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Introduction: In primary coffee factories the coffee beans are cleaned and sorted. Studies from the 80- and 90-ties indicated respiratory health effects among the workers, but these results may not represent the present status. Our aim was to review recent studies on dust exposure and respiratory health among coffee factory workers in Tanzania and Ethiopia, two major coffee producing countries in Africa.Methods: This study merged data from cross-sectional studies from 2010 to 2019 in 4 and 12 factories in Tanzania and Ethiopia, respectively. Personal samples of “total” dust and endotoxin were taken in the breathing zone. Chronic respiratory symptoms were assessed using the American Thoracic Society (ATS) questionnaire. Lung function was measured by a spirometer in accordance with ATS guidelines.Results: Dust exposure among male production workers was higher in Ethiopia (GM 12 mg/m3; range 1.1–81) than in Tanzania (2.5; 0.24–36). Exposure to endotoxins was high (3,500; 42–75,083) compared to the Dutch OEL of 90 EU/m3. The male workers had higher prevalence of respiratory symptoms than controls. The highest symptom prevalence and odds ratio were found for cough (48.4%; OR = 11.3), while for breathlessness and wheezing the odds ratios were 3.2 and 2.4, respectively. There was a significant difference between the male coffee workers and controls in the adjusted FEV1 (0.26 l/s) and FVC (0.21 l) and in the prevalence of airflow limitation (FEV1/FVC < 0.7) (6.3 vs. 0.9%). Among the male coffee workers, there was a significant association between cumulative dust exposure and the lung function variables FEV1 and FVC, respectively.Conclusions: The results suggest that coffee production workers are at risk of developing chronic respiratory symptoms and reduced lung function, and that the findings are related to high dust levels. Measures to reduce dust exposure should be targeted to factors identified as significant determinants of exposure.

Aim To estimate the prevalence of sleep medication and melatonin use among nurses and to assess if factors related to work, sleep or mental health, were associated with such use. Design A cross-sectional study. Methods A questionnaire survey including 2,798 Norwegian nurses. Associations were estimated using a modified Poisson regression model. Results In total, 7.5%, 4.6% and 2.0% of the nurses included in the present study reported prescribed sleep medication, over-the-counter sleep medication or melatonin use in the last year, respectively. Short sleep duration, sleep problems and psychological conditions were strongly associated with both prescribed and over-the-counter sleep medication use. Nurses who worked more than 60 night shifts in the last year were at increased risk of sleep medication use. publishedVersion

Background Traumatic brain injury (TBI) is an important cause of trauma-related mortality and morbidity in Ethiopia. There are significant resource limitations along the entire continuum of care, and little is known about the neurosurgical activity and patient outcomes. Methods All surgically treated TBI patients at the 4 teaching hospitals in Addis Ababa, Ethiopia were prospectively registered from October 2012 to December 2016. Data registration included surgical procedures, complications, reoperations, discharge outcomes, and mortality. Results A total of 1087 patients were included. The most common procedures were elevation of depressed skull fractures (49.5%) and craniotomies (47.9%). Epidural hematoma was the most frequent indication for a craniotomy (74.7%). Most (77.7%) patients were operated within 24 hours of admission. The median hospital stay for depressed skull fracture operations or craniotomies was 4 days. Decompressive craniectomy was only done in 10 patients. Postoperative complications were seen in 17% of patients, and only 3% were reoperated. Cerebrospinal fluid leak was the most common complication (7.9%). The overall mortality was 8.2%. Diagnosis, admission Glasgow Coma Scale (GCS) score, surgical procedure, and complications were significant predictors of discharge GCS score (P < 0.01). Age, admission GCS score, and length of hospital stay were significantly associated with mortality (P ≤ 0.005). Conclusions The injury panorama, surgical activity, and outcome are significantly influenced by patient selection due to deficits within both prehospital and hospital care. Still, the neurosurgical services benefit a large number of patients in the greater Addis region and are qualitatively comparable with reports from high-income countries. acceptedVersion

Background Traumatic brain injury (TBI) is a public health problem in Ethiopia. More knowledge about the epidemiology and neurosurgical management of TBI patients is needed to identify possible focus areas for quality improvement and preventive efforts. Methods This prospective cross-sectional study (2012–2016) was performed at the 4 teaching hospitals in Addis Ababa, Ethiopia. All surgically treated TBI patients were included, and data on clinical presentation, injury types, and trauma causes were collected. Results We included 1087 patients (mean age 29 years; 8.7% females; 17.1% 50 km from the hospitals, whereas 46% of road traffic accident victims came from the urban area. Delayed admission was associated with higher Glasgow Coma Scale scores and nonsevere TBI (P < 0.01). Conclusions The injury panorama, delayed admission, and small number of operations performed for severe TBI are linked to a substantial patient selection bias both before and after hospital admission. Our results also suggest that there should be a geographical framework for tailored guidelines, preventive efforts, and development of prehospital and hospital services. acceptedVersion

Background: Workers in iron and steel factories in Tanzania are exposed to noise levels above recommended limit values, without using hearing protection devices. Exposure to noise levels above 85 dB(A) is associated with temporary threshold shifts (TTS) of human hearing. Nevertheless, there are few studies of noise and hearing from African countries. Objective: To determine whether the normal hearing workers in Tanzania experiences TTS after full-shift occupational noise exposure of 85 dB(A) and above. Methods: A total of 55 workers were included. Full-shift personal noise measurements were conducted. Pre- and post-shifts pure-tone audiometry were conducted for each worker. TTS was defined as a 10 dB or greater change at 1000, 2000, 3000 or 4000 Hz in either ear. Results: We found that 85.5% of the workers developed TTS across the work shift. There was significant increase in mean hearing thresholds across shift at 1000, 2000, 3000 and 4000 Hz among the workers exposed to an average personal noise exposure (LAeq,8h) of 90.4 dB(A) (SD = 2.7). The difference in mean hearing thresholds was higher at 4000 Hz [Arithmetic Mean (AM) = 10 dB SD = 4 dB] compared to that of 1000 Hz (AM = 4 dB SD = 3 dB), 2000 Hz (AM = 4 dB SD = 4 dB), and 3000 Hz (AM = 9 dB SD = 6 dB), respectively. Conclusions: Interventions to reduce occupational personal noise exposure are warranted to reduce the high risk of developing a permanent threshold shift with persistent high noise exposure. An intervention study is planned for this group of workers. publishedVersion

Background Untreated surgical conditions may lead to lifelong disability in children. Treating children with surgical conditions may reduce long-term effects of morbidity and disability. Unfortunately, low- and middle-income countries have limited resources for paediatric surgical care. Malawi, for example, has very few paediatric surgeons. There are also significantly inadequate infrastructures and personnel to treat these children. In order to strengthen resources that could provide such services, we need to begin by quantifying the need. Aim To estimate the approximate prevalence of surgical conditions among children in Malawi, to describe the anatomical locations and diagnoses of the conditions and the presence of injuries. Methods A cross-sectional, nationwide survey of surgical needs was performed in 28 of 29 districts of Malawi. Villages, households and household members were randomly selected. A total of 1487 households were visited and 2960 persons were interviewed. This paper is a sub analysis of the children in the dataset. Information was obtained from 255 living children and inquiry from household respondents for the 255 children who had died in the past year. The interviews were conducted by medical students over a 60-day period, and the validated SOSAS tool was used for data collection. Results There were 67 out of 255 (26.3%) total children living with a surgical condition at the time of the study, with most of the conditions located in the extremities. Half of the children lived with problems due to injuries. Traffic accidents were the most common cause. Two-thirds of the children living with a surgical condition had some kind of disability, and one-third of them were grossly disabled. There were 255 total deceased children, with 34 who died from a surgical condition. The most prevalent causes of death were congenital anomalies of the abdomen, groin and genital region. Conclusion An extrapolation of the 26% of children found to be living with a surgical condition indicates that there could be 2 million children living with a condition that needs surgical consultation or treatment in Malawi. Congenital anomalies cause significant numbers of deaths among Malawian children. Children living with surgical conditions had disorders in their extremities, causing severe disability. Many of these disorders could have been corrected by surgical care. publishedVersion

Background Textile and garment factories are growing in low and middle-income countries as worldwide demand for inexpensive clothing increases each year. These integrated textile and garment production factories are often built-in areas with few workplaces and environmental regulations, and employees can be regularly exposed to workplace hazards with little regulatory oversight. Consequently, workers’ health may be significantly affected due to long term exposure to hazards. This study describes registered health problems and their association to work-related and personal factors among workers in integrated textile factories in Ethiopia. Methods Institution-based cross-sectional study design was employed for this analysis. A one-year recording of worker’s clinical diagnoses (between March 2016 and February 2017) was gathered from the factory clinics of three integrated textile factories. Clinical diagnosis data was obtained as factory workers visited the clinics if feeling unwell. Sociodemographic characteristics and work-related information were obtained from the factory’s human resource departments. The sociodemographic and clinical diagnosis statuses of 7992 workers were analyzed. The association between the registered diagnoses and workplace factors (work in textile production, garment production and support process) and personal factors (age, sex and educational status) were studied using logistic regression analysis. Results The average employee age and years of service were 40 years and 11 years respectively. 60% of workers were females, comprising of 4778 women. 66% of all workers (5276) had 27,320 clinical diagnoses. In total, this caused 16,993 absent working days due to sick leave. Respiratory diseases (34%) and musculoskeletal disorders (29%) were the most prevalent diagnoses, while bodily injuries were the cause of most work absences. Work department, sex and educational status are variables that were most significantly associated with higher prevalence of disease groups. Conclusions About two-thirds of the integrated textile factory workers were diagnosed with different types of disease. The textile and garment production department workers were affected at a greater rate than the support process workers, indicating that some diseases may be related to workplace exposure. Further study should investigate rare chronic diseases such as cancer, heart diseases, renal diseases and diabetes.

Background: Although provision of sanitary facilities in workplaces is an important issue, very few studies have been undertaken in this regard. Objective: This study assessed the provision of sanitary facilities for market traders and their perceptions of the provided facilities in Lusaka district Zambia. Methods: A cross-sectional study of workplace observations in 12 randomly selected markets and interviews with 386 traders, conducted in Lusaka district. Findings: The study revealed that eleven of the twelve markets provided toilets, hand-washing and drying facilities, water, urinals, soap, and toilet paper. However, most of the markets did not comply with the Zambian laws in terms of the adequacy and privacy of facilities. One market did not have any of the listed facilities. Most traders perceived facilities to be unsatisfactory and used them only because of the lack of alternatives. Poor provision of sanitary facilities was observed at markets thus predisposing its workforce and trading population to multiple public health hazards. Conclusions: The findings of this study call for urgent investments in sanitary structures and surveillance systems to guarantee the safety of the population and to promote the health of market traders as well as the community at large. publishedVersion

This study assesses whether farmers’ suicides were associated with the pesticide use in Spain. The cohort study followed 9.5 million men aged 20–64 years who were employed in 2001. The mortality among farmers and non-farmers during the period 2001–2011 was estimated in a geographical area with high pesticide use and in an area with low pesticide use. For three major causes of death (suicide, unintentional accidents, and rest of causes of death), we estimated the age-standardized mortality rates with 95% confidence intervals (CI) between farmers and non-farmers in both areas. Farmers in the high pesticide use area showed a lower mortality rate of suicide and unintentional accidents than farmers in the rest of Spain, with mortality rate ratios of 0.74 (95% CI 0.65–0.85) and 0.57 (95% CI 0.52–0.62), respectively. Our findings on pesticide use and farmers’ suicide are different from those observed in several previous investigations.

Background: Textile and garment factories are growing in low and middle-income countries; integrated textile and garment production factories are developing, where workers are exposed to dust and dangerous, noisy machines in the work environment. Hence, workers' health might be affected negatively due to exposure to different occupational hazards. However, the health condition of workers in this sector is not adequately investigated. The aim of this study is to describe the registered diagnoses of health problems and their association to work-related and personal factors among workers in integrated textile factories in Ethiopia. Methods: A one year recording of worker’s clinical diagnoses (between March 2016 and February 2017) was gathered from the respective factory clinics in three integrated textile factories. Sociodemographic characteristics and work-related information is obtained from the factory’s human resource departments. The association between the registered diagnoses and work-related factors (work in textile production, garment production and support department) and personal factors (age, gender and educational status) were studied using logistic regression analyses.Results: The socio-demographic and clinical diagnosis statuses of 7992 workers are analyzed. The average of workers' age and years of service is 40 years and 11 years, respectively. Majority 4778(60%) of workers are females; a total of 5276 (66%) of workers had 27320 clinical diagnoses; in total this causes 16993 working days lost due to sick leave. Respiratory diseases (34%) and musculoskeletal disorders (29%) were the most prevalent diagnoses, while injuries cause most of the days of work absence. Work department, gender and educational status are the variables that are significantly associated with several disease groups.Conclusions: About two-thirds of the integrated textile factory workers were diagnosed with different types of diseases. The textile and garment production department workers were more affected than the support department workers, indicating that some of the diseases are related to work in these departments. Further study should investigate the occurrence of rare chronic diseases such as cancer, heart diseases, renal diseases and diabetics in relation with workers exposure profile.

Objectives: Shift work is associated with several negative health effects. The underlying pathophysiological mechanisms are unclear, but low-grade inflammation has been suggested to play a role. This project aimed to determine whether levels of immunological biomarkers differ depending on work schedule, self-reported sleep duration, self-reported sleep quality, and presence of shift work disorder (study 1). Furthermore, we aimed to determine whether these biomarkers differ after a night of sleep vs. at the end of a night or a day shift (study 2). Methods: In study 1, 390 nurses provided blood samples after a night of sleep with the dried blood spot method. In study 2, a subset of 55 nurses also provided blood samples after a day shift and after a night shift. The following biomarkers were measured: interleukin-1alpha, interleukin-1beta, interleukin-4, interleukin-6, interleukin-8, interleukin-10, interleukin-13, monocyte chemoattractant protein-1, interferon-gamma, and tumor necrosis factor-alpha. Multiple linear regressions with adjustment for age, sex and body mass index (study 1) and ANOVAs with repeated measures (study 2) were conducted. Results: In study 1, neither work schedule, number of night shifts, number of quick returns (

We assessed Knowledge Attitude and Practice (KAP) regarding occupational noise exposure, Noise-induced hearing loss, audiometry and use of hearing protection devices among iron and steel factory workers exposed to high noise level. A modified, validated, structured questionnaire was used to collect information from 253 male workers randomly selected from the four factories. The sum scores for each domain of KAP were computed. Scores above 75% were defined as good knowledge and positive attitude. For practice, scores of >50% were defined as good. Independent samples t-test and Chi-squared test were used to analyze association between KAP and continuous/categorical variables respectively. Majority of workers displayed poor knowledge and poor practice (94%), but 76% displayed a positive attitude. Most of the workers (86%) had never been provided with hearing protection devices. The mean scores for attitude and practice differed significantly between the four factories (one-way ANOVA, p

Background Relatively little is known about deaths from surgical conditions in low- and middle- income African countries. The prevalence of untreated surgical conditions in Malawi has previously been estimated at 35%, with 24% of the total deaths associated with untreated surgical conditions. In this study, we wished to analyse the causes of deaths related to surgical disease in Malawi and where the deaths took place; at or outside a health facility. Methods The study is based on data collected in a randomised multi-stage cross-sectional national household survey, which was carried out using the Surgeons Overseas Assessment of Surgical Need (SOSAS) tool. Randomisation was done on 48,233 settlements, using 55 villages from each district as data collection sites. Two to four households were randomly selected from each village. Two members from each household were interviewed. A total of 1479 households (2909 interviewees) across the whole country were visited as part of the survey. Results The survey data showed that in 2016, the total number of reported deaths from all causes was 616 in the 1479 households visited. Data related to cause of death were available for 558 persons (52.7% male). Surgical conditions accounted for 26.9% of these deaths. The conditions mostly associated with the 150 surgical deaths were body masses, injuries, and acute abdominal distension (24.3, 21.5 and 18.0% respectively). 12 women died from child delivery complications. Significantly more deaths from surgical conditions or injuries (55.3%) occurred outside a health facility compared to 43.6% of deaths from other medical conditions, (p = 0.0047). 82.3% of people that died sought formal health care and 12.9% visited a traditional healer additionally prior to their death. 17.7% received no health care at all. Of 150 deaths from potentially treatable surgical conditions, only 21.3% received surgical care. Conclusion In Malawi, a large proportion of deaths from possible surgical conditions occur outside a health facility. Conditions associated with surgical death were body masses, acute abdominal distention and injuries. These findings indicate an urgent need for scale up of surgical services at all health care levels in Malawi.

Volcanic rock for use as building material is mined extensively in the North Eastern Region of Tanzania. Dust emitted from the rock may contain harmful elements such as crystalline silica, arsenic (As), cobalt (Co), boron (B) and mercury (Hg) which might contribute to severity and onset of health symptoms. Objective: This study assessed respiratory symptoms and fractional exhaled nitric oxide as a marker for respiratory inflammation in relation to dust exposure among workers in different job sections in volcanic block mining. Materials and Methods: A cross-sectional study assessed a total of 135 workers in which 70 were exposed and 65 none exposed. The mining activities are mainly manual, and include cutting of blocks underground, transporting blocks to the shaping area, shaping blocks, loading blocks and aggregates (Murom) to vehicles and clearing or expanding the site. Respiratory health questionnaires were administered through face–to-face interviews. A total of 28 samples of “total” dust were collected around the breathing zone of the workers using SKC Sidekick pump (model 224–50) with a flow rate of 2.0 l/min. FE NO assessed respiratory system inflammation using a portable electrochemistry-based sensor (NIOX MINO). Findings: The overall arithmetic mean concentration of personal total dust exposure among the workers was 4.37 mg/m 3 (range 0.15-20.84). The prevalence of acute cough and red eyes were significantly higher among exposed than among non exposed (35% vs 10% and 45% vs 14%, respectively). The ANOVA Boniferroni test showed a significant difference in mean FENO between stone cutters and none exposed (P = 0.005). Conclusions: This study suggests the strong association between working as a stone cutting and shaping with respiratory inflammation. There is a need for respiratory mask type P2 use to protect workers from the exposure. There is also need for the follow up study involving cohorts of all workers happened to be in the mine.

Although workplace violence and aggression have been identified as important stressors in the nursing profession, studies simultaneously comparing patient-initiated aggression and exposure to bullying behaviors at work are rather scarce. The aim of this study was to compare aggression from patients or next of kin and exposure to bullying behaviors in terms of prevalence, health-related quality of life outcomes, and potential overlap in those targeted. In the period of 2008-2009, data were collected among 2059 members of the Norwegian Nurses Organization. Latent class (LC) analysis and a multivariate analysis of variance (MANOVA) were used to investigate the proposed relationships. The results showed that aggression from patients or next of kin and exposure to bullying behaviors were perceived as separate and independent stressors. Although aggression from patients or next of kin was more frequent than workplace bullying, the latter was the only significant stressor related to health-related quality of life in terms of reduced mental health functioning. Although being a rather infrequent experience, exposure to bullying behaviors seems to have more severe health-related outcomes for nurses than aggression from patients or next of kin. Hence, the results of the study strengthen previous findings and suggest that managers must aim to maintain a positive psychosocial work environment with zero-tolerance for bullying. publishedVersion

Objectives: To evaluate different work schedules, short rest time between shifts (quick returns), and night shift exposure for their possible adverse effects on different lifestyle factors in a 6-year follow-up study. Methods: Data stemmed from “The Survey of Shiftwork, Sleep and Health,” a cohort study of Norwegian nurses started in 2008/9. The data analyzed in this sub-cohort of SUSSH were from 2008/9 to 2015 and consisted of 1,371 nurses. The lifestyle factors were: Exercise (≥1 h/week

Work in the wood industry might be associated with respiratory health problems. The production of particleboard used for furniture making and construction is increasing in many countries, and cause dust, endotoxin and formaldehyde exposure of the workers. The aim of the study was to assess the prevalence of respiratory symptoms and to measure lung function among Ethiopian particleboard workers using Eucalyptus trees as the raw material. In total 147 workers, 74 from particleboard production and 73 controls, participated in the study. Mean wood dust in the particleboard factories was measured to be above recommended limit values. Particleboard workers had a mean age of 28 years and the controls were 25 years. They had been working for 4 and 2 years, respectively. Lung function test was done using spirometry following American Thoracic Society (ATS) recommendations. Respiratory symptoms were collected using a standard questionnaire of ATS. Particleboard workers had higher prevalence of wheezing, cough, cough with sputum production, phlegm, and shortness of breath compared to controls. Lung function status was similar in the two groups. The symptoms might be related to the work in the factories. Longitudinal studies are recommended to explore the chronic impact of work in particleboard factories on respiratory health. publishedVersion

Workers represent half of the world’s population and are the major contributors to socio-economic development. Continued, sustainable socio-economic development is only possible if workers have a decent working environment. The headline for Sustainable Development Goal 8 is to ‘Promote sustained, inclusive and sustainable economic growth, full and productive employment and decent work for all’, while sub-goal 8.8 is to ‘Protect labour rights and promote safe and secure working environments for all workers’. However, globally millions of working men and women have poor and hazardous working conditions. Despite knowledge about effective interventions to prevent occupational hazards and to protect and promote health at the workplace, large gaps exist between and within countries regarding the health status of workers and their exposure to occupational risks. This chapter will describe present work environment situations in Sub-Saharan Africa through focusing on four important industries: floriculture, construction, mining and textiles. Actions are suggested for improvements while the importance of developing competence and knowledge on occupational health in these Sub-Saharan African countries are underlined. There must be increased awareness of dangerous workplaces as well as efforts to prevent occupational accidents and diseases.

Iron and steel factory workers in Tanzania are likely to develop noise-induced hearing loss (NIHL) due to exposure to high sound levels. Studies on hearing status in this population are lacking. The aims of this study were to determine prevalence of NIHL among iron and steel workers and compare hearing thresholds at different frequencies with a control group. We conducted a cross-sectional study among 221 iron and steel workers exposed to average noise level of 92 dB(A), compared with 107 primary school teachers recruited as controls and exposed to average noise level of 79.7 dB(A). We used a questionnaire-based interview to collect information on socio demographic characteristics and other confounding variables. Hearing loss was defined as hearing threshold levels &ge, 25 dB hearing loss in either ear at 3000, 4000 or 6000 Hz. The prevalence of hearing loss was significantly higher among the exposed group than among the controls, i.e. 48% and 31%, respectively. There were significant differences in hearing thresholds between the exposed and control groups at 3000, 4000, 6000, and 8000 Hz. Hearing loss was more frequent among workers exposed to higher noise levels than among the controls suggesting that iron and steel workers run a higher risk of developing hearing loss.

Background Work in the wood industry is often associated with exposure to wood dust and formaldehyde. The aims of this study were to describe the Knowledge, Attitude and Practice (KAP) concerning chemical health hazards among particleboard workers and to compare the KAP among temporary and permanent workers. Methods A cross-sectional study design was used to collect data by structured questionnaires in two particleboard factories in Ethiopia. A total of 159 workers and 13 management personnel participated in this study. Both closed-ended and open-ended questions were included in the interviews. Chi-square tests, T tests and correlation analyses were used for categorical and continuous data. Total knowledge score (range 0–8) was calculated as the sum score of 8 items weighing one point each. Multiple linear regression was applied to estimate the impact of employment status on total knowledge score adjusted for level of education. Content analysis was applied to analyse collected data from open-ended questions. Results The mean age of the respondents was 28 (SD = 6) years and on average they had 3.7 [3] years of service. The permanent workers were older than the temporary workers (29 vs 26 years, p = 0.001), and a considerably high fraction of the permanent workers had vocational education (90%) compared to the temporary workers (11%). Permanent workers had higher proportion of response on knowledge of 10 of 12 topics regarding chemical hazards and attitudes on 6 of 11 of these topics than temporary workers. Permanent workers had higher knowledge scores (3.7) compared to temporary workers (1.3) (p

Purpose: The aim of this study was to examine whether less than 11 h between shifts (i.e., quick returns, QRs) and night shifts is associated with self-reported work-related accidents, near accidents or dozing off at work in a sample of nurses. Methods: The study was based on cross-sectional data from 1784 nurses (response rate = 60%; mean age = 40.1 years, SD = 8.4; 91% female). Negative binomial regression analyses were conducted to investigate the association between the shift exposures, and eight different self-reported work-related items on accidents, near accidents and dozing off at work, controlling for demographics and work factors. Results: The number of QRs during a year was positively associated with seven of the eight items on work-related accidents, near-accidents and dozing off at work, and number of night shifts was positively associated with five items. Some of the key findings were that QRs were associated with nurses causing harm to themselves (incidence rate ratio [IRR] = 1.009; 95% CI = 1.005–1.013), causing harm to patients/others (IRR = 1.006; 95% CI = 1.002–1.010) and causing harm to equipment (IRR = 1.004; 95% CI = 1.001–1.007); while night shifts were associated with nurses involuntarily dozing off at work (IRR = 1.015; 95% CI = 1.013–1.018), dozing off while driving to/from work (IRR = 1.009; 95% CI = 1.006–1.011), and harming patients/others (IRR = 1.005; 95% CI = 1.001–1.009). Conclusion: QRs and night shifts were both associated with the self-reported work-related accidents, near-accidents and dozing off at work. Studies that can establish the causal relationship between QRs and accidents are called for. acceptedVersion

Objective: The aim of this study was to assess chronic respiratory symptoms and lung function among female hand pickers. Methods: A total of 374 hand pickers exposed to coffee dust and 175 female controls from water bottling factories were included. The symptoms were assessed using a standardized questionnaire. Personal total dust exposure and lung function tests were performed. Results: Hand pickers experienced a higher dust exposure, displayed a higher prevalence ratio for cough [prevalence ratio (PR) = 3.0, 95% confidence interval (95% CI): 1.4 to 6.2] and work-related shortness of breath (PR = 2.5, 95% CI: 1.1 to 5.6), and had a lower FEF25–75 than controls. Hand pickers without tables had a significantly higher prevalence ratio of cough with sputum (PR = 3.9, 95% CI: 1.6 to 9.5) and lower forced vital capacity, forced expiratory volume in 1 second, and mean forced expiratory flow between 25% and 75% of the FVC than hand pickers with tables. Conclusion: Hand pickers show a range of adverse symptoms and lung function impairments that warrant efforts to improve working conditions. publishedVersion

Aim and objective To assess the association between work in a rotating shift schedule and menstruation characteristics among nurse staff in a prospective study. Background Rotating shifts have been linked to alterations in the reproductive cycle. In the case of menstrual alterations, the conclusions are not clear. Design Prospective epidemiological study with follow-up over four months. Method All the female nurse staff (

Numerous cross-sectional studies report high prevalence rates of sleepiness and insomnia in shift workers, but few longitudinal studies exist. We investigated trajectories of sleepiness and insomnia symptoms in a sample of Norwegian nurses across four measurements, spanning a total of four years (sleepiness) and five years (insomnia). The participants completed the Epworth Sleepiness Scale and the Bergen Insomnia Scale at each measurement instance. Latent growth curve models were used to analyse the data. Separate models examined night work (night work, entering and leaving night work) and rotational work (rotational work, entering and leaving rotational work) as predictors for trajectories of sleepiness and insomnia symptoms, respectively. Baseline values of sleepiness and insomnia were higher among rotational shift workers than among workers with fixed shifts (day or night). The results showed that night work throughout the period and entering night work during the period were not associated with different trajectories of sleepiness or insomnia symptoms, compared to not having night work. The same results were found for rotational work and entering rotational work, compared to not having rotational work. Leaving night work and leaving rotational work were associated with a decrease in sleepiness and insomnia symptoms, compared to staying in such work.

The aims of this longitudinal study were to investigate a significant threshold shift (STS) among personnel working on board the Royal Norwegian Navy′s (RNoN) vessels between 2012 and 2014 and to identify possible determinants of STS. Hearing thresholds were measured by pure tone audiometry in two consecutive examinations (n = 226). STS was defined as an average change in hearing thresholds ≥ + 10 dB at 2,000 Hz, 3,000 Hz, and 4,000 Hz in either ear. Determinants of STS were assessed through a questionnaire. The incidence of STS was 23.0%. Significant determinants of STS were the number of episodes of temporary threshold shifts (TTS) in the Navy, exposure to continuous loud noise during work on board, and the number of gun shots (in the Navy, hunting, and sports). This study indicated a significant association between noise exposure on board Navy vessels and development of STS.

Chronic respiratory symptoms and reduction in lung function has been described as a common health problem among textile workers in low- and middle-income countries. The objective of this study was to measure lung function and respiratory symptoms among workers from an integrated textile factory. A comparative cross-sectional study design with a cross-shift lung function measurement was performed in 306 cotton dust exposed workers from an integrated textile factory and 156 control workers from a water bottling factory. An integrated textile factory typically has four main production departments (spinning, weaving, finishing, and garment) that process raw cotton and manufacture clothes or fabrics. Respiratory symptoms were assessed by adopting the standard American Thoracic Society questionnaire. Descriptive statistics and logistic and linear regression analysis were used. The prevalence of respiratory symptoms was significantly higher among textile workers (54%) than in controls (28%). Chronic cough, chest tightness, and breathlessness were significantly higher among textile workers (23%, 33%, and 37%, respectively) than in the control group (5%, 17% and 6%, respectively). Breathlessness was the most prevalent chronic respiratory symptom with highest adjusted odds ratio 9.4 (95% CI 4.4&ndash, 20.3). A significantly higher cross-shift lung function reduction was observed among textile workers (123 mL for FEV1 and 129 mL for FVC) compared with the control group (14 mL for FEV1 and 12 mL for FVC). Thus, workers&rsquo, respiratory health protection programs should be strengthened in textile factories.

Personality has been hypothesized to act as antecedent as well as an outcome of workplace bullying. Still, investigations on the longitudinal relationship between bullying and personality are scarce. We investigated the relationship between accumulated exposure to bullying at work and subsequent changes in psychological hardiness. Additionally, we examined whether hardiness predicted subsequent exposure to bullying. The data were based on the Survey of Shiftwork, Sleep, and Health (SUSSH), a cohort study with annual surveys among Norwegian nurses. The participants who completed standardized instruments measuring exposure to bullying behavior at T1 (2008/09) to T4 (2012) and psychological hardiness at T1 (2008/09) and T5 (2012) were included (n = 938). The results showed that accumulated exposure to bullying (sum of exposure from T1&ndash, T4) was associated with reduced psychological hardiness at T5, adjusted for age, sex, and hardiness at baseline (&beta, = &ndash, 0.16, t = &ndash, 5.70, p &lt, 0.001). Accumulated exposure to bullying behaviors explained 2.3% of the change in hardiness. Less hardy individuals experienced higher levels of subsequent exposure to bullying behaviors, adjusted for age, sex, and bullying at baseline (&beta, 0.04, t = &ndash, 2.21 p &lt, 0.05). Long-term accumulated exposure to bullying behaviors seemed to be a stronger predictor for changes in hardiness as compared to hardiness in predicting exposure to bullying.

The flower industry in East Africa has grown in recent years, especially in the production and export of roses. The aim of this study was to assess pesticide use on selected flower farms in Ethiopia. Serum cholinesterase levels in workers were used as a marker of pesticide exposure. This study was a cross-sectional study involving 588 workers from 15 different flower farms. It had a response rate of 95.5%. The participants included 277 males (mean age 26 years, 148 pesticide sprayers and 129 non-sprayers) and 311 females (mean age 25 years, 156 working in greenhouses and 155 working outside the greenhouses). The researchers undertook structured interviews, blood sampling, and walkthrough surveys. Descriptive statistics and Poisson regression were used in the statistical analyses. A total of 154 different trade names of pesticides were found. Of them, 31 (27%) were classified as moderately hazardous by the WHO, and 9% were organophosphates. Serum levels of cholinesterase deviating from 50&ndash, 140 Michel units were considered abnormal. Abnormal serum cholinesterase levels (above 140 Michel units) were found in 97 participants (16.5%, 95% confidence interval 13.7&ndash, 19.7%). There were no differences between the four job groups regarding cholinesterase levels. The high prevalence of abnormal serum cholinesterase levels might indicate the presence of pesticide intoxication. Thus, there is a need for routine monitoring of all workers exposed to pesticides, not only sprayers.

Background Quality of life among abused women in Norway in 2006 was found to be significantly low compared to women at the same age in general. The aim of this study was to examine how quality of life is associated with experience of psychological and physical violence intimate partner violence among abused women seeking help after domestic partner abuse comparted to quality of life in a random sample of women in Norway. Methods A cross-sectional study in a random sample of 1500 women (response rate 36%, n = 469) in Norway were performed. In addition, 191 women who sought help after domestic partner abuse were invited (44%, n = 84). The experience of intimate partner violence (IPV) and health-related quality of life were measured in both samples. The participants were divided into: “Women seeking help” after domestic partner abuse (n = 84); “Random sample, abused women” (n = 127); and “Random sample, not abused women” (n = 342). Results The experience of psychological and physical violence was significantly different between the groups (p

Introduction In 2007, an oil tank in an industrial area in Norway exploded and caused a prolonged malodorous pollution. Previous studies have shown that acute physical and psychological health complaints are prevalent in populations recently affected by industrial accidents. However, follow-up studies of human health effects after such accidents are limited, and knowledge about long-term health effects among workers exposed to malodourous emissions following a chemical accident is scarce. The aim of the study was to assess whether subjective health complaints among employees in the industrial area and clean-up workers declined over a four-year period after an oil tank explosion, a period that included removal of the malodorous pollution. Methods A longitudinal survey from 2008 (1 ½ years after the explosion) to 2012 (5 ½ years after the explosion) was performed using the Subjective Health Complaints Inventory, a validated questionnaire. Data were analysed using a linear mixed effects model. Results In 2008, exposed workers (n=147) had significantly more health complaints such as headache, tiredness, sleep problems, dizziness and depression, compared to unexposed controls living far away from the explosion site (n=137). In 2012, there was a reduction of subjective health complaints among the exposed workers, but they still had significantly more subjective neurological symptoms (p Discussion It is likely that the overall decrease of subjective health complaints among exposed workers could be due to decreased exposure to malodorous pollutants or time passed since explosion. However, the persistent subjective neurological complaints might be mediated by perceived pollution and health risk perception. Worry might have caused a chronic effect, manifested by a dysfunctional and persistent neuropsychological response. A possible implication is that quick clean-up of malodorous chemical spills is important to avoid persistent health effects.

Introduction Noise induced hearing loss (NIHL) is apreventable disease. However, the global burden of NIHL is increasing; especially in developing countries. The prevalence of NIHL among metal industry workers in Sub Saharan countries including Tanzania is not well documented. Methods This study was conducted among male metal industry workers (Exposed, n=226) and Public Primary School teachers (Controls, n=110) between June 2016 and June 2017, in Dar es Salaam. The exposed were from four metal industries (Factory A, n=65; B, n=45; C, n=53; D, n=63). Hearing thresholds at 0.5, 1, 2, 3, 4, 6 and 8 KHz were examined using Interacoustic AD 226 audiometer. NIHL was defined as hearing threshold levels>25 dB in either ear at 3, 4 and 6 KHz. The WHO classification of hearing loss was used. Results The prevalence of NIHL among exposed was 50% and 47% in the right and left ear, respectively. The highest prevalence was found in factory B(71% and 62%), followed by D(48% and 54%), A(48% and 48%), and the lowest in factory C(37% and 25%) in the right and left ear, respectively. The proportion of mild, moderate and severe NIHL in the right and left ear was 80% and 79%, 20% and 18%, 0% and 2%, respectively. Among controls, the prevalence of NIHL was 31% and 28% in the right and left ear, respectively. The proportion of mild, moderate, severe NIHL in the right and left ear was 86% and 76, 11% and 15%, 3% and 0%, respectively. Nine percent of the controls had profound NIHL in the left ear and none among exposed. Discussion We found high prevalence of NIHL among Tanzanian metal industry workers. Further studies on noise exposure and the determinants for reduced hearing are needed. Establishment of a hearing conservation program in the metal industries seems to be important.

Introduction The occupations involving working with animal production have for so long been known to bring significant health risks to workers, with distinctive attention to injuries. However, workers employed at slaughterhouses are at risk of pathogen exposure and especially zoonotic ones due to general working condition that exposes them directly to live animals, carcasses and viscera of possibly infected animals. The increased use and misuse of antimicrobials in animal treatments and feed to promote growth have increased the development of antimicrobial resistance, exposing workers to a more serious infection. This study aimed to determine the prevalence of nasal antibiotic resistant Staphylococcus aureus and associated risk factors. Methods A cross-sectional study was conducted to collect data using questionnaire for information on occupational and personal history, checklist for working conditions and nasal swabs from 427 workers at slaughterhouses in Dar es Salaam, Dodoma and Arusha regions in Tanzania. Swabs were tested for S.aureus and later isolates were screened for antibiotic susceptibility. Results Overall prevalence of S. aureus nasal carriage was about 30.0% where as 5% was resistant to antibiotic. The prevalence was higher in slaughter or carcass processing workers but also about 5 times higher in cleaning. Many slaughterhouses had poor infrastructure, less than 60% had a toilet and less than 20% had hand-washing facilities. Slaughtering of sick animals was observed in about 10% of slaughterhouses. Less than half of workers wore personal protective clothing Conclusion Working conditions of majority of cattle slaughterhouses visited in Tanzania are not in line with the health and safety recommendations. Current facilities and practices may increase occupational exposure to biological hazards. Cattle slaughterhouse workers may have increased exposure to livestock-associated S. aureus, particularly MRSA. Therefore, further epidemiologic investigation on occupational exposure to livestock-associated S. aureus is required.

Introduction Exposure to organic dust may lead to decrease in lung function among healthy subjects or development of respiratory symptoms. Studies done among coffee workers reported significant exposure to endotoxins with no evidence of decrease in lung function. The current study aimed at determining seasonal variation of lung function among coffee workers due to endotoxin exposure. Methods The study was done in coffee factory where 30 workers were monitored for one season of coffee processing that is from June 2016 to February 2017. Lung function tests were performed once in the morning on any day before the season, then on Monday morning and Friday evening at mid-season and end of the season. A portable spirometer WinspiroLIGHT was used. ATS/ERS guidelines were followed. All measurements were taken in standing position. Data was analysed by paired-sample T-test. Smoking and age used to adjust lung function change in linear regression. Results The mean age of participants was 38 (8.4) and mean time of working in coffee factories was 10 (6.8) years. There was a significant decrease of 24 and 20 mls for FEV 1 and FVC, the change being high in the mid-season compared to end season. Improved in FEV 1 (3.29 l/s – 3.65 l/s) at the beginning of season to mid-season was observed. Discussion Lung function decrease is observed along the season with higher decrease at the end of season. The slight increase in FEV 1 between beginning of season and mid-season could be due to cessation of exposure.

PURPOSE: We investigated which job demands and job resources were predictive of mental health-related long-term sickness absence (LTSA) in nurses. METHODS: The data of 2059 nurses were obtained from the Norwegian survey of Shift work, Sleep and Health. Job demands (psychological demands, role conflict, and harassment at the workplace) and job resources (social support at work, role clarity, and fair leadership) were measured at baseline and linked to mental health-related LTSA during 2-year follow-up. Cox regression models estimated hazard ratios (HR) and related 95% confidence intervals (CI). The c-statistic was used to investigate the discriminative ability of the Cox regression models. RESULTS: A total of 1533 (75%) nurses were included in the analyses; 103 (7%) of them had mental health-related LTSA during 2-year follow-up. Harassment (HR = 1.07; 95% CI 1.01-1.17) and social support (HR = 0.92; 95% CI 0.87-0.98) were associated with mental health-related LTSA. However, the Cox regression model did not discriminate between nurses with and without mental health-related LTSA (c = 0.59; 95% CI 0.53-0.65). CONCLUSIONS: Harassment was positively and social support at the workplace was negatively related to mental health-related LTSA, but both failed to discriminate between nurses with and without mental health-related LTSA during 2-year follow-up. ispartof: INTERNATIONAL ARCHIVES OF OCCUPATIONAL AND ENVIRONMENTAL HEALTH vol:91 issue:2 pages:195-203 ispartof: location:Germany status: published

ObjectivesTo investigate associations between different types of headaches and shift work.Design, participants and outcome measuresNurses with different work schedules (day work, two-shift rotation, night work, three-shift rotation) participated in a cohort study with annual surveys that started in 2008/2009. In 2014 (wave 6), a comprehensive headache instrument was included in the survey, in which 1585 nurses participated. Headaches were assessed according to the International Classification of Headache Disorders IIIb. Frequent headache (≥1 day per month), migraine, tension-type headache, chronic headache (headache >14 days per month) and medication-overuse headache (chronic headache + acute headache medication ≥10 days last month) comprised the dependent variables. Adjusted (for sex, age, percentage of full-time equivalent, marital status, children living at home) logistic regression analyses were conducted with work schedule, number of night shifts worked last year, number of quick returns (ResultsFrequent headache, migraine and chronic headache were associated with shift work disorder (OR 2.04, 95% CI 1.62 to 2.59; 1.60, 1.21 to 2.12; 2.45, 1.25 to 4.80, respectively) and insomnia disorder (OR 1.79, 95% CI 1.43 to 2.23; 1.55, 1.18 to 2.02; 3.03, 1.54 to 5.95, respectively), but not with work schedule, number of night shifts or number of quick returns. Tension-type headache was only associated with >20 night shifts last year (OR 1.41, 95% CI 1.07 to 1.86). Medication-overuse headache was only associated with insomnia disorder (OR 7.62, 95% CI 2.48 to 23.41).ConclusionsWe did not find any association between different types of headaches and work schedule. However, tension-type headache was associated with high number of night shifts. Nurses with sleep disorders (insomnia disorder and shift work disorder) reported higher prevalence of frequent headaches, migraine, chronic headache and medication-overuse headache (only insomnia) compared with nurses not having insomnia disorder and shift work disorder, respectively.

Shift workers often experience circadian misalignment and problems adjusting adequately to their work schedules, which is manifested in the high prevalence rates of shift work disorder, insomnia and sleepiness in this group of workers compared to day workers. However, there exist large inter-individual differences in tolerance to shift work. We investigated whether frequency variation in single nucleotide polymorphisms capturing genetic variation in genes involved in the regulation of circadian rhythms (clock genes) was associated with insomnia, sleepiness, and shift work disorder in a sample of Norwegian nurses employed in various work schedules. Saliva samples from 691 female nurses participating in “the Survey on Shift work, Sleep and Health” were analysed for associations between genetic variations in clock genes and the nurses’ survey responses. A total of 662 single nucleotide polymorphisms were analysed. After multiple testing correction, we did not observe any statistically significant associations between the genetic variants and insomnia, sleepiness, or shift work disorder.

The aim of this study was to investigate whether different shift work schedules were associated with nonrapid eye movement (NREM)- and/or REM-related parasomnias. A total of 2198 nurses with different work schedules participated in a longitudinal cohort study. The parasomnia questions were included in the fourth wave of the data collection, with a response rate of 74.1%. Logistic regression analyses with the different parasomnias as dependent variables were conducted. Nurses working two shift (day and evening) and nurses working three shift (day, evening and night) rotational schedules had increased risk of confusional arousal, a NREM-related parasomnia, compared to nurses working daytime only (odds ratios = 2.10 and 1.71, respectively). Similarly, nurses working two and three shift rotational schedules had increased risk of nightmares, a REM-related parasomnia (odds ratios = 1.64 and 1.57, respectively). The other parasomnias were not significantly associated with work schedule. Working night shifts only was not associated with any of the parasomnias. In conclusion, confusional arousal and nightmares were more commonly reported by nurses working rotational shift work schedules compared to nurses working daytime only. This is likely related to the circadian rhythm misalignment and sleep deprivation caused by such shift schedules.

Research about prenatal exposure to electromagnetic fields from cell phones among expectant parents and reproductive outcome is limited. The aim of this article is to investigate the association between pregnancy outcome and parental cell phone exposure in a large prospective study.The study was based on the Norwegian Mother and Child Cohort Study conducted during the decade 1999-2009. In that study, pregnant women were recruited before a routine ultrasound examination during gestational week 15; they answered a questionnaire at that time and again around gestational week 30. The expectant father was invited to answer a questionnaire during gestational week 15 (2001-2009). The forms contained questions regarding cell phone use. The response rate was 38.7% and the cohort comprised 100,730 singleton births. Pregnancy outcomes were obtained by linkage to the Medical Birth Registry of Norway.The risk of preeclampsia was slightly lower among women with medium and high cell phone exposure compared with low exposure after adjusting for potential confounders. Fathers with testis exposure when using cell phones had a borderline increased risk of perinatal mortality among offspring and a slightly decreased risk of partner developing preeclampsia during pregnancy compared with no cell phone exposure of head or testis. None of the other pregnancy outcomes was associated with cell phone exposure.We found no association between maternal prenatal or paternal preconceptional cell phone exposure and any of the studied pregnancy outcomes. The only risk estimate suggesting a potential increased risk was not consistent with other findings.

Background: Self-rated health (SRH) has been found to predict sickness absence (SA). The present study investigated the effect of replacing single-item SRH by a multi-item health measure on SA predictions. Methods: Longitudinal study of 2059 Norwegian nurses with assessments in three waves each separated by 1 year. Health was measured by single-item SRH and multi-item SF-12 in waves 1 and 2. SA was self-reported in all three waves and high SA was defined as more than or equal to 31 SA days within the last 12 months. Predictions of high SA by a model including age, prior SA and single-item SRH were compared with predictions by a model including age, prior SA and multi-item SF-12. Both models were bootstrapped to correct for over-optimism and prospectively validated for their predictions in a new time frame. Results: 1253 nurses (61%) had complete data for analysis. The SF-12 model predicted the risk of high SA more accurately (χ2 = 4.294; df = 8) and was more stable over time than the SRH model (model χ2 = 14.495; df = 8). Both prediction models correctly discriminated between high-risk and low-risk individuals in 73% of the cases at wave 2 and in 71% of the cases at wave 3. Conclusions: The accuracy of predictions increased when single-item SRH was replaced by multi-item SF-12, but the discriminative ability did not improve. Single-item SRH suffices to identify employees at increased risk of high SA.

Night work has been associated with adverse effects in terms of reproductive health. Specifically, menstruation has been suggested to be negatively impacted by night work, which again may influence fertility. This study investigated whether working nights is related to menstrual characteristics and if there is a relationship between shift work disorder (SWD) and menstruation. The study was cross-sectional, response rate 38%. The sample comprised female nurses who were members of the Norwegian Nurses Association; below 50 yr of age, who were not pregnant, did not use hormonal pills or intrauterine devices and who had not reached menopause (n=766). The nurses answered a postal survey including questions about night work and menstrual characteristics. Fifteen per cent reported to have irregular menstruations. Thirty-nine per cent of the nurses were classified as having SWD. Logistic regression analyses concerning the relationship between irregular menstruations and night work did not show any associations. Furthermore, no associations were found between cycle length or bleeding period and night work parameters. No associations were found between menstrual characteristics and SWD.

Background Foul-smelling environmental pollution was a major concern following a chemical workplace explosion. Malodorous pollution has previously been associated with aggravated physical and psychological health. Furthermore, in persons affected by a trauma, an incidence-related odour can act as a traumatic reminder. Olfaction may even be of significance in the development and persistence of post-traumatic stress symptoms (PTSS). Aims To assess whether perceived smell related to malodorous environmental pollution in the aftermath of the explosion was a determinant of subjective health complaints (SHC) and PTSS among gainfully employed adults before and after clean-up of the malodorous pollution. Methods Questionnaire data from validated instruments, the Subjective Health Complaints Inventory and the Impact of Event Scale-Revised, were analysed using mixed effects models in a longitudinal study design comprising three surveys. Individual odour scores were computed, and the participants (n=486) were divided into high (n=233) and low (n=253) odour score groups. Results Participants in the high odour score group reported more SHC and PTSS than those in the low odour score group, before and also after the pollution was eliminated. The difference between the groups lasted for at least three years after the pollution was eliminated. Conclusion Perception of malodorous environmental air pollution was a determinant of both SHC and PTSS. Prompt clean-up might be important to avoid persistent health effects after malodorous chemical spills.

Foul-smelling environmental pollution was a major concern following a chemical workplace explosion. Malodorous pollution has previously been associated with aggravated physical and psychological health, and in persons affected by a trauma, an incidence-related odour can act as a traumatic reminder. Olfaction may even be of significance in the development and persistence of post-traumatic stress symptoms (PTSS). The present longitudinal study assessed whether perceived smell related to malodorous environmental pollution in the aftermath of the explosion was a determinant of subjective health complaints (SHC) and PTSS among gainfully employed adults, when the malodorous pollution was present, and after pollution clean-up. Questionnaire data from validated instruments were analysed using mixed effects models. Individual odour scores were computed, and the participants (n=486) were divided into high and low odour score groups, respectively. Participants in the high odour score group (n=233) reported more SHC and PTSS than those in the low odour score group (n=253), before and even after the pollution was eliminated. These associations lasted for at least three years after the pollution was removed, and might indicate that prompt clean-up is important to avoid persistent health effects after malodorous chemical spills. publishedVersion

Purpose The study aimed to evaluate the possible influence of prolonged sleep deprivation on achromatic and chromatic (red–green and blue–yellow) contrast sensitivity (CS). Methods During 60-hr sleep deprivation, CS was measured in 11 naval officers every sixth hour using videographic (Vigra-C) sine-wave-generated stimuli. Results When comparing the CS measurements obtained in the first and last 24 hr of the study, no statistically significant mean changes of achromatic CS (2.0, 5.9 and 11.8 cpd) or yellow–blue CS (0.6, 2.0 and 4.7 cpd) were found, while a significantly increased mean red–green CS at 2.0 and 4.7 cpd was recorded in the last 24 hr (p = 0.003 in both). The variance of achromatic and chromatic CS measurements in the group did not differ significantly in the first and last 24 hr test periods. Conclusions Prolonged sleep deprivation does apparently not cause clinically or occupationally significant changes of contrast sensitivity in otherwise healthy subjects with normal visual acuity.

Objectives Prior studies have indicated a high prevalence of noise-induced hearing loss (NIHL) among Navy personnel; however, it is not clear whether this is caused by work on board. The present study aimed to assess the prevalence of hearing loss among Navy personnel in the Royal Norwegian Navy (RNoN), and to investigate whether there is an association between work on board RNoN vessels and occurrence of hearing loss. Methods Navy personnel currently working on board RNoN vessels were recruited to complete a questionnaire on noise exposure and health followed by pure tone audiometry. Hearing loss was defined as hearing threshold levels ≥25 dB in either ear at the frequencies 3,000, 4,000 or 6,000 Hz. Hearing thresholds were adjusted for age and gender using ISO 7029. Results The prevalence of hearing loss among Navy personnel was 31.4 %. The work exposure variables: years of work in the Navy, years on vessel(s) in the Navy and years of sailing in the Navy were associated with reduced hearing after adjusting for age, gender and otitis as an adult. Among the work exposure variables, years of sailing in the Navy was the strongest predictor of reduced hearing, and significantly reduced hearing was found at the frequencies 1,000, 3,000 and 4,000 Hz. Conclusions Our results indicate that time spent on board vessels in the RNoN is a predictor of reduced hearing. publishedVersion

The aim of the study was to assess whether exposed workers had more subjective health complaints than controls 1 1/2 years after a chemical explosion involving a mixture of hydrocarbons and sulfurous compounds. A cross-sectional survey based on the Subjective Health Complaints Inventory (SHC) was conducted among 147 exposed workers and 137 controls. A significantly higher total SCH score (linear regression, p=.01) was found for the exposed workers compared with controls when adjusting for gender, age, smoking habits, and educational level. The exposed workers reported significantly more headache, hot flashes, sleep problems, tiredness, dizziness, and sadness/depression. The cause of these complaints is unknown, but health personnel should be aware that health complaints might be related to polluting episodes even when exposure levels are below occupational guideline levels.

To compare total dust exposure, prevalence of chronic respiratory symptoms, lung function, and chronic obstructive pulmonary disease (COPD) among Tanzanian cement workers before (2002) and after (2010-2011) establishment of dust-control measures.Personal total dust-exposure measurements, questionnaire assessment for chronic respiratory symptoms, and spirometry were conducted in both examination periods.Total dust exposure was lower in 2010-2011 than in 2002. The prevalence of most chronic respiratory symptoms and COPD was lower in 2010 than in 2002. Forced expiratory volume in 1 second (FEV1), percentage predicted FEV1, and percentage predicted forced vital capacity were higher among cement workers in 2010 than in 2002.There was reduced total dust exposure level, lower prevalence of chronic respiratory symptoms and COPD, and higher lung function among cement workers in 2010 than in 2002.

We investigated whether fatigue can be used to screen nursing populations for risk of sickness absence. Data were available from a prospective cohort study of 2,059 Norwegian nurses working in hospital care, psychiatric care, and nursing home/home care settings. Physical and mental fatigue were measured at baseline with Chalder's Fatigue Questionnaire (FQ). Self-rated sickness absence at 1-year follow-up was considered high if nurses reported >30 sick days in the past year. Physical fatigue accurately predicted high sickness absence and adequately discriminated between high- and low-risk nurses in nursing home/home care settings. Mental fatigue was not predictive in any setting. The FQ is suitable for screening specific nursing populations for the risk of high sickness absence. (c) 2013 Wiley Periodicals, Inc. Res Nurs Health 36: 453-465, 2013

Background: Sickness absence is high in healthcare and contributes to nursing staff shortages reducing the efficiency and quality of patient care. Assessing the risk of sickness absence in working nurses opens opportunities for preventive strategies. Job satisfaction has attracted much attention in healthcare research and has been associated with sickness absence among nurses.Objectives: To investigate if job satisfaction scores are useful to identify working nurses at risk of future sickness absence.Design: Prospective cohort study with a baseline period from November 2008 to March 2009 and 1-year follow-up.Settings: Hospitals, nursing homes, and ambulant care settings in Norway.Participants: 2059 Norwegian nurses, of whom 1582 (77%) could be followed-up.Methods: Nurses received a questionnaire at baseline and after 1-year follow-up. The questionnaire contained the Job Satisfaction Index (JSI), a 5-item scale measuring overall job satisfaction, and asked for sickness absence in the last 12 months. Baseline JSI scores were included in a logistic regression model with self-rated sickness absence at 1-year follow-up as outcome variable. Predictions of sickness absence were calibrated by the Hosmer-Lemeshow goodness-of-fit test. The ability of JSI scores to discriminate between nurses with and without sickness absence was examined by receiver operating characteristic analysis and expressed as area under the curve (AUC).Results: Low job satisfaction was associated with higher odds of sickness absence (odds ratio [OR] = 1.05; 95% confidence interval [CI] 1.01-1.09) and high (>= 31 days) sickness absence (OR = 1.10; 95% CI 1.06-1.14). Calibration was acceptable, but job satisfaction neither discriminated between nurses with and without sickness absence (AUC = 0.54; 95% CI 0.51-0.58) nor between nurses with and without high (>= 31 days) sickness absence (AUC = 0.58; 95% CI 0.54-0.63).Conclusions: The results of this study indicated that job satisfaction was associated with sickness absence, though job satisfaction scores as measured with the JSI did not identify working nurses at risk of sickness absence. (C) 2012 Elsevier Ltd. All rights reserved.

This study compared subjective sleep and subjective health complaints among Norwegian oil rig workers, before and after a two week work period. The study also compared differences between two different work schedules. The workers worked either two weeks of day shift (n=90) or two weeks of a swing shift schedule (n=93), involving one week of night shifts, immediately followed by one week of day shifts. Overall, the workers reported significantly poorer sleep quality and more complaints of insomnia at the end compared to the start of the work period. However, there was no significant difference in terms of subjective health complaints. Furthermore, there were no clear differences in changes in sleep quality, insomnia or subjective health complaints during the work period between day- and swing shift workers. However, at the end of the work period a higher proportion of insomniacs were seen among swing shift workers compared with day workers. To conclude, sleep quality and complaints of insomnia became worse during the work period. However, there were few differences in changes in terms of sleep or subjective health complaints between day- and swing shift, suggesting that 12 h day shift affected sleep and health similarly to the schedule involving night work.

Objective Over the years increasing use of cell phone technology have raised concern regarding this technology. Due to this concern, studies have been performed and some indicates a negative effect of cell phone on reproduction hormones testosterone and luteinizing hormone. However, methodological weaknesses have been a major issue in this research. The present study assesses reproductive hormones among healthy young men who use cell phones. Materials and methods 24 healthy male students were investigated with questionnaire on background factors and cell phone habits. In addition three repeated blood-samples, all taken with a very specific protocol were collected. Analyses has been done on testosterone and luteinizing hormone. Results The hormone levels of testosterone and luteinizing hormone revealed no major differences in regards to how the participants used the cell phone in number of minutes per day, and nor by which cell phone technology they had (GSM or 3G). Conclusions This study does not find an influence on the male reproductive hormones testosterone and luteinizing hormone, neither by cell phone use nor cell phone technology among young men. The protocol for the study was very strict and potential confounding was addressed. However, uncertainties in exposure assessment warrant future studies with better exposure classification to confirm our findings.