bluuebunny/crossref_metadata_2025_split huggingface dataset:
O1B.1 Modeling infertility in a cohort of canadian tradeswomen
Authors: Cherry Nicola , Galarneau Jean-Michel 
Published: May 2020

IntroductionWith few female occupational cohorts, little is known about the contribution of work exposures to female infertility.MethodsA cohort of 888 tradeswomen across Canada was established (450 welders and 438 in the electrical trades) to examine effects on the fetus, with investigation of infertility a secondary objective. Women completed an extensive questionnaire at recruitment and follow-up questionnaires every six-months for up to 5 years. At each contact she was asked about attempts to get pregnant and barriers to conception. Fertility issues were identified both by self-report of failure to conceive for ≥12 months and as the likelihood of conceiving in any month at risk. Determinants of infertility were examined in a Cox regression with time dependent covariates. Employment factors examined in each month were paid work, trade work and cumulative months in trade. Maternal age, prior conceptions, smoking, use of alcohol and BMI were examined as confounders.Results96 periods of infertility ≥12 months were reported among 38 women from welding and 52 from electrical trades giving the risk of infertility for welders relative to electricians of 0.71 (95%CI 0.48–1.06). Total person months at risk (excluding months with no sex, pregnancy, surgical sterility or menopause) were 12 696 for welders and 13 313 for electricians. Likelihood of conceiving in any month at risk was significantly reduced with use of better contraception, drinking >7 units of alcohol, increasing age, number of previous pregnancies and, for welders, smoking >10 cigarettes/day. No effect of either current or cumulative work in trade was evident having adjusted for confounding. HR for working as a welder was −0.07 95% CI −0.49–0.35.ConclusionsFemale infertility presents challenges as an outcome in occupational epidemiology, but data can be structured to allow for time at risk. Analysis to date has demonstrated no important effect of exposure to welding.
O5C.1 The NZ vietnam veteran family study: a multi-generational perspective on health and wellbeing
Authors: McBride David , Richardson Amy , Cox Brian 
Published: May 2020

BackgroundThe serious impact of Vietnam service on New Zealand veterans arose from high levels of combat experience and exposure to chemical agents including Agent Orange. In 2009, we assembled a cohort of 2783 men and 23 women Vietnam veterans. They had significantly increased risks of head and neck cancer and chronic lymphatic leukaemia, with high rates of hospitalisation for renal failure and drug and alcohol problems. Overseas data indicates that families have been affected by relationship difficulties, with subsequent risks of adverse psychological outcomes in children. There have been few longitudinal studies which include a comprehensive exposure assessment (the exposome) and include both veteran and family, which is what we propose.Study populationUsing the cohort data, the electoral roll and an information campaign, we will recruit veterans, their spouses and their children for follow up. For all groups, we will obtain data to inform the general exposome through a base-line health survey using some of the brief measures deployed in our ‘contemporary veterans’ study, including the Post Traumatic Checklist (Civilian or military) for PTSD, and the Brief Family Relationship Scale exposure history.The specific exposome, including chemicals and ‘other’ specific exposures, will be recorded by on-line questionnaire and subsequent interview.Effects will be assessed through linkage to the Birth Defects Register, Mortality Collection, routine datasets for hospital discharge, and the Cancer Registry, using comparisons with national rates where appropriate. Most importantly, permission will be sought to flag individuals at the Cancer Registry, with access to blood or tissue samples facilitating the identification of genomic ‘effect biomarkers’. We hope that the method will be extended to other cohorts and for future deployments.
O5C.6 The health and wellbeing of new zealand veterans
Authors: McBride David , Gardner Dianne , Richardson Amy , Wyeth Emma , Samaranayaka Ari , Gurung Gagan , Derrett Sarah 
Published: May 2020

The psychological and physical health and wellbeing of New Zealand contemporary veteransBackgroundFor New Zealand veterans, operational service and transition to civilian life are critical life events. Most veterans do well, but a significant minority fare poorly. Adverse outcomes are associated with post-traumatic stress disorder, PTSD, and also the development of minor but multiple health complaints, ‘multiple symptom illness’ (MSI).AimThis project investigates factors associated with both wellbeing and ill health in NZ veterans, with the aim of developing a parsimonious instrument to detect ‘at risk’ veterans prior to, or at, transition.MethodsAn on-line cross-sectional survey.Wellbeing is measured by the EQ-5D, a health-related quality of life instrument assessing mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. The adverse outcome is PTSD, identified using the PCL-M, an instrument reflecting DSM-IV PTSD symptoms.Risk factors include MSI conforming to the Centers for Disease Control definition as ‘the presence, for at least six months, of one or more chronic symptoms from at least two of three categories, namely fatigue, mood-cognition and musculoskeletal symptoms’. The General Health Questionnaire-28 (GHQ-28) screens for emotional distress and possible psychiatric morbidity. The Brief Trauma Questionnaire (BTQ), a 10-item self-report questionnaire derived from the Brief Trauma Interview, assesses the role of stressors contributing to PTSD.Protective factors include the 24-item Social Provisions Scale (SPS) assessing social relationships and various dimensions of social support.AnalysisLogistic regression will identify the model of best fit for PTSD (PCL-M) and wellbeing (EQ-5D) respectively.For MSI, a factor analysis will describe the pattern of symptom reporting. If this matches international experience, 3 factors will explain the majority of the variance in the data.ResultsAs at the 14th Nov 2018 we have 1592 completed questionnaires. Analysis will commence in mid-November 2018.
O6A.2 Breast cancer risk in 40.000 danish women by industry
Authors: Pedersen Julie Elbæk , Hansen Johnni 
Published: May 2020

BackgroundOccupational exposures have been hypothesized as contributors to breast cancer. Nevertheless, studies exploring the risk of breast cancer by occupation or industry generally show somewhat inconsistent results. In addition to small study size and lack of lifetime work history, potential confounders, such as reproductive history, have often not been taking into account and mortality has often been used as outcome. We conducted a nationwide register based nested case-control study in order to explore associations between occupation and incidence of breast cancer, including reproductive history.MethodsA total of 38,347 employed women born in Denmark during the period 1946 to 1995, and diagnosed with breast cancer 1970–2015 were identified in the nationwide Danish Cancer Registry. Five control subjects, work active and born in Denmark, and free of breast cancer at the date of diagnosis of the corresponding case, were chosen randomly from the Danish Civil Register. Using the unique personal identification number assigned to all residents in Denmark, we obtain lifetime employment history from the nationwide Pension Fund Register, which on an individual level has kept detailed information on all employments in Denmark since 1964. Lastly, information on reproductive factors, and socioeconomic status was retrieved from the Danish Civil Register. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated by conditional logistic regression analysis.Preliminary results: Risk elevations were e.g. seen in the military (2.1; 1.49–2.90), printing (1.6; 1.22–2.06), airline transportation (2.4; 1.33–4.47), automobile service (1.3; 95% CI 1.12–1.49), laundries (2.4; 1.48–3.79), hairdressing (1.9; 1.11–3.23) and paint factories (1.6; 95% CI 1.22–2.06). Risk reductions were seen in farming (0.4; 0.21–0.59), window cleaning (0.6; 0.44–0.84) and building and carpentry (0.8; 0.70–0.98).ConclusionsThe study suggests that breast cancer risk varies significantly by industry and that occupational exposures, including night-shift work, solvents and outdoor work, may play a possible role.
O6A.3 Implications of the workplace gender composition for depression-related service utilization: a retrospective cohort study of U.S. aluminum workers
Authors: Elser Holly , Rehkopf David , Bradshaw Patrick , Brick Carmen , Schneider Daniel , Eisen Ellen , Cullen Mark 
Published: May 2020

IntroductionPast research finds that both male and female workers in male-dominated workplaces experience decreased job satisfaction and increased work-related stress. Female workers in particular are more likely to experience gender discrimination, sexual harassment, and social isolation. Nevertheless, systematic evidence regarding the association between workplace gender composition and worker mental healthcare utilization remains limited.MethodsUsing data from the American Manufacturing Cohort Study (AMC), we examined the association between workplace gender composition and risk of depression-related outpatient visits among hourly workers employed at one of 32 U.S. aluminum plants between 2003 - 2013.Using generalized additive models (GAM) with a logit link, we modeled risk of depression-related outpatient visits as a function of annual workplace gender composition (i.e. percent women) and covariates (baseline age, race, sex, plant, and calendar year). We captured potential nonlinear relationships using cubic smoothing splines. We used g-computation to summarize the counterfactual risk of depression-related outpatient visits under three hypothetical interventions wherein women comprised at least 10, 20, or 30 percent of the workforce at all plants for all years of follow-up. We compared these counterfactual risks to the risk under no intervention (the observed data).ResultsAcross all 32 U.S. plants, the final study sample included 5,279 female and 24,124 male hourly workers. We observed significant reductions in the number of depression-related outpatient visits when women comprised at least 20% (RD=-6.2, 95% CI -8.75, -3.65) and 30% (-14.6; 95% CI -19.0, -10.2) of the workforce. Findings were consistent within subgroups of male and female workers.ConclusionThe gender composition of industries, occupations, and workplaces is an important expression of social structure. We find that modest increases in the percent women employed in otherwise male-dominated work environments can lead to measurable reductions in the frequency of depression-related outpatient visits among male and female hourly workers.
O6A.5 Mortality and risk behaviours in spanish female farmers
Authors: Zhao Guanlan , Ronda Elena , Barrio Gregorio , Regidor Enrique 
Published: May 2020

IntroductionNumerous epidemiological studies have been conducted among farmers, but very few of them have included female farmers. Therefore, the health status of female farmers remains understudied. Our aim is to compare the mortality rates and the prevalence of risk behaviours in a cohort of female farmers and female non-farmers in Spain.MethodsThe cohort study followed 5,919,413 female workers in Spain from 2001 to 2011. Participants aged 20–64 years were employed in 2001. The study subjects were grouped as farmers and non-farmers The prevalence of risk behaviours was calculated from the 2001 National Health Survey for 5573 employed women. For each cause of death, we estimated the age-standardized mortality rates per 1 00 000 person-years of follow-up, the ratio of age-standardized mortality rates with 95% confidence intervals (CI), and for each risk behaviours age-standardized prevalence ratio in female farmers compared female non-farmers.ResultsThe mortality rate ratio of female farmers compared to the female non-farmers was 1.00 (95% CI 0.96–1.05). For most these cause of deaths no significant differences were observed in the mortality rates between both groups, except in mortality from lung cancer, chronic lower respiratory disease, transport accidents and suicide, which mortality rate ratios were 0.56 (0.46–0.67), 0.44 (0.23–0.87), 1.47 (1.16–1.86) and 1.41 (1.10–1.81), respectively. The prevalence of smoking and excessive alcohol consumption was lower in female farmers.DiscussionWe found a decreased in the mortality ratio for tobacco-related cancers. Exposure to psychosocial risk factors could be the reason of higher mortality of external causes of death of Spanish female farmers.
O6B.5 Variation in nordic work-related cancer risks after adjustment for alcohol and tobacco
Authors: Kjaerheim Kristina , Haldorsen Tor , Lynge Elsebeth , Martinsen Jan Ivar , Pukkala Eero , Weiderpass Elisabete , Kr Grimsrud Tom 
Published: May 2020

BackgroundConsumption of alcohol and tobacco strongly increases risk of cancer of the tongue, mouth, pharynx, larynx, and oesophagus, and are established risk factors also for cancer of the liver, colon, and rectum. It is well documented that these habits are unequally distributed among occupational groups. Most occupational cohort studies do not have information on these potentially important confounders, and may therefore be prone to bias.AimThe aim of the study was to calculate standardized incidence ratios (SIRs) adjusted for alcohol and tobacco by occupation, and to compare to the unadjusted SIRs.Material and methodsThe study is based on the Nordic Occupational Cancer (NOCCA) database.We used confirmatory factor analysis models where the unobserved pattern of alcohol and tobacco consumption were considered a latent common factor, and the potential occupational variation on each cancer type latent site specific factors. Results were used to compute adjusted expected numbers of cancer from the reference rates and to calculate adjusted SIRs for the relevant cancer sites for each occupation.ResultsChanges of risk estimates from significantly high to significantly low and vice versa were seen. Among Nordic farmers, unadjusted SIRs for cancer of the mouth and oesophagus were 0.56 (95% confidence interval [CI] 0.51–0.61) and 0.67 (CI 0.63–0.70), respectively. After adjustment, estimates changed to 1.10 (CI 1.01–1.21) and 1.16 (CI 1.10–1.22). Unadjusted SIR for pharynx cancer among wood workers was 0.83 (CI 0.75–0.91), adjusted SIR was 1.14 (CI 1.03–1.25). For larynx cancer, results in the opposite direction were seen: unadjusted SIR for economically inactive was 1.38 (CI 1.31–1.46) while the adjusted SIR was 0.91 (CI 0.86–0.96).ConclusionAdjustment for the latent indicators of alcohol and tobacco consumption changed risk estimates for several occupations, and may guide in the identification of true risk factors and preventive strategies.
O6C.4 The relationship between the demand-control model and incident cardiovascular disease in ontario canada. A linked analysis of 12,358 workers
Authors: Smith Peter 
Published: May 2020

Dimensions of the demand-control psychosocial work environment model have previously been linked increased incidence of both diabetes and hypertension in Canada. However, few investigations in Canada have examined the relationship between the demand-control model and cardiovascular disease.We linked Ontario respondents to the 2000, 2002 and 2003 cycles of the Canadian Community Health Survey, to administrative health care and hospitalisation databases to identify incident cases of cardiovascular disease over a 15 years follow-up period. Our sample included employed labour market respondents, aged 35 and older, working 15 or more hours per week, with information on the psychosocial work environment, and who were free of heart disease at baseline (n=12,358). The demand-control model was defined based on median splits (active, passive, low strain and high strain), although models using the mid-population approach and the ratio of control to demands were also examined.Over the study period 507 incident cardiovascular events occurred. The incidence was higher among men (5.5%) compared to women (2.6%). No statistically significant differences were observed across the four different demand-control categories in the full sample. In stratified analysis, passive work environments (low control and low demands) and low-strain environments (high control and low demands) were associated with increased risk of heart disease (HR=1.94, 95% CI 0.99–3.81; HR=2.06, 95% CI 1.01–4.17), compared to active work (high demands and high control) among women. No similar relationship was observed among men.Among a representative sample of Ontario workers, high strain work environments were not associated with increased risk of heart disease. Passive and low strain environments (both characterised by low psychological demands) were associated with increased risk of heart disease among women, but not men. Implications of these findings for assessment of the psychosocial work environment in Canada will be discussed.
O6D.5 Electronic waste recycling exposure and hormone levels in workers
Authors: Gravel Sabrina , Bakhiyi Bouchra , Lavoué Jérôme , Verner Marc-André , Zayed Joseph , Labrèche France 
Published: May 2020

Background and objectiveElectronic waste recycling (e-recycling) exposes workers to several contaminants, including flame retardants that are suspected endocrine disruptors. We aimed to explore the association between polybrominated diphenyl ethers (PBDEs) and hormone levels in the serum of Canadian e-recycling workers.MethodsIn a cross-sectional study, blood samples were collected from 85 e-recycling workers (six facilities) and from 15 workers in other types of recycling (two facilities), at the end of a work shift. Socio-demographic information was obtained by questionnaire and body mass index (BMI) was calculated from measured height and weight. Serum concentrations of 13 PBDE congeners were measured as well as thyroid hormones (free and total thyroxine [T4], triiodothyronine [T3], thyroid stimulating hormone [TSH]) and testosterone (free and total). Linear regressions were stratified on sex and adjusted for age, BMI, seniority, smoking status, and type of recycling. Ten participants were excluded because of thyroid or testicular problems.ResultsParticipants were 23 women and 77 men (mean 40 years old, SD=12 years). Average hormone levels were within the laboratory normal range. In e-recycling, geometric mean concentrations of the most detected congeners were 11, 11 and 20 ng/g lipids for BDE47, BDE153 and BDE209, respectively. Only BDE209 concentrations were higher in e-recycling than in the control group. A two-fold increase in serum BDE209 was associated with a significant increase of 2.48 nmol/L in total T4 in men (p=0.011), and with a close to significant increase in the free/total testosterone ratio of 6% in men (p=0.053). BDE47 and BDE153 were not associated with hormone levels.ConclusionsThe clinical significance of high exposure to BDE209 in working adults is yet to be established, but endocrine effects were observed in this population. E-recycling workers are highly exposed to PBDEs among other substances, which may make them more vulnerable to hormonal disruption.
O6E.3 Can the multistage model be applied to amyotrophic lateral sclerosis (ALS)?
Authors: Pearce Neil 
Published: May 2020

BackgroundThere are several intriguing features of amyotrophic lateral sclerosis (ALS). Some people with genetic susceptibility never develop ALS; ALS develops in late life and progresses rapidly; the same mutation can predispose to ALS or other diseases; ALS starts in one region and spreads; degeneration is specific to a subgroup of neurons; and ALS shows complex inheritance. Cancer shares many of these characteristics, and these have been incorporated into the Armitage-Doll multistage model. We therefore used this model to investigate the hypothesis that ALS is a multistage process.MethodsIncidence data by age and sex were generated from five ALS population registers, in Ireland, the Netherlands, Italy, Scotland and England; age and sex adjusted incidences were calculated for each register.Findings6274 cases were identified from 73 million people. There was a linear relationship between log incidence and log age in all five registers: Ireland R2=0·99, Netherlands R2=0·99, Italy R2=0·95, Scotland R2=0·97, England R2=0·95, overall R2=0·99. All five registers gave very similar estimates of the linear slope ranging from 4·5 to 5·1, with overlapping confidence intervals. Combining all five registers gave an overall slope of 4·8 (95% CI 4·5, 5·0) with similar estimates for males and females. In persons with known genetic mutations which predispose to ALS, the risk of ALS was higher, but the log-incidence/log-age slope was lower, as predicted by the multistage modelo.InterpretationA linear relationship between the log incidence and log age of onset of ALS is consistent with a multistage model of disease. The slope estimate is about 5, suggesting that ALS is a 6-step process; the slope is 3–4 in persons with known genetic causes. These findings have implications for the search for causes of ALS, including occupational causes and gene-environment interactions.
O7C.3 Effectiveness of a multi-faceted intervention to prevent musculoskeletal pain in nurses and aides: results of a cluster-randomized controlled trial
Authors: Font Mercè Soler , Maria Ramada Rodilla José , Zon Sander van , Ortega Josué Almansa , Bültmann Ute , Pujadas Consol Serra 
Published: May 2020

BackgroundHealth workers are at high risk of developing musculoskeletal pain (MSP). This study aimed to evaluate a multi-faceted intervention in two public tertiary hospitals, encompassing three levels of prevention and health promotion to prevent and manage MSP.MethodsA two-armed cluster randomized controlled trial, with a late intervention control group was performed. Clusters were independent hospital units, and participants were the nursing staff. The intervention comprised three components: participatory ergonomics, case management, and health promotion. The control group received usual occupational health care. The intervention lasted one year and data were collected at baseline, 6 and 12 months follow-up. Primary outcomes were self-perceived MSP and its associated sickness absence. The process evaluation included recruitment, context, reach, dose administered and received, fidelity, satisfaction, implementation strategy, and discussion groups of experts and participants.ResultsEight clusters, including 445 participants, were randomized. In the intervention group a 20% statistically significant reduction of neck, shoulders and upper back pain compared to the control group (OR=0.37; 95% CI=0.14–0.96) was observed at 12 months follow-up. We found no significant differences in incidence and duration of sickness absence. Organizational culture (secondary outcome) improved significantly in the intervention group in the domains of ‘formal safety audits’, ‘availability of information for safety at work’, and ‘involvement of workers in decisions that affect their safety and health’ compared to the control group. The intervention was implemented with 96.6% fidelity, and participants’ adherence was 75.5%. Participant’s satisfaction was 9.1/10.ConclusionsThis intervention showed effectiveness to reduce MSP and improve organizational culture, through to an integral management of MSP. Although our results are modest, strategies should focus on multi-faceted interventions, and occupational health services might be excellent opportunity for.