bluuebunny/crossref_metadata_2025_split huggingface dataset:
Implications of the use of mechanical thrombectomy on outcome in large vessel occlusion following the 2015 landmark trials
Authors: Kuybu Okkes , Javalkar Vijayakumar , Amireh Abdallah , Kaur Arshpreet , Kelley Roger E , Cuellar-Saenz Hugo H , Sharma Pankaj 
Published: May 2020

BackgroundThe effectiveness of mechanical thrombectomy (MT) was demonstrated in five landmark trials published in2015.Mechanical thrombectomy is now standard of care for acute ischemic stroke and has been growing in popularity after publication of landmark trials.ObjectiveTo analyze outcomes and trends of the use of MT and intravenous thrombolysis (IVT) in patients with acute ischemic stroke in US hospitals before and after publication of these trials.MethodsPatients discharged with a diagnosis of ischemic stroke between 2012 to 2017 were diagnosed using ICD codes from the National Inpatient Sample. Thereafter, patients given acute stroke treatment were identified using the corresponding procedure codes for IVT and MT. The primary clinical outcomes of in-hospital mortality and disability were then compared between two time periods: 2012–2014 (pre-landmark trials) and 2015–2017 (post-landmark trials). Binary logistic regression and Χ2tests were used for statistical analysis.ResultsA total of 57 675 patients (median age 68.9 years (range 18-90), 50.1% female) were identified with acute procedures. Of these patients, 57.6% were from the post-landmark trials time period. Despite an increased number of cases, the rate of IVT decreased from 84.3% to 75.9% and the rate of IVT+MT decreased from 7.1% to 6.3%. After publication of the pivotal trials in 2015, the rates of MT increased from 8.7% to 17.8%. Significant reductions of in-hospital mortality (7.1% vs 8.7%, p<0.001) and disability (64% vs 66.2%, p<0.001) were noted.ConclusionThe analysis showed a significant increase in the proportion of patients receiving MT after 2015. This has translated into reduction of in-hospital mortality and improvement in disability.
O5A.1 Definition of case management for return-to-work in the approach of workers with musculoskeletal disorders: an update using a scoping review
Authors: Font Mercè Soler , Maria Ramada Rodilla José , Maria Gonzalez José , Sanchez Francisco Palencia , Pujadas Consol Serra 
Published: May 2020

PurposeWe aim to identify the elements and functions that define the case management in the individual approach of workers with musculoskeletal disorders for return to work and to propose an updated definition.MethodsRelevant articles were identified through a computerized search up to 1 December 2017 in the bibliographic databases PubMed, Web of Science, Scopus, Cochrane Library, IBECS, EMBASE, and LILACS. Language filter (English and Spanish) was included in the search. The inclusion criteria were working age population with musculoskeletal disorders, studies that described or evaluated case management interventions, and return to work interventions. Military personnel, and rheumatic and surgical pathologies were excluded. Independent pairs reviewed all cites and articles and extracted data, and narrative synthesis was carried out.ResultsOur searches identified 1950 possible relevant articles, of which 27 were included for data extraction. Of these, 15 papers included definitions of case management, and 14 common elements were identified. Twenty two explained the role of case manager and in 18 a description of tasks was found. In 25 articles referral services were mentioned. The most common defining elements were ‘return to work intervention’, ‘multidisciplinary assessment’ and ‘interdisciplinary intervention’ (53.8%). The 40% of the articles emphasized the ’coordination’, ‘to influence multiple factors’ (33.3%) and ‘individual approach’ (26.7%). The tasks included ’to establish goals and plan the rehabilitation for return to work’ (50%), and ’supervise or coordinate return to work process and to offer/refer the employee to services/adaptations or therapeutic workplaces’ (36.4%) The most common offered services were mental health (64.0%), and rehabilitation (48.0%).ConclusionsDespite the increase in the number of published articles dealing with case management, usually it is not clearly defined. This scoping review emphasizes the need to define case management and its organizational characteristics, and proposes an extended and updated definition.
O5A.6 Objectively assessed arm elevation and the course of neck and shoulder pain during a 2-year follow-up: a compositional approach
Authors: Merkus Suzanne , Lunde Lars-Kristian , Koch Markus , Knardahl Stein , Veiersted Kaj Bo 
Published: May 2020

PurposeTo use a compositional data analysis approach and objective exposure assessments to study the association between the duration of arm elevation and the course of neck and shoulder pain (NSP) during a 2-year follow-up in physically demanding occupations.MethodsConstruction (n=59) and healthcare (n=59) employees wore accelerometers on the dominant upper-arm during a full working day at baseline. Objective assessments using accelerometers addresses biases found in previous studies that estimate duration of arm elevation with self-reports. At baseline and every 6 months for two years, participants reported on NSP (scale 0–3). Duration of arm elevation within predefined ranges (<30°; 30–60°; ≥60) formed the parts of the composition. Compositional data analysis is a new statistical analysis method within occupational health and it is the correct way of analysing data with a compositional nature. The associations between the relative importance of the duration within the levels of arm elevation and the course of NSP during the 2-year follow-up were estimated with compositional linear mixed models, adjusted for confounders.ResultsIn non-adjusted analyses, only duration arm elevation <30° was associated with NSP at baseline (β = 0.37; p=0.015). Duration arm elevation <30° had a tendency to be associated with an improvement in NSP over the 2-year follow-up (<30°*time (β=-0.07; p=0.089)). Neither duration 30–60° nor ≥60 were associated with the course of NSP during follow-up. After adjusting for confounders, none of the durations of arm elevation were associated with the course of NSP over the 2-year period (<30° and NSP (β = 0.20; p=0.126); <30°*time (β=-0.06; p=0.097)).ConclusionAmong construction and healthcare personnel, duration of working in awkward arm elevation postures was not associated with the course of NSP over a 2-year period. Arm elevation alone, without considering force exertion, may not be sufficient to influence the course of NSP.
O5D.3 Methods of estimating lifetime occupational exposure in the general population, based on job-exposure matrices
Authors: Houot Marie , Homère Julie , Goulard Hélène , Garras Loïc , Delabre Laurène , workgroup Matgéné , Pilorget Corinne 
Published: May 2020

ObjectivesTo estimate proportion of pathologies attributable to occupational exposure, lifetime occupational exposure prevalence (LOEP) and relative risk are necessary. LOEP estimates are commonly used but often estimated with different methods. The method choice and the impact on estimates are rarely discuss in the literature. This study present and discuss the most widely used means of estimating LOEP and their respective impacts on estimates.MethodsA sample of individuals representative of the French population from 2007 was linked with four Matgéné job-exposure matrices: flour dust, cement dust, silica dust and benzene. LOEP and the 95% confidence interval were estimated using five methods: the maximum exposure probability during the career (Method 1), four using individual exposure probabilities, three of which subdivide careers into job-periods (Methods 2–4) and one which subdivides them into job-years (Method 5). To quantify differences between methods, percentage of variation were calculated for prevalence values on Methods 2 to 5 versus Method 1.ResultsFor each agent, LOEP estimated from the maximum probability during the career (Method 1) was consistently lower than prevalence taking account of job-periods or job-years. LOEP on Method 1 for flour dust, cement dust, silica dust and benzene were respectively 4.4%–95% CI [4.0–4.7], 4.3% [3.9–4.6], 6.1% [5.7–6.5] and 3.9% [3.6–4.2]. Percentage of variation ranged from 0% to 25.0% for flour dust, from 11.6% to 55.8% for cement dust, from 11.5% to 49.1% for silica dust and from 0% to 53.8% for benzene.ConclusionsThe present study provides a description of several LOEP estimation methods in the general population based on job-exposure matrices. It specifies the strong and weak points of each of the five chosen methods. For health monitoring purposes, LOEP should be reported as intervals, with low and high estimates obtained on different methods using job-periods (Methods 2–4).
O5D.5 Construction of finnish ISCO-88 job exposure matrix: examination of dataset with two different classification of occupations in consecutive censuses
Authors: Sallmén Markku , Uuksulainen Sanni 
Published: May 2020

Finnish Job exposure matrix (FINJEM) assesses occupational exposure for 84 factors in 311 FINJEM occupations. Finnish version of ISCO-88 International Standard Classification of Occupations 1988 (F-ISCO-88) occupational codes (n=445), used in population censuses from 1995 to 2009, often split into more than one FINJEM code. We describe the construction of a crosswalk between F-ISCO-88 codes and FINJEM codes and the resulting F-ISCO88 job exposure matrix (F-ISCO-88-JEM).In total, we found 1144 conversion candidate pairs from two sources: 1) Statistics Finland crosswalks from three sequential classification of occupations (2001–1997, 1997–1987, 1987–1980) combined with crosswalk between the classification of occupations in 1980 and FINJEM, and 2) preliminary expert judgement-based conversion of F-ISCO-88–FINJEM.We counted frequencies for all 9900 F-ISCO88 (in 1995) and FINJEM (1990) occupational code pairs from a study of neurodegenerative disease (n=103,969). Correctness of every candidate pair and prevalent non-candidate pairs was checked using occupational coding manuals of FINJEM and F-ISCO88, including occupational titles. Final list of accepted pairs was agreed by the authors.The number of verified F-ISCO-88–FINJEM conversion pairs was 835, including 88 pairs from non-candidates. In total, 397 (34.7%) candidate pairs were incorrect. We could solve FINJEM occupation for 84 252 (81.0% from total population) persons with direct conversions or verified conversion pairs. Occupation of the remaining 19 717 persons changed between 1990 and 1995. Direct conversions totaled 27 716 (26.6%) solutions and split F-ISCO-88 codes 56 536 (54.4%) solutions. The resulting F-ISCO-88–JEM comprises original FINJEM exposure estimates for direct conversions and estimates for split F-ISCO-88 codes, calculated using proportions of corresponding FINJEM codes as weights.A quarter of F-ISCO-88 codes can be converted to FINJEM codes in data with F-ISCO-88 occupational codes. This proportion could be tripled in a dataset including FINJEM and F-ISCO88 codes in consecutive censuses, resulting in more accurate exposure estimates.
O5E.1 Data on acknowledgment and costs of work-related mental diseases in france
Authors: Lasfargues Gérard , Jacquetin Pascal , Vongmany Nathalie , Chauvet Claire , Durand-Moreau Quentin 
Published: May 2020

ObjectiveTo report data concerning the reality of work-related mental diseases (WRMD) in France, their acknowledgment as occupational diseases and some socio-economic data.MethodsData were collected from the French National Health Insurance Fund (NHIF) and from the database of the French national occupational surveillance and prevention network (rnv3p). Rnv3p collects data from French Occupational Disease Centers to identify and describe risks and/or emerging work-related diseases.ResultsData from NHIF indicate that the number of requests for acknowledgment of WRMD has increased significantly from 2012 to 2017 (200 to 1500). About 50% are acknowledged and compensated as occupational diseases. Within these affections, the share of depressions is the majority. Durations of work stoppages (more than 400 days on average) were much longer than for other occupational diseases.Mental disorders related to psychosocial risk factors may also be compensated as work injuries. In 2016, NHIF compensated over 10 000 mental disorders as work injuries, mostly caused by external events or inadequate working conditions. The proportion of people with permanent disability was 4.6%. Finally, the management of WRMD acknowledged will have represented € 230 million for the Work Injuries-Occupational Diseases branch of the NHIF.Rnv3p data are globally consistent with NHIF concerning compensated occupational mental diseases, highlighting the increase of WRMD in some sectors such as public administration, health and social action, retail business and education. Over 18000 WRMD (33% men, 67% women; mean age=46.0±8.9) were recorded in the database between 2010 and 2016, and 1833 cases of burnout situations currently non acknowledged as occupational diseases by the NHIF. Rnv3p data also illustrate the importance of under-reporting of WRMD as occupational diseases.ConclusionThen, RNV3P provides important data to assist in the acknowledgment of WRMD and to carry out preventive actions in the sectors and enterprises most concerned.
O5E.3 Occupational diseases among workers in different socioeconomic positions
Authors: van der Molen Henk , Vries Sanne de , Sluiter Judith 
Published: May 2020

IntroductionTo determine differences between workers in lower and higher socioeconomic positions (SEP) in: i) incidence, trends and type of occupational disease (OD) and ii) incapacity for work due to ODs. It is hypothesized that workers in lower and higher SEP still differ in health disparities from an occupational perspective.MethodsFrom a Dutch cohort of occupational physicians (OPs), ODs assessed by OPs were retrieved over a seven year period (2010–2016) for lower and higher SEP groups. Incidence and type of OD and incapacity for work were determined for the total number of ODs and six frequently occurring ODs. Trends in incidence were estimated using a multilevel negative binominal regression model.ResultIn total, 54 per 100,000 workers in elementary occupations, machine operating and assembly jobs, as well as managerial and intellectual jobs during 2016 had an OD diagnosed and reported by an OP, from which 98 per 100,000 were for lower SEP, and 36 per 100,000 for higher SEP. Among the lower SEP, musculoskeletal disorders (37%) and noise-induced hearing loss (NIHL) (32%) comprised two-thirds of the OD diagnoses. Among the higher SEP, distress/burnout comprised 60% of the OD diagnoses, with an increasing trend (6%; 95% CI: 3%-8%). Incapacity for work due to work-related low back disorders (69% vs 9%) and shoulder-, arm- and wrist disorders (89% vs 47%) differed significantly between workers in lower compared to higher SEP.DiscussionOccupational diseases occur at a 2.7 higher incidence rate for workers in lower SEP compared with higher SEP. Incapacity for work due to work-related musculoskeletal disorders are higher for workers in lower SEP compared with higher SEP, suggesting fewer opportunities to modify work tasks and working circumstances for lower SEP. Psychosocial risk factors constitute the greatest problem for workers in higher SEP, resulting in distress/burnout, accompanied by incapacity for work.
O5E.4 Bridging the gap between clinical cases and epidemiological evidence
Authors: Godderis Lode , Bakusic Jelena , Pauwels Sara , Molen Henk Van der , Lenderink Annet 
Published: May 2020

One of the current gaps in the prevention of work-related diseases (WRDs) is the missing link between the assessment of occupational hazards introduced at the workplace, clinical alerts, epidemiological studies and policy actions. Alert systems aim to bridge this gap, by collecting information on diseases and exposures to raise alerts to different stakeholders and trigger timely prevention.This project started with a review of international alert systems to identifying good practices and learning about prerequisites, drivers and obstacles to implement alert and sentinel systems. Next, the findings led to the implementation of an integrated approach consisting of alert systems on three levels in the Belgian context:Signal detection and assessment: suspected clinical cases of new WRDs (new exposure–disease combinations) can be reported though an online platform called ‘SIGNAAL’. Each reported case is followed by an extensive assessment of exposure– and work–relatedness performed by clinical experts. Since the start, 22 cases have been reported to the platform.Signal strengthening though a network of occupational health physicians. This sentinel approach has been introduced though the PROBE system, in which 47 occupational physicians participated. During the periodic health examinations of workers, the physicians filled in a web survey regarding occupational exposure of a random sample of workers to 22 selected hazardous chemicals during the last working week. Results of the first study showed that 47% of workers were exposed to at least one chemical product from the list, with diesel exhaust being the most frequently reported substance (n=91; 14% of workers).Alerts to public health authorities are mainly communicated though collaboration with Federal Public Services and Federal Agency for Occupational Risks.These agencies provide support in the maintenance of systems and in turn, data from the systems is used as input for potential preventive strategies on company and societal level.
O6C.1 Ischaemic heart disease and occupation: a linkage between two new zealand surveys and the integrated data infrastructure
Authors: Corbin M , Barnes L , Denison HJ , Eng A , Mannetje A , McLean D , Ellison-Loschmann L , Jackson R , Douwes J 
Published: May 2020

BackgroundAssociations between ischaemic heart disease (IHD) and occupation are poorly understood. We linked two previously conducted New Zealand workforce surveys with routinely collected health data to assess occupational risk factors of IHD in New Zealand.MethodsTwo probability-based sample surveys of the general New Zealand adult population (2004–2006; n=3003) and of the New Zealand indigenous peoples (M&_x0101;ori; 2009–2010; n=2107), for which occupational history was collected, were linked with health data up to the end of 2017 using Statistics New Zealand individual-level microdata. Incident IHD events were identified using hospitalisations, prescriptions and deaths. The odds ratios associated with ever being employed in occupational groups were estimated by logistic regression adjusting for age, smoking and socio-economic status separately for males and females in each cohort.ResultsA total of 282 IHD cases were identified in both surveys. Statistically significant elevated IHD risks were observed for male clerks in the general survey (OR=1.60, 95%CI=1.02–2.49) and agriculture and fishery male workers in the M&_x0101;ori survey (OR=1.70, 95%CI=1.02–2.82). Among females, the odds ratios for agriculture and fishery workers were 1.69 (95%CI=0.81–3.51) and 1.49 (95%CI=0.81–2.75) in the general survey and the M&_x0101;ori survey, respectively. A statistically significant increased risk was observed for female plant and machine operators and assemblers in the M&_x0101;ori survey (OR=1.87, 95%CI=1.05–3.31). In the general survey, male plant and machine operators and assemblers had an odds ratio of 1.26 (95%CI=0.81–1.95). We also identified borderline increased odds ratios for trades workers among males in the general survey (OR=1.39, 95%CI=0.92–2.12, p-value=0.12) and among females in the M&_x0101;ori survey (OR=2.26, 95%CI=0.98–5.21, p-value=0.06).ConclusionThis study identified associations between several occupational groups and IHD in the New Zealand population. Further analyses will be conducted to assess specific occupational exposures associated with IHD risk.
O6C.3 The association between long-term exposure from heavy physical work load and coronary heart disease in middle aged men
Authors: Hemmingsson Tomas , Selander Jenny , Kjellberg Katarina 
Published: May 2020

ObjectivesPrevious studies have shown conflicting results concerning the association between heavy physical work load and risk of coronary heart disease (CHD). The aim of this study was to investigate the association between long-term exposure to heavy physical work load in middle age and risk of CHD among Swedish men during almost 20 years of follow-up.MethodsThe study is based on a cohort of around 40 000 Swedish males, born 1949–51, with census information on occupation in 1985 and 1990 (at ages 34–41). Aspects of physical workload was estimated from job exposure matrices based on questions concerning heavy lifting, strenuous work postures, and physically strenuous work from the Swedish Work Environment Surveys 1989–97. Mean values for each physical exposure variable were assigned to over 300 occupational titles from the censuses conducted in 1985 and 1990. Only those 29 530 subjects who were in the same quintile of exposure both years were included in the analyses. Information on smoking behavior and body mass index (BMI) was collected at compulsory conscription for military training in 1969/70 (at 18–20 years of age), and follow up data on CHD (1457 cases) between the years 1991–2009.ResultsAn increased relative risk of CHD were found among workers in the quintiles with medium low (HR=1.36 CI95%=1.14–1.62), medium (HR=1.46 CI95%=1.23–1.74), medium-high (HR=1.62 CI95%=1.36–1.91), and high (HR=1.45 CI95%=1.22–1.71) exposure to heavy lifting at work compared with those in the quintile with low exposure to heavy lifting. After adjustment for smoking and BMI the risk estimates were somewhat lower but still significantly increased. Risk estimates of the same magnitude were seen for a number of other aspects of the physical work environment.ConclusionThere was an association between long-term exposure from heavy physical work load and CHD even after adjustement for smoking and BMI.
O6D.1 Inflammatory markers in the plasma of firefighters heavily exposed to particulates
Authors: Galarneau Jean-Michel , Cherry Nicola 
Published: May 2020

IntroductionIn 2016 firefighters from Alberta, Canada deployed to a catastrophic fire in Fort McMurray. In the first few days, firefighters experienced heavy smoke exposures during greatly extended work shifts. Blood samples were collected to determine whether inflammatory markers might constitute a useful biomarker of exposure. In first responders exposed during the Word Trade Center disaster, inflammatory markers in serum samples collected within 6 months post-event were associated with poor recovery from exposure-related lung disorders.MethodsBlood samples were collected at two fire services. At Service A, first samples were drawn two weeks from the start of the fire and second samples after 3–4 months. At Service B samples were collected over 4 weeks, starting 4 months from the first exposure. Samples were immediately centrifuged and the plasma stored at −80C before being evaluated for 42 cytokines or chemokines using a multiplex assay. A principal component analysis was carried out to reduce the number of correlated outcomes. Exposure to particulates was estimated for each firefighter using environmental PM2.5, total hours exposed, tasks carried out and the use of respiratory protection. Respiratory symptoms immediately before the fire, immediately post fire and at 4 months were collected using visual analogue (VA) scales.ResultsInflammatory markers were assayed for 242 plasma samples from 175 firefighters. Six components were extracted of which only one, labelled the inflammatory marker component (IMC) was related to estimated exposure (p<0.001): values decreased with time since last exposure (p<0.001). All respiratory symptoms post-fire were greater in those with higher estimated PM2.5. IMC scores were independently related to cough and wheeze at 4 months, but the biomarker did not contribute to models for these endpoints that also included PM2.5.ConclusionsInflammatory markers were related to exposure but did not improve prediction of symptoms in the first months post fire.