bluuebunny/crossref_metadata_2025_split huggingface dataset:
P.1.36 Occupational cohort studies: safeguarding a valuable resource
Authors: Venables Katherine , Fear Nicola , Carpenter Lucy , Keegan Thomas , Brooks Claire , Archer Gemma 
Published: May 2020

An occupational cohort study is the most robust epidemiological design for studying the effects of workplace hazards and the findings can be extended to the general environment. A cohort may be time-consuming, expensive, and labour-intensive to set up but, once done, it can be extended forward in time, as well as laterally to incorporate new outcome variables, and it can also support nested case-control studies. It is therefore important that the human and material investment is preserved so that these valuable resources can be fully exploited.In recent years, the bureaucratic burden on researchers in many countries has increased. In the UK, for example, research ethics, data protection, and data access application procedures have become more cumbersome, with an increase in the number of supporting documents required from researchers. Although fast-track procedures exist, epidemiological studies often require the same formal procedures and oversights as more invasive and potentially dangerous physiological and pharmacological studies.Fortunately, there are now initiatives which support occupational cohort studies. The UK Medical Research Council (MRC), for example, published in 2014 a review and guidance about maximising the value of UK population cohorts and it has also set up a Cohort Strategic Review Group to pre-assess funding applications for new cohorts and for updates to existing cohorts (http://mrc.ukri.org). As another example, OMEGA-NET has been set up to ‘create a network to optimize and integrate occupational, industrial, and population cohorts at the European level’ (http://omeganetcohorts.eu/).We propose that a checklist be defined for assessment of research protocols for new cohorts or updates to existing cohorts, in order to assist official committees in their work and streamline the approval process for both researchers and committees. EPICOH would be well-placed to draft and promulgate such a checklist, working with interested organisations, such as OMEGA-NET and the UK MRC.
P.1.37 A study of the incidence rate and risk factors of metabolic syndrome among workers of different job categories in taiwan
Authors: Yang Chen-Chang , Wu Hsin-Chien 
Published: May 2020

BackgroundIn Taiwan, the prevalence of metabolic syndrome among people over the age of 20 years is as high as 19.7%. With the increase in age, the prevalence of metabolic syndrome is even higher, with the prevalence being more than 30 years among those aged 45–65 years. Notably, very limited follow-up studies have examined the incidence and risk factors of metabolic syndrome among workers of different job categories in Taiwan.MethodsWe conducted a retrospective follow-up study that included 6,284 Taiwanese subjects who had been working in the same job category for 5 years and who received periodic health checkups at a regional hospital from 2006 to 2017 to better understand the incidence rate and risk factors of metabolic syndrome in Taiwan. All participants’ demographic data and health examination data were then analyzed. Metabolic syndrome was diagnosed according to the criteria proposd by the US National Cholesterol Education Program (NCEP) Third Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (ATP III).ResultsAfter an average follow-up of 6.0 years, the incidence rate of metabolic syndrome among workers who had been working in the same job category for five years was 32.42 per 1000 person-years. Moreover, the largest number of cases with metabolic syndrome appeared in the transportation industry.ConclusionThe results of this study should help the employers of various industries to better plan health education and monitoring programs of their employees to ameliorate the incidence of metabolic syndrome.
P.1.38 Effects of paraoxonase 1 (PON1) genotype and nanomaterials exposure on heart rate variability
Authors: Wu Wei-te , Liou Saou-Hsing 
Published: May 2020

BackgroundAlthough paraoxonase 1 (PON1) is a high-density lipoprotein (HDL) associated antioxidant enzyme that has beneficial effects on atherosclerosis and cardiovascular disease, whether PON1 Q192R polymorphism have any effect on cardiac autonomic function is yet to be investigated. Moreover, there is limited data regarding the influence of NPs exposure on HRV parameters in humans. The purpose of the study was to exam whether PON1 genotype or NPs exposure has an association with HRV levels.MethodsThis cross-sectional study recruited 235 workers exposed to NM and 185 non-exposed controls from 14 NM handling plants in Taiwan from 2009 to 2011. For each participant, we collected blood specimens to determine the genotype of the PON1 Q192R polymorphism and PON1 paraoxonase and arylesterase activities. In addition, short-term HRV was tested.ResultsThe results showed that PON1 Q192R genotype and PON1 paraoxonase/arylesterase activities associated with HRV, and was particularly noteworthy in RMSSD and HF. The relationship between NPs exposure and HRV was only found in workers exposed to nano-Ag, but the apparent relationship between NPs exposure and HRV is lacking.ConclusionsIt is a novel finding that both RR genotype of PON1 (Q192R) and activities of PON1 increased with HRV levels. PON1 Q192R genotype may play an important role in cardiac protection. Considering the global prevalence of NMs market, further studies of NPs-induced cardiac events and stresses still are required to establish.
P.1.40 Farmer’s suicide with the use of pesticides in different areas in spain
Authors: Zhao Guanlan , Ronda Elena , Barrio Gregorio , Regidor Enrique 
Published: May 2020

IntroductionThere is considerable interest in the potential relation of suicide with the pesticide. Agriculture is the leading professional sector for pesticide use in the world with a turnover of about 40 billion US dollars in 2010. According to the WHO report in 2014, autointoxication with agricultural pesticides contributes greatly to the global burden of suicide. The aim of this study is to evaluate whether suicide of farmers was associated with the use of pesticide in different areas during the period 2001–2011 in Spain.MethodsThe cohort study followed 9.5 million men 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. We divided Spain into two areas depending on both geographical location and the mean annual amount of pesticides used: southeast Spain and the rest of Spain. The southeast Spain shows higher use of pesticides than the rest of Spain. For three major causes of death (suicide, unintentional accidents and rest of causes of death), we estimated the age-standardized mortality rates per 1000,000 person-years of follow-up, the ratio of age-standardized mortality rates with 95% confidence intervals (CI) between farmers and non-farmers in two areas were calculated.ResultsWith respect to the rest area of Spain, farmers in the southeast showed a lower mortality rate of suicide and unintentional accidents, which mortality rate ratios were 0.74 (95% CI 0.65–0.85) and 0.57 (95% CI 0.52–0.62).ConclusionOur findings do no support a possible association between pesticide use and suicide of farmers in Spain.
P.2.01 Epidemiological studies of the porton down veterans: an update of cancer incidence and mortality to 2018
Authors: Archer Gemma , Keegan Thomas , Brooks Claire , Carpenter Lucy , Venables Katherine , Fear Nicola 
Published: May 2020

IntroductionAn update to the Porton Down Veterans Cohort study is planned for 2018–2021.BackgroundChemical warfare agents continue to be deployed by rogue states and terrorists, e.g. in Syria, Iraq, Tokyo, and Salisbury UK, yet their impact on long-term health is largely unknown. The Porton Down cohort comprises of 18 276 men who took part in the ‘human volunteer programme’ of chemical warfare agent research at Porton Down, UK, between 1941 to 1989, and a comparison group of 17 600 men who also served in the military. An original study linked veterans’ records to national registry data on cancer incidence and mortality up to 2004. By the end of 2004, 7306 of the Porton Down veterans and 6900 of the comparison cohort had died. The results showed Porton Down veterans had no overall excess of cancers (rate ratio (RR)=1.00, 95% CI 0.95–1.05) and a small (6%) excess of all-cause mortality (RR=1.06, 1.03–1.10) when compared with non-Porton Down veterans. Porton Down veterans had higher rates of certain cancers (e.g. ill-defined malignant neoplasms, andin situneoplasms) and specific causes of death (e.g. genitourinary, circulatory and external causes).ObjectivesThe updated study aims to replicate the original analyses but with an additional 15 years of follow-up – estimated to increase the number of deaths available for study to c 22 200. This will improve statistical power, allowing exposures and outcomes of interest from prior literature to be examined at a level of detail not possible in the original study, e.g. nerve agent antidotes, riot control agents, neurological mortality, and rarer cancers.ImplicationsGreater understanding of the long-term risks associated with exposure to chemical agents could lead to raised awareness among policy makers and health care providers, leading to improved diagnosis and quality of care.Conflict of interestNone
P.2.04 Occupational skin disease in a tertiary occupational dermatologic clinic: a retrospective analysis from 2010 to 2017
Authors: Chang Heng-Hao , Wang Bour-Jr , Guo How-Ran , Lee I-Ru 
Published: May 2020

BackgroundOccupational skin disease (OSD) is one of the most common occupational disorders in Taiwan. As reporting OSD was not compulsory, there was limited information on the exact causes and patient characteristics. The objective of this study was to investigate the causes and common allergens among OSD patients in Taiwan.MethodsWe recruited patients from Occupational Dermatology Clinic in National Cheng Kung University Hospital, a tertiary referral center in Tainan city, between 1 January 2010 and 31 July 2017. Patch testing with European baseline series, additional occupation-oriented series, and personal material exposed at work or during daily life was carried out if the patients were suspected of allergic skin diseases.ResultsAmong the 273 patients who received patch testing, 51 (18.7%) patients had a final diagnosis of OSD. 82.4% of the 51 patients were diagnosed with allergic contact dermatitis (ACD), 11.8% with irritant contact dermatitis (ICD), while the rest 5.9% with both. Patient reported 3.0 years of skin problem prior to the clinic visit. The vast majority of patients suffered from hand eczema. Epoxy resin workers, food workers, hairdressers and beauty salon beauticians were the most common occupations related to OSD. The most important allergens were nickel, fragrance mix I, potassium dichromate and paraben mix. Around half of the patients showed allergic reaction to their personal material.DiscussionAs worker compensation statistics may not accurately estimate the characteristics of OSD patients, our study was crucial to identify the high-risk groups as well as the common allergens related to their work. Although the results might not represent the proportion of patients of OSD in other clinic, drawing information from patch testing may reflect those patients of severer or longer duration of symptoms. Future occupational measures should be taken on these industries for the detection and prevention of OSD.
P.2.11 Vitamin D deficiency and hepatitis B virus infection and risk of hematological malignancies among korean semiconductor workers: a case-control study
Authors: Lee Seokwon , Yang Sarah , Koh Jaewoo , Kim Soo-Geun , Lee Kyoungho 
Published: May 2020

ObjectivesThis study aims to identify an association between potential risk factors and risk of hematological malignancies, especially for Non-Hodgkin’s Lymphoma (NHL) and leukemia, among Korean semiconductor workers.MethodsWe collected 54 cases who ever worked over 30 days at a Korean semiconductor manufacturing company and were diagnosed as NHL (ICD-10 codes: C82–C85) and leukemia (C91–C95) from January 1 st 1998 to December 31 st 2017. A total of 324 controls, frequency matched by age and sex (1:6 ratios) with no diagnosis of hematological malignancies, were randomly selected. The information on work history, occupational exposure and medical examination data was also collected for the study analysis. Multivariable logistic regression analyses were performed to estimate odds ratios (ORs) after adjusting age, sex, education, employment year, smoking, alcohol and body mass index.ResultsNo significant association between hematological malignancies and occupational risk factors, including job title, cleanroom work and occupational exposures, was observed. As for leukemia, however, ORs were significantly increased by natural immunity to hepatitis B virus (HBV) [HBsAg(-), HBsAb(+), HBcAb(+)] (OR=11.92, 95% confidential interval 1.05–135.89) and a past or current (ever) HBV infection [HBsAg(+/-), HBsAb(+/-), HBcAb(+)] (6.52, 1.51–28.10). Furthermore, ORs for NHL were also significantly increased by insufficient serum 25-hydroxyvitamin D [25(OH)D] (12–20 ng/mL) (10.67, 1.27–89.53) and deficient 25(OH)D levels (<12 ng/mL) (12.22, 1.37–109.16) (p<0.05).ConclusionsRisk of hematological malignancies was not associated with occupational risk factors but significantly elevated by two factors, such as HBV infection and insufficient or deficient 25(OH)D level. A longitudinal cohort study is needed to confirm the association between these risk factors and cancers.
P.2.20 Epidemic of bladder cancer in japanese male workers exposed mainly to ortho-toluidine
Authors: Nakano Makiko , Omae Kazuyuki , Eitaki Yoko , Iwasawa Satoko , Fukai Kota , Yoshioka Noriyuki , Tanaka Shigeru , Koda Shigeki , Takebayashi Toru 
Published: May 2020

BackgroundIn 2012, ortho-toluidine (OT) was listed as a Group 1 carcinogen by the International Agency for Research on Cancer, based on epidemiologic observations in workers co-exposed to OT and aromatic amines. Between 2014 and 2017, 10 cases of bladder cancer (BC) were identified in Japanese males working at two plants of the same company manufacturing intermediates of organic dyes and pigments.ObjectiveTo describe the features of the BC epidemic at the plants.MethodsWe conducted a cross-sectional study of 76 OT and/or aromatic amine-exposed workers including the 10 BC cases at the plants in 2017. The co-exposed aromatic amines were para-toluidine, ortho-anisidine, aniline, 2,4-dimethylaniline, and/or ortho-chloroaniline. Details of each worker’s job-site histories were obtained from the company records. Past medical symptoms and histories were checked in physician interviews. The subjects were divided into the BC group (n=10) and the non-BC group (n=66) and compared. No quantitative exposure data were available. The surrogate level of exposure to each aromatic amine was calculated as the summed job-weight-month in each process in each job-year.ResultsThe mean ages of the non-BC and BC groups were 50 and 56 years and the durations of employment were 23 and 20 years, respectively. The smoking rate in both groups was 80%. Significantly higher rates of gross hematuria (70%) and cystitis (70%) were identified in the BC group’s past medical histories. In the BC group, the surrogate levels of exposure to OT were higher than those of exposures to other aromatic amines. The surrogate levels were high in the job processes of filtering, rinsing, drying and packing products.ConclusionsThe subjects with BC were associated with a high surrogate level of exposure to OT. OT-exposed workers with past histories of gross hematuria and cystitis need a careful follow-up.
P.2.23 Adverse childhood experiences (ACE) in early life and the risk of childhood asthma: a danish nationwide cohort study
Authors: Pape Kathrine , Sejbæk Camilla S , Andersson Niklas W , Hougaard Karin S , Svanes Cecilie , Liu Xiaoqin , Cowell Whitney , Wright Rosalind , Schlünssen Vivi 
Published: May 2020

ObjectiveA link between adverse childhood experience (ACE) in early life and subsequent asthma is suggested, but existing studies are often based on parent-reported data for both exposure and outcome. We aimed to examine the association of ACE in early life (bereavement, parental chronic somatic illness, or psychiatric illness/suicide attempt) with childhood asthma, using registry information of exposures and outcome.MethodsWe used registry data of 466 556 children born in Denmark, 1997–2004. ACE and asthma diagnosis or medication was obtained from the Danish National Patient or Prescription Registry. We used multinomial logistic regression to examine the association between ACE in early life and phenotypes of childhood asthma, which we empirically estimated using group-based trajectory modeling. We adjusted for year of birth, maternal age, smoking, place of living, parity, parental education and atopic status; we imputed missing data using multiple imputations with chained equations.ResultsWe identified four asthma trajectories: early onset (before age 3) transient asthma, late onset (3 years or later) asthma, early onset persistent asthma, and never/infrequent asthma. Girls exposed to at least one ACE before the age of 2 years, compared to the non-exposed, had higher odds of being assigned to the early-onset transient asthma group (odds ratio (OR) 1.13 [95% Confidence Interval (CI): 1.04–1.24]), the late-onset asthma group (OR 1.28 [95% CI: 1.11–1.48]) or the early-onset persistent asthma group (OR 1.27 [95% CI: 1.08–1.48]) compared to the never/infrequent asthma group. Similar results were seen for boys, OR 1.16 [95% CI: 1.08–1.25], OR 1.11 [95% CI: 0.98–1.25], and OR 1.34 [95% CI: 1.20–1.51] respectively. The odds remained largely the same in imputed and unadjusted models.ConclusionIn a Danish nationwide population four asthma trajectories were identified, in agreement with clinical studies. ACE in early life was associated with all asthma phenotypes for both boys and girls.
P.2.31 Association between work and chronic obstructive pulmonary disease review of systematic reviews
Authors: Molen Henk van der , Groene Gerda de , Hulshof Carel , Frings-Dresen Monique 
Published: May 2020

IntroductionChronic Obstructive Pulmonary Disease (COPD) is a highly prevalent disease with reported prevalence up to 12%. Although smoking is one of the main factors in causing COPD, evidence from systematic reviews grows that also occupational exposures contribute. To examine whether work-related risk factors are associated with chronic pulmonary obstructive disease (COPD) a review of systematic reviews was performed.MethodsMedline was searched from 2009 until 20 June 2017 for systematic reviews. Systematic reviews were included when outcome data were described in terms of clinically assessed COPD by means of data on lung function and at least two levels of work-related exposure were mentioned (exposed versus low or non-exposed). One author selected studies and extracted data, two authors assessed study quality with AMSTAR.ResultEight systematic reviews met the inclusion criteria. In all reviews various exposures to vapour, dusts, gases, and fumes (VGDF) at work are associated with COPD. Most of the included studies are cross-sectional and show a high heterogeneity in population, setting and – mostly self-reported – exposures. Two high-quality reviews including meta-analyses show associations and excess risk of COPD for work-related general exposure to VGDF with a summary odds ratio of 1.4 (95% CI 1.19–1.73) and for work exposure to inorganic dust with a mean difference in predicted FEV1 of −5.7% (95%CI: - 8.62% to – 2.71%).DiscussionExposure to VGDF at work is associated with a small but increased risk of COPD. More detailed workplace measurements of specific VGDF are warranted to gain an insight into dose-response relationships.
P.2.35 Heart rate variability and sleep-related breathing disorders in commercial drivers
Authors: Wu Wei-te , Lin Yu-Jen , Liou Saou-Hsing 
Published: May 2020

BackgroundSleep-related breathing disorders, such as obstructive sleep apnea (OSA), seems to have an important influence on the autonomic nervous function on the heart, and associated with cardiovascular mortality. Therefore, we assessed the relations of sleep apnea-related parameters with 5 min heart rate variability (HRV) in a large cohort of male commercial drivers.MethodsThis cross-sectional study recruited 245 male bus drivers from one transportation company in Taiwan. Each participant was evaluated by a polysomnography (PSG) test and by blood lipids examination. Severity of OSA was categorized according to the apnea-hypopnea index (AHI). In addition, short-term HRV was tested.ResultsSubjects were categorized into severe OSA group (n=44; 17.9%), moderate and mild OSA group (n=117; 47.8%), and non-OSA group (n=84; 34.3%). AHI had negative correlations with SDNN (β=−0.075, p=0.007) and RMSSD (β=−0.121, p<0.001), adjusting for age, body mass index, smoking, drinking, systolic blood pressure, HDL, and fasting blood glucose. RMSSD level was decreased with severe OSA (β=−0.266, p=0.042) even adjusting for confounders.ConclusionsThe findings showed a low level of RMSSD in OSA among commercial drivers, especially in the severe group category. Decreased SDNN and RMSSD levels are associated with AHI level in commercial drivers, suggesting that they are tightly linked with autonomic dysfunction.
P.2.39 Periconceptional exposure to ambient air pollution and congenital hypospadias
Authors: Huang Ching-chun , Guo Yue Leon 
Published: May 2020

BackgroundEvidence regarding whether prenatal exposure to air pollution increases the risk of hypospadias is limited.ObjectivesThe aim of the study is to evaluate the association between exposure to ambient air pollution during early pregnancy and occurrence of hypospadias.MethodsWe conducted a 1:10 case-control study using the Taiwanese Birth Registry database. Those male births reported to have hypospadias were defined as cases; while controls were randomly, matched by birth year, selected from those male births without any congenital anomaly. Monthly average of ambient air pollutants, including PM10, PM2.5, NO2, NOx, and O3, from three months pre- to six months post-conception were retrieved from the 76 air quality monitoring stations and interpolated to the level of township using empirical bayesian kriging. Potential covariates to be adjusted included gestational age, birth weight, birth season, maternal age, maternal diabetes and hypertension, maternal smoking, annual household income and population density of the residential township.ResultsDuring 2007–2014, a total of 265 hypospadias was reported, and 230 (87%) of them were full-term births. Results of multivariate logistic regression models revealed that for per IQR increase of O3 (8.0 p.p.b) exposure during the first months after conception increased the risk of hypospadias (aOR=1.38, 95% CI=1.07–1.78). In subgroup analysis of full-term births, we further found that PM2.5 exposure during the first three months post-conception significantly increased the risk of developing hypospadias (aOR=1.29, 95% CI=1.01–1.65, per IQR=15.4 ug/m3).ConclusionsThe results of the study suggested that early gestational exposure to ambient air pollution increased the risk of hypospadias occurrence.