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Background The impact of societal factors on the occurrence of head and neck cancers (HNCs) remains understudied, especially in the Nordic countries. Methods To quantify the association between socio-economic status (SES) and the occurrence of HNCs, this cohort study uses data from the Nordic Occupational Cancer project that combine occupational and cancer registry data from 1961 to 2005 of 14.9 million individuals aged between 30 and 64 years. Occupational categories were combined into seven socio-economic categories. Standardized incidence ratio (SIR) analyses were conducted with the cancer incidence rates for the entire national study populations used as reference rates. Results Altogether, 83 997 HNCs—72% in men and 28% in women—were recorded. Among men, a gradient of risk associated with SES was observed for cancers of the tongue, other oral cavity subsites, pharynx, oropharynx and larynx in groups with lower SES. Managers showed decreased SIRs of 0.50 to –0.90 also for cancers of the lip, tongue, other oral cavity subsites, oropharynx, nasopharynx, nose and larynx. In contrast, excess risks of tongue, other oral cavity subsites, pharyngeal, oropharyngeal and laryngeal cancers were observed among clerical (SIRs 1.05–1.16), skilled workers (1.04–1.14), unskilled workers (1.16–1.26) and economically inactive men (1.38–1.87). Among women, no risk gradient similar to that in men was revealed. Conclusions The current study underscores the influence of SES on the incidence of HNCs and highlights the need for targeted interventions, including tobacco and alcohol control policies, and improved access to healthcare services, particularly for socio-economically disadvantaged populations. [ABSTRACT FROM AUTHOR]

Objective Within the scope of the Exposome Project for Health and Occupational Research on applying the exposome concept to working life health, we aimed to provide a broad overview of the status of knowledge on occupational exposures and associated health effects across multiple noncommunicable diseases (NCDs) to help inform research priorities. Methods We conducted a narrative review of occupational risk factors that can be considered to have "consistent evidence for an association," or where there is "limited/inadequate evidence for an association" for 6 NCD groups: nonmalignant respiratory diseases; neurodegenerative diseases; cardiovascular/metabolic diseases; mental disorders; musculoskeletal diseases; and cancer. The assessment was done in expert sessions, primarily based on systematic reviews, supplemented with narrative reviews, reports, and original studies. Subsequently, knowledge gaps were identified, e.g. based on missing information on exposure–response relationships, gender differences, critical time-windows, interactions, and inadequate study quality. Results We identified over 200 occupational exposures with consistent or limited/inadequate evidence for associations with one or more of 60+ NCDs. Various exposures were identified as possible risk factors for multiple outcomes. Examples are diesel engine exhaust and cadmium, with consistent evidence for lung cancer, but limited/inadequate evidence for other cancer sites, respiratory, neurodegenerative, and cardiovascular diseases. Other examples are physically heavy work, shift work, and decision latitude/job control. For associations with limited/inadequate evidence, new studies are needed to confirm the association. For risk factors with consistent evidence, improvements in study design, exposure assessment, and case definition could lead to a better understanding of the association and help inform health-based threshold levels. Conclusions By providing an overview of knowledge gaps in the associations between occupational exposures and their health effects, our narrative review will help setting priorities in occupational health research. Future epidemiological studies should prioritize to include large sample sizes, assess exposures prior to disease onset, and quantify exposures. Potential sources of biases and confounding need to be identified and accounted for in both original studies and systematic reviews. [ABSTRACT FROM AUTHOR]

Background: Transportation noise may induce cardiovascular disease, but the public health implications are unclear. Objectives: The study aimed to assess exposure-response relationships for different transportation noise sources and ischemic heart disease (IHD), including subtypes. Methods: Pooled analyses were performed of nine cohorts from Denmark and Sweden, together including 132,801 subjects. Time-weighted longterm exposure to road, railway, and aircraft noise, as well as air pollution, was estimated based on residential histories. Hazard ratios (HRs) were calculated using Cox proportional hazards models following adjustment for lifestyle and socioeconomic risk factors. Results: A total of 22,459 incident cases of IHD were identified during follow-up from national patient and mortality registers, including 7,682 cases of myocardial infarction. The adjusted HR for IHD was 1.03 [95% confidence interval (CI) 1.00, 1.05] per 10 dB [L.sub.den] for both road and railway noise exposure during 5 y prior to the event. Higher risks were indicated for IHD excluding angina pectoris cases, with HRs of 1.06 (95% CI: 1.03, 1.08) and 1.05 (95% CI: 1.01, 1.08) per 10 dB [L.sub.den] for road and railway noise, respectively. Corresponding HRs for myocardial infarction were 1.02 (95% CI: 0.99, 1.05) and 1.04 (95% CI: 0.99, 1.08). Increased risks were observed for aircraft noise but without clear exposure-response relations. A threshold at around 55 dB [L.sub.den] was suggested in the exposure-response relation for road traffic noise and IHD. Discussion: Exposure to road, railway, and aircraft noise in the prior 5 y was associated with an increased risk of IHD, particularly after exclusion of angina pectoris cases, which are less well identified in the registries. https://doi.org/10.1289/EHP10745, Introduction Exposure to traffic noise is increasing because of ongoing urbanization, densification of urban settlements, and growth of the transport sector. In 2017, 113 million Europeans were estimated to be [...]

Objectives The aim of this study was to create a quantitative job-exposure matrix (JEM) for noise including a large set of measurements for the Swedish workforce, a detailed exposure-level assessment, spanning over an extensive time period from 1970 to 2014. Methods The JEM was developed by 2 teams, each with an experienced occupational hygienist and an occupational safety engineer. Each pair assessed the exposure using measurements performed and reported by occupational hygienists, occupational safety engineers, or similar, from 1970 to 2014. The measurements included either the original LAeq(8h) measurements or an LAeq(8h) levels calculated from partial measurements of the working day, provided that the measurement targeted a regular task usually performed during a full workday. The collection of measurement reports was done in 2008 and 2012 by contacting clinics working in the area of occupational health or occupational safety engineers and their submitted reports were added to our own material. Noise exposure assessments were inserted at the appropriate time period for the relevant job family. The final matrix was developed in a consensus procedure and the validity was investigated by comparison of the 2 team's individual results. Results The noise JEM contains 321 job families with information regarding occupational noise from 1970 to 2014. The time-period label has a 5-yr scale starting in 1970. The estimated average 8 h (TWA) noise level in decibels [dB(A)] for every job family and 5-yr period was coded as 1: <70 dB(A), 2: 70 to 74 dB(A), 3: 75 to 79 dB(A), 4: 80 to 84 dB(A) or 5: 85(+) dB(A). The validation showed no systematic difference in relative position and very high agreement in the ordering of paired ordinal classifications. The JEM has also successfully been applied in several epidemiological studies. Conclusions We present a JEM for occupational noise using Swedish data from 1970 to 2014 with a higher degree of sensitivity in assessed noise exposure compared with the previously existing version. Repeated application of the JEM, in epidemiological studies, has shown consistent results and contributed to yielding important findings. [ABSTRACT FROM AUTHOR]

Background: Transportation noise is increasingly acknowledged as a cardiovascular risk factor, but the evidence base for an association with stroke is sparse. Objective: We aimed to investigate the association between transportation noise and stroke incidence in a large Scandinavian population. Methods: We harmonized and pooled data from nine Scandinavian cohorts (seven Swedish, two Danish), totaling 135,951 participants. We identified residential address history and estimated road, railway, and aircraft noise for all addresses. Information on stroke incidence was acquired through linkage to national patient and mortality registries. We analyzed data using Cox proportional hazards models, including socioeconomic and lifestyle confounders, and air pollution. Results: During follow-up (median = 19.5 y), 11,056 stroke cases were identified. Road traffic noise ([L.sub.den]) was associated with risk of stroke, with a hazard ratio (HR) of 1.06 [95% confidence interval (CI): 1.03, 1.08] per 10-dB higher 5-y mean time-weighted exposure in analyses adjusted for individual-and area-level socioeconomic covariates. The association was approximately linear and persisted after adjustment for air pollution [particulate matter (PM) with an aerodynamic diameter of Discussion: In this pooled study, road traffic noise was associated with a higher risk of stroke. This finding supports road traffic noise as an important cardiovascular risk factor that should be included when estimating the burden of disease due to traffic noise. https://doi.org/10.1289/EHP8949, Introduction Stroke is a leading cause of morbidity and mortality worldwide, and identification of new, modifiable risk factors is a crucial step in prevention (Zhang et al. 2019). Transportation noise [...]