bluuebunny/crossref_metadata_2025_split huggingface dataset:
P.2.36 Assessment of serum and urinary biomarkers for pneumoconiosis in a cohort of stone workers exposed to asbestos-contaminated minerals
Authors: Yang Hsiao-Yu , Chen Pau-Chung 
Published: May 2020

BackgroundPneumoconiosis is still a problem in workers process non-asbestiform asbestos minerals and serpentinite rocks, such as nephrite, antigorite or talc that may contaminate with paragenetic asbestos minerals. An effective screening method is still lacking. The objective of this study was to assess the diagnostic accuracy using the serum and urinary biomarkers for pneumoconiosis in workers exposed to asbestos-contaminated minerals.MethodsPrediction models of pneumoconiosis were constructed from 140 stone workers (48 cases of pneumoconiosis and 118 controls) exposed to asbestos-contaminated minerals. We measured serum soluble mesothelin-related peptide (SMRP), fibulin-3, carcinoembryonic antigen, and urinary 8-Oxo-2’-deoxyguanosine (8-OHdG)/creatinine levels. Using the ILO international classification of radiographs of pneumoconiosis profusion subcategory ≥1/0 as the reference standard, we established a prediction model by machine learning algorithm. We assessed the accuracy by the area under the receiver operating characteristic curve (AUROC).ResultsThe SMRP level increased in workers exposed to nephrite. A dose-response relationship was found between the SMRP level and the severity of pneumoconiosis in workers exposed to asbestos-contaminated minerals. Machine learning algorithm composed of sex, age, and 4 serum and urinary biomarkers is able to predict pneumoconiosis with high accuracy (AUROC ranged from 0.76 to 1.00).ConclusionOur finding highlight the use of serum and urinary biomarkers can be developed as a screening tool for pneumoconiosis in workers exposed to potential asbestos contaminated minerals.
P.2.38 Occupational exposure and incidence of asthma based on prescription of drugs
Authors: Bælum Jesper , Skadhauge Lars Rauff , Thilsing Trine , Davidsen Jesper Rønhild , Omland Øjvind , Schlünssen Vivi 
Published: May 2020

Prescription of drugs for obstructive lung diseases (ATC code R03) has previously been shown to be an indicator of actual asthma. In this cohort study, we have combined occupational information with data from redeemed prescriptions between 2000 and 2013 extracted from the National Danish Prescription register.In 2003 a total of 7255 persons aged 20 and 44 years fulfilled a questionnaire, which among other things, included information on their longest held job. The jobs of 6470 were coded according to ISCO-88 and an asthma Job Exposure Matrix (JEM) was applied. Prevalent asthma was defined as at least two redeemed prescriptions of a R03 drug within 2 years. Incident asthma between 2003 and 2013 was defined as not having redeemed a R03 prescription in the previous years. Data was analyzed separately for each gender using multivariate logistic regression and presented as odds ratios (OR) with 95% confidence intervals (CI).Among those having a job 327 (5.1%) were identified as incident cases and 467 (7.2%) as prevalent cases. In females increased incidences were seen in exposures to reactive low molecular weight (LMW) substances (OR1.47 (95% CI 1.04–2.07)), cleaning agents (OR 1.52 (1.05–2.18)), metals (OR 3.31 (1.63–6.64)), while increased prevalence was seen with mite exposure (OR 4.41 (1.74–11.2)) and irritant gases (OR 1.76 (1.16–2.69)). In males no increased incidences were seen and only an increased prevalence with mixed environments (OR 2.24 (1.13–4.43)).In jobs increased prevalence and incidence were seen in female cleaners and drivers. Increased prevalence was seen in male printing workers.Meaningful associations with well-known asthmagenic exposures in young adults with asthma can be identified in administrative register data, and implementing the analyses of register data from larger populations will have the power to detect potential increased risks due to rare exposures or changes in risk over time.
P.3.11 Implementation of community-based occupational health programs for informal workers in indonesia
Authors: Ferdiana Astri , Baiquni Fahmi , Rahman Dhiya Ur , Febriana Awalia , Solikhah Siti , Nervilia Ajeng Viska , Kusumaningrum Fitrina , Supriyati Supriyati , Sari Tetra Dewi Fatwa 
Published: May 2020

Informal workers account for 60% of workforce in Indonesia. Most do not have access to occupational health and safety (OHS) services. The study aims to explore the implementation of community-based OHS program consisting of OHS post and cadres (referred to as UKK program) among informal workers in rural areas in Indonesia. This study was an implementation research using focus group discussion (FGDs) and key informant interviews (KIIs) to workers, primary health care (PHC) staff, and provincial and district program managers. Thematic analysis was used to identify barriers and enablers of UKK implementation at intrapersonal, interpersonal, community, organizational and policy level.A total of 10 FGDs with informal workers from different areas of occupation, two FGDs with PHC staff and 6 KIIs with program managers were conducted. Informal workers faced various occupational risks yet personal protective equipment were rarely available or used. OHS was perceived as important, however, participation in UKK was low because of lack of time and information. There was lack of workers empowerment, resulting in top-down planning of activities by PHC. Informal workers expected PHC health workers to provide OHS services rather than UKK cadres. Not all PHCs have implemented UKK. Few programmers were trained on OHS. The program was assigned low priority and resource allocation by PHC and District Health Office. The absence of OHS regulation for informal workers offered little incentive for government departments to implement OHS programs and services for informal workers.Informal workers had unmet needs of OHS. Substantial efforts are needed to implement UKK, especially investment in financial and human resources. UKK establishment should be focused at workplace with the highest occupational risks. Technical capacity of programmers responsible for health promotion and OHS should be improved. Local policy on social protection and OHS services for informal workers should be developed.
O2A.1 Pesticides and work-related asthma: how this relates to self-reported exposures
Authors: Fishwick David , Harding Anne-Helen , Fox David , Chen Yiqun , Pearce Neil , Frost Gillian 
Published: May 2020

Pesticide exposure has been linked to a number of potentially adverse health outcomes, including asthma. We were interested to explore the relationship between asthma and pesticide use, particularly from the perspective of self-reported work-related asthma.Using the existing UK PIPAH (Prospective Investigation of Pesticide Applicators’ Health) study population, we administered a respiratory questionnaire to 4814 current and past pesticide users. Participants were asked about doctor-diagnosed and self-reported asthma symptoms, and, if present, their views about the cause of work-related asthma (asthma reported to be worse at work).Of the 2562 respondents (53% response) with a median age of 60.2 years, 97.4% were male and 34.1% ever smoked. The prevalence of ever being doctor diagnosed asthma was 11.4% (n=292), and 123 of these (42.1% of those with asthma) reported that their asthma was caused, or made worse, by their work. 17.8% reported wheeze in the last 12 months.Grouping relevant exposures, 117 of the 123 participants reported in decreasing order of proportion, the following agents as being responsible for worsening of their asthma; organic dusts (n=73, 59%), unspecified dust (n=12, 10%), mixed exposures (n=12, 10%), any mention of chemical (n=9, 7%), physical work environment, e.g. temperature, exercise (n=7, 6%), other, e.g. irritant, fumes (n=4, 3%).This large study of pesticide applicators has confirmed a prevalence of 11.4% for doctor-diagnosed asthma. Self-reported exposures thought by workers to aggravate their asthma were predominantly organic in nature, although a smaller proportion identified chemicals as aggravants. Workplace based preventative strategies in this sector should address all potential inhaled hazards and their associated risks to respiratory health.
O2C.3 What predicts a secondary absence following return to work among workers’ compensation claimants in victoria? Results from a longitudinal cohort
Authors: Smith Peter 
Published: May 2020

Time taken to first return to work (RTW) is often a primary endpoint for studies among injured workers. However, studies using administrative workers’ compensation claims data have documented that a substantial proportion (approximately one half) of claimants will incur a subsequent period of wage replacement. Unfortunately, workers’ compensation data is limited in the information collected to better understand which claimants are more likely to have a subsequent absence from work. The objective of this study is to address this gap using a cohort of workers’ compensation claimants in the Australian state of Victoria.The sample for this study is drawn from a longitudinal cohort of workers’ compensation claimants (n=869). For the purpose of this analysis we focused on those claimants who had returned to work (self-reported) at the baseline interview, which was conducted approximately 4 months after the injury had occurred (n=372). Independent variables examined included if the respondent was working on full or partial duties, currently receiving health care for their injury, type of injury (musculoskeletal versus psychological), co-worker responses when they returned to work (measured using nine questions), and work limitations, measured using an abbreviated form of the work limitations questionnaire.A total of 205 respondents (55% of the sample) reported a subsequent absence from work when interviewed 6 months later. All independent variables, with the exception of injury type, were associated with subsequent absences from work. In a multivariable model, only working modified duties and greater limitations remained statistically significant.The results of the current study help inform our understanding of trajectories in RTW and factors, measured after the first RTW, which may be associated with a subsequent absence from work. These findings can be integrated into RTW programs to help more workers achieve sustainable RTW following a work injury.
O2D.1 A follow-up study of occupational styrene exposure and risk of systemic sclerosis, rheumatoid arthritis, and other systemic autoimmune rheumatological diseases
Authors: Boudigaard Signe Hjuler , Stokholm Zara Ann , Vestergaard Jesper Medom , Mohr Mette Skovgaard , Søndergaard Klaus , Schlünssen Vivi , Kolstad Henrik Albert 
Published: May 2020

BackgroundIncreased risk of systemic sclerosis, systemic lupus erythematosus, rheumatoid arthritis, primary systemic vasculitis, and systemic Sjogren’s syndrome has been suggested following occupational solvent exposure. The evidence for specific solvents is, however, limited and little is known about exposure and risk patterns.AimOur aim is to examine the exposure response relation for systemic sclerosis, rheumatoid arthritis, systemic lupus erythematosus, primary systemic vasculitis, and systemic Sjogren’s syndrome following occupational styrene exposure.MethodsWe followed 72 467 styrene exposed workers of the Danish reinforced plastics industry from 1977–2012. We modelled styrene exposure from employment history, survey data and historical styrene exposure measurements. We identified cases in a national patient register, and investigated gender specific exposure response relations by cumulative styrene exposure for different exposure time windows adjusting for age, decade, educational level and a proxy for tobacco smoking.ResultsDuring 1,553,577 person-years, we identified 223 women and 453 men diagnosed with a systemic autoimmune rheumatological disease, of which three out of four were rheumatoid arthritis. When adjusting for potential confounders and comparing the highest with the lowest styrene exposure tertile, we observed a statistically non- significantly increased risk of systemic sclerosis among men (IRR=1.79; 95% CI 0.48–6.87) and women (IRR=2.58; 95% CI 0.51–12.94), based on 20 and 9 cases respectively. However, for women with systemic sclerosis, we saw a significantly increasing trend of 1.19 (1.01–1.40) pr. 100 mg/m3-years. Increased risks were also suggested for primary systemic vasculitis (IRR=2.32; 95% CI 0.63–8.52) and rheumatoid arthritis (IRR=1.26; 95% CI 0.95–1.67) among men. Analyses of exposure time windows suggest a latency period for rheumatoid arthritis of about 15 years.ConclusionThis study might indicate that styrene exposure is associated with the occurrence of systemic sclerosis among men and women, and primary systemic vasculitis and rheumatoid arthritis among men.
O2D.2 Occupational exposure to oxygenated, petroleum-based and chlorinated solvents of women in childbearing age in france in 2013
Authors: Lagarrigue Robin , Houot Marie , workgroup Matgéné , Yamani Mounia El , Pilorget Corinne 
Published: May 2020

ObjectiveOccupational exposure to chemical agents including solvents is sparsely described among women although they constitute a vulnerable population at certain points in life and particularly during the procreative period. The aim of this study is to document the occupational exposure to oxygenated, petroleum-based and chlorinated solvents in women of childbearing age (WCA).MethodsWe linked 17 job-exposure matrices describing exposure to oxygenated, petroleum-based and chlorinated solvents from the MATGÉNÉ programme to the 2013 French census. The occupational exposure prevalence was estimated in women aged from 15 to 44 years. The occupational exposure prevalence was described by 5 year age group, occupation and worker status (salaried or self-employed).ResultsThe most frequently used solvents in French workplace in 2013 by WCA are oxygenated solvents (15% of WCA at work, n=1,112,000), then petroleum-based solvents (1%, n=73,000) and chlorinated solvents (0.1%, n=9,000). The younger WCA (15–29 years) are more exposed to oxygenated solvents than their elders (19.9% vs 14.9%). On the contrary, the elderly (35–44 years) are more exposed to petroleum-based and chlorinated solvents. Three quarters of the WCA exposed to at least one oxygenated solvent are civil and public servants (41%), health and social workers (21%) or direct personal services staff (19%). Half of WCA exposed to at least one petroleum-based solvent are drivers (20%) and skilled workers of industrial and artisanal fields (13% respectively). For WCA exposed to at least one chlorinated solvent, nearly half worked as non-skilled workers of industrial and artisanal type (17% respectively) and health and social workers (15%).ConclusionsThis study is the first describing occupational exposure to three major solvents’ families for the entire working WCA in France regardless of working status or occupation. These information will help in the surveillance of this occupational risk and to prioritize prevention actions.
O2D.5 Risk of parkinson disease in solvent exposed workers in finland
Authors: Sallmén Markku , Uuksulainen Sanni , Hublin Christer , Koskinen Aki , Sainio Markku 
Published: May 2020

Epidemiologic studies indicate that occupational exposure to solvents may increase risk of Parkinson disease (PD).We constructed a population-based case-control study of incident PD using a register of Reimbursement of medicine costs of the Social Insurance Institution of Finland, along with the Population Information System, including census records for all Finnish residents. PD cases were diagnosed between 1995–2014. Controls were randomly selected from the population while matching on diagnosis year, birth year (1930–1950), and sex. A total of 11,757 PD cases and 23 236 controls had data from the occupational census in 1990, ensuring ≥4 years exposure lagging and 21 years of occupational history data (5 censuses from 1970–1990). We used the Finnish Job Exposure Matrix to assess cumulative exposure (CE) to four groups of solvents (aliphatic/alicyclic hydrocarbon, aromatic hydrocarbon, chlorinated hydrocarbon, other). We estimated PD-solvent odds ratios (ORs) and 95% confidence intervals (CIs) using unconditional logistic regression, while adjusting for age, sex, socioeconomic status and smoking (a_OR), or additionally for CE to chromium and one of the other solvent groups (ab_OR).In total, 3758 cases (30.4%) and 7445 controls (32.0%) were potentially exposed to solvents (a_OR 0.99; CI: 0.94–1.05). Exposure to chlorinated hydrocarbons was associated with PD (a_OR 1.20; CI: 1.05–1.36; ab_OR 1.21 CI: 1.04–1.40) at the highest CE group (20–145 ppm-years, n=409 cases and 728 controls) but not at lower CE levels. Overall, CE to chlorinated hydrocarbons (n=1840 cases and 3693 controls) was associated with increased risk of PD (p-for-trend=0.01). There was no evidence of a positive association for any of the other solvent groups.We observed a positive association between occupational exposure to chlorinated hydrocarbons and risk of PD. This was especially true for greatest duration and/or level of exposure.
O2E.1 Why the quality of exposure assessment matters in human observational studies and consequent hazard and risk assessment
Authors: Kromhout Hans 
Published: May 2020

Occupational exposures can vary dramatically and therefore their assessment and assignment in epidemiological studies often come with considerable error. In prior eras of occupational epidemiology, exposure was treated as static; often in a binary (yes/no) or ordinal (no/low/medium/high) manner. In modern times the need for better quality exposure assessment and assignment is clear, particularly in situations where occupational exposures and outcomes are less convincingly associated. High quality exposure assessment is imperative for informative human observational studies that permit better hazard classifications and quantification of exposure response relationships.A wide range of exposure assessment methods exist and have been applied; varying from self-reports general and specific job-exposure matrices, and case-by-case expert-based assessments to elaborate quantitative algorithms using the collective information of thousands of workplace measurements. The selection of method largely depends on the type of epidemiological study performed (retrospective versus prospective; case-control versus cohort; general population versus worker-based), the agent under consideration, and the extent of access to experts and measurement data. In addition, each method has its own specific limitations and possibilities, and will not be feasible for use in every study.Formal methods to evaluate exposure assessment quality in epidemiological studies are largely non-existent, but recent work within the IARC Monographs Programme and elsewhere have provided a direction for a more systematic approach. Several systematic literature reviews of human observational studies have shown that incorporating the quality of exposure assessment can produce a more convincing and informative evaluation when reviewing a body of evidence.As part of a mini-symposium on the importance of exposure assessment in epidemiology for hazard identification and risk characterization, this presentation will provide a brief introduction to exposure assessment and assignment for human observational studies, as well as directions for a more formal approach to their evaluation.
O2E.6 Defining shift work exposure in epidemiological studies of cancer: where have we been, and what comes next?
Authors: Hall Amy 
Published: May 2020

In the epidemiological context, ‘exposure’ to shift work encompasses a variety of social, workplace, and individual characteristics. This complexity lends itself to coarse exposure assessment and assignment, which increases misclassification error and often reduces contrast between comparison groups. In early epidemiological studies of shift work, broad exposure assignment, such as ‘day’ versus ‘night’ worker, was commonly used; a technique that ignored various characteristics (e.g., shift intensity, timing, and work history) with potential impacts on long-term health risks.In 2007, The International Agency for Research on Cancer classified ‘shift work that involves circadian disruption’ as a probable human carcinogen (Group 2A), on the basis of limited human evidence and sufficient evidence in experimental animals. In this evaluation, a major limitation of the epidemiological studies reviewed was the definition of shift work. A subsequent workshop convened by IARC considered how shift work should be assessed and quantified to improve the validity of future shift work and cancer studies. Since the publication of this working group’s recommendations in 2011, the role of strong exposure assessment as a vital component of informative epidemiological studies of shift work has increasingly been recognized.As part of a proposed symposium on the importance of exposure assessment in epidemiology for hazard identification and risk characterization, this presentation will summarize progress to date in the adoption of stronger exposure assessment methodologies in epidemiological studies of shift work, and offer ideas for next steps. A particular focus will be placed on the refinement of measurement techniques to assess long-term exposure to shift work (e.g., roster-based assessment and validity studies), and on quantitative considerations of important co-exposures (e.g., light-at-night).
O3B.3 Estimating the impact of changes to occupational standards for silica exposure on lung cancer mortality
Authors: Keil Alex , Richardson David , Westreich Daniel , Steenland Kyle 
Published: May 2020

BackgroundRespiratory exposure to silica is associated with the risk of death due to malignant and non-malignant disease. 2.3 million U.S. workers are exposed to silica. Occupational exposure limits for silica are derived from a number of lines of evidence, including observational studies. Observational studies may be subject to healthy worker survivor bias, which could result in underestimates of silica’s impact on worker mortality and, in turn, bias risk estimates for occupational exposure limits.MethodsUsing data on 65 999 workers pooled across multiple industries, we estimate the impacts of several hypothetical occupational exposure limits on silica exposure on lung cancer and all-cause mortality. We use the parametric g-formula, which can account for healthy worker survivor bias.ResultsAssuming we could eliminate occupational exposure, we estimate that there would be 20.7 fewer deaths per 1000 workers in our pooled study by age 80 (95% confidence interval: 14.5, 26.8), including 3.91 fewer deaths due to lung cancer (95% CI: 1.53, 6.30). Less restrictive interventions demonstrated smaller, but still substantial risk reductions.ConclusionsOur results suggest that occupational exposure limits for silica can be further strengthened to reduce silica-associated mortality and illustrate how current risk analysis for occupational limits can be improved.