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Purpose The primary aim of this study was to estimate the prevalence of NTDs at ultrasound examination in communities of Addis Ababa and secondarily to provide a description of the dysmorphology of the NTD cases. Methods We enrolled 958 pregnant women from 20 randomly selected health centers in Addis Ababa during the period from October 1, 2018, to April 30, 2019. Of these 958 women, 891 had an ultrasound examination after enrollment, with a special focus on NTDs. We estimated the prevalence of NTDs and compared it with previously reported hospital-based birth prevalence estimates from Addis Ababa. Results Among 891 women, 13 had twin pregnancies. We identified 15 NTD cases among 904 fetuses, corresponding to an ultrasound-based prevalence of 166 per 10,000 (95% CI: 100–274). There were no NTD cases among the 26 twins. Eleven had spina bifida (122 per 10,000, 95% CI: 67–219). Among the 11 fetuses with spina bifida, three had a cervical and one had a thoracolumbar defect while the anatomical site for 7 was not registered. Seven of the 11 spina bifida defects had skin covering, while two of the cervical lesions were uncovered. Conclusion We report a high prevalence of NTDs among pregnancies in communities of Addis Ababa based on screening by ultrasound. The prevalence was higher than in previous hospital-based studies in Addis, and the prevalence of spina bifida was particularly high.

Background: Cancer in Africa is an emerging public health problem that needs urgent preventive measures, particularly in workplaces where exposure to carcinogens may occur. In Tanzania, the incidence rate of cancer and mortality rates due to cancers are increasing, with approximately 50,000 new cases each year. This is estimated to double by 2030. Methods: Our hospital-based cross-sectional study describes the characteristics of newly diagnosed patients with head and neck or esophageal cancer from the Ocean Road Cancer Institute (ORCI), Tanzania. We used an ORCI electronic system to extract secondary data for these patients. Results: According to the cancer registration, there were 611 head and neck and 975 esophageal cancers recorded in 2019–2021. Two-thirds of these cancer patients were male. About 25% of the cancer patients used tobacco and alcohol, and over 50% were involved in agriculture. Conclusion: Descriptions of 1586 head and neck cancer patients and esophageal cancer patients enrolled in a cancer hospital in Tanzania are given. The information may be important for designing future studies of these cancers and may be of value in the development of cancer prevention measures.

Chronic subdural hematoma (CSDH) is one of the most common neurosurgical conditions. Here, we studied differences in demographics, treatment, and outcome for CSDH patients in low-income (Ethiopia) and high-income (Norway) countries and assessed potential outcome determinants.We included patients from Addis Ababa University Hospitals (AAUH) and Haukeland University Hospital (HUH) who had surgery for CSDH (2013-2017). Patients were included prospectively in Ethiopia and retrospectively in Norway.We enrolled 314 patients from AAUH and 284 patients from HUH, with a median age of 60 and 75 years, respectively. Trauma history was more common in AAUH (72%) than in HUH patients (64.1%). More patients at HUH (45.1%) used anticoagulants/antiplatelets than at AAUH (3.2%). Comorbidities were more frequent in HUH (77.5%) than in AAUH patients (30.3%). Burr hole craniostomy under local anesthesia and postoperative drainage was the standard treatment in both countries. Postoperative CT scanning was more common at HUH (99.3%) than at AAUH (5.2%). Reoperations were more frequent at HUH (10.9%) than at AAUH (6.1%), and in both countries, mostly due to hematoma recurrence. Medical complications were more common at HUH (6.7%) than at AAUH (1.3%). The 1-year mortality rate at HUH was 7% and at AAUH 3.5%. At the end of follow-up ( 3 years), the Glasgow Outcome Scale Extended (GOSE) score was 8 in 82.9% of AAUH and 46.8% of HUH patients.The surgical treatment was similar at AAUH and HUH. The poorer outcome in Norway could largely be explained by age, comorbidity, medication, and complication rates.

To investigate the relationship between self-reported everyday memory problems the last month, and: (a) shift work schedule, (b) night shifts and quick returns worked the last year, and (c) sleep duration the last month.In all, 1,275 nurses completed the Everyday Memory Questionnaire - revised, and answered questions about shift work exposure and sleep duration. We performed multiple linear regression analyses with memory score as dependent variable, and the shift work exposure variables as well as sleep duration as predictors, while adjusting for potential confounders.High exposure to quick returns (β = .10, p.05) and short sleep duration (β = .10, p.05) were both positively associated with memory problems, whereas shift work schedule, long sleep duration, night shift exposure, and low and moderate exposure to quick returns were not.Frequent insufficient time for rest between shifts as well as short sleep was associated with poorer everyday memory.

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

Coffee workers respiratory health problems, found to be associated with dust exposure in the coffee factories, but the content of the dust is not well known. A cross-sectional survey was conducted to assess the microbial contamination of coffee in dry and wet coffee process, from four farms in two regions of Ethiopia. A total of 36 samples of coffee were collected for laboratory investigation. The microbial load in the dry process ranged from 6.9 × 10

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

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

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

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

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

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

This study aimed to explore how changes in the work schedule would affect the prevalence of Shift Work Disorder (SWD) over time. Two-year follow-up data from 1076 nurses participating in the longitudinal SUrvey of Shift work, Sleep and Health among Norwegian nurses (SUSSH) were included in the study. The questionnaires included measures of work-related factors, i.e., work schedule and numbers of night shifts and quick returns (QRs) worked the last year, as well as questions related to SWD according to the ICSD-3 diagnostic criteria at both baseline and at 2-year follow-up. Data were analyzed with paired samples t-tests, chi-square tests, and logistic regression analyses adjusting for sex and age. Terminating night work was the strongest predictor for recovering from SWD from baseline to follow-up (OR 10.91, 95% CI 6.11–19.46). Additionally, changing the work schedule from day work to night work from baseline to follow-up was the strongest predictor for developing SWD in the same period (OR 4.75, 95% CI 2.39–9.47). Reductions in number of nights (more than 10) and QRs (more than 10) worked the last year were associated with recovering from SWD between baseline and follow-up. Nurses who recovered from SWD had significantly reduced the mean number of night shifts worked the last year from 32.3 at baseline to 20.4 at follow-up (p = .001). Furthermore, an increase of more than 10 nights or more than 10 QRs worked the last year between baseline and follow-up predicted developing SWD. Nurses developing SWD between baseline and follow-up had significantly increased the mean number of nights worked the last year from 25.8 at baseline to 31.0 at follow-up (p =-.043). Changes in night work exposure were the strongest predictors for both recovering from or developing SWD from baseline to follow-up. Reducing exposure to night work and QRs were associated with recovering from SWD and increasing exposure to night work and QRs were associated with developing SWD. The results imply that unfavorable work schedules play a role in the development of sleep problems among nurses. These results may be useful when designing healthy working schedules.

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

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

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

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

Objectives: Eucalyptus trees are used in the particleboard wood industry in Ethiopia. Dust and chemicals from this production may cause respiratory health problems, but the exposure levels have not been studied previously. The aim of this study was to assess workers’ exposure to inhalable dust, endotoxin, and formaldehyde in the two largest particleboard factories in Ethiopia, and compare the results with occupational exposure limits. Methods: A total of 152 inhalable dust and endotoxin samples were collected using a conductive plastic inhalable conical sampler (CIS), in addition to 45 formaldehyde samples using Dräger tubes for collection in two particleboard factories in Ethiopia. Linear mixed models were used to identify exposure determinants. Results: The geometric mean (GM) of inhalable dust exposure was 4.66 mg/m3 and 93% of the samples were above the threshold limit value of 1 mg/m3. For endotoxin exposure GM was 62.2 EU/m3, and 41% of samples were above the recommended occupational limit value of 90 EU/m3. Formaldehyde was added in a blending section of the production line, and the formaldehyde level was highest here (3.5 ppm). The level decreased at the workstations following blending, and 13% of the formaldehyde samples were above the peak exposure limit value of 1.0 ppm. Conclusions: The findings revealed exposure levels higher than recommended for inhalable dust, endotoxin, and formaldehyde in the particleboard factories. A reduction in dust, endotoxin, and formaldehyde exposure levels in these workplaces is recommended. We also recommend provision of proper personal protective equipment.

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

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

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

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

Background: This study investigates insomnia as a partial mediator in the relationship between personality and symptoms of anxiety and depression. Methods: The study is based on partly longitudinal data from the ongoing cohort study “Survey of Shift work, Sleep, and Health” (SUSSH) among Norwegian nurses, a survey examining the work situation and health status of Norwegian nurses measured with annual questionnaires. The present study uses data collected in 2012 (Wave 4), 2013 (Wave 5), and 2014 (Wave 6). The final sample at Wave 6 consisted of 2002 participants, of which 91% were females. The questionnaires included items measuring, among others, demographic variables, work time schedule, insomnia (Bergen Insomnia Scale), personality (Mini-IPIP) and anxiety and depression (Hospital Anxiety and Depression Scale). Results: Extraversion and conscientiousness had no significant direct or indirect association with insomnia, anxiety or depression. Neuroticism and insomnia had direct associations to future symptoms of anxiety and depression. Insomnia was also a significant partial mediator of the relationship between both neuroticism and anxiety, and neuroticism and depression, meaning that neuroticism had an indirect relation to symptoms of anxiety and depression through insomnia. When adjusting for previous symptoms of anxiety and depression at Wave 5, insomnia was no longer a significant mediator between neuroticism and anxiety, and only marginally mediated the relationship between neuroticism and depression. Conclusion: The results showed that insomnia may act as a mediator between neuroticism and symptoms of anxiety and depression, but the indirect relationship between neuroticism and anxiety and depression through insomnia is considerably weaker than the direct association. Hence, the mediating effect of insomnia should be interpreted with caution. The sample mainly consisted of female nurses, and the generalizability of the findings to male dominated occupations is limited. Findings from the present study highlight the importance of an integrated approach and strengthen the understanding of how personality and psychopathology are connected. Copyright © 2019 Sørengaard, Karlsen, Langvik, Pallesen, Bjorvatn, Waage, Moen and Saksvik-Lehouillier. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY).

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

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

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

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

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

The aim of the present study was to investigate if bullied nurses have a more negative coping style when facing stressful events than do non-bullied nurses, and to determine if coping style moderates the well-established bullying-anxiety relationship. Cohort data were gathered in 2008/2009 and 2010 with a time lag of approximately one year for all respondents. At T1 2059 Norwegian nurses participated, whereof 1582 also responded at T2. A t-test and a hierarchical regression analysis were conducted to obtain results for the hypothesized relationships. The results show that bullied nurses use an active goal-oriented coping style less often compared to non-bullied nurses. Furthermore, active goal-oriented coping seems beneficial only when exposure to bullying behaviors is very low. This effect diminishes however as the bullying behavior intensifies. Hence, victims of bullying seem to cope more negatively with stressful events than others. On the other hand, high exposure to bullying behaviors has negative consequences for the subsequent level of anxiety for those affected, regardless of their general coping style. Language: en

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

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