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This study aimed to examine whether different agricultural work patterns may cause MSDs in different body areas and assess their severity. In previous studies, musculoskeletal disorders (MSDs) have been recognized as an occupational disease in agricultural workers. However, not all MSDs resulting from agriculture occur in the same body areas or have similar severity. This study conducted a questionnaire survey to inquire about the body areas and severity of MSDs among fruit farmers. A total of 212 valid answers were collected. Subsequently, their main harvesting postures were classified into three groups to examine the differences in MSD occurrence and severity among those groups. The results indicate that the harvesting posture did result in different severities of MSDs in certain body areas. Raising hands above the shoulders caused significantly higher MSD severity in the neck, shoulder, upper back, and elbows despite the same standing posture. Additionally, those who squatted, bent, or kneeled had a significantly higher severity of MSDs in the shoulders compared to those who stood but did not raise their hands above their shoulders. This study confirmed that the different harvesting heights of fruits can affect farmers’ posture, leading to differences in the body areas affected by, and severity of, MSDs.

Background Serious concerns surround the potential risks resulting from inhalation exposure to pesticides amongst agricultural workers when mixing and applying these compounds. In Eswatini (formerly known as Swaziland), Southern Africa, pesticides are widely used to improve the yield and quality of sugar cane production, the largest contributor to the country's economy. We assessed applicators' inhalation exposures from multiple spraying sources to four commonly used herbicides in Eswatini. Results Analysis of 76 personal air samples by liquid chromatography with tandem mass spectrometry (LC-MS/MS) revealed four pesticides: ametryn, atrazine, pendimethalin and 2,4-dichlorophenoxyacetic acid, with mean concentrations of 36.91, 21.57, 31.05 and 0.89 μg m-3 , respectively. These inhalation exposures are much higher than those recorded in previous similar studies. Conclusion Although all applicators in this study used personal protective equipment (PPE), they nevertheless recorded high levels of inhalation exposure to commonly used pesticides. Our findings suggest that in addition to observing mandated regular changing and cleaning practices with PPE for ultimate personal protection, pesticide applicators should distance themselves from each other when spraying to effectively reduce their exposure to pesticides from multiple spraying sources. Further studies are needed to determine the optimal spraying distance between pesticide applicators. © 2021 Society of Chemical Industry.

Distinct differences exist between public-private sector organizations with respect to the market environment and operational objectives; furthermore, among private sector businesses, organizational structures and work conditions often vary between large- and small-sized companies. Despite these obvious structural distinctions, however, sectoral differences in employees' psychosocial risks and burnout status in national level have rarely been systematically investigated. Based on 2013 national employee survey data, 15,000 full-time employees were studied. Sector types were classified into "public," "private enterprise-large (LE)," and "private enterprise-small and medium (SME);" based on the definition of SMEs by Taiwan Ministry of Economic Affairs, and the associations of sector types with self-reported burnout status (measured by the Chinese version of Copenhagen Burnout Inventory) were examined, taking into account other work characteristics and job instability indicators. Significantly longer working hours and higher perceived job insecurity were found among private sector employees than their public sector counterparts. With further consideration of company size, greater dissatisfaction of job control and career prospect were found among SME employees than the other two sector type workers. This study explores the pattern of public-private differences in work conditions and employees' stress-related problems to have policy implications for supporting mechanism for disadvantaged workers in private sectors.

Pesticides are extensively used to improve crop yield and quality in many African countries where agricultural production is a critical economic activity, including Eswatini (formerly Swaziland) in southern Africa. However, the potential health effects of indoor exposure to agricultural pesticides are deeply concerning, and children are particularly vulnerable. This case study assessed such exposure and its risks by sampling and analyzing the air inside the homes of 15 pesticide applicators and 12 non-applicators in Swazi communities surrounded by nearby (~200 m) sugarcane fields on pesticide spraying days. Applying liquid chromatography with tandem mass spectrometry (LC-MS/MS) to the samples revealed mean ametryn, atrazine, pendimethalin and 2,4-dichlorophenoxyacetic acid (2,4-D) concentrations of 0.75, 0.32, 0.57 and 0.004 µg m–3, respectively, in the applicator households and corresponding values of 0.19, 0.03, 0.04 and 0.003 µg m–3, respectively, in the non-applicator households. Notably, the non-applicator households exhibited pesticide concentrations far exceeding previously published data. Furthermore, we measured significantly higher levels of ametryn and pendimethalin inside the homes of the applicators than those of the non-applicators. Daily inhalation exposure to agricultural pesticides resulted in cumulative hazard index values above 1.0 at the 95th percentile for children 3 years of age and younger in the applicator households. Thus, the take-home pathway, spray drift and household-to-field distance all play crucial roles in determining the pesticide exposure and health risks indoors. Owing to the dominance of the first factor, we advise applicators to shower and change into clean clothes before returning home to their families. This safety measure is essential for the many families living near agricultural land throughout Africa.

Associations of neighborhood‐level workplace violence with workers’ mental distress problems: a multilevel analysis of Taiwanese employees: Li‐Chung Pien, et al. Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taiwan OBJECTIVE: Workplace violence is known to pose mental health risks. However, whether or not workplace violence in a surrounding area might further increase the risk of mental distress in workers has rarely been examined. METHODS: The study subjects were 9,393 male and 7,716 female employees who participated in a nationwide survey in 2010. Their personal experiences of workplace violence over the past 1 year were ascertained by a standardized questionnaire. Also assessed were their psychosocial work characteristics and mental distress problems. Neighborhood‐level workplace violence was computed based on aggregated data at the county level and was categorized into low‐, medium, and high‐level categories. Multilevel logistic regression models were constructed to examine the associations between neighborhood‐level workplace violence and individual‐level mental distress problems, with adjustment of individual‐level experience of workplace violence. FINDINGS: The neighborhood‐level prevalence of workplace violence ranged from 4.7 to 14.7% in men and from 6.4 to 14.8% in women across 22 counties. As compared with those who live in counties of the lowest tertile of workplace violence, female workers who lived in counties of the highest tertile of workplace violence had a 1.72‐fold increased risk for mental distress problems after controlling for individual experience of workplace violence and other psychosocial work characteristics. CONCLUSION: Neighborhood‐level workplace violence was associated with poor mental health in female workers. Preventative strategies targeting workplace violence should pay attention to neighborhood factors and gender‐specific effects that might influence societal tolerance of abusive work practices and workers’ vulnerability to mental health impacts of workplace violence.

Noise exposure is associated with elevated blood pressure, but the effects on susceptible workers have not been reported. This repeated-measure study investigated the effects of noise exposure on 24-h ambulatory blood pressure among hypertensive, pre-hypertensive, and normotensive adults.We enrolled 113 volunteers in an occupational cohort in 2009. Individual noise exposure and personal blood pressure were measured simultaneously over 24 h on working and non-working days. Linear mixed-effects regressions were used to estimate the effects on SBP and DBP by controlling for potential confounders.Each A-weighted decibel (dBA) increase in a 30-min time-lagged exposure was associated with transient elevations of work-time SBP [0.30 (95% confidence interval: 0.06, 0.54) mmHg] on working days as well as sleep-time SBP [0.39 (0.12, 0.66) mmHg] and DBP [0.33 (0.14, 0.51) mmHg] on non-working days among 19 hypertensive adults. In contrast, 46 normotensive workers had transient increases in work-time SBP [0.16 (0.03, 0.29) mmHg] and DBP [0.25 (0.15, 0.34) mmHg] on working days as well as sleep-time SBP [0.17 (0.06, 0.29) mmHg] and DBP [0.21 (0.14, 0.29) mmHg] on non-working days caused by a 1-dBA increase in the current exposure. All groups had sustained increases in 24-h average ambulatory SBP and DBP induced by noise exposure on 2 days, but the hypertensive workers had the most pronounced increase in SBP.Hypertensive adults are more susceptible to noise exposure with a greater effect on ambulatory SBP. These results suggest a need for more protection for this subpopulation.

Background High-frequency noise from handpieces has caused concerns of hearing loss among dentists. However, data on dentists' workplace noise exposure are inconsistent and the literature on the consequent annoyance is limited. Aim This study evaluated dentists' workplace noise exposure and investigated its role in causing annoyance and its role in communication function in daily life. Methods The workplace noise levels were measured in dental clinics in a hospital. The dentists' personal noise doses and the 8-hour time-weighted average noise levels were also measured. The communication difficulties and annoyance because of workplace noise exposure were furthermore evaluated by using a self-reported questionnaire. Results In this study, the average age of the participating dentists was 30.1 ± 7.2 years (age range, 24–50 years) and the service seniority was 5.4 ± 6.8 years (range, 1–26 years). The general noise level in dental clinics was moderate with an average equivalent sound pressure level of 64.2 ± 2.4 decibels (dB). Nearly all participants were annoyed by dental noise sources (prevalence, 93.6–96.8%). A low average score (1.73) showed no communication difficulty among dentists. The level of seniority was not correlated with scores of communication function or annoyance resulting from workplace noise. Conclusion In the studied dental clinics, the dentists exposed routinely to a low workplace noise and the risk of workplace noise-induced hearing loss should be low. However, the high prevalence of annoyance resulting from dental noise sources need to be investigated in the future.

OBJECTIVE The aim of this study was to examine changes in working hours, shift work, psychological and physical job demands, job control and job insecurity in Taiwanese employees by gender and age during the period of 2001 to 2010. METHODS The study subjects were 36,750 men and 27,549 women, aged 25-64, from 4 rounds of cross-sectional surveys of representative employees. Psychosocial work conditions were assessed by a validated questionnaire. RESULTS Regression analyses with adjustment of education and employment grade showed that from 2001 to 2010, the proportions of workers with long working hours (>48 hours/week) (OR=1.4 in men and 1.5 in women) and workers with short working hours (

To explore the effectiveness of exercise program for banking and insurance workers and clarify the association between exercise, burnout, and metabolic syndrome components. In the process of the study, a practicable worksite exercise program was developed for bank and insurance enterprises. A three-month (12-wk) exercise course was conducted, and its benefits evaluated. Levels of burnout and metabolic syndrome components were analyzed after exercise intervention. After intervention, the indicators of burnout and metabolic syndrome components were significantly improved in both low and high intensity groups, and the improvement were expressed in reduction of waist circumference, systolic blood pressure, person burnout and work-related burnout. A dose-response of burnouts and metabolic syndrome components with exercise intensity are shown (p

To examine the association between work characteristics and the risk of alcohol dependence across different employment types and occupations, including the pattern of alcohol consumption in the form of energy drinks and its association with alcohol dependence.A total of 13,501 men and 8584 women participated in a national survey in Taiwan. Alcohol dependence was defined as ≥2 points in the CAGE questionnaire. A self-administered questionnaire recorded drinking behaviors, consumption of alcoholic energy drinks, employment type, occupation and a number of psychosocial work stressors, namely job demands, job control, employment security and workplace justice.Of the total, 9.4% of men and 0.8% of women were CAGE-positive, and 6.0% of men and 0.7% of women regularly consumed alcoholic energy drinks. In male and female regular consumers of alcoholic energy drinks, 38.7 and 23.3%, respectively, were alcohol-dependent. Multivariate regression analyses showed that male employees in manual skilled occupations, with lower workplace justice, having weekly working hours40 h and on piece-rated or time-based pay systems were at higher risks of alcohol dependence.Certain occupational groups and workers with adverse psychosocial work characteristics should be targets for prevention of alcohol dependence. Alcoholic energy drink consumption should be taken into consideration while studying alcohol dependence in the work population in Taiwan.

To investigate the effects of shift work schedules on sleep quality and mental health in female nurses in south Taiwan. This study recruited 1,360 female registered nurses in the Kaohsiung area for the first survey, and among them, 769 nurses had a rotation shift schedule. Among the 769 rotation shift work nurses, 407 completed another second survey 6–10 months later. Data collection included demographic variables, work status, shift work schedule, sleep quality (Pittsburgh Sleep Quality Index), and mental health (Chinese Health Questionnaire-12). Nurses on rotation shift had the poor sleep quality and mental health compared to nurses on day shift. The nurses on rotation shift had a relatively higher OR of reporting poor sleep quality and poor mental health (OR, 2.26; 95% CI, 1.57–3.28; and OR, 1.91; 95% CI, 1.39–2.63, respectively). Additionally, rotation shift nurses who had ≥2 days off after their most recent night shifts showed significantly improved sleep quality and mental health (PSQI decreased of 1.23 and CHQ-12 decreased of 0.86, respectively). Comparison of sleep quality between the first and second surveys showed aggravated sleep quality only in nurses who had an increased frequency of night shifts. Female nurses who have a rotation shift work schedule tend to experience poor sleep quality and mental health, but their sleep quality and mental health improve if they have ≥2 days off after their most recent night shifts. This empirical information is useful for optimizing work schedules for nurses.

Bioaerosols generated during livestock and poultry production are significant occupational hazards. This study investigates the characteristics of bioaerosols released from animal feces. Fresh feces from pigs and chickens were obtained and tested in a controlled-environment facility. Airborne viable (culturable) bacteria and fungi were sampled hourly for 48 hr. The predominant species were identified via polymerase chain reaction analysis. The number of bacterial colonies released from chicken feces increased gradually, peaked at approximately 20 hr, and remained relatively constant to test end; however, the bacterial colonies released from swine feces did not increase significantly. The chicken feces released significantly (P0.05) more bacterial aerosols than swine feces over 40 hr, by approximately 1 order of magnitude. However, the difference in total fungal aerosols released from the two feces types was relatively small (30-40%) and insignificant (P0.05). Aerosols sized between approximately 0.65 and 1.1 microm were predominant for bacteria, whereas aerosols sized between approximately 2.1 and 3.3 microm prevailed for fungi. Genera Stenotrophomonas were the predominant bacterial aerosols, whereas Cladosporium and Acremonium accounted for the greatest amounts of fungi from chicken and swine feces, respectively. More than 1000 culturable bacterial colonies can be released from 1 g of chicken feces per hour, and approximately 80% of these bioaerosols are respirable. Most bacterial aerosols released from swine and chicken feces were opportunistic human pathogens; thus, the significance of their presence warrants further investigations.

yuan s.c., chou m.c., chen c.j., lin y.j., chen m.-c., liu h.-h., & kuo h.-w. (2011) Journal of Nursing Management 19, 339–345 Influences of shift work on fatigue among nurses Aim To compare the symptoms of fatigue and physiological indices in nurses who work during the day with nurses who work in shifts. Method One-hundred and seven nurses were recruited and asked to assess their symptoms of fatigue before their work commenced and after it finished. Results Using logistic regression analysis adjusted for covariates, it was found that nurses who work in shifts were more fatigued than nurses who work during the day (odds ratio = 2.44, P

The purpose of this study was to inactivate indoor bioaerosols using carbon nanotube corona discharge plasma technology. Escherichia coli, Bacillus subtilis, and λ virus bioaerosols were generated using a Collison nebulizer. The effect of various factors, including the flow rate (30, 60, and 90 lpm) and the operating voltages (−1.5, −3.0, −4.5, −6.0, and −7.5 kV), on bioaerosol reduction was examined. The results indicated that the corona discharge using the carbon nanotube electrodes decreased the threshold voltage of plasma. The inactivation efficiencies of E. coli bioaerosols using the carbon nanotube corona discharge system at discharge voltages of −1.5, −3.0, −4.5, −6.0, and −7.5 kV were 57, 61, 71, 93, and 97%, respectively. The corona discharge system using carbon nanotube electrodes had higher bioaerosol inactivation efficiency than the corona discharge system using stainless steel electrodes. The results further demonstrated that the inactivation efficiency decreased with an increasing flow rate. The inactivation efficiencies of E. coli, B. subtilis, and λ virus bioaerosols using carbon nanotube corona discharge plasma were 93, 88, and 81%, respectively.

BackgroundA new engineering intervention measure, an embracing air curtain device (EACD), was used to increase the capture efficiency of cooker hoods and reduce cooking oil fume (COF) exposure in Chinese restaurants.MethodsAn EACD was installed in six Chinese restaurants where the cooks complained of COF exposure. Before- and after-installation measurements were taken to compare changes in particulate matter (PM) and polycyclic aromatic hydrocarbons (PAHs) in kitchen air, and changes in levels of urinary 8-hydroxy-2′-deoxyguanosine (8-OHdG) and malondialdehyde (MDA). The association between PM and PAHs in air and 8-OHdG and MDA in urine was evaluated by linear mixed-effects regression analysis.ResultsResults showed that geometric mean kitchen air levels of PM10, PM2.5, PM1.0and total particulate PAHs were significantly reduced after the EACDs were introduced. Urinary levels of 8-OHdG and MDA in cooks were also significantly lower after EACD instalment. PM2.5, PM1.0and benzo(a)pyrene (BaP) levels were positively associated with urinary 8-OHdG levels after adjusting for key personal covariates. Urinary MDA levels in cooks were also positively associated with BaP levels after adjusting for key personal covariates.ConclusionThis study demonstrates that the EACD is effective for reducing COF and oxidative stress levels in cooks working in Chinese kitchens.

Background: Ferrous sulfate (FeSO4) added to cement has been used to reduce the prevalence of dermatitis in workers. However, the effect of dermatitis on the total uptake of chromium in cement with or without FeSO4 has not been previously explored. Objective: The objective of this study was to compare the urinary chromium levels before and after FeSO4 addition among cement workers with or without hand dermatitis. Methods: Thirty-five male workers were recruited in this study for two consecutive years: 2003 without using FeSO4 and 2004 after adding FeSO4. Urinary chromium was used as a biomarker to estimate the total body burden of chromium. Results: Urinary chromium concentration showed significant decreases after FeSO4 was used, and a larger decrease of urinary chromium was observed in workers with hand dermatitis than for those without hand dermatitis. Moreover, a significant decrease of urinary chromium was observed in workers with hand dermatitis in both 2003 and 2004. Conclusion: FeSO4 decreases the total body burden of chromium, especially in workers with severe and continuous hand dermatitis.

To investigate the incidence of musculoskeletal disorders (MSDs) and the particular MSDs to which Chinese restaurant cooks are most at risk in Taiwan, National Health Insurance Data from 1998 to 2002 were used to identify MSDs for study populations, including 52,261 certified cooks and 209,044 references matched for age and sex. The annual incidence of MSDs was around 25% and 20% for cooks and references, respectively, and the cook-to-reference risk ratios ranged from 1.29 to 1.35 (p0.001). The most frequently affected body part was the low back, but the epicondyle was at higher risk (OR2) than other sites for the cooks. Cooks are at higher risk of having MSDs complaints and MSDs related to the elbow show the highest risk.

Background: Hand eczema and other skin diseases have been associated with the exposure of chromium among cement workers. Studies on skin disease and other factors associated with the body burden of chromium are limited. Objective: The present study investigated the role of skin disease and smoking in the association with body burden of chromium among cement workers. Methods: Forty five workers (38 men and 7 women) were recruited for this study and interviewed to obtain information on demographic status, lifestyle, employment history, and affecting factors. Urine samples were collected to measure the urinary chromium concentration to represent the body burden of chromium. Results: The average urinary chromium concentration was approximately 6 times higher in non-smoking workers with hand eczema than in non-smoking workers with no skin disease (45.5 vs. 7.6 μg/L). The average chromium level increase to 87.0 μg/L for smokers with the disease. Compared with workers with no hand eczema, the odds ratio of having urinary chromium concentration exceeding the biological exposure index level significantly increased to 11.6 (95% CI = 1.3–102.2) for non-smoking workers with skin disease, and to 48.0 (95% CI = 4.5–510.8) for smoking workers with skin disease. The multiple regression analysis showed that the use of gloves may reduce significantly the chromium exposure. Conclusions: Inadequate protection and personal behavior increase the internal dose of chromium in cement workers. Total body burden of chromium are higher among cement workers with skin disease and smoking habit. These workers deserve intervention education on personal hygiene to reduce the exposure of chromium.

We established a standardized surveillance system using the Chinese Exposure Prevention Information Network to estimate the frequency of percutaneous injuries (PCIs) in Taiwanese healthcare workers (HCWs). Fourteen hospitals employing 8,132 HCWs participated and a total of 583 PCIs were reported. The annual number was estimated to be 8,058 PCIs per hospital size, 8,100 per HCWs, and 8,286 per inpatient-day; indicating similar estimates using different denominators. The estimated annual frequency of pathogen-specific PCIs was 1,168 for hepatitis B, 1,263 for hepatitis C, and 59 for HIV. This study documents the annual incidence of PCI among HCWs showing important potential exposure to viral hepatitis and HIV in Taiwan.

Background: Construction workers exposed to cement are known to suffer from occupational contact dermatitis because of chromate sensitization. It is not clear whether certain genotypes are associated with increased susceptibility of chromate sensitization in those workers regularly exposed to cement. Objective: The objective of this study was to determine the genotypes predisposing workers to cement-induced contact dermatitis. Methods: A total of 153 current cement workers who had regular contact with cement were telephone interviewed for skin problems in the past 12 months, work exposure, and personal protection. A dermatologist examined their skin and conducted patch test with common skin allergens. Blood samples were donated for genotypic determination by polymerase chain reaction-based assays for GST-T1, GST-M1 (null/non-null), tumour necrosis factor (TNF) alpha promoter-308G/A, and interleukin (IL) 4-590C/T. Result: High percentage of dermatitis was noted in the 153 workers examined, which was correlated with reported skin problems. By patch testing, construction workers had a high-prevalence rate (12%) of sensitivity to chromate. Sensitivity to chromate was significantly associated with TNF alpha promoter-308 heterozygous (GA) as compared with GG genotype (odds ratio 3.9, 95% confidence interval 1.1–13.2), as well as with GST-T1 null genotype (odds ratio 5.5, 95% confidence interval 1.4–36.2), but neither the GST-M1 nor the IL-4 genotypes. Conclusion: It is concluded that among workers frequently exposed to cement in Southern Taiwan, those with TNF alpha promoter-308 heterozygous (GA) genotype or GST-T1 null genotype had increased risk of chromate sensitization.

Needlestick/sharp injuries (NSIs/SIs) are a serious threat to medical/nursing students in hospital internships. Education for preventing NSIs/SIs is important for healthcare workers but is rarely conducted and evaluated among vocational school nursing students. We conducted an educational intervention for such students after their internship rotations before graduation. This program consisted of a lecture to the students after the internship training and a self-study brochure for them to study before their graduation. This study used the pre-test questionnaires completed by all students and the post-test questionnaires completed by 107 graduates after work experience as licensed nurses to assess the effectiveness of the intervention. After educational intervention, the incidence of NSIs/SIs decreased significantly from 50.5% pre-test to 25.2% post-test, and the report rate increased from 37.0% to 55.6%, respectively. In conclusion, this intervention significantly reduced the incidence of NSIs/SIs and increased the report rate of such events.

OBJECTIVE The aim of this study was to examine relationships of organizational culture and health behaviors with presenteeism. METHOD Data of a self-reported questionnaire were collected from 816 employees, who joined the study on a voluntary basis, in seven enterprises in northern Taiwan. RESULTS Organizational culture and health behaviors were found to be significantly associated with presenteeism. After adjusting for confounding factors, the number of health complaints seemed to be more suitable than chronic diseases in predicting presenteeism. CONCLUSIONS This study result implied that advantage could be taken of organizational culture and employees' health behaviors to reduce presenteeism in the workplace.

In this study we investigated the risk of hearing loss among workers exposed to both toluene and noise. We recruited 58 workers at an adhesive materials manufacturing plant who were exposured to both toluene and noise [78.6–87.1 A-weighted decibels; dB(A)], 58 workers exposed to noise only [83.5–90.1 dB(A)], and 58 administrative clerks [67.9–72.6 dB(A)] at the same company. We interviewed participants to obtain sociodemographic and employment information and performed physical examinations, including pure-tone audiometry tests between 0.5 and 6 kHz. A contracted laboratory certified by the Council of Labor in Taiwan conducted on-site toluene and noise exposure measurements. The prevalence of hearing loss of ≥25 dB in the toluene plus noise group (86.2%) was much greater than that in the noise-only group (44.8%) and the administrative clerks (5.0%) (p < 0.001). The prevalence rates were 67.2, 32.8, and 8.3% (p < 0.001), respectively, when 0.5 kHz was excluded from the estimation. Multivariate logistic regression analysis showed that the toluene plus noise group had an estimated risk for hearing loss ≥25 dB, 10.9 times higher than that of the noise–only group. The risk ratio dropped to 5.8 when 0.5 kHz was excluded from the risk estimation. Hearing impairment was greater for the pure-tone frequency of 1 kHz than for that of 2 kHz. However, the mean hearing threshold was the poorest for 6 kHz, and the least effect was observed for 2 kHz. Our results suggest that toluene exacerbates hearing loss in a noisy environment, with the main impact on the lower frequencies.

Objective: This study investigated electrocardiography (ECG) manifestations for male workers with carbon disulfide exposure at rayon manufacturing plants. Methods: A total of 251 men in the exposure group and 226 administrative clerks in the reference group received physical examinations and completed questionnaires. Results: The prevalence of ECG abnormalities was much higher in the carbon disulfide exposure group (25.9%, n = 65) than in the reference group (2.7%, n = 6), with an odds ratio (OR) of 12.8 (95% confidence interval [CI] = 5. 4 -30. 2). The foremen were at the highest risk of abnormal ECG (OR = 20.6, 95% CI = 6.5-65.2), followed by filament-spinning workers (OR = 14.2, 95% CI = 5.7-35.3), viscose-manufacturing workers (OR = 11.3, 95% CI = 4.3-30.1), and carbon disulfide-manufacturing workers (OR = 8.1, 95% CI = 2.7-25.6). The multivariate logistic regression analysis based on cumulative exposure index also showed a dose-response relationship with the exposure, and the risk of ECG abnormality could be initiated at the exposure history of 31 to 57 year-ppm with an OR of 7.2 (95 % CI = 1.5-36.7). Conclusions: In general, the ECG abnormalities observed in workers at the permissible exposure level of carbon disulfide implicate the importance of environmental control of the chemical and of workers' education in exposure prevention at work.

Background Chronic exposure to carbon disulfide (CS2) has been associated with hypertension, elevated cholesterol, arteriosclerosis, ischemic heart disease and related mortality, adverse nervous and reproductive health effects, and hearing impairment. This study assessed the hypertension risk for male rayon workers exposed to CS2. Methods A total of 251 rayon workers and 226 administrative clerks at two plants in Taiwan received health examination and interviews, and were compared for hypertension risk. On-site CS2 levels were measured. Results The hypertension was more prevalent in the exposure group (43.4%) than in controls (7.1%) with greater impact on systolic blood pressure than diastolic. Multivariate logistic regression analysis showed a significant dose–response relationship between hypertensive risk and cumulative exposure index (CEI) with an odds ratio of 15.1 for workers exposed to 343–468 year-ppm of CS2. The overall risk was elevated to 7.6 times higher for rayon workers. The risk increased significantly after more than 10 years of employment. Conclusions This study suggests that it takes a long exposure period to develop hypertension for rayon workers with CS2 exposure. Am. J. Ind. Med. 50:22–27, 2007. © 2006 Wiley-Liss, Inc.

As employers respond to intensive global competition through the deregulation of labor, job insecurity has become a widespread problem. It has been shown to have significant health impacts in a growing number of workers, but less is known about its social distribution, the mechanisms through which it may act, and the moderating effects of gender, socioeconomic position, and company size. Utilizing data from a national survey of a representative sample of paid employees in Taiwan, we examined the prevalence of job insecurity and its associations with psychosocial work characteristics and health status. A total of 8705 men and 5986 women aged between 25 and 65 years old were studied. Information on perceived job insecurity, industrial and occupational types, psychosocial work characteristics as assessed by the Job Strain model, and various measures of health status were obtained by a self-administered questionnaire. The overall prevalence of job insecurity was high (50%). Job insecurity was more prevalent among employees with lower education attainment, in blue-collar and construction workers, those employed in smaller companies, and in older women. Insecure employees also reported lower job control, higher job demands, and poor workplace social support, as compared with those who held secure positions. Regression analyses showed that job insecurity was strongly associated with poor health, even with adjustment of age, job control, job demands, and work place social support. The deleterious effects of job insecurity appeared to be stronger in men than women, in women who held managerial or professional jobs than women in other employment grades, and in those working in larger companies than smaller ones. The findings of this study suggest that perceived job insecurity is an important source of stress, and it is accompanied with adverse psychosocial work conditions and poor health. High-risk groups were identified for further investigation.

Objective: To assess the effectiveness of 3 different health promotion exercise programs for work-related shoulder and neck pain. Design: Comparative study design. Subjects: A total of 178 employees were recruited and grouped. Methods: Those in the “Self-exercise group” (n = 56) were given a lecture about the exercise program and then performed the program by themselves during their office break. “Team-exercise group I” (n = 69) performed the program once under the supervision of a physiotherapist after the lecture. “Team-exercise group II” (n = 14) performed the program twice; once under a physiotherapist’s supervision. A modified Nordic questionnaire, pain threshold and cervical range of motion were used to evaluate the effect of intervention. There were 39 subjects in the reference group. Results: When daily change of pain threshold (post-work – pre-work) was treated as an improvement index, the odds ratios for the self-exercise group, team-exercise group I and team-exercise group II were 1.39, 4.63 ( p < 0.05) and 7.06 ( p < 0.05), respectively, compared with the reference group. A dose-response effect of intervention intensity was demonstrated. Conclusion: An intensive team-exercise program is beneficial in reducing neck and shoulder symptoms in sedentary workers.

Hearing protection is very important for workers in noisy work environments, although the willingness of workers to wear hearing protectors depends heavily on their comfort. This paper evaluates and recommends improvements for the comfort of hearing protection. Workers’ experience and comfort needs for hearing protection were investigated through a questionnaire that established the “comfort indices” for hearing protection. An earmuff “comfort tester” was designed to measure the comfort indices, and an experiment was conducted to measure workers’ perceived comfort into quantitative data. From the data, the range of these comfort indices in which workers will feel comfortable was determined. Finally, guidelines to improve the design of current hearing protection based on these “comfort indices” are proposed, which may help increase workers’ willingness to wear hearing protection. Relevance to industry Using these proposed guidelines may help improve the comfort of hearing protection and increase workers’ willingness to wear hearing protection in noisy work environments.

Background It is often difficult and expensive to make direct measurements of an individual's occupational or environmental exposures in large epidemiologic studies. Methods In this study, we used information collected in validation studies to develop a prediction rule for assessing exposure in a study with no direct measurement. We established a prediction rule through mixed-effect modeling of direct measurement data and information on observable exposure predictors and their interactions. Specifically, we used 383 measures of whole-body vibration from 247 professional taxi drivers and attempted to quantify vibration exposures for individuals in a large study on low back pain. Results Using the "jackknife method," we found that our prediction rule had an acceptably low relative prediction error of 11% (95% confidence interval-10-12%). Implementing the prediction rule would result in measurement errors independent of low back pain and of all identified and observable predictors of whole-body vibration. We applied the predicted levels to compute each person's daily exposure, and found a strong association between the predicted daily whole-body vibration exposure and prevalence of low back pain. This supported the construct validity of the exposure prediction rule. Conclusions The predictive and construct validity of our prediction rule suggests that this general statistical approach can be useful in other occupational settings to improve the quality of exposure assessment.

Background Coke-oven workers (COWs) are occupationally exposed to high concentrations of polycyclic aromatic hydrocarbons (PAHs). Urinary 8-hydroxy-2-deoxyguanosine (8-OH-dG) and 1-hydroxypyrene (1-OHP) are biological markers of oxidative DNA damage and PAHs metabolism, respectively. In this study, we investigated whether polymorphisms of glutathione S-transferase (GSTM1 and GSTT1) can modulate the relationship between urinary 8-OH-dG and 1-OHP concentrations among the COWs. Methods This was a cross-sectional study. Between February and November of 2001, 53 topside-oven and 130 side-oven workers with the presence of GSTM1 and GSTT1 genotypes were investigated. Results Urinary 1-OHP and 8-OH-dG concentrations (mean ± SD) in the topside-oven workers with the presence of GSTM1 were 107.2 ± 107.9 and 15.3 ± 9.7 ng/ml, respectively, which were not significantly different from those in the absence of GSTM1 (84.1 ± 104.5 and 12.8 ± 14.1 ng/ml). The similar insignificant results were also noted in the sideoven workers. For GSTT1 polymorphism, the results remained insignificant. In contrast, individual excretion of urinary 8-OH-dG and 1-OHP concentrations were still highly correlated (Spearman correlation coefficients: r = 0.43, P

Simultaneous exposure to carbon disulfide and noise may have a combined effect on hearing impairment. In this study we investigated hearing loss in 131 men with exposure to noise [80-91 A-weighted decibels; dB(A)] and CS(2) (1.6-20.1 ppm) in a viscose rayon plant. These men were compared with 105 men in the adhesive tape and electronic industries who were exposed to noise only and with 110 men employed in the administrative office of the rayon plant who were exposed to low noise and no CS(2). We conducted interviews to obtain sociodemographic information and exposure assessments, and we performed physical examinations, including hearing tests. Results showed that the prevalence of hearing loss of > 25 dB hearing loss (dBHL) in rayon workers (67.9%) was much higher than that in administrative workers (23.6%) and in the adhesive tape and electronic industrial workers (32.4%). Hearing loss occurred mainly for speech frequencies of 0.5, 1, and 2 kHz. When the CS(2) exposure was measured by the product of CS(2 )exposure level and employment years, the adjusted odds ratios of hearing loss of > 25 dBHL in rayon workers, compared with administrative workers, were 3.8 [95% confidence interval (CI), 1.5-9.4] for those with the exposure of 37-214 year-ppm, 14.2 (95% CI, 4.4-45.9) with 215-453 year-ppm exposure, and 70.3 (95% CI, 8.7-569.7) with exposure of > 453 year-ppm. The study suggests that CS(2) exposure enhances human hearing loss in a noisy environment and mainly affects hearing in lower frequencies.

Phosphine (PH(3)), generated from aluminium, magnesium and zinc phosphide, is a widely used pesticide. PH(3) induces oxidative stress in insects, mammalian cells, animals, and humans. The involvement of glutathione (GSH) in PH(3)-induced oxidative toxicity is controversial. GSH levels in various tested tissues were reduced in aluminium phosphide-poisoned rats and humans, while the levels remained unchanged in insects and mammalian cells. This study examines the effectiveness of endogenous GSH as a protective agent against PH(3)-induced oxidative damage in rats. The association of PH(3)-induced nephrotoxicity and cardiotoxicity with free radical production was also tested. Male Wistar rats, administered intraperitoneally (I.P.) with PH(3) at 4 mg/kg, were evaluated 30 min after treatment for PH(3) toxicity to organs. PH(3) significantly decreased GSH, GSH peroxidase and catalase, while significantly increased lipid peroxidation (as malondialdehyde and 4-hydroxyalkenals), DNA oxidation (as 8-hydroxydeoxyguaonsoine) and superoxide dismutase (SOD) levels in kidney and heart. These changes were significantly alleviated by melatonin (10 mg/kg I.P., 30 min before PH(3)), with the exception of SOD activity in heart tissue. The study also found that buthionine sulfoximine (1 g/kg I.P., 24 h before PH(3)) significantly enhanced the effect of PH(3) on GSH loss and lipid peroxidation elevation in lung. These findings indicate that (1) endogenous GSH plays a crucial role as a protective factor in modulating PH(3)-induced oxidative damage, and (2) PH(3) could injure kidney and heart (as noted earlier with brain, liver and lung) via oxidative stress and the antioxidant melatonin effectively prevents the damage.

Prevalence of Self-Reported Work-Related Skin Conditions in Taiwanese Working Population: Yu-Hsuan SHAO, et al. Environmental and Occupational Health, National Cheng Kung University—Work-related skin conditions are among the most prevalent occupational diseases, but population-based studies of occupational skin diseases are few. This study was conducted by a nationwide representative sampling of employed workers in Taiwan to estimate the prevalence of work-related skin conditions. A total of 18942 non-self-employed workers participated in this survey. Data were collected by selfadministered questionnaires. Those workers who reported having upper extremity skin conditions and considered their skin conditions caused by work exposure were defined as having work-related skin conditions. More than a half of the skin conditions were considered work-related. Overall, 4.4% of male employees and 4.2% of female employees reported having work-related skin conditions in the past year. Work-related skin conditions were more prevalent among male workers than female workers (adjusted OR=0.8, p

The levels of serum selenium in 2755 individuals (1424 males, 1331 females) in Taiwan were determined by graphite furnace atomic absorption spectrometry. The average selenium concentration in serum was 110.9 microg/l with a standard deviation of 21.5 microg/l, ranging from 40.5 to 186 microg/l. The observation was higher than those recently reported in European regions but comparable to those observed in the USA or seleniferous regions. Serum selenium level did not vary with the gender, educational levels of the subjects and smoking habits. Serum selenium content seemed drop considerably if one is older than 39 years old. Age and alcohol consumption had statistically significant difference with serum selenium concentration.

The aim of this study was to identify the health hazards and possible exposure surveillance markers of workers exposed to nanoparticles during manufacturing and application in comparison to a group of unexposed workers. For this longitudinal study, we recruited 158 nanomaterial-handling workers and 104 non-exposed workers from 14 manufacturing plants in Taiwan (baseline). Among them, 124 nanomaterial-handling workers and 77 unexposed workers were monitored 6 months later. We investigated pulmonary and cardiovascular disease markers, inflammation and oxidative stress markers, antioxidant enzymes and genotoxicity markers. Antioxidant enzymes (superoxide dismutase, glutathione peroxidase) and cardiovascular markers (vascular cell adhesion molecule, paraoxonase) were significantly associated with nanomaterial-handling during the 6-month follow-up period. In addition, the small airway damage marker (Clara cell protein 16) and lung function test parameters were also significantly associated with handling nanomaterials. The study markers and lung function tests are possible markers that could be useful for surveillance of nanomaterial-handling workers.

Background/Purpose Work-related fatigue among medical personnel is a major concern for patient safety, however heavy on-call duty is common in many hospitals. The purpose of this study was to investigate the prevalence of self-reported work-related fatigue and its associated factors. Methods A cross-sectional survey of 1833 participants was conducted in two hospitals in Taipei City, Taiwan, using a self-administered questionnaire. Participants reported their demographic characteristics, health-related behavior, health status and symptoms, and work-related fatigue during the past 3 months. Results The prevalence of work-related fatigue among the 1833 participants was 30.9%. Younger participants (20–29 years old) were more likely to report work-related fatigue than older participants (40–65 years old) [adjusted odds ratio (aOR) = 1.55, 95% confidence interval (CI) = 1.18–2.01]. Physicians, nurses, and medical technicians were more likely to report work-related fatigue symptoms than administrative personnel (aOR = 2.30, 95% CI = 1.57–2.79; aOR = 2.83, 95% CI = 1.87–3.99; and aOR = 2.01, 95% CI = 1.12–3.06, respectively). Those who drank coffee more than five times a week were more likely to report work-related fatigue than those who did not drink coffee at all (aOR = 2.53, 95% CI = 1.25–1.93). Participants with poor and very poor self-reported health were more likely to report work-related fatigue (aOR = 1.80, 95% CI = 1.26–2.38) than those who reported that their health was fair, good, or very good. Conclusion We identified factors associated with work-related fatigue among hospital workers in Taipei City. These findings can be applied toward on-the-job training and the development of preventive measures for occupational safety in general hospitals.

Objective Self-rated health (SRH) and burnout are commonly used health indicators. This study was designed to examine the age-specific patterns of SRH and burnout and their correlations with self-reported disease symptoms, and to investigate the moderating effects of age on the associations of psychosocial work conditions with these two health measures. Methods Study subjects were 20,454 male and 16,875 female employees from 2 representative surveys conducted in 2007 and 2010 in Taiwan. SRH was assessed by a single item and burnout was assessed by the general burnout subscale of the Copenhagen Burnout Inventory (CBI). Psychosocial work conditions including working hours, psychological and physical job demands, job control, job insecurity and workplace justice were assessed by a validated questionnaire. Results Older workers were at higher risk for poor SRH which was correlated with the presence of multiple disease symptoms. In contrast, employees aged 30–40 years had higher burnout which was strongly correlated with emotional disturbance. Among all the examined work factors, low workplace justice was found to be the most predominant predictor for poor SRH and high burnout, and the associations were more profound in younger workers than in older workers. Conclusion SRH and burnout were differentially related to age, and there were evidences of moderating effects of age on the associations between psychosocial work conditions and health. Researchers and health practitioners should pay attention to the influence of age when using the measures of SRH and burnout as indicators to detect health risk in association with adverse psychosocial work conditions.

This study examined the distribution of perceived workplace justice and examined the modifying effects of gender, age and enterprise size on the associations between workplace justice and poor health. A total of 9,636 male and 7,406 female employees from a national survey conducted in 2007 in Taiwan were studied. A self-administered questionnaire was used to assess workplace justice (9 items), psychosocial work conditions, self-rated health and burnout status. A clear gradient was observed across employment grades, with employees of lower grades reporting lower workplace justice. Government employees were found to have higher levels of workplace justice than those in private sectors, and among those in private sectors, female employees in larger enterprises were found to have significantly lower workplace justice. Multivariate regression analyses showed that employees with workplace justice in the lowest tertile had increased scores in work-related burnout (11.0 and 12.8 points in men and women, respectively) and increased risks for poor self-rated health (OR = 2.5, 2.6) as compared to those with workplace justice in the highest tertile. The associations were stronger in younger groups than in older groups, and in female employees of larger enterprises than those of smaller enterprises. Employees with lower socioeconomic position and female employees in larger enterprises might be more likely to be exposed to work practices that give rise to the sense of injustice. The underlying mechanisms for the observed stronger associations between lower workplace justice and poor health in younger groups and in workers of larger enterprises deserve further investigation.

Background and Aims: According to a 2007 Taiwan Annual Mortality Report, female breast cancer was the fourth of the top 10 cancer mortality. Ever since the industrial revolution, there has been a s...

Objectives: The object of this study was to assess the modulating effects of genetic polymorphisms of glycine N-methyltransferase (GNMT) genotypes on 1-hydroxypyrene (1-OHP) and 8-hydroxy-2′-deoxyguanosine (8-OHdG) in urine from coke-oven workers, consistently exposed to polycyclic aromatic hydrocarbons (PAHs). Methods: The study participants included 289 coke-oven workers from a steel company in Taiwan. Personal air samples, spot urine samples, peripheral blood samples, and questionnaires were used to quantify PAH exposure, oxidative DNA damage, GNMT gene polymorphisms, demographic data, and environmental pollutants. Results: Urinary 1-OHP level, GNMT STRP1 genotype, and worksite were significant predictors of urinary 8-OHdG levels after adjustments were made for covariates. Conclusions: This study suggests that GNMT STRP1 could modulate urinary 1-OHP and 8-OHdG levels in coke-oven workers exposed to PAHs.

The aim of this study is to develop a practicable worksite physical fitness program for small and medium-sized enterprises (SMEs). Community-based intervention consisting of a three-month exercise course was conducted, and its benefits evaluated. A self-administrated structured questionnaire and physical fitness examination were designed to compare the difference between pre and post intervention. A total of 133 SME workers completed the lifestyle/exercise course and filled out the questionnaire, but 16 were excluded from the exercise group due to health reasons. After the intervention, health indicators such as weight, blood pressure, resting heart rate, waistline, BMI, front and back trunk flexibility, abdominal muscle durability and back muscle strength were significantly improved, and improvements in musculoskeletal disorders were seen in reduced neck pain (18.8%), wrist pain (17.4%), and upper/lower back pain (8.7% and 21.7%, respectively). Cardiovascular risk factors (BMI and resting heart rate) showed a significant improvement related to frequent participation in the program (p=0.02), and the exercise group reported a significant difference in overall health (p=0.02). This study has demonstrated an effective approach to community-based fitness intervention through SMEs.

Objectives: As an occupational injury, percutaneous injury (PI) can result in chronic morbidity and death for healthcare workers (HCWs). A pilot surveillance system for PIs using the Chinese version of Exposure Prevention Information Network (EPINet) was introduced in Taiwan in 2003. We compared data from EPINet and recall of PIs using a cross-sectional survey for rates to establish the reliability of the new system. Methods: HCWs from hospitals that had implemented EPINet for ≥12 months completed a survey for recall of contaminated PIs sustained between October 2004 and September 2005, type of item involved, and reasons for reporting or not reporting the PI. Comparative data from EPINet for the same period were analyzed. Results: The EPINet rate, 36.1/1,000 HCW (95%CI 31.8-41.1) was almost 5 times lower (p

This study examined the psychometric properties of two selected scales--'personal burnout' and 'work-related burnout'--from the Chinese version of the Copenhagen Burnout Inventory (C-CBI) in 384 employees from two companies in Taiwan. A self-administered questionnaire was used that included the two C-CBI scales, the scales of mental health, vitality and general health from the Short Form 36 (SF-36), perceived level of job stress, job satisfaction, working hours, as well as measures for psychological job demands, job control, work-related social support, and over-commitment to work. Both the C-CBI personal burnout scale and work-related burnout scale had high internal consistency and were correlated well with other health, job characteristics, and perception of work measures;furthermore, exploratory factor analysis extracted two empirical factors. However, the two C-CBI scales were highly correlated in the present population and appeared to measure overlapping concepts. Some comments and suggestions were raised for further improvement.