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Objective Within the scope of the Exposome Project for Health and Occupational Research on applying the exposome concept to working life health, we aimed to provide a broad overview of the status of knowledge on occupational exposures and associated health effects across multiple noncommunicable diseases (NCDs) to help inform research priorities. Methods We conducted a narrative review of occupational risk factors that can be considered to have "consistent evidence for an association," or where there is "limited/inadequate evidence for an association" for 6 NCD groups: nonmalignant respiratory diseases; neurodegenerative diseases; cardiovascular/metabolic diseases; mental disorders; musculoskeletal diseases; and cancer. The assessment was done in expert sessions, primarily based on systematic reviews, supplemented with narrative reviews, reports, and original studies. Subsequently, knowledge gaps were identified, e.g. based on missing information on exposure–response relationships, gender differences, critical time-windows, interactions, and inadequate study quality. Results We identified over 200 occupational exposures with consistent or limited/inadequate evidence for associations with one or more of 60+ NCDs. Various exposures were identified as possible risk factors for multiple outcomes. Examples are diesel engine exhaust and cadmium, with consistent evidence for lung cancer, but limited/inadequate evidence for other cancer sites, respiratory, neurodegenerative, and cardiovascular diseases. Other examples are physically heavy work, shift work, and decision latitude/job control. For associations with limited/inadequate evidence, new studies are needed to confirm the association. For risk factors with consistent evidence, improvements in study design, exposure assessment, and case definition could lead to a better understanding of the association and help inform health-based threshold levels. Conclusions By providing an overview of knowledge gaps in the associations between occupational exposures and their health effects, our narrative review will help setting priorities in occupational health research. Future epidemiological studies should prioritize to include large sample sizes, assess exposures prior to disease onset, and quantify exposures. Potential sources of biases and confounding need to be identified and accounted for in both original studies and systematic reviews. [ABSTRACT FROM AUTHOR]

Introduction Upper respiratory tract infections (URTI) are common and a common cause of sick-leave for healthcare workers, and furthermore pose a threat especially for patients susceptible to other diseases. Sufficient use of respiratory protective equipment (RPE) may protect both the workers and the patients. The COVID-19 pandemic provided a unique opportunity to study the association between use of RPE and URTI in a real-life setting. The aim of this study was to examine if failure of RPE or non-compliance with RPE guidelines increases the risk of non-COVID-19 URTI symptoms among healthcare workers. Methods In a longitudinal cohort study, we collected self-reported data daily on work tasks, use of RPE, and URTI symptoms among healthcare workers with patient contact in 2 Danish Regions in 2 time periods during the COVID-19 pandemic. The association between failure of RPE or non-compliance with RPE guidelines and URTI symptoms was analyzed separately by generalized linear models. Persons tested positive for severe acute respiratory syndrome coronavirus 2 were censored from the analyses. The 2 waves of data collection were analyzed separately, as there were differences in recommendations of RPE during the 2 waves. Results We found that for healthcare workers performing work tasks with a risk of transmission of viruses or bacteria, failure of RPE was associated with an increased risk of URTI symptoms, RR: 1.65[0.53–5.14] in wave 1 and RR: 1.30[0.56–3.03] in wave 2. Also non-compliance with RPE guidelines was associated with an increased risk of URTI symptoms compared to the use of RPE in wave 1, RR: 1.28[0.87–1.87] and wave 2, RR: 1.39[1.01–1.91]. Stratifying on high- versus low-risk tasks showed that the risk related to failure and non-compliance was primarily associated with high-risk tasks, although not statistically significant. Discussion The study was conducted during the COVID-19 pandemic and thus may be affected by other preventive measures in society. However, this gave the opportunity to study the use of RPE in a real-life setting, also in departments that did not previously use RPE. The circumstances in the 2 time periods of data collection differed and were analyzed separately and thus the sample size was limited and affected the precision of the estimates. Conclusion Failures of RPE and non-compliance with RPE guidelines may increase the risk of URTI, compared to those who reported use of RPE as recommended. The implications of these findings are that the use of RPE to prevent URTI could be considered, especially while performing high-risk tasks where other prevention strategies are not achievable. [ABSTRACT FROM AUTHOR]

The article informs about the validity of self-reported night shift work among women with and without breast cancer, highlighting its impact on breast cancer risk estimates. Topic include study reveals that breast cancer patients had slightly better recall of previous night shift work compared to controls, with both groups showing low specificity in recalling never-night shift work, resulting in a small overestimation of the relative breast cancer risk associated with night shift work.

Aim: One-fifth of the Danish population smoke and exposure to second-hand smoke has well-documented adverse health effects. The smoking policy at hospital level prohibits hospital staff from smoking on the hospital grounds while patients and visitors may smoke in outdoor smoking cabins. This study aimed to quantify smoking at a Danish hospital and document any policy breaches. Methods: In April 2020, we collected cigarette butts and observed smokers at the outdoor grounds to document smoking behaviour. Results: In total, 7152 cigarette butts were collected during one week and 368 people were observed smoking at the outdoor grounds during four observation days. Of all collected cigarette butts, 55% were collected outside the smoking cabins and 62% of all smokers were observed smoking outside the smoking cabins. In addition, 31 staff were observed smoking. Conclusions: This study documents that smoking is prevalent at a smoke-free hospital and that the smoking policy is frequently violated. The frequency of smoking outside the cabins may at least partly be influenced by the COVID-19 pandemic. Smoking at a hospital can expose patients, visitors and staff to second-hand smoke with subsequent adverse health effects. Hospitals could play an exemplary role towards a smoke-free society (and not the exception), but the opportunity is not always seized. [ABSTRACT FROM AUTHOR]

We aimed to assess the association between occupational noise exposure and long-term hearing decline. This prospective cohort study used linear regression to investigate the association between occupational noise exposure and 20-year hearing decline, adjusted for important confounders. The Norwegian cohort (N = 4,448) participated in two population-based health studies with pure-tone audiometry; HUNT2 1996–1998 and HUNT4 2017–2019. Exposure assessments included a quantitative job exposure matrix (JEM) and questionnaires. The participants (40.2% men, 20–39 years at baseline) had a mean 20-year decline (3–6 kHz) of 11.3 ± 9.8 decibels (dB). There was a positive association between 20-year logarithmic average noise level (JEM-based, LEX,20y) and 20-year hearing decline among men. Compared with no exposure ≥80 dB during follow-up, minimum 5 years of exposure ≥85 dB (JEM-based) predicted 2.6 dB (95% CI: 0.2–5.0) larger 20-year decline for workers aged 30–39 years at baseline, and −0.2 dB (95% CI: −2.2 to 1.7) for workers aged 20–29 years. Combining JEM information with self-reported noise exposure data resulted in stronger associations. This large longitudinal study shows an association between JEM-based noise exposure level and increased 20-year hearing decline among men. Contrary to expectations, the associations were weaker among younger workers, which might reflect a latency period. [ABSTRACT FROM AUTHOR]

Background: Allergic contact allergy and dermatitis are frequently reported among epoxy‐exposed workers. Objectives: To determine the risk of dermatitis associated with epoxy exposure. Methods: We followed 825 epoxy‐exposed and 1091 non‐exposed blue‐collar workers, and 493 white‐collar workers of a Danish wind turbine blade factory during 2017–2022 with linked data from national health registers on diagnoses, patch testing, or fillings of prescriptions for topical corticosteroids. Incidence rate ratios of dermatitis or a first‐time topical corticosteroid prescription were estimated with Poisson regression using non‐exposed blue‐collar workers as reference. We similarly estimated incidence rate ratios for the duration of epoxy exposure and current epoxy exposure. Results: Epoxy‐exposed blue‐collar workers showed a dermatitis incidence rate of 2.1 per 100 000 person days, a two‐fold increased risk of dermatitis and a 20% increased risk of filling a prescription for topical corticosteroids. Incidence rate ratios were higher during early exposure and declined with further exposure for both outcomes. White‐collar workers had generally lower risks. Conclusion: We observed an increased risk of dermatitis following epoxy exposure confirming previous case reports and cross‐sectional studies emphasizing the need for intensified focus on preventive efforts for this group of workers. [ABSTRACT FROM AUTHOR]

Background Night work has been associated with coronary heart disease. The present study examined exposure-response relations between quantitative night work characteristics and coronary heart disease (angina pectoris or myocardial infarction) with the aim to contribute to evidence-based recommendations for low-risk night work schedules. Methods We followed 100 149 night workers (80% women) and 153 882 day workers (78% women), all health care workers in Denmark with day by day payroll information on night shifts from 2007 to 2015. We analysed data with Poisson regression stratified by sex and adjusted for age, calendar year, diabetes, family history of cardiovascular disease, educational level, occupation, indicators for obesity, hypercholesterolaemia, and hypertension. Results Female and male night workers worked on average 1.7 and 1.8 night shifts per month for an average duration of less than 4 years. During follow-up, 1198 night and 2128 day workers were hospitalized with first-time coronary heart disease. When compared with day workers, the overall incidence rate ratios for female and male night workers were 1.06 [95% confidence interval (CI): 0.97, 1.17] and 1.22 (95% CI 1.07, 1.39). Highest risks were observed in top exposure categories for several night work characteristics. However, no consistent exposure-response relations by number of monthly night shifts, cumulative night shifts, years with rotating night shifts, years with any night shift and consecutive night shifts were observed among the night workers of either sex. Conclusions This study of a population with low exposure to night work does not indicate that reducing extent of monthly night shifts, cumulative night shifts, years with rotating night shifts, years with any night shift and consecutive night shifts would reduce the risk of coronary heart disease. [ABSTRACT FROM AUTHOR]

Pigeon breeders are exposed to high levels of fine particulate organic matter in the pigeon lofts. A total of 6,704 pigeon breeders and their 1:30 sex and age-matched referents from the general Danish population were followed from 1980 or first year of membership in the Danish Racing Pigeon Association, until first event of myocardial infarction, emigration, death, or end of study, on December 31, 2013. Information on outcomes and covariates was obtained by record linkage with national registers. Stratified Cox regression models estimated the hazard ratio of myocardial infarction, adjusted for occupation and residence at the start of follow-up. Compared with referents, pigeon breeders had an adjusted hazard ratio of 1.14 (95% CI: 1.05–1.22) for myocardial infarction. Exposure to pigeon-derived organic dust may increase the risk of myocardial infarction, but this finding needs to be corroborated. [ABSTRACT FROM AUTHOR]