, DICA3=6.4%); Bleeding in Diverticulitis (DICA1=0.4%, DICA2=1.2%, DICA3=4.5%); Diverticular Perforation (DICA1=0.0%, DICA2=0.1%, DICA3=0.4%). The complications that needed a surgical procedure were for DICA1 about 0.2%, for DICA2 0.8% and for DICA3 2.5%. As well the average of the occupant days in the hospital and the cost, respectively, was for DICA1:8.5 days and 2300 €; for DICA2:9.5 days and 3080 €; for DICA 3:13 days and 4090 €.

The majority of the patients with Diverticular Disease belonged to the severity score DICA1 and the patients classified with DICA3 were mainly female and older than 69 years old. The study confirmed the prognostic value of the endoscopic classification DICA since the occurrence of complication resulted in a statistically significant relation with the score DICA3.

Key messages

DICA classification was able to discriminate, based on endoscopic records, the patients that could develop complications for Diverticular Disease. DICA classification is a valid parameter to predict the outcome of the disease, with great impact on public health improving the effectiveness of treatment.
Leadership and chronic diseases: a bibliometric review
Authors: Cabral M , Daminani G
Published: November 2019

Background

Leadership and chronic diseases are two frequent topics in current public health discussions. We performed a bibliometric analysis to study what interactions exist between these two themes. This study allows an insight on what is being published and also identifies potential gaps that need to be addressed.

Methods

We have reviewed all the titles and abstracts of articles available at PUBMED with the MESH terms ’Leadership’ and ’Chronic Disease’. We collected information about the authors, year, journal and type of publication and country where the study was done. We have also done a qualitative analysis on the themes addressed.

Results

We have found 171 entries, of witch 85 (49,7%) referred to apparent peer reviewed studies in English. All other publications referred to editorials, commentaries or the PUBMED entry did not allow for greater clarification. From 1998 the publication of articles became regular, with a peak of 14 articles published in 2014. The average of authors per publication was 3,19. The most frequent country involved was the USA (62), follow by the UK (14), Canada (11) and Australia (10). 128 publications were identified, of which BMC Health Serv Res was the one with the highest number of articles included (5). There was some form of a call for greater leadership from nurses in 22 articles. We also highlight 5 articles that called for a greater role of pastors and religious communities in this field.

Conclusions

Despite the perception of being common topics, there is still a low rate of publication of studies in the field of leadership and chronic diseases. There is a predominance of articles from the USA. There was not a predominant publication in this field. Despite doctors being typically seen as the leaders within the health field, the articles included seem to point to a trend in calling for a bigger leadership role of other actors, such as nurses.

Key messages

There is a need for more research in the field of leadership in chronic diseases. There seems to be a trend calling for greater leadership in the field from non-physician actors.
Metabolic complications of obesity
Authors: Mizouri R , Khiari M , Boukhayatia F , Ben Naceur K , Ben Othman R , Mahjoub F , Berriche O , Jamoussi H
Published: November 2019

Background

Obesity, through its numerous complications, influences the functional and vital prognosis, especially in situations of massive or morbid obesity. The aim of our study was to study the metabolic complications associated with obesity.

Methods

This was a descriptive cross-sectional study carried out in the first half of 2018 involving 100 obese patients attending the Obesity Unit of the National Institute of Nutrition in Tunis. Each patient received a complete clinical examination with a standard biological assessment. Obesity is defined by a body mass index ≥ 30 Kg / m2.

Results

The average age of our patients was 45.08 ± 13.9 years with a female predominance of 88%. The average weight was 103.76 ± 17.9 Kg. The average BMI was 38.95 ± 5.72 Kg / m2. The average waist circumference was 123.88 ± 13.13 cm and the average fat mass was 45.98 ± 12.22 kg. Twenty percent of our population was diabetic with an average duration of progression of 6.6. ± 4.04 years. The prevalence of dyslipidemia was high in morbidly obese patients with a rate of 18.6% compared to moderate to severe obesity at 6.4%. Arterial hypertension was noted in 33% of our population. The presence of moderate sleep apnea syndrome was noted in 31.3% of cases. Hyperuricemia was found in 8.6% of cases. Rheumatologic complications were marked by gonalgia in 26% of cases and low back pain in 6.8% of our patients.

Conclusions

Screening for complications related to obesity is necessary and essential for the comprehensive care of the obese person. Their treatment must be specific and it should not be limited to weight loss.

Key messages

Obesity. Metabolic complications.
Environment and Health: Official knowledge and lay response
Authors: Elliott P , Payne N
Published: November 2019

Due to its history, Halton, United Kingdom, provides a natural experiment to investigate the divide between lay and official knowledge about environment and deprivation, and how these may influence health choices and outcomes. 55 semi-structured interviews were carried out to assess a cross-section of residents’ perceptions and experiences of health, environment and lifestyle, taking a life history approach to examine health over time, and how choices were constructed. These were analysed for themes using a structuration theory approach. Residents’ viewpoints were then presented to twenty local public organisation officials, with their own perceptions also discussed. The overall standpoints were very different to those expressed by residents, being based on quantifiable knowledge such as that gained by officially collected statistics. Residents were not only sceptical about the knowledge presented by public health organisations, but valued lay knowledge gained through observation and experience. Official knowledge was interpreted primarily via an analysis of why this knowledge was created rather than an assessment of the knowledge itself. The interpretation was formed by a perception amongst residents that lay fears about pollution were being, at best, downplayed or, at worst, discounted by ’the powers that be’ who, in turn, placed faith in checks carried out by other official bodies. Official knowledge represented an expression of vested interests, presented by superordinate and external agents. A feeling of disempowerment co-existed alongside a perception that there was access to a form of truth via observation and experience rather than empirical knowledge. Whereas scientific information was discredited, lay knowledge was seen to be a more reliable guide as it remained free from a perceived bias. A degree of agency could be exercised perhaps only in this perception of ’pure’, if unprovable, knowledge.

Key messages

Formulation of official knowledge and reception of issued messages by lay residents in an area of high deprivation and compromised environment. Factors influencing perception, and adoption, of health messages which may impact on health and well-being in a local population.
Associations of environmental variables with different types of stroke
Authors: Vaiciulis V , Vencloviene J , Radisauskas R , Kranciukaite-Butylkiniene D , Tamosiunas A , Rastenyte D
Published: November 2019

Background

Air temperature (T) and atmospheric pressure (AP) are among the most closely studied weather variables; increases, decreases, and fluctuations in both have been significantly linked to numerous stroke subtypes. We decided to detect the association between daily numbers of ischaemic stroke (IS) and haemorrhagic stroke (HS) and daily North Atlantic Oscillation (NAO) and Arctic Oscillation (AO) indices and monthly indices of Quasi-Biennal Oscillation (QBO).

Methods

The study was conducted in Kaunas city from 2000 to 2010. Kaunas stroke register presented daily numbers of IS, subarachnoid haemorrhages (SAH), and intracerebral haemorrhages (ICH). We evaluated the association between these types of stroke and NAO, AO, and QBO indices (NAOI, AOI, and QBOI) by applying Poisson regression, adjusting for month and other weather variables.

Results

During the study period, we analysed 3,992 cases (2,205 men and 1,787 women) with stroke. IS composed 3,199 (80.1%), ICH 533 (13.4%), and SAH - 260 (6.5%). A change in mean daily atmospheric pressure (AP) of > 3.9 hPa and QBOI <-27 were associated with the risk of SAH (RRs with 95% CI were, respectively, 1.54 (1.18-2.03), and 1.68 (1.06-2.66)). The risk of HS was associated with daily increases in AP and QBOI <8.37 (p < 0.05). The risk of IS was negatively associated with AOI (RR = 0.97 (0.94-0.99). During November-March, NAOI >0 was associated with HS (RR = 1.29 (1.03-1.62)), and a negative association between NAOI and IS (RR = 0.91 (0.84-0.98)) was found.

Conclusions

The results of our study provided new evidence that the NAO, AO, and QBO pattern may affect the risk of stroke. The impact of these teleconnection indices is not identical for different types of stroke.

Key messages

This abstract is part of publication, which will be published later on. In some cases, environmental impact is not essential, but quite often determines the course of various diseases, especially of the circulatory system.
Bridging worlds: community led visual methods amidst climate change related disasters in Australia
Authors: Macdougall C , Gibbs L
Published: November 2019

Background

In February 2009 Victorian rural communities were hit by the worst bushfires in Australian history. Immediately we evaluated community groups preparing residents for bushfires. Ten years on, we are one of the few teams to evaluate medium to long term community recovery using multiple methods. As climate change becomes more visible, the frequency and intensity of disasters will increase so communities, governments and service providers need more evidence based strategies and policies. We explore how participant led visual methods provide new knowledge.

Methods

In study 1 participants in 3 of 7 focus groups in peoples’ homes spontaneously brought photos for us to examine before the discussions. In another participants spoke of the importance of photos they took at the time. We returned to the field to interview people in their homes about the meaning and role of photos.

Results

Participants wanted to inform us-as outsiders-of the awe and enormity of the fires. They created a visual record to communicate with key interest groups and ward off complacity as memories receded. Photos helped them construct timelines and meanings of the intense fires. Crucially, they recorded recovery and rebuilding in both the built and natural environments. Over the next ten years we chronicled stories from community led visual methods of communication, recovery and empowerment. We incorporated into qualitative methods participant led tours of their environments, with visual methods. Visual data collected by communities focused more strongly on the natural environment than researcher led verbal methods.

Conclusions

Visual sociology changes as technology provides participants in research with increased access to, and control over, visual methods. These changes can rebalance power relations between qualitative researchers and participants and bridge visual and verbal methods; crafting striking stories to influence those Australian policies unresponsive to climate change.

Key messages

Technological change enables participants in qualitative research to initiate visual methods to build bridges between them and researchers. Community led visual methods provide new types of data useful for theory and knowledge translation.
The impact of joining the Eurozone on nutrition habits in Lithuania
Authors: Dobrovolskij V
Published: November 2019

Background

Increases in the cost of food often leads to changes in the quantity and type of foods that are purchased. World Health Organization estimates that today’s global food prices rose to the highest level. Numerous research results show that the effect of the conversion of national currencies to the euro on the growth of consumer prices in euro area countries was generally mild and one-off.

The aim - to explore the eating habits in 2019 of the Lithuanian population and compare it with results of an eating habits research which was made before the joining euro zone in 2013.

Methods

The sample under the survey included 1007 of the Lithuania’s population. The interviewing under a questionnaire was carried out in March 2019 using the questionnaire developed for this purpose. Statistical analysis was performed using SPSS program package. The results were compared with nutritional habits of the survey done in 2013.

Results

The results showed that only one-fifth of the Lithuanian adult population thinks about food choices for health benefits - 22 % (in 2013 - 21 %). Food choice is affected by the taste - 37 % (in 2013 - 28%), to a lesser extent - the food price, which represents 24 % (in 2013 - 37%). 67% of the Lithuanian population (in 2013 - 43%) do not always eat at the same time. 59% (in 2013 - 59%) of the adult population eats three times a day. The majority - 98% (in 2013 - 92.9%) of the respondents had a snack between main meals. It is recommended to eat fresh vegetables every day, but this recommendation is shared by 55% (in 2013 - 40%). The milk and milk products are used each day by 51% (37% in 2013) of the population. The majority - 42% (in 2013 - 82%) of adult Lithuanian population most frequently used vegetable oil.

Conclusions

More people started to choose food by taste, and a decreased number of those who choose by price. There is increased number of people who eat fresh vegetables every day and decreased number of people who use vegetable oil.

Key messages

There are differents in nutrition habits among Lithuania population before and after joining Eurozone. The study showed the impact of joining the Eurozone on the diet of the population.
Main sources of information on nutrition of various socio-economic groups
Authors: Žandaras Ž , Stukas R
Published: November 2019

Backgroud

For effective non-communicable disease prevention and health promotion programs, it is very important to know from where the targeted audience gets all the information on nutrition (NI). The shortage of this information lead to the aim of this study - to determine the main sources of NI of various socio-economic groups.

Methods

Cross-sectional study was conducted in 2019. 1007 residents of Lithuania aged 18-75 were surveyed by anonymous questionnaire. Survey was carried out by using multi-stage stratified random sampling. Chi square test was used for the data analysis.

Results

More than half respondents (58.6% (95% CI: 55.5; 61.6)) indicated that one of their main sources of NI is internet, 47.2% (95% CI: 44.1; 50.3) of respondents trusts television and radio. Only one third of residents (36% (95% CI: 33.1; 39.1)) indicated physicians and pharmacists as the main source of NI and only 20.6% (95% CI: 18.2; 23.2) of them received NI from specialized nutrition and health magazines. Younger people were more likely to choose internet as the main source of NI (65,7%, 58%, 54,1% accordingly (p = 0.004)). Internet as the main source of NI was significantly related to residence, education, income and marital status. The number of respondents who identified television as the main source of IN was significantly higher among the rural population (53.2%) and small-town population (52.9%) than among the population of big cities (39.4%) (p < 0.0001). Choosing television as one of main source of NI was significantly related to age, education, income and marital status. 24.3% of women and 16.4% of man indicated that the main source is specialized nutrition and health magazines (p = 0.002).

Conclusions

Best place for spreading NI is internet and television. When trying to target young people the best place is internet and for targeting senior citizens NI is better to carry out by television and radio.

Key messages

Most population gets information about nutrition from internet and television. Most young people gets information about nutrition from internet and most older people gets information from television and radio.
Background characteristics of meat consumption exceeding the Finnish Dietary Guidelines in 2000-2017
Authors: Lehto E , Kaartinen N , Sääksjärvi K , Männistö S , Jallinoja P
Published: November 2019

Background

Abundant consumption of animal-based foods such as red and processed meat pose a threat to sustainability and public health. This study clarifies how the share of the population group with high red and processed meat consumption has changed in the past two decades.

Methods

We used data of four Finnish cross-sectional surveys: Health 2000 (n = 5976), DILGOM 2007 (n = 4874), FINRISK 2012 (n = 4812), and FinHealth 2017 (n = 6010) concerning 25-74 year-old subjects (in year 2000 30-74 year-olds). Habitual food consumption over the past 12 months was assessed with a validated130-item food frequency questionnaire (FFQ) and daily meat consumption was computed. Questionnaires inquired on general background factors. The risk in belonging to the meat consumption quintiles exceeding the Finnish Dietary Guidelines (500 g /week) was examined with logistic regression analyses.

Results

In 2000, consuming more meat than recommended was more probable among men and those with lower or middle educational level. In 2007 and 2012, in addition to gender and education, having middle or higher income level and belonging to the age group of 35-44 years was associated with higher meat consumption. In 2017, meat consumption was higher among men, those with lower educational level and among 45-64 years old, but no income level differences were observed.

Conclusions

Actions aiming to reduce meat consumption should be targeted to those consuming the largest amount of meat: men, middle-aged, and those having lower educational level.

Key messages

The group consuming more meat than recommended has remained stable in the 21th century to include more often men, middle-aged, and people having lower education but income has become non-significant. Identification of population groups with high meat consumption helps to better design and target the interventions and to change the consumption patterns in a healthier and more sustainable direction.
Dietary polyphenol intake and socioeconomic status in adult russian/siberian population
Authors: Berezovikova I , Denisova D
Published: November 2019

Background

Polyphenol consumption from polyphenol-rich foods (tea, coffee, fruits, vegetables at all) is inverse associated with the risk of cardiovascular- and other noncommunicable chronic diseases and varies in different regions due to dietary habits, as well as by socioeconomic factors.

Methods

Participants: the Siberian urban population (Novosibirsk, HAPIEE study, 9324 (4,249 men and 5,075 women) aged 45-69 years. Dietary data collected using a 141-item food frequency questionnaire. Data on the polyphenols were taken from the Phenol-Explorer database (version 3.6). Total polyphenols (TPH) were considered as a sum of all individual classes: flavonoids, phenolic acids, stilbenes, lignans and other polyphenols and their food sources. Socioeconomic status included gender, educational, occupational and marital status.

Results

The main sources of TPH were tea, coffee, fruits, vegetables and rye bread. Average total polyphenol consumption was 1273 (647) in men and 1203 (626) mg/day in women (P < 0,05). By occupational status, consumption of TPH in unemployed men was lower - 1139 (442) mg/day vs 1282 (648) in employed, working pensioners and unemployed pensioners (P < 0,05). The consumption of TPH in women: in unemployed pensioners: 1176 (613) vs 1220 mg/day in employed and working pensioners. The main polyphenols intake in all occupational groups were flavonoids (66,1-67,6 % total polyphenols), followed by phenolic acids (21,4-22,3%). TPH consumption in groups with less education than primary in men was lowest: 1052 (476) mg/day vs 1273 (646) (P < 0,05 vs men with higher education). In men and women with high education was highest consumption of lignans. The maximum consumption of polyphenol compounds was established in groups of married men and women:1279 (646) and 1231 (632) mg/day, respectively, P < 0,05 vs single individuals.

Conclusions

The consumption of polyphenol compounds in the Siberian urban population is determined by the socioeconomic status.

Key messages

The main individual classes of polyphenols consumed in all educational and marital status groups were the same as in the employment group: flavonoids, followed by phenolic acids. Recommendations for consumption of polyphenol compounds for the prevention of chronic non-communicable diseases in Siberia should consider the socioeconomic status of the population.
Identification of a strategy for disinvestment in the Italian National Health Service (NHS)
Authors: Cadeddu C , Di Brino E , Campisi F , Meloni A , Romeo S , Montemagno M , Cicchetti A , Marchetti M
Published: November 2019

The disinvestment of ineffective or inappropriate technologies or interventions with an inadequate value for money ratio is a growing priority in order to contribute to the objectives of maintaining high quality and appropriate care and allocation of resources that guarantee the sustainability of the National Health System (NHS).The possibility of reallocating resources from obsolete and no longer appropriate technologies, allows for recovered resources to be allocated to technological innovation and therefore to the overall sustainability of the system.In order to define criteria concerning disinvestment techniques of health technologies and strategies of obsolete technologies to be applied within the Italian reference framework, we started an ongoing research project.

A systematic review of the scientific literature of the last 10 years was carried out on 5 different databases with the purpose of analyzing the international disinvestment experiences of health technologies using the Health Technology Assessment (HTA) method and focusing on orthopedic prosthesis procedure and cardiac stenting procedure.By means of National Dataset of the Italian National Institute of Health, real consumption and estimated consumption have been identified,using the Italian NHS perspective.

The preliminary systematic review retrieved a total of 548 records. Nine results were finally included. In the development of disinvestment strategies, particular attention must be paid to the identification of an integrated model between the different levels of the NHS (national,regional,local). In Italy there are no prior example of broad and complex disinvestment experiences using HTA methodologies. Effective disinvestment strategies require a systematic approach coordinated by a national body and implemented at regional level,to be extended to cascade to the organization and provision of services and services by health companies,and required to actively involve health professionals and citizens.

Key messages

Identifying effective strategies for disinvestment of health technologies is crucial, considering continuous health innovation and improvement and development opportunities. HTA methodologies, such as reassessment, could support disinvestment processes and represent a systematic and objective approach to be implemented and used at different levels of Italian NHS.
Cardiovascular and respiratory diseases and neoplasms in seafarers and farmers in Denmark
Authors: Herttua K
Published: November 2019

Background

Seafaring is a very specific occupational environment and seafarers are exposed to many health risks. On the other hand, regular medical examinations are obligatory to get permission for working onboard. We sought to estimate relative risk of hospital contacts due to neoplasms, cardiovascular and respiratory diseases among seafarers compared to farmers, as a relevant land-based trade.

Methods

The participants were all seafarers and all farmers aged 18-65 year at the baseline and residing in Denmark. Two cohorts with baselines in 2002 (n = 56,216) and 2012 (n = 42,000) were linked to records from Danish health registers. We calculated the hazard ratios of hospital contacts using Cox regression models separately for men and women.

Results

In all disease categories, the risk for hospital contact was greater among male seafarers compared with male farmers. The adjusted hazard ratios (HR) for the 2012 cohort for neoplasms, cardiovascular and respiratory diseases were 1.36 (95% CI: 1.17 to 1.58), 1.16 (1.01 to 1.32), and 1.51 (1.28 to 1.78), respectively. Among female seafarers, the HR for the 2012 cohort for respiratory diseases was 1.58 (1.18 to 2.10), but for cardiovascular diseases 0.73 (0.54 to 0.99). Differences for neoplasms were marginal among women. The incident rates and differences decreased in cardiovascular diseases and increased in neoplasms and respiratory diseases, particularly in men.

Conclusions:These data suggest that seafaring is associated, compared with farmers, with a substantially increased risk of neoplasms, cardiovascular and respiratory diseases among men.

Key messages

Seafaring is associated, compared with farmers, with a substantially increased risk of neoplasms, cardiovascular and respiratory diseases among men. The incidence rates were highest for CVD in men and for neoplasms in women.
Work-related diseases in temporary workers in France between 2009 and 2014
Authors: Rivière S , Tassy V , Bonmarin I , Chatelot J
Published: November 2019

Background

The percentage of temporary workers in the workforce has increased in many European countries. The working environments of temporary workers are often characterized by job insecurity and exposure to hazardous working conditions. Studies have investigated the health status of this population but few of them have specifically investigated work-related diseases. The aim of this study is to compare the risk of uncompensated work-related diseases (UWRD) in temporary workers with permanent contract workers in France between 2009 and 2014.

Methods

UWRD and suspected associated exposure factors were notified by occupational physicians involved in French UWRD surveillance programme. Sociodemographic and professional characteristics were recorded for all salaried workers consulted by occupational physicians. We analysed musculoskeletal (MSD) disorders (elbow, hand/wrist, shoulder, back) and mental health disorders (MHD) according the type of consultation (periodic check-up, hiring...) using logistic regression. The distributions of notified exposure factors for MSD and MHD were compared between temporary and permanent workers.

Results

Of the 433 148 salaried workers consulted as part of the surveillance programme, 5.3% and 80.2% had temporary and permanent contracts, respectively. Temporary workers were as likely to have work-related shoulder, elbow and hand/wrist MSD as permanent workers. The former had a lower risk of MHD irrespective of the type of consultation ([OR] = 0.4, 95 % CI 0.3-0.5) and a lower risk of back MSD during on-demand/return-to-work consultations ([OR] = 0.2, 95% CI 0.1-0.5) and during periodic check-ups ([OR] = 0.3, 95% CI 0.2-0.7).

Conclusions

Temporary workers were not at a higher risk of UWRD (MSD and MHD) than permanent workers. This suggests that the generally poor health status found in temporary workers in previous studies may be linked more to their general health status and perceived job insecurity than to poorer working conditions.

Key messages

In our study, the risk of work related musculoskeletal disorders and mental health disorders in temporary workers was no greater than that in permanent workers. Poor general health known in temporary workers, may be linked more to their general health status, job insecurity and decreasing career trajectory than to poorer working conditions.
Psychosocial working conditions and future sick leave and disability pension trajectories in Sweden
Authors: Salonen L , Alexanderson K , Rugulies R , Framke E , Niemelä M , Farrants K
Published: November 2019

Background

Psychosocial working conditions such as job demands and job control have been found to be associated with employee health and well-being, but studies on the associations with sickness absence (SA) and disability pension (DP) are scarce. We examined 11-year SA/DP trajectories and the association between psychosocial working conditions and subsequent SA/DP trajectories in the Swedish workforce.

Methods

Using a prospective cohort study with microdata we explored SA/DP trajectories among female and male employees, respectively, aged 30-53 years in 2001 in Sweden (1,076,042 women; 1,102,721 men). Group-based trajectory analysis was used to model annual mean SA/DP net days trajectories in 2002-2012. Based on a Swedish Job Exposure Matrix (JEM), individuals were assigned an age-, sex- and occupation-specific mean score for demands and control, respectively. Mean scores were categorized into tertiles and categorised into 3x3 combinations of exposure categories. Using multinomial regression we predicted trajectory group memberships for the JEM.

Results

The highest rate of women were in occupations with low demands and control (24.8%), while the highest rate of men (22.9%) was in occupations with high demands and control. We found three SA/DP trajectories for women (low, medium, high increasing) and two for men (low, high increasing). In fully adjusted models, those in occupations with low demands and low control were at higher risk of belonging to the high increasing SA/DP trajectory compared to those in occupations with high job demands and control in both women (OR 3.86; 95% CI: 3.75-3.97) and men (OR 3.0; 2.99-3.16).

Conclusions

Low job demands and low job control were associated with more high increasing future SA/DP trajectories compared to high job demands and job control in both women and men.

Key messages

In Sweden, women are more often in occupations characterized by low job demands and low job control and men are more often in occupations with high job demands and high job control. Occupations with low job demands and low job control were associated with more adverse SA/SP trajectories compared to occupations with high job demands and high job control in both women and men.
Approach for Compensation System of Asbestos-Related Lung Cancer
Authors: Nishina Y , Niino M , Higashi T
Published: November 2019

Background

The health hazards of asbestos have been globally recognized, especially those among industrial workers with long-term exposure. Lung cancer is one such asbestos-related disease. It occurs not only among workers but also among residents with environmental exposure to asbestos. Patients with work-related exposure can receive occupational compensation, and patients with non-occupational exposure are supported by a separate compensation system in Japan. However, the latter is not well-known among clinicians, and a substantial number of patients may have been left out. We need an effective way to find patients eligible to receive benefits by better understanding the clinical conditions that characterize patients with asbestos-related lung cancer.

Methods

We conducted two types of research: 1. Comparison of clinical characteristics between compensation system recipients (N = 65) and general lung cancer patients diagnosed in 2015, using Japan’s National Database of Hospital-Based Cancer Registry.

2. Estimation of the frequency of pleural plaques among lung cancer patients by double-checking CT scan images of a random sample of lung cancer patients obtained from the HBCR national database (N = 3585).

Results

Patients with squamous cell carcinoma are twice as likely asbestos-induced as patients with other histology overall after adjusting for age, sex and cancer stages, but not smoking status and history. As many as 20% of the CT images were read inconsistently between two radiologists or respiratory disease doctors and we could not obtain the accurate rate of candidacy for the compensation system.

Conclusions

We require more accurate information about pathological characteristics by controlling for smoking status and history among compensation recipients. For radiologic interpretation, more effective education is needed for the radiologists and respiratory disease doctors who treat lung cancer patients.

Key messages

Specific information about asbestos-related lung cancer would lead clinicians to correctly identify asbestos-related lung cancer. Educational system for clinicians would help patients to receive the benefit of compensation.
An investigation of putative exposure of staff to novel psychoactive substances in a prison
Authors: Mark K , Waugh C , McCormick D , Joyce J
Published: November 2019

Issue

In a prison in Scotland, an increasing number of incidents occurred where staff became unwell secondary to potential exposure to novel psychoactive substances (NPS) smoked by prisoners. There were high levels of concern for the safety of individual staff, and for establishment staffing. NPS use is a significant problem in custodial settings, and impacts individuals and establishments.

Methods

HMP and HPT led an incident response: HMP focused on prevention and direct management of incidents; HPT focused on exposure circumstances, clinical presentation and toxicological testing of symptomatic staff. A protocol was agreed between all agencies involved. Over 8 months, all incidents’ initial assessment and any subsequent clinical and toxicological results were collated and analysed by HPT.

Results

There were 19 incidents involving 16 staff members. Cases presented in clusters, in one instance 13 people presented over 5 days. Five presented in early 2018.

Individuals reported a wide range of non-specific physical and psychological effects; some cases experienced severe impairment of day-to-day function. The most common effects were headache and fatigue but some reported sleep disturbance and confusion lasting up to 72 hrs. There were no significant clinical observations at hospital, and the 3 tests for toxicology were negative.

Lessons

The individuals affected by these incidents experienced physical and psychological distress, and impairment of daily functioning which impacted on the safe function of the establishment. It is unlikely staff presentations were due to toxicological effects from substances used by prisoners. It is possible their symptoms were psychosomatic. This could be further investigated, and consideration given to supportive intervention for staff affected by exposure to NPS. The investigation demonstrated excellent collaborative work between the prison, health services, and forensic laboratories in a novel investigation into NPS exposure in prisons.

Key messages

NPS use, and subsequent exposure to staff, is a growing issue in custodial settings. A combination of supportive interventions for staff, including reduction and mitigation of risk of exposure to NPS, plus control of substances use in prisons can help.
Occupational Eye Trauma: a major public health issue in Rabat, Morocco
Authors: Harrak Y El , Boutimzine N , Cherkaoui L O
Published: November 2019

Occupational eye trauma is a global cause of visual morbidity. According to the WHO, 55 million ocular lesions occur each year, and 1.6 million cases of total blindness caused by trauma. Although common in Morocco, these traumas have not been the subject of recent and targeted investigations.

The objective of our work is to evaluate the frequency of occupational eye trauma per projectile, and to encourage the reinforcement of safety measures. This is a cross-sectional descriptive study, carried out in the Ophthalmic Emergency Department, at the University Hospital of Rabat, Morocco, and including all patients who presented to the same doctor’s consultation, between December 2016 and December 2018. The study involved 914 patients, 406 women and 508 men, with an average age of 36. The average consultation time is 35 days after the onset of symptomatology.

In 2 years, and out of 914 people, 382 (42%) are victims of ocular trauma; and 167 are victims of projectile eye trauma during professional practice, an overall prevalence of 18%, or 51% of all trauma.

The average age was 32 years, 92% of males. The average consultation time was 2 days after the accident. In addition, 75% of consultants for occupational eye trauma have a similar history of trauma, 3 out of 4 people. As a consequence, the study shows that 85% of these patients had a superficial corneal foreign body; 11% presented with a corneal ulcer without individualization of a foreign body; while 4% of these had a corneal wound, an intraocular foreign body and posttraumatic retinal detachment. Therefore, eye trauma is a real public health problem. They account for 42% of consultations, half of which are associated with professional activities, mainly affecting young and active men. If they are benign in most cases, these traumas can nevertheless cause blindness in 4%.

The high number of recidivism (75%) highlights the lack of awareness of the target population for better prevention.

Key messages

The results of this work prove that occupational ocular trauma, avoidable circumstances, are however frequent in our context and can cause severe lesions, with a reserved prognosis. Workplaces with a high risk of eye trauma should strengthen their protective measures and training programs should be put in place for both workers and occupational physicians.
Developing a Patient Advocacy Scale for Nurses
Authors: Sermet E , Kadioglu H
Published: November 2019

Background

Patients can sometimes become defenseless. Patient advocacy is one of the most important roles of nurses in healthcare. No valid and reliable instrument that evaluates nurses’ behavior as patient advocates has been encountered in the literature. The purpose of this study was to develop a patient advocacy scale for nurses.

Methods

This methodological study was conducted in Istanbul over the period October - December 2018 with 500 nurses. Initially, a scale of 57 items was devised after discussions with 14 academic and clinical nurses. The scale was tested for content validity using the Content Validity Index and for construct validity with Exploratory Factor Analysis, after which the scale’s reliability was evaluated for item-total correlations using Pearson’s correlation analysis and for internal consistency with Cronbach’s Alpha.

Results

Content validity index for the scale was found to be .97. The first factor analysis resulted in a 10-factor construct, where the eigenvalue for the scale was greater than 1 and the construct explained 63.43% of total variance. At the end of the factor analysis, items with factor loadings of less than .30 and those that appeared in more than one factor with differences of less than %10 were removed from the scale one by one and the analysis was repeated 18 times. In the last factor analysis of the 39-item scale, a 7-factor construct was found with an eigenvalue greater than 1 that explained 61.3% of total variance. The scale’s item-total correlations ranged between .42 - .75 and Cronbach’s coefficient alpha was calculated to be .95.

Conclusions

The newly developed instrument was found to be valid and reliable. The scale can be used to assess the patient advocacy behavior of nurses working in Turkey. Its intercultural adaptation for use with nurses working in other countries is recommended.

Key messages

The Patient Advocacy Scale for Nurses has been found to be valid and reliable. It can be used to assess nurses’ patient advocacy behavior.