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Developing nations bear a substantial portion of the global burden of injury. Public health surveillance models in developing countries should recognize injury risks for all levels of society and all causes and should incorporate various groups of workers and industries, including subsistence agriculture. However, many developing nations do not have an injury registration system; current data collection methods result in gross national undercounts of injuries, failing to distinguish injuries that occur during work. In 2006, we established an active surveillance system in Vietnam's Xuan Tien commune and investigated potential methods for surveillance of work-related injuries. On the basis of our findings, we recommend a national model for work-related injury surveillance in Vietnam that builds on the existing health surveillance system. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the association between external beam radiotherapy (EBRT) for prostate cancer and mesothelioma using data from the US Surveillance, Epidemiology, and End Results (SEER) cancer registries. Methods: We analyzed data from the SEER database (1973-2009). We compared EBRT versus no radiotherapy. Incidence rate ratios (IRR) and 95 % confidence intervals (95 % CI) of mesothelioma among prostate cancer patients were estimated with multilevel Poisson models adjusted by race, age, and calendar year. Confounding by asbestos was investigated using relative risk of mesothelioma in each case's county of residence as a proxy for asbestos exposure. Results: Four hundred and seventy-one mesothelioma cases (93.6 % pleural) occurred in 3,985,991 person-years. The IRR of mesothelioma was increased for subjects exposed to EBRT (1.28; 95 % CI 1.05, 1.55) compared to non-irradiated patients, and a population attributable fraction of 0.49 % (95 % CI 0.11, 0.81) was estimated. The IRR increased with latency period: 0-4 years, IRR 1.08 (95 % CI 0.81, 1.44); 5-9 years, IRR 1.31 (95 % CI 0.93, 1.85); ≥10 years, IRR 1.59 (95 % CI 1.05, 2.42). Despite the fairly strong evidence of association with EBRT, the population attributable rate of mesothelioma was modest-3.3 cases per 100,000 person-years. The cumulative incidence of mesothelioma attributable to EBRT was 4.0/100,000 over 5 years, 24.5/100,000 over 10 years, and 65.0/100,000 over 15 years. Conclusions: Our study provides evidence that EBRT for prostate cancer is a small but detectable risk factor for mesothelioma. Patients should be advised of risk of radiation-induced second malignancies. [ABSTRACT FROM AUTHOR]

Background Developing nations carry a substantial portion of the global burden of injury, but without reliable injury surveillance, there is no way to characterize or prioritize the causes of work-related injury for prevention. Methods Injury data from 52 treatment sites in the Xuan Tien Commune, Vietnam with over 10,000 inhabitants were collected between January 1 and December 31, 2006. Injured residents were interviewed to determine work-relatedness, relevant causes, disability, and burden. Results Five hundred four work-related injuries were reported from formal treatment sites (incidence rate of 87 per 1,000 FTE) with a mean lost work day of 11 days. Four thousand five hundred seventy-four lost work day equivalents were estimated based on actual days lost to recover plus work days lost earning income to pay for medical costs, accumulating a total direct burden to the community of 8,641 lost work day equivalents. Almost half of that burden was caused by work in manufacturing. First aid boxes placed in 40 manufacturing enterprises yielded the 2nd highest reporting source. Conclusion This study demonstrated the feasibility and value at the local level to build an active injury surveillance system which could have a large impact on preventing the burden of injuries in workplaces in Vietnam. Am. J. Ind. Med. 55:205-216, 2012. © 2011 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Objectives The objective of this work was to apply the two-stage clonal expansion model, with the intention to expand the literature on epidemiological applications of the model and demonstrate the feasibility of incorporating biologically based modelling methods into the widely used retrospective cohort study. Methods The authors fitted the two-stage clonal expansion model model to three occupational cohort studies: (1) a cohort of textile workers exposed to asbestos and followed for lung cancer mortality; (2) a cohort of diatomaceous earth workers exposed to silica and also followed for lung cancer mortality; and (3) a cohort of automotive manufacturing workers exposed to straight metalworking fluid (MWF) and followed for larynx cancer incidence. The model allowed the authors to estimate exposure effects in three stages: cancer initiation (early effects), promotion or malignant transformation (late effects). Results In the first cohort, the authors found strong evidence for an early effect of asbestos on lung cancer risk. Findings from analyses of the second cohort suggested early and less evidently late effects of silica on lung cancer risk. In the MWF (third) cohort, there was only weak evidence of straight MWF exposure effects on both early and late stages. The authors also observed a late birth cohort effect on larynx cancer risk. Conclusions The findings for asbestos and silica were essentially confirmatory, supporting evidence for their early effects on lung cancer from a large body of literature. The effect of straight MWF on larynx cancer was less clear. [ABSTRACT FROM AUTHOR]

Risk of aplastic anemia (AA) from occupational exposures to pesticides and industrial chemicals was evaluated in a hospital-based case control study in Thailand (541 cases of AA and 2261 controls). Exposure data were obtained via participants’ self-reports and by experts’ assessments and the data from these 2 exposure assessment methods were compared. There was an increased risk of AA associated with several classes of pesticides measured by either self-report or expert assessment. The strongest associations were seen in those whose exposures were identified both by self-report and by expert assessment. Comparing very high/high to no exposure, odds ratios (95% confidence intervals) were as follows: for organophosphates 3.20 (1.87-5.46), carbamates 4.75 (1.92-11.75), organochlorines 6.04 (1.31-27.84), and paraquat 2.17 (1.11-4.25). There were correlations among the pesticides because many types were used in the same job, so it was not possible to determine whether these risks were independent or because of confounding of one by another. [ABSTRACT FROM PUBLISHER]

Objectives. We explored the impact on work-related injuries of workers splitting time between industry and agriculture, a common situation in developing countries. Methods. In 2005, we administered a cross-sectional survey to 2615 households of Xuan Tien, a developing rural community of Vietnam, regarding self-reported injuries and hours worked for 1 year. We defined groups as working in industry, agriculture, or a mix of both. Results. Overlapping employment (part time in agriculture and up to full time in industry) increased the risk of injury in both agricultural and industrial work. This pattern held across all work groups defined by the relative amount of time worked in agriculture. Those working fewer than 500 hours annually in agriculture had an agricultural injury rate (872 per 1000 full-time equivalents) that was more than 4 times higher than the average rate overall (203 per 1000) and the rate for workers employed only in industry (178 per 1000). Conclusions. Working in agriculture for short durations while working in industry increased the risk of injury substantially in both types of work. (Am J Public Health. 2011:101:854-860.) [ABSTRACT FROM AUTHOR]

The article presents a study which evaluates a conceptual model for using near-misses for sharps injuries (SI) and other blood/body fluid exposures (BBFE) and its usage in statistical analysis of SI and BBFE risk factors. The study conducted a survey of home healthcare (HHC) nurses and aides which questions focused on the circumstances leading up to the SI, BBFE, and near misses. It says that data on event and near-misses confirms that part time HHC aides were at higher risk than full-timers.

The article presents a study on the sociodemographic influences on the agreement between individual reports and expert ratings of workplace exposures. It says that 1,282 employees at four industries and 14 worksites were given questionnaires on workplace exposure for a 12 month period while occupational hygienists used an exposure evaluation checklist. The study concluded that there was poor agreement between the reports and that it was affected by factors which included gender, age and race.

The article discusses powwowing, a Pennsylvania German form of mystic ritual healing. It focuses on the religious and mystic experiences of Chris R. Bildari, author of the book "The Red Church, or the Art of Pennsylvania German Braucherei: The Traditional Blessed Healing Art for the Good of Man and Beast." He took a ten-week training program to become a powwower involving the use of gestures and incantations in English, Pennsylvania German, and High German. Also considered is neo-pagan author Silver Raven Wolf who considers powwowing an example of pre-Christian magic and mysticism.

Objectives. We quantified risks of sharp medical device (sharps) injuries and other blood and body fluid exposures among home health care nurses and aides, identified risk factors, assessed the use of sharps with safety features, and evaluated underreporting in workplace-based surveillance. Methods. We conducted a questionnaire survey and workplace-based surveillance, collaborating with 9 home health care agencies and 2 labor unions from 2006 to 2007. Results. Approximately 35% of nurses and 6.4% of aides had experienced at least 1 sharps injury during their home health care career; corresponding figures for other blood and body fluid exposures were 15.1% and 6.7%, respectively. Annual sharps injuries incidence rates were 5.1 per 100 full-time equivalent (FTE) nurses and 1.0 per 100 FTE aides. Medical procedures contributing to sharps injuries were injecting medications, administering fingersticks and heelsticks, and drawing blood. Other contributing factors were sharps disposal, contact with waste, and patient handling. Sharps with safety features frequently were not used. Underreporting of sharps injuries to the workplace-based surveillance system was estimated to be about 50%. Conclusions. Sharps injuries and other blood and body fluid exposures are serious hazards for home health care nurses and aides. Improvements in hazard intervention are needed. (Am J Public Health. 2009;99:S710-S717. doi:10.2105/AJPH.2008.150169) [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article on the commentary in cancer epidemiology's false-positive results by Boffetta and colleagues.

The article discusses the conventions in the conduct of science and scientific information communicate through nonscientists in the U.S. In states that the method presents some issues on the methods in conveying the information of scientific data due to the lack of causal interference. It also cites the different types of conventions of causal interference applications as well as some examples on how causal interference can help contribute to the development and understanding of environmental health problems. It notes that causal interference is an essential way in which scientific research and policymaking can be associated by maintaining objectivity and legitimacy to communication an essential message.

Home health care (HHC) is growing rapidly and yet health and safety conditions of HHC clinicians are poorly understood. Study of this workforce presents unique challenges because it is decentralised, often part-time and mobile. As part of a larger project on sharps injuries and blood exposures in HHC, this paper addresses the challenges of recruiting a large cohort of HHC nurses and aides and describes novel cross-sectional survey methodology. Recruitment was conducted with cooperation from eight HHC agencies and two labour unions. Intensive personal contacts and a financial incentive ($25) were employed. Some groups of HHC clinicians could be contacted only by mail, while others were contacted during a promotional “mini-fair” at their agency. A total of 1772, 18-page health and safety surveys were distributed and 1225 usable surveys were collected. This 69% overall response rate is better than that in many recent health surveys. Survey returns were highest (67—91%) where promotional events were held. The mailing-only strategy generated lower response rates (53—55%), despite the same financial incentive. Despite the challenges of reaching out to the decentralised HHC workforce, adequate response to a detailed health survey is possible, using appropriate techniques and with the close cooperation of employers and labour unions. [ABSTRACT FROM PUBLISHER]

The article presents a case study which examines the role of benzene exposure in causing leukemia and multiple myeloma (MM) in Italy. The study involves the assessment of patients' exposure at individual level to a range of chemicals. The authors claim that they found no association between exposure to any solvent and acute myeloid leukemia (AML). They also found elevated point estimates for the associations between medium/high benzene exposure and chronic lymphatic leukemia.

This article presents a study regarding cancer incidence among male firefighters in Massachusetts from 1987 to 2003. The study aims to investigate the elevated risks of various types of cancers in firefighters because firefighters are known to be exposed to recognizable or probable carcinogens. Standardized morbidity odds ratio were employed to examine the cancer risk in white, male firefighters compared to police and all other occupations recorded in the Massachusetts Cancer Registry from 1986 to 2003.

The article presents a study on the effects of job strain on survey response among workers in the healthcare industry. The study examines 1,613 healthcare workers using questionnaires wherein job strain was defined by the ratio of job demands to job control. Binomial pseudo Poisson regressions and multi-level logistic models were used to find the correlations between factors including survey response, job strain, socioeconomic status, and demographic variables. The study found that survey response was affected by less job strain and high socioeconomic status .

Objectives: Several studies have reported an association between cigarette smoking and psychiatric illness. A common finding is that the prevalence of psychiatric illness among former smokers is much lower than among current smokers and is often similar to that among never-smokers. There are two alternative causal explanations for this association: either improved mental well-being results from smoking cessation; or those with poorer mental well-being are less successful at smoking cessation. The objective was to analyse a unique longitudinal data set to shed light on the direction of causality and to distinguish between these alternative explanations. Methods: Information on smoking status and indicators of poor mental well-being from childhood and adolescence was collected at age 18 in 1969 from 49 321 men at compulsory conscription for military service. Follow-up data on smoking status were collected among a random subset (n = 694) who participated in one or more annual national Swedish Surveys of Living Conditions in 1981-2001. Results: Approximately half of the smokers at age 18 in 1969 had quit by the time they were resurveyed (1981-2002). Those who had not quit and who reported smoking more than 10 cigarettes/day at age 18 (called persistent heavy smokers), were more likely to have had childhood and adolescent indicators of poor mental health measured at age 18 in 1969 than non-smokers or quitters. Conclusion: Our findings indicate that men who would subsequently be successful at smoking cessation reported better mental health and a lower prevalence of childhood mental health indicators at age 18 than persistent heavy smokers. [ABSTRACT FROM AUTHOR]

The article summarizes some study designs which can be used in addressing specific research questions in occupational epidemiology. The basic principles of study design are outlined. Each study design option has various features that make it more or less suitable for investigating particular exposure. A summary of the types of health outcomes and the corresponding study design choice is shown. The two variants of the case-control design, namely the case-cohort and case-crossover designs, are described.