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Background Choosing cutoff values for nerve conduction studies (NCS) and ultrasound cross-sectional area (CSA) in the diagnosis of carpal tunnel syndrome (CTS) is critical in determining the diagnostic accuracy of the tests. The goals of this study were to: (1) determine the sensitivity and specificity of various electrodiagnostic and ultrasound threshold values for diagnosis of CTS; and (2) determine the number of hands that underwent NCS and ultrasound that were within 10% of threshold values. Methods A total of 309 hands of 235 patients were included in this study. Diagnosis of median neuropathy was made based on NCS by the independent physician performing the NCS. Criteria analyzed included distal motor latency of 4.4+ ms, distal sensory latency of 3.6+ ms, difference in median-ulnar mixed nerve palmar latency of 0.4+ ms, and CSA of the median nerve of 10+ mm2. Results Median neuropathy was diagnosed in 235 hands, whereas 74 hands were found not to have median neuropathy. Overall, 141 hands (46%) had at least 1 of the 3 electrodiagnostic variables within 10% of the diagnostic cutoff values, and 137 hands (44%) had a median nerve CSA within 10% of 10 mm2. By performing ultrasound in addition to NCS for each patient, an additional 65 hands (21%) had a definitive diagnosis on at least 1 of the 2 diagnostic modalities. Conclusions Ultrasound and NCS yielded a similar number of patients within 10% of their diagnostic threshold values. When used together, the number of patients with a nonborderline diagnosis on at least 1 diagnostic modality was increased substantially.

In response to the COVID-19 pandemic, many countries have adopted a broad spectrum of containment measures, from recommendations to stay at home to quarantines of large geographic regions. As part of this response, corporations and governments alike have strongly encouraged workers to telecommute where possible. More than 3.4 billion people in 84 countries have been confined to their homes, as estimated in late March 2020, which potentially translates to many millions of workers temporarily exposed to telecommuting. Since 2000, the emergence of digital and broadband internet has facilitated the development of home telework. Despite limited research interest on its impact on occupational health, several health benefits and risks of telework have been identified in academic or grey literature (table 1) (for a review see Ref. 1). …

The latest technological innovations have considerably increased the field of application for infrasound, and the possible risks that infrasound may present to those exposed to it must be taken into account. The main task of this article is to organize and summarize recent studies on the most common artificial emitting sources and the effects that these non-audible frequencies have on health when absorbed by the body, as well as presenting the existing regulations, a discussion and a series of conclusions that clarify aspects of infrasound. The intention of the authors of this article is that what is exposed in this review can be used to address and determine future lines of research and promote architects to take the spaces of installations within a building very seriously as well as carry out competent administration considering a minimum distance from the road to where habitable buildings are planned.

ObjectivesPrevious studies on the association between psychosocial work factors and blood pressure mainly focused on specific occupations or populations and had limited sample sizes. We, therefore, investigated the associations between psychosocial work factors and blood pressure in a large general working population in the Netherlands.MethodsWe included 63 800 employees from the Netherlands, aged 18–65 years, with blood pressure measurements and a reliable job code at baseline. Psychosocial work factors (job strain, effort–reward imbalance (ERI) and emotional demands) in the current job were estimated with three recently developed psychosocial job exposure matrices. To examine the associations, regression analyses adjusted for covariates (age, sex, body mass index, education, monthly income, pack-years, smoking, alcohol consumption and antihypertensive medication (not included for hypertension)) were performed.ResultsHigher job strain was associated with higher systolic blood pressure (SBP) (B (regression coefficients) (95% CI) 2.14 (1.23 to 3.06)) and diastolic blood pressure (DBP) (B (95% CI) 1.26 (0.65 to 1.86)) and with higher odds of hypertension (OR (95% CI) 1.43 (1.17 to 1.74)). Higher ERI was associated with higher DBP (B (95% CI) 4.37 (3.05 to 5.68)), but not with SBP or hypertension. Higher emotional demands were associated with lower SBP (B (95% CI) −0.90 (−1.14 to −0.66)) and lower odds of hypertension ((OR) (95% CI) 0.91 (0.87 to 0.96)).ConclusionsIn the general working population, employees in jobs with high job strain and ERI have higher blood pressure compared with employees with low job strain and ERI. Emotional demands at work are inversely associated with blood pressure.

BACKGROUND: A validated method to assess sitting and standing posture in a clinical setting is needed to guide diagnosis, treatment and evaluation of these postures. At present, no systematic overview of assessment methods, their clinimetric properties, and usability is available. OBJECTIVE: The objective of this study was to provide such an overview and to interpret the results for clinical practice. METHODS: A systematic literature review was performed according to international guidelines. Two independent reviewers assessed risk of bias, clinimetric values of the assessment methods, and their usability. Quality of evidence and strength of recommendations were determined according to the Grading of Recommendations Assessment, Development and Evaluation working group (GRADE). RESULTS: Out of 27,680 records, 41 eligible studies were included. Thirty-two assessment instruments were identified, clustered into five categories. The methodological quality of 27 (66%) of the articles was moderate to good. Reliability was most frequently studied. Little information was found about validity and none about responsiveness. CONCLUSIONS: Based on a moderate level of evidence, a tentative recommendation can be made to use a direct visual observation method with global posture recorded by a trained observer applying a rating scale.

Background To examine the association of job strain with cognitive ability and the influence of life-course job strain on later life cognitive decline. Methods Data were derived from six waves of the Survey of Health, Aging, and Retirement in Europe. The study sample consists of 13349 participants aged 50 to 98 years at wave 2 and has been followed up for 12-years. Job strain status across working life was assessed using a short demand-control job strain model containing two core dimensions: job demands and job control collected in wave 3. Cognitive abilities concerning episodic memory was assessed by immediate recall and delayed recall tests, executive function was evaluated by verbal fluency test collected in all waves (waves 2–7) except wave 3. Mixed-effects model was used to estimate working life job strain and its cumulative effect on cognitive decline. Results Both passive and high strain jobs were associated with lower levels of cognitive ability (episodic memory and verbal fluency) in comparison with active job. Long exposure to active- or low strain-job was associated with higher cognitive ability whereas long exposure to passive job or moderate duration of high strain job was associated with lower cognitive ability. The rate of memory decline was positively related to moderate duration of passive job and negatively related to long-term exposure to low strain job. Limitations Information on working conditions was based on self-reported recollections. Conclusions Working life variation in job strain status and their duration may explain individual differences in cognitive ability in later life.

Objective To identify latent components from among 13 work and non-work stressors and to examine whether the accumulation of stress factors within these components was associated with sleep problems. Methods A cohort of older employees (n = 2771 individuals, n = 3921 person-observations) responded to at least two surveys. Principal Component Analysis (PCA) was used to identify latent components. Analysis of variance was used to examine their associations with sleep. Results The components were: 'Physical workload and shift work', 'Psychosocial workload', 'Social and environmental non-work adversity' and 'Life event- and health-related non-work adversity'. They were consistently associated with sleep problems, except for 'Physical workload and shift work'. 'Social and environmental non-work adversity' was associated with sleep problems at follow-up. Conclusions Clusters of work- and non-work-related stressors were identified, and their accumulation was associated with sleep problems among older employees.

Objectives Previous studies on the effect of low social support at work on blood pressure showed mixed results. Few previous studies have used ambulatory blood pressure and examined whether the effect of low social support at work vary among men and women. The aim of this study was to examine the association between low social support at work, ambulatory blood pressure means and hypertension prevalence, in a sample of white-collar workers men and women. Methods A repeated cross-sectional design was used. Data were collected three times during a 5-year period, among 3919 white-collar women and men. At each time, coworker and supervisor social support at work were measured using validated scales. Ambulatory blood pressure was measured every 15 min during a working day. General estimating equations were used. Results In adjusted models, women exposed to low coworker (+0.6 mmHg) and low supervisor social support at work (+0.7 mmHg) had slightly higher diastolic blood pressure means when compared to unexposed women. In men, those with low coworker social support at work had higher diastolic (+0.7 mmHg) blood pressure while those with low supervisor social support had a higher prevalence of hypertension (prevalence ratio = 1.14, 95% CI: 1.04–1.24). Conclusions Men with low supervisor social support at work had a higher prevalence of hypertension. Low social support at work was associated with modest increases in diastolic blood pressure among men and women. Workplace prevention strategies aiming to increase social support at work could lead to beneficial effects on worker’s cardiovascular health.

BACKGROUND: Environmental hazards in healthcare institutions affect the quality of patient care as well as personnel and patient safety. OBJECTIVE: The aim of this study was to develop and apply a semi-quantitative risk assessment method to calculate occupational health risk levels with regard to the sensitivities of healthcare institutions. METHODS: The present research was conducted in three phases. In phases 1 and 2, the model was developed using a review of different risk assessment methods, extracting expert opinions (N = 10) through semi-structured interviews, and using the fuzzy analytical hierarchy process (FAHP). In phase 3, in order to validate the proposed method, one of the five public hospitals was randomly selected and a case study comprising 6 sections was performed. RESULTS: A total of 43 health risks were identified and evaluated using the present method, 41.86% of which were at very high levels, 16.27% at high levels, 30.23% at substantial ones, 9.3% at medium and 2.32% at low levels. The highest health risks were found in paraclinical and operating room wards. CONCLUSION: To overcome the shortcomings of the proposed health risk assessment methods, a semi-quantitative method was used in the present study to more accurately calculate the risk levels in the healthcare institutions and also calculate the risk level of each hospital unit. The proposed semi-quantitative method can be used as a tool for assessing occupational health risks as a key element of risk management. In addition, by focusing on an appropriate framework for occupational health risk assessment, specialists in the organization will be able to take significant and effective steps to implement an efficient risk management system.

Workers who experience language barriers are more likely to get injured or sick because of their work and have poorer claim and return-to-work outcomes compared to other workers. To better understand the systemic factors that shape access to compensation in contexts of language barriers, we compared language accommodation policies and practices in the Quebec and Ontario workers’ compensation systems. We uncovered gaps limiting access to professional interpreters in both provinces, although gaps were more pronounced in Quebec where workers were responsible for the cost of interpreters. We argue that simply improving the linguistic competence of workers’ compensation systems is not sufficient to tackle access barriers and must be accompanied by efforts to address the root causes of social and economic inequities for workers who experience language barriers.

Publisher Copyright: © 2021 The Author(s). Published with license by Taylor & Francis Group, LLC. Physicians often work long hours and on-call shifts, which may expose them to circadian misalignment and negative health outcomes. However, few studies have examined whether these working hour characteristics, ascertained using objective working hour records, are associated with the physicians’ risk of sickness absence. We investigated the associations of 14 characteristics of payroll-based working hours and on-call work with the risk of short sickness absence among hospital physicians. In this cohort study, 2845 physicians from six Finnish hospital districts were linked to electronic payroll-based records of daily working hours, on-call duty and short (1–3 days) sickness absence between 2005 and 2019. A case-crossover design was applied using conditional logistic regression with the 28 day case and control windows to estimate odds ratios (ORs) and 95% confidence intervals (CI) for short sickness absence. After controlling for weekly working hours and the number of normal (≤12 h) shifts, a higher number of long (>12 h) shifts (ORs for ≥5 versus none: 2.54, 95% CI 1.68–3.84), very long (>24 h) shifts (ORs for ≥5 versus none: 2.62, 95%CI 1.61–4.27), and on-call shifts (OR for ≥5 versus none: 2.15, 95% CI 1.44–3.21) and a higher number of short (

Publisher Copyright: © 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under CC BY-NC-ND 4.0 license Background: High emotional demands at work can affect employees’ health and there is a need to understand whether such an association might be modified by other working conditions. We aimed to examine emotional demands at work as a risk factor for long-term sickness absence and analyse whether influence, possibilities for development, role conflicts, and physical demands at work might modify this risk. Methods: We did a nationwide, population-based, prospective cohort study in Denmark and included employed individuals who were residing in Denmark in 2000, aged 30–59 years, who had complete data on age, sex, and migration background, with information on emotional demands and possible effect modifiers from job exposure matrices, and covariates and outcome (sickness absence) from population registers. Individuals with long-term sickness absence (≥6 weeks of consecutive sickness absence) between Jan 1, 1998, and Dec 31, 2000, and self-employed individuals were excluded. We assessed long-term sickness absence during a 10-year period from Jan 1, 2001, to Dec 31, 2010. Using Cox regression, we estimated hazard ratios (HRs) and 95% CIs and tested interaction as departure from additivity, estimating relative excess risk due to interaction (RERI). Multivariable adjusted models included sex, age, cohabitation, migration background, and income. Findings: 1 521 352 employed individuals were included and contributed data between Jan 1, 2000, and Dec 31, 2010. During 11 919 021 person-years (mean follow-up 7·8 years), we identified 480 685 new cases of long-term sickness absence. High emotional demands were associated with increased risk of long-term sickness absence compared with low emotional demands, after adjusting for age, sex, cohabitation, migration background, income, and the four possible effect modifiers (adjusted HR 1·55 [95% CI 1·53–1·56]). The association between high emotional demands and risk of long-term sickness absence was stronger in a synergistic way when individuals were also exposed to low possibilities for development (RERI 0·35 [95% CI 0·22–0·47]; 28·9 additional cases per 1000 person-years) and high role conflicts (0·13 [0·11–0·15]; 22·0 additional cases per 1000 person-years). No synergy was observed for influence and physical demands at work. Interpretation: People in occupations with high emotional demands were at increased risk of long-term sickness absence. Our findings on synergistic interactions suggest that, in emotionally demanding occupations, increasing possibilities for development and reducing work-related role conflicts might reduce long-term sickness absence. Further interventional studies are needed to confirm or refute this hypothesis. Funding: Danish Work Environment Research Fund, NordForsk.

Purpose Physical work exposures are associated with sickness absence among older employees. We aimed to examine if they similarly contribute to all-cause sickness absence during early and mid-careers. Methods We used questionnaire data on physical work exposures linked to register data on sickness absence from 3542 municipal employees aged 19–39 years. Follow-up for the number of sickness absence days was 12 months. Exposures to physical workload, occupational environmental hazards, and sedentary work were divided into quartiles. In addition, duration of daily exposure to heavy work was included. Negative binomial regression models were used. Results Higher exposure to physical workload or hazardous exposures was associated with a higher number of sickness absence days. The age and gender adjusted rate ratios for sickness absence days among the participants whose exposure to physical workload was in the highest exposure quartile were 2.1 (95% CI 1.8‒2.5) compared with those whose exposure was in the lowest quartile. In addition, rate ratios for sickness absence days among participants who reported that they do heavy physical work 1.1‒2.0 h, 2.1‒4.0 h or over 4 h daily were 1.6 (1.3‒1.9), 1.5 (1.3‒1.8) and 1.7 (1.5‒2.1), respectively, compared with those who reported not doing physical work. Further adjustment for lifestyle factors or health characteristics attenuated the associations only slightly. Conclusion Exposure to physically demanding work is associated with a higher number of sickness absence days among municipal employees below 40 years of age. Physical working conditions should be considered when aiming to support later work ability.

Background Rodeo is an extreme sport involving powerful forces created by large animals. Objective The objective of this study was to characterize rodeo-related injuries among adolescents treated at United States emergency departments (EDs). Methods Cases were rodeo-related injuries among patients ages 13–19 years reported to the National Electronic Injury Surveillance System during 2000–2019. The distribution of the national injury estimates was determined for selected variables. Results A total of 408 adolescent rodeo-related injuries were identified, resulting in a national estimate of 17,363 injuries. Bulls were involved in 58.4% of the injuries and horses in 28.8%. The patients were 84.7% male and 15.3% female. The most frequently reported mechanisms of injury were: fell or thrown from an animal (41.4%), stepped on by an animal (22.4%), other contact with an animal (7.4%), contact with infrastructure (6.6%), and kicked by an animal (5.9%). The most common diagnoses were contusion or abrasion (29.5%), fracture (22.8%), strain or sprain (15.0%), laceration (8.1%), and concussion (8.0%). The affected body part was 26.9% head and neck, 25.9% upper extremity, 24.6% lower extremity, and 21.6% trunk. Conclusion Most of the injuries involved bulls. The majority of patients were male. Most of the injuries resulted from falling or being thrown by an animal or stepped on by an animal. The most frequently reported injuries were contusion or abrasion, fracture, strain or sprain, laceration, and concussion. The injuries most often affected the head and neck followed by the upper extremity and lower extremity.

ObjectiveThis study investigates if gradual return to work (GRTW) is associated with full sustainable return to work (RTW) for seriously injured workers with a musculoskeletal disorder (MSD), in British Columbia, Canada.MethodsThis is an effectiveness study using a retrospective cohort study design. Accepted workers’ compensation lost-time claims were extracted for workers with an MSD who were on full work disability for at least 30 days, between 2010 and 2015 (n=37 356). Coarsened exact matching yielded a final matched cohort of 12 494 workers who experienced GRTW at any point 30 days post-injury and 12 494 workers without any GRTW. The association between GRTW and sustainable RTW through to end of 12 months was estimated with multivariable quantile regression.ResultsWorkers who were provided with GRTW experienced more time-loss days until sustainable RTW between the 2nd and 5th months after the first time-loss day (ConclusionsFor seriously injured workers with at least 30 days of disability due to a work-acquired MSD, the effect of GRTW becomes apparent at longer disability durations (more than 6 months), with larger beneficial effects for women, workers with soft-tissue injuries and for trade and manufacturing sectors.

Objectives This study aimed to investigate the prevalence of musculoskeletal disorders in the hands and wrists of fishermen working as oyster shuckers, and to identify the risk factors associated with oyster shucking. Material and Methods A total of 590 fishery workers including those working as oyster shuckers in 2015–2017 were included in the study analysis. Hand osteoarthritis (OA), carpal tunnel syndrome (CTS), and ulnar impaction syndrome were diagnosed using X-ray, magnetic resonance imaging, and physical examinations according to each diagnostic criterion. The Rapid Entire Body Assessment was used as a measurement tool for analyzing the occupation-related burden factors. Results The prevalence of hand OA, CTS, and ulnar impaction syndrome was higher in oyster shuckers than in aquaculture/offshore fishery workers. The prevalence of upper limb disease was higher in oyster shuckers than in other fishery workers, even in the prevalence of exposure to occupational burden factors. In oyster shuckers, the incidence of hand and wrist OA was 84%, that of CTS was 72%, and that of ulnar impaction syndrome was 41%. In addition, oyster shuckers were more likely to be exposed to occupational burden factors than were other types of fishermen. Conclusions The prevalence of hand OA, CTS, and ulnar impaction syndrome was higher in oyster shuckers. Therefore, proper stretching or exercises for rest and musculoskeletal relaxation, along with health-care education and promotion, will be needed for the fishermen’s repeated posture and impact work. Int J Occup Med Environ Health. 2021;34(5):603–15

Introduction Current Brazilian legislation requires that all workers exposed to noise are to be given an audiogram upon hiring, after 6 months of employment (first periodic test), and annually after the first periodic test. In other countries, the regulations of hearing conservation programs do not include the requirement for audiometric testing at 6 months of employment, but only annually. There is no evidence that the periodicity adopted by Brazilian legislation is the most appropriate. Objective The present study aimed to evaluate the first 3 occupational audiometric tests of workers exposed to noise. Methods Historical cohort study with cross-sectional analysis. Participants were all male metallurgy workers aged up to 40 years. The first 3 audiograms of each worker were analyzed: pre-employment audiometric test, periodic audiometric test 1, and periodic audiometric test 2. For each worker, mean frequency thresholds were calculated at 3, 4, and 6 kHz in the left and right ears for each test. Statistical analysis was performed using the nonparametric Wilcoxon test. Results A total of 988 workers were included. There was a significant difference in auditory thresholds between the pre-employment test and the 2 subsequent periodic tests for the right and left ears. There was no significant difference between Test1 and Test2 in either ear. Conclusion Given the lack of difference between the first 2 periodic tests, we believe that they could be merged into a single test, i.e., first periodic audiometric testing could be performed at 12 months of employment without compromising workers’ health.

There is growing interest in the use of systems-based risk assessment methods in Human Factors and Ergonomics (HFE). The purpose of this study was to test the intra-rater reliability and criterion-referenced concurrent validity of three systems-based risk assessment approaches: (i) the Systems-Theoretic Process Analysis (STPA) method; (ii) the Event Analysis of Systemic Teamwork Broken Links (EAST-BL) method; and, (iii) the Network Hazard Analysis and Risk Management System (Net-HARMS) method. Reliability and validity measures were obtained using the Signal Detection Theory (SDT) paradigm. Whilst STPA identified the highest number of risks, the findings indicate a weak to moderate level of reliability and validity for STPA, EAST-BL and Net-HARMS. There were no statistically significant differences between the methods across analyses. The results suggest that there is merit to the continued use of systems-based risk assessment methods following a series of methodological extensions that aim to enhance the reliability and validity of future applications. Practitioner summary The three risk assessment methods produced weak to moderate levels of stability and accuracy regarding their capability to predict risks. There is a pressing need to further test the reliability and validity of safety methods in Human Factors and Ergonomics.

Legionella pneumophila is an opportunistic bacterial respiratory pathogen that is one of the leading causes of drinking water outbreaks in the United States. Dental offices pose a potential risk for inhalation or aspiration of L. pneumophila due to the high surface area to volume ratio of dental unit water lines—a feature that is conducive to biofilm growth. This is coupled with the use of high-pressure water devices (e.g., ultrasonic scalers) that produce fine aerosols within the breathing zone. Prior research confirms that L. pneumophila occurs in dental unit water lines, but the associated human health risks have not been assessed. We aimed to: (1) synthesize the evidence for transmission and management of Legionnaires’ disease in dental offices; (2) create a quantitative modeling framework for predicting associated L. pneumophila infection risk; and (3) highlight influential parameters and research gaps requiring further study. We reviewed outbreaks, management guidance, and exposure studies and used these data to parameterize a quantitative microbial risk assessment (QMRA) model for L. pneumophila in dental applications. Probabilities of infection for dental hygienists and patients were assessed on a per-exposure and annual basis. We also assessed the impact of varying ventilation rates and the use of personal protective equipment (PPE). Following an instrument purge (i.e., flush) and with a ventilation rate of 1.2 air changes per hour, the median per-exposure probability of infection for dental hygienists and patients exceeded a 1-in-10,000 infection risk benchmark. Per-exposure risks for workers during a purge and annual risks for workers wearing N95 masks did not exceed the benchmark. Increasing air change rates in the treatment room from 1.2 to 10 would achieve an ∼85% risk reduction, while utilization of N95 respirators would reduce risks by ∼95%. The concentration of L. pneumophila in dental unit water lines was a dominant parameter in the model and driver of risk. Future risk assessment efforts and refinement of microbiological control protocols would benefit from expanded occurrence datasets for L. pneumophila in dental applications.

Occupational heat exposure is linked to the development of kidney injury and disease in individuals who frequently perform physically demanding work in the heat. For instance, in Central America, an epidemic of chronic kidney disease of nontraditional origin (CKDnt) is occurring among manual laborers, whereas potentially related epidemics have emerged in India and Sri Lanka. There is growing concern that workers in the United States suffer with CKDnt, but reports are limited. One of the leading hypotheses is that repetitive kidney injury caused by physical work in the heat can progress to CKDnt. Whether heat stress is the primary causal agent or accelerates existing underlying pathology remains contested. However, the current evidence supports that heat stress induces tubular kidney injury, which is worsened by higher core temperatures, dehydration, longer work durations, muscle damaging exercise, and consumption of beverages containing high levels of fructose. The purpose of this narrative review is to identify occupations that may place US workers at greater risk of kidney injury and CKDnt. Specifically, we reviewed the scientific literature to characterize the demographics, environmental conditions, physiological strain (i.e., core temperature increase, dehydration, heart rate), and work durations in sectors typically experiencing occupational heat exposure, including farming, wildland firefighting, landscaping, and utilities. Overall, the surprisingly limited available evidence characterizing occupational heat exposure in US workers supports the need for future investigations to understand this risk of CKDnt.

Background Drivers suffering from epilepsy are commonly regarded as a threat to road safety. However, inability to use their own means of transport very often implies specific professional effects and lowers the quality of life. The aim of this study was to analyze the driving status of patients with epilepsy in Poland. Material and methods The prospective study was performed using an independent questionnaire developed by the authors, consisting of 4 parts: 1) socio-demographic information, 2) clinical information, 3) driving information, and 4) opinions about patients with epilepsy as drivers. The study was conducted in November 2018-September 2019. A total of 188 patients completed this study. Results More than one-quarter of the patients have a driving license. Among them, 35 individuals (accounting for 18.62% of the whole study group) said that they had received their driving license after the diagnosis of epilepsy. In 10 cases (5.32%), seizures occurred while the patients were driving and in 72 cases (38.30%) while they were traveling as passengers. Among all socio-clinical factors, having a driving license was conditioned by the marital status (p = 0.008) and education (p = 0.007). Other factors did not affect having a driving license or the time of obtaining the license (p > 0.05 for all cases). A relationship was observed between the occurrence of side effects of antiepileptic drugs and the occurrence of seizures while traveling as a car passenger (p = 0.001). Other factors did not affect the occurrence of epileptic seizures while traveling by car, either as a driver or a passenger (p > 0.05). Conclusions A significant proportion of the respondents were of the opinion that patients with epilepsy should not be allowed to obtain a driving license, which is probably related to concerns about the occurrence of epileptic seizures while driving. It is necessary to conduct a nationwide educational and information campaign on epilepsy in various aspects. Med Pr. 2021;72(4):341-50.

Objectives This paper investigates the sense of occupational burnout among people working with older persons in the long-term care sector in relation to their personality traits. The study objective is to examine the correlation between the sense of burnout and personality traits of persons working in the helping professions, the so-called human services. According to researchers, these professionals are susceptible to occupational burnout due to the involvement of their personal emotions in the helping process. Material and Methods The study encompassed 238 workers employed at care institutions for older people. The authors used a diagnostic survey as the research method, and the following research instruments: the Maslach Burnout Inventory by C. Maslach (to assess an individual’s sense of burnout) and the NEO Five-Factor Inventory by P.T. Costa and R.R. McCrae (to assess personality traits). Results The survey indicates that workers are at risk of occupational burnout, and statistically significant differences have been observed in their sense of burnout depending on their personality traits in all the inventories analyzed: emotional exhaustion, depersonalization, and personal accomplishment. Conclusions Since the survey results confirm the differences in the sense of occupational burnout among the respondents with different personality traits, measures should be taken for the prevention and early detection of burnout in workers. For the intervention methods to be effective, workers’ personality traits should be taken into account. Int J Occup Med Environ Health. 2021;34(4):491–504

Boredom is a common workplace problem. Previous research has suggested that repetitive and monotonous work tasks may lead to boredom. However, these tasks have been reduced due to increased workplace automation. Thus, the current cause of boredom may be due to low mental workload. This research developed a general boredom model and compared the effects of feedback type (performance and ranking) and intervention method (game and quiz) on boredom and task performance. Results revealed that the secondary task interventions can reduce boredom and feedback could shorten the response time. Gender also had a significant influence on response time. Notably, results revealed a 4% probability of task failure during the experiment, indicating other interventions are also required. This research indicates that interventions to reduce boredom caused by low mental workload should be designed differently from tasks that have been designed to combat the boredom caused by repetitive and monotonous work.

Objectives. The purpose of this study was to examine the effectiveness of intervention strategies to control mass concentrations and peak exposures of flour dust in two Finnish bakeries. The effect of the intervention on the proportion of various particle size fractions of the total particulate matter was also investigated. Methods. Mass concentrations of flour dust were measured during three working days in a pre-intervention and post-intervention study in both an industrial and a traditional bakery. Gravimetric sampling and real-time measurements were performed. Relevant intervention strategies focused on working methods were planned in collaboration with the managers of the bakeries. Results. The average mass concentration of inhalable flour dust reduced in most of the stationary locations post intervention. The reductions in exposure levels were between 39 and 45%. However, the exposure levels increased 28–55% in the breathing zone. Real-time measurements showed reductions in the peak mass concentrations in the traditional bakery post intervention. In both bakeries, the total particulate matter size fraction consisted predominantly of particles with an aerodynamic diameter lower than 1 µm and greater than 10 µm. Conclusion. Further studies are needed to plan more effective intervention measures supplemented by technical control methods in both bakeries.

Recently, many postural analysis techniques have been developed in order to reduce the risk of musculoskeletal problems. Methods such as rapid entire body assessment are capable of analyzing the most constant or awkward positions, but the selection of these postures is subjective. To make an objective postural analysis, devices such as electromagnetic trackers can be used continuously during the job task, but utilizing such devices is costly. Therefore, in this study a cost-effective marker-based video processing algorithm is developed for measuring three-dimensional (3D) information regarding both the location and the orientation of human posture. To investigate the precision of the measurements, an experiment was designed. With the average of 2.88 mm and 1.34° for location and orientation, respectively, the algorithm was able to measure six degrees of freedom information regarding 3D space. Furthermore, the precision of the algorithm is found to be significantly affected by the marker pattern.

We identified the occupations that employ California women and a list of chemicals of concern for breast cancer. We evaluated the likelihood of on-the-job exposure to the categories of chemicals by occupation among formally and informally employed women. We selected 145 occupations representing more than 6.6 million women (85% of California working women), along with an additional sixteen occupations for informal workers only. We organized 1012 chemicals (including mammary gland carcinogens, developmental toxicants, and endocrine-disrupting chemicals) into twenty-five categories. More than 80 percent of occupations investigated had possible or probable exposure to at least one category of chemicals. This is the first categorization of occupational exposure to chemicals of concern for breast cancer among California working women. Our investigation revealed significant data gaps, which could be improved by policy changes resulting in enhanced collection of data on occupation and chemical exposure.

Introduction The assessment of energy expenditure (EE) at workplaces maintains a central topic in occupational health due to increasing work-related issues. Today 80% of employees in the healthcare system are women. Limited research concerning their physical activity at work is available. The purpose of the study was the investigation of body composition, maximum physical capacity and quantification of physical work activity for female healthcare workers under real-time conditions. Methods Occupational physical activity (PA) of 33 female healthcare workers in a university hospital was quantified. Health associate professionals (HAP), health professionals (HP), and females working from cleaners and helpers (CH) department participated. All underwent cardio pulmonary exercise test. For every working task VO2, VCO2 and RER were measured and EE was calculated individually for each task. Results Forty-two different working tasks were identified and grouped in seven categories to compare physical activity (PA): ‘office and laboratory work’, ‘bedside patient care’, ‘instrument reprocessing, packing boxes’, ‘walking with patient, or alone’, ‘pushing carts or wheelchairs’, ‘strenuous cleaning in bent posture’ and ‘lifting heavy boxes, weights or items’. By comparing groups of healthcare workers, CH and HAP spent significant (p < 0.01) more EE (in kcal/min) 3.9 resp. 3.2 than HP 2.5. Light PA e.g. office and laboratory work (2.7 ± 0.6) and bedside patient care (2.9 ± 0.7) were accomplished by HP and HAP while HAP and CH performed moderate PA such as ‘packing boxes’ (3.6 ± 0.8), ‘pushing carts’ and ‘strenuous cleaning’ (4.7 ± 0.9). Work performed by CH and HAP, i.e. ‘strenuous cleaning’ and ‘lifting heavy items’ showed highest kcal per kg Fat Free Mass (FFM) per hour with 5.80 [4.05–7.81] and 6.94 [5.18–9.03] kcal/kgFFM/h. Conclusion Our findings lend preliminary support to the hypothesis that the majority of activities in female healthcare workers were of low and moderate PA and can be accomplished by middle aged and even older female workers. CH performed tasks with heavy physical activities (PA) like cleaning and lifting heavy weights. HAP performed light/moderate PA below their maximum physical capacity.

Background: Shift work is associated with long-term health risks. Workplace-based health interventions hold promise for improving or maintaining the health of shift workers; yet, the impact of workplace-based interventions on shift worker sleep duration has not been assessed. We conducted a systematic review of workplace interventions on shift worker sleep. Methods: We conducted searches in PubMed, Web of Knowledge, EMBASE, Scopus, and PsycINFO ( n = 6,868 records) of all studies published through May 15, 2019. Eligibility criteria included the following: (a) individuals aged ≥18 years; (b) a workplace-based employee intervention; (c) an employee population comprised predominantly of shift workers (>50%); and (d) sleep duration as a study outcome. Findings: Twenty workplace interventions met eligibility criteria. Mean intervention duration was 125 ( SD = 187) days and mean sample size was 116 employees ( SD = 256) with a mean age of 36.4 years ( SD = 6.5). Interventions most commonly focused on light exposure (25%) or shift timing (25%), followed by sleep hygiene (20%). Most interventions were conducted in the health care and social assistance sector (60%). Study quality on average was 64% ( SD = 7%). A majority of the studies found that a workplace-based health intervention was associated with a desirable increase in 24-hour total sleep duration (55%). The overall average increase in daily employee sleep duration achieved by interventions ranged for RCT studies from 0.34 to 0.99 hours and for non-RCT studies from 0.02 to 1.15 hours. Conclusions/Applications to Practice: More than half of the employee health interventions, especially yoga or mindfulness interventions, resulted in a desirable increase in sleep duration. Workplaces hold promise as an avenue? for delivering programs and policies that aim to improve sleep duration among shift workers.

The British Occupational Hygiene Society (BOHS) COVID-19 Working Group developed a control banding matrix to provide guidance for employers and others to help assess the risks of COVID-19 infection during the pandemic. The matrix was based on occupational hygiene principles and the judgement of the occupational health practitioners involved; since objective data on workers’ exposure were unavailable. Users of the matrix identify one of five exposure categories based on generic job descriptions and example occupations, and these categories are linked to generic guidance on interventions at source, on the exposure pathway and for individual workers. The risk matrix was published on the BOHS website and the guidance has been downloaded more than 2000 times. The matrix has had limited evaluation for reliability, but the data suggest that the highest exposure ranked jobs were associated with higher age-standardized mortality in Britain during the pandemic. However, there was considerable variability in exposure assignments between assessors, which underlines the need for the control guidance to be precautionary. The BOHS calls on academic researchers to undertake further work to validate the reliability of the tool.

BackgroundWe hypothesised that occupational exposures differently affect subtypes of adult-onset asthma.ObjectiveWe investigated potential relations between occupation and three subtypes of adult asthma, namely atopic asthma, non-atopic asthma and asthma–COPD overlap syndrome (ACOS).MethodsThis is a population-based case–control study of incident asthma among working-age adults living in Pirkanmaa Hospital District in Southern Finland. The determinant of interest was occupation at the time of diagnosis of asthma or the job that the subject had quit due to respiratory symptoms. Asthma was divided into three mutually exclusive subtypes on the basis of any positive IgE antibody (atopic and non-atopic asthma) and presence of persistent airways obstruction in spirometry (ACOS). We applied unconditional logistic regression analysis to estimate adjusted OR (aOR), taking into account gender, age and smoking.ResultsThe following occupational groups showed significantly increased risk of atopic asthma: chemical industry workers (aOR 15.76, 95% CI 2.64 to 94.12), bakers and food processors (aOR 4.69, 95% CI 1.18 to 18.69), waiters (aOR 4.67, 95% CI 1.40 to 15.56) and those unemployed (aOR 3.06, 95% CI 1.52 to 6.17). The following occupations showed clearly increased risk of non-atopic asthma: metal workers (aOR 8.37, 95% CI 3.77 to 18.59) and farmers and other agricultural workers (aOR 2.36, 95% CI 1.10 to 5.06). Some occupational groups showed statistically significantly increased OR of ACOS: electrical and electronic production workers (aOR 30.6, 95% CI 6.10 to 153.35), fur and leather workers (aOR 16.41, 95% CI 1.25 to 215.85) and those retired (aOR 5.55, 95% CI 1.63 to 18.97).ConclusionsOur results show that different occupations are associated with different subtypes of adult-onset asthma.

Background Recent increases in common mental disorders (CMDs) among young adults are of great concern although studies of CMDs in young employees are sparse. This study investigated the independent and interacting effects of sector of employment, occupational class and CMDs. Additionally, associations between type of employment branch and CMDs within each sector were examined. Methods This population-based longitudinal cohort study included 665 138 employees, 19–29 years, residing in Sweden in 2009. Employment sector (i.e. private/public) and occupational class (non-manual/manual workers) were measured in 2009. Risk estimates of CMDs, measured as new prescription of antidepressants and/or psychiatric care with a diagnosis of CMDs, between 2010 and 2016, were calculated as hazard ratios (HRs) with 95% confidence intervals (CIs), using Cox multivariable regression analysis. Results Public sector employees (whereof 60% manual workers) had an elevated risk for CMDs compared to private sector employees [adjusted HR: 1.14 (95% CI 1.12–1.16)]. Within each sector, manual workers were at increased risk of CMDs compared to non-manual workers. There was an interaction between sector of employment and occupational class; manual workers in the public sector had the highest CMD risk [adjusted synergy index: 1.51 (95% CI 1.29–1.76)]. The most elevated risk for CMDs was observed in those employed in health and social services and the lowest risk among construction workers. Conclusion Sector of employment and occupational class play a role in CMDs in young employees. These findings should be taken into account in the attempts to reduce CMDs in the young working population.

BACKGROUND: The shipbuilding industry has various risks such as slipping, falling, mechanical, chemical, and confined space work. OBJECTIVE: The purpose of this study is to compare the characteristics of the occupational accidents between novice and skilled workers in the shipbuilding industry and to analyze factors affecting death and disability accidents. METHODS: From the national work-related compensation data of South Korea, an experimental design was established to analyze a population of occupational injuries related to workers working in the shipbuilding industry. This study compares accident characteristics of 2,069 injuries registered as work-related accidents. Also, logistic regression analysis is performed to identify the factors affecting death and disability accidents. RESULTS: The prevalence of occupational accidents caused by novices was high in older workers, female workers, foreign workers, irregular workers, or companies with less than 100 employees. The proportion of source of accident by novices was high in ‘manhole,’‘ladder,’ and ‘scaffold,’ while the prevalence of accident type was high in ‘fall,’ ‘cut/bruise,’ and ‘struck by.’ According to logistic regression analysis, if the face was injured, the possibility of being death or disability was higher than that of other parts of the body. Also, if the rupture caused the injury, the possibility of being death or disability was higher than the different types of injury. CONCLUSIONS: The results of this study are expected to be useful as basic data for the prevention of accidents of novice and death/disabilities in the shipbuilding industry.

BACKGROUND: The increasing globalization and the advances in communication technology have expedited the formation of virtual teams. The geographical distribution of virtual team members entails significant changes in working conditions. There is limited knowledge about the demands and resources virtual team members experience and how these can affect their mental health. OBJECTIVE: The aim of this study is to identify work-related psychological demands and resources of virtual team members. METHODS: 14 semi-structured interviews with virtual team members were conducted. Study participants were recruited based on the gatekeeper principle and the snowball principle. The interviewees were asked about self-perceived job demands and resources of virtual teamwork. The interviews were analyzed according to Mayring’s structuring content analysis. RESULTS: Based on the qualitative analysis, the following job demands were explored among virtual team members: challenges due to permanent availability, technical conditions, and communication issues with other virtual team members. Job-related resources among virtual team members were also identified and are reflected in increased autonomy, flexibility and improved compatibility of private and professional working life. CONCLUSION: This study contributes to the understanding of the specific working conditions of virtual team members and identified job demands and resources of virtual teamwork. In addition, this study can be used as a basis for further quantitative investigations.

BACKGROUND: This research work establishes the relationship between job strain and being overweight among Mexican managers. Recently in Mexico, there has been a sharp increase in work-related diseases and mental health disorders. Furthermore, evidence shows that Mexicans rank top among employees who suffer from stress, yet research on the impact of job strain on the phenomena of obesity and being overweight among such vulnerable job positions in the industrial field is scarce. METHODS: The sample included 170 overweight middle and senior managers from six companies in the Mexican Manufacturing Industry. Cedillo’s Spanish version of the Job Content Questionnaire by Karasek was used, and the Body Mass Index (BMI) was used to characterize an overweight condition. Structural Equations Modelling studied the relationships among variables. RESULTS: Even though, the model shows a power of explanation of 6%(R2 = 0.06), the variable showing the greatest direct effect on the overweight variable is social support, with 21%(p

The Australian Senate announced a Select Committee in December of 2020 “to inquire into and report on the impact of insecure or precarious employment on the economy, wages, social cohesion and workplace rights and conditions.” This New Solutions “Document” is a submission to the Australian Senate from independent Australian researchers focusing on the role of perceived job (in)security in this context, acknowledging that it only briefly addresses the role of unemployment, precarious employment, and other aspects of the broader phenomenon of insecure work. Submissions closed in March of 2021, and the Australian Senate is due to report its findings on 30 November 2021.

BACKGROUND: The number of studies investigating the relationship between office employees and the development of musculoskeletal disorders (MSDs) is limited. Only a few focused on assessing workplace ergonomics of office employees. OBJECTIVE: This study aims to investigate the risk of MSDs and associated factors in the office workplaces of a large-size manufacturing company. METHODS: Data were gathered from 208 office employees from a manufacturing company via Rapid Office Strain Assessment (ROSA) and Cornell questionnaire. The collected data were analyzed to examine the relationship between ergonomic risk levels and MSDs reported by the office staff. RESULTS: The mean ROSA final score is 3.52 (std. dev. = 0.71), chair section is 3.30, monitor and telephone section is 2.18, and mouse and keyboard section is 2.69. Thirty-nine of 208 (18.8%) office workplaces are at risk. The most important factor to raise the risk level is found to be the height and depth of the chair. The Cornell questionnaire results highlight that the highest discomfort severity is related to the neck (32.26%), lower back (23.23%) and upper back (22.26%). The discomforts in the neck (r = 0.362), upper back (r = 0.404) and lower back (r = 0.368) are moderately and positively correlated according to the final ROSA score. The results indicate that the highest risked departments are Accounting, Sub Industry, Production Planning, and Manufacturing Management. CONCLUSION: The parameters associated with the chair section should be considered a priority for reducing and eliminating MSDs among office employees.

BACKGROUND: Computer workstation use is a risk factor for the development of musculoskeletal disorders. Governmental guidelines have been developed as a resource for workstation set-up to minimize this risk. The degree of worksite compliance with guidelines has not been examined. OBJECTIVE: The purpose of this study was to examine workstations using the VDT Workstation Checklist to determine compliance, and potential modifications. METHODS: Subjects were recruited from a variety of work settings in Erie, PA. Workstations were assessed with the worker present, using the VDT Workstation Checklist. Adjustments and recommendations were made as appropriate. RESULTS: Of the 60 workstations examined, 48%did not receive a passing score. All but one were correctable to an acceptable level with minimal low-cost modifications. The recommendation for wrist rests (43%), changes in monitor height (30%) or position (27%) and reposition of the keyboard (13.3%) and mouse (13.3%) were the most frequent modifications. Ten (16.7%) workstations did not require modification. CONCLUSIONS: Almost half of workstations reviewed were not in compliance with current guidelines, however almost all (98%) could be brought into compliance with simple modifications. Office workers need guidance in setting up workspace and adjusting ergonomic equipment to provide comfortable and safe work settings and minimize musculoskeletal symptoms.

Background Precarious employment is a potent occupational health risk, but little is known about its association with work-related disability and its causes. This study analyzes whether employment precariousness is associated with receiving disability pension (DP) due to depression and whether this differs according to gender. Methods Statistics Finland’s Quality of Work Life Surveys (1997, 2003, 2008 and 2013) were merged with register-based DP data obtained from the Finnish Centre for Pensions. The survey material was used to measure employment precariousness using five variables: fear of job loss, poor employability prospects, previous unemployment, low earnings and temporary contracts. We followed 20–60-year-old employees until 2016 and studied Cox proportional hazard ratios (HRs) for receiving DP among women and men, adjusting for sociodemographic covariates, working conditions and health at baseline. Results The overall risk of receiving DP tended to increase as precarious job features accumulated. Among men, a higher risk of receiving DP due to depression was associated with previous unemployment [HR 2.2, 95% confidence interval (CI) 1.1–4.2] and poor employability (HR 2.4, 95% CI 1.3–4.7), whereas no corresponding association was found among women. Conclusions Employment precariousness may reflect a psychological stress mechanism that predisposes the individual to mental health problems, predicting future disability. Work disability risk shows gendered differences depending on the cause of DP. Promoting employability at workplace and policy levels could offset the health risks associated with precariousness.

Objectives. Despite widespread use of scaffolds on construction sites, they are the most common causes of accidents, injuries and fatalities in this sector. About 80-90% of all occupational accidents occur as a result of human factors. On construction sites, proper erection/dismantling of scaffold is possibly the most essential factor in preventing accidents as it is one of the factors reported to be highly statistically significant in correlation to a high overall scaffold safety rating. Therefore, analysis of human errors (HEs) caused by scaffolders is important to be implemented. The main objective of this study was to evaluate possible HEs during scaffold erection and dismantling (SE&D). Methods. Stages involved were identified using hierarchical task analysis (HTA). Risk values of HEs were then evaluated using the fuzzy analytical hierarchy process (FAHP). Results. Our findings indicate that the highest and lowest risk values were related to the errors of 'failure to reattach braces and connections prior to dismantling scaffolds' and 'insufficient preparation of the firm foundation', respectively. Conclusion. This study formulates a method to estimate the risk of potential HEs in SE&D.

Shift work can be associated with health and sleep problems, which may lead to cognitive impairment. This study investigated the effects of shift work on sleep, health behaviours and cognitive functions of Polish rescue service workers. We tested 18 paramedics working 12-h shifts, 15 firefighters working 24-h shifts and 17 daytime workers. We measured general sleepiness, workload during shifts and the occurrence of health behaviours. Additionally, we measured attention, executive function and subjective alertness. Paramedics showed lower average sleep duration and quality, and fewer health behaviours than firefighters and the control group. However, no differences were found in performance on cognitive tests between the groups and between the measures. The results indicate that the differences in job specificity may contribute to the effects of shift work on the sleep and health of the workers.

ObjectiveTo investigate the role of maternal night shift work in occurrence of urogenital anomalies in offspring, considering a possible interaction with mode of conception.MethodsA population-based cohort comprising births in South Australia (1986–2002) was produced via linkage of fertility clinic records, perinatal and birth defects data. This study concerned first births to women in paid employment (n=98 103). Potential exposure to night shift was imputed by applying a job-exposure matrix to recorded occupation. Associations were examined using logistic regression, first for nurses and other night shift workers separately, then combined. An interaction term for night shift work and mode of conception was included in all models, while adjusting for covariates.ResultsAssociations were similar for nurses and other night shift workers, although only statistically significant for the former when considered separately. A multiplicative interaction was supported: for natural conceptions, maternal night shift work was not associated with offspring urogenital anomalies (OR=0.99, 95% CI 0.84 to 1.15); where a birth arose from fertility treatment, urogenital anomalies were significantly higher among births to all night shift workers compared with day workers (OR=2.07, 95% CI 1.20 to 3.55). This was not due to differences in the type of fertility treatment received.ConclusionsWomen in occupations that probably involved night shift did not have offspring with increased prevalence of urogenital anomalies if they conceived naturally. When night shift workers conceived with fertility treatment, the prevalence of urogenital anomalies was elevated. Possibly these women had the greatest exposure to night shift work, or least tolerance for this work schedule, or heightened sensitivity to hormonal aspects of fertility treatment.

Objectives: Investigate biosecurity principles on Minnesota and Wisconsin dairy farms in response to COVID-19 and the effects of the pandemic on the dairy industry.Methods: Dairy farms that had participated in previous and ongoing projects with the National Farm Medicine Center (NFMC), Migrant Clinicians Network (MCN), and Upper Midwest Agricultural Safety and Health Center (UMASH) were asked to participate in a 17-question survey by phone or email. Three additional farms were recruited via a press release published in agricultural newsletters. Of 76 farms contacted, 37 chose to participate in this study from June to July 2020.Results: In response to the COVID-19 pandemic, dairies have implemented or increased biosecurity measures and COVID-19 precautions. Dairies reported adequate personal protective equipment for their workers, though face masks were not required on most dairies (n=32, 86%). Producers were concerned about the safety of their families, maintaining a healthy workforce, and keeping their farms profitable. Access to healthcare was not perceived to be an issue for their workers. One-quarter of dairies reported COVID-19 infections on their farms. Even though the majority had an isolation protocol in place if someone on the farm were to become ill, less than half of respondents felt their farm was protected against COVID-19. Two-thirds of producers have not had to decrease production, and a majority of operations have not furloughed or terminated employees due to COVID-19.Conclusions: Our data suggest that dairy farms in Minnesota and Wisconsin have implemented biosecurity and safety measures in response to COVID-19. These measures can be improved. Farms would benefit from additional guidance and education on implementation of personal protective measures and disease prevention strategies to keep workers employed and safe.

BackgroundDespite the existence of hearing conservation programmes complying with regulatory standards, noise-induced hearing loss (NIHL) remains one of the most prevalent occupational diseases. Compulsory daily monitoring of noise exposure has been associated with decreased NIHL risk. We report on the experience of a voluntary daily noise monitoring intervention among noise-exposed workers.MethodsWorkers at three locations of a metals manufacturing company voluntarily used an in-ear noise monitoring device that could record and download, on a daily basis, the noise exposure inside of their hearing protection. We compared the hearing loss rates (in decibels hearing level/year) in these volunteers to controls from the same company matched for job title, age, gender, race, plant location, and baseline hearing level.ResultsOver the follow-up period, 110 volunteers for whom controls could be identified monitored daily noise exposures an average of 150 times per year. Noise exposures inside of hearing protection were lower than ambient noise levels estimated from company records. While there was no significant difference in hearing loss rates between volunteers and controls, volunteers downloading exposures 150 times per year or had less hearing loss than those who downloaded less frequently.ConclusionThese results indicate that voluntary daily noise exposure monitoring by workers is feasible and that greater frequency of downloading is associated with less hearing loss. If further development of noise monitoring technology can improve usability and address barriers to daily use, regular self-monitoring of noise exposure could improve the effectiveness of hearing conservation programmes.Trial registration numberNCT01714375.

Objective To analyse the genotoxic risk of cytostatic drugs in health professionals after occupational exposure. Method Literature was searched for the databases PubMed, Lilacs, The Cochrane Library and Scopus with free and controlled language (MeSH terms) using boolean operators AND and OR. The research was limited to articles published between 2005–2016. Results 11 articles were selected depending on their relevancy to this review’s aim. Nine of the 11 articles proved the existence of damage to genetic material (DNA) of health workers, who were exposed to cytostatics. Furthermore, current security practices do not eliminate the chance of exposure completely. Therefore, the creation of new clinical trials is required. Conclusions Handling cytostatic drugs can cause a genotoxic risk to health workers who are exposed to these substances. This exposure may cause damage on the workers’ DNA. There are not enough data to prove a cause-effect relationship between the genotoxic risk and adverse reactions on individuals. Health education will be the main way to raise the awareness and prevention this problem.

ObjectiveDespite increasing prevalence of end-stage renal disease (ESRD), little attention has been directed to how occupational exposures may contribute to risk. Our objective was to investigate the relationship between metalworking fluids (MWF) and ESRD in a cohort of 36 703 male autoworkers.MethodsWe accounted for competing risk of death, using the subdistribution hazard approach to estimate subhazard ratios (sHRs) and 95% CIs in models with cubic splines for cumulative exposure to MWF (straight, soluble or synthetic).ResultsBased on 501 ESRD cases and 13 434 deaths, we did not observe an association between MWF and ESRD overall. We observed modest associations between MWF and ESRD classification of glomerulonephritis and diabetic nephropathy. For glomerulonephritis, the 60th percentile of straight MWF was associated with an 18% increased subhazard (sHR=1.18, 95% CI: 0.99 to 1.41). For diabetic nephropathy, the subhazard increased 28% at the 60th percentile of soluble MWF (sHR=1.28, 95% CI: 1.00 to 1.64). Differences by race suggest that black males may have higher disease rates following MWF exposure.ConclusionsExposure to straight and soluble MWF may be related to ESRD classification, though this relationship should be further examined.

BackgroundMusculoskeletal disorders (MSDs), a common type of occupational diseases, have become the main cause of absenteeism and early retirement in the occupational population, as well as a major risk factor for occupational disability. The purpose of this study was to investigate the effects of occupational stress and mental health on MSDs in coal miners in Xinjiang, China, to provide a theoretical basis for reducing the incidence of MSDs in coal miners and improving their physical and mental health.MethodsIn this study, stratified cluster random sampling was used to randomly select six coal mining companies in Xinjiang, and 1675 coal miners were surveyed by questionnaire. The status of occupational stress, mental health and MSDs among coal miners was investigated by means of the Effort–Reward Imbalance questionnaire (ERI), Symptom Checklist-90(SCL-90), and Musculoskeletal disorders scale (MSDs) questionnaire.ResultsThe prevalence of MSDs among coal miners was higher, and there were statistical differences among different sexes, ages, working years, shifts, types of work, educational level and monthly income (P OR = 2.23, 95%CI.:1.50,3.33). The risk of MSDs was higher with age OR = 2.39, 95%CI.,1.68,3.40; 40-49 years,OR = 2.15, 95%CI.:1.52,3.04; 50-60 years:OR = 3.25, 95%CI.:2.09,5.07), and the longer the working years, the higher the risk of MSDs (OR = 1.90, 95%CI.:1.38,2.62). The two shifts group (OR = 2.18, 95%CI.:1.59,2.98) had an increased risk of developing MSDs compared with the fixed day shift group. The risk of MSDs was lower in heading drivers (OR = 0.41, 95%CI.:0.29,0.60,) and transport workers (OR = 0.30, 95%CI.:0.20,0.43). The higher the education level, the lower the risk of MSDs (high school:OR = 0.46, 95%CI.:0.34,0.62, junior college and above:OR = 0.12, 95%CI.:0.08,0.17), and the higher the monthly income, the lower the risk of MSDs (OR = 0.50, 95%CI.:0.34,0.74). Occupational stress (OR = 1.32, 95%CI.:1.05,1.67) and mental disorder(OR = 2.94, 95%CI.:2.25,3.84) increased the risk of MSDs. A Bayesian network diagram showed that occupational stress and MSDs have direct effects on mental disorders, and occupational stress can have indirect effects on mental disorders through MSDs.ConclusionOur research shows that MSDs are common among coal miners. Occupational stress and psychological disorders can increase the incidence of MSDs.

Background: While increased face mask use has helped reduce COVID-19 transmission, there have been concerns about its influence on thermoregulation during exercise in the heat, but consistent, evidence-based recommendations are lacking. Hypothesis: No physiological differences would exist during low-to-moderate exercise intensity in the heat between trials with and without face masks, but perceptual sensations could vary. Study Design: Crossover study. Level of Evidence: Level 2. Methods: Twelve physically active participants (8 male, 4 female; age = 24 ± 3 years) completed 4 face mask trials and 1 control trial (no mask) in the heat (32.3°C ± 0.04°C; 54.4% ± 0.7% relative humidity [RH]). The protocol was 60 minutes of walking and jogging between 35% and 60% of relative VO2max. Rectal temperature (Trec), heart rate (HR), temperature and humidity inside and outside of the face mask (Tmicro_in, Tmicro_out, RHmicro_in, RHmicro_out) and perceptual variables (rating of perceived exertion (RPE), thermal sensation, thirst sensation, fatigue level, and overall breathing discomfort) were monitored throughout all trials. Results: Mean Trec and HR increased at 30- and 60-minute time points compared with 0-minute time points, but no difference existed between face mask trials and control trials ( P > 0.05). Mean Tmicro_in, RHmicro_in, and humidity difference inside and outside of the face mask (ΔRHmicro) were significantly different between face mask trials ( P < 0.05). There was no significant difference in perceptual variables between face mask trials and control trials ( P > 0.05), except overall breathing discomfort ( P < 0.01). Higher RHmicro_in, RPE, and thermal sensation significantly predicted higher overall breathing discomfort ( r2 = 0.418; P < 0.01). Conclusion: Face mask use during 60 minutes of low-to-moderate exercise intensity in the heat did not significantly affect Trec or HR. Although face mask use may affect overall breathing discomfort due to the changes in the face mask microenvironment, face mask use itself did not cause an increase in whole body thermal stress. Clinical Relevance: Face mask use is feasible and safe during exercise in the heat, at low-to-moderate exercise intensities, for physically active, healthy individuals.

Objectives Increased use of small affordable alarm sensors with logging or network capabilities has improved the ability to monitor exposure. The large datasets generated from these monitors calls for development of a computer algorithm to assess these data. Methods We examined 88 time series of hydrogen sulphide (H2S) from wastewater works previously used for developing the exposure index. The time series covered 331 h, where 16 h had readings different from zero. Results The developed algorithm reproduced the manual assessed index almost perfectly (linear regression β = 1.02, R2 = 0.97, P < 0.001). Time-weighted average (TWA) values of the 88 time series showed a mean value of 0.04 ppm (range 0.0–0.9). The mean index value was 18 (range 0–337), with a good linear fit (β = 0.002, R2 = 0.93, and P < 0.001). The index gave us a better resolution and basis for risk assessment than the TWA, and managed to combine evaluation of TWA and exceedance of ceiling value in one number. Conclusions As long as peaks above ceiling value occur, we find alarm tools with an H2S sensor to be an essential personal protective equipment against H2S. The proposed method has been verified, and it removes some common human errors in graph evaluation. Use of the index is a possible way of quantifying risk level in exposure to H2S in one single number and provides better understanding of the risk of exposure, as it eases the analysis and evaluation of large numbers of time series.

Objectives Exposure to light at night (LAN) can disturb circadian endocrine and metabolic rhythms. Hyperuricemia (HUA) is an early-onset metabolic disorder. However, it is still not clear whether LAN exposure increases the prevalence of HUA. Material and Methods The authors used crosssectional data on the Beijing-Tianjin-Hebei occupational populations cohort from March–July 2017. A total of 7664 steel workers were finally selected to investigate the relationship between LAN exposure and the prevalence of HUA among steel workers. The authors collected demographic and socio-economic data, as well as information on lifestyle factors, anthropometric measures, and laboratory tests. The restricted cubic spline method was used to analyze the dose-response relationship between cumulative LAN exposure and the prevalence of HUA. Logistic regression analyses were used to fit the relationship between them. Results The average age of the participants was 43.5±8.6 years; 7051 (91.7%) of them were males, 2749 (35.9%) reported to suffer from HUA, and 1241 (16.2%) were not exposed to LAN. There was a significant non-linear dose-response relationship between them. After adjustment for the confounding factors, including demographic data, lifestyle factors, etc., the lower LAN exposure was significantly associated with HUA (0–1931.7 days, OR = 1.180, and the 95% CI: 1.000–1.394; 1931.7–4343 days, OR = 1.215, 95% CI: 1.035–1.426). Conclusions This study revealed that a certain amount of exposure to LAN is independently related to the prevalence of HUA in steel workers in China. Int J Occup Med Environ Health. 2021;34(3):385–401

Objectives This study aimed to assess the surgical outcomes of patients with work-related upper extremity musculoskeletal disorders (UE-MSDs) who failed conservative treatment. Material and Methods This was a retrospective study of 17 patients who had work-related UE-MSDs and underwent the following surgeries and follow-up evaluations: decompression, external and internal neurolysis of the upper trunk of the brachial plexus and the long thoracic nerve (LTN), and a partial resection of the anterior and middle scalene muscle. A detailed history of clinical presentation including pain, physical and clinical examinations of the extent of scapular winging (ESW), and upper extremity anatomical postures, such as active forward arm flexion and shoulder abduction, were recorded before and after 3 months of the surgery. Nerve conduction velocity and electromyography examination reports were obtained to assess the sensory or motor loss of the nerve injury before their operation. Results All 17 patients included in this report showed some improvement anatomically in the scapula appearance and functionally in their shoulder movements. More specifically, 9 (53%) patients got a restored to near healthy appearance of the scapula, and 11 (65%) patients recovered a full range of motion, 180° post-surgically. Overall, the mean shoulder flexion and abduction improved to 157±37.5° and 155±40.2° after the surgery from 106±30.2° and 111±34.8°, respectively (p < 0.0001). The ESW score also significantly improved from a mean of 1.5±0.51 to 3.5±0.71 (p < 0.0001). The post-surgical improvements were statistically highly significant (p < 0.0001). Conclusions Decompression and neurolysis of the upper brachial plexus and the LTN, and the partial release of the scalene muscle contracture procedures have fostered improvements in the shoulder anatomical appearance and movements in all 17 patients. Int J Occup Med Environ Health. 2021;34(3):427–35